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Abdelkarim V, Thapa S. Anxiety, depression, and lower quality of life among Danish women with polycystic ovarian syndrome. Eur J Public Health 2022. [DOI: 10.1093/eurpub/ckac131.500] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Abstract
Background
Polycystic Ovarian Syndrome (PCOS) is the most frequent hormonal/endocrine disorder in women of reproductive age and is one of the most common causes of infertility. Approximately 20% of Danish women of reproductive age are diagnosed with PCOS, and yet only a little attention has been paid to the psychological symptoms appearing in women with PCOS. The present study investigated anxiety, depression, and lower quality of life among Danish women of reproductive age who are diagnosed with PCOS.
Methods
This was a cross-sectional survey study among 326 Danish women who self-reported as being diagnosed with PCOS. The Hospital Anxiety and Depression Scale (HADS) was used to measure anxiety and depression, and the PCOS-QOL scale was used to measure the quality of life. Chi-square tests and logistic regression analyses were used for analyzing data.
Results
Sixty-six percent of women were found to have anxiety (n = 216), 41% of women had depression and 70% of women had low quality of life The most frequently reported symptoms were irregular menstrual cycle (86%), overweight (73%), and mood swings (65%), and irregular menstrual cycle, overweight and infertility were the were perceived of having higher severity. After adjusting for age, ethnicity, education, and income, the severity of symptoms, namely irregular menstrual cycle, infertility, overweight, and hirsutism, were independently and positively associated with depression, and severity of symptoms, namely irregular menstrual cycle, mood swings, and hirsutism, was independently and positively associated with anxiety. Lower quality of life was independently associated with both anxiety and depression.
Conclusions
Women with PCOS are at higher risk of anxiety, depression, and consequently, lower quality of life. Clinicians and other healthcare professionals should pay attention to the importance of mental health support in women with PCOS and work towards promoting it.
Key messages
• Women with PCOS are at higher risk of anxiety and depression, and lower quality of life.
• Health care professionals working with women with PCOS should be aware of this and be prepared to offer necessary support.
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Affiliation(s)
- V Abdelkarim
- Public Health, University of Southern Denmark , Odense, Denmark
| | - S Thapa
- Research Unit of General Practice, University of Southern Denmark , Odense, Denmark
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Tewogbola OT, Thapa S. Barriers to HIV testing among transgender women and men who have sex with men in sub-Saharan Africa. Eur J Public Health 2022. [DOI: 10.1093/eurpub/ckac130.035] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Abstract
Background
Accessing HIV testing services is a challenge for transgender women and men who have sex with men (MSM) in sub-Saharan Africa. Only a little about this issue has been understood and discussed. No systematic review exists that discusses barriers to HIV testing among transgender women and MSM on the regional level.
Methods
We systematically searched databases namely MEDLINE, CINAHL, and Google Scholar to identify qualitative studies that reported decision-making and/or experiences with HIV testing uptake among transgender women or MSM and that were conducted in sub-Saharan Africa between January 2005 and March 2020. Two independent authors performed the selection, extraction, and thematic analysis of data.
Results
Twelve out of 794 studies were found eligible and included for synthesis. The synthesis led to the development of a framework illustrating multi-level, inter-related barriers to HIV testing. Couple-based HIV testing policies, criminalizing same-sex behaviors, and (health) governance being influenced by traditional religious (Islamic or Christianity) belief systems were the barriers at the regional level. Discriminatory practices in the communities and health institutions were the community-specific barriers. Interpersonal barriers included interactions with healthcare providers leading to forced disclosure and/or discrimination, and individual level barriers included fears and depressive thoughts, and poor healthcare access.
Conclusions
We identified policies and practices at the regional and country levels that hindered HIV testing practices among transgender women and MSM, which should be reconsidered while providing HIV prevention services to people of gender-minority backgrounds. We also think that countries from the global west do have a responsibility to question the sovereignty of some African countries for their inability to provide optimal health care to gender minority populations.
Key messages
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Affiliation(s)
- OT Tewogbola
- Department of Public Health, University of Southern Denmark , Odense, Denmark
| | - S Thapa
- Research Unit of General Practice, University of Southern Denmark , Odense, Denmark
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Basnet A, Tamang B, Pokhrel N, Khadka S, Shrestha MR, Ghimire S, Prajapati R, Thapa S, Duwal Shrestha SK, Chand AB, Amatya I, Rai SK. First-Generation SARS-CoV-2 Vaccines: A Comparative Analysis between Vaccinated and Unvaccinated Hospitalized Patients Infected with SARS-CoV-2. Kathmandu Univ Med J (KUMJ) 2022; 20:316-322. [PMID: 37042373] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/13/2023]
Abstract
Background Severe acute respiratory syndrome corona virus-2 (SARS-CoV-2) variants, which have emerged due to several mutations in spike protein, have a potential to escape immune protection provided by the first-generation vaccines, thereby resulting in breakthrough infections. Objective To identify the socio-demographic factors, clinical features, and outcomes in both vaccinated and unvaccinated hospitalized patients infected with SARS-CoV-2. Method Socio-demographic details, clinical features, and the outcomes among fully vaccinated (double for Covishield/AstraZeneca and BBIBP-CorV and single for Janssen), partially vaccinated, and unvaccinated hospitalized patients with coronavirus disease of 2019 (COVID-19) were collected and analyzed using SPSS version 17. Result Among the hospitalized COVID-19 patients (n=299), 175 (58.5%) patients received a single-dose, 82 (27.4%) double-dose, and 124 (41.5%) did not receive any dose of the COVID-19 vaccines. The risk of SARS-CoV-2 infection when compared between vaccinated and unvaccinated patients was found to be associated among professional degree holders (23.4% versus 9.7%) (p<0.05), professional workers (43.4% vs. 25.0%) (p<0.05), hospitalization to general ward (76.6% vs. 72.6%) (p<0.05), and presence of multiple symptoms (> or equel 3) (86.8% vs. 75.0%) (p>0.05) and comorbidities (> or equal 2) (15.5% vs. 13.7%) (p>0.05). Despite such approximate incidences, the risk of in-hospital mortality among the vaccinated patients was reduced (0.6% vs. 3.2%) (p>0.05), when compared to the unvaccinated patients. The risk of in-hospital mortality was associated with the older age and the presence of multiple comorbidities including bronchial asthma, diabetes, and hypertension. Conclusion Full or partial vaccination against the SARS-CoV-2 variants of concerns might be effective in preventing in-hospital mortality among COVID-19 patients.
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Affiliation(s)
- A Basnet
- Department of Medical Microbiology, Shi-Gan International College of Science and Technology, Tribhuvan University, Shankha marg, Kathmandu, Nepal. and Department of Clinical Laboratory, Nepal Armed Police Force Hospital, Balambu, Kathmandu, Nepal
| | - B Tamang
- Department of Clinical Laboratory, Nepal Armed Police Force Hospital, Balambu, Kathmandu, Nepal
| | - N Pokhrel
- Research Section, Nepal Health Research Council, Kathmandu, Ramshah path, Kathmandu, Nepal
| | - S Khadka
- Department of Immunology, Mayo Clinic, Rochester, Minnesota, United States. and Department of Microbiology and Immunology, Stanford University, Palo Alto, California, United States
| | - M R Shrestha
- Department of Clinical Laboratory, Nepal Armed Police Force Hospital, Balambu, Kathmandu, Nepal
| | - S Ghimire
- Department of Clinical Laboratory, Nepal Armed Police Force Hospital, Balambu, Kathmandu, Nepal
| | - R Prajapati
- Department of Clinical Laboratory, Nepal Armed Police Force Hospital, Balambu, Kathmandu, Nepal
| | - S Thapa
- Department of Clinical Laboratory, Nepal Armed Police Force Hospital, Balambu, Kathmandu, Nepal
| | - S K Duwal Shrestha
- Department of Orthopedic, Nepal Armed Police Force Hospital, Balambu, Kathmandu, Nepal
| | - A B Chand
- Department of Clinical Laboratory, KIST Medical College and Teaching Hospital, Gwarko, Lalitpur, Nepal
| | - I Amatya
- Research Section, Nepal Health Research Council, Kathmandu, Ramshah path, Kathmandu, Nepal
| | - S K Rai
- Research Division, Nepal Medical College and Teaching Hospital, Gokarneswor-08, Kathmandu, Nepal
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Tyssen R, Sandbu M, Thapa S, Rø K, Jávo C, Preljevic V. Perceived clinical challenges when treating patients from another culture: a study among doctors training in psychiatry in Norway. Eur Psychiatry 2022. [PMCID: PMC9565520 DOI: 10.1192/j.eurpsy.2022.524] [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] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
Introduction
There is increased migration of patients and physicians worldwide. In Norway, psychiatry is the medical discipline with highest proportion of foreign doctors (24%). We need empirical studies on transcultural clinical challenges among doctors training in psychiatry.
Objectives
What perceived clinical challenges do foreign and native Norwegian young doctors meet when they treat patients from another culture, and what independent factors are associated with such challenges?
Methods
We developed a new 6-item instrument (alpha=0.80), Clinical Transcultural Challenges (CTC), with items about assessing psychosis, risk of suicide, violence etc. The doctors were recruited at mandatory training courses, and they filled in questionnaires about individual factors (age, gender, foreign/native) and work-related factors (training stage, frequency of transcultural meetings, number of working hours, work stress). Associations with CTC were analyzed by linear multiple regression.
Results
The response rate was 93% (216/233), of whom 83% were native and 17% were foreign doctors, 68% were women. Native doctors reported higher levels of CTC than did foreign doctors, 28.8 (6.2) vs 23.8 (7.2), p<0.001, d=0.73. Both native and foreign doctors rated “assessing psychosis” and “lack of helping tools” as most demanding. Independent factors associated with CTC were being a native doctor, Beta 3.9, p<0.01, and high levels of work-home stress, Beta 0.29, p<0.05.
Conclusions
Native doctors training in psychiatry report higher levels of transcultural clinical challenges than foreign doctors do. Both groups of doctors may need more training in transcultural assessment of psychotic disorders. They also report needs for more helping tools, and we should explore this further.
Disclosure
No significant relationships.
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Dhungana S, Koirala R, Ojha S, Thapa S. Resilience and its association with post-traumatic stress disorder, anxiety, and depression symptomatology in the aftermath of trauma: a cross-sectional study from Nepal. Eur Psychiatry 2022. [PMCID: PMC9567145 DOI: 10.1192/j.eurpsy.2022.1732] [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] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
Introduction
Resilience is a multidimensional construct. Despite being quoted as protective against mental disorders, it remains largely unexplored in our context.
Objectives
We attempted to explore the role of resilience in the development of various psychiatric symptoms as depression, anxiety and post-traumatic stress disorder following trauma in clinical population in a psychiatry outpatient of a university hospital.
Methods
We interviewed one hundred patients who sought treatment in psychiatry outpatient in a university hospital in Kathmandu, Nepal. We collected sociodemographic and trauma related information using semi-structured interview format. Other instruments used were the World Health Organization Composite International Diagnostic Interview version 2.1 for trauma categorization, the Post-Traumatic Stress Disorder Checklist-Civilian version to measure the post-traumatic stress disorder symptoms, and the 25-item Hopkins Symptom Checklist-25 to assess the level of depression and anxiety symptoms. We used Nepali adapted resilience scale derived from the original Wagnild and Young Resilience scale to measure resilience. We explored the associations between resilience scores and the scores on depression, anxiety and posttraumatic stress disorder using bivariate and multivariate analysis.
Results
Resilience had negative correlations with depression, anxiety, and post-traumatic stress disorder symptoms after adjusting for other variables such as gender, marital status, employment status, socioeconomic status and trauma types which were observed to have significant association in the bivariate analysis.
Conclusions
There was inverse correlation between resilience scores and depression, anxiety, and post-traumatic stress symptoms. Resilience should be considered in studies involving trauma population.
Disclosure
No significant relationships.
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Rijal H, Thapa S, Jha P. Electrical Cardioversion in Pregnancy: A Case Report. Nepal J Obstet Gynaecol 2022. [DOI: 10.3126/njog.v16i2.42119] [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
A case of 28 years primigravida with refractory tachycardia at term is reported. She was refractory to medical cardioversion. Electrical cardioversion was applied before and after the delivery of baby. With several cycles of variable joules of electrical cardioversion, the normal rhythm was not obtained. However, patient’s rhythm reverted to sinus with anti-arrhythmic medication after third week of cesearean delivery.
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Shrestha R, Khadka SK, Basi A, Malla M, Thapa S, Tripathi A, Shrestha R. Meniscal Tear at Knee: Repair or Resect? An Early Experience from a University Hospital in Nepal. Kathmandu Univ Med J (KUMJ) 2022; 20:47-50. [PMID: 36273290] [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: 06/16/2023]
Abstract
Background The meniscus plays an important role in maintaining healthy articular cartilage. Meniscus tear, one of the common intra-articular knee lesions, is treated by either debridement or repair. Objective This study aims at identifying the early outcome of meniscus tears treated by debridement or repair. This study also elaborates on the spectrum of meniscal injuries presented in a tertiary care hospital in Nepal. Method A retrospective descriptive cross-sectional study was conducted at Orthopedic Department of Dhulikhel Hospital from February 2018 until January 2020 among patients who underwent knee arthroscopies for meniscal tears treated either by debridement or repair. Patients having intra articular fractures, osteochondral injuries and multi-ligament injuries were excluded. The meniscal tears were classified according to location and type of tear. Those patients who had at least one-year of follow up were evaluated with Lysholm score for functional outcome. Data were compiled and analyzed with Microsoft Excel 2011. Result One hundred and ten cases of meniscal tears were managed over the study period. Ninty-three cases could be traced for outcome evaluation, which included 50 cases of meniscal debridement and 43 cases of meniscal repair. The mean Lysholm score of the patients who received debridement was 81.5 (SD 10.4) and those who received meniscal repair was 84.9 (SD 9.1) (p=0.105). The population distribution was found to be similar in both the groups according to age and sex distribution and associated ligamentous injuries. Conclusion Good functional outcome was seen for meniscal tears managed with debridement or repair in at least one year follow up and could not establish one modality of management better than the other.
