Background: Stroke is a disabling condition that has physical and mental impact on a patient’s life. Stroke is an important morbidity for low and middle income countries like Nepal. Hypertension, diabetes, smoking, and dyslipidemia are common risk factors in this regard and are inadequately controlled; mainly because of poor public awareness, inadequate infrastructure, lack of service and qualified manpower.Objectives: This study aims to provide insight into the epidemiology and risk factors in ischemic stroke patients.Methodology: A descriptive cross sectional study was conducted in 92 ischemic stroke patients at a tertiary care hospital Kathmandu Medical College and Teaching Hospital (KMCTH), Sinamangal, Nepal from December 2017 to June 2018. Consecutive sampling technique was used and data was collected from ischemic stroke patients above 14 years of age who were admitted in the Department of Neurology. Information regarding pre-morbid and morbid conditions, imaging findings as well as results was obtained from biochemical analysis of blood after taking consent from the patient or patient’s relative. Statistical Package for the Social Sciences Version 20 was used as a tool for statistical analysis.Results: Their mean age was 63.25 years with standard deviation of 16.45. Dyslipidemia was the most commonly found risk factor which was present in 77.2% of the subjects, followed by smoking (59.8%), presence of carotid artery atherosclerosis (59.8%), hypertension (50%), atrial fibrillation (26.1%) and diabetes mellitus(15.2%). Smoking was significant in males and heart disease was mostly seen in females.Conclusion: Dyslipidemia and smoking were the most common risk factors followed by carotid artery atherosclerosis. Patients with hypertension and dyslipidemia had higher incidence of stroke in both young and elderly group.

Background: With advancing treatment of stroke patients, their mortality has decreased but morbidity and disability has increased. Hence, it becomes increasingly important to find the measures to improve these areas. The study aims to assess the quality of life (QOL) and disability in stroke survivors at least six months post stroke. Methods: Descriptive, cross sectional design was used to assess the QOL and disability in stroke patients attending Neuromedicine and Neurosurgery out-patient departments of Kathmandu Medical College. Data was collected purposively using interview from 155 respondents. QOL was assessed using Health Related Quality of Life in Stroke Patients (HRQOLISP-40) and disability was measured by using World Health Organization Disability Assessment Schedule 2.0 (WHODAS 2.0). Analysis was done using Pearson’s correlation and Mann Whitney U test. Results: The QOL was found to be best in the ‘ecosocial’ and worst in the ‘soul’ domain. In disability, patients scored the best in ‘Getting along with people’ and ‘self-care’ domains and worst in the ‘life activities: school/ work’ domain. Respondents with hemorrhagic stroke, only one admission and those who did not exercise had better QOL. Patients with less than 10 years of formal education, those not earning and those with comorbidities had more disability. Correlation analysis showed better QOL with lesser age, higher monthly family income and higher Barthel index whereas higher disability was found in respondents with higher age and lower Barthel index. Conclusions: Disability in stroke patients needs to be addressed inorder to improve their QOL. The domains affected should be given attention during rehabilitation of stroke patients.

Introduction: Diabetes mellitus is associated with various metabolic disorders, which leads to the progression of the disease and its complications. The aim of the study is to find out prevalence of metabolic syndrome and its association with the components and demographic variables. Methods: This cross-sectional study was conducted among diabetes mellitus patients at a Tertiary level teaching hospital over a period of one year (April 2015 to March 2016). The study involved the use of a questionnaire to obtain information on diabetes by performing anthropometric measurements and corroborating it with respective blood samples collected for the measurement of biochemical parameters, fasting blood glucose and lipid profile. Metabolic syndrome was defined according to the current guidelines, revised in 2005 by the National Heart, Lung and Blood Institute and the American Heart Association. Statistical Package for the Social Sciences Version 20 was used as a tool for statistical analysis. Results: This cross-sectional study involved 200 type 2 diabetes mellitus patients. The prevalence of metabolic syndrome was 71% in the studied Nepalese population. Central obesity (77.5%) and hypertension (76.8%) were the commonest risk factors. It was followed by dyslipidemia among which 65.5% had high triglyceride level and 50.7% had low level of high density lipoprotein cholesterol. Higher prevalence of metabolic syndrome was seen in male patients with type 2 diabetes which accounted for 84 (73.3%). Three components of metabolic syndrome were seen among 70 (35%) and five components among 29 (14.5%) patients. Among the patients who were studied, the age group 45 to 54, 55 to 64 and 65 to 74 years had 14 (20%), 20 (28.6%) and 19 (27.1%) of more than three components of metabolic syndrome respectively. Conclusions: The prevalence of metabolic syndrome was 71% among the patients with type 2 diabetes, where high prevalence was seen among males. In our study central obesity and hypertension along with increasing age were the most common component causing metabolic syndrome.

