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Biomedical subjects

R Khandekar

Publications and source records attributed to R Khandekar.

12 recordsLinked to original sources
PubMed2005

Active trachoma, face washing (F) and environmental improvement (E) in a high-risk population in Oman.

Oman aims to eliminate blinding trachoma by 2010. As a part of a study to review the health institution approach of trachoma surveillance, "F" (facial cleanliness) and "E" (environmental improvement) components of the SAFE trachoma control strategy were assessed in a high-risk population in Nizwa wilayat. Thus 50 households with 1 member treated for active trachoma in the last 6 months were evaluated for active trachoma and forwater and sanitation facilities. In all, 229 children under 15 years of age were clinically examined; the rate of active trachoma was 3.5% in the children. Clean face was found in 97.8% of the children and 70% of houses had piped water or water supplied by tankers. The status of "F" and "E" in the study area was generally high.

Adolescent↗
PubMed2004

One year recurrence of trachomatous trichiasis in routinely operated Cuenod Nataf procedure cases in Vietnam.

BACKGROUND: Recurrence of trichiasis following surgery remains unacceptably high, regardless of the surgical procedure. Few prospective studies of sufficient size are available to assess the rate of recurrence and the factors contributing to recurrence. A prospective study of the modified Cuenod Nataf surgical procedure was conducted in Vietnam to determine recurrence and co-factors. METHODS: The prospective study of Cuenod Nataf surgery for trachomatous trichiasis took place in four districts of Vietnam. All patients from identified villages who had surgery were followed for a period of 1 year. 10 Surgeons using standard techniques and recording procedures carried out the surgery. The presence of an eyelash touching the eyeball in the operated eye was considered as recurrence. Information on all subjects was recorded preoperatively, intraoperatively, and postoperatively. An independent examiner recorded postoperative information. Relative risks were calculated to assess the contribution of various risk factors to recurrence (by eye and by person). Cox proportional hazards modelling was used to assess the independent contribution of relevant factors to the outcome. RESULTS: 471 individuals had trichiasis surgery; 463 were followed for a period of 1 year. Overall, the recurrence rate was 10.8% (95% CI 8.0 to 13.6). Among people having surgery recurrence (one or both eyes) was most common in the most elderly (relative risk (RR) 2.49) and among those with a history of previous surgery (RR = 2.49). Cox proportional hazards analysis (by eye) revealed that visual acuity, conjunctival scarring, and suture adjustment were associated with recurrence at 1 year. CONCLUSION: The Cuenod Nataf procedure, which is well accepted in the community and by eye care providers in Vietnam, has an acceptable 1 year success rate. Individuals with severe conjunctival scarring have the highest rate of recurrence suggesting that other surgical approaches are needed to manage these patients or that these patients need to be educated regarding the risk of recurrence. Active follow up of these patients would be warranted. The association with suture adjustment requires further investigation.

Adult↗
PubMed2004

Cost-effectiveness of audiometric screening of first-year preparatory pupils in Dhofar Region, Oman.

Audiometric screening was conducted in Dhofar region to study the magnitude of ear problems and cost-effectiveness of screening first-year preparatory-school children in Oman. None of the 1894 pupils had otitis media with effusion or sensory neuronal hearing loss. Six children (0.32%) had impacted wax, 4 (0.21%) chronic suppurative otitis media and 2 (0.11%) dry perforation of eardrum. In all, 14 children (0.74%) with suspected hearing impairment were referred to a specialist but only 2 attended. Physicians and nurses spent 8-10 minutes for ear examination per child for a yield of less than 1%. The screening expenditure was US$ 5 per pupil. As the prevalence of serious ear conditions was low, we conclude that expanding the audiometric screening of schoolchildren to first-year preparatory pupils is not cost-effective.

Audiometry↗
PubMed2003

Low vision and blindness in adults in Gurage Zone, central Ethiopia.

