Browsing by Author "S, Shrestha"
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Publication A comparison of haemodynamic responses with pethidine vs. butorphanol in open cholecystectomy cases(Kathmandu University, 2004) S, Tabedar; SK, Maharjan; BR, Shrestha; S, ShresthaObjective: The present study was undertaken to compare the haemodynamic responses with pethidine vs. Butorphanol intraoperatively in open cholecystectomy cases in KMCTH. Method: In this randomized study, all together 40 patients undergoing routine cholecystectomy surgery were included. Group A received Pethidine 1mg/kg and Group B received Butorphanol 0.04mg/kg intraoperatively. Heart rate and blood pressure were recorded before injection of the drug, after injection, before intubation, after intubation, before skin incision, after incision, before extubation and after extubation Data analysis was done using independent sample “t” test. Result: Our study showed no statistical significance in haemodynamic responses with either pethidine or Butorphanol in open cholecystectomy cases. Conclusion: Both drugs appear equally good analgesics in our study. Key words: analgesics, pethidine, Butorphanol, haemodynamic responses, surgery, cholecystectomy.Publication Acute haemorrhagic conjunctivitis: an epidemic in august/ September 2003(Kathmandu University, 2003) DB, Karki; CD, Shrestha; S, ShresthaObjective: To clinically analyze 400 cases of red eye attending Nepal Eye Hospital in August/ September 2003 and to study the aetiology of the disease on the clinical basis with available laboratory resources. Materials and methods: It is a prospective study of 400 cases of acute conjunctivitis visiting Nepal Eye Hospital during the epidemic of acute haemorrhagic conjunctivitis in August/September 2003. Result: 30.5% presented in the age group of 20-29 years. Males presented predominantly (73.3%). Maximum number of patients presented at two days of onset of symptoms. All 400 cases had red eye, 89.8% had pain, 86.3% had foreign body sensation and 87.5% had discharge. Bilateral involvement was seen in 73.5% and unilateral involvement in 26.5%, 4.3 % of the total cases had corneal involvement and 20% of the cases had associated fever and preauricular lymphadenopathy. Conclusion: Based on clinical presentation and the report of available laboratory results, picorna virus was found to be responsible for this epidemic of acute haemorrhagic conjunctivitis. Keywords: Haemorrhage, Conjunctivitis, Superficial Punctate Keratitis, Lymphadenopathy, Picorna virus.Publication Analysis of 400 cases of posterior segment diseases visiting retina clinic of Nepal eye hospital(Kathmandu University, 2003) DB, Karki; OK, Malla; RN, Byanju; S, ShresthaObjective: To determine the disease pattern of 400 patients attending Nepal Eye Hospital for strategic planning. Materials and methods: A retrospective hospital based analysis of 400 cases visiting Retina Clinic of Nepal Eye Hospital (NEH) over a period of one year was carried out in order to know the disease pattern for planning purpose. Results: Males slightly outnumbered females (58% versus 42%). The diseases were more common in age group 50 to 59 years. Diabetes mellitus with or without retinopathy was the commonest cause (20.25 %) for attendance in retina clinic followed by hypertensive retinopathy and venous occlusive disorders. Keywords: Posterior segment disease pattern, diabetic retinopathy, hypertension, venous occlusive disease.Publication Environmental noise induced hearing loss in Nepal(Kathmandu University, 2003) SK, Joshi; S, Devkota; S, Chamling; S, ShresthaIntroduction: Noise pollution in urban cities is a serious problem and steadily increasing over the years. This has direct and indirect affect to the people that can lead to the health hazard. Objectives: To find out environmental noise induced health effect on people residing in an urban community and to predict the risk of the environmental noise induced hearing loss Material and methods: One hundred fifty questionnaires were filled up for the environmental noise pollution survey. For the case control study, 36 exposed and 25 non-exposed residents of Kupondole were included. Based on the place of residence (main road and 20 min. walking distance from the main road), subjects were divided into exposed and non-exposed group concerning environmental noise. Demographic data and information about health problems was obtained by a structured interview. Audiometric test was performed using manual audiometer. Odds ratios (OR) and their 95% confidence intervals (95% CI) for noise induced hearing loss were estimated using logistic regression. Adjustment for occupational noise was done Results: The major health effect induced by the environmental noise was observed as lack of concentration followed by irritation, fatigue and