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Affiliation(s)
- R Shrestha
- Department of Orthopedics and Traumatology, Dhulikhel Hospital, Kathmandu University Hospital, Kathmandu University School of Medical Sciences, Dhulikhel, Kavre, Nepal
| | - S K Khadka
- Department of Orthopedics and Traumatology, Dhulikhel Hospital, Kathmandu University Hospital, Kathmandu University School of Medical Sciences, Dhulikhel, Kavre, Nepal
| | - A Basi
- Department of Orthopedics and Traumatology, Dhulikhel Hospital, Kathmandu University Hospital, Kathmandu University School of Medical Sciences, Dhulikhel, Kavre, Nepal
| | - M Malla
- Department of Orthopedics and Traumatology, Dhulikhel Hospital, Kathmandu University Hospital, Kathmandu University School of Medical Sciences, Dhulikhel, Kavre, Nepal
| | - S Thapa
- Department of Orthopedics and Traumatology, Dhulikhel Hospital, Kathmandu University Hospital, Kathmandu University School of Medical Sciences, Dhulikhel, Kavre, Nepal
| | - A Tripathi
- Department of Orthopedics and Traumatology, Dhulikhel Hospital, Kathmandu University Hospital, Kathmandu University School of Medical Sciences, Dhulikhel, Kavre, Nepal
| | - R Shrestha
- Department of Orthopedics and Traumatology, Dhulikhel Hospital, Kathmandu University Hospital, Kathmandu University School of Medical Sciences, Dhulikhel, Kavre, Nepal
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Pathak SR, Gajurel RM, Poudel CM, Shrestha H, Thapa S, Thapa S, Koirala P. Angiographic Severity of Coronary Artery Disease in Diabetic and Non-diabetic Acute STEMI Patients in a Tertiary Care Centre of Nepal. Kathmandu Univ Med J (KUMJ) 2021; 19:410-414. [PMID: 36259180] [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: 06/16/2023]
Abstract
Background Patients with diabetes mellitus have a higher prevalence of atherosclerotic heart disease and a higher incidence of myocardial infarction than the general population. Definitive diagnosis and precise assessment of anatomic severity of Coronary Artery Disease requires invasive diagnostic modality like coronary angiography. Objective To study angiographic characteristics and severity involving coronary arteries in patients with acute ST segment elevation Myocardial infarction and to compare the same in diabetics and non-diabetics. Method Among 150 patients with acute coronary syndrome, 75 diabetics and 75 nondiabetics admitted in Manmohan Cardiothoracic vascular and transplant Centre were selected randomly during a period of one year formed the study group. Random Blood Sugar, Fasting Blood Sugar was done in all 150 patients, HbA1c in all diabetics. All subjects with acute ST Elevation Myocardial Infarction were taken up for coronary angiography intended for primary PCI. Result In our study, 35 (46.7%) out of 75 diabetic patients had triple or multi-vessel disease compared to 10 (13.4%) out of 75 non diabetics. Non-diabetic patients had significantly higher single vessel disease (65.3%). There was a statistically significant association of duration of DM with vessels involved. The occurrence of Triple Vessel Disease/Multivessel Disease was significantly higher in the patients with DM duration > 10 years compared to patients with DM duration < 10 years (64.7% vs. 35.3%, P < 0.001), however there was no significant difference in type of vessel involved. Similarly, a significantly higher proportion of Triple vessel disease was observed in patients with poor glycemic control (HbA1c > 8.5%). 72.2% of the patients with HbA1c > 8.5% had Triple vessel disease/Multi vessel disease, whereas patients with good glycemic control (HbA1c < 7.0%) had predominantly Single vessel disease (90.0%), with no occurrence of Triple vessel disease/Multi vessel disease Conclusion Diabetic patients presenting with ST Elevation Myocardial Infarction are likely to have triple/multiple vessel disease compared to non-diabetic patients. The occurrence of Triple Vessel Disease/Multivessel Disease was significantly higher in the patients with DM duration > 10 years compared to patients with DM duration <10 years.
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Affiliation(s)
- S R Pathak
- Department of Cardiology, Manmohan Cardiothoracic Vascular and Transplant Centre (MCVTC), TU Teaching Hospital, Maharajgunj, Kathmandu, Nepal
| | - R M Gajurel
- Department of Cardiology, Manmohan Cardiothoracic Vascular and Transplant Centre (MCVTC), TU Teaching Hospital, Maharajgunj, Kathmandu, Nepal
| | - C M Poudel
- Department of Cardiology, Manmohan Cardiothoracic Vascular and Transplant Centre (MCVTC), TU Teaching Hospital, Maharajgunj, Kathmandu, Nepal
| | - H Shrestha
- Department of Cardiology, Manmohan Cardiothoracic Vascular and Transplant Centre (MCVTC), TU Teaching Hospital, Maharajgunj, Kathmandu, Nepal
| | - S Thapa
- Department of Cardiology, Manmohan Cardiothoracic Vascular and Transplant Centre (MCVTC), TU Teaching Hospital, Maharajgunj, Kathmandu, Nepal
| | - S Thapa
- Department of Cardiology, Manmohan Cardiothoracic Vascular and Transplant Centre (MCVTC), TU Teaching Hospital, Maharajgunj, Kathmandu, Nepal
| | - P Koirala
- Department of Cardiology, Manmohan Cardiothoracic Vascular and Transplant Centre (MCVTC), TU Teaching Hospital, Maharajgunj, Kathmandu, Nepal
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Thapa S, Thakur N, Kunwar AJ, Joshi G. Differentiating Entamoeba hystolytica, E. disparand E. moshkovskii in stool sample from rural community of Nepal using nested-PCR. Int J Infect Dis 2020. [DOI: 10.1016/j.ijid.2020.09.520] [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: 11/25/2022] Open
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You T, Ogawa EF, Thapa S, Cai Y, Yeh GY, Wayne PM, Shi L, Leveille SG. Effects of Tai Chi on beta endorphin and inflammatory markers in older adults with chronic pain: an exploratory study. Aging Clin Exp Res 2020; 32:1389-1392. [PMID: 31432432 DOI: 10.1007/s40520-019-01316-1] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2019] [Accepted: 08/09/2019] [Indexed: 12/11/2022]
Abstract
The purpose of this exploratory study was to examine the effects of Tai Chi on blood levels of beta endorphin (β-endorphin) and inflammatory markers in older adults with chronic pain. Forty community-dwelling older adults with chronic pain were randomized to Tai Chi or light physical exercise, and each offered twice weekly for 12 weeks. Following the 12-week intervention, neither Tai Chi nor light physical exercise changed levels of β-endorphin and inflammatory markers. However, in older adults who completed 70% or more classes, Tai Chi significantly lowered levels of β-endorphin (p < 0.05), whereas light physical exercise did not change levels of β-endorphin. The results suggest that Tai Chi may reduce levels of β-endorphin in older adults with chronic pain. Future studies are needed to better understand the role of the opioid analgesic system and immune system in regulating pain with aging and the long-term effects of Tai Chi on pain-related biomarkers.
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Affiliation(s)
- Tongjian You
- Department of Exercise and Health Sciences, College of Nursing and Health Sciences, University of Massachusetts Boston, Boston, MA, 02125, USA.
| | - Elisa F Ogawa
- Department of Exercise and Health Sciences, College of Nursing and Health Sciences, University of Massachusetts Boston, Boston, MA, 02125, USA
- New England GRECC, VA Boston Healthcare System, Boston, MA, 02130, USA
| | - Saurja Thapa
- Department of Nursing, College of Nursing and Health Sciences, University of Massachusetts Boston, Boston, MA, 02125, USA
| | - Yurun Cai
- Department of Nursing, College of Nursing and Health Sciences, University of Massachusetts Boston, Boston, MA, 02125, USA
| | - Gloria Y Yeh
- Department of Medicine, Beth Israel Deaconess Medical Center, Boston, MA, 02215, USA
- Harvard Medical School, Boston, MA, 02115, USA
- Osher Center for Integrative Medicine, Brigham and Women's Hospital, Boston, MA, 02115, USA
| | - Peter M Wayne
- Harvard Medical School, Boston, MA, 02115, USA
- Osher Center for Integrative Medicine, Brigham and Women's Hospital, Boston, MA, 02115, USA
| | - Ling Shi
- Department of Nursing, College of Nursing and Health Sciences, University of Massachusetts Boston, Boston, MA, 02125, USA
| | - Suzanne G Leveille
- Department of Nursing, College of Nursing and Health Sciences, University of Massachusetts Boston, Boston, MA, 02125, USA
- Department of Medicine, Beth Israel Deaconess Medical Center, Boston, MA, 02215, USA
- Harvard Medical School, Boston, MA, 02115, USA
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Abstract
Hysteroscopy is the gold standard for evaluating the uterine cavity, diagnosing intrauterine pathology, and operative intervention for some causes of abnormal uterine bleeding. The American College of Obstetricians and Gynecologists concluded that, when the endometrium measures ≤4 mm with transvaginal ultrasonography, the likelihood that bleeding is secondary to endometrial carcinoma is less than 1% (negative predictive value 99%), and endometrial biopsy is not recommended. Endometrial sampling in this clinical scenario will likely result in insufficient tissue for evaluation and it is reasonable to consider initial management for atrophy. A thickened endometrium on transvaginal ultrasonography (>4 mm in a postmenopausal woman with postmenopausal bleeding) warrants additional evaluation with endometrial sampling. A negative tissue biopsy following 'blind' endometrial sampling in women with postmenopausal bleeding is not considered to be an endpoint, and further evaluation of the endometrial cavity with hysteroscopy to exclude focal disease is imperative.
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Affiliation(s)
- R Manchanda
- Gynaecological Endoscopy Unit, Manchanda's Endoscopic Centre and PSRI Hospital, Delhi, India
| | - S Thapa
- Gynaecological Endoscopy, Rosewalk Hospital, New Delhi, India
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El-Ghazali S, Wilson-Morkeh H, Porter A, Thapa S, Mason J, Fontana M, Singh A, Cole G, Youngstein T. AB1023 CARDIAC MRI IN HYPERFERRITINAEMIC DISEASE STATES REVEALS MYOCARDIAL INFLAMMATION NOT IDENTIFIED BY ECHOCARDIOGRAPHY. Ann Rheum Dis 2020. [DOI: 10.1136/annrheumdis-2020-eular.2666] [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: 11/04/2022]
Abstract
Background:Acutely unwell adult patients with hyperinflammatory hyperferritinaemic states are typically challenging to diagnose. Case series suggest that cardiac involvement may be common (up to 20%) but the phenotype has not been well characterised1.The elevation of cardiac biomarkers suggests cardiac involvement, but are non-specific in acute illness. Cardiac MRI (CMR) offers the ability to characterise the myocardium and identify inflammation, and modern motion-corrected sequences now allow the assessment of patients who may struggle to breath-hold in the recovery from acute illness.Objectives:We report 3 patients who underwent CMR in the acute phase of illness with raised cardiac biomarkers.Methods:Case records of acutely ill patients with hyperferritinaemia from two major London centres were reviewed and cases who had undergone CMR in the acute phase of illness were identified.Results:3 cases were identified from a cohort of 22, we report CMR findings from differing aetiologies of hyperferritinaemic states:Case 1: A female in her 60s presented acutely unwell with fever, swollen joints and salmon pink rash. Ferritin was raised at 50574ug/L (20-300ug/L), troponin I 384ng/L (<34ng/L) and Brain Natriuretic Peptide (BNP) 324ng/L (<159ng/L). Echocardiography was normal. However CMR with T2 mapping revealed several small areas of raised signal consistent with myocardial inflammation. A diagnosis of systemic Adult Onset Stills Disease (AOSD) was made. She received IV methylprednisolone and anakinra with normalisation of cardiac biomarkers.Case 2: A male in his 20s with known SLE with associated end stage renal failure requiring transplant. He had a previous prolonged admission secondary to HLH. He presented with chest pain and concave shaped ST elevation on ECG. Troponin peak 2168ng/L, BNP 1334ng/L. Peak ferritin 1300ug/l.He was initiated on colchicine for likely pericarditis. Echocardiography showed a dilated left ventricle and mildly increased wall thickness, but overall systolic function within normal limits.CMR reported nodular patchy late gadolinium enhancement in the mid inferoseptum and inferior wall associated with areas of raised T2 mapping values. NM cardiac rest gated PET reported abnormal FDG uptake to the myocardium with sites including the apical inferior wall, apical RV insertion point and basal septal/anterior right ventricular walls. Features were deemed in keeping with active myocarditis.He responded to colchicine with improved troponin, and was discharged with close follow up.Case 3: A male in his 20s presented with septic shock attributed to meningococcal septicaemia requiring ITU admission. Troponin was elevated at >9000ng/L. Bloods demonstrated raised ferritin and features consistent with HLH were identified.CMR reported elevated native myocardial T1/T2 signal of the lateral and mid-anterior walls in keeping with myocardial oedema. Pericardium adjacent to the anterolateral wall had elevated T1/T2 signal with hyperenhancement on delayed enhancement imaging. Tissue characterisation was in keeping with an acute myopericarditis process.In addition to broad spectrum antibiotics to treat his underlying infection, he received therapy for HLH including methylprednisolone, anakinra and IVIG. He subsequently made a good recovery to treatment.Conclusion:CMR in acute illness with hyperferritinaemia reveals abnormal tissue characterisation with myocardial inflammation, even when echocardiography is normal. We suggest CMR may be a useful test to expand our understanding of hyperferritinaemic disease states.References:[1]M Gerfaud-Valentin et al. Myocarditis in Adult-Onset Still Disease. Medicine (Baltimore) 2014 Oct; 93(17): 280-289Disclosure of Interests:None declared
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Thapa S, Agrawal S, Kryger M. 0707 “What We’Ve Got Here Is Failure To Communicate”: Apnea Patients And Their DME Suppliers. Sleep 2020. [DOI: 10.1093/sleep/zsaa056.703] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Abstract
Introduction
Successful treatment of obstructive sleep apnea requires adherence to positive airway pressure (PAP) therapy. A key factor is the relationship between the DME provider and the patient so that treatment can be initiated and continued in a timely manner. Our quality improvement project aims to empower and enable patients towards active participation in their sleep apnea care. Our goal is to ultimately increase patients’ knowledge of their Durable Medical Equipment (DME) supplies company, and thus improve their treatment. The first step was to determine patients’ familiarity with their DME.
