Asian Journal of Medical Sciences 2019-01-04T09:38:48+00:00 Dr Arun Kumar Open Journal Systems <p>The inaugural issue of the Asian Journal of Medical Sciences was published in May 2010. Full text articles available.</p> The impact of obesity on cardiovascular disease risk factor 2019-01-02T17:14:39+00:00 Arun Kumar <p>Obesity has emerged as the most potential cardiovascular risk factor and has raised concern among public and their health related issues not only in developed but also in developing countries. The Worldwide obesity occurrence has almost has gone three times since 1975. Research suggests there are about 775 million obese people in the World including adult, children, and adolescents. Nearly 50% of the children who are obese and overweight in Asia in are below 5 years. There is a steep incline of childhood obesity when compared to 1971 which is not only in developed countries but also in developing countries. A considerable amount of weight gain occurs during the transition phase from adolescence to young adulthood. It is also suggested that those adults<br>who were obese in childhood also remained obese in their adulthood with a higher metabolic risk than those who became obese in their adulthood. In India, the urban Indian female in the age group of 30-45 years have emerged as an 〝at risk population” for cardiovascular diseases. To understand how obesity can influence cardiovascular function, it becomes immense important to understand the changes which can take place in adipose tissue due to obesity. There are two proposed concepts explaining the inflammatory status of macrophage. The predominant cause of insulin resistance is obesity. Epidemiological and research studies have indicated that the pathogenesis of obesity-related metabolic dysfunction involves the development of a systemic, low-grade inflammatory state. It is becoming clear that targeting the pro-inflammatory pathway<br>may provide a novel therapeutic approach to prevent insulin resistance, particularly in obesity induced<br>insulin resistance. Some cost effective interventions that are feasible by all and can be implemented even in low-resource settings includes - population-wide and individual, which are recommended to be used in combination to reduce the greatest cardiovascular disease burden. The sixth target in the Global NCD action plan is to reduce the prevalence of hypertension by 25%. Reducing the incidence of hypertension by implementing population-wide policies to educe behavioral risk factors. Reducing cigarette smoking, body weight, blood pressure, blood cholesterol, and blood glucose all have a beneficial impact on major biological cardiovascular risk factors. A variety of lifestyle modifications have been shown, in clinical trials, to lower blood<br>pressure, includes weight loss, physical activity, moderation of alcohol intake, increased fresh fruit and vegetables and reduced saturated fat in the diet, reduction of dietary sodium intake, andincreased potassium intake. Also, trials of reduction of saturated fat and its partial replacement by unsaturated fats have improved dyslipidaemia and lowered risk of cardiovascular events. This initiative driven by the Ministry of Health and Family Welfare, State Governments, Indian Council of Medical Research and the World Health Organization are remarkable. The Government of India has adopted a national action plan for the prevention and control of non-communicable diseases (NCDs) with specific targets to be achieved by 2025, including a 25% reduction in<br>overall mortality from cardiovascular diseases, a 25% relative reduction in the prevalence of raised blood pressure and a 30% reduction in salt/sodium intake. In a nutshell increased BMI values can predict the nature of obesity and its aftermaths in terms inflammation and other disease associated with obesity. It’s high time; we must realize it and keep an eye on health status in order to live long and healthy life.</p> 2018-12-12T00:00:00+00:00 ##submission.copyrightStatement## Non-Clinic Blood Pressure Measurement – More Light, Less Darkness 2019-01-02T17:14:40+00:00 Vinay Kapur <p>Non-clinic blood pressure measurements are very important in confirming diagnosis of hypertension and they give us an idea of associated cardiovascular risk more precisely than clinic BP measurements. It can detect masked hypertension and white coat hypertension &amp; ABPM especially can monitor night-time BP diagnosing individuals with nocturnal hypertension.