Computer vision syndrome: a rising problem during COVID-19 period amongst students and online workers

Dear Editor, Computer vision syndrome (CVS) is defined as complex eye discomfort and vision problems associated with prolonged exposure to digital screens.1 Symptoms include headache, dry eyes, eye strain, blurring of vision, and ocular discomfort after prolonged exposure to light from computers.2,3 Blue light filtering lenses can be used to minimize CVS.2 Globally, around 70 million workers are at risk for computer vision syndrome which reduces the quality of life and work productivity.1 In the western world, use of computers, for both vocational and non-vocational activities, is almost mandatory.1 In today's COVID-19 (Corona-Virus Disease - 2019) era, use of computers and other digital screen devices is surging in Nepal as well, especially for online study and work from home to control the further spread of coronavirus. Moreover, the lockdown and shutdown done for the virus control by minimizing human gathering increase the demand for virtual learning and working through the online medium.

Clinical profile of patients presenting to emergency with upper gastrointestinal bleeding in a tertiary hospital of Nepal

Introduction: Upper gastrointestinal bleeding is an acute emergency condition. It is an important cause for the hospital admission. This study descriptively analyses the clinical profile of upper gastrointestinal bleeding presenting to a tertiary hospital in Nepal. Method: This is a cross-sectional study of patients presenting with upper gastrointestinal bleeding from 01 Oct 2018 to 30 Sep 2019 at Patan Hospital Emergency Department, Patan Academy of Health Sciences, Nepal. Patient’s demographics, clinical presentation, duration of illness before presenting to Emergency, vitals, and laboratory parameters were descriptively analyzed. Ethical approval was obtained. Result: There were 121 patients, male 82(67.8%) and female 38(31.4%) aging 14 to 90 years. Fifty-three patients (43.8 %) presented with hematemesis, 38(31.4%) with melena, and 27(22.3%) with both hematemesis and melena. Variceal bleeding was the main cause of upper gastrointestinal bleeding found in 73(60.33%) followed by ulcer bleeding in 48(39.66%). Conclusion: Variceal bleeding was the main cause of upper gastrointestinal bleeding and hematemesis was the most common clinical presentation in patients presenting to the Emergency Department.

Histopathological evaluation of kidney disease in patients with diabetes mellitus

Introduction: Non diabetic kidney disease (NDKD), a treatable condition, is common in diabetic patients with atypical clinical presentations. Present study aimed to find out histopathological diagnosis of kidney disease in type 2 Diabetes mellitus with such presentations. Method: This was a hospital based cross sectional study conducted in Nephrology department, Bir hospital, Nepal from Aug 2019 to January 2021. Total 29 diabetic patients with atypical presentations, rapid rise of proteinuria alone (n=5), with microscopic hematuria (n=6), with impaired renal function (n=8) and rapid rise of creatinine with (n=8) or without (n=2) microscopic hematuria were included. The baseline information was recorded and kidney biopsy was performed. Result: The mean age of patients was 52.6±10.4 y and 22(75.9%) were male. Diabetic retinopathy (DR) was absent in 24(82.8%) patients. Presence of NDKD alone was in 6(20.7%) and superimposed on diabetic kidney disease (DKD) in 10(34.5%) with total NDKD in 16(55.2%) and isolated DKD in 13(44.8%) patients. Non diabetic kidney disease were glomerulonephritis 12(75%) with membranous nephropathy 4(25%) and IgA nephropathy 4(25%) patients. The significant difference between NDKD and isolated DKD was only the duration of diabetes < 5 y in 8(61.5%) of isolated DKD and ≥5 y in 13(81.2%) patients with NDKD (p=0.018). Diabetic retinopathy was absent in 6(100%) patients with isolated NDKD, 8(80%) of class III and 5(62.5%) of class IV DKD. Conclusion: Glomerulonephritis is the commonest NDKD in type 2 DM with atypical presentation and advance DKD (Class III & IV) is present even in absence of diabetic retinopathy and short duration of diabetes.

Perception of nursing students towards online learning during COVID-19 pandemic

Introduction: During COVID-19 pandemic, many academic institutions in Nepal and the world turned to online learning. The present study aimed to explore nursing students’ perception towards online learning. Method: A cross-sectional analytical study was conducted to identify the perception of nursing students towards online learning in School of Nursing and Midwifery, Patan Academy of Health Sciences (PAHS), Lalitpur, Nepal during October 2020. A total enumerative sampling technique was used to collect data. Ethical approval was taken from the Institutional Review Committee (IRC) of PAHS. Data were collected using a self-developed structured questionnaire via Google form. The collected data were entered into SPSS version 16. Descriptive statistics (frequency, percentage, mean and standard division) and Chi-square test was used to analyze the data. Result: Out of 348 nursing students, it was found that 186(53.4%) of the nursing students had positive perception and 162(46.6%) of the students had negative perceptions towards online learning during COVID-19 pandemic. The perception was associated with the academic year, access to the internet, need for use of mobile data, and academic level. Conclusion: The overall perception of nursing students is not satisfactory towards online learning. Academic institution should plan the online learning giving the priorities on the factors associated with negative perception so that students can learn effectively through virtual.

