Hypertension is a leading attributable risk factor for mortality in South Asia. However, a systematic review on prevalence and risk factors for hypertension in the region of the South Asian Association for Regional Cooperation (SAARC) has not carried out before.The study was conducted according to the Meta-Analysis of Observational Studies in Epidemiology Guideline. A literature search was performed with a combination of medical subject headings terms, "hypertension" and "Epidemiology/EP". The search was supplemented by cross-references. Thirty-three publications that met the inclusion criteria were included in the synthesis and meta-analyses. Hypertension is defined when an individual had a systolic blood pressure (SBP) ≥140 mm Hg and/or diastolic blood pressure (DBP) ≥90 mm Hg, was taking antihypertensive drugs, or had previously been diagnosed as hypertensive by health care professionals. Prehypertension is defined as SBP 120-139 mm Hg and DBP 80-89 mm Hg.The overall prevalence of hypertension and prehypertension from the studies was found to be 27% and 29.6%, respectively. Hypertension varied between the studies, which ranged from 13.6% to 47.9% and was found to be higher in the studies conducted in urban areas than in rural areas. The prevalence of hypertension from the latest studies was: Bangladesh: 17.9%; Bhutan: 23.9%; India: 31.4%; Maldives: 31.5%; Nepal: 33.8%; Pakistan: 25%; and Sri Lanka: 20.9%. Eight out of 19 studies with information about prevalence of hypertension in both sexes showed that the prevalence was higher among women than men. Meta-analyses showed that sex (men: odds ratio [OR] 1.19; 95% confidence interval [CI]: 1.02, 1.37), obesity (OR 2.33; 95% CI: 1.87, 2.78), and central obesity (OR 2.16; 95% CI: 1.37, 2.95) were associated with hypertension.Our study found a variable prevalence of hypertension across SAARC countries, with a number of countries with blood pressure above the global average. We also noted that studies are not consistent in their data collection about hypertension and related modifiable risk factors.

Prevalence of type 2 diabetes in Nepal: a systematic review and meta-analysis from 2000 to 2014

Nepal, a developing country in South Asia, is currently experiencing an epidemic of diabetes as a result of epidemiologic and demographic transitions that have impacted lifestyle changes. A systematic review and meta-analysis¹ of 10 studies involving 30 218 adults estimated the prevalence of type 2 diabetes to be 8.4%. Despite the large burden of type 2 diabetes in Nepal, awareness of diabetes control is poor,² and effective strategies to manage this disease are urgently warranted.

Peer reviewed article authored by (Bhandari R, Sharma R). Read article or submit your manuscript for publishing.

Background and Objectives Prostate-specific membrane antigen (PSMA) positron emission tomography (PET) combined with computed tomography (CT) is a new imaging modality to detect the extra-prostatic spread of prostate cancer. PSMA PET/CT has a higher sensitivity and specificity than conventional imaging (CT ± whole body bone scan [WBBS]). This study conducted a cost-utility analysis of PSMA PET/CT compared with conventional imaging for patients with newly diagnosed, intermediate-risk or high-risk primary prostate cancer. Perspective Australian healthcare perspective. Setting Tertiary. Methods A decision-analytic Markov model combined data from a variety of sources. The time horizon was 35 years. The sensitivity and specificity of PSMA PET/CT and CT alone were based on meta-analyses and the test accuracy of CT+WBBS was based on a single randomised controlled trial. Health outcomes included cases detected, life-years, and quality-adjusted life-years. Costs related to other diagnostic tests, initial treatment, adverse events, and post-disease progression were included. All costs were reported in 2021 Australian Dollars (A$). Results The deterministic incremental cost-effectiveness ratio of PSMA PET/CT was estimated to be A $21,147/quality-adjusted life-year gained versus CT+WBBS, and A$36,231/quality-adjusted life-year gained versus CT alone. The results were most sensitive to the time horizon, and the initial treatments received by patients diagnosed with metastatic cancer. The probability of PSMA PET/CT being cost effective was estimated to be 91% versus CT+WBBS and 89% versus CT alone, using a threshold of AU$50,000/quality-adjusted life-year gained. Conclusions PSMA PET/CT is likely to be more costly than CT+WBBS or CT alone in Australia; however, it is still likely to be considered cost effective compared with conventional imaging.

Background This study was carried out to estimate the prevalence of intestinal parasites among school-going children of the Baglung municipality from December 2010 to January 2011. Objective To find out prevalence of parasitosis among school aged children and to make necessary recommendations for preventive measures. Method A total of 260 stool samples were collected. A structured questionnaire was used to collect data on predisposing factors. Nails were observed without prior information to the subjects so as to find their hygienic practice. The stool samples were examined by direct wet mount and formal ether concentration technique. Results The total prevalence of the intestinal parasitosis was found to be 21.05%. The prevalence for individual parasites was as follows: Entamoeba histolytica (9.23%), Giardia lamblia (5.76%), Trichuris trichuria (5%), Ancylostoma duodenale (2.65%) and Ascaris lumbricoides (2.3%). Nail hygiene and level of education were significantly associated with intestinal parasitosis. The gender and age of the children, sanitary habits including toilet use, hand washing practice, and the use of the antihelminthic drug (albendazole) were not significantly associated with intestinal parasitosis. Higher prevalence was seen in boys, children belonging to age group 10-14 years, lower secondary students, among those who reported gastrointestinal problems within last six months, children from agriculture-based families and children with untrimmed nail. Conclusion Major contributors for the prevalence of parasites were found to be poor personal hygiene and educational level of the children. Health education and mass treatment are recommended as a preventive measures. KATHMANDU UNIVERSITY MEDICAL JOURNAL VOL.10 | NO. 1 | ISSUE 37 | JAN - MAR 2012 | 3-6 DOI: http://dx.doi.org/10.3126/kumj.v10i1.6904