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Kamar SB, Pandey H, Puri S, Shahi R, Bhatta U, Khadka S, Yadav GK, Subedi P, Amgain K. Serum iron Profile of Patients with Sickle Cell Disease and its Association with Socio-demographic Characteristics and Duration of Diagnosis. J Nepal Health Res Counc 2024; 21:550-556. [PMID: 38616582 DOI: 10.33314/jnhrc.v21i4.4716] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Received: 04/05/2023] [Accepted: 03/31/2024] [Indexed: 04/16/2024]
Abstract
BACKGROUND Sickle cell anemia is the most common hemoglobinopathy in the world. The study aimed to evaluate the iron profile and its association with socio-demographic characteristics in patients with sickle cell disease. METHODS A hospital-based descriptive cross-sectional study was conducted to know the iron profile and its socio-demographic association in patients with sickle cell disease. RESULTS The average serum iron, TIBC, and transferrin saturation were 16.75 ± 6.40 mcgMole/L, 69.46 ± 16.94 mcg/dl and 25.15 ± 12.51% respectively. The serum ferritin ranged from 10.00 to 3000.00 ng/ml. The proportion of participants with normal serum iron, TIBC, serum ferritin, and transferrin saturation were 86.10%, 0.00%, 33.90% and 36.40% respectively. All of the participants of this study had low TIBC (1005), and more than half of the participants had elevated serum ferritin (56.40%). CONCLUSIONS Iron overload is a common complication of sickle cell disease. There was no association of age and sex with iron profile. The TIBC variation between the Chaudhary ethnic group compared to other ethnic groups signifies the ethnic role in the iron profile.
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Affiliation(s)
| | | | | | - Ramesh Shahi
- Department of Pathology, Seti Provincial Hospital
| | - Uttam Bhatta
- Department of Internal Medicine, Seti Provincial Hospital
| | | | | | - Prativa Subedi
- Department of Internal Medicine, KIST Medical College and Teaching Hospital, Lalitpur, Nepal
| | - Kapil Amgain
- Department of Clinical Anatomy, Karnali Academy of Health Sciences
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Kamar SB, Pandey H, Shahi R, Puri S, Yadav GK, Amgain K. Evaluation of SARS-CoV-2 Humoral Response Following Vaccination with ChAdOx1 nCoV-19 (Covishield™) and/or Sinopharm, BBIBP-CorV (Vero cell™). J Nepal Health Res Counc 2024; 21:523-529. [PMID: 38615227 DOI: 10.33314/jnhrc.v21i3.4634] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Received: 01/25/2023] [Accepted: 03/22/2024] [Indexed: 04/15/2024]
Abstract
BACKGROUND Billions of doses of COVID-19 vaccine have been introducing in the world to prevent pandemic COVID-19. Higher efficacy but limited data are available for its longevity. We aimed to find out the IgG Anti-SARS Cov-2 antibody level among frontline healthcare workers after two doses of vaccines. METHODS A cross-sectional study was carried among 170 HCPs of Seti Provincial Hospital of western Nepal, who were more than 18 years, and had taken two doses of either one of COVID 19 vaccine. All those participants, who were on leave during the data collection tenure (1st February 2022 to 28th February 2022) and/or did not consent to participate were excluded. Mindray SARS-CoV-2 S-RBD IgG assay kit based on CLIA method, was used whose target antigen is S-RBD (spike protein of receptor binding domain) antigen. The IgG immunoglobulin is detected and cut off value ≥10 AU/ml is considered positive. RESULTS Based on the recommended cut off, the antibody was present in more than 90% across both groups of vaccinee i.e. the positive antibody titer at a mean duration of 7.31 months was 93.53% overall (93.75% and 93.44% in Vero cell™ and Covishield™ vaccinees respectively). There were 3.92 times high odds of high antibody titer (≥250 AU/ml) in Covishield™ group (OR: 3.92, 95% CI: 1.86-8.26, P-value: <0.001) than in Vero cell™ group of vaccinee. Similarly, there were significant difference of high titer of antibody across groups with more than six months of elapse of vaccination (OR: 2.18, 95% CI: 1.06-4.49, P-value: <0.001) than with less than six months of elapse of vaccination. CONCLUSIONS The humoral response was higher among HCPs who received two-doses vaccination with ChAdOx1 nCoV-19 (Covishield™) and/or Sinopharm, BBIBP-CorV (Vero cell™) vaccine, and among those with six or more months of elapse of vaccination. The seroprevalence of SARS-CoV-2 following two-doses vaccination among HCPs was more than nine-tenths.
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Affiliation(s)
- Sher Bahadur Kamar
- Department of Internal Medicine, Seti Provincial Hospital, Kailali, Nepal
| | - Hemraj Pandey
- Department of Paediatrics, Seti Provincial Hospital, Kailali, Nepal
| | - Ramesh Shahi
- Department of Pathology, Seti Provincial Hospital, Kailali, Nepal
| | - Shurehraman Puri
- Department of Emergency Medicine, Seti Provincial Hospital, Kailali, Nepal
| | - Gopal Kumar Yadav
- Department of Internal Medicine, Narayani Hospital, Ministry of Health and Population, Birgunj, Nepal
| | - Kapil Amgain
- Department of Anatomy and Cell Biology, Karnali Academy of Health Science, Jumla, Nepal
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Bhattarai AM, Gurung S, Adhikari A, Karki S, Pathak BD, Regmi B, Khadka M, Yadav GK, Basnet S. Prevalence and clinical characteristics of hyperuricemia among patients with chronic kidney disease under haemodialysis in a tertiary care center: a cross-sectional study. Ann Med Surg (Lond) 2024; 86:1329-1334. [PMID: 38463060 PMCID: PMC10923382 DOI: 10.1097/ms9.0000000000001731] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2023] [Accepted: 01/08/2024] [Indexed: 03/12/2024] Open
Abstract
Background Hyperuricemia is common in chronic kidney disease patients. This study aimed to investigate the prevalence and clinical characteristics of hyperuricemia in patients with chronic kidney disease undergoing haemodialysis. Materials and methods This cross-sectional study was conducted among 104 patients with chronic kidney disease who visited the haemodialysis unit of a tertiary centre hospital from 11 September 2022, to 11 November 2022. A convenience sampling technique was used. The data were collected using a proforma form, entered into, and analyzed using the Statistical Package for Social Sciences version 21. Results The mean age group of the study participants was 54.02 ± 14.03 years, and around two-thirds were male (n=70, 67.3%). Almost half of the participants (50, 48.07%) had hyperuricemia with a mean uric acid level of 6.76 ± 2.62 mg/dl. The majority of the participants had associated hypertension (n=100, 96.2%). More than three-fourths of the respondents (83, 79.8%) had haemoglobin levels below the target range. Conclusion Nearly half of the study participants had hyperuricemia.
