Browsing by Author "Pokhrel, BR"
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Publication Effect of Sub-maximal Exercise Stress on Cold Pressor Pain: A Gender Based Study(Kathmandu University, 2013) Pokhrel, BR; Malik, SL; Ansari, AH; Paudel, BH; Sinha, R; Sinha, MABSTRACT Background Analgesic effect of exercise is a well established fact; however available reports are contradictory on gender differences in pain perception following exercise stress test. Objective The current study is prospectively designed to evaluate and compare the effect of acute bout of sub-maximal exercise stress on cold pressor pain in normal adult males and females. Method The experimental study design involved healthy adults (n= 41); females (n = 18) and males (n=23) aged between 18 to 25 years and included them into four sets of experiments: SET I (Control), “resting blood pressure, radial pulse and respiratory rate were recorded after 15 minutes of complete supine relaxation. SET II (Cold Pressor Pain Test): Pain Threshold, Pain Tolerance, and Pain Duration in seconds were taken. SET III (Exercise Stress Test): Sub-maximal exercise of 70 to 75% of maximum predicted heart rate was given for 6 minutes. SET IV (Cold Pressor Pain Test immediately after Exercise Stress Test): At 0 minute of recovery again the pain parameters; Pain Threshold, Pain Tolerance, and Pain Duration in seconds were taken. SET I, SET II were performed in order on the first day and SET III and SET IV on the second day to ensure only a single Cold Pressor Pain Test is performed in each day. Result The data (Mean ±SD) analysis showed significant increased in pain threshold (males: 14.36±10.6 Vs 21.47±13seconds, p<0.001, females: 14.1±11.5 Vs 23.81± 20.22 seconds, p<0.001) and pain tolerance time (males: 41.3±19.31Vs 54.1±21.7 seconds, p<0.001) in both sexes after 6 min of acute bout of sub-maximal exercise stress test with comparable age, BMI and baseline resting values of pain parameters and pulse rate and blood pressure. The percentage increment pain tolerance time following the exercise stress in female is higher than male (78.6 Vs 68.9%). Conclusion The result suggests that pain sensation decreases immediately after a brief period of exercise challenge irrespective of gender, and the analgesic effect of the acute bout of exercise in terms of pain tolerant time is more enhanced in females than males. KEY WORDS Analgesia, exercise, gender, pain tolerancePublication Liver Function Parameters and Validation of Health-Related Quality of Life Assessment of β-Thalassemia Cases at a Tertiary Care Hospital, Lumbini Province, Nepal(Kathmandu University, 2025) Gautam, N; Risal, P; Gupta, RT; Agrawal, KK; Chaudhary, D; Paudel, MS; Adhikari, B; Pokhrel, BR; Tamang, B; Shrestha, J; Sharma, B; Ghimire, SABSTRACT Background Individuals affected by β-thalassemia experience complications such as hepatic hemosiderosis and fibrosis due to frequent blood transfusions, which can lead to iron overload. Multiple blood transfusion burdens in thalassemia, particularly in low- income countries, impact health-related quality of life. Objective Liver function parameters and health-related quality of life were assessed using Nepali version 36 short-form survey instruments to reveal the vitality, physical, mental, emotional, pain, general health, and social functioning of β-thalassemia cases. Method In this cross-sectional study, forty β-thalassemia cases who had visited the Universal College of Medical Sciences tertiary care teaching hospital of Lumbini Province, Nepal were enrolled. The hemoglobin variant band percentage was estimated by D-10 BioRad high performance liquid chromatography (HPLC), Mentzer Index (Mean Cell Volume by Red Blood Cell count) by Beckman hematological analyzer, and serum liver parameters (Bilirubin, Total protein, Albumin, Alanine aminotransferase, Aspartate aminotransferase, Alkaline phosphatase) were estimated by using Diatron fully automated analyzer. The internal consistency of the Nepali version of 36 short- form survey instruments was checked by Cronbach`s alpha was found to be > 0.70 from the recoded value. Data are analyzed using the STATA/MP14, and ANOVA and t-test are applied to test the significance considering p-value < 0.05. Result The frequency of the β-thalassemia Trait (60%) was higher than β-thalassemia Major (30%) and 7.5% β-thalassemia Intermedia co-morbidities with Sickle cell (2.5%) and β/δ variants (2.5%). Higher frequency was found in ethnic groups Muslim (32.5%) followed by Terai indigenous-Tharu (30%) and Madheshi (27.5%). The transfusion- dependent cases have significantly higher Total, Direct, Indirect Bilirubin, and Alkaline phosphatase levels than non-transfusion dependent cases (p<0.001). The physical functioning, general health, emotional health, and vitality were significantly decreased in β-thalassemia Major as compared to β-thalassemia Trait (p<0.001), and significantly correlated with Mentzer index and HPLC patterns (HBA2/HBF) (p<0.05). Conclusion Transfusion dependent β-thalassemia Major and Intermedia had elevated Bilirubin and Alkaline phosphatase levels as compared to non-transfusion dependent β-thalassemia Trait, exacerbating health-related quality of life, emphasizing the preventable disparities for optimized transfusion protocols and psychosocial support. KEY WORDS β-thalassemia, Health-related quality of life, Liver function testsPublication Peripheral Airway Responsiveness to Sub-maximal Exercise in Asymptomatic Cigarette Smokers(Kathmandu University, 2011) Pokhrel, BR; Chatopadhyaya, S; Paudel, BHABSTRACT Background Cigarette smoking is one of the cardinal causes for the development of bronchial hyperresponsiveness among the smokers. Objectives This study was perspectively designed to determine the peripheral bronchial responsiveness to sub-maximal exercise challenge in the asymptomatic smokers. Methods The subjects were between age of 18-25 years without any findings of cardio- respiratory diseases. We performed the 5 min step test exercise at intensity of 80 to 90% of maximum predicted heart rate in 42 young adult male asymptomatic smokers to examine the effect of cigarette smoking on airway responsiveness. Forced expiratory spirogram was recorded before and at 0, 5, 10, 15 min after the completion of exercise. Pre- to post exercise drop in Forced Expiratory Volume in first second ≥ 15% was considered hyperresponsive to the challenge. Result The analysis of data (mean± SE) indicated the bronchial hyper-responsiveness in 22 (52%) smokers. The post exercise recovery time pattern showed drop in forced expiratory spirogram from the resting baseline in the responsive smokers and the maximum percentage fall in the parameters or increase in airway resistance which reflect the peripheral airway integrity such as Forced Expiratory Flow 25% (20.30 ±2.18 Vs 7.88 ±3.23, p<0.01), Forced Expiratory Flow 50% (18.46 ±4.40 Vs 1.93 ±2.78, p<0.01), Forced Expiratory Flow 75% (23.94 ±3.68 Vs 0.80 ±4.72, p<0.001) and Forced Expiratory Flow 25-75% (32.50 ±4.79 Vs 3.64 ±3.32, p<0.001) was significantly higher in the responsive than non-responsive subgroup of the smokers. Conclusion The occurrence of peripheral airway resistance is more in the responsive than non- responsive subset of smokers to the exercise challenge and hence more prone to develop obstructive airway disease in the long run. KEY WORDS airway hyper-responsiveness, cigarette smokers, forced expiratory flowPublication Thyroid Hormone levels in Highlanders- A Comparison Be- tween Residents of Two Altitudes in Nepal(Kathmandu University, 2013) Nepal, O; Pokhrel, BR; Khanal, K; Gyawali, P; Malik, SL; Koju, R; Kapoor, BKABSTRACT Background The endocrine changes related to altitude adaptation in human have attracted physiologists around the globe for long. A number of high altitude studies to detect the physiological changes have been performed now and then. But, the study to see the hormonal changes to compare populations residing at different high altitudes is a scarce. Hence, we have performed a study in native populations of different high altitude comparing changes in thyroid hormones in western Nepal. The Jharkot population included in this study is at altitude of 3760m and Jomsom population at 2800m height from sea bed. Objective The study is to compare changes in thyroid hormones at two different high altitude natives. Methods To compare thyroid status between high altitude natives at two different altitudes a cross sectional study is performed by random sampling method. The blood sample was collected in a vacutainer from fifty eight individuals after obtaining the informed consent of participants. The blood collected from antecubital vein was centrifuged in an hour and the serum obtained was used for biochemical analysis of free triiodothyronine, free thyroxine and thyroid stimulating hormone. Results Mean free thyroxine (fT4) of Jharkot population is significantly larger (p = 0.001) than Jomsom population. Mean thyroid stimulating hormone (TSH) with p = 0.597, does not indicate the difference between this two population. There is no significant difference between mean free triiodothyronine (fT3) of Jharkot and Jomsom population (p = 0.345). Conclusion The rise in free thyroid hormone at high altitude is not dependent on the thyroid stimulating hormone released from anterior pituitary. The rise in free thyroxine is found at higher altitude and no difference in fT3 level is detected in population studied at high altitudes. KEY WORDS Free triiodothyronine, free thyroxine, TSH, high altitude, t-test