It has been nearly six decades since Nepal introduced a family planning program.1,2 At present, the average number of children that a woman in Nepal has is just two, which is defined as a ‘replacement level’ of fertility (that is, two offspring to replace the couple themselves).3 In contrast, about fifty-years ago (in the mid-1970s), the average was more than six children for a married woman in Nepal.4,5 This change in reproductive behavior (certainly influenced by attitudes towards smaller family size) should be considered a ‘reproductive revolution’ in an essentially patriarchal and patrilocal society like Nepal – a transition several other countries have experienced in recent decades as well.6,7 This reproductive revolution is driven principally by the adaption of modern methods of contraception. In 1966, Nepal became one of only a handful of countries where family planning was officially adopted as a ‘fundamental human right and a policy tool in long-range national planning’.1 Sterilization (mainly female sterilization) has been the principal method of fertility control.8,9 At present, more than 50% of married women in Nepal use some form of contraception.8 By all measures, the country’s family planning program must be considered a success. In more recent years however, other factors including abortion and rising age of marriage, as well as male-selected out-migration, have also contributed to the further decline in fertility.10-14
{"title":"Nepal’s Family Planning Program has Come a Long Way: A Conversation with Dr. Badri Raj Pande","authors":"S. Thapa","doi":"10.46405/ejms.v4i0.453","DOIUrl":"https://doi.org/10.46405/ejms.v4i0.453","url":null,"abstract":"It has been nearly six decades since Nepal introduced a family planning program.1,2 At present, the average number of children that a woman in Nepal has is just two, which is defined as a ‘replacement level’ of fertility (that is, two offspring to replace the couple themselves).3 In contrast, about fifty-years ago (in the mid-1970s), the average was more than six children for a married woman in Nepal.4,5 This change in reproductive behavior (certainly influenced by attitudes towards smaller family size) should be considered a ‘reproductive revolution’ in an essentially patriarchal and patrilocal society like Nepal – a transition several other countries have experienced in recent decades as well.6,7 This reproductive revolution is driven principally by the adaption of modern methods of contraception. In 1966, Nepal became one of only a handful of countries where family planning was officially adopted as a ‘fundamental human right and a policy tool in long-range national planning’.1 Sterilization (mainly female sterilization) has been the principal method of fertility control.8,9 At present, more than 50% of married women in Nepal use some form of contraception.8 By all measures, the country’s family planning program must be considered a success. In more recent years however, other factors including abortion and rising age of marriage, as well as male-selected out-migration, have also contributed to the further decline in fertility.10-14","PeriodicalId":254508,"journal":{"name":"Europasian Journal of Medical Sciences","volume":"15 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2022-12-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"125585957","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Endometriosis is a common gynecological entity that usually occurs in the pelvic organs. Umbilical endometriosis is a rare condition that accounts for 0.5-1% of all extragenital endometriosis. It usually arises secondary to prior surgery but may arise de novo as well. We report a case of this condition with the spontaneous occurrence, which was diagnosed preoperatively as umbilical granuloma. Umbilical endometriosis should be kept in differential diagnoses in women with umbilical lesions.
{"title":"Spontaneous Umbilical Endometriosis: A Case Report","authors":"Sailuja Maharjan, B. Satyal, Reena Baidya","doi":"10.46405/ejms.v4i0.431","DOIUrl":"https://doi.org/10.46405/ejms.v4i0.431","url":null,"abstract":"Endometriosis is a common gynecological entity that usually occurs in the pelvic organs. Umbilical endometriosis is a rare condition that accounts for 0.5-1% of all extragenital endometriosis. It usually arises secondary to prior surgery but may arise de novo as well. We report a case of this condition with the spontaneous occurrence, which was diagnosed preoperatively as umbilical granuloma. Umbilical endometriosis should be kept in differential diagnoses in women with umbilical lesions.","PeriodicalId":254508,"journal":{"name":"Europasian Journal of Medical Sciences","volume":"56 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2022-09-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"129856679","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Research on workplace violence in the health sector in India is emerging. This paper reports on a study on violence against nurses working in hospitals in Bangalore, India. A descriptive cross-sectional study was undertaken with both qualitative and quantitative approaches. The respondents were female nurses working in hospitals located in Bangalore city, India. Data was collected through a self-administered questionnaire, completed during the period from May-June 2017. Of the total of 175 nurses requested, 110 (62.8%) consented to participate in the study. Over a six months period preceding the interview, 33.6% of the respondents faced at least one type of violence. The overwhelming majority (73%) experienced verbal only violence; the rest experienced multiple violence that included verbal, physical and sexual. The factors associated with workplace violence were stressful conditions, miscommunication, excessive workload, lack of security, and working alone. The majority of the assaults were not reported. The study concludes that policies and intervention programs need to be developed towards making a work environment free from violence.
