Pub Date : 2023-03-21DOI: 10.3126/nmcj.v25i1.53380
S. Yadav, V. Shirol, J. Prasad, Shilpa M. Bhimalli
Knowledge regarding changes of proteoglycans (acid mucins) in human osteoarthritis (OA) meniscus may help in understanding development of meniscal degeneration. Therefore, present study was planned to know changes in acid mucins in human knee OA menisci by histochemical analysis of different parts of medial and lateral menisci of both legs. Medial and lateral OA menisci were collected from 110 human knee joints of both sexes. Normal meniscal tissue of sheep was taken as control and studied for histological stain with alcian blue pH 2.5, to find acid mucins changes in OA menisci. Data were analyzed by bivariate and one-way ANOVA using MS-Excel. Osteoarthritis is more common in females than males. OA changes were found to be more on right side in females and on left side in males, while OA was more common in both legs in number of cases in 60-69 years. Further, decreased staining intensity for acid mucins was observed in different parts of medial and lateral OA menisci of both legs than control meniscus. A significant change in level of acid mucin was observed at anterior, middle, and posterior parts of medial and lateral OA menisci of both legs (P-value=0.0306). Significant changes in acid mucins in human OA meniscus provide information on scientific evidence of OA progression, which could help health professionals in development of structure-modifying drugs for OA therapy.
{"title":"Histochemical study of acid mucins in osteoarthritic menisci of the human knee joint","authors":"S. Yadav, V. Shirol, J. Prasad, Shilpa M. Bhimalli","doi":"10.3126/nmcj.v25i1.53380","DOIUrl":"https://doi.org/10.3126/nmcj.v25i1.53380","url":null,"abstract":"Knowledge regarding changes of proteoglycans (acid mucins) in human osteoarthritis (OA) meniscus may help in understanding development of meniscal degeneration. Therefore, present study was planned to know changes in acid mucins in human knee OA menisci by histochemical analysis of different parts of medial and lateral menisci of both legs. Medial and lateral OA menisci were collected from 110 human knee joints of both sexes. Normal meniscal tissue of sheep was taken as control and studied for histological stain with alcian blue pH 2.5, to find acid mucins changes in OA menisci. Data were analyzed by bivariate and one-way ANOVA using MS-Excel. Osteoarthritis is more common in females than males. OA changes were found to be more on right side in females and on left side in males, while OA was more common in both legs in number of cases in 60-69 years. Further, decreased staining intensity for acid mucins was observed in different parts of medial and lateral OA menisci of both legs than control meniscus. A significant change in level of acid mucin was observed at anterior, middle, and posterior parts of medial and lateral OA menisci of both legs (P-value=0.0306). Significant changes in acid mucins in human OA meniscus provide information on scientific evidence of OA progression, which could help health professionals in development of structure-modifying drugs for OA therapy.","PeriodicalId":87122,"journal":{"name":"Nepal Medical College journal : NMCJ","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-03-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"48643786","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}
Pub Date : 2023-03-21DOI: 10.3126/nmcj.v25i1.53364
Atul Kasaju, J. L. Baidya, R. Batajoo, B. Shrestha, C. Yadav, Nasim Alam
Retrograde intrarenal surgery (RIRS) is an effective and safe method for the management of intrarenal stone showing high stone-free rates. Its main advantage is decrease in operative morbidity for the patient, as well as a faster recovery. The current study aimed to study the factors influencing operating time during retrograde intrarenal surgery for renal stone in tertiary care hospital. It is an observational descriptive cross sectional study using purposive sampling method which was conducted among 188 patients who underwent retrograde intrarenal surgery (RIRS) for management of nephrolithiasis in Department of Urology of B&B hospital, Lalitpur, Nepal. The baseline information of the factors affecting operating time were obtained like age, gender, site of renal stone, prestented or not, body mass index (BMI), ureteral access sheath (UAS) use, stone volume and stone density. The mean operating time was high in renal stone with calcium ammonium urate composition. On linear regression analysis, operative times significantly increased with greater stone volumes and also pre-stenting and ureteral access sheath use did significantly difference on operative time. It revealed stone volume to be the most significant predictor of operative time. Thus, the present study provides valuable information regarding the factors influencing operating time during retrograde intrarenal surgery for renal stone.