headache. The crude OR and 95% CI for the exposed subjects was 4.2 (1.4, 12). After adjustment for occupational noise, the OR (95% CI) was 4.0 (1.2, 13). Conclusion: This study shows that exposure to noise causes wide range of health effects. For the exposed subjects there was an increased risk of noise induced hearing loss. The risk was significantly increased also after adjusting for occupational noise. Keywords: Environmental Noise, Noise Induced Hearing Loss (NIHL), Audiometric Test, Noise Pollution Survey, NepalPublication Intermediate uveitis: a hospital based study(Kathmandu University, 2004) OK, Malla; DB, Karki; RN, Byanju; S, ShresthaIntermediate uveitis affecting pars plana, peripheral retina and underlying choroid affects primarily healthy children and young adults. Objective: To study the components of intermediate uveitis at Nepal Eye Hospital in the year 2003 August to 2004 March. Materials and Methods: A prospective study was done in patients with intermediate uveitis visiting Nepal Eye Hospital. Sample size was 50. Specially designed proforma of intermediate uveitis was used to collect particulars of the patients, history, clinical examination findings, investigation reports, management protocols used and the final visual outcome. Results: Intermediate uveitis was seen more in 20 to 29 years age group (38%) and more prevalent in males (52%). Among the study population farmers constituted maximum proportion (36%) and Mongoloid origin was mostly affected (30%). High number of patients were from the central development region with highest proportion from Dhading district (34%). Anterior segment affection with keratic precipitates and anterior chamber cells were noted in 72% of involved eyes. Vitreous cells were noted in all affected eyes while 4% had vitreous snow banking and 3% had vitreous snow balls. Most of the patients (52%) received between topical steroid and posterior subtenon injection of Triamcinolone. Visual Acuity was improved in 52% of cases and remained static in 46%.while deteriorated in 2%. Conclusion: Significantly high number of patients with intermediate uveitis has been reported from the central development region, mainly from Dhading, Kathmandu and Nuwakot districts. People in their third decade were found to be commonly involved and Mongloid origin were more commonly affected. Anterior chamber spill over was seen in higher percentage of patients than described in literature. As the patients presented in milder forms, visual acuity improved is 52% of cases with the treatment protocol followedPublication Odontogenic origin of necrotizing fasciitis of head and neck - a case report(Kathmandu University, 2004) Toran, KC; S, Nath; S, Shrestha; BBS JB, RanaNecrotizing fasciitis (NF) of head and neck is a fulminant infection associated with necrosis of connective tissue which spreads along the fascial planes with high mortality rate. It is usually polymicrobial, odontogenic and occurs more frequently in immunocompromised patients. Because of the rarity of the disease, early diagnosis and early management is often delayed. We present a diabetic patient who developed NF of head and neck following tooth extraction. Because of vigorous teamwork he could be saved from the fatal disease but required extensive plastic repair. Every clinician should be aware of such a disease, particularly in immunocompromised patients and necessitates earliest diagnosis and intervention to save their life. Keywords: Necrotizing fasciitis, necrotizing soft tissue infections,Publication Regarding “Tonsillar microbial flora: A comparison of infected and non-infected tonsils”(Kathmandu University, 2006) S, Bhandary; RK, Singh; S, ShresthaNAPublication Surgical management of sinus tympani cholesteatoma(Kathmandu University, 2004) Toran, KC; S, Shrestha; P, Kafle; SK, DeyasiObjective: the aim of this study is to describe the extension of unsafe middle ear disease in the sinus tympani and to review the methods of surgical access to remove the disease from this area. Methods: Of the 164 operated ears with unsafe chronic suppurative otitis media 64(39%) ears had variable disease extension into the sinus tympani and were included in the study. Sixty-two ears underwent canal wall down (CWD) procedure while remaining two underwent tympanoplasty with bone work. Result: Five operated ears had deeper extension of the disease into the sinus tympani. And despite of different maneuver the complete removal of the disease could not be confirmed. Six ears (9.4%) had recidivism. Conclusion: The study emphasizes on the greater incidence of this disease extension into this difficult anatomical area and their complete removal may not be always possible. But one should require thorough knowledge and surgical expertise to work in this difficult area of posterior mesotympanum. Keywords: