Self-Assembly and the Properties of Micro-Mesoporous Carbon.

This study introduces a new approach for constructing atomistic models of nanoporous carbon by randomly distributing carbon atoms and pore volumes in a periodic box and then using empirical and ab initio molecular simulation tools to find the suitable energy-minimum structures. The models, consisting of 5000, 8000, 12000, and 64000 atoms, each at mass densities of 0.5, 0.75, and 1 g/cm3, were analyzed to determine their structural characteristics and relaxed pore size distribution. Surface analysis of the pore region revealed that sp atoms exist predominantly on surfaces and act as active sites for oxygen adsorption. We also investigated the electronic and vibrational properties of the models, and localized states near the Fermi level were found to be primarily situated at sp carbon atoms through which electrical conduction may occur. Additionally, the thermal conductivity was calculated using heat flux correlations and the Green-Kubo formula, and its dependence on pore geometry and connectivity was analyzed. The behavior of the mechanical elasticity moduli (Shear, Bulk, and Young's moduli) of nanoporous carbons at the densities of interest was discussed.

Machine Learning Differentiation of Autism Spectrum Sub-Classifications.

PURPOSE: Disorders on the autism spectrum have characteristics that can manifest as difficulties with communication, executive functioning, daily living, and more. These challenges can be mitigated with early identification. However, diagnostic criteria has changed from DSM-IV to DSM-5, which can make diagnosing a disorder on the autism spectrum complex. We evaluated machine learning to classify individuals as having one of three disorders of the autism spectrum under DSM-IV, or as non-spectrum. METHODS: We employed machine learning to analyze retrospective data from 38,560 individuals. Inputs encompassed clinical, demographic, and assessment data. RESULTS: The algorithm achieved AUROCs ranging from 0.863 to 0.980. The model correctly classified 80.5% individuals; 12.6% of individuals from this dataset were misclassified with another disorder on the autism spectrum. CONCLUSION: Machine learning can classify individuals as having a disorder on the autism spectrum or as non-spectrum using minimal data inputs.

Novel on-site follow-up and enhancement program (FEP) improves knowledge, clinical skills and enabling environment of skilled birth attendants in Nepal.

INTRODUCTION: Although great strides have been made in maternal and newborn health in Nepal, the maternal mortality ratio (MMR) is still high at 186 per 100,000 births. Many maternal deaths are preventable if there is access to a skilled birth attendant (SBA). The Ministry of Health and Population of Nepal launched the in-service SBA training program in 2007 and has trained over 10,000 SBAs to date. Evidence shows that one episode of training is not enough to retain skills. Therefore, the Nick Simons Institute (NSI) in collaboration with National Health Training Center (NHTC) devised a Follow-Up and Enhancement Program (FEP) in 2011 where the knowledge, clinical skills, and working environment of SBA graduates were assessed directly at their worksites. FEP allows on-site coaching and feedback so that graduates may continue to improve upon any gaps in their knowledge, skills, and working environment. This study aims to assess the effectiveness of FEP. METHODS: We used a mixed-methods research design. A total of 73 SBAs who had a pre-FEP assessment in 2016 were followed up for a post-FEP assessment in 2017. We also collected data from 3 additional districts (115 SBAs) that had not previously had FEP, to compare SBAs in FEP versus non-FEP districts. Qualitative data was collected from 16 health facilities on the perceptions, motivation, and satisfaction of stakeholders. RESULTS: Of the total 188 SBAs that were sampled, a one-time FEP increased knowledge scores by 9%, clinical skills scores by 29%, and enabling environment scores by 7%. The number of deliveries conducted improved with a one-time FEP, although this increase was not statistically significant. We found a trickle-down effect of working in a facility that has had prior FEP, with SBAs that have never had FEP improving their clinical skills. FEP was found to be a highly accepted program and is beneficial to SBAs, trainers, and the Hospital Management Committee (HFOMC). However, a one-time FEP is not sufficient in retaining clinical skills and knowledge. CONCLUSION: FEP is a highly effective program by both quantitative and qualitative evaluation. Our study suggests that FEP should be frequent and continuous to retain the knowledge and clinical skills of SBAs, motivate them through on-site coaching, and improve their working environment through direct feedback to the Ministry of Health and Population.