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Affiliation(s)
| | | | | | | | | | - Bishal Regmi
- Nepalese Army Institute of Health Sciences, Kathmandu
| | - Manoj Khadka
- Nepalese Army Institute of Health Sciences, Kathmandu
| | | | - Somika Basnet
- Kist Medical College and Teaching Hospital, Lalitpur, Nepal
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Mahat A, Bhusal A, Yadav GK, Mishra U, Duwadi B, Katwal S. Left-sided acute appendicitis in a patient with situs inversus totalis: A case report and a comprehensive review. Radiol Case Rep 2024; 19:1020-1025. [PMID: 38226055 PMCID: PMC10788372 DOI: 10.1016/j.radcr.2023.11.073] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/25/2023] [Revised: 11/04/2023] [Accepted: 11/28/2023] [Indexed: 01/17/2024] Open
Abstract
AA is a frequent surgical condition that demands urgent intervention. It accounts for approximately 6% of all emergency department visits. Situs inversus is a rare condition in which the orientation of asymmetric organs is a mirror image of normal anatomy. It can be partial (involving either the abdominal or thoracic cavities) or complete (situs inversus totalis: transposition of both abdominal and thoracic organs). SIT is very rare, with an incidence of 1 per 5000 to 10,000 live births. It is inherited in an autosomal recessive pattern with incomplete penetrance. LSAA is very rare and can happen in association with other congenital abnormalities such as situs inversus, midgut malrotation (MM), or a usually long right-sided appendix projecting into the left lower quadrant. SIT is responsible for greater than 67% of left-sided appendicitis cases. Due to atypical clinical presentation, the diagnosis of AA can be difficult and often delayed. Hence, a complete medical history, physical examination, laboratory tests, and imaging tools are necessary to reach a correct diagnosis in a timely manner and prevent complications like abscesses, perforations, and peritonitis. We report a case of a 50-year-old male with symptoms of left lower abdominal pain along with fever, nausea, vomiting, and loose stools that were later diagnosed as LSAA in the setting of SIT.
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Affiliation(s)
- Asim Mahat
- Department of Radiodiagnosis and Imaging, Nepalese Army Institute of Health Sciences, Kathmandu, Nepal
| | - Amrit Bhusal
- Department of Radio-diagnostics and Imaging, BP Koirala Institute of Health Sciences (BPKIHS), Dharan, Sunsari, Nepal
| | - Gopal Kumar Yadav
- Department of Radio-diagnostics and Imaging, BP Koirala Institute of Health Sciences (BPKIHS), Dharan, Sunsari, Nepal
| | - Upama Mishra
- Department of Obstetrics and Gynaecology, BP Koirala Institute of Health Sciences (BPKIHS), Dharan, Sunsari, Nepal
| | - Bikash Duwadi
- Department of Radiodiagnosis and Imaging, Nepalese Army Institute of Health Sciences, Kathmandu, Nepal
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Mahat A, Yadav GK, Mishra U, Mehta B. Mountainous terrain of Nepal and lack of trauma radiography: A fatal duo. Radiography (Lond) 2023; 29:1068-1069. [PMID: 37748381 DOI: 10.1016/j.radi.2023.09.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2023] [Accepted: 09/08/2023] [Indexed: 09/27/2023]
Affiliation(s)
- A Mahat
- Faxton St. Luke's Healthcare- Mohawk Valley Health System, Utica, New York, USA.
| | - G K Yadav
- Department of Radiodiagnosis and Imaging, B.P. Koirala Institute of Health Sciences, Dharan, Nepal
| | - U Mishra
- Department of Obstetrics and Gynaecology, B.P. Koirala Institute of Health Sciences, Dharan, Nepal
| | - B Mehta
- Department of Internal Medicine, B.P. Koirala Institute of Health Sciences, Dharan, Nepal
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Subedi B, Yadav GK, Raut A, Joshi N, Subedi BK, Joshi N, Neupane RP, Bhandari V, Maharjan RK, Acharya RP. The relationship of serum amylase levels in acute organophosphorus poisoning with its clinical severity and outcome: a cross-sectional study. Ann Med Surg (Lond) 2023; 85:778-782. [PMID: 37113851 PMCID: PMC10129235 DOI: 10.1097/ms9.0000000000000433] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2022] [Accepted: 03/12/2023] [Indexed: 04/29/2023] Open
Abstract
There are limited literatures studying the pancreatic involvement in organophosphate (OP) poisoning using biochemical means. This study focused on assessing the type of OP poisoning and determining the association of serum amylase levels with the patient's presentation and outcome. Materials and methods A cross-sectional study was carried out in the Maharajgunj Medical Campus, Tribhuwan University Teaching Hospital, Kathmandu, Nepal, after ethical approval [Ref: IRB/308 (6-11-E)]. We collected data from 172 participants with OP poisoning over the period of 2 years using nonprobability purposive sampling method. All patients with age group 16-75 years having a history of OP poisoning within the previous 24 h with clinical features and physical evidence of poisoning were included in the study. Those participants with indications of exposure to an entirely different poisons, poisoning with multiple poisons, OP poisoning along with alcohol, chronic alcoholics, comorbid conditions, taking drugs that could affect serum amylase levels (azathioprine, thiazides, furosemide, etc.), and/or treated in other hospitals after poisoning were excluded from the study. Appropriate statistical calculations were made using the statistical package for social sciences (SPSS), version 21. The P-value of less than 0.05 was considered statistically significant. Results Metacid (53.5%, 92) was the most common OP poison. There were significantly higher mean values of serum amylase levels either within 12 h of exposure (468.60 vs. 135.4 IU/ml, P<0.001) or after 12 h of exposure (152.0 vs. 58.9 IU/ml, P<0.001) in dead participants than alive ones. The participants with initial and after 12 h of exposure-serum amylase level 100 or more IU/ml had more than two-fold and 18-fold higher odds of severe/life-threatening severity (odds ratio=2.40, 95% CI: 1.28-4.52, P=0.007 and odds ratio=18.67, 95% CI: 8.02-43.47, P<0.001) respectively than those with less than 100 IU/ml. Conclusions The clinical severity of OP poisoning is directly related to serum amylase levels. Importantly, higher mean values of serum amylase levels were depicted in those participants with OP poisoning culminating to death. Thus, serum amylase level could be one of the easy measurable prognostic marker of OP poisonings.
