scholarly journals Changing Epidemiology of Stroke in Nepalese Population

2018 ◽  
Vol 15 (1) ◽  
pp. 10-18
Author(s):  
Amit Thapa ◽  
Bidur KC ◽  
Bikram Shakya ◽  
Dipesh Kumar Yadav ◽  
Karjome Lama ◽  
...  
Keyword(s):  
Risk Factors ◽  
Ischemic Stroke ◽  
Teaching Hospital ◽  
Hemorrhagic Stroke ◽  
Surgical Intervention ◽  
Vegetative State ◽  
College Teaching ◽  
Diabetic Patients ◽  
Medical College ◽  
First Time

Corrigendum:The article published in Nepal Journal of Neurosciences 2018;15:10-18 by Amit Thapa et al was mistakenlypublished with wrong affi liation of some of the co-authors. The correct affi liation of the co-authors should read asBikram Shakya, MBBS, MS, MChLecturerDepartment of Neurological SurgeryKathmandu Medical College Teaching Hospital (KMCTH)Sinamangal, Kathmandu, NepalDipesh Kumar Yadav, MBBSMedical OfficerDepartment of Neurological SurgeryKathmandu Medical College Teaching Hospital (KMCTH)Sinamangal, Kathmandu, NepalKarjome Lama, MBBSMedical OfficerDepartment of Neurological SurgeryKathmandu Medical College Teaching Hospital (KMCTH)Sinamangal, Kathmandu, Nepal Abstract: We are witnessing changing patterns in stroke in our practice. Documenting changes in epidemiological profile are important for public health policy. We hereby present analysis of patients with stroke to stress upon the dynamics and update the improvement in their care. We retrospectively studied all patients with first time stroke presenting in Kathmandu Medical College Teaching Hospital during June 2012 till November 2015. Diagnosis was made on clinico-radiological basis with prospective follow up for at least 1 year from the event. Risk factors as well outcome in terms of Glasgow outcome score were studied. Statistical analysis was performed on SPSS. A total of 1017 patients of 16260 patients admitted to the hospital during the study period had first time stroke, a hospital based annual incidence of stroke of 64 per thousand admissions was hence calculated. Mean age was 55 years with 60.5% males. 503 patients (49.5%) had infarction with 20 patients having hemorrhagic conversion while 3 had TIA. 50.2% had hemorrhagic stroke. 56.7% females had ischemic stroke whereas 54.9% of males had hemorrhagic stroke (p=0.002). Common risk factors like HTN (54.7%), Smoking (41.5%), Alcohol (39.2%), dyslipidemia (34.1%) and DM (4.8%) were seen with stroke however, active smoker were more at risk of hemorrhagic stroke (p=0.000) while diabetic patients for ischemic stroke (p=0.000). Due to availability of neurosurgical services, 14.6% patient could undergo procedures like decompressive craniectomy, hematoma evacuation, CSF diversion procedures and carotid endarterectomy for stroke. 66.9% patients required surgical intervention within 48 hours of admission. We had 30 days mortality of 0.5% mortality in this series (majority in hemorrhagic stroke), however over 3 years duration of study mortality rose to 8.3% (majority in ischemic stroke). Almost 88.5% patients achieved mRS< Nepal Journal of Neuroscience, Volume 15, Number 1, 2018 11 2 over a period of 3 years. Persistent vegetative state was seen in 7.6% cases after 1 year. We observe a very high incidence of hemorrhagic stroke in general with higher than reported proportion of females being involved with ischemic stroke in our series. Most of the vegetative state conditions occurred in ischemic stroke patients however early mortality was common in hemorrhagic stroke. This change in pattern of stroke as well as need of surgical intervention mandates early involvement of neurosurgical services. Poor long term prognosis in ischemic stroke may be reversed by timely thrombolytic services and prevented by mitigating risk factors. Nepal Journal of Neuroscience 15:10-18, 2018

scholarly journals Study of Risk Factors of Stroke in Patients Admitted at Kohalpur Teaching Hospital