{"title":"Assessment of factors influencing operating time during retrograde intrarenal surgery for renal stone in tertiary care hospital of Nepal","authors":"Atul Kasaju, J. L. Baidya, R. Batajoo, B. Shrestha, C. Yadav, Nasim Alam","doi":"10.3126/nmcj.v25i1.53364","DOIUrl":"https://doi.org/10.3126/nmcj.v25i1.53364","url":null,"abstract":"Retrograde intrarenal surgery (RIRS) is an effective and safe method for the management of intrarenal stone showing high stone-free rates. Its main advantage is decrease in operative morbidity for the patient, as well as a faster recovery. The current study aimed to study the factors influencing operating time during retrograde intrarenal surgery for renal stone in tertiary care hospital. It is an observational descriptive cross sectional study using purposive sampling method which was conducted among 188 patients who underwent retrograde intrarenal surgery (RIRS) for management of nephrolithiasis in Department of Urology of B&B hospital, Lalitpur, Nepal. The baseline information of the factors affecting operating time were obtained like age, gender, site of renal stone, prestented or not, body mass index (BMI), ureteral access sheath (UAS) use, stone volume and stone density. The mean operating time was high in renal stone with calcium ammonium urate composition. On linear regression analysis, operative times significantly increased with greater stone volumes and also pre-stenting and ureteral access sheath use did significantly difference on operative time. It revealed stone volume to be the most significant predictor of operative time. Thus, the present study provides valuable information regarding the factors influencing operating time during retrograde intrarenal surgery for renal stone.","PeriodicalId":87122,"journal":{"name":"Nepal Medical College journal : NMCJ","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-03-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43679618","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}
Pub Date : 2023-03-21DOI: 10.3126/nmcj.v25i1.53374
Neyaz Kausar, K. Thapa, Leesha Shrestha Joshi
This study was conducted to know the effectiveness of topical 0.5% timolol maleate for the intraocular pressure rise after Nd-YAG laser posterior capsulotomy. Ninety-six eyes of 92 patients undergoing Nd-YAG laser posterior capsulotomy were randomly selected for pretreatment with topical 0.5% timolol maleate, 48 patients (Group A) or control 48 patients (Group B). The mean IOP of the group A was 14.8±3.0 mmHg before capsulotomy and 15.7±3.4 mmHg after capsulotomy (P >0.05), whereas 15.1±3.3 mmHg and 17.2±4.3 mmHg (P <0.05) of the group B. There was no statistically significant difference between the two groups with regard to mean IOP before capsulotomy (P >0.05), but statistically significant difference between two groups after capsulotomy (P <0.05). Pretreatment with topical 0.5% timolol maleate is effective in preventing IOP elevation after Nd-YAG laser posterior capsulotomy.
{"title":"Prophylactic role of Timolol to prevent rise of intraocular pressure after Nd-YAG laser posterior capsulotomy","authors":"Neyaz Kausar, K. Thapa, Leesha Shrestha Joshi","doi":"10.3126/nmcj.v25i1.53374","DOIUrl":"https://doi.org/10.3126/nmcj.v25i1.53374","url":null,"abstract":"This study was conducted to know the effectiveness of topical 0.5% timolol maleate for the intraocular pressure rise after Nd-YAG laser posterior capsulotomy. Ninety-six eyes of 92 patients undergoing Nd-YAG laser posterior capsulotomy were randomly selected for pretreatment with topical 0.5% timolol maleate, 48 patients (Group A) or control 48 patients (Group B). The mean IOP of the group A was 14.8±3.0 mmHg before capsulotomy and 15.7±3.4 mmHg after capsulotomy (P >0.05), whereas 15.1±3.3 mmHg and 17.2±4.3 mmHg (P <0.05) of the group B. There was no statistically significant difference between the two groups with regard to mean IOP before capsulotomy (P >0.05), but statistically significant difference between two groups after capsulotomy (P <0.05). Pretreatment with topical 0.5% timolol maleate is effective in preventing IOP elevation after Nd-YAG laser posterior capsulotomy.","PeriodicalId":87122,"journal":{"name":"Nepal Medical College journal : NMCJ","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-03-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"47144780","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}
Pub Date : 2022-12-23DOI: 10.3126/nmcj.v24i4.50587
J. Prasad, Prashanta Uprety, S. Khatiwada, Ashish Ghimire, K. Guddy, D. Sarraf
