1
|
Sitaula D, Shrestha N, Timalsina S, Pokharel B, Sapkota S, Acharya S, Thapa R, Dhakal A, Dhakal S. Knowledge, attitude and practice regarding diabetes and hypertension among school students of Nepal: A rural vs. urban study. PLoS One 2022; 17:e0270186. [PMID: 36044457 PMCID: PMC9432731 DOI: 10.1371/journal.pone.0270186] [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] [Subscribe] [Scholar Register] [Received: 02/01/2022] [Accepted: 06/07/2022] [Indexed: 11/18/2022] Open
Abstract
Background The burden of non-communicable diseases like diabetes and hypertension is increasing worldwide including low-and middle-income countries. Good knowledge of such diseases among young people will make them adopt a healthy lifestyle from an early age, which will, in turn, prevent them from developing such non-communicable diseases. This study aimed to assess the knowledge, attitude, and practice of rural and urban school students regarding diabetes and hypertension. We also aimed to see the differences in the knowledge, attitude, and practice of students from rural vs. urban communities. Methods A school-based cross-sectional study was conducted from May 1 2021 to June 30, 2021, in four schools in Nepal (1 from a metropolitan city, 2 from an urban municipality, and 1 from a rural municipality). The study was conducted among the secondary-level students of classes 9 and 10 in each school. The data were collected from the participants via pre-tested questionnaires and analyzed in the Statistical Packages for Social Sciences (SPSS) version 20.0. Logistic regression analysis was carried out to determine the determinants of knowledge and attitude regarding diabetes and hypertension. Results Of 380 respondents, 35.5% were residents of metropolitan city, 37.4% were from the urban municipality and 27.1% were from the rural municipality. The mean age of respondents was 15.61±0.99 years and 51.1% were male. Respondents having a family history of diabetes and hypertension were 21.1% and 37.9% respectively. Respondents from the metropolitan city had significantly higher mean knowledge scores than the respondents from the urban and rural municipality (p<0.001) while there was no significant difference in mean attitude scores. There was significantly higher daily consumption of fruits and vegetables among the participants from rural municipality (p<0.01) while no significant difference was seen in salt consumption and time spent on physical activity. In univariate regression analysis, place of residence, family occupation, parental education, and family history of diabetes and hypertension were significantly associated with good knowledge level. In multivariate analysis, only a higher grade of study (grade 10 in comparison to grade 9) was an independent predictor of a student’s good attitude level. Conclusion In general, there was a good attitude towards diabetes and hypertension despite poor knowledge. The mean knowledge scores were lower in urban municipality and rural municipality compared to metropolitan city. Low knowledge scores on diabetes and hypertension among the students show an urgent need for school-based interventional programs focusing on non-communicable diseases and lifestyle modification with more emphasis on rural communities.
Collapse
Affiliation(s)
- Deekshanta Sitaula
- Department of General Medicine, Rasuwa District Hospital, Dhunche, Bagmati Province, Nepal
- * E-mail:
| | - Niki Shrestha
- Department of Community Medicine, Chitwan Medical College, Chitwan, Bagmati Province, Nepal
| | - Santosh Timalsina
- Research Unit, Chitwan Medical College, Chitwan, Bagmati Province, Nepal
| | - Bandana Pokharel
- School of Medicine, Chitwan Medical College, Chitwan, Bagmati Province, Nepal
| | - Sachin Sapkota
- School of Medicine, Chitwan Medical College, Chitwan, Bagmati Province, Nepal
| | - Suchita Acharya
- School of Medicine, Chitwan Medical College, Chitwan, Bagmati Province, Nepal
| | - Rohit Thapa
- School of Medicine, Chitwan Medical College, Chitwan, Bagmati Province, Nepal
| | - Aarati Dhakal
- Department of Community Program, Kathmandu University Hospital, Dhulikhel, Bagmati Province, Nepal
| | - Sarita Dhakal
- Department of Emergency Medicine, Ramechhap District Hospital, Ramechhap, Bagmati Province, Nepal
| |
Collapse
|
2
|
