D. Paudel, H. Regmi, U. Bajracharya, G. K. Shrestha
Introduction: Urinary bladder cancers are heterogeneous diseases consisting of a divergent group of tumors. Diseases of the urinary bladder, both neoplastic and nonneoplastic contribute to notable mortality and morbidity. Histopathology remains the gold standard of diagnosis. Bladder transurethral resection of the tumor is a therapeutic procedure that ensures the material necessary for histopathological diagnosis because it allows assessment of the degree of differentiation, depth of tumor invasion, parameters useful in the elaboration of diagnosis and prognosis assessment Material and Methods: All the urinary bladder biopsies submitted in the pathology laboratory during 1 year time period were included in the study. Results: Among the 51 total cases in the study, the male to female ratio was 4.67:1 with the age group of 22-96 years. Among the study population, 30 (52.7%) presented with hematuria, 10 (19.2%) with burning micturition, frequent urination, and lower abdominal pain. In the study, 44 (86%) showed neoplastic lesions while 7(14%) remaining were non-neoplastic lesions. Infiltrative urothelial carcinoma with low and high grades was diagnosed in 23% (12/51) Conclusions: This study has revealed that neoplastic lesions are more common than non-neoplastic lesions. A great majority of neoplastic lesions are of urothelial origin. Majority of which are invasive urothelial neoplasm. All urothelial neoplasms are more common in males. Cystoscopic studies and biopsies help in the early detection of bladder neoplasms and they form the mainstay of the diagnosis and follow-up.
{"title":"Spectrum and Presentation of Urinary Bladder Growth: a Single-Center Retrospective Study","authors":"D. Paudel, H. Regmi, U. Bajracharya, G. K. Shrestha","doi":"10.3126/nmj.v4i2.42055","DOIUrl":"https://doi.org/10.3126/nmj.v4i2.42055","url":null,"abstract":"Introduction: Urinary bladder cancers are heterogeneous diseases consisting of a divergent group of tumors. Diseases of the urinary bladder, both neoplastic and nonneoplastic contribute to notable mortality and morbidity. Histopathology remains the gold standard of diagnosis. Bladder transurethral resection of the tumor is a therapeutic procedure that ensures the material necessary for histopathological diagnosis because it allows assessment of the degree of differentiation, depth of tumor invasion, parameters useful in the elaboration of diagnosis and prognosis assessment \u0000Material and Methods: All the urinary bladder biopsies submitted in the pathology laboratory during 1 year time period were included in the study. \u0000Results: Among the 51 total cases in the study, the male to female ratio was 4.67:1 with the age group of 22-96 years. Among the study population, 30 (52.7%) presented with hematuria, 10 (19.2%) with burning micturition, frequent urination, and lower abdominal pain. In the study, 44 (86%) showed neoplastic lesions while 7(14%) remaining were non-neoplastic lesions. Infiltrative urothelial carcinoma with low and high grades was diagnosed in 23% (12/51) \u0000Conclusions: This study has revealed that neoplastic lesions are more common than non-neoplastic lesions. A great majority of neoplastic lesions are of urothelial origin. Majority of which are invasive urothelial neoplasm. All urothelial neoplasms are more common in males. Cystoscopic studies and biopsies help in the early detection of bladder neoplasms and they form the mainstay of the diagnosis and follow-up.","PeriodicalId":52856,"journal":{"name":"Nepalese Medical Journal","volume":"43 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-12-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"78949087","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}
S. Thapa, A.R. Ghosh, Dilasma Ghartimagar, S. Regmi, A. Jhunjhunwala
Introduction: The incidence of skin cancer is increasing exponentially around the world. This study aims to analyze different malignant skin tumors concerning age pattern, gender, and site-wise distribution. Materials and Methods: This is a descriptive cross-sectional hospital-based study carried out in the Department of Pathology, a tertiary care center for over ten years from April 2011 to March 2021. All malignant skin tumors arising from the epidermis along with melanocytic and adnexal tumors were included in the study. Results: A total of 208 cases of skin malignancies among which 117 (56.3%) cases were males and 91 (43.8%) females with a male to female ratio of 1.3:1. Overall, the majority were seen in the sixth decade 49 (23.6%) with head and neck region 113 (54.3%) being the commonest site of involvement. Basal cell carcinoma 79 (38%) was the most frequent non-melanoma skin cancer followed by squamous cell carcinoma 75 (36.1%). A maximum number of basal cell carcinoma were observed in the sixth decade 19 (24.1%) whereas squamous cell carcinoma in the seventh decade 21 (28%) cases. Other skin cancers were malignant melanoma 31 (14.9%), verrucous carcinoma 13 (6.3%), trichilemmal carcinoma five (2.4%), sebaceous carcinoma two (1%), and one case each of eccrine carcinoma, malignant nodular hidradenoma, and malignant proliferating trichilemmal tumor. Conclusions: Skin malignancies were seen in the sixth decade with male preponderance. Overall, the head and neck region was the commonest site of involvement. Basal cell carcinoma was the most frequent non-melanoma skin cancer followed by squamous cell carcinoma.
