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Browsing by Author "Shah, A"

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    A comparative study of body mass index (BMI) in diabetic and non- diabetic individuals in Nepalese population
    (Kathmandu University, 2006) Shah, A; Parthasarathi, D; Sarkar, D; Saha, CG
    Introduction and Objectives: Diabetes Mellitus (DM) is the most common endocrine disorder world-wide. The prevalence of diabetes mellitus is increasing. In the present study an attempt has been made (i) to examine the relation between obesity and diabetes mellitus in Nepalese people, (ii) to find out whether BMI cut-off points for determining over weight and obesity as per WHO criteria are applicable in Nepalese study population. Materials and methods: The present study was carried out in Manipal College of Medical Sciences (MCOMS) and Manipal Teaching Hospital (MTH), Pokhara. The Diabetic patients of Pokhara and surroundings who attended the 'Diabetic Clinic' and Out Patient Department (OPD) during August 2004 to November 2004 at Manipal Teaching Hospital were included in the present study. The number of diabetic patients was two hundred (200), out of which, one hundred and fourteen (114) were male and eighty six (86) were female. In addition one hundred (100) non- diabetic subjects who attended the OPD at MTH were taken for comparison with the diabetic patients, of which, forty seven (47) were male and fifty three (53) were female. Age, height and weight were recorded for every subject. BMI was calculated by the standard formula. In the present study, body mass index (BMI) of the diabetic subjects was found to be more than that of non-diabetic subjects. BMI of non-diabetic males and females were found to be around 22 kg/m2 which is within normal range as per WHO recommendations. On the other hand, diabetic subjects’ BMI were found to be around 25 kg/m2, which denotes borderline obesity. It is clear from the present study that 51.5% of the diabetic subjects were within the normal range (BMI 18.5-24.9 kg/m2 ). More diabetic subjects were found in over-weight (25-29.9) category than non-diabetic subjects. As per WHO criteria 56% of the non-diabetic subjects were within the normal BMI range (BMI 18.5-24.9 kg/m2). It is also evident that when BMI in the range of 25.0-29.9 kg/m2 is considered as over-weight, only 33% were found to be over-weight in diabetic subjects. But when BMI ≥23 kg/m2 (as recommended for Asians) is taken as the determining factor for overweight, 64% of overweight male subjects and 72.09% of overweight female subjects were found to be diabetic. Conclusion: According to the observations of the present study on Nepalese it can be concluded that BMI cut-off points for determining over-weight and obesity should be lowered to 23 kg/m2 or less which can provide an adequate basis of taking action on risks related to overweight and obesity in Nepal. Key words: Diabetes, Nepalese Population, BMI, Obesity
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    Antimicrobial susceptibility pattern and serotyping of Streptococcus pneumoniae isolated from Kanti Children Hospital in Nepal
    (Kathmandu University, 2010) Rijal, B; Tandukar, S; Adhikari, R; Tuladhar, NR; Sharma, PR; Pokharel, BM; Gami, FC; Shah, A; Sharma, A; Gauchan, P; Sherchand, JB; Burlakoti, T; Upreti, HC; Lalitha, MK; Thomas, K; Steinhoff, M
    Abstract Background: Invasive pneumococcal disease is a significant cause of morbidity and mortality worldwide and it is a major cause for childhood deaths in Nepal. Objectives: The aim of this study was to establish the antimicrobial susceptibility pattern of Streptococcus pneumoniae and perform serotype responsible for pneumococcal disease in Nepal. Materials and methods: All together 3774 children from 2 to 60 months who fulfilled the enrollment criteria for suspect of bacterial pneumonia, sepsis or meningitis were enrolled for etiologic studies of severe illness. During the study period 60 isolates of Streptococcus pneumoniae were isolated and the antimicrobial susceptibility testing and serotyping were performed. Results: The study showed that 24 (52.17%) isolates were resistant to Cotrimoxazole, 3 (6.5%) isolates were intermediately resistant to Penicillin but no Penicillin resistant strains were isolated. The 1 (2.17%) isolate was recorded as Erythromycin and Chloramphenicol resistant and only 1 (2.17%) isolate was found intermediately resistant to Cefotaxime. Of the 60 isolates, serotyping result was available only for 46 isolates. The most common serotypes were serotype 1 (27. 65%) followed by serotype 5 (19.14%) and serotype 4 (8. 5%) respectively followed by serotype 39, 23F, 7F, 19B, 12A, 14, 18F, 6B, 32, 16, 19F and 25F. Conclusions: Alarming level of Cotrimoxazole resistance demands revision of pneumonia treatment policy in Nepal and rising tendency of other drug resistance against Streptococcus pneumoniae showed use of these drugs for the treatment of meningitis, pneumonia and other serious infections needs extended research. The common serotype 1, 5 and 4 need to be incorporated in pneumococcal vaccine to immunise children in Nepal. Key words: Antimicrobial susceptibility, Streptococcus pneumoniae, Serotyping, Nepal
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    Appropriate body mass index cut-off point in relation to type 2 diabetes mellitus in the population of Kavre district
    (Kathmandu University, 2008) Shah, A; Bhandary, S; Malik, SL
    Abstract Objective: The objective of the present study was to find out the appropriate BMI cut-off point in relation to type 2 Diabetes Mellitus (DM) in the population of Kavre district of Nepal. Materials and methods: Thirty-five “known type 2 diabetic” and Thirty-five “self-reported non-diabetic” subjects above thirty years of age were included in the present study. Height and weight were recorded for every subject. BMI was calculated by the standard formula. The data was analyzed using SPSS Version 11.5. Results: Our results showed that the reference BMI range for both diabetic male (23.26 ± 6.88 kg/m2) and diabetic female (22.51 ± 6.28 kg/m2) subjects were within normal BMI range according to WHO. Odds ratio showed an irregular pattern at different BMI ranges indicating the risk of having diabetes did not increase constantly. Comparison of number and percentage of both diabetic and non-diabetic male and female subjects according to various recommended normal BMI categories showed gradual reduction in percentage of both diabetic and non-diabetic male and female subjects that were within normal ranges from BMI category 18.5-24.9 kg/m2 to BMI category 18.5-21.9 kg/m2 .The BMI cut-off point was found 22 kg/m2 using Receiver Operating Characteristic (ROC) curves. Conclusion: The appropriate BMI cut-off point for both men and women was found 22 kg/m2 in the population of Kavre district of Nepal. Key words: BMI cut-off points, Type 2 DM, Kavre district

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