• 제목/요약/키워드: Pokhara

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Profile of Skin Biopsies and Patterns of Skin Cancer in a Tertiary Care Center of Western Nepal

  • Kumar, Ajay;Shrestha, Prashanna Raj;Pun, Jenny;Thapa, Pratichya;Manandhar, Merina;Sathian, Brijesh
    • Asian Pacific Journal of Cancer Prevention
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    • 제16권8호
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    • pp.3403-3406
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    • 2015
  • Background: Skin biopsy is the method to assist clinicians to make definite dermatological diagnosis which further helps in holistic management. Skin cancers are relatively rare clinical diagnosis in developing countries like Nepal, but the prevalence is on rise. Objectives: To investigate the profile of skin biopsies and frequencies and pattern of skin cancers in a tertiary care centre of Western Nepal. Materials and Methods: The materials consisted of 434 biopsies (1.37%) out of 31,450 OPD visits performed in the Department of Dermatology, Manipal Teaching Hospital, Pokhara, Nepal, during the period of Dec 2011-Nov 2014. Data were collected and analyzed using SPSS-16 with reference to incidence, age, sex, race and clinical and histopathological features. Results: The commonest disorders observed in biopsies were papulosquamous lesions, skin tuberculosis of different types, benign skin tumors, leprosy, collagen and fungal diseases. Viral diseases were rarely seen, probably due to straight forward clinical diagnosis. Dermatological malignancies accounted for 55/434 (12.67%) of biopsies. Skin disorders in general were commoner in females 280/434 (64%), including malignancies 32/55(58.2%). Mean age of patients with skin cancer was 54.5 years. Facilities for proper laboratory investigation of dermatological disorders will improve the quality of life. Conclusions: The most prevalent lesion in skin biopsies was papulosquamous disorders followed by skin tuberculosis of different types. Dermatological malignancy constituted 55/434 (12.67%) cases. The prevalence of skin malignancy is on rise in Nepalese society probably due to increase in life expectancy and better diagnostic services.

Metabolic Changes Enhance the Cardiovascular Risk with Differentiated Thyroid Carcinoma - A Case Control Study from Manipal Teaching Hospital of Nepal

  • Mittal, Ankush;Poudel, Bibek;Pandeya, Dipendra Raj;Gupta, Satrudhan Pd;Sathian, Brijesh;Yadav, Shambhu Kumar
    • Asian Pacific Journal of Cancer Prevention
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    • 제13권5호
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    • pp.2335-2338
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    • 2012
  • Objective: To evaluate several metabolic changes in patients with differentiated thyroid carcinoma (DTC ) which enhance cardiovascular risk in the western region of Nepal. Materials and Methods: This hospital based case control study was carried out using data retrieved from the register maintained in the Department of Biochemistry of the Manipal Teaching Hospital, Pokhara, Nepal between $1^{st}$ January, 2009 and $31^{st}$ December, 2011. The variables collected were age, gender, BMI, glucose, insulin, HbA1C, CRP, fibrinogen, total cholesterol, triglycerides, HDL, LDL, VLDL, f-T3, f-T4, TSH. One way ANOVA was used to examine statistical significance of differences between groups, along with the Post Hoc test LSD for comparison of means. Results: fT3 values were markedly raised in DTC cases ($5.7{\pm}SD1.4$) when compared to controls ($2.2{\pm}SD0.9$). Similarly, fT4 values were also moderately raised in cases of DTC ($4.9{\pm}SD1.3$ and $1.7{\pm}SD0.9$). In contrast, TSH values were lowered in DTC cases ($0.39{\pm}SD0.4$) when compared to controls ($4.2{\pm}SD1.4$). Mean blood glucose levels were decreased while insulin was increased and HDL reduced ($39.5{\pm}SD4.7$ as compared to the control $43.1{\pm}SD2.2$). Conclusion: Cardiovascular risk may be aggravated by insulin resistance, a hypercoagulable state, and an atherogenic lipid profile in patients with differentiated thyroid cancer.

