Browsing by Author "Shakya, R"
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Publication A Study on Nutritional Status of Rural School going Children in Kavre District(Kathmandu University, 2015) Mansur, DI; Haque, MK; Sharma, K; Mehta, DK; Shakya, RABSTRACT Background Childhood is a time of active growth in terms of physical size, mental, emotional and psychological development. Normal growth is dependent on adequate nutrition and encompasses major transformations from birth to adulthood. Nutrition is a focal point for health and well being; and has special significance in countries with disadvantages in socioeconomic and hygienic standards. Objective The objective of the present study was to assess the nutritional status in terms of prevalence of underweight, stunting and thinness among rural school going children. Method The present study was cross-sectional study, conducted on 438 rural school going children (169 male and 259 female) with the age group 4-16 years, during the period from April 2014 to July 2014. Age was recorded in year; height and weight were measured in centimeter and kilogram respectively. BMI was calculated by using standard equation. Result The present study concluded that the nutritional status in terms of prevalence of underweight, stunting and thinness were found to be 30.85%, 24.54% and 10.05% respectively among rural school going children of Kavre district. It was revealed that 37.87% was underweight, 29.59% was stunted and 11.25% was thinness among male children whereas in female children, 26.27% was underweight, 21.24% was stunted and 9.27% was thinness. Hence, high prevalence of underweight, stunting and thinness were observed in male than in female children. Conclusion The present study has successfully documented the nutritional status in terms of prevalence of underweight, stunting and thinness among the rural school going children of Kavre district. The results of the present study will be useful for policy makers in their endeavor to formulate various developmental and health care programs. KEY WORDS Age, anthropometry, BMI, children, stunting, thinness, underweight.Publication Association of Waist Circumference and Body Mass Index among the Students of a Medical College(Kathmandu University, 2023) Sharma, K; Mansur, DI; Shakya, R; Maskey, S; Shrestha, A; Nepal, OABSTRACT Background Obesity and overweight have emerged as significant public health concerns on a global scale. In the pursuit of evaluating body composition and identifying potential health risks, two widely utilized measures are Body Mass Index and waist circumference. These anthropometric indicators are considered economical, practical, and also crucial for screening, monitoring the individual’s nutritional status, and anticipating future disease risk. Objective To explore the correlation between waist circumference and Body Mass Index and find out its significance as indicators of health and nutritional status in young adults. Method The study comprises 260 healthy young adults, aged 18-25 years from pre-clinical sciences, Kathmandu University School of Medical Sciences (KUSMS). Anthropometric measurements of height (m), weight (kg), and waist circumference (cm) were recorded. Body Mass Index was calculated by using the formula as body weight (kg) divided by the square of body height (m2). Demographic factors such as age, sex, obesity, and life style factors like smoking, alcohol consumption, and physical activity were noted. Result The study found a positive correlation between Body Mass Index, waist circumference (WC) and weight. However, no association was found between waist circumference and height. The findings also indicated a notably high percentage of 17.69% participants, who were categorized as overweight, while a 9.23% fell into the underweight category. The study confirms that 83.08% of the students have moderate physical activity whereas 14.62% have insufficient and 2.31% have heavy physical activity. Conclusion The study shows a positive correlation between body mass index (BMI) and waist circumference (WC) in young adults aged 18-25 years. KEY WORDS Anthropometric measurement, Body mass index , Obesity, Waist circumferencePublication Development of a Model One Stop Approach to Post-COVID-19 and other Rehabilitation Conditions(Kathmandu University, 2024) Adhikari, P; Tamrakar, D; Thakur, C; Shakya, R; Vaidya, N; Acharya, R; Shrestha, J; Byanju Shrestha, IABSTRACT Background Post-COVID-19 cases can cause severe disabling symptoms and functional disabilities. WHO recognizes the severity of the condition and publishes a standardised Case Report Form to inform clinical management and public health response. Objective To determine the post-COVID-19 case load. A multidisciplinary team including a diverse team were composed and priority intervention areas were identified through a transdisciplinary approach eventually developing a Model One Stop Approach to post-COVID-19 and other Rehabilitation Conditions. Method The COVID-19 cases recorded at Dhulikhel Hospital were monitored through phone calls to post-COVID-19 complications. Patients were then invited for additional clinical