Methods
Forty-one patients with sleep apnea on PAP therapy volunteered to be questioned about their DME company during clinic visits at the Yale North Haven Sleep Center, Connecticut, starting November 2019. Patients were asked if they knew the name or the contact of their DME; whether they received adequate training on PAP therapy initiation; if they were receiving timely and correct PAP therapy supplies. They were asked to rate their satisfaction with the DME on a scale of 1 to 5; one being very dissatisfied and five being very satisfied.
Results
Only 12 out of 41 patients (29.3 percent) knew the names of their DME companies. The average satisfaction rating was 3 (neutral); 44% of patients were dissatisfied, or very dissatisfied with the performance of their DME. Detailed comments were mostly related to poor contact and communication with the DME.
Conclusion
Most apnea patients had difficulty identifying and contacting their DME. As the next step of this quality improvement project we plan to intervene to ensure that the patients have the name and contact information of their DME available and attached to their PAP machine equipment. We plan to repeat this questionnaire after this intervention to study the impact of this quality improvement project.
Support
None
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Affiliation(s)
- S Thapa
- Yale University, New Haven, CT
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14
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Koirala R, Panthee N, Pradhan S, Rajbhandari N, Shrestha DK, Chhetri S, Shrestha Y, Dahal A, Dhakal S, Thapa S. Multi-drug Resistant and Extended Spectrum β-lactamase Producing Salmonella Species Isolated from Fresh Chicken Liver Samples. Kathmandu Univ Med J (KUMJ) 2020; 18:133-138. [PMID: 33594018] [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 Ductus arteriosus is a vascular structure which connects the roof of main pulmonary artery near the origin of the left branch pulmonary artery to the proximal descending aorta. Patent ductus arteriosus (PDA) closure is indicated for any patient who is symptomatic from left to right shunting. Objective To investigate the hospital outcomes of surgical closure of patent ductus arteriosus over last 19 years starting from the very first case of our center. Method This is a retrospective analysis of all patent ductus arteriosus treated surgically from August 2001 to July 2019. Patients who underwent isolated surgical closure of patent ductus arteriosus were included. Data have been presented in three different eras (Era 1: 2001-2007, Era 2: 2008-2013, and Era 3: 2014-2019) to see the trend of evolution of this surgery. Result A total of 901 patients aged 8.67±8.76 years under went patent ductus arteriosus surgical closure over last 19 years. Patients in the initial era 2001-2007 were significantly older compared with other 2 eras (p=0.000). Males accounted for 35.5% of all cases. Twenty percent had severe pulmonary artery hypertension.Duration of mechanical ventilation was 3.57±9.64 hours with ICU stay of 1.55±1.53 days, and hospital stay of 3.9±2.3 days. Overall in hospital mortality was 0.8%; for isolated patent ductus arteriosus diagnosis, mortality was 0.2%. Chylothorax was noted in 0.4%. Conclusion This is the first report to analyze surgical outcomes of patent ductus arteriosus ligation in our center. We have discussed the evolution of patent ductus arteriosus surgery in our center, and have shown favorable outcomes in terms of morbidity and mortality.
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Affiliation(s)
- R Koirala
- Department of Cardiac Surgery, Shahid Gangalal National Heart Center, Bansbari, Kathmandu, Nepal
| | - N Panthee
- Department of Cardiac Surgery, Shahid Gangalal National Heart Center, Bansbari, Kathmandu, Nepal
| | - S Pradhan
- Department of Cardiac Surgery, Shahid Gangalal National Heart Center, Bansbari, Kathmandu, Nepal
| | - N Rajbhandari
- Department of Cardiac Surgery, Shahid Gangalal National Heart Center, Bansbari, Kathmandu, Nepal
| | - D K Shrestha
- Department of Cardiac Surgery, Shahid Gangalal National Heart Center, Bansbari, Kathmandu, Nepal
| | - S Chhetri
- Department of Cardiac Surgery, Shahid Gangalal National Heart Center, Bansbari, Kathmandu, Nepal
| | - Y Shrestha
- Department of Cardiac Surgery, Shahid Gangalal National Heart Center, Bansbari, Kathmandu, Nepal
| | - A Dahal
- Department of Cardiac Surgery, Shahid Gangalal National Heart Center, Bansbari, Kathmandu, Nepal
| | - S Dhakal
- Department of Cardiac Surgery, Shahid Gangalal National Heart Center, Bansbari, Kathmandu, Nepal
| | - S Thapa
- Department of Cardiac Surgery, Shahid Gangalal National Heart Center, Bansbari, Kathmandu, Nepal
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15
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Thapa S. Accuracy of distress thermometer to measure cancer-related mood disorders in Chinese patients with cancer. Ann Oncol 2019. [DOI: 10.1093/annonc/mdz265.056] [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: 11/14/2022] Open
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Thapa S, Shmerling RH, Bean JF, Cai Y, Leveille SG. Chronic multisite pain: evaluation of a new geriatric syndrome. Aging Clin Exp Res 2019; 31:1129-1137. [PMID: 30361952 DOI: 10.1007/s40520-018-1061-3] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2018] [Accepted: 10/16/2018] [Indexed: 02/03/2023]
Abstract
BACKGROUND Chronic musculoskeletal pain is highly prevalent in the older adults, and individuals with musculoskeletal pain frequently report pain in two or more sites. AIMS To determine the prevalence and characteristics of multisite pain in relation to other geriatric syndromes and to evaluate whether multisite pain may represent a distinct geriatric syndrome. METHODS The MOBILIZE Boston Study is a population-based cohort study of older adults that enrolled 749 participants aged 70 and older. Persistent pain in the back and major joint areas was assessed using a joint pain questionnaire. Assessment of other geriatric syndromes included urinary incontinence, fall history, ADL disability, and frailty. A number of risk factors for geriatric syndromes were assessed. RESULTS The prevalence of multisite pain was 40% in this population of older adults. Many participants had more than one geriatric syndrome, indicating substantial overlap in the prevalence of these conditions. Nearly half (48%) of participants with urinary incontinence or falls, 61% with ADL disability, and 49% of those with frailty also had multisite pain. Shared risk factors for established geriatric conditions were similarly distributed among the elderly population who had multisite pain. Demographic and health characteristics associated with multisite pain and other geriatric syndromes, included gender (female), depression, number of comorbid conditions, and mobility limitations. CONCLUSION Although prior studies have explored risk factors for chronic multisite pain, these findings reveal that multisite pain, often unexplained, bears many similarities to established geriatric syndromes. Multisite pain warrants further consideration as a unique geriatric syndrome.
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Affiliation(s)
- Saurja Thapa
- College of Nursing and Health Sciences, University of Massachusetts Boston, Boston, MA, USA
| | - Robert H Shmerling
- Department of Medicine, Beth Israel Deaconess Medical Center, Boston, MA, USA
- Harvard Medical School, Boston, MA, USA
| | - Jonathan F Bean
- Harvard Medical School, Boston, MA, USA
- New England Geriatric, Research, Education and Clinical Center, Boston Veterans Administration Health System, Boston, MA, USA
- Spaulding Rehabilitation Hospital, Boston, MA, USA
| | - Yurun Cai
- College of Nursing and Health Sciences, University of Massachusetts Boston, Boston, MA, USA
| | - Suzanne G Leveille
- College of Nursing and Health Sciences, University of Massachusetts Boston, Boston, MA, USA.
- Department of Medicine, Beth Israel Deaconess Medical Center, Boston, MA, USA.
- Harvard Medical School, Boston, MA, USA.
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You T, Ogawa EF, Thapa S, Cai Y, Zhang H, Nagae S, Yeh GY, Wayne PM, Shi L, Leveille SG. Tai Chi for older adults with chronic multisite pain: a randomized controlled pilot study. Aging Clin Exp Res 2018; 30:1335-1343. [PMID: 29512041 DOI: 10.1007/s40520-018-0922-0] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2017] [Accepted: 02/26/2018] [Indexed: 01/10/2023]
Abstract
BACKGROUND Chronic pain is associated with poorer cognition and mobility, and fall risk in older adults. AIMS To investigate the feasibility of a randomized controlled trial of mind-body exercise (Tai Chi) versus light physical exercise in older adults with multisite pain. METHODS Adults aged ≥ 65 years with multisite pain who reported falling in the past year or current use of an assistive device were recruited from Boston area communities. Participants were randomized to either a Tai Chi or a light physical exercise program, offered twice weekly for 12 weeks. The primary outcomes were feasibility and acceptability. Secondary outcomes included pain characteristics, cognition, physical function, gait mobility, fear of falling, and fall rate. RESULTS Of 176 adults screened, 85 were eligible, and 54 consented and enrolled (average age 75 ± 8 years; 96.30% white; 75.93% female). The dropout rate was 18% for Tai Chi and 12% for light physical exercise. For those completing the study, exercise class attendance rate was 76% for Tai Chi and 82% for light physical exercise. There were no significant group differences in most secondary outcomes. Tai Chi significantly lowered pain severity (4.58 ± 1.73 to 3.73 ± 1.79, p < 0.01) and pain interference (4.20 ± 2.53 to 3.16 ± 2.28, p < 0.05), reduced fear of falling (90.82 ± 9.59 to 96.84 ± 10.67, p < 0.05), and improved several single-task and dual-task gait variables, while light physical exercise did not change these measures. DISCUSSION AND CONCLUSIONS This study demonstrated the feasibility and acceptability of conducting a larger randomized controlled trial in older adults with multisite pain. Study findings and challenges encountered will inform future research.
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Affiliation(s)
- Tongjian You
- Department of Exercise and Health Sciences, College of Nursing and Health Sciences, University of Massachusetts Boston, Boston, MA, 02125, USA.
| | - Elisa F Ogawa
- Department of Exercise and Health Sciences, College of Nursing and Health Sciences, University of Massachusetts Boston, Boston, MA, 02125, USA
| | - Saurja Thapa
- Department of Nursing, College of Nursing and Health Sciences, University of Massachusetts Boston, Boston, MA, 02125, USA
| | - Yurun Cai
- Department of Nursing, College of Nursing and Health Sciences, University of Massachusetts Boston, Boston, MA, 02125, USA
| | - Huan Zhang
- Huan's Tai Chi, Cambridge, MA, 02139, USA
| | - Satoshi Nagae
- Department of Exercise and Health Sciences, College of Nursing and Health Sciences, University of Massachusetts Boston, Boston, MA, 02125, USA
| | - Gloria Y Yeh
- Department of Medicine, Beth Israel Deaconess Medical Center, Boston, MA, 02215, USA
- Harvard Medical School, Boston, MA, 02115, USA
| | - Peter M Wayne
- Harvard Medical School, Boston, MA, 02115, USA
- Osher Center for Integrative Medicine, Brigham and Women's Hospital, Boston, MA, 02115, USA
| | - Ling Shi
- Department of Nursing, College of Nursing and Health Sciences, University of Massachusetts Boston, Boston, MA, 02125, USA
| | - Suzanne G Leveille
- Department of Nursing, College of Nursing and Health Sciences, University of Massachusetts Boston, Boston, MA, 02125, USA
- Department of Medicine, Beth Israel Deaconess Medical Center, Boston, MA, 02215, USA
- Harvard Medical School, Boston, MA, 02115, USA
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Binod G, Sapkota R, Rayamajhee B, Poudel P, Thapa S, Lekhak S, Khanal S. Detection of blaNDM-1 gene among the carbapenem resistant Escherichia coli and Klebsiella pneumoniae isolates. N Biotechnol 2018. [DOI: 10.1016/j.nbt.2018.05.1038] [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: 11/25/2022]
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Niraula A, Thapa S, Kunwar S, Lamsal M, Baral N, Maskey R. Adenosine deaminase activity in type 2 diabetes mellitus: does it have any role? BMC Endocr Disord 2018; 18:58. [PMID: 30126383 PMCID: PMC6102918 DOI: 10.1186/s12902-018-0284-9] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/13/2017] [Accepted: 08/03/2018] [Indexed: 01/21/2023] Open
Abstract
BACKGROUND Diabetes mellitus is a group of metabolic disorders of carbohydrate metabolism in which glucose is underused, producing hyperglycemia. Diabetic patients are prone to opportunistic infection, thus serum ADA levels in these patients is very important as a screening test for Tuberculosis and autoimmune diseases. Thus, the present study was conducted to estimate the Serum ADA activity, glycated Haemoglobin (HbA1c), fasting and postprandial glucose level in patients with T2DM and to correlate the serum level of ADA with glycated Hemoglobin (HbA1c), fasting and postprandial glucose level in T2DM. METHODS This is a Hospital based cross-sectional study done in BPKIHs, Dharan, Nepal. 204 diagnosed patients (102 males and 102 females) with T2DM and 102 healthy controls were enrolled in the study. Diabetic patients were categorized into Uncontrolled and Controlled Diabetes on the basis of HbA1C; HbA1c > 7% = Uncontrolled Diabetes, HbA1c < 7% = Controlled Diabetes. RESULTS Serum ADA levels (U/L) was significantly raised in Uncontrolled Diabetic patients (49.24 ± 16.89) compared to controlled population (35.74 ± 16.78) and healthy controls (10.55 ± 2.20), p value < 0.001. A significant positive correlation was obtained between Serum ADA and HbA1c, Fasting Plasma Glucose and Post-prandial Glucose respectively. CONCLUSION There is a significant increase in Serum ADA activity in DM with increase in HbA1c levels which may play an important role in predicting the glycemic and immunological status in these patients.