Serum Amyloid A as an Independent Prognostic Factor for Renal Cell Carcinoma - A Hospital Based Study from the Western Region of Nepal

  • Mittal, Ankush;Poudel, Bibek;Pandeya, Dipendra Raj;Gupta, Satrudhan Pd;Sathian, Brijesh;Yadav, Shambhu Kumar
    • Asian Pacific Journal of Cancer Prevention
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    • 제13권5호
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    • pp.2253-2255
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    • 2012
  • Objective: The objective of our present study was to assess the role of serum amyloid A (SAA) in stages and prognosis of renal cell carcinoma. Material and Methods: It was a hospital based retrospective study carried out in the Department of Medicine and Biochemistry of Manipal Teaching Hospital, Pokhara, Nepal between $1^{st}$ January 2008 and $31^{st}$ December 2011. The variables collected were SAA, CRP. Approval for the study was obtained from the institutional research ethical committee. Quantitative analysis of human SAA and C-reactive protein (CRP) was performed by radial immune diffusion (RID) assay for all cases. Results: Of the 422 total cases of renal cell carcinoma, 218 patients had normal and 204 abnormal SAA. SAA levels were grossly elevated in T3 stage ($122.3{\pm}SD35.7$) when compared to the mean for the T2 stage ($84.2{\pm}SD24.4$) (p value: 0.0001). Similarly, SAA levels were grossly elevated in M1 stage ($190.0{\pm}SD12.7$) when compared to the M0 stage ($160.9{\pm}SD24.8$) (p: 0.0001). There was no significant association with elevated CRP levels ($209.1{\pm}SD22.7$, normal $199.0{\pm}SD19.5$). Conclusion: The validity of SAA in serum as being of independent prognostic significance in RCC was demonstrated with higher levels in advanced stage disease.

Prostate Biomarkers with Reference to Body Mass Index and Duration of Prostate Cancer

  • Poudel, Bibek;Mittal, Ankush;Shrestha, Rojeet;Nepal, Ashwini Kumar;Shukla, Pramod Shanker
    • Asian Pacific Journal of Cancer Prevention
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    • 제13권5호
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    • pp.2149-2152
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    • 2012
  • Objective: This study was performed to assess prostate biomarkers with reference to body mass index and duration of prostate cancer. Materials and Methods: A hospital based retrospective study was undertaken using data retrieved from the register maintained in the Department of Biochemistry of Manipal Teaching Hospital, Pokhara, Nepal between $1^{st}$ January, 2009 and $28^{th}$ February, 2012. Biomarkers studied were prostate specific antigen (PSA), acid phosphatase (ACP) and prostatic acid phosphatase (PAP), alkaline phosphatase (ALP) and gamma glutamyl transpeptidase (${\gamma}GT$). Demographic data including age, duration of disease, body weight, height and body mass index (BMI) were also collected. Duration of disease was categorized into three groups: <1 year, 1-2years and >2 years. Similarly, BMI ($kg/m^2$) was categorized into three groups: <23 $kg/m^2$, 23-25 $kg/m^2$ and >25 $kg/m^2$. Descriptive statistics and testing of hypothesis were used for the analysis using EPI INFO and SPSS 16 software. Results: Out of 57 prostate cancers, serum level of PSA, ACP and PAP were increased above the cut-off point in 50 (87.5%), 30 (52.63%) and 40 (70.18%) respectively. Serum levels of PSA, ACP and PAP significantly declined with the duration of disease after diagnosis. We observed significant and inverse relation between PSA and BMI. Similar non-signficiant tendencies were apparent for ACP and PAP. Conclusions: Decreasing levels of prostate biomarkers were found with the duration of prostate cancer and with increased BMI. Out of prostate biomarkers, PSA was found to be significantly decreased with the duration of disease and BMI.

