27 results on '"Prem Bhattarai"'
Search Results
2. Airway inflammatory changes in the lungs of patients with asthma-COPD overlap (ACO): a bronchoscopy endobronchial biopsy study
- Author
-
Surajit Dey, Wenying Lu, Greg Haug, Collin Chia, Josie Larby, Heinrich C. Weber, Archana Vijay Gaikwad, Prem Bhattarai, Affan Mahmood Shahzad, Prabuddha S. Pathinayake, Peter A. B. Wark, Mathew Suji Eapen, and Sukhwinder Singh Sohal
- Subjects
ACO ,Asthma ,COPD ,Inflammatory cells ,Macrophage ,CD + 8 T-cells ,Diseases of the respiratory system ,RC705-779 - Abstract
Abstract Background Although asthma and chronic obstructive pulmonary disease (COPD) are two distinct chronic airway inflammatory diseases, they often co-exist in a patient and the condition is referred to as asthma-COPD overlap (ACO). Lack of evidence regarding the inflammatory cells in ACO airways has led to their poor prognosis and treatment. The objective of this endobronchial biopsy (EBB) study was to enumerate inflammatory cellular changes in the airway wall of ACO compared with asthma, COPD current smokers (CS) and ex-smokers (ES), normal lung function smokers (NLFS), and non-smoker controls (HC). Methods EBB tissues from 74 patients were immunohistochemically stained for macrophages, mast cells, eosinophils, neutrophils, CD8+ T-cells and CD4+ T-cells. The microscopic images of stained tissues were evaluated in the epithelium, reticular basement membrane (RBM) cells/mm RBM length, and lamina propria (LP) cells/mm2 up to a depth of 120 µM using the image analysis software Image-Pro Plus 7.0. The observer was blinded to the images and disease diagnosis. Statistical analysis was performed using GraphPad Prism v9. Results The tissue macrophages in ACO were substantially higher in the epithelium and RBM than in HC (P
- Published
- 2023
- Full Text
- View/download PDF
3. Platelet Activating Factor Receptor and Intercellular Adhesion Molecule–1 Expression Increases in the Small Airway Epithelium and Parenchyma of Patients with Idiopathic Pulmonary Fibrosis: Implications for Microbial Pathogenesis
- Author
-
Affan Mahmood Shahzad, Wenying Lu, Surajit Dey, Prem Bhattarai, Archana Vijay Gaikwad, Jade Jaffar, Glen Westall, Darren Sutherland, Gurpreet Kaur Singhera, Tillie-Louise Hackett, Mathew Suji Eapen, and Sukhwinder Singh Sohal
- Subjects
alveolar macrophages ,ICAM–1 ,idiopathic pulmonary fibrosis ,infections ,PAFR ,type 2 pneumocytes ,Medicine - Abstract
Background: Idiopathic pulmonary fibrosis (IPF) is an irreversible lung fibrotic disorder of unknown cause. It has been reported that bacterial and viral co-infections exacerbate disease pathogenesis. These pathogens use adhesion molecules such as platelet activating factor receptor (PAFR) and intercellular adhesion molecule-1 (ICAM–1) to gain cellular entry, causing infections. Methods: Immunohistochemical staining was carried out for lung resections from IPF patients (n = 11) and normal controls (n = 12). The quantification of PAFR and ICAM–1 expression is presented as a percentage in the small airway epithelium. Also, type 2 pneumocytes and alveolar macrophages were counted as cells per mm2 of the parenchymal area and presented as a percentage. All image analysis was done using Image Pro Plus 7.0 software. Results: PAFR expression significantly increased in the small airway epithelium (p < 0.0001), type 2 pneumocytes (p < 0.0001) and alveolar macrophages (p < 0.0001) compared to normal controls. Similar trend was observed for ICAM–1 expression in the small airway epithelium (p < 0.0001), type 2 pneumocytes (p < 0.0001) and alveolar macrophages (p < 0.0001) compared to normal controls. Furthermore, the proportion of positively expressed type 2 pneumocytes and alveolar macrophages was higher in IPF than in normal control. Conclusions: This is the first study to show PAFR and ICAM–1 expression in small airway epithelium, type 2 pneumocytes and alveolar macrophages in IPF. These findings could help intervene microbial impact and facilitate management of disease pathogenesis.
- Published
- 2024
- Full Text
- View/download PDF
4. TGF-β1, pSmad-2/3, Smad-7, and β-Catenin Are Augmented in the Pulmonary Arteries from Patients with Idiopathic Pulmonary Fibrosis (IPF): Role in Driving Endothelial-to-Mesenchymal Transition (EndMT)
- Author
-
Archana Vijay Gaikwad, Mathew Suji Eapen, Surajit Dey, Prem Bhattarai, Affan Mahmood Shahzad, Collin Chia, Jade Jaffar, Glen Westall, Darren Sutherland, Gurpreet Kaur Singhera, Tillie-Louise Hackett, Wenying Lu, and Sukhwinder Singh Sohal
- Subjects
idiopathic pulmonary fibrosis ,pulmonary hypertension ,pulmonary artery ,vascular remodelling ,endothelial-to-mesenchymal transition ,Medicine - Abstract
Background: We have previously reported that endothelial-to-mesenchymal transition (EndMT) is an active process in patients with idiopathic pulmonary fibrosis (IPF) contributing to arterial remodelling. Here, we aim to quantify drivers of EndMT in IPF patients compared to normal controls (NCs). Methods: Lung resections from thirteen IPF patients and eleven NCs were immunohistochemically stained for EndMT drivers, including TGF-β1, pSmad-2/3, Smad-7, and β-catenin. Intima, media, and adventitia were analysed for expression of each EndMT driver in pulmonary arteries. Computer- and microscope-assisted Image ProPlus7.0 image analysis software was used for quantifications. Results: Significant TGF-β1, pSmad-2/3, Smad-7, and β-catenin expression was apparent across all arterial sizes in IPF (p < 0.05). Intimal TGF-β1, pSmad-2/3, Smad-7, and β-catenin were augmented in the arterial range of 100–1000 μm (p < 0.001) compared to NC. Intimal TGF-β1 and β-catenin percentage expression showed a strong correlation with the percentage expression of intimal vimentin (r′ = 0.54, p = 0.05 and r′ = 0.61, p = 0.02, respectively) and intimal N-cadherin (r′ = 0.62, p = 0.03 and r′ = 0.70, p = 0.001, respectively). Intimal TGF-β1 and β-catenin expression were significantly correlated with increased intimal thickness as well (r′ = 0.52, p = 0.04; r′ = 0.052, p = 0.04, respectively). Moreover, intimal TGF-β1 expression was also significantly associated with increased intimal elastin deposition (r′ = 0.79, p = 0.002). Furthermore, total TGF-β1 expression significantly impacted the percentage of DLCO (r′ = −0.61, p = 0.03). Conclusions: This is the first study to illustrate the involvement of active TGF-β/Smad-2/3-dependent and β-catenin-dependent Wnt signalling pathways in driving EndMT and resultant pulmonary arterial remodelling in patients with IPF. EndMT is a potential therapeutic target for vascular remodelling and fibrosis in general in patients with IPF.