assessments. A diverse team conducted these assessments to identify the needs for expanding a post-COVID-19 clinic and devised rehabilitation services based on predefined criteria. Result A total of 550 respondents were included in the study. The proportion of males (51.7%) was slightly higher than females (48.3%) with the majority of them being Brahmin/Chettri. The primary comorbidities identified were diabetes (10.55%) and hypertension (11.4%). Of the participants, about 50.73% experienced persistent symptoms. About 17.8% reported lasting muscle-related problems, 12.1% had persistent joint pain, and 33% faced temporary cardiac issues. Less than 10% experienced enduring health problems related to vision, hearing, and sleep patterns. Conclusion After COVID-19, patients experienced cardiac and muscle-related issues, increasing morbidity, financial burdens, and pressure on healthcare systems. With the need of sustainable rehabilitation training package, Dhulikhel Hospital serves as a model for a One-Stop Approach to post-COVID-19 and other rehabilitation conditions. KEY WORDS Model, Persistent, Post-COVID-19, Rehabilitation, SymptomsPublication Differential Hepatotoxic Effects of Sodium Valproate at Different Doses in Albino Rats(Kathmandu University, 2018) Shakya, R; Hoque, MK; Sapkota, AS; Gupta, PKABSTRACT Background Liver plays an essential role for transforming and clearing chemicals that may cause harmful effects to it. Sodium Valproate, renowned to be a potent antiepileptic drug, when taken in overdose may cause toxic effects to liver and other organs as well. Liver damage can be assessed with histological changes and measurement of enzymes produced by it. Objective To investigate the histological changes induced by different doses of Sodium Valproate ranging from 100-500 mg/kg/day and observe its correlation with liver enzymes level in serum. Method Three-months old albino rats were divided into six groups, five in each. Control group was treated with normal saline and rest five groups with Sodium Valproate in different doses 100, 200, 300, 400 and 500 mg/kg/day respectively. Then, liver of those experimented rats were examined histologically under the light microscope. Furthermore, Liver enzymes; Alanine Transaminase and Aspartate transaminase were measured to assess the micro-anatomical changes in liver. Result Distorted hepatic lobular architecture with aggregations of nuclei at certain interval was observed in the groups of higher doses; 300 mg/kg/day and above. However, accumulation of adipocytes was observed in all the Sodium Valproate treated rats unlike the control group. When compared the enzyme levels among the groups, it was found to be significantly increased in dose dependent manner. Besides, it also showed skin lesions in all rats treated with the dose 400 mg/kg/day and above. Conclusion Higher doses of Sodium Valproate; 300 mg/kg/day and above induces hepatotoxicity and skin lesions in adult albino rats. KEY WORDS Hepatotoxicity, Liver enzymes, Sodium valproatePublication Management of antitubercular drugs-induced hepatotoxicity and therapy reintroduction strategy in a TB clinic of Nepal(Kathmandu University, 2005) Shakya, R; Rao, BS; Shrestha, BBackground: PZA, INH and R have potential for hepatotoxic side effects. Although anti-tuberculosis drug-induced hepatotoxicity is well known, there is no agreement on the clinical approach for cases in whom hepatotoxicity has developed. Objective: To study the management of anti-TB-drugs induced hepatotoxicity and the standard anti-TB drugs therapy reintroduction procedure. Design: In prospective cohort analysis, 4 patients with active TB infection had developed anti-TB drugs induced hepatotoxicity. Retreatment of therapy was done on the basis of severity of hepatitis. If damage is mild, all the drugs were reintroduced at once in a tapering dose and if patient’s condition is worse, INH and E is introduced in lower dose, later increasing the dose and the number of drugs. Results: All the patients tolerated anti-TB drugs well after reintroduction. There was no incidence of recurrence. All the patients completed their 8 months treatment regimen and all are cured. Conclusion: Timely detection and temporary withdrawal of the offending agent can completely cure anti-TB drugs-induced hepatotoxicity. The recurrence of hepatotoxicity is rare if reintroduction in done in a well planned manner.Publication Medication Adherence to Oral Hypoglycemic Agents Among Type II Diabetic Patients and Their Clinical Outcomes with Special Reference to Fasting Blood Glucose and Glycosylated Hemoglobin Levels(Kathmandu University, 2013) Shrestha, SS; Shakya, R; Karmacharya, BM; Thapa, PABSTRACT Background Oral hypoglycemic agents (OHAs) are the major treatment for people with type 2 diabetes mellitus (DM2). However, non-adherence to OHAs remains as one of the main reasons for poor glycemic control. Objectives To assess the adherence pattern to OHAs and clinical outcomes with special reference to fasting blood glucose (FBG) level and glycosylated hemoglobin (HbA1c) levels. Methods Informed consent was obtained from patients fulfilling the criteria and from the patient