Introduction: Anemia of chronic kidney disease (CKD) can be managed by regular administration of erythropoiesis stimulating agents (ESAs) and/or blood transfusion. The response to these therapies can be monitored by serial packed cell volume (PCV). Objective: This study was done to compare the temporal changes in PCV after ESA therapy and blood transfusion in patients with recently diagnosed anemia in CKD stage 5 on hemodialysis (CKD 5 HD). Methods: Medical records of patients undergoing hemodialysis at the National Kidney Center, Balaju, Kathmandu from July to September 2013 were examined retrospectively. The data collected were analyzed using Minitab 16. Results: A total of 44 patients were on ESA therapy while 48 patients were on blood transfusion. The mean PCV at the start of blood transfusion was significantly lower than the mean PCV at the start of ESA therapy (p = 0.000) but at four weeks, the mean PCV in blood transfusion group was significantly greater than that in ESA therapy group (p = 0.008). At eight weeks and twelve weeks, the mean PCVs in both groups were not significantly different from each other (p = 0.949 and p = 0.747). Conclusions: Blood transfusion increases PCV immediately and in sustained manner while with ESA therapy, the response takes a longer time to manifest. A large number of non-responders to ESA therapy may have influenced the findings of this study. It is recommended that adequate dosing of ESA and attention to comorbid conditions be followed during ESA therapy. Keywords: Anemia; chronic renal insufficiency; blood transfusion; hematinics.

Introduction: Sustainable maintenance of good menstrual hygiene practice is crucial for sound reproductive health, education, dignity, and empowerment of adolescent girls. Menstrual hygiene is less addressed in Nepalese context. So this study aimed to assess the menstrual hygiene practices among adolescent girls in the public schools of Mahalaxmi Municipality in Lalitpur district. Methods: A cross sectional study was adopted among 190 respondents of grades 8, 9 and 10 from three public schools of Mahalaxmi Municipality in Lalitpur District. Sample was selected by using simple random technique through lottery method. Data were collected using pre-tested self-administered semi-structured questionnaire and analyzed in SPSS version 16 for window. Bivariables and multivariable logistic analysis were computed to identify factors associated with good menstrual hygiene practice. Results: The mean age (±SD) of the study participants and menarche were 15.04 ±1.10 years and 12.86 ±0.96 years. About 43.7% used sanitary pad to absorb their menstrual bleeding, 65.8% disposed the used absorbent in dustbin, 41.1% took daily bath and 40% changed their absorbent three or more times during menstruation. Overall, 62.1% of them had good level of menstrual hygiene practices. Good menstrual hygiene practice was significantly associated with increase in age (AOR: 1.186, 95% CI: 0.540-2.603) living in nuclear family (AOR: 1.664, 95% CI: 0.884-3.281) up in grade (AOR: 2.688, 95% CI: 1.216-5.940) having regular menstruation one year and more(AOR:1.763, 95% CI: 0.838-3.711) and availability of water inside the toilet (AOR:1.226, 95% CI: 0.533-2.820). Conclusion: Considerable percentages of adolescent girls in the public schools have poor menstrual hygiene practice. Therefore, provision of appropriate school health programs and basic sustainable sanitation is needed to enhance menstrual hygiene practices among adolescent girls.

Myo-Inositol oxygenase (MIOX) is an enzyme that catabolizes myo-inositol in humans. There is increased MIOX expression and increased MIOX activity in renal tubular cells in diabetic nephropathy. One potential mechanism of increased expression and activity of MIOX is the production of one or more highly stable alternative splice isoform of MIOX transcript. Based on the evidence gathered from the expressed sequence tags (ESTs) associated with MIOX protein sequence, we report that retention of intron 9 in MIOX transcript is a valid alternative splice mechanism. This alternative splice isoform is predicted to have higher stability than the canonical MIOX transcript. Higher stability of the alternative splice variant leads to increased production of MIOX protein isoform with retained structural and potentially, functional features of canonical MIOX protein. Production of this MIOX transcript isoform could be the mechanism of increased expression and activity of MIOX in renal tissues affected by diabetes mellitus. Alteration of the splice mechanism could be a new therapeutic target in prevention and treatment of complications of diabetes mellitus.