Ultrasound (USG) guided supraclavicular brachial plexus block (BPB) helps in precise delivery of local anesthetic injection, reduced volume or dose of drug providing excellent surgical anesthesia with fewer complications. Objective of the study was to compare effect of two different volumes of Ropivacaine and Lignocaine at two different sites of USG-guided supraclavicular BPB on diaphragmatic motility, quality of block and tourniquet pain. A prospective randomized double-blinded comparative study was conducted among adult patient with below elbow elective surgery. In group A patients (n=17), 20ml of anesthetic solution was injected in the corner pocket and 10ml in the nerve cluster guided with USG. In group B patients (n=17), 15ml of the anesthetic solution was injected in the corner pocket and 5ml in the nerve cluster guided with USG. Hemodynamic parameters, diaphragmatic excursion, onset of anesthetic effects were measured at frequent intervals. The data were analyzed using Statistical Package for Social Sciences at P-value less than 0.05. Hemodynamic profile of the patients were similar in both groups (P-value>0.05). Statistically significant hemi-diaphragmatic dysfunction (partial and complete paralysis) after 15 and 30minutes of blockade was more common in group A than Group B (P<0.05). At 30 minutes after the injection of the anesthesia, all patient in both the groups had complete sensory and motor block in all nerve territory. Tourniquet time was lower in group A (80.35±9.59 minutes vs 84.12±7.75 minutes); however, it was statistically not significant (P-value>0.05). The present study showed that the patients who received lesser half of the required volume of local anesthetics had less incidence of hemidiaphragmatic dysfunction with similar successful rate of blockage (100%) and similar quality of the block as compared to the patients who received greater half of the required volume of local anesthetics.
{"title":"Effect of Two Different Volumes of Ropivacaine and Lignocaine at Two Different Sites in Ultrasound-Guided Supraclavicular Brachial Plexus Block on Diaphragm Motility","authors":"J. Prasad, Prashanta Uprety, S. Khatiwada, Ashish Ghimire, K. Guddy, D. Sarraf","doi":"10.3126/nmcj.v24i4.50587","DOIUrl":"https://doi.org/10.3126/nmcj.v24i4.50587","url":null,"abstract":"Ultrasound (USG) guided supraclavicular brachial plexus block (BPB) helps in precise delivery of local anesthetic injection, reduced volume or dose of drug providing excellent surgical anesthesia with fewer complications. Objective of the study was to compare effect of two different volumes of Ropivacaine and Lignocaine at two different sites of USG-guided supraclavicular BPB on diaphragmatic motility, quality of block and tourniquet pain. A prospective randomized double-blinded comparative study was conducted among adult patient with below elbow elective surgery. In group A patients (n=17), 20ml of anesthetic solution was injected in the corner pocket and 10ml in the nerve cluster guided with USG. In group B patients (n=17), 15ml of the anesthetic solution was injected in the corner pocket and 5ml in the nerve cluster guided with USG. Hemodynamic parameters, diaphragmatic excursion, onset of anesthetic effects were measured at frequent intervals. The data were analyzed using Statistical Package for Social Sciences at P-value less than 0.05. Hemodynamic profile of the patients were similar in both groups (P-value>0.05). Statistically significant hemi-diaphragmatic dysfunction (partial and complete paralysis) after 15 and 30minutes of blockade was more common in group A than Group B (P<0.05). At 30 minutes after the injection of the anesthesia, all patient in both the groups had complete sensory and motor block in all nerve territory. Tourniquet time was lower in group A (80.35±9.59 minutes vs 84.12±7.75 minutes); however, it was statistically not significant (P-value>0.05). The present study showed that the patients who received lesser half of the required volume of local anesthetics had less incidence of hemidiaphragmatic dysfunction with similar successful rate of blockage (100%) and similar quality of the block as compared to the patients who received greater half of the required volume of local anesthetics.","PeriodicalId":87122,"journal":{"name":"Nepal Medical College journal : NMCJ","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-12-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49636170","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}
Pub Date : 2022-12-23DOI: 10.3126/nmcj.v24i4.50586
Diwakar Manandhar, Bikram Bir Bajracharya, N. Shah, Asia Khanum, T. Parvin
The development of acute renal dysfunction in patients with acute heart failure is known as cardiorenal syndrome (CRS) type 1. Cystatin C has emerged as an alternative to serum creatinine which helps to detect early deterioration of the renal function, and in turn help to initiate necessary interventions in management to prevent acute kidney injury (AKI). This is a prospective observational study which was conducted in the Department of Cardiology, Bangabandhu Sheikh Mujib Medical University, Dhaka, Bangladesh. The blood sample of the patients was collected on the day of admission for serum cystatin C and serum creatinine, then serum creatinine was subsequently followed on days 2 and 7, to identify the development of cardiorenal syndrome type 1. Cardiorenal syndrome type 1 developed in 18 (35.3%) of 51 patients admitted to the CCU. Most of the patients were men and had a median age of 57.61±12.99 years. Patients who had developed AKI had a higher serum cystatin C level (1.58±0.191mg/L vs. 0.971±0.344 mg/L) and also revealed that the stage of severity of the KDIGO AKI was correlated with a higher serum cystatin C. Serum cystatin C was proven as a good early biomarker for the diagnosis of cardiorenal syndrome type 1.
