Socio-demographic and Clinical Profile of Children with Asthma attending Chest Clinic at B. P. Koirala Institute of Health Sciences, Nepal

Introduction: Asthma in children is one of the most common chronic diseases and little information available on factors associated with this disease in our part of the world. Objective: The present study is an attempt to find out the socio-demographic and clinical profile of children with asthma. Methodology: This was a retrospective analysis of data of asthmatic children below 14 years attending pediatric chest clinic from July 2014 till March 2016. Results: Of the 200 children, there were 142 (71%) males. The median age of presentation was 3 years and 139 (69.5%) from the age group 1-5years One third had poorly controlled asthma. Comorbidity was present in 59(29.5%) and allergic rhinitis (7%) was the most common. 90.5% had onset of wheezing before 5 years of age. Family history of asthma and/or atopy and smoking was present in 24% and 31%, respectively. 22% had exposure to pet animals. Upper respiratory tract infection (URTI) (37%) was the most common trigger for exacerbation. Cough (99%) and fast breathing (98%) were the most common symptoms. Conclusion: The majorities were males of young age with rhinitis as most common co-morbidity and many of them had a history of parental smoking at home. One third of them had poorly controlled asthma which shows the need for proper management of asthma including its comorbidity in younger children and changing certain habits like parental smoking at home.

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Utility of Triglyceride-Glucose index in predicting glycemic control in type 2 diabetes mellitus

Introduction: Insulin resistance (IR) and glycemic control are two very important aspects to be considered during management of patients with Type 2 Diabetes Mellitus (T2DM). The triglyceride-glucose (TyG) index has been proposed as a simple and inexpensive parameter that correlates well with IR and glycemic control. Objectives: To explore the association of TyG index (and other TyG derived indices) with glycated hemoglobin (HbA1c) and evaluate their predictive ability for glycemic control in patients with T2DM. Methodology: This cross-sectional study comprised of 160 adult patients diagnosed with T2DM visiting the medical outpatient department of Chitwan Medical College, Bharatpur, Chitwan between July–December 2019. Socio-demographic data and anthropometric measurements were collected. Glycemic control was assessed by HbA1c. TyG index was calculated by the formula: ln [fasting TG (mg/dl) x fasting glucose (mg/dl)/2]. Receiver operating characteristic (ROC) curve analysis was performed to analyze the predictive ability of TyG-index for poor glycemic control. Results: One hundred and sixty patients (mean age: 53.6 ± 10.7 years, 55.0% males) were included in the study. Eighty (50.0%) had good glycemic control (HbA1c <7.0%). TyG index, along with TyG-BMI and TyG-WC (other TyG derived indices) were significantly increased in the poor glycemic control group. TyG index had a good predictive ability for poor glycemic control (AUC: 0.803, 95% CI: 0.731 – 0.874). A TyG cutoff ≥ 9.12 was optimal for predicting poor glycemic control, with 86.1% sensitivity and 61.5% specificity. Conclusion: TyG index could be a simple and cost-effective screening tool for assessment of glycemic control in patients with T2DM.

Outcome of Tobacco Smoking Habit on Lipid Peroxidation and Antioxidant parameters in Anemic Individuals

Introduction: Globally tobacco smoking is considered as a foremost public health problem. Erythrocytes membrane lipids are rich in polyunsaturated fatty acids and the oxidative effects of oxygen on its membrane are greater than other tissues and the condition is heightened by tobacco smoke.Free radicals present in the tobacco increases peroxidation products in blood and vascular tissues are chiefly responsible for harmful effects. Objective: The present study was designed to investigate the impact of stress induced by tobacco smoke on lipid peroxidation and antioxidant parameters in patients with anemia. Methodology: A hospital-based case-control study was carried out in Kantipur Dental College Teaching Hospital, included 150 tobacco smoking anemic and 150 healthy volunteers. The stress parameter was assessed by the determination of malondialdehyde, lipid hydroperoxide and nitric oxide. The non-enzymatic antioxidants such as vitamins A, C and E and total antioxidant activity and enzymatic antioxidants were catalase, superoxide dismutase and glutathione peroxidase were also determined. Result: Hemoglobin level in anemic smokers showed raised level as compared to healthyindividualsbut there was diminished antioxidants status and elevated free radical parameters in anemic smokersdespite their raised hemoglobin status.We found statistically increased malondialdehyde, lipid hydroperoxide and nitric oxide levels and decreased enzymatic and non-enzymatic antioxidant status, thus increasing the oxidative stress. Conclusion: The present study showed high concentration of hemoglobin, low status of non-enzymatic antioxidants and high levels of oxidants as compared to controls reflecting the destructive and oxidative effects of tobacco smoke.

Influence of Gender on Total Serum Creatine Kinase and Creatine Kinase-Mb Levels of Nigerian Hypertensives

Introduction: Hypertension is a long-term medical condition which when not detected and managed properly and on time often results to complications leading to disabilities and mortality. Gender has been known to affect the interpretation of some variables necessitating the need for gender-specific ranges. Objectives:This study evaluated total creatine kinase (CK) and creatine kinase-MB (CK-MB) isoenzyme activities of hypertensive subjects in Calabar, Nigeria and to assess if gender has influence on the activities of these enzymes. Methodology:One hundred and two participants were consecutively enrolled in this case control study. Serum total serum CK and CK-MB activity were evaluated in fifty one hypertensive and 51 normotensive subjects. The total CK levels were assessed using a spectrophotometric method while immunoinhibition method was used to determine the activity of CK-MB. Data was analyzed using Student’s t-test and Pearson’s correlation. Statistical significance was set at p<0.05. Results:The total creatine kinase activities of the hypertensives did not differ significantly from those of the normotensive controls (p = 0.428) while the serum CK-MB activities of the hypertensive subjects were significantly higher than those of the normotensive controls (p=0.000). The body mass index of the hypertensives was significantly higher than those of the normotensive subjects (p=0.030). Gender had no effect on the blood pressure, body mass index and levels of CK and CK-MB (p>0.05). There was also no significant correlation (p>0.05) between blood pressure, body mass index and the levels of CK and CK-MB. Conclusion:CK-MB activities were significantly higher in hypertensive subjects compared to normotensive controls. There were no gender specific differences in the CK-MB levels of male and female hypertensives. This cardiac marker should be included in the routine assessment of hypertensives and gender-specific considerations may not be necessary in the interpretation of the data.

Association Between Body Mass Index and Blood Pressure Among Medical Students of Tertiary Care Teaching Hospital in Birgunj

Introduction: Body mass index is an important parameter associated with a variety of disease processes. The risk of hypertension and cardiovascular diseases increases with an increase in body mass index. The study was conducted to compare the relationship between body mass index and blood pressure. Objective: To evaluate the prevalence and correlate the Obesity and Hypertension in medical students Methodology: The study was conducted in 200 students (113 males and 87 females). Height, weight and blood pressure were recorded from all participants and body mass index was calculated. The recorded body mass index was utilized to divide the student into underweight, normal, over weight and obese category according to the World Health organization body mass index classification. Hypertension was determined from the measure of blood pressure. Then comparison of blood pressure with body mass index was made. Results: Among 200 students 6% were obese, 22% were overweight, 65% were normal and 7% underweight. The mean height was 163cm and mean weight 60.48kg. The mean value of systolic blood pressure (105.85, 115.45, 134.95, 137.16 mmHg) and diastolic blood pressure (70.14, 76.15, 90.72, 93.33 mmHg) increased with increasing body mass index. Conclusion: Overweight and obesity increases the risk of hypertension among students.

Sexual Dimorphism in Maxillary First Molar among Nepalese Population of Eastern Nepal

Introduction: Sexual dimorphism refers to differences in size, stature and appearance between male and female. It is a known fact that tooth crown is formed to full size in childhood even before eruption into oral cavity. The shape and size of the teeth permits an interesting dimension of study for sexual dimorphism, we aimed to delineate the sexual dimorphism by measuring the mesiodistal (MD) and buccolingual (BL) diameters of permanent maxillary first molar in Nepalese population of Eastern Nepal. Objectives: The aim of this study was to evaluate the sexual dimorphism in maxillary first molar among Nepalese population of eastern Nepal Methodology: 100 participants of either sex (50 males & 50 females) aged between 17 to 25 years were enrolled in the study. After thorough dental examination, impression of the maxillary arch was made and MD diameter and BL diameters were measured with the help of vernier caliper. A P value of <0.05 was considered as statistically significant. Results: Sexual dimorphism was found in MD and BL diameters of maxillary first molar in males measuring higher than females. Right mesiodistal showed the highest sexual dimorphism, whereas right buccolingual showed the least. Conclusions: This study confirms that permanent maxillary first molar shows significant sexual dimorphism, out of which mesiodistal measurement stands out to be the best parameter in Nepalese population of Eastern region.

