Browsing by Author "DL, Gurubacharya"
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Publication Clinical profile of typhoid patients(Kathmandu University, 2003) Mathura,KC; DL, Gurubacharya; A, Shrestha; S, Pant; P, Basnet; DB, KarkiObjective: The present study was undertaken to determine the clinical profile of typhoid fever in hospitalised patients. Design: Prospective cross-sectional study. Setting: Kathmandu Medical College and Teaching Hospital Method: Total of thirty patients above fifteen years of age who had clinical features strongly suggestive of typhoid fever and on blood culture found to be positive for salmonella typhi were analysed for clinical features. Result: Among total of thirty cases, there were 17 (57%) males and 13(43%) females. 86% of cases of typhoid fever clustered around 15-30 years of age. Predominant symptoms were fever (100%), headache (90%), abdominal Pain (37%) and constipation (33%). Common clinical signs were splenomegaly (37%), relative bradycardia (27%) and hepatomegaly (17%). None of the patients presented with complications. Conclusion: The clinical profile of typhoid fever in our study revealed not much difference from that of other studies on typhoid fever. Rose spots were not noticed and we did not find a single case of complication of typhoid fever. Probably early initiation of antibiotics prevented the complications. Key words: Typhoid fever, S. Typhi.Publication Correlation between serum-ascites albumin concentration gradient and endoscopic parameters of portal hypertension(Kathmandu University, 2005) DL, Gurubacharya; Mathura, KC; DB, KarkiObjective: We sought to determine the correlation between the level of serum-ascites albumin concentration gradient (SAAG) and the complications of portal hypertension (PHTN), manifested by the presence and grade of esophageal varices (EV). Material and methods: Our study included 32 patients with ascites, demonstrated by ultrasonography, who had measurement of the SAAG. All had upper gastrointestinal endoscopy with assessment of the presence and size of EV. High SAAG was considered to be present when SAAG was >= 1.1 g/dl and Low SAAG when it measured < 1.1 g/dl. Results: We found that 25 of 32 (78.13%) patients had High SAAG and 7 of 32 (21.87%) had Low SAAG. Esophageal varices were present in 18 of 25 (72%) patients with High SAAG and in none of 7 (0%) patients with Low SAAG (p =< 0.001). Among patients with High SAAG, EV were present in four of 8 patients (50%) with SAAG values of 1.10-1.49g/dl; in four of seven patients (57.1%) with SAAG values of 1.50-1.99g/dl; and in ten of ten (100%) with SAAG values of >= 2.0g/dl (p = 0.037). The size of the esophageal varices had no association with the level of SAAG in patients with High SAAG (p = 0.426). Conclusions: In patients with ascites the presence of esophageal varices is associated only with patients with High SAAG. The presence of EV in patients with ascites and High SAAG is directly related to the degree of SAAG. The size of the EV in patients with ascites and High SAAG is not associated with the degree of SAAG. Keywords: Ascites, Serum-ascites albumin concentration gradient (SAAG), Esophageal varices (EV), Portal Hypertension (PHTN)Publication HIV/AIDS and STI related knowledge, attitude and practice among high school students in Kathmandu valley(Kathmandu University, 2005) S, Jaiswal; BS, Magar; K, Thakali; A, Pradhan; DL, GurubacharyaObjective: To assess the knowledge, attitude and practice of high school students regarding HIV/ AIDS and STI and to determine if a school education programme would bring about statistically significant positive change in the knowledge, attitude and practice regarding HIV/AIDS and STI. Methods: The study was conducted among 1012 students of various schools in Kathmandu Valley (Kathmandu, Bhaktapur and Lalitpur). The tool for assessment was confidentially administered closed questionnaire both before and after the education programme of 45 minutes single class, standardized education package. Results: Knowledge on some aspect of the disease was quite low in the study group. 45.8% had prior knowledge of HIV, 65.2% knew that HIV/AIDS could be transmitted by sharing same needle, 46.2% knew that vaccine is not yet available for HIV/AIDS. Knowledge about STI was also quite low, 41.5% knew that pus in the urine is a symptom of STI and 41.7% knew that STI is curable. 4.2% of the study group had previous sexual intercourse, 64.2% had sexual intercourse with friend and 35.17% had sexual intercourse with commercial sex workers. 1.8% would commit suicide if they contracted HIV/AIDS. According to sex wise distribution of the sample, female’s knowledge about HIV was low 43.2% as compared to male 48%, male’s knowledge about transmission of HIV/AIDS from pregnant mother to child was low; 89.7% as compared to female’s knowledge 94.2%. Female’s knowledge about commercial sex worker as high risk group was low (87.8%) as compared to male’s knowledge 90.6%. Key words: HIV, AIDS, STI, high school children.Publication Study of clinical profile and antibiotic sensitivity pattern in culture positive typhoid fever cases(Kathmandu University, 2005) Mathura, K.C.; D, Chaudhary; R, Simkhada; M, Pradhan; P, Shrestha; DL, GurubacharyaObjectives: The present study was designed to analyze the clinical profile and antibiotic sensitivity pattern in the cases of culture positive typhoid fever. Method: The study was conducted over a period of 1year. Total of 46 culture positive cases of Typhoid fever were included in the study. The sensitivity pattern of isolates from blood culture was recorded. The modes of presentation, clinical course, lab investigation reports were also recorded. Results: Out of 46 cases, 33 (71.7%) were males and 13 (28.3%) were females. Average age of presentation was 26.17 years. Fever was present in all patients. Resistance of S .typhi to amoxycillin, chloramphenicol and co- trimoxazole were significantly high. Ciprofloxacin showed resistance in 2 (4.3%) cases. Sensitivity to ceftriaxone was 100% in our study. Conclusion: Typhoid fever is one of the most common health problem in Nepal. Various drugs are being used in the treatment of typhoid fever, in the mean time resistance to many of them are emerging. An appropriate antibiotic has to be initiated only after culture sensitivity in typhoid fever. Keywords: Typhoid fever, S. typhi, Sensitivity, Drug resistance