Knowledge, Attitude and Practice about Hypertension among adult Population of Letang Municipality, Morang District, Eastern Nepal

Introduction:Hypertension has been identified as one of the major public health and medical challenges with 1/4 adults worldwide estimated to have high blood pressure (BP).Objectives: To assess knowledge, attitude and practices regarding hypertension and to measure the association between socio-demographic characteristics with knowledge, attitude and practice regarding hypertension among adult population.Methods:The cross-sectional study was conducted among the 335 adult populationsin Letang Municipality of Nepal. Semi-structured questionnaire wasused for data collection. Chi-square test was applied to measure the association between socio-demographic characteristics with knowledge, attitude and practice regarding hypertension.Results:Majority of the respondents (67.2) have knowledge about the meaning of hypertension and symptoms of hypertension (52.2%). Mostof the respondents think that regular physical activity (83.9%) and reduce salt intake (84.2%) can be prevent hypertension.Almost 73.4% of respondents didn’t know their blood pressure and never checked their BP regularly(66.6%). Almost 12.8% of the study population sufferingfrom hypertension. The adult Population with age group of 41-60years (62.6%) was seen significantly good knowledge in comparison to other age groups. The study population having educational level SLC and above was seen significantly good knowledge,attitude and practice regarding prevention of hypertension in comparison to below SLC and illiterate. The study population belong to above poverty line had significantly good knowledge,attitude and practice regarding prevention of hypertensionin comparison to below poverty line.Conclusions:We conclude that majority of the study population of Letang Municipality had higher knowledge and positive attitude toward prevention of hypertension but the level of practices was poor.

Combined brilliant blue G and xenon light induced outer retinal layer damage following macular hole surgery

We report a case of combined brilliant blue G and endoilluminator retinal toxicity in a patient who has undergone macular hole surgery. The patient developed extensive degeneration of the retinal pigment epithelium as early as 1 week following surgery that eventually lead to poor visual outcome. We look into the pathogenesis of BBG and endoilluminator causing retinal toxicity and also suggest measures to avoid this irreversible retinal damage.

Retinal cafe-au-lait macules: A rare retinal finding in a patient with neurofibromatosis type 1

We report the retinal and choroidal manifestations using multimodal imaging in a patient with Neurofibromatosis type 1 (NF-1). In this report, we describe the occurrence of a new retinal finding which we label as retinal caf�-au-lait macules. Also, we describe the superiority of multicolour imaging in comparison to colour fundus photography for identifying the retinal manifestations in NF-1.

Newer indices for predicting macular hole closure in idiopathic macular holes: A retrospective, comparative study

Purpose: To study the utility and predictive ability of newer macular hole (MH) indices for closure following surgery. Methods: In this retrospective study, pre- and post-operative optical coherence tomography images of 49 eyes with idiopathic full-thickness MH were reviewed and analysed. Various quantitative parameters of MH like maximum outer diameter (OD), minimum diameter between edges, height, nasal and temporal arm lengths, macular hole angle were noted. Indices including hole form factor, Macular Hole Index, (MHI), Diameter Hole Index (DHI) and Tractional Hole Index (THI) were calculated. Newer area indices like macular hole area index (MAI), cystoid space area index (MCSAI) and tissue area index (MTAI) were calculated using Image J (Ver. 1.51). Receiver operating characteristic (ROC) curves and cut-off values were derived for indices predicting type 1 or type 2 closure. Stepwise regression analysis and binary logistic regression analysis were carried out to predict the chances of hole closure. Results: ROC curve analysis showed indices like MHI, THI and MCSAI were capable of successfully predicting type 1 closure while OD, DHI and MAI predicted type 2 closure. On stepwise regression analysis, MAI was identified as the most important index in predicting the type of hole closure. Using the binary logistic regression analysis, the predictive ability of the model to identify success or failure following MH surgery was 89.7% and 80% respectively. Conclusion: MAI measurement could be used as a single important index in predicting hole closure in idiopathic MH. Further research is required to study this area index in detail.

Clinical applications of the retinal functional imager: A brief review

The advances in treating blinding conditions often depends on the development of new techniques that allows early detection, treatment, and follow-up of the disease. Functional changes often precede structural changes in many retinal disorders. Therefore, detecting these changes helps in early diagnosis and management, with the intention of preventing permanent morbidity. The Retinal Functional Imager (RFI) is a non-invasive imaging system that allows us to assess the various functional parameters of the retina. The RFI quantitatively measures the retinal blood-flow velocity, oxygen saturation, metabolic demand and generates a non-invasive capillary perfusion map that provides details similar to a fluorescein angiography. All of these parameters correlate with the health of the retina, and are known to get deranged in retinal disease. This article is a brief review of published literature on the clinical utility of the RFI.

Morphometric analysis of retinal arterioles in control and hypertensive population using adaptive optics imaging

Purpose: To measure the wall-to-lumen ratio (WLR) and the vascular wall cross-sectional area (WCSA) of retinal arterioles by an Adaptive Optics (AO) retinal camera using semi-automated software and comparing them between control and hypertensive population. Methods: This was a cross-sectional observational study including a hypertensive group and a control group. Subjects were examined and their medical history recorded. Retinal arteriolar morphometry was assessed by rtx1 AO retinal camera using AOdetect Artery semiautomated software. Main Outcome Measures: WLR and WCSA were measured on the basis of retinal arteriolar wall thickness (W1, W2), lumen diameter (LD) and vessel diameter (VD). Influence of age and arterial hypertension on the WLR and WCSA were examined. Results: A total of 150 human subjects were included out of which 110 were controls and 40 were hypertensives under treatment. There was statistically significant difference in the age, systolic and diastolic blood pressures between the control and hypertensive groups (P < 0.01). We found no significant correlation between age and WLR (R2 = 0.049, P > 0.05) or age and WCSA (R2 = 0.045, P > 0.05). We observed a significant difference in WLR and WCSA measurements between control and hypertensive groups (P < 0.01). On measuring intra-observer variability (IOV) we found excellent consistency. Conclusion: AO retinal imaging allows a direct measurement of the retinal vessel wall and LD with excellent IOV. WLR and WCSA reflect the remodelling process and can be used to further aid the early detection and monitoring of systemic hypertension.

Structural-functional correlation using adaptive optics, visual fields, optical coherence tomography and multifocal electroretinogram in a case of torpedo maculopathy

We present a case of a 37-year-old gentleman with a rare diagnosis of Torpedo maculopathy (TM). We describe the multimodal imaging features of torpedo maculopathy using adaptive optics, visual fields, OCT and multifocal ERG, and understand the clinical and structural-functional correlation in TM. According to us, this is the first case report to describe the adaptive optics imaging findings in Torpedo maculopathy in English Medical literature.

Multicolor imaging findings in torpedo maculopathy

We describe the multicolor imaging findings in two cases of Torpedo maculopathy (TM). Multicolor imaging can be a useful tool in identifying the level of retinal and choroidal layer involvement in TM. This imaging modality further confirms the hypothesis that TM is a localized congenital abnormality of retinal pigment epithelium pigmentation which leads to outer retinal and inner choroidal degeneration.

Physico-chemical evaluation of Gastroretentive Ranitidine Hydrochloride: An Anti-Ulcer Drug

Background  and  Objectives:  The  prevention  and  treatment  of  peptic  ulcers  has  become  an important challenge in the current medicine  world.   Modern progress in novel drug delivery system aims to improve the efficacy of the drug molecule by formulating a dosage form of RHCL. One of the most feasible approaches for achieving a prolonged and predictable drug delivery profile in GI tract is to control the gastric residence time.  Therefore, a multi-unit gastro retentive dosage form of RHCL capable of floating on simulated gastric fluid for more than 12 hours was formulated and evaluated.Materials  and  Methods:  Nine  batches  of  the  light  liquid  paraffin  entrapped  emulsion  gel  beads were  prepared  by  a  new  emulsion  gelation  technique  using  sodium  alginate  and  xanthan  gum  as polymers.  The  polymeric  solution  was  extruded  into  Calcium  chloride  solution  by  the  use  of  21G needles.  Morphology  of  beads,  drug  content,  drug  entrapment  efficiency,  floating  lag  time  and buoyancy were studied. Compatibility study of Ranitidine HCl with polymers used in the formulation was performed using DSC and FT-IR.Results:  Mean  surface  diameter  were  between  1.220  ±  2.259%  (F1)  to  1.230  ±  2.316%  (F9)  and floating lag time were between 6 minute (F9) to 11 minute (F1). All formulations were buoyant for more than 12 hours in simulated gastric  fluid  at  37ºC.  The  drug  content  and  drug  entrapment efficiency  among  the  formulations  were  between  17.48%~19.68%  and  71.06%  ~84.32% respectively. Formulation F1 showed lowest drug content and drug entrapment efficiency while F9 showed highest drug content and drug entrapment efficiency. F4 showed most acceptable sustained drug release profile.Conclusion:  The gastro retentive drug delivery system designed as floating beads was found to be satisfactory drug delivery system for Ranitidine HCl to improve the bioavailability of the drug.