Browsing by Author "S, Kumar"
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Publication Abdomino-scrotal hydrocele in 35 years old: A case report(Kathmandu University, 2007) SK, Tiwary; S, Kumar; A, Agarwal; R, Khanna; AK, KhannaAbstract: Abdomino-scrotal hydrocele is a condition usually affecting children. It is unusual to find an abdomino- scrotal hydrocele in middle aged adult. Most of the patients are asymptomatic except cystic abdominal mass and discomfort occasionally. We hereby report an unusual presentation of abdomino-scrotal hydrocele at age of 35 years and presenting as large cystic abdominal mass extending into scrotum. Key words: Hydrocele, Cystic mass, Abdomino-scrotal, Abdominal, Scrotal.Publication Acid base and electrolyte disturbance in diarrhoea(Kathmandu University, 2007) GS, Shah; BK, Das; S, Kumar; MK, Singh; GP, BhandariObjective: The present study was undertaken to study the frequency of electrolyte imbalance in children with diarrhoea and the relationship between electrolyte abnormalities and mortality. Materials and methods: This is a retrospective, observational hospital based study. Fifty seven children admitted to paediatric ward with diarrhoea and dehydration was evaluated for electrolyte and acid base status at presentation. The variables were analyzed using chi-square and student t- test. Results: Majority (70%) of patients were below 2 years of age. There were 37 (65%) males and 20(35%) females. Electrolyte disturbance was observed in 46 (80%) patients while acid base disturbance was observed in all (100%) where the estimations were done. The major electrolyte disturbances noted were hyponatremia (56%), which was either isolated (26%) or associated with hypokalemia (26%). The second common abnormality was hypokalemia (46%) which was again either isolated (14%) or associated with hyponatremia (26%). About 10% patient had hypernatremia and about 3% had hyperkalemia. Twenty one (37 %) patients had mixed electrolyte imbalance. ABG analysis was performed only in 16 patients. Arterial blood gas analysis could be performed only in 16 patients. Metabolic acidosis was present in 15 (94%) while one (6%) had metabolic alkalosis. Out of 57, five patients (8.7%) expired. All of them had electrolyte abnormalities. Out of five patients who died one had isolated hyponatremia, 2 had hyponatremia + hypokalemia, while one each had hypernatremia + hypokalemia and hypernatremia+ hyperkalemia. Statistically significant mortality was observed in patients presenting with either hyponatremia or hypokalemia as compared to the group with normal electrolytes. Conclusion: Hyponatremia, hypokalemia and metabolic acidosis are common electrolyte and acid-base abnormalities in children with diarrhoea and dehydration and often responsible for mortality. Key words: Diarrhoea, Dehydration, Electrolytes, Acid-Base statusPublication Alcohol use among physicians in a medical school in Nepal(Kathmandu University, 2006) S, Kumar; B, Pokharel; S, Nagesh; BK, YadavObjective: The objective of the study was to know about the use of alcohol among physicians and factors that were related to it. Methods: This was a cross sectional study conducted among the physicians in a medical school of eastern Nepal. A semi structured questionnaire was used to collect information. Results: There were 55 subjects in the study. Half of them were between 35-45 years age group and one fourth among them were female. There were more than 88% physicians consuming alcohol for more than 10 years. One third used to preferred whisky as their favorites drink. Use of alcohol among them was due to peer pressure and to become a social human being. Most of them drink alcohol occasionally with an average amount 30-60ml in a sitting and usually in the evening. Most of the time, they use alcohol either in parties or at home. Conclusion: Alcohol use in Nepal is very much prevalent. The use of alcohol is socially accepted in many communities. Uses of alcohol by physicians have direct effect on their health as well as the health of many people because they are role model for many people. They are also in direct contact with the patients. Steps to council the physicians may reduce the consumption of alcohol. Key words: Alcohol, Nepal, Physicians, Dependence, AbusePublication An anomaly of inferior vena cava: A rare case report(Kathmandu University, 2006) S, KumarA double Inferior Vena cava (IVC) was observed during routine dissection of the posterior abdominal wall in a middle aged male cadaver. The left IVC was formed at the Junction of left external and internal iliac veins. It ascended upwards medial to left psoas major and at the level of second Lumbar vertebra, opened into left renal vein. The IVC is a retro peritoneal structure whose location and integrity is very important for the surgeons. The vast variability of the overall rare congenital anomalies of the IVC were mostly detected by different imaging modalities. The embryogenesis of the inferior vena cava is a complicated process involving development, regression, anastomoses and replacement of three pairs of venous channels, posterior cardinal, subcardinal and supracardinal veins, resulting in numerous but rare anomalies. Key words: inferior vena cava; double; variationsPublication Association of obesity and physical activity in adult males of Dharan, Nepal(kathmandu University, 2006) A, Vaidya; PK, Pokharel; S, Nagesh; P, Karki; S, Kumar; S, MajhiObjectives: Obesity is one of the most apparent-yet most neglected public health problems. Physical activity is a crucial element in the development of obesity but still its importance in the occurrence of obesity varies in different populations. This paper aims to study the burden of obesity and its association with physical activity was carried out in a rapidly urbanizing town. Methods: A cross-sectional study to investigate the prevalence of obesity and its association with physical activity was carried out in one thousand adult males of Dharan municipality. Tools of data collection included interview and physical measurements such as blood pressure, height and weight measurements, and waist and hip circumferences. Odds ratios (ORs) and their 95% confidence intervals for obesity were computed across various demographic and other variables without adjusting and then adjusting for physical activity. Results: The prevalence of overweight and obesity in the population was 32.9% and 7.2% respectively. The study showed that physical inactivity is more importantly associated with obesity in the older population. The trend of young being more obese is reversed after adjusting for physical activity so that those in the older age were more obese than the younger ones. Similarly, those in to the business, vocational and clerical works, those who were more literate and those in the higher socio-economic status were significantly associated with obesity even after correcting for physical activity. Conclusion: The prevalence of overweight and obesity is high in the males of Dharan. The value and effect of physical activity seem to vary across different age-groups and socio-economic status and occupations. The young, the technical persons or businessmen and the more prosperous ones probably need to bring down their calorie intake along with emphasis on physical activity in order to bring down their weight and cardiovascular risk.Publication Attitude of women towards family planning methods and its use – Study from a slum of Delhi(Kathmandu University, 2005) S, Kumar; A, Priyadarshni; S, Kant; K, Anand; BK, YadavBackground: To predict the need of family planning methods, family planning managers often rely on unmet need derived from measure of contraceptive demand. However women’s intention and her background knowledge of family planning methods not received as much attention as a measure of family planning methods demand. Objective: To know the attitude of women regarding use of family planning methods and to find out the factors that restricts its use, and the change in pattern of use over a period of one year. Methods: This was a prospective study. One (Block G) out of eight blocks was selected randomly. Using convenient sample method, families were selected starting from a point in the selected block (Block G). 40 women of childbearing age group (15- 49 years) were enrolled. All women were followed for a period of one year. Results: Weakness was narrated as the commonest side effect from all family planning methods. More than 70% women told that irregular menstruation from Oral Contraceptive pills and ill health from tubectomy as the other side effects. Demands for more children and for son preferences were the leading reason for not using any methods followed by afraid of side effects and health problems. There was negligible change in the use of family planning methods during the period of the study. Conclusion: Effective family planning methods use should be advocated through adequate counseling about the correct use, side effects and their proper management and their benefit in the back ground of custom and belief. Key words: Family planning, Contraceptives, Family planning methods, Attitude.Publication Impact of family health exercise program on health knowledge and practice of a rural population of eastern Nepal(Kathmandu University, 2006) N, Jha; S, Kumar; BK, Yadav; GCP, Singh; SR, NiraulaBackground: It is important to know the impact of health education on community. This may lead to improve the programs, commitment to students and staffs by taking feedback. These activities are aimed at producing changes in the community. Objective: To assess the impact of health education as intervention program during Family Health Exercise (FHE) about the knowledge and practice of people related to health in a village of eastern Nepal. Methods: During FHE, health education was given by the 3rd year medical students to the head of the 30 families. The neighbour 30 families were taken as control, where no health education was given. These two groups were compared after 6 months. Results: Sanitary practice (Hand washing) before meal was known to both groups. But the material used for washing hand (soap and ash) was 53% in intervention as compared to 30% in control group. People were aware about the importance of care of the mother during pregnancy and lactation, but more in intervention group. The knowledge and practice for starting semisolid food other than breast milk for infants during weaning were higher in intervention (89%) than control (31%) group. Conclusion: There was significant change in the knowledge and practice of woman (mainly host) who received health education. The community also benefited in terms of their health knowledge and practices. Such programs are useful for the community at large. Key words: Family Health Exercise, Impact of Health Education, Health education, Nepal.