Neupane HC, Tamang TY, Timalsina S, Tamrakar KK, Bhattarai A. Complications among Patients Undergoing Pancreaticoduodenectomy in Tertiary Care Centers of Nepal: A Descriptive Cross-sectional Study. JNMA J Nepal Med Assoc 2022; 60:77-82. [PMID: 35199675 PMCID: PMC9157660 DOI: 10.31729/jnma.7050] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2021] [Accepted: 01/23/2022] [Indexed: 11/05/2022] Open
Abstract
Introduction: Pancreaticoduodenectomy (Whipple procedure), even after significant evolution, continues to be associated with a high morbidity. The study aimed to find out the prevalence of complications following pancreaticoduodenectomies performed by a single surgeon over a span of 20 years in tertiary care hospitals of Nepal. Methods: This was a descriptive cross-sectional study conducted from hospital records of patients who underwent pancreaticoduodenectomy between 1999 and 2019 at different institutions in Chitwan, where the principal author was involved. Ethical clearance was taken from the Institutional Review Committee. Convenience sampling was done. Patients' clinical characteristics and diagnoses were noted. Data entry was done using Statistical Package for the Social Sciences version 20. Point estimate at 95% Confidence Interval was calculated, with frequency and percentage. Results: Out of 327 patients who underwent pancreaticoduodenectomy, complications were found in 125 (38.2%) (32.9-43.7 at 95% Confidence Interval). Respiratory complications were the commonest 32 (9.8%), followed by septicemia 25 (7.6%) and cardiac complications 24 (7.3%). Delayed gastric emptying and postoperative pancreatic fistula were seen in 11 (6.8%) and 4 (2.5%) in the first decade respectively. In the second decade, delayed gastric emptying was noted in 2 (1.2%) and postoperative pancreatic fistula in 1 (0.6%) patient. Conclusions: The prevalence of complications in our study was comparable to other national and international studies. Surgery-specific complications such as delayed gastric emptying and postoperative pancreatic fistula showed a decline over the decade.
Collapse
Affiliation(s)
- Harish Chandra Neupane
- Department of Surgery, Chitwan Medical College, Bharatpur-10, Nepal
- Correspondence: Dr. Harish Chandra Neupane, Department of Surgery, Chitwan Medical College, Bharatpur-10, Chitwan, Nepal. , Phone: +977-9855055155, +977-9860916172
| | | | | | | | | |
Collapse
|
3
|
Timalsina S, Mahato S, Nepal S. Utility of Triglyceride-Glucose index in predicting glycemic control in type 2 diabetes mellitus. Birat J Health Sci 2021. [DOI: 10.3126/bjhs.v6i2.40308] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
Abstract
Introduction: Insulin resistance (IR) and glycemic control are two very important aspects to be considered during management of patients with Type 2 Diabetes Mellitus (T2DM). The triglyceride-glucose (TyG) index has been proposed as a simple and inexpensive parameter that correlates well with IR and glycemic control.
Objectives: To explore the association of TyG index (and other TyG derived indices) with glycated hemoglobin (HbA1c) and evaluate their predictive ability for glycemic control in patients with T2DM.
Methodology: This cross-sectional study comprised of 160 adult patients diagnosed with T2DM visiting the medical outpatient department of Chitwan Medical College, Bharatpur, Chitwan between July–December 2019. Socio-demographic data and anthropometric measurements were collected. Glycemic control was assessed by HbA1c. TyG index was calculated by the formula: ln [fasting TG (mg/dl) x fasting glucose (mg/dl)/2]. Receiver operating characteristic (ROC) curve analysis was performed to analyze the predictive ability of TyG-index for poor glycemic control.
Results: One hundred and sixty patients (mean age: 53.6 ± 10.7 years, 55.0% males) were included in the study. Eighty (50.0%) had good glycemic control (HbA1c <7.0%). TyG index, along with TyG-BMI and TyG-WC (other TyG derived indices) were significantly increased in the poor glycemic control group. TyG index had a good predictive ability for poor glycemic control (AUC: 0.803, 95% CI: 0.731 – 0.874). A TyG cutoff ≥ 9.12 was optimal for predicting poor glycemic control, with 86.1% sensitivity and 61.5% specificity.
Conclusion: TyG index could be a simple and cost-effective screening tool for assessment of glycemic control in patients with T2DM.