{"title":"Workplace violence against nurses in Bangalore city, India","authors":"Laxmi Adhikari","doi":"10.46405/ejms.v4i1.410","DOIUrl":"https://doi.org/10.46405/ejms.v4i1.410","url":null,"abstract":"Research on workplace violence in the health sector in India is emerging. This paper reports on a study on violence against nurses working in hospitals in Bangalore, India. A descriptive cross-sectional study was undertaken with both qualitative and quantitative approaches. The respondents were female nurses working in hospitals located in Bangalore city, India. Data was collected through a self-administered questionnaire, completed during the period from May-June 2017. Of the total of 175 nurses requested, 110 (62.8%) consented to participate in the study. Over a six months period preceding the interview, 33.6% of the respondents faced at least one type of violence. The overwhelming majority (73%) experienced verbal only violence; the rest experienced multiple violence that included verbal, physical and sexual. The factors associated with workplace violence were stressful conditions, miscommunication, excessive workload, lack of security, and working alone. The majority of the assaults were not reported. The study concludes that policies and intervention programs need to be developed towards making a work environment free from violence.","PeriodicalId":254508,"journal":{"name":"Europasian Journal of Medical Sciences","volume":"13 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2022-06-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"126817619","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
A. Devkota, S. Pandey, Yadav Pandey, H. Neupane, A. Basnet, A. Shah, R. Thakur, S. Sah, D. Chaudhary, Aakash Mahato, Shradha Acharya, P. Paudel, Amrit Pathak, Yam Acharya
COVID-19 pandemic, caused by severe acute respiratory syndrome coronavirus 2 has been occurring in waves due to emergence of different strains. During second wave of COVID pandemic in Nepal, largely caused by Delta variant, due to rapid rise in cases, existing hospitals and health facilities were overwhelmed. As a result, telemedicine was expanded to help reduce strain on the healthcare system and meet unusually high demands. A team of physicians with the support from the local government provided hospital level care for patients at home in rural district of Dang in Nepal. This research analyzes implementation of this model of care and outcomes based on review of patient records and treatment guidelines. Within a month, from May 5 to June 13, 2021, a total of 102 patients received care at home. While most patients had mild to moderate disease, 12.8% of patients had severe disease. Telemedicine usage was highest among the 40-59 years age group, with overall recovery rate of 85.3%. The patient satisfaction survey revealed that majority, 86.5% were happy with the medical care they received. This home hospital care model has shown excellent clinical outcomes and high patient satisfaction even in resource limited setting.