AIM: To determine the magnitude and causes of low vision and blindness in the Gurage zone, central Ethiopia. METHODS: A cross sectional study using a multistage cluster sampling technique was used to identify the study subjects. Visual acuity was recorded for all adults 40 years and older. Subjects who had a visual acuity of <6/18 were examined by an ophthalmologist to determine the cause of low vision or blindness. RESULTS: From the enumerated population, 2693 (90.8%) were examined. The prevalence of blindness (<3/60 better eye presenting vision) was 7.9% (95% CI 6.9 to 8.9) and of low vision (6/24-3/60 better eye presenting vision) was 12.1% (95% CI 10.9 to 13.3). Monocular blindness was recorded in 16.3% of the population. Blindness and low vision increased with age. The odds of low vision and blindness in women were 1.8 times that of the men. The leading causes of blindness were cataract (46.1%), trachoma (22.9%), and glaucoma (7.6%). While the prevalence of vision reducing cataract increased with age, the prevalence of trachoma related vision loss did not increase with age, suggesting that trichiasis related vision loss in this population might not be cumulative. CONCLUSION: The magnitude of low vision and blindness is high in this zone and requires urgent intervention, particularly for women. Further investigation of the pattern of vision loss, particularly as a result of trachomatous trichiasis, is warranted.

Adult↗
PubMed2003

Diabetic retinopathy in Oman: a hospital based study.

The magnitude of diabetic retinopathy, its determinants, and coverage of laser treatment for diabetic retinopathy among registered people with diabetes in Oman are presented. 2249 randomly selected subjects representing 5564 registered diabetics were examined. WHO recommended definitions of diabetes, retinopathy, and other related conditions were used. Physicians reported the profile of the diabetes while ophthalmologists reported ocular profile and the eye care provided to them. The prevalence of diabetic retinopathy was 14.39% (95% CI 13.46 to 15.31). Men had significantly higher rate of retinopathy than women. The retinopathy rate was higher in age groups 50-59 years and 60-69 years. The rates of background retinopathy, proliferative retinopathy, and diabetic maculopathy were 8.65%, 2.66%, and 5.12%, respectively. The rate was higher among subjects with longer duration of diabetes than those with a shorter duration. Those with an HbA(1c) level more than 9% had significantly higher rates of diabetic retinopathy than those with an HbA(1c) level less than 9%. The retinopathy rate was higher in cases with hypertension, nephropathy, and neuropathy. Of those with diabetic retinopathy who were advised to have treatment at the time of registration, only 20% were treated with laser therapy.

Adult↗
PubMed2002

The prevalence and causes of blindness in the Sultanate of Oman: the Oman Eye Study (OES).

AIMS: To estimate the magnitude and the causes of blindness through a community based nationwide survey in Oman. This was conducted in 1996-7. METHODS: A stratified cluster random sampling procedure was used to select 12 400 people. The WHO/PBD standardised survey methodology was used, with suitable adaptation. The major causes of blindness were identified among those found blind. RESULTS: A total of 11 417 people were examined (response rate 91.8%) The prevalence of blindness in the Omani population was estimated to be 1.1% (95% CI 0.9 to 1.3), blindness being defined according to the WHO Tenth Revision of the International Classification of Diseases. Prevalence of blindness was clearly related to increasing age, with estimates of 0.08% for the 0-14 age group, 0.1% for the 15-39 age group, 2.3% for the 40-59 age group, and 16.8% for the group aged 60 +. There was a statistically significant difference between the prevalence in females (1.4%) and males (0.8%). The northern and central regions had a higher prevalence of blindness (1.3% to 3%). The major causes of blindness were unoperated cataract (30.5%), trachomatous corneal opacities (23.7%), and glaucoma (11.5%) CONCLUSIONS: Despite an active eye healthcare programme, blindness due to cataract and trachoma remains a public health problem of great concern in several regions of the sultanate. These results highlight the need, when planning effective intervention strategies, to target the eye healthcare programme to the ageing population, with special emphasis on women.

Adolescent↗
PubMed2001

Recurrence of trichiasis: a long-term follow-up study in the Sultanate of Oman.

BACKGROUND: The prevalence of long-term trichiasis recurrence following tarsal rotation and electro-epilation procedures has not been determined. A non-concurrent prospective study of surgical cases of trichiasis was therefore undertaken in Oman. METHODS: A sample of 603 surgical cases of trichiasis (approximately half tarsal rotation and half electro-epilation) was followed for an average of 3.1 years to determine recurrence. Recurrence was defined as either mild (<5 lashes touching the globe) or severe (5 or more lashes touching the globe). RESULTS: Overall, 56% (95% confidence interval of 50.6%-61.0%) of all surgical cases recurred; ranging from 61.8% of tarsal rotation patients to 50.6% of electro-epilation patients. Severe recurrence was detected among 27% of tarsal rotation patients and 10% of electro-epilation patients. Recurrence was associated with female sex, residence in a high-risk region, and time since surgery. DISCUSSION: The risk of recurrence after electro-epilation and bilamellar tarsal rotation surgery is high; strategies that account for recurrence need to be introduced.

