Electro-physiological Changes in the Central Nervous System by Visual Evoked Potential in Diabetic Patients.

BACKGROUND: Increasing sedentary lifestyle in today's world has increased the prevalence of Diabetes Mellitus. Loss of vision due to diabetic retinopathy is a major public health burden. Visual evoked potential identifies the neuronal degenerative changes in chronic metabolic disorders specially Diabetes Mellitus. The study aimed at evaluating changes in visual evoked potential waves in diabetic patients. METHODS: This is a cross sectional comparative study consisting of 90 participants, out of which 60 were diabetic patients and 30 were non-diabetic control group. Among diabetic patients, 30 were without retinopathy, 10 with mild non-proliferative retinopathy, 10 with moderate non-proliferative retinopathy and 10 with severe non-proliferative retinopathy. Visually evoked potential latencies and amplitudes were compared among diabetic patients and the control group and also among individuals with different grades of retinopathy. RESULTS: Delay in P100 latency and decrease in its amplitude were statistically significant in diabetic patients. The changes in P100 latency, P100 amplitude and N75 latency were also significant in different grades of retinopathy. CONCLUSIONS: There are statistically significant changes in visually evoked potential in diabetes patients. Visual evoked potential is a useful, non-invasive investigation which can establish the central nervous system neuropathy in diabetes at an early stage of the disease. So Diabetic retinopathy can be prevented due to early detection of neuropathy by visual evoked potential test Keywords: Diabetes mellitus; diabetic retinopathy; visual evoked potential.

Early Canities among Undergraduate Medical Students of a Medical College: A Descriptive Cross-sectional Study.

Introduction: Early canities are the premature greying of hair before the age of 25 years in Asians. The condition is a matter of concern for young adults aesthetically. This study aimed to find out the prevalence of early canities among undergraduate medical students of a medical college. Methods: A descriptive cross-sectional study was carried out from 1 December 2021 to 30 June 2022 among undergraduate medical students at a medical college. The study was conducted after receiving ethical approval from the Institutional Review Committee [Reference number: 146(6-11)C-2 078/079]. The participants with ages less than 25 years without a history of vitiligo, intake of chemotherapeutic drugs, progeria, pangeria and recent dyeing of hair were enrolled. A convenience sampling method was used. Point estimate and 95% Confidence Interval were calculated. Results: Out of 235 students, 95 (40.42%) (34.15-46.69, 95% Confidence Interval) had early canities. The most prevalent premature greying was grade I early canities i.e.79 (83.15%) of participants. Among the participants with early canities, 56 (58.94%) were male, 41 (43.15%) had a positive family history for early canities, 67 (70.52%) had normal body mass index and 38 (40%) had O+ve blood group. Conclusions: The prevalence of early canities among undergraduate medical students was lower than in other studies done in similar settings. The grade I early canities was seen more among the participants with premature greying of hair. Keywords: epidemiology; hair colour; medical students; physiology.

Pre-eclampsia among Pregnant Women Admitted to the Department of Obstetrics and Gynaecology of a Tertiary Care Centre.

Introduction: Pre-eclampsia is a pregnancy-related hypertensive disorder with maternal and neonatal complications. Many studies are done regarding the prevalence of pre-eclampsia in Nepal but ascertaining the maternal risk factors and fetal outcomes are important. The aim of this study was to find out the prevalence of pre-eclampsia among pregnant women admitted to the Department of Obstetrics and Gynaecology of a tertiary care centre. Methods: A descriptive cross-sectional study was conducted among pregnant women admitted to the Department of Obstetrics and Gynaecology of a tertiary care hospital from 13 July 2023 to 29 September 2023 after obtaining ethical approval from the Institutional Review Committee. Convenience sampling method was used. Point estimate was calculated at a 95% Confidence Interval. Results: Among 5065 patient, pre-eclampsia was seen in 44 (0.87%) (0.61-1.13, 95% Confidence Interval). A total of 16 (36.36%) cases of pre-eclampsia were in the age group 25-29 years and 30 (68.18%) of them were nulliparous. A total of 38 (86.36%) of the newborns of the pre-eclamptic cases had low birth weight. The APGAR score of newborns at the 1 minute after birth was 26 (59.09%) followed by the newborns who needed re-evaluation 16 (36.36%). The APGAR score recorded at 5 minutes showed maximum newborns with normal APGAR score 40 (90.90%). Conclusions: The prevalence of pre-eclampsia among pregnant women was found to be lower than other studies done in similar settings. Keywords: maternity; Nepal; pre-eclampsia; prevalence.

