Accuracy of Glucose Meter Among Adults in a Semi-urban Area in Kathmandu, Nepal

Introduction: Glucose meters are gaining popularity in monitoring of blood glucose at household levels and in health care set-ups due to their portability, affordability and convenience of use over the laboratory based reference methods. Still they are not free of limitations. Operator’s technique, extreme temperatures, humidity, patients’ medication, hematocrit values can affect the reliability of glucose meter results. Hence, the accuracy of glucose meter has been the topic of concern since years. Therefore, present study aims to evaluate the analytical and clinical accuracy of glucose meter using International Organization for Standardization 15197 guideline. Methods: A community based descriptive cross-sectional study was conducted in Kapan, Kathmandu, Nepal in April 2018. Glucose levels were measured using glucose meter and reference laboratory method simultaneously among 203 adults ≥20 years, after an overnight fasting and two hours of ingestion of 75 grams glucose. Modified Bland-Altman plots were created by incorporating ISO 15197 guidelines to check the analytical accuracy and Park error grid was used to evaluate the clinical accuracy of the device. Results: Modified Bland-Altman plots showed>95% of the test results were beyond the acceptable analytical criteria of ISO 15197:2003 and 2013. Park Error Grid-Analysis showed 99% of the data within zones A and B of the consensus error grid. Conclusions: Glucose meter readings were within clinically acceptable parameters despite discrepancies on analytical merit. Possible sources of interferences must be avoided during the measurement to minimize the disparities and the values should be interpreted with caution.

Changes in the Liver Function and Hematological Parameters in Dengue Patients at a Tertiary Care Center: A Descriptive Cross-sectional Study

Introduction: Liver is most commonly affected in dengue often resulting in changes in the liver function test parameters. Alterations in hematological parameters are also reported which could serve as early prognostic markers especially in resource limited settings where serological tests for the diagnosis of dengue is not available. This study aims to analyze liver function test and hematological parameter changes in dengue infected patients. Methods: A descriptive cross-sectional study was conducted from December 2022 to October 2023 in serologically dengue positive patients. Liver function parameters and blood parameters were analyzed from 220 patients. The purposive sampling technique was employed during the selection of participants. Results: Out of 220 study participants, 113 (51.36%) were males and 107 (49.64%) were females. The median age of the participants was 35 years (IQR: 26 - 48 years). Elevated serum AST and ALT levels were present in 121 (55%) and 80 (36.36%) of the participants respectively. Thrombocytopenia and leukopenia were observed in 92 (41.82%) and 88 (40%) of the study participants respectively. The median hemoglobin level was 14.4 (IQR: 13-15.47) g/dl. Low hemoglobin level was found in 31 (14.09%) participants. The median red blood cell count was 4.91 (IQR: 4.49 – 5.28) millions/mm3 with decreased red blood cell count noted in 27 (12.27%) participants. Conclusions: Increased serum transaminases levels, thrombocytopenia and leukopenia are common laboratory findings in dengue patients

VARIABILITY OF ROOT AND AGRO-MORPHOLOGICAL TRAITS, AND GRAIN YIELD OF ELITE SPRING WHEAT LINES DEVELOPED FOR HIGH TEMPERATURE TOLERANCE

