Browsing by Author "Manandhar, B"
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Publication Hypohiderotic ectodermal dysplasia(Kathmandu University, 2006) Neopane, A; Singh, SK; Manandhar, BWe report a case of a six years age girl who presented to our out patients department with the history and findings suggestive of recurrent respiratory tract infections. She was also noticed to have; non homogeneous hyper- pigmented patches on the face since three months of age, sparse hair on the scalp and eyebrows, conical peg like teeth and delayed dentition, prominent and low set ears, perpetually flexed third toe bilaterally. Axillary skin biopsy showed adenexal structures and eccrine glands in subcutaneous fat which were reduced in number. The diagnosis made was: Anhydrotic/ Hypohidrotic type of ectodermal dysplasia. Key words: Ectodermal Dysplasia, Anhidreotic, HypohidroticPublication Maternal cardiac diseases complicating pregnancy: a review of 105 cases(Institute of Medicine, 2001) Rana, A; Singh, M; Manandhar, B; Pradhan, N; Gurung, G; Dali, B; Koirala, B; Koirala, RRAbstract The outcome of pregnancies in 105 patients with heart diseases in TUTH, Kathmandu, Nepal between April 1995 and May 2001 was reviewed. The incidence of heart disease was 0.55% of the total 19038 deliveries. Rheumatic (79), congenital (17) and miscellaneous groups (9) complicated the pregnancy. Significant number (53) had their diagnosis made at the index pregnancy. Patients who developed cardiac failure (17) mostly did during antenatal period (20-42 weeks); the majority had cardiac failure (14) at third trimester. Two of the cases that had cardiac failure at 33 weeks ultimately had stillbirths later at term. Induction of labour for such cases, which was discouraged earlier, should be considered. In our hospital labour analgesia with epidural anaesthesia, pethidine or morphine is not a routine practice. Injection Methergin is also generally withheld. Save one or two, most Cesaerean sections had obstetrical indication. Prophylactic forceps or ventouse were barely used. There were two maternal deaths. One of them had pregnancy complication as eclampsia and presented with SVT and MI at 34 weeks. The other case died within 48 hours of Caesarean delivery for critical mitral stenosis with pulmonary hypertension. The perinatal losses were 7. This article strongly emphasizes the need for routine cardiac evaluation of patients at their very first antenatal check up so that patie nts with cardiac disease can benefit from shared co-operation between cardiologist, cardiothoracic surgeon, anaesthelogist and obstetrician. Keywords: Heart disease, pregnancy, cardiac failure, obstretic analgesia, induction of labourPublication Uterine torsion in pregnancy(Institute of Medicine, 1998) Sharma, J; Manandhar, B; Dangal, DAbstract Torsion of the gravid uterus is defined as rotation of more than 45 degrees around the long axis of the uterus. Torsion to the extent of arresting uterine circulation and causing acute abdomen is, however, rare. Torsion ranging from 60 degrees to 720 degrees has been reported. It is difficult to explain why torsion occurs but various abnormalities have been associated with this condition such as uterine fibromyoma, ovarian tumours, foetal malformations and abnormal foetal presentations. The incidence of uterine torsion in pregnancy is very rare as uptil 1992 only 212 cases have been reported in the world literature. Such cases can be mistaken for accidental haemorrhage, rupture uterus, or ectopic pregnancy depending upon the stage of gestation at which it presents. We present a case of uterine torsion at 32-week gestation which we mistook for rupture uterus. The diagnosis could be established during laparotomy. Keywords: Pregnancy, Torsion, Classical caesarean section, Rupture uterusPublication Young teenagers and child birth(Institute of Medicine, 2000) Pradhan, N; Rana, A; Singh, M; Gurung, G; Manandhar, BAbstract In a retrospective analysis done at TU Teaching Hospital between 15 Aug 1997 and 14 Aug 1998, 57 teenage mothers (13-17 years) represented twenty per thousand deliveries (total deliveries, 2799). The usual documented complications like prematurity and low-birthweight were seen in 16% and 24.5% respectively. Pregnancy complication such as eclampsia was seen in one case that delivered a low birthweight baby with poor apgar. Most of these young mothers had vaginal deliveries (86%). The caesarean section rate was 14%, which could have been further lowered, if there were no complications like foetal distress (3) and abnormal presentation (2). Excepting a case of pregnancy that occurred in a 13-year old girl due to sexual abuse, all the other pregnancies followed marriage. This indicates that adolescent reproductive health is a neglected arena requiring some change. Hence full attention has yet to be focused on adolescent reproductive health, particularly directed towards preventing early marriage and early child bearing which is detrimental to adolescent reproductive health. Keywords: Teenage pregnancy, early marriage, adolescent reproductive health