Demographic pattern, clinical features and treatment outcome of patients with infective keratitis in the eastern region of Nepal

Background: Corneal ulcer is one of the major causes of monocular blindness in developing countries. Objective: To determine demographic pattern, risk factors, microbiological pattern and treatment outcome of infective keratitis. Materials and methods: A retrospective analysis of hospital records of 44 patients with clinically-diagnosed infective keratitis presenting to B.P. Koirala Institute of Health Sciences in the eastern region of Nepal was carried out. Outcome measures: The parameters studied were risk factors and organisms responsible for keratitis. Results: The infective keratitis was mostly prevalent among the males between 21-40 years of age (50%). 79.5 % of them were engaged in agricultural work. A history of corneal injury was found in 30 eyes (68.1%). Vegetative matter was the most common agent of trauma in 17 (56.6%). Culture positivity for microorganisms was observed in 20 (45.5%) samples. Of these, 8 (40%) patients had purely bacterial corneal ulcer. Purely fungal growth was seen in 4 (20%) and mixed in 8 (40%). Staphylococcus aureus was the most commonly isolated bacteria (70%). The other bacteria included Pseudomonas species, E. coli and Acinetobactor. Aspergillus species was the most common fungal organism isolated in 8 (40%) samples. 65.9 % of the patients improved with medical treatment alone. Perforation, endophthalmitis and panophthalmitis were the common complications encountered in 11.3%, 4.5% and 4.5% respectively. Conclusion: Corneal ulcer is prevalent in males, predominantly amongst the farmers. Ocular trauma with vegetative matter is the commonest predisposing factor. Staphylococcus aureus and Aspergillus species are the most commonly isolated organisms in corneal ulcers. Keywords: corneal ulcer; fungal keratitis; ocular trauma DOI: 10.3126/nepjoph.v1i2.3683 Nep J Oph 2009;1(2):101-106

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Epidemiology and etiological diagnosis of infective keratitis in eastern region of Nepal

Nepalese Journal of Ophthalmology ◽

10.3126/nepjoph.v7i1.13146 ◽

2015 ◽

Vol 7 (1) ◽

pp. 10-15 ◽

Cited By ~ 4

Author(s):

R P Sitoula ◽

S K Singh ◽

V Mahaseth ◽

A Sharma ◽

R K Labh

Keyword(s):

Risk Factors ◽

Corneal Ulcer ◽

Ocular Trauma ◽

Eastern Region ◽

Corneal Ulceration ◽

Corneal Scraping ◽

One Year ◽

Age Range ◽

Epidemiological Characteristics ◽

Preventable Blindness

Objective: This study aimed to determine the epidemiological characteristics and risk factors predisposing to corneal ulceration in patients presenting to Biratnagar Eye Hospital (Nepal). Methods: All patients presenting to Biratnagar Eye Hospital between January 1 and December 31, 2011 with corneal ulceration were retrospectively reviewed. Sociodemographic data and information pertaining to risk factors were recorded, all patients were examined and corneal scrapping and cultures were carried out. Results: Over one year period 1644 patients with corneal ulcer were evaluated, out of which 76.6% of patients were in the age range of 30 to 69 years and 65% of patients had presenting visual acuity < 3/60. Ocular trauma was the most common cause of keratitis accounting for 60.3% of corneal ulcer and majority of the patients (40%) presented after 2 weeks of symptoms. Among corneal scraping positive cases 1150 (70%) showed fungus, 73 (4.4%) showed bacteria and 20 (1.2%) showed both bacterial and fungus. Conclusion: Corneal ulcer continues to be one of the leading causes of preventable blindness in this region. Lack of awareness about gravity of this disease, financial constraints and geographic barriers remain the major reasons for delay in seeking proper medical help.

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Profile of Corneal Ulcer in a Month of harvesting Season in a Tertiary Level Eye Hospital of Eastern Nepal

Nepalese Journal of Ophthalmology ◽

10.3126/nepjoph.v10i1.21686 ◽

2018 ◽

Vol 10 (1) ◽

pp. 32-38 ◽

Cited By ~ 1

Author(s):

Vijay Gautam ◽

Abinash Chaudhary ◽

Sanjay Kumar Singh ◽

Pooja Gautam Rai

Keyword(s):