Comparison of Spirometric Parameters in different Postures among Young Healthy Volunteers.

BACKGROUND: Spirometry is the most common pulmonary function tests that specifically measures volume and flow of air during respiration. It helps to identify obstructive and restrictive diseases of the lungs. The alterations of the results in spirometry can happen even in normal health due to change in body postures that alter lung volumes and muscle biomechanics. So, the objective of this study is to determine the effects of change of postures mainly supine, sitting and standing on pulmonary parameters of young healthy volunteers. METHODS: A cross-sectional analytical study was conducted among young medical students of Maharajgunj Medical Campus in the department of Clinical Physiology. A total of 31 students were selected by convenient sampling technique. Pulmonary parameters: Forced Vital Capacity (FVC), Forced Expiratory Volume in 1st second (FEV1), FEV1/FVC, Peak Expiratory Flow(PEF), EF2575 were collected from spirometry. The spirometry was done in supine, sitting and standing postures and the best value of each posture was selected for the comparison and obtained data were analyzed using repeated measures ANOVA with confidence interval of 95%. RESULTS: The pulmonary parameters recorded in different postures showed that the mean of these variables comparatively increased in standing posture than others with mean FVC 3.98±0.66 L, mean FEV1 3.53±0.55L, mean FEV1/FVC 89.23±5.60%, mean PEF 8.60±1.62L/s and mean PEF2575 4.46±1.08 L/s. The mean comparisons of these pulmonary parameters in supine, sitting and standing postures showed statistically significant differences with P value < 0.05. CONCLUSIONS: The pulmonary parameters are affected by body postures. Those parameters are recorded highest during standing posture and lowest during supine posture.

Stakeholder perspectives on current determinants of ultrasound-guided thoracentesis in resource limited settings: a qualitative study.

OBJECTIVE: Preprocedure pleural fluid localization using bedside ultrasound has been shown to reduce complications related to thoracentesis and is now considered the standard of care. However, ultrasound-guided thoracentesis (USGT) has not been broadly adopted in many low-resource settings. With increasing affordability and portability of ultrasound equipment, barriers to USGT are changing. The aim of this multisite qualitative study is to understand the current barriers to USGT in two resource-limited settings. SETTING: We studied two geographically diverse settings, Harare, Zimbabwe, and Kathmandu, Nepal. PARTICIPANTS: 19 multilevel stakeholders including clinical trainees, attendings, clinical educators and hospital administrators were interviewed. There were no exclusion criteria. PRIMARY OUTCOME: To understand the current determinants of USGT adoption in these settings. RESULTS: Three main themes emerged from these interviews: (1) stakeholders perceived multiple advantages of USGT, (2) access to equipment and training were perceived as limited and (3) while an online training approach is feasible, stakeholders expressed scepticism that this was an appropriate modality for procedural training. CONCLUSION: Our data suggests that USGT implementation is desired by local stakeholders and that the development of an educational intervention, cocreated with local stakeholders, should be explored to ensure optimal contextual fit.

Effects of Face Masks on Pulse Rate and Blood Pressure Components During Stairs Climbing.