&nbsp; Masked hypertension and nocturnal hypertension are strongly related with target organ damage along with enhanced morbidity and mortality due to cardiovascular causes. ABPM can also measure early morning rise of BP, mean 24 hour BP, diurnal variation as well as average real variability. Home BP monitoring by patients themselves leads to their greater involvement in maintaining BP records and in achieving treatment goals. The purpose of this review is to preferentially discuss role of non-clinic BP monitoring in making accurate diagnosis and deciding treatment of hypertension that might help a great deal in reducing morbidity and mortality associated with it.&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;</p> <p>Asian Journal of Medical Sciences Vol.10(1) 2019 13-18&nbsp;</p> 2018-12-11T00:00:00+00:00 ##submission.copyrightStatement## Morphological spectrum of atherosclerotic lesions in a tertiary care Institute in Punjab 2019-01-04T09:38:48+00:00 Rajiv Kumar Gupta Ruchita Tyagi Vikrampal Singh Samir Kapoor Gurmeet Singh Sarju Ralhan Pavneet Kaur Selhi Bhavna Garg Harpreet Kaur Neena Sood Naved Aslam Gurpreet Singh Wander <p><strong>Background:&nbsp;</strong>The incidence of coronary artery disease (CAD) has risen considerably in developing world due to industrialization, urbanisation and lifestyle changes, especially among Indians and South Asians. The onset of CAD has been seen to occur at an early age and the severity of the disease and mortality associated with CAD has also increased. The pathology of atherosclerosis needs to be re-evaluated to develop targeted therapy which can contain the disease process at the earliest stage.</p> <p><strong>Aims and Objectives:&nbsp;</strong>Most of the morphological studies on atherosclerosis have been done on autopsy cases. In this study, we have analysed the morphological spectrum of atherosclerotic lesions in live patients.</p> <p><strong>Materials and Methods:&nbsp; </strong>We retrospectively analysed the histopathology slides of 85 cases whose endarterectomy plaques were received in the Department of Pathology over a period of three and half years (January 2014 to June 2017) and classified the lesions according to Modified American Heart Association classification of atherosclerosis.</p> <p><strong>Results: </strong>The average age of patients was 60 years and male to female ratio of 4.3:1. Left anterior descending artery was the commonest vessel involved (52.4%). Majority of the cases had fibrocalcific plaques,followed by fibrous cap atheroma and calcified nodules.</p> <p><strong>Conclusion:&nbsp;</strong>Coronary artery plaques were found even in patients less than 40 years old.&nbsp; Aggressive lipid defense therapy needs to be the cornerstone of management of CAD.</p> 2018-12-13T00:00:00+00:00 ##submission.copyrightStatement## The enzymopathy of G6PD deficiency in Jordan: a demographic and biochemical analysis 2019-01-02T17:14:43+00:00 Ahmed Al-Imam <p><strong>Background: </strong>G6PD deficiency is an inherited X-linked recessive condition leading to insufficient levels of glucose-6-phosphate dehydrogenase, thus causing hemolytic anaemia under certain circumstances.</p> <p><strong>Materials and Methods:</strong> Our study is explorative for cases admitted to Jordan University Hospital. The studied parameters include demographics, clinical manifestations, biochemical markers including Hb level, WBC count, liver enzymes, and blood grouping.</p> <p><strong>Results:</strong> Most of the patients were admitted to the emergency unit (53.13%). Individuals who were Rh-positive represented 57.81%, while patients of AB blood group accounted for 75%. The mean values were 4.81 years (age), 29.06 hours (time-to-hospital admission), 38.10 degree Celsius (temperature), 6.11 gm/dl (Hb), 13242.19 (WBC count), 343.20 U/L (S. ALP), and 50.98 IU/L (S. ALT). There was no significant difference between males and females or between favism-induced versus drug-induced hemolytic episodes. AB and Rh positive blood groups are of a protective effect in relation to liver enzymes. Patients who were admitted to the hospital within 24 hours from having clinical manifestations had a better prognosis.</p> <p><strong>Conclusion:</strong> This study is the first inferential research on G6PD deficiency from the Middle East to explore cases from one of the largest healthcare centres in Jordan. The role of blood grouping should be investigated prospectively.