{"title":"Cystatin C as an Early Marker of Cardiorenal Syndrome Type 1 in Patients Admitted with Acute Heart Failure","authors":"Diwakar Manandhar, Bikram Bir Bajracharya, N. Shah, Asia Khanum, T. Parvin","doi":"10.3126/nmcj.v24i4.50586","DOIUrl":"https://doi.org/10.3126/nmcj.v24i4.50586","url":null,"abstract":"The development of acute renal dysfunction in patients with acute heart failure is known as cardiorenal syndrome (CRS) type 1. Cystatin C has emerged as an alternative to serum creatinine which helps to detect early deterioration of the renal function, and in turn help to initiate necessary interventions in management to prevent acute kidney injury (AKI). This is a prospective observational study which was conducted in the Department of Cardiology, Bangabandhu Sheikh Mujib Medical University, Dhaka, Bangladesh. The blood sample of the patients was collected on the day of admission for serum cystatin C and serum creatinine, then serum creatinine was subsequently followed on days 2 and 7, to identify the development of cardiorenal syndrome type 1. Cardiorenal syndrome type 1 developed in 18 (35.3%) of 51 patients admitted to the CCU. Most of the patients were men and had a median age of 57.61±12.99 years. Patients who had developed AKI had a higher serum cystatin C level (1.58±0.191mg/L vs. 0.971±0.344 mg/L) and also revealed that the stage of severity of the KDIGO AKI was correlated with a higher serum cystatin C. Serum cystatin C was proven as a good early biomarker for the diagnosis of cardiorenal syndrome type 1.","PeriodicalId":87122,"journal":{"name":"Nepal Medical College journal : NMCJ","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-12-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43885896","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}
Pub Date : 2022-12-23DOI: 10.3126/nmcj.v24i4.50590
A. Giri, A. Joshi, Manita Upreti
The recent increase in prevalence of overweight and obesity in pregnancy has become a major public health problem as it is associated with increased risk of obstetric and neonatal complications. A hospital based observational comparative study was done on women attending obstetrics and gynecology outpatient department of a tertiary care hospital in Kathmandu from September 2021 to January 2022 after taking ethical clearance from Institutional Review Committee. A total of 113 overweight/obese women in first trimester of singleton pregnancies and similar number of women with normal BMI were recruited for the study and followed throughout pregnancy for the development of maternal complications like gestational hypertension, gestational diabetes mellites, antepartum hemorrhage, preterm labor and postpartum hemorrhage. The neonatal outcome compared were birth weight, low Apgar score at birth and NICU admission. Maternal overweight/obesity as compared to normal BMI was associated with increased risk of gestational diabetes mellites (RR 2.06, 95% CI: 1.2 to 3.52; P value = 0.006), gestational hypertension (RR 2.2, 95% CI: 1.09 to 4.43; P value = 0.02) and caesarean delivery (RR 1.81, 95% CI: 1.28 to 2.55; P value = 0.004). The risk of primary postpartum hemorrhage was also increased in overweight/ obese women than in normal weight women (RR 2.8, 95% CI: 1.04 to 7.51; P value=0.03). In neonatal outcomes, the mean birth weight (3.18 + 0.54 kg vs 2.9 + 0.33kg, P value < 0.001) and admission to NICU (28.3% vs 10.61%, P value = 0.008) were significantly higher in overweight/ obese women. Maternal overweight/obesity in early pregnancy is associated with higher risk of adverse pregnancy and neonatal outcome.
