Aarem Karkee, S. Singh, P. Shrestha, Nani Shova Shakya, S. Shrestha, Samiksha Niroula
Introduction: Low-carbohydrate diet is effective in improving blood glucose parameters, glycated hemoglobin A1c, weight, and waist circumference. The effectiveness of this diet is well accepted in America and the United Kingdom but in Nepal due to many preexisted misbeliefs regarding carbohydrates, we still have a carbohydrate-based diet for type 2 diabetes mellitus.Material and Methods: Fifty-four newly diagnosed type 2 diabetes mellitus without any treatment were selected for solely low-carbohydrate diet intervention (<130g carbohydrate) in the endocrinology unit of Tribhuvan University Teaching Hospital, Kathmandu from March to August 2019. Antidiabetic medications were not used. Individualized diet plans and repeated counseling were given and followed for 3 months. Blood glucose (fasting and postprandial),glycated hemoglobin A1c, weight, and waist circumference were compared at entry and 3 months. Statistical analysis was done using SPSS version 21.Results: The mean ± SD age was 44.77 ± 10.32. The mean body weight decreased by 4.52 ± 1.79 kg (p<0.001), mean waist circumference decreased by 7.85±0.72 cm (p<0.001), mean fasting blood glucose decreased from 10.44±3.52 mmol/L to 6.18±1.02 mmol/L (p<0.001), mean postprandial blood glucose decreased from 16.76±8.26 mmol/L to 8.26±1.66 mmol/L (p<0.001) and mean glycated hemoglobin A1c decreased by 2.38 ± 1.49 % (p<0.001) after 3months of low-carbohydrate diet intervention.Conclusions: The use of a low-carbohydrate diet may effectively produce glycemic control and decrease glycated hemoglobin A1c without medication in newly diagnosed type 2 diabetes mellitus. Additionally, this diet may also help to lower weight and waist circumference in newly diagnosed type 2 diabetes mellitus.
简介:低碳水化合物饮食对改善血糖参数、糖化血红蛋白A1c、体重和腰围有效。这种饮食的有效性在美国和英国被广泛接受，但在尼泊尔，由于许多先前存在的关于碳水化合物的误解，我们仍然以碳水化合物为基础的饮食来治疗2型糖尿病。材料与方法:选择2019年3 - 8月在加德满都特里布万大学教学医院内分泌科进行单纯低碳水化合物饮食干预(<130g碳水化合物)的54例未接受任何治疗的新诊断2型糖尿病患者。未使用抗糖尿病药物。给予个体化饮食计划和反复咨询，并随访3个月。在入院和3个月时比较血糖(空腹和餐后)、糖化血红蛋白A1c、体重和腰围。采用SPSS 21进行统计分析。结果:平均±SD年龄为44.77±10.32岁。低碳水化合物饮食干预3个月后，平均体重下降了4.52±1.79 kg (p<0.001)，平均腰围下降了7.85±0.72 cm (p<0.001)，平均空腹血糖从10.44±3.52 mmol/L下降到6.18±1.02 mmol/L (p<0.001)，平均餐后血糖从16.76±8.26 mmol/L下降到8.26±1.66 mmol/L (p<0.001)，平均糖化血红蛋白A1c下降了2.38±1.49% (p<0.001)。结论:新诊断的2型糖尿病患者采用低碳水化合物饮食可有效控制血糖，降低糖化血红蛋白A1c，无需药物治疗。此外，这种饮食也有助于降低新诊断的2型糖尿病患者的体重和腰围。
{"title":"Effect of Dietary Intervention Using Low-Carbohydrate Diet to Manage Newly Diagnosed Type 2 Diabetes Mellitus in TUTH Hospital, Nepal","authors":"Aarem Karkee, S. Singh, P. Shrestha, Nani Shova Shakya, S. Shrestha, Samiksha Niroula","doi":"10.3126/nmj.v4i1.34710","DOIUrl":"https://doi.org/10.3126/nmj.v4i1.34710","url":null,"abstract":"Introduction: Low-carbohydrate diet is effective in improving blood glucose parameters, glycated hemoglobin A1c, weight, and waist circumference. The effectiveness of this diet is well accepted in America and the United Kingdom but in Nepal due to many preexisted misbeliefs regarding carbohydrates, we still have a carbohydrate-based diet for type 2 diabetes mellitus.Material and Methods: Fifty-four newly diagnosed type 2 diabetes mellitus without any treatment were selected for solely low-carbohydrate diet intervention (<130g carbohydrate) in the endocrinology unit of Tribhuvan University Teaching Hospital, Kathmandu from March to August 2019. Antidiabetic medications were not used. Individualized diet plans and repeated