</p> 2018-12-11T00:00:00+00:00 ##submission.copyrightStatement## Angiographic characteristics of contralateral asymptomatic eyes in acute Central serous chorio-retinopathy in an Asian population 2019-01-02T17:14:45+00:00 Rajya L Gurung Afaque Anwar <p class="p1"><span class="s1"><strong>Background:</strong> Acute Central serous chorioretinopathy (CSCR) is characterised by an idiopathic circumscribed serous retinal detachment, usually confined to the central macula. </span></p> <p class="p1"><span class="s1"><strong>Aims and Objective: </strong>We aimed to analyse the angiographic characteristics of contra-lateral asymptomatic eyes of<span class="Apple-converted-space">&nbsp; </span>patients presenting with acute CSCR in an Asian population. </span></p> <p class="p1"><span class="s1"><strong>Materials and methods:</strong> This is a retrospective study of 70 consecutive patients presenting with acute CSCR who underwent detailed fundus evaluation and fluorescein angiography within 1 year period. </span></p> <p class="p1"><span class="s1"><strong>Results:</strong> Fluorescein angiograms of 70 patients were analysed . Male to female ratio was 10.66 : 1. The age range of patients was ( 24-54 ) years , median 37 years and mean age<span class="Apple-converted-space">&nbsp; </span>38.37 years with standard deviation 6.78 . Active tobacco use was found in 34 (48.6%) eyes and<span class="Apple-converted-space">&nbsp; </span>systemic steroid use in 2 (2.8%) eyes. Majority, 48 (34.3% ) of symptomatic and all 70(100% ) of contralateral asymptomatic eyes had presenting best corrected visual acuity ( BCVA ) of<span class="Apple-converted-space">&nbsp; </span>≥ 20/60.&nbsp; All 70 (100%) of symptomatic eyes had angiographic evidence of leakage in comparison to only 25(35.7%) of contralateral asymptomatic eyes.<span class="Apple-converted-space">&nbsp; </span>Multi-focal leakage was seen in 21 (30%) of symptomatic eyes and 6(8%) of asymptomatic eyes , inkblot<span class="Apple-converted-space">&nbsp; </span>leakage<span class="Apple-converted-space">&nbsp; </span>pattern being the most common in seen in 57 (81.4%) of<span class="Apple-converted-space">&nbsp; </span>symptomatic and 16 (22.8%) of asymptomatic<span class="Apple-converted-space">&nbsp; </span>eyes.<span class="Apple-converted-space">&nbsp; </span>The most common site of leakage was central seen in 62 (88.5%) of symptomatic eyes and 19 (27.1%) of contralateral asymptomatic eyes. </span></p> <p class="p1"><span class="s1"><strong>Conclusion:</strong> The findings in our study was comparable to other Asian studies.<span class="Apple-converted-space">&nbsp; </span>A considerable number of patients had angiographic evidence of CSCR in the contralateral<span class="Apple-converted-space">&nbsp; </span>asymptomatic eye.<span class="Apple-converted-space">&nbsp;</span></span></p> 2018-12-11T00:00:00+00:00 ##submission.copyrightStatement## Cervical cancer analysis: From burden to treatment 2019-01-02T17:14:46+00:00 Disha Tiwari Kirti Srivastava Dewesh Kishan Manjari Shah <p><strong>Background:</strong> Cancer has emerged as huge epidemic over past two decades. There is a declining trend in the incidence of cervical cancer in the western world on the contrary in India we have observed that this disease is a great menace to a women’s health and is showing rising trend. Within the country there is wide range of variation in demography and epidemiology. There is lack of published data available on epidemiology such as age, incidence, burden, compliance of patients having cervical cancer in Uttar Pradesh.</p> <p><strong>Aims and Objectives:</strong> Current study aims to gather the evidence to understand the pattern of cervical cancer burden in the community and to find out the lacunae in the treatment delivery and receiving end.</p> <p><strong>Materials and Methods:</strong> A retrospective study was conducted on patients of cancer cervix visiting OPD of department of radiation oncology. The study comprised retrieval of medical records for different variables like age, stage, district etc and analysing it to understand the presentation and burden of disease.</p> <p><strong>Results:</strong> A total of 470 patients were studied for their epidemiology. Majority of patients were from Lucknow (78) and its nearby districts. Out of 75 districts of Uttar Pradesh, patients from 38 different districts had come to seek radiation treatment which is almost half of the Uttar Pradesh. Majority of patients in study were women in their 5th&amp; 6th decade. The most common stage of diagnosis was II B. On histopathological evaluation most common variant found was squamous cell carcinoma with moderate differentiation 26.38%.