Browsing by Author "Khatri, R"
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Publication A simple new technique of performing myomectomy for a predominantly subserosal myoma quickly within few minutes(Kathmandu University, 2007) Rana, A; Gurung, G; Amatya, A; Khatri, RRemoving a degenerated myoma located around the uterine cornu by an innovative technique shelling the myoma a little away from the base by choice of a low placed incision, advantageous in terms of no requirement of blood transfusion because of the reduction in the surgical time is described in a 24 years old lady demanding a fertility conserving surgery.Publication Allergic Fungal Rhinosinusitis in Chronic Rhinosinusitis(Nepal Health Research Council, 2011) Shrestha, S; Kafle, P; Akhter, J; Acharya, L; Khatri, R; KC, TBackground: Rhinosinusitis is the inflammation of nasal and paranasal sinus mucosa and is associated with mucosal alteration ranging from inflammatory thickening or gross nasal polyp formation.The main objective of this study is to etermine the prevalence of allergic fungal rhino sinusitis among the patients having chronic rhino sinusitis with or without polyps who under goes functional endoscopic sinus surgery. Methods: The patient with chronic rhinosinusitis with or without polyp who FESS were studied. Surgical specimens were sent for mycology and histopathological analysis for identification of fungus. Results: Headache 41(82%) and nasal block 45(90%) were the commonest clinical presentation. Out of 50 patients,fungal elements were detected by KOH in 8(16%) of cases and histopathological examination in 11(22%) of cases. Conclusions: Allergic Fungal Rhinosinusitisis a common disorder in patients with chronic rhinosinusitis, it needdifferent specific tests for the diagnosis, a more specific diagnostic tests are fungus culture, and IgE to fungal antigen and skin test are needed for definite diagnosis. Keywords: allergy, fungus, rhinosinusitis, sinusitisPublication Basic Sciences: An Alternative career?(Kathmandu University, 2013) Khatri, RABSTRACT Career selection is a crucial and a complex process which is also true in the medical profession as well. In the context of our country, due to the limited opportunity and proper guidance, migration of medical graduates to foreign countries is increasing. Though, clinical subjects have a huge attraction, basic science field has failed to impress our medical graduates. In current scenario, basic science field seems to be a dumping site for the incompetent as the candidates who have failed trying their luck elsewhere stumble upon basic science careers though it is not true for all. Moreover, a very few medical graduates are interested in developing their career as a basic scientist. Therefore, to motivate today’s young medical graduates, there is a need of a good mentor along with a proper career guidance which can help them to understand the basic science field as an alternative career. KEY WORDS Basic science, career, clinical sciencePublication Comparative study of Methotrexate and Cyclosporine in the treatment of Psoriasis(Society of Dermatologists, Venereologists and Leprologists of Nepal (SODVELON), 2010) Karn, D; Amatya, A; Khatri, RAbstract Background Psoriasis is a chronic skin disease characterized by sharply demarcated, erythematous squamous lesions, with an estimated worldwide prevalence of 0 to 11.8%. Methotrexate (MTX) and cyclosporine (CsA) are well known systemic therapies for moderate to severe chronic plague psoriasis. Objective The aim of this study is compare the efficacy of methotrexate and cyclosporine in the treatment of Psoriasis. Methods A prospective randomized study was conducting at the Dhulikhel Hospital, KUTH, Dhulikhel during November 2008 to July 2009 with the objective to compare the effectiveness, side effects and cost of MTX and CsA treatment in a context reflecting normal clinical practice. Results A total of 64 patients (33 receiving MTX and 31 receiving CsA) were enrolled. These patients were followed every week for first month and their PASI score and side effects were recorded at 0, 1st, 2nd and 3rd month interval. In the study, the mean (± S.E) PASI score at base line was 23.34 ± 1.12 for MTX and 21.25 ± 1.07 for CsA group. After 12 weeks of treatment the mean ± S.E PASI score found to be 5.37 ± 0.42 for MTX and 4.56 ± 0.41 for CsA group. The difference in the response between the groups acquired statistically not significance (p=0.160 > 0.05) meaning there is no difference in the effectiveness of MTX and CsA. Conclusions The efficacy, side effects, ease of administration (once weekly vs. twice daily treatment) and cost, it seems that treatment of psoriasis patient with systemic therapy using MTX is preferable than CsA even though, both have similar clinical efficacy. Keywords Methotrexate; Cyclosporine; Psoriasis.Publication Histomorphological Spetrum of Breast Lesions(Nepal Health Research Council, 2011) Parajuli, S; Koirala, U; Khatri, R; Acharya, L; Suwal, ABackground: Cancer of the breast is the second most common cause of cancer in women. Mass in the breast, whether benign or malignant is a cause of anxiety to the patients and the family members. All breast lumps are considered to be carcinomas until proved otherwise and are the causes of concern both for the patient and surgeon. Methods: This is a retrospective study conducted in Kathmandu Model Hospital for a total duration of three years from August 2007 to August 2010. Results: 114 sample of breast tissue sent for histopathology were studied. Peak incidence of benign lesion was in between 21-30 years and malignant lesions in between 31-50 years. No breast lesions were seen in the first decade of life. Cancer of the breast was seen in 12.28% of cases. Fibroadenoma and fibrocystic disease were the commonest benign lesion and infiltrating ductal carcinoma was the commonest malignant lesion. Specimens from 10 male breasts were received. Gynaecomastia was the most common lesion encountered in males. Infiltrating ductal carcinoma was seen in a 70 year old male. Conclusions: Breast cancer is one of the commonest causes of breast lump particularly in women and is growing public health problem in Nepal. Keywords: breast cancer, breast lumps, excisional