Background Sleep disorders are considered as one of the important risk factor which have a great impact on patients with type 2 diabetes mellitus. Objective The objectives of this study was to determine the effect of sleep quality on the glycemic level among type 2 diabetic patients. Method This was a cross sectional study done in 208 type 2 diabetic patients visiting Kathmandu Medical College Public Limited from July 2019 to December 2019. Data regarding sleep quality was collected by using Pittsburgh Sleep Quality Index taking global cut off score ≥ 8 as poor sleeper. Glycated hemoglobin level ≥ 7 was considered as poor glycemic control. Chi square test was used to compare parameters between good sleeper and poor sleeper. Independent sample t test compared the means of Pittsburgh Sleep Quality Index factors and glycemic contol. A logistic regression analysis of Pittsburgh Sleep Quality Index factors and glycated hemoglobin was done. Values of p ≤ 0.05 were considered statistically significant. Result The study findings revealed that 62 % had poor glycemic control and 58.7 % were poor quality sleeper. There was a significant association of sleep quality with glycemic control and duration of diabetes. Logistic regression analyses showed that subjective sleep quality was risk factor for poor glycemic control. The odds ratio for subjective sleep quality was found to be 4.59 (2.13-9.91). Conclusion Poor sleep quality was common in type 2 diabetic patients. This study showed that the risk factors for poor subjective sleep quality include poor glycemic control and longer duration of diabetes mellitus.

Background: World Health Organization defines childhood obesity as “one of the most serious public health challenges”. Low income countries like Nepal experience a burden of infectious diseases as well as rising incidence of noncommunicable diseases frequently associated with obesity. There is paucity of information on childhood obesity in Nepal. Objectives: This study aims to determine the prevalence of childhood obesity and overweight in school going children and find its association with blood pressure.Methodology: A school based cross-sectional analytical study was conducted on 509 children aged between 10-16 years, studying in grade 5-10 of private schools in Kathmandu and Bhaktapur. Simple random sampling technique was used for data collection. Anthropometric measurements and blood pressure were taken using standard protocol. Obesity was assessed using Body Mass Index criteria.Results: The overall prevalence of obesity and overweight in children were found to be 1.6% and 6.1% respectively. This study also showed that prevalence of obesity in children from Kathmandu is comparatively more, which was statistically significant (p<0.001). A highly significant relationship was observed for diastolic blood pressure and Body Mass Index (p<0.001) between the two groups.Conclusion: This study concludes that obesity though small in percentage, was found in rising trend when compared with previous data. Also, there was strong association with blood pressure, so timely identification and control of obesity is required for prevention of development of other cardiovascular comorbidities.

Background: Complications are common in patients with ischemic stroke and hinder successful rehabilitation. Timely identification and management of complications are key factors in the management of patients with ischemic stroke. Objectives: The aim of this study is to find the occurrence of different types of complications in patients admitted with the diagnosis of ischemic stroke and to find the risk factors associated with the occurrence of complications. Methodology: The study is a cross sectional descriptive study. A total of 96 patients with ischemic stroke admitted to the Department of Neurology of Kathmandu Medical College Teaching Hospital over a period of six months (July 2018 to December 2018) were recruited. Data was recorded according to a designed proforma and analysed using Statistical Package for the Social Sciences version 20. Results: The age group ranged from 25 to 91 years with the mean age of 64.36 years and 50 (52.1%)patients were male. A total of 62 (64.6%) patients developed at least one complication during hospital stay. Pneumonia and urinary tract infection were the most common complications occurring in 22(22.9%) patients. The occurrence of complications was positively correlated with National Institutes of Health Stroke Scale and Glasgow Coma Scale. Conclusion: Pneumonia and urinary tract infection were the most common complications in our study and were similar to those quoted in the western literature. Severity of stroke had positive correlations with occurrence of complications.

Background: Seizure is a common clinical condition. It represents a majority of patients visiting neurology OPD as well as inpatient department in Kathmandu Medical College Teaching Hospital. While the number of patients with seizure is increasing in Nepal, data on the clinical profile of patients with seizure is scarce. Thus, this study aims to find out the relative frequency of seizure in different age and sex groups. It also aims to find out the common causes of seizure in our Nepalese population. Materials and Methods: A descriptive cross sectional study was carried out in patients attending outpatient and inpatient of Neurology department of Kathmandu Medical College Teaching Hospital between periods of July 2018 to December 2018. Demographic characteristics, radiographic findings, EEG findings and drugs taken by patients were recorded according to the proforma. Results: Data from one hundred patients were collected and analyzed. Most of the patients were less than 41 years of age. Most of the patients were male. The prime cause of seizure was found to be neurocysticercosis (25%). Majority of the patients were on monotherapy. Conclusion: Our data regarding the frequency of seizure in different age and sex groups is comparable to data in South East Asia region whilst, different from the western data. In our population, neurocysticercosiswas the most common cause of seizures. Also, most seizures were controlled with monotherapy.