NepMed Repository :: Browsing by Author "Adhikari, K"

Browsing by Author "Adhikari, K"

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Behavioural risk factors of non-communicable diseases among adolescents
(Institute of Medicine, 2012) Adhikari, K; Adak, M R
Abstract Introduction: Cardiovascular and other chronic diseases are becoming the major causes of morbidity and mortality in most of the third world countries, including Nepal. Unhealthy diet, physical inactivity and consumption of tobacco, alcohol, drugs etc. are major global determinants of non-communicable diseases and contribute to the excess death and disability among the poor in terms of mortality. This study was done to estimate the prevalence of behavioral risk factors of NCDs among adolescent. Methods: A cross-sectional study based on WHO stepwise approach for surveillance of Non Communicable Diseases (NCDs) risk factors was conducted in Chitwan District to assess the risk factors of NCDs. Information was collected on substance abuse, dietary habits and physical activity through personal interview. Results: A bout 50% male and 30% female respondents were currently abusing one or other forms of substance. Male (39%) and female (26%) were using tobacco products. It was found that only 14% of respondents were doing satisfactory level of physical activities. Conclusions: Substantially high levels of the various behavioral risk factors among adolescents in Chitwan District suggest an urgent need for awareness raising programmes. Keywords: Addiction, Non-communicable Diseases (NCD s), Risk factors
Disease Profile and Hospital Outcome of Newborn Admitted to Neonatal Intermediate Care Unit at Tertiary Care Center in Nepal
(Kathmandu University, 2017) Chapagain, RH; Basaula, YN; Kayatha, M; Adhikari, K; Shrestha, SM
ABSTRACT Background Neonatal mortality rate (NMR) is decreasing in Nepal but at a slower pace than infant and child mortality. In order to improve neonatal outcome, Care of sick children can be done better so as to aid in reducing neonatal mortality rate. Objective The objective was to identify pattern of diseases and outcome admitted to Neonatal Intermediate care Unit (NIMCU). Method A retrospective study was conducted at Neonatal Intermediate care Unit of Kanti Children’s hospital from Bhadra 2071 to Shravan 2073 (August 2014 to July 2016). Result Total 1286 neonates were admitted in Neonatal Intermediate care Unit with the highest admission in the months of Bhadra (August-September) 12.52% and the lowest in Push (December-January) 4.82%. Among the admitted cases, 1,028 (80.0%) were full term while 256 (20.0%) were preterm. Among the total admission, 43.6% were less than 7 days old which is the most vulnerable period during the newborn phase. Admission due to neonatal sepsis was 892 (69.36%). Among them, 628 (70.40%) were late onset neonatal sepsis while 264 (29.60%) were early onset. Neonatal jaundice accounted for 12.36% (159) of the cases while Hypoxic Ischemic Encephalopathy accounted for 4.80% (62) of cases. Congenital Heart Disease were 53 (4.12%) and neonatal pustulosis were 27 (2.20%). Meningitis accounted for 45 (3.49%) of cases and UTI 29 (2.22). Death during treatment were 18 (1.39%). 7% of cases deteriorated and referred to NICU while, 3.2 % of cases were referred to other centers and 5.1% of cases were either discharged on request or left against medical advice. Conclusion Neonatal sepsis including both early and late onset, Congenital Heart disease, birth asphyxia and neonatal Jaundice accounted for majority of admission in NICU. Three of four these etiologies are preventable up to some extent. KEY WORDS Morbidity, mortality neonate, sepsis, outcome
Primary Laryngotracheal Amyloidosis Masquerading as Malignancy
(Kathmandu University, 2019) Devkota, K; Adhikari, K; Poudel, S
ABSTRACT Amyloidosis represents a heterogeneous group of disorders characterized by the deposition of amyloid protein in various target organs of the body. Amyloidosis is classified as systemic or local. Larynx is the common site for localized amyloid deposition and patient usually presents with hoarseness of voice. Because of the similar clinical and imaging features to malignant laryngeal mass, diagnostic confusion occurs and histopathological confirmation is usually needed. Although laryngeal tracheo-bronchial amyloidosis is rare, it should be considered among the differentials of benign laryngeal tumors. KEY WORDS Amyloidosis, Laryngotracheal, Malignancy
Radiological Assessment of Femoroacetabular Impingement Morphology Using Computed Tomography in Asymptomatic Young Population
