Simple Treadmill Score: Does It Have Better Predictability for Coronary Artery Disease?

Coronary artery disease is one of the most prevalent causes of increasing mortalitiy in current time. Early detection of such dreadful condition by a non-invasive test like exercise treadmill test, is a much-required option to prevent future complications like myocardial infarction. The aim of this study was to find out how different the predictability of simple treadmill score in comparison to other treadmill scores namely the well-known Duke treadmill score and Cleveland clinic score. In a cross-sectional analytical study of total 130 individuals with stable angina were included according to criteria set before the study. The treadmill scores of these patients were calculated and compared to coronary angiogram findings where coronary artery angiograms were done according to clinical need. Simple treadmill test had similar predictability for coronary artery disease when we compared it with much-applied Duke Treadmill Test and Cleveland Clinic Score- which is currently used for mortality prediction. Receiver Operator Characteristics (ROC) Curve showd all scores had around 0.7 area under the curve (AUC) which is highly statistically significant (p<0.0001) though simple treadmill score in females has higher sensitivity (92.3%). Simple treadmill score can be considered to exclude female patients from undergoing invasive investigation as it has higher sensitivity than other currently practiced treadmill scores i.e., Duke treadmill score.

Population dynamics in Nepal: features and issues.

PIP: This article features a discussion of Nepal's population dynamics and several major demographic issues for the future. The fertility rate in Nepal has declined, but insufficiently. There is a need to increase the contraceptive prevalence rate (CPR) from 29% to 40% over the next decade. CPR may be increased by improving functional literacy, increasing the length of schooling, awareness creation among subgroups, and improvement in the socioeconomic status of the population. Nepal has uncontrolled migration. There is a need to define appropriate international and internal migration policies and to improve regional development. There is also the need for nutrition programs targeted to malnourished children and pregnant mothers. Nepal is a country with a high birthrate of 37.5/1000, a declining death rate of 13.8/1000, high infant mortality of 97.5/1000 live births, high child mortality of 165/1000, and high total fertility of 5.5 children/woman. 42.7% of population are aged under 15 years. In 1991, the population growth rate was the highest in the terai region at 2.8%. Migration has increased population in the terai. The share of population in the hill and mountain regions has increased. The sex ratio of population was favorable to females in 1991. The sex ratio among persons aged 0-14 years and among those aged 45-60 and over favored males. The young and old populations continue to grow. The mean age of population was 18.8 years in 1991. The share of urban population was about 9.2% in 1991, but it is growing. Migration pressure arises at the destination due to social and political conflict, population pressure, land issues, and lack of social services.^ieng