Ocular Manifestations of Meningitis in Children.

Introduction: Meningitis is the most common central nervous system disease affecting children leading to focal neurological deficits and various oculovisual anomalies including blindness in children. The objective of this study was to evaluate the oculovisual anomalies occurring in Nepalese children suffering from different types of bacterial meningitis. Materials and Methods: A Prospective, study was undertaken for 18 months at B.P.Koirala Lion’s Center for ophthalmic studies, TU Teaching Hospital to study the children suffering from bacterial meningitis admitted at Kanti Children’s Hospital for ocular involvement. A through history, anterior and posterior segment ocular examination and investigations like blood, CSF and CT scan were done. Results: A total of 182 cases of bacterial meningitis were screened. Tubercular meningitis cases were 40 (21.97%) and Pyogenic were 142 (78.02%). Oculovisual anomalies were seen in 70 (38.46%) cases. The ocular abnormalities included pupillary changes (34.28%), Cranial Nerve Palsy (22.86%), Fundus changes (35.72%), Cortical Blindness (4.28%), Panophthalmitis and Proptosis (1.43%). Third nerve involvement was seen in 17.14% cases, sixth nerve in 4.29% cases, Papilledema in 11.43 % and Optic atrophy in 22.86 %. Risk factors included late presentation; hydrocephalous and increased CSF cell count and protein level. Conclusion: Oculovisual anomalies formed an important group of clinical manifestations of bacterial meningitis. Incidence of oculovisual anomalies was more frequently seen in Tubercular meningitis (55%).Children with early presentation and intervention had better prognosis. Hence, timely intervention and health education is important.

Vernal keratoconjunctivitis: modes of presentation in Nepalese population.

OBJECTIVE: To determine pattern of clinical presentation in Vernal Keratoconjunctivitis (VKC) in our context. METHODS: Thirty-four VKC patients were included in this study. RESULTS: The study revealed prepubertal onset with male preponderance and most frequently encountered symptom in the study among VKC cases was itching (100%) followed by redness of eyes and discharge (76.5% each) and the commonest sign was tarsal papillae (100%) followed by conjunctival hyperemia (91%) in 68 eyes of 34 cases of VKC. CONCLUSION: The clinical presentation of VKC cases in our country is very much similar to the findings of other parts of the world.

Association of systemic diseases with retinal vein occlusive disease.

Retinal vein occlusion (RVO) is the second commonest vascular disease of the eye, second only to Diabetic Retinopathy. The association of the retinal vein occlusion with other systemic disease likes hypertension, diabetes mellitus and others has been well documented. With the increase in persons being affected from these disorders, patients with retinal vein obstruction are also increasing. Hence, a study was designed to evaluate all cases of RVO to find out its association with systemic disorders. A total of 100 patients (106 eyes) were enrolled in the study. Out of which, 66 cases reported to have Brach Retinal Vein Occlusion (BRVO) and rest 34 cases with Central Retinal Vein Occlusion (CRVO). Among the associated systemic diseases, hypertension and diabetes mellitus accounted for 84% cases. Isolated hypertension (54%) was most commonly seen followed by diabetes mellitus (8%). The prevalence of BRVO was almost twice as compared to CRVO. The high association of various systemic disorder especially Hypertension and diabetes further supports the need of early and periodic eye examination for those suffering from these disorders.

An electromyographic study of masseter muscle activity amongst overdenture and complete denture patients.

In recent years the dental profession has extended preventive Dentistry Concept in Prosthodontics by using overdenture. An Overdenture has a number of advantages over ordinary full dentures, including an improved neuromuscular performance. This study was carried out on two groups of patients wearing complete overdenture and conventional complete dentures to find out the masseter muscle activity in different oral condition and how muscle activity of patients with overdentures differ from that of patients with conventional complete denture.