BACKGROUND: The use of face masks has been associated with physiological changes in body. This study aims to know the changes in pulse rate and blood pressure components after wearing face masks during stairs climbing. METHODS: An experimental study was conducted among 60 apparently healthy young adults between 18-35 years of age. The pulse rate and blood pressure of the participants were recorded during rest at ground floor and after climbing the stairs till 5th floor at brisk and regular pace without wearing the face masks. The uniform KN95 masks were distributed and proper coverage of nose, mouth and chin were ensured. After 5 minutes interval, the pulse rate and blood pressure were recorded again at rest in ground floor and after climbing stairs with use of KN95 masks. RESULTS: At rest, the difference in mean pulse rate was statistically significant after wearing masks in participants between 21-25 years of age (86.46±14.59 bpm, p=0.014). After climbing the stairs, the mean pulse rate (131.16±18.48 bpm), mean systolic blood pressure (137.67±16.13 mmHg) and mean rate pressure product (182.87±41.70) were higher in participants (age group: 26-30 years) wearing masks and the difference was statistically significant (p=0.001; 0.013; 0.001respectively). During stairs climbing, the change in mean systolic blood pressure (32.66±16.73 mmHg), mean pulse pressure (43.77±24.64 mmHg) and mean rate pressure product (96.58±37.23) were higher in participants (age group: 26-30 years) and the difference was statistically significant (p=0.036; 0.047 and 0.009 respectively). CONCLUSIONS: The changes in systolic blood pressure, pulse pressure and rate pressure product are found to increase after wearing face masks during stairs climbing. It can be suggestive of increase workload to the heart by wearing face masks in addition to climbing the stairs.

Association of ABO blood group with susceptibility to SARS-CoV-2 infection in Rupandehi district of Nepal.

Objectives: Recent studies after the outbreak of coronavirus disease 2019 have shown an association of the ABO blood group to the susceptibility of severe acute respiratory syndrome coronavirus 2 infection. Anti-A and anti-B antibodies, carbohydrate clustering, interleukin-6 levels and host transmembrane protease serine subtype 2 were suggested to cause the variable susceptibility of severe acute respiratory syndrome coronavirus 2 infection to the ABO blood groups. This study aims to find the association of the ABO blood group with severe acute respiratory syndrome coronavirus 2 infection susceptibility in Nepal. Methods: Population-based matched case-control study was conducted from October 2021 to February 2022 in Rupandehi district of Nepal. A total of 1091 reverse transcription-polymerase chain reaction confirmed coronavirus disease 2019 cases and 2182 controls were included in the study by convenient sampling method. Results: A statistically significant association of severe acute respiratory syndrome coronavirus 2 infection was observed for the blood group AB between cases and controls (11.5% vs 8.5%; odds ratio = 1.4, 95% confidence interval = 1.10-1.78). However, there was no association of severe acute respiratory syndrome coronavirus 2 infection for blood group A (26.7% vs 28.23%; odds ratio = 0.93, 95% confidence interval = 0.79-1.09), B (26.9% vs 29.84%; odds ratio = 0.86, 95% confidence interval = 0.73-1.02) and O (34.9% vs 33.41%; odds ratio = 1.07, 95% confidence interval = 0.92-1.25). Conclusion: This study reported slightly more susceptibility to severe acute respiratory syndrome coronavirus 2 infection among individuals with blood group AB.

Validity of Elite-HRV Smartphone Application for Measuring Heart Rate Variability Compared to Polar V800 Heart Rate Monitor.

BACKGROUND: With technological advancement, it has become very easy to obtain heart rate variability data with handy heart rate monitors as well as smartphone applications. This study was conducted to assess the validity of Elite HRV smartphone application to measure time domain heart rate variability indices at rest, in comparison to Polar V-800 heart rate monitor. METHODS: Heart rate variability data were acquired from twenty apparently healthy male medical students in supine position after simultaneously connecting Polar V800 and Elite HRV to chest-worn Polar H7 sensor. Time domain indices viz. Mean RR intervals, mean heart rate, standard deviation of normal to normal intervals and root mean square of successive differences of interval were taken for comparison. Difference, validity and agreement were assessed using students t-test, intraclass correlation coefficient and Bland Altman plot and limits of agreement. RESULTS: Students t-test showed that there was no significant difference between the data obtained from Elite HRV and Polar V-800 in all the parameters viz. mean RR intervals, mean heart rate, standard deviation of normal to normal intervals and root mean square of successive differences of interval (p>0.05). Correlation was excellent as shown by Intra-class correlation coefficient of >0.999 in all the parameters. Bland Altman analysis revealed small bias and narrow limits of agreement with all the parameters: mean heart rate [-0.003 (0.05 - 0.04)], mean RR [0.01 (-0.58 - 0.60)], standard deviation of normal to normal intervals [-0.01 (-0.32 - 0.30)] and root mean square of successive differences of interval [-0.05 (-0.89 - 0.79)]. CONCLUSIONS: Elite HRV smartphone application provided reliable time-domain heart rate variability data consistent with the data obtained from validity tested Polar V800 heart rate monitor.