A set of fifty bread wheat genotypes that comprised of 49 high temperature tolerant lines from CIMMYT and a local check Gautam were evaluated for root, early vigor and agro-morphological traits at the research farm of Agriculture and Forestry University, Rampur during the winter season 2016/2017 under late sown condition to facilitate screening for post anthesis heat stress. The experiment was laid out following Alpha Lattice design with two replications. Significant differences were observed in the field experiment for number of roots, root length of field (assessed at Zadok's growth stage 12), days to booting, heading, flowering, flag leaf senescence and maturity among the studied genotypes. Similarly, significant differences were observed  for plant height, grains per spike, thousand grain weight, grain yield, biomass yield, harvest index, canopy temperature depression 10 days after flowering (CTD-2), SPAD reading immediately after flowering (SPAD-1), 10 days after flowering (SPAD-2) and 20 days after flowering (SPAD-3), flag leaf area and  number of tiller per square meter. The mean root length was 8.24 cm. The mean grain yield was 3.23 ton ha-1. 15HTWYT-41 had the highest yield 4.35 ton ha-1 followed by 15HTWYT-38, 15HTWYT-30 and 15HTWYT-42 while genotype Gautam had 2.83 ton ha-1. Thirty seven genotypes out-numbered local check Gautam in terms of yield.  Biomass yield, number of grain per spike and CTD-2 were found to be the major traits. Correlation analysis revealed significant positive correlation between grain with flag leaf area, plant height, number of grain per spike, biomass yield, harvest index, thousand kernel eight, SPAD-1, SPAD-2. Days to booting, days to heading and days to flowering showed negative significant correlation with the grain yield. From the overall analysis, genotypes 15HTWYT-41, 15HTWYT-38 15HTWYT-30 15HTWYT-42 performed superior to the check Gautam

The Personal Social Networks of Resettled Bhutanese Refugees During Pregnancy in the United States: A Social Network Analysis

Women comprise 50% of the refugee population, 25% of whom are of reproductive age. Female refugees are at risk for experiencing significant hardships associated with the refugee experience, including after resettlement. For refugee women, the strength of their personal social networks can play an important role in mitigating the stress of resettlement and can be an influential source of support during specific health events, such as pregnancy. A personal social network analysis was conducted among 45 resettled Bhutanese refugee women who had given birth within the past 2 years in the Akron Metropolitan Area of Northeast Ohio. Data were collected using in-depth interviews conducted in Nepali over a 6-month period in 2016. Size, demographic characteristics of ties, frequency of communication, length of relationship, and strength of connection were the social network measures used to describe the personal networks of participants. A qualitative analysis was also conducted to assess what matters were commonly discussed within networks and how supportive participants perceived their networks to be. Overall, participants reported an average of 3 close personal connections during their pregnancy. The networks were comprised primarily of female family members whom the participant knew prior to resettlement in the U.S. Participants reported their networks as “very close” and perceived their connections to be supportive of them during their pregnancies. These results may be used to guide future research, as well as public health programming, that seeks to improve the pregnancy experiences of resettled refugee women

Factors Associated with the Presence of Strong Social Supports in Bhutanese Refugee Women During Pregnancy

Social support may mitigate stress related to the refugee experience, including during resettlement. For refugee women, social support can play an important role during pregnancy. In-depth interviews were conducted within a sample of 45 Bhutanese refugee women. Perceived social support was measured using the Norbeck Social Support Questionnaire. Averaged social support scores are reported to account for personal network size. Participants were identified as “low support” and “high support” based on their reported score. The mean social support score reported was 18.9. Participants experiencing a secondary resettlement within the U.S. were 4.52 (95% CI 1.19–17.15) times as likely to report a “high support” network compared to participants who resettled directly from Nepal. Personal social networks are an important source of support for resettled refugee women during pregnancy in the U.S.. Refugee women who experience secondary resettlement may perceive stronger support from their personal connections

Correlation of Serum Uric Acid and Lipid Profile in Patients with Type 2 Diabetes Mellitus

