Increased Serum Ferritin Levels in Type 2 Diabetes Mellitus Patients: A Hospital Based Cross-Sectional Study

INTRODUCTION: Type 2 diabetes mellitus is a metabolic disorder of multiple etiology characterized by chronic hyperglycemia with a derangement in carbohydrate, fat and protein metabolism resulting from defects in insulin secretion and action. Ferritin is a ubiquitous intracellular protein complex that reflects the iron stores of the body. Studies have shown that the increased body iron stores are associated with the development of glucose intolerance often leading to metabolic syndrome and type 2 diabetes (T2DM). The objective of the study was to find out association of serum ferritin level with T2DM and assess the correlation between serum ferritin and HbA1c. MATERIAL AND METHODS: A hospital based comparative cross-sectional study was conducted in 43 diabetic patients and 42 age and sex matched healthy controls. Fasting blood glucose (FBG), postprandial blood glucose (PBG), Glycated hemoglobin (HbA1c) and serum ferritin were estimated in cobas c311 autoanalyser using standard protocol. RESULTS: Mean age of healthy control and T2DM were found 54.83 ± 6.48 and 55.95±10.92 years respectively. Mean FBG (mg/dL) (170.41 ± 71.7 v/s 98.38 ± 9.7), PBG (mg/dL) (266.16 ± 110.09 v/s 123.20 ± 17.0), HbA1c (%) (8.17 ± 1.83 v/s 4.9 ± 0.29 and median ferritin (μg/L) 207.90 (138, 306.0) v/s 127.95 (85.75, 210.25) were significantly higher in T2DM compared to the healthy controls. Spearman’s correlation depicted that ferritin level was positively correlated with HbA1c level but the correlation was statistically insignificant. CONCLUSION: Serum ferritin level was found significantly higher in T2DM compared to healthy age and sex matched controls in our study.

Analgesic Effect of Ethanolic Extract of Seeds and Leaves of Coriandrum Sativum on Swiss Albino Mice

INTRODUCTION: Pain has been described by the International Association for the Study of Pain as an unpleasant sensory and emotional experience associated with actual or potential tissue damage, or described in terms of such damage. Although NSAIDS and OPIOIDS are available for the treatment, still pain (chronic) is major problem. The present study was designed to study the analgesic effect of ethanolic extract of Coriandrum sativum using hot plate method and acetic acid induced writhing method in experimental animals (Swiss albino mice). MATERIAL AND METHODS:The analgesic effect of leaves and seeds of Coriandrum sativum was assessed using hot plate method and acetic acid induced writhing method in Swiss albino mice. The animals were treated with the ethanolic extract of leaves and seeds of Coriandrum sativum orally at two doses of 100, 500 mg/kg body weight after electric heat and acetic acid induced pain in mice. RESULTS: The study showed that ethanolic extract of leaves and seeds of Coriandrum sativum presented significant (p<0.05) and (p<0.05) analgesic activity in mice simultaneously. The data were analyzed by one-way ANOVA followed by Dunette's multiple comparison test. The results demonstrate that ethanolic extract of leaves and seeds of Coriandrum sativum has got analgesic potential. CONCLUSION: The results demonstrate that ethanolic extract of leaves and seeds of Coriandrum sativum has got significant analgesic effect.

An Emerging, Neglected and Underestimated Zoonotic Parasitic Ocular Infestation: A Comprehensive Review on Thelaziasis

Human thelaziasis is an emerging insect-borne zoonotic ocular parasitic infestation, occur more commonly in rural communities with poor living and low socioeconomic living, and mainly affects the children and old age people, where humans live in close proximity with animals. Human thelaziasis is caused by both Thelazia callipaeda and Thelazia californiensis. T. callipaeda lives under the eye lids, nictitating membranes, orbit, conjunctival sac, lachrymal glands, and lacrimal ducts of cats, dogs, rabbits, horses, cattle, deer, badgers, monkeys, wolves, foxes (definitive hosts) and man being an accidental host. The vectors (intermediate hosts) are non-biting, tear-seeking, diptera flies of family Drosophilidae (fruit flies) Phortica variegata, which feeds on tears of their definitive hosts, including humans. Clinical manifestations include conjunctivitis, lacrimation, itching or pain with foreign body sensation, epiphora, follicular hypertrophy, and less often with severe signs and symptoms such as keratitis, photophobia, ectropion, corneal opacities (due to the migration of worm across the cornea), floaters within the eye chamber leading to visual impairment/blindness. The knowledge and scientific information on human thelaziasis is still unknown or relatively limited to many ophthalmologists and clinicians, and received little attention; hence this comprehensive and systematic review of human thelaziasis, is undertaken to highlight its importance and further research.