2018 ◽  
Vol 14 (2) ◽  
pp. 53-55
Author(s):  
Sanjib Kumar Shah ◽  
Sunil Shah ◽  
Sujeet Kumar Shah ◽  
Shyam B.K.
Keyword(s):  
Risk Factors ◽  
Ischemic Stroke ◽  
Retrospective Study ◽  
Teaching Hospital ◽  
Hemorrhagic Stroke ◽  
Early Recognition ◽  
Modifiable Risk Factors ◽  
Public Health Burden ◽  
Medical College ◽  
Conventional Risk Factors

 Background: Stroke is the major public health burden and the second major cause of death worldwide. This disease is common in old age persons, however the disease can also be seen in young persons. Identifying the modifiable risk factors of stroke may have contribution in prevention.Objective: The retrospective study was done to study risk factors of stroke in adult patients.Method and Material: This is a hospital based retrospective study conducted in Department of Medicine, Nepalgunj Medical College and st th Teaching Hospital, Kohalpur from the period of 1 January 2015 to 30 October 2016. A total of 119 patients were involved in this study. The diagnosis was confirmed using CT scan after taking history and performing clinical examination. Patients were then evaluated for the presence of both non-modifiable as well as modifiable risk factors. The data analysis was done using SPSS 13.0.Results: The mean age of the patient was 59.76±11.22. Among the collected patients, the higher percentage were male in comparison to female. Ischemic Stroke was more common than hemorrhagic stroke in our study. Other conventional risk factors were as follows: Alcohol use75(63%),cigarette smoking 70(58.8%), hypertension 60 (50.4%),diabetes 11(9.2%),previous vascular event 9(7.6%), heart disease 4(3.4%).Conclusions: Ischemic stroke was more common than hemorrhagic stroke; with alcohol use followed by smoking, hypertension and diabetes mellitus being the most common modifiable risk factors. Incidence of stroke increases with the age and the early recognition and management of the risk factors might reduce this major public burden. JNGMC,  Vol. 14 No. 2 December 2016, Page: 53-55

scholarly journals Dermatological Manifestations in Diabetes Mellitus at NGMCTH Kohalpur

2017 ◽  
Vol 13 (2) ◽  
pp. 31-34
Author(s):  
Sumit Pandey ◽  
Pradip Mishra ◽  
Nirmala Sharma ◽  
Shyam B.K.
Keyword(s):  
Diabetes Mellitus ◽  
Chronic Disease ◽  
Teaching Hospital ◽  
College Teaching ◽  
The Body ◽  
Diabetic Patients ◽  
Cutaneous Infections ◽  
Medical College ◽  
Patients With Diabetes ◽  
Sugar Levels