Collapse
|
4
|
Sitaula D, Timalsina S, Sharma B, Pokharel B, Thapa R. Prevalence and Pregnancy Outcomes of Intrahepatic Cholestasis of Pregnancy. J Nepal Health Res Counc 2021; 19:321-326. [PMID: 34601524 DOI: 10.33314/jnhrc.v19i2.3455] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Received: 03/05/2021] [Accepted: 09/06/2021] [Indexed: 06/13/2023]
Abstract
BACKGROUND Intrahepatic cholestasis of pregnancy is a common pregnancy-specific liver disease associated with increased risk of adverse fetal and maternal outcomes. We sought to determine its prevalence, risk factors and feto-maternal outcomes. METHODS A retrospective review of data of 164 pregnant women diagnosed with intrahepatic cholestasis of pregnancy at Chitwan Medical College, Nepal from August 2018 to September 2020 was done. Socio-demographic data, clinic-laboratory profile and feto-maternal outcomes were obtained from clinical audit books and electronic records. A multivariate logistic regression analysis was used to evaluate the predictors of adverse neonatal outcome. RESULTS The prevalence of intrahepatic cholestasis of pregnancy was 2.5% (164 out of 6539 deliveries). The mean age was 27.5 ± 4.4 years and 51.2% were multigravida. The preterm delivery rate was 15.2% and Caesarean delivery rate was 69.5%. 22% of the neonates needed intensive care admission out of which Respiratory Distress Syndrome or Transient Tachypnea of Newborn was seen in half of them. There were 2 cases of Intrauterine Fetal Death. In multivariate analysis, delivery <34 weeks of gestation was only found to be a significant independent predictor of adverse neonatal outcome Conclusion: The prevalence of intrahepatic cholestasis of pregnancy among pregnant women is significant in our setting which is associated with adverse fetal outcome. Early diagnosis and timely intervention is necessary in order to reduce associated perinatal morbidity.
Collapse
Affiliation(s)
- Deekshanta Sitaula
- Department of Obstetrics and Gynecology, Chitwan Medical College, Bharatpur, Chitwan, Bagmati Province, Nepal
| | - Santosh Timalsina
- Department of Biochemistry, Chitwan Medical College, Bharatpur, Chitwan, Bagmati Province, Nepal
| | - Basant Sharma
- Department of Obstetrics and Gynecology, Chitwan Medical College, Bharatpur, Chitwan, Bagmati Province, Nepal
| | - Bandana Pokharel
- Department of Obstetrics and Gynecology, Chitwan Medical College, Bharatpur, Chitwan, Bagmati Province, Nepal
| | - Rohit Thapa
- Department of Obstetrics and Gynecology, Chitwan Medical College, Bharatpur, Chitwan, Bagmati Province, Nepal
| |
Collapse
|
5
|
Sharma K, Deo G, Timalsina S, Joshi A, Shrestha N, Neupane HC. Online Learning in the Face of COVID-19 Pandemic: Assessment of Students' Satisfaction at Chitwan Medical College of Nepal. Kathmandu Univ Med J (KUMJ) 2021; 18:40-47. [PMID: 33605237] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/12/2023]
Abstract
Background Online learning can play a vital role in the process of teaching and learning during Corona Virus Disease 2019 (COVID-19) pandemic. However, learners' satisfaction is extremely important in effective implementation of the online learning, especially at institutions where it is newly adopted. Objective To assess satisfaction towards online learning and its predictors among students at Chitwan Medical College, Bharatpur. Method A web-based cross-sectional survey was undertaken among 434 undergraduate and postgraduate students from various academic programs who had participated in the online classes started during this COVID-19 pandemic. A structured questionnaire consisting of 31 items (5-point Likert scale) covering four major student satisfaction domains (learners' dimensions, technological characteristics, instructors' characteristics and course management and coordination) was distributed to the students using Google Form. Result More than half (53.5%) of the students were satisfied with the online learning, while 29.7% gave neutral views. Bivariate analyses found that all four domains scores were positively correlated with each other as well as with the students' overall satisfaction towards learning. In multivariate analysis, female gender [aOR: 2.72, p = 0.013], WiFi as internet modality for learning [aOR: 3.36, p = 0.001) and learners' dimension score [aOR: 1.27, p<0.001] were the significant predictors of students' satisfaction. Conclusion Although recently adopted, the satisfaction of the students towards online classes appears good, and prioritizing the identified predictors and working on the weak links could assist in enhancing students' satisfaction and better outcomes.
