Browsing by Author "Bhandari, R"
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Publication Clinical profile of patients with pleural effusion admitted to KMCTH(Kathmandu University, 2009) Dhital, KR; Acharya, R; Bhandari, R; Kharel, P; Giri, KP; Tamrakar, RAbstract Background: pleural effusion is the common findings in patients presenting with cardiopulmonary symptoms but specific studies are lacking in Nepal. Objective: The main objective of this study is to find out the various causes of pleural effusion, their mode of clinical presentation and laboratory analysis of blood and pleural fluid to aid diagnosis of patients with pleural effusion. Materials and methods: Retrospective data from July 2009 to July 2007 from all the cases diagnosed with pleural effusion were taken. Altogether 100 cases diagnosed with pleural effusion by chest X-ray (Posterior- Anterior and Lateral view) and Ultrasonogram of the chest were studied. The following parameters were analysed: Patients demographic profile, causes, location (Unilateral, Bilateral), Blood haemoglobin and count, sputum profile, Monteux test, chest X- ray and USG findings and pleural fluid analysis[Biochemical, Haematological, Microbiological(culture and stain) and cytological]. This study was analysed by using SPSS 16. Results: The mean age of the patient was 44.89 ± 21.59 and must patients with pleural effusion belong to age group 21- 30. Most common cause of pleural effusion was found to be tubercular effusion followed by parapneumonic effusion. Right sided effusion was seen in most cases of tubercular parapneumonic and malignant effusion whereas bilateral effusion was seen in 87.5% of the patient (7 out of 8) having congestive heart failure and all cases of renal disease (4 out of 4). Shortness of breath (83%), cough (67%) and fever (66%) are the most common mode of clinical presentation. Conclusion: Our study concluded that the most common cause of unilateral pleural effusion is tuberculosis followed by parapneumonic effusion and most cases of those belong to younger age group (21 -30yrs) and most common cause of bilateral pleural effusion is congestive cardiac failure. Key words: Pleural effusion, Tuberculosis, pneumonia, malignancy, protein, ADAPublication Non Medical Interventions for Childhood Diarrhoea Control:Way Forward in Nepal(Kathmandu University, 2013) Khanal, V; Bhandari, R; Karkee, RABSTRACT Background Diarrhoeal diseases remain a major cause of mortality of children aged under-five years in the developing countries including Nepal. The transmission of diarrhoea mostly caused by biological agents and is facilitated by the behavioural, social and environmental factors. More recently, the concept of prevention altering these factors is getting momentum. Objective To recommend the most effective non medical intervention that can prevent and control childhood diarrhoeal disease in Nepal. Methods Litrature review was conducted to analyse the successful interventions in developing countries. Peer review articles were accessed from “Science direct”, “Google Scholar”, and “Pubmed”. Interventions focussing on social and environmental determinants of diarrhoea were included. Results Four interventions (with primary focus in social and environmental determinants of diarrhoeal disease) were purposively selected, summarized and discussed. Saniya programme (Burkina Faso 1995 to 1998) is considered successful in modifying the risk behaviours. Intensive hand washing programme (Pakistan 2002 to 2003), a cluster randomized controlled trail, was not sustainable as the results did not last long once the free supply of soap was stopped. School Led Total Sanitation (Nepal 2006) is a participatory, community centred program whose focus is on local ownership. This program approach is effective and feasible for scaling up in Nepal. Global Public Private Partnership for Hand washing with Soap (Ghana 2002) was based on the marketing researches and hence yielded effective results. Conclusion Combination of School Led Total Sanitation and Global Public Private Partnership for hand washing with soap suits Nepal. These interventions focus on creating demand, changing behaviour and thereby, improving the sanitation status. KEYWORDS Burning mouth syndrome, idiopathic, stomatodynia, xerostomia