最近妊娠期超重和肥胖患病率的增加已成为一个主要的公共卫生问题，因为这与产科和新生儿并发症的风险增加有关。在获得机构审查委员会的伦理许可后，于2021年9月至2022年1月对加德满都一家三级护理医院妇产科门诊的女性进行了一项基于医院的观察性比较研究。本研究共招募了113名单胎妊娠前三个月的超重/肥胖女性和类似数量的BMI正常的女性，并在整个妊娠期对其发生妊娠高血压、妊娠糖尿病、产前出血、早产和产后出血等母体并发症的情况进行了随访。比较新生儿的结局是出生体重、出生时Apgar评分低和新生儿重症监护室入院。与正常BMI相比，母亲超重/肥胖与妊娠期糖尿病的风险增加相关（RR 2.06、95%CI：1.2至3.52；P值=0.006），妊娠期高血压（RR 2.2，95%CI:1.09至4.43；P值=0.02）和剖腹产（RR 1.81，95%CI:1.28至2.55；P值=0.004）。超重/肥胖女性的原发性产后出血风险也高于正常体重女性（RR 2.8，95%CI:1.04至7.51；P值=0.03），超重/肥胖女性的平均出生体重（3.18±0.54 kg vs 2.9±0.33 kg，P值<0.001）和新生儿重症监护室的入院率（28.3%vs 10.61%，P值=0.008）显著较高。妊娠早期的母亲超重/肥胖与不良妊娠和新生儿结局的风险较高有关。
{"title":"The Impact of Overweight and Obesity in Early Pregnancy on Maternal and Fetal Outcome","authors":"A. Giri, A. Joshi, Manita Upreti","doi":"10.3126/nmcj.v24i4.50590","DOIUrl":"https://doi.org/10.3126/nmcj.v24i4.50590","url":null,"abstract":"The recent increase in prevalence of overweight and obesity in pregnancy has become a major public health problem as it is associated with increased risk of obstetric and neonatal complications. A hospital based observational comparative study was done on women attending obstetrics and gynecology outpatient department of a tertiary care hospital in Kathmandu from September 2021 to January 2022 after taking ethical clearance from Institutional Review Committee. A total of 113 overweight/obese women in first trimester of singleton pregnancies and similar number of women with normal BMI were recruited for the study and followed throughout pregnancy for the development of maternal complications like gestational hypertension, gestational diabetes mellites, antepartum hemorrhage, preterm labor and postpartum hemorrhage. The neonatal outcome compared were birth weight, low Apgar score at birth and NICU admission. Maternal overweight/obesity as compared to normal BMI was associated with increased risk of gestational diabetes mellites (RR 2.06, 95% CI: 1.2 to 3.52; P value = 0.006), gestational hypertension (RR 2.2, 95% CI: 1.09 to 4.43; P value = 0.02) and caesarean delivery (RR 1.81, 95% CI: 1.28 to 2.55; P value = 0.004). The risk of primary postpartum hemorrhage was also increased in overweight/ obese women than in normal weight women (RR 2.8, 95% CI: 1.04 to 7.51; P value=0.03). In neonatal outcomes, the mean birth weight (3.18 + 0.54 kg vs 2.9 + 0.33kg, P value < 0.001) and admission to NICU (28.3% vs 10.61%, P value = 0.008) were significantly higher in overweight/ obese women. Maternal overweight/obesity in early pregnancy is associated with higher risk of adverse pregnancy and neonatal outcome.","PeriodicalId":87122,"journal":{"name":"Nepal Medical College journal : NMCJ","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-12-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46948962","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}
Pub Date : 2022-12-23DOI: 10.3126/nmcj.v24i4.50580
S. Shrestha, V. Silvanus, D. Joshi
The world is experiencing growth in the number and proportion of older population and their population are found to be growing much faster in the developing countries. The ageing population tends to have a higher prevalence of chronic diseases worldwide. These problems can lead to decrease in quality of life of elderly. The current study aimed to study the prevalence of chronic diseases and quality of life among elderly people of Kathmandu. This is a community based cross sectional study done among 200 elderly people who are more than or equal to 60 years at Budanilkantha Municipality-13, Chunikhel. The information was obtained using semi structured questionnaire. A standardized tool of the WHOQOL‑BREF questionnaire was used to assess the quality of life (QoL) of participants. Among various chronic diseases, the prevalence of hypertension was highest. The mean score of environment domain was better than physical health, psychological and social relationships domain respectively. QoL was statistically significant with increase in literacy status, education of head of family and their involvement in decision making. The overall mean score of QoL among both the diseased and not diseased elderly were similar. Thus, the present study provides valuable information regarding the QoL of the elderly in the community.