Evidence of a reduced role for circumscribed interests in the social attention patterns of children with Autism Spectrum Disorder.

Reduced social attention is characteristic of Autism Spectrum Disorder (ASD). It has been suggested to result from an early onset and excessive influence of circumscribed interests (CIs) on gaze behaviour, compared to typically developing (TYP) individuals. To date, these findings have been mixed. The current eye-tracking study utilised a visual preference paradigm to investigate the influence of CI versus non-CI objects on attention patterns in children with ASD (aged 3-12 years, n = 37) and their age-matched TYP peers (n = 30). Compared to TYP, social and object attention was reduced in the ASD group irrespective of the presence of CIs. Results suggest a reduced role for CIs and extend recent evidence of atypical attention patterns across social and non-social domains in ASD.

Ab Initio Simulation of Amorphous Graphite.

An amorphous graphite material has been predicted from molecular dynamics simulation using ab initio methods. Carbon materials reveal a strong proclivity to convert into a sp^{2} network and then layer at temperatures near 3000 K within a density range of ca. 2.2-2.8 g/cm^{3}. Each layer of amorphous graphite is a monolayer of amorphous graphene including pentagons and heptagons in addition to hexagons, and the planes are separated by about 3.1 Å. The layering transition has been studied using various structural and dynamical analyses. The transition is unique as one of partial ordering (long range order of planes and galleries, but topological disorder in the planes). The planes are quite flat, even though monolayer amorphous graphene puckers near pentagonal sites. Interplane cohesion is due partly to non-Van der Waals interactions. The structural disorder has been studied closely, especially the consequences of disorder to electronic transport. It is expected that the transition elucidated here may be salient to other layered materials.

An evaluation of homesickness in children: A systematic review and meta-analysis.

OBJECTIVE: To provide a systematic review and meta-analysis of the quantitative literature on homesickness in children, including how it is assessed and relationship to other negative states. STUDY SELECTION AND SYNTHESIS: A literature search was conducted using Medline, PsychINFO and Scopus databases. Studies were included if they assessed homesickness in children under eighteen years of age and were published in peer reviewed journals in the English language between 1990 and December 2020. A total of 176 studies were screened for relevance and 17 met the inclusion criteria for the systematic review with five studies included in the meta-analysis. MAIN OUTCOMES AND MEASURES: The primary outcome measure was homesickness severity, and it was examined in relation to measures of depression and anxiety. The literature in relation to known risk and protective factors was also reviewed. RESULTS: Homesickness was reported in the majority of children who were separated from their home. It was associated with negative emotional states. A total of seventeen studies were included in the quantitative review. The meta-analysis showed a significant relationship between homesickness and depression r=0.431 (95% CI 0.344-0.510; p<0.001) and homesickness and anxiety r=0.426 (95% CI 0.369-0.479; p<0.001). Age was not a significant moderator of homesickness severity. Consideration of effective interventions to address homesickness was limited. CONCLUSIONS AND RELEVANCE: Homesickness significantly impacts children's well-being regardless of age and is associated with overall distress, depression and anxiety. Future studies are required to examine homesickness interventions and supports to improve well-being in children.

Annual consumption of parenteral antibiotics in a tertiary hospital of Nepal, 2017-2019: a cross-sectional study.