Adult↗
PubMedDate not supplied

Glaucoma among Omani diabetic patients: a cross-sectional descriptive study: (Oman diabetic eye study 2002).

PURPOSE/METHODS: A cross-sectional study was carried out to review the ocular status of 2,063 diabetic patients in Oman. A part of this study is presented to highlight the magnitude and determinants of glaucoma. The study also recommends policies for comprehensive care of glaucoma among diabetic patients. The ocular pressure, disc changes, and field changes were noted by ophthalmologists. The diabetes profile was noted by physicians. RESULTS: The rate of glaucoma among diabetic patients was 8.87% (95% CI 8.12 to 9.62). Male diabetic patients had significantly higher rates of glaucoma than female diabetic patients. The rate was significantly higher in higher age groups. The mean ocular pressure in glaucomatous eyes was 28.6 mm Hg. The rate was not significantly different in patients with type I and type II diabetes (RR 1.03 [95% CI 0.61 to 1.79]). The risk of visual disability was higher among diabetic patients with glaucoma than diabetic patients without glaucoma (RR 1.56 [95% CI 1.14 to 2.13]). CONCLUSIONS: Ocular pressure measurement could be a simple and reliable first-level screening tool. Diabetic patients with glaucoma should be given special care to reduce visual disability. All patients with diabetes should be thoroughly checked periodically to rule out glaucoma.

Adult↗
PubMedDate not supplied

Distichiasis and dysplastic eyelashes in trachomatous trichiasis cases in Oman: a case series.

The study was a prospective evaluation of the prevalence of distichiasis and/or dysplastic eyelashes among trachomatous trichiasis cases at the oculoplasty unit of a hospital in Oman over 3 months in 2000. An oculoplasty surgeon examined and photographed cases using a bio-microscope. Out of 80 cases, 58 (72.5%) had abnormal eyelashes in addition to trachomatous trichiasis. The rate of distichiasis and dysplastic lashes were 13.8% (95% CI 6.2%-21.3%) and 33.8% (95% CI 23.5%-44.1%) respectively; 25.0% (95% CI 15.5%-34.5%) had both. Dysplastic and distichiasis eyelashes were significantly more prevalent in trachomatous trichiasis cases aged < 50 years and those with entropion. Presence of distichiasis and/or dysplastic eyelashes in trachomatous trichiasis cases warrants further analytical studies to confirm the observation and establish any causal association.

Adult↗
PubMedDate not supplied

Validity of vision screening by school nurses in seven regions of Oman.

We tested the validity of vision screening in schools in 7 regions of Oman in 2003. Two researchers tested 1719 randomly selected students in 4 school grades using the Snellen E acuity test. Trained school nurses had previously screened 182 233 students. The visual status recorded in the 2 screenings was compared. Sensitivity of screening by nurses was 68.34% (95% CI: 67.30-69.38) and specificity 99.23% (95% CI: 99.19-99.27). The positive predictive value was 85.42% (95% CI: 84.63-86.21) and negative predictive value was 97.93% (95% CI: 97.87-98.00). The sensitivity of the vision test was significantly higher in females, older students and in North Sharqiya region. In general, the vision screening of school students in Oman has satisfactory validity. Periodic training of nurses and supervision of the screening procedures could improve its sensitivity. Underlying causes of the high numbers of false negative cases should be further investigated.

Adolescent↗
PubMedDate not supplied

National Register for the Blind: a tool for health programme management.

We carried out a retrospective analytical study of 3525 bilaterally blind people registered in Oman to the end of 2000. We described the examination method, maintenance of the register and analysis of data. Lists of different categories of blind people were distributed to various organizations for management and rehabilitation purposes. The role of the national register in addressing blinding cataract, corneal blindness, eradication of congenital rubella syndrome and care of blind people in Oman was also examined. The register was useful in identifying candidates for rehabilitation and also for monitoring regional efforts to manage curable blindness. This multiple use of the register could make it an important tool for health programme management in Oman.

Adolescent↗