Nepal Journal of Epidemiology

Vaping and e-cigarettes: A public health warning or a health promotion tool?

2019-12-31T11:07:46+00:00

Over the past decade the use of electronic cigarettes (e-cigarettes) or so-called vaping has become increasingly popular in many parts of the world. The e-cigarette is a battery-operated device which releases vapours of flavoured nicotine instead of tobacco smoke. The e-cigarette is a way to consume nicotine which gives the ‘high’ without the consumption of tar and other cancerous chemicals normally present in conventional tobacco cigarettes.

Serum calcium level among pregnant women and its association with pre-eclampsia and delivery outcomes: A cross-sectional study from North India

2019-12-31T11:07:48+00:00

Background: Calcium requirement increases during pregnancy, thereby increasing the chances of developing hypocalcaemia. Hypocalcaemia may be associated with pregnancy-related complications. Therefore, we planned this study to estimate the prevalence of hypocalcaemia among pregnant women attending secondary care hospital, and to study the association between hypocalcaemia and pregnancy outcomes.

Materials and Methods: This study was conducted in a secondary level hospital at Ballabgarh, district Faridabad, Haryana, India. Consecutive pregnant women with gestation period more than 28 weeks were enrolled. Dietary calcium intake was ascertained using 24-hour dietary recall method. Serum calcium estimation was done by Biolis 24i auto analyser. Outcome of pregnancy (preterm delivery, low birth weight (LBW) babies, and neonatal mortality) was assessed telephonically 3 months after the enrolment.

Results: A total of 696 pregnant women were enrolled in the study. Mean (SD) dietary calcium intake and serum calcium level was 796.4 (360.4) mg/day and 9.56 (0.94) mg/dl respectively. Prevalence (95% CI) of hypocalcaemia was 23.9% (20.8 – 27.2%). Serum total calcium level was not associated with dietary calcium intake (p-value – 0.36). Mean serum calcium level was significantly lower in mothers who had LBW babies. Pre-eclampsia, preterm delivery, and neonatal mortality were not associated with serum calcium level.

Conclusion: Serum calcium level may not be related to dietary calcium level. Hence, the current recommendation of calcium supplementation during antenatal period appears to be inconclusive among our study population.

Clinico-epidemiological profile of Acinetobacter and Pseudomonas infections, and their antibiotic resistant pattern in a tertiary care center, Western Nepal

2019-12-31T11:07:51+00:00

Background: Infections caused by Acinetobacter species and Pseudomonas species, especially multidrug-resistant (MDR) strains pose a serious management challenge with a public health threat.

Materials and Methods: A hospital-based retrospective study of patients who were infected with Acinetobacter spp or Pseudomonas aeruginosa was carried out at Manipal Teaching Hospital from 2014 to 2016.

Results: A total of 170 cases of infections with Acinetobacter spp. and 313 cases with Pseudomonas aeruginosa were studied. The rate of nosocomial infections was higher than non-nosocomial infections. ICU was found as the major hub for both the organisms; (53.5% of cases due to Acinetobacter spp. and 39.6% due to Pseudomonas aeruginosa). Most isolates were of respiratory tract origin (Acinetobacter 74.7% and Pseudomonas aeruginosa 65.8%). Percentage resistance of Acinetobacter spp. towards polymyxin B was found to be quite low (18.8%). Similarly, resistance rates of Pseudomonas aeruginosa against amikacin were also found to be low, i.e., 17.4%. A higher prevalence of multidrug resistance was seen among Acinetobacter spp than among Pseudomonas aeruginosa (75.9% vs. 60.1%). The hospital stay was longer for patients infected with MDR isolate (p=0.001 for Acinetobacter spp. and p=0.003 for Pseudomonas aeruginosa). The mortality rate was higher in infections due to Acinetobacter spp (15.9%) as compared to Pseudomonas aeruginosa (8.3%).

Conclusion: These clinico-epidemiological data will help to implement better infection control strategies. Developing a local antibiogram database will improve the knowledge of antimicrobial resistance patterns in our region, facilitating the treating physician in advocating empiric therapy if need be.

Breast Cancer and Dietary Fat Intake: A correlational study

2019-12-31T11:07:50+00:00

Background: Breast cancer (BC) is reported to be the most common malignancies affecting women worldwide. There is a sharp increase in the BC incidence rate over the past three decades as previously low risk countries are moving towards high -calorie western diets. Few epidemiologic studies along with animal experiments have ascertained the role of dietary fat in developing BC. This study aimed to determine the correlation between per capita dietary fat consumption and incidence of BC.

Methods: Three major data bases were used to conduct this correlational study. The data regarding consumption of fat and breast cancer incidence from 88 countries across five continents were extracted. The correlation coefficients between the incidence of BC and the fat consumption from the year 1990 to 2007 were calculated.

Results: A statistically significant (P<0.001) correlation between the average fat consumption and the crude BC incidence rate was observed and was more than 0.6, clearly indicating that there is a moderate to strong correlation with fat consumption and incidence of breast cancer (P<0.001).

Conclusions: Our observation indicated that increased total fat consumption increases the risk of developing BC. Consumption of dietary fat increases obesity thereby, increasing the risk of BC development. Dietary fat gets stored in the body since they undergo minimum oxidation as compared to carbohydrates and protein thereby, contributing to obesity a known risk factors for BC. Current study strengthens the evidence to support the hypothesis that non-genetic factors contribute to the occurrence of this disease.