(Kathmandu University, 2025) Koirala, S; Gupta, MK; Baral, P; Adhikari, K
ABSTRACT Background Femoroacetabular impingement is regarded as precursor of osteoarthritis. Various studies have discussed the prevalence of femoroacetabular morphology but only few studies have been done on asymptomatic population using cross-sectional imaging. Objective To determine the prevalence of femoroacetabular impingement morphology in young asymptomatic population on computed tomography. Method This cross-sectional study was done in 200 individuals who underwent computed tomography for abdominal pathologies without any symptoms of hip pain, hip pathology or osteoarthritis. Multiplanar images were reformatted and assessed for the presence of parameters associated with femoroacetabular impingement; alpha angle greater than 55°, femoral head-neck offset less than 8 mm, angle of acetabular version less than 15°, lateral center edge angle greater than 40°. Result At least one of the femoroacetabular impingement morphology was detected in 162 hips. The prevalence of abnormal hip joint was higher in male patients than in female patients (47.3% vs 31.8%). Prevalence of cam morphology was 14.5%, pincher was 17.5% and mixed morphology was 8.5%. Prevalence of cam and mixed morphology were common in male hips however there was no statistically significant difference in prevalence of pincher morphology between male and female hips. Conclusion Femoroacetabular morphology was noted with high frequency in asymptomatic young population on computed tomography. Diagnosis of femoroacetabular impingement syndrome should be based on combination of clinical and radiological findings. KEY WORDS Alpha-angle, Cam, Femoroacetabular impingement, Pincher
Retrospective study of HIV infection in Anti Retroviral Treatment center of Mahendranagar, Nepal
(Kathmandu University, 2016) Chapagain, RH; Adhikari, K; Kamar, SB; Singh, DR
ABSTRACT Background Being the most backward region, The Far Western Development Region has high illiteracy rate, low socioeconomic status and high migration rate contributing the progression of epidemiological status of Human Immunodeficiency Virus (HIV) towards generalized form. Objective To study the demographic profile of the HIV positive patients, along with their CD4 status and tuberculosis during diagnosis. Method A retrospective descriptive study carried out from May 2006 to July 2012 in 271 HIV patients registered in HIV clinic of Mahakali Zonal Hospital, Mahendranagar. Result Among 271 patients enrolled, 48.30% (131) were male and 51.7% (140) were females. Thirty seven (13.7%) were less than 15 years and 76.3% (207) were of age 16-45 years. 38.7% were household workers by occupation and 34.50% were involved in agriculture and 3.70%were migrant labour. At the time of presentation, 22.4% (60) were stage I according to WHO staging and 18.5% (50), 58.5 (158) and 0.7% (2) were of stage II, III and IV respectively. Similarly, 33.0% (89) had more than 350 CD4 count at the time of presentation. 20.8% (56) of patients were infected with tuberculosis. Among 236 families, 2 or more members were found to be affected in 24 families. In most of the cases, female were diagnosed first followed by male in the families, where both the couple were infected. Conclusion Most of the HIV infected patients were of productive age group. Majority of patients were uneducated and Tuberculosis was found to be common opportunistic infections associated with HIV infection. KEY WORDS HIV infection, opportunistic infection, sexual activity
Self-Reported Emotional and Behavioural Problems among Adolescents, Kathmandu
(Kathmandu University, 2023) Pandey, A; Adhikari, K; Dhakal, K; Pandey, AR; Upadhyay, R; Devkota, N
ABSTRACT Background Adolescents are highly vulnerable to different types of behavioural problems that can affect their academic and social lives. If left untreated, serious mental illness can develop. Objective The objective of this study was to find out emotional and behavioural problems among adolescents. Method A descriptive cross-sectional study was conducted among 275 adolescents studying in grades 7-11 at five private schools in Kathmandu. A non-probability convenience sampling technique was used to select required sample. The self-reported Strengths and Difficulties Questionnaire was used to collect data. Ethical approval was obtained from the Institutional Review Committee at the Institute of Medicine, Tribhuvan University. Descriptive statistics were used to analyse the data. The chi-square test was used to measure the association between behavioural problems and selected variables at a 95.0% confidence level. Result The mean age of