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Affiliation(s)
| | | | - Amar Raut
- Department of Emergency Medicine, Kakani Primary Health Care Center, Nuwakot, Nepal
- Corresponding author. Address: Department of Emergency Medicine, Kakani Primary Health Care Center, Nuwakot, Nepal 44900. Tel.: +9779841154581. E-mail address: (A. Raut)
| | - Nisha Joshi
- Departments of General Practice and Emergency Medicine
| | | | - Nimesh Joshi
- Departments of General Practice and Emergency Medicine
| | | | - Ved Bhandari
- Maharajgunj Medical Campus, Tribhuwan University Teaching Hospital, Kathmandu
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Khadka S, Neupane G, Yadav GK, Sharma A, Giri S, Amgain K, Bhushal A, Basnet B. Assessment of Understanding and Practices of Community Pharmacy Personnel to Tackle COVID-19 Pandemic. J Nepal Health Res Counc 2023; 20:739-745. [PMID: 36974867 DOI: 10.33314/jnhrc.v20i3.4388] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Received: 07/29/2022] [Accepted: 03/10/2023] [Indexed: 06/18/2023]
Abstract
BACKGROUND The skill, accessibility, and knowledge of community pharmacists have been paramount in managing pandemics. This study was conducted to assess the knowledge, attitude, and practice of community pharmacy personnel towards tackling COVID-19 pandemic which might help concerned authorities to take effective actions to eliminate the gaps for the management of such pandemic in an efficient way. METHODS A cross-sectional study was conducted among 428 community pharmacy personnel from different community pharmacies in Kathmandu, Nepal from December 2021 to February 2022. Statistical analysis was done through SPSS® v21 and MedCalc for Windows v12.3.0. RESULTS Most of the participants (42.76%) had certificate-level degrees in their respective fields and one to five years of working experience (48.84%). Only 29.67% of the respondents had good knowledge towards tackling COVID-19, whereas good attitude and practice were demonstrated by 59.11% and 42.29% respectively. The participants with higher degrees and more working experience had better knowledge, attitude, and practice. Education level bachelor and above was independent predictor of good knowledge (OR 20.69, 95% CI 11.30-37.90). Knowledge and practice (Spearman's rho: 0.135; P ≤0.005) and attitude and practice (Spearman's rho: 0.095; P = 0.049) scores were positively correlated. CONCLUSIONS The significant association of community pharmacy personnel's educational level with knowledge, attitude, and practices demands the necessity of policy-making bodies' involvement for the mandatory presence of well-qualified pharmacists and regular training at the community pharmacy level. Furthermore, it is high time to reinforce the drug regulatory acts, regulations, and codes all over the nation.
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Affiliation(s)
- Sitaram Khadka
- Nepalese Army Institute of Health Sciences, Kathmandu, Nepal
| | - Gyata Neupane
- Nepalese Army Institute of Health Sciences, Kathmandu, Nepal
| | | | - Arun Sharma
- Nepalese Army Institute of Health Sciences, Kathmandu, Nepal
| | - Santoshi Giri
- Nepal Public Health Research and Development Center, Kathmandu, Nepal
| | - Kapil Amgain
- Karnali Academy of Health Sciences, Jumla, Nepal
| | - Arjun Bhushal
- Nepalese Army Institute of Health Sciences, Kathmandu, Nepal
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Yadav GK, Paudel B, Chaudhary AP, Mahato G, Pyakurel P. Low Birth Weight among Deliveries, and Adolescent and Advanced Maternal Age Pregnancy. J Nepal Health Res Counc 2023; 20:653-658. [PMID: 36974852 DOI: 10.33314/jnhrc.v20i3.3774] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Received: 08/11/2021] [Accepted: 03/09/2023] [Indexed: 06/18/2023]
Abstract
BACKGROUND We did this study to evaluate the prevalence of low birth weight among deliveries, adolescent pregnancy and advanced maternal age pregnancy. We also assessed the factors affecting the low birth weight among institutional deliveries at the level of primary hospital. METHODS A hospital-based retrospective cross-sectional study was done in Grahun Primary Hospital of Syangja, Nepal using data maintained in register book over last five years. We excluded all those deliveries with multiple pregnancy and incomplete records, and included 2473 participants in final analysis using convenient sampling. The relevant information was filled up in Microsoft Excel 2019 v16.0 and descriptive and inferential statistics was calculated using statistical package for social sciences, IBM SPSS® v21 (IBM, Armonk, New York). RESULTS The prevalence of low birth weight at Grahun Primary Hospital was 11.08%. The prevalence of adolescent pregnancy and advanced maternal age pregnancy was 18.03% and 02.18% respectively. Male newborns had significantly higher mean birth weight as compared to the female newborns (3101.48 ± 506.60 v/s 2967.53 ± 484.97, P-value <0.001). Female newborns had higher odds of low birth weight as compared to those male newborns (11.99% v/s 8.29%, AOR=1.56, 95% CI= 1.17-2.07). Pregnant women with lower gestational age (<37 weeks or preterm) had a higher odds of low birth weight as compared to pregnant women with normal gestational age (37-42 weeks) (AOR = 11.59, 95% CI 8.49-15.83). CONCLUSIONS The low birth weight depends upon gestational age of mother and gender of newborn. Local organizations should work to bring down low birth weight, and adolescent pregnancy and advanced maternal age pregnancy of mother.
