Search

Background Pre-existing cardiovascular disease (CVD) or cardiovascular risk factors have been associated with an increased risk of complications following hospitalisation with COVID-19, but their impact on the rate of recovery following discharge is not known.Objectives To determine whether the rate of patient-perceived recovery following hospitalisation with COVID-19 was affected by the presence of CVD or cardiovascular risk factors.Methods In a multicentre prospective cohort study, patients were recruited following discharge from the hospital with COVID-19 undertaking two comprehensive assessments at 5 months and 12 months. Patients were stratified by the presence of either CVD or cardiovascular risk factors prior to hospitalisation with COVID-19 and compared with controls with neither. Full recovery was determined by the response to a patient-perceived evaluation of full recovery from COVID-19 in the context of physical, physiological and cognitive determinants of health.Results From a total population of 2545 patients (38.8% women), 472 (18.5%) and 1355 (53.2%) had CVD or cardiovascular risk factors, respectively. Compared with controls (n=718), patients with CVD and cardiovascular risk factors were older and more likely to have had severe COVID-19. Full recovery was significantly lower at 12 months in patients with CVD (adjusted OR (aOR) 0.62, 95% CI 0.43 to 0.89) and cardiovascular risk factors (aOR 0.66, 95% CI 0.50 to 0.86).Conclusion Patients with CVD or cardiovascular risk factors had a delayed recovery at 12 months following hospitalisation with COVID-19. Targeted interventions to reduce the impact of COVID-19 in patients with cardiovascular disease remain an unmet need.Trail registration number ISRCTN10980107.

According to the American Counseling Association and the Council for Accreditation of Counseling and Related Educational Programs, social justice advocacy is an ethical imperative for counselors and a training standard for counseling students. As a group of socially conscious mental health counseling students and faculty, we developed and facilitated a social justice advocacy group to learn about tangible ways to engage in social justice action. Using the S-Quad model developed by Toporek and Ahluwalia, we formed and facilitated a social justice advocacy group for our peers. This paper will serve as a reflection of our experiences engaging in the process.

Background: Meditation is a mind and body practice for increasing calmness and physical relaxation, improving psychological balance, coping with illness, and enhancing overall health and well-being. Many studies have already been carried out to see the effect of Yoga, Pranayam, meditation, Sudarhan Kriya on physiological parameters, but till date, there is not a single study which shows the cumulative effect of yoga, pranayam, meditation along with sudarshankriya on physiological parameters. Methods: This observational study was conducted in the Department of Physiology, Rajasthan University of Health Sciences, Jaipur and in association with Art of living organization. The study participants were enrolled into three groups. In the first group, 10 participants of Advance Meditation Program (AMP), who were doing this program for the first time, in second group, 10 participants who were doing AMP along with regularly practicing Padam Sadhna for at least 2 years and finally, in the third group, 10 participants who were not practicing any kind of meditation or yoga. After consent, subjects filled the Cohen's stress questionnaire. Electrocardiography (ECG) was recorded before AMP and after AMP. Results: There was significant difference in heart rate (P = 0.002), systolic blood pressure (P = 0.028), diastolic blood pressure (P = 0.005), RR interval (P = 0.020), PR interval (P = 0.040), and stress score (P = 0.027) in first time participants. Similarly, in the second group (repeaters) also significant difference was noticed. Conclusion: AMP has its positive effects on ECG, blood pressure, and stress level. Thus, it can be considered as one of the important nonpharmacological methods for prevention of stress, anxiety, and cardiovascular diseases.

The present investigation was conducted to study the prevalence and molecular characterization of chlamydiae associated with the respiratory infections of equines in the Sub-Himalayan region of India. Equine nasal swab samples (119) from 20 diseased and 99 apparently healthy equines were collected and tested by family Chlamydiaceae specific nested PCR based on ompA gene, besides 89 serum samples for AGPT. The molecular characterization of chlamydial species/strains was done by analyzing variation in VD II region of ompA gene. The chlamydia infections were detected in 48.74% of the nasal swabs (55% in diseased and 47.47% in apparently healthy animals) by nested PCR. Prevalence of two genetically variant strains of Chlamydia abortus and a single strain of Chlamydia psittaci was detected. AGPT showed 4.49% seropositive equines. High prevalence of chlamydiae was found among equines in the Sub-Himalayan region of India in Himachal Pradesh in both healthy and diseased equines.

