The prevalence of persistent metopic sutures comparing the Nepalese bone collection with Korean bone collection / Prevalencia de suturas metópicas persistentes que comparan una colección de huesos nepaleses con una colección de huesos coreanos

SUMMARY: Metopic suture can be visualized from the nasion to the bregma along the arch of the frontal bone in mid-sagittal plane. Persistent metopic suture normally closing between 1st and 2nd year of life has also been related with ethnicity. The present study reports the presence of complete and incomplete metopic sutures in Nepalese and Korean population skulls which helps to shed light on its incidence rate. Out of 121 adult skulls in Nepalese population, metopic suture was found to be present in 33 skulls. Incomplete metopic sutures showed variations of morphology, like linear (6.61 %), V-shaped (8.26 %) and double incomplete (10.74 %) and two cases with complete metopic suture, which showed variation in interdigitation between its anterior and posterior ends. Korean population showed metopic suture to be present in 8 skulls out of 104 with metopism in 3 skulls. Incomplete metopic sutures like double incomplete (1.92 %) and linear (2.88 %) were also noted. Alterations to local strains could be the contributing factor for such variation and complexity of interdigitation, which occur during the growth of the braincase. The knowledge of the metopic suture and its variations according to ethnicity is important and should be considered to prevent wrong diagnosis. The presence of different types of metopic sutures as reported by the present study provides informative value on the presence and variation of such sutures in population depending on ethnicity and ought to be helpful in diagnostic sequences in emergency setting.

RESUMEN: La sutura metópica se puede visualizar desde nasión hasta el bregma a lo largo del arco del hueso frontal en el plano mediano sagital. La sutura metópica persistente que normalmente se cierra entre el primer y segundo año de vida, también se ha relacionado con el origen étnico. El presente estudio informa la presencia de suturas metópicas completas e incompletas en los cráneos de la población nepalesa y coreana, lo que además de entregar información sobre su tasa de incidencia. De 121 cráneos adultos en la población nepalesa, en 33 de ellos se encontró la sutura metópica. Las suturas metópicas incompletas mostraron variaciones de la morfología, como lineal (6,61 %), en forma de V (8,26 %) y doble incompleta (10,74 %), además de dos casos con sutura metópica completa, que mostraron variación en la interdigitación entre sus extremos anterior y posterior. De los 104 cráneos de la población coreana en 8 se presentó la sutura metópica y en 3 metopismo. También se observaron suturas metópicas incompletas como doble incompleta (1,92 %) y lineal (2,88 %). Las alteraciones en las etnias locales podrían ser el factor contribuyente para tal variación y complejidad de la interdigitación, que ocurre durante el crecimiento de la cráneo. El conocimiento de la sutura metópica y sus variaciones según el origen étnico es importante y debe considerarse para prevenir un diagnóstico incorrecto. La presencia de diferentes tipos de suturas metópicas según lo informado en el estudio, proporciona un valor informativo sobre la presencia y la variación de tales suturas en la población, dependiendo de la etnia, y debería ser útil en las secuencias de diagnóstico en situaciones de emergencia.

An epidemiological study on the prevalence of temporomandibular disorder and associated history and problems in Nepalese subjects

BACKGROUND: Temporomandibular disorder (TMD) represents a subgroup of painful orofacial disorders involving pain in the temporomandibular joint (TMJ) region, fatigue of the cranio-cervico-facial muscles (especially masticatory muscles), limitation of mandible movement, and the presence of a clicking sound in the TMJ. TMD is associated with multiple factors and systemic diseases. This study aimed to assess the prevalence of TMD in Nepalese subjects for the first time. METHODS: A total of 500 medical and dental students (127 men and 373 women) participated in this study from May 2016 to September 2016. The Fonseca questionnaire was used as a tool to evaluate the prevalence of TMD, and Fonseca's Anamnestic Index (FAI) was used to classify the severity of TMD. RESULTS: The majority of the participants with TMD had a history of head trauma, psychological stress, and dental treatment or dental problems. The prevalence of TMD in Nepalese students was mild to moderate. CONCLUSIONS: The prevalence of TMD in Nepalese subjects was mild to moderate. The majority of the study subjects had eyesight problems, history of head trauma, psychological stress, and drinking alcohol and had received dental treatments.

