Browsing by Author "Bhattarai, S"
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Publication A Study of Clinical and Endoscopic Profile of Acute Upper Gastrointestinal Bleeding(Kathmandu University, 2014) Dewan, KR; Patowary, BS; Bhattarai, SABSTRACT Backgroud Acute Upper Gastrointestinal Bleeding is a common medical emergency with a hospital mortality of approximately 10 percent. Higher mortality rate is associated with rebleeding. Rockall scoring system identifies patients at higher risk of rebleed and mortality. Objective To study the clinical and endoscopic profile of acute upper gastrointestinal bleed to know the etiology, clinical presentation, severity of bleeding and outcome. Method This is a prospective, descriptive hospital based study conducted in Gastroenterology unit of College of Medical Sciences and Teaching Hospital, Bharatpur, Nepal from January 2012 to January 2013. It included 120 patients at random presenting with manifestations of upper gastrointestinal bleed. Their clinical and endoscopic profiles were studied. Rockall scoring system was used to assess their prognosis. Result Males were predominant (75%). Age ranged from 14 to 88 years, mean being 48.76+17.19. At presentation 86 patients (71.7%) had both hematemesis and malena, 24 patients (20%) had only malena and 10 patients (8.3%) had only hematemesis. Shock was detected in 21.7%, severe anemia and high blood urea were found in 34.2% and 38.3% respectively. Upper Gastrointestinal Bleeding endoscopy revealed esophageal varices (47.5%), peptic ulcer disease (33.3%), erosive mucosal disease (11.6%), Mallory Weiss tear (4.1%) and malignancy (3.3%). Median hospital stay was 7.28+3.18 days. Comorbidities were present in 43.3%. Eighty six patients (71.7%) had Rockall score < 5 and 34 (28.3%) had >6. Five patients (4.2%) expired. Risk factors for death being massive rebleeeding, comorbidities and Rockall score >6. Conclusion Acute Upper Gastrointestinal bleeding is a medical emergency. Mortality is associated with massive bleeding, comorbidities and Rockall score >6. Urgent, appropriate hospital management definitely helps to reduce morbidity and mortality. KEY WORD Comorbiditis, massive bleed, rockall score, upper gastrointestinal bleedPublication A Study of Prevalence of Taenia Infestation and Associated Risk Factors Among the School Children of Dharan(Kathmandu University, 2012) Sah, RB; Pokharel, PK; Paudel, IS; Acharya, A; Jha, N; Bhattarai, SABSTRACT Background Taenia prevalence has remained high among certain ethnic groups and occupational diseases in Nepal. Taenia saginata and Taenia solium species are worldwide in distribution. Infection is found most often in rural areas of developing countries with poor hygiene and living in close contact with pigs and eating undercooked pork meats. This allows the tapeworm infection to be completed and its cycle to continue. Objectives To measure the prevalence of taenia infestation and to identify risk factors associated with taenia infestation among the school children of Dharan. Methods A cross sectional study was conducted among 935 Government and private school going children of Grade VI, VII, and VIII of Dharan during 2007 to 2008. Stratified random sampling method was applied to choose the schools and the study subjects. The prevalence was calculated, Chi-square test was used to measure the association of risk factors and taenia infestation. Results Taenia species was found to be high (5.5%) among the school children of Dharan. Infection rate of taenia among the male children (6.0%) was slightly higher than female (4.8%). There were no cases of taenia infestation found among children washing hands with soap. Regarding meat consumption in the non-vegetarian group, taenia infestation was found higher (6.5%) among pork eating than non- pork eating (4.7%). No significant relationship was traced among the factors in the causation of taenia infestation although slight indications present. Conclusion Taenia species was found very high among the school children of Dharan. No such association was found with the risk factors. KEY WORDS Prevalence, risk factors, taenia infestation, school children, DharanPublication Clinico-epidemiological Profile of Rosacea at a Tertiary Care Hospital in Eastern Nepal(Society of Dermatologists, Venereologists and Leprologists of Nepal (SODVELON), 2012) Bhattarai, S; Agrawal, S; Rijal, ANA Keywords: Rosacea, epidemiology, aggravating factorsPublication Do Contacts have a Role in the Transmission of Leprosy?(Society of Dermatologists, Venereologists and Leprologists of Nepal (SODVELON), 2012) Rijal, A; Agrawal, S; Bhattarai, SNA Keywords: Contact, Transmission, LeprosyPublication Factors Contributing to Antenatal Care and Delivery Prac- tices in Village Development Committees of Ilam District, Nepal(Kathmandu University, 2013) Pradhan, PMS; Bhattarai, S; Paudel, IS; Gaurav, K; Pokharel, PKABSTRACT Background Proper antenatal care and good delivery practice helps to prevent the complications of childbirth and ensures a wholesome maternal and child health in the future. Almost half of the births in the developing countries take place without a skilled birth attendant. Objectives To assess the antenatal care (ANC) and delivery practices in the Village Development Committees (VDC) of Ilam district, Nepal and to identify the relationship with the socio-demographic factors. Method Cross sectional study of 262 mothers of reproductive age group having at least one child of less than five years of age, selected by simple random sampling, was carried out over different VDCs of Ilam by face to face interview using semi-structured questionnaire. Results Among 262 mothers, 34.7% were married before the age of 18 years. 