Knowledge and Practice Regarding Self-care Management among Patients with Permanent Pacemaker at Cardiac Center.

BACKGROUND: Permanent pacemaker can be implanted as a life shaving measures for the patients with cardiovascular disease. Complications of permanent pacemaker are preventable if the patients have adequate knowledge regarding its usage, complications, and precautionary measures. The objective of this study was to find out the knowledge and practice regarding self-care management among patients with permanent pacemaker. METHODS: A descriptive, cross-sectional study was adopted among patients with permanent pacemaker at Outpatient Department of Manmohan Cardiothoracic Vascular and Transplant Center, Maharajgunj, Kathmandu. A total of 98 patients were selected by using non-probability consecutive sampling technique. Data were collected using structured interview schedule. RESULTS: The study revealed that 40.8% of patient had adequate knowledge and 32.7% of patient had good practice regarding self-care management of permanent pacemaker. There was significant association between level of knowledge with age (p=.006), sex (p=.005), ethnicity (p=.045), education status (p=<.001) and regular exercise (p=.031) after permanent pacemaker implantation (PPI). Likewise, level of practice was significantly associated with sex (p=<.001), education status (p=<.001), occupation (p=<.001) and regular exercise (p=<.001) after PPI. The knowledge score and practice score were moderately positively correlated. CONCLUSIONS: More than half of the patient had inadequate knowledge and nearly half of the patients followed poor practice regarding self-care management of permanent pacemaker.

Impact of Climate Change on Health and Well-Being of People in Hindu Kush Himalayan Region: A Narrative Review.

Climate change and variability affect virtually everyone and every region of the world but the effects are nowhere more prominent than in mountain regions and people living therein. The Hindu Kush Himalayan (HKH) region is a vast expanse encompassing 18% of the world's mountainous area. Sprawling over 4.3 million km2, the HKH region occupies areas of eight countries namely Nepal, Bhutan, Afghanistan, Bangladesh, China, India, Myanmar, and Pakistan. The HKH region is warming at a rate higher than the global average and precipitation has also increased significantly over the last 6 decades along with increased frequency and intensity of some extreme events. Changes in temperature and precipitation have affected and will like to affect the climate-dependent sectors such as hydrology, agriculture, biodiversity, and human health. This paper aims to document how climate change has impacted and will impact, health and well-being of the people in the HKH region and offers adaptation and mitigation measures to reduce the impacts of climate change on health and well-being of the people. In the HKH region, climate change boosts infectious diseases, non-communicable diseases (NCDs), malnutrition, and injuries. Hence, climate change adaptation and mitigation measures are needed urgently to safeguard vulnerable populations residing in the HKH region.

Socio-demographic and Healthcare-seeking Predictors of Undernutrition among Children Under-five Years of Age in a Western District of Nepal.

BACKGROUND: Undernutrition is highly prevalent in Nepal, which interferes with physical and mental development among children. It is one of the severe health problems contributing to the significant portion of the disease burden. This study aimed to explore socio-demographic and healthcare-seeking related predictors of undernutrition among children under five years old in Dang, Nepal. METHODS: This was a descriptive cross-sectional study. A sample of 426 children was participated through stratified proportionate random sampling to identify socio-demographics and healthcare-seeking predictors of undernutrition. Multivariable regression was applied to identify the independent predictors of undernutrition. RESULTS: This study found that children below 24 months of age were more likely to be undernourished than children aged 24-36 months. Female children (OR=2.32, 95% CI: 1.19-4.54), illiterate or non-formally educated women (OR=4.09, 95% CI: 1.84-9.08), mother's occupation other than a housewife (OR=13.05, 95% CI: 4.19-40.68), labor work of father (OR=2.40, 95% CI: 1.04-5.57) had increased risk of undernutrition among children. Similarly, food insufficiency from their land, antenatal care visit, postnatal care visit, and delivery place were significantly associated with childhood undernutrition among children.  Conclusions: The study showed that undernutrition among children is associated with age and gender of children, educational attainment of the mother, food sufficiency, health-seeking practices of the mother during pregnancy, delivery, and postnatal. Socio-demographics and health-seeking practices related predictors must be explicitly considered to address undernutrition among children under the age of five years.