Statistical Analysis ◽

Corneal Ulcer ◽

Ocular Trauma ◽

Tertiary Level ◽

Topical Steroids ◽

Eye Care ◽

Cross Sectional ◽

Detailed History ◽

Corneal Injury ◽

History Of

Introduction: Agricultural workers are prone to corneal injuries due to vegetative trauma especially during the harvesting season. This study reports the number of new cases of corneal injuries and corneal ulcer presenting in a month of harvesting season.Methods: This is a cross-sectional, hospital based study of all new cases of corneal injury and corneal ulcer presenting to the cornea department from 1st November, 2016 to 30th November, 2016. Typical or suspected cases of corneal ulcer of viral, immunologic or metabolic causes were excluded. Detailed history and clinical examination was carried out. Corneal scrapes in cases with corneal ulcer were taken and subjected to direct microscopy. Details of the findings were recorded in a proforma designed for the study. Statistical analysis was done by SPSS 18.Results: 259 cases presented during that period. Females were more affected (54%). Fifty-one percent of the cases presented from Nepal. Forty-eight percent gave history of ocular trauma by vegetative material. 40% presented within a week of development of symptoms, and about 40% after 2 weeks. Fifty percent of the cases had not presented to an eye care professional. 9% were using topical steroids. Progressive status of the disease was noted in 80%. Sixty-five percent presented with corneal ulcer of less than 2 mm size. Direct smear examination was carried out in 105 cases and 73% of them showed fungal elements.Conclusion: Awareness of agriculture related corneal injuries due to trauma by vegetative materials and methods to prevent such injuries is very important.

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Corneal injuries: incidence and risk factors in the Intensive Care Unit

Revista Latino-Americana de Enfermagem ◽

10.1590/s0104-11692011000500005 ◽

2011 ◽

Vol 19 (5) ◽

pp. 1088-1095 ◽

Cited By ~ 26

Author(s):

Andreza Werli-Alvarenga ◽

Flávia Falci Ercole ◽

Fernando Antônio Botoni ◽

José Aloísio Dias Massote Mourão Oliveira ◽

Tânia Couto Machado Chianca

Keyword(s):

Risk Factors ◽

Intensive Care Unit ◽

Intensive Care ◽

Risk Prediction ◽

Prediction Models ◽

Corneal Ulcer ◽

Ventilatory Support ◽

Corneal Injury ◽

Corneal Ulcers ◽

Duration Of Hospitalization

Patients hospitalized in the Intensive Care Unit (ICU) may present risk for corneal injury due to sedation or coma. This study aimed to estimate the incidence of corneal injuries; to identify the risk factors and to propose a risk prediction model for the development of corneal injury, in adult patients, in an intensive care unit of a public hospital. This is a one year, prospective cohort study with 254 patients. The data were analyzed using descriptive statistics, univariate and logistic regression. Of the 254 patients, 59.4% had corneal injuries and the mean time to onset was 8.9 days. The independent variables that predispose to risk for punctate type corneal injury were: duration of hospitalization, other ventilatory support device, presence of edema and blinking less than five times a minute. The Glasgow Coma Scale and exposure of the ocular globe were the variables related to corneal ulcer type corneal injury. The injury frequencies were punctate type (55.1%) and corneal ulcers (11.8%). Risk prediction models for the development of punctate and corneal ulcer type corneal injury were established.

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Staphylococcus aureus nasal colonization among Vietnamese adults: prevalence, risk factors and antibiotic susceptibility profile

MedPharmRes ◽

10.32895/ump.mpr.2.2.21 ◽

2018 ◽

Vol 2 (2) ◽

pp. 21-31

Author(s):

Nguyen Phan ◽

Hien Pham ◽

Thuc Nguyen ◽

Hoai Nguyen

Keyword(s):

