Oral Hypoglycemic Drugs in the Management of Type 2 Diabetes Mellitus: A Review

Diabetes mellitus is a chronic, progressive, heterogeneous group of metabolic disorder mainly characterized by hyperglycemia. T2DM results due to insulin resistance or secretory defects of a beta cell or both and gradually progress to a state characterized by complete loss of pancreatic beta cells secretion. 2hour oral glucose tolerance test or HbA1c testing is performed for the screening for diabetes mellitus. In this review, we attempt to outline the basic pharmacological and non-pharmacological principles for the management of T2DM. Keywords: diabetes, clinical management, non-pharmacological management, primary car

Evaluation of the functional outcome of surgically corrected uretero-pelvic junction obstruction

Introductions: Ureteropelvic junction obstruction (UPJO) is a common renal disease where flow of urine is obstructed from renal pelvis to ureter leading to renal function deterioration. This study analysed the functional outcome of patients after Anderson-Hynes (A-H) pyeloplasty for UPJO. Methods: Retrospective analysis was done for renal function outcome on patients who underwent either open or laparoscopic dismembered A-H pyeloplasty during 20 months period from May 2017 to November 2018 in the Department of Urology in Bir Hospital, National Academy of Medical Sciences (NAMS), Kathmandu, Nepal. Renal functional outcome was based on pre and post-operative glomerular filtration rate and split renal function. Ethical approval was obtained from institutional review board (IRB-NAMS). Descriptive analysis of data was performed. Results: Total 22 patients, 15 male and 7 female underwent dismembered pyeloplasty. The age ranged from 18 months to 65 years. Improvement of split renal functions was noted in 18 out of 22 (81.3%). Conclusions: A-H pyeloplasty is effective surgical option for functional renal improvement in patients with obstructive UPJO . Keywords: Anderson-Hynes pyeloplasty, split renal function, ureteropelvic junction obstructio

Infective complications after percutaneous nephrolithotomy in relation to preoperative urine culture status

Introductions: Fever and sepsis after percutaneous nephrolithotomy (PCNL) secondary to urinary tract infection is a major determinant of overall post PCNL complications. This study aims to analyse infective complications after PCNL in relation to pre-operative urine culture status. Methods: A comparative analysis of post PCNL infective complications in pre-operative urine culture positive (Group A) and negative (Group B) was done for one year during June 2017 to May 2018 in department of urology, Bir Hospital, National Academy of Medical Sciences, Kathmandu, Nepal. Demographics, stone characteristics, mean operative time, post-operative hospital stay and post-operative complications as per Modified Clavien classification were compared between the two groups. Results: Out of total 136 PCNL patients, 51 were in Group A and 85 in Group B. Infective complications were significantly high, 28 (54.90%) in group A compared to 20 (23.53%) in group B, p=0.004. The most common isolate was Escherichia coli 19 (37.25%), sensitive to amikacin 37 (72.55%). The mean operation time, transfusion and hospital stay was not statically different in two groups. Morality occurred in 1 (1.96%) in group A. Conclusions: Infective complications were significantly high after PCNL in patients with preoperative positive urine culture, even when it was treated to sterile with sensitive antibiotics, compared to patients with preoperative negative urine culture. Keywords: modified Clavien classification, percutaneous nephrolithotomy PCNL, sepsis, urine cultur

Storability of sweet potato genotypes under ordinary ambient storage conditions

Saabunud / Received 26.04.2021 ; Aktsepteeritud / Accepted 30.08.2021 ; Avaldatud veebis / Published online 30.08.2021 ; Vastutav autor / Corresponding author: Prakash Bhattarai [email protected] study was carried out to evaluate the storage performance of sweet potatoes in different conditions under ordinary ambient temperature (10.11–17.49 °C) at Khumaltar, Lalitpur (1350 masl) district of Nepal from December, 20 to March, 13 during the years 2018/19 and 2019/20. The experiment was laid out in Factorial Completely Randomized Design with three replications. Tuberous roots of three sweet potato genotypes (CIP 440015, CIP 440267, and Local White) harvested at 4-month maturity were stored inside an ordinary room in dry sand, sawdust, thin jute sack, natural mud pot, and open crates (control). Data were taken on the 2nd, 4th, 6th, 8th, 10th, and 12th weeks of storage. The pooled results showed a significant effect of storage conditions on physiological loss in weight and rotting (%) of sweet potato genotypes. With the progression of the storage period, physiological weight loss (PLW) and rotting (%) were significantly increased in all treatments. At the 12th week of storage, the highest PLW was recorded in the tubers stored in open crates (70.2%) followed by natural mud pot (65.2%) whereas the lowest PLW was observed in tubers stored inside the dry sand (50.2%). Genotype CIP 440015 showed good storability with minimum PLW. No weevil infestation and sprouting were observed during the experimental period. The lowest percentage of tuber rotting was recorded in the genotype CIP 440015 (55.3%) and inside dry sand (48.7%) at the 12th week of storage while it was the highest up to 85.9% in CIP 440267. The highest rotting 76.7%) was recorded in thin jute bags which is statistically at par with natural mud pot (76.5%). The interaction effect of storage conditions and genotypes was found not significant. The results showed an increment in dry matter and reducing sugar content while the reduction in ß-carotene and starch content of tubers after 3 months of storage inside dry sand. There was positive and strong correlation of storage duration with dry matter (r = 0.750) and reducing sugar (r = 0.658) whereas, negative correlation with starch (r = –0.918) and ß-carotene (r = –0.352) content of sweet potato genotypes. The study concluded that sweet potato tuber can be kept for 8 to 10 weeks in dry sand with minimum postharvest loss in ordinary room condition and the genotype CIP 440015 has good storability among the tested genotypes in similar conditions

