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This study aimed to evaluate the antioxidant, antiarthritic, and anti-inflammatory properties of extracts from the leaves of twelve different medicinal plants in Nepal. We then evaluated the total phenolic, flavonoid, and tannin contents of the extract using in-vitro assays and characterized it using GC-MS analysis. Results revealed that most of the leaf extracts contained phenolic compounds, flavonoids, tannins, alkaloids, and saponins. Few plants also showed the presence of glycosides, phytate, and vitamin C. Among the studied plants, Neolamarckia cadamba exhibited the highest total phenolic and tannin contents, as 241.53 ± 0.20 µg of gallic acid equivalent/mg and 74.48 ± 1.081 µg of tannic acid equivalent/mg, respectively. Ipomoea batatas exhibited the highest total flavonoid content, as 53.051 ± 1.11 µg of quercetin equivalent/mg. Moreover, Raphanus sativus demonstrated significant ferrous ion chelating, 2,2-diphenyl-1-picrylhydrazyl, hydrogen peroxide scavenging, and total antioxidant activities with IC50 value of 4.76 ± 0.68 µg/mL, 5.84 ± 0.14 µg/mL, 6.89 ± 0.16 µg/mL, and 8.99 ± 0.20 µg/mL, respectively. Similarly, Colocasia esculenta and Cicer arietinum exhibited the highest hydroxyl radical and nitric oxide scavenging activities, measuring IC50 value of 7.22 ± 0.56 µg/mL and 9.06 ± 0.10 µg/mL, respectively. Among all the extracts, Amorphophallus paeoniifolius displayed significant human red blood cell (HRBC) membrane stabilization activity (IC50 = 6.22 ± 0.78 µg/mL). Furthermore, Raphanus sativus, Chenopodium album, Cicer arietinum, and Murraya koenigii exhibited the highest inhibitory activities against protein denaturation with bovine serum albumin, antiarthritic, lipoxygenase inhibitory, and proteinase inhibitory, measuring IC50 of 7.48 ± 0.48 µg/mL, 9.44 ± 1.62 µg/mL, 14.67 ± 1.94 µg/mL, and 28.57 ± 2.39 µg/mL, respectively. In conclusion, this study demonstrated the twelve leaf extracts' significant antioxidant, antiarthritic, and anti-inflammatory activities. [ABSTRACT FROM AUTHOR]

Rice, wheat, maize, millet, and barley are the five major staple cereal crops in Nepal. However, their yields are low, and imports are needed to meet domestic demand. In this study, we quantify the gap between current and potentially attainable yields in Nepal, estimate how much additional fertilizer and irrigation are required to close the gap, and assess if self-sufficiency can thus be achieved. For this, we first test the ability of the crop model EPIC to reproduce reported yields in 1999–2014 accurately. On average, simulated and reported yields at the national level were in the same range, but at the district level, the error was large, as the resolutions of the available climate and soil input data were not high enough to depict the heterogenic conditions in Nepal adequately. In the main study, we show that average yield gaps in Nepal amount to 3.0 t/ha (wheat), 2.7 t/ha (rice), 2.9 t/ha (maize), 0.4 t/ha (barley), and 0.5 t/ha (millet). With additional irrigation and fertilization, yields can be increased by 0.1/2.3 t/ha (wheat), 0.4/1.3 t/ha (rice), 1.6/1.9 t/ha (maize), 0.1/0.3 t/ha (barley), and 0.1/0.4 t/ha (millet), respectively. The results show that providing reliable and affordable access to fertilizer should be a priority for closing yield gaps in Nepal. [ABSTRACT FROM AUTHOR]