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Affiliation(s)
- Gopal Kumar Yadav
- Department of Internal Medicine, Kalaiya District Hospital, Bara, Nepal
| | - Binod Paudel
- Department of Internal Medicine, Grahun Primary Hospital, Syangja, Nepal
| | | | - Gaurav Mahato
- Department of Internal Medicine, Kalaiya District Hospital, Bara, Nepal
| | - Prajjwal Pyakurel
- School of Public health and Community Medicine, BP Koirala Institute of Health Sciences, Sunsari, Nepal
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Joshi R, Subedi P, Yadav GK, Khadka S, Rijal T, Amgain K, Rajbhandari S. Prevalence and risk factors of chronic kidney disease among patients with type 2 diabetes mellitus at a tertiary care hospital in Nepal: a cross-sectional study. BMJ Open 2023; 13:e067238. [PMID: 36854582 PMCID: PMC9980322 DOI: 10.1136/bmjopen-2022-067238] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 03/02/2023] Open
Abstract
OBJECTIVE To estimate the prevalence of chronic kidney disease (CKD) among patients with type 2 diabetes mellitus (T2DM) and determine the sociodemographic and clinical risk factors associated with CKD. DESIGN AND SETTINGS Cross-sectional study among diabetic outpatients of a tertiary hospital in Nepal. PARTICIPANTS 201 patients with T2DM above 18 years of age. INTERVENTION Participants completed a questionnaire regarding their socioeconomic information and underwent pertinent physical and haematological examinations. PRIMARY AND SECONDARY OUTCOMES MEASURE The prevalence and risk factors of CKD among patients with T2DM. RESULTS The prevalence of CKD in T2DM was 86.6%. In univariable analysis, the variables like age (p=0.026), hypertension status (p=0.002), duration of diabetes (p=0.009) and haemoglobin levels (p=0.027) were significantly associated with CKD among the participants with T2DM. Kruskal-Wallis H test showed that age was significantly different between various CKD stages. Multivariate analysis demonstrated a significant relationship between CKD with age (Adjusted odds ratio (AOR) 3, 95% CI 1.1 to 8.8) and literacy status (AOR 5.8, 95% CI 1.4 to 24.6) CONCLUSION: Advancing age, concomitant hypertension, increasing duration of T2DM and presence of anaemia were found to be important risk factors of CKD. Age is the most important predictor of CKD showing increasing prevalence in the elderly population. Periodic screening tests are essential at an early age to identify kidney diseases at incipient stages, thereby preventing progression to end-stage renal disease.
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Affiliation(s)
- Rinku Joshi
- Department of Internal Medicine, Shree Birendra Hospital; Nepalese Army Institute of Health Sciences, Kathmandu, Nepal
| | - Prativa Subedi
- Department of Emergency Medicine and General Practice, Rolpa District Hospital, Rolpa, Nepal
| | - Gopal Kumar Yadav
- Department of Internal Medicine, BP Koirala Institute of Health Sciences, Dharan, Nepal
| | - Sitaram Khadka
- Department of Pharmacy, Shree Birendra Hospital; Nepalese Army Institute of Health Sciences, Kathmandu, Nepal
| | - Thaneshwar Rijal
- Department of Anesthesia, Shree Birendra Hospital; Nepalese Army Institute of Health Sciences, Kathmandu, Nepal
| | - Kapil Amgain
- Department of Human Anatomy and Cell Biology, Karnali Academy of Health Sciences, Jumla, Nepal
| | - Sabin Rajbhandari
- Department of Internal Medicine, Shree Birendra Hospital; Nepalese Army Institute of Health Sciences, Kathmandu, Nepal
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Rai S, Gautam S, Yadav GK, Niraula SR, Singh SB, Rai R, Poudel S, Sah RB. Catastrophic health expenditure on chronic non-communicable diseases among elder population: A cross-sectional study from a sub-metropolitan city of Eastern Nepal. PLoS One 2022; 17:e0279212. [PMID: 36512634 PMCID: PMC9747046 DOI: 10.1371/journal.pone.0279212] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2022] [Accepted: 12/02/2022] [Indexed: 12/15/2022] Open
Abstract
INTRODUCTION This study was conducted with the objective to analyze the out-of-pocket (OOP) healthcare expenditure and catastrophic healthcare expenditure (CHE) on chronic non-communicable diseases (CNCD) among the elderly population, and the association of CHE on CNCD with associated factors among the same population. MATERIALS AND METHODS We collected data from the elderly population of Dharan Sub-metropolitan city of the Eastern Nepal via door-to-door survey and face-to-face interview. The ten wards out of twenty were chosen by lottery method, and the equal proportion out of 280 samples was purposively chosen from each of ten wards (28 participants from each selected ward). The data were entered in Microsoft Excel 2019 v16.0 and statistical analysis was performed by using statistical package for social sciences, IBM SPSS® v21. The chi-square test was used to test the group differences. Multivariable logistic regression was used to determine independent factors associated with CHE (all variables with P < 0.20), and adjusted odds ratios (AOR) were calculated at 95% confidence interval (CI). RESULTS The median household, food and health expenditures were 95325 (72112.50-126262.50), 45000 (33000-60000) and 2100 (885.00-6107.50) NPR respectively. The proportion of the participants with CHE was 14.6%. The single living participants had 3.4 times higher odds of catastrophic health expenditure (AOR = 3.4, 95% CI = 1.2-9.6, P-value = 0.022) than those who are married. Similarly, those who had cancer had 0.1 times lower odds of CHE (AOR = 0.1, 95% CI = 0.0-0.2, P-value = <0.001) than those without cancer. CONCLUSION The elder population had significant financial health shocks due to chronic health ailments. There should be the provision of mandatory health insurance programmes for elderly to cut down the catastrophic healthcare expenditure. Similarly, there should be the provision of exemption scheme for vulnerable elderly who are more likely to face catastrophic expenditure from all available health facilities.
