Seeking laboratory investigations by diabetic patients during COVID-19 lockdown of Eastern Nepal

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The Sensor Management for Applied Research Technologies (SMART) Project

NASA seeks on-demand data processing and analysis of Earth science observations to facilitate timely decision-making that can lead to the realization of the practical benefits of satellite instruments, airborne and surface remote sensing systems. However, a significant challenge exists in accessing and integrating data from multiple sensors or platforms to address Earth science problems because of the large data volumes, varying sensor scan characteristics, unique orbital coverage, and the steep "learning curve" associated with each sensor, data type, and associated products. The development of sensor web capabilities to autonomously process these data streams (whether real-time or archived) provides an opportunity to overcome these obstacles and facilitate the integration and synthesis of Earth science data and weather model output

Experimental, numerical and field study investigating a heritage structure collapse after the 2015 Gorkha earthquake

This paper presents an investigation of the collapse of a 325-year-old multi-tiered heritage temple during the 2015 Gorkha earthquake in Kathmandu, Nepal. The research comprises a reconnaissance survey followed by a geotechnical investigation and numerical back-analysis carried out to understand the potential causes of the collapse. The assessment of the structural configuration of the temple indicated seismic vulnerability in the design due to the presence of discontinuous columns over the height of the temple and age-weakened bonding in the masonry walls. The geotechnical investigation revealed the presence of competent soil strata at the location, assisting the survey which indicated no differential or excessive settlement in the foundation. A series of cyclic triaxial tests were conducted on samples recovered during the geotechnical investigation to determine dynamic behaviour of the soil. Further, dynamic analysis of the plinth of the temple under the recorded acceleration–time history indicated a maximum drift percentage of 1.4% and residual relative displacement of 32 mm suggesting the potential reason behind the collapse. The output of this research will support seismic rehabilitation of ancient structures within World Heritage sites across Nepal and effective action plans to safeguard them against future earthquake hazard

Primary hyperparathyroidism in India: A cocktail of contemporary and classical presentations: Lesson from 47 cases

Primary hyperparathyroidism (PHPT) is now the contemporary form of previously existing classical disease, which is increasingly diagnosed due to hypercalcemia with asymptomatic form predominant in developed countries, whereas symptomatic form predominant in developing countries. So, we highlighted important subtle features of PHPT, problems in diagnosis in day to day practice in patients with PHPT at our center

A case of androgen-secreting adrenal carcinoma with non-classical congenital adrenal hyperplasia

Androgen excess is one of the most common and disturbing endocrine disorder of reproductive-aged women, affecting approximately 7% of this population Androgen excess results in the development of androgenic features in the women affected, with the development of hirsutism, androgenic alopecia, ovulatory dysfunction, and, if extreme, even virilization and masculinization. Adrenocortical carcinoma (ACC) is a rare malignancy accounting for 0.02% of all annual cancers reported. About 60% are functional tumors secreting hormones, with its consequent clinical manifestations, the Cushing′s syndrome due to cortisone, virilization due to androgens, feminization due to estrogens, or hypertension due to aldosterone. Adrenal tumors that secrete androgens exclusively are extremely rare. Here, we present a rare case of androgen-secreting adrenocortical carcinoma with non-classical congenital adrenal hyperplasia

Prevalence of and risk factors for diabetic retinopathy among the patients with diabetes mellitus in Dharan municipality, Nepal

Background &amp; Objectives: The individuals with diabetes have 29 times higher chance of becoming blind due to diabetic retinopathy than non-diabetic of similar age and gender. The knowledge on the factors for it can help detect the disease in its early course. The study was conducted with objectives to study the prevalence of diabetic retinopathy and its risk factors in a diabetic population.Materials and Methods: A community based cross-sectional study that involved 418 subjects with type 2 diabetes, living in the Dharan municipality of Nepal was carried out using convenient sampling method.Results: The prevalence of diabetic retinopathy was 38.8%. Prevalence of mild, moderate, severe and very severe non-proliferative diabetic retinopathy was 9.1%, 16.3%, 6.2% and 17.2% respectively. Prevalence of proliferative diabetic retinopathy and clinically significant macular edema was 3.8% and 1.9% respectively. Among the risk factors studied age, hypoglycemic drug intake, family history and duration of diabetes mellitus had a significant association with the occurrence of diabetic retinopathy (p&lt;0.05).Conclusions: The prevalence of diabetic retinopathy in patients with diabetes mellitus was 38.8% and increase risk factors for it are age, hypoglycemic drug intake, family history of diabetes, duration of diabetes.JCMS Nepal. 2015;11(1): 17-21</p

