Browsing by Author "Dulal, P"
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Publication PCR based molecular detection of M. tuberculosis and comparison of its efficacy against AFB based bacteriological detection in diagnosis of Pulmonary Tuberculosis in Nepal(Institute of Medicine, 2011) Karmacharya, D; Shrestha, L; Bajracharya, B; Dulal, P; Shrestha, S; Dixit, SMAbstract Introduction: Tuberculosis is high burden infectious disease in Nepal. Diagnosis strategy for tuberculosis includes Chest X-Ray, Ziehl-Nelson staining method and culture. Culture is considered to be a “gold standard” in TB diagnosis; however, it takes almost 3 weeks to do culture which affects rapid diagnosis of TB. This study investigates molecular based TB diagnosis and compares the result with the AFB staining. Methods: Sputum samples from the National Tuberculosis centre (NTBC), Sano Thimi, Nepal were tested with Real Time PCR (QPCR) based assay for MTB detection at the affiliated laboratory of the Center for molecular Dynamics Nepal (CMDN), Kathmandu, Nepal. Results: Out of 47 samples, 7 AFB positive samples yielded quantifiable QPCR positive result. However, of the 40 AFB negative samples assessed, 3 were found to contain quantifiable amount of M. tuberculosis using TB DNA detection. This amounts to 6.38% under detection using just AFB microscopy alone. Conclusions: There is added benefits of using PCR in detection of M. tuberculosis .This method, if used in conjunction with traditional AFB will provide a more rapid, reliable and accurate diagnosis of M. tuberculosis. Keywords: Real-Time PCR, Molecular detection, Tuberculosis, TB, Comparative analysis, Diagnosis, AFB methodPublication Victims of road traffic crashes attending the emergency department of Kathmandu Medical College Teaching Hospital(Kathmandu University, 2004) Dulal, P; Khadka, SBObjective: To study the epidemiological factors and pattern of impact and injuries in victims of road traffic crashes visiting the emergency room of an urban teaching hospital in Kathmandu. Design: Retrospective observational study. Methods and Materials: Review of medical records of all the victims of road traffic crashes of one year. Results and Conclusion: Victims of road traffic crashes formed 6.2% of all emergency attendees of the hospital. Two-thirds of the victims came between midday and midnight. The most vulnerable age group to get involved in the crashes was the 15-to-45-year group, which is also the working age group. Pedestrians constitute approximately 40.0% of the victims. Most of the injuries occurred in the lower extremities. Most impacts were seen in upper and lower extremities or in head/face region. The non-fatal nature of injuries can be attributed to the low velocity at which crashes might have occurred. Key words: Road traffic crashes; road traffic injuries; emergency department; Kathmandu.