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Affiliation(s)
- Sangita Rai
- School of Public Health and Community Medicine, B. P. Koirala Institute of Health Sciences, Dharan, Nepal
- Ministry of Health, Biratnagar, Nepal
- * E-mail:
| | - Swotantra Gautam
- Department of Internal Medicine, Advent Health, Orlando, Florida, United States of America
| | - Gopal Kumar Yadav
- Department of Internal Medicine, B. P. Koirala Institute of Health Sciences, Dharan, Nepal
- Ministry of Health and Population, Amphipath, Kathmandu, Nepal
| | - Surya Raj Niraula
- School of Public Health and Community Medicine, B. P. Koirala Institute of Health Sciences, Dharan, Nepal
| | - Suman Bahadur Singh
- School of Public Health and Community Medicine, B. P. Koirala Institute of Health Sciences, Dharan, Nepal
| | - Rajan Rai
- Department of Anaesthesiology and Critical Care, Koshi Hospital, Biratnagar, Nepal
| | - Sagar Poudel
- Department of Community Medicine, All India Institute of Medical Sciences, New Delhi, India
| | - Ram Bilakshan Sah
- School of Public Health and Community Medicine, B. P. Koirala Institute of Health Sciences, Dharan, Nepal
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Bhattarai B, Panthi S, Yadav GK, Gautam S, Acharya R, Neupane D, Khanal N, Khatri B, Neupane K, Adhikari S, Lageju N, Basnet LB, Pyakurel P, Yadav SP. Association of geographic distribution and birth weight with sociodemographic factors of the maternal and newborn child of hilly and mountain regions of eastern Nepal: a cross-sectional study. BMJ Paediatr Open 2022; 6:10.1136/bmjpo-2022-001579. [PMID: 36645745 PMCID: PMC9716932 DOI: 10.1136/bmjpo-2022-001579] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/18/2022] [Accepted: 11/18/2022] [Indexed: 12/05/2022] Open
Abstract
OBJECTIVES To determine the association of geographic distribution, and birth weight with sociodemographic factors of the maternal and newborn child of hilly region (lower altitude) and mountain region (high altitude) of eastern Nepal as well as the prevalence of low birth weight (LBW) and large for gestational age (LGA) among term singleton deliveries in eastern Nepal. METHODOLOGY A cross-sectional study was conducted in the district-level hospitals of Dhankuta, Tehrathum, Solukhumbu and Taplejung districts of eastern Nepal of Province 1. Mothers with preterm or post-term delivery, multiple pregnancies, stillbirth/intrauterine fetal death and incomplete records were excluded from the study with only 1386 term pregnancies (37-42 weeks) delivered at the respective facilities between 17 July 2019 and 16 July 2020 were included. The appropriate data were entered in Microsoft Excel 2019 V.16.0 and statistical analysis was performed by using the statistical package for social sciences, IBM SPSS V.29. RESULTS The low maternal age, Dalit ethnic group, low gravidity, low parity, higher antenatal care (ANC) visits (≥4), incomplete deworming and dT vaccination status, breech deliveries and LBW newborns were significantly attributed to hilly region (lower altitude) (p value <0.05). Similarly, the hilly region, lower and/or no ANC visits and early term gestation had significant negative association with birth weight at the lower quantiles only. Meanwhile, the female newborn had significant and negative association with birth weight distribution at all seven quantiles. The prevalence of the LBW, average for gestational age and LGA newborn child among term singleton deliveries in Eastern Nepal is 6.6%, 85.8% and 7.6%, respectively. CONCLUSIONS The local organisations should focus on adequate antenatal care visits in mountain region and coverage of dT vaccine and deworming medications in hilly region. Appropriate measures and programmes should be initiated to bring down LBW in hilly region.
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Affiliation(s)
- Bharosha Bhattarai
- Department of Pediatrics and Adolescent Medicine, BP Koirala Institute of Health Sciences, Dharan, Nepal
| | - Sagar Panthi
- Department of Pediatrics and Adolescent Medicine, BP Koirala Institute of Health Sciences, Dharan, Nepal
| | - Gopal Kumar Yadav
- Department of Pediatrics and Adolescent Medicine, BP Koirala Institute of Health Sciences, Dharan, Nepal
| | - Swotantra Gautam
- Department of Internal Medicine, Advent Health, Orlando, Florida, USA
| | - Rochana Acharya
- Department of Pediatrics and Adolescent Medicine, BP Koirala Institute of Health Sciences, Dharan, Nepal
| | - Durga Neupane
- Department of Pediatrics and Adolescent Medicine, BP Koirala Institute of Health Sciences, Dharan, Nepal
| | - Nimesh Khanal
- Department of Internal Medicine, Tower Health Reading Hospital, Reading, Pennsylvania, USA
| | - Bharat Khatri
- Department of Pediatrics and Adolescent Medicine, BP Koirala Institute of Health Sciences, Dharan, Nepal
| | - Krishna Neupane
- Department of Pediatrics and Adolescent Medicine, BP Koirala Institute of Health Sciences, Dharan, Nepal
| | - Sugat Adhikari
- Department of Pediatrics and Adolescent Medicine, BP Koirala Institute of Health Sciences, Dharan, Nepal
| | - Nimesh Lageju
- Department of Pediatrics and Adolescent Medicine, BP Koirala Institute of Health Sciences, Dharan, Nepal
| | - Lila Bahadur Basnet
- Curative Service Division, Ministry of Health and Population, Department of Health Services, Kathmandu, Nepal
| | - Prajjwal Pyakurel
- School of Public Health and Community Medicine, BP Koirala Institute of Health Sciences, Dharan, Nepal
| | - Shankar Prasad Yadav
- Department of Pediatrics and Adolescent Medicine, BP Koirala Institute of Health Sciences, Dharan, Nepal
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Shrestha DB, Budhathoki P, Gurung B, Subedi S, Aryal S, Basukala A, Aryal B, Adhikari A, Poudel A, Yadav GK, Khoury M, Rayamajhee B, Shrestha LB. Epidemiology of dengue in SAARC territory: a systematic review and meta-analysis. Parasit Vectors 2022; 15:389. [PMID: 36280877 PMCID: PMC9594905 DOI: 10.1186/s13071-022-05409-1] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2022] [Accepted: 07/13/2022] [Indexed: 11/27/2022] Open
Abstract
BACKGROUND Dengue is one of the common arboviral infections and is a public health problem in South East Asia. The aim of this systematic review and meta-analysis was to evaluate the prevalence and distribution of dengue in SAARC (South Asian Association for Regional Cooperation) countries. METHODS The PubMed, PubMed Central, Embase and Scopus databases were searched for relevant studies. Statistical analysis on data extracted from the selected studied was conducted using the Comprehensive Meta-Analysis Software (CMA) version 3 software package. Proportions were used to estimate the outcome with a 95% confidence interval (CI). RESULTS Across all studies, among cases of suspected dengue, 30.7% were confirmed dengue cases (proportion: 0.307, 95% CI: 0.277-0.339). The seroprevalence of dengue immunoglobulin (Ig)G, IgM or both (IgM and IgG) antibodies and dengue NS1 antigen was 34.6, 34.2, 29.0 and 24.1%, respectively. Among the different strains of dengue, dengue virus (DENV) strains DENV-1, DENV-2, DENV-3 and DENV-4 accounted for 21.8, 41.2, 14.7 and 6.3% of cases, respectively. The prevalence of dengue fever, dengue hemorrhagic fever and dengue shock syndrome was 80.5, 18.2 and 1.5%, respectively. Fever was a commonly reported symptom, and thrombocytopenia was present in 44.7% of cases. Mortality was reported in 1.9% of dengue cases. CONCLUSIONS Dengue is a common health problem in South East Asia with high seroprevalence. DENV-2 was found to be the most common strain causing infection, and most dengue cases were dengue fever. In addition, thrombocytopenia was reported in almost half of the dengue cases.