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Affiliation(s)
- A. Niraula
- Department of Biochemistry, B.P. Koirala Institute of Health Sciences, Dharan, Nepal
| | - S. Thapa
- Department of Biochemistry, Kathmandu University School of Medical Sciences, Kavre, Dhulikhel, Nepal
| | - S. Kunwar
- Department of Biochemistry, Modern Technical Institute, Satdobato, Lalitpur, Nepal
| | - M. Lamsal
- Department of Biochemistry, B.P. Koirala Institute of Health Sciences, Dharan, Nepal
| | - N. Baral
- Department of Biochemistry, B.P. Koirala Institute of Health Sciences, Dharan, Nepal
| | - R. Maskey
- Department of Internal Medicine, B.P. Koirala Institute of Health Sciences, Dharan, Nepal
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Shrestha R, Shrestha R, Thapa S, Khadka SK, Shrestha D. Clinical Outcome following Intra-articular Triamcinolone Injection in Osteoarthritic Knee at the Community: A Randomized Double Blind Placebo Controlled Trial. Kathmandu Univ Med J (KUMJ) 2018; 16:175-180. [PMID: 30636761] [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: 06/09/2023]
Abstract
Background Knee pain is one of the common complaints patients present with in any community based health camps and Osteoarthritis of knee is a usual diagnosis. Injecting a long acting steroid is a common practice to alleviate the symptoms of osteoarthritic knee. Objective To evaluate the clinical outcome of injecting Triamcinolone acetenoid in osteoarthritis of knee in a community set up over a randomized double-blind placebo control trial. Method A prospective, randomized, double blind, placebo control trial was carried out in community after obtaining the ethical clearance from the IRC. Patients with clinically diagnosed osteoarthritis of knee were injected either Triamcinolone or Placebo after recording the baseline scores of the knee by Knee injury and Osteoarthritis Outcome Score (KOOS) - Physical Function Short form (KOOS-PS), the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) and Visual Analogue Scale (VAS). The same tools were used at two, six and at twelve weeks post injection to evaluate the functional outcome and pain. Result One hundred and seventeen patients were available for analysis among which, 55(48.7%) patients received Triamcinolone and 58(51.3%) received placebo. The baseline status of knees of two groups was comparable at the start of study. There was significant pain relief in the group receiving Triamcinolone at two and six week but not in twelve weeks. Group receiving placebo had pain relief only for first two weeks. Functional outcome was significantly improved compared to baseline in both the groups until six weeks however, in the triamcinolone group, it was significant until twelve weeks. No major complications were noted. Conclusion Intra-articular injection of Triamcinolone acetenoid is effective in symptoms control and improving functional outcome in clinically diagnosed osteoarthritis of knees in community set up during health camps.
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Affiliation(s)
- R Shrestha
- Department of Orthopedics and Traumatology, Kathmandu University School of Medical Sciences, Dhulikhel, Kavre, Nepal
| | - R Shrestha
- Department of Pharmacology, Kathmandu University School of Medical Sciences, Dhulikhel, Kavre, Nepal
| | - S Thapa
- Department of Orthopedics and Traumatology, Kathmandu University School of Medical Sciences, Dhulikhel, Kavre, Nepal
| | - S K Khadka
- Department of Orthopedics and Traumatology, Kathmandu University School of Medical Sciences, Dhulikhel, Kavre, Nepal
| | - D Shrestha
- Department of Orthopedics and Traumatology, Kathmandu University School of Medical Sciences, Dhulikhel, Kavre, Nepal
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Shrestha R, Khadka SK, Thapa S, Shrestha B, Shrestha SK, Ranjit S, Pradhan BB, Shakya YR, Lama D, Shrestha J. Improving Knowledge, Skill and Confidence of Novice Medical Doctors in Trauma Management with Principles of ABCDE. Kathmandu Univ Med J (KUMJ) 2018; 16:69-73. [PMID: 30631021] [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: 06/09/2023]
Abstract
Background Trauma is one of the major public health concerns clamming about five million death annually worldwide. Experience and confidence of a doctor in the management of trauma patients have big impact on the overall outcome. Objective This study aims to evaluate the outcome of a trauma course in improving the knowledge, skill and confidence of novice doctors in managing trauma victims. Method A pre/post test analytical study was carried out among novice medical doctors from Kathmandu University School of Medical Science (KUSMS) who participated in a standard two and a half day trauma course, that utilizes the principles of ABCDE, as a part of their regular training. Pre-course knowledge and skill were compared with immediate post-course scores on the same guidelines. Objective structured and subjective written feedbacks from the participants were analyzed qualitatively to identify the perceptions of candidates. Result Sixty-eight males and twenty-nine females completed the course. The average pre-test scores in knowledge and skill were 8.3(33.2%) and 19.6(78.5%) respectively. Similarly the post-test scores were 16.04(64.2%) and 22.45 (89.5%) respectively, showing statistically significant improvements (P 0.000). The mean percentage improvement in knowledge was 48.8% and that in skill was 160.9%. The feedback analysis showed majority of the participants were satisfied with the course and they perceived improved "self-confident" in handling trauma cases. Conclusion All the novice doctors should participate in a standard trauma course hence their knowledge, skill and confidence in handling a trauma can be improved.
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Affiliation(s)
- R Shrestha
- Department of Orthopedics, Dhulikhel Hospital, Kathmandu University Hospital, Kathmandu University School of Medical Sciences Dhulikhel, Kavre, Nepal
| | - S K Khadka
- Department of Orthopedics, Dhulikhel Hospital, Kathmandu University Hospital, Kathmandu University School of Medical Sciences Dhulikhel, Kavre, Nepal
| | - S Thapa
- Department of Orthopedics, Dhulikhel Hospital, Kathmandu University Hospital, Kathmandu University School of Medical Sciences Dhulikhel, Kavre, Nepal
| | - B Shrestha
- Department of Orthopedics, Dhulikhel Hospital, Kathmandu University Hospital, Kathmandu University School of Medical Sciences Dhulikhel, Kavre, Nepal
| | - S K Shrestha
- Department of Emergency Medicine, Dhulikhel Hospital, Kathmandu University Hospital, Kathmandu University School of Medical Sciences Dhulikhel, Kavre, Nepal
| | - S Ranjit
- Department of Anesthesia, Dhulikhel Hospital, Kathmandu University Hospital, Kathmandu University School of Medical Sciences Dhulikhel, Kavre, Nepal
| | - B B Pradhan
- Department of Anesthesia, Dhulikhel Hospital, Kathmandu University Hospital, Kathmandu University School of Medical Sciences Dhulikhel, Kavre, Nepal
| | - Y R Shakya
- Department of Surgery, Dhulikhel Hospital, Kathmandu University Hospital, Kathmandu University School of Medical Sciences Dhulikhel, Kavre, Nepal
| | - D Lama
- Department of Surgery, Armed Police Force Hospital, Kathmandu, Nepal
| | - J Shrestha
- International Committee of the Red Cross (ICRC), Kathmandu, Nepal
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Aprile E, Aalbers J, Agostini F, Alfonsi M, Amaro FD, Anthony M, Arneodo F, Barrow P, Baudis L, Bauermeister B, Benabderrahmane ML, Berger T, Breur PA, Brown A, Brown A, Brown E, Bruenner S, Bruno G, Budnik R, Bütikofer L, Calvén J, Cardoso JMR, Cervantes M, Cichon D, Coderre D, Colijn AP, Conrad J, Cussonneau JP, Decowski MP, de Perio P, Di Gangi P, Di Giovanni A, Diglio S, Eurin G, Fei J, Ferella AD, Fieguth A, Fulgione W, Gallo Rosso A, Galloway M, Gao F, Garbini M, Gardner R, Geis C, Goetzke LW, Grandi L, Greene Z, Grignon C, Hasterok C, Hogenbirk E, Howlett J, Itay R, Kaminsky B, Kazama S, Kessler G, Kish A, Landsman H, Lang RF, Lellouch D, Levinson L, Lin Q, Lindemann S, Lindner M, Lombardi F, Lopes JAM, Manfredini A, Mariş I, Marrodán Undagoitia T, Masbou J, Massoli FV, Masson D, Mayani D, Messina M, Micheneau K, Molinario A, Morå K, Murra M, Naganoma J, Ni K, Oberlack U, Pakarha P, Pelssers B, Persiani R, Piastra F, Pienaar J, Pizzella V, Piro MC, Plante G, Priel N, Rauch L, Reichard S, Reuter C, Riedel B, Rizzo A, Rosendahl S, Rupp N, Saldanha R, Dos Santos JMF, Sartorelli G, Scheibelhut M, Schindler S, Schreiner J, Schumann M, Scotto Lavina L, Selvi M, Shagin P, Shockley E, Silva M, Simgen H, Sivers MV, Stein A, Thapa S, Thers D, Tiseni A, Trinchero G, Tunnell C, Vargas M, Upole N, Wang H, Wang Z, Wei Y, Weinheimer C, Wulf J, Ye J, Zhang Y, Zhu T. First Dark Matter Search Results from the XENON1T Experiment. Phys Rev Lett 2017; 119:181301. [PMID: 29219593 DOI: 10.1103/physrevlett.119.181301] [Citation(s) in RCA: 67] [Impact Index Per Article: 9.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/25/2017] [Indexed: 06/07/2023]
Abstract
We report the first dark matter search results from XENON1T, a ∼2000-kg-target-mass dual-phase (liquid-gas) xenon time projection chamber in operation at the Laboratori Nazionali del Gran Sasso in Italy and the first ton-scale detector of this kind. The blinded search used 34.2 live days of data acquired between November 2016 and January 2017. Inside the (1042±12)-kg fiducial mass and in the [5,40] keV_{nr} energy range of interest for weakly interacting massive particle (WIMP) dark matter searches, the electronic recoil background was (1.93±0.25)×10^{-4} events/(kg×day×keV_{ee}), the lowest ever achieved in such a dark matter detector. A profile likelihood analysis shows that the data are consistent with the background-only hypothesis. We derive the most stringent exclusion limits on the spin-independent WIMP-nucleon interaction cross section for WIMP masses above 10 GeV/c^{2}, with a minimum of 7.7×10^{-47} cm^{2} for 35-GeV/c^{2} WIMPs at 90% C.L.