counseling were given and followed for 3 months. Blood glucose (fasting and postprandial),glycated hemoglobin A1c, weight, and waist circumference were compared at entry and 3 months. Statistical analysis was done using SPSS version 21.Results: The mean ± SD age was 44.77 ± 10.32. The mean body weight decreased by 4.52 ± 1.79 kg (p<0.001), mean waist circumference decreased by 7.85±0.72 cm (p<0.001), mean fasting blood glucose decreased from 10.44±3.52 mmol/L to 6.18±1.02 mmol/L (p<0.001), mean postprandial blood glucose decreased from 16.76±8.26 mmol/L to 8.26±1.66 mmol/L (p<0.001) and mean glycated hemoglobin A1c decreased by 2.38 ± 1.49 % (p<0.001) after 3months of low-carbohydrate diet intervention.Conclusions: The use of a low-carbohydrate diet may effectively produce glycemic control and decrease glycated hemoglobin A1c without medication in newly diagnosed type 2 diabetes mellitus. Additionally, this diet may also help to lower weight and waist circumference in newly diagnosed type 2 diabetes mellitus.","PeriodicalId":52856,"journal":{"name":"Nepalese Medical Journal","volume":"78 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-06-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"83904314","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}
Acquired port wine stain though an uncommon entity that develops later in life, resembles congenital port wine stain morphologically and histologically. Congenital port wine stains are vascular lesions caused by progressive ectasia of blood vessels which is located in the vascular plexus of the dermis. Congenital port-wine stains may be associated with Sturge Weber syndrome causing neurological and eye abnormalities such as glaucoma. Here we report a 60-year-old male presenting with a complaint of asymptomatic reddish patches over the nose for 15 years.
{"title":"A Rare Presentation of Acquired Port Wine Stain in an Elderly Male","authors":"P. Jha, S. Singh","doi":"10.3126/nmj.v4i1.36714","DOIUrl":"https://doi.org/10.3126/nmj.v4i1.36714","url":null,"abstract":"Acquired port wine stain though an uncommon entity that develops later in life, resembles congenital port wine stain morphologically and histologically. Congenital port wine stains are vascular lesions caused by progressive ectasia of blood vessels which is located in the vascular plexus of the dermis. Congenital port-wine stains may be associated with Sturge Weber syndrome causing neurological and eye abnormalities such as glaucoma. Here we report a 60-year-old male presenting with a complaint of asymptomatic reddish patches over the nose for 15 years.","PeriodicalId":52856,"journal":{"name":"Nepalese Medical Journal","volume":"3 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-06-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"72640150","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}
COVID-19, the pandemic caused by SARS- CoV-2 has affected more than 220 countries including Nepal, costing millions of lives around the globe. Despite the government’s effort to contain the virus by initiating several public health measures, the exponential growth of COVID-19 cases has been noted in due course. Our review is focused on preventive health measures and the role of government in implementation, in the context of Nepal. We found that while the government did enact some policy and guidelines in response to COVID-19, the response was lacking in timely execution, coordination and monitoring, and was not in compliance with human rights principles.