Status of Maternal and Child Health Seeking Behavior among Women Aged 15-45 Years during Earthquake of 2015 in Nepal: A Mixed Method Study.

BACKGROUND: Delivery of the maternal and child health services are generally affected during the time of disaster. This study aims to assess the maternal and child health service utilization in areas in Nepal affected by the 2015 earthquake. METHODS: A mixed method study was carried in 29 Village Development Committees from nine earthquake-affected districts in Nepal. Quantitative data on maternal, neonatal and child health indicators before and after the earthquake were collected from the Health Management Information System. Focus group discussions and key informant interviews with different stakeholders were conducted to collect qualitative data. Quantitative data was analyzed using Microsoft Excel 2013. Qualitative data was analyzed manually using thematic analysis technique. RESULTS: Most of the indicators were comparable before and after the earthquake. Indicators such as Bacille Calmette-Guerin vs. Measles-Rubella vaccine drop-out rate, 1st antenatal care visit, delivery by skilled birth attendant and 1st postnatal care visit within 24 hours of delivery improved after the earthquake. Though most of the health facilities were damaged, health services resumed under tents or in open spaces. Some of the common problems among pregnant women included stomachache, headache, malnutrition, diarrhea, and mental stress. CONCLUSIONS: There was not much effect in the delivery of maternal neonatal and child health services. This reflects the coordinated efforts from government as well as non-government organizations and civil societies during and after the earthquake in Nepal.

Efficacy and safety of inhaled budesonide on prevention of acute mountain sickness during emergent ascent: a meta-analysis of randomized controlled trials.

BACKGROUND: Acute Mountain Sickness (AMS) is a pathophysiologic process that occurs in non-acclimated susceptible individuals rapidly ascending to high-altitude. Barometric pressure falls at high altitude and it translates to a decreased partial pressure of alveolar oxygen (PAO2) and arterial oxygen (PaO2). A gradual staged ascent with sufficient acclimatization can prevent AMS but emergent circumstances requiring exposure to rapid atmospheric pressure changes - such as for climbers, disaster or rescue team procedures, and military operations - establishes a need for effective prophylactic medications. This systematic review and meta-analysis aim to analyze the incidence of AMS during emergent ascent of non-acclimatized individuals receiving inhaled budesonide compared to placebo. METHODS: This current meta-analysis was conducted according to the guidance of the Preferred Reporting Items for Systematic Reviews and Meta-Analyses statement. We searched PubMed, Google Scholar and Embase for relevant studies. The efficacy of budesonide in reducing incidence of AMS was evaluated by calculating the pooled ORs and 95% CIs. The efficacy of budesonide in maintaining hemoglobin-oxygen saturation was evaluated by calculating standard mean difference (SMD) and 95% confidence intervals. RESULTS: We found that at high altitude, inhaled budesonide was effective in reducing the incidence of mild AMS [OR: 0.37; 95% CI, 0.14 to 0.9, p = 0.042] but was ineffective in reducing the incidence of severe AMS [OR: 0.46; 95% CI, 0.14 to 1.41, p = 0.17]. Inhaled budesonide was also effective in maintaining SpO2 (SMD: 0.47; 95% CI, 0.09 to 0.84, p = 0.014) at high altitude. However, it was not effective in maintaining or improving pulmonary function at high altitude. Systematic-review found no adverse effects of budesoide in the dose used for prophylaxis of AMS. CONCLUSIONS: Our systematic review showed that prophylactic inhaled budesonide is effective in preventing mild AMS during emergency ascent but not effective in preventing severe AMS. Though statistically significant, authors recommend caution in interpretation of data and questions for further well designed randomized studies to evaluate the role of budesonide in prophylaxis of AMS during an emergent ascent.