Background: Skin is the largest and most visible organ in the body. It undoubtedly determines to a great extent our appearance and plays  a  major  role  in  socio-sexual  communication.  More  than  one  third  of  diabetic  patients  have  some  type  of  dermatologic 1 manifestations during the course of their chronic disease . The association of certain skin diseases with diabetes mellitus has been 2 3 fairly well recognized with an incidence rate ranging from 11.4% to 66%.  At least 30% of patients with diabetes mellitus have some 4 5 type of cutaneous involvement during the course of their chronic disease.  Skin sugar levels run parallel to the blood sugar levels. Skin changes generally appear subsequent to the development of DM but may be the first presenting sign or even precede the 6 diagnosis by many years. Among the many skin manifestations in DM, none is pathognomonic of this disease. Cutaneous findings in DM can be classified into four categories: (1) skin disease with strong association and others with less distinct association with DM, (2) cutaneous infections, (3) dermatological disorders related to diabetic complications, and (4) skin conditions related to diabetes 7 treatments.Objectives: This study was undertaken to find out the pattern of Dermatological manifestations in Diabetes patients attending Nepalgunj Medical College Teaching Hospital, Kohalpur. Method and material: This is a hospital- based descriptive study conducted  in  the  Department  of  Dermatology,  Venereology  and  Leprology  of  Nepalgunj  Medical  College  Teaching  Hospital, Kohalpur  between   September 2013 to August 2014.  A total of 100 patients were included in the study. History and clinical examinations were performed and the data were recorded and analyzed. Results: The age of the patients ranged from 20 years to 85 years with the mean age of 51.7+12.13 years. The most common age groups were 46-55 years (36%) followed by 56-65 years (24.7%) and 36-45 years (17.3%), 66-75 years (9.3%), 76-85 years (12.7%). Among the 100 patients of diabetes ellitus, there were 44(44%) males and 56 (56%) females.  Among  the  cutaneous  disorders  commonly  associated  with  diabetes,  infections  were  the  most prevalent. 59(59%) out of 100 patients had skin infections.Conclusions: Patients with Diabetes can present with array of cutaneous disorders. Cutaneous infections formed the largest group of dermatoses in this study. Increased incidence of cutaneous infections mainly fungal and bacterial was noticed in majority diabetics emphasizing the need for more aggressive management of diabetes mellitus. Among infective dermatoses, fungal infections were the most common, with Candidal infections being more common than dermatophytosis.JNGMC Vol. 13 No. 2 December 2015, Page: 31-34

scholarly journals Prevalence of Perinatal Asphyxia in Neonates at a Tertiary Care Hospital: A Descriptive Cross-sectional Study

2019 ◽  
Vol 57 (219) ◽  
Author(s):  
Sunil Raja Manandhar ◽  
Rydam Basnet
Keyword(s):  
Risk Factors ◽  
Confidence Interval ◽  
Teaching Hospital ◽  
Perinatal Asphyxia ◽  
Tertiary Care ◽  
College Teaching ◽  
Cross Sectional Study ◽  
Sectional Study ◽  
Cross Sectional ◽  
Medical College

  Introduction: Perinatal asphyxia is one of the major causes of perinatal and early neonatal mortality in developing countries. The main objective of this study was to observe the prevalence of perinatal asphyxia in babies born at Kathmandu Medical College Teaching Hospital. Methods: This was a descriptive cross-sectional study conducted at Kathmandu Medical College Teaching Hospital over six month period (January to June 2019). All preterm, term and post term babies delivered at Kathmandu Medical College Teaching Hospital were included. Ethical clearance was received from Institutional Review Committee of Kathmandu Medical College (Ref.:2812201808). Convenient sampling method was applied. Data analysis was done in Statistical Package for Social Sciences (SPSS 18), point estimate at 95% Confidence Interval was calculated along with frequency and proportion for binary data. Results: A total of 1284 babies delivered over six months period were enrolled in this study and 47 (3.66 %) babies were asphyxiated, at 95% Confidence Interval (2.64%-4.68%). The mean birth weight of asphyxiated babies was 2759.75±65 grams and gestational age was 37.57±2 weeks. Among asphyxiated babies, 15 (32%) babies were normal, 15 (32%) babies were in Hypoxic Ischemic Encephalopathy stage I, 14 (30%) were in stage II and 3 (6%) were in stage III. Twenty Three (49%) asphyxiated babies had antenatal risk factors and all 47 babies had intrapartum risk factors leading to asphyxia. Conclusions: Prevalence of perinatal asphyxia was lower compared to that of other similar tertiary care hospitals. Perinatal asphyxia remains a major cause of neonatal morbidity and mortality.

scholarly journals Prevalence and pattern of lipid profile among patients with diabetes mellitus attending a tertiary teaching hospital in Nepal

2020 ◽  
Vol 9 (3) ◽  
pp. 150-153
Author(s):  
Rita Kafle ◽  
Anuj Raj Kadel
Keyword(s):  
Diabetes Mellitus ◽  
General Practice ◽  
Lipid Profile ◽  
Teaching Hospital ◽  
College Teaching ◽  
Diabetic Patients ◽  
Medical College ◽  
Tertiary Teaching ◽  
Patients With Diabetes ◽  
Lipid Abnormalities