{"title":"Prevalence of Chronic Diseases and Quality of Life among Elderly People of Kathmandu, Nepal","authors":"S. Shrestha, V. Silvanus, D. Joshi","doi":"10.3126/nmcj.v24i4.50580","DOIUrl":"https://doi.org/10.3126/nmcj.v24i4.50580","url":null,"abstract":"The world is experiencing growth in the number and proportion of older population and their population are found to be growing much faster in the developing countries. The ageing population tends to have a higher prevalence of chronic diseases worldwide. These problems can lead to decrease in quality of life of elderly. The current study aimed to study the prevalence of chronic diseases and quality of life among elderly people of Kathmandu. This is a community based cross sectional study done among 200 elderly people who are more than or equal to 60 years at Budanilkantha Municipality-13, Chunikhel. The information was obtained using semi structured questionnaire. A standardized tool of the WHOQOL‑BREF questionnaire was used to assess the quality of life (QoL) of participants. Among various chronic diseases, the prevalence of hypertension was highest. The mean score of environment domain was better than physical health, psychological and social relationships domain respectively. QoL was statistically significant with increase in literacy status, education of head of family and their involvement in decision making. The overall mean score of QoL among both the diseased and not diseased elderly were similar. Thus, the present study provides valuable information regarding the QoL of the elderly in the community.","PeriodicalId":87122,"journal":{"name":"Nepal Medical College journal : NMCJ","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-12-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"45818453","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}
Pub Date : 2022-12-23DOI: 10.3126/nmcj.v24i4.50579
C. Thapa, G. R. Bajracharya, Samyukta Acharya, Aarati Thakur
Hypotension is a frequent complication of spinal anesthesia. Decrease in peripheral vascular tone that occurs during pregnancy is one of the factors causing hypotension in patients undergoing cesarean section under spinal anesthesia. Perfusion index derived from pulse oximeter can be an easy and non-invasive measure of peripheral perfusion. This study was conducted to test the usefulness of pulse oximeter in predicting hypotension following spinal anesthesia for cesarean section. In this study, 247 parturients undergoing elective cesarean section under spinal anesthesia were included. Parturients who had baseline PI<3.5 were kept in Group I and parturients who had baseline PI>3.5 were kept in Group II. All the patients were given 0.5% bupivacaine heavy 2.2 ml for spinal anesthesia. In group I, 30 patients (23.62%) had hypotension whereas in Group II, 119 patients (100%) had hypotension. The episodes of hypotension were significantly lower in Group I as compared to Group II (p<0.001). The dose of mephentermine (p<0.001) used was also significantly lower in Group I as compared to Group II. Therefore, we concluded that a baseline PI>3.5 is a prediction of hypotension following spinal anesthesia in patients undergoing cesarean section.