HIMALAYAN MEDICINAL RESOURCES: PRESENT AND FUTURE. A CASE STUDY: ANTIDIABETIC ACTIVITY OF SHILAJIT

  • Basnet, Purusotam
    • 한국자원식물학회:학술대회논문집
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    • 한국자원식물학회 2001년도 The 8th International Symposium
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    • pp.20-33
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    • 2001
  • A major portion of drugs used in Ayurvedic system of medicine which has been practiced since the early human civilization in Indian subcontinent were of plant origin. It should be noted that 70% of the population in this region depends on Ayurveda for their medical treatment and 60% of the drug resources are obtained from the Himalayan region. Therefore, Nepal becomes a potential source of plant drug resource since it occupies a major portion of the Himalaya. In the present paper, in general a current status of medicinal plant resources of Himalayan region especially Nepal will be discussed. In addition to this, a typical example of antidiabetic activity of Shilajit will be taken for the discussion. Shilajit is one of the crucial elements in several formulations including those of Rasayana, a therapy in Ayurveda, which has been practiced in the prevention of ageing and mental disorder. Although, Shilaiit is widely used for the treatment of diabetes, no satisfactory scientific reports are available up to now. The crude Shilajit in the market is a dark brown or black rock-like substance collected from the Himalayan region with a strong smell of cow's stale urine. In our studies, Shilajit (collected in the central Himalayan region) prevented the diabetes in nonobese diabetic (NOD) mice model. Shilajit also prevented the diabetes in the rats against the action of multiple low-dose (10 ㎎/㎏, i.v., 5 times) of streptozotocin. On the other hand, Shilajit did not show antioxidative activity. The preventive action of Shilajit on diabetes is mainly focused on the Th1 and Th2 cell activities, since Th2 cells activity was found to be significantly upregulated. Shilajit, however, showed a mild action in controlling the blood sugar level in young, old, and mild diabetic rats, but not in the severe diabetic rats. It also stimulated the nitric oxide production in macrophages. Based on these evidences, the antidiabetic activities of Shilajit appear to be immunomodulative probably by protecting or strengthening insulin-producing b-cells In the pancreas. further systematic research on constituents of Shilajit and its quality evaluation is necessary to enable the use of natural medicines in the treatment of diabetes.

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Study and Evaluation of Tourism Websites based on User Perspective

  • Shrestha, Deepanjal;Wenan, Tan;Rajkarnikar, Neesha;Shrestha, Deepmala;Jeong, Seung Ryul
    • 인터넷정보학회논문지
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    • 제22권4호
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    • pp.65-82
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    • 2021
  • A well-designed website is mandatory for good marketing and proper tourism business. This research considers Nepal as a domain of study and specifically explores welcomenepal.com, the official tourism portal as a reference for the study. The work is based on the study of the existing literature, user-survey, and technical testing of the website using open-source testing tools to identify user perspective, design issues, website architecture and design quality of the tourism website. A population size of 400 respondents, which consist of both domestic and international tourist, are considered for the survey. Data is received from 360 respondents, which is analyzed using statistical tests like Cronbach's alpha, Pearson's correlation, cross-tabulations, bars charts and graphs to draw inferences and consclusion. The software-based test results serve as another important parameter for the evaluation of the current official website. This study brings out core needs of the tourist in terms of expectations from a tourism website and access technical quality of the current portal to provide necessary feedback and suggestions. The government officials, business houses, and web designers can utilize this work as a knowledge base to build tourism websites, which are user-centric. Further, the work is specifically important for Nepal government and tourism officials to identify shortcomings in their current website and make improvements for better design and user adaptability in future.