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Affiliation(s)
| | | | | | | | | | - Anisha Basukala
- Nepalese Army Institute of Health Sciences, Kathmandu, Nepal
| | - Barun Aryal
- Department of Emergency Medicine, Patan Academy of Health Sciences, Lalitpur, Nepal
| | - Anurag Adhikari
- Department of Emergency Medicine, Nepal National Hospital, Kathmandu, Nepal
| | - Ayusha Poudel
- Department of Emergency Medicine, Alka Hospital, Kathmandu, Nepal
| | | | - Mtanis Khoury
- Department of Internal Medicine, Mount Sinai Hospital, Chicago, IL USA
| | - Binod Rayamajhee
- School of Optometry & Vision Science, Faculty of Medicine and Health, University of New South Wales, Sydney, Australia
- Department of Infection and Immunology, Kathmandu Research Institute for Biological Sciences (KRIBS), Lalitpur, Nepal
| | - Lok Bahadur Shrestha
- Department of Microbiology & Infectious Diseases, B. P. Koirala Institute of Health Sciences, Dharan, 56700 Nepal
- School of Medical Sciences and the Kirby Institute, University of New South Wales, Sydney, Australia
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Mandal S, Baniya S, Rohita DK, Yadav GK, Lowry P. A case report on non-metastatic Ewing sarcoma of the lumbar spine in a young patient. Cancer Rep (Hoboken) 2022; 5:e1725. [PMID: 36193025 PMCID: PMC9675370 DOI: 10.1002/cnr2.1725] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2022] [Revised: 09/04/2022] [Accepted: 09/14/2022] [Indexed: 11/06/2022] Open
Abstract
BACKGROUND Ewing sarcoma (ES), the second most common malignant bone tumor after osteosarcoma in the second decade, occurs in 0.9% of cases as the primary non-sacral form. CASE A 20-years-old male presented with acute paraparesis of bilateral lower limb and numbness following initial back pain for the last 6 months. Magnetic resonance imaging (MRI) of the lumbar spine revealed a 4 cm enhancing soft tissue mass at the L4/L5 vertebra extending into the spinal canal with compression of the thecal sac. The computed tomography (CT) of the chest, abdomen, and pelvis revealed aggressive lytic lesions in the L4 spinous process with soft tissue extension into the spinal canal with no other site of distant metastasis. He was treated with IV steroids (Injection dexamethasone 10 mg IV followed by 4 mg tablet dexamethasone q6h; subsequently tapered off). A core needle biopsy showed a small, round blue cell neoplasm, (suggestive of a primitive neuroectodermal) stained positive for CD99 and vimentin stain. The diagnosis of ES lumbar spine was made which was treated with surgical resection with an appropriate margin measuring 8 × 4.5 × 2.5 cm with decompression and L4/5 laminectomies, which had a negative margin in the surgical pathology report. Concomitant local radiotherapy and chemotherapy [cycles of vincristine 2 mg/m2 , adriamycin/doxorubicin 75 mg/m2 , cyclophosphamide 1200 mg/m2 (VDC) with mesna rescue alternating with cycles of ifosfamide 1800 mg/m2 and etoposide 100 mg/m2 (IE)] was started. The motor strength was regained gradually with preserved spine biomechanics and oncological control with no recurrence in 2-year follow-ups. CONCLUSIONS The presentation of lumbar ES can vary from local pain and swelling to acute paraparesis. Timely diagnosis and treatment with multimodal therapy, namely, steroids for acute spinal cord compression and surgery with chemoradiotherapy for ES can improve spinal biomechanics and oncological control.