</p> <p><strong>Conclusion:</strong> Our study highlights lack of resources in Uttar Pradesh as patients had travelled from peripheral districts to seek treatment, which lead to frequent treatment breaks and poor compliance for follow up.</p> 2018-12-11T00:00:00+00:00 ##submission.copyrightStatement## Electroencephalographic study of real-time arithmetic task recognition in learning disabilities children 2019-01-02T17:14:47+00:00 Phakkharawat Sittiprapaporn Shao-Chin Chang <p><strong>Background:</strong> Mathematics form is universally understood in modern society. It is natural to ask whether there is neurophysiological evidence for putative cognitive components of the task and the practice in mental arithmetic will lead to a detectable transition in primary locus of brain activity.</p> <p><strong>Aims and Objectives:</strong> The purpose of this study was to determine the effect of real-time arithmetic recognition task for cognitive performance and electroencephalographic activities.</p> <p><strong>Materials and Methods:</strong> While practicing the real-time arithmetic recognition task named SpeedMath developed by NeuroSky, Inc., electroencephalographic activities were also recorded by using the commercial lightweight electroencephalographic device, Mindwave Mobile, NeuroSky, Inc. Eight participants included learning disabilities children participating in this study. All participants were instructed and trained to practice the simple the arithmetic recognition task which included arithmetic and mathematic skills.</p> <p><strong>Results:</strong> The results showed that both alpha and beta frequency bands were increased with statistically significant at the 0.05 level.</p> <p><strong>Conclusions:</strong> The real-time arithmetic recognition task might improve the real-time arithmetic recognition task and performance.</p> <p>Asian Journal of Medical Sciences Vol.10(1) 2019 43-46</p> 2018-12-11T00:00:00+00:00 ##submission.copyrightStatement## A study of CBS gene polymorphism, plasma H2S levels and their association in type-2 diabetes mellitus 2019-01-02T17:14:49+00:00 Sayantan Dasgupta Ishita Mondal Utpal Kumar Biswas <p><strong>Background:</strong> Hydrogen Sulphide (H2S), in recent years, is getting significant attention, as more evidences are emerging about its diverse biological roles. There are evidences of H2S having anti-inflammatory, neuro-modulator, vasodilator, anti-apoptotic and mitochondrial protective roles in various tissues. Among different tissues, β-cells of pancreas, according to some recent studies, get significantly affected by the imbalance in H2S homeostasis, leading to β-cell dysfunction and Diabetes Mellitus (DM). Cystathionine- β-synthase (CBS) enzyme is involved in the synthesis of H2S from cysteine in various tissues. Among various possible mutations in the CBS gene, a particular 833T-C mutation, has been found to be associated with various diseases.</p> <p><strong>Aims and Objectives:</strong> The present study was aimed to determine the extent of abnormality of H2S homeostasis in type-2 DM patients, and to find out presence and association (if any) of 833T-C mutation in CBS gene, in the patients of type-2 DM, in comparison to healthy control subjects, in the Indian population.</p> <p><strong>Materials and Methods:</strong> A cross sectional study was done with 40 clinically and biochemically diagnosed DM type II patients attending OPD of Endocrinology department of NRS Medical College &amp; Hospital, Kolkata, and 40 age and gender matched non-diabetic control subjects. DNA was isolated from EDTA blood of all the study subjects, PCR done and results compared. Plasma H2S was measured by the N,N-dimethyl-p-phenylene-diamine method. Plasma glucose and serum insulin were measured by standardized commercial kits.</p> <p><strong>Results:</strong> Our study found the plasma H2S levels in the patients of type II DM to be significantly higher(P&lt;0.001) than the control subjects. The results also found significant positive correlation between plasma H2S level with fasting serum Insulin level (P&lt;0.001) and fasting plasma glucose level (P&lt;0.001) in the diabetic patients. Among 40 DM patients, only two were heterozygous for the mutation, and had both mutated allele (242bp) and normal allele (174bp). Rest of the patients and all the control subjects were homozygous for the normal allele (174bp). This marginal difference in the incidence of mutated allele was not found to be statistically significant.