{"title":"Home hospital care through telehealth during COVID-19 pandemic in Nepal","authors":"A. Devkota, S. Pandey, Yadav Pandey, H. Neupane, A. Basnet, A. Shah, R. Thakur, S. Sah, D. Chaudhary, Aakash Mahato, Shradha Acharya, P. Paudel, Amrit Pathak, Yam Acharya","doi":"10.46405/ejms.v4i1.375","DOIUrl":"https://doi.org/10.46405/ejms.v4i1.375","url":null,"abstract":"COVID-19 pandemic, caused by severe acute respiratory syndrome coronavirus 2 has been occurring in waves due to emergence of different strains. During second wave of COVID pandemic in Nepal, largely caused by Delta variant, due to rapid rise in cases, existing hospitals and health facilities were overwhelmed. As a result, telemedicine was expanded to help reduce strain on the healthcare system and meet unusually high demands. A team of physicians with the support from the local government provided hospital level care for patients at home in rural district of Dang in Nepal. This research analyzes implementation of this model of care and outcomes based on review of patient records and treatment guidelines. Within a month, from May 5 to June 13, 2021, a total of 102 patients received care at home. While most patients had mild to moderate disease, 12.8% of patients had severe disease. Telemedicine usage was highest among the 40-59 years age group, with overall recovery rate of 85.3%. The patient satisfaction survey revealed that majority, 86.5% were happy with the medical care they received. This home hospital care model has shown excellent clinical outcomes and high patient satisfaction even in resource limited setting.","PeriodicalId":254508,"journal":{"name":"Europasian Journal of Medical Sciences","volume":"26 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2022-03-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"133473997","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Background: Coronavirus Disease 2019 (COVID-19) is caused by novel coronavirus Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2). The mortality of patients in the Intensive Care Unit (ICU) is variable and has been reported to be as high as 80%. Not much is known about the factors leading to the progression of hospitalized patients to requiring ICU care and the predictors of mortality among ICU patients. We performed univariate followed by multivariate logistic regression analysis to determine predictors of progression of the disease and factors associated with mortality. Method: Retrospective data were collected from 101 consecutive patients admitted from March, 2020 to June, 2020. Data were collected from five different community hospitals in eastern Virginia with varied demographics. Result: A total of 101 consecutive hospitalized patients in five community hospitals in eastern Virginia were enrolled in the study. Out of the 101 patients, 53 were admitted into the ICU for respiratory failure. Of these 53, 40 patients required intubation and mechanical ventilation. Altogether, 30 of the 53 patients admitted to the ICU died. Of these 30 patients, 25 required intubations. Of these 25 patients, one had mild, 6 moderate and 18 severe Adult Respiratory Distress Syndrome (ARDS). Patients aged 60 years and above accounted for >2/3rd of the cases in ICU. Conclusion: Logistic regression analysis revealed multiple factors associated with progression of disease leading to transfer into the ICU from floor and unfavorable outcome.
{"title":"Predictors of ICU Admission and Mortality in Patients with Coronavirus Disease – 2019 (COVID 19) in Community Hospitals","authors":"V. Pathak, Courtney Conklin","doi":"10.46405/ejms.v4i1.386","DOIUrl":"https://doi.org/10.46405/ejms.v4i1.386","url":null,"abstract":"Background: \u0000Coronavirus Disease 2019 (COVID-19) is caused by novel coronavirus Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2). The mortality of patients in the Intensive Care Unit (ICU) is variable and has been reported to be as high as 80%. Not much is known about the factors leading to the progression of hospitalized patients to requiring ICU care and the predictors of mortality among ICU patients. We performed univariate followed by multivariate logistic regression analysis to determine predictors of progression of the disease and factors associated with mortality. \u0000 \u0000Method: \u0000Retrospective data were collected from 101 consecutive patients admitted from March, 2020 to June, 2020. Data were collected from five different community hospitals in eastern Virginia with varied demographics. \u0000 \u0000Result: \u0000A total of 101 consecutive hospitalized patients in five community hospitals in eastern Virginia were enrolled in the study. Out of the 101 patients, 53 were admitted into the ICU for respiratory failure. Of these 53, 40 patients required intubation and mechanical ventilation. Altogether, 30 of the 53 patients admitted to the ICU died. Of these 30 patients, 25 required intubations. Of these 25 patients, one had mild, 6 moderate and 18 severe Adult Respiratory Distress Syndrome (ARDS). Patients aged 60 years and above accounted for >2/3rd of the cases in ICU. \u0000 \u0000Conclusion: \u0000Logistic regression analysis revealed multiple factors associated with progression of disease leading to transfer into the ICU from floor and unfavorable outcome. \u0000 ","PeriodicalId":254508,"journal":{"name":"Europasian Journal of Medical Sciences","volume":"1 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2022-03-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"130991992","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Supplimentary