Knowledge, Attitude, and Compliance of Healthcare-associated Infection Control among Nurses in the Western Development Region, Nepal / 병원감염관리

BACKGROUND: Healthcare-associated infection (HAI) affects the morbidity and mortality of inpatients worldwide. Nepal is a developing country in which HAIs pose a major problem in terms of patient safety. Therefore, this study was designed to assess the level of knowledge and attitude toward HAIs and compliance for infection control among nurses. METHODS: A cross-sectional survey was conducted using a self-administered questionnaire including general characteristics, and knowledge of, attitude toward, and compliance with HAI control practices, on a sample of 259 nurses from 11 hospitals in 3 cities in Nepal, from July 17 to August 5, 2014. RESULTS: The average score on knowledge of HAI was 6.56, on a 13-point scale. In total, 59 nurses had undergone HAI control training and 211 nurses reported that they were governed by some guidelines, but there were no significant differences. The overall level of compliance with HAI control guidelines was 79.2 points based on a 100-point scale, which did not differ in terms of age, exposure to infection control training, and the presence of any guidelines. CONCLUSION: The level of knowledge of HAI control among nurses was very low and a majority had never undergone any HAI control training. Evidently, there is an urgent need to provide HAI control training to nurses, and to develop infrastructure to provide training for them.

Do parental coronary heart disease risk factors (non-modifiable) effect their young ones?

Objective: To study the differences between the lipid profiles of the subjects whose parents are having known non-modifiable risk factors such as obesity, hypertension (HTN), myocardial infarction and diabetes, and compare them with the lipid profiles of the subjects whose parents are not having those risk factors. Methods: A total of 402 subjects were recruited to this study. A detailed questionnaire which included information on the past medical history, height, weight, blood pressure, physical activity, smoke, alcohol, family history of coronary heart disease, HTN, diabetics and obesity. Basic demographic data and dietary habits were completed by all participants. Blood samples were obtained from all subjects after 14 h. Lipid profiles were analyzed using automated analyzer. The results were analyzed using SPSS software packages. Results: The mean body mass index of the population was well below the cut-off value of obesity (>24.5 kg/m

MSX1 Polymorphism in an Eastern Nepalese Non Syndromic cleft lip/palate patient population.

This study was carried out to evaluate the role of MSX1 799 G >T gene polymorphism with non Syndromic cleft lip/palate in Eastern Nepalese patient population. For the study, whole blood samples (2 ml) were obtained from 40 subjects and controls. Genomic DNA was extracted from the blood of the subjects by using ethanol, chloroform treatment. Polymerase chain reaction restriction fragment length polymorphism (PCR-RFLP) method was used to check for the presence of polymorphism. The results indicated that a patient has MSX1 799 G>T variant. The patient was a male aged 24 years was a complete unilateral left sided cleft lip/palate involving alveolus, hard and soft palate. He had normal development and no associated anomaly. There was no family history of cleft lip/palate and no history of any teratogenic exposure during embryonic life as revealed by his mother. This may be a case of sporadic polymorphism. It may be concluded that ,although we detected the presence of a MSX1 799 G>T polymorphism in one patient, a further investigation with large sample size, including many SNP’s on families must be performed to get conclusive results.

Distribution of ABO and Rh blood groups in Nepalese medical students

Background and Objectives: The distribution of ABO and Rh blood groups vary from population to population. With an interest of finding out rare blood group in Nepalese population, we studied the blood group distribution was studied in five different medical colleges in Nepal. Material and Methods: Capillary Blood sample were taken to determine blood group of of 2208 twenty two hundred and eight Nepalese students from five different medical colleges, viz. Manipal College of medical sciences, Pokhara; Nepalgunj Medical College, Chisapani, Banke ; College of Medical sciences, Bharatpur, Chitwan; Kist Medical College, Lalitpur and Janaki Medical College, Janakpur were recorded. Slide test method was used to determine the blood group of the subjects. Results: In our study subjects, 28.17% were blood group A, 30.17% were blood group B, 34.87% were blood group O and 6.79% were blood group AB. Similarly, 95.38% were Rh +ve and 4.62% were Rh –ve. The blood group distribution patterns in male and female were different. Conclusion: This result demonstrates that AB blood group is the most rare blood group among the studied Nepalese population, followed by group A, B and O.

