Biography:

Mahdi Asadi has received Aesthetic Medicine fellowship from American Academy (A4M) and is boarded in Emergency Medicine from Shahid Beheshti University. He is completed his medical degree from Tehran University, Tehran, Iran. He is currently working in the Department of Emergency Medicine of referral center of Iran University, Tehran, Iran. His clinical and research interests involved in the wound management of both surgical and non-surgical methods.

Abstract:

Introduction: The anti-infective properties of CO₂ were described by Boyle in the 17 the century and by Lavoisier in the 18th century. Laloue+e, in 1777 proposed a serial application of CO₂ for the treatment of chronic skin ulcers. The hemodynamic effects includes: increased blood flow and dilatation of precapillary arterioles, capillaries that were functionally closed are open once again, angiogenesis is induced due to transient ischemia, and release of growth factors leads to tissue regeneration and rejuvenation.

Indication: Indications of carboxytherapy includes: cellulite, localized adiposities, stretch marks, acne scars, skin laxity and wrinkle reduction, under eye dark circles, hair loss, poor healing leg ulcers, in patients with peripheral diabetic complications. Since optimal ulcer-healing requires adequate tissue perfusion, it is considered that carboxytherapy could be useful in the treatment of diabetic foot ulcer. A recent prospective clinical study included 40 patients with different sizes and types of chronic DFU. In addition to cleaning of the wound, antibiotics, and debridement as necessary, the treatment protocol included blood sugar control, medication, healthy habits, no weight-bearing, and carboxytherapy. The results showed that this treatment that included carboxytherapy promoted wound-healing and prevented amputation.

Application: For the application itself the parameters (gas flow in ml/min, overall volume in ml) are selected and set individually depending on indication and site. Injections are made using a 30G mesotherapy needle, which may be 4, 12 or 13 mm long. The gas installation is controlled by using a foot pedal. The injection angle is of great importance.  In the superficial subcutaneous application, the angle comprises 30°. In the deeper intradermal application of gas, the injection angle comprises 45°.

Biography:

Yagya Laxmi Shakya has done MD in General Practice from Institution of Medicine, Tribhuvan University, Kathmandu, Nepal in 2003. She is working as a faculty in the Department of Emergency and General practice for the last 13 yrs. Now she is designated as Associate Professor since 2014. She has the responsibility of clinical works, teaching-learning activities, guidance for medical officer MD resident, intern, junior intern, supervises elective students from a European and South Asian country. She is a general practitioner works in general practice outpatient department and also in General Health checkup where different types of the patient come for screening and regular checkup and for required treatment. She acted as a guide for MD resident for their thesis/research. She has done various researches such as geriatric problems, patterns of diseases in Nepali women, causes of self-harm in Nepal. She is doing Distance Fellowship in Diabetes (DFID)  management from Vellore, India.

Abstract:

Knowledge about complications of diabetes among diabetic patients attending in general health checkup, Nepal

Yagya Laxmi Shakya¹, Mandira Shahi², and Ranga Raj Dhungana³

¹Tribhuvan University Teaching Hospital, Nepal

²National Centre for Health Professions Education, Tribhuvan University, Nepal

³HASTI, Nepal

Statement of the Problem: Diabetes Mellitus (DM) has risen exponentially over the last three decades, with a resultant increase in morbidity and mortality mainly due to its complications. The study aimed to assess the knowledge about the complications of diabetes and its management among diabetic patients attended in general checkup.

Methodology & Theoretical  Orientation: A cross-sectional observational study was conducted among 100 diabetic patients in Tribhuvan University Teaching Hospital with written informed consents. The data were entered in Microsoft Excel version 2010 and analyzed using SPSS version 20.

Findings: Majority of female patients (78.8%) had knowledge of diabetes mellitus (DM). Over half (51.9%), (53.8%) and (57.7%) had knowledge that diabetes can cause the problems of CVS, kidney failure, and retinopathy respectively, but identified lacking comprehensive management. Moreover, the majority (92.3%) of the patients with more than 5 years duration of diabetes had knowledge of diabetic complications. Out of them, slightly over four-fifths (82.1%) had the knowledge that the diabetic patient have to do eye check-up annually and approximately seventy-two percent (71.8%) knew about the kidney failure as the complication of diabetes.

Conclusion: Female diabetic patients had slightly more knowledge in comparison to their male counterparts that was generally higher among 40 years of age above patients with more than 5 years duration of diabetes. Sex and age were not associated with the knowledge of diabetic complications such as eye check-up annual, kidney and CVS problem, hypoglycemia, neuropathy, foot problem, retinopathy, DKA, and stroke. However, duration of patient’s diabetics was associated with CVS problem, eye check-up, and retinopathy, but was not associated with a kidney problem, hypoglycemia, neuropathy, foot problem, DKA, and stroke. In order to make patients along with their family know about diabetes and its complications, Comprehensive Diabetic Management (CDM) including peer educations and counseling can be implemented.

