ABSTRACT
Frosted branched angiitis (FBA) is characteristic florid translucent retinal perivascular sheathing of both arterioles and venules in association with variable uveitis and vasculitis affecting the entire retina. The vascular sheathing is supposed to be an immune-mediated reaction, possibly due to immune complex deposition in vessel walls secondary to various underlying etiologies. The authors aim to report a case of FBA secondary to herpes simplex virus and Toxoplasma gondii infection causing the diagnostic dilemma. This is the first case report on FBA from Nepal. Case report: An 18-year-old young boy hospitalized with the diagnosis of acute viral meningo-encephalitis presented with the complaint of diminution of vision and floaters in both eyes for a week. Herpetic infection was confirmed with the cerebro-spinal fluid analysis and was under antiviral drugs. His presenting visual acuity was 20/80 in both eyes and ocular features were suggestive of FBA. The vitreous sample analysis revealed raised toxoplasma titre so intravitreal clindamycin was administered twice. The ocular features resolved in the subsequent follow ups with intravenous antiviral treatment and intravitreal antitoxoplasma treatment. Conclusions: FBA is a very rare clinical syndrome secondary to many immunological or pathological causes. So, possible etiologies must be ruled out for timely management and good visual prognosis.
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Central nervous system (CNS) manifestation with cranial nerve palsy in multiple myeloma (MM) is a rare manifestation. Plasmacytoma originates from the bones of the skull base in 3% patients with MM but rarely develops from the soft tissues of the nasal cavity and paranasal sinuses. Here, we present a case of 68-year-old male patient with multiple myeloma, clivus bone plasmacytoma, and cavernous sinus syndrome.
ABSTRACT
BACKGROUND: The use of computers and other Visual Display Terminal (VDT) screens is increasing in Nepal. However, there is a paucity of evidence on the prevalence of Computer Vision Syndrome (CVS) and other occupational health concerns among employees working in front of VDT screens in the Nepalese population. OBJECTIVES: This study aims to estimate the prevalence of CVS, musculoskeletal and work-related stress among VDT screen users in the office, as well as their understanding and usage of preventive measures. METHODS: The study was a cross-sectional descriptive study among 319 VDT users in office settings in Kathmandu Metropolitan City, Nepal, using a semi-structured self-administered questionnaire. Multivariate logistic regression analysis was conducted to identify the associated factors at 95% CI. P-value <0.05 was considered as statistically significant. RESULTS: The prevalence of CVS was 89.4%. More than eight out of ten study participants reported at least one visual and musculoskeletal symptom. Work-related stress, which was moderate-difficult to handle, was present in 36.7% of the study population. The mean±SD computer usage per day was 7.9±1.9 hours. Tired eye (63.3%), feeling of dry eye (57.8%), headache (56.9%) were the common visual symptoms of CVS reported. Total computer use/day > = 8 hours OR 2.6, improper viewing distance OR 3.2, Not using an anti-glare screen OR 2.6, not using eye-drops, and not wearing protective goggles OR 3.1 were significantly associated with the presence of CVS. There was no statistically significant association between visual symptoms of CVS, musculoskeletal symptoms, and stress with gender. CONCLUSION: CVS was substantially related to not employing preventive measures, working longer hours, and having an incorrect viewing distance. With more hours per day spent in front of a VDT screen, work-related stress and musculoskeletal complaints were also found to be important correlates. Similarly, work-related stress was found more among those who had less than five years of job.
Subject(s)
Occupational Diseases , Occupational Stress , Computer Terminals , Computers , Cross-Sectional Studies , Humans , Nepal/epidemiology , Occupational Diseases/epidemiology , Surveys and QuestionnairesABSTRACT
INTRODUCTION: Stereopsis is defined as the ability to perceive object depth. It is measured in seconds of arc. Reduced stereoacuity impinges one's academic as well as a professional performance. Hence in this study, we aim to find out the mean stereoacuity among the undergraduate medical and nursing students using the Titmus fly test. METHODS: A descriptive cross-sectional study was conducted among undergraduate students at a medical college of Nepal from April 2021 to July 2021. Ethical approval was obtained from the Institutional review committee (Registration number: 487 (6-11) E2 077/078). Simple random sampling method was used. Data were collected from undergraduate medical and nursing students while the post-graduate students were excluded from the study. Overall, 80 students were included in the study. Titmus fly test was used to assess the stereopsis. Statistical Package for Social Sciences version 21 and Microsoft Excel was used for data analysis. Point estimate at 95% confidence interval was calculated along with mean, standard deviation, frequency, and proportion. RESULTS: The mean stereoacuity was 62.63±46.56 (range 40-800) sec of arc (52.77-72.49 at 90% Confidence Interval). A total of 80 participants in our study among which 50 (62.5%) were male and 30 (37.5%)were female. About 41 (51.2%) of the study participants had normal, borderline (>40 and ≤ 120) stereopsis was seen in 35 (43.8%) of the study participants while only 4 (5%) had reduced stereopsis (≥120 sec of arc). CONCLUSIONS: This study showed that the mean stereoacuity among the undergraduate medical and nursing students was in subnormal range which was similar to other studies.