Perceived Fear and Preventive Behaviors of Pregnant Women during COVID-19 Pandemic in Western Nepal

INTRODUCTION: The perceived fear of COVID-19 is expected to have a significant positive impact on preventive behaviors as it triggers people to prevent themselves against threats. People take necessary actions to engage in preventive behaviors if they perceive high fear of transmission of disease. MATERIAL AND METHODS: Cross-sectional analytical study was conducted to find out the perceived fear and preventive behaviors of pregnant women during COVID-19 pandemic. One hundred and fifty normal pregnant women attending Antenatal Checkup (ANC) out-patient department and ward of Universal College of Medical Sciences Teaching Hospital (UCMSTH), Rupandehi were selected by using purposive sampling technique. Structured interview schedule was used for data collection. Descriptive statistics and inferential statistics were used for analysis with Statistical Package for Social Science (SPSS) software version 16. RESULTS: The study findings revealed that more than half of the respondents had high level of fear regarding COVID-19. Although participants were largely engaged in all preventive behaviors like wearing facemask, hand washing, covering nose and mouth, cleaning and disinfecting and maintaining healthy diet, while maintaining social distance, avoiding public transport, avoiding crowd, exercising regularly and quitting tobacco and alcohol were the least. There was positive correlation between perceived fear and preventive behaviors although it was not proved significantly. CONCLUSION: The study findings concluded that more than half of the respondents had high level of fear regarding COVID-19. Adequate counseling and reassurance of these pregnant women in the current scenario might reduce their fears and increase the probability of adapting preventive measures against the spread of COVID-19.

Lessons Learnt in the COVID-19 Pandemic- Multisystem Inflammatory Syndrome in Children (MIS-C)

No abstract available.

Psychiatric Morbidity in Elderly Patients attending OPD of Lumbini Medical College and Teaching Hospital

INTRODUCTION: Geriatric psychiatry patients are increasing but enough work has not been done in this area of Nepal. We conducted this study to find out the prevalence of different psychiatric morbidities in elderly population and to find out if there are any age and gender specific differences. MATERIAL AND METHODS: Medical records of psychiatric patients above 65 years of age visiting outpatient department of Lumbini Medical College and Teaching Hospitalfrom April 1, 2018 to March 31, 2019 were reviewed. Risks of having different psychiatric disorders was estimated using odds ratio. RESULTS: A total of 300 cases were enrolled in the study. Mean age of the study group was 71.49(SD=6.99). There were more females. Depressive disorderwas the most common diagnosis followed by somatoform disorder, anxiety disorder, dementia and others. Depressive disorder was higher in females and in younger subgroup of the elderly patient.The risk of having dementia was higher in older group. CONCLUSION: Depressive disorder was the most common psychiatric disorderfollowed by somatoform disorder in elderly patients above 65 years of age. Male patients were more likely to suffer psychiatric disorder as compared to females in this age.

Assessment of Feeding Practice among Mothers Attending the Immunisation Clinic of UCMS Hospital, Nepal: A Cross-Sectional Study

INTRODUCTION: Practice of exclusive breast feeding has dramatically reduced infant mortality in developing countries due to reduction in diarrhea and infectious diseases. We conducted a study to assess the feeding practices among mothers with children less than 12 months of age attending the immunization clinic of UCMS hospital, Nepal. MATERIAL AND METHODS: A hospital based cross sectional study was carried out in the immunization clinic of Pediatric ward of UCMS, Nepal for a period of four months. Mothers of child of 0-12 months were included in the study. Sample size was 372 which was based on the number of mothers visited Pediatric ward for immunization of their child of age group 0-12 months during the duration of the study. Mothers were interviewed by using a pre-validated structured questionnaire. Data was analyzed by using SPSS version-20 software and presented by descriptive statistics as frequency and percentages. RESULTS: Most of the children were above six months, 56.5% were of 7-12 months of age group. Exclusive breastfeeding was done in 48.4% children for first six months. Maximum population preferred hospital as their mode of delivery. 93.5% mothers opted for hospital as their place of delivery. 23.4% mothers were illiterate. Night feeding was practiced by 96.2% mothers. CONCLUSION: Breast feeding awareness must be spread among mothers by workshops and health education programs.