{"title":"Histomorphological Pattern of Malignant Skin Tumors – A Cross-sectional Study in a Teaching Hospital","authors":"S. Thapa, A.R. Ghosh, Dilasma Ghartimagar, S. Regmi, A. Jhunjhunwala","doi":"10.3126/nmj.v4i2.41335","DOIUrl":"https://doi.org/10.3126/nmj.v4i2.41335","url":null,"abstract":"Introduction: The incidence of skin cancer is increasing exponentially around the world. This study aims to analyze different malignant skin tumors concerning age pattern, gender, and site-wise distribution. \u0000Materials and Methods: This is a descriptive cross-sectional hospital-based study carried out in the Department of Pathology, a tertiary care center for over ten years from April 2011 to March 2021. All malignant skin tumors arising from the epidermis along with melanocytic and adnexal tumors were included in the study. \u0000Results: A total of 208 cases of skin malignancies among which 117 (56.3%) cases were males and 91 (43.8%) females with a male to female ratio of 1.3:1. Overall, the majority were seen in the sixth decade 49 (23.6%) with head and neck region 113 (54.3%) being the commonest site of involvement. Basal cell carcinoma 79 (38%) was the most frequent non-melanoma skin cancer followed by squamous cell carcinoma 75 (36.1%). A maximum number of basal cell carcinoma were observed in the sixth decade 19 (24.1%) whereas squamous cell carcinoma in the seventh decade 21 (28%) cases. Other skin cancers were malignant melanoma 31 (14.9%), verrucous carcinoma 13 (6.3%), trichilemmal carcinoma five (2.4%), sebaceous carcinoma two (1%), and one case each of eccrine carcinoma, malignant nodular hidradenoma, and malignant proliferating trichilemmal tumor. \u0000Conclusions: Skin malignancies were seen in the sixth decade with male preponderance. Overall, the head and neck region was the commonest site of involvement. Basal cell carcinoma was the most frequent non-melanoma skin cancer followed by squamous cell carcinoma.","PeriodicalId":52856,"journal":{"name":"Nepalese Medical Journal","volume":"17 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-12-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"82341792","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: Perinatal deaths are potentially preventable and reflect the quality of care provided in the prenatal period, during labor, and to a newborn. The purpose of this study was to assess the causes and avoidable factors contributing to perinatal deaths in the year 2018-19 and compare these with the previous two years at Tertiary Care Hospital.Materials and Methods: This study was conducted from a retrospective analysis of all stillbirths and early neonatal deaths in the year July 2018 to July 2019. The Perinatal Mortality Rate, causes, and avoidable factors leading to perinatal deaths were analysed during this year and were compared with that of the previous two years at KIST Medical College and Teaching hospital.Results: PMR was 16.09 per 1000 births in the year 2018-19. Previous two studies at this hospital in the year 2017-18 and 2016-17 showed a Perinatal Mortality Rate of 14.61 and 16.27/1000 births respectively. The commonest primary cause of perinatal deaths was intrapartum hypoxia 6 (30%), preterm delivery 5 (31.25%), and congenital anomalies4 (19%) during the year 2018-19, 2017-18, and 2016-17 respectively. The most common avoidable factors identified were a maternal delay to seek health care, inadequate antenatal checkups, and inadequate antenatal counseling of danger signs by a service provider over the last three years.Conclusions: Maternal delay to seek health care and lack of maternal knowledge of danger signs during pregnancy were the common avoidable factors identified. More efforts should be made to raise awareness of pregnant women during antenatal care visits regarding early healthcare-seeking behavior when needed.
