Noninvasive three-state sleep-wake staging in mice using electric field sensors

STUDY OBJECTIVE

Validate a novel method for sleep-wake staging in mice using noninvasive electric field (EF) sensors.

METHODS

Mice were implanted with electroencephalogram (EEG) and electromyogram (EMG) electrodes and housed individually. Noninvasive EF sensors were attached to the exterior of each chamber to record respiration and other movement simultaneously with EEG, EMG, and video. A sleep-wake scoring method based on EF sensor data was developed with reference to EEG/EMG and then validated by three expert scorers. Additionally, novice scorers without sleep-wake scoring experience were self-trained to score sleep using only the EF sensor data, and results were compared to those from expert scorers. Lastly, ability to capture three-state sleep-wake staging with EF sensors attached to traditional mouse home-cages was tested.

RESULTS

EF sensors quantified wake, rapid eye movement (REM) sleep, and non-REM sleep with high agreement (>93%) and comparable inter- and intra-scorer error as EEG/EMG. Novice scorers successfully learned sleep-wake scoring using only EF sensor data and scoring criteria, and achieved high agreement with expert scorers (>91%). When applied to traditional home-cages, EF sensors enabled classification of three-state (wake, NREM and REM) sleep-wake independent of EEG/EMG.

CONCLUSIONS

EF sensors score three-state sleep-wake architecture with high agreement to conventional EEG/EMG sleep-wake scoring 1) without invasive surgery, 2) from outside the home-cage, and 3) and without requiring specialized training or equipment. EF sensors provide an alternative method to assess rodent sleep for animal models and research laboratories in which EEG/EMG is not possible or where noninvasive approaches are preferred.

Magnitude and Correlates of Anemia in Elderly Women of a Resettlement Colony of Delhi

BACKGROUND

Anemia of any degree contributes significantly to morbidity and mortality and has a significant effect on the quality of life of elderly women. Despite its clinical importance, anemia in the elderly women is underrecognized.

OBJECTIVES

The objective of this study was to assess the magnitude and correlates of anemia in elderly women of a resettlement colony of Delhi.

MATERIALS AND METHODS

A community-based, cross-sectional study for the duration of 1 year was conducted among 512 geriatric women (≥60 years). Demographic characteristics, dietary assessment, and behavioral risk factors were determined by interview, and the participants underwent physical examination followed by hemoglobin estimation by HemoCue. Anemia was defined using the WHO criteria of hemoglobin <12 g/dl. Chi-square test was employed to study the association between sociodemographic factors and anemia followed by multivariate regression analysis.

RESULTS

The prevalence of anemia was 79.9% according to the WHO criteria of hemoglobin <12 g/dl in females. Age, education, marital status, financial dependence, diagnosed chronic disease, diet, calorie intake, history of worm infestation, and body mass index (BMI) were significantly associated with anemia on univariate analysis. In multivariate analysis, age, marital status, financial dependence, diagnosed chronic disease, diet, calorie intake, and BMI were significant explanatory variables for anemia.

CONCLUSION

Our study points out high prevalence of and some of the major factors associated with anemia in elderly women. The need of the hour is to include our elderly women under the gamut of National Anemia Prophylaxis Program.

The Burden of Injury in terms of Economic Loss and Disability Days: A Community Based Study from Eastern Nepal

Background Injuries are already a substantial public Health problem all over the world and are expected to increase in the 211st Century. They are major causes of deaths and disability in the population and also involve high societal costs. Objectives This study was designed to assess the economic loss due to the injury and the disability days due to different types of injuries. Methods A systematic random sampling technique was used to select 1388 households from 19 wards. A detailed questionnaire was used to collect information related to injuries to the persons suffered from injuries including treatment obtained, cost of treatment (direct/indirect cost) and length of disability. Results Among the minor injured persons, majority (93.2%) did not spend any indirect cost. 36.7% of the major inured persons spent Nepalese rupees 10,001 to NRs 100,000 as direct treatment costs. But 50% spent less than 5000 NRs as indirect cost for major injury treatment. Maximum number (67.4%) of major injured persons had disability days of 31 to 90 days. Conclusion The high incidence of injuries, especially road traffic injuries, adds a huge economic burden to nation.DOI: http://dx.doi.org/10.3126/kumj.v9i2.6283Kathmandu Univ Med J 2011;9(2):27-30

An epidemiological study of injury among urban population

BACKGROUND

Injuries are a focus of public health practice because they pose a serious health threat, occur frequently and are preventable. Injuries affect people of all ages and range from minor cuts and bruises to major catastrophes that take thousands of lives.

OBJECTIVES

This paper aims to fi nd out the prevalence of injuries and to study the various epidemiological factors related to the injuries in Dharan.

MATERIALS AND METHODS

A sample of 1398 households was taken as study sample. A systematic random sampling technique was used to select the 10% households from each 19 wards. A pre-tested questionnaire was used to collect demographic information and information related to injuries to the persons suffered from injuries.