- Published
- 2024
- Full Text
- View/download PDF
5. Endothelial-to-mesenchymal transition: a precursor to pulmonary arterial remodelling in patients with idiopathic pulmonary fibrosis
- Author
-
Archana Vijay Gaikwad, Wenying Lu, Surajit Dey, Prem Bhattarai, Greg Haug, Josie Larby, Collin Chia, Jade Jaffar, Glen Westall, Gurpreet Kaur Singhera, Tillie-Louise Hackett, Mathew Suji Eapen, and Sukhwinder Singh Sohal
- Subjects
Medicine - Abstract
Background We have previously reported arterial remodelling in patients with idiopathic pulmonary fibrosis (IPF) and suggested that endothelial-to-mesenchymal transition (EndMT) might be central to these changes. This study aims to provide evidence for active EndMT in IPF patients. Methods Lung resections from 13 patients with IPF and 15 normal controls (NCs) were immunostained for EndMT biomarkers: vascular endothelial cadherin (VE-cadherin), neural cadherin (N-cadherin), S100A4 and vimentin. Pulmonary arteries were analysed for EndMT markers by using computer- and microscope-assisted image analysis software Image ProPlus7.0. All the analysis was done with observer blinded to subject and diagnosis. Results Increased expression of mesenchymal markers N-cadherin (p
- Published
- 2023
- Full Text
- View/download PDF
6. Arterial remodelling in smokers and in patients with small airway disease and COPD: implications for lung physiology and early origins of pulmonary hypertension
- Author
-
Prem Bhattarai, Wenying Lu, Archana Vijay Gaikwad, Surajit Dey, Collin Chia, Josie Larby, Greg Haug, Ashutosh Hardikar, Andrew Williams, Gurpreet Kaur Singhera, Tillie-Louise Hackett, Mathew Suji Eapen, and Sukhwinder Singh Sohal
- Subjects
Medicine - Abstract
Introduction Pulmonary vascular remodelling in chronic obstructive pulmonary disease (COPD) has detrimental consequences for lung physiology. The aim of our study was to provide a comprehensive size-based morphometric quantification of pulmonary arterial remodelling in smokers and in patients with small airway disease (SAD) or COPD. Method Movat's pentachrome staining was performed on lung resections for 46 subjects: 12 never-smoker normal controls (NC), six normal lung function smokers (NLFS), nine patients with SAD, nine patients with mild-to-moderate COPD who were current smokers (COPD-CS) and 10 patients with mild-to-moderate COPD who were ex-smokers (COPD-ES). Following a size-based classification of pulmonary arteries, image analysis software was used to measure their number, total wall thickness, individual layer thickness and elastin percentage. Results All pathological groups showed decreased numbers of pulmonary arteries compared with the NC group in all artery sizes. Arterial wall thickness was greater in NLFS and COPD-CS than in NC. Thickness in COPD-ES was decreased compared with COPD-CS. Intimal thickness was greater in all pathological groups in all arterial sizes than in the NC group. Medial thickness was also greater in small and medium arteries. Intimal thickness of larger arteries in COPD-CS correlated negatively to forced expiratory volume in 1 s/forced vital capacity (FVC) % and forced expiratory flow at 25–75% of FVC. Elastin deposition in small arteries was greatest in COPD-CS. Intimal elastin deposition had a more negative correlation with intimal thickness in NLFS and SAD than in COPD-CS. Conclusion Smoking, SAD and mild-to-moderate COPD are associated with pruning and a decrease in the number of pulmonary arteries, increased wall thickness and variable elastin deposition. These changes were associated with worse airway obstruction.
