The Adnexal Phenotype of Sagging Eye Syndrome.

PURPOSE: The sagging eye syndrome (SES) describes a condition that presents with age-related distance esotropia, alone or in combination with cyclovertical strabismus. It has a high prevalence in those aged over age 40 years presenting with binocular diplopia. The authors aim to characterize the adnexal phenotype of those who have been diagnosed with SES. METHODS: In this case-control study, patients were recruited from a prospectively maintained clinical and imaging database. The inclusion criteria required that subjects be above the age of 18 years and have a diagnosis of age-related distance esotropia or cyclovertical strabismus due to SES. Age-matched controls were selected from a validated database of normal faces that were not affected by any medical or surgical conditions. The margin to reflex distance from the upper eyelid, margin to reflex distance to the lower eyelid, the tarsal platform show, intracanthal distance, and inferior scleral bow were measured. Differences in the measurements between patients and controls were analyzed using a 2-tailed Student t tests. RESULTS: Twenty-two patients and 22 age-matched controls (11 males and 11 females per group) were included for study. Females with SES had a significantly greater margin to reflex distance to the lower eyelid and inferior scleral bow, with a lower tarsal platform show and margin to reflex distance from the upper eyelid than controls. Male patients with SES had a significantly greater margin to reflex distance to the lower eyelid and inferior scleral bow with a significantly lower margin to reflex distance from the upper eyelid and tarsal platform show than controls. DISCUSSION: This study supports the growing body of evidence which suggests that the SES represents age-related mechanical changes in the orbit that manifest as a specific adnexal phenotype.

Canthoplasty repair for canthal rounding.

BACKGROUND: Canthal rounding can occur following trauma or surgery to the medial or lateral canthus, causing possible aesthetic or functional deficits to patients. Several surgical techniques to repair canthal rounding have been described previously. We report a new technique for canthoplasty repair of canthal rounding with the use of illustrative cases. METHODS: This is a retrospective case series describing the technique using illustrative cases from across three sites (London [UK], Adelaide [Australia], Sydney [Australia]). Twelve patients with post-surgical canthal rounding were included. Information collected for our illustrative cases include patient demographics, diagnosis, complications, outcomes and further treatment. RESULTS: There were no peri- or post-operative complications. All except one patient reported good surgical outcomes after one procedure. In one patient there was rounding recurrence. CONCLUSIONS: Our patients reported excellent outcomes post-operatively without any significant scarring.

Body Image Dissatisfaction among Adolescent Girls of a Municipality in Kathmandu: A Cross-sectional Survey.

INTRODUCTION: Body image is the person's perceptions, thoughts and feelings about his/her body which is a multi-dimensional concept. Body Image Dissatisfaction can be measured using a Body Shape Questionnaire. The main aim of this study was to find out the prevalence of body image dissatisfaction among adolescent girls of a municipality in Kathmandu. METHODS: A cross-sectional survey was done from July 2019 to December 2019 among the female students from grade eight to twelve of the selected private schools of Budhanilkantha municipality. Stratified random sampling was done. Body Shape Questionnaire short version was used to measure the prevalence of body dissatisfaction. Data were analyzed using Statistical Package for the Social Sciences version 23. Point estimate at 95% Confidence Interval was done, frequency and percentage were calculated. RESULTS: One hundred ninety seven (75.2%) at 95% Confidence Interval (69.97-80.43) students were found to have body image dissatisfaction, among which Positive Body Image Dissatisfaction was found to be in 85 (42%) respondents which indicates that 112 (58%) respondents with healthy Body Mass Index were dissatisfied with their body shape. CONCLUSIONS: Prevalence of body image dissatisfaction was found to be high in adolescent girls though most of the girls had normal body weight and a healthy Body Mass Index.

Verbal Abuse among Nurses in Tertiary Care Hospitals.