{"title":"The Usefulness of Perfusion Index Derived from a Pulse Oximeter in Predicting Hypotension following Spinal Anesthesia for Cesarean Section","authors":"C. Thapa, G. R. Bajracharya, Samyukta Acharya, Aarati Thakur","doi":"10.3126/nmcj.v24i4.50579","DOIUrl":"https://doi.org/10.3126/nmcj.v24i4.50579","url":null,"abstract":"Hypotension is a frequent complication of spinal anesthesia. Decrease in peripheral vascular tone that occurs during pregnancy is one of the factors causing hypotension in patients undergoing cesarean section under spinal anesthesia. Perfusion index derived from pulse oximeter can be an easy and non-invasive measure of peripheral perfusion. This study was conducted to test the usefulness of pulse oximeter in predicting hypotension following spinal anesthesia for cesarean section. In this study, 247 parturients undergoing elective cesarean section under spinal anesthesia were included. Parturients who had baseline PI<3.5 were kept in Group I and parturients who had baseline PI>3.5 were kept in Group II. All the patients were given 0.5% bupivacaine heavy 2.2 ml for spinal anesthesia. In group I, 30 patients (23.62%) had hypotension whereas in Group II, 119 patients (100%) had hypotension. The episodes of hypotension were significantly lower in Group I as compared to Group II (p<0.001). The dose of mephentermine (p<0.001) used was also significantly lower in Group I as compared to Group II. Therefore, we concluded that a baseline PI>3.5 is a prediction of hypotension following spinal anesthesia in patients undergoing cesarean section.","PeriodicalId":87122,"journal":{"name":"Nepal Medical College journal : NMCJ","volume":"1 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-12-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"69323774","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}
Pub Date : 2022-12-23DOI: 10.3126/nmcj.v24i4.50578
S. A. Manandhar, T. Pramanik, M. Amatya, V. Silvanus
The cyclical variation of ovarian hormones during the menstrual cycle has been implicated as the causative factor for many psychological and physical symptoms referred as premenstrual syndrome (PMS) causing varying degree of stress in females. This study is aimed to find out whether premenstrual stress might cause any alteration in the visual reaction time (VRT) in pre-menstrual and post-menstrual phase. Reaction time is an efficient non-invasive tool to evaluate the sensorimotor efficacy of a person. A cross sectional observational study was carried out in consenting and regularly menstruating 86 undergraduate medical and dental students of age ranging from 18-22 years, for a study period of April 2022 to June 2022. PMS was screened by using the PSST (premenstrual symptoms screening tool) to evaluate the incidence of PMS and the degree of premenstrual stress among the participants. All the participants showed some degree of PMS with 53.4% showing mild and 46.5% showing moderate to severe symptoms while none showed premenstrual dysphoric disorder (PMDD). A significant difference in body weight and visual reaction time (P<0.0001) was observed between the premenstrual phase and postmenstrual phase (54.6 ± 7.23 kg Vs 54.2 ± 7.24 kg and 0.959 ± 0.271ms vs 0.811 ± 0.138ms, respectively) irrespective of the PMS degree. The results indicate that premenstrual stress do affect the sensorimotor efficacy in females having PMS.
月经周期中卵巢激素的周期性变化被认为是许多心理和身体症状的诱因，这些症状被称为经前综合征（PMS），会导致女性不同程度的压力。本研究旨在了解经前压力是否会导致月经前和月经后视觉反应时间（VRT）的任何变化。反应时间是一种有效的非侵入性工具，用于评估一个人的感觉运动疗效。在2022年4月至2022年6月的研究期间，对86名年龄在18-22岁之间的医学和牙科本科生进行了一项横断面观察性研究。使用PSST（经前症状筛查工具）对经前综合症进行筛查，以评估参与者中经前综合症的发生率和经前压力的程度。所有参与者都表现出一定程度的经前综合症，53.4%表现出轻度症状，46.5%表现出中度至重度症状，而没有人表现出经前烦躁不安（PMDD）。经前期和经后期的体重和视觉反应时间存在显著差异（P＜0.0001）（分别为54.6±7.23 kg Vs 54.2±7.24 kg和0.959±0.271ms Vs 0.811±0.138ms），与PMS程度无关。研究结果表明，经前应激确实会影响经前综合症女性的感觉运动效能。
{"title":"Effect of Premenstrual Stress on Reaction Time among Medical and Dental Students of a Medical College in Kathmandu, Nepal","authors":"S. A. Manandhar, T. Pramanik, M. Amatya, V. Silvanus","doi":"10.3126/nmcj.v24i4.50578","DOIUrl":"https://doi.org/10.3126/nmcj.v24i4.50578","url":null,"abstract":"The cyclical variation of ovarian hormones during the menstrual cycle has been implicated as the causative factor for many psychological and physical symptoms referred as premenstrual syndrome (PMS) causing varying degree of stress in females. This study is aimed to find out whether premenstrual stress might cause any alteration in the visual reaction time (VRT) in pre-menstrual and post-menstrual phase. Reaction time is an efficient non-invasive tool to evaluate the sensorimotor efficacy of a person. A cross sectional observational study was carried out in consenting and regularly menstruating 86 undergraduate medical and dental students of age ranging from 