- Published
- 2022
- Full Text
- View/download PDF
7. Vascular remodelling in idiopathic pulmonary fibrosis patients and its detrimental effect on lung physiology: potential role of endothelial-to-mesenchymal transition
- Author
-
Archana Vijay Gaikwad, Wenying Lu, Surajit Dey, Prem Bhattarai, Collin Chia, Josie Larby, Greg Haug, Stephen Myers, Jade Jaffar, Glen Westall, Gurpreet Kaur Singhera, Tillie-Louise Hackett, James Markos, Mathew Suji Eapen, and Sukhwinder Singh Sohal
- Subjects
Medicine - Abstract
Background Idiopathic pulmonary fibrosis (IPF) is a progressive, irreversible fibrotic interstitial lung disease. We performed size-based quantitation of pulmonary arterial remodelling in IPF and examined the role of endothelial-to-mesenchymal transition (EndMT) and effects on lung physiology. Methods Resected lung tissues from 11 normal controls (NCs), and 13 IPF patients were differentially stained using the Movat Pentachrome technique. Size-based classification for pulmonary arteries was conducted in NC and IPF tissues. For each pulmonary artery, arterial size, luminal diameter, thickness of the intima, media and adventitia, and elastin deposition were quantified using Image ProPlus7.0 software. In addition, immunohistochemical staining was performed for EndMT markers and collagen. Results Large and medium-size arterial numbers were significantly reduced in IPF compared to NCs (p
- Published
- 2022
- Full Text
- View/download PDF
8. Self-Medication Practices in Surrounding Communities of Birat Medical College and Teaching Hospital of Eastern Nepal
- Author
-
Surya Bahadur Parajuli, Anjali Mishra, Heera KC, Prem Bhattarai, Sharad Karki, Rajan Pandit, and Prasanna Dahal
- Subjects
AMR ,Hospitals ,Nepal ,self-medication ,Medicine (General) ,R5-920 - Abstract
Background: Self-medication is the use of drugs to treat self-diagnosed disorders/symptoms, or the intermittent/continued use of a prescribed drug for chronic/recurrent disease/symptoms (WHO). It is the cause for antibiotic resistance, inappropriate treatment, financial burden and many deaths. WHO listed self-medication as one of the priority research area at the local context. The objective of the study was to find the prevalence and pattern of self-medication in surrounding communities of Birat Medical College and Teaching Hospital. Methods: A community-based cross-sectional study was conducted at the surrounding communities of Birat Medical College from 1st August 2018 to 15th December 2018. Multistage sampling was used to collect information from 348 household having family members aged 16 years and above. Ethical approval was taken from Institutional Review Committee of Birat Medical College. Pre-tested semi-structured questionnaire was used. Results: The mean age of the participants was 40.5±15.9 years. Prevalence of self-medication was 44.04%. Majority took self-medication for headache 43.6% followed by common cold 39.1% etc. Majority used allopathic drugs 82.7% followed by traditional healers 9.8%. Common medication were antipyretics 18.8%, antibiotics 16.5%, proton pump inhibitor 7.5%, antihistamines 6.8% etc. The reason behind self-medication were low cost 30.1%, time saving 24.1%, illness too trivial/mild for consultation 18.8%, quick relief 18.1%, high doctor fee 15 %, lack of awareness 13.5 %, familiar with treatment options 12.8%, long waiting line in hospital 12% etc. Out of them 8.3% noticed side effects of self-medication. Out of all 59.5% felt the need of awareness program on rational use of medicines. Age, sex, marital status, ethnicity, religion, education and occupation of participants, education and occupation of head of household, poverty status, family type, house residence type, type of house has no significant association with self-medication. Participants residing in alani/rent households were 1.93 times more likely to self-medicate than those residing in their own and participants having negative attitude were 1.90 times more likely to self-medicate than those who had positive attitude and both were statistically significant. Conclusions: The burden of self-medication was present and allopathic drugs including antibiotics were common. Adverse drug reactions were reported but participants were unaware about the place to report. Participants had negative attitude towards self-medication which is harmful for their health. As pharmacy was the common source of self-medication, the prescription based medicine dispensary should be advocated.
- Published
- 2019
- Full Text
- View/download PDF
9. Heart Rate Variability as a Marker of Changes in Mood State in Daily Life by Photoplethysmography Technique
- Author
-
Santosh Kumar Deo, Kopila Agrawal, and Prem Bhattarai
- Subjects
Heart Rate Variability ,Mood States ,Photoplethysmography ,Medicine - Abstract
Introduction: The different mood states in our daily life can affect our mental and emotional health. The aim of our study was to explore photoplethysmography to record heart rate variability as a marker of changes in mood states in our daily life. Materials and Methods: Two groups of affective pictures categorized into positive and negative sets were shown to thirty subjects on two different consecutive days with simultaneously recording of heart rate variability for 5 minutes by photoplethysmography technique. Immediately after recording on each day, 0-9 self-assessment scale was used to assess the mood state of the subject after viewing the set of pictures. Results: Sympathetic domains of heart rate variability like low frequency (200.3 ±4.1 vs. 166.7 ±2.8, p
- Published
- 2018
- Full Text
- View/download PDF
10. Effect of long term high altitude exposure on cardiovascular autonomic adjustment during rest and post-exercise recovery
- Author
-
Prem Bhattarai, Bishnu H. Paudel, Dilip Thakur, Balkrishna Bhattarai, Bijay Subedi, and Rita Khadka
- Subjects
Highlanders ,Heart rate variability ,Exercise ,Industrial medicine. Industrial hygiene ,RC963-969 - Abstract
Abstract Background Despite the successful adaptation to high altitude, some differences do occur due to long term exposure to the hypoxic environment. The effect of long term high altitude exposure on cardiac autonomic adjustment during basal and post-exercise recovery is less known. Thus we aimed to study the differences in basal cardiac autonomic adjustment and its response to exercise in highlanders and to compare it with lowlanders. Methods The study was conducted on 29 healthy highlander males who were born and brought up at altitude of 3000 m and above from the sea level, their cardiac autonomic adjustment was compared with age, sex, physical activity and ethnicity-matched 29 healthy lowlanders using Heart Rate Variability (HRV) during rest and recovery from sub-maximal exercise (3 m step test). Intergroup comparison between the highlanders and lowlanders and intragroup comparison between the rest and the postexercise recovery conditions were done. Results Resting heart rate and HRV during rest was comparable between the groups. However, heart rate recovery after 3 min step test was faster in highlanders (p
- Published
- 2018
- Full Text
- View/download PDF