INTRODUCTION: Verbal abuse against nurses who are major working force can affect the work performance and productivity in hospital. Verbal abuse is epidemic in tertiary care hospitals though it is most preventable with healthcare professions. The study aims to identify the prevalence of verbal abuse among nurses in a Tertiary Care Hospital. METHODS: A descriptive cross-sectional study was conducted among nurses in two tertiary care hospitals in Chitwan using self-administered questionnaire from August-December, 2018. The researcher used the convenient sampling technique and total 331 nurses were taken for the study. RESULTS: Prevalence of verbal abuse was found to be 122 (36.9 %) [34.25%-39.55% at 95% CI] among nurses. Perpetrators of the verbal abuse were relatives of the patients 64 (48.9%) followed by staff member 29 ( 23.77%), patient 23 (17.6%), management or supervisor 4 (3.1%) and from colleague 2 (1.5%). Frequency of verbal abuse as sometimes, once and all the times were 95 (77.86%), 20 (16.03%) and 7 (5.7 %) respectively. Study showed that verbal abuse was mostly done by relatives of the patient. Consequence of verbal abuse was disturbing memories, thoughts or an image ultimately reducing the job satisfaction. No any action was taken except verbal warning for 20 (58.8%) perpetrators. CONCLUSIONS: Verbal abuse is frequently prevalent in nurses and mostly from patient's visitors. Hence, nurses should maintain their respect and authority otherwise it will lead to decrease in their performance that shows direct impact on patient care and consequently the effectiveness of the health care system.

Prevalence of Verbal Abuse Among Doctors in Tertiary Care Hospital.

INTRODUCTION: Verbal abuse is the act of forcefully criticizing, insulting or denouncing another person. Verbal abuse can be devastating to doctors and may cause long lasting emotional and psychological damage. This study aims to find the prevalence of verbal abuse among doctors in tertiary care hospital. METHODS: This descriptive cross-sectional study was conducted among doctors in a tertiary care hospitals, Chitwan from January to July, 2019 after taking ethical approval. Convenience sampling was done. Self administered questionnaire was distributed and data was collected. Point estimate at 95% CI was done for binary data along with frequency and proportion. Data were entered and calculations were done in Microsoft excel. RESULTS: Verbal abuse was found among 80 (33.3%) respondents at 95% Confidence Interval (27.51- 39.09%) and most 51 (63.8%) of perpetrators were relatives of the patients. Most 38 (47.5%) of the doctors were often worried in workplace. Incident of the verbal abuse was more 35 (43.6%) in morning and least 14 (17.4%) in night. Most 22 (27.5%) of the doctors did not take any action for incident although most 42 (52.5 %) of the doctors were encouraged by colleagues to take action. CONCLUSIONS: Prevalence of verbral abuse among the doctors were found out to be similar as the previous studies conducted in similar settings. This study has shown that doctors were frequently verbal abused by patient's relatives and were abused mostly in morning shift and were often worried in workplace.

Health-Related Quality of Life of Nepalese Children With Leukemia Using Pediatric Quality of Life Inventory 4.0 Generic Core Scale.

Health-related quality of life (HRQOL) is an essential measure to consider when evaluating the full impact of illness in children diagnosed with leukemia. The purpose of the current study was to assess the overall HRQOL and specific functioning subscales of Nepalese children with leukemia using Pediatric Quality of Life Inventory 4.0 Generic Core Scale (PedsQL 4.0), compare self-report with parent proxy report of HRQOL and to identify the determinants affecting HRQOL. After cultural linguistic validation of PedsQL, a descriptive cross-sectional study was conducted on 43 children with leukemia and their parents in B. P. Koirala Memorial Cancer Hospital, Bharatpur via interview schedule. Among the subscales of HRQOL both the child's self-report and parent proxy report scores were highest in social functioning and lowest in emotional functioning subscale. Intraclass correlation coefficient between proxy reports and self-reports were highest (0.828) in physical functioning and lowest (0.493) in social functioning subscales. Age group was significantly associated with the total score, physical functioning subscale, and emotional functioning subscale of only proxy scores. Leukemic children's age-specific needs should be addressed properly to improve their overall HRQOL.

Study of antibody recognition pattern of HCV by western blot method.

HCV is a positive strand RNA virus, and is a member of the Family Flaviviridie. HCV show substantial nucleotide sequence variability distributed throughout the viral genome, particularly the HVR1 region that is suggested to be immunogenic in humans. HVR1 is the most heterogeneous region within the E2 genome and peptide corresponding to this region, can be detected by homologous sera. To study the serum reactivity to peptides obtained from HVR1 region of the E2 region of the HCV genome, western blot can be performed in place of Enzyme-Linked Immuno Sorbent Assay (ELISA), if the expressed recombinant protein is insoluble & cannot be extracted or purified from the host cell.