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Affiliation(s)
- Shobha Mandal
- Department of Internal MedicineGuthrie Robert Packer HospitalSayrePennsylvaniaUSA
| | - Srijana Baniya
- Department of Internal MedicinePenn State College of MedicineHersheyPennsylvaniaUSA
| | - Dipesh Kumar Rohita
- Department of Internal MedicineBP Koirala Institute of Health SciencesDharanNepal
| | - Gopal Kumar Yadav
- Department of Internal MedicineBP Koirala Institute of Health SciencesDharanNepal
| | - Philip Lowry
- Department of Internal MedicineGuthrie Robert Packer HospitalSayrePennsylvaniaUSA
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Yadav GK, Keshari B, Rohita DK, Mandal KC, Bogati S, Mishra DR. A case report of secondary spontaneous pneumothorax in acute exacerbation of COPD managed with improvised chest tube drain. Ann Med Surg (Lond) 2022; 79:104064. [PMID: 35860074 PMCID: PMC9289406 DOI: 10.1016/j.amsu.2022.104064] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2022] [Revised: 06/19/2022] [Accepted: 06/21/2022] [Indexed: 11/26/2022] Open
Abstract
Introduction and importance: We reported a case of secondary spontaneous pneumothorax (SSP) in a 70-years-old male with acute exacerbation of COPD (AE COPD) managed with improvised chest tube drain (ICD). Case presentation He presented with sudden onset breathlessness and oxygen saturation of 78%. With prolonged expiration on auscultation, he was treated as AE COPD with oxygen therapy, nebulization with albuterol/ipratropium, and injectable antibiotics and steroids. The patient was not improving with treatment on third day, and non-critical respiratory distress continued. Considering the alternative diagnosis, the chest X-ray was done which revealed right sided spontaneous pneumothorax and COPD. Due to his reluctancy to go to higher center for chest tube insertion during ongoing COVID-19 pandemic, we inserted ICD (intravenous set put in saline bottle) at our primary care. Following drainage, breathlessness improved and saturation increased. Then inpatient symptomatic treatment for COPD was continued for three more days. He was discharged on inhalers after fifth day and asked for follow up after 10 days. He came after 1 month and on repeat chest X-ray, his right sided pneumothorax resolved completely and COPD was in control with inhaled medications. There was no recurrence of pneumothorax in five months follow up. Clinical discussion ICD is a safe, and an alternative option in resource limited setting. However, the guidelines recommend chest tube insertion as appropriate treatment. Conclusion This would remind the physicians to anticipate the alternative possibility, and to re-examine those with AE COPD who are not improving as expected with oxygen and nebulization therapy. High level of clinical acumen is required to early anticipate the spontaneous pneumothorax in acute exacerbation of COPD. We should be vigilant and re-examine the cases of acute exacerbation of COPD, not improving with oxygen and nebulization. Improvised chest drain is an alternative option for treating secondary spontaneous pneumothorax.
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Gautam S, Chamlagain M, Yadav GK, Acharya S. Once was not enough: A case report of the concomitant intoxication of amlodipine (calcium channel blocker) and clonazepam (benzodiazepine). Clin Case Rep 2022; 10:e6042. [PMID: 35846941 PMCID: PMC9272439 DOI: 10.1002/ccr3.6042] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2022] [Revised: 06/09/2022] [Accepted: 06/26/2022] [Indexed: 11/23/2022] Open
Abstract
We report a case of concurrent ingestion of Clonazepam and Amlodipine in a 25‐year‐old man, in a second attempt to take his life, which resulted in unconsciousness, hypotension, and hypokalemia. The clinical and/or biochemical presentation varied from the individual pattern when ingested. In the scarcity of consensus recommendations, supportive treatment helped. Supportive treatment is the rule of management of concomitant ingestion of Amlodipine and Clonazepam. The clinical and/or biochemical presentation of benzodiazepine and calcium channel blocker may vary from the individual pattern.
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Affiliation(s)
- Swotantra Gautam
- Department of Critical Care Medicine Nidan Hospital Lalitpur Nepal
| | | | - Gopal Kumar Yadav
- Department of Emergency Medicine Kakani Primary Health Care Centre Nuwakot Nepal
| | - Santosh Acharya
- Department of Anesthesiology and Critical Care Nidan Hospital Lalitpur Nepal
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Yadav GK, Rohita DK, Mandal KC, Paudel B, Devkot AR. An accidental emamectin benzoate poisoning in child: A case report. Clin Case Rep 2022; 10:e6133. [PMID: 35898734 PMCID: PMC9309617 DOI: 10.1002/ccr3.6133] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2022] [Revised: 07/08/2022] [Accepted: 07/13/2022] [Indexed: 11/11/2022] Open
Affiliation(s)
- Gopal Kumar Yadav
- Department of Internal Medicine Kalaiya District Hospital Bara Nepal
| | - Dipesh Kumar Rohita
- Department of Internal Medicine BP Koirala Institute of Health Sciences Dharan Nepal
| | | | - Binod Paudel
- Department of Emergency Medicine Grahun Primary Hospital Syangja Nepal
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Amgain K, Subedi P, Yadav GK, Neupane S, Khadka S, Sapkota SD. Association of Anthropometric Indices with Menstrual Abnormality among Nursing Students of Nepal: A Cross-Sectional Study. J Obes 2022; 2022:6755436. [PMID: 35342646 PMCID: PMC8956380 DOI: 10.1155/2022/6755436] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/07/2021] [Accepted: 03/04/2022] [Indexed: 12/02/2022] Open
Abstract
INTRODUCTION Obesity has been reported to be linked with menstrual abnormalities including abnormality in cycle length, duration, and period blood loss. However, which anthropometric parameter is a better marker of menstrual abnormality is yet unknown. This study aims to explore the association of BMI, waist-hip ratio (WHR), and waist-height ratio (WHtR) with menstrual abnormalities. METHODS This was a cross-sectional study conducted among 240 nursing students on two nursing campuses of Nepal. Demographic and menstrual characteristics related data were collected from the participants via the face-to-face interview technique followed by anthropometric measurements. Binary logistic regression was used to study the association of BMI, WHR, and WHtR with menstrual characteristics. Univariable and multivariable regression models were calculated at 95% confidence interval and a P value of 0.05 using a Statistical Package for Social Sciences, IBM SPSS® v21 (IBM, Armonk, New York). RESULTS Out of 240 participants, 52 participants (21.67%) were underweight (<18.5 kg/m2), and 47 participants (19.58%) were either overweight (≥23 kg/m2) or obese (≥25 kg/m2). Overweight and obese BMI was associated with abnormality in menstrual cycle length (AOR = 4.24; 95% CI = 1.77-10.17), duration of the menstrual period (AOR = 2.52; 95% CI = 1.09-5.81), and periodic menstrual blood loss (AOR = 9.04; 95% CI = 3.55-23.01). Increase in WHtR (>0.5) was associated with abnormal cycle length (AOR = 3.09; 95% CI = 1.09-8.80) and abnormal period duration (AOR = 3.05; 95% CI = 1.10-8.44). An increase in WHR (>0.8) was associated with abnormal cyclical menstrual blood loss (AOR = 4.93; 95% CI = 1.55-15.71). CONCLUSIONS Obesity predisposes to menstrual irregularities. BMI is a better predictor of menstrual irregularity as the increase in BMI is associated with abnormality in menstrual cycle length, period duration, and blood loss. Increased WHR was associated with periodic blood loss only. Increased WHtR was associated with abnormal cycle length and period duration, but not menstrual blood loss.