Study on the Prevalence and Associated Factors of Perceived Stress on COVID-19 Among Healthcare Providers in Rupandehi District Health Institutions, Western Nepal

INTRODUCTION: Healthcare providers (HCPs) though stood as front-liners during the crisis situation were not themselves immune to the psychological consequences due to COVID-19. The present study aimed to find the prevalence of perceived stress on COVID-19 pandemic and its associated factors among health care providers in Rupandehi district health institutions. MATERIAL AND METHODS: This cross- sectional study was conducted among the HCPs in the institutions of Rupandehi district in Western Nepal, from August to November, 2020. Total 126 subjects were included and probability sampling technique was applied for sample collection. After written consent from participants socio-demographic data were collected and Perceived Stress Scale (PSS-10) was applied. RESULTS: The study showed the prevalence of perceived stress in COVID-19 HCPs found to be 65.1% considering score 20 as cut-off. Age, work place, precaution measures taken and staying with family were statistically significant with the perceived stress level (p<0.05). Multivariate logistic regression showed perceived stress level had statistically significant association with precaution means and work place of HCPs. Healthcare providers who had unsatisfactory precaution means followed at work were 2.66 times more likely to have perceived stress as compared to satisfactory precaution means as adjusted odds ratio (AOR) = 2.66 (1.09-6.51). Healthcare providers who stayed with family members were 2.28 times more likely to have perceived stress level as AOR=2.28 (0.94-5.52). CONCLUSION: The study showed increased prevalence of perceived stress among HCPs during the initial stage of COVID‐19 pandemic in Nepal. Considering the findings, there is urgent need to develop and implement appropriate stress management and coping strategies to the target group.

Vitamin D Deficiency among Children with Sepsis in a Tertiary Care Center in Eastern Nepal

INTRODUCTION: Vitamin D deficiency (VDD) is exceedingly predominant in children leading to dysregulation of the immune system and inflammation. Data on the prevalence of VDD in children with sepsis and its association with sepsis severity are limited from our part of the world. The primary aim of this study was to identify the burden of VDD in children with sepsis. MATERIAL AND METHODS: One hundred and five children (< 15 years) with sepsis were enrolled from April 15, 2017 to April 14, 2018 from a tertiary care center in Eastern Nepal. Demographic data including BMI, sequential organ failure assessment (SOFA) scores were recorded at the time of admission. Plasma 25-hydroxy vitamin D [25(OH)D] levels were measured by chemiluminescence immunoassay technique (CLIA) (MAGLUMI 25-OH Vitamin D; CLIA) within 24 hours of admission. Vitamin D concentrations of <20 ng/mL (50 nmol/L) were considered as deficient. RESULTS: Of the 105 children enrolled, the majority 74 (70.55%) had vitamin D deficiency. Vitamin D was deficient in 77, 65, and 66% of children in 1-5, 5-10, and 10-15 years of age group respectively. Vitamin D deficiency was maximum (80%) in underweight children. In the VDD group, 60% had severe sepsis, whereas only 32% had severe sepsis in vitamin D sufficient group with significant statistical association with sepsis severity and vitamin D deficiency. CONCLUSION: A high burden of VDD is present in children with sepsis which was found to be associated with greater severity of illness.

Mental Health of Health Science Students during COVID-19 Pandemic: A Cross-Sectional Study in a Medical College of Nepal

INTRODUCTION: Mental health impact of COVID-19 is a well-known entity. Health science students are among the high risk groups for developing mental health issues due to lengthy and rigorous studies they undertake. This study aims to explore the mental health of health science undergraduate students of Maharajgunj Medical Campus, and Maharajgunj Nursing Campus during the COVID pandemic in Nepal. MATERIAL AND METHODS: A descriptive cross-sectional study was conducted from February 2021 to July 2021 using convenience sampling technique using Nepali version of DASS-21 to undergraduate health science students of Maharajgunj Medical Campus and Maharajgunj Nursing campus. RESULTS: Out of 164 participants, depression, anxiety and stress was seen in 43%, 33% and 29% respectively. Females showed more depression (47.6%) and anxiety (38.8%) and stress (32%) as compared to males CONCLUSION:Mental health of health science students is adversely affected during the COVID-19 pandemic.