Information","authors":"Ejms Journals","doi":"10.46405/ejms.v1i1.407","DOIUrl":"https://doi.org/10.46405/ejms.v1i1.407","url":null,"abstract":"Supplimentary Information","PeriodicalId":254508,"journal":{"name":"Europasian Journal of Medical Sciences","volume":"20 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2022-03-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"129882326","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Background: Extubation is associated with various circulatory and airway responses. Various pharmacological measures including fentanyl and dexmedetomidine have been used to blunt the reflex without compromising the spontaneous respiration. In this study we wanted to compare dexmedetomidine and fentanyl on airway response, smoothness of extubation and hemodynamic changes. Methodology: A total of 68 patients undergoing surgery under general anesthesia with endotracheal intubation, were randomized into two groups. Group A received dexmedetomidine 0.5 mcg/kg and Group B received 1 mcg/kg of fentanyl with the start of skin suturing over a period of 10 minutes via syringe pump. Airway reflex during suction and smoothness of extubation were assessed. Level of sedation during suction, extubation and then every 5 minutes post extubation for 15 minutes were recorded. Hemodynamic parameters were assessed every 5 minutes with start of test solution till extubation and then every 5 minutes for 15 minutes. Results: A total of 68 patients were evaluated in the study. In dexmedetomidine group, 67.6% of patients had no cough on extubation while in fentanyl group 35.3% of patients had no cough on extubation which was statistically significant (p value 0.015). Mean heart rate during extubation increased in both the groups but the increase was 39% in Group B and 11% in Group A from baseline which was statistically significant (p value < 0.001). There was rise in mean systolic and mean arterial pressure during extubation in both the groups but the increase was significantly higher in fentanyl group. Patients in dexmedetomidine group were more sedated but there were no any adverse events. Conclusion: With the results obtained from the study, it is concluded that dexmedetomidine 0.5 mcg/kg over 10 minutes before extubation is effective in alleviating airway response and haemodynamics compared to fentanyl 1 mcg/kg.
{"title":"COMPARISON OF DEXMEDETOMIDINE AND FENTANYL ON AIRWAY RESPONSE AND HEMODYNAMICS DURING TRACHEAL EXTUBATION","authors":"H. Gyawali, Renu Gurung, P. Bastola, M. Koirala","doi":"10.46405/ejms.v3i2.273","DOIUrl":"https://doi.org/10.46405/ejms.v3i2.273","url":null,"abstract":"Background: Extubation is associated with various circulatory and airway responses. Various pharmacological measures including fentanyl and dexmedetomidine have been used to blunt the reflex without compromising the spontaneous respiration. In this study we wanted to compare dexmedetomidine and fentanyl on airway response, smoothness of extubation and hemodynamic changes. \u0000Methodology: A total of 68 patients undergoing surgery under general anesthesia with endotracheal intubation, were randomized into two groups. Group A received dexmedetomidine 0.5 mcg/kg and Group B received 1 mcg/kg of fentanyl with the start of skin suturing over a period of 10 minutes via syringe pump. Airway reflex during suction and smoothness of extubation were assessed. Level of sedation during suction, extubation and then every 5 minutes post extubation for 15 minutes were recorded. Hemodynamic parameters were assessed every 5 minutes with start of test solution till extubation and then every 5 minutes for 15 minutes. \u0000Results: A total of 68 patients were evaluated in the study. In dexmedetomidine group, 67.6% of patients had no cough on extubation while in fentanyl group 35.3% of patients had no cough on extubation which was statistically significant (p value 0.015). Mean heart rate during extubation increased in both the groups but the increase was 39% in Group B and 11% in Group A from baseline which was statistically significant (p value < 0.001). There was rise in mean systolic and mean arterial pressure during extubation in both the groups but the increase was significantly higher in fentanyl group. Patients in dexmedetomidine group were more sedated but there were no any adverse events. \u0000Conclusion: With the results obtained from the study, it is concluded that dexmedetomidine 0.5 mcg/kg over 10 minutes before extubation is effective in alleviating airway response and haemodynamics compared to fentanyl 1 mcg/kg.","PeriodicalId":254508,"journal":{"name":"Europasian Journal of Medical Sciences","volume":"49 4 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2022-01-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"134177427","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Globally, financing healthcare is one of the biggest challenges and it becomes a life or death issue in poor countries. Nepal is strongly committed to universal health coverage and Sustainable Development Goals. Existing public health services are inadequate to cater to the growing demands of quality health care and Public Private Partnership (PPP) evolved as newer arrangement for robust healthcare system, improved healthcare quality and enhance cost-effectiveness. Nepal has successfully utilized the PPP model in multiple sectors, however there is limited experience in healthcare. Strengthening PPP models in healthcare could be the pathway for Nepal toward SDG’s and UHC achievement.