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Affiliation(s)
- E Aprile
- Physics Department, Columbia University, New York, New York 10027, USA
| | - J Aalbers
- Nikhef and the University of Amsterdam, Science Park, 1098XG Amsterdam, Netherlands
| | - F Agostini
- INFN-Laboratori Nazionali del Gran Sasso and Gran Sasso Science Institute, 67100 L'Aquila, Italy
- Department of Physics and Astrophysics, University of Bologna and INFN-Bologna, 40126 Bologna, Italy
| | - M Alfonsi
- Institut für Physik and Exzellenzcluster PRISMA, Johannes Gutenberg-Universität Mainz, 55099 Mainz, Germany
| | - F D Amaro
- LIBPhys, Department of Physics, University of Coimbra, 3004-516 Coimbra, Portugal
| | - M Anthony
- Physics Department, Columbia University, New York, New York 10027, USA
| | - F Arneodo
- New York University Abu Dhabi, Abu Dhabi, United Arab Emirates
| | - P Barrow
- Physik-Institut, University of Zurich, 8057 Zurich, Switzerland
| | - L Baudis
- Physik-Institut, University of Zurich, 8057 Zurich, Switzerland
| | - B Bauermeister
- Oskar Klein Centre, Department of Physics, Stockholm University, AlbaNova, Stockholm SE-10691, Sweden
| | | | - T Berger
- Department of Physics, Applied Physics and Astronomy, Rensselaer Polytechnic Institute, Troy, New York 12180, USA
| | - P A Breur
- Nikhef and the University of Amsterdam, Science Park, 1098XG Amsterdam, Netherlands
| | - A Brown
- Nikhef and the University of Amsterdam, Science Park, 1098XG Amsterdam, Netherlands
| | - A Brown
- Physik-Institut, University of Zurich, 8057 Zurich, Switzerland
| | - E Brown
- Department of Physics, Applied Physics and Astronomy, Rensselaer Polytechnic Institute, Troy, New York 12180, USA
| | - S Bruenner
- Max-Planck-Institut für Kernphysik, 69117 Heidelberg, Germany
| | - G Bruno
- INFN-Laboratori Nazionali del Gran Sasso and Gran Sasso Science Institute, 67100 L'Aquila, Italy
| | - R Budnik
- Department of Particle Physics and Astrophysics, Weizmann Institute of Science, Rehovot 7610001, Israel
| | - L Bütikofer
- Physikalisches Institut, Universität Freiburg, 79104 Freiburg, Germany
| | - J Calvén
- Oskar Klein Centre, Department of Physics, Stockholm University, AlbaNova, Stockholm SE-10691, Sweden
| | - J M R Cardoso
- LIBPhys, Department of Physics, University of Coimbra, 3004-516 Coimbra, Portugal
| | - M Cervantes
- Department of Physics and Astronomy, Purdue University, West Lafayette, Indiana 47907, USA
| | - D Cichon
- Max-Planck-Institut für Kernphysik, 69117 Heidelberg, Germany
| | - D Coderre
- Physikalisches Institut, Universität Freiburg, 79104 Freiburg, Germany
| | - A P Colijn
- Nikhef and the University of Amsterdam, Science Park, 1098XG Amsterdam, Netherlands
| | - J Conrad
- Oskar Klein Centre, Department of Physics, Stockholm University, AlbaNova, Stockholm SE-10691, Sweden
| | - J P Cussonneau
- SUBATECH, IMT Atlantique, CNRS/IN2P3, Université de Nantes, Nantes 44307, France
| | - M P Decowski
- Nikhef and the University of Amsterdam, Science Park, 1098XG Amsterdam, Netherlands
| | - P de Perio
- Physics Department, Columbia University, New York, New York 10027, USA
| | - P Di Gangi
- Department of Physics and Astrophysics, University of Bologna and INFN-Bologna, 40126 Bologna, Italy
| | - A Di Giovanni
- New York University Abu Dhabi, Abu Dhabi, United Arab Emirates
| | - S Diglio
- SUBATECH, IMT Atlantique, CNRS/IN2P3, Université de Nantes, Nantes 44307, France
| | - G Eurin
- Max-Planck-Institut für Kernphysik, 69117 Heidelberg, Germany
| | - J Fei
- Department of Physics, University of California, San Diego, California 92093, USA
| | - A D Ferella
- Oskar Klein Centre, Department of Physics, Stockholm University, AlbaNova, Stockholm SE-10691, Sweden
| | - A Fieguth
- Institut für Kernphysik, Westfälische Wilhelms-Universität Münster, 48149 Münster, Germany
| | - W Fulgione
- INFN-Laboratori Nazionali del Gran Sasso and Gran Sasso Science Institute, 67100 L'Aquila, Italy
- INFN-Torino and Osservatorio Astrofisico di Torino, 10125 Torino, Italy
| | - A Gallo Rosso
- INFN-Laboratori Nazionali del Gran Sasso and Gran Sasso Science Institute, 67100 L'Aquila, Italy
| | - M Galloway
- Physik-Institut, University of Zurich, 8057 Zurich, Switzerland
| | - F Gao
- Physics Department, Columbia University, New York, New York 10027, USA
| | - M Garbini
- Department of Physics and Astrophysics, University of Bologna and INFN-Bologna, 40126 Bologna, Italy
| | - R Gardner
- Department of Physics and Kavli Institute for Cosmological Physics, University of Chicago, Chicago, Illinois 60637, USA
| | - C Geis
- Institut für Physik and Exzellenzcluster PRISMA, Johannes Gutenberg-Universität Mainz, 55099 Mainz, Germany
| | - L W Goetzke
- Physics Department, Columbia University, New York, New York 10027, USA
| | - L Grandi
- Department of Physics and Kavli Institute for Cosmological Physics, University of Chicago, Chicago, Illinois 60637, USA
| | - Z Greene
- Physics Department, Columbia University, New York, New York 10027, USA
| | - C Grignon
- Institut für Physik and Exzellenzcluster PRISMA, Johannes Gutenberg-Universität Mainz, 55099 Mainz, Germany
| | - C Hasterok
- Max-Planck-Institut für Kernphysik, 69117 Heidelberg, Germany
| | - E Hogenbirk
- Nikhef and the University of Amsterdam, Science Park, 1098XG Amsterdam, Netherlands
| | - J Howlett
- Physics Department, Columbia University, New York, New York 10027, USA
| | - R Itay
- Department of Particle Physics and Astrophysics, Weizmann Institute of Science, Rehovot 7610001, Israel
| | - B Kaminsky
- Physikalisches Institut, Universität Freiburg, 79104 Freiburg, Germany
| | - S Kazama
- Physik-Institut, University of Zurich, 8057 Zurich, Switzerland
| | - G Kessler
- Physik-Institut, University of Zurich, 8057 Zurich, Switzerland
| | - A Kish
- Physik-Institut, University of Zurich, 8057 Zurich, Switzerland
| | - H Landsman
- Department of Particle Physics and Astrophysics, Weizmann Institute of Science, Rehovot 7610001, Israel
| | - R F Lang
- Department of Physics and Astronomy, Purdue University, West Lafayette, Indiana 47907, USA
| | - D Lellouch
- Department of Particle Physics and Astrophysics, Weizmann Institute of Science, Rehovot 7610001, Israel
| | - L Levinson
- Department of Particle Physics and Astrophysics, Weizmann Institute of Science, Rehovot 7610001, Israel
| | - Q Lin
- Physics Department, Columbia University, New York, New York 10027, USA
| | - S Lindemann
- Max-Planck-Institut für Kernphysik, 69117 Heidelberg, Germany
- Physikalisches Institut, Universität Freiburg, 79104 Freiburg, Germany
| | - M Lindner
- Max-Planck-Institut für Kernphysik, 69117 Heidelberg, Germany
| | - F Lombardi
- Department of Physics, University of California, San Diego, California 92093, USA
| | - J A M Lopes
- LIBPhys, Department of Physics, University of Coimbra, 3004-516 Coimbra, Portugal
| | - A Manfredini
- Department of Particle Physics and Astrophysics, Weizmann Institute of Science, Rehovot 7610001, Israel
| | - I Mariş
- New York University Abu Dhabi, Abu Dhabi, United Arab Emirates
| | | | - J Masbou
- SUBATECH, IMT Atlantique, CNRS/IN2P3, Université de Nantes, Nantes 44307, France
| | - F V Massoli
- Department of Physics and Astrophysics, University of Bologna and INFN-Bologna, 40126 Bologna, Italy
| | - D Masson
- Department of Physics and Astronomy, Purdue University, West Lafayette, Indiana 47907, USA
| | - D Mayani
- Physik-Institut, University of Zurich, 8057 Zurich, Switzerland
| | - M Messina
- Physics Department, Columbia University, New York, New York 10027, USA
| | - K Micheneau
- SUBATECH, IMT Atlantique, CNRS/IN2P3, Université de Nantes, Nantes 44307, France
| | - A Molinario
- INFN-Laboratori Nazionali del Gran Sasso and Gran Sasso Science Institute, 67100 L'Aquila, Italy
| | - K Morå
- Oskar Klein Centre, Department of Physics, Stockholm University, AlbaNova, Stockholm SE-10691, Sweden
| | - M Murra
- Institut für Kernphysik, Westfälische Wilhelms-Universität Münster, 48149 Münster, Germany
| | - J Naganoma
- Department of Physics and Astronomy, Rice University, Houston, Texas 77005, USA
| | - K Ni
- Department of Physics, University of California, San Diego, California 92093, USA
| | - U Oberlack
- Institut für Physik and Exzellenzcluster PRISMA, Johannes Gutenberg-Universität Mainz, 55099 Mainz, Germany
| | - P Pakarha
- Physik-Institut, University of Zurich, 8057 Zurich, Switzerland
| | - B Pelssers
- Oskar Klein Centre, Department of Physics, Stockholm University, AlbaNova, Stockholm SE-10691, Sweden
| | - R Persiani
- SUBATECH, IMT Atlantique, CNRS/IN2P3, Université de Nantes, Nantes 44307, France
| | - F Piastra
- Physik-Institut, University of Zurich, 8057 Zurich, Switzerland
| | - J Pienaar
- Department of Physics and Astronomy, Purdue University, West Lafayette, Indiana 47907, USA
| | - V Pizzella
- Max-Planck-Institut für Kernphysik, 69117 Heidelberg, Germany
| | - M-C Piro
- Department of Physics, Applied Physics and Astronomy, Rensselaer Polytechnic Institute, Troy, New York 12180, USA
| | - G Plante
- Physics Department, Columbia University, New York, New York 10027, USA
| | - N Priel
- Department of Particle Physics and Astrophysics, Weizmann Institute of Science, Rehovot 7610001, Israel
| | - L Rauch
- Max-Planck-Institut für Kernphysik, 69117 Heidelberg, Germany
| | - S Reichard
- Physik-Institut, University of Zurich, 8057 Zurich, Switzerland
- Department of Physics and Astronomy, Purdue University, West Lafayette, Indiana 47907, USA
| | - C Reuter
- Department of Physics and Astronomy, Purdue University, West Lafayette, Indiana 47907, USA
| | - B Riedel
- Department of Physics and Kavli Institute for Cosmological Physics, University of Chicago, Chicago, Illinois 60637, USA
| | - A Rizzo
- Physics Department, Columbia University, New York, New York 10027, USA
| | - S Rosendahl
- Institut für Kernphysik, Westfälische Wilhelms-Universität Münster, 48149 Münster, Germany
| | - N Rupp
- Max-Planck-Institut für Kernphysik, 69117 Heidelberg, Germany
| | - R Saldanha
- Department of Physics and Kavli Institute for Cosmological Physics, University of Chicago, Chicago, Illinois 60637, USA
| | - J M F Dos Santos
- LIBPhys, Department of Physics, University of Coimbra, 3004-516 Coimbra, Portugal
| | - G Sartorelli
- Department of Physics and Astrophysics, University of Bologna and INFN-Bologna, 40126 Bologna, Italy
| | - M Scheibelhut
- Institut für Physik and Exzellenzcluster PRISMA, Johannes Gutenberg-Universität Mainz, 55099 Mainz, Germany
| | - S Schindler
- Institut für Physik and Exzellenzcluster PRISMA, Johannes Gutenberg-Universität Mainz, 55099 Mainz, Germany
| | - J Schreiner
- Max-Planck-Institut für Kernphysik, 69117 Heidelberg, Germany
| | - M Schumann
- Physikalisches Institut, Universität Freiburg, 79104 Freiburg, Germany
| | - L Scotto Lavina
- LPNHE, Université Pierre et Marie Curie, Université Paris Diderot, CNRS/IN2P3, Paris 75252, France
| | - M Selvi
- Department of Physics and Astrophysics, University of Bologna and INFN-Bologna, 40126 Bologna, Italy
| | - P Shagin
- Department of Physics and Astronomy, Rice University, Houston, Texas 77005, USA
| | - E Shockley
- Department of Physics and Kavli Institute for Cosmological Physics, University of Chicago, Chicago, Illinois 60637, USA
| | - M Silva
- LIBPhys, Department of Physics, University of Coimbra, 3004-516 Coimbra, Portugal
| | - H Simgen
- Max-Planck-Institut für Kernphysik, 69117 Heidelberg, Germany
| | - M V Sivers
- Physikalisches Institut, Universität Freiburg, 79104 Freiburg, Germany
| | - A Stein
- Physics & Astronomy Department, University of California, Los Angeles, California 90095, USA
| | - S Thapa
- Department of Physics and Kavli Institute for Cosmological Physics, University of Chicago, Chicago, Illinois 60637, USA
| | - D Thers
- SUBATECH, IMT Atlantique, CNRS/IN2P3, Université de Nantes, Nantes 44307, France
| | - A Tiseni
- Nikhef and the University of Amsterdam, Science Park, 1098XG Amsterdam, Netherlands
| | - G Trinchero
- INFN-Torino and Osservatorio Astrofisico di Torino, 10125 Torino, Italy
| | - C Tunnell
- Department of Physics and Kavli Institute for Cosmological Physics, University of Chicago, Chicago, Illinois 60637, USA
| | - M Vargas
- Institut für Kernphysik, Westfälische Wilhelms-Universität Münster, 48149 Münster, Germany
| | - N Upole
- Department of Physics and Kavli Institute for Cosmological Physics, University of Chicago, Chicago, Illinois 60637, USA
| | - H Wang
- Physics & Astronomy Department, University of California, Los Angeles, California 90095, USA
| | - Z Wang
- INFN-Laboratori Nazionali del Gran Sasso and Gran Sasso Science Institute, 67100 L'Aquila, Italy
| | - Y Wei
- Physik-Institut, University of Zurich, 8057 Zurich, Switzerland
| | - C Weinheimer
- Institut für Kernphysik, Westfälische Wilhelms-Universität Münster, 48149 Münster, Germany
| | - J Wulf
- Physik-Institut, University of Zurich, 8057 Zurich, Switzerland
| | - J Ye
- Department of Physics, University of California, San Diego, California 92093, USA
| | - Y Zhang
- Physics Department, Columbia University, New York, New York 10027, USA
| | - T Zhu
- Physics Department, Columbia University, New York, New York 10027, USA
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Ogawa E, You T, Thapa S, Cai Y, Yeh G, Wayne P, Shi L, Leveille S. EFFECTS OF TAI CHI ON MULTISITE PAIN AND PHYSICAL FUNCTION IN OLDER ADULTS. Innov Aging 2017. [DOI: 10.1093/geroni/igx004.352] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Affiliation(s)
- E. Ogawa
- University of Massachusetts Boston, Boston, Massachusetts,
| | - T. You
- University of Massachusetts Boston, Boston, Massachusetts,
| | - S. Thapa
- University of Massachusetts Boston, Boston, Massachusetts,
| | - Y. Cai
- University of Massachusetts Boston, Boston, Massachusetts,
| | - G. Yeh
- Beth Israel Deaconess Medical Center, Boston, Massachusetts,
- Harvard Medical School, Boston, Massachusetts
| | - P. Wayne
- Harvard Medical School, Boston, Massachusetts
| | - L. Shi
- University of Massachusetts Boston, Boston, Massachusetts,
| | - S.G. Leveille
- University of Massachusetts Boston, Boston, Massachusetts,
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Thapa S, Leveille S, Bean J, McLean R, You T. GENDER DIFFERENCES IN ASSOCIATION OF PAIN AND PHYSICAL PERFORMANCE WITH FEAR OF FALLING. Innov Aging 2017. [DOI: 10.1093/geroni/igx004.3130] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Affiliation(s)
- S. Thapa
- University of Massachusetts Boston, Boston, Massachusetts
| | - S.G. Leveille
- University of Massachusetts Boston, Boston, Massachusetts
| | - J.F. Bean
- Spaulding Center for Lifelong Health and Fitness, Partners Health Care, Boston, Massachusetts,
| | - R. McLean
- Hebrew Senior Life Institute for Aging Research, Boston, Massachusetts,
| | - T. You
- University of Massachusetts Boston, Boston, Massachusetts
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You T, Ogawa E, Thapa S, Cai Y, Zhang H, Nagae S, Yeh G, Wayne P, Leveille S. Effects of Tai Chi on Mobility in Older Adults with Multisite Pain. Med Sci Sports Exerc 2017. [DOI: 10.1249/01.mss.0000516811.06643.ea] [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: 11/21/2022]
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Thapa S. Return to work in women after work-related musculoskeletal injuries in Western Australia 2014-2016. Intern Med J 2017. [DOI: 10.1111/imj.8_13456] [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: 11/26/2022]
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Ghartimagar D, Ghosh A, Shrestha MK, Karki S, Shrestha S, Thapa S, Talwar OP. Orbital lymphoma in an elderly patient. J Pathol Nep 2017. [DOI: 10.3126/jpn.v7i1.16939] [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
Lymphomas of the orbit and orbital adnexae are rare tumors, comprising only 1% of all non-Hodgkin’s lymphoma. Lymphomas are the most common primary orbital tumor in adults of age 60 years and older. Here we present a case of 49 year male with left upper lid swelling since 1 year who was diagnosed histopathologically as non-Hodgkin’s lymphoma of orbital region.