Background: The palpebral fissure (PF) is the space between the upper and lower eyelids when the eye is open. The bilateral orbital region which is located in the face acts as one of the important determinants in the perception of facial attractiveness, youthfulness, and health conditions of the individuals. The PF dimensions may get altered in cases of facial deformities and road traffic traumas. Aims and Objectives: The aim of this study was to analyze the mode of distribution of PF dimensions in medical and paramedical students in correlation with gender. Materials and Methods: The study was a cross-sectional study conducted in the duration of August 2021-November 2021 including the sample of 300 medical and paramedical students in an equal number of male and female of age group 16-22 years from Nobel Medical College Teaching Hospital, Biratnagar, Nepal. We measured the dimensions of PF during the normal gaze. The data analysis was done using the SPSS version 16. Results: The mean length of PF (LPF) in males and females was 23.24 mm and 22.72 mm, respectively. The mean height of PF (HPF) in male and female was 8.52 mm and 8.60 mm, respectively. The difference between males and females LPF and HPF was significant (<0.05). The mean PF index (PFI) in male and female subjects was, respectively, 37.20 and 38.68 which were statistically significant. Conclusion: It was found that the LPF and HPF were more in males and PFI was slightly more in females than the male which confirms the sexual dimorphism. The data obtained will be helpful in the esthetic consideration of the student'spersonality as well. [ABSTRACT FROM AUTHOR]

Background: Cephalic index is one of the important craniofacial parameters which is commonly used for investigating the length and breadth of the head. Cephalic Index (CI) is defined as the ratio between maximum breadth of the head and the maximum length of the head multiplied by 100. Body mass index (BMI) is a nutritional marker of the body derived from the measurement of height (in m2) and weight (in kg). Aims and Objective: To analyse the effect of BMI on the CI. Materials and Methods: This study was a cross-sectional study conducted from April 2021 to June 2021 with sample size of 200 children of age groups 5-8 years from Ramnagar Gaupalika of Sarlahi, Province 2, of Nepal. We measured the cephalic index of the children and asked a set of structured questionnaire to the guardian or parent of the children. Height and weight of the children were also measured and BMI was determined. Data analysis was completed using SPSS version 16. Results: The mean age of the participants was 6.56 years, BMI of 18.09 and cephalic index (CI) of 81.82. The mean CI in males and females were 82.05 and 81.59 respectively. Our results show significant association between BMI category and CI category (chisquare test, p-value=0.000), mode of delivery and BMI category (chisquare test, p=0.042) and significant negative correlation between BMI and CI (Pearson's R=-0.591, p=0.037).Conclusion: The most common pattern of CI was hyperbrachycephalic in the children of low BMI whereas the pattern of CI in case of the normal BMI was the mesocephalic type. It also confirmed that the sexual dimorphism exists in both the low BMI and the normal BMI. [ABSTRACT FROM AUTHOR]

Introduction: To evaluate the trends of acquired ocular motor nerve palsy in an eye care centre without a dedicated neuro-ophthalmology setup based in Eastern region of Nepal. Methods and Materials: A retrospective, cross-sectional study was conducted after reviewing the medical records of all the patients with newly diagnosed acquired ocular motor nerve palsy. All the patients underwent comprehensive ocular examination by general ophthalmologist and detailed orthoptics evaluation by an optometrist. Necessary blood investigations were obtained and neuro-imaging were ordered as appropriate. Neurology and otorhinolaryngology consultation were advised in indispensable cases. Results: A total of 167 patients were included in this profile. Sixth cranial nerve was found to be the most commonly affected ocular motor nerve followed by third, fourth and combined ocular motor nerves respectively. Males were predominantly affected with male: female ratio of 2.63:1. The overall mean age of the patients was 45 ± 15.33 (15 to 82) years. Diplopia was the major complaint for presentation. The etiology was undetermined in 68/167 (40.7%) cases whereas among the identifiable causes; vascular etiology accounted for 58/167 (34.7%) cases followed by trauma in 22/167 (13.2%) cases. Conclusion: The trends in distribution and etiology of ocular motor nerve palsies can be constant even though separated by geographical location. Ocular motor nerve palsy should be examined and diagnosed properly in collaboration with other specialists where there is lack of sophisticated complementary investigations. Multidisciplinary approach is recommended which may compensate for the missed diagnosis and indeterminate aetiologies. [ABSTRACT FROM AUTHOR]