18-22 years, for a study period of April 2022 to June 2022. PMS was screened by using the PSST (premenstrual symptoms screening tool) to evaluate the incidence of PMS and the degree of premenstrual stress among the participants. All the participants showed some degree of PMS with 53.4% showing mild and 46.5% showing moderate to severe symptoms while none showed premenstrual dysphoric disorder (PMDD). A significant difference in body weight and visual reaction time (P<0.0001) was observed between the premenstrual phase and postmenstrual phase (54.6 ± 7.23 kg Vs 54.2 ± 7.24 kg and 0.959 ± 0.271ms vs 0.811 ± 0.138ms, respectively) irrespective of the PMS degree. The results indicate that premenstrual stress do affect the sensorimotor efficacy in females having PMS.","PeriodicalId":87122,"journal":{"name":"Nepal Medical College journal : NMCJ","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-12-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41870777","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}
Pub Date : 2022-12-23DOI: 10.3126/nmcj.v24i4.50577
B. Katwal, N. Gautam, Sujata Shrestha, Lushan Singh, R. Gautam, Rojan Adhikari, H. Baral, S. Jha, Goody Jha
In present scenario, nephrolithiasis (renal stones) are more prevalent and highly related with morbidity worldwide. The aim of the study is to associate different biochemical and hemodynamic parameters of renal stones and to see post-operative outcomes. Hundred patients from January 2019 to January 2021 having renal stone in ultrasonography at Shahid Dharmbhakta National Transplant Centre Bhaktapur are included in the study. All variables are measured following the standard protocol. Nephrolithiasis was found to be frequent in male population (60%) who has a habit of regular alcohol intake (65%, p=0.009) and mixed dietary habit (mostly non-vegetarians) (92%, p= 0.042). Calcium oxalate either solely (21%) or mixed type (41%) were higher in proportion. The most common dyslipidemia in recurrent cases were hypercholesterolemia and increased LDL (p<0.001). The significant increase in serum urea (p=0.006) and creatinine (p=0.004) signify decrease in eGFR (p=0.007). Serum creatinine with IQR (1-2.5 mg/dl) was noticed significantly higher in others stone group V in contrast to mixed calcium containing stones group IV. Hydronephrosis was seen in 96% of patient, 7% developed post-operative complication comprising 57% haematuria, 28.5% wound infection and 14.5 % chest infection. Biochemical and hemodynamic parameters should be incorporated in nephrolithiasis to rule out risk of dyslipidemia, chronic kidney disorder and stratify the risk group based on stone composition.
{"title":"Biochemical and Hemodynamic Characterization of Nephrolithiasis Patients visiting National Transplant Centre, Bhaktapur, Nepal","authors":"B. Katwal, N. Gautam, Sujata Shrestha, Lushan Singh, R. Gautam, Rojan Adhikari, H. Baral, S. Jha, Goody Jha","doi":"10.3126/nmcj.v24i4.50577","DOIUrl":"https://doi.org/10.3126/nmcj.v24i4.50577","url":null,"abstract":"In present scenario, nephrolithiasis (renal stones) are more prevalent and highly related with morbidity worldwide. The aim of the study is to associate different biochemical and hemodynamic parameters of renal stones and to see post-operative outcomes. Hundred patients from January 2019 to January 2021 having renal stone in ultrasonography at Shahid Dharmbhakta National Transplant Centre Bhaktapur are included in the study. All variables are measured following the standard protocol. Nephrolithiasis was found to be frequent in male population (60%) who has a habit of regular alcohol intake (65%, p=0.009) and mixed dietary habit (mostly non-vegetarians) (92%, p= 0.042). Calcium oxalate either solely (21%) or mixed type (41%) were higher in proportion. The most common dyslipidemia in recurrent cases were hypercholesterolemia and increased LDL (p<0.001). The significant increase in serum urea (p=0.006) and creatinine (p=0.004) signify decrease in eGFR (p=0.007). Serum creatinine with IQR (1-2.5 mg/dl) was noticed significantly higher in others stone group V in contrast to mixed calcium containing stones group IV. Hydronephrosis was seen in 96% of patient, 7% developed post-operative complication comprising 57% haematuria, 28.5% wound infection and 14.5 % chest infection. Biochemical and hemodynamic parameters should be incorporated in nephrolithiasis to rule out risk of dyslipidemia, chronic kidney disorder and stratify the risk group based on stone composition.","PeriodicalId":87122,"journal":{"name":"Nepal Medical College journal : NMCJ","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-12-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42241809","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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