Browsing by Author "Giri, A"
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Publication Hereditary spherocytosis(Kathmandu University, 2004) Bajracharya, BL; Giri, A; Baral, MRHereditary spherocytosis is a congenital haemolytic anaemia due to defect in spectrin-a RBC membrane protein and is transmitted as autosomal dominant. Due to this defect there is presence of characteristic spherical cell in peripheral blood smear and osmotic fragility is increased. Haemolytic anaemia, reticulocytosis, jaundice and splenomegaly are present. This article reports a case of a 9 year old boy who presented with a history of prolonged jaundice since the age of 4 years and recurrent pain in the right upper quadrant of abdomen. Clinical examination revealed jaundice, enlarged liver and marked splenomegaly. Investigations confirmed the diagnosis of hereditary spherocytosis by the presence of spherocytes in blood smear, raised reticulocytes and increased osmotic fragility. The patient was subjected to splenectomy after vaccination against coccobacillus and was discharged after proper advice and on post splenectomy antibiotic prophylaxis. Key words: Prolonged jaundice, microspherocytes, splenectomy, prophylaxisPublication Stigma Related to Tuberculosis Among Patients Attending DOTS Clinics of Dharan Municipality(Kathmandu University, 2012) Aryal, S; Badhu, A; Pandey, S; Bhandari, A; Khatiwoda, P; Khatiwada, P; Giri, AABSTRACT Background The patients suffering from tuberculosis are receiving shame and unfair treatment from the people living around them within their own society attending DOTS clinic of Dharan municipality. Objective To assess the stigma experienced by tuberculosis patients and to find out the association between stigma experienced by Tuberculosis patient and the selected variables (socio-demographic characteristics, clinical profile and illness experience). Methods Descriptive Cross Sectional study was done among sixty tuberculosis patients. Stratified random sampling was used to select the main center and sub center of Tuberculosis treatment and population proportionate simple random sampling using lottery method was done. Data was collected using predesigned, pretested performa from Explanatory Model Interview Catalogue developed by World Health Organization. Results The study revealed that 63.3% of the subjects were stigmatized. There was association between stigma and variables such as occupation, monthly family income and past history of Tuberculosis. There was also association of stigma with treatment phase, category of the patient and past outcome of illness. Conclusion Due to lack of knowledge and awareness about Tuberculosis, many patients were stigmatized. Efforts should be made to educate the public about Tuberculosis to reduce stigma experienced by Tuberculosis patients and improve the compliance of the patient. KEY WORDS direct observed treatment therapy, stigma, tuberculosisPublication The Demographics of Molar Pregnancies in BPKIHS(Kathmandu University, 2011) Koirala, A; Khatiwada, P; Giri, A; Kandel, P; Regmi, M; Upreti, DABSTRACT This is an analysis of the incidence of molar pregnancies and those of complete and partial molar pregnancies across the reproductive age range for BP Koirala Institute of Health Sciences (BPKIHS) in the period 2010-2011. Patients with molar pregnancies registered with BPKIHS from January 2008 to January 2010 were identified. The overall number of molar pregnancies registered was compared to the number of maternities (live births and still births) and total viable conceptions for this year. A retrospective study of 64 cases of molar pregnancies recorded at BPKIHS during the two year time was done. Medical records were reviewed. Incidence, clinical presentation and methods of diagnosis were studied. During the study period, there were 37 complete moles, 23 partial moles, 1 persistent gestational trophoblastic tumor, 1 choriocarcinoma, and 2 invasive moles. The incidence of molarpregnancy was 3.94 per 1000 deliveries. Median distribution was at 22 years of age, and majority (67%) presented during early second trimester. Twenty one (32.8%) women were of blood group A positive and ten (15.6%) presented with severe form of anemia. This study provides detailed data regarding the incidence of partial and complete molar pregnancies with increasing maternal age. It confirms the relation of molar pregnancy with age, and blood group. Complete mole had the highest incidence, affecting mostly younger age group, and usually in the first half of their pregnancy. KEY WORDS gestational trophoblastic disease, hyaditiform mole, persistant gestational tumors