Nerve Conduction and Heart Rate variability in Patients with Hypothyroidism at a Tertiary Care Centre in Eastern Nepal

Introduction: Thyroid hormone effects on many organs including central and peripheral nervous systems. However, these hormones do not affect all systems/organs to a similar extent. Thus, we conducted this study to explore the effect of thyroid hormones on somatic nervous system assessed by Nerve conduction study and cardiac autonomic activity assessed by heart rate variability. Methods: The study included newly diagnosed hypothyroid patients and healthy controls. In all subjects NCS were performed in median, ulnar, tibial and sural nerves using Nihonkohden machine Cardiac autonomic control was assessed using Short-term Heart Rate Variability and parameters were analyzed by Time Domain and Frequency Domain methods. Results: Both the groups were comparable in term of age, Body Mass Index, Pulse Rate, Systolic Blood Pressure and Diastolic Blood Pressure. Sensory parameters of NCS showed significant decrease in left median nerve SNAP amplitude (38.24±10.23 Vs 31.59±14.06, P=0.048) and nerve conduction velocity of bilateral median nerve in hypothyroid patients. In motor parameters of NCS, onset latencies of bilateral median nerves and right ulnar nerve were significantly increased in hypothyroid patients.  All Time Domain measures of HRV and Frequency Domain measures; LF Power, HF Power and Total Power were significantly decreased (P<0.05) in hypothyroid patients. These HRV parameters are indicators of parasympathetic activity. Conclusions: In newly diagnosed hypothyroid patients, especially median nerve functions (both sensory and motor) and parasympathetic activity were decreased.  It reflects that in hypothyroidism both autonomic nervous system and other somatic nerves are not affected in a similar extent. Keywords:  hypothyroidism; heart rate variability; nerve conduction study

Comparison of complications in diabetic outpatients with or without mental illness

Diabetes Mellitus (DM) and psychiatric illness are related in many ways by prevalence, burden, course, and outcome. Co-morbid mental illness may play a role in determining the complication in diabetic patients. This study was conducted in 2010 among consecutive diabetic out-patients diagnosed as per American Diabetes Association (ADA) guidelines 2009, of age above 14 years, to compare the complications in diabetic patients with or without mental illness. Diabetic neuropathies, cardiovascular complications, and morbid obesity were among the complications significantly more among diabetic patients with mental illness (GHQ-12 ≥ 2) than without mental illness (GHQ-12 ≤ 2)

Hypothyroidism in diabetes mellitus patients in Eastern Nepal

Context: The coexistence of diabetes mellitus (DM) with hypothyroidism is a known clinical observation. Aims: To estimate prevalence and co-relate that of hypothyroidism in patients with DM in relation to the age and sex, the lipid profile, body mass index visiting diabetes clinic and inpatients in B. P. Koirala Institute of Health Sciences. Settings and Design: The hospital-based descriptive study. Materials and Methods: Two hundred and seventy-one known or newly detected cases of DM aged more than 15 years were selected randomly from September 2012 to September 2013 and subjected to evaluation for thyroid function - clinically and biochemically and other relevant investigations were done. Statistical Analysis Used: For descriptive statistics mean, standard deviation, percentage, proportion were calculated. For inferential statistics following test were carried out at the level of significant 0.05 where confidence interval is 95%. The statistical operations were done through Statistical Package for the Social Sciences version 10. Results: Of 271 subjects, the prevalence of hypothyroidism (clinical and subclinical) in diabetics was, 4.05% (11/271) with females preponderance, of which 7 (30.4%) were clinically hypothyroid and 4 (17.4%) were subclinical hypothyroid. One (4.3%) patient had subclinical hyperthyroidism. The mean age at diagnosis of type 2 DM was 51-60 years. 8.69% of diabetics with primary hypothyroids were having morbid obesity. High-density lipoprotein among different thyroid status were statistically significant (P = 0.042). Conclusions: Hypothyroidism is not uncommon in diabetes, and we found body mass index, mean triglyceride and cholesterol levels were more in those diabetic patients having coexisting hypothyroidism