Burden of injuries in Nepal, 1990-2017: findings from the Global Burden of Disease Study 2017.

BACKGROUND: Nepal is a low-income country undergoing rapid political, economic and social development. To date, there has been little evidence published on the burden of injuries during this period of transition. METHODS: The Global Burden of Disease Study (GBD) is a comprehensive measurement of population health outcomes in terms of morbidity and mortality. We analysed the GBD 2017 estimates for deaths, years of life lost, years lived with disability, incidence and disability-adjusted life years (DALYs) from injuries to ascertain the burden of injuries in Nepal from 1990 to 2017. RESULTS: There were 16 831 (95% uncertainty interval 13 323 to 20 579) deaths caused by injuries (9.21% of all-cause deaths (7.45% to 11.25%)) in 2017 while the proportion of deaths from injuries was 6.31% in 1990. Overall, the injury-specific age-standardised mortality rate declined from 88.91 (71.54 to 105.31) per 100 000 in 1990 to 70.25 (56.75 to 85.11) per 100 000 in 2017. In 2017, 4.11% (2.47% to 6.10%) of all deaths in Nepal were attributed to transport injuries, 3.54% (2.86% to 4.08%) were attributed to unintentional injuries and 1.55% (1.16% to 1.85%) were attributed to self-harm and interpersonal violence. From 1990 to 2017, road injuries, falls and self-harm all rose in rank for all causes of death. CONCLUSIONS: The increase in injury-related deaths and DALYs in Nepal between 1990 and 2017 indicates the need for further research and prevention interventions. Injuries remain an important public health burden in Nepal with the magnitude and trend of burden varying over time by cause-specific, sex and age group. Findings from this study may be used by the federal, provincial and local governments in Nepal to prioritise injury prevention as a public health agenda and as evidence for country-specific interventions.

An update on the epidemiology, length of stay, and cost of Kawasaki disease hospitalisation in the United States.

BACKGROUND: Kawasaki disease is an acute vasculitis of childhood and is the leading cause of acquired heart disease in the developed countries. METHODS: Data from hospital discharge records were obtained from the National Kids Inpatient Database for years 2009 and 2012. Hospitalisations by months, hospital regions, timing of admission, insurance types, and ethnicity were analysed. Length of stay and total charges were also analysed. RESULTS: There were 10,486 cases of Kawasaki disease from 12,678,005 children hospitalisation. Kawasaki disease was more common between 0 and 5 years old, in male, and in Asian. The January-March quarter had the highest rate compared to the lowest in the July-September quarter (OR=1.62, p < 0.001). Admissions on the weekend had longer length of stay [4.1 days (95 % CI: 3.97-4.31)] as compared to admissions on a weekday [3.72 days (95 % CI: 3.64-3.80), p < 0.001]. Blacks had the longest length of stay and whites had the shortest [4.33 days (95 % CI: 4.12-4.54 days) versus 3.60 days (95 % CI: 3.48-3.72 days), p < 0.001]. Coronary artery aneurysm was identified in 2.7 % of all patients with Kawasaki disease. Children with coronary artery aneurysm were hospitalised longer and had higher hospital charge. Age, admission during weekend, and the presence of coronary artery aneurysm had significant effect on the length of stay. CONCLUSIONS: This report provides the most updated epidemiological information on Kawasaki disease hospitalisation. Age, admissions during weekend, and the presence of coronary artery aneurysm are significant contributors to the length of stay.

Prevalence of behavioral risk factors of cardiovascular diseases and associated socio-economic factors among pregnant women in a rural area in Southern Nepal.