INTRODUCTION Diabetes mellitus (DM) is a metabolic disorder with a very high prevalence. Adequate knowledge about diabetes mellitus is essential for medical students as they are future frontline warriors for its management. In the present study, we have attempted to assess the knowledge of medical students related to various aspects of DM. MATERIAL AND METHODS In this cross-sectional study, 445 medical students studying in the Universal College of Medical Sciences (UCMS), Bhairahawa, Nepal were included. A total of 20 self-designed questionnaires regarding DM were used as a study tool. Each question was allocated a score of one making 20 the highest possible score. The students who scored 13 (65%) or more were regarded as having good knowledge, and those scoring below 13 were considered as having poor knowledge related to DM. Statistical package for social sciences (SPSS) version 16 was used for data analysis. RESULTS Among all the participants, 309 (69.4%) were pre-clinical and 136 (30.6%) were clinical students. The mean knowledge score of the total participants was 13.54 ±3.68. The clinical students (16.23 ±2.26) was found to have better knowledge about DM than the preclinical students (12.36 ±3.56). Year wise evaluation showed that, on average, all except first-year students had good knowledge regarding DM, with the final year students having highest mean score (18.80 ±2.29). No significant difference in the knowledge was found between MBBS and BDS students. CONCLUSION The majority of the medical students had good basic knowledge regarding DM. Clinical students had significantly higher knowledge in comparison to preclinical students. [ABSTRACT FROM AUTHOR]

Background: Subclinical hyperthyroidism is an increasingly recognized entity that is defined as normal serum free thyroxine and free triiodothyronine levels with thyroid-stimulating hormone level suppressed below the normal range and usually undetectable. Subclinical hyperthyroidism may be related only in part to Graves' disease or multi nodular goitre. The burden of thyroid disease in the general population is enormous. Here, we critically study the prevalence of subclinical hyperthyroid disease in the population of Central Nepal. Materials and Methods: The study was carried out at National Medical College and Teaching Hospital, Birgunj, Nepal Anthropometric data were collected including thyroid function profile (free T3 and free T4). Results: Of the 680 patients in the study group, 165 were males and 515 were females, ranging from 21 to 60 years of age. Status of euthyroid, overt hyperthyroid, subclinical hyperthyroid, and low free T3 & T4 levels were seen in 70.74%, 12.65%, 10.44%, and 6.18% respectively in cases. The prevalence of subclinical thyroid disease was found to be 10.44%, with 2.4% in males and 8.04% in females; and being more prevalent in age group 21-40 years age compared to other age groups (p<0.05). Conclusion: The prevalence of subclinical hypethyroidism amongst the suspected cases was 10.44 % which is much higher compared to the other parts of the world, with higher prevalence seen in females as compared to males. The reason(s) for such a high prevalence of hyperthyroidism in central Nepal needs to be studied further. [ABSTRACT FROM AUTHOR]

High nitrate-nitrogen (NO3−–N) content is a typical feature of groundwater, which is the primary water source in the Kathmandu Valley, Nepal. Considering the Kathmandu Valley's current problem of water scarcity, a user-friendly system for removing NO3−–N from groundwater is promptly desired. In this study, a simplified hydrogenotrophic denitrification (HD) reactor was developed for the Kathmandu Valley, and its effectiveness was evaluated by its ability to treat raw groundwater. The reactor operated for 157 days and showed stability and robustness. It had an average nitrogen removal efficiency of 80.9 ± 16.1%, and its nitrogen loading rate and nitrogen removal rate varied from 23.8 to 92.3 g–N/(m3∙d) and from 18.3 to 73.7 g–N/(m3∙d), respectively. Compared to previous HD reactors, this simplified HD reactor is a more user-friendly option for the Kathmandu Valley, as most of the materials used for the reactor were locally available and require less maintenance. The reactor is recommended for groundwater treatment at the household level. It has a current treatment capacity of 40 L/d, which can fulfill the daily requirements for drinking and cooking water in a household with 4–5 people. [ABSTRACT FROM AUTHOR]

