Browsing by Author "Pant, S"
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Publication Clinical profile of typhoid patients(Kathmandu University, 2003) KC, Mathura; Gurubacharya, DL; Shrestha, A; Pant, S; Basnet, P; Karki, DBObjective: The present study was undertaken to determine the clinical profile of typhoid fever in hospitalised patients. Design: Prospective cross-sectional study. Setting: Kathmandu Medical College and Teaching Hospital Method: Total of thirty patients above fifteen years of age who had clinical features strongly suggestive of typhoid fever and on blood culture found to be positive for salmonella typhi were analysed for clinical features. Result: Among total of thirty cases, there were 17 (57%) males and 13(43%) females. 86% of cases of typhoid fever clustered around 15-30 years of age. Predominant symptoms were fever (100%), headache (90%), abdominal Pain (37%) and constipation (33%). Common clinical signs were splenomegaly (37%), relative bradycardia (27%) and hepatomegaly (17%). None of the patients presented with complications. Conclusion: The clinical profile of typhoid fever in our study revealed not much difference from that of other studies on typhoid fever. Rose spots were not noticed and we did not find a single case of complication of typhoid fever. Probably early initiation of antibiotics prevented the complications. Key words: Typhoid fever, S. Typhi.Publication Drowsy Drivers - Medical Implications of Highway Traffic Safety(Kathmandu University, 2011) Pant, SABSTRACT The estimates of the contribution of drowsiness and fatigue to the number of road crashes is often neglected considerably, due both to under-reporting of these factors by drivers, and technical difficulty in investigating the problem. Preventing and treating the reasons for falling asleep behind the wheel may have considerable contribution in traffic safety. Therefore the licensing authorities in co-operation with the medical profession should attend more closely to the issue of sleep related disorders and their implications for driving in cases with notoriously high risk. The police and other enforcement authorities need appropriate knowledge and procedures to detect drivers at risk of falling asleep while driving. Considering the increasing number of road traffic accidents day per day, it is a need of the hour to detect drivers possibly at risk, and to take appropriate precautions in terms of education, advice and treatment regimes, as well as restrictions on licensing. KEY WORDS drowsy driver, Epworth Sleepiness Scale, highway accidents, primary prevention, secondary prevention, sleep apnea syndrome, sleep disorders.Publication Hydranencephaly(Kathmandu University, 2010) Pant, S; Kaur, G; De, JKAbstract Hydranencephaly is a rare congenital condition where the greater portions of the cerebral hemispheres and the corpus striatum are replaced by cerebrospinal fluid and glial tissue. The meninges and the skull are well formed, which is consistent with earlier normal embryogenesis of the telencephalon. Bilateral occlusion of the internal carotid arteries in utero is a potential mechanism. Clinical features include intact brainstem reflexes without evidence of higher cortical activity. The infant’s head size and the spontaneous reflexes such as sucking, swallowing, crying, and moving the arms and legs may all seem normal at birth. However, after a few weeks the infant usually becomes irritable and has increased muscle tone and after a few months of life, seizures and hydrocephalus (excessive accumulation of cerebrospinal fluid in the brain) may develop. Other symptoms may include visual impairment, lack of growth, deafness, blindness, spastic quadriparesis (paralysis), and intellectual deficits. Since the early behaviour appears to be relatively normal, the diagnosis may be delayed for months sometimes. There is no definitive treatment for hydranencephaly. The outlook for children with hydranencephaly is generally poor, and many children with this disorder die before their first birthday. Key words: hydranencephaly, congenital anomaly, vascular disruption, thromboplastin,Publication Management of Different Types of Pneumothorax at Dhulikhel Hospital, Kathmandu University Hospital(Kathmandu University, 2020) Shrestha, B; Karmacharya, RM; Pant, SABSTRACT Background Pneumothorax is defined as the presence of air in the pleural cavity. Pneumothorax can be classified as Spontaneous and Traumatic according to the etiology. Spontaneous pneumothorax is further classified as Primary and Secondary. Objective This study was conducted to know the management of different types of pneumothorax at Dhulikhel Hospital, Kathmandu University Hospital. Method This was a hospital based retrospective study conducted at Dhulikhel Hospital, Kathmandu University Hospital. Patients admitted in Surgery Ward with diagnosis of Pneumothorax from January 