ORCID Profile
0000-0002-4470-4830
Current Organisation
La Trobe University
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Publisher: Lumbini Medical College
Date: 29-06-2017
Abstract: Introduction: Oral hypoglycemic agents (OHAs) are the most common drugs used in Type 2 Diabetes Mellitus. There are various established adverse effects related to their use including hypoglycemia, weight gain, gastrointestinal disturbance, lactic acidosis, and fluid retention. However, the pattern of adverse effects related to OHAs in Nepalese patients still needs to be explored. Our study aims to determine the pattern of adverse effects resulting from the use of OHAs among Type 2 Diabetes mellitus patients and their adherence to the medication. Methods: All diabetic patients who met the inclusion criteria were enrolled in the study. After informed consent, patients were interviewed and evaluated as per the designed proforma. They were mainly studied for common drug used, adverse effects of the drugs, occurrence of hypoglycemia, and adherence to treatment. Results: The study comprised of 183 patients with mean age of 58.73 years (SD = 12.95). Fifty-six (30.6%) patients said that they developed adverse effects of drugs but only 21 (11.5%) of them reported to their treating physician. Most common adverse effect were related to central nervous system such as tingling sensation of hands and feet, dizziness, drowsiness, etc. Though 91 (49.7%) patients had developed symptoms suggestive of hypoglycemia, only 31 (16.9%) knew that it was due to hypoglycemia. Majority of the patients (n = 143, 78.1%) administered the drugs as prescribed by the physician. Among the defaulters, the most important reasons for failure to properly administer the drugs was forgetfulness in 82.5% (n = 33, N = 40) of cases. Among the study variables family history of chronic illness (p = 0.046) and information about adverse effects from physician (p = 0.001) had a significant relationship with incidence of adverse effects. Whereas none of them had a significant relationship with adherence to hypoglycemic medication. Conclusion: The incidence of adverse effects was high with hypoglycemia occurring in 49.7% of the cases, though only one-third of them recognized it to be due to hypoglycemia, in the patients with Type 2 Diabetes Mellitus. Family history of chronic illness and information about adverse effects from the physician had significant relationship with the incidence of adverse effects of hypoglycemic treatment.
Publisher: Journal of Nepal Medical Association (JNMA)
Date: 11-12-2021
DOI: 10.31729/JNMA.7047
Abstract: Introduction: Sepsis is the most common cause of mortality among patients admitted to intensive care unit. There is emerging evidence on the role of C-reactive protein to albumin ratio (C-reactive protein/Albumin) in predicting outcomes in patients with critical illness and sepsis, admitted to intensive care unit. We aimed to find out the median value of C-reactive protein/Albumin ratio among patients admitted to intensive care unit of a tertiary care hospital. Methods: We conducted a descriptive cross-sectional study of 110 critically ill patients ( years old) admitted to intensive care unit of Dhulikhel Hospital from April, 2014 to June, 2016. The ethical approval (Reference number.51/16) was obtained from Institutional Review Committee at Kathmandu University School of Medical Sciences. C-reactive protein/albumin ratio was calculated from records of patients admitted to the intensive care unit. Convenience s ling was done. Data were entered into Microsoft Excel and analysed using Statistical Package for Social Sciences version 20. Point estimate at 95% Confidence Interval was calculated along with frequencies and percentages for binary data. Results: Among 110 patients admitted to the intensive care unit, the median value of C-reactive protein/Albumin ratio was found to be 3.4 (Interquartile range: 3.1-4.5). Out of these patients, 44 (39.5%) patients were septic and their median C-reactive protein/albumin ratio was 3.4 (Interquartile range: 3.1-4.5). Conclusions: Our study showed higher median C-reactive protein /Albumin similar to other studies. Sepsis is a common finding among patients admitted to intensive care unit. Monitoring of C-reactive protein/albumin level in a patient admitted to intensive care unit could be useful for stratifying patients with a high risk of developing sepsis.
Publisher: Cold Spring Harbor Laboratory
Date: 22-02-2023
DOI: 10.1101/2023.02.14.23285937
Abstract: Population genetics is crucial for understanding the transmission dynamics of diseases like onchocerciasis. Landscape genetics identifies the ecological features that impact genetic variation between s ling sites. Here, we have used a landscape genetics framework to understand the relationship between environmental features and gene flow of the filarial parasite Onchocerca volvulus and of its intermediate host and vector, blackflies in the genus Simulium . We analysed s les from the ecological transition region separating the savannah and forest ecological regions of Ghana, where the transmission of O. volvulus has persisted despite almost half a century of onchocerciasis control efforts. We generated a baseline microfilarial prevalence map from the point estimates of pre-ivermectin microfilarial prevalence from 47 locations in the study area. We analysed mitochondrial data from 164 parasites and 93 blackflies collected from 15 communities and four breeding sites, respectively. We estimated population genetic ersity and identified correlations with environmental variables. Finally, we compared baseline prevalence maps to movement suitability maps that were based on significant environmental variables. We found that the resistance surfaces derived from elevation (r = 0.793, p = 0.005) and soil moisture (r = 0.507, p = 0.002) were significantly associated with genetic distance between parasite s ling locations. Similarly, for the vector populations, the resistance surfaces derived from soil moisture (r = 0.788, p = 0.0417) and precipitation (r = 0.835, p = 0.0417) were significant. The correlation between the baseline parasite prevalence map and the parasite resistance surface map was stronger than the correlation between baseline prevalence and the vector resistance surface map. The central parts of the transition region which were conducive for both the parasite and the vector gene flow were most strongly associated with high baseline onchocerciasis prevalence. We present a framework for incorporating environmental, genetic, and prevalence data for identifying when ecological conditions are favourable for onchocerciasis transmission between communities. We identified areas with higher suitability for parasite and vector gene flow, which ultimately might help us gain deeper insights into defining transmission zones for onchocerciasis. Furthermore, this framework is translatable to other onchocerciasis endemic areas and to other vector-borne diseases.
Publisher: Begell House
Date: 2017
Publisher: Wiley
Date: 04-03-2022
DOI: 10.1002/FSN3.2803
Abstract: Brown rice consumption reduces the risk of diabetes. The prevalence of diabetes is increasing in Nepal however, dietary preference remains for white rice. This study aimed to understand the perception, enablers, barriers, and facilitators of acceptance brown rice at a worksite cafeteria. We conducted a mixed‐method qualitative research among 42 employees of a hospital in central Nepal. The participants tasted and rated the qualities of five different combinations of brown and white rice on a hedonic scale. We conducted eight focus group discussions (FGDs)—four before and four after tasting rice combinations. FGDs were recorded, transcribed, and coded verbatim and analyzed manually using inductive–deductive thematic method. Before tasting, the participants perceived brown rice as poor in quality. After tasting, the participants found that brown rice had better quality and were willing to switch gradually starting with a 25B ratio. Eighty‐three percent of participants liked a combination of 25B. Major barriers were poor perception of its quality, tradition, unavailability, lack of awareness of health benefits, and high price. Major facilitators were availability, self and family awareness about the health benefits, knowledge, the brown rice cooking process, serving with side dishes, prior tasting, and gradual substitution of brown rice. We found that brown rice should be promoted stepwise, first as a mixture with white rice and gradually increasing the proportion of brown rice. Brown rice acceptance can be increased by improved knowledge of its nutrition and health benefits, increasing availability, and affordability.
No related grants have been discovered for Himal Shrestha.