Background: Bacterial colonization of central venous catheter (CVC) carries risk of developing catheter-related blood stream infections (CRBSI). The purpose of this study is to find out the frequency of colonization of CVC by different bacterial pathogens and their antibiotic sensitivity pattern.Materials and Methods: A total of 53 CVC tip were received in one-year duration for culture and antibiotic sensitivity pattern. The isolated organisms were identified by standard microbiological procedure and subjected to antimicrobial sensitivity.Results: out of 53 CVC tip sent for culture and sensitivity, 21 (39.6%) showed significant growth. Out of 21 culture positive 52.3% were gram negative bacilli, 33.3% were gram positive cocci, 4.8% were Candida spp. Acenitobacter baumannii and Staphylococcus aureus were frequent pathogens isolated. Gram negative bacteria were less sensitive to antibiotics whereas gram positive bacteria were sensitive to Vancomycin.Conclusion: Though various organisms were isolated as colonizer of CVC, Acenitobacter baumannii is the most common colonizer. Antibiotic resistance has already emerged and represents a major problem.

In an agriculture based economy like Nepal farm related accidents are not uncommon. Indigenous farm machinery like winnowing fan is common in our villages. Five cases of fan related head injuries presenting to the Department of Surgery, Tribhuvan University Teaching Hospital in a single month of winnowing season are discussed. JSSN 2015; 18 (1), Page: 29-31

Objective Stroke is one of the leading causes of mortality and morbidity worldwide. Stroke patients require longterm care for better outcome. Most often family members are the back bone of the service provided to people affected by stroke. Stroke patients and their caregivers are known to have large gaps in stroke knowledge and have suboptimal personal health behaviors, thereby putting the patient at high risk for complications. Our study was designed to explore the stroke care awareness among stroke patients' caregivers. Methods 50 stroke caregivers aged >18 years from neurology ward of College of Medical Sciences-Teaching Hospital were selected by non-probability purposive sampling from June 2012 to July 2012. Questionnaire focusing basic stroke care was prepared by researchers with the help of literature and a neurophysician. Validity and reliability of the tools were tested and data collected. Analysis of collected data was done using SPSS 16.0. Results The mean age of the respondents was 40 years (range: 20-80 years). Thirty-nine (78%) were either spouse or children. Thirty-eight (76%) caregivers were literate. Overall, 27 (54%) caregivers had low level of awareness regarding stroke care and mean knowledge score was 23.7. Conclusion This study has revealed the existence of low level of stroke care awareness amongst stroke caregivers. Interventional education program oriented to address this important yet neglected area can improve the stroke care in countries like Nepal where recent advancement for stroke management is lacking. Journal of College of Medical Sciences-Nepal, 2013, Vol-9, No-3, 1-8 DOI: http://dx.doi.org/10.3126/jcmsn.v9i3.10208

Background: Limited data is available on the clinical expression of chronic obstructive pulmonary disease (COPD) from India. The impact of gender on expression of COPD has received even less attention. Apart from tobacco smoke, indoor air pollution, especially from biomass fuel may play an important role in development of COPD in women. Materials and Methods: Seven hundred and two patients of COPD were studied regarding the etiological and risk factors leading to COPD, gender-related differences in clinical presentation, radiological expression of COPD and the co-morbidities in COPD. Results: Tobacco smoke in the form of beedi smoking was the predominant smoke exposure in males, whereas smoke from biofuel burning was the predominant exposure in females. As compared to males, females were younger, reported more dyspnea, more severe bronchial obstruction, more exacerbations, and exhibited higher prevalence of systemic features. Also, females smoked less and had lesser incidence of productive cough, lower body mass index, lesser co-morbidities and less number of hospital admissions as compared to males. Males were more likely than females to have an emphysema-predominant phenotype, while airway-predominant disease was more common among females. Conclusion: The current study shows that gender-related differences do exist in COPD patients. Understanding these differences in etiological agent and clinical picture will help early diagnosis of COPD in females.

This report analyses the trends in the cholera epidemic that hit Ecuador in 1991. The study is based on personal experiences and analysis of epidemiological databases from the Ministry of Public Health of Ecuador. The number of cases and initial attack rates in an immunologically naive population are described by province. An analysis of the Andean and coastal cholera patterns of transmission are described along with its associated risk factors. The logistical, environmental, and socio-cultural risk factors prevalent during the epidemic and the control measures implemented are also reviewed. Also, the role of the epidemic in the development of the public health and healthcare resources in Ecuador is discussed here. Current data indicate favorable conditions for another outbreak of cholera in Ecuador. In view of the existing risk factors, new strategies are proposed to prevent such an epidemic in the future.

The genetic divergence study in 46 maize inbred lines was conducted based on Mahalanobis D2 statistics by using Tocher’s canonical (vector) and Euclidean methods at Maize (Zea mays L.) Breeding Research Sub-Station, Poonch during 2009-2011. The genotypes were grouped into seven clusters by both the methods of divergence study. The grouping of genotypes in different clusters was beyond their geographic origins. This indicated appreciable amount of diversity present in the inbred lines under study. Canonical (vector) analysis suggested that plant height, stem girth and number of leaves per plant had contributed maximum towards total variability in the lines. 3D plotting of individual genotypes, based on principal component analysis scores and Euclidean distance matrix, showed that the PMS134 was the most diverse inbred with CML324 followed by M8-3, CML158, 6152 and CML399. These diversely related inbred lines can be utilized as parents in maize breeding programme to isolate desire hybrids for yield and component characters.

