Random images from Jiri, Nepal

As the US-based team bids farewell to our Nepali friends/colleagues from Tilganga and gets ready to depart Kathmandu for home, we leave you with yet another collection of random images taken throughout our time here, this time from Jiri. We sincerely thank the Jirel community and thank you for your interest. We'll be in touch very soon with more blog updates. Until then...

A safe return to Kathmandu; n = 1,801!

The research team is now back safe and resting up in Kathmandu after yet another successful field trip. We again exceeded our goal of 250 individuals with 254 individuals recruited to the project. This now brings the total recruitment to 1,801 individuals who have completed all elements of the comprehensive eye exam and other aspects of data collection. We have a few more official duties at the Tilganga Institute of Ophthalmology today before we start to prepare for our journey home tomorrow. In the meantime, here's a brief report on our journey from Jiri to Kathmandu...

We left Jiri a bit before 08:00 h, one of our earliest and successful departures to date.

Sunrise, the morning of our departure from Jiri.

But it wasn't long before we made one of several stops along the way...

#1: Toilet break for Dr. Suman-ji's pet dog.

This first stop did allow us to capture a picture of Chhettrappa (right of picture), though, the village where most of the Jirels recruited on this trip reside.

#2: We stop to find a truck, stopped along a temporary one lane section of the road, being loaded with rocks. Fortunately, we didn't have to wait too long as the truck was near fully loaded.

#3: Through Rammechap, the road was blocked in both directions as a backhoe loader was lifting what appeared to be a large, heavy printing press.

Not long after this third stop, as we negotiated the traffic backlog...

#4: ...we come to a fourth stop. Another truck was being loaded with dirt and this time it was the backhoe loader that was obstructing our path.

#5: Once we had some open road we had to slow down for things like...steamrollers and tractors pulling trailers!

#6: Until we came to another complete stop to allow police officers to direct the flow of traffic along a temporary one lane section.

And all of this was before lunch!! After which, we enjoyed a good run home.

Only to hit the customary traffic congestion in Kathmandu.

Macular hole

In what has been observed in a few of the JES research participants to date, is what is known as a macular hole. As part of the normal aging process, the vitreous humor (also termed, vitreous) will slowly contract and pull away from the surface of the retina. However, if the vitreous is firmly attached, or sticks to the retina when it pulls away, this can cause the macula to stretch and create a tear in the retina, thus creating a macular hole. As the hole forms, one's central vision will become blurred or distorted (remembering that the macula, the central part of the retina, is responsible for central, high-resolution vision). As the hole grows, a dark or blind spot will appear in the central vision. Peripheral vision is not affected by a macular hole.

In the fundus (red and red free) image below, a macular hole is observed. The macula (the dark 'spot' in the near center of the fundus image) can best be described by having a clear and defined boundary.

In comparison, in the fundus image (below) of a normal eye, the macula is best described by having a more diffuse (less defined) boundary.

With the aid of OCT technology, a macular hole is more clearly displayed. In the left image (below), the macular hole is clearly evident when compared to a normal, healthy retina (right image below). Both OCT images of the retina are captured traversing the superior-inferior quadrants of the retina.

Diabetes, hypertension and ocular health

Diabetes and hypertension (high blood pressure) are systemic diseases that inflict a significant impact on global health. One of the many complications arising from these systemic diseases is perturbed ocular health, for example, retinal hemorrhage. Hypertensive retinopathy and diabetic retinopathy are two such conditions where retinal hemorrhages can occur.

Here, we see Dr. Suman-ji (ophthalmologist) and Pradeep-ji (OCT specialist) review fundus photos at the conclusion of a day's sampling.

Following the review, one research participant had what appeared to be a retinal hemorrhage. In the participants fundus photograph (below), the hemorrhage (red 'spot') can be seen below the macula (dark 'spot' just left of center) and at about '8 o'clock' to the optic nerve head (bright 'spot' to the right of the image). While the participant did have high blood pressure (systolic and diastolic blood pressure > 140 and 90 mm Hg, respectively), we cannot definitely conclude that this high blood pressure is the cause of the hemorrhage.

Jiri welcome's back the JES research team.

Hi everyone. Sorry for the delay. With internet connectivity problems, and the first couple of sampling days being cold, wet and long, we've now only had time to catch our breath and update the blog. Both the US and Nepali-based research team members arrived in Jiri safe and sound to kick off the next data collection session. Everyone is excited and already working hard to ensure we have another successful trip; the target is another 250 individuals. Until the next time, here are a few images from our trip from Kathmandu to Jiri.

Morning of our departure: View from hotel window. In the foreground, prayer flags can be seen.

Just your average commute to through Kathmandu!

Many things are often seen being transported by all kinds of vehicles. This time, a buffalo in the back of a small utility vehicle.

You may be able to make out a small part of the winding road (in the hill) to Jiri.

Having to slow down for animals on/crossing the road is a common aspect of the trip. Drivers are very respectful of the animals as they are part of someone's livelihood.

And then there's other things that can slow the journey down too.

JES Research Staff Profiles: Matthew Johnson

Well, it's that time of year again when the US-based research team is gearing up, or should I say, making last minute packing preparations (some of which include updating this blog) to embark on their next data collection session in Jiri, Nepal. We're looking forward to catching up with our Nepali colleagues/friends and another successful field trip.

Meanwhile, we continue with our staff research profiles. This time, we bring you the individual behind these words...

NAME:
Matthew Johnson

INSTITUTION:
South Texas Diabetes & Obesity Institute; Department of Human Genetics, School of Medicine, University of Texas Rio Grande Valley

POSITION:
Associate Professor

JES ROLE/TASKS:
General field clinic operations, phlebotomy assistant, HbA1c assay manager, blood sample processing, data collation, a bunch of other stuff back in Texas

PROFESSIONAL INTERESTS:
Genetics of common complex diseases, molecular genetics, alternative splicing

PERSONAL INTERESTS:
Mountain biking/Trail riding, Cooking, LEGO, Star Wars universe (or is it the multiverse?), all other things SciFi, Music: metal, hard rock \m/

SOMETHING RANDOM ABOUT YOU:
During high school, aspired to be an accountant (that was a long, long time ago in a galaxy far, far away (cue opening crawl ); thankfully common sense prevailed)