Biography:

Mandira Shahi is currently working as a Professor in the National Center for Health Professions Education (NCHPE) Tribhuvan University, Institute of Medicine. She has done her Master of Health Professions Education (MHPE) from the University of Maastricht, The Netherlands in 2001. She also did her M. Phil in Education from 'The Global Open University Nagaland', India in 2010. Now she is a PhD Scholar in Singhania University, Rajasthan, India and also holds the title of PhD in Distance Education in Nepal: Its Application. She became the Coordinator of the Clinical Elective Programme for Foreign Medical/Nursing Students and Coordinator for Faculty Development Training as well as facilitator/resource person to develop and revise curriculum of various levels in health professions education. Similarly, she has had experience in various educational health-related research and module development as well as dedicated herself to teaching medical education for numerous levels in the health profession from Bachelors to Masters level

Abstract:

Prevalence and factors associated with obesity among adult women of Nepal

Mandira Shahi, Laxmi Rai, Raj Devi Adhikari, and Muna Sharma

Tribhuvan University, Nepal

More than 1.4 billion adults, 20 years and older, were overweight, of these overweight adults, over 200 million men and nearly 300 million women were obese. The objective of the study was to explore the prevalence and factors associated with obesity among adult women of Ramkot VDC (Village Development Committee), Kathmandu district of Nepal. A cross-sectional descriptive study was used to explore the prevalence and factors associated with obesity among adult women of the age group between 20 to 59 years. Five wards were selected randomly on the lottery is drawn and quota sampling basis. 22 samples were drawn from each selected wards and there were 110 sample sizes. A questionnaire guided interview method was incorporated BMI was calculated by following the formula: weight in kg/height in m². The prevalence of obesity and overweight is 24.5% and 1.8% respectively. There is no association of BMI with caste, education, and age. 81.7% of respondents, who consumed fruits more than five times a week had low BMI, whereas 44% of respondents, who consumed fruits less than once a week, had high BMI indicating overweight and obesity. The significant difference between consuming fruits daily or not was shown by the chi-square (p-value) i.e. 0.013. The finding of this study shows that the prevalence of overweight and obesity among women was 24.5% and 1.8% respectively. Overweight and obesity of women was not associated with physical activities, vegetarian or non-vegetarian diet nor the frequency of food they usually took. But the women who consumed fruits frequently in their diet had a low body mass index than women who consumed fruits less frequently. To conclude, overweight and obesity among adult women in Nepal were associated with scarce fruit intake.

Biography:

Sanaa Alsubheen is a physical Therapist with 10 years of clinical experience. She completed her master’s of science in kinesiology (exercise and work physiology) from Memorial university of Newfoundland, Canada on October 2016. Currently she is a PhD candidate at Western university, London, Ontario, Canada. She is interested in investigating the association between diabetes and adhesive capsulitis of the shoulder joint

Abstract:

Does diabetes affect functional outcomes after shoulder arthroplasty

Sana'a A Alsubheen¹, Tom J Overend, Joy C MacDermid^1,2, and Kenneth J Faber ²

¹Western University, Canada

²St. Joseph’s Health Care London, Canada

Background: Shoulder arthroplasty improves shoulder function in patients with severe arthritic changes. Diabetes is a known risk factor for postoperative complications. However, the impact of diabetes on functional outcomes after shoulder arthroplasty is uncertain.

Purpose: This prospective cohort assessed whether diabetes affects functional outcomes after shoulder arthroplasty.

Methods: Diabetic patients undergoing shoulder arthroplasty (n=140), were evaluated at baseline, at an early follow-up visit (between 3-6 months) and at the late follow-up visit (between 1-3 years). The American Shoulder and Elbow Surgeons (ASES) assessed shoulder function and the Short-Form-12 (SF-12) assessed physical health status. Shoulder goniometry and dynamometry were used to assess motion and strength.

Results: Despite significantly poorer ASES and SF-12 scores at baseline in diabetic patients, later scores were not different than those without diabetes. For patients with diabetes, ASES pain [7 (3) to 2 (2)], ASES function [5 (5) to 18 (6)], and physical health status [27 (6) to 38 (8)] scores improved significantly over time similar to patients without diabetes [ASES pain: 6 (3) to 2(2); ASES function: 8 (5) to 18 (8); physical health status: 31 (8) to 40 (12)]. However, all these scores remained below the normal values for both groups.

Conclusion: Patients with diabetes achieve a large benefit from shoulder arthroplasty, with follow-up outcomes similar to those without diabetes