RESULT

The prevalence of minor injury in Dharan was 3.5% per month. The injury was common in the age group, 40-49 years (4.6%) and majority of injured persons were farmers (6.9%). Home was the common place (55.6%) for the minor injury. Cut/stab (32.8%) was the most common types of minor injury. The prevalence of major injury was 0.7% per year and occurred more among 50-59 years age group (1.7%). The commonest place for major injury was at road (53.1%) and service holders were at more risk (1.4%). Falls from the height (46.9%) were the most common types of major injury.

CONCLUSION

The injuries related to lifestyle profession and road traffic accidents (RTA) is the commonest burden revealed in the study sample. Promotion of safety and education for protection at work and safe driving can prevent the major socio-economic loss to the family and community at large.

Prevalence of coronary heart disease in the urban adult males of eastern Nepal: a population-based analytical cross-sectional study

OBJECTIVE

Despite being a rising public health problem, the burden of cardiovascular diseases (CVDs) at population level have not been studied in Nepal. The paper aims to bridge the gap and study the prevalence of coronary heart disease (CHD) and associated risk factors in adult males of urban Nepal.

METHODS

A population-based analytical cross-sectional study was carried out in the Dharan municipality of Nepal with one thousand males aged > or = 35 years selected by systematic random sampling of the households. Data collection included WHO Rose angina questionnaire and electrocardiograms in all who had positive Rose Questionnaire. Those with documented CHD, positive Rose Questionnaire and positive electrocardiographic changes according to the Minnesota codes were labelled as having CHD.

FINDINGS

The prevalence of CHD in the study population was 5.7% (95% confidence interval: 4.26 - 7.13). The significant associated risk factors included tobacco use, history of hypertension, family history and age.

CONCLUSION

This is the first population-based prevalence study of coronary heart disease in Nepal. The burden of CHD in the study population is comparable to the findings from urban studies of North India. Nepal urgently requires public health policies and programmes to address CVDs including CHD.

Exploring the iceberg of hypertension: a community based study in an eastern Nepal town

OBJECTIVES

Hypertension is an important public health challenge in the developing and the developed world alike. However, community-based studies on cardiovascular diseases including hypertension in a developing country like Nepal have been limited. The primary aim of this study is to measure the prevalence of hypertension in the Dharan town of Eastern Nepal and to explore the 'iceberg phenomenon' of hypertension in the study population.

METHODS

A population-based cross-sectional analytical study was undertaken in the Dharan municipality in 2004-5 with one thousand males aged 35 years and above as participants. The subjects were recruited by simple random sampling of the households in each ward.

RESULTS

The overall prevalence of hypertension in the study population was 22.7% which was comparable to the studies from Northern and Western India. The comparison between the population with normal and high blood pressure at time of study shows significant differences in terms of age, religion, current job status, occupation, socio-economic status, physical activity and tobacco use.

CONCLUSION

The study shows that while a vast majority of the hypertensive population was not aware of their high blood pressure status, at the same time, a large fraction of the population with increased blood pressure did not have their blood pressure under control. A surveillance system to detect population with high blood pressure, follow up the detected cases of hypertension, as well as motivate and/or counsel the 'hard-to-treat' cases for regular follow-up should be valuable.

Role of rehabilitation centres in reducing drug abuse problem in a town of Eastern Nepal

OBJECTIVES

This paper focuses to describe the role and activities of Drug Rehabilitation Centres (DRCs) in reducing the drug-abuse problem in Dharan. It also offers suggestions for increasing the effectiveness of prevention programs.

MATERIALS AND METHODS

Records of three DRCs working in Dharan for the past 9 years were analyzed using appropriate statistical tools.

RESULTS

The yearly clean rate is significantly higher in these centres. Harm reduction program was currently available only in one centre. Pharmacotherapy along with short-term rehabilitation was available at de-addiction unit of B. P. Koirala Institute of Health Sciences whereas long-term rehabilitation was at others centres.

CONCLUSION

Thus, there should be a strong coordination and network with each other to increase the effectiveness of the treatment program for drug abuse. The treatment centres should be increased in number as well as in quality. BPKIHS should take initiation to start long-term management with repeated booster programs.

Alcohol use among physicians in a medical school in Nepal

OBJECTIVE

The objective of the study was to know about the use of alcohol among physicians and factors that were related to it.

METHODS

This was a cross sectional study conducted among the physicians in a medical school of eastern Nepal. A semi structured questionnaire was used to collect information.

RESULTS

There were 55 subjects in the study. Half of them were between 35-45 years age group and one fourth among them were female. There were more than 88% physicians consuming alcohol for more than 10 years. One third used to preferred whisky as their favorites drink. Use of alcohol among them was due to peer pressure and to become a social human being. Most of them drink alcohol occasionally with an average amount 30-60 ml in a sitting and usually in the evening. Most of the time, they use alcohol either in parties or at home.

CONCLUSION

Alcohol use in Nepal is very much prevalent. The use of alcohol is socially accepted in many communities. Uses of alcohol by physicians have direct effect on their health as well as the health of many people because they are role model for many people. They are also in direct contact with the patients. Steps to council the physicians may reduce the consumption of alcohol.

Prevalence and determinants of unmet need for family planning in a district of eastern region of Nepal

OBJECTIVES

The unmet need for family planning is defined as the discrepancy between individual's contraceptive behaviors and their stated fertility preferences--The extent of which is very high in developing countries like Nepal. This study explores the unmet need and its determinants.