Background: Diabetes complication poses a new challenge in Nepal as the disease is becoming endemic. Identifying risk factor for diabetes can be an essential step in preventing complication related to diabetes. Abnormal Uric acid and lipid profile are the important risk indicators of diabetes mellitus complications, so the study was done to know the association between uric acid and lipid profile in type 2 diabetes. Methods: A cross-sectional study was done from 118 patients with type 2 diabetes mellitus visiting Nepal Medical College and Teaching Hospital. Three ml of venous blood was analyzed for fasting blood glucose, uric acid, and lipid profile. Correlational analysis was done between fasting blood glucose with triglycerides, high density lipoproteins and uric acid. Results: A significant positive correlation between fasting blood glucose and triglyceride (r =.211, p = .022) was found in diabetic. There was significant negative correlation of fasting blood glucose with uric acid (r = -.196, p =.034) and high-density lipoprotein cholesterol (r = -.181, p = .049). Uric acid was also found to have significant positive correlation with triglyceride (r = .235, p = .010) and negative correlation with high density lipoprotein cholesterol (r = -.420, p = .000). Conclusions: Negative correlation of serum uric acid with fasting blood glucose and high-density lipoprotein and positive correlation with triglycerides suggests a possible connection of uric acid as a risk factor for diabetes. Keywords: Diabetes mellitus;f blood glucose; lipid profile; uric aci

Cardiovascular Risk Assessment in Hemodialysis Patients

Cardiovascular diseases are the leading cause of death in hemodialysis patients. We aimed to evaluate non-traditional cardiovascular risk factors: homocysteine, high sensitive C-reactive protein, oxidized LDL antibodies, phosphate, and red cell distribution width in chronic kidney disease patients under maintenance hemodialysis along with traditional cardiovascular risk factors like age, hypertension, diabetes mellitus, among others. A total of 78 diagnosed chronic kidney disease patients under maintenance hemodialysis visiting a tertiary care center were included in the study, of which 59% were male. Hyperhomocysteinemia was present in 79.5% of the participants, with the median homocysteine level being 28.43 µmol/L. The median hsCRP level was 4.74 mg/L, and 59% and 24.4% of the total participants were at high and moderate cardiovascular risk respectively. The median oxidized LDL antibody level was 4235 U/mL, which is within the reference range. The median red cell distribution width was 14.05%, which is within the normal range. Left ventricular hypertrophy, a common cardiovascular disease in such patients, was found in 55.13% of the participants. Serum homocysteine level was significantly higher in patients with left ventricular hypertrophy, whereas serum C- reactive protein level was significantly lower in patients with left ventricular hypertrophy. The mean serum phosphate was 6.23 mg/dL (i.e. higher than normal) and hyperphosphatemia was seen among 76.9% of the patients. The mean age of the patients was 47.5 years, which is distinctly lower when compared to the hemodialysis patients in the Western population. The prevalence of hypertension, diabetes mellitus, and anemia were 95%, 18.25%, and 92.3%, respectively

Artemisinin derivatives as potential drug candidates against <i>Mycobacterium tuberculosis</i>: insights from molecular docking, MD simulations, PCA, MM/GBSA and ADMET analysis

Tuberculosis, one of the most ancient and formidable infectious diseases, primarily arises from the pathogenic bacterium Mycobacterium tuberculosis (Mtb). Phosphoenolpyruvate carboxykinase (Pck), a potential drug target, is essential for the growth of Mtb that involves in the pathway of gluconeogenesis at the centre of phosphoenolpyruvate-pyruvate-oxaloacetate node. This study aims to understand drug-like properties of the compounds derived from artemisinin, and to investigate their inhibitory roles against Mtb. Molecular docking was performed on a set of 56 artemisinin compounds to identify their binding efficacy to the Mtb protein target. Subsequently, the selected top three complexes were subjected to molecular dynamics simulations. By the trajectory analysis, root mean square deviation and radius of gyration indicated the compactness of the systems without much fluctuation. The principal component analysis revealed that the complexes were less dynamic and energetically more favourable, and Gibbs energy landscape revealed the favourable energetic transitions between conformations. The artemisinin dimer primary alcohol holding good bioavailability scores appears highly stable in complex with Pck (MM/GBSA of −37.67 kcal/mol) that stands as a potential inhibitor of the Mtb target. However, further preclinical experiments and investigations are necessary to evaluate the intrinsic properties and to confirm effectiveness of the drug candidate.</p