Browsing by Author "Ghimire, P"
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Publication Epidemiology of malaria in two Eastern districts of Nepal(Kathmandu University, 2010) Parajuli, K; Ghimire, PAbstract Backgrounds: Malaria is one of the major public health problems in Southeast Asia including Nepal having relatively high burden of malaria. Jhapa and Morang districts are malaria endemic plain area of South-eastern part of Nepal Objectives: The evaluate the recent epidemiology of malaria situation in Jhapa and Morang districts, which are the districts in eastern Nepal with high transmission of malaria and to assess the knowledge, attitudes and practices of the people in prevention and treatment for malaria infection. Materials and methods: This descriptive cross-sectional study was carried out with volunteer participation of suspected malaria patients seeking care at the government of Nepal managed primary health care centres located in 2 malaria endemic districts in eastern Nepal. Conventional Giemsa stained thick and thin blood smears prepared from finger prick blood were examined following standard protocols. Suspected patients’ / attendants’ knowledge on malaria, disease symptoms, prevention and control measures were assessed using a structured questionnaire. Chi square and Fisher exact test were used for statistical analysis of the data. Results: Among the total 199 malaria suspected cases studied, 32 (16.1%) cases were confirmed by microscopic findings; where, P. vivax was 12.6% (25/199) and P. falciparum in only 3.1% (6/199). The highest numbers of cases were in age group 20-29 years. Among the total positive cases 75% were male and 37.5% were labourers in occupation. Among the total cases, 32 had provided the history of recent travel to malaria endemic area in India, among them 43.8% (P<0.001) were found to be infected with the malarial parasites (P<0.001). Among the total cases, 69.7% showed some knowledge of malaria, among which fever was the most common symptom mentioned by 68.3%. Occupation (P<0.001) and education (P<0.001) were found significantly associated with the knowledge on mode of transmission. Conclusion: Jhapa district showed higher SPR than Morang, which indicated that Jhapa may be more malaria affected than Morang. Knowledge on malaria transmission and preventive measures are still lacking in deep villages, in spite of different efforts of the government. To improve the malaria morbidity in the districts, health education of the most marginalized people through audio visual methods may be beneficial. Key words: Epidemiology, Malaria, Knowledge, Practice, Eastern NepalPublication Incidence of incidental carcinoma gall bladder in cases of routine cholecystectomy(Kathmandu University, 2011) Ghimire, P; Yogi, N; Shrestha, BBABSTRACT Background Carcinoma of gall bladder is the most common malignancy of the billiary tract. Most of the cases are diagnosed as an incidental case among patients undergoing cholecystectomy. Objectives To establish the rate of incidental carcinoma of gall bladder in patients undergoing routine cholecystectomy to study the demographic profile and prognosis of these patients. Methods A retrospective study was carried out in Fishtail Hospital and Research Center, Pokhara during 1998-2009. The surgical notes, hospital records and histopathology reports of 783 patients undergoing routine cholecystectomy were studied. Results Out of 783 cases, gall bladder cancer was detected in 10(1.28%) of cases and was more common in females (M:F ratio 1:2.3) and the mean age of occurrence was 63.8 years. Most of the cases diagnosed were at their early stages and none of them were in T3 and T4 stages. Six of these patients have survived till a mean follow up duration of 23.7 months. Conclusion The rate of incidental carcinoma of gall bladder is 1.28%. KEY WORDS carcinoma gallbladder, cholecystectomy, incidentalPublication Seroprevalence of anti HCV antibodies among blood donors in Kathmandu valley, Nepal(Kathmandu University, 2008) Karki, S; Ghimire, P; Tiwari, BR; Rajkarnikar, MAbstract Aims and objectives: To study the seroprevalence of anti HCV antibodies among Nepalese blood donors in relation to their age, sex, type of donation and times of donation. Materials and methods: Descriptive cross-sectional study conducted in Nepal Red Cross Society (NRCS), Central Blood Transfusion Service (CBTS), Kathmandu, from December 1, 2006 to September 1, 2007. A total of 33,255 blood donors were screened for anti HCV antibodies by ELISA. Donor’s information was collected from blood donor’s record form and statistical analysis was done using the software ‘SPSS 11.5’ and ‘Winpepi ver. 3.8’. Result: The seroprevalence of anti HCV antibodies in blood donors was 0.66% (95% CI= 0.58-0.76). Higher seroprevalence was observed in male donors (0.7%, 95% CI= 0.6-0.8) than in female donors (0.4%, 95% CI= 0.2-0.6) (P < 0.05). The seroprevalence was highest (0.82%) in the age group of 21-30 years and there was signi cantly decreasing trends in seroprevalence with increasing age (P < 0.05). The highest seroprevalence among the male donors (0.88%) was also observed in the age group of 21-30 years (P < 0.001). Among female donors the seroprevalence (0.47 %) was highest in age group 41-50 years (P > 0.05). The seroprevalence of anti HCV was signi cantly higher in volunteer donors (0.7%) than in replacement donors (0.4%) (P < 0.05). Similar seroprevalence of anti HCV was observed in rst time (0.65%) and repeat blood donors (0.67%) (P > 0.05). Conclusion: The seroprevalence of anti HCV antibodies among blood donors in this study was similar to the seroprevalence reported for general population by other studies. Similar seroprevalence in rst time and repeat blood donors as well as higher seroprevalence in volunteer donors than in replacement donors are the potential threats to safe blood supply, which urges the need of more effective donor education and counselling of blood donors. Key words: Seroprevalence, Anti HCV antibodies, Blood donors, Kathmandu valley, Nepal.Publication Spigelian hernia(Kathmandu University, 2010) Bhatia, TP; Ghimire, P; Panhani, MLAbstract A Spigelian hernia (or lateral ventral hernia) is a hernia through the spigelian fascia, which is the aponeurotic layer between the rectus abdominis muscle medially, and the semilunar line laterally. So far, about 1000 cases have been reported worldwide. These hernias are difficult to diagnose as they do not present with a subcutaneous swelling and have high risk of going for strangulation. We discuss the case of a 36 year old female who presented with history of pain and lumpiness in left lower abdomen, both of which decreased on lying down. She presented to emergency with an episode severe pain at same site which subsided spontaneously. Diagnosis was confirmed on C T scan, plication and onlay prolene mesh repair performed. Spigelian hernias are rare, interparietal type of hernias which have high risk undergoing strangulation. Knowledge of symptoms and signs is vital to diagnosis and treatment of these rare type of hernias. Key words: Spigelian hernia, Interparietal hernia, Rare herniasPublication Tuberculosis and other clinical presentation of HIV/AIDS in patients with or without undergoing antiretroviral therapy in Kathmandu(Kathmandu University, 2007) Dhungana, GP; Ghimire, P; Sharma, S; Rijal, BPObjectives: To screen tuberculosis (TB) and examine the clinical presentation of AIDS in HIV sero-positive persons. Methods: A Cross-sectional study was designed. One hundred HIV infected persons were randomly selected from different parts of the country visiting Tribhuvan University, Teaching Hospital, Kathmandu and different HIV/AIDS care centres. After taking informed consent, questionnaires were filled and three sputum specimens from each person were collected to investigate tuberculosis by Ziehl-Neelsen staining and culture. Data generated were entered into SPSS 11.5 and relevant statistical tools were applied. Results: Among 100 HIV infected cases, 66 (66%) were males and 34 (34%) were females. Sixty percent of the cases were in the age group of 21-30 years. Majority of them were Smokers (41%), alcoholics (34%), illiterates (54%) and unemployed (59%). Heterosexual activity (51%) was found to be the major risk factor for HIV infection. Of the 100 HIV cases, 23 (23%) were co-infected with tuberculosis of which 18(78%) were sputum smear negative tuberculosis, mostly developed in late stage of HIV infection. Weight loss (54%) and diarrhoea (43%) were the major clinical presentations of AIDS. Antiretro-viral therapy non-receiver were more likely to suffer with various clinical disorders/TB as compared to ARV therapy receiver but the values were statistically insignificant, χ2 values ranging from 0.003 to 2.24, p>0.05. Conclusion: Prevalence of tuberculosis was still high in HIV/AIDS patients, and specifically, sputum smear negative tuberculosis cases constituted the significant proportion, particularly in late stage of HIV infection. Weight loss and diarrhoea were found to be the major clinical presentation of AIDS. Illiterate and unemployed young adults involved in unsafe sexual practice and drug addiction were high risk of acquiring HIV infection. Key words: Clinical features, HIV/AIDS, Kathmandu; Smear Negative Tuberculosis