Introduction: Heart failure (HF) is a common cardiovascular condition whose incidence and prevalence are increasing. Being a common reason for urgent hospital admission, it is a major cause of morbidity and mortality for the patients. In the developed countries coronary artery disease remains the leading cause of HF, whereas, in the underdeveloped countries, rheumatic heart disease leading to valvular lesion still remains the commonest causes of HF admission. The current study was designed to evaluate the clinical proile and medications prescribed reflecting the extent to which evidence based medicine is being practiced at our community. Methods: Clinical profile and prescribed medications of patients with diagnosis of HF who were admitted in the cardiology department of College of Medical Sciences & Teaching Hospital (CMS-TH), Bharatpur, Nepal, April 2010 to May 2012, were analyzed. A total of 255 patients presented with HF during the studied period were included. Results: Coronary artery disease, rheumatic heart disease, dilated cardiomyopathy, hypertensive heart failure, cor-pulmonale, and congenital heart disease leading to HF were found in 93 (36.5%), 65 (25.5%), 37 (14.5%), 22 (8.6%), 31 (12.2%),and 7 (2.7%) patients respectively. The commonest presenting symptom was shortness of breath (81%) and the commonest sign was bilateral basal crepitations (68%). From all patients, 89%, 64%, 51%, 16%, 48%, and 32% received loop diuretics, angiotensin-converting enzyme inhibitor, digoxin, angiotensin receptor blocker, spironolactone, and beta-blocking agents respectively. Conclusion: Coronary artery disease leading to HF was the commonest cause of HF admission in our centre. Despite current guidelines suggesting the use of beta-blocking agent in patients with HF, only 32% of our patients received this class of medications. Thus, many patients were not being managed fully in accordance with the evidence-based guidelines. [ABSTRACT FROM AUTHOR]

Introduction: The modality and quality of care received during hospitalization affects a child's response to their illness. Thus, any intervention delivered by healthcare providers including nurses must be based on principles of atraumatic care. This study aims to assess the knowledge and attitude of nurses in the implementation of atraumatic care among hospitalized children in a tertiary care center in Eastern Nepal. Methods: A descriptive cross-sectional study was conducted among 106 nurses in a tertiary hospital from 4th January to 1st February 2020. Ethical approval was received from the Institutional Review Committee. Sampling was done by total population enumeration method. Data was collected using a self-administered three-part questionnaire and analyzed using Statistical Package for the Social Sciences version 11.5 by utilizing descriptive statistics. Results: The mean knowledge and attitude of nurses towards implementation of atraumatic care among hospitalized children was found to be 14.90 ± 3.90 and 74.74 ± 7.5 respectively. Out of 106 nurses, 73 (68.90%) had adequate knowledge whereas 56 (52.80%) had favorable attitudes towards principles and implementation of atraumatic care, assessed using reliable scales. Variations due to socio-demographic and professional parameters were insignificant. Conclusions: The study shows that majority of the surveyed nurses had adequate knowledge of the principles of atraumatic care and a favorable attitude towards its application among hospitalized children. However, the measured attitude of nursing practitioners was relatively lower in terms of favorability. [ABSTRACT FROM AUTHOR]

[Display omitted] • Eastern Himalayan regions of India, Nepal and Bhutan have unsurpassed ethnic fermented foods unknown outside world. • Ethnic people invented the indigenous knowledge using unseen microorganisms to obtain the organoleptically desirable and culturally acceptable fermented foods. • Some fermented products of India and Nepal were scientifically studied and reported till date, except of Bhutan. • This study is aimed to review the updates on the beneficial importance of abundant microbiota and health-promoting benefits of Himalayan fermented foods. The Eastern Himalayan regions of India, Nepal and Bhutan have more than 200 varieties of unsurpassed ethnic fermented foods and alcoholic beverages, which are lesser known outside the world. However, these ethnic foods are region- and community-specific, unique and some are exotic and rare, which include fermented vegetables, bamboo shoots, soybeans, cereals, milk (cow and yak), meats, fishes, and cereal-based alcoholic beverages and drinks. Ethnic communities living in the Eastern Himalayas have invented the indigenous knowledge of utilization of unseen microorganisms present in and around the environment for preservation and fermentation of perishable plant or animal substrates to obtain organoleptically desirable and culturally acceptable ethnic fermented food and alcoholic beverages. Some ethnic fermented products and traditionally prepared dry starters for production of alcoholic beverages of North Eastern states of India and Nepal were scientifically studied and reported till date, and however, limited publications are available on microbiological and nutritional aspects of ethnic fermented foods of Bhutan except on few products. Most of the beneficial microorganisms isolated from some ethnic fermented foods of the EH are listed in microbial food cultures (MFC) safe inventory. This study is aimed to review the updates on the beneficial importance of abundant microbiota and health-promoting benefits and functionalities of some ethnic fermented foods of the Eastern Himalayan regions of North East India, Nepal and Bhutan. [ABSTRACT FROM AUTHOR]

Background/objective: To determine the prevalence of visual impairment (VI), uncorrected refractive errors (URE), and effective refractive error coverage among individuals aged 15-50 years in Koshi Province, Nepal., Methods: A population-based cross-sectional study was conducted in Koshi Province in which 4800 participants were selected from 80 clusters. The study teams visited the selected households and conducted eye examinations. This included monocular unaided (and aided) visual acuity assessment using a Snellen chart with tumbling E optotypes at a distance of 6 meters. Near vision was assessed binocularly using the N notation chart at a fixed distance of 40 cm for each individual. Torchlight examination and distance direct ophthalmoscopy was done. VI was defined as presenting visual acuity worse than 6/12 in the better eye. URE was defined as presenting visual acuity worse than 6/12 and improving to 6/12 or better on using a pinhole. Near Vision Impairment was defined as binocular presenting near vision worse than N8 among those age 35 years and older., Results: In total, 4057 were examined (84.5% response rate). The prevalence of VI was 3.52% (95% CI:2.89-4.13; n = 143). The prevalence of URE in the better eye was 1.95% (95% CI:1.54-2.42; n = 79). The Refractive Error Coverage and Effective Refractive Error Coverage were 34.8% and 31.3% respectively. The prevalence of NVI was 34.24% (95% CI: 32.1-36.40; n = 666)., Conclusion: The prevalence of VI and  URE was low, attributed to the availability and uptake of services in Koshi province in Nepal., (© 2023. The Author(s), under exclusive licence to The Royal College of Ophthalmologists.)

Abstract: Nepal has a health care system that is complicated by access, affordability, and availability. The geographical difficulty makes the health care reach to public more difficult. Nepal being a disasterprone country, it makes very important to strengthen the disaster preparedness up to the mark before the disaster strikes. During disaster and public health emergencies, the healthcare system quickly becomes overwhelmed or structural damage makes it non-functional, which necessitate the prior identification of Alternate Care Site by health service providers. Incorporating the identification of Alternate Care Sites into the Hospital Disaster Preparedness Plan represents a crucial transition from theoretical discussion to practical implementation for strengthening healthcare facilities. . This paper discusses the concept of Alternate Care site and its implementation in Nepal's health emergency preparedness for disaster and public health emergencies.

