ObjectiveThis non-inferiority study aimed to determine the burden of obesity in a hospital outpatient setting of a developing country, using three commonly employed metrics as predictors of hypertension (HTN).DesignA cross-sectional study design was adopted.SettingThis study was conducted in Health Promotion and Risk Factor Screening Services of a tertiary hospital for eye and ear, nose, throat in a semiurban area of Nepal.Participants2256 randomly selected outpatients between 40 and 69 years old.Outcome measuresThe three obesity metrics and HTN were analysed for association using correlation, the area under the receiver operating characteristic (ROC) curve and ORs.ResultsThe prevalence of obesity or overweight by body mass index (BMI) was 58.29%; by waist-to-height ratio (WHtR) was 85.95%, high waist circumference (WC) was observed among 66.76% of participants. Female participants had a greater prevalence of high WC (77.46%) than males (53.73%) (p<0.001). Prevalence of HTN and pre-HTN were 40.67% and 36.77%, respectively. The areas under the ROC curve were significantly higher than 0.5 for BMI (0.593), WHtR (0.602) and WC (0.610).ConclusionThis study showed that WHtR and WC measured were not inferior to BMI as a metric for obesity detection and HTN prediction. Because of its low cost, simplicity of measurement and better ability to predict HTN, it may become a more usable metric in health facilities of low-income and middle-income countries.

ObjectiveThis study aims to determine the prevalence of high screen time among schoolchildren aged 3–10 years in Bhaktapur, its correlates and the parents’ strategies to reduce screen time during the COVID-19 pandemic in Nepal.Methods and analysisThis cross-sectional descriptive study was conducted during March 2021. A total of 630 households were selected for the study from 21 randomly selected clusters in Bhaktapur, Nepal. Correlates of high screen time were determined using a logistic model. P<0.002 was taken as significant.ResultsAmong all the participants, the mean (SD) age was 7.0 (2.2) years, with 50.3% male participation. Few participants had online classes (n=24, 3.8%). The prevalence of high screen time among the participants was very high (55.2%, 95% CI=51.3% to 59.1%), which is even higher in boys (61.8%, 95% CI=58.0% to 65.6%). The median screen time before the COVID-19 pandemic was 1.0 hours (mean rank=275.8) which increased to 2.2 hours (mean rank=116.6) during the pandemic (p<0.001). Participants having smartphones were about seven times (adjusted OR=6.9, 95% CI=1.5 to 31.3, p=0.013) more likely to have high screen time than those who did not have the device. Most parents used to reprimand and urge their children to play outside to limit their screen usage.ConclusionDuring the COVID-19 pandemic, about one in two schoolchildren of 3–10 years had higher screen time than before the COVID-19 pandemic. Parents’ strategies to reduce screen time were not effective. An intervention study is recommended to design and test effective strategies to reduce screen time and its negative effects on children’s health.

Introduction: Diabetes mellitus is a chronic metabolic disease characterised by elevated blood sugar levels and is a pandemic of public health importance. Screening programs can help reduce morbidity and mortality by preventing or delaying complications. This study aimed to find out the prevalence of diabetes mellitus among adult outpatients visiting a tertiary care centre. Methods: This descriptive cross-sectional study was conducted among outpatients visiting a tertiary care centre between 1 January 2019 to 31 December 2019. Ethical approval was obtained from the Ethical Review Board (Registration number: 408/2020 P). Patients with unknown history of diabetes participating in free random blood sugar examinations were included in the study. Systematic random sampling was used. Point estimate and 95% Confidence Interval were calculated. Results: Among 385 adult outpatients, 17 (4.42%) (2.37–6.47, 95% Confidence Interval) had diabetes. The mean random blood sugar level of the diabetic patients was 281.41±57.49 mg/dl. Conclusions: The prevalence of diabetes mellitus among adult outpatients was similar to previous studies conducted in similar settings. Random blood sugar test in hospital outpatient settings is feasible to identify people with diabetes mellitus.

Objective The study aimed to determine the burden of obesity, using three commonly employed metrics in the hospital outpatient setting of a developing country as predictors of hypertension through a non-inferiority study.Design A cross-sectional study design was adopted.Setting This study was conducted in Health Promotion and Risk Factor Screening Service in a tertiary Eye and ENT hospital in a semi-urban area of Nepal.Participants 2,256 randomly selected 40-69 years outpatients.Outcome measures Correlation analysis, the area under the Receiver Operating Characteristic curve, Odds ratios (OR) were calculated between three obesity metrices and hypertension.Results The prevalence of obesity and overweight by BMI was 16.09% and 42.20%, respectively; by WHtR was 32.76%, which is two times higher than obesity measured by BMI. High WC was observed among 66.76% of participants. Female participants had a greater prevalence of high WC (77.46%) than males (53.73%) (p<0.001). Prevalence of hypertension and pre-hypertension was 40.67% and 36.77%, respectively. The areas under the curve were significantly higher than 0.5 for BMI (0.593), WHtR (0.602), and WC (0.610).Conclusion WC correlated well with obesity and hypertension. It also had a higher predicting ability than WHtR and BMI to predict hypertension. WC thus proved to be non-inferior to two other commonly used metrics. It proved superior in detecting obesity in female. This inexpensive and simple non-tension tape measurement may play an important role in the future diagnosis of obesity and the prediction of HTN in resource-constrained settings of developing countries.

INTRODUCTION: Diabetes is a pandemic of public health importance, and prediabetes has also emerged as a major public health concern. Unfortunately, one-third of individuals with diabetes are identified only after developing complications, and nearly three-fourths are unaware of their raised blood sugar status. Opportunistic screening at an earlier stage has good prognosis. The study aimed at an opportunistic screening of raised plasma glucose levels of outpatients and diagnosing prediabetes and diabetes among them. MATERIALS AND METHODS: This descriptive cross-sectional study was conducted among patients visiting an Eye ENT hospital in Bhaktapur, Nepal, between January to December 2019. Outpatients aged 40-79 years with unknown history of diabetes were invited for free hyperglycemia screening. Descriptive analysis was computed for patients participating in random plasma glucose (RPG) screening and patients coming for definitive tests for diabetes with elevated RPG levels. RESULTS: Amongst 6,913 outpatients, 14.9% had RPG levels of 140 mg/dL and higher. Among 159 patients with RPG levels 140 mg/dL and higher, 40.9% had prediabetes, and 32.7% had diabetes. CONCLUSIONS: Opportunistic screening in hospital OPD settings is feasible to identify people at risk of hyperglycemia. Timely detection of a silent killer - diabetes and prediabetes can be useful for early intervention and preventing complications.