Effects of Long-term Use of Depo-medroxyprogesterone Acetate on Lipid Metabolism in Nepalese Women / 대한진단검사의학회지

Various synthetic progestogens that are used as contraceptives have been reported to influence lipid and lipoprotein fractions differently. Depo-medroxyprogesterone acetate (DMPA), a synthetic progestogen, is used by Nepalese women as a contraceptive agent. Our study aims to determine the effects of long-term use of DMPA on lipid metabolism. We performed this study on 60 healthy Nepalese women who had been using DMPA for more than 2 yr and age- and weight-matched control subjects who were not using hormonal contraceptives. Fasting blood samples were collected from the subjects for the estimation of total cholesterol (TC) and triglyceride (TG) levels, and the levels of high-density lipoprotein cholesterol (HDL-C) and low-density lipoprotein cholesterol (LDL-C) were estimated using the Friedewald's equation. TC and LDL-C levels in DMPA users were significantly higher than those in non-users. Our study concluded that DMPA use induces lipid metabolism changes that can increase the risk of cardiovascular diseases.

A Case of Type 2N von Willebrand Disease with Homozygous R816W Mutation of the VWF Gene in a Nepalese Woman / 대한진단검사의학회지

Type 2N von Willebrand disease (vWD) can be confused with hemophilia A due to decreased factor VIII levels and a bleeding tendency, and differential diagnosis is of importance for providing the optimal treatment and genetic counseling. For the accurate diagnosis of type 2N vWD, von Willebrand Factor (vWF) function tests, multimer assay and gene mutation analysis are needed. The patient was a 38-yr-old Nepalese woman with a history of bleeding manifestations from childhood, such as hemarthrosis, intramuscular hematoma, and menorrhagia. Family history revealed that her mother and elder brothers also had bleeding manifestations from childhood. When she had a laparotomy in 1991, she was diagnosed as hemophilia A with factor VIII level of 3.6% and was transfused with whole blood, factor VIII and cryoprecipitates. In June 2007, she was admitted to our hospital for further evaluation of bleeding tendency. Blood tests revealed normal CBC; bleeding time, 2 min; PT, 14.9 sec (11-14 sec); aPTT, 51.2 sec (24-38 sec); and factor VIII, 4.9% (50-150%). The prolonged aPTT was corrected by 1:1 mixing test to the levels of 106% and 84%, respectively, before and after 2 hr-incubation at 37degrees C. No abnormalities were found in the vWF antigen level (71.3%), ristocetin cofactor assay (130.4%), and multimer assay. Direct DNA sequencing of the VWF gene revealed homozygous missense mutation located in exon 19, c.2446C>T (p.Arg816Trp), confirming the diagnosis of type 2N vWD.

Food consumption and serum nutritional status of people living in the Kathmandu valley in Nepal

<p><b>OBJECTIVE</b>The food consumption and serum nutritional status of people living in the Kathmandu valley, Nepal, were examined to obtain actual data for comparison with our previous findings.</p><p><b>METHODS</b>A dietary survey of 45 males and 60 females was carried out in March 1997 by the 24-hr dietary recall method and nutrient intake was calculated from food tables of India and Japan. Fasting venous blood samples were obtained and serum biochemical parameters were measured using clinical kits.</p><p><b>RESULTS</b>The mean body mass index values was at about the same level in both sexes, although the mean percentage body fat of females was higher than that of males, and vice versa for packed red cell volume. The main foods consumed by both sexes, were rice, potatoes, meats, milk & dairy products and vegetables, with a difference in the amounts consumed. Females did not drink alcoholic beverages. The mean daily intakes of energy, protein, lipids, iron and vitamin B group for the males were higher than those for the females, while those of vitamins A and C for the males were lower than those for the females. The mean values of serum biochemical parameters for both sexes were generally at the normal levels, but those of ALT and TG were at the higher end of the normal range. Differences of correlation between food groups and between serum parameters were observed depending on the sex, however, no clear relationship between food and nutrient intake and serum biochemical parameters were observed.</p><p><b>CONCLUSIONS</b>The present food intake study revealed that the amounts of food consumption for both sexes, especially for the females, were mostly insufficient although the serum parameters were at the normal levels. The energy intake of both sexes was lower than that of estimated requirements and those in Terai region. The relatively high serum TG level of the subjects may be due to the consumption of large amounts of cereals containing much carbohydrate. Our findings suggested a marked influence on food consumption by food price and income in spite of the easier food availability in the city, and also lack of knowledge about nutrients and health, thus there is need for improvement of the nutritional status of this group of people.</p>