Background: Dyslipidemia, a well-known major risk factor for coronary heart disease, is commonly associated with macro-vascular complications in patients with diabetes mellitus. Increased level of triglycerides and reduced levels of HDL cholesterol are common lipid abnormalities in diabetes. Objectives: The aim of the study was to study the prevalence and pattern of lipid abnormalities among diabetic patients attending general practice outpatient department in Kathmandu Medical College Teaching Hospital. Methodology: This is a descriptive cross-sectional study conducted in the Department of General Practice and Emergency of Kathmandu Medical College Teaching Hospital, Duwakot, Bhaktapur. Convenience sampling technique was used.After obtaining informed consent, 120 diabetic patients from January 2020 to March 2020 were included. The data collected was entered in the Statistical Package for the Social Sciences software and analyzed. Ethical clearance was taken from the Institutional Review Committee of Kathmandu Medical College.   Results:The average TC, HDL, TG and LDL level among the female participants were 186.18 mg/dl, 41.91 mg/dl, 194.63 mg/dl, 111.88 mg/dl respectively and 186.30 mg/dl, 38.80 mg/dl, 205.60 mg/dl, 125.80 mg/dl among the male participants respectively.Eighty-five (71%) patients had a low HDL level. Total cholesterol was found to be high in 38(32%) participants. LDL cholesterol was high in 77(64%) participants. The triglyceride level was high in 85(71%) participants. Conclusion: This study showed that some diabetic individuals have a lipid abnormality while others did not. This shines light on the importance of regular testing for lipid profile in diabetic individuals because we cannot reasonably predict when a patient will develop dyslipidemia.

scholarly journals Profile of Macrosomic Babies at a Tertiary Level Hospital

2016 ◽  
Vol 35 (2) ◽  
pp. 136-140
Author(s):  
Subhash Chandra Shah ◽  
Devendra Shrestha ◽  
Ajaya Kumar Dhakal ◽  
Arati Shakya ◽  
Henish Shakya ◽  
...  
Keyword(s):  
Risk Factors ◽  
Teaching Hospital ◽  
Neonatal Sepsis ◽  
Mode Of Delivery ◽  
College Teaching ◽  
Maternal Diabetes ◽  
Neonatal Complications ◽  
Medical College ◽  
Tertiary Teaching ◽  
Adverse Neonatal Outcomes

Introduction: Macrosomia is known to be associated with adverse neonatal outcomes. The aim of this study was to estimate the incidence of macrosomia in a tertiary teaching hospital of Nepal based on local intrauterine foetal growth percentile curve according to gestational age, risk factors for morbidity and mortality and neonatal outcome of macrosomia.Materials and Methods: This was a descriptive observational study done on live term macrosomic babies delivered during the study period at KIST Medical College Teaching Hospital, Lalitpur Nepal. The maternal and neonatal records of macrosomic babies were reviewed. All the macrosomic babies were followed up till discharge. Macrosomic babies needing admission into the neonatal care unit were considered as ones with complication. Maternal and neonatal risk factors associated with neonatal complications were analysed.Results: Among total of 2922 live singleton deliveries, 342 (11.7%) babies were macrosomic. The neonatal complications associated with macrosomia were seen in 19.6%. The risk factors significantly associated with neonatal complications were mode of delivery via caesarean section, instrumental delivery and 1 min low Apgar score. Maternal diabetes leading to macrosomia however was seen in only one case. The most common neonatal complications were neonatal sepsis (11.4%), significant hyperbilirubinaemia (2%) and transient tachypnoea of newborn (1.6%).Conclusions: Neonatal sepsis was the major cause of morbidity even in the macrosomic babies. Importance of early interventions for prevention and management of macrosomic babies with neonatal sepsis needs to be emphasized.J Nepal Paediatr Soc 2015;35(2):135-140

scholarly journals Diabetic and Non-diabetic Subjects with Ischemic Stroke: Risk Factors, Stroke Topography and Hospital Outcome