{"title":"An Analysis of Causes and Avoidable Factors of Perinatal Deaths at Tertiary Care Hospital","authors":"Sunita Bhandari, Y. Dwa, Riya Sharma","doi":"10.3126/nmj.v4i1.36994","DOIUrl":"https://doi.org/10.3126/nmj.v4i1.36994","url":null,"abstract":"Introduction: Perinatal deaths are potentially preventable and reflect the quality of care provided in the prenatal period, during labor, and to a newborn. The purpose of this study was to assess the causes and avoidable factors contributing to perinatal deaths in the year 2018-19 and compare these with the previous two years at Tertiary Care Hospital.Materials and Methods: This study was conducted from a retrospective analysis of all stillbirths and early neonatal deaths in the year July 2018 to July 2019. The Perinatal Mortality Rate, causes, and avoidable factors leading to perinatal deaths were analysed during this year and were compared with that of the previous two years at KIST Medical College and Teaching hospital.Results: PMR was 16.09 per 1000 births in the year 2018-19. Previous two studies at this hospital in the year 2017-18 and 2016-17 showed a Perinatal Mortality Rate of 14.61 and 16.27/1000 births respectively. The commonest primary cause of perinatal deaths was intrapartum hypoxia 6 (30%), preterm delivery 5 (31.25%), and congenital anomalies4 (19%) during the year 2018-19, 2017-18, and 2016-17 respectively. The most common avoidable factors identified were a maternal delay to seek health care, inadequate antenatal checkups, and inadequate antenatal counseling of danger signs by a service provider over the last three years.Conclusions: Maternal delay to seek health care and lack of maternal knowledge of danger signs during pregnancy were the common avoidable factors identified. More efforts should be made to raise awareness of pregnant women during antenatal care visits regarding early healthcare-seeking behavior when needed.","PeriodicalId":52856,"journal":{"name":"Nepalese Medical Journal","volume":"46 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-06-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"83736188","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: Dyslipidemia is a risk factor for coronary artery disease, a leading cause of mortality in patients with type 2 diabetes mellitus. This study aims to study the dietary pattern and dyslipidemia of type 2 diabetes mellitus patients visiting Tribhuvan University Teaching Hospital. Materials and Methods: Quantitative study was done to find out the dietary pattern and dyslipidemia of type 2 diabetes mellitus patients visiting Tribhuvan University Teaching Hospital. Patients with type 2 diabetes mellitus diagnosed for more than one year were included in the study. Results: The percentage of dyslipidemia in type 2 diabetes mellitus was found to be 88.5%. Dyslipidemia was found to be significantly associated (p<0.05) with alcohol consumption, regular dietary management, sedentary behavior, waist-hip ratio, body mass index, glycated hemoglobin, and hypertension. Dyslipidemia was also found to be significantly associated (p<0.05) with the dietary habit (vegetarian and non-vegetarian), consumption of cereals and its product, consumption of fruits, consumption of fast foods and street foods, consumption of red meat, and consumption of oilseeds. Conclusions: This study indicates the importance of dietary awareness and lifestyle modification for the management of dyslipidemia among type 2 diabetes mellitus.
{"title":"Diet Pattern and Dyslipidemia Among Type II Diabetes Mellitus Patients Diagnosed More Tthan One Year Visiting Tribhuvan University Teaching Hospital","authors":"Samiksha Niroula, Rama Subba, Aarem Karkee","doi":"10.3126/nmj.v4i1.37495","DOIUrl":"https://doi.org/10.3126/nmj.v4i1.37495","url":null,"abstract":"Introduction: Dyslipidemia is a risk factor for coronary artery disease, a leading cause of mortality in patients with type 2 diabetes mellitus. This study aims to study the dietary pattern and dyslipidemia of type 2 diabetes mellitus patients visiting Tribhuvan University Teaching Hospital.\u0000Materials and Methods: Quantitative study was done to find out the dietary pattern and dyslipidemia of type 2 diabetes mellitus patients visiting Tribhuvan University Teaching Hospital. Patients with type 2 diabetes mellitus diagnosed for more than one year were included in the study.\u0000Results: The percentage of dyslipidemia in type 2 diabetes mellitus was found to be 88.5%. Dyslipidemia was found to be significantly associated (p<0.05) with alcohol consumption, regular dietary management, sedentary behavior, waist-hip ratio, body mass index, glycated hemoglobin, and hypertension. Dyslipidemia was also found to be significantly associated (p<0.05) with the dietary habit (vegetarian and non-vegetarian), consumption of cereals and its product, consumption of fruits, consumption of fast foods and street foods, consumption of red meat, and consumption of oilseeds.\u0000Conclusions: This study indicates the importance of dietary awareness and lifestyle modification for the management of dyslipidemia among type 2 diabetes mellitus.","PeriodicalId":52856,"journal":{"name":"Nepalese Medical Journal","volume":"39 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-06-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"82660729","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: Nepal is a developing country where most of the population does not have access to proper health care services and on top of that eye care services do not reach the entire population. This study aimed to determine the pattern of ocular morbidity in patients attending the ophthalmic OPD of Rapti Academy of Health Sciences. Materials and Methods: This was a prospective cross-sectional study conducted in the Department of Ophthalmology of Rapti Academy of Health Science, Dang. The study period was Poush 2077 to Chaitra 2077. All the patients visiting the OPD of the Ophthalmology department with an ocular problem were included in the study. Results: A total of 1000 patients were examined during the study period. The patient's ages below 1 year were excluded so a total of 970 samples was selected. In which 625 (64.4%) were female and 345 (35.6%) were male. Most patients 92.9% were from Dang followed by Rolpa 4.1%, Rukum 1.4%, Pyuthan 0.9%, and Salyan 0.6%. Patients were examined from all age groups except for 1 year which was excluded. Out of the total patients, a maximum number of patients were female and the maximum number of patients were in the age group of 21- 30 years and followed by more than or equal to 60 years age group. Conclusions: This study will help in obtaining epidemiology of Ocular disease for proper planning and management in the hospital.
