Exploring the iceberg of hypertension: a community based study in an eastern Nepal town.

Objectives: Hypertension is an important public health challenge in the developing and the developed world alike. However, community-based studies on cardiovascular diseases including hypertension in a developing country like Nepal have been limited. The primary aim of this study is to measure the prevalence of hypertension in the Dharan town of Eastern Nepal and to explore the 'iceberg phenomenon' of hypertension in the study population.

Social health insurance: a knowledge-do gap in eastern Nepal.

Health care costs, and those for inpatient care in particular, pose a barrier to seeking health care, and cost be a major cause of indebtedness and impoverishment, particularly among the poor. The Ministry of Health in Nepal intends to initiate alternative financing schemes such as community and social health insurance schemes as a means to supplement the government health sector financing source. Social Health Insurance (SHI) is a mechanism for financing and purchasing / delivering health care to workers in the formal sector regulated by the government.

Spontaneous bacterial peritonitis (SBP) in cirrhotic ascites: a prospective study in a tertiary care hospital, Nepal.

Background: Spontaneous bacterial peritonitis (SBP) is one of the potentially lethal complications of cirrhosis and is defined as infected ascites in the absence of any recognizable secondary cause of infection. Objective was to study the occurrence of SBP, clinical and laboratory characteristics and the response to antibiotics.

Methods: We had prospectively evaluated 81 cirrhotic patients with ascites during one-year period.

Sinonasal inverted papilloma in eastern part of Nepal.

Objective: To evaluate the clinicopathological profile of sinonasal inverted papilloma in a tertiary referral center in eastern part of Nepal.

Methods: A prospective study consisting of total 28 histologically proven cases of sinonasal inverted papilloma was conducted in the ENT department of the center. The study period was from April 2002 to November 2005.

Association of obesity and physical activity in adult males of Dharan, Nepal.

Objectives: Obesity is one of the most apparent-yet most neglected public health problems. Physical activity is a crucial element in the development of obesity but still its importance in the occurrence of obesity varies in different populations. This paper aims to study the burden of obesity and its association with physical activity was carried out in a rapidly urbanizing town.

Cervical necrotizing fasciitis in an uncontrolled type II diabetic patient.

We report a case of cervical necrotizing fasciitis (CNF) in a female having uncontrolled type II diabetes mellitus. The patient was presented to us after 20 days of preliminary symptoms. The aetiology of microbial inoculation in subdermal tissue was not known.

Risk factors, associated health problems, reasons for admission and knowledge profile of diabetes patients admitted in BPKIHS.

Objectives: The objective of the study was to find out the demographic profile, identify the known risk factors, assess the associated health problems, find out the reasons for admission and explore the knowledge profile of the patients admitted with diabetes in medical units of BPKIHS.

Methods: It was hospital based exploratory study conducted among the admitted DM patients during the period of 1-3-2003 to 29-2-2004 in medical units using simple random sampling, which included 35 samples. The data was analysed using Excel and SPSS programme.

Assessment of quality of life in patients of end stage renal disease on different modalities of treatment.

This study was conducted to measure quality of life of patients with end stage renal disease on different modalities of treatment. A total of 30 diagnosed cases of end stage renal disease (ESRD) attending BPKIHS were included in the study. Group 1 included 10 patients on regular maintenance hemodialysis, group 2 included 10 patients on continuous ambulatory peritoneal dialysis (CAPD) and group 3 included 10 patients on regular conservative drugs.

Purification of inclusion body-forming peptides and proteins in soluble form by fusion to Escherichia coli thermostable proteins.

Proteins and peptides expressed in the prokaryotic system often form inclusion bodies. Solubilization and refolding procedures can be used for their recovery, but this process remains difficult. One strategy for improving the solubility of a protein of interest is to fuse it to a highly soluble protein.

Fatty acid composition of yak (Bos grunniens) cheese including conjugated linoleic acid and trans-18:1 fatty acids.

The esterified fatty acid composition of cheese (YC) from yak ( Bos grunniens), reared in the highlands of the Nepalese Himalayas, was studied using capillary gas-liquid chromatography and compared with that of dairy cow Cheddar cheese (DC) purchased in a local market. The YC was collected from Dolakha, Nepal. The YC had a lower (P<0.

Population preference of net texture prior to bed net trial in Kala-Azar-endemic areas.

Prior to a community-based efficacy trial of long-lasting insecticidal nets (LLINs) in the prevention of visceral leishmaniasis (VL; also called kala-azar), a pilot study on preference of tools was held in endemic areas of India and Nepal in September 2005.LLINs made of polyester and polyethylene were distributed to 60 participants, who used the nets sequentially for 7 d. Acceptability and preference were evaluated via indirect indicators through questionnaires at three defined time points before and after use of the LLINs and through focus group discussions (FGDs).

Caspase-2 cleaves DNA fragmentation factor (DFF45)/inhibitor of caspase-activated DNase (ICAD).