METHODS

Among the teaching district of B.P. Koirala institute of Health Sciences, in the Eastern Region of Nepal, a district was selected randomly to conduct a cross-sectional study. A total of 1079 women were selected using systematic random sampling. We compared different demographic variables and sex-ration to unmet need by using means, percentage and applied chi-squared test where applicable.

RESULT

The extent of unmet need is 25 percent with 9.5 percent for spacing and 15.5 percent for limiting. The mean age at marriage is 16(+/-3.2) years. A strong association of gender preferences towards male child and unmet need exist, which is highly significant.

CONCLUSION

Unmet need is high despite extensive family planning program in Nepal. Mean age at marriage below legal age, low female education and gender discrimination are the factors responsible for unmet need.

Association of obesity and physical activity in adult males of Dharan, Nepal

OBJECTIVES

Obesity is one of the most apparent-yet most neglected public health problems. Physical activity is a crucial element in the development of obesity but still its importance in the occurrence of obesity varies in different populations. This paper aims to study the burden of obesity and its association with physical activity was carried out in a rapidly urbanizing town.

METHODS

A cross-sectional study to investigate the prevalence of obesity and its association with physical activity was carried out in one thousand adult males of Dharan municipality. Tools of data collection included interview and physical measurements such as blood pressure, height and weight measurements, and waist and hip circumferences. Odds ratios (ORs) and their 95% confidence intervals for obesity were computed across various demographic and other variables without adjusting and then adjusting for physical activity.

RESULTS

The prevalence of overweight and obesity in the population was 32.9% and 7.2% respectively. The study showed that physical inactivity is more importantly associated with obesity in the older population. The trend of young being more obese is reversed after adjusting for physical activity so that those in the older age were more obese than the younger ones. Similarly, those in to the business, vocational and clerical works, those who were more literate and those in the higher socio-economic status were significantly associated with obesity even after correcting for physical activity.

CONCLUSION

The prevalence of overweight and obesity is high in the males of Dharan. The value and effect of physical activity seem to vary across different age-groups and socio-economic status and occupations. The young, the technical persons or businessmen and the more prosperous ones probably need to bring down their calorie intake along with emphasis on physical activity in order to bring down their weight and cardiovascular risk.

Five-star Doctors for the 21st Century

The term ‘five-star doctor’ has been promoted to denote the model physician for today's society, who should be able to respond to the needs of both individual patients and their community. The B.P. Koirala Institute of Health Sciences (BPKIHS) has adopted integrated, partially problem-based, organ system and community-oriented curriculum for medical graduates. The various field programmes related to community diagnosis, health care delivery system, family health exercise, epidemiology for health management, managerial skills for health services, and learning in fields are incorporated in the MBBS curriculum. Five-month postings during internships in zonal and district hospitals and one month in district public health offices and primary health centres are unique programmes to make it more socially accountable. Such exposure for MBBS students makes them to attain five-star status, that is, caregiver, decision maker, communicator, community leader and manager. Thus, BPKIHS is working as a pioneer in an endeavour to create five-star doctors for the 21st century.

Prescribing patterns in medical outpatients

A drug utilisation review was carried out in the medical outpatient department of the Manipal teaching hospital, a tertiary care hospital in Pokhara, western Nepal, to determine the prescribing frequency of commonly used drugs. An attempt was made to relate prescription data to age and sex of the patients. A total of 530 prescriptions were analysed, and the mean +/- SD drugs per prescription was 2.15 +/- 1.71; 67.4% of the drugs were prescribed by brand name and only 39.56% of the drugs prescribed were from the WHO essential drug list. The average cost of drugs per prescription was US$2.75 +/- 2.21. The frequency of prescribing of antiulcer drugs, antibiotics, antiasthma drugs, antihypertensives and analgesics was 24.15% (n=128), 23.96% (n=127), 20.56% (n=109), 19.81% (n=105) and 15.09% (n=80), respectively. This study revealed considerable scope for educating prescribers to improve their prescribing practice.

Patterns of various modes of delivery in relation to presence of different risk factors in term pregnant mothers--a case-control study

A case-control study, was carried out, which aimed to determine whether a relation exists between risk factors present in mother and the mode of delivery i.e., outcome. Cases were those mothers who had one or more risk factors present during pregnancy (namely, short stature, malpresentation, antepartum haemorrhage, pre-eclamptic toxaemia/eclampsia, anaemia-haemoglobin less than 10 g/dl, twins, bad obstetric history, prolonged pregnancy, history of previous caesarean section and instrumental delivery, pregnancy associated with general diseases, prolonged difficult labour and RH-iso-immunisation). Controls were those mothers who did not have any of the above mentioned risk factors. Total of 250 cases and 250 controls were taken. Results showed that surgical and instrumental deliveries were strongly associated with presence of risk factors (odd's ratio: 5.94; attributable risks: 72%). Out of risk factors among cases, most common indication of caesarean section, was previous caesarean section followed by malpresentation, prolonged difficult labour and short statured mothers in descending order.