</p> <p><strong>Conclusion:</strong> our study shows significant association of H2S dys-regulation with the type-2 Diabetes Mellitus in Indian population. The marginal but insignificantly higher incidence of 833T-C mutation in CBS gene, found in our study, warrants further research with higher number of study population, to more conclusively infer about the role of this mutation in the pathogenesis of type-2 DM.</p> 2018-12-11T00:00:00+00:00 ##submission.copyrightStatement## A study assessing the outcome of endoscopic endonasal transsphenoidal excision of pituitary adenoma at a tertiary care institutions- An Initial experience of 30 cases 2019-01-02T17:14:50+00:00 Sourabh Dixit Nirmalya Samanta Suniti Kumar Saha Kaushik Roy Partha Ghosh Abta Bachchan <p><strong>Background:</strong> Endoscopic Endonasal Transphenoidal Pituitary Surgery (EETS), has been proved to be a preferred alternative to conventional surgery because of its salient features like wider, more panoramic field of visualization, improved illumination and mobility of instruments, and an ability to look around anatomical corners using angled lens and minimal invasiveness.The current study was done to analyse the effectiveness and morbidity in the patients operated in our centre by Endoscopic Endonasal Transphenoidal Pituitary Surgery (EETS) done by single team in single centre in15 months.</p> <p><strong>Aims and Objective:</strong> To describe a case series of patients with pituitary adenomas with endoscopic endonasaltranssphenoidal approach, the technique performed and complications in our centre.</p> <p><strong>Materials and Methods:</strong> The technique performed in a series of 30 consecutive patients, and description of their complications and the protocol followed to treat these complications.</p> <p><strong>Results:</strong> The tumor removal was gross total in 18 (60.0%) patients, subtotal in 8 (30.7%), and partial in 4 (7.7%) patient. Two patients with growth hormone-secreting adenomas had normalization of hormonal status. Four patients developed temporary diabetes insipidus. Four patients developed post-operative CSF rhinorrhea and were managed conservatively.Two patient had recurrence of patient had meningitis and one patient expired in perioperative periods.</p> <p><strong>Conclusions:</strong> Our experience suggests that the Endoscopic transsphenoidal approach offers a potentially viable and cost economic treatment option in pituitary tumors which are difficult to remove by the standard microscopic approaches. In past one and half year we have witnessed encouraging results without much of the anticipated complications.</p> 2018-12-12T00:00:00+00:00 ##submission.copyrightStatement## A comparative study of albumin-bilirubin score, MELD and Child Pugh scores for predicting the in-hospital mortality in cirrhotic patients complicated with Upper GI bleeding in a Tertiary care hospital 2019-01-02T17:14:52+00:00 B.S. Nagaraja R. Madhumati K.J. Umesh U. Rashwith <p><strong>Background:</strong> Alcoholic liver Disease (ALD) encompasses a spectrum of Injury, ranging from simple steatosis to frank cirrhosis which is evaluated by many scoring systems.</p> <p><strong>Aims and Objective:</strong> Our study aims at evaluating the discriminative abilities of Child-Pugh, model for end-stage liver disease (MELD), and albumin-bilirubin (ALBI) scores in predicting the inhospital mortality in cirrhotic patients complicated with acute upper gastrointestinal bleeding.</p> <p><strong>Materials and Methods:</strong> Data of Patients with Liver cirrhosis secondary to ethanol presented with Upper GI bleed were retrospectively reviewed. Child Pugh, MELD and ALBI scores were calculated for the patients and results from ROC curves were analysed.</p> <p><strong>Results:</strong> In our study conducted on 112 patients, the age distribution was between 18-74 yrs with mean age of<br>patients being 46.47+/-10.9 years, sex ratio Male: Female: 105:7 with mortality rate of 33.4%.the Area under curves of ROC of ALBI, Child Pugh and MELD are 0.743, 0.864 and 0.763.</p> <p><strong>Conclusion:</strong> The prognostic performance of all 3 scores was comparable but Child Pugh score was found to have better prognostic significance than ALBI and MELD score.</p> 2018-12-11T00:00:00+00:00 ##submission.copyrightStatement## Clinicoradiological profile of interstitial lung disease in rheumatoid arthritis 2019-01-02T17:14:53+00:00 Paramita Bhattacharya Susmita Ghosh Sarbani Sengupta Angira Dasgupta Kaushik Ghosh Bhaskar Ghosh <p><strong>Background:</strong> The burden of interstitial lung disease (ILD) in rheumatoid arthritis (RA) patients in resource limited countries like India is often under-reported. This study was conducted to find out the clinicoradiological profile of ILD in patients with RA in India.