{"title":"Covid-19 in Nepal: Governance and its Implication on Public Health Measures","authors":"A. T. Sherpa, T. Sherpa","doi":"10.3126/nmj.v4i1.38463","DOIUrl":"https://doi.org/10.3126/nmj.v4i1.38463","url":null,"abstract":"COVID-19, the pandemic caused by SARS- CoV-2 has affected more than 220 countries including Nepal, costing millions of lives around the globe. Despite the government’s effort to contain the virus by initiating several public health measures, the exponential growth of COVID-19 cases has been noted in due course. Our review is focused on preventive health measures and the role of government in implementation, in the context of Nepal. We found that while the government did enact some policy and guidelines in response to COVID-19, the response was lacking in timely execution, coordination and monitoring, and was not in compliance with human rights principles. ","PeriodicalId":52856,"journal":{"name":"Nepalese Medical Journal","volume":"47 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-06-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"81418672","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}
Introduction: Infertility has been rising steeply as the prime health issue among women around the world these days. This study aims to investigate the causes, hormonal profi le, and clinical spectrum of infertility.Materials and Methods: This is a descriptive cross-sectional study conducted throughout a one year duration in an infertility clinic. The couples meeting the inclusion criteria were included and a pre-formed proforma was used to collect the data regarding history, examination, and investigations.Results: A total of 118 infertile couples were analyzed. The mean age of the females was 28.3±4.5 years. There were 72.1 %cases of primary infertility and 27.9 %of secondary infertility. Regarding obesity status,35.5% were overweight and 15.2 % were obese. Thirty-one (26.2%) males were smokers, 41 (34.7%) used to consume alcohol, and 14 (11.8%) had a habit of chewing tobacco. Among the different fi ndings of semen analysis, 21.1% asthenozoospermia, 9.3% oligoasthenozospermia,7.6% oligospermia, 1.6% azoospermia. Female factor accounted for 45.3%, the malefactor for 28% and in 19.3% the defi nite factor was not determined. The ovulatory disorder was diagnosed in 38.6% of females and hysterosalpingography (HSG) revealed that around 10% had a unilateral block and 1.7% had a bilateral block.Conclusions: Infertility is becoming a global issue affecting a signifi cant number of young couples. About forty-six percent were female aging more than thirty years. The female factor for infertility was more common than the male factor among which ovulatory disorder was the commonest one. Asthenozoospermiawas the commonest abnormal fi nding on semen analysis in a male partner.
{"title":"Clinical Spectrum of Infertile Couple: a Retrospective Study at Teaching Hospital","authors":"H. Rijal, S. Maskey","doi":"10.3126/NMJ.V3I2.35117","DOIUrl":"https://doi.org/10.3126/NMJ.V3I2.35117","url":null,"abstract":"Introduction: Infertility has been rising steeply as the prime health issue among women around the world these days. This study aims to investigate the causes, hormonal profi le, and clinical spectrum of infertility.Materials and Methods: This is a descriptive cross-sectional study conducted throughout a one year duration in an infertility clinic. The couples meeting the inclusion criteria were included and a pre-formed proforma was used to collect the data regarding history, examination, and investigations.Results: A total of 118 infertile couples were analyzed. The mean age of the females was 28.3±4.5 years. There were 72.1 %cases of primary infertility and 27.9 %of secondary infertility. Regarding obesity status,35.5% were overweight and 15.2 % were obese. Thirty-one (26.2%) males were smokers, 41 (34.7%) used to consume alcohol, and 14 (11.8%) had a habit of chewing tobacco. Among the different fi ndings of semen analysis, 21.1% asthenozoospermia, 9.3% oligoasthenozospermia,7.6% oligospermia, 1.6% azoospermia. Female factor accounted for 45.3%, the malefactor for 28% and in 19.3% the defi nite factor was not determined. The ovulatory disorder was diagnosed in 38.6% of females and hysterosalpingography (HSG) revealed that around 10% had a unilateral block and 1.7% had a bilateral block.Conclusions: Infertility is becoming a global issue affecting a signifi cant number of young couples. About forty-six percent were female aging more than thirty years. The female factor for infertility was more common than the male factor among which ovulatory disorder was the commonest one. Asthenozoospermiawas the commonest abnormal fi nding on semen analysis in a male partner.","PeriodicalId":52856,"journal":{"name":"Nepalese Medical Journal","volume":"49 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2020-12-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"79150270","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}