SETTING: Patan Hospital, a tertiary care hospital in Lalitpur District, Nepal. OBJECTIVES: To describe the annual parenteral antibiotic consumption in 1) defined daily dose (DDD) and DDD per 100 admissions; 2) calculate DDD per 100 admissions and proportions by pharmacological subgroup, chemical subgroup and AWaRe categories; and 3) describe patient expenditure on parenteral antibiotics as a proportion of the total patient expenditure on drugs and consumables between 2017 and 2019. DESIGN: This was a cross-sectional study. RESULTS: Total DDD of parenteral antibiotics increased by 23% from 39,639.7 in 2017 to 48,947.7 in 2019. DDD per 100 admissions increased by 10% from 172.1 in 2017 to 190.2 in 2019. Other beta-lactam antibacterials comprised the most frequently consumed pharmacological subgroup. The chemical substance most often consumed was ceftriaxone, with an increasing trend in the consumption of vancomycin and meropenem. Parenteral antibiotics in 'Watch' category were the most consumed over the study period, with a decreasing trend in 'Access' and increasing trend in 'Reserve' categories. CONCLUSION: We aimed to understand the consumption of parenteral antibiotics at a tertiary care hospital and found that Watch antibiotics comprised the bulk of antibiotic consumption. Overconsumption of antibiotics from the 'Watch' and 'Reserve' categories can promote antimicrobial resistance; recommendations were therefore made for their rational use.

CONTEXTE: Hôpital de Patan, un hôpital de soins tertiaires du District de Lalitpur, Népal. OBJECTIFS: Décrire la consommation annuelle d'antibiotiques parentéraux en 1) dose définie journalière (DDD) et DDD pour 100 admissions ; 2) calculer la DDD pour 100 admissions et les pourcentages par sous-groupe pharmacologique, sous-groupe chimique et catégories de la classification AWaRe ; et 3) décrire les dépenses des patients en antibiotiques parentéraux en tant que proportion du total des dépenses des patients en médicaments et consommables de 2017 à 2019. MÉTHODE: Il s'agissait d'une étude transversale. RÉSULTATS: La DDD totale d'antibiotiques parentéraux a augmenté de 23%, de 39 639,7 en 2017 à 48 947,7 en 2019. La DDD pour 100 admissions a augmenté de 10%, de 172,1 en 2017 à 190,2 en 2019. Les autres bêtalactamines étaient le sous-groupe pharmacologique le plus consommé. La substance chimique la plus consommée était la ceftriaxone, avec une tendance à la hausse de la consommation de vancomycine et de méropénème. Les antibiotiques parentéraux du groupe « antibiotiques à utiliser sélectivement ¼ étaient les plus consommés pendant la période d'étude, avec une tendance à la baisse de ceux du groupe « antibiotiques dont l'accessibilité est essentielle ¼ et une tendance à la hausse de ceux du groupe « antibiotiques de réserve ¼. CONCLUSION: Nous avons cherché à comprendre la consommation d'antibiotiques parentéraux dans un hôpital tertiaire et avons observé que les « antibiotiques à utiliser sélectivement ¼ représentaient la majorité de la consommation d'antibiotiques. La surconsommation d'« antibiotiques à utiliser sélectivement ¼ et d'« antibiotiques de réserve ¼ peut favoriser la résistance antimicrobienne. Des recommandations ont donc été émises pour un usage raisonné de ces antibiotiques.

Modulation of optical absorption in m-Fe1-xRuxS2 and exploring stability in new m-RuS2.

A first-principle computational method has been used to investigate the effects of Ru dopants on the electronic and optical absorption properties of marcasite FeS2. In addition, we have also revealed a new marcasite phase in RuS2, unlike most studied pyrite structures. The new phase has fulfilled all the necessary criteria of structural stability and its practical existence. The transition pressure of 8 GPa drives the structural change from pyrite to orthorhombic phase in RuS2. From the thermodynamical calculation, we have reported the stability of new-phase under various ranges of applied pressure and temperature. Further, from the results of phonon dispersion calculated at Zero Point Energy, pyrite structure exhibits ground state stability and the marcasite phase has all modes of frequencies positive. The newly proposed phase is a semiconductor with a band gap comparable to its pyrite counterpart but vary in optical absorption by around 106 cm-1. The various Ru doped structures have also shown similar optical absorption spectra in the same order of magnitude. We have used crystal field theory to explain high optical absorption which is due to the involvement of different electronic states in formation of electronic and optical band gaps. LÓ§wdin charge analysis is used over the customarily Mulliken charges to predict 89% of covalence in the compound. Our results indicate the importance of new phase to enhance the efficiency of photovoltaic materials for practical applications.

Pressure dependent half-metallic ferromagnetism in inverse Heusler alloy Fe2CoAl: a DFT+U calculations.