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Ghosh A, Ghartimagar G, Thapa S, Shrestha MK, Talwar OP. Primary nasal meningioma- a case report. J Pathol Nep 2017. [DOI: 10.3126/jpn.v7i1.16940] [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
Extracranial meningiomas may be subdivided into primary and secondary types based on absence or presence of intracranial attachments respectively. Primary sinonasal tract meningiomas are rare with unknown etiopathology and non-specific clinical presentation. Of these PEMs only 11.5% are in the nasal cavity and nasal septum. To our knowledge less than 50 cases of PEM of nasal cavity have been reported in the literature. We report a case of a 22 years old male who presented with epistaxis and increasing nasal stuffiness for the last one year.
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Paudyal P, Pande K, Pradhan A, Shah R, Upadhyaya P, Thapa S. Pleomorphic adenoma of nasal septum: A case report. J Pathol Nep 2017. [DOI: 10.3126/jpn.v7i1.16947] [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
Pleomorphic adenomas are the most common benign tumor of the major salivary glands. Other rare sites for the occurrence of pleomorphic adenoma have been described in the larynx, pharynx, nasal cavity, lacrimal glands and trachea. We report here a case of intranasal pleomorphic adenoma arising from the nasal septum causing nasal obstruction which was clinically diagnosed as papilloma. Histopathology confirmed the diagnosis of pleomorphic adenoma.
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Thapa S, Ghosh A, Ghartimagar D, Prasad T, Narasimhan R, Talwar O. Clinicopathological Study of Malignant Melanoma at Tertiary Care Centre. JNMA J Nepal Med Assoc 2017; 56:132-136. [PMID: 28598449] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/07/2023] Open
Abstract
INTRODUCTION Malignant melanoma, which causes three fourth of all deaths related to skin cancer, is more common in Caucasian population compared to Asian population. There is no reliable information about malignant melanoma in Nepal hence an effort has been made to assess the clinical and pathological features of melanoma patients. METHODS This was a retrospective hospital based study done in the department of Pathology. All cases of malignant melanoma diagnosed on biopsy during a period of 13 years were retrieved, reviewed and collated. RESULTS We had 35 cases with age range from 15 to 84 years with the mean of 51.4 years and M: F of 1.3:1. The predominant site was lower extremities. Most cases were less than 3 cm. Majority of histologic subtypes were nodular melanoma 29 (82.8%) followed by mucosal lentiginous melanoma 3 (8.6%), superficial spreading melanoma 2 (5.7%) and acral lentiginous melanoma 1 (2.9%). Half (50%) of the excisional biopsies were at Clark's level IV and 75% were at high Breslow thickness. CONCLUSIONS The most frequent site in males and females were lower extremities and trunk respectively in contrast to Western studies where it is opposite. Nodular melanoma was the commonest histologic subtype while in other Asian studies and in Western studies majority were acral lentiginous melanoma and superficial spreading melanoma respectively.
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Affiliation(s)
- S Thapa
- Department of Pathology, Manipal Teaching Hospital, Pokhara, Nepal
| | - A Ghosh
- Department of Pathology, Manipal Teaching Hospital, Pokhara, Nepal
| | - D Ghartimagar
- Department of Pathology, Manipal Teaching Hospital, Pokhara, Nepal
| | - T Prasad
- Department of Pathology, Manipal Teaching Hospital, Pokhara, Nepal
| | - R Narasimhan
- Department of Pathology, Manipal Teaching Hospital, Pokhara, Nepal
| | - O Talwar
- Department of Pathology, Manipal Teaching Hospital, Pokhara, Nepal
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Thapa S, Ghosh A, Ghartimagar D, Narasimhan R, Prasad T, Talwar OP. Histopathological Analysis of Non-Neoplastic Superficial Lymphadenopathies. Kathmandu Univ Med J (KUMJ) 2017; 15:51-55. [PMID: 29446363] [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: 06/08/2023]
Abstract
Background Lymphadenopathies are the clinical manifestation of enlargement of lymph nodes which are a common occurrence and are processes of lymph nodes in response to a variety of exogenous and endogenous stimulants. The vast majority of enlarged lymph nodes are non- neoplastic. Objective The objective of the study is to analyze the spectrum of non-neoplastic lesions of superficial lymphadenopathies with their histomorphological features. Method This was a retrospective hospital based study done in the department of Pathology. All cases of superficial lymph node biopsies received during a period of 7 years were retrieved and divided into 2 broad categories: neoplastic and non-neoplastic. The latter group is the material for the present study. The diagnosis was made on morphological basis. Result Of all the 268 superficial lymph node biopsies, 25.4% (68 cases) were neoplastic and 74.6% (200 cases) were non-neoplastic. The non-neoplastic cases were further categorized into non-infectious 60.5% (121 cases) and infectious 39.5% (79 cases). Neck node (70%) was the most common site of involvement. There were 102 male and 98 female patients with male to female ratio 1.04:1. The age range of the patients was 2 years to 83 years with a mean of 27.16 years and most common being 11-20 years 29% (58 cases). Majority of the cases were non-specific reactive lymphadenitis 84.3% (102 cases) followed by tuberculosis 36.5% (73 cases). Conclusion The major cause for the superficial lymphadenopathy was found to be non-neoplastic etiology with slight male predominance. Reactive lymphadenitis was the leading cause unlike the studies done in other Asian and Tropical countries where tuberculosis was more common.
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Affiliation(s)
- S Thapa
- Department of Pathology, Manipal Teaching Hospital, Manipal College of Medical Sciences, Pokhara, Nepal
| | - A Ghosh
- Department of Pathology, Manipal Teaching Hospital, Manipal College of Medical Sciences, Pokhara, Nepal
| | - D Ghartimagar
- Department of Pathology, Manipal Teaching Hospital, Manipal College of Medical Sciences, Pokhara, Nepal
| | - R Narasimhan
- Department of Pathology, Manipal Teaching Hospital, Manipal College of Medical Sciences, Pokhara, Nepal
| | - T Prasad
- Department of Pathology, Manipal Teaching Hospital, Manipal College of Medical Sciences, Pokhara, Nepal
| | - O P Talwar
- Department of Pathology, Manipal Teaching Hospital, Manipal College of Medical Sciences, Pokhara, Nepal
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Abstract
Persons surviving to older ages with HIV/AIDS often face an accelerated aging accompanied by increased comorbidity and decline in health and function. In this chapter, we review the process of disablement among persons aging with HIV/AIDS, from chronic conditions to impairments and functional limitations, leading to disability. Chronic immune activation related to chronic HIV infection may contribute to early development of chronic conditions that are common in older adults resulting in premature disablement. Anatomical and physiological changes related to the aging process make people vulnerable to physical and cognitive impairments. In old age, quality of life depends mainly on avoidance and management of age-associated diseases rather than chronological parameters. Interventions to manage chronic conditions associated with aging may have a significant impact on quality of life in older persons with HIV infection. Because of the complexity of physical and cognitive impairments among persons aging with HIV infection, a range of supports and interventions will be needed to effectively address the problem of disablement in this population.
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Thapa S, Berg-Beckhoff G, Lauritzen L. Methyl mercury exposure in children cognitive development due to prenatal intake of fish. Eur J Public Health 2016. [DOI: 10.1093/eurpub/ckw170.068] [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: 11/12/2022] Open
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Scrafford C, Basnet S, Ansari I, Shrestha L, Shrestha S, Ghimire R, Katz J, Khatry S, Checkley W, Basnet S, Shrestha M, Thapa S, Kansakar P, Puree S, Todi V, Tielsch J. Evaluation of Digital Auscultation to Diagnose Pneumonia in Children 2 to 35 Months of Age in a Clinical Setting in Kathmandu, Nepal: A Prospective Case–Control Study. J PEDIAT INF DIS-GER 2016. [DOI: 10.1055/s-0036-1593749] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Affiliation(s)
- C. Scrafford
- Health Sciences, Exponent, Inc., Washington, District of Columbia, United States
| | - S. Basnet
- Department of Pediatrics, Institute of Medicine, Tribhuvan University, Kathmandu, Nepal
| | - I. Ansari
- Department of Pediatrics, Patan Hospital, Lalitpur, Kathmandu, Nepal
| | - L. Shrestha
- Department of Pediatrics, Institute of Medicine, Tribhuvan University, Kathmandu, Nepal
| | - S. Shrestha
- Department of Pediatrics, Patan Hospital, Lalitpur, Kathmandu, Nepal
| | - R. Ghimire
- Department of Pediatrics, Institute of Medicine, Tribhuvan University, Kathmandu, Nepal
| | - J. Katz
- Department of International Health, Johns Hopkins Bloomberg School of Public Health, Johns Hopkins University, Baltimore, Maryland, United States
| | - S. Khatry
- Nepal Nutrition Intervention Project, Sarlahi, Kathmandu, Nepal
| | - W. Checkley
- Department of International Health, Johns Hopkins Bloomberg School of Public Health, Johns Hopkins University, Baltimore, Maryland, United States
| | - S. Basnet
- Department of Pediatrics, Institute of Medicine, Tribhuvan University, Kathmandu, Nepal
| | - M. Shrestha
- Department of Pediatrics, Institute of Medicine, Tribhuvan University, Kathmandu, Nepal
| | - S. Thapa
- Department of Pediatrics, Institute of Medicine, Tribhuvan University, Kathmandu, Nepal
| | - P. Kansakar
- Department of Pediatrics, Patan Hospital, Lalitpur, Kathmandu, Nepal
| | - S. Puree
- Department of Pediatrics, Patan Hospital, Lalitpur, Kathmandu, Nepal
| | - V. Todi
- Department of Pediatrics, Patan Hospital, Lalitpur, Kathmandu, Nepal
| | - J. Tielsch
- Department of Global Health, George Washington University, Washington, District of Columbia, United States
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Singh S, Verma A, Aryal G, Thapa S, Khakurel S, Shrestha K. Thyroid hormone profile in patients with chronic kidney disease: a single centre study. J Nepal Health Res Counc 2016; 14:197-201. [PMID: 28327686] [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] [Indexed: 06/06/2023]
Abstract
BACKGROUND Chronic kidney disease (CKD) is a global burden and now recognized as a major public health problem worldwide. Patients with CKD have alteration in thyroid hormone metabolism. This study aims to evaluate the status of thyroid hormone profile in different stages of CKD. METHODS The cross-sectional study included 103 CKD patients attending Nephrology and Dialysis unit of KIST Medical College Teaching Hospital, Lalitpur, Nepal. Serum creatinine, free triiodothyronine (fT3), free thyroxine (fT4), and thyroid stimulating hormone (TSH) were measured. Risk factors, duration of illness and physical examination of patients were recorded along with their written informed consent. Patients with history of any thyroid function abnormalities, on medication for hypothyroidism and pregnancy were excluded. RESULTS Out of 103 CKD patients, 59 (57.28%) were males and 44 (42.71%) were females. Thirty five (33.98%) CKD patients had low fT3 and 19 (18.44%) had low fT4 with normal TSH. Six (5.82%) CKD patients had increased TSH concentrations with normal fT3 and fT4. The median value of creatinine, fT3 and fT4 were significantly altered at different stages of CKD. Among the risk factors for CKD, diabetic nephropathy (44.66%) was found to be the lead primary cause followed by chronic glomerulonephritis (26.21%) and hypertension (23.30%). CONCLUSIONS In our study thyroid hormone profile was altered in CKD patients, mainly in the stage 5 CKD. Most common thyroid dysfunction was low fT3 and low fT4 with normal TSH levels.