69.5% of the mothers had attended four antenatal care visits. Nearly 47% of the deliveries were conducted at home out of which only 33.6% were conducted by skilled birth attendant. Number of children and maternal education were found to significantly affect the ANC visit and place of delivery. Age at marriage and age at first pregnancy were significantly associated with the place of delivery. Conclusion Large proportion of mothers still do not have adequate antenatal visits and this is supported by the fact that nearly half of the deliveries were conducted at home. Motivation and incentives are required for pregnant mothers especially in rural areas regarding importance of adequate antenatal visits and delivery in health institutions. Population policies should be aimed at reducing proportion of women marrying and giving birth in their teens. KEY WORDS Antenatal care, delivery practices, home delivery, pregnancy, NepalPublication Impact of Patch Testing on Quality of Life in Patients with Hand Eczema: A Follow-up Study(Kathmandu University, 2013) Agrawal, S; Rijal, A; Bhattarai, SABSTRACT Background Patch testing has previously been shown to influence the quality of life, although a very few studies have shown if this is dependent on the result of the patch tests. Objective To assess the impact of patch testing on the quality of life (QOL) in patients with hand eczema (HE). Methods A total of 50 patients diagnosed of hand eczema at the time of patch testing, aged 16 years and above participated in this study. Detailed demographic information and diagnosis of hand eczema were collected on the day of the patch test. After six weeks, the patients were asked about the hand eczema, knowledge of their allergies and change in their life style to avoid the relevant allergens demonstrated on the patch test. Dermatology Life Quality Index (DLQI) was used to measure the QOL on both occasions. Results The patch test positivity was found in 68% of patients to one or more allergens. The sum score of DLQI at baseline was 12.16 ± 5.58 with median 12.0. HE had most impact on symptoms and feelings. Patients with both positive patch test (mean baseline= 11.94± 5.88; mean at six weeks=2.81± 2.01; P<0.001) and negative patch test (mean baseline=12.63± 5.03; mean at 6 weeks=5.4± 3.56; P=0.001) showed significant improvement in DLQI scores, however it was more improved in patients with positive patch test than in patients with negative patch test. Conclusions Hand eczema had an appreciable impact on the QOL. Patch testing had been beneficial to most patients in improving patient quality of life considerably. KEY WORDS Dermatology life quality index (DLQI), hand eczema, patch test, quality of life (QOL)Publication Leprosy after the Elimination: A BPKIHS experience(Society of Dermatologists, Venereologists and Leprologists of Nepal (SODVELON), 2013) Bhattarai, S; Agrawal, S; Rijal, A; Marahatta, SNo Abstract:Publication Malnutrition Status Among Under - 5 Children in a Hill Community of Nepal(Kathmandu University, 2014) Gaurav, K; Poudel, I S; Bhattarai, S; Pradhan, PMS; Pokharel, PKABSTRACT Background Malnutrition, especially under nutrition puts children at increased risk of morbidity and mortality and remains a serious barrier in child growth, development and survival. This is a major public health problem among under- 5 children in Nepal particularly in rural areas. Objective To assess the burden and contributing factors for malnutrition in hill community of Ilam district in eastern Nepal. Method A cross sectional study was conducted in rural hill communities of Ilam district, Nepal with a sample of 240 under- 5 children. Anthropometric measurements were used as per WHO guidelines to asses three nutritional status: Underweight, Stunting, and Wasting using descriptive statistics and chi square test was applied using SPSS 12.0 to assess social and predisposing factors. Result Seventeen percent of under- 5 children were moderately and 10.4 % were severely underweight. Similarly, 22.9%, and 17.5% were found to be moderately and severely stunted respectively. Less than 10% were found to be moderately and severely wasted. Older age group of children, education level of mother, not exclusive breast feeding practice had significant (p <0.05) effect on stunting. More than 50% children were affected with stunting, underweight and wasting at the same time. Conclusion Significant proportion of under - 5 children were malnourished in the communities of the hilly areas. The study unveiled the importance of literacy and exclusive breast feeding for the prevention of malnutrition in under- 5 children. KEY WORDS Contributing factors, malnutrition, Nepal, under- 5 children.Publication Skin Rejuvenation(Society of Dermatologists, Venereologists and Leprologists of Nepal (SODVELON), 2009) Bhattarai, S; Rijal, A; Sapam, RAbstract: NAPublication The Study of Prevalence of Helicobacter Pylori in Patients with Acne Rosacea(Kathmandu University, 2012) Bhattarai, S; Agrawal, S; Rijal, A; Majhi, S; Pradhan, B; Dhakal, SSABSTRACT Background Acne rosacea is an inflammatory disease affecting the central part of the face characterized by erythema, papules, papulo pustules and telangiectasias of unknown etiology. More recently numerous studies have described an association with Helicobacter pylori (Hp) and the extra gastric symptoms of cutaneous origin. Objectives To establish the prevalence of Helicobacter pylori (Hp) infection in the stomach in patients with rosacea based on standard Hp serological test. Methods All patients with the clinical staging of 2, 3 and 4 rosacea attending the Dermatology Out Patient Department from May 2009 – April 2010 were included in the study. Quantitative serological test using the SERION ELISA classic Helicobacter pylori IgG was done. Result A total of 26 patients were enrolled in the study with the age ranging from 26- 82 years. There were 14 males and 12 females and the male: female ratio was 1.6:1. Three (11.53%) patients presented with Grade IV rosacea, a severe clinical presentation and symptoms suggestive of acid peptic diseases were found in 14/26 (53.8%) patients. A positive serology to H. pylori was found in 17/26 (65.4%) of patients. A statistically significant correlation was found when association of H.pylori positivity in patients of rosacea compared with the seropositivity in controls. However correlation in the seropositivity was not found amongst the patients having gastritis and rosacea. Conclusion There still proves to find a correlation of Hp infection with patients with rosacea but it can still be hypothesised as a cutaneous manifestation of an internal peptic ulcer disease . KEY WORDS H.pylori, rosacea