R. Sah, H. Khanal, D. Shrestha, B. Paudel, R. Gautam, Andrea M. Straus, R. Love
Effective doctor-patient communication is key to addressing the signifi cant issue of nonadherence to hypertension treatment in Nepal. Common clinical messages about hypertension are evaluated utilizing the framework of the Common-Sense Model of Self-Regulation for their role in shaping the patient models that underlie nonadherent behavior. Clinical communications and practices are recommended: to respectfully elicit and address patient reliance on self-identifi ed symptoms; to accompany warnings of hypertension’s serious consequences with specifi c individual action-plans for durable effects; to emphasize the necessity of long-term continuous treatment without creating fears of dependence and withdrawal effects or burdensome monitoring and counseling; to inform of side-effects while presenting medication as nontoxic and necessary for the body’s maintenance of a healthy balance. By acknowledging the patient as an active agent engaged in self-regulation and by employing culturally consonant concepts (often Ayurvedic), we can encourage accurate patientillness and treatment representations that guide medication adherence.
{"title":"Doctor-Patient Communication for Adherence to Hypertension Treatment in Nepal","authors":"R. Sah, H. Khanal, D. Shrestha, B. Paudel, R. Gautam, Andrea M. Straus, R. Love","doi":"10.3126/NMJ.V3I2.32946","DOIUrl":"https://doi.org/10.3126/NMJ.V3I2.32946","url":null,"abstract":"Effective doctor-patient communication is key to addressing the signifi cant issue of nonadherence to hypertension treatment in Nepal. Common clinical messages about hypertension are evaluated utilizing the framework of the Common-Sense Model of Self-Regulation for their role in shaping the patient models that underlie nonadherent behavior. Clinical communications and practices are recommended: to respectfully elicit and address patient reliance on self-identifi ed symptoms; to accompany warnings of hypertension’s serious consequences with specifi c individual action-plans for durable effects; to emphasize the necessity of long-term continuous treatment without creating fears of dependence and withdrawal effects or burdensome monitoring and counseling; to inform of side-effects while presenting medication as nontoxic and necessary for the body’s maintenance of a healthy balance. By acknowledging the patient as an active agent engaged in self-regulation and by employing culturally consonant concepts (often Ayurvedic), we can encourage accurate patientillness and treatment representations that guide medication adherence.","PeriodicalId":52856,"journal":{"name":"Nepalese Medical Journal","volume":"9 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2020-12-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"90832564","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. Jhunjhunwala, Arnab Ghosh, M. Shrestha, Dilasma Ghartimagar, S. Thapa, S. Regmi, B. Dhakal
A 15-year-old boy reported a 2-month history of severe left thigh pain Physical examination revealed left thigh swelling measuring 6x5 cm. X-ray of the region showed mixed lytic and sclerotic lesion involving the femoral head and neck. A Computed Tomography scan showed mixed lytic and sclerotic lesion involving the femoral head and neck with cortical irregularity and mild periosteal reaction with associated soft tissue in the anterior aspect. Magnetic resonance imaging demonstrated heterogeneous signal intensity lesion with areas of sclerosis involving the femoral head and neck. The large associated soft tissue in the anterior aspect appears predominantly hyperintense on T2W images. On post-contrast axial and sagittal images, heterogeneous enhancement with areas of necrosis involving soft tissue was seen. A presumptive radiological differential diagnosis of Ewing Sarcoma and Osteosarcoma was made. However, on histopathology, it was a case of mesenchymal chondrosarcoma.