</p> <p><strong>Aims and Objectives:</strong> (1)To find out the frequency of Interstitial Lung Disease (ILD) in Rheumatoid Arthritis (RA) (2) To correlate the clinical findings with those of radiological(Chest x-ray &amp; HRCT Thorax) and pulmonary function tests including Spirometry, TLCO (Diffusing capacity of the Lung for Carbon monoxide/DLCO Corrected for alveolar volume i.e., DLCO/V) Estimation.</p> <p><strong>Materials and Methods:</strong> Thirty consecutive patients of RA (with or without pulmonary symptoms or signs) who fulfill the American Classification of Rheumatology criteria1987 were selected from the patients attending the General Medicine OPD (Rheumatology Division) of B.R. Singh Hospital during the study period regardless of being on any medications for RA. This was a cross-sectional, descriptive study. Results were tabulated in Microsoft office excel worksheet and descriptive statistics were expressed as means, standard deviations (SD) mean for continuous normally distributed data and as percentages. Statistical software SPSS version 19.0 was used for data analysis. Unpaired t test (for continuous data)/Chi square test (for proportion) was used for comparing cases and controls.</p> <p><strong>Results:</strong> The frequency of ILD in RA was 60%. Female patients with a positive rheumatoid factor had a greater chance of development of ILD.The frequency was found to be increased after the age of 40 years. Though in this study 60% of patients had restrictive pattern, 31% had obstructive and 3 % had mixed pattern on Spirometry. The patients with deforming RA had greater frequency of restrictive or mixed pattern on Spirometry. 22.22% patients had a decreased TLCO despite having normal CXR. Despite being asymptomatic<br>12 patients had restrictive lung disease and reduced TLCO with HRCT evidence of ILD. Overall, Spirometry &amp; TLCO are the most appropriate tests to detect restrictive lung disease in patients with RA. In fact, HRCT can show evidence of ILD even when clinical parameters and Chest X-ray are normal.On HRCT of thorax reticular pattern and sub-pleural fibrosis (UIP-Usual interstitial pneumonia) are the predominant pattern.</p> <p><strong>Conclusion:</strong> The frequency of ILD in RA is quite high. It may be recommended to use Spirometry &amp; TLCO as screening test for detection of restrictive lung disease in patients with RA who should undergo HRCT of chest to confirm presence of ILD in a resource limited setting.</p> 2018-12-11T00:00:00+00:00 ##submission.copyrightStatement## Prevalence of peripheral neuropathy in diabetes mellitus and its association with therapy, ethnicity and duration of diabetes mellitus 2019-01-02T17:14:55+00:00 Dipesh Karki Amar Nagila Niraj Dhakal Sumit Chhetri <p><strong>Background: </strong>Diabetic peripheral neuropathy (DPN) is a most common micro vascular complication of diabetes posing significant morbidity and mortality with early and insidious onset. Studies has variably pointed that older age, gender, duration of diabetes, dyslipidemia, are linked with development of DPN.</p> <p><strong>Aims and Objectives: </strong>To determine the prevalence of neuropathy in diabetic patients and see its link with age, gender, duration of diabetes, therapy and ethnicity.</p> <p><strong>Materials and Methods: </strong>This is a cross-sectional study involving 110 clinically diagnosed diabetic patients, meeting the inclusion criteria. Basic demographic data were taken during clinical examination. Presence of degree of neuropathy was screened by measuring vibration perception threshold using Biothesiometer. Data was entered on SPSS and were categorized, necessary non parametric statistical tests were applied to these categorical variables as needed. The level of significance was set at <em>p</em> value less than 0.05.</p> <p><strong>Results: </strong>Presence of neuropathy was measured in 110 diabetic patients. The overall prevalence of DPN was 45.45%. Frequency of neuropathy was higher with increase in age with 72.7% in more than 60 years of age and 23.5% in less than or equal to 40 years of age group (<em>p</em>=0.007). Similarly, the increasing trend of DPN with increase in duration of DM was evident in this study with DPN present in more than 55% of patients with more than 5 years of diabetes(<em>p</em>=0.004).</p> <p><strong>Conclusion: </strong>The prevalence rate of DPN in diabetes was observed to be higher (45.45%). Our result suggested that DPN is associated with old age and the duration of diabetes mellitus.