Browsing by Author "Gupta, SK"
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Publication Augmented Post-Induction Therapy for Children with High-Risk Acute Lymphoblastic Leukemia and a Slow Response to Initial Therapy(Kathmandu University, 2012) Rahman, ATMA; Gupta, SK; Mannan, MA; Nahar, KABSTRACT Background Children with high-risk acute lymphoblastic leukemia (ALL) who have a slow response to initial chemotherapy (more than 25 percent blasts in the bone marrow on day 7) have a poor outcome despite intensive therapy. We conducted a randomized trial in which such patients were treated with either an augmented intensive regimen of post-induction chemotherapy or a standard regimen of intensive post-induction chemotherapy. Objective To compare the effect of augmented therapy with standard intensive post induction therapy in children with high-risk ALL who entered remission after a slow response to initial therapy. Methods Between January 2005 and December 2011, 311 children with newly diagnosed ALL who were either 1 to 9 years of age with white cell counts of at least 50,000 per cubic millimeter or 10 years of age or older, had a slow response to initial therapy, and entered remission at the end of induction chemotherapy were randomly assigned to receive standard therapy (156 children) or augmented therapy (155). Those with lymphomatous features were excluded. Event-free survival and overall survival were assessed from the end of induction treatment. Results The outcome at five years was significantly better in the augmented-therapy group than in the standard-therapy group. The difference between treatments was most pronounced among patients one to nine years of age, all of whom had white-cell counts of at least 50,000 per cubic millimeter (P<0.001). Risk factors for an adverse event in the entire cohort included a white-cell count of 200,000 per cubic millimeter or higher (P=0.004). The toxic effects of augmented therapy were considerable but manageable. Conclusion Augmented post-induction chemotherapy results in an excellent outcome for most patients with high-risk ALL and a slow response to initial therapy. KEY WORDS Augmented post induction therapy, leukemiaPublication Efficacy of Miniature Punch Grafting Followed by Puvasol Therapy in Refractory Stable Vitiligo(Society of Dermatologists, Venereologists and Leprologists of Nepal (SODVELON), 2017) Gupta, Anu; Chaudhary, C; Goyal, V; Lal, D; Gupta, SKAbstract: Introduction: Vitiligo affects approximately 2% of the worldwide population regardless of race, ethnic background or gender. When the medical methods are not successful, surgical procedures may be considered with the aim of placing a new source of pigment cells to reinitiate melanogenesis within the affected areas. This study was conducted to evaluate the efficacy of combining punch grafting followed by PUVASOL therapy in vitiligo patients. After punch grafting patients are given PUVA/PUVASOL exposure. Objective: To study the efficacy of miniature punch grafting followed by PUVASOL therapy in refractory stable vitiligo. Material and Methods: The present study was conducted in the Department of Dermatology and Venereology of Dayanand Medical College & Hospital, Ludhiana from May 2005 to March 2007. Fifteen patients of chronic stable vitiligo not responding to medical treatment and attending the outpatient department of dermatology were included in study. Appropriate statistical methods were used to analyse the data. Conclusion: Patients subjected to Miniature Punch Grafting showed more than 80% acceptance in all selected age groups and among both the sex. There was an inverse relationship between number of grafts inserted and rejection rate. Most common side effect seen was cobblestoning (60%) with few patients showing graft displacement and hematoma formation too. Keywords: vitiligo, miniature punch grafting, puvasolPublication Knowledge, Attitude and Practice regarding Diabetes among Diabetes Patients at a Tertiary Teaching Hospital in Nepal(Institute of Medicine, 2018) Gupta, SK; Yadav, RS; Gupta, RK; Shrestha, S; Shakya, YL; Prasad, PNAbstract Introduction: Diabetes is a chronic metabolic disease which is prevalent all over the world. Its burden has immensely increased in the last two decades. The problem in young people is equally worrisome. Its number in Nepal is estimated to reach 6,38,000 by the year 2025. Many lifestyle and environmental factors have contributed to its rapid rise. It has several microvascular and macrovascular along with systemic complications. There is lack of public awareness on diabetes in our communities. This study aims to assess knowledge, attitude and practice about diabetes among diabetic patients. Methods: This study was conducted in Tribhuvan University Teaching Hospital General Practice OPD. All the diabetic cases attending to OPD were taken for a sample size of 120. Diabetic cases were followed and informed written consent was taken from each patient. All statistical tests were performed using 0.05 as level of significance. Results: Among 120 study patients, 59.16% were male and 40.83% were female. Majority of cases belonged to 41-60 years. More male (40.83%) were literate than female (10%). Knowledge regarding dryness of mouth, urinary frequency, kidney failure as complication, effect of high blood pressure, blood pressure measurement, foot care and exercise was 36.67%, 19.17%, 47.5%, 73.33%, 85%, 19.17% and 43.33% respectively. Practice of diet plan was found in 56.67%. Practice of blood pressure monitoring and eye checkup at an interval of one month was 30% and 20% respectively whereas 41.67% had never had their eye checkup. Compliance to antidiabetic medicines was found in 71.66%. Knowledge on exercise among age group (P=0.032), knowledge on effects of high blood pressure among male and female (P=0.009) as well as literacy among male and female (P=<0.001) were found statistically significant. Conclusion: This study shows that patient’s knowledge about foot care and practice of diet plan was not appreciable. Patient’s attitude and practice about diabetes was also not significant. Diabetes health knowledge need to be improved for better health promotion. Key words: Diabetes; diet; foot care; KAPPublication Risk Factors for Acute Respiratory Infections in Hospitalized Under Five Children in Central Nepal(Nepal Paediatric Society (JNPS), 2013) Yadav, S; Khinchi, Y; Pan, A; Gupta, SK; Shah, GS; Baral, DD; Poudel, PAbstract: Introduction: Acute respiratory infection is a leading cause of morbidity and mortality in under 5 children in developing countries. There are various modifiable risk factors associated with Acute Respiratory Tract Infection (ARI). Hence, identification of associated risk factors for ARI may be helpful to reduce the burden of disease. The aims of this study were to study the risk factors for ARI in under five hospitalized children and to correlate risk factors with ARI related morbidity. It was a hospital- based prospective study. Materials and Methods: Children of less than 5 years admitted in ward with diagnosis of ARI were enrolled in the study as cases. Control included children under 5 years of age attending to Well Baby Clinic, Immunization Clinic and siblings or relatives under 5 years who came with patients in the Paediatric outpatient department of the same institution during the same period. Various risk factors, demographic and clinical data of each child were recorded in a pre-designed proforma of both groups. Results: A total of 200 cases and 200 controls were enrolled. The various risk factors associated with ARI on stepwise logistic regression were male gender, rural residency, overcrowding, history of ARI in any family member within two weeks and undernutrition. The statistically insignificant risk factors were infancy, economic status, illiterate parents, cooking fuel other than LPG, low birth weight, prematurity, lack of exclusive breast feeding, vitamin A deficiency and incomplete immunization. Conclusion: The various risk factors for ARI identified in this study were male gender, rural residency, overcrowding, history of ARI in any family member within two weeks and undernutrition.