11. Quality of life of elderly people living with family and in old age home in Morang District, Nepal
- Author
-
Menuka Shrestha, Heera KC, Prem Bhattarai, Anjali Mishra, and Surya B. Parajuli
- Subjects
Humans ,Homes for the Aged ,Quality of Life. ,Technology ,Technology (General) ,T1-995 ,Science - Abstract
Introduction: Nepal like many other developing countries in the world is witnessing the rapid ageing of population. Quality of life (QOL) of elderly people is becoming even more relevant towards an ageing society. In Nepal, less is known regarding special needs and quality of life of elderly people either in familial situations or in old age residences. Objectives: The present study was undertaken to assess and compare the quality of life of elderly living with the family and in old age home. Methodology: A Cross sectional descriptive study was conducted from October 2016 to April 2017 among elderly population aged 60 years and above. A total of 50 elderly people were enrolled from old age home (OAH) using total enumeration sampling technique and equal number of sample was selected from the family setting. QOL of elderly was assessed using WHOQOL-BRIEF questionnaire after taking informed consent from the participants. Data was analyzed using SPSS. Results: The mean scores of QOL domains were better among the age group 60-70 years, males, married, literates and who had children. The mean scores of QOL in physical, psychological and environmental domains were better in elderly living with the family than living in OAH. Low scores were found on social domain among elderly compared to other domain irrespective of their residence. Conclusion: QOL score among elderly is average, while social relationship domain of QOL scores was found to be low. Social activities should be expanded for these residents in order to promote social health. The QOL which each individual possesses is very important in all aspects be it physical, psychological, social & environmental. Furthermore, programs that help elderly people live in their own homes and social environments should be promoted. BIBECHANA 16 (2019) 221-227
- Published
- 2018
12. Clinical Application of Forced Oscillation Technique (FOT) in Early Detection of Airway Changes in Smokers
- Author
-
Prem Bhattarai, Stephen Myers, Collin Chia, Heinrich C. Weber, Sally Young, Andrew D. Williams, and Sukhwinder Singh Sohal
- Subjects
COPD ,forced oscillation technique ,smoking ,small airways ,Medicine - Abstract
The forced oscillation technique (FOT) is a non-invasive method to assess airway function by emitting oscillatory signals into the respiratory tract during tidal ventilation. This opinion piece discusses the current use, trialled modification and future directions in utilizing FOT as a novel diagnostic tool for early detection of small airway changes in smokers. The published evidence to date has shown that FOT parameters could be a sensitive diagnostic tool to detect early respiratory changes in smokers. Multiple frequencies and the frequency dependence of resistance and reactance can provide the most valuable and early information regarding smoking induced changes in airways. Considering its non-invasiveness, lower level of discomfort to patients than spirometry, feasibility, and cost effectiveness, it could be the first-choice diagnostic technique for detection of early respiratory changes in smokers. The finding of FOT could further be supported and correlated with inflammatory markers.
- Published
- 2020
- Full Text
- View/download PDF
13. Pattern of Thyroid Dysfunction in Patients with Metabolic Syndrome and Its Relationship with Components of Metabolic Syndrome
- Author
-
Prabin Gyawali, Jyoti Shrestha Takanche, Raj Kumar Shrestha, Prem Bhattarai, Kishor Khanal, Prabodh Risal, and Rajendra Koju
- Subjects
Atherosclerotic cardiovascular disease risk ,Metabolic syndrome ,Subclinical hypothyroidism ,Thyroid dysfunction ,Diseases of the endocrine glands. Clinical endocrinology ,RC648-665 - Abstract
BackgroundThyroid dysfunction (TD) and metabolic syndrome (MetS) are known risk factors for atherosclerotic cardiovascular disease (ASCVD). TD is risk factor for ASCVD mediated by the effects of thyroid hormones on lipid metabolism and blood pressure hence the components of MetS. It is possible that coexistence of these two disease entities and unrecognized TD in patients with MetS might substantially increase ASCVD risk. Moreover, little is known about the relationship between TD and the components of MetS. Thus, the purpose of this study was to evaluate the pattern of TD in patients with MetS and its relationship with components of the MetS.MethodsA total of 358 previously diagnosed patients with MetS were recruited in the study. The thyroid function test parameters were measured to classify TD at Dhulikhel Hospital-Kathmandu University Hospital, Dhulikhel, Nepal. Statistical analyses were performed using SPSS version 16.0 to evaluate pattern and relationship.ResultsThe overall prevalence of TD in patients with MetS was 31.84% with high prevalence of subclinical hypothyroidism (29.32%). We found no evidence of a relationship between TD and components of MetS, although there was significant difference in waist circumference between four groups of TD.ConclusionPatients with MetS had subclinical hypothyroidism greatly. Although there was no evidence of any relationship between thyroid status and all components of MetS, TD should be taken into account when evaluating and treating patients with MetS to reduce the impending risk.
- Published
- 2015
- Full Text
- View/download PDF
14. Vascular remodelling in IPF patients and its detrimental effect on lung physiology: potential role of endothelial to mesenchymal transition (EndMT)
- Author
-
Archana Vijay Gaikwad, Wenying Lu, Surajit Dey, Prem Bhattarai, Collin Chia, Josie Larby, Greg Haug, Stephen Myers, Jade Jaffar, Glen Westall, Gurpreet Kaur Singhera, Tillie-Louise Hackett, James Markos, Mathew Suji Eapen, and Sukhwinder Singh Sohal
- Subjects
Pulmonary and Respiratory Medicine ,respiratory system ,respiratory tract diseases - Abstract
BackgroundIPF is a progressive, irreversible fibrotic interstitial lung disease. We performed size-based quantitation of pulmonary arterial remodelling in IPF, examined the role of EndMT and effects on lung physiology.MethodsResected lung tissues from 11 normal controls (NC), and 13 IPF patients, were differentially stained using the Movat Pentachrome technique. Size-based classification for pulmonary arteries was conducted in NC and IPF tissues. For each pulmonary artery, arterial size, luminal diameter, thickness of the intima, media, adventitia, and elastin deposition was quantified using Image ProPlus7.0 software. In addition, immunohistochemical staining was performed for EndMT markers and collagen.ResultsLarge and medium size arterial numbers were significantly reduced in IPF compared to NC (pConclusionsThis is the first study demonstrating size-based differences in pulmonary arteries in IPF and its detrimental effect on lung physiology. The process of EndMT might be central to these vascular remodelling changes and could be a potential novel therapeutic target.
