Browsing by Author "Kishore, PV"
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Publication A clinical review of three case vignettes(Institute of Medicine, 2007) Kishore, PV; Palaian, S; Mishra, PAbstract Poisoning is a common problem worldwide. Among the various poisonings, rat poison accounts for a significant number of cases. The common rat poisons are anticoagulant containing (superwarfarins) and phosphide containing. In case of superwarafin poisoning, the major symptom is increased prothrombin time and the management is directed towards coagulation. In case of phosphide containing, the symptoms are non-specific and the patient should be managed symptomatically. We present three case vignettes of rat poisoning cases treated at our hospital. Since rat poisoning is a common problem, the hospitals should also develop standard treatment guidelines regarding the management of rat poisoning. One should also make the differential diagnosis of the poisoning based on the type of rat poison prior to the management. Keywords: Management, Poisoning, Rat poison, RodenticidePublication Consumption of rodenticides by humans(Institute of Medicine, 2007) Kishore, PV; Palaian, S; Prabhu, M; Mishra, PAbstract Case report: Poisoning is a common problem worldwide. Among the various poisonings, rat poison accounts for a significant number of cases. The common rat poisons are anticoagulant containing (superwarfarins) and phosphide containing. In case of superwarfin poisoning, the major symptom is increased prothrombin time and the management is directed towards coagulation. In case of phosphide containing, the symptoms are non-specific and the patient should be managed symptomatically. We present three case vignettes of rat poisoning cases treated at our hospital. Since rat poisoning is a common problem, the hospitals should also develop standard treatment guidelines regarding the management of rat poisoning. One should also make the differential diagnosis of the poisoning based on the type of rat poison prior to the management. Keywords: Superwarfarin, prothrombin, RodenticidePublication Drug induced hepatitis with anti-tubercular chemotherapy: Challenges and difficulties in treatment(Kathmandu University, 2007) Kishore, PV; Palaian, S; Paudel, R; Mishra, P; Prabhu, M; Shankar, PRTuberculosis is a major health burden worldwide. In Nepal, it is a significant cause of morbidity and mortality. Although better drugs are available for managing tuberculosis, treatment failure is one of the common problems encountered. Among the various causes which can cause treatment interruption, drug induced hepatotoxicity is a common cause. Isoniazid and Pyrazinamide are the common drugs causing hepatotoxicity. Upon occurrence of hepatotoxicity, the hepatotoxic drugs should be stopped and reintroduced as per the available guidelines. The healthcare professional should also counsel the patients for recognizing the early symptoms due to hepatotoxicity which could prevent morbidity. Key words: Adverse effects, Hepatotoxicity, Tuberculosis.Publication Interaction between warfarin and tamoxifen: A case report(Kathmandu University, 2007) Mishra, D; Paudel, R; Kishore, PV; Palaian, S; Bista, D; Mishra, PWarfarin is a commonly used anticoagulant with documented reports of drug interactions. Tamoxifen is used in the adjuvant hormonal treatment of women with oestrogen-receptor- positive breast cancer. Warfarin and tamoxifen are known to interact with each other with a resultant increase in the bleeding tendency. These reports are mainly from the white population. We report a case of drug interaction between warfarin and tamoxifen with an acute onset. This report suggests that when these drugs are co administered, careful monitoring of the coagulation profile is needed. Key words: Drug interaction, Tamoxifen, WarfarinPublication Pattern of poisoning cases in a teaching hospital in Western Nepal(Institute of Medicine, 2008) Kishore, PV; Palaian, S; Paudel, R; Mishra, D; Ojha, P; Alam, K; Mishra, PAbstract Introduction: Poisoning is a common problem in Nepal. Data from the Western region of Nepal are lacking. The present study analyzed the clinical profile and the management pattern of poisoning cases admitted to the Manipal Teaching Hospital (MTH). Methods: The poisoning cases treated at Manipal Teaching Hospital from January 2003 to June 2006 were studied. Results: A total of 98 poisoning cases (0.51% of Emergency department admissions) were treated (female 54.08 %) and age group 21-40 years (44.90 %). Nearly one third (32.65%) reached the hospital with in two hours of poison consumption. The median (interquartile range) duration of the hospital stay was 4 (2) days. The poisoning was intentional in 79.59% cases. The route of exposure was mainly oral (96.94%). Rat poison was the commonest poison (31.68%) followed by drugs (22.77%). Majority (83.67%) received symptomatic treatment. Secondary complications were observed in 28.57% and the overall fatality rate was 18.37%. Rat poison was responsible for 5 deaths. Nearly two thirds (65.31%) of the total cases received psychological counseling. Conclusion: Similar studies covering different hospitals conducted over a long period are needed to confirm our findings. Keywords: Drug over dosage, Poisoning profile, Rodenticide, Western NepalPublication Why treat? Better prevent: Adult immunization(Kathmandu University, 2008) Kishore, PV; Palaian, S; Paudel, R; Paudel, B; Mishra, P; Prabhu, MAbstract Immunization is a safe, effective and simple way to prevent life threatening illnesses not only in children but also in adults. Vaccines are some of the safest medicines available which can relieve suffering costs related to these preventable diseases. The reason for underutilization of vaccines in adults are 1) Low prioritization of the importance of vaccines preventable diseases among adults 2) Uncertainty or lack of knowledge about the safety and efficacy 3) Lack of universal recommendations for all adults and 4) Financial constraints, especially in developing countries. Adult immunizations are administered in primary series like previously immunized, booster doses and periodic doses. Agents include Toxoids (Diphtheria and Tetanus), Live Virus Vaccines (Measles, Mumps and Rubella), and inactivated virus vaccines (Influenza), Inactive viral particles (Hepatitis B), inactivated bacterial polysaccharide vaccine (Pneumococcal) and Conjugate / Polysaccharide vaccine (Meningococcal). And also vaccines like Hepatitis A, Polio and Varicella may be recommended in some. Since the economy and literacy rate has shown a steady rise in the South Asia and people are being aware of different health problems through the recently advanced global communication, the education and awareness for immunization not only in children but also in adults need a special consideration. Keeping in view the statistical data of suffering costs related to the non-utilization of immunization in adults, the need of hour has come for utilization of immunization to emphasize its importance. Key words: Adult immunization, Vaccines.