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Affiliation(s)
- Kapil Amgain
- Department of Clinical Anatomy and Cell Biology, Karnali Academy of Health Sciences, Jumla, Nepal
| | - Prativa Subedi
- Department of Emergency Medicine, Rolpa District Hospital, Rolpa, Nepal
| | - Gopal Kumar Yadav
- Department of Emergency Medicine, Kalaiya District Hospital, Bara, Nepal
| | - Sujana Neupane
- Department of Nursing, Manmohan Cardiothoracic Vascular and Transplant Center, Maharajgunj, Kathmandu, Nepal
| | - Sitaram Khadka
- Clinical Pharmacist and Pharmacologist, Shree Birendra Hospital, Nepalese Army Institute of Health Sciences, Kathmandu, Nepal
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Subedi P, Yadav GK, Paudel B, Regmi A, Pyakurel P. Adverse events following the first dose of Covishield (ChAdOx1 nCoV-19) vaccination among health workers in selected districts of central and western Nepal: A cross-sectional study. PLoS One 2021; 16:e0260638. [PMID: 34932553 PMCID: PMC8691599 DOI: 10.1371/journal.pone.0260638] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2021] [Accepted: 11/14/2021] [Indexed: 01/31/2023] Open
Abstract
INTRODUCTION The study aimed at exploring the adverse events following immunization (AEFI) and their incidences among health workers in three different districts of central and western Nepal following the first dose of Covishield vaccine,. It also aimed at studying the association of AEFI with demographic and clinical characteristics of vaccinees, pre-vaccination anxiety level and prior history of COVID-19 infection (RT- PCR confirmed) status. MATERIALS AND METHODS This was a cross-sectional study carried out via face-to-face or telephonic interview among 1006 health workers one week after receiving their first dose of the Covishield vaccine. Incidence of adverse events was calculated in percentage while Chi-square Test was used to check the association of AEFI with independent variables. Logistic regression was used to find out the adjusted odd's ratio at 95% CI. RESULTS Incidence of AEFI was 79.8% with local and systemic AEFI being 68.0% and 59.7% respectively. Injection site tenderness was the commonest manifestation. Local and systemic symptoms resolved in less than one week among 96.8% and 98.7% vaccinees respectively. Females were more likely to develop AEFI than males (AOR = 1.7, 95% CI = 1.2-2.4). Vaccinees aged 45-59 years were 50% less likely to develop AEFI as compared to those aged less than 30 years (AOR 0.5, 95% CI = 0.3-0.8). Most of the vaccinees had not undergone RT-PCR testing for COVID-19 (59.8%). Those who were not tested for COVID-19 prior were 1.5 odds more likely to develop AEFI compared to those who were negative (AOR = 1.5, 95% CI = 1.1-2.1). CONCLUSION More than two-third of the vaccinees developed one or more forms of adverse events, but most events were self-limiting. Females and young adults were more prone to develop AEFI.
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Affiliation(s)
- Prativa Subedi
- Department of Internal Medicine, Rolpa District Hospital, Rolpa, Nepal
| | - Gopal Kumar Yadav
- Department of Internal Medicine, Kalaiya District Hospital, Bara, Nepal
- * E-mail:
| | - Binod Paudel
- Department of Emergency Medicine, Grahun Primary Hospital, Syangja, Nepal
| | - Anu Regmi
- Department of Medical and Surgical Nursing, Rolpa District Hospital, Rolpa, Nepal
| | - Prajjwal Pyakurel
- School of Public Health and Community Medicine, B. P. Koirala Institute of Health Sciences, Sunsari, Nepal
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Yadav GK, Lal S, Dange N, Marwah KG, Singh JP. Poland's syndrome with unusual hand and chest anomalies: a rare case report. Indian J Chest Dis Allied Sci 2014; 56:191-194. [PMID: 25823118] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/04/2023]
Abstract
Poland's syndrome is a rare congenital anomaly consisting of a unilateral absence of the pectoralis major, ipsilateral muscle, hand anomaly and occasionally associated other malformations of the chest wall and breast. Many structural and functional abnormalities have been described in association with this syndrome. We report an incidentally diagnosed case in a 27-year-old male patient who presented to us with symbrachydactyly. In addition to this, anterior depression of 2nd, 3rd and 4th ribs and bifid (forked) 5th rib was present on radiological investigations. The body of sternum was short and deformed on the right side with absence of xiphoid process. All middle phalanges were absent on righthand. It is a rare variant of Poland's syndrome.
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Lal S, Shrivastava GP, Singh S, Yadav GK, Bain J, Gupta R. Mortality pattern of burn patients admitted in S. G. M. Hospital Rewa: A teaching institute of central India. J Sci Soc 2012. [DOI: 10.4103/0974-5009.105917] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
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Abstract
Free amino acids together with copper, iron and zinc were measured in sera of 67 adult patients with thyrotoxicosis (n = 29) or hypothyroidism (n = 38). In contradistinction to the almost indifferences exhibited by the three metals, many amino acids displayed significant relationships with the thyrometabolic activity (mainly tyrosine and arginine with r values of 0.5 and 0.44, respectively). Additional analyses revealed certain patterns, between trace metals and amino acids, which conferred challenging difficulties to interpretation. Thus while zinc was associated positively with some amino acids (such as glutamic acid and alanine), copper correlated almost invariably in a negative manner with citrulline, alpha-amino-butyric acid, proline, glycine and valine. This new information should contribute to our knowledge of the complex metabolism of both trace metals and amino acids.
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Affiliation(s)
- M A Hassan
- Department of Nuclear Medicine, Kuwait University, Safat
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