{"title":"The public-private partnership (PPP) initiative in healthcare system: as the pathways to achieve the SDGs in Nepal","authors":"L. Bhatt, R. Shrestha, V. Bhandari","doi":"10.46405/ejms.v3i2.266","DOIUrl":"https://doi.org/10.46405/ejms.v3i2.266","url":null,"abstract":"Globally, financing healthcare is one of the biggest challenges and it becomes a life or death issue in poor countries. Nepal is strongly committed to universal health coverage and Sustainable Development Goals. Existing public health services are inadequate to cater to the growing demands of quality health care and Public Private Partnership (PPP) evolved as newer arrangement for robust healthcare system, improved healthcare quality and enhance cost-effectiveness. Nepal has successfully utilized the PPP model in multiple sectors, however there is limited experience in healthcare. Strengthening PPP models in healthcare could be the pathway for Nepal toward SDG’s and UHC achievement.","PeriodicalId":254508,"journal":{"name":"Europasian Journal of Medical Sciences","volume":"1 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2021-12-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"130368488","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
B. P. Magar, Dilli Pun Magar, K. Amgain, K. Joshi, Niranjan Satyal, Jharendra Bahadur Oli
Background: Polycystic ovary syndrome (PCOS) is a complex endocrine disorder in women of reproductive age and a major cause of infertility. Anti- Mullerian Hormone (AMH), a valid marker of ovarian function, is used for the diagnosis of PCOS. The aim of this study is to assess the serum level of total antioxidant status (TAS) and malondialdehyde (MDA) in the premenopausal women with PCOS. Methods: A cross-sectional analytical study was conducted at Padmashree Diagnostics, Department of Gynecology, India from April 2016 to March 2017. Census method was used to select the samples. The oxidative stress was measured by measuring the level of TAS and MDA. The data was recorded in structured proforma and and enter in SPSS version 16.0. The data were expressed in frequency, percentage, mean and standard deviation and the results obtained were analyzed using pearson’s correlation and student’s t-test. The p-value less than 0.05 was taken as statistically significant. Results: The measured serum AMH level among the patients with PCOS was within normal range in 67.5% (27) and above normal range in 32.5% (13). The serum TAS level in normal AMH group was 814.0 + 291 µMol/L and in above normal range group was 720 + 240 µMol/L, (p <0.001). Similarly, the serum level of MDA in normal AMH group was 6.64 + 0.21 µMol/L, and in above normal range group was 8.78 + 0.22 µMol/L (p = 0.01). The measured level of AMH was significantly associated with the increased level of MDA (p<0.001) and decreased level of TAS (p<0.001). The measured MDA level in high AMH group did show statistically significant than the normal AMH group. Conclusions: Serum level of TAS and MDA along with AMH are valuable diagnostic biomarker for the diagnosis of PCOS in the resource poor settings where ultrasound facility is unavailable.