{"title":"Clinical Profile of Ocular Diseases at a Tertiary Eye Care Centre in Mid-Western Nepal","authors":"P. Basnet, Sagun Malla, Deepa Sharma, R. Gautam","doi":"10.3126/nmj.v4i1.37847","DOIUrl":"https://doi.org/10.3126/nmj.v4i1.37847","url":null,"abstract":"Introduction: Nepal is a developing country where most of the population does not have access to proper health care services and on top of that eye care services do not reach the entire population. This study aimed to determine the pattern of ocular morbidity in patients attending the ophthalmic OPD of Rapti Academy of Health Sciences.\u0000Materials and Methods: This was a prospective cross-sectional study conducted in the Department of Ophthalmology of Rapti Academy of Health Science, Dang. The study period was Poush 2077 to Chaitra 2077. All the patients visiting the OPD of the Ophthalmology department with an ocular problem were included in the study.\u0000Results: A total of 1000 patients were examined during the study period. The patient's ages below 1 year were excluded so a total of 970 samples was selected. In which 625 (64.4%) were female and 345 (35.6%) were male. Most patients 92.9% were from Dang followed by Rolpa 4.1%, Rukum 1.4%, Pyuthan 0.9%, and Salyan 0.6%. Patients were examined from all age groups except for 1 year which was excluded. Out of the total patients, a maximum number of patients were female and the maximum number of patients were in the age group of 21- 30 years and followed by more than or equal to 60 years age group.\u0000Conclusions: This study will help in obtaining epidemiology of Ocular disease for proper planning and management in the hospital.","PeriodicalId":52856,"journal":{"name":"Nepalese Medical Journal","volume":"129 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-06-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"90608657","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: This study was done to find out the causes of visual impairment in students studying in schools for the blind in the central development region of Nepal. Materials and Methods: The study was done in six schools for the blind in the central development region of Nepal. It was conducted by a team of Eye care professionals using standard eye examination protocols of the World Health Organization Prevention of Blindness Program in the year 2009. Results: A total of 133 students (5 - 21 years age group) enrolled in six schools for the blind were examined. 52.6% of children were visually impaired at birth and 12% developed vision impairment within one year of age. Twenty-one students (15.8%) had mild visual impairment, 5 students (3.8%) had severe visual impairment and 101 students (76%) were blind. The main cause of vision impairment was found to be lens-related anomaly 23.3% and retinal diseases, 18% followed by corneal lesions, 16.5%, and problems with the whole globe, optic nerve, and glaucoma accounting for 12.03%, 11.3%, and 7.5% respectively. The etiology could not be identified in 48.1% followed by hereditary causes (31.6%) and childhood factors (12%). Of the total students examined, 37.6% were visually impaired due to avoidable causes; preventable in 22.6% and treatable in 15% of cases. Conclusions: A high proportion of childhood blindness in schools for the blind in the central development region of Nepal is avoidable.
