Browsing by Author "Bajracharya, BL"
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Publication A study of therapeutic effect of the growth of children with hypothyroidism(Kathmandu University, 2006) Bajracharya, BL; Baral, MR; Thapa, P ChhetriObjectives: This study was done to see the therapeutic effect of the growth of children who was diagnosed as hypothyroidism. Methods: Thirty-four children with primary hypothyroidism were included in this study. Height, weight and head circumference were measured at initial diagnosis and at every follow up visit. Thyroid function was done. The value was interpreted as abnormal if the range was above or below the normal (T3=70-200 u/L, T4=4-13 u/L, TSH=0.3-6 u/L). X-ray to see the bone age for the chronological age was performed. The value was interpreted as abnormal if the ossification center for the chronological age in inappropriate. Treatment was started with Eltroxine from the day of diagnosis. Dose was adjusted according to the response to the medicine. T3, T4 and TSH level was taken as the guideline to adjust the dose of the drug. X-ray was considered in the follow up where it was indicated. Result: Marked improvement in the anthropometry was seen in comparison to the initial assessment which was well correlated with the normalization of the TSH level and the x-ray of the bone. Conclusion: Serial follow up of these patients was necessary in order to assess the growth in height, weight and head circumference along with the repeated thyroid function to correlate the response of the drug. Key words: Therapeutic effect, growth, primary hypothyroidism, TSH levelPublication Clinical profile and antibiotics response in typhoid fever(Kathmandu University, 2005) Bajracharya, BL; Baral, MR; Shakya, S; Tuladhar, P; Paudel, M; Acharya, BObjective: The objective of this study is to evaluate the clinical profile and drug response in typhoid fever. Methods: This is a retrospective analysis of paediatric patients suffering from typhoid fever who were admitted at Kathmandu Medical College Teaching Hospital, Sinamangal during the period of two years and nine months. Results: Total numbers of 100 cases of typhoid were studied. Diagnosis of Typhoid fever was based on clinical features, Widal test and blood culture. The sensitivity pattern of drugs in blood culture was recorded. The mode of presentation, treatment history, laboratory investigations reports, antibiotics administered and response to therapy were recorded. Conclusion: Quinolone is still the highly sensitive drug and most widely used for Salmonella typhi. Because of the indiscriminate use of these drugs, resistant to ciprofloxacin has been quite high and the duration of the defeverscence period has also been prolonged. But Ofloxacin is still showed highly effective and widely used with good response. Key words: clinical profile, antibiotics response, typhoid fever.Publication Hereditary spherocytosis(Kathmandu University, 2004) Bajracharya, BL; Giri, A; Baral, MRHereditary spherocytosis is a congenital haemolytic anaemia due to defect in spectrin-a RBC membrane protein and is transmitted as autosomal dominant. Due to this defect there is presence of characteristic spherical cell in peripheral blood smear and osmotic fragility is increased. Haemolytic anaemia, reticulocytosis, jaundice and splenomegaly are present. This article reports a case of a 9 year old boy who presented with a history of prolonged jaundice since the age of 4 years and recurrent pain in the right upper quadrant of abdomen. Clinical examination revealed jaundice, enlarged liver and marked splenomegaly. Investigations confirmed the diagnosis of hereditary spherocytosis by the presence of spherocytes in blood smear, raised reticulocytes and increased osmotic fragility. The patient was subjected to splenectomy after vaccination against coccobacillus and was discharged after proper advice and on post splenectomy antibiotic prophylaxis. Key words: Prolonged jaundice, microspherocytes, splenectomy, prophylaxisPublication Reye’s syndrome(Kathmandu University, 2003) Bajracharya, BL; Piya, A; Manandhar, DSFive and half years male child with one day history of pain abdomen and vomiting who was on aspirin for suspected rheumatoid arthritis presented initially with acute gastritis. Next day, however he developed the signs of encephalopathy with altered liver function. Key words: Rheumatoid Arthritis, Aspirin, Hepatic Encephalopathy, Reye’s syndrome.