Food Consumption and Serum Nutritional Status of People Living in the Kathmandu Valley in Nepal

Objective: The food consumption and serum nutritional status of people living in the Kathmandu valley, Nepal, were examined to obtain actual data for comparison with our previous findings. Methods: A dietary survey of 45 males and 60 females was carried out in March 1997 by the 24-hr dietary recall method and nutrient intake was calculated from food tables of India and Japan. Fasting venous blood samples were obtained and serum biochemical parameters were measured using clinical kits. Results: The mean body mass index value was at about the same level in both sexes, although the mean percentage body fat of females was higher than that of males, and vice versa for packed red cell volume. The main foods consumed by both sexes, were rice, potatoes, meats, milk & dairy products and vegetables, with a difference in the amounts consumed. Females did not drink alcoholic beverages. The mean daily intakes of energy, protein, lipids, iron and vitamin B group for the males were higher than those for the females, while those of vitamins A and C for the males were lower than those for the females. The mean values of serum biochemical parameters for both sexes were generally at the normal levels, but those of ALT and TG were at the higher end of the normal range. Differences of correlation between food groups and between serum parameters were observed depending on the sex, however, no clear relationship between food and nutrient intake and serum biochemical parameters were observed. Conclusions: The present food intake study revealed that the amounts of food consumption for both sexes, especially for the females, were mostly insufficient although the serum parameters were at the normal levels. The energy intake of both sexes was lower than that of estimated requirements and those in Terai region. The relatively high serum TG level of the subjects may be due to the consumption of large amounts of cereals containing much carbohydrate. Our findings suggested a marked influence on food consumption by food price and income in spite of the easier food availability in the city, and also lack of knowledge about nutrients and health, thus there is need for improvement of the nutritional status of this group of people.

Serum nutritional status of tocopherol and retinol normalized to lipids of persons living in the southern rural Terai region in Nepal

<p><b>OBJECTIVE</b>The present study examined the levels of serum α-Tocopherol (Toc), retinol (Ret), cholesterol (Chol) and triglycerides (TG), and their correlations in the sera of people in Nepal.</p><p><b>METHODS</b>The survey was conducted on the general populace in the agricultural Terai region in southern Nepal. The study population consisted of 93 males and 83 females aged 10-68 years. Serum Toc and Ret were measured by high-performance liquid chromatography.</p><p><b>RESULTS</b>No significant differences were observed between the genders for the average of total Chol (T-Chol) (140 and 145 mg/100 ml, respectively), HDL-C (45 and 47 mg/100 ml), LDL-C (94 and 97 mg/100 ml), and TG (106 and 110 mg/100 ml), and the ratio of LDL/HDL (2.16). The levels of mean Toc (4.32 and 4.27 μg/ml) were about the same for both genders, while the mean Ret levels were significantly higher for males (624 ng/ml) than for females (535 ng/ml) (p<0.001). A direct relationship was found between the levels of Toc and Ret (r=0.46, p<0.001 and r=0.28, p<0.05 for males and females, respectively). Serum levels of Toc and Ret were positively related to the levels of Chol (r=0.48 and r=0.58, p<0.001 for males and r=0.49, p<0.01 and r-0.28, p<0.05 for females, respectively). The ratio of Toc/TG normalized to serum TG was directly correlated to the ratio of Ret/TG (r=0.79 for males, and r=0.72 for females, p<0.001, respectively) and the ratios of Toc/TG and Ret/TG were negatively related to the LDL/HDL levels (r=-0.49 and r=-0.43, for males, and r=-0.46 and r=-0.57 for females, p<0.001, respectively).</p><p><b>CONCLUSION</b>The levels of Toc and Ret were low in the sera of people living in the southern rural Terai region in Nepal, and it was found that lower levels of Toc and Ret normalized to TG increased the ratio of LDL/HDL. These results suggest that greater intake of foods rich in Toc and Ret should be encouraged to reduce the erisk of coronary heart disease.</p>