We report the electronic and magnetic properties along with the Curie temperature (T C) of the inverse full Heusler alloy (HA) Fe2CoAl obtained by using the first-principles computational method. Our calculations suggests that Fe2CoAl is a magnetic metal when treated within PBE-GGA under the applied compressive pressures. However, the implementation of electron-electron (U) (i.e., GGA+U) with varying compressive pressure (P) drastically changes the profile of the electronic structure. The application of GGA+U along with pressure induces ferromagnetic half-metallicity with an integer value of total magnetic moment ∼4.0 µ B per unit cell. The integer value is in accordance with the Slater-Pauling's rule. Here, we demonstrate the variation of semiconducting gap in the spin down channel. The band gap increases from 0.0 eV to 0.72 eV when increasing the pressure from 0 to 30 GPa. Beyond 30 GPa, the electronic band gap decreases, and it is completely diminished at 60 GPa, exhibiting metallic behaviour. The analysis of the computed results shows that the treatment of electron-electron interactions within GGA+U and the application of compressive pressure in Fe2CoAl enables d-d orbital hybridization giving rise to a half-metal ferromagnet. The T C calculated from mean field approximation (MFA) decreases up to 30 GPa and then increases linearly up to 60 GPa.

Electronic, magnetic, optical and thermoelectric properties of Ca2Cr1-x Ni x OsO6 double perovskites.

With the help of density functional theory calculations, we explored the recently synthesized double perovskite material Ca2CrOsO6 and found it to be a ferrimagnetic insulator with a band gap of ∼0.6 eV. Its effective magnetic moment is found to be ∼0.23 µ B per unit cell. The proposed behavior arises from the cooperative effect of spin-orbit coupling and Coulomb correlation of Cr-3d and Os-5d electrons along with the crystal field. Within the ferrimagnetic configuration, doping with 50% Ni in the Cr-sites resulted in a half-metallic state with a total moment of nearly zero, a characteristic of spintronic materials. Meanwhile, the optical study reveals that both ε 1 xx and ε 1 zz decrease first and then increase rapidly with increasing photon energy up to 1.055 eV. We also found optical anisotropy up to ∼14 eV, where the material becomes almost optically isotropic. This material has a plateau like region in the σ xx and σ zz parts of the optical conductivity due to a strong 3d-5d interband transition between Cr and Os. In addition, we performed thermoelectric calculations whose results predict that the material might not be good as a thermoelectric device due to its small power factor.

Electronic properties and low lattice thermal conductivity (κ l) of mono-layer (ML) MoS2: FP-LAPW incorporated with spin-orbit coupling (SOC).

This paper focuses on the electronic and thermoelectric properties of monolayer MoS2. Here, we have examined the structure of MoS2, in which the hole in the center of the hexagonal cage is considered as a void atom, termed 1H-MoS2. Density functional theory (DFT) employing the generalized gradient approximation (GGA) and spin-orbit coupling (SOC) has been used for all calculations. Incorporation of SOC resulted in a significant change in the profile of the band energy, specifically the splitting of the valence band maximum (VBM) into two sub-bands. The "split-off" energy is found to be ∼20.6 meV. The reduction of the band gap with SOC is a prominent feature at the K-K location in the Brillouin zone. The band gap calculated with the GGA is ∼1.75 eV. However, on implementation of SOC, the GGA band gap was reduced to ∼1.68 eV. The frequency-dependent phonon dispersion curve was obtained to analyse the thermodynamical stability. 1H-MoS2 is found to be thermodynamically stable with no imaginary frequency. We report a low value of lattice thermal conductivity (κ l) and low electron effective masses, which are desirable for potential applications in thermoelectric devices.

A theoretical analysis of elastic and optical properties of half Heusler MCoSb (M=Ti, Zr and Hf).