party in case of incapacitated patients. Information was obtained by interviewing them and filled in the appropriate questionnaire. All the medical information of the patients was obtained from the medical case records and laboratory reports. Results OHAs had been discontinued by 25% of patients. Overall 38% had ever discontinued and/ or often missed OHAs. Intentional discontinuation of OHAs attributed for 72% of the patients, followed by forgetfulness (42.9%), carelessness (30.6%), and hypoglycemia, (24%). There were 50.50% patients who had uncontrolled FBG (>130 mg/dl) level and 39% had uncontrolled HbA1c (≥ 7%) level. Taking reference age group 51-60 years, control of FBG level was found to be statistically associated with the decreasing age group (p = 0.006, OR = 4.8) as well as increasing age group (p = 0.008, OR = 4.034). There was significant association between controlled HbA1c level and patients’ knowledge about the precautions to be taken while using OHAs (p = 0.044, OR = 4). However, there was no significant association between glycemic control and OHAs adherence. Conclusion Majority of the patients who had missed OHAs attributed it to forgetfulness. Hypoglycemia may also be one of the contributing factors for poor adherence to OHAs. However no association was found between adherence and various other factors like age groups, treatment complexity, health literacy and social or family support. KEY WORDS Adherence, diabetes, HbA1c, hypoglycemia, non-adherencePublication Morphometric Analysis of Clavicle in Nepalese Population(Kathmandu University, 2011) Haque, MK; Mansur, DI; Krishnamurthy, A; Karki, R; Sharma, K; Shakya, RABSTRACT Background Determining the sex of deceased is easy when a complete skeleton is available for examination. On the whole, the bones are heavier, larger and markings of muscular attachments are more pronounced in the male than in the female. Objective The purpose of this study was attempted to evolve an easily applied formula to enable the assessment of sex in an unknown clavicles and to know about comparative differences between the right and left clavicles, from certain metrical parameters. Methods The study was an observational, cross-sectional and descriptive in nature. The present study was conducted on 257 adult clavicles out of which, 135 were of the right side and 122 of left side. The maximum length of the clavicle (in mm) was taken. Results The length of the right clavicles varies from 108 mm to 178 mm with an average of 143.21 mm ±11.13 mm S.D. The length of the left clavicles varies from 111mm to 181 mm with an average 145.53 mm ±11.04 mm S.D. It has been observed that the left clavicle was longer than the right clavicle by 2.32 mm. There was no such single character which can determine the sex of all clavicles. Depending on the length alone, the sex can be decided in 13.33% male and 4.44% female right clavicles and 16.39% male and 9.83% female bones if the left clavicle is considered. Conclusion The left clavicle was longer than the right clavicle. The determination of sex from the clavicle has a great medico legal significance to the toxicologists. It also helps the anthropologists in their study of evolution of mankind and migration of races. KEY WORDS Clavicle, card board, measuring tape, thread, vernier caliperPublication Use of Head Circumference as a Predictor of Height of Individual(Kathmandu University, 2014) Mansur, DI; Haque, MK; Sharma, K; Mehta, DK; Shakya, RABSTRACT Background Establishing personal identity is one of the main concerns in forensic investigations. In forensic anthropology, estimation of height from head circumference has a significant role in establishing personal identity. Objective The objective of the present study was an attempt to understand the relationship between height and head circumference of an individual and to derive regression formulae to estimate the height from the head circumference. Method The present study consisted of 440 (258 male and 182 female) students of age group 17 to 25 years studying in Kathmandu University School of Medical Sciences, Dhulikhel, Nepal during the period from November 2012 to October 2013. Height and head circumference of an individual were measured in centimeter. Data were analyzed by using statistical software SPSS-16 Result The findings of the present study were significant correlation between height and head circumference (r = 0.443, p < 0.01 for male, r = 0.302, p<0.01 for female, and r = 0. 398, p < 0.01 for combined (male and female). The regression equation for height and head circumference was found to be Y = 1.734X + 70.36 (R2 = 0.196) for male, Y = 0.916X + 106.8 (R2 = 0.091) for female, and Y = 1.648 X + 71.69 (R2 = 0.158) for combined (male and female), where Y is the height of Individual and X is the Head Circumference. Conclusion Head circumference showed highly significant positive correlation with individual’s height. Therefore, the present study will help in medico-legal cases in establishing the identity of an individual and this would also be useful for Anatomists and Anthropologists. KEY WORDS Forensic anthropology, head circumference, height of individual