Depressive symptoms and associated factors among persons with physical disabilities in disability care homes of Kathmandu district, Nepal: A mixed method study.

Depression is one of the most common mental disorders, affecting 300 million people worldwide and 75% of these occur in low- and middle-income countries. Persons with physical disabilities are vulnerable groups and are more prone to experience depressive symptoms than the general population. This study investigated the prevalence of depressive symptoms and the associated factors among persons with a physical disability. We conducted a concurrent triangulation mixed methods design using Beck's Depression Inventory scale among 162 persons with physical disabilities in the Kathmandu district. In parallel, eight in-depth interviews were conducted with an interview guideline to collect the participants' perceptions and experiences of disability. Both quantitative and qualitative findings were integrated into the results. We found that about 77% of the participants with a physical disability had experienced depressive symptoms. Unemployment status (adjusted odds ratio (AOR) 2.7, 95% confidence interval (CI) 1.0-7.3) and comorbidity (AOR 2.5, 95% CI 1.0-6.0) had a statistically significant association with depressive symptoms. The majority of people with physical disabilities had negative experiences with societal prejudice and coping with their limitations. They were depressed as well as angry over having to stop their careers, education, and possibilities. Nevertheless, they were significantly happier and less sad than in their earlier years of life because of the possibilities, family environment, improved means of subsistence, therapeutic facilities, and supportive atmosphere at disability care homes. The policymakers should focus on preventing comorbidity and providing technical skills to persons with physical disabilities to improve their employment status and promote a healthy lifestyle.

Use of Statins as Lipid Lowering Agent in Hypercholesterolemia in a Tertiary Care Hospital: A Descriptive Cross-sectional Study.

INTRODUCTION: Lipids contribute to atherosclerosis and obesity that can lead to different cardiovascular diseases. Statins are hydroxymethylglutaryl reductase inhibitors that effectively lower the cholesterol level. It is widely prescribed in the treatment of hypercholesterolemia. Thus it optimizes the lipoprotein profile. The selection of a particular drug by the practitioner should be primarily based on clinical outcome. This study was conducted to find the type of statins that are most preferred by the doctors for treating dyslipidemia and preferred the fixed-dose in a tertiary care hospital. METHODS: This was a descriptive cross-sectional study conducted among the practicing doctors of Kathmandu Medical College from July to August 2020. Ethical approval was taken from the Institutional Review Committee of the college (Ref: 207202006). Convenient sampling was done. A semi-structured questionnaire was used with consent. The data were analyzed with Social Statistical Package for the Social Sciences version 20. RESULTS: Statins, with the score 4.25 was accounted for most preferred for the treatment of dyslipidemia. Among different statins, atorvastatin with a score of 4.48 was most popular followed by rosuvastatin 2.9 score and simvastatin 2.1 scores. CONCLUSIONS: Statins were the most preferred agents for the treatment of dyslipidemia. Although different types of statins ought to have similar efficacy in treating dyslipidemia, atorvastatin was found to be popular and the most commonly prescribed one. The most common side effect reported with statins was myopathy.

Atherogenic Index of Plasma in Postmenopausal Women.

BACKGROUND: Hyperlipidemia is one of the important risk factor for development of cardiovascular disease in post menopausal women.Our study compared the serum lipid profile and atherogenic index of plasma between premenopausal and post menopausal women. METHODS: This was a cross sectional study conducted in Kathmandu Medical College. A total number of 194 women in the age group 30 to 60 years were studied. They include 108 postmenopausal women and 86 premenopausal controls. Total cholesterol, low density lipoprotein cholesterol, high density lipoprotein cholesterol and triglycerides were determined. RESULTS: The mean value of total cholesterol, low-density lipoprotein cholesterol and triglyceride were significantly increased in postmenopausal women when compared to premenopausal women. There was increase in high-density lipoprotein cholesterol in postmenopausal women but the difference was not significant. The atherogenic index of plasma was increased in postmenopausal women (0.22 ± 0.25 mmol/l). This shows that postmenopausal women in our setting are at medium risk of developing cardiovascular disease. Atherogenic index of plasma was positively and significantly correlated with age (r= 0.29, p<0.05), body mass index (r=0.24, p<0.05), systolic blood pressure (r=0.20, p<0.05) and diastolic blood pressure (r=0.45, p<0.05). CONCLUSIONS: Postmenopausal women were at greater risk for developing cardiovascular disease when compared to premenopausal women due to increase in atherogenic lipid profile. There was a significant correlation of atherogenic index of plasma with age, body mass index, systolic blood pressure and diastolic blood pressure.