Collapse
Affiliation(s)
- K Sharma
- School of Nursing, Chitwan Medical College, Bharatpur, Nepal
| | - G Deo
- Department of Anesthesia, Chitwan Medical College, Bharatpur, Nepal
| | - S Timalsina
- Research Unit, Chitwan Medical College, Bharatpur, Nepal
| | - A Joshi
- School of Nursing, Chitwan Medical College, Bharatpur, Nepal
| | - N Shrestha
- Department of Community Medicine, Chitwan Medical College, Bharatpur, Nepal
| | - H C Neupane
- Department of Surgery, Chitwan Medical College, Bharatpur, Nepal
| |
Collapse
|
6
|
Timilsina S, Karki S, Timalsina S, Gautam A, Sharma S. Does packed red cell transfusion provide symptomatic benefits to cancer palliative patients?: a longitudinal study from a single private oncology center in Nepal. BMC Palliat Care 2019; 18:67. [PMID: 31387568 PMCID: PMC6685247 DOI: 10.1186/s12904-019-0454-1] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/09/2018] [Accepted: 07/31/2019] [Indexed: 11/20/2022] Open
Abstract
Background Palliative patients generally present with symptoms of dyspnea, easy fatigability, lethargy and feeling of being unwell which can broadly be attributed to one root cause: cancer-related anemia. So, packed red cell transfusion is often carried out aiming to improve patients’ functional status. Different cut off hemoglobin values have been suggested, with Hb < 9 g/dL the most commonly accepted. The present study aims at evaluating and comparing the benefits in subjective symptoms of fatigue and breathlessness among transfused and non-transfused palliative patients on Day 0 and Day 7. Methods Hemoglobin values, anemia related subjective symptoms of fatigue and breathlessness were recorded from 122 patients. The patients were re-evaluated on day-7 post-transfusion. The pre and post-transfusion symptomatic benefit was compared in both transfused and non-transfused palliative care patients. Results The currently practiced hemoglobin trigger for packed red cell transfusion is 10 g/dL. The units of packed red cell to be transfused was decided according to the hemoglobin values targeting the rise to > 10 g/dL. A mean 1.36 units were transfused. Statistically significant improvement was observed in patient reported symptoms of fatigue and breathlessness among both transfused and non-transfused palliative patients. Conclusion Anemic cancer palliative patients were found to benefit following packed red cell transfusion, suggesting a favorable association between the transfusion and patient-reported fatigue and dyspnea.
Collapse
Affiliation(s)
- Sameer Timilsina
- Department of Physiology, Tribhuvan University, Chitwan Medical College, Post Box No.: 42, Bharatpur-5, Chitwan, Nepal.