{"title":"Mesenchymal Chondrosarcoma: A Rare Aggressive Variant of Chondrosarcoma","authors":"A. Jhunjhunwala, Arnab Ghosh, M. Shrestha, Dilasma Ghartimagar, S. Thapa, S. Regmi, B. Dhakal","doi":"10.3126/NMJ.V3I2.35048","DOIUrl":"https://doi.org/10.3126/NMJ.V3I2.35048","url":null,"abstract":"A 15-year-old boy reported a 2-month history of severe left thigh pain Physical examination revealed left thigh swelling measuring 6x5 cm. X-ray of the region showed mixed lytic and sclerotic lesion involving the femoral head and neck. A Computed Tomography scan showed mixed lytic and sclerotic lesion involving the femoral head and neck with cortical irregularity and mild periosteal reaction with associated soft tissue in the anterior aspect. Magnetic resonance imaging demonstrated heterogeneous signal intensity lesion with areas of sclerosis involving the femoral head and neck. The large associated soft tissue in the anterior aspect appears predominantly hyperintense on T2W images. On post-contrast axial and sagittal images, heterogeneous enhancement with areas of necrosis involving soft tissue was seen. A presumptive radiological differential diagnosis of Ewing Sarcoma and Osteosarcoma was made. However, on histopathology, it was a case of mesenchymal chondrosarcoma.","PeriodicalId":52856,"journal":{"name":"Nepalese Medical Journal","volume":"30 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2020-12-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"81336395","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}
Female pseudohermaphroditism occurs when normal ovaries are present but the body is partially masculinized as individuals with congenital adrenal hyperplasia, also known as adrenogenital syndrome. This is an inherited disorder that accounts for about one-half of all cases of human intersexuality. We report a case of a 24-year-old male presenting with abdominal pain and increasing abdominal distension for one month. Computed tomography scan revealed large multiloculated heterogeneously enhancing solid –cystic lesion in the abdominopelvic cavity– malignant gonadal mass, gross ascites, and visualization of the poorly formed elongated uterus-like structure in the recto-uterine pouch and phallus-like structure with non-visualization of bilateral testes. Histopathology report suggested germ cell tumor and immunohistochemistry confirmed the diagnosis of dysgerminoma. Since dysgerminoma is sensitive to platinum-based chemotherapy patient was subjected to chemotherapy and the patient showed a good response. The patient underwent exploratory laparotomy with right salpingo-oophorectomy with omentectomy and appendectomy.
{"title":"Dysgerminoma in Pseudohermaphroditism: A Case Report","authors":"R. Pun, S. Pudasaini, R. Mahaseth, K. Shrestha","doi":"10.3126/NMJ.V3I2.34909","DOIUrl":"https://doi.org/10.3126/NMJ.V3I2.34909","url":null,"abstract":"Female pseudohermaphroditism occurs when normal ovaries are present but the body is partially masculinized as individuals with congenital adrenal hyperplasia, also known as adrenogenital syndrome. This is an inherited disorder that accounts for about one-half of all cases of human intersexuality. We report a case of a 24-year-old male presenting with abdominal pain and increasing abdominal distension for one month. Computed tomography scan revealed large multiloculated heterogeneously enhancing solid –cystic lesion in the abdominopelvic cavity– malignant gonadal mass, gross ascites, and visualization of the poorly formed elongated uterus-like structure in the recto-uterine pouch and phallus-like structure with non-visualization of bilateral testes. Histopathology report suggested germ cell tumor and immunohistochemistry confirmed the diagnosis of dysgerminoma. Since dysgerminoma is sensitive to platinum-based chemotherapy patient was subjected to chemotherapy and the patient showed a good response. The patient underwent exploratory laparotomy with right salpingo-oophorectomy with omentectomy and appendectomy.","PeriodicalId":52856,"journal":{"name":"Nepalese Medical Journal","volume":"2 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2020-12-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"89159896","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":"Re: Statin Drug Therapy May Increase COVID-19 Infection","authors":"D. Lamichhane","doi":"10.3126/NMJ.V3I2.28349","DOIUrl":"https://doi.org/10.3126/NMJ.V3I2.28349","url":null,"abstract":"","PeriodicalId":52856,"journal":{"name":"Nepalese Medical Journal","volume":"134 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2020-12-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"79888113","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}