{"title":"Serum level of Total Antioxidant Status and Malondialdehyde in the Patients with Polycystic Ovarian Syndrome: a Comparative Study","authors":"B. P. Magar, Dilli Pun Magar, K. Amgain, K. Joshi, Niranjan Satyal, Jharendra Bahadur Oli","doi":"10.46405/ejms.v3i2.367","DOIUrl":"https://doi.org/10.46405/ejms.v3i2.367","url":null,"abstract":"Background: Polycystic ovary syndrome (PCOS) is a complex endocrine disorder in women of reproductive age and a major cause of infertility. Anti- Mullerian Hormone (AMH), a valid marker of ovarian function, is used for the diagnosis of PCOS. The aim of this study is to assess the serum level of total antioxidant status (TAS) and malondialdehyde (MDA) in the premenopausal women with PCOS. \u0000Methods: A cross-sectional analytical study was conducted at Padmashree Diagnostics, Department of Gynecology, India from April 2016 to March 2017. Census method was used to select the samples. The oxidative stress was measured by measuring the level of TAS and MDA. The data was recorded in structured proforma and and enter in SPSS version 16.0. The data were expressed in frequency, percentage, mean and standard deviation and the results obtained were analyzed using pearson’s correlation and student’s t-test. The p-value less than 0.05 was taken as statistically significant. \u0000Results: The measured serum AMH level among the patients with PCOS was within normal range in 67.5% (27) and above normal range in 32.5% (13). The serum TAS level in normal AMH group was 814.0 + 291 µMol/L and in above normal range group was 720 + 240 µMol/L, (p <0.001). Similarly, the serum level of MDA in normal AMH group was 6.64 + 0.21 µMol/L, and in above normal range group was 8.78 + 0.22 µMol/L (p = 0.01). The measured level of AMH was significantly associated with the increased level of MDA (p<0.001) and decreased level of TAS (p<0.001). The measured MDA level in high AMH group did show statistically significant than the normal AMH group. \u0000Conclusions: Serum level of TAS and MDA along with AMH are valuable diagnostic biomarker for the diagnosis of PCOS in the resource poor settings where ultrasound facility is unavailable.","PeriodicalId":254508,"journal":{"name":"Europasian Journal of Medical Sciences","volume":"34 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2021-12-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"125655770","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
A. Pandeya, N. Shreevastva, A. Dhungana, Anup Pandeya, B. Pradhan
Background: Acute viral hepatitis is a common liver-associated abnormality encountered in clinical practice. The number of biochemical parameters is estimated to detect a hepatic abnormality, which can measure the severity and types of damage to hepatocytes, among which liver enzymes and bilirubin levels are assessed routinely which are raised in acute viral hepatitis.Objective: This study aims to assess the liver enzymes, such as aspartate aminotransferase (AST), alanine aminotransferase (ALT), bilirubin, and calculation of AST to ALT ratio in acute viral hepatitis and to compare these parameters with the control group.Methodology: This study included a total of 81 subjects diagnosed with acute viral hepatitis as cases and age and sex-matched, the same number of healthy subjects as control. Serum levels of AST and ALT, alkaline phosphatase (ALP), and bilirubin were analyzed using standard methods. Serum AST to ALT ratio was calculated. Data analysis was done using SPSS Version 17.0 and the results were expressed as mean ±standard deviation (SD).Results: A mean serum activities of aminotransferases were statistically significantly raised in viral hepatitis compared to that in control.AST (514.85±350.66 VS 25.65±5.29; p<0.001) and ALT (781.65±525.69 VS 27.94±6.50; p<0.001). Similarly, serum levels of(ALP)were significantly increased in acute viral hepatitis compared to that in control (202.17±75.46 VS 98.83±27.99; p<0.001. However, a ratio of AST to ALT was decreased significantly (0.66±0.15 VS 0.94±0.21; p= 0.001) in acute viral hepatitis compared to that in control.Conclusion: Both the aminotransferases and bilirubin levels are raised significantly, where, a rise in ALT is greater than a rise in AST, hence, the ratio of AST to ALT is decreased significantly in acute viral hepatitis than that in control. Thus, this decreased pattern of AST to ALT can diagnose acute viral hepatitis at an early stage and can help appropriate care and treatment to the patients.