Author-level metrics: Its impact on scholarly output evaluation among various publication metrics

Publication metrics indicate the visibility and reach of a research publication. The metrics can be at article-level, author-level, and journal-level to measure the scholarly output and its impact. Bibliometrics is the use of statistical methods to analyze various publications mostly used in the field of library and information science; whereas, scientometrics is the sub-field concerned with the science of metrics for the measurement and analysis of scholarly publications. Readers are not always well informed about the various publication metrics, and use them without knowing how to interpret them, their strength and limitations.

The scenario of childhood blindness and its remedy in Nepal

Childhood blindness represents one of the most common disabling and for children. There are approximately 1.4 million blind children worldwide and two-thirds live in the developing countries like Nepal. In Nepal more than 80% of the causes of childhood blindness are preventable. The main causes of blindness are diseases related to cornea, retina, lens optic nerve, refractive errors, amblyopia and hereditary. Most of the cases of unilateral childhood blindness are due to corneal causes. To decrease the burden of blindness, awareness program about various ocular diseases, nutritional blindness, ocular trauma, refractive errors, strabismus and amblyopia should be provided to the community health workers and parents. School screening programs and free eye camps should be conducted and motivate the community for regular eye checkup and follow up. Eye services should reach to rural areas and for poor socio-economic condition. Eye health education should focus on proper nutrition of children and harmful effects of traditional eye medicines. The objective of this study was to investigate the magnitude of childhood blindness in Nepal along with their possible causes. Similarly, this study is aimed to highlight the best possible modalities for the remedy of childhood blindness in the developing countries like Nepal.

Ocular manifestations in patients with corona virus disease (COVID-19)

Introduction: Corona virus disease (COVID-19) has affected many subspecialties including ophthalmology. We aimed to determine the ocular manifestations of COVID-19 patients treated in a dedicated tertiary care hospital, in Nepal. Method: This was a descriptive cross-sectional study in hospitalized COVID-19 patients in Patan Hospital, Patan Academy of Health Sciences, Kathmandu, Nepal. Data were collected during 6 months from November 2020 to May 2021 to achieve a for a specified sample size of 90. Ophthalmological manifestations were recorded in the consenting participants. Ethical approval was obtained. Result: One or more ocular manifestations were seen in 3.4% of admitted COVID-19 patients. Bilateral diffuse red eyes was the most common manifestation. Conclusion: Bilateral diffuse red eye was the common ocular manifestation in admitted COVID-19 patients.

COVID-19 impact on liver: inter-organ cross-talk in an acute inflammation

Since coronavirus disease 2019 (COVID-19) has been a new disease, very less is known about the disease, and guidance for the treatment are often being made on the basis of an experiences or expert opinions. Now it is known that COVID-19 is caused by a new Severe Acute Respiratory Syndrome Coronavirus-2 (SARS-CoV-2) virus which elicit infection to the cells by binding of the spike protein to angiotensin converting enzyme 2 (ACE2). Given the high transmissibility rate of the SARS-Cov-2 virus and known to have cytokine dysregulation by inducing an immune-mediated systemic inflammation, patients with underlying liver disease might be at an increased risk of severe infection and death. Here we report different mechanisms based on the organ cross-talk and other causes that how COVID-19 patients are prone to have liver injury.

Stroke patients presenting to the emergency department of a tertiary care hospital

Introduction: Stroke is one of the most common causes of morbidity and mortality in Nepal. It is the 3rd most common cause of death worldwide. In Nepal Non-communicable diseases in Nepal(NCDs) states that stroke accounts for 42% of all deaths and is estimated to reach about 66.3% of all deaths by 2030. Method: A retrospective cross-sectional study of all stroke patients seen in Patan Hospital Emergency Department for a period of 1 y. Demographic data, presenting complaint, time of onset of symptoms, time presenting to the Emergency, patient’s risk factors for stroke, head CT findings (hemorrhagic or ischemic stroke) were analyzed descriptively. Ethical approval was taken. Result: Total 170 patients (96 males i.e.56.5% and 74 females i.e. 43.5%) were analyzed. 130(76.5%) were ischemic CVA and 40 (23.5%) were hemorrhagic CVA. The most common presenting symptoms was hemiparesis and speech changes. Conclusion: Stroke is a common disease seen in Nepal, with higher percentages of hemorrhagic stroke.

Gynecologic surgery during the COVID-19 pandemic: Patan Hospital experience

Introduction: The COVID-19 pandemic is a major challenge for health care services including safe and effective surgery. This study aims to analyze gynecological surgery delivery during COVID-19 pandemic. Method: Data on gynecologic surgeries performed at Patan Hospital from 01 Jan to 31 Dec,2020 during pre-lockdown , lockdown and post-lockdown period of the COVID-19 pandemic were analyzed from medical record for surgical procedures, blood transfusion, ICU stay, length of hospital stay, mortality, COVID-19 PCR positive cases. Chi-square and Anova tests were used to compare between three periods, p value <0.05 was considered statistically significant. Ethical approval was obtained. Result: Out of 413 surgeries, 149(36.1%) were done during pre-lockdown, 116(28.1%) during lockdown and 148(35.8%) during post-lockdown period. Major surgery was 155(37.5%), minor 249(60.3%), minimally invasive 9(2.2%) and 61(14.8%) required blood transfusion. Mean hospital stay was 3.75±3.711 d, 15(3.63%) stayed in ICU following procedure and 1(0.2%) expired. Thirteen patients were suspected with COVID-19 infection 8 were PCR positive. Conclusion: There was decrease in major procedures during lockdown period.