Equipment maintenance

As all (most) of us can attest to, maintaining mechanical objects (e.g., car) is important to ensure their smooth and continued running. Maintaining the ophthalmic equipment being used for the Jiri Eye Study is no exception. Each year JES' optical coherence tomography (OCT) instrument, visual field analyzer, A-scan ultrasound biometry instrument, and slit lamp undergo their annual preventative maintenance. Prior to our spring field sessions JES researchers from the Tilgnaga Institute of Ophthalmology travel to the field site with instrument technicians from the respective companies to conduct the essential maintenance and upkeep of the instruments. Poorly performing instruments may provide poor data or no data at all. Like all aspects of our study, this technical aspect is equally as important.

Tom ji (an important member of the research team) checks the uninterruptible power supply (UPS) units. During the "odd" power outages we experience in the field, these UPS units are vital to maintain power to the ophthalmic instruments prior to starting up the generator to supply power to the clinic building.

Annual preventative maintenance for the visual field analyzer.

Annual preventative maintenance for the OCT instrument.

Testing blood sugar levels

This field trip marks the first time the JES researchers are testing blood sugar levels in the Jirel population. To do so we are measuring levels of glycated hemoglobin, specifically, hemoglobin A1c (HbA1c). Chronic high blood sugar levels (hyperglycemia) is the defining characteristic of diabetes mellitus, a debilitating disease that is becoming more prevalent in the global population and impacts several physiological processes, vision being one of them. People living with diabetes may be at high risk of developing diabetic eye disease which includes diabetic retinopathy (includes diabetic macular edema), glaucoma, and cataract.

Samples ready to be processed.

Loading blood sample onto glass slide.

Loading blood sample into sample dilution kit.

Loading sample test cartridge into test monitor.

Running the HbA1c test.

Namaste from Jiri!

The research team arrived into Jiri without incident (all vehicle brake lines were intact) and in good time (approx. 8 hours). In fact, we would have likely made it in less time if it were not for a brief delay we encountered. Due to some ongoing road works (about 4.5 to 5 hours into our trip) we had to wait approx. 45 to 60 minutes before taking a slight detour. The detour consisted of a one lane road that was controlled by two Nepali government officials at either ends of the detour road. While one side was allowed to pass the other side of the detour had to wait their turn.

Here we are waiting for traffic from the other side to pass.

While we were waiting for our turn to cross, we catch a glimpse of Dr. Janardin ji, a recent recipient of the Distinguished Scholar award at Miami University, Ohio. Congratulations, Dr. Janardin ji!

Oh look, it's our turn to cross!

Made it!

As you can see the wait time to cross can be long and traffic can be banked up for a considerable distance…

And can be a bit of a tight squeeze. Don’t worry negotiating this traffic takes place a calm 5 to 10 km/hour (3.1 to 6.2 miles/hour) which provides for a great photo opportunity out the window.

Needless to say, we made it, had enough time to get unpacked, fed and into bed at a reasonable hour in readiness for our first day of clinic/sampling.

Good morning, Jiri! Some morning views of the Jiri Valley as seen from our hotel balcony and taken before breakfast on our first day of research activities.

Good to be back in Kathmandu.

Hi everyone. Just a quick update to let you know the research team made it to Kathmandu safe and sound. After touching down around 14:00 hours local time (today) we have made our last minute supply run at our local supermarket (Bhat-bhateni) and are now going over last minute details before we head off to Jiri tomorrow morning (March 19). We start sampling/clinic duties on the 20th. Looking forward to sharing more of our project with you in the coming days.

Off again on our next field trip.

So over course of today and tomorrow the US-based research team start their journey back to Nepal to conduct the next data collection session. Given that this is our 5th trip to collect data you would think by now that all of the research team members would be used to the early morning start that is often the case when embarking on such a trip. It is apparent that this is not so, as was the case this morning when one member had to be woken up by the other team members banging on the door and bedroom window at 3:45am as the van for the trip to the airport idled in the driveway.  Despite a bad start to the journey, all research team members made it on the same flight and are now en route to Kathmandu, Nepal.

As you may have read in our previous post, we are transporting recycled reading glasses that were kindly donated by the Texas Lions Eyeglass Recycling Center. In addition to the reading glasses we will now also be measuring HbA1c (glycated hemoglobin) levels for all research participants. Measuring HbA1c is a means to determine blood sugar levels, an important determinant for diabetes diagnosis and more will be posted on this topic when we are out in Jiri, Nepal. With the addition of reading glasses and HbA1c test kits the supply inventory is a little more than normal but we managed to fit it all in! Talk to you next from Nepal!

Reading glasses donation: Lions Club International

You may recall from our blog archive (entry title, Day 6...) that the Jiri Eye Study is having an immediate impact on the research participants, in particular, providing reading glasses to enhance an individual's quality of life. We are now pleased to say, for our upcoming field trip, reading glasses that will be provided to the participants have been very kindly donated by the Texas Lions Eyeglass Recycling Center (TLERC), Midland, Texas. The TLERC is a nonprofit foundation of the Lions of Texas, and with the support of the Lions International Foundation, TLERC recycles eyeglasses for use in Texas, the United States and around the world. The Lions Club International is an outstanding organization that empowers volunteers to serve their communities, meet humanitarian needs, encourage peace and promote international understanding through Lions clubs around the globe. In 1925 the Lions answered a challenge from Helen Keller to become "knights of the blind in the crusade against darkness." Since then, the Lions have worked tirelessly to aid the blind and visually impaired. The Jiri Eye Study is truly honored for the Lions' contribution. Thank you!!

Donated reading glasses from the TLERC.

Donated reading glasses from the TLERC.