| | - Sirisa Karki
- Department of Pharmacology, Tribhuvan University, Chitwan Medical College, Bharatpur-5, Chitwan, Nepal
| | - Santosh Timalsina
- Department of Biochemistry, Tribhuvan University, Chitwan Medical College, Bharatpur-5, Chitwan, Nepal
| | - Aajeevan Gautam
- Department of Anatomy, Tribhuvan University, Chitwan Medical College, Bharatpur-5, Chitwan, Nepal
| | - Sabitri Sharma
- Palliative Care Unit, Nepal Cancer Hospital and Research Center, Harisiddhi, Lalitpur, Nepal
| |
Collapse
|
7
|
Timalsina S, Sigdel MR, Baniya S, Subedee S. Status of vitamin D and parameters of calcium homeostasis in renal transplant recipients in Nepal: a cross sectional study. BMC Nephrol 2018; 19:290. [PMID: 30348109 PMCID: PMC6198466 DOI: 10.1186/s12882-018-1088-x] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [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: 06/11/2018] [Accepted: 10/09/2018] [Indexed: 01/02/2023] Open
Abstract
BACKGROUND Vitamin D, apart from being an important part of the "calcium-vitamin D-parathyroid hormone" endocrine axis, has diverse range of "non-calcemic" biological actions. A high prevalence of vitamin D deficiency has been observed in renal transplant recipients (RTRs) worldwide. This study aimed to determine the prevalence of hypovitaminosis D in Nepalese RTRs and interrelations between serum 25-hydroxyvitamin D [25(OH) D] and other biochemical parameters. METHODS A total of 80 adult RTRs visiting a university hospital were enrolled in this cross sectional study. Serum 25(OH) D and intact parathyroid hormone (iPTH) were measured using Enhanced Chemiluminiscent Immunoassay. The RTR population was categorized into recent transplant recipients (≤1 year) and long term recipients (> 1 year). The vitamin D status was defined as per NKF/KDOQI guidelines. SPSS version 20.0 was used to analyze the data. Appropriate statistical tests were applied to compare variables between groups and establish correlation. P < 0.05 was considered to be statistically significant. RESULTS The mean age of the recipients was 38.11 ± 11.47 years (68 males, 85.0%). Chronic glomerulonephritis was the leading cause of CKD. The two RTR groups (recent and long term) didn't differ in demographic and biochemical characteristics. 83.75% of the recipients had PTH levels above the upper limit of the recommended range for their stage of CKD. 57.5% had hypocalcemia and none of the recipients had hypercalcemia. The median serum 25(OH) D was 24.15 ng/ml (8.00-51.50 ng/ml). Only 27.5% had sufficient vitamin D status whereas 53.8% were vitamin D insufficient and 18.8% were vitamin D deficient, the distribution almost comparable in the 2 transplant group. The serum 25(OH) D was not significantly affected by the time post-transplant, gender and sunlight avoidance. There was a significant negative correlation between serum 25(OH) D and iPTH (Pearson's r = - 0.35, P = 0.001), but not so with the graft function. CONCLUSION There is a high prevalence of vitamin D insufficiency in RTRs. The deficiency status is not corrected despite of nutritional improvement and normalization of GFR post-transplantation and likely exacerbates secondary hyperparathyroidism. Vitamin D supplementation coupled with sensible sun exposure could be important strategies in optimization of the vitamin D status in this population.
Collapse
Affiliation(s)
- Santosh Timalsina
- Department of Biochemistry, Chitwan Medical College, Bharatpur, Nepal
| | - Mahesh Raj Sigdel
- Department of Nephrology, Tribhuvan University Teaching Hospital, Kathmandu, Nepal
| | - Santosh Baniya
- Department of General Practice and Emergency Medicine, Tribhuvan University Teaching Hospital, Kathmandu, Nepal
| | | |
Collapse
|
8
|
Sedhai YR, Golamari R, Konda P, Basnyat S, Goud S, Timalsina S, Acharya D. Use of Chest Ct Angiography Derived Left Atrial Size as a Predictor of Diastolic Dysfunction. J Card Fail 2017. [DOI: 10.1016/j.cardfail.2017.07.137] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
|
9
|
Sedhai YR, Timalsina S, Asija A, Choksi T, Ahangar W, Gevorgyan D, Golamari R, Borikar M, Dar T, Alukal J, Missri J. CAN CHA2DS2-VASC SCORE BE USED AS A PREDICTOR OF CONTRAST INDUCED NEPHROPATHY AFTER CARDIAC CATHETERIZATION? J Am Coll Cardiol 2017. [DOI: 10.1016/s0735-1097(17)34471-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
|
10
|
Timalsina S, Gyawali P, Bhattarai A. Comparison of lipid profile parameters and oxidized low-density lipoprotein between normal and preeclamptic pregnancies in a tertiary care hospital in Nepal. Int J Womens Health 2016; 8:627-631. [PMID: 27822126 PMCID: PMC5089828 DOI: 10.2147/ijwh.s117850] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