背景:急性病毒性肝炎是临床中常见的肝脏相关异常。估计生化参数的数量来检测肝脏异常，可以测量肝细胞损伤的严重程度和类型，其中肝酶和胆红素水平是常规评估，在急性病毒性肝炎中升高。目的:本研究旨在评估急性病毒性肝炎患者的肝酶如天冬氨酸转氨酶(AST)、丙氨酸转氨酶(ALT)、胆红素及计算AST / ALT比值，并与对照组进行比较。方法:本研究共纳入81例诊断为急性病毒性肝炎的受试者作为病例，年龄和性别匹配，健康受试者人数相同。采用标准方法分析血清AST、ALT、碱性磷酸酶(ALP)、胆红素水平。计算血清AST / ALT比值。数据分析采用SPSS 17.0版本，结果以均数±标准差(SD)表示。结果:病毒性肝炎患者血清中转氨酶活性明显高于对照组。Ast(514.85±350.66 vs 25.65±5.29);p<0.001)和ALT(781.65±525.69 VS 27.94±6.50;p < 0.001)。与对照组相比，急性病毒性肝炎患者血清ALP水平显著升高(202.17±75.46 VS 98.83±27.99;p < 0.001。但AST / ALT比值明显降低(0.66±0.15 VS 0.94±0.21;P = 0.001)。结论:急性病毒性肝炎患者的转氨酶和胆红素水平均明显升高，其中ALT升高幅度大于AST升高幅度，因此，急性病毒性肝炎患者的AST / ALT比值明显低于对照组。因此，这种AST对ALT的降低模式可以在早期诊断急性病毒性肝炎，有助于对患者进行适当的护理和治疗。
{"title":"Evaluation of Liver Enzymes and calculation of AST to ALT ratio in patients with acute viral hepatitis","authors":"A. Pandeya, N. Shreevastva, A. Dhungana, Anup Pandeya, B. Pradhan","doi":"10.46405/ejms.v3i2.255","DOIUrl":"https://doi.org/10.46405/ejms.v3i2.255","url":null,"abstract":"Background: Acute viral hepatitis is a common liver-associated abnormality encountered in clinical practice. The number of biochemical parameters is estimated to detect a hepatic abnormality, which can measure the severity and types of damage to hepatocytes, among which liver enzymes and bilirubin levels are assessed routinely which are raised in acute viral hepatitis.Objective: This study aims to assess the liver enzymes, such as aspartate aminotransferase (AST), alanine aminotransferase (ALT), bilirubin, and calculation of AST to ALT ratio in acute viral hepatitis and to compare these parameters with the control group.Methodology: This study included a total of 81 subjects diagnosed with acute viral hepatitis as cases and age and sex-matched, the same number of healthy subjects as control. Serum levels of AST and ALT, alkaline phosphatase (ALP), and bilirubin were analyzed using standard methods. Serum AST to ALT ratio was calculated. Data analysis was done using SPSS Version 17.0 and the results were expressed as mean ±standard deviation (SD).Results: A mean serum activities of aminotransferases were statistically significantly raised in viral hepatitis compared to that in control.AST (514.85±350.66 VS 25.65±5.29; p<0.001) and ALT (781.65±525.69 VS 27.94±6.50; p<0.001). Similarly, serum levels of(ALP)were significantly increased in acute viral hepatitis compared to that in control (202.17±75.46 VS 98.83±27.99; p<0.001. However, a ratio of AST to ALT was decreased significantly (0.66±0.15 VS 0.94±0.21; p= 0.001) in acute viral hepatitis compared to that in control.Conclusion: Both the aminotransferases and bilirubin levels are raised significantly, where, a rise in ALT is greater than a rise in AST, hence, the ratio of AST to ALT is decreased significantly in acute viral hepatitis than that in control. Thus, this decreased pattern of AST to ALT can diagnose acute viral hepatitis at an early stage and can help appropriate care and treatment to the patients.","PeriodicalId":254508,"journal":{"name":"Europasian Journal of Medical Sciences","volume":"105 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2021-12-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"124077049","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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