</p> <p>Asian Journal of Medical Sciences Vol.10(1) 2019 72-76</p> 2018-12-13T00:00:00+00:00 ##submission.copyrightStatement## Prevalence of low birth weight babies and its association with socio-cultural and maternal risk factors among the institutional deliveries in Bharatpur, Nepal 2019-01-02T17:14:56+00:00 Prerna Bansal Sandeep Garg Hari Prasad Upadhyay <p><strong>Background:</strong> The low birth weight (LBW) is considered as sensitive index of nation’s health and development. Almost a third of the newborn in the South East Asia region is low birth weight. Over three- quarters of newborn deaths in Nepal occur in low birth weight babies. The causes of low birth weight are multi-factorial and birth weight is determined by the interaction of both socio-demographic and biological factors.</p> <p><strong>Aims and Objective:</strong> To find out the prevalence of low birth weight babies among institutional deliveries and its association with socio-cultural and maternal risk factors.</p> <p><strong>Materials and</strong> <strong>Methods:</strong> A hospital based cross-sectional study was undertaken comprising of 220 postnatal mothers along with singleton live born baby delivered in College of Medical Sciences and Teaching Hospital, Bharatpur, Nepal during the study period of April 2011 to March 2012. Binary logistic regression was used to find the association between dependent variable (LBW) and independent variables. Model accuracy test in binary logistic regression was done by using Hosmer and Lemeshow Test . To find the strength of binary logistic regression Pseudo R-square was used.</p> <p><strong>Results:</strong> Out of 220 respondents, the prevalence of LBW was 23.6% (with 95% CI 21.88 to 25.32%). The risk factors like rest received in afternoon during pregnancy, dietary intake during pregnancy and period of gestation were found to be statistically significant. The odds of having LBW babies was 9.07 times higher in preterm births, 2.44 times higher among mothers who took afternoon rest of less than two hours and 3.44 times higher among those mothers who took dietary intake less or same as before during pregnancy. The variation in LBW due to these factors was found to be 22.9% to 34.4%.&nbsp;</p> <p><strong>Conclusion:</strong> The prevalence of low birth weight was found to be significantly high among institutional deliveries of this region of the country. Socio-cultural and maternal risk factors like rest received in the afternoon during pregnancy, dietary intake during pregnancy and period of gestation were found to be significantly associated with low birth weight babies. The problem of low birth weight babies can be lessened down as most of these factors can be tackled easily by providing adequate and effective antenatal care services with its maximum utilisation as well as home care by emphasising upon education of mothers and family members, hence decreasing infant and child mortality rates.&nbsp;</p> 2018-12-09T00:00:00+00:00 ##submission.copyrightStatement## Prevalence of gestational diabetes mellitus and associated factors in Southern Ethiopia 2019-01-02T17:14:58+00:00 Eskinder Wolka Woticha Wakgari Deressa Ahmed Reja <p><strong>Background: </strong>Presence of gestational diabetes mellitus during pregnancy has serious complications for both mother and child. Its burden is increasing in low and middle-income countries but, little is known about its contribution in Ethiopia.</p> <p><strong>Aims and Objective:</strong> The aim of this study was to determine the prevalence of gestational diabetes mellitus and to identify associated factors in Wolaita Zone, Southern Ethiopia.</p> <p><strong>Materials and Methods: </strong>Institution based cross sectional study was carried out from August 2017 to October 2017 in Wolaita Zone, southern Ethiopia. A total of 518 pregnant women were participated from 2 hospitals and 4 health centers. Capillary blood samples were collected at fasting and 2 hours after 75gm glucose load to measure blood sugar and diagnosis of gestational diabetes mellitus was made by using 2013 World Health Organization (WHO) criteria. Binary logistic regression model was applied to assess risk factors of gestational diabetes mellitus.</p> <p><strong>Results: </strong>Prevalence of gestational diabetes mellitus was 4.2% (95% CI, 2.5, 6.2) with mean post glucose load level of 160.1 mg/dl (6.3) and 15(4%) among urban residents and 7(4.9%) among rural residents. The proportion of gestational diabetes mellitus increases with increase in number of pregnancies. Previous history of spontaneous abortion (AOR: 3.5; 95%CI: 1.7-14.6), family history of type II diabetes (AOR: 4.3; 95%CI: 1.3-8.7) and previous caesarean section (AOR: 7.5; 95%CI: 1.3-14.4) were found to be significantly associated with gestational diabetes mellitus.