Browsing by Author "Pandey, S"
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Publication Drug prescribing pattern and disease pattern in KMC Duwakot Health Center(Kathmandu University, 2004) Bajracharya, S; Pandey, S; Shakya, YLObjective To ascertain the disease pattern and drug prescribing pattern of the patients attending Kathmandu Medical College Health Center, Duwakot. Methods It is a cross sectional study conducted at Kathmandu Medical College (KMC) health Center, Duwakot during the month of Ashad to Mangshir, 2060. The sample size included was 292 patients attending the Health Center during this period. Prescription details were used as study tools to acquire information regarding patient’s name, age, complaints for which consultation was sought, investigations, diagnosis, name of the drug which is prescribed and instruction for diet. Results Age of patients in this study ranged from 0-80 years. A total of 165 (56.50%) were male and 127 (43.49%) were female. Out of 165 male of different age group ranging from 0-80 years, most of the patient i.e. 25(15.15%) were suffering from viral fever followed by cut/injury, allergy, diarrhoea, abdomen pain, fungal infection, HTN (hypertension), cold/cough/sore throat, sinusitis, muscular skeletal pain, joint pain, contact dermatitis, acute peptic disease (APD), headache, worm infestation, tonsillitis, pharyngitis, dizziness, eye infection, chest infection, calf and backache, viral rashes, hypo pigmentation, tension/depression, Urinary tract infection (UTI), coliolilethis, diabetes, p/r bleeding and insect bite poisoning. Out of 127 female of different age group ranging from 0-80 years 21 (16.54%) patients were suffering from viral fever, followed by backache, cold/cough / sore throat, allergy, weakness, acne, diarrhoea, sinusitis, flue, pneumonia, headache, acid peptic disease, dysmenorrhoea, Lower Respiratory Tract Infection and Upper Respiratory Tract Infection, muscular skeletal pain, joint pain, eye infection, Urinary Tract Infection, hypertension, abdomen pain, tonsillitis, tinea corporis, rhinitis, ear problems, insect bite poisoning, CSOM, trichiasis, uteric colic, otitis media, entropion and epiphora, worm infestation and pharyngitis. All together 384 drugs (23 category) were distributed to the different patient of different age group ranging from 0- 80 years, to cure the different types of diseases. Among the different categories of drugs prescribed antipyretic (31.8%), antibiotics (17.2%) and (Non steroid Antiinflammatory Drugs (NSAIDs) (11.2%) were the most common. Conclusion The assessment of the existing prescribing practices in a health facility helps to identify the specific drug use problems, which need to be understood before any meaningful intervention can take place. A prescription provides an insight into a prescriber’s attitude to the disease being treated and the nature of health care delivery system in the community3. The average number of drugs per prescription is an important index of a prescription audit. It is preferable to keep the number of drugs per prescription as low as possible to minimize the risk of drug interactions, development of bacterial resistance and hospital costs 9. Key words: drug prescribing, health centre, disease patternPublication Evaluation of Lipid Peroxidation and Antioxidants’ Status in Metabolic Syndrome(Kathmandu University, 2010) Shrestha, S; Chandra, L; Aryal, M; Das, BKL; Pandey, S; Baral, NABSTRACT Background Metabolic syndrome is a constellation of physical conditions and metabolic abnormalities, commonly occurring together, that increases an individual’s risk for development of type 2 diabetes mellitus and cardiovascular diseases. Oxidative stress is associated with diabetes, hypertension and other cardiovascular diseases while the role of oxidative stress in pathogenesis of MS is not clearly defined. Objectives The study aims to find out the prevalence of metabolic syndrome in faculty and staff members at BP Koirala Institute of Health Sciences, Dharan, Nepal and to evaluate oxidative stress levels in subjects with metabolic syndrome. Methods 118 healthy participants working at B. P. Koirala Institute of Health Sciences, Dharan, Nepal were selected at random for this cross-sectional study and blood samples were collected for the estimation of the following biochemical analytes; fasting glucose; triglycerides; total cholesterol; high density lipoprotein cholesterol; Albumin; uric acid; Bilirubin; Malondialdehyde; Catalase; Glutathione peroxidase; Superoxide Dismutase; Glutathione; vitamin C; and lastly vitamin E. Results In this cross-sectional study, 39% subjects were diagnosed with metabolic syndrome , particularly in sedentary subjects. There was no difference in oxidative stress except significant rises