Browsing by Author "Pyakurel, M"
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Publication Burden of Stroke in Nepal: Findings from Global Burden of Disease Dataset 2017(Kathmandu University, 2021) Pyakurel, M; Bhattarai, S; Joshi, B; Koju, RP; Shrestha, AABSTRACT Background Stroke is the second leading cause of death and disability worldwide including Asian countries, surpassing ischemic heart disease. Stroke accounts for 10% of global death, of which more than three fourth occur in low- and middle-income countries. An exact estimate of the burden of stroke in Nepal is not available. Objective To assess the burden of stroke including disability and death over time in Nepal and compare it with other South Asian countries. Method We retrieved data from the Institute of Health Metrics and Evaluation’s Global Burden of Diseases database of 2017 on stroke deaths, disability-adjusted life years, incidence, and prevalence rates, for both genders from Nepal, Bangladesh, Pakistan, Bhutan, and India by year. We assessed the trend of deaths and Disability-Adjusted Life Years (DALYs) due to stroke from 1990 to 2017; and the contribution of major risk factors to stroke burden in 2017. Result Stroke contributed 7.6% of total deaths and 3.5% of total DALYs in Nepal, with a higher burden among the male and old age population. Intracerebral hemorrhage was the dominant type of stroke in Nepal with the highest proportion of deaths and DALYs. Among the South Asian countries, incidence, prevalence, and burden of stroke were highest in Bangladesh. Intracerebral hemorrhage contributed the highest DALYs in South Asian countries. High systolic blood pressure was contributing the maximum DALYs due to stroke in Nepal. Conclusion Hemorrhagic stroke causes high mortality and DALYs in Nepal. Most of the burden of stroke is attributed to high blood pressure in Nepal. KEY WORDS Global burden of disease (GBD), Nepal, Prevalence, Risk factor, StrokePublication Dietary Salt Intake in a Suburban Nepali Community: A Cross-sectional Study Using 24-Hour Urinary Sodium(Kathmandu University, 2025) Bhatt, RD; Shrestha, A; Karmacharya, BM; Timalsena, D; Dhimal, MN; Pradhan, P; Oli, N; Bista, D; Pyakurel, M; Barakoti, R; Mishra, R; Risal, PABSTRACT Background High dietary salt intake is a recognized contributor to hypertension and cardiovascular diseases, particularly in low- and middle-income countries. Despite the high burden of hypertension in Nepal, robust estimates of salt intake using the gold standard 24- hour urinary sodium collection remain scarce, especially in suburban populations. Objective To accurately assess dietary salt intake using 24-hour urinary sodium excretion and evaluate factors influencing salt consumption in a suburban Nepali population. Method A cross-sectional study was conducted in 2023-2024 as part of the Dhulikhel Heart Study’s second phase. A total of 381 adult participants were recruited from randomly selected wards of Dhulikhel Municipality. Data on sociodemographic characteristics, dietary habits, salt-related knowledge, and anthropometry were collected. Salt intake was estimated from 24-hour urinary sodium excretion. Generalized Estimating Equations (GEE) and multivariate analyses were used to identify associated factors. Result The mean age of the participants was 49.9 ± 15.5 years and average salt consumption was 9.55 ± 3.2 g/day. The mean dietary salt intake significantly exceeded WHO recommendations, with notable variations by sex, education, and frequency of eating out. Conclusion This study highlights alarmingly high salt intake in a suburban Nepali community and underscores the need for population-specific strategies to reduce sodium consumption. Policy action, public education, and promotion of healthier dietary behaviors are essential to combat the growing burden of salt-related non- communicable diseases. KEY WORDS Blood pressure, Dietary salt intake, 24-hours urine sodium