To investigate the signal transduction pathway of caspase-2, cell permeable Tat-reverse-caspase-2 was constructed, characterized and utilized for biochemical and cellular studies. It could induce the cell death as early as 2h, and caspase-2-specific VDVADase activity but not other caspase activities including DEVDase and IETDase. Interestingly, nuclear DNA fragmentation occurred and consistently DNA fragmentation factor (DFF45)/Inhibitor of caspase-activated DNase (ICAD) was cleaved inside the cell as well as in vitro, suggesting a role of caspase-2 in nuclear DNA fragmentation.

Intracellular K(+) inhibits apoptosis by suppressing the Apaf-1 apoptosome formation and subsequent downstream pathways but not cytochrome c release.

Cellular ionic homeostasis, fundamentally K(+) homeostasis, has been implicated as a critical regulator of apoptosis. The intracellular K(+) efflux on apoptotic insult and suppression of apoptosis by high concentration of extracellular K(+) or after inhibition of this efflux by K(+) channel blockers have established the crucial role of K(+) in turning on the apoptotic machinery. Several contrasting observations have reported the antiapoptotic effect of intracellular K(+) concentration to be the result of inhibition of cytochrome c release from mitochondria, but the exact inhibitory mechanism remains obscure.

Both dimerization and interdomain processing are essential for caspase-4 activation.

A subgroup of caspase family of inflammatory caspases (-1, -4, -5, -11, and -12) play important role during cytokine maturation and inflammation but their regulation is not well understood as much as the initiator and effector caspases. Here, the biochemical mechanism of caspase-4 activation is elucidated. With citrate, a well-known kosmotrope to enhance the monomer-dimer transition, caspase-4 was activated approximately 40 times that was comparable with that of caspase-9 ( approximately 75-fold increments).

Association of lipid profile and body mass index (bmi) in hypertensive patients of Eastern Nepal.

Dyslipidemia is closely associated with hypertension. Out of different fractions of lipoprotein, definite association of elevated LDL-Cholesterol (LDLc) and other lipid parameters has been well observed in hypertensive patients. The present cross sectional study was undertaken at BP Koirala Institute of Health Sciences with the aim to find out association of different lipid parameters and Body Mass Index (BMI) among newly diagnosed hypertension without any medications in Eastern Nepal.

Incidence of megaloblastic anaemia and its correction in leishmaniasis--a prospective study at BPKIHS hospital, Nepal.

Fifty (50) cases of Leishmaniasis were included in a prospective study after making the diagnosis based on the demonstration of L D Bodies on bone marrow aspirate. Hemoglobin (Hb) and total leucocyte count (TLC) were less than 10 gm/dl and 4000 per/ml respectively in 22 out of 50 cases. Among 50 cases, 30 showed macrocytic red cell and hypersegmented neutrophils on peripheral blood smear as features of megaloblastic anemia.

Typhoid fever in an 8-month-old infant.

Typhoid fever occurs both in epidemic and endemic forms and is a public health problem in developing countries. Typhoid fever is rare under 2 years of age. The clinical profile of typhoid fever in an infant is variable and non-specific.

Chest radiographs and their reliability in the diagnosis of tuberculosis.

Radiology plays an important role in the diagnosis of pulmonary tuberculosis. Many medical practitioners believe in and rely primarily on the chest x-ray for the diagnosis of pulmonary tuberculosis. This study attempts to evaluate the reliability and validity of chest radiographs.

Comparative study of apoptosis induced by H(2)O(2) and NO: limitation of apoptosis induced by NO due to slower recovery of activity of NO-modified caspase.

Both H(2)O(2) and NO can act as apoptogens, triggering apoptosis in many cells. They are also well known inhibitors of caspases, essential enzymes in apoptosis. The differences between these two agents as apoptosis inducers and how caspases mediate apoptosis with these inhibitory agents is still unclear.

Pott's spine and paraplegia.

Spinal tuberculosis is usually secondary to lung or abdominal involvement and may also be the first manifestation of tuberculosis. Spinal tuberculosis (often called Pott's disease) is by definition, an advanced disease, requiring meticulous assessment and aggressive systemic therapy. Physicians should keep the diagnosis in mind, especially in a patient from a group with a high rate of tuberculosis infection.

Kinetic comparison of procaspase-3 and caspase-3.

Caspases, the key enzymes in apoptosis, are synthesized as proenzymes and converted into active form by proteolytic cleavage. The residues on active site reorganize during the activation process as shown in the comparative studies of crystallographic structures of procaspase-7 and its mature form. On the other hand, the proenzyme itself has some activity.

Liver abscess in the tropics: an experience from Nepal.

Thirty-six consecutive cases of liver abscess seen at the BP Koirala Institute of Health Sciences Hospital, Dharan, Nepal, from 1995 to 1998, were reviewed. Twenty-one cases were male and 15 female, with a mean age of 42 years. Twenty-four cases (66.