Browsing by Author "Sharma, D"
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Publication Impact of Adolescent’s Obesity in Cardiac Function: An Association of Cardiac Structural and Metabolic Risk Factors with Physical Fitness(Kathmandu University, 2023) Yadav, RL; Yadav, LK; Mahotra, NB; Sharma, DABSTRACT Background Elderly obese results metabolic, cardiac structural and functional derangements. However, such alterations including physical fitness in early age obesity are still controversial. Objective To evaluate physical fitness, cardiac structural, functional and metabolic remodeling and their association with obesity markers in adolescents. Method This cross-sectional comparative study included 90 adolescents with median age -14(2) years were grouped into Normal weight (NW) and Overweight/Obese (OW/OB) based on the BMI percentile for age and sex. International Diabetes Federation criteria for adolescents selected for lipid profiles, fasting sugar, systolic (SBP) and diastolic blood pressure (DBP). Echocardiographic standard 2-dimensional measurements for cardiac structures, percent ejection fraction (EF%) were performed with standard procedure. Physical fitness index (PFI) was graded using the modified Harvard step test. The data compared with Mann Whitney U test and Spearman’s Rank correlation test used to find association among study variables. Result Compared to normal weight adolescents, overweight/obese individuals exhibited significantly higher cardiac function parameters, including heart rate, systolic and diastolic blood pressure. Within the realm of cardio-metabolic parameters, it was observed that individuals exhibited diminished levels of high-density lipoproteins and elevated levels of low-density lipoproteins. Notably, these individuals manifested cardiac structural remodeling characterized by augmented left atrial wall and aortal base thickness, and increased left ventricular end-diastolic diameter, concomitant with a markedly decreased percentage of left ventricular ejection fraction. Cardiac structural and functional parameters revealed adverse correlation with obesity markers. Conclusion The onset of obesity in early age has been ascertained to exert profound ramifications, encompassing not solely metabolic and biochemical parameters, but also extending to the structural integrity of the cardiovascular system. These outcomes synergistically contribute to a notable attenuation in overall physical fitness. KEY WORDS Adolescent’s obesity, Body mass index percentile, Cardiac structure, Lipid profile, Physical fitnessPublication Prevalence of Hepatic Hydrothorax in Patients with Chronic Liver Disease Presenting in Tertiary Center of Nepal(Kathmandu University, 2024) Shankhadev, A; KC, S; Karki, N; Sharma, D; Pradhan, PABSTRACT Background Hepatic hydrothorax is a common cause of pleural effusion in chronic liver disease. It is associated with poor outcome of the disease. Objective To study the prevalence of hepatic hydrothorax in patient with chronic liver disease. Method A hospital based prospective observational study conducted from July 15, 2022 to July 15, 2023. Diagnostic thoracentesis was performed to the patients presenting with pleural effusion at the time of admission. Chest x-ray was repeated at day 7 to assess the outcome of the appropriate treatment. Result Out of 752 enrolled participants, 105 were diagnosed with pleural effusion. The predominant cause was hepatic hydrothorax (80%), followed by tuberculosis (13.3%). 26.2% experienced spontaneous bacterial empyema. Most of the patients (74%) were classified as Child-Pugh C score. The prevalence of hepatic hydrothorax was 11.17%. Among 84 patients with hepatic hydrothorax, the mean age was 49.42±11.93 years, with a male predominance (male to female ratio, 68:32). Hepatic hydrothorax primarily occurred on the right side (78.6%), followed by left (15.5%) and bilaterally (6%). Mild hepatic hydrothorax was most common (48.8%), followed by moderate (31%) and massive (20.2%). About 65.5% were improved with treatment, while the mortality rate was 34.52%. Renal causes were the most common cause of death, accounting for 58.62% of mortalities. Conclusion Hepatic hydrothorax was prevalent in 11.17% of patients. It predominantly occurred on right side, with advanced Child Pugh score and often associated with spontaneous bacterial empyema (26.2%). The condition carried a mortality rate of 34.52%, with renal causes accounting for the majority of deaths (58.62%). All pleural effusions in chronic liver disease should undergo prompt evaluation because it is often associated with various complications and carries high mortality rate. KEY WORDS Ascites, Chronic liver disease, Hepatic hydrothorax, Prevalence, Spontaneous bacterial empyema, TuberculosisPublication Refractive Errors and Visual Anomalies in Schoolchildren in the Kavrepalanchowk District(Kathmandu University, 2010) Marasini, S; Sharma, R; Sthapit, PR; Sharma, D; Koju, U; Thapa, G; Nepal, BPABSTRACT Background Schoolchildren form an important target group for a nation, as any ocular morbidity in this age group has huge physical, psychological and socio-economical implications. Childhood eye disorders can contribute to the burden of blindness in any society. This study aims to highlight the prevalence of ocular morbidity in governmental schools in a sub-urbanised area of Nepal, in relation to ethnic variation. Methods A descriptive study, and the study population used were schoolchildren who were examined in their schools and afterwards referred to the hospital if required. Presenting and best corrected visual acuity, refraction, binocularity assessment, anterior and posterior segment evaluation was carried out. Data was analysed statistically using SPSS software, version 14. Results We examined 1,802 school children. The mean age was 10.78±3.61 years. Ocular abnormality was detected in 11.7%. Low vision and blindness was rare (0.11% and 0.05%). Ocular morbidities were more common in Newar communities (3.71%) followed by Brahamans (3.38%). Lid abnormalities were the most common (3.55%), and morbidities in each ethnicity were followed by refractive errors (3%), conjunctival abnormalities (1.10%), strabismus (0.88%) and amblyopia (0.33%). Refractive errors were most common among Newar communities (1.16%) at almost twice as many Brahamans (0.61%) followed by Mongolians (0.49%). Convergence insufficiency was detected in 2.49% (p<0.01). Conclusions Ocular morbidities are common in children in Kavhrepalanchowk District with lid abnormalities being the most common issue, probably due to a lack of hygienic practice. Ethnic variation of ocular morbidities is an important observation mostly for refractive error and strabismus. Key Words blepharitis, blindness, ethnicity, oculo-visual, visual acuity