- Published
- 2022
15. Differential airway remodeling changes were observed in patients with asthma COPD overlap compared to patients with asthma and COPD alone
- Author
-
Surajit Dey, Wenying Lu, Heinrich C. Weber, Sally Young, Josie Larby, Collin Chia, Greg Haug, Samuel James Brake, Stephen Myers, Archana Vijay Gaikwad, Prem Bhattarai, Prabuddha S. Pathinayake, Peter A. B. Wark, Mathew Suji Eapen, and Sukhwinder Singh Sohal
- Subjects
Pulmonary and Respiratory Medicine ,Pulmonary Disease, Chronic Obstructive ,Cross-Sectional Studies ,Smokers ,Physiology ,Physiology (medical) ,Airway Remodeling ,Humans ,Cell Biology ,Asthma - Abstract
Management of patients with asthma COPD overlap (ACO) is clinically challenging due to insufficient evidence of pathological changes in these patients. In this cross-sectional study, we evaluated airway remodeling in endobronchial biopsies from a total of 90 subjects, which included 12 ACO, 14 patients with asthma, 12 COPD exsmokers (ES), 11 current smokers (CS), 28 healthy controls (HC), and 13 normal lung function smokers (NLFS). Tissue was stained with Masson’s trichrome. Epithelium, goblet cells, reticular basement membrane (RBM), cellularity, lamina propria (LP), and smooth muscle (SM) changes were measured using Image-Pro Plus v7 software. Differential airway remodeling pattern was seen in patients with ACO. A limited change was noted in the ACO epithelium compared with other pathological groups. RBM was substantially thicker in patients with ACO than in HC ( P < 0.0002) and tended to be thicker than in patients with asthma and NLFS. The total RBM cells were higher in ACO than in the HC ( P < 0.0001), COPD-CS ( P = 0.0559), -ES ( P = 0.0345), and NLFS ( P < 0.0002), but did not differ from patients with asthma. Goblet cells were higher in the ACO than in the HC ( P = 0.0028) and COPD-ES ( P = 0.0081). The total LP cells in ACO appeared to be higher than in HC, COPD-CS, and NLFS but appeared to be lower than in patients with asthma. Finally, SM area was significantly lower in the ACO than in patients with asthma ( P = 0.001), COPD-CS (=0.0290), and NLFS ( P = 0.0011). This first comprehensive study suggests that patients with ACO had distinguishable tissue remodeling that appeared to be more severe than patients with asthma and COPD. This study will help in informed decision-making for better patient management in clinical practice.
- Published
- 2022
16. Vascular remodelling in idiopathic pulmonary fibrosis patients and its detrimental effect on lung physiology: potential role of endothelial-to-mesenchymal transition
- Author
-
Archana Vijay, Gaikwad, Wenying, Lu, Surajit, Dey, Prem, Bhattarai, Collin, Chia, Josie, Larby, Greg, Haug, Stephen, Myers, Jade, Jaffar, Glen, Westall, Gurpreet Kaur, Singhera, Tillie-Louise, Hackett, James, Markos, Mathew Suji, Eapen, and Sukhwinder Singh, Sohal
- Abstract
Idiopathic pulmonary fibrosis (IPF) is a progressive, irreversible fibrotic interstitial lung disease. We performed size-based quantitation of pulmonary arterial remodelling in IPF and examined the role of endothelial-to-mesenchymal transition (EndMT) and effects on lung physiology.Resected lung tissues from 11 normal controls (NCs), and 13 IPF patients were differentially stained using the Movat Pentachrome technique. Size-based classification for pulmonary arteries was conducted in NC and IPF tissues. For each pulmonary artery, arterial size, luminal diameter, thickness of the intima, media and adventitia, and elastin deposition were quantified using Image ProPlus7.0 software. In addition, immunohistochemical staining was performed for EndMT markers and collagen.Large and medium-size arterial numbers were significantly reduced in IPF compared to NCs (p0.0001). Intima thickness was highest in the arterial range of 200-399 μm and 600-1000 μm (p0.0001), while medial and adventitial thickness was significant across 200-1000 μm (p0.05) compared to NC. Medial thickness was found to significantly affect the diffusing capacity of the lungs for carbon monoxide (This is the first study demonstrating size-based differences in pulmonary arteries in IPF and its detrimental effect on lung physiology. The process of EndMT might be central to these vascular remodelling changes and could be a potential novel therapeutic target.
- Published
- 2021
17. Airway remodelling augmented in patients with asthma COPD overlap (ACO) compared to asthma and COPD
- Author
-
James Markos, Heinrich C. Weber, Samuel James Brake, Josie Larby, Mathew Suji Eapen, Greg Haug, Peter A. B. Wark, Wenying Lu, Surajit Dey, Archana Vijay Gaikwad, Stephen Myers, Prem Bhattarai, Collin Chia, and Sukhwinder Singh Sohal
- Subjects
Basement membrane ,medicine.medical_specialty ,COPD ,Lamina propria ,business.industry ,medicine.disease ,Gastroenterology ,respiratory tract diseases ,medicine.anatomical_structure ,Trichrome ,Internal medicine ,Reticular connective tissue ,medicine ,In patient ,business ,Pathological ,Asthma - Abstract
Background: Management of ACO is clinically challenging due to insufficient evidence on pathological changes in these patients. Aim: To evaluate large airway remodelling changes in patients with ACO compared to asthma, COPD ex-smokers (ES) and current smokers (CS), non-smoking normal controls (NC), and normal lung function smokers (NLFS). Methods: Endobronchial biopsy tissue from 12 ACO, 14 asthmatics, 12 COPD‑ES, 11 CS, 28 NC, and 13 NLFS were stained with Masson’s trichrome. Epithelial and goblet cells/mm reticular basement membrane (RBM); total lamina propria (LP) cells/mm2 up to 120 µm deep were enumerated for the area surveyed; RBM, epithelial, and smooth muscle (SM) thickness were analysed using imaging software ImageProPlus V7.0. Results: Compared to asthma and COPD, ACO showed differential remodelling pattern. The RBM was significantly thicker in ACO than asthmatics (p Conclusions: Our findings suggest that ACO patients had severe tissue remodelling changes than asthmatics and COPD patients.