</p> <p><strong>Conclusions: </strong>The prevalence of gestational diabetes mellitus is higher as compared to other studies conducted in the country. Strengthening screening, care and prevention strategies for gestational diabetes mellitus are important to improve maternal and child health.</p> 2018-12-11T00:00:00+00:00 ##submission.copyrightStatement## Treatment of midshaft clavicle fracture with anatomical contoured clavicular locking plate 2019-01-02T17:14:59+00:00 Pratyenta Raj Onta Krishna Sapkota Krishna Wahegaonkar Niraj Ranjeet Pabin Thapa Upendra Jung Thapa <p><strong>Background:</strong> Fracture clavicle is a common fracture around the shoulder joint accounting about 2.6% of all fracture and 44% in shoulder region. Mid shaft clavicle fracture accounts about 81% of total clavicle fracture. Open reduction and plate fixation is a good treatment method for displaced mid shaft clavicle fracture with benefit of early pain free movement of shoulder joint and early return to work. The anatomical contoured clavicular plate maintains mechanical strength and has less soft tissue complications.</p> <p><strong> Aims and Objective:</strong> The aim of the study was to evaluate the clinical and radiological outcome, time for fracture union and complications in midshaft clavicle fracture managed with anatomical contoured clavicular<br>locking plate. Material and Methods: This study was done in Manipal Teaching Hospital, Pokhara, Nepal.There were a total of 30 patients (19 male and 11 female) who had displaced mid shaft fracture. All patients underwent plate osteosynthesis with anatomical contoured locking plate. The patients were followed up at 3 weeks, 6 weeks, 3 month and 6 months’ time.</p> <p><strong> Results:</strong> There were 30 patients among whom; one patient had bilateral clavicle fracture. The mean age of the patient was 37.19 (11.96) years. The mean time for clinical and radiological union was 8.77 (1.17) weeks and 17.03 (3.06) weeks. All patients in our study had union of fracture with only one patient having superficial surgical site infection.</p> <p><strong>Conclusion:</strong> Open reduction and plate fixation is a good option for displaced mid shaft clavicle fracture which help the patient for early pain-free movement of shoulder. Use of anatomical contoured clavicle plate provides fixation of clavicle to its normal contour and provides better fixation and stability.</p> <p>&nbsp;</p> 2018-12-11T00:00:00+00:00 ##submission.copyrightStatement## Use of a shade guide to test the perception and prevalence of natural tooth colour in people of Nepal 2019-01-02T17:15:01+00:00 Manu Rana Sandeep Sharma <p><strong>Background:</strong> Recent advances in colour matching have been driven by the market demand for high-quality esthetic restorations. Improved shade guides, availability of shade-taking devices and research in the area of human colour vision have improved the potential of clinicians to achieve excellent colour matched restorations. A thorough understanding of appearance attributes of natural teeth is required along with these new tools to maximize shade matching results.</p> <p><strong>Aims and Objectives:</strong> The aim of the present investigation is to determine tooth shade among the people of Nepal.</p> <p><strong>Materials and Methods:</strong> In the present study, shade of cervical, middle and incisal third of the facial surface of natural maxillary central incisor was measured with digital colorimeter, VITA Easy shade Advance 4.0. It is an optical reading device that can assess the wavelengths reflected back to its sensors. Lighting in operatory does not affect the shade measurement. It is extremely accurate. The limitation of study was its small sample size.</p> <p><strong>Result:</strong> The shade obtained in the cervical third of tooth is 1M2 (37.33%), in the middle 1M1 (32.88%), and in the incisal third 2M1 (37.33%). Value 1 indicates lighter tooth colour and colour saturation is up to 2.</p> <p><strong>Conclusion:</strong> It was concluded that the most prevalent shade in cervical third was 1M2, middle third was 1M1 and incisal third was 2M1.</p> 2018-12-11T00:00:00+00:00 ##submission.copyrightStatement## Too bad the limbs are swollen 2019-01-02T17:15:02+00:00 Kaushik Ghosh Ambarish Bhattacharya Muhammad Imran Ahmad Qureshi <p>No abstract available.</p> 2018-12-09T00:00:00+00:00 ##submission.copyrightStatement##