Screening of Peripheral Arterial Disease in Patients with Diabetes.

BACKGROUND: Out of many atherosclerotic complications, peripheral arterial disease (PAD) is also important one. To prevent morbidity and mortality related with PAD, early detection is must, and is possible by duplex screening. This study aims at screening for PAD in patients with type 2 Diabetes mellitus. METHODS: This study is single centered cross- sectional, observational study conducted in department of internal medicine of DMCRI- a tertiary care hospital. A total of 140, type 2 diabetes patients were screened for peripheral arterial disease by duplex ultrasound after taking informed consent and fulfilling inclusion and exclusion criteria. RESULTS: In our study among 140 Participants, 50% are male and 50% are female with mean age of 57.6 ± 10.4 years standard deviation (SD) and mean duration of diabetes was 8.31± 5.9 SD years with 13.6% were alcohol consumer; 1.4% were smokers; 59.3% of them had high blood pressure; (28.6%) had dyslipidaemia and 11.4% had hypothyroidism. The prevalence of PAD in type 2 diabetes was 27.1% in our study. The mean of glycated hemoglobin (HBA1c) was 7.23 ± 1.75% and while performing analytical test {chi-square (χ)}, we found there was no association between HBA1c level and presence of peripheral arterial disease. CONCLUSIONS: The prevalence of peripheral arterial disease is high almost more than one quarter (27.1%). Screening of diabetic patients is must especially those aged and high glycated hemoglobin for early detection and effective management of PAD.

Morphometric analysis of the foramen magnum in sex estimation: An additional 3DCT study from Nepal on a larger sample.

Background: Estimation of sex of the skeletal remains plays a vital part in the identification of an individual. This study is focused on the morphometric measurements of the foramen magnum region and examining the accuracy of sexual dimorphism in the Nepalese population. Methods: Measurements were obtained from 3D computed tomography (CT) scan of 261 Nepalese adult cranial bases with known age and sex. Length and breadth of the foramen magnum, length and breadth of right and left occipital condyles and maximum and minimum intercondylar distance were measured on the base of the skull CT images. Results: The mean values for all parameters were higher in males than females except for the maximum intercondylar distance. Sex prediction done with discriminant function analysis could classify the skull with an overall accuracy of 70.5%-71%. Conclusions: It can be concluded from the results that the morphometric study of the foramen magnum is less reliable for sex estimation in the Nepalese population.

Clavicle Morphometry for Sexual Dimorphism and Bilateral Asymmetry: Radiographic Assessment.

BACKGROUND: The clavicle, modified long bone, presents morphological and bilateral variations. This may be due to genetic factors, hormones, or environmental and occupational influences. Anthropometric studies in clavicle of Nepalese population using radiograph has not been reported to best of our knowledge. This study, aimed to determine the sexual dimorphism and bilateral asymmetry of clavicle in Nepalese Population using Postero-Anterior Chest X Ray. METHODS: Chest x-rays with normal and clearly visible both clavicles of 1260 Nepalese adults (591 male, 669 female), aged above 20 years were utilized. Inbuilt software "Computed Radiography Fuji Computer System 7" was used for measurements (in centimeter) of sternal head length, acromial end length, mid shaft diameter and length of clavicle. Demarcating point and identification point were calculated. Patients having history of clavicles fractures in the past were excluded. RESULTS:   All the parameters in male is greater than female which is significant except Length/Mid Shaft Diameter. Similarly, all the parameters of right clavicle is significantly greater than left clavicle in both sexes except Sternal Head Length and Mid Shaft Diameter. Demarcating point calculated from length of the clavicle (right >16.17, left >16.10 for male and right <11.20, left <10.65 for female) and Mid Shaft Diameter (right >1.33, left >1.38 for male and right <0.66 and left <0.67 for female) are important parameters to determine sex.    Conclusions:The clavicle shows significant sexual dimorphism and bilateral asymmetry in Nepalese population. The result of this study is helpful to anthropologist and forensic medicine.