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Affiliation(s)
- S Singh
- Jaipur National University, Jaipur, Rajasthan, India
| | - A Verma
- School of Life and Basic Sciences, Jaipur National University, Jaipur, Rajasthan, India
| | - G Aryal
- Department Pathology, KIST Medical College, Lalitpur, Nepal
| | - S Thapa
- Department of Nephrology, KIST Medical College, Lalitpur, Nepal
| | - S Khakurel
- Department of Nephrology, KIST Medical College, Lalitpur, Nepal
| | - K Shrestha
- Department of Nephrology, KIST Medical College, Lalitpur, Nepal
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Venkatachalam S, Ranjan K, Prasanna R, Ramakrishnan B, Thapa S, Kanchan A. Diversity and functional traits of culturable microbiome members, including cyanobacteria in the rice phyllosphere. Plant Biol (Stuttg) 2016; 18:627-37. [PMID: 26849835 DOI: 10.1111/plb.12441] [Citation(s) in RCA: 38] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/13/2015] [Accepted: 02/01/2016] [Indexed: 05/13/2023]
Abstract
The diversity and abundance of culturable microbiome members of the rice phyllosphere was investigated using cv. Pusa Punjab Basmati 1509. Both diversity and species richness of bacteria were significantly higher in plants in pots in a semi-controlled environment than those in fields. Application of fertilisers reduced both diversity and species richness in field-grown plants under a conventional flooded system of rice intensification (SRI) and in dry-seeded rice (DSR) modes. Sequence analyses of 16S rDNA of culturable bacteria, those selected after amplified ribosomal DNA restriction analysis (ARDRA), showed the dominance of α-proteobacteria (35%) and actinobacteria (38%); Pantoea, Exiguobacterium and Bacillus were common among the culturable phyllospheric bacteria. About 34% of 83 culturable bacterial isolates had higher potential (>2 μg·ml(-1) ) for indole acetic acid production in the absence of tryptophan. Interestingly, the phyllosphere bacterial isolates from the pot experiment had significantly higher potential for nitrogen fixation than isolates from the field experiment. Enrichment for cyanobacteria showed both unicellular forms and non-heterocystous filaments under aerobic as well as anaerobic conditions. PCR-DGGE analysis of these showed that aerobic and anaerobic conditions as well as the three modes of cultivation of rice in the field strongly influenced the number and abundance of phylotypes. The adaptability and functional traits of these culturable microbiome members suggest enormous diversity in the phyllosphere, including potential for plant growth promotion, which was also significantly influenced by the different methods of growing rice.
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Affiliation(s)
- S Venkatachalam
- Division of Microbiology, ICAR - Indian Agricultural Research Institute (IARI), New Delhi, India
| | - K Ranjan
- Division of Microbiology, ICAR - Indian Agricultural Research Institute (IARI), New Delhi, India
| | - R Prasanna
- Division of Microbiology, ICAR - Indian Agricultural Research Institute (IARI), New Delhi, India
| | - B Ramakrishnan
- Division of Microbiology, ICAR - Indian Agricultural Research Institute (IARI), New Delhi, India
| | - S Thapa
- Division of Microbiology, ICAR - Indian Agricultural Research Institute (IARI), New Delhi, India
| | - A Kanchan
- Division of Microbiology, ICAR - Indian Agricultural Research Institute (IARI), New Delhi, India
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Nagae S, Ogawa E, Thapa S, Zhang H, Tierno L, Tsegai N, Shi L, Leveille S, You T. The Association between Pain Severity and Attendance Rate in Older Adults Participating in an Exercise Program. Med Sci Sports Exerc 2016. [DOI: 10.1249/01.mss.0000487530.60438.ea] [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: 11/21/2022]
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Tsegai N, You T, Ogawa E, Thapa S, Tierno L, Zhang Y, Leveille S. Global Pain Severity is Associated with Lower Extremity Strength in Older Adults with Multisite Pain. Med Sci Sports Exerc 2016. [DOI: 10.1249/01.mss.0000487151.60472.90] [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: 11/21/2022]
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Tierno L, You T, Ogawa E, Thapa S, Tsegai N, Cai Y, Leveille S. The Relationship between Global Pain Severity and Gait Speed in Older Adults with Multisite Pain. Med Sci Sports Exerc 2016. [DOI: 10.1249/01.mss.0000487152.68095.22] [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: 11/21/2022]
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Ghosh A, Ghartimagar D, Thapa S, Sathian B, Narasimhan R, Talwar OP. Ovarian Tumors: Pattern of Histomorphological Types- A 10 Years Study in a Tertiary Referral Center and Review of Literature. Kathmandu Univ Med J (KUMJ) 2016; 14:153-158. [PMID: 28166073] [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: 06/06/2023]
Abstract
Background Ovarian cancer accounts for 6% of all cancers in females. Among cancers of female genital tract, the incidence of ovarian cancers ranks below only carcinoma of the cervix and the endometrium. Objective To find the frequency of different types of histomorphological types and their association with age, side and size distribution. Method This study is a hospital based retrospective study carried out in the Department of Pathology, Manipal Teaching Hospital over a time period from Jan. 2006 to Sep. 2015. Specimens were received from the Manipal Teaching Hospital and other hospitals within the Himalayan valley of Pokhara. All the clinical and histolpathological data were retrieved from the departmental data bank and were analyzed. Result A total of 409 cases of ovarian tumors have been reported in the same period. Among them, 215 cases were of surface epithelial origin including 172 benign, 07 borderline and 36 malignant cases. Among the surface epithelial tumors, the commonest was serous cystadenoma (119 cases) followed by mucinous cyst adenoma (40 cases). There were 176 cases of tumors with germ cell origin which included 170 cases of teratoma, four dysgerminoma and one each case of choriocarcinoma and yolk sac tumor. Among seven metastatic tumors, one case was of Krukenberg tumor. Age range was 12 to 90 years and the size range from 3 to 36 cm. Conclusion In our study, we analyzed all the spectrum of ovarian tumors diagnosed on morphological bases and most of the findings were similar to other national and international studies. However, we have reported increased percentage of mucinous tumors and less sex cord stromal tumors.
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Affiliation(s)
- A Ghosh
- Department of Pathology, Manipal Teaching Hospital, Manipal College of Medical Science, Pokhara, Nepal
| | - D Ghartimagar
- Department of Pathology, Manipal Teaching Hospital, Manipal College of Medical Science, Pokhara, Nepal
| | - S Thapa
- Department of Pathology, Manipal Teaching Hospital, Manipal College of Medical Science, Pokhara, Nepal
| | - B Sathian
- Department of Community Medicine, Manipal Teaching Hospital, Manipal College of Medical Science, Pokhara, Nepal
| | - R Narasimhan
- Department of Pathology, Manipal Teaching Hospital, Manipal College of Medical Science, Pokhara, Nepal
| | - O P Talwar
- Department of Pathology, Manipal Teaching Hospital, Manipal College of Medical Science, Pokhara, Nepal
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Jadhav S, Chedjieu IP, Faramawi MF, Ndetan H, Fischbach L, Thapa S, Johnson ES. Non-cancer mortality in workers in the meat and delicatessen departments of supermarkets (1950-2006). Environ Res 2015; 142:155-160. [PMID: 26160045 DOI: 10.1016/j.envres.2015.06.030] [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] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/19/2015] [Revised: 06/23/2015] [Accepted: 06/24/2015] [Indexed: 06/04/2023]
Abstract
We studied non-cancer mortality in 10,701 workers in the meat and delicatessen departments of supermarkets because they have increased exposure to a variety of microorganisms that infect and cause disease in food animals such as cattle, pigs, sheep, and poultry, to which subjects in the general population are also exposed, albeit to a lesser degree. These workers were also exposed to fumes from the wrapping machine. Standardized mortality ratios were estimated in the cohort as a whole and in race/sex subgroups, using the US population for comparison. Study subjects were followed up from January 1950 to December 2006. Significantly increased deaths from diabetes, ischemic heart disease, pulmonary embolism, chronic bronchitis, peritonitis, intracranial and intraspinal abscess, other bacterial diseases, and significantly decreased deaths from diffuse diseases of connective tissue, functional diseases of the heart, intracerebral hemorrhage, occlusion/stenosis of the precerebral and cerebral arteries, and various types of accidents were observed in certain race/sex subgroups or in the cohort as a whole. The observed increased risks of several infectious conditions suggest that the increased occupational exposure to microorganisms may be responsible for at least some of the observed excess deaths, while exposure to fumes may also contribute to the excess of chronic bronchitis. The findings are important not only for supermarket workers and other workers in the meat and poultry industries, but also because the general population is exposed to these microorganisms found in food animals and their products. Nested case-control studies within cohorts that include both workers in supermarkets and other sectors of the meat and poultry industries, are now needed to examine specific risks from occupational exposures while adequately controlling for confounding factors, so that the role of these infectious agents in the occurrence of these diseases in workers and in general population subjects can be adequately assessed.
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Affiliation(s)
- S Jadhav
- University of Arkansas for Medical Sciences, Department of Epidemiology, Little Rock, AR, USA
| | - I P Chedjieu
- University of Arkansas for Medical Sciences, Department of Epidemiology, Little Rock, AR, USA
| | - M F Faramawi
- University of Arkansas for Medical Sciences, Department of Epidemiology, Little Rock, AR, USA
| | - H Ndetan
- Parker Research Institute, Parker University, Dallas, TX, USA
| | - L Fischbach
- University of Arkansas for Medical Sciences, Department of Epidemiology, Little Rock, AR, USA
| | - S Thapa
- University of Arkansas for Medical Sciences, Department of Epidemiology, Little Rock, AR, USA
| | - E S Johnson
- University of Arkansas for Medical Sciences, Department of Epidemiology, Little Rock, AR, USA.
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Fawcett J, Aronowitz T, AbuFannouneh A, Usta MA, Fraley HE, Howlett MSL, Mtengezo JT, Muchira JM, Nava A, Thapa S, Zhang Y. Thoughts about the Name of Our Discipline. Nurs Sci Q 2015; 28:330-3. [DOI: 10.1177/0894318415599224] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
This essay addresses the name of our discipline. Discussion of the use of the term, nursology, focuses on the origin of the term, its use as a name for our discipline and its use as a research method and a practice methodology. Advantages and disadvantages of nursology as the name for our discipline are gleaned from PhD program students’ responses to a question posed by Reed (1997).
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Khanal A, Thapa S, Chettri PK. Conventional Brain MRI in Carbon Monoxide Poisoning. JNMA J Nepal Med Assoc 2015; 53:195-197. [PMID: 27549505] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/06/2023] Open
Abstract
Carbon monoxide poisoning is a common fatal condition which can have acute or chronic presentation with varying severity. It commonly involves globus pallidus and putamen but can involve other parts of brain. Conventional MRI using T1 weighted,T2 weighted and FLAIR sequences are helpful in determining the extent of damage to the brain. However, appropriate clinical and laboratory findings should supplement findings on imaging.
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Affiliation(s)
- A Khanal
- Department of Radiology, College of Medical Sciences, Bharatpur, Nepal
| | - S Thapa
- Department of Radiology, College of Medical Sciences, Bharatpur, Nepal
| | - P K Chettri
- Department of Radiology, College of Medical Sciences, Bharatpur, Nepal
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Khanal J, Poudyal RR, Devkota S, Thapa S, Dhungana RR. Clinical Profile and Early Complications after Single and Dual Chamber Permanent Pacemaker Implantation at Manmohan Cardiothoracic Vascular and Transplant Centre, Kathmandu, Nepal. J Nepal Health Res Counc 2015; 13:138-143. [PMID: 26744199] [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] [Indexed: 06/05/2023]
Abstract
BACKGROUND Permanent pacemaker implantation is a minimally invasive surgical procedure in the management of patients with cardiac problems. However, complications during and after implantation are not uncommon. There is lack of evidences in rate of complications with the selection of pacemakers in Nepal. Therefore, this study was performed to compare the frequency of implantation and complication rate between single chamber and dual chamber pacemaker. METHODS The present study is based on all consecutive pacemaker implantations in a single centre between April 2014 and May 2015. A total of 116 patients were categorized into two cohorts according to the type of pacemaker implanted- single chamber or dual chamber. All patients had regular 2-weeks follow-up intervals with standardized documentation of all relevant patient data till 6-week after implantation. Data were presented as means ± standard deviation (SD) for continuous variables and as proportions for categorical variables. Comparison of continuous variables between the groups was made with independent Student's t-test. For discrete variables distribution between groups were compared with Chi-square test. RESULTS The mean age (±SD) of total population at implant was 64.08 (± 15.09) years. Dual chamber units were implanted in 44 (37.93%) of patients, single chamber in 72 (62.06%). Only 14 women (31.81%) received dual chamber compared with 42 women (58.33%) who received single chamber (Chi-square=18, DF=1, P = 0.0084). Complete atrioventricular block was the commonest (56.03%) indication for permanent pacemaker insertion followed by sick sinus syndrome (33.62%), symptomatic high-grade AV block (11.20%). Hypertension (dual chamber 21.55%, single chamber 40.51%) was the most common comorbidity in both cohorts. Complications occurred in 11 (9.48%) patients. More proportion of complication occurred in single chamber group (9 patients, 12.50%) than in dual chamber (2 patients, 4.54%). Complications occurring in dual chamber group include pocket hematoma 1 patient (2.27%) and arrhythmia in 1 patient (2.27%). Similarly, complications occurring in single chamber include RV perforation in two patients (2.77%) and one each (1.38%) had pocket hematoma, pneumothorax, infection, swelling at pocket site, arrhythmia in the form of NSVT, leads displacement, DVT and mortality. CONCLUSIONS Women were more likely to receive single chamber systems than men. More proportion of complication occurred in single chamber group than in dual chamber. Future prospective studies on larger number of patients are needed to confirm and support our findings.
