Browsing by Author "Mishra, S"
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Publication Abnormal Length and Position of the Sigmoid Colon and Its Clinical Significance(Kathmandu university, 2012) Nayak, SB; George, BM; Mishra, SABSTRACT Sigmoid colon is one of the most variable parts of the large intestine. Here we report a very rare type of variation of the sigmoid colon. This variation was observed during the routine dissections for undergraduate medical students at Melaka Manipal Medical College (Manipal Campus) India in September 2012. In the current case, the sigmoid colon was about 60cms long and made an inverted U shaped loop in front of the descending colon and the left kidney. It had a sigmoid mesocolon which covered the left kidney. The sigmoid colon had an ascending and a descending limb. This position of sigmoid colon and its mesocolon is dangerous as it can get twisted to form a volvulus. It also might cause confusions in radiologic and sigmoidoscopy techniques. KEY WORDS Colon, descending colon, pelvic colon, sigmoid colon, sigmoid mesocolon, variationPublication Accessory Lobe of Liver Associated with a “Bean Shaped” Gall Bladder(Kathmandu University, 2016) Nayak Satheesha B, , ,; Reghunathan D; George BM; Mishra, SABSTRACT Occurrence of accessory lobes of liver and anomalies of gall bladder is quite common. A thorough knowledge of their variation can minimise diagnostic and surgical errors. We found concurrent variations of liver and gall bladder. A small accessory liver lobe was attached to the quadrate lobe through a stalk formed by peritoneum. The gall bladder was “bean shaped” due to the presence of a constriction in the middle of its body. Since the accessory lobe was quite close to gall bladder, it could compress the gall bladder and hinder normal functioning of it. The knowledge of these variations might be of importance to radiologists and surgeons dealing with the hepatobiliary system. KEY WORDS Accessory lobe, gall bladder, hepatic-biliary, liver, quadrate lobePublication Anxiety and Depression during COVID-19 Pandemic among Medical Students in Nepal(Kathmandu University, 2020) Risal, A; Shikhrakar, S; Mishra, S; Kunwar, D; Karki, E; Shrestha, B; Khadka, S; Holen, AABSTRACT Background Medical students’ psychological response to societal lockdown during the COVID-19 pandemic has not been studied much. Objective To assess levels of anxiety and depression among medical students during initial stages of COVID-19 pandemic in Nepal and relate their distress to relevant variables. Method A cross-sectional study with online questionnaire was conducted among medical students at different colleges in Nepal. Hospital Anxiety and Depression Scale (HADS) detected ‘anxiety’ and ‘depression’. The covariates were explored by logistic regression analyses. Result A total 416 medical students [mean age: 22.2 (2.1); males 57.7%, females 42.3%] participated. HADS-anxiety scores [mean: 7.1(4.3)] were significantly and positively correlated with HADS-depression [mean: 5.9 (4.1)] (r=0.695; p < 0.001). Point prevalence of total HADS caseness (HADS-T) was 26.7%. Specific HADS-defined caseness were: anxiety (HADS-A) 11.8%, depression (HADS-D) 5.5%, and comorbid anxiety and depression (HADS-cAD) 9.4%. All four types of caseness were significantly more prevalent among students with a history of mental problems (AOR=4.7, 3.2, 2.6, and 3.2 respectively). HADS-T was higher among those with a concurrent physical illness (AOR=2.4). HADS-T, HADS-A and HADS-D scores were higher among the age group > 22 years (AOR= 2.2, 2.5 and 4.4 respectively). HADS-cAD was almost three- times higher among those with a possible COVID-19 exposure (AOR=2.8). Conclusion A significant number of medical students in Nepal suffered from high levels of anxiety and depression during the COVID-19 shut-down. The students in the higher (> 22 years) age group, those with past mental disorders, possible COVID-19 exposure, and concurrent physical illness showed elevated levels of anxiety and/or depression. KEY WORDS COVID-19, Medical students, Pandemic, Psychological distress, Self-quarantinePublication katG (SER 315 THR) Gene Mutation in Isoniazid Resistant Mycobacterium tuberculosis(Kathmandu University, 2011) Marahatta, SB; Gautam, S; Dhital, S; Pote, N; Jha, AK; Mahato, R; Mishra, S; Poudel, BH; Ramasoota, P; Kaewkungwal, J; Singhasivanon, PABSTRACT Background Isoniazid (INH) together with Rifampicin (RFP) forms the cornerstone of a short chemotherapy course for tuberculosis (TB) treatment. Mutation at codon 315 of katG gene is most prevalent in isoniazid resistant Mycobacterium tuberculosis (MTB) and is high in area with high TB incidence. Polymerase Chain Reaction Restriction Fragment Length Polymorphism (PCR-RFLP) has been found to be a reliable and effective tool for the identification of the specific gene alteration. Objective The objective of this study was to screen Ser315Thr mutation of KatG gene of INH resistant MTB strain by PCR-RFLP technique. Methods Altogether 37 INHr MTB isolates obtained from German Nepal Tuberculosis Project (GENETUP) Kathmandu Nepal was included in the study. Deoxyribonucleic Acid (DNA) extraction was performed according to protocol of SORPOCLEAN™ from the culture isolates. Amplification of the fragment with katG codon 315 was performed in a Biometra Thermocycler using primers. The amplified fragment was cleaved with MspI. The restriction fragments obtained were electrophoresed in a 2% agarose gel and were visualized using transilluminator. Results The katG Ser315Thr mutation was observed in 23 (62.2%) out of 37 INH resistant isolates. The drug susceptibility profile of INHr MTB isolates showed all isolates to be resistant to INH and RFP whereas 26 and 27 MTB isolates were resistant to Ethambutol (EMB) and Streptomycin (S) respectively. Seventeen (17) patients were harbouring katG gene mutated strain among Ethambutol and Streptomycin resistant cases. Conclusion The study identified high prevalence of Ser315Thr mutation in katG. The isolates harbouring this mutation were also simultaneously resistant to RFP. Ser315Th could be a potential genetic marker for predicting MDR-TB. KEY WORDS Isoniazid resistant MTB, katG gene, Mycobacterium tuberculosis, PCR-RFLP, mutation.Publication Vitamin D Deficiency and Acute Otitis Media among Children Visiting a Tertiary Care Centre in Eastern Nepal(Kathmandu University, 2023) Dahal, R; Shah, SP; Mishra, S; Baaniya, BABSTRACT Background There have been various studies to draw out the association between acute otitis media (AOM) and vitamin D deficiency but the results are conflicting. Objective To explore the relationship between vitamin D deficiency and acute otitis media. Method The comparative cross-sectional study was conducted in which children aged five to fifteen years were included. Sixty children diagnosed with acute otitis media were kept in group A while 60 children diagnosed with conditions other than acute otitis media were included in Group B. Then the Vitamin D level was sent in both the groups and compared. Result Fifty-four participants in group A had an insufficient level of Vitamin D while six participants had a sufficient level of Vitamin D and none had an excess level of Vitamin D while in Group B, fiftywo participants had an insufficient level of Vitamin D while eight participants had a sufficient level of Vitamin D. The mean vitamin D of the cases was 22.12 ±7.896 ng/ml, and that of the controls was 22.58 ±7.056 ng/ml for the controls (p = 0.737). Conclusion Both the children with acute otitis media and without acute otitis media had lower levels of Vitamin D in similar proportions. Therefore, we can conclude that there is no association between Vitamin D level and acute otitis media. KEY WORDS Acute otitis media, Children, Vitamin D