BACKGROUND: Cardiovascular diseases (CVDs) have dramatically infiltrated populations living in abject poverty in Low- and Middle-income Countries (LMICs), and poor maternal and child health outcomes have been frequently reported for those with CVD risk factors. However, few studies have explored the behavioral risk factors of CVDs among pregnant women in rural settings. This study aimed at determining the prevalence and identifying the socio-economic predictors of behavioral risk factors of CVDs among pregnant women in rural area in Southern Nepal. METHODS: A Community-based cross-sectional study was conducted in 52 clusters of Dhanusha District of Nepal in a total of 426 pregnant women in their second trimester using multistage cluster sampling method. Multivariable logistic regression model was used to assess independent associations between behavioral risk factors during pregnancy and maternal socio-economic characteristics. RESULTS: Of the 426 study participants, 86.9, 53.9, 21.3 and 13.3%, respectively, reported insufficient fruits and vegetables consumption, insufficient physical activity, tobacco use, and harmful alcohol drinking. Socio-economic factors significantly associated with more than one behavioral risk factors in expectant mothers with a primary level education (adjusted odds ratio (AOR) 2.78; 95% Confidence Interval (CI) (1.35-5.72)), 20-34 years age group (Adjusted Odds Ratio (AOR) 0.27; 95% CI (0.13-0.56)), and those with the highest wealth index (AOR 0.36; 95% CI (0.16-0.84)). CONCLUSION: Higher prevalence of behavioral risk factors for CVDs and their socio-economic factors prevailing among pregnant women living in rural Nepal call for immediate health promotion interventions such as community awareness and appropriate antenatal counseling.

Physiology and applied sciences in Nepal: 1st annual conference.

With the increasing number of medical schools in Nepal, there is an expected increase in the number of Nepalese physiologists. The first medical school was established in the 1970s. We report here about the first annual conference of Nepalese physiologists on 27-28 September 2013 organized by the Department of Clinical Physiology of the Nepalese Army Institute of Health Sciences (NAIHS) and Kathmandu University School of Medical Sciences (KUMS). Nepalese physiologists are trying to form their own physiological society. In this regard, NAIHS and KUMS have played an important role to bring physiologists from different parts of Nepal involved in teaching, learning, and research activities in medical schools. There were a number of foreign invitees (India, Israel, Italy, Japan, and Sweden). There were plenary presentations on the topics that are relevant in Nepal, e.g., high-altitude physiology and wilderness medicine. The final session of the conference was an open session meeting of Nepalese physiologists. There was an open interaction about establishing Nepalese Physiological Society. After much deliberation, there was an agreement to register the society in Kathmandu with the current ad hoc committee which will elect the first executive body of the society.

ABO and Rh blood groups and their ethnic distribution in a teaching hospital of Kathmandu, Nepal.

INTRODUCTION: ABO and Rh blood group systems are the most important blood grouping systems from clinical aspect. Determination of blood group is important for blood transfusion therapy, medico-legal purposes, organ transplantation, settlement of paternity disputes etc. METHODS: A cross-sectional descriptive study was carried out for a period of one year from 1st January 2011 to 31st December 2011 in blood bank of Tribhuvan University Teaching Hospital. All blood samples collected for blood group determination were included in the study. Blood group was determined by slide agglutination method using commercial antisera. RESULTS: A total of 13568 blood samples were analyzed, 5123 (37.75%) were male and 8445 (62.25%) were female. Frequencies of blood groups A, B, AB and O were found to be 4034 (29.7%), 3665 (27.0%), 1114 (8.2%) and 4755 (35.1%). Frequencies of Rh positive and Rh negative blood groups were found to be 13200 (97.3%) and 368 (2.7%). Blood group O was common in Brahmin, Chhetri, Tamang, Lama, Gurung, Sherpa, Terai Brahmin, Muslim and Yadav ethnicities; blood group A was common in Newar, Rai, Magar, Limbu and Sanyasi ethnicitites; and blood group B was common in Tharu and Marwari ethnicities. CONCLUSIONS: Blood group O was found to be the most common blood group while AB was the rarest one. It was found that blood group O is the more common in Sherpa, Brahmin and Yadav; A in Limbu, Rai and Newar; and B in Tharu and Marwari ethnicities.