Background: Tobacco use is the leading cause of cancer, accounting for approximately 20% of all cancer deaths and 70% of lung cancer deaths worldwide. The use of tobacco has multiple consequences; it damages health and pushes the household below the poverty line. The treatment of cancer is very costly. The study attempts to determine the cost associated with the diagnosis and treatment of tobacco-related cancer in Nepal., Methods: A descriptive cross-sectional study was conducted among 103 patients from public and private hospitals in 2019. Patients with the second and third stages of cancer who had ever used tobacco were randomly selected for the study purpose. All patients who met the inclusion criteria were selected for interviews. The data were analyzed using SPSS version 22, and summarized in descriptive form only., Results: The total cost of tobacco-related cancer was NPR 9,81,370 per patient in 2019. A patient's average direct medical cost was found to be NPR 5,88,740 (60%), whereas the average direct non-medical cost was NPR 1,23,147(13%). The wage loss as a result of illness accounted for over one-fourth (27%) of the total cost. Approximately one-sixth of the patients sold their property for the treatment of cancer. The majority of the cancer patients were found to be illiterate or with primary education only, and financially dependent on their families., Conclusions: Treatment of cancer is costly and patients in Nepal can hardly afford the expenses. Enrolling clients in health insurance and increasing the government subsidy by raising the tax on tobacco products can be a long-term source of health financing to protect patients from sliding into poverty. The increased price of tobacco due to an increase in tax would reduce tobacco consumption, particularly among youth and the poor.

Introduction: Peripheral vascular trauma can result in limb or life-threatening injuries. Early surgical intervention leads to a better outcome. Diagnosis is made clinically, by non-invasive and invasive imaging modalities. Our aim in this study is to find out the prevalence of peripheral vascular trauma among vascular surgery cases operated in a tertiary care centre of Nepal., Methods: This is a descriptive cross-sectional study of peripheral vascular injuries that underwent operative management in a tertiary care hospital of Nepal from January 2018 to May 2020. Ethical approval was taken from the Institutional Review Committee of Kathmandu University School of Medical Sciences (Registration Number 79/20). Convenience sampling technique was used. Data for the study was retrieved from operation records of the patients along with their treatment summaries and entered and analyzed in the Statistical Package for Social Sciences version 20.0. All cases with complete records were included. Conservatively managed cases and cases that underwent primary amputation were not included in the study. Point estimate at 95% Confidence Interval was calculated along with frequency and proportion for binary data., Results: Among 624 vascular surgery patients, 40 (6.41%) (4.48-8.33 at 95% Confidence Interval) patients had presented with peripheral vascular trauma during the study period. There were 26 (65%) cases where the upper limb was involved., Conclusions: The prevalence of vascular surgery for peripheral vascular trauma among vascular surgeries operated in our study was similar to other studies done in similar settings. Vascular injury needs urgent intervention and appropriate management will result in a high chance of limb salvage and survival.

WHO recommends participatory learning and action cycles with women's groups as a cost-effective strategy to reduce neonatal deaths. Coverage is a determinant of intervention effectiveness, but little is known about why cost-effectiveness estimates vary significantly. This article reanalyses primary cost data from six trials in India, Nepal, Bangladesh and Malawi to describe resource use, explore reasons for differences in costs and cost-effectiveness ratios, and model the cost of scale-up. Primary cost data were collated, and costing methods harmonized. Effectiveness was extracted from a meta-analysis and converted to neonatal life-years saved. Cost-effectiveness ratios were calculated from the provider perspective compared with current practice. Associations between unit costs and cost-effectiveness ratios with coverage, scale and intensity were explored. Scale-up costs and outcomes were modelled using local unit costs and the meta-analysis effect estimate for neonatal mortality. Results were expressed in 2016 international dollars. The average cost was $203 (range: $61-$537) per live birth. Start-up costs were large, and spending on staff was the main cost component. The cost per neonatal life-year saved ranged from $135 to $1627. The intervention was highly cost-effective when using income-based thresholds. Variation in cost-effectiveness across trials was strongly correlated with costs. Removing discounting of costs and life-years substantially reduced all cost-effectiveness ratios. The cost of rolling out the intervention to rural populations ranges from 1.2% to 6.3% of government health expenditure in the four countries. Our analyses demonstrate the challenges faced by economic evaluations of community-based interventions evaluated using a cluster randomized controlled trial design. Our results confirm that women's groups are a cost-effective and potentially affordable strategy for improving birth outcomes among rural populations., (© The Author(s) 2020. Published by Oxford University Press in association with The London School of Hygiene and Tropical Medicine.)