Vitamin D status of pregnant women and their infants in South India: VIPIS study

Background: Aim was to estimate the prevalence of vitamin D deficiency in pregnant women and their infants and to analyse the effect of maternal vitamin D deficiency on the infant.Methods: A prospective study was done in the Department of Obstetrics and Neonatology in a tertiary centre in South India with 150 women seen in the antenatal clinic after 36 weeks of pregnancy were recruited. Serum vitamin D levels were obtained. Babies were followed up and sampled once between 10 and 20 weeks of age for vitamin D, calcium, phosphate and alkaline phosphatase. Vitamin D levels less than 20 ng/ml was considered as deficiency. Analysis of the data was done using SPSS 16.0 version.Results: Vitamin D deficiency was seen in 64.8% of the pregnant women. Follow up of 76 babies showed vitamin D deficiency in 72.6% infants. Significantly high levels of alkaline phosphatase were noted in infants who were born to mothers with vitamin D deficiency, which indicates risk of developing bone disease.Conclusions: This study highlights the high prevalence of Vitamin D deficiency in pregnant women and their infants in South India in a region with abundant sunshine. This study also emphasises treating vitamin D deficiency in pregnancy to reduce the risk of developing rickets in infancy

Editorial: The Role of Flower Color in Angiosperm Evolution

European Regional Development Fund (ERDF) and grants from the Spanish government (PID2020-116222GB-I00)Andalusian Regional Ministry of Economy, Knowledge, Business and University (PY18-3651, US-1265280, and UPO1261687)

Economics of production and marketing of banana in Chitwan district, Nepal

The study was conducted in several place of Chitwan, Nepal from where 90 representative farmers and 20 traders were selected randomly as sample. The farmers were categorized into small, medium and large farm based on land holding size. The finding showed average productivity was maximum in medium size farm. Total cost of banana cultivation per bigha (1.5 bigha = 1 hector) was NRs. 239031 (106 NRs. = $1) excluding land rent. The share of planting material was 12.66%, manure 13.55%, fertilizer 16.49%, micro-nutrient 2.59%, pesticides 10.54%, labor 19.48%, animal/ machine 19.23%, marketing & transport cost 2%, and miscellaneous 3.46%. The average return rate found to be highest in large farm and lowest in small farm. The average profit of banana cultivation found to be NRs. 131902.3 per bigha. The average benefit cost ratio was 1.55 in the study area. Producer–Collector–Wholesaler–Retailer–Consumer was the most prevalent marketing channel, through which 94.74% volume was traded. Disease and pest infestation was the major production problem and fluctuation in price for marketing. The average share of banana on annual income for farmers found to be 41.34 %, indicating commercial cultivation in study area

Outcome of anterior cruciate ligament reconstruction using bone-patellar tendon-bone auto graft

Introductions: A rupture of the Anterior Cruciate Ligament (ACL) is the most common ligament injury resulting in instability of the knee which can cause secondary articular injury and early osteoarthritis (OA). Aim of this study was to evaluate the short term outcomes of ACL reconstruction using Bone Patellar Tendon Bone Auto Graft (BPTB) auto graft and factors that might contribute to poor results. Methods: Patients with Anterior Cruciate Ligament injury during the period of July 2013 to May 2014 were enrolled to observe the outcome of the ACL reconstruction using BPTB without arthroscopy. Lysholm Knee Scoring Scale was used to determine the clinical outcome. Outcome parameters were evaluated using Statistical Package for Social Science Version 20 (SPSS). Results: Total 30 normal or near normal function outcome of knee was reported in 29 (97%) patients after ACL reconstruction using BPTB without arthroscopy. There was no failure of grafts. Good static knee stability achieved with increased patient’s satisfaction. Lysholm Score was excellent in 27 (90%) and good in 3 (10 %) cases. Anterior knee pain persisted in 6 cases (20%). Conclusions: Excellent functional outcome with BPTB auto graft in Anterior Cruciate Ligament injury was achieved. Keywords: ACL reconstruction, bone-patellar tendon-bone auto graft, clinical outcom