in serum uric acid levels and catalase activity in subjects diagnosed with metabolic syndrome . Conclusion The prevalence of metabolic syndrome is higher without oxidative stress in this study, which suggests that oxidative stress does not contribute to the pathogenesis of MS in otherwise healthy subjects. Key Words antioxidants, lipid peroxidation, metabolic syndrome, oxidative stressPublication Health profile of school children in Bhaktapur(Kathmandu University, 2005) Pandey, S; Dudani, I; Pradhan, AObjectives: To find out the existing common health problems among school children and to arouse health consciousness among the children. Material and methods: All the students studying in Mandev Amrit Smriti School, Jhaukhel VDC of Bhaktapur District were included in the sample. The methods used were the interview, clinical history and check-up for provisional diagnosis. A semi-structured questionnaire was used to record information regarding name, age, sex, standard in which s/he was studying, physical examination/ personal hygiene, anthropometric measurements, clinical findings, provisional diagnosis etc. The medical instruments used in the survey were: weighing machine, measuring tape, and thermometer. Common medicines like Jeevanjal packets, Albendazole tablets for deworming, Metron, amoxicyllin, paracetamol, Tagyl etc were also distributed to the needy students. Results and Conclusion: The physical examination of all 118 students in age group ranging from 3 to 13 years of Mandev Amrit Smriti School situated at Jhaukhel VDc of Bhaktapur district was carried out. Thirteen health related problems were detected in this study. The most important three problems were ear problems (22.03%), worm infestation (16.10%) and dental caries (13.56%). Thus school health education should mainly aim at these problems and the care and cleanliness of ears and teeth by proper and regular brushing should be stressed. Applying Water low classification, 33% males were found normal as per their weight for age. 61.9% males were stunted and 4.8 % males were wasted. Likewise, 54.6% females were found normal as per their weight for age. 43.6% females were stunted and 1.8 % females were wasted. Key Word: School health, Health problemsPublication High risk nonmetastatic persistent gestational trophoblastic tumour following an abortion(Kathmandu University, 2007) Pandey, S; Shrestha, NS; Thapa, MLocally invasive non-metastatic persistent gestational trophoblastic tumours (PGTT) following a non-molar pregnancy occur very rarely. Non-metastatic tumours usually falls in low risk group in WHO scoring system based on prognostic factors. We report a case of high risk non-metastatic PGTT which followed a spontaneous first trimester abortion. Complete remission of the tumour was achieved by chemotherapy EMA-CO regimen. Key words: Persistent gestational trophoblastic tumour, Abortion, ChemotherapyPublication Hysterectomy: an analysis of perioperative and post operative complication(Kathmandu University, 2003) Saha, R; Sharma, M; Padhye, S; Karki, U; Pandey, S; Thapa, JObjective : To document peri operative and post operative complication observed after hysterectomy, regardless of route on the operator. Material and methods: A hospital based prospective study was carried out in department of obstetrics and gynaecology, KMCTH Sinamangal for six months. The study was carried out in patients undergoing hysterectomy who were followed from the time of admission to the time of discharge and two weeks thereafter. And followings were noted-Indication; route of hysterectomy, intraoperative and postoperative morbidities during hospital stay and after two weeks of discharge was noted. Result: Total number of hysterectomy carried out was 50. 31(62%) were Total abdominal hysterectomy, and 19(38%) were vaginal hysterectomy. Indication for total abdominal hysterectomy were fibroid uterus 12(24%), DUB 8 (16%), CIN 4(8%), chronic cervicitis 1 (2%). II U-V prolapse with previous LSCS 1 (2%), endometriosis 1(2%). Prophylactic for Ca breast 1(2%), Postmenopausal bleeding 1(2%). All cases of vaginal hysterectomy were performed for 2nd degree U-V prolapse. Intra operative complication during surgery were two cases of haemorrhage (4%) each in both total abdominal hysterectomy and vaginal hysterectomy. There was one case of bladder injury during abdominal hysterectomy. Postoperative complication noted were febrile morbidity 1(2%) in abdominal hysterectomy. Urinary tract infection remains the single most common febrile morbidity. There was one case of secondary haemorrhage in both type of hysterectomy. One was managed conservatively and other required laprotomy. There were three(6%) cases of wound infection in abdominal hysterectomy of two which were sanguineous discharge and