Background: The study compared the peak reflux velocity and reflux time in cases of varicose veins and non-varicose veins with a focus on quantifying the reflux parameters., Methods: This is a hospital based observational comparative study. The limbs with CEAP Clinical classification of C2 or more were taken as diseased limbs and contra-lateral limbs with no symptoms or disease were taken as control limbs., Results: Altogether 792 limbs (452 diseased limbs and 340 control limbs) were evaluated with color duplex. Mean Great Saphenous Vein diameter was 5.68 ± 2.07 mm and 4.00 ± 1.34mmin diseased limbs and control limbs respectively (p=0.0001). Mean sapheno-femoral junction diameter was 8.23 ± 2.64 mm and 6.16 ± 1.93 mm in diseased limbs and control limbs respectively (p=0.0001). Mean peak reflux velocity in diseased limbs was significantly higher than control limbs (77.38 cm/sec vs 7.95 cm/sec; p=0.0001).  Similarly mean reflux time was significantly longer in diseased limbs than non-diseased limb (406.58ms and 67.28 ms respectively; p=0.0001). An optimal cut-off point of 27.4 cm/s for peak reflux velocity and 250 ms for the reflux time at Sapheno-Femoral junction had a discriminatory power between the two groups., Conclusion: The quantification of peak reflux velocity seems to be more consistent than reflux time in determining the superficial venous reflux. An optimal peak reflux velocity cut off point of 27.4 cm/sec has the discriminatory power between diseased and non-diseased limb.

Introduction: Arteriovenous fistulas are a preferred choice for hemodialysis access in chronic kidney disease patients. There is increased adoption of arteriovenous fistula creation in Nepal. Our objective is to study various arteriovenous fistulas that have been created in our center., Methods: This is a descriptive cross-sectional study conducted in a tertiary care hospital including all cases of arteriovenous fistula creation from January 2018 to December 2019. We obtained the ethical clearance from the institutional review committee of Kathmandu University School of Medical sciences. Convenient sampling method was used. Detailed vascular mapping and color doppler ultrasonography was done in the bilateral upper limb as preoperative preparation and to choose a site for arteriovenous fistula creation. Data were entered into the Statistical Package for the Social Sciences version 20 for analysis., Results: Among 50 patients, the most common location was brachiobasilic 20 (40%) patients followed by brachiocephalic 18 (36%), radiocephalic 11 (22%), and arteriovenous graft between the brachial artery and axillary vein 1 (2%). The mean duration of hospital stay was 1.44 days. Three (6%) patients required re-intervention, all within 24 hours. Two (4%) patients had a failure of arteriovenous fistula requiring the creation of a new arteriovenous fistula., Conclusions: Brachiobasilic was the most common location for arteriovenous fistula creation. Reintervention was not common.

We have analyzed 7,137 samples from 125 different caste, tribal and religious groups of India and 99 samples from three populations of Nepal for the length variation in the COII/tRNA(Lys) region of mtDNA. Samples showing length variation were subjected to detailed phylogenetic analysis based on HVS-I and informative coding region sequence variation. The overall frequencies of the 9-bp deletion and insertion variants in South Asia were 1.9 and 0.6%, respectively. We have also defined a novel deep-rooting haplogroup M43 and identified the rare haplogroup H14 in Indian populations carrying the 9-bp deletion by complete mtDNA sequencing. Moreover, we redefined haplogroup M6 and dissected it into two well-defined subclades. The presence of haplogroups F1 and B5a in Uttar Pradesh suggests minor maternal contribution from Southeast Asia to Northern India. The occurrence of haplogroup F1 in the Nepalese sample implies that Nepal might have served as a bridge for the flow of eastern lineages to India. The presence of R6 in the Nepalese, on the other hand, suggests that the gene flow between India and Nepal has been reciprocal., (Copyright (c) 2008 S. Karger AG, Basel.)