Journal Issue: No 1, Issue 17, JAN-MAR, 2007
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Volume
1
Number
Issue Date
Journal Title
Journal ISSN
1812-2027
1812-2027
1812-2027
Journal Volume
Articles
Involvement of HIV positive persons in AIDS prevention activities
(Kathmandu University, 2007) BK, Suvedi
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Prevalence of peripheral arterial disease by ankle-brachial index and its correlation with carotid intimal thickness and coronary risk factors in Nepalese population over the age of forty years
(Kathmandu University, 2007) HS, Sodhi; SK, Shrestha; R, Rauniyar; B, Rawat
Objectives: Noninvasive measures of subclinical atherosclerosis such as the ankle brachial index (ABI) and
common carotid artery intima-media thickness (CCA IMT) could improve risk prediction and provide more focused
primary prevention strategies. This report describes the prevalence of subclinical atherosclerotic vascular disease in
a Nepalese population over the age of forty years as measured by ABI and CCA IMT and their association with
established cardiovascular risk factors.
Materials and methods: Ultrasonic evaluation of ABI and CCA IMT was done in 195 individuals of age 40 years
and above who had presented to an outpatient department. Patients with established diagnosis of coronary artery
disease or symptomatic for peripheral arterial disease were excluded from the study.
Results: The prevalence of atherosclerotic disease as measured by ABI was 18.5% and there was a statistically
significant correlation between ABI and CCA IMT and other established cardiovascular risk factors such as
smoking, diabetes mellitus and hypertension.
Conclusions: We recommend that ABI as measured by sphygmomanometer be incorporated into routine
cardiovascular screening and when found to be abnormal further confirmed by Doppler assessment of ABI and CCA
IMT as surrogate markers of atherosclerotic vascular disease.
Key words: atherosclerosis, cardiovascular disease, peripheral vascular disease, carotid arteries
Prescribing patterns in the orthopaedics outpatient department in a teaching hospital in Pokhara, western Nepal
(Kathmandu University, 2007) PR, Shankar; R, Pai; AK, Dubey; DK, Upadhyay
Objectives: Information on the utilization patterns of drugs in the orthopaedics outpatient department (OPD) are
lacking in hospitals in western Nepal. The present study was carried out to obtain demographic information about
the respondents selected for analysis, information on the average number of drugs prescribed and the average cost of
drugs per prescription. The prescriptions were critically analyzed using predetermined criteria.
Materials and methods: The study was carried out over a four-month period (01.09.2002 to 31.12.2002) at the
Manipal Teaching hospital, Pokhara, Nepal. The percentage of encounters with an injection or an antibiotic
prescribed was noted. The percentage of drugs prescribed from the Essential drug list of Nepal and the mean cost of
drugs per prescription was calculated.
Results: 1238 patients attended the orthopaedics OPD during the study period. 186 prescriptions were randomly
selected for analysis. The mean number of drugs per prescription was 1.9. Low backache was the most common
reason for attending the OPD. Nonsteroidal anti-inflammatory drugs (NSAIDs) were the most commonly prescribed
drug group. Diclofenac and meloxicam were the most commonly prescribed drugs. Mean cost of drugs was 166.2
Nepalese rupees. Injections and antibiotics were prescribed in 16 (8.6%) and 7 (3.8%) encounters respectively. 51
prescriptions (27.4%) had various problems. Absence of diagnosis on the prescriptions and the duration of treatment
were most commonly observed.
Conclusions: Percentage of prescribing by generic name was low. Educational sessions for the doctors at different
levels to encourage prescribing by generic names and on correct writing of prescriptions may be considered. Studies
covering a larger number of patients and for a longer time period are required. A greater number of patients can be
studied, seasonal variations can be overcome and drug utilization can be measured quantitatively.
Key words: Drug use patterns, Drug utilization studies, NSAIDs, Prescription audit, Tertiary care hospital
Tuberculosis and other clinical presentation of HIV/AIDS in patients with or without undergoing antiretroviral therapy in Kathmandu
(Kathmandu University, 2007) GP, Dhungana; P, Ghimire; S, Sharma; BP, Rijal
Objectives: To screen tuberculosis (TB) and examine the clinical presentation of AIDS in HIV sero-positive
persons.
Methods: A Cross-sectional study was designed. One hundred HIV infected persons were randomly selected from
different parts of the country visiting Tribhuvan University, Teaching Hospital, Kathmandu and different HIV/AIDS
care centres. After taking informed consent, questionnaires were filled and three sputum specimens from each
person were collected to investigate tuberculosis by Ziehl-Neelsen staining and culture. Data generated were entered
into SPSS 11.5 and relevant statistical tools were applied.
Results: Among 100 HIV infected cases, 66 (66%) were males and 34 (34%) were females. Sixty percent of the
cases were in the age group of 21-30 years. Majority of them were Smokers (41%), alcoholics (34%), illiterates
(54%) and unemployed (59%). Heterosexual activity (51%) was found to be the major risk factor for HIV infection.
Of the 100 HIV cases, 23 (23%) were co-infected with tuberculosis of which 18(78%) were sputum smear negative
tuberculosis, mostly developed in late stage of HIV infection. Weight loss (54%) and diarrhoea (43%) were the
major clinical presentations of AIDS. Antiretro-viral therapy non-receiver were more likely to suffer with
various clinical disorders/TB as compared to ARV therapy receiver but the values were statistically
insignificant, χ2 values ranging from 0.003 to 2.24, p>0.05.
Conclusion: Prevalence of tuberculosis was still high in HIV/AIDS patients, and specifically, sputum smear
negative tuberculosis cases constituted the significant proportion, particularly in late stage of HIV infection. Weight
loss and diarrhoea were found to be the major clinical presentation of AIDS. Illiterate and unemployed young adults
involved in unsafe sexual practice and drug addiction were high risk of acquiring HIV infection.
Key words: Clinical features, HIV/AIDS, Kathmandu; Smear Negative Tuberculosis