Corneal edema following phacoemusification surgery in diabetic eyes is likely to be more frequent than in non-diabetic eyes.

IntroductionAny disturbance to the normal ouVlow of tears through the nasolacrimal passage causes overflow known as epiphora. The clinical symptoms of epiphora range from mild dribble to the continuous ouVlow of tears. Watering of eyes caused by the nasolacrimal drainage  obstruction  is  managed  by surgery. One of the many surgeries to treat this is external dacryocystorhinostomy.ObjectiveThe objective of this study was to evaluate the success rate of external dacryocystorhinostomy as well as factors affecting it.MethodologyThis is a retrospective cross-sectional study, conducted in the Department of Ophthalmology, B. P. Koirala Institute of Health Sciences (BPKIHS), Dharan with the approval of Institutional Review Committee, BPKIHS. The medical records of patients who underwent external Dacryocystorhinostomy surgery from April 2011 to April 2016 at BPKIHS were retrospectively reviewed. Statistical analysis was performed using SPSS for windows, version 11.5 (SPSS Inc., Chicago, IL). Binary logistic regression models were used to investigate the association of the surgical outcome with various predicting variables.ResultsThe success rate of the external dacryocystorhinostomy was 78.09%. Factors studied were: age, with a range of 2-81 years; duration of symptoms with a range of 1-84 months; and gender of the patients. The intra-operative factors studied were use of silastic tube, types of flap, and osteotomy size. Among these factors, the duration of symptoms and osteotomy size had significant association with the outcome of the surgery p<0.05.ConclusionOur study yielded high success rate in patients with shorter duration of watering of eyes and larger osteotomy size during surgery. Hence, a larger osteotomy size and early intervention is recommended for better surgical outcome. Birat Journal of Health Sciences Vol.2/No.1/Issue 2/ Jan - April 2017, Page: 196-200

Background: Megakaryocyte morphology plays an important role in thrombopoiesis. A defect in any stage of megakaryocytopoiesis can lead to dysmegakaryocytopoiesis and thrombocytopenia. This study was conducted to understand megakaryocytic alterations and their contribution in the diagnosis of cases of thrombocytopenia.Materials and Methods: This was a cross-sectional study was conducted on all consecutive cases of bone marrow aspirates of thrombocytopenia over a duration of one year in BPKIHS. Megakaryocyte morphology was studied with a 100X objective. Data were entered into Microsoft excel 10 and analysed with SPSS version 11.5. Descriptive statistics charted and Chi-square tests were done for inferential statistics to find any association at 95% Confidence Interval.Results: Among the 38 subjects, megakaryocytic thrombocytopenia (44.7%) was the most common cause of thrombocytopenia.  Hypolobated megakaryocytes (63.2%), bare megakaryocytic nuclei (57.9%) were the common morphological changes in megakaryocytes. Odds of increased megakaryocyte count in megakaryocytic thrombocytopenia was found to be 12.5 times than for other causes of thrombocytopenia and the presence of bare megakaryocytic nuclei in MTP was statistically significant. (p –value<0.05)Conclusion: Many similarities were observed in megakaryocytic morphology among different hematological diseases. However, increased megakaryocyte count and presence of bare megakaryocytic nuclei, hypolobated forms were significant in megakaryocytic thrombocytopenia.

Melanotrichoblastoma is a variant of pigmented trichoblastoma. It shows heavily pigmented epithelial lobules and differentiaion toward the hair bulb. Abundant dendritic melanocytes are found within the tumor masses. These melanocytes show positivity for S100 protein, HMG45/gp 100 and tyrosinase. The case is being reported because of its rarity.A twenty eight year lady presented to Dermatology OPD with a single nodular lesion on the right temporal region since last five years. Punch biopsy was done. Haematoxylin and eosin stained slides were studied and immunohistochemistry analysis was also done.Variably sized epithelial lobules of basaloid cells spanning the entire dermis was noted on H and E stained slides. Some lobules showed pale looking cells- a reminiscent of follicular germinative cells. Intralesional melanocytes with pigmentation were observed. Immunohistochemistry results showed the melanocytes positive for HMB-45 and S100 and the stroma positive for CD 34. Hence, a definitive diagnosis of Melanotrichoblastoma was made.This case is being presented to emphasize the difficulty posed by adnexal tumors in clinical diagnosis due to their clinical similarity with malignant lesion and rarity.Birat Journal of Health Sciences Vol.2/No.1/Issue 2/ Jan - April 2017

Background & Objectives: The individuals with diabetes have 29 times higher chance of becoming blind due to diabetic retinopathy than non-diabetic of similar age and gender. The knowledge on the factors for it can help detect the disease in its early course. The study was conducted with objectives to study the prevalence of diabetic retinopathy and its risk factors in a diabetic population.Materials and Methods: A community based cross-sectional study that involved 418 subjects with type 2 diabetes, living in the Dharan municipality of Nepal was carried out using convenient sampling method.Results: The prevalence of diabetic retinopathy was 38.8%. Prevalence of mild, moderate, severe and very severe non-proliferative diabetic retinopathy was 9.1%, 16.3%, 6.2% and 17.2% respectively. Prevalence of proliferative diabetic retinopathy and clinically significant macular edema was 3.8% and 1.9% respectively. Among the risk factors studied age, hypoglycemic drug intake, family history and duration of diabetes mellitus had a significant association with the occurrence of diabetic retinopathy (p<0.05).Conclusions: The prevalence of diabetic retinopathy in patients with diabetes mellitus was 38.8% and increase risk factors for it are age, hypoglycemic drug intake, family history of diabetes, duration of diabetes.JCMS Nepal. 2015;11(1): 17-21