Sharpemcintyre1587

Shear wave elastography is currently most widely used method for determining the elasticity of liver. Liver fibrosis, final common pathway of chronic liver disease, is associated with increased liver stiffness. This study aimed to obtain normal liver elasticity in Nepalese population, as it can be used as reference in future for determination of elasticity in abnormal liver.

Quantitative prospective study was done in 132 individuals with normal liver function tests. Shear wave elastography was done to measure elasticity of both lobes of liver and thus obtained values were also correlated with age, gender and fatty changes in liver.

Forty seven out of 132 individuals had fatty liver. Mean elasticity of liver was 4.40±0.60 kPa with range of 3.12-6.62 kPa. There was no significant difference between mean elasticity of right and left lobe of liver. No significant correlation was found between mean liver elasticity with age and gender. There was statistically significant difference in the mean elasticity between non-fatty and fatty liver (p=0.041).

The study established normal elasticity of liver in Nepalese population and this reference can be used to obtain abnormal liver elasticities.

The study established normal elasticity of liver in Nepalese population and this reference can be used to obtain abnormal liver elasticities.

Female hormones fluctuate with the phases of menstrual cycle. Estrogen, which has attributes in cardio-protection, is secreted less during luteal phase. In post-ovulatory phase, days 1-2 before menstruation has minimal female hormone influence due to less secretion. Mental stress subjected at this phase might enhance sympathetic activation which in long run may precipitate cardiovascular diseases. Hence, to explore the autonomic activity to mental stress during this phase of menstrual cycle the study was undertaken.

Thirty apparently healthy young postovulatory female medical students of B. P. Koirala Institute of Health Sciences, Nepal of age 19.93 (± 0.91) years with BMI of 20.70 kg/m2 (± 2.49) kg/m2 were recruited for the present study. Their short term heart rate variability (HRV) of 5 min was recorded during rest at sitting position. Then each subject was given a mental stress (nine questions selected from MENSA workout questionnaire) for 5 min. During the stress, HRV was recorded simultaneously. Data was statistically analyzed using Friedman test followed by multiple comparisons. The p<0.005 was considered statistically significant.

Mental stress significantly decreased RMSSD (p= 0.001), NN50 (p= 0.001) and PNN50 (p=0.001) in time domain and HF nu (p=0.012) in frequency domain parameters of HRV.

Young healthy post ovulatory females responded to acute mental stress by withdrawing cardiac parasympathetic activity.

Young healthy post ovulatory females responded to acute mental stress by withdrawing cardiac parasympathetic activity.

The objective of this study was to determine the quality of life and factors associated with quality of life among primary caregivers of children with Cerebral palsy.

A cross-sectional study was carried between primary caregivers of children with cerebral palsy in rehabilitation group and non-rehabilitation group. Purposive sampling technique was used to collect data Results Median age of caregivers was 34 years (age 20-70 years), and there was significant difference between age in two groups (p=0.028). 83 (86.5%) caregivers were female with significant difference between gender in rehabilitation and non-rehabilitation group (p=0.03). Majority of primary caregivers were mother 71 (74%) in both groups. Among all 96 caregivers, 78.1% of caregivers had poor quality of life (Score in questionnaire below 75% taken as poor quality of life).There was no significant difference between quality of life in rehabilitation and non-rehabilitation group (p=0.42). Factors associated with quality of life in rehabilitation groups was illiteracy (p=0.005), aggressive nature of child (p=0.050), uncooperative nature of child (p=0.025), poor knowledge about child condition (p<0.001), and low financial support (p=0.051). Similarly, factor associated with quality of life in non-rehabilitation group was gross motor function classification system level of child (p< 0.001) and more perceived stress (p=0.048).

Majority of primary caregivers was mother and had poor quality of life and there was no significant difference between overall quality of life of caregivers in rehabilitation and non-rehabilitation group.

Majority of primary caregivers was mother and had poor quality of life and there was no significant difference between overall quality of life of caregivers in rehabilitation and non-rehabilitation group.

Skin prick tests identify allergens for chronic urticaria. The objective of this study was to determine skin prick test positivity in patients with chronic urticaria visiting skin outpatient department in one of the tertiary referral centre of Nepal.

This was a hospital based cross-sectional study conducted at Department of Dermatology and Venereology, Tribhuvan University Teaching Hospital. All patients of chronic urticaria aged more than 16 years were taken into study and were prick tested with seven groups of 21 allergens, taking normal saline as negative control and histamine as positive control as per the standard protocol by the Global Allergy and Asthma European Network. Frequency of positivity to each allergen was assessed.

Out of 62 patients of chronic urticaria enrolled in the study, 52% were females and 48% were males. Overall, 71% were positive for at least one allergen. The most common allergens which tested positive included Dermatophagoides farinae (50%), Cotton dust (17.7%), Mosquito (16%), hay dust (14.5%), Cladosporium herbarum (14.5%), Candida albicans (12.9%), Parthenium hysterophorus (9.6%), House fly (9.6%), Soya bean (9.6%) and fish sardine (8%). Out of all these patients, 55% patients showed positivity to more than one allergens.