2017 ◽  
Vol 18 (2) ◽  
pp. 75-79
Author(s):  
Md Mahfuj Ul Anwar ◽  
Shah Md Sarwer Jahan ◽  
Sajeda Afrin ◽  
Md Zakir Hossain
Keyword(s):  
Risk Factors ◽  
Risk Factor ◽  
Ischemic Stroke ◽  
Diabetic Patients ◽  
College Hospital ◽  
Hospital Outcome ◽  
Medical College ◽  
Cerebrovascular Risk Factor ◽  
Healthy Life Style ◽  
A Prospective Study

Background and Purpose: Diabetes and ischemic stroke are common diseases that frequently occurring together. Several studies have shown that people with diabetes have approximately twice the risk of ischemic stroke compared with those without diabetes. Although diabetes is a strong risk factor for ischemic stroke, it is still unclear whether risk factors, neuroimaging findings and hospital outcome are different in diabetic and nondiabetic patients. The aim of the present study was to evaluate cerebrovascular risk factor prevalence, neuroimaging findings and hospital outcome in patients between diabetic and non-diabetic of ischaemic stroke.Methods: We conducted a prospective study of 380 consecutive patients with cerebral infarction admitted into Rangpur Medical College Hospital over a 18-month period. With the use of a simple identical data sheet, we recorded the demographics, cardiovascular risk factors, neuroimaging findings and outcome in ischemic stroke patients with and without diabetes.Results: Overall, diabetes was present in 76 patients (20%). Diabetic patients, compared with those without diabetes, were younger (p=.034) and they were more likely to have hypertension (69.7%), hyperlipidemia (28.9%), ischemic heart disease (22.4%), previous cerebral infract (23.7%) and renal impairment (19.7%). Diabetic infract more frequently occurred in thalamus (11.8%), pons (9.2%) and with cerebral posterior involvement (13.2%). Mortality was higher in diabetic group (P = .046).Conclusions: Diabetic patients had higher risk burden for ischemic stroke with poorer short term hospital outcome than non-diabetic subjects. So control of diabetes and other risk factors along with a strict observation of adult individuals’ healthy life-style should warrant successful ischemic stroke prevention in our country.J MEDICINE July 2017; 18 (2) : 75-79

scholarly journals Awareness regarding diabetes mellitus among individuals attending a hospital, Bhaktapur

2019 ◽  
Vol 8 (2) ◽  
pp. 103-107
Author(s):  
Rita Kafle ◽  
Binita Pradhan ◽  
Ram Krishna Chandyo
Keyword(s):  
Physical Activity ◽  
Diabetes Mellitus ◽  
Risk Factors ◽  
General Practice ◽  
Teaching Hospital ◽  
Preventive Measures ◽  
College Teaching ◽  
Outpatient Department ◽  
Medical College ◽  
Prevention Of Diabetes

Background: Diabetes mellitus is the most prevalent metabolic condition and one of the major health and socioeconomic problems worldwide. Awareness of risk factors and prevention of diabetes plays a major role for prevention of diabetes mellitus in general population.Objectives: To assess level of awareness regarding diabetes mellitus risk factors and preventive measures among individuals who attended General Practice outpatient department at Kathmandu Medical College Teaching Hospital, Duwakot, Bhaktapur.Methodology: This is a descriptive study conducted in Department of General Practice and Emergency of Kathmandu Medical College Teaching Hospital. The study included 370 patients attending General Practice outpatient department from November 2018 to April 2019. The data collected was entered in the Statistical Package for the Social Sciences software and analysed for results. Ethical clearance was taken from Institutional Review Committee of Kathmandu Medical College.Results: The study included 370 participants; the mean age was 40.83±12.21 years. More than half of the participants (56.5%) were females and 43.5% were males. The most commonly mentioned risk factor was lack of physical activity and obesity. Almost 80% participants correctly stated that physical activity could help prevent diabetes mellitus. There was no statistical significance between awareness and educational level of participants.Conclusion: This study showed that proper awareness programs need to be carried out in rural and urban communities to prevent diabetes and its complications. In this study, patient awareness about risk factors and preventive measures was not appreciable. Association of awareness with age, sex and education level was not statistically significant.