- Published
- 2021
18. Increased arterial remodelling in smokers and mild-moderate COPD patients are indicative of potential early onset of pulmonary hypertension
- Author
-
James Markos, Andrew Williams, Wenying Lu, Prem Bhattarai, Gurpreet K. Singhera, Greg Haug, Josie Larby, Surajit Dey, Collin Chia, Mathew Suji Eapen, Tillie L. Hackett, Sukhwinder Singh Sohal, Stephen Myers, Archana Vijay Gaikwad, and Ashutosh Hardikar
- Subjects
medicine.medical_specialty ,Copd patients ,business.industry ,Internal medicine ,medicine ,Cardiology ,business ,medicine.disease ,Pulmonary hypertension ,Early onset - Published
- 2021
19. Arterial remodelling in patients with idiopathic pulmonary fibrosis (IPF) and the possible role of endothelial to mesenchymal transition (EndMT)
- Author
-
Prem Bhattarai, Jade Jaffar, Collin Chia, Tillie-Louise Hackett, Mathew Suji Eapen, Gurpreet K. Singhera, Sukhwinder Singh Sohal, Archana Vijay Gaikwad, Greg Haug, Surajit Dey, Samuel James Brake, Josie Larby, James Markos, Glen P. Westall, Wenying Lu, and Stephen Myers
- Subjects
Pathology ,medicine.medical_specialty ,biology ,business.industry ,Mesenchymal stem cell ,Vimentin ,Respiratory physiology ,respiratory system ,medicine.disease ,respiratory tract diseases ,Vascular remodelling in the embryo ,Idiopathic pulmonary fibrosis ,medicine.anatomical_structure ,Adventitia ,biology.protein ,Medicine ,Immunohistochemistry ,business ,Elastin - Abstract
Aim: To perform a comprehensive quantitative analysis of pulmonary arterial changes in IPF. Methods: Movat’s Pentachrome staining was conducted on lung tissue from patients with IPF (n=13) and healthy controls (HC; n=11). Based on position and size pulmonary arteries (PA) from IPF and HC were grouped (100-199µm, 200-299µm, 300-399µm, 400-599µm and >600-1000µm). The total arterial to luminal length ratio was calculated. We measured total arterial thickness, individual arterial layer (intima, media, and adventitia) thickness, and elastin. Immunohistochemical staining for EndMT markers S100A4 and Vimentin was conducted. Tissue was quantified by using Image ProPlus 7.0 software. Results: Significant differences were apparent across all arterial sizes in IPF (p 600 600 Conclusion: We observed substantial vascular remodelling in IPF and its detrimental impact on lung physiology. EndMT appears decisive in these vascular changes.
- Published
- 2021
20. Self-Medication Practices in Surrounding Communities of Birat Medical College and Teaching Hospital of Eastern Nepal
- Author
-
Anjali Mishra, Sharad Karki, Prem Bhattarai, Surya B. Parajuli, Heera Kc, Rajan Pandit, and Prasanna Dahal
- Subjects
medicine.medical_specialty ,lcsh:R5-920 ,business.industry ,Pharmacy ,Context (language use) ,Hospitals ,self-medication ,Head of Household ,Dispensary ,Nepal ,Family medicine ,Medicine ,Marital status ,Residence ,AMR ,Medical prescription ,business ,lcsh:Medicine (General) ,Self-medication - Abstract
DOI: https://doi.org/10.3126/jcmsn.v15i1.23021 Background: Self-medication is the use of drugs to treat self-diagnosed disorders/symptoms, or the intermittent/continued use of a prescribed drug for chronic/recurrent disease/symptoms (WHO). It is the cause for antibiotic resistance, inappropriate treatment, financial burden and many deaths. WHO listed self-medication as one of the priority research area at the local context. The objective of the study was to find the prevalence and pattern of self-medication in surrounding communities of Birat Medical College and Teaching Hospital. Methods: A community-based cross-sectional study was conducted at the surrounding communities of Birat Medical College from 1st August 2018 to 15th December 2018. Multistage sampling was used to collect information from 348 household having family members aged 16 years and above. Ethical approval was taken from Institutional Review Committee of Birat Medical College. Pre-tested semi-structured questionnaire was used. Results: The mean age of the participants was 40.5±15.9 years. Prevalence of self-medication was 44.04%. Majority took self-medication for headache 43.6% followed by common cold 39.1% etc. Majority used allopathic drugs 82.7% followed by traditional healers 9.8%. Common medication were antipyretics 18.8%, antibiotics 16.5%, proton pump inhibitor 7.5%, antihistamines 6.8% etc. The reason behind self-medication were low cost 30.1%, time saving 24.1%, illness too trivial/mild for consultation 18.8%, quick relief 18.1%, high doctor fee 15 %, lack of awareness 13.5 %, familiar with treatment options 12.8%, long waiting line in hospital 12% etc. Out of them 8.3% noticed side effects of self-medication. Out of all 59.5% felt the need of awareness program on rational use of medicines. Age, sex, marital status, ethnicity, religion, education and occupation of participants, education and occupation of head of household, poverty status, family type, house residence type, type of house has no significant association with self-medication. Participants residing in alani/rent households were 1.93 times more likely to self-medicate than those residing in their own and participants having negative attitude were 1.90 times more likely to self-medicate than those who had positive attitude and both were statistically significant. Conclusions: The burden of self-medication was present and allopathic drugs including antibiotics were common. Adverse drug reactions were reported but participants were unaware about the place to report. Participants had negative attitude towards self-medication which is harmful for their health. As pharmacy was the common source of self-medication, the prescription based medicine dispensary should be advocated. Keywords: AMR; hospitals; Nepal; self-medication.