A significant proportion of cases with chronic urticaria demonstrated sensitivity to various allergens. Skin prick test can be considered as important diagnostic procedure in cases of chronic urticaria in our population.

A significant proportion of cases with chronic urticaria demonstrated sensitivity to various allergens. Skin prick test can be considered as important diagnostic procedure in cases of chronic urticaria in our population.

Periodontitis is inflammatory disorder resulting in progressive destruction of the periodontal ligament and alveolar bone with pocket formation, recession, or both. Vitamin D has a benefit in bone metabolism and anti-inflammatory activity involving T-cell homeostasis. The objective of this study was to compare the vitamin D level in patient with chronic periodontitis and healthy periodontium and evaluate its correlation.

A comparative cross-sectional study was done in 80 patients (40 with healthy periodontium and 40 with chronic periodontitis) visiting to Department of Dental Surgery (Periodontology and Oral Implantology Section) of Bir Hospital. Parameters measured were plaque index, gingival index, clinical attachment level and pocket depth for the evaluation of healthy periodontium and chronic periodontitis.

The result showed 16.58±6.65ng/mL and 19.06±11.52ng/mL level of vitamin D in female and male respectively (p-value 0.230) and 16.85±13.30 ng/mL and 19.78±5.87 ng/mL level of vitamin D in healthy and chronic periodontitis groups respectively (p-value 0.209).

There are no differences in the level of serum vitamin D between healthy and chronic periodontitis groups. No association was seen between vitamin D level and chronic periodontitis.

There are no differences in the level of serum vitamin D between healthy and chronic periodontitis groups. No association was seen between vitamin D level and chronic periodontitis.

Anterior Cruciate Ligament Blumensaat line angle and Anterior Cruciate Ligament Inclination angle can be measured when Anterior Cruciate Ligament is visualized on Magnetic Resonance Imaging. Both these angles can be helpful to determine the intactness of Anterior Cruciate Ligament. The aim of this study was to evaluate the diagnostic accuracy of Anterior Cruciate Ligament - Blumensaat line angle, apex of Anterior Cruciate Ligament - Blumensaat line angle and Anterior Cruciate Ligament - Inclination angle to determine the status of Anterior Cruciate Ligament in terms of tear or no tear.

We conducted a prospective observational study with Magnetic Resonance Imagings of knees of 71 patients, who were divided into Anterior Cruciate Ligament tear and Anterior Cruciate Ligament intact groups based on Anterior Cruciate Ligament - Blumensaat line angle (<150- intact; ? 150 - torn Anterior Cruciate Ligament), Anterior Cruciate Ligament - Inclination angle (>450 - intact ACL; ? 450 - Anterior Cruciate Ligamenn determination of Anterior Cruciate Ligament tear.

Antiretroviral drugs are lifeline for patients living with HIV. Adverse drug reactions can compromise the compliance to antiretroviral therapy. The objectives of the study were to estimate the prevalence of adverse drug reactions and to assess its risk factors in patients living with HIV and receiving antiretroviral therapy.

A prospective cohort study was conducted among 496 patients living with HIV at B.P. Koirala Institute of Health Sciences for a period of one year. see more Adverse drug reactions were evaluated based upon clinical history, clinical examination and investigations.

Majority of patients were of 31-45 year age group (58.1%) and on first-line antiretroviral therapy regimen (94.3%). Total of 240 adverse drug reactions were documented. Prevalence of adverse drug reaction was 34.7%. Skin rash, anemia and nausea and vomiting were the three most common adverse drug reactions. The adverse drug reactions were more common in patients having non-communicable diseases, chronic co-infections, taking more than 3 non-HIV drugs, second and third-line antiretroviral regimen and it was statistically significant (P-value < 0.05).

Prevalence of adverse drug reaction was high in the patients living with HIV. Age, gender, co-infections, non-communicable diseases, taking more than three non-HIV drugs and second and third-line antiretroviral regimen were identified as possible risk factor for occurrence of adverse drug reactions and their prior identification is important to optimize the best suited antiretroviral regimen.

Prevalence of adverse drug reaction was high in the patients living with HIV. Age, gender, co-infections, non-communicable diseases, taking more than three non-HIV drugs and second and third-line antiretroviral regimen were identified as possible risk factor for occurrence of adverse drug reactions and their prior identification is important to optimize the best suited antiretroviral regimen.

Adolescent pregnancy is a global health problem. Early pregnancies among adolescents have major health consequences for adolescent mothers and their babies. Contraceptives can prevent early pregnancy and its consequences. However, there is a low use of contraceptives among adolescents. Global evidence has shown which programmatic approaches are effective to increase the use of contraceptives among adolescents.

This is not a systematic review. Desk review was done using Google Scholar and PubMed. Different policies, strategies, and reports published by agencies were also reviewed.

There is a low use of contraceptives and high unmet need for family planning and high adolescent fertility rate. Various studies conducted in different parts of the world have shown that there are some programmatic approaches implemented which are effective to improve the contraceptives use among adolescents. We have categorized the findings into three parts; i) delivery of services ii) increasing demand for services, and iii) creating an enabling environment.