Study on Knowledge and Prevalence of Computer Vision Syndrome among Computer Operators in Nobel Medical College Teaching Hospital, Biratnagar, Nepal

2020 ◽  
Vol 9 (2) ◽  
pp. 45-49
Author(s):  
Pramod Sharma Gautam ◽  
Uday Chandra Prakash ◽  
Subreena Dangol
Keyword(s):  
Computer Vision ◽  
Teaching Hospital ◽  
Human Life ◽  
College Teaching ◽  
Extended Period ◽  
Visual Display ◽  
Work Place ◽  
Medical College ◽  
Computer Vision Syndrome ◽  
Department Of Ophthalmology

Background: The eye and vision related problems that results from continuous use of computers and other visual display terminals for extended period of time leads to computer vision syndrome. Due to rapid digitalization in human life, the risk of developing it has also increased in many folds. So, with an aim of determining the prevalence and level of awareness of computer vision syndrome among computer users along with their attitude and practices to prevent it, this study was conducted in the office employees who use computer for a considerable period of time. Materials and Methods: A hospital based observational descriptive study was conducted in the out-patient department of Ophthalmology in Nobel Medical College and Teaching Hospital, Biratnagar, where 105 employees working in different work stations of same institution were enrolled. A questionnaire and the clinical findings were used to collect data. Results: About 80% of the employees were using computer for about (8-11) hours per day. Prevalence of computer vision syndrome noted was (92.4%) with low level of knowledge (85.7%) about it. About 45% of them wore glasses for their refractive errors but attitude and practices in work place to prevent the bad effects of using visual display terminals were found to be lacking (53.3%). Burning sensation in the eye, headache, ocular irritation and itching and neck, shoulder or back pain were the common symptoms. Around (60-70)% of the eyes tested positive for dry eye. Conclusion: Lack of awareness of computer vision syndrome and lack of personal protective measures were associated with its high level of prevalence.  

The physiopathology of spontaneous hemorrhagic stroke: a systematic review

2021 ◽  
Vol 0 (0) ◽  
Author(s):  
Alcivan Batista de Morais Filho ◽  
Thiago Luis de Holanda Rego ◽  
Letícia de Lima Mendonça ◽  
Sulyanne Saraiva de Almeida ◽  
Mariana Lima da Nóbrega ◽  
...  
Keyword(s):  
Risk Factors ◽  
Systematic Review ◽  
Ischemic Stroke ◽  
Subarachnoid Hemorrhage ◽  
Natural History ◽  
Hemorrhagic Stroke ◽  
Recent Literature ◽  
Clinical Manifestations ◽  
The Road ◽  
History Of

Abstract Hemorrhagic stroke (HS) is a major cause of death and disability worldwide, despite being less common, it presents more aggressively and leads to more severe sequelae than ischemic stroke. There are two types of HS: Intracerebral Hemorrhage (ICH) and Subarachnoid Hemorrhage (SAH), differing not only in the site of bleeding, but also in the mechanisms responsible for acute and subacute symptoms. This is a systematic review of databases in search of works of the last five years relating to the comprehension of both kinds of HS. Sixty two articles composed the direct findings of the recent literature and were further characterized to construct the pathophysiology in the order of events. The road to the understanding of the spontaneous HS pathophysiology is far from complete. Our findings show specific and individual results relating to the natural history of the disease of ICH and SAH, presenting common and different risk factors, distinct and similar clinical manifestations at onset or later days to weeks, and possible complications for both.

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