NepMed Repository :: Browsing by Author "Chalise, S"

Browsing by Author "Chalise, S"

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Assessment of Obesity Indices in Predicting Hyperglycemia in Adults of Duwakot, Bhaktapur
(Kathmandu University, 2025) Khakurel, G; Gautam, K; Karki, PK; Chalise, S
ABSTRACT Background Obesity is a major risk factor for metabolic disorders, including hyperglycemia, which is a precursor to diabetes. Various obesity indices, such as Body Mass Index (BMI), Waist Circumference (WC) and Waist-to-Height Ratio (WHtR), are used to assess adiposity. Objective To evaluate and compare the effectiveness of obesity indices in predicting hyperglycemia among adults in Duwakot, Bhaktapur. Method This was a cross-sectional study conducted among 128 adults visiting Kathmandu Medical College Public Limited, Duwakot from August 2024 to January 2025. Anthropometric measurements (BMI, WC and WHtR) were recorded, and fasting blood glucose (FBG) levels were measured to define hyperglycemia (FBG ≥ 126 mg/ dL). Pearson correlation was used to evaluate the relationship between obesity indices and FBG levels, while an independent t-test compared the mean values between males and females. The predictive ability of obesity indices was assessed using Receiver Operating Characteristic (ROC) curve analysis, and the area under the curve (AUC) and optimal cut-off values were determined. Values of p≤0.05 were considered statistically significant. Result The prevalence of hyperglycemia among the participants was 17.2 %. Pearson correlation analysis showed that FBG was significantly correlated with WC (Male: r = 0.233, p < 0.05; Female: r = 0.459, p < 0.05), and WHtR (Male: r = 0.227, p < 0.05; Female: r = 0.482, p < 0.05). Independent t-test analysis revealed a statistically significant difference in WC (p = 0.025) and WHtR (p = 0.014), with males having higher WC and females having higher WHtR. However, BMI (p = 0.179) did not show a significant difference between the two groups. ROC curve analysis revealed that WHtR had the highest AUC (Male:0.607, Female:0.721), followed by WC and BMI. Conclusion This study found that WHtR was the strongest predictor of hyperglycemia, followed by WC, and BMI. WHtR could be an effective screening tool for early hyperglycemia detection in community settings. KEY WORDS Hyperglycemia, Predictive value, Obesity indices
Association of Subjective Sleep Quality and Glycemic Level in Patients with Type 2 Diabetes Mellitus: A cross sectional study
(Kathmandu University, 2020) Khakurel, G; Shakya, D; Chalise, P; Chalise, S
ABSTRACT Background Sleep disorders are considered as one of the important risk factor which have a great impact on patients with type 2 diabetes mellitus. Objective The objectives of this study was to determine the effect of sleep quality on the glycemic level among type 2 diabetic patients. Method This was a cross sectional study done in 208 type 2 diabetic patients visiting Kathmandu Medical College Public Limited from July 2019 to December 2019. Data regarding sleep quality was collected by using Pittsburgh Sleep Quality Index taking global cut off score ≥ 8 as poor sleeper. Glycated hemoglobin level ≥ 7 was considered as poor glycemic control. Chi square test was used to compare parameters between good sleeper and poor sleeper. Independent sample t test compared the means of Pittsburgh Sleep Quality Index factors and glycemic contol. A logistic regression analysis of Pittsburgh Sleep Quality Index factors and glycated hemoglobin was done. Values of p ≤ 0.05 were considered statistically significant. Result The study findings revealed that 62 % had poor glycemic control and 58.7 % were poor quality sleeper. There was a significant association of sleep quality with glycemic control and duration of diabetes. Logistic regression analyses showed that subjective sleep quality was risk factor for poor glycemic control. The odds ratio for subjective sleep quality was found to be 4.59 (2.13-9.91). Conclusion Poor sleep quality was common in type 2 diabetic patients. This study showed that the risk factors for poor subjective sleep quality include poor glycemic control and longer duration of diabetes mellitus. KEY WORDS Diabetes mellitus, Glycemic level, Sleep
Clinical Dilemma of Diabetic Ketoacidosis and COVID-19 Infection
(Kathmandu University, 2021) Sapkota, P; Chalise, S; Shrestha, P
ABSTRACT The COVID-19 Pneumonia with diabetic ketoacidosis is a dreadful health condition. Diabetic ketoacidosis is one of the severe metabolic complications and it can be precipitated by infection. We presented a case of 48 years female with no known comorbidities who presented with COVID-19 symptoms and with Diabetic Ketoacidosis. The case presented with elevated inflammatory markers, high anion gap metabolic acidosis with type I respiratory failure. During admission, the oxygen saturation had marked drop, later her improvement was steady followed by gradual tapering of the oxygenation. Marked improvement was noticed in the subsequent follow-up. COVID-19 infection can be precipitated by preexisting diabetes or newly diagnosed diabetes and the severity of COVID-19 infection is more pronounced in patients with diabetes mellitus, thus should be managed timely and accordingly. The scarce studies among the COVID-19 cases with diabetic ketoacidosis reflect the need for further studies for the availability of a wider range of information. KEY WORDS Diabetic ketoacidosis, Metabolic complications, Severe COVID-19 pneumonia
Rickettsial Infection amongst Febrile Illness Patient in a Tertiary Care Hospital: A Retrospective Cross-sectional Study
(Kathmandu University, 2022) Gurung, RB; Sapkota, P; Bhatt, S; Tamang, A; Joshi, S; Khadka, S; Jaisy, DN; Chalise, S; Shrestha, P
ABSTRACT Background Rickettsial infection is an emerging neglected tropical disease in the Southeast Asia. In past few years Nepal is also reporting escalating prevalence of rickettsia. The under evaluation is resulting it as undiagnosed or are simply labeled as pyrexia of unknown origin. Objective To find out the prevalence of rickettsia in a hospital setting, assess the socio- demographic and other relevant clinical features of the rickettsia patients. Method This is a hospital based retrospective cross-sectional study from October 2020 to October 2021. This study reviewed the medical records of the department. Result The study included 105 eligible patients and the prevalence rate was 4.38 per 100 patients. The mean age of the participants was 42 years, and the mean hospital stay was 3 (SD ±2.06) days. More than 55% of the participants had fever for less than or equal to 5 days and 9% had Eschar present. Vomiting, headache, and myalgia were the most common symptoms and hypertension, and diabetes were the common comorbidities. Pneumonia and the acute kidney injury were the two complications of the patients as stated in the study. The severity of the thrombocytopenia deducted from admission time to discharge, and the case fatality was 4%. Conclusion The future studies shall consider on collaborative clinical and entomological research. This would help in better understanding of the etiology of supposedly unknown febrile illness and the under-investigated field of emerging rickettsia in Nepal. KEY WORDS Eschar, Febrile illness, IgM titer, Rickettsia, Thrombocytopenia

Browsing by Author "Chalise, S"

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