- Published
- 2019
21. Heart Rate Variability as a Marker of Changes in Mood State in Daily Life by Photoplethysmography Technique
- Author
-
Kopila Agrawal, Santosh Deo, and Prem Bhattarai
- Subjects
medicine.medical_specialty ,business.industry ,Frequency ratio ,lcsh:R ,Heart Rate Variability ,lcsh:Medicine ,Affect (psychology) ,Negative mood ,Mood States ,Mood ,Photoplethysmogram ,Internal medicine ,Heart rate ,mental disorders ,Mood state ,Cardiology ,Medicine ,Heart rate variability ,business ,Photoplethysmography - Abstract
Introduction: The different mood states in our daily life can affect our mental and emotional health. The aim of our study was to explore photoplethysmography to record heart rate variability as a marker of changes in mood states in our daily life.Materials and Methods: Two groups of affective pictures categorized into positive and negative sets were shown to thirty subjects on two different consecutive days with simultaneously recording of heart rate variability for 5 minutes by photoplethysmography technique. Immediately after recording on each day, 0-9 self-assessment scale was used to assess the mood state of the subject after viewing the set of pictures.Results: Sympathetic domains of heart rate variability like low frequency (200.3 ±4.1 vs. 166.7 ±2.8, p
- Published
- 2018
22. Quality of life of elderly people living with family and in old age home in Morang District, Nepal
- Author
-
Prem Bhattarai, Menuka Shrestha, Anjali Mishra, Surya B. Parajuli, and Heera Kc
- Subjects
0106 biological sciences ,Gerontology ,Embryology ,Quality of Life ,Population ,Developing country ,Special needs ,lcsh:Technology ,01 natural sciences ,03 medical and health sciences ,Quality of life ,Informed consent ,lcsh:Technology (General) ,Humans ,Homes for the Aged ,Elderly people ,Medicine ,Social determinants of health ,lcsh:Science ,education ,education.field_of_study ,lcsh:T ,business.industry ,030503 health policy & services ,Cell Biology ,humanities ,010602 entomology ,lcsh:T1-995 ,lcsh:Q ,Anatomy ,Descriptive research ,0305 other medical science ,business ,Developmental Biology - Abstract
Introduction: Nepal like many other developing countries in the world is witnessing the rapid ageing of population. Quality of life (QOL) of elderly people is becoming even more relevant towards an ageing society. In Nepal, less is known regarding special needs and quality of life of elderly people either in familial situations or in old age residences. Objectives: The present study was undertaken to assess and compare the quality of life of elderly living with the family and in old age home. Methodology: A Cross sectional descriptive study was conducted from October 2016 to April 2017 among elderly population aged 60 years and above. A total of 50 elderly people were enrolled from old age home (OAH) using total enumeration sampling technique and equal number of sample was selected from the family setting. QOL of elderly was assessed using WHOQOL-BRIEF questionnaire after taking informed consent from the participants. Data was analyzed using SPSS. Results: The mean scores of QOL domains were better among the age group 60-70 years, males, married, literates and who had children. The mean scores of QOL in physical, psychological and environmental domains were better in elderly living with the family than living in OAH. Low scores were found on social domain among elderly compared to other domain irrespective of their residence. Conclusion: QOL score among elderly is average, while social relationship domain of QOL scores was found to be low. Social activities should be expanded for these residents in order to promote social health. The QOL which each individual possesses is very important in all aspects be it physical, psychological, social & environmental. Furthermore, programs that help elderly people live in their own homes and social environments should be promoted.BIBECHANA 16 (2019) 221-227
- Published
- 2018
23. Translational research: Current status, challenges and future strategies in Nepal
- Author
-
Heera Kc, Prem Bhattarai, and Surya B. Parajuli
- Subjects
Evidence-based practice ,business.industry ,Globe ,Translational research ,Public relations ,Review article ,Health care delivery ,Health promotion ,medicine.anatomical_structure ,Political science ,Paradigm shift ,medicine ,Clinical care ,business - Abstract
The concept of translational research is emerging around the globe. The practice of clinical care, health promotion and health care delivery system need to be evidence based. Translational research is the utmost solution to generate evidence and implement the scientific findings. Now the time has come to conduct translational research in Nepal to generate our own evidence and to integrate it into the policy of new federal health system. The objective of this review article was to identify status, challenges and future strategies of translational research in Nepal.
- Published
- 2018
24. Pharmacovigilance by World Health Organisation Uppsala Monitoring Center Causality Assessment Algorithm in Medicine Ward of Tertiary Care Hospital of New Delhi
- Author
-
Rinku Shah, Prem Bhattarai, S. Karki, P.K. Chowdhary, and Surya B. Parajuli
- Subjects
Abdominal pain ,Pediatrics ,medicine.medical_specialty ,Nausea ,business.industry ,Incidence (epidemiology) ,Common Terminology Criteria for Adverse Events ,General Medicine ,Level of consciousness ,Pharmacovigilance ,medicine ,Vomiting ,medicine.symptom ,Prospective cohort study ,business ,Algorithm - Abstract
Introduction Pharmacovigilance is not new to India and has in fact been going on since 1998. Adverse drugs reaction (ADRs) are important causes of morbidity and mortality all over the world. They account for approximately 10-20% of all hospitalized patients. The overall incidence of serious ADRs is 6.7% and that of fatal is 0.32%. Objective The objectives of the study was to find the pattern of adverse drug reactions in patients attending medicine ward of a tertiary care center of New Delhi. Methodology A prospective study was conducted from March 2013 to December 2013. On the basis of WHO-UMC causality assessment algorithm, the incidence and pattern of ADRs were assessed from 300 patients of 18 to 70 years of age. The collected data was entered in Microsoft Excel, Common Terminology Criteria for Adverse Events (CTCAE) and analysed by SPSS. Results The incidence of ADRs was found to be 13.67%. More than one ADRs has been reported from some patients. The gender of the patients has no significance in the occurance of ADRs (p=0.194). Highest number of ADRs were found in gastrointestional system followed by central nervous system. Gastrointestional ADRs were must commonly associated with the uses of antimicrobials. The most frequently seen ADRs were diarrhea, gastritis, abdominal pain followed by nausea and vomiting. Decreased level of consciousness (sedation, drowsiness) followed by dizziness and tremors were the frequent ADRs related to the central nervous systems. Based on WHO-UMC causality assessment algorithm, it was observed that a total of 57 ADRs were possible and 2 were probable. No other causality assessment category was observed. Conclusion The ADRs incidence was common even in a tertiary care center. The Gastrointestional and central nervous system disorder were common. The concern of Pharmacovigilance should be initiated. Birat Journal of Health Sciences 2016 1(1): 61-64
- Published
- 2017
25. Endothelial to mesenchymal transition: a precursor to post-COVID-19 interstitial pulmonary fibrosis and vascular obliteration?