Ab initio calculation of the Elastic and Optical properties of cubic half-Heusler compounds MCoSb (M = Ti, Zr and Hf) are reported using the FP-LAPW approach of the Density Functional Theory. Generalized Gradient Approximation was used as the exchange and correlation potential for investigating these properties. It was found that the Bulk modulus decreases with the increase in temperature and increases with the increase in pressure for all of the three Heusler compounds under study. The Debye's temperature along with compressional, Shear and average elastic wave velocities has also been calculated. The elastic results are compared with the available theoretical and experimental works. The optical investigation of the compounds shows high reflectivity at the infrared region of the photon energy. The imaginary part of the dielectric function reveled the optically non-metallic behavior of the MCoSb compounds, with optical band gap being around 1 eV.

Perception about Medicines among the General Public in the Semi-rural Areas of Nepal.

Background Patients' perceptions and beliefs about medicine are affected by their culture, tradition, socioeconomic status, peer influence, educational level, advertisements among other factors. Objective To explore the perception about medicines among the general public in different semi-rural areas of Nepal. Method Cross-sectional study was conducted at different locations within Kathmandu valley from July 2015 to December 2016; 385 individuals were approached using simple random sampling but only 260, aged 18 years and above, who were taking medicines for their health problems, completed the interviewer-administered survey. Their perceptions about medicines were studied using a structured questionnaire based on the WHO booklet "How to investigate the use of medicines by consumers" and analysed using SPSS version 22. Association between respondents' age, gender, education level and perception were statistically analysed using χ2 test and/or Fisher's exact test and multivariate analysis of variance. Result Sixty-one respondents (23.5%) were in age group 56-65 years. Patients' perceptions of medicine safety based on colour, shape, name of medicine, method of administration, compatibility, etc. was statistically different among respondents with regard to their level of education (p = 0.022). More individuals with lower education believed that expensive medicines were more effective (p < 0.001). Increased level of education made them more aware of negative consequences of reusing previous prescriptions (p=0.039). Conclusion Problems with knowledge about medicines were noted among lesser educated individuals. Based on findings, policy makers may develop educational strategies to increase awareness about medicines.

Systemic association of newly diagnosed proliferative diabetic retinopathy among type 2 diabetes patients presented at a tertiary eye hospital of Nepal.

INTRODUCTION: Proliferative diabetic retinopathy (PDR) is the leading cause of blindness among the diabetics. OBJECTIVE: to study the systemic association of proliferative diabetic retinopathy. MATERIALS AND METHODS: A prospective, case-series study was conducted among the newly diagnosed proliferative diabetic retinopathy cases presenting at the Tilganga Institute of Ophthalmology (TIO) from January 2012 to January 2013. Diabetic retinopathy was classified using the Early Treatment Diabetic Retinopathy Study criteria. Blood pressure, fasting and postprandial blood sugar, glycosylated hemoglobin, lipid profile, urine for microalbumin, urea, and creatinine were evaluated at the time of diagnosis. RESULTS: A total of 104 type 2 diabetic patients with newly diagnosed PDR presented during the study period. Concurrent macular edema was present in 93 cases (89.42 %). The mean age was 56.96 ± 9.394 (range 32 - 78) years. Males and females comprised of 75.7 % and 24.3 % respectively. The majority (37.5 %) were involved in business, followed by government service (17.30 %), and housewives (16.34 %). Mean duration of diabetes was 11.42 ± 5.356 years (range 1 month - 26 years). Concurrent hypertension was found in 55.76 %, uncontrolled fasting and or postprandial blood sugar in 72.54 %, poor glycemic control (HbA1C > 7 %) in 73.97 %, abnormal lipid profile in 52.56 %, microalbuminuria in 67.85 %, and positive urine albumin in 50 % of the cases. CONCLUSION: Despite the short duration of diabetes, the concurrent hypertension, poor glycemic control, proteinuria and dyslipidemia were the main systemic associations for PDR at our clinical set-up. Awareness, identification and management of these systemic problems could reduce the rapid progression to PDR.

Prevalence, risk factors and awareness of diabetic retinopathy among admitted diabetic patients at a tertiary level hospital in Kathmandu.