Link Prediction in Bipartite Network Using Composite Similarities

  • Bijay Gaudel;Deepanjal Shrestha;Niosh Basnet;Neesha Rajkarnikar;Seung Ryul Jeong;Donghai Guan
    • KSII Transactions on Internet and Information Systems (TIIS)
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    • 제17권8호
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    • pp.2030-2052
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    • 2023
  • Analysis of a bipartite (two-mode) network is a significant research area to understand the formation of social communities, economic systems, drug side effect topology, etc. in complex information systems. Most of the previous works talk about a projection-based model or latent feature model, which predicts the link based on singular similarity. The projection-based models suffer from the loss of structural information in the projected network and the latent feature is hardly present. This work proposes a novel method for link prediction in the bipartite network based on an ensemble of composite similarities, overcoming the issues of model-based and latent feature models. The proposed method analyzes the structure, neighborhood nodes as well as latent attributes between the nodes to predict the link in the network. To illustrate the proposed method, experiments are performed with five real-world data sets and compared with various state-of-art link prediction methods and it is inferred that this method outperforms with ~3% to ~9% higher using area under the precision-recall curve (AUC-PR) measure. This work holds great significance in the study of biological networks, e-commerce networks, complex web-based systems, networks of drug binding, enzyme protein, and other related networks in understanding the formation of such complex networks. Further, this study helps in link prediction and its usability for different purposes ranging from building intelligent systems to providing services in big data and web-based systems.

Des-Gamma-Carboxyprothrombin for Early Identification and Prognosis of Hepatocellular Carcinoma - A Case Control Study from Western Nepal

  • Mittal, Ankush;Gupta, Satrudhan Pd;Sathian, Brijesh;Sreedharan, Jayadevan;Poudel, Bibek;Yadav, Shambhu Kumar;Pandeya, Dipendra Raj
    • Asian Pacific Journal of Cancer Prevention
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    • 제13권11호
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    • pp.5773-5775
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    • 2012
  • Objective: To assess the diagnostic and prognostic value of AFP and des-gamma-carboxyprothrombin (DCP) in combination and alone for hepatocellular carcinoma. Materials and Methods: A case control study carried out in the Department of Biochemistry of Manipal College of Medical Sciences, Pokhara, Nepal between $1^{st}$ January 2010 and $31^{st}$ December 2011. The variables collected were age, gender, BMI, total proteins, albumin, AST, ALT, total bilirubin, DCP, AFP. Approval for the study was obtained from the institutional research ethical committee. Estimation of AFP was performed by ELISA reader for all cases. Analysis was done using descriptive statistics and confidence interval (CI). The data was analyzed using Excel 2003, R 2.8.0 Statistical Package for the Social Sciences (SPSS) for Windows Version 16.0 (SPSS Inc; Chicago, IL, USA) and the EPI Info 3.5.1 Windows Version. Results:The mean age of HCC cases was $53.6{\pm}14.93$ yrs. The percentage of females was less than males in both cases (23%) and controls (29%). The specificity of DCP reached 100% when its values was equal or greater than 150 (MAU/ml) for 0, 3, 6, 9, 12 months preceding the diagnosis of HCC. Similarly, the specificity for AFP was also nearly 100% when its value was equal or greater than 200 ng/ml 0, 3, 6, 9, 12 months earlier to the finding of HCC. The specificity of DCP (${\geq}40MAU/mL$) and AFP(${\geq}20$ ng/mL) in combination was 93%, 97%, 95%, 96%, 97% in respect to 0, 3, 6, 9, 12 months prior to the diagnosis of HCC. Conclusion: The combination of both DCP and AFP will improve the finding of initial HCC and the sensitivity of these markers was utmost at the time of HCC identification and noticeably lesser at former time points.