Risk Factors ◽

Staphylococcus Aureus ◽

Antibiotic Susceptibility ◽

Nasal Carriage ◽

Resistance Rate ◽

High Rate ◽

Weight History ◽

Potential Risk Factors ◽

History Of ◽

Vietnamese Community

Staphylococcus aureus (S. aureus) has long been recognized as an important human pathogen causing many severe diseases. It is also a part of human normal flora with its ecological niche in the human anterior nares. This study focused on screening S. aureus nasal carriage in community and its relationship to human physiological and pathological factors which have not been studied in Vietnam previously. Two hundred and five volunteers in Ho Chi Minh City from 18 to 35 and over 59 years old both male and female participated in the study. Result showed that the prevalence of S. aureus nasal carriage in southern Vietnamese community was relatively low, only 11.2% (23/205), much lower than that in other international reports on human S. aureus. In addition, nasal carriage of the older age group (> 59 years old, 13.7%) was higher than that of younger age (18-35 years old, 10.4%). Other potential risk factors such as gender, career, height, weight, history of antibiotic usage, daily nasal wash, use of nasal medication sprays, acne problems, smoking and nasal problems showed no significant impact on S. aureus carriage. The obtained S. aureus nasal isolates were all sensitive to vancomycin. Lincomycin and tetracycline had low resistance rate with 4.3 % and 17.4 %, respectively. However, the isolates showed particularly high rate of multidrug resistance (54.2%) In summary, our data provided researchers an overview on S. aureus nasal carriage and antibiotic susceptibility profile of the community- isolated S. aureus in Vietnam. This would serve as valuable information on assessing risk of community-acquired S. aureus infections.

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Indications and practice of enteral nutrition

Orvosi Hetilap ◽

10.1556/oh.2014.30066 ◽

2014 ◽

Vol 155 (51) ◽

pp. 2028-2033 ◽

Cited By ~ 1

Author(s):

Judit Hallay ◽

Dániel Nagy ◽

Béla Fülesdi

Keyword(s):

Risk Factors ◽

Treatment Outcome ◽

Enteral Nutrition ◽

Hospital Stay ◽

Length Of Hospital Stay ◽

Nutrition Therapy ◽

Present Review ◽

Hospitalised Patients ◽

Impact On Treatment ◽

Efficacy Of Treatment

Malnutrition in hospitalised patients has a significant and disadvantageous impact on treatment outcome. If possible, enteral nutrition with an energy/protein-balanced nutrient should be preferred depending on the patient’s condition, type of illness and risk factors. The aim of the nutrition therapy is to increase the efficacy of treatment and shorten the length of hospital stay in order to ensure rapid rehabilitation. In the present review the authors summarize the most important clinical and practical aspects of enteral nutrition therapy. Orv. Hetil., 2014, 155(51), 2028–2033.

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Path Analysis on Determinants of Childhood Obesity and Associated Risk Factors of Cardiovascular, Renal, and Hepatic Diseases: The CASPIAN-V Study

Journal of Child Science ◽

10.1055/s-0040-1716917 ◽

2020 ◽

Vol 10 (01) ◽

pp. e148-e158

Author(s):

Vahid Mansouri ◽

Marjan Mansourian ◽

Mostafa Qorbani ◽

Roya Riahi ◽

Rahele Karimi ◽

...

Keyword(s):

Risk Factors ◽

Childhood Obesity ◽

Latent Variables ◽

Mutual Influence ◽

Risk Indicators ◽

Noncommunicable Diseases ◽

Surveillance Program ◽

Predisposing Factor ◽

Blood Samples ◽

Hepatic Diseases

AbstractThe interaction between several lifestyle and obesogenic environmental factors is considered as the main underlying factor for the escalating trend of childhood obesity and its adverse consequences. In this study, we assessed the mutual influence of lifestyle habits and body mass index (BMI) as well as risk factors for cardiometabolic, hepatic, and renal disorders to define the causality power of each item. This nationwide cross-sectional study was conducted as the fifth round of a school-based surveillance program. Overall, 14,800 students living in Iran were studied, and blood samples were obtained from 4,200 of them. Demographic factors, anthropometric and biochemical measures were used to define lifestyle-related latent variables as well as cardiac, renal, and hepatic risk indicators. Total, direct, and indirect effects between factors were analyzed using the standardized regression weights for each pathway. Data from 14,274 students (participation rate of 99%) and 3,843 blood samples were included. All of the latent variables had a significant direct effect on BMI, with the most potent effect of unhealthy nutrition (β ≅ 0.63) in boys and girls. BMI has significant direct effects on risk indicators of cardiovascular, renal, and hepatic diseases with the most powerful effect on cardiovascular risk factors (β ≅ − 0.08). The most important predisposing factor for obesity was unhealthy nutrition, whereas increased activity, adequate sleep, and better hygiene had protective roles. BMI shows the strongest association with indicator of cardiovascular diseases. These findings underscore the importance of implementing public health programs for the prevention of chronic noncommunicable diseases.