Management and Awareness on Health Hazards of Household Waste: A Community based study

Introduction: Waste is physical things or unwanted materials that are of no use to the human beings.1 Waste management is the activities and actions required to manage waste from its inception to its final disposal. Objectives: The objective of study is to assess the management and awareness on health hazards of household waste in a community of Khopasi, Kavrepalanchowk district. Methodology: The study design was descriptive cross-sectional and it was conducted from 10th November to 15th November 2019 at Khopasi, Kavrepalanchowk using convenience sampling technique in 281 households. The statistical package for social sciences (SPSS) version 20 was used for data entry and analysis. Descriptive statistics like frequency, mean, percentage etc was calculated. Results: The mean age of 281 respondents was 44.89 years. Similarly 43.8% of respondents considered waste management as a major issue and 84.3% had knowledge about health hazards due to improper waste disposal. Forty-seven percentages of the respondents disposed of their waste through waste collecting vehicle, 26% by burning, 17% threw their waste by riverbank, and 9% threw their waste indiscriminately in the surrounding area. Conclusion: The majority of respondents were aware about adverse effect on their health due to improper waste disposal. However the knowledge of waste management program is poor. They throw waste in the river bank or indiscriminately in open places.

Knowledge and practice modifications regarding COVID-19 among dental practitioners of Nepal

Introduction: COVID-19 has adversely gridlocked many sectors including dentistry. A good knowledge regarding the disease eventually determines the preparedness of dentists to provide relatively safe dental services. Objectives: This research was conducted to evaluate knowledge and relevant practice modifications among dental practitioners of Nepal during COVID-19 pandemic. Methodology: A cross-sectional online questionnaire survey was conducted among dental practitioners of all the provinces of Nepal. They were enquired for sociodemographic details and their knowledge, and the modifications they adopted while practising dentistry during this pandemic. The scores were summed up, and mean scores for knowledge and practice were calculated respectively which were further expressed as a percentage. Inferential statistics (Independent t-test and ANOVA, p < 0.05) were used to examine differences between study variables. Results: Out of 422 participants, most of them belonged to 31-40 years age group (178, 42.2%) and majority were females (246, 58.3%). Mean knowledge scores were significantly higher among practitioners of age ≥51 years, males, specialists, those working in both clinic and hospital, and those who have been practising dentistry for ≥10 years. Mean practice scores were significantly better among specialists. Conclusion: The overall mean scores for knowledge was good (81.3%) while for practice, overall mean score was poor (44.6%). The main reason behind the poor practice modifications despite good knowledge score could be the lack of minimum requirements for infection control in developing countries like Nepal.

Perception of Online Lectures among Undergraduate Medical, Dental and Nursing Students during COVID-19 Pandemic: a Cross-Sectional Study at a Tertiary Teaching Hospital

Introduction: The COVID-19 pandemic significantly affected medical education and has forced educators to switch to online teaching-learning activities worldwide. Online teaching-learning activities has ensured the safe delivery of the lectures to the students. Objective: To assess the perception of students towards online lectures and to analyze the perceived barriers to online learning in our context during the COVID-19 lockdown period. Methodology: A cross-sectional online descriptive study was conducted among undergraduate students at a tertiary teaching college in Eastern Nepal during September-November 2020. The link of the Google form consisting of the semi-structured questionnaire was sent to the students through email. Descriptive statistics frequency and percentage were calculated using Microsoft Excel 2010. The study was approved by the Institutional Review Committee (IRC/2069/20). Results: A total of 211 students participated in the study. Mean age of the students was 20.5±1.5 years. Out of 211, 130 (61.61%) students used smartphones to attend online lectures and 176 (83.41%) students had not attended any online classes before the COVID-19 pandemic. The most common perceived advantage of the online lectures was availability of recorded lectures (186, 88.15%) whereas reduced interaction (179, 84.83%) was the most common disadvantage. More than half (126, 59.72%) of the students disagreed/strongly disagreed that online lectures are more effective than traditional face-to-face lectures. Conclusions: Most of the students had negative perception towards the online lectures. The study findings recommend using a hybrid of conventional face-to-face classroom based teaching and newer online teaching-learning activities for delivering medical education.