Introduction Preeclampsia is a pregnancy-specific complication that significantly contributes to maternal and perinatal morbidity and mortality worldwide, even more so in developing countries such as Nepal. The potential contribution of dyslipidemia and elevated levels of oxidized low-density lipoprotein (oxLDL) in the pathogenesis of preeclamptic pregnancies has been observed in several studies. The aim of this study was to compare the maternal lipid profile parameters and particularly oxLDL between preeclamptic and healthy pregnancies and also correlate oxLDL with other lipid profile parameters. Patients and methods A total of 54 preeclamptic women were selected as cases for this cross-sectional study. Age and gestational week-matched 60 pregnant women were enrolled as controls. Preeclampsia was defined as per Australasian Society Consensus Statement research definition. The serum lipid parameters were measured using automated enzymatic systems and a competitive enzyme-linked immunosorbent assay was used to determine oxLDL concentrations in the serum. Student’s t-test was used to compare oxLDL levels between preeclamptic and healthy pregnancies, and Pearson’s correlation analysis was carried out to assess the relation between oxLDL and other variables. Results The mean values of serum total cholesterol, triglyceride, non-high-density lipoprotein-cholesterol (non-HDL-c) and oxLDL were significantly higher in the preeclamptic cases (P<0.01). However, the levels of low-density lipoprotein cholesterol (LDL-c and HDL-c) did not significantly differ between the two groups. oxLDL had a significant positive correlation (P<0.01) with total cholesterol, triglyceride, LDL-c and non-HDL-c, and a negative correlation with HDL-c. Conclusion The atherogenic type of dyslipidemia and high oxLDL levels are associated with preeclamptic pregnancies. The lipid parameters, however, seem to be poor markers of the severity of preeclampsia. Further prospective studies are needed to see if the observed dyslipidemia has a causal role in preeclampsia and imparts a long-term cardiovascular risk.
Collapse
Affiliation(s)
| | - Prajwal Gyawali
- Department of Biochemistry, Maharajgunj Medical Campus, Maharajgunj, Kathmandu, Nepal
| | - Aseem Bhattarai
- Department of Biochemistry, Maharajgunj Medical Campus, Maharajgunj, Kathmandu, Nepal
| |
Collapse
|
11
|
Ghimire B, Singh YP, Timalsina S. Post operative diagnosis of early gastric cancer in a low risk population and the possibility of risk stratified screening. Kathmandu Univ Med J (KUMJ) 2015; 12:32-7. [PMID: 25219991 DOI: 10.3126/kumj.v12i1.13630] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
BACKGROUND Gastric cancer is the second commonest cause of cancer related mortality worldwide. Though its incidence is more in Eastern Asia, it is increasing in the South Asian subcontinent. The diagnosis of early gastric cancer (EGC) confined to the mucosa or submucosa, is an important concern due to a better outcome at this stage where five year survival rates could increase by 90 percent. Though mass screening is done in few countries, it has not been applied in developing countries like Nepal. Preoperative diagnosis of EGC is rare in Nepal. The aim of this study is to analyze the clinicopathological features of postoperative cases of gastric cancer managed in a tertiary care university hospital of Nepal. METHODS All patients with histological diagnosis of gastric cancer admitted in the Department of Surgery, Tribhuvan University Teaching Hospital, Kathmandu, Nepal during the three year period (September 2010 to August 2013) were analyzed retrospectively. RESULTS Ninety two patients with endoscopic diagnosis of gastric cancers were admitted during the past three years. The mean age was 60 years ranging from 28 years to 85 years with the male to female ratio of 2.8:1. Five patients were younger than 40 years and all were in advanced stage. Thirty five percent of the patients belonged to Janajatis (Hill) community though they comprise only 23% of the population and about 65% of them belonged to an area involving 25% of the country. Seventy six cases were operated. Out of 92 patients, 4 patients were diagnosed as early gastric cancer postoperatively. All patients with early gastric cancer were above 50 years with CT Scan abdomen revealing focal thickening without lymphadenopathy. CONCLUSION Over the years, the incidence of gastric cancer is increasing in Nepal. Though 92% are advance gastric cancers, few have been diagnosed and treated early. A screening program in a country like Nepal with diverse ethnicity and difficult terrain might be helpful if it targets high risk people in high risk areas.
