ABSTRACT
INTRODUCTION: Paediatric keratoplasty is rarely performed surgery with high risk of graft failure. Developing countries have not benefited due to lack of sufficient facilities and trained surgeons. OBJECTIVES: The objectives of the study were to analyze the indications and its outcome in terms of vision and graft survival. MATERIALS AND METHODS: This retrospective chart review used electronic medical records from January 2017 to December 2019 of all consecutive patients aged upto18 years or below that underwent paediatric keratoplasty after ethical approval at Tilganga Institute of Ophthalmology. Outcome was defined as anatomical or visual success and graft clarity. Different demographic and surgical parameters were studied among 59 eyes of 48 patients. RESULTS: Mean age of recipient was 12.23± 3.81 years. Majority 37 (52.5%) had unilateral grafts with keratoconus being the most common 24 (40.6%) acquired non-traumatic indication. Mean post-operative best corrected visual acuity 0.6 Logmar was significantly (p <0.001) low as compared to preoperative 1.3 Logmar. Overall graft survival rate was 47 (78%) at one-year follow-up; keratoconus accounting for 24 (100%). Major factors in contributing for graft failure were rejection, infection, and glaucoma. CONCLUSION: A good outcome in terms of anatomical and visual success was achieved in our study. Keratoconus has an excellent graft survival. Visual rehabilitation by cycloplegic refraction should be done to prevent amblyopia. Enhancing the training of surgeons and addressing challenges faced in a paediatric population will help decrease corneal blindness among paediatric patients in the future.
ABSTRACT
BACKGROUND: Family planning among people living with Human Immuno Deficiency Virus/Acquired Immune Deficiency Syndrome is proved to be effective in preventing Human Immuno Deficiency Virus transmission through sexual and mother to child transmission.We studied family planning practice among people living with Human Immuno Deficiency Virus/Acquired Immune Deficiency Syndrome at reproductive age and its associated factors. METHODS: We conducted a cross-sectional study in four anti retro viral therapy centers in eastern Nepal from September 2015 to February 2016. Data was collected among 200 samples by face to face interview using pretested semi-structured questionnaire. Bivariate analysis and logistic regression was performed to analyze the associated factors. RESULTS: Fifty one percent (51%) of participants in reproductive age were currently using family planning methods with male condom being the most common. On bivariate analysis, higher income, higher education, having living children, involvement in decision making, low fertility desire, longer duration in anti-retroviral therapy, family planning knowledge and past counseling were found to be statistically significant in having higher family planning practice. In multivariate analysis,participants with duration in anti-retroviral therapy for 1- 4 years(AOR: 9.2, 95% CI: 1.7-47.5), both spousal involvement in decision making (AOR:37.1, 95% CI: 6.5-211.9) and family planning counseling (AOR: 3.4, 95% CI: 1.0-11.3) were found to have higher odds of family planning practice. CONCLUSIONS: Male condom is the most common method of family planning practice among HIV patients. Higher income, education status of both partners and having living childrens are the encouraging factor for better practice. Involvement of both partners is associated with higher use of family planning practices. Duration of anti-retroviral therapy use has positive impact on use of family planning practices.