INTRODUCTION: Diabetic retinopathy (DR) is one of the commonest causes of visual impairment and blindness in Nepal. OBJECTIVES: The study aims to explore the prevalence, risk factors and awareness of DR among admitted diabetic patients. MATERIALS AND METHODS: A non-interventional case series study was conducted among the inpatient diabetic cases referred for ophthalmic consultation. The patients' detailed demographics, awareness on DR, concurrent systemic problems, and glycemic control status were recorded. DR was graded using the Early Treatment Diabetic Retinopathy Study Criteria. MAIN OUTCOME MEASURES: The prevalence, risk factors and awareness of diabetic retinopathy among the study participants was analyzed. RESULTS: A total of 277 diabetic patients were enrolled in the study. The mean age was 62.25 ± 13.26 years. Only one-third (34.6 %) of the cases were admitted for sugar control and newly diagnosed cases comprised of 19.49 %. Nearly half of the cases (46.6 %) were not aware of diabetic retinopathy and dilated fundus evaluation was done for the first time in 44.4 %. DR was found in 38.26 % of the cases and was diagnosed in 13 % of the new cases. Almost four-fifths (78 %) of the diabetics had had the disease for a duration of 16 to 20 years. Clinically significant macular edema was found in 5.78 % and proliferative DR in 2.52 %. DR was significantly associated with the duration of diabetes (P value = 0.001) and concurrent hypertension (P value = 0.004). CONCLUSION: The prevalence of DR was 38 % among the admitted diabetic cases and the DR was significantly associated with the duration of diabetes and systemic hypertension. Almost half of the cases had been unaware of DR before referral. This emphasizes the importance of the collaboration of the physician and the ophthalmologist for an early DR detection.

Clinico-microbiological Profile and Visual outcome in Traumatic Endophthalmitis following Pars Plana Vitrectomy at a Tertiary Eye Care Centre of Nepal.

INTRODUCTION: Endophthalmitis is a potentially devastating ocular complication of perforating eye injury (PEI) where prompt intervention can save some vision. This study aims to explore the clinico-microbiologic profile and visual outcome following pars plana vitrectomy (PPV) in traumatic endophthalmitis. METHODS: This is a retrospective interventional case series study conducted at a tertiary eye care centre of Nepal. A total of 49 consecutive cases (49 eyes) of endophthalmitis following PEI, who underwent PPV from January 2007 to June 2010 were included in the study. RESULTS: Mean age was 14.7 years (S.D. 14.27). Twenty seven patients (55%) were of age group below 10 years. Male to female ratio was 2.75:1. Mean duration of presentation was 8.9 days. Nineteen eyes (36.73%) had injuries with wooden sticks, followed by injury with metallic objects in 16 patients (32.56%). PEI involving zone I was found in 31 eyes (63.25%). The retained intraocular foreign body was found in seven patients (14.2%). The post operative vision improved in almost 24 cases (49%) with visual recovery of 20/200 and better in six cases (12.24%). The vitreous culture was positive in five cases (12.8%) with predominant streptococcus pneumonia in four cases (10.25%). CONCLUSIONS: Children were the mostly affected group with males outnumbering females. Wooden sticks and metallic objects were the commonest insulting agents. Despite the late presentation and predominant zone I injury, eye could be salvaged in majority with visual recovery of 20/200 and better in six cases (12.24%).

Vitreo-retinal disorders at high altitude in Nepal.