the adolescents was 13.66 (SD ± 1.13) years, and 53.1% were female. In total, 7.3% and 13.8% of adolescents had abnormal and borderline levels of behavioural problems (total difficulties), respectively. Across different domains of difficulty levels, 5.0%, 12.0%, 3.3%, 5.5%, and 1.5% of adolescents had abnormal levels of emotional problems, conduct problems, hyperactivity/ inattention problems, peer relationship problems, and pro-social behaviours, respectively. Fathers’ occupation was significantly associated with behavioural problems among adolescents (p=0.020), and 15.3% of adolescents had a significant impact on their daily life, such as at home, with friends, in the classroom, or during leisure activities, due to emotional and behavioural difficulties. Conclusion Emotional and behavioural problems are quite prevalent among adolescents and have a significant adverse impact on their daily lives. KEY WORDS Adolescents, Behavioural and emotional problems, Self-report, Strengths and difficulties questionnaire
Study of antifungal activity of amphotericin B-lipid formulations with five lipid carriers
(Institute of Medicine, 2016) Adhikari, K
Abstract Introduction:Invasive pulmonary aspergillosis (IPA) is a prime cause of morbidity and mortality in immunocompromised individuals, who is undergoing lung transplantation.Mortality among infected patients is high. Death rate in excess of 90% has been shown in study by Richardson. Most of these invasive mould infections are acquired through the respiratory tract.An increased incidence of invasive fungal infection has created major challenges for medical practitioners. Amphotericin B(AmB) has been the drug of choice for the treatment of many fungal infections, and it is still used as a gold standard therapy against invasive fungal infection and most commonly used to treat life-threatening conditions such as cryptococcosis, histoplasmosis, and IPA.Currently, lipid formulations are accepted as a less toxic alternative to the traditional colloidal dispersion. Drug toxicity, the nephrotoxicity of AmB is the major clinical problem, which could lead to treatment discontinuation. We designed five lipid formulations of AmB, and compared the dose-response effects of all lipid formulations in-vitro against three different fungal strains including Cryptococcus neoformans, Candida albicans and Saccharomyces cerevisiae. Methods: Five lipid formulations amphotericin B were formulated by lyophilization process. The cylinder plate method performs the relative potency by determining the clear zone of AmB-lipid formulation in the inoculum medium as compared with a clear zone of AmB standard. Broth microdilution method can be used to measure the minimum inhibitory concentration (MIC). The MIC value is based upon predetermined end point, which may be interpreted as an absence of visible growth in a broth containing known concentration of AmB.The minimal inhibitory concentration (MIC) and minimal fungicidal concentration (MFC) were determined using Cryptococcus neoformans ATCC 90113 NS and Candida albicans ATCC 90028. Results: All fiveformulations showed good responses against C. neoformans and Candida albicans, with the MIC and MFC values in the range between 0.16-0.32 µg/ml. The potency of these formulations was equivalent to pure AmB (100%). Conclusions: The results indicate that the investigateded potassium cholate, potassium deoxycholate, sodium deoxycholate sulfate, sodium cholate and sodium deoxycholate may be used as a promising alternative carrier system for amphotericin B. Keywords: Amphotericin B, Cryptococcus neoformans, Candida albicans, Potency, Lipid drug carriers
Undifferentiated Embryonal Sarcoma of the Liver in Adult Mimicking Hepatic Abscess
(Kathmandu University, 2025) Adhikari, K; Bhattarai, M; Devkota, K
ABSTRACT Undifferentiated embryonal sarcoma is an uncommon malignant tumor of liver of mesenchymal cell origin, usually observed in children. We report a case in a 34 years old male who presented with right upper quadrant pain. Ultrasonography showed a complex solid cystic lesion. However, on computed tomography it appeared as predominantly cystic with small solid components within. It was initially diagnosed as hepatic abscess. After failure to improve on conservative treatment, the patient underwent surgical resection and histopathology revealed undifferentiated embryonal sarcoma. Here we describe the typical clinical and radiologic features of this rare tumor. KEY WORDS Adult, CT scan, Undifferentiated embryonal sarcoma of liver, Ultrasonography

Browsing by Author "Adhikari, K"

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