{"title":"Causes of Blindness and Visual Impairment Among Children Studying in Schools for the Blind in Central Development Region of Nepal","authors":"J. Shrestha, Pragati Gautam Adhikari, G. Shrestha","doi":"10.3126/nmj.v5i1.42151","DOIUrl":"https://doi.org/10.3126/nmj.v5i1.42151","url":null,"abstract":"Introduction: This study was done to find out the causes of visual impairment in students studying in schools for the blind in the central development region of Nepal.\u0000Materials and Methods: The study was done in six schools for the blind in the central development region of Nepal. It was conducted by a team of Eye care professionals using standard eye examination protocols of the World Health Organization Prevention of Blindness Program in the year 2009.\u0000Results: A total of 133 students (5 - 21 years age group) enrolled in six schools for the blind were examined. 52.6% of children were visually impaired at birth and 12% developed vision impairment within one year of age. Twenty-one students (15.8%) had mild visual impairment, 5 students (3.8%) had severe visual impairment and 101 students (76%) were blind. The main cause of vision impairment was found to be lens-related anomaly 23.3% and retinal diseases, 18% followed by corneal lesions, 16.5%, and problems with the whole globe, optic nerve, and glaucoma accounting for 12.03%, 11.3%, and 7.5% respectively. The etiology could not be identified in 48.1% followed by hereditary causes (31.6%) and childhood factors (12%). Of the total students examined, 37.6% were visually impaired due to avoidable causes; preventable in 22.6% and treatable in 15% of cases.\u0000Conclusions: A high proportion of childhood blindness in schools for the blind in the central development region of Nepal is avoidable.","PeriodicalId":52856,"journal":{"name":"Nepalese Medical Journal","volume":"23 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-06-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"76370286","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}
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}
Surendra Shah, Sanjaya Paudyal, S. Maharjan, Shailendra Shah, J. Shah
Introduction: Acute severe pancreatitis is associated with increased mortality. Several scoring systems have been used to predict severe acute pancreatitis which are either time-consuming or calculated 48 hours after admission. This study was aimed to assess the utility of neutrophils to lymphocyte ratio and platelet to lymphocyte ratio as an early predictor of severe acute biliary pancreatitis.Materials and Methods: This was a retrospective cohort study conducted from January 2017 to January 2020. Patients with non-biliary pancreatitis, referred after initial treatment, missed data, and acute pancreatitis with acute cholecystitis or cholangitis were excluded from the study. Data were collected from case sheets. Patients were divided into two groups according to the development of severe acute biliary pancreatitis based on the revised Atlanta Classification. Association of neutrophil to lymphocyte ratio and platelet to lymphocyte ratio with severe acute biliary pancreatitis was assessed using Mann Whitney U-test. p-value < 0.05 was considered as statistically significant.Results: Total 73 cases included in the study (males/females= 0.55). Sixty-six patients (90.4%) had mild/moderate acute biliary pancreatitis, and 7 (9.6%) patients had severe acute biliary pancreatitis. There was a development of complications in 7 (9.6%) patients who had severe acute biliary pancreatitis including one mortality. The mean neutrophil to lymphocyte ratio and mean platelet to lymphocyte ratio were high in the severe acute biliary pancreatitis group compared to the nonsevere acute biliary pancreatitis group, however, these differences were not statistically significant.Conclusions: Neutrophil to lymphocyte ratio and platelet to lymphocyte ratio cannot predict severe acute biliary pancreatitis.
{"title":"Utility of Neutrophil to Lymphocyte ratio and platelet to lymphocyte ratio as early predicter of severe acute biliary pancreatitis","authors":"Surendra Shah, Sanjaya Paudyal, S. Maharjan, Shailendra Shah, J. Shah","doi":"10.3126/nmj.v4i1.37094","DOIUrl":"https://doi.org/10.3126/nmj.v4i1.37094","url":null,"abstract":"Introduction: Acute severe pancreatitis is associated with increased mortality. Several scoring systems have been used to predict severe acute pancreatitis which are either time-consuming or calculated 48 hours after admission. This study was aimed to assess the utility of neutrophils to lymphocyte ratio and platelet to lymphocyte ratio as an early predictor of severe acute biliary pancreatitis.Materials and Methods: This was a retrospective cohort study conducted from January 2017 to January 2020. Patients with non-biliary pancreatitis, referred after initial treatment, missed data, and acute pancreatitis with acute cholecystitis or cholangitis were excluded from the study. Data were collected from case sheets. Patients were divided into two groups according to the development of severe acute biliary pancreatitis based on the revised Atlanta Classification. Association of neutrophil to lymphocyte ratio and platelet to lymphocyte ratio with severe acute biliary pancreatitis was assessed using Mann Whitney U-test. p-value < 0.05 was considered as statistically significant.Results: Total 73 cases included in the study (males/females= 0.55). Sixty-six patients (90.4%) had mild/moderate acute biliary pancreatitis, and 7 (9.6%) patients had severe acute biliary pancreatitis. There was a development of complications in 7 (9.6%) patients who had severe acute biliary pancreatitis including one mortality. The mean neutrophil to lymphocyte ratio and mean platelet to lymphocyte ratio were high in the severe acute biliary pancreatitis group compared to the nonsevere acute biliary pancreatitis group, however, these differences were not statistically significant.Conclusions: Neutrophil to lymphocyte ratio and platelet to lymphocyte ratio cannot predict severe acute biliary pancreatitis.","PeriodicalId":52856,"journal":{"name":"Nepalese Medical Journal","volume":"55 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-06-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"90409786","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}
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}
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