Clinicopathological Profile of Head and Neck Cancers in the Western Development Region, Nepal: A 4-Year Snapshot

  • Lasrado, Savita;Prabhu, Prashanth;Kakria, Anjali;Kanchan, Tanuj;Pant, Sadip;Sathian, Brijesh;Gangadharan, P.;Binu, V.S.;Arathisenthil, S.V.;Jeergal, Prabhakar A.;Luis, Neil A.;Menezes, Ritesh G.
    • Asian Pacific Journal of Cancer Prevention
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    • 제13권12호
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    • pp.6059-6062
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    • 2012
  • Regional cancer epidemiology is an important basis for determining the priorities for cancer control in different countries worldwide. There is no reliable information about the pattern of head and neck cancer in western Nepal and hence an attempt was here made to evaluate the situation based on hospital data, which provide the only source in the western region of Nepal. A clinicopathological analysis of head and neck cancers treated between 2003 and 2006 in Manipal Teaching Hospital affiliated to Manipal College of Medical Sciences, Pokhara, Western Development Region, Nepal was performed. A total of 105 head and neck cancer cases were identified with a male to female ratio of 1.8:1. The median ages of male and female patients were 62 and 64 years, respectively. Ninety-seven (92.4%) of the cancer patients were suffering from carcinoma, three (2.9%) had blastoma, three (2.9%) had sarcoma, and two (1.9%) had lymphoma. The majority (61.9%) of carcinoma cases were squamous cell carcinoma followed by anaplastic carcinoma (7.2%). Of the carcinoma cases, the most common site of primary lesion was larynx (19.6%), followed by the thyroid (14.4%), the tongue and hypopharynx with 10.3% cases each. Comparative analysis among males and females did not reveal any sex difference in type of head and neck cancers. The head and neck cancer pattern revealed by the present study provides valuable leads to cancer epidemiology in western Nepal and useful information for health planning and cancer control, and future research in western Nepal.

Liver Involvement in Multiple Myeloma: A Hospital Based Retrospective Study

  • Poudel, Bibek;Mittal, Ankush;Shrestha, Rojeet;Farooqui, Mohammad Shamim;Yadav, Naval Kishor;Shukla, Pramod Shanker
    • Asian Pacific Journal of Cancer Prevention
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    • 제13권5호
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    • pp.2153-2155
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    • 2012
  • Objective: This study was to assess liver involvement in multiple myeloma with the aid of liver function tests. Materials and Methods: A hospital based retrospective study was undertaken using data retrieved of multiple myeloma from the register maintained in the Department of Biochemistry of the Manipal Teaching Hospital, Pokhara, Nepal between $1^{st}$ January, 2007 and $28^{th}$ February, 2012. We collected biomarkers of liver profiles including bilirubin (Total, Direct and Indirect), total protein, albumin, AG ratio, SGOT, SGPT, ALP, ${\gamma}GT$, LDH, ferritin, renal profile and hematological profile. Descriptive statistics and testing of hypothesis were used for the analysis using EPI INFO and SPSS 16 software. Results: Out of 37 cases of multiple myeloma, serum level of AST, ALT, ALP, ${\gamma}GT$ and LDH were increased above the cut-off point in 22 (59.5%), 24 (64.86%), 13 (35.13%), 9 (24.3%) and 11 (29.7%) respectively. The mean values of AST ($65.5{\pm}28.18$ U/L), ALT ($68.37{\pm}29.74$ U/L), ALP ($328.0{\pm}148.4$ U/L), ${\gamma}GT$ ($44.5{\pm}29.6$ U/L) and LDH ($361.7{\pm}116.5$ U/L), total protein ($9.79{\pm}1.03$ gm/dl) were significantly increased when compared with controls. In contrast, albumin ($3.68{\pm}0.43$ gm/dl) and the AG ratio ($0.62{\pm}0.15$) were significantly decreased. Similarly, anemia, hyperuricemia, azotemia, hypercalcaemia and Bence Jones proteinuria were found in 30 (78.9%), 27 (71.1%), 19 (51.5%), 15 (39.5%) and 16 (42.1%) respectively, in cases of multiple myeloma. Conclusions: While clinical manifestation of liver disease among the multiple myeloma was not common, abnormalities in liver function were characteristic.