one was frank pus which required secondary suture.Publication Leflunomide Induced DRESS Syndrome: A Case Report(Society of Dermatologists, Venereologists and Leprologists of Nepal (SODVELON), 2012) Parajuli, S; Chaudhary, D; Pandey, S; Baral, S; Pokhrel, D BNA Keywords: Leflunomide, Dress syndromePublication Microbiological Analysis of the Urine Isolates in Kathmandu Medical College Teaching Hospital, Kathmandu, Nepal(Kathmandu University, 2011) Raza, S; Pandey, S; Bhatt, CPABSTRACT Background Urinary tract infections (UTIs) are the common cause of bacterial infection. Recently UTI become more complicated and difficult to treat because of appearance of pathogen with increasing resistance to antimicrobial agents. Objective To determine the etiology of the urinary tract infections and their susceptibility to antimicrobial agents. Methods This study was carried out in Kathmandu Medical College, at department of microbiology. Total 3,460 urine samples were tested microbiologically by standard procedure. Antibiotic susceptibility test was performed for all the isolates by Kirby Bauer disc diffusion method and result was interpreted according to National Committee for Clinical Laboratory Standards (NCCLS) guide line. Results Out of 3,460 urine samples 680 (19.7%) showed the significant bacteriuria. The most common pathogens isolated were Escherichia coli 75.7% followed by Klebsiella pneumoniae 10.7%, Acinetobacter spp 5.5%, Proteus spp 3.5% and Pseudomonas aeruginosa 1.2%. Most susceptible antibiotic was Amikacin, Ceftriaxone and Ciprofloxacin for most of the isolates. E. coli which was the main isolate was found to be most susceptible to Amikacin 96.1%, Nitrofurantoin 91.3% and Gentamicin 77.7% followed by Ceftriaxone 65.8% and Ciprofloxacin 64.1%. Conclusion Regular surveillance of the resistance rate among uro-pathogens is needed to ensure the appropriate therapy of UTI. KEY WORDS antibiotic susceptibility, bacteriuria, UTI.Publication One year audit of perinatal mortality at Kathmandu Medical College Hospital(Kathmandu University, 2004) Manandhar, SR; Manandhar, DS; Baral, MR; Pandey, S; Padhey, SIntroduction: Perinatal mortality is a sensitive indicator of the quality of service provided to pregnant women and their new borns. Regular audit of perinatal mortality will help in finding out preventive factors and thus helps in reducing perinatal mortality rate in an institution. Objective: This study was carried out to determine perinatal mortality rate (PMR) and the factors associated with it at KMCTH in the one year period (Bhadra 2059 – Shrawan 2060) Materials and Methods: This is a retrospective study of entire still births and early neonatal deaths that occurred at KMCTH during the one year period (Bhadra 2059 –Shrawan 2060). The study was done by collecting the data of all stillbirths and early neonatal deaths from record books of the Special Care Baby Unit, Labour Room and operation theatre. Results: Out of 563 total births in the one year study period, 17 were still births (SB) and 10 were early neonatal death (ENND). Out of 17 SB, 7 were of < 1 kg and out of 10 ENND, 3 were of < 1 kg. Thus, perinatal mortality rate during the study period was 30.7 and extended perinatal mortality rate was 47.9 per 1000 births. Perinatal deaths were mostly due to extreme prematurity, birth asphyxia, septicemia and congenital anomalies. According to Wiggleworth’s classification, 18.5% of perinatal deaths were in Group I, 14.8 % in Group II, 22.3 % in Group III, 40.7 % in Group IV and 3.7 % in Group V. Intrapartum asphyxia was the commonest cause of perinatal deaths, but majority of these babies were of low birth weight. Prevention of preterm births, better care during intrapartum period, more intensive care of very low birth weight and preterm babies would help in reducing the present high perinatal mortality. Key words: Perinatal Death Audit, Perinatal MortalityPublication Pachydermoperiostosis ('Touraine-Solente-Gole' Syndrome)(Society of Dermatologists, Venereologists and Leprologists of Nepal (SODVELON), 2013) Sharma, R; Pandey, S; Choudhary, D; Pokhrel, DBNo Abstract Keywords: Pachydermia, primary hypertrophic osteoarthropathy, clubbingPublication Stigma Related to Tuberculosis Among Patients Attending DOTS Clinics of Dharan Municipality(Kathmandu University, 2012) Aryal, S; Badhu, A; Pandey, S; Bhandari, A; Khatiwoda, P; Khatiwada, P; Giri, AABSTRACT Background The patients suffering from tuberculosis are receiving shame and unfair treatment from the people living around them within their own society attending DOTS clinic of Dharan municipality. Objective To assess the stigma experienced by tuberculosis patients and to find out the association between stigma experienced by Tuberculosis patient and the selected variables (socio-demographic characteristics, clinical profile and illness experience). Methods Descriptive Cross Sectional study was done among sixty tuberculosis patients. Stratified random sampling was used to select the main center and sub center of Tuberculosis treatment and population proportionate simple random sampling using lottery method was done. Data was collected using predesigned, pretested performa from Explanatory Model Interview Catalogue developed by World Health Organization. Results The study revealed that 63.3% of the subjects were stigmatized. There was association between stigma and variables such as occupation, monthly family income and past history of Tuberculosis. There was also association of stigma with treatment phase, category of the patient and past outcome of illness. Conclusion Due to lack of knowledge and awareness about Tuberculosis, many patients were stigmatized. Efforts should be made to educate the public about Tuberculosis to reduce stigma experienced by Tuberculosis patients and improve the compliance of the patient. KEY WORDS direct observed treatment therapy, stigma, tuberculosisPublication Treatment of supracondylar fracture of the humerus (type IIB and III) in children: A prospective randomized controlled trial comparing two methods(Kathmandu University, 2008) Pandey, S; Shrestha, D; Gorg, M; Singh, GK; Singh, MPAbstract Background: Consensus on method of treatment of displaced supracondylar fracture of the humerus in children is still lacking. Purpose of this prospective randomized controlled study is to compare closed reduction and long arm slab application with closed reduction and percutaneous crossed Kirschner wires xation. Materials and methods: Children of age less than 12 years presented in B.P. Koirala institute of health sciences, Dharan in one year were randomly allocated to group A and group B consisting 30 patients in each group. Closed reduction and long arm posterior slab was applied in group A and in group B, closed reduction was followed by crossed Kirschner wires xation. Clinical and radiological evaluation of reduction was performed immediately after procedure and at the end of rst week, third week, third month and sixth month. Results: The groups were matched for pre fracture characteristics and post reduction evaluation. The mean follow up period in group A was 6.9 months and in group B was 7.1 months. Closed reduction failed in two patients at the rst attempt and one patient failed to retain reduction at rst week in group A. 11 patients (5 in group A and 6 in group B) were lost to follow up. Range of movement, valgus, varus and carrying angle of elbow in two groups were not signi cantly different. The mean difference of carrying angle of affected elbow as compare to normal elbow was signi cant in group A (p 0.05). Flynn’s overall rating showed 32% excellent, 36% good, 18% fair and14 % poor result in patents treated with long arm slab as compared to 58% excellent, 29% good, 13 % fair and no poor results in patients with crossed Kirschner wires xation. Conclusion: The outcome of displaced extension type supracondylar fracture of the humerus in children, managed with closed reduction and slab application are comparable with closed reduction and crossed Kirschner wire xation in terms of range of motion but is inferior in restoration of carrying angle. Good to excellent cosmetic and functional results are higher with crossed percutaneous Kirschner wires xation than with slab immobilization. Key words: closed reduction; percutaneous xation; supracondylar fracturePublication Water pollution and health(Kathmandu University, 2006) Pandey, SWater is the important constituent of life support system. No one can live and even dream to live without water. Most of our water bodies have become polluted due to industrial growth; urbanization and man made problems mainly the result of population growth. Poor sanitation and contaminated drinking water arising from human activity and natural phenomena create serious problems in human health. The chief sources of water pollution are sewage and other waste, industrial effluents, agricultural discharges and industrial wastes from chemical industries, fossils fuel plants and nuclear power plants. They create a larger problem of water pollution rendering water no longer fit for drinking, agriculture and, as well as for aquatic life. More than 2.6 billion people-40% of the world’s population – lack basic sanitation facilities and over one billion people still use unsafe drinking water sources. As a result thousands of children die everyday from diarrhoea and other water, sanitation and hygiene related diseases and many suffer and are weakened by illness.1 Key words: Water pollution, Poor sanitation, contaminated drinking water, human health