Serum Nutritional Status of Tocopherol and Retinol Normalized to Lipids of Persons Living in the Southern Rural Terai Region in Nepal

Objective: The present study examined the levels of serum α-Tocopherol (Toc), retinol (Ret), cholesterol (Chol) and triglycerides (TG), and their correlations in the sera of people in Nepal. Methods: The survey was conducted on the general populace in the agricultural Terai region in southern Nepal. The study population consisted of 93 males and 83 females aged 10–68 years. Serum Toc and Ret were measured by high-performance liquid chromatography. Results: No significant differences were observed between the genders for the average of total Chol (T-Chol) (140 and 145 mg/100 ml, respectively), HDL-C (45 and 47 mg/100 ml), LDL-C (94 and 97 mg/100 ml), and TG (106 and 110 mg/100 ml), and the ratio of LDL/HDL (2.16). The levels of mean Toc (4.32 and 4.27 μg/ml) were about the same for both genders, while the mean Ret levels were significantly higher for males (624 ng/ml) than for females (535 ng/ml) (p<0.001). A direct relationship was found between the levels of Toc and Ret (r=0.46, p<0.001 and r=0.28, p<0.05 for males and females, respectively). Serum levels of Toc and Ret were positively related to the levels of Chol (r=0.48 and r=0.58, p<0.001 for males and r=0.49, p<0.001 and r=0.33, p<0.01 for females, respectively) and TG (r=0.23 and r=0.28, p<0.05 for males and r=0.29, p<0.01 and r=0.28, p<0.05 for females, respectively). The ratio of Toc/TG normalized to serum TG was directly correlated to the ratio of Ret/TG (r=0.79 for males, and r=0.72 for females, p<0.001, respectively) and the ratios of Toc/TG and Ret/TG were negatively related to the LDL/HDL levels (r=−0.49 and r=−0.43, for males, and r=−0.46 and r=−0.57 for females, p<0.001, respectively). Conclusion: The levels of Toc and Ret were low in the sera of people living in the southern rural Terai region in Nepal, and it was found that lower levels of Toc and Ret normalized to TG increased the ratio of LDL/HDL. These results suggest that greater intake of foods rich in Toc and Ret should be encouraged to reduce the risk of coronary heart disease.

Serum protein and immunoglobulin levels among nepalese living in southern Nepal

<p><b>OBJECTIVE</b>This study examined the levels of serum protein fractionation, immunoglobulin (Ig) and antistreptolysin O (ASO) of people (91 males and 84 females aged 10-68 years) living in the Terai region of southern Nepal, as there has previously been no information available about them.</p><p><b>METHODS</b>Blood samples were collected early in the morning after overnight fasting. Serum protein fractionation was carried out by cellulose-acetate electrophoresis. IgG, IgA, IgM and ASO were measured by immuno-turbidimetry with clinical kits.</p><p><b>RESULTS</b>The mean proportion of albumin (Alb) was rather low due to increased globulin (Glb). The Alb level of males was significantly higher than that of females, while the male γ-Glb level was significantly lower than that of females. The mean values of IgG, IgM and ASO for males were lower than those values for females, although the difference was significant only for the IgM value. The mean values of IgM for female age groups of 30-39 years or less were significantly higher than those for the corresponding male age groups. Age correlated positively with IgA, and negatively with ASO in both sexes. γ-Glb and IgG correlated significantly with TP, AlB, α(1)-Glb and IgA in both sexes. ASO correlated with β-Glb and IgA in males, and with γ-Glb and IgG in females.</p><p><b>CONCLUSIONS</b>The fact that the level of γ-Glb, a major component of serum globulin, was high suggested exposure to a highly bacterial and viral environment. These results point to the need to prevent infectious diseases as well as improve their nutritional status, especially for children and young adults.</p>

Serum Protein and Immunoglobulin Levels among Nepalese Living in Southern Nepal

Objective: This study examined the levels of serum protein fractionation, immunoglobulin (Ig) and antistreptolysin O (ASO) of people (91 males and 84 females aged 10−68 years) living in the Terai region of southern Nepal, as there had previously been no information available about them. Methods: Blood samples were collected early in the morning after overnight fasting. Serum protein fractionation was carried out by cellulose-acetate electrophoresis. IgG, IgA, IgM and ASO were measured by immuno-turbidimetry with clinical kits. Results: The mean proportion of albumin (Alb) was rather low due to increased globulin (Glb). The Alb level of males was significantly higher than that of females, while the male γ-Glb level was significantly lower than that of females. The mean values of IgG, IgM and ASO for males were lower than those values for females, although the difference was significant only for the IgM value. The mean values of IgM for female age groups of 30-39 years or less were significantly higher than those for the corresponding male age groups. Age correlated positively with IgA, and negatively with ASO in both sexes. γ-Glb and IgG correlated significantly with TP, Alb, α1-Glb and IgA in both sexes. ASO correlated with β-Glb and IgA in males, and with γ-Glb and IgG in females. Conclusions: The fact that the level of γ-Glb, a major component of serum globulin, was high suggested exposure to a highly bacterial and viral environment. These results point to the need to prevent infectious diseases as well as improve their nutritional status, especially for children and young adults.

Serum Mineral Levels among Nepalese Living in the Southern Agricultural Terai Region

The physical status and serum mineral concentrations for people aged 10 to 68 years living in an agricultural southern region of Nepal were determined. Systolic (SBP) and diastolic blood pressure (DBP) for both sexes in the 10−14 year age group were low (p<0.05, vs the other age groups) and those for the over 50−year−olds tended to be higher than the other age groups. The mean values of total proteins (TP) (8.6±0.5 g/dl for males and 8.7±0.6 g/dl for females) were high due to an increase of globulin (3.9±0.4 g/dl for males and 4.1±0.5 g/dl for females). More than three−fourths of the subjects of both sexes showed calcium (Ca) levels of 9.0−11.2 mg/dl and about 65% of them showed potassium (K) Ievels of 4.8−5.4 mEq/l. A significant positive correlation between DBP and serum K was observed (p<0.05). Serum inorganic phosphorus (IP) correlated with age (p<0.001) and body mass index (BMI) (p<0.001). The serum Ca levels correlated with TP (r=0.31, p<0.001), albumin (Alb) (r=0.50, p<0.001), IP (r=0.31, p<0.001), K (r=0.32, p<0.001) and chlorine (Cl)(r=−0.37, p<0.001). Cl was associated with TP (r=−0.21, p<0.05), Alb (r=−0.36, p<0.001) and IP (r= −0.21, p<0.05). These results suggested that Ca intake for the subjects seemed to be insufficient although their serum Ca level was within normal.

Transcultural research for mental health between the rural population of Nepalese and Korean / 영남의대학술지

In order to make transcultural research for mental health centered on anxiety and depression between two countries of which psychosocial factors are different, the author studied 698 Nepalese in Dolka in January 1990 and 417 Korean of Chungdo and Kyungju in Korea from July to August 1990 by using the Combined Self-Rating Anxiety Depression Scale (CSADS). The author applied t-test and ANOVA to compare these two groups. The results were as follows: The total scored of Nepalese scored 51.27±11.10 while Korean Scored 44.29±11.79. The anxiety-depression scores relating to the items of restlessness, depressed affect, apprehension, crying spells and fatigue were significantly high in Nepalese, while fatigue, sleep disturbance, dissatisfaction, dizziness, and anxiousness were significantly high in Korean. Both groups showed an increase of score with age. The item relating to education, the scores of the CSADS was significantly high in lower education level in Nepal but Korean showed no significant difference among education level. The score of the CSADS above 50 (clinically significant level) was seen in 361 (51.7%) Nepalese and 116 (27.9%) Korean, which shows the proportion of Nepalese are significantly higher than that of Korean.