INTRODUCTION: Nepal has many mountains including the highest one in the world. People living in high altitude are often involved in climbing mountains. OBJECTIVE: To explore the pattern of vitreo-retinal disorders at high altitude in Nepal. MATERIALS AND METHODS: Consecutive patients aged 40 years and older who presented at the micro-surgical eye camp at Lukla of Solukhumbu district (2,860 metres) were included. Detailed ocular and systemic histories and ocular examination including dilated fundus evaluation were done. RESULTS: There were a total 81 patients with the mean age of 56.7 years (S.D 11.15). Females (51.9 %) outnumbered males. Sherpa comprised of 76.5 % followed by Rai (9.8 %). The main occupation was agriculture (51.9 %) followed by mountain trekking (28.4 %). Smokers comprised of 13.5 %. Hypertension was the predominant systemic problem (28 %). The best corrected visual acuity of 6/18 and better was found in 86.4 % of cases and less than 3/ 60 in 3.6 % of cases. Age-related macular degeneration (AMD) was found in 19.6 % of cases with a predominant mild AMD (16 %), hypertensive retinopathy in 12.2 %, with grade I hypertensive change in 8.6 %, retinal vein occlusion (RVO) in 7.1 % of cases and with a branch RVO in 4.9 %. Dilated and tortuous retinal vessels were present in 25.9 % of cases; out of this, 9.8 % of the cases had concurrent AMD and/or hypertensive retinopathy. Other retinal problems were macular hole (2.46 %), solar retinopathy (2.46 %) and choroidal tear (1.2 %). CONCLUSION: AMD, hypertensive retinopathy, and RVO are the main vitreo-retinal disorders besides the dilated and tortuous retinal vessels in people living at high altitude in Nepal.

Short term results of intra-vitreal bevacizumab for the treatment of macular edema secondary to retinal vein occlusion.

INTRODUCTION: Macular edema (ME) is the leading cause of visual impairment in retinal vein occlusion (RVO). OBJECTIVE: To evaluate the efficacy and safety of intravitreal bevacizumab (Avastin; Genentech) on ME secondary to RVO. MATERIALS AND METHODS: A prospective, interventional study was conducted among patients with ME due to RVO from June 2008 to February 2010. Intravitreal bevacizumab (1.25 mg/0.05 ml) was given at 4 to 6 weekly intervals until the ME subsided. Complete ophthalmic evaluation and measurement of central retinal thickness (CRT) by optical coherence tomography (OCT) were performed at baseline and follow up visits. RESULTS: Thirty four eyes (18 CRVO and 16 BRVO) were included in the study. The mean duration of visual symptoms and follow up period were 5.1 months (range 0.3 - 24 months) and 7.5 ± 4.8 months respectively. In CRVO, the CRT improved from 652 ± 206 ?m at the baseline to 257 ± 132 ?m (p less than 0.0001) at the final follow up, and in BRVO, the CRT improved from 540 ±197 ?m to 219 ± 135 ?m (p 0.0001). The improvement in BCVA was significant at each follow up interval for BRVO; in CRVO, there was only a significant improvement between the baseline and the 6 weeks' follow up. BCVA was improved in 75 % cases of BRVO and in 61.6 % in CRVO at the final follow up. There were no ocular or systemic adverse effects. CONCLUSION: Intravitreal bevacizumab is an effective and safe drug for reducing ME and improving visual acuity secondary to RVO in the short term follow up.

Demographics and awareness of diabetic retinopathy among diabetic patients attending the vitreo-retinal service at a tertiary eye care center in Nepal.

INTRODUCTION: Diabetic retinopathy (DR) is one of the leading causes of blindness in Nepal. OBJECTIVE: To investigate the demographic characteristics and awareness of diabetic retinopathy among new cases of diabetes mellitus (DM) attending the vitreo-retinal service of a tertiary eye care centre in Nepal. MATERIALS AND METHODS: A hospital-based, cross-sectional study including all consecutive new cases of DM was carried out. Detailed demographics of the subjects and their awareness of potential ocular problems from diabetes mellitus were noted. RESULTS: A total of 210 patients with a mean age of 57 +/- 10.4 years were included. Brahmins (34.8 %) and Newars (34.3 %) were the predominant ethnic groups. Housewives (38.6 %) and office workers (18.6 %) were the major groups affected. Two-fifths (37 %) of the cases were unaware of DR and its potential for blindness. Awareness was significantly higher among literate patients (P = 0.006). Fundus evaluation was done for the first time in 48.6 %, although almost four-fifths had a duration of diabetes of five years or more. DR was found in 78 % of the cases, with 16.7 % already at the proliferative stage and about 40 % exhibiting clinically significant diabetic macular edema. CONCLUSION: A lack of awareness of DR coupled with a high proportion of cases already at a sight-threatening stage of retinopathy at their first presentation reflects the need for improved awareness programs to reduce the burden of blindness from DR in Nepal.