- Author
-
Prem Bhattarai, Ashutosh Hardikar, Collin Chia, Archana Vijay Gaikwad, Sukhwinder Singh Sohal, Mathew Suji Eapen, Greg Haug, and Wenying Lu
- Subjects
Pulmonary and Respiratory Medicine ,Pathology ,medicine.medical_specialty ,Transition (genetics) ,Endothelium ,Coronavirus disease 2019 (COVID-19) ,business.industry ,Mesenchymal stem cell ,medicine.disease ,Pulmonary hypertension ,Pneumonia ,medicine.anatomical_structure ,Pulmonary fibrosis ,medicine ,Epithelial–mesenchymal transition ,business - Abstract
Endothelial to mesenchymal transition (EndMT) could lead to post-COVID-19 pulmonary fibrosis and vascular remodellinghttps://bit.ly/2QqSKxT
- Published
- 2020
26. Effect of long term high altitude exposure on cardiovascular autonomic adjustment during rest and post-exercise recovery
- Author
-
Bijay Subedi, Dilip Thakur, Balkrishna Bhattarai, Rita Khadka, Bishnu Hari Paudel, and Prem Bhattarai
- Subjects
medicine.medical_specialty ,03 medical and health sciences ,0302 clinical medicine ,Altitude ,Rest (finance) ,Internal medicine ,Heart rate ,Post exercise ,parasitic diseases ,Medicine ,Heart rate variability ,030212 general & internal medicine ,Exercise ,Resting state fMRI ,business.industry ,Public Health, Environmental and Occupational Health ,Effects of high altitude on humans ,030210 environmental & occupational health ,Industrial medicine. Industrial hygiene ,RC963-969 ,Cardiology ,Public aspects of medicine ,RA1-1270 ,business ,Recovery phase ,Research Article ,Highlanders - Abstract
Background Despite the successful adaptation to high altitude, some differences do occur due to long term exposure to the hypoxic environment. The effect of long term high altitude exposure on cardiac autonomic adjustment during basal and post-exercise recovery is less known. Thus we aimed to study the differences in basal cardiac autonomic adjustment and its response to exercise in highlanders and to compare it with lowlanders. Methods The study was conducted on 29 healthy highlander males who were born and brought up at altitude of 3000 m and above from the sea level, their cardiac autonomic adjustment was compared with age, sex, physical activity and ethnicity-matched 29 healthy lowlanders using Heart Rate Variability (HRV) during rest and recovery from sub-maximal exercise (3 m step test). Intergroup comparison between the highlanders and lowlanders and intragroup comparison between the rest and the postexercise recovery conditions were done. Results Resting heart rate and HRV during rest was comparable between the groups. However, heart rate recovery after 3 min step test was faster in highlanders (p
- Published
- 2018
27. Pattern of Thyroid Dysfunction in Patients with Metabolic Syndrome and Its Relationship with Components of Metabolic Syndrome
- Author
-
Rajendra Koju, Prabodh Risal, Prem Bhattarai, Jyoti Shrestha Takanche, Raj K. Shrestha, Prabin Gyawali, and K Khanal
- Subjects
medicine.medical_specialty ,Waist ,Endocrinology, Diabetes and Metabolism ,Thyroid function tests ,Atherosclerotic cardiovascular disease risk ,lcsh:Diseases of the endocrine glands. Clinical endocrinology ,Subclinical hypothyroidism ,Diabetes mellitus ,Internal medicine ,medicine ,Risk factor ,Subclinical infection ,lcsh:RC648-665 ,medicine.diagnostic_test ,business.industry ,Thyroid ,Thyroid dysfunction ,medicine.disease ,Metabolic syndrome ,Obesity and Metabolic Syndrome ,Blood pressure ,medicine.anatomical_structure ,Endocrinology ,Original Article ,business - Abstract
Background Thyroid dysfunction (TD) and metabolic syndrome (MetS) are known risk factors for atherosclerotic cardiovascular disease (ASCVD). TD is risk factor for ASCVD mediated by the effects of thyroid hormones on lipid metabolism and blood pressure hence the components of MetS. It is possible that coexistence of these two disease entities and unrecognized TD in patients with MetS might substantially increase ASCVD risk. Moreover, little is known about the relationship between TD and the components of MetS. Thus, the purpose of this study was to evaluate the pattern of TD in patients with MetS and its relationship with components of the MetS. Methods A total of 358 previously diagnosed patients with MetS were recruited in the study. The thyroid function test parameters were measured to classify TD at Dhulikhel Hospital-Kathmandu University Hospital, Dhulikhel, Nepal. Statistical analyses were performed using SPSS version 16.0 to evaluate pattern and relationship. Results The overall prevalence of TD in patients with MetS was 31.84% with high prevalence of subclinical hypothyroidism (29.32%). We found no evidence of a relationship between TD and components of MetS, although there was significant difference in waist circumference between four groups of TD. Conclusion Patients with MetS had subclinical hypothyroidism greatly. Although there was no evidence of any relationship between thyroid status and all components of MetS, TD should be taken into account when evaluating and treating patients with MetS to reduce the impending risk.
- Published
- 2015
Catalog
Discovery Service for Jio Institute Digital Library
For full access to our library's resources, please sign in.