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Staphylococcus aureus Keratitis: Incidence, Pathophysiology, Risk Factors and Novel Strategies for Treatment

Journal of Clinical Medicine ◽

10.3390/jcm10040758 ◽

2021 ◽

Vol 10 (4) ◽

pp. 758

Author(s):

Jason W. Lee ◽

Tobi Somerville ◽

Stephen B. Kaye ◽

Vito Romano

Keyword(s):

Risk Factors ◽

Staphylococcus Aureus ◽

Pseudomonas Aeruginosa ◽

Clinical Characteristics ◽

Surgical Intervention ◽

Current Evidence ◽

Bacterial Keratitis ◽

Novel Therapies ◽

Causative Pathogen ◽

Novel Treatments

Bacterial keratitis is a devastating condition that can rapidly progress to serious complications if not treated promptly. Certain causative microorganisms such as Staphylococcus aureus and Pseudomonas aeruginosa are notorious for their resistance to antibiotics. Resistant bacterial keratitis results in poorer outcomes such as scarring and the need for surgical intervention. Thorough understanding of the causative pathogen and its virulence factors is vital for the discovery of novel treatments to avoid further antibiotic resistance. While much has been previously reported on P. aeruginosa, S. aureus has been less extensively studied. This review aims to give a brief overview of S. aureus epidemiology, pathophysiology and clinical characteristics as well as summarise the current evidence for potential novel therapies.

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Gamma-Irradiated Cornea in Combat-related Ocular Trauma

Military Medicine ◽

10.1093/milmed/usaa479 ◽

2020 ◽

Author(s):

Brian M Davis ◽

Carson Clabeaux ◽

Anton Vlasov ◽

Paul Houghtaling

Keyword(s):

Ocular Trauma ◽

Cost Savings ◽

Corneal Tissue ◽

Significant Cost ◽

Visual Rehabilitation ◽

Military Health ◽

Corneal Injury ◽

Gamma Irradiated ◽

The Military ◽

Penetrating Ocular Trauma

ABSTRACT Corneal injury is a known risk for deployed troops worldwide. To the authors’ knowledge, there has been no reported use of gamma-irradiated corneas in the setting of severe corneal trauma. Our report highlights the case of a 36-year-old active duty solider who sustained bilateral penetrating ocular trauma from a nearby ordnance explosion. We propose that ocular surgeons should consider utilizing gamma-irradiated corneas in (1) a situation where the corneal tissue is so damaged that it would be challenging to accomplish an adequate repair while providing the opportunity for future visual rehabilitation and (2) remote and/or deployed environments where storage of fresh donor tissue is limited. The long shelf life of gamma-irradiated corneas reduces the need for specialized storage equipment and the need for continuous resupply, both potentially leading to significant cost savings for the Military Health System.

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Nasopharyngeal bacterial carriage in young children in Greenland: a population at high risk of respiratory infections

Epidemiology and Infection ◽

10.1017/s0950268816001461 ◽

2016 ◽

Vol 144 (15) ◽

pp. 3226-3236 ◽

Cited By ~ 14

Author(s):

J. E. NAVNE ◽

M. L. BØRRESEN ◽

H. C. SLOTVED ◽

M. ANDERSSON ◽

M. MELBYE ◽

...

Keyword(s):

Risk Factors ◽

Staphylococcus Aureus ◽

Moraxella Catarrhalis ◽

Respiratory Infections ◽

Positive Association ◽

Population Based ◽

Carriage Rate ◽

Population Based Study ◽

Pneumococcal Carriage ◽

Bacterial Associations

SUMMARYThe incidence of childhood respiratory infections in Greenland is among the highest globally. We performed a population-based study of 352 Greenlandic children aged 0–6 years aiming to describe rates and risk factors for carriage of four key bacteria associated with respiratory infections, their antimicrobial susceptibility and inter-bacterial associations. Nasopharyngeal swabs were tested for Streptococcus pneumoniae grouped by serotypes included (VT) or not included (NVT) in the 13-valent pneumococcal conjugate vaccine, non-typable Haemophilus influenzae (NTHi), Staphylococcus aureus and Moraxella catarrhalis. S. pneumoniae was detected from age 2 weeks with a peak carriage rate of 60% in 2-year-olds. Young age and having siblings attending a daycare institution were associated with pneumococcal carriage. Overall co-colonization with ⩾2 of the studied bacteria was 52%. NTHi showed a positive association with NVT pneumococci and M. catarrhalis, respectively, M. catarrhalis was positively associated with S. pneumoniae, particular VT pneumococci, whereas S. aureus were negatively associated with NTHi and M. catarrhalis. Nasopharyngeal bacterial carriage was present unusually early in life and with frequent co-colonization. Domestic crowding increased odds of carriage. Due to important bacterial associations we suggest future surveillance of pneumococcal conjugate vaccine's impact on carriage in Greenland to also include other pathogens.

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