Browsing by Author "Baral, R"
Now showing 1 - 3 of 3
Results Per Page
Sort Options
Publication Outbreak of Cholera in Tilathi VDC Saptari Nepal(Kathmandu University, 2012) Yadav, DK; Tamrakar, D; Baral, R; Jha, P; Gautam, S; Pokharel, PKABSTRACT Background On 2011, Cluster of cholera cases was reported in the Tilathi VDC of Saptari, Nepal. Objective The outbreak was investigated to identify the etiological agent and possible source of infection and guiding the prevention and control measures. Methods Demographic and clinical details were collected from the suspected case-patients, and the outbreak was described by time, place, and person. Focus group discussion and Key informant interview were conducted to assess the practice of sanitation, source of drinking water and probable cause of diarrheal disease. Five stool samples and 10 water samples of tube well and ponds were collected and microbiological study was done in BPKIHS Dharan. Results A total of 111 persons suffered with diarrhea and 02 died of it (attack rate 3.05%, case fatality rate 1.8%). All age groups were affected with disease (median age 26 yrs) and males were affected more than females. Descriptive epidemiology suggested the clustering of cases were around the pond where they clean utensils, take bath and wash clothes. The Vibrio cholerae 01 El Tor, Ogawa serotype was isolated in 03 out of 05 suspected stool samples and in all three of the pond water samples. They reported that most of the houses do not have the toilet and people do not wash their hands regularly with soap and water after defecation. Conclusion Vibrio cholerae was the causative agent behind the outbreak and probable source of infection was the problematic pond water which they used for different purpose. Immediate chlorination of the pond was recommended to halt further spread of the epidemics. KEY WORDS Cholera, outbreak, tilathi, saptariPublication Utility of Micronucleus Study on Breast Cytology Smears(Kathmandu University, 2025) Shrestha, O; Baral, R; Tiwari, AABSTRACT Background Micronuclei (MN) are extranuclear chromatin bodies that arise due to chromosomal breakage and serve as biomarkers of genomic instability. Their presence has been linked to malignant transformation. Breast cytology offers a minimally invasive method for early detection of breast lesions. Evaluating micronuclei in these smears may enhance diagnostic accuracy by providing an additional objective parameter. Objective To compare the MN score in benign and malignant epithelial neoplasms of the breast as well as compare it within different grades of breast carcinomas. Method A retrospective cross-sectional study was conducted including epithelial breast neoplasms over a period of three years from February, 2021 to February, 2024. May– Grünwald–Giemsa (MGG) and Papanicolaou stained cytology smears of cases whose biopsy sample was also received in department of Pathology were included after ethical approval from institutional review committee. Micronuclei were identified based on established criteria and scored in 1,000 epithelial cells per case. The micronuclei frequency was compared across cytologically diagnosed benign and malignant lesions proven histopathologically. Statistical analysis was performed to evaluate significance. Result The mean micronuclei score was significantly higher in malignant smears compared to benign lesions (p < 0.05). A progressive increase in micronuclei frequency was observed from grade 1 to grade 3 amongst the malignant category. Conclusion Micronuclei scoring on breast cytology smears is a simple, cost-effective and potentially reliable marker of malignancy. It can serve as a useful adjunct in routine cytological evaluation, and also help in predicting the grade of malignancy. KEY WORDS Breast, Chromosomal instability, NeoplasmPublication Video-Thoracoscopic Management of Empyema Thoracis in tertiary level thoracic unit(Institute of Medicine, 2013) Shrestha, UK; Thapa, B; Baral, R; Sapkota, R; Sayami, PAbstract Introduction: Thoracic empyema is a common problem. Use of minimal access surgery for the treatment is comparatively new. We audited our results with VATS in thoracic empyema. Methods: We analyzed the retrospective data from the patients who received Video-Assisted Thoracoscopic Surgery (VATS) for empyema thoracis from April 2011 to April 2013 at Manmohan Cardio-thoracic Vascular and Transplant Center (MCVTC). Results: Of the 44 patients who underwent surgery for empyema of various stages, 37 patients underwent the procedure via VATS. The average age was 26.4 ±17.19 yrs (1-64). The male to female ratio was 2:1. The duration of symptoms before VATS intervention varied very widely (7-712 days avg: 92.7±28.8 days). The duration was 32 days on an average among patients in whom deloculation sufficed but was 111 days among those in whom decortication was required. A complete VATS procedure with satisfactory lung expansion at the end of the procedure was possible in 34 patients (100% patients who underwent deloculation and 88% of those who underwent decortications). Inadequate lung expansion forced conversion in three and subsequent collapse necessitated re-operation in one. The operative times were: VATS converted to open decortication (150 mins), completed VATS decortication (60-180 mins, avg: 125.7 mins) and VATS deloculation (45-120 mins, avg: 69 mins). Post-operative chest tube drainage was shorter in patients in whom a successful VATS procedure was completed 4.0 Vs 40 days). Conclusion: Videothoracoscopic approach is feasible in surgical management of empyema thoracis. The results seem to be better in earlier stages. Keywords: Deloculation, decortication, empyema, Video-assisted thoracoscopic Surgery (VATS)