Browsing by Author "Gupta, MP"
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Publication Body mass index and its relation with hypertension, diabetes mellitus and ischemic heart disease in a general health clinic in Nepal(Institute of Medicine, 2006) Acharya, RP; Prasad, PN; Gupta, MPAbstract Background: Obesity is increasing rapidly in both developed and developing countries and the new generations are at increased risk. Similarly, the prevalence of non-communicable diseases are also increasing. In this context, attempt has been made to correlate the situation. Objective: To find out the Body Mass Index (BMI) in patient suffering from three common noncommunicable diseases - hypertension, diabetes mellitus and ischemic heart disease (IHD). Material and Methods: Aretrospective study was carried out in the clients attending General Health Check up Clinic at Tribhuvan University Teaching Hospital, Katmandu during a period of six months. Those suffering from Hypertension, Diabetes Mellitus and Ischaemic Heart Disease were included and BMI was analysed. Results: In this study, a total of 464 records were analyzed. Analysis of BMI revealed 5.8% to be underweight (<18.5), 52.2% to be normal (18.5-25.0), 37.9% to be overweight (25.1-30.0) and 4.1% to be obese (>30.0). Out of 19 obese cases, 73.7% had hypertension, 10.5% had diabetes mellitus and 5.3% had IHD. Similarly, out of 176 overweight cases 46.0% had hypertension, 6.8% had diabetes mellitus and 3.4% had IHD. The cases with normal weight or underweight had significantly lower incidence of these diseases. Out of 242 normal cases, 21.1% had hypertension, 5.4% had diabetes mellitus and 2.9% had IHD. Out of 27 underweight cases, 3.7% had hypertension, 3.7% had diabetes mellitus and none had IHD. Conclusion: This study showed that overweight and obesity is not uncommon in Nepali population; and is related with the higher incidence of hypertension, diabetes mellitus and IHD.Publication Factors determining self-harm(Institute of Medicine, 2010) Shakya, YL; Acharya, R; Gupta, MP; Banjara, MR; Prasad, PNAbstract Introduction: Self-harm forms a significant proportion of patient attending in emergency departments, typically 10-30 per 100000 people commit suicide annually. The objective of this study was to find out the factors responsible for self harm. Methods: This is a cross-sectional study of 100 patients of self-harm coming to Emergency Department of Tribhuvan University Teaching Hospital from from 1st October 2007 to 31st March, 2008. Questionnaire about demographic information of patient along with details about cause of self-harm, and any other illnesses associated was filled. Information about duration of arrival in emergency department, place of self-harm was gathered. Patients were clinically examined and hematological and biochemical tests including liver function test and the type of poison used and its level in blood were examined. Results: Total number of patients with self-harm was 100 (female - 71%; male- 29%). Among female,16-30 years age group to be the largest (76%). Mean duration of arrival in emergency department was3.08 hour. Metacid ingestion (29%) was found to be the most common cause for self-harm. There is no difference of self-harm for suicide and threat cause. Only 5% of patient with self-harm has psychiatry illness in the past. Conclusions: Self harm forms a significant proportion of patient attending the Emergency department and the most common form of self-harm used was metacid ingestion. There is compelling evidence for the need to improve delivery of care for patients who inflict self-harm. Keywords: Cause, emergency department, self harmPublication Prophylactic leg wrapping in elective cesarean section under bupivacain spinal anesthesia(Institute of Medicine, 2006) Sharma, SA; Prasad, PN; Marhatha, MN; Gupta, MPAbstract Background: Hypotension is the most frequent and serious complication associated with spinal anesthesia in obstetrics. Over the years many interventions have been tried to prevent the hypotension. Preloading with fluid, prophylactic vasopressors and leg wrapping have been seen as effective interventions. Leg wrapping, a noninvasive and a nonpharmacologic method, has consistently been seen as an easy and effective intervention. Various studies using Esmarch bandage, graduated compression bandage and inflatable boots are found in the literature. Till now no study has been done using Elastic leukocrepe bandage, which is cheap and widely available. This study was thus carried out with the aim of finding out if wrapping with elastic leukocrepe would have a similar effect. Methods: In a randomized controlled study, 30 patients (15 in each group) had either their legs wrapped or no wrapping prior to spinal anesthesia before cesarean section. Systolic blood pressure and rescue mephentermine use were recorded. Result: The mean systolic blood pressure, SBP, at different time intervals was compared. The leg wrapped group had consistently higher SBP. Overall, 12 out of 15 patients in the leg wrapped group and all 15 patients in the control group experienced hypotensive episodes requiring rescue dose of mephentermine. The number of patients who had more than one hypotensive episodes during the surgery was also analyzed. 5 out of 15 cases compared to 14 out of 15 controls had more than one hypotensive episodes requiring supplemental mephentermine. Conclusion: The findings of my study suggest that the wrapping of lower limbs with Leukocrepe elastic bandage (like other methods of wrapping) decreases the incidence of hypotensive episodes to a significant degree however it does not eliminate the incidence of hypotension in spinal anesthesia given to elective cesarean section patients. Keywords: prophylactic leg wrapping, elective CS, spinal anesthesia