Collapse
Affiliation(s)
- B Ghimire
- Department of Surgery, Institute of Medicine Tribhuvan University Teaching Hospital Kathmandu, Nepal
| | - Y P Singh
- Department of Surgery, Institute of Medicine Tribhuvan University Teaching Hospital Kathmandu, Nepal
| | - S Timalsina
- Department of Biochemistry, Institute of Medicine Tribhuvan University Teaching Hospital, Kathmandu, Nepal
| |
Collapse
|
12
|
Giri S, Neupane M, Pant S, Timalsina U, Koirala S, Timalsina S, Sharma S. Quality of life among people living with acquired immune deficiency syndrome receiving anti-retroviral therapy: a study from Nepal. HIV AIDS (Auckl) 2013; 5:277-82. [PMID: 24101885 PMCID: PMC3790835 DOI: 10.2147/hiv.s50726] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
Purpose The present study was undertaken to determine the impact of acquired immune deficiency syndrome (AIDS) on the quality of life of affected individuals in Nepal. Patients and methods A cross sectional study was done among 70 individuals attending the Anti-Retroviral Therapy clinic of the University Hospital in Nepal. Quality of life (QOL) was evaluated using World Health Organization Quality of life questionnaire (WHO QOL-BREF) instrument. Statistical analysis was done using SPSS Version 17.0. Results The median scores with interquartile range (IQR) in four domains of QOL in descending order were physical (61; IQR 22), social (58; IQR 33), environmental (56; IQR 13), and psychological (54; IQR 8). Older age was associated with lower perceived overall QOL. Females were more likely to have lower QOL scores in the social and psychological domains. Higher CD4 counts and a married status were significant predictors of higher QOL scores in the environmental domain. Conclusion Being older, female, single, and having advanced clinical stage is associated with lower QOL scores in people living with AIDS. Lowest QOL scores were seen in the psychological domain suggesting the need of psychological interventions.
Collapse
Affiliation(s)
- Smith Giri
- Department of Medicine, Tribhuvan University Teaching Hospital, Kathmandu, Nepal
| | | | | | | | | | | | | |
Collapse
|
13
|
Giri S, Sharma SR, Timalsina S, Yadav V, Koirala S, Kumar A, Neupane S, Neupane M. Cardiovascular health risk behavior among medical students in a teaching hospital. J Nepal Health Res Counc 2012; 10:187-191. [PMID: 23281448] [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] [Subscribe] [Scholar Register] [Indexed: 06/01/2023]
Abstract
BACKGROUND Medical students are the health care providers of tomorrow. The health behaviors that are acquired in early life and in medical school will influence their future acceptance and practice of preventive strategies including their interaction with patients. The main objective of our study was to assess the health behavior and perceptions of medical students in relation to cardiovascular diseases. METHODS A cross sectional descriptive study was done among 159 medical students of Institute of Medicine, Tribhuvan University Teaching Hospital in Kathmandu, Nepal from September 2010 to December 2010. Data collection was done using a self administered questionnaire. RESULTS The mean age was 22.9±2.5 yrs and a male:female ratio of 2.1:1. Thirty Five (22%) were current smokers, 56 (35%) indulged in episodic heavy drinking, 25 (15.7%) were overweight, 34 (21%) engaged in recommended amount of physical activitiy,58 (33%) regulated fat consumption and 46 (28%) regulated salt consumption. Regarding developing cardiovascular disease in the future, 85(53%) showed concern but only 33 (38%) of these adopted preventive practices. 101 (64%) believed that their medical school life had a harmful effect on their health. CONCLUSIONS Our study shows a high prevalence of cardiovascular risk behaviours among the medical students. This highlights the urgency that we must take to promote preventive knowledge and practices among medical students. This will help them to become prevention oriented clinicians in future to counter the increasing burden of cardiovascular diseases in this part of the world.
Collapse
Affiliation(s)
- S Giri
- Institute of Medicine, Tribhuvan University Teaching Hospital, Kathmandu, Nepal.
| | | | | | | | | | | | | | | |
Collapse
|
14
|
Kumar A, Sharma SR, Timalsina S, Giri S, Yadav V. High Prevalence of Depression and Anxiety Symptoms among Hospitalized Geriatric Medical Inpatients: A study from a Tertiary Level Hospital in Nepal. UTMJ 2010. [DOI: 10.5015/utmj.v88i1.1283] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
|