Milesh Jung Sijapati, M. Pandey, Poojyashree Karki, N. Khadka
Introduction: Sleep-disordered breathing comprises of obstructive sleep apnea, central sleep apnea, and periodic breathing. There is a link between obesity diabetes and sleep apnea with its association with retinopathy. Therefore this study was done to find out the association of sleep-disordered breathing in uncontrolled diabetes mellitus and association with retinopathy.Materials and Methods: This study was done from 2015 September to 2018 September in Sleep center, Nepal. Patients diagnosed with Type 2 diabetes mellitus were included. Diabetes mellitus was diagnosed as blood sugar fasting ≥ 126mg/dl, or blood sugar postprandial ≥200mg/dl and glycosylated hemoglobin above 6.5%. Obstructive sleep apnea risk was determined using the STOP-BANG questionnaire. Relationships between the risk of Obstructive sleep apnea and clinical variables along with its association with diabetic retinopathy were evaluated using bivariate analyses and covariate-adjusted logistic regression models.Results: A total of 150 diabetic patients were analyzed. Among them 30 (20.0%) patients had mild Obstructive sleep apnea, 14 (9.3%) patients had moderate Obstructive sleep apnea and 15 (10.0%) patients had severe sleep apnea. Among patients with diabetes mellitus on multivariate regression analysis Obstructive sleep apnea was associated with diabetes mellitus OR 2.05, 95% CI (1.69- 8.83) and diabetic retinopathy OR 1.20 (0.67-5.89).Conclusions: This study concludes that those individuals having diabetes may be suffering from obstructive sleep apnea and association with retinopathy these individuals can be considered for the screening of sleep-disordered breathing by polysomnography.
{"title":"Sleep Disordered Breathing in Patient with Type 2 Diabetes Mellitus and its Association with Diabetic Retinopathy: Single Center Study","authors":"Milesh Jung Sijapati, M. Pandey, Poojyashree Karki, N. Khadka","doi":"10.3126/NMJ.V2I1.23546","DOIUrl":"https://doi.org/10.3126/NMJ.V2I1.23546","url":null,"abstract":"Introduction: Sleep-disordered breathing comprises of obstructive sleep apnea, central sleep apnea, and periodic breathing. There is a link between obesity diabetes and sleep apnea with its association with retinopathy. Therefore this study was done to find out the association of sleep-disordered breathing in uncontrolled diabetes mellitus and association with retinopathy.Materials and Methods: This study was done from 2015 September to 2018 September in Sleep center, Nepal. Patients diagnosed with Type 2 diabetes mellitus were included. Diabetes mellitus was diagnosed as blood sugar fasting ≥ 126mg/dl, or blood sugar postprandial ≥200mg/dl and glycosylated hemoglobin above 6.5%. Obstructive sleep apnea risk was determined using the STOP-BANG questionnaire. Relationships between the risk of Obstructive sleep apnea and clinical variables along with its association with diabetic retinopathy were evaluated using bivariate analyses and covariate-adjusted logistic regression models.Results: A total of 150 diabetic patients were analyzed. Among them 30 (20.0%) patients had mild Obstructive sleep apnea, 14 (9.3%) patients had moderate Obstructive sleep apnea and 15 (10.0%) patients had severe sleep apnea. Among patients with diabetes mellitus on multivariate regression analysis Obstructive sleep apnea was associated with diabetes mellitus OR 2.05, 95% CI (1.69- 8.83) and diabetic retinopathy OR 1.20 (0.67-5.89).Conclusions: This study concludes that those individuals having diabetes may be suffering from obstructive sleep apnea and association with retinopathy these individuals can be considered for the screening of sleep-disordered breathing by polysomnography.","PeriodicalId":52856,"journal":{"name":"Nepalese Medical Journal","volume":"7 4","pages":""},"PeriodicalIF":0.0,"publicationDate":"2019-06-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.3126/NMJ.V2I1.23546","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"72487617","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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