biopsy.Publication Knowledge, Behavior and Attitude towards Sexually Transmitted Infections and Acquired Immunodeficiency Syndrome of Adolescent Students(Nepal Health Research Council, 2011) Gupta, S; Khanal, T R; Gupta, N; Thakur, A; Khatri, R; Suwal, A; Seomangal, KBackground: Adolescence is a period of great physical, mental and emotional turmoil within teenagers. The objective of the study was to assess the knowledge of, attitude to and behaviour towards STI and AIDS among adolescence. Methods: Four randomly selected higher secondary school from students of class XI and XII were included after taking their verbal consent. A pre-designed and pre-tested questionnaire was given to all the participants of the school. In order to get correct answers, specific questions were explained to the students with the help of their class teachers. Results: The results were encouraging with the majority (94.16%) have heard about STIs and HIV/AIDS. Teachers (100%), Newspaper/magazine (90%) and Television (78.33%) were the main informational source about disease. Respondents correctly identified that unsafe sexual contact (86.66%) as major mode of transmission of AIDS and more than 90% of students regarded the use of condoms as the true preventive method for the disease. Among those respondents 6% were sexually active and their partners were either sex worker (71%) or friends (29%). Conclusions: The student’s attitude towards disease was positive and most of the adolescent wished inclusion of sex education in their text book from secondary level school’s curriculum. Keywords: acquired immunodeficiency syndrome, adolescent, sexually transmitted infectionPublication Nimesulide induced Stevens- Johnson Syndrome(Society of Dermatologists, Venereologists and Leprologists of Nepal (SODVELON), 2010) Karunaratne, D; Khatri, RAbstract Stevens - Johnson syndrome (SJS) is a severe, episodic, acute mucocutaneous reaction that is most often elicited by drugs and occasionally by infections. We report a case of 29 years old woman who developed Stevens - Johnson syndrome following the ingestion of Nimesulide tablets. Nimesulide is a nonsteroidal anti-inflammatory (NSAID) drug with antipyretic and analgesic properties. To the best of our knowledge there have been no previous reports of SJS induced by the ingestion of Nimesulide in the medical literature. This case highlights the importance of Nimesulide and other NSAIDS as the possible cause of Stevens - Johnson syndrome which needs to be borne in mind by the treating physician in cases of drug reactions. Key words Nimesulide; Stevens - Johnson syndrome.Publication Prevalence of Skin Diseases in Kavre District, Nepal(Society of Dermatologists, Venereologists and Leprologists of Nepal (SODVELON), 2010) Karn, D; Khatri, R; Timalsina, MAbstract Background Skin is the major interface of human to the environment . It is the major susceptible organ for any disease. Wide prevalence of skin diseases in the community is a well established fact. Objectve The aim of this study is to determine the prevalence of skin diseases among the general population of Kavre District,Nepal . Methods This is a hospital based, retrospective study done among all the patients visiting Dhulikhel Hospital, Kathmandu University Teaching Hospital, in Dhulikhel, Kavre during the year 2007-2008 AD. Data were obtained from the hospital out-patient records and analyzed. The total number of patients who visited the hospital were 74,279 (male-30,809 female- 43,470), out of which 7374 (9 .92 %), male 4155, female 3219, visited the Dermatology Department. Among this total study population now comparative study of the prevalence of skin diseases was performed based on sex, age and type of dermatological condition. Results The overall prevalence of skin diseases were 9.92% with slight higher rates seen among males ( 56.34 %) than females (43.65 %).Non-infective conditions , 6063 ( 82.22% ) outweighed infective conditions 1311 (17.78 %), commonest one being the pigmentary disorders (32.56 %) and in the age group 16-35 years old (31.23% ). Conclusion This study demonstrates that skin diseases are one of the most prevalent disease condition among the general population, representing a major public health problem. Keywords Prevalence; infective diseases; non-infective diseases.Publication Triiodothyronin, Thyroxine and Thyrotropin in Vitiligo(Kathmandu University, 2011) Subba, K; Karn, D; Khatri, RABSTRACT Background Vitiligo is a common pigmentary disorder of the skin, affecting individuals globally. Not only is this ailment psychologically incapacitating, it also has a high incidence of autoimmunity, signifying that its manifestations may be the portrayal of dysfunction of immune system. Objective The aim of this study is to find out the situations of abnormal thyroid function test (TFT) in vitiligo patients. Methods A prospective cross sectional study was conducted at the Dhulikhel Hospital, KUTH, Dhulikhel during November 2008 to January 2011 with the objective to assess the thyroid function tests in vitiligo patients. Results Total 66 vitiligo patients with male 30 (45%) and female 36 (55%). Total 26 (39.39%) vitiligo patients have been found to have abnormal thyroid function test. Among them 10 had abnormal T3, seven had abnormal T4 and 12 had abnormal TSH level. Thyroid function test were normal in other vitiligo patients. Total seven vitiligo had high level of T3 than normal value, four male and three female. Two had higher level of T4 above 2.0 ng/dl and all were male, while five had abnormally low level of T4 with three male and two female. There were seven vitiligo patient with increased T3 level and three with decreased T3 level, among them six were males and four were females, the age group was ranged from seven to 68 years old. The T4 level were found abnormal in seven vitiligo patients among which five were males and two were females with the age group ranging from 7 to 51 years. Conclusions There has been significant association of thyroid disorder in the patient with vitiligo. Therefore, patient with vitiligo need to undergo thyroid function test to rule out the thyroid disorder and prevent from long-term complications. KEYWORDS thyroid, thyroxin, thyroid function test, vitiligo