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Affiliation(s)
- J Khanal
- Department of Cardiology, Manmohan Cardiothoracic Vascular and Transplant Centre, Kathmandu, Nepal
| | - R R Poudyal
- Department of Cardiology, Manmohan Cardiothoracic Vascular and Transplant Centre, Kathmandu, Nepal
| | - S Devkota
- Department of Cardiology, Manmohan Cardiothoracic Vascular and Transplant Centre, Kathmandu, Nepal
| | - S Thapa
- Department of Cardiology, Manmohan Cardiothoracic Vascular and Transplant Centre, Kathmandu, Nepal
| | - R R Dhungana
- Nepal Family Development Foundation, Kathmandu, Nepal
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Gupta SK, Sarmah BK, Tiwari D, Thapa S. Pattern of Pediatric Admissions in a Tertiary Care Hospital of Central Nepal. JNMA J Nepal Med Assoc 2015; 53:118-122. [PMID: 26994032] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/05/2023] Open
Abstract
INTRODUCTION An understanding of the epidemiological trend in hospital admissions, including morbidity and mortality patterns and the economic impact, is critical for healthcare planning and appropriate resource allocation. As we find very few literature on the pattern of paediatric admissions outside Kathmandu Valley, it is essential to conduct studies in the various parts of the country to determine the paediatric inpatient burden as well resource allocations. METHODS A retrospective study was carried out at Department of Pediatrics, College of Medical Sciences-Teaching Hospital, Bharatpur, Chitwan, Nepal over a period of one year. All the admissions were analyzed for age, sex, address, seasonal variation, frequency of diseases according to the organ system involved, duration of hospital stay, and the outcome. RESULTS Out of the total 814 cases admitted 68.8% of the patients were younger than five years. There was male preponderance with male to female ratio of 1.9:1. Majority (43.6%) admissions were from Chitwan itself. Respiratory, gastrointestinal and neurologic conditions were the main cause for admission. The mean duration of hospital stay was 5.28 days and the mortality was only 0.1%. CONCLUSIONS In this study under five-year patients contributed to 2/3rd of the hospital admissions. Respiratory, gastrointestinal and neurologic conditions were the main cause for admission with pneumonia, URTI and acute gastroenteritis being the most common diseases.
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Affiliation(s)
- S K Gupta
- Department of Pediatrics, College of Medical Sciences, Bharatpur, Chitwan, Nepal
| | - B K Sarmah
- Department of Pediatrics, College of Medical Sciences, Bharatpur, Chitwan, Nepal
| | - D Tiwari
- Department of Pediatrics, College of Medical Sciences, Bharatpur, Chitwan, Nepal
| | - S Thapa
- Department of Pediatrics, College of Medical Sciences, Bharatpur, Chitwan, Nepal
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Thapa S, Nagy E, Abdul-Careem MF. In ovo delivery of Toll-like receptor 2 ligand, lipoteichoic acid induces pro-inflammatory mediators reducing post-hatch infectious laryngotracheitis virus infection. Vet Immunol Immunopathol 2015; 164:170-8. [PMID: 25764942 DOI: 10.1016/j.vetimm.2015.02.006] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.8] [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: 07/31/2014] [Revised: 02/12/2015] [Accepted: 02/13/2015] [Indexed: 01/07/2023]
Abstract
Toll-like receptor (TLR) ligands are pathogen associated molecular patterns (PAMPs) recognized by the TLRs resulting in induction of host innate immune responses. One of the PAMPs that binds to TLR2 and cluster of differentiation (CD) 14 is lipotechoic acid (LTA), which activates downstream signals culminating in the release of pro-inflammatory cytokines. In this study, we investigated whether in ovo LTA delivery leads to the induction of antiviral responses against post-hatch infectious laryngotracheitis virus (ILTV) infection. We first delivered the LTA into embryo day (ED)18 eggs via in ovo route so that the compound is available at the respiratory mucosa. Then the LTA treated and control ED18 eggs were allowed to hatch and the hatched chicken was infected with ILTV intratracheally on the day of hatch. We found that in ovo delivered LTA reduces ILTV infection post-hatch. We also found that in ovo delivery of LTA significantly increases mRNA expression of pro-inflammatory mediators in pre-hatch embryo lungs as well as mononuclear cell infiltration, predominantly macrophages, in lung of post-hatch chickens. Altogether, the data suggest that in ovo delivered LTA could be used to reduce ILTV infection in newly hatched chickens.
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Affiliation(s)
- S Thapa
- Department of Ecosystem and Public Health, Faculty of Veterinary Medicine, University of Calgary, Health Research Innovation Center 2C53, 3330 Hospital Drive NW, Calgary, Canada AB T2N 2Z6
| | - E Nagy
- Department of Pathobiology, University of Guelph, Guelph, Canada
| | - M F Abdul-Careem
- Department of Ecosystem and Public Health, Faculty of Veterinary Medicine, University of Calgary, Health Research Innovation Center 2C53, 3330 Hospital Drive NW, Calgary, Canada AB T2N 2Z6.
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Haddadi S, Thapa S, Kameka AM, Hui J, Czub M, Nagy E, Muench G, Abdul-Careem MF. Toll-like receptor 2 ligand, lipoteichoic acid is inhibitory against infectious laryngotracheitis virus infection in vitro and in vivo. Dev Comp Immunol 2015; 48:22-32. [PMID: 25195716 DOI: 10.1016/j.dci.2014.08.011] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/04/2014] [Revised: 08/22/2014] [Accepted: 08/24/2014] [Indexed: 06/03/2023]
Abstract
Lipoteichoic acid (LTA) is one of the pathogen associated molecular patterns (PAMPs) that activates toll-like receptor (TLR)2-cluster of differentiation (CD)14 signalling pathway. This recognition elicits antiviral responses that have been recorded against viruses of mammals although such responses have not been characterized adequately against avian viruses. In this investigation, we characterized the LTA induced antiviral responses against infectious laryntotracheitis virus (ILTV) infection in vitro and in vivo. We found that LTA is capable of up regulating mRNA expression of innate proteins in macrophages such as MyD88, iNOS and IL-1β and reduces the ILTV plaques in vitro. Similarly, we found that LTA treatment of embryonic day 18 (ED18) eggs can lead to the antiviral response against pre-hatch ILTV infection in vivo and is associated with expansion of macrophage populations and expression of IL-1β and MyD88 in the lung. The data highlight that LTA can be a potential innate immune stimulant that can be used against ILTV infection in chickens.
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Affiliation(s)
- S Haddadi
- Department of Ecosystem and Public Health, Faculty of Veterinary Medicine, University of Calgary, Health Research Innovation Center 2C64, 3330 Hospital Drive NW, Calgary, Canada AB T2N 2Z6
| | - S Thapa
- Department of Ecosystem and Public Health, Faculty of Veterinary Medicine, University of Calgary, Health Research Innovation Center 2C64, 3330 Hospital Drive NW, Calgary, Canada AB T2N 2Z6
| | - A M Kameka
- Department of Ecosystem and Public Health, Faculty of Veterinary Medicine, University of Calgary, Health Research Innovation Center 2C64, 3330 Hospital Drive NW, Calgary, Canada AB T2N 2Z6
| | - J Hui
- Department of Ecosystem and Public Health, Faculty of Veterinary Medicine, University of Calgary, Health Research Innovation Center 2C64, 3330 Hospital Drive NW, Calgary, Canada AB T2N 2Z6
| | - M Czub
- Department of Ecosystem and Public Health, Faculty of Veterinary Medicine, University of Calgary, Health Research Innovation Center 2C64, 3330 Hospital Drive NW, Calgary, Canada AB T2N 2Z6
| | - E Nagy
- Department of Pathobiology, University of Guelph, Guelph, Canada
| | - G Muench
- Veterinary Science Research Station, Faculty of Veterinary Medicine, University of Calgary, Calgary, Canada
| | - M F Abdul-Careem
- Department of Ecosystem and Public Health, Faculty of Veterinary Medicine, University of Calgary, Health Research Innovation Center 2C64, 3330 Hospital Drive NW, Calgary, Canada AB T2N 2Z6.
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Ghartimagar D, Ghosh A, Gautam K, Thapa S, Shrestha SR, Narasimhan R. Clinicopathological features of pilomatricoma cases: Analysis of 21 cases. J Pathol Nep 2014. [DOI: 10.3126/jpn.v4i7.10293] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [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
Background: Pilomatricoma is a slow-growing, asymptomatic tumour originating from outer sheath cells of hair follicle. In this study, we describe the clinical presentation and histopathological features of pilomatricoma. Materials and Methods: This was a hospital based retrospective study carried out in all patients who were diagnosed as pilomatricoma over a period of January 2001 to December 2013. The study was done in department of pathology, Manipal Teaching Hospital, Nepal. Results: A total of 21 cases of pilomatricoma were reported with age range of 9-53 years (mean age 23.7) and male female ratio of 1:1.1. The most common site of occurrence was neck and preauricular region. The size of the tumour ranged from 0.3 to 4.7cm with a mean of 1.2cm. Multiple occurrences were seen in 3 patients and ossifying pilomarticoma was seen in 4 cases. Conclusion: Pilomatricoma is a benign skin neoplasm of hair follicle matrix cells. Calcification is a common finding while dystrophic ossification also can occur in the tumour. Histopathology gives the definite diagnosis as fine needle aspiration cytology and clinical impression may be misleading. DOI: http://dx.doi.org/10.3126/jpn.v4i7.10293 Journal of Pathology of Nepal (2014) Vol. 4, 530-533
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Joshi R, Bhattarai S, Simkhada K, Thapa S. Determinants of Intrauterine Contraceptive Device Use Among the Women of Urban Areas of Nepal. Nepal j obstet gynaecol 2014. [DOI: 10.3126/njog.v8i2.9760] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [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
Aims: This study aimed to identify the determinants of Intrauterine Contraceptive Device (IUCD) use among the married women of reproductive age group living in urban areas of Nepal. Methods: This study was an analytical cross-sectional study which aimed to compare different factors between 110 IUCD users and 110 non-users. Both groups were selected randomlyand interviewed by using semi-structured questionnaire. Chi-square test was used to detect the difference between two groups and corresponding odds ratios with 95% confidence intervals were also computed. Results: When the IUCD users were compared to non-users, religion, occupational status of women, occupational status of the husbands, total number of children, sources of information about IUCD, having wrong beliefs about IUCD, availability of IUCD services, reproductive intention and spousal communication were significantly associated with the use of IUCD.The main reason for using IUCD was due to the effectiveness for longer duration and for not using IUCD was due to the feeling of no need. Conclusions: Wrong beliefs about the device discouraged women from using IUCD, hence, awareness programs are strongly recommended.Nepal Journal of Obstetrics and Gynaecology / Vol 8 / No. 2 / Issue 16 / July-Dec, 2013 / 16-20 DOI: http://dx.doi.org/10.3126/njog.v8i2.9760
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Abstract
BACKGROUND The use of abortion services at the Maternity Hospital clinic, the largest public sector abortion clinic in Nepal, has risen over the years. Whether the profile of the clients, reasons for abortion, and contraceptive use have changed are not known and need to be investigated. OBJECTIVES This paper evaluates changes between 2005 and 2010 in the socio-demographic profile of abortion users, reasons for seeking abortion, and contraceptive use of two cohorts of women who had first-trimester abortion at the Maternity Hospital. METHODS We used data from two similar surveys conducted in 2005 and 2010 among 672 and 392 women, respectively, who obtained first-trimester surgical abortion in a large public sector clinic. We analyzed trend data in service utilization and carried out a cost analysis. RESULTS The number of women having abortions has steadily increased over the years, and cumulatively about 19,800 women have received services. The profile of the clients at this clinic remained essentially the same between 2005 and 2010. The typical users of abortion services at the clinic has were 27 years old with two living children, mostly married, with the majority not wanting to have more children. About half of them used a contraceptive method-mostly condoms, withdrawal, the pill and rhythm-in the month of unintended pregnancy, suggesting failures with these methods. Health concerns, dislike of available methods, and perceived low risk of pregnancy were common reasons for not using a contraceptive method. CONCLUSION Despite increases in the number of clients, the socio-demographic profile of the abortion clients has remained similar over the years. The linkage between the abortion and family planning clinics needs to be strengthened.
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Affiliation(s)
- S Thapa
- Public Health Institute, 1201 Pennsylvania Ave, Washington, DC 20004, USA.
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