Introduction: CD4 T lymphocyte is the most commonly used cellular marker in tracking Human Immunodeficiency Virus (HIV) infection progression and monitoring effect of antiretroviral therapy (ART). Due to lack of local reference values of CD4 and other T lymphocytes in Nepal, most clinical decisions are based on the reference renges of western countries. Methods: This study was conducted at three major hospitals/laboratory of central, eastern and western Nepal during November 2008 through July 2009. Using the predefined criteria, 602 (200, 202 and 200 from central, eastern and western regions respectively) healthy adult volunteers of age range 18-60 years were recruited wiht equal representation from each age group and sex. Blood specimens were screened for HIV following standard algorithm using ELISA and two rapid test kits based on different principles. Samples with discordant test-results were excluded. HIV sero-negative specimens were further analyzed for CD4, CD8 and CD4:CD8 ratio, and absolute lymphocyte count (ALC) by FACS count (Becton Dickinson, USA) and automated cell counter (BC-3000 Plus, Shenzhen Mindray Biomedical Electronics, Germany) respectively. Results: The average value (mean± standard deviation) of CD4, CD8, CD4/CD8 ratio and ALC of Nepalese adult population were found to be 786 ± 248, 567±230, 1.52 ± 0.59 and 2712 ± 836 respectively. All four parameters but CD8 were significantly different with sex and females had relatively higher values. However, none of these parameters reported significant difference with age except the ALC. Conclusions: Nepalese healthy adult populations have significantly different T lymphocyte subsets compared to other countries. The present reference ranges of CD4 and other T lymphocytes may be used for any clinical purposes including classifying and monitoring disease status in HIV infected individuals, immune status evaluation, monitoring ART and accordingly making amendment in national HIV treatment guidelines in Nepal. Keywords:Absolute lymphocyte count, CD4, CD8, human immunodeficiency virus, T lymphocytes.

Abstract

Management of postburn cicatricial ectroption of the upper lid is always a challenge for the oculoplastic surgeon, as they are often associated with exposure keratitis and ulceration. Traditionally, split thickness grafts have been described for upper lid reconstruction and tarsorrhaphies have been discouraged. We present a case of corneal ulceration associated with postburn cicatricial ectropion presenting 10 years following the initial trauma. The patient underwent full thickness skin grafting and tarsorrhaphy to release the ectropion with resolution of corneal ulceration.We believe that full thickness skin grafts and tarsorrhaphy are effective in correcting upper lid cicatricial ectropion, without functional compromise. Key Words: Cicatricial ectropion, corneal ulcer, skin graft, tarsorrhaphy

The main objective of this study is to review the HIV/AIDS status and trend in Nepal. The design of the study was retrospective in nature. Review was made of published and unpublished documents during the period 1988 to 2004. Year-wise data indicates that the cases of HIV/AIDS have been increased sharply since mid 1990s. In 1992, more than double numbers of new cases were reported than the formerly reported cumulative cases. The latest cumulative HIV/AIDS cases as of May 2004 were reported as 747 cases of AIDS and 3765 cases of HIV infections. Among total HIV/AIDS cases, clients of sex workers (57.8 percent) were predominant followed by sex workers (13.9 percent) and injecting drug users (15.6 percent). Similarly, others included housewives (10.6 percent), children (1.8 percent) from vertical transmission and blood or organ recipients (0.2 percent). Male cases (73.0 percent) were found predominant than female cases (27.0 percent). HIV prevalence among risk group population was found highest in injecting drug users (38.4 percent) followed by Female Sex Workers (4.1 percent) and migrants (3.0 percent). The risk population and HIV/AIDS prevalence has been found sharply increasing after mid 1990s. The increasing trend of the disease certainly has given pressure to focus on the use of comprehensive targeted intervention programs in risk group sub-populations. Key Words: HIV/AIDS, Trend, Risk populations, Prevalence.

Acute respiratory infections (ARI) are the commonest infections in children under the age of five years in Nepal. An under five child will have 4-6 episodes of ARI per year in Nepal. ARI episode does not differ much between developed and developing countries. Pneumonia is the commonest single cause that causes death in a child with respiratory infections in developing countries. Treating pneumonia is still confusing. This article re-visits the basic concept in the treatment of pneumonia. Key Words: Pneumonia, persistent, pneumonia, antibiotics, treatment.