2018 to December 2019 were included in this study. Result This study included 144 patients with pneumothorax age ranging from 14 years to 94 years. Most of the patients were male with male:female ratio of 3.8:1. Eighty-four (58.03%) patients had Traumatic pneumothorax followed by Secondary spontaneous pneumothorax in 53(36.08%) patients and Primary spontaneous pneumothorax in seven (4.86%) patients. Among 144 patients, chest tube drain was required in 135 patients and nine patients were managed conservatively. One patient underwent Video Assisted Thoracoscopic Surgery (VATS) with Bullectomy and mechanical pleurodesis. Sixteen patients had persistent pneumothorax, among which six patients required chemical pleurodesis, two patients required negative suction therapy and five patients required both chemical pleurodesis and negative suction therapy. Conclusion This study showed pneumothorax to be more common in male population. Traumatic pneumothorax was the most common type followed by Secondary spontaneous pneumothorax and Primary spontaneous pneumothorax. KEY WORDS Chest tube drainage, Pleurodesis, Pneumothorax, Video assisted thoracoscopic surgeryPublication Measurement of Right Atrial Volume and Diameters in Healthy Nepalese with Normal Echocardiogram(Kathmandu University, 2014) Karki, DB; Pant, S; Yadava, SK; Vaidya, A; Neupane, DK; Joshi, SABSTRACT Background The size of right atrium is expected to be different in diverse healthy ethnic groups. It is important to know the normal size of right atrium in our healthy population. Objective The study aimed to find out the normal values of right atrial volume, right atrial short axis diameter and right atrial long axis diameter in healthy Nepalese population with normal echocardiographic findings. It also looked at correlations between right atrial dimensions and the right atrial volume. Method Verbal consent was taken from all the participants. One hundred participants between the age of 18 and 60 years with normal echocardiographic findings and without any chronic disease were included in this study. Right atrial volume was measured by using area length method. Right atrial short axis diameter and Right atrial long axis diameter were measured in the four chamber view. Result The mean right atrial volume was 23.64±5.36 ml (range 11.30 - 40.00 ml).The range of right atrial short axis diameter and right atrial long axis diameter were 1.34-3.80 cm and 2.4-4.7 cm respectively. Conclusion The size of right atrium in the Nepalese population is smaller compared to western population. Male right atrial volume size is greater than female in Nepalese population similar to western population. The findings of normal value of right atrial volume and right atrial diameter in Nepalese population will help the physician to assess patients with various conditions affecting the right atrium. KEY WORDS Nepalese population, right atrial short axis diameter, right atrial long axis diameter, right atrial volume.Publication Prevalence of Sensory Neuropathy in Type 2 Diabetes Mellitus and Its Correlation with Duration of Disease(Kathmandu University, 2016) Karki, DB; Yadava, SK; Pant, S; Thusa, N; Dangol, E; Ghimire, SABSTRACT Background Peripheral neuropathy is one of the most common and distressing late complication of diabetes mellitus. Ignorance of the complications may develop foot ulcers and gangrene requiring amputation. Objective The main objective of this study is to find out the prevalence of sensory neuropathy in type 2 diabetes mellitus and to compare it with the duration of disease. Method Two hundred seventy one patients with type 2 diabetes mellitus of both gender age 30 years and above willing to participate were included in this study. Patients having hypothyroidism, rheumatoid arthritis, B12 deficiency, cerebrovascular disease, chronic musculoskeletal disease, Parkinson’s disease, alcohol abuse, chronic renal or liver failure and cancer were excluded from the study. Touch, pin prick and vibration sensation were tested. Vibration perception threshold was recorded from six different sites of the sole of each foot using Biothesiometer. Result Two hundreds seventy one type 2 diabetic outpatients were studied. The mean age was 59.81±22.85 years. The overall prevalence of diabetic sensory neuropathy in the study population was 58.70%. A rising trend of diabetic sensory neuropathy with increasing age and duration of diabetes was observed. Neuropathy was found more in patients having urinary microalbuminuria. Burning and pins and needles sensation were most common symptoms. Conclusion The overall prevalence of diabetic sensory neuropathy in the study population was 58.70% (mean age 59.81±22.85 yrs), and its prevalence increased with duration of diabetes and increasing age. Its prevalence was found more in patients having microalbuminuria. KEY WORDS Biothesiometer, sensory neuropathy, type 2 diabetes mellitusPublication Public Awareness and Attitude towards COVID-19 Infection and Vaccines: A cross-sectional national survey in Nepal(Kathmandu University, 2023) Pant, S; Bhattarai, S; Ranabhat, K; Dumre, SP; Rajbhandari, B; Mudvari, A; Bista, B; Bhandari, R; Adhikari, SK; Dhimal, M; Gyanwali, PABSTRACT Background To combat COVID-19, high vaccination rates are essential. However, challenges such as vaccine denial, lack of knowledge, and negative attitudes hinder progress. Assessing public understanding of vaccination is crucial to promote acceptance and reducing reluctance. Objective To understand people’s awareness and attitude regarding COVID-19 infection and vaccines in Nepal. Method A cross-sectional web-based survey was conducted among the Nepali population of age 18 years and above in April 2021 during the early phase of vaccination deployment. A structured questionnaire was used to collect awareness data, and a five-point Likert scale was employed to assess participants’ attitudes. The survey categorized participants into two groups based on whether their awareness level or attitude score was above or below the mean. The secondary outcome was the association between socio-demographic factors and COVID-19 awareness or attitude. Result Of 475 eligible participants, 46% had a low level of awareness on COVID-19 infection whereas 56% had low awareness on COVID-19 vaccines. Every six out of ten participants had a positive attitude towards the national COVID-19 vaccination program. Most of the participants had high awareness of COVID-19 symptoms and preventive measures (hand hygiene, physical distancing, mask), but two-thirds had a false perception of vaccine safety and contraindications. People’s education status, occupation, province, and current/prior COVID-19 infection status were found to be significantly associated with their awareness regarding COVID-19 disease or vaccines. Conclusion The study revealed limited COVID-19 awareness among the Nepali population but a positive attitude toward the national vaccination program. Regular updates on COVID-19 and vaccines are important as new variants and vaccines emerge. KEY WORDS Attitude, COVID-19 virus, Public awareness, VaccinationPublication Sensitivity and Specificity of Lateral Flow Antigen Test Kits for COVID-19 in Asymptomatic Population of Quarantine Centre of Province 3(Kathmandu University, 2020) Shrestha, B; Neupane, AK; Pant, S; Shrestha, A; Bastola, A; Rajbhandari, B; Thapa, A; Singh, AABSTRACT Background Nearly after 6 months of the spread of Corona Virus Disease 19, along with the world Nepal is still trying to control the spread and prevent general population from acquiring it. With limited resources in manpower, technology and evidence it has been a difficult battle. But with time and more understanding of the virus new technology to detect the virus are coming up. It is a major breakthrough in the diagnostic field as this helps us in not only detecting the virus but also helps us to mobilize our human resources. This comes in a time where the cases are increasing at an alarming rate. Although numbers of Polymerase Chain Reaction testing have increased but due to the time consuming and the cost wise, we need a faster and equally reliable alternative. Antigen test approved by different countries can be used for point of care, screening and surveillance depending upon the requirements after calculating its sensitivity, specificity and accuracy. Objective To find out sensitivity and specificity of the Antigen test kit for COVID-19. Method Antigen tests were compared with Reverse Transcription Polymerase Chain Reaction as a reference standard in calculated sample size of 113 subjects in a high risk population. Both Reverse Transcription Polymerase Chain Reaction and antigen test were performed in a same subject with in maximum of 2 days’ interval. Convenience sampling technique was used to select the subjects. Ethical approval was taken from Nepal Health Research Council before data collection. Study was done from August to September 2020 from Quarantine center of Province 3. Result There were total of 113 test carried out, among those 47 were positive and 66 were negative in Reverse Transcription Polymerase Chain Reaction. After preparing two by two table, Sensitivity and specificity of the tested was calculated which came out to be 85% and 100% respectively, with accuracy of 93.80%. Conclusion Even though the sensitivity and specificity came to be higher, this test should be interpreted cautiously depending upon the prevalence of Corona Virus Disease 19 in that particular community and the clinical and epidemiological context of the person who has been tested. When in doubt by clinical correlation should be confirmed with Reverse Transcription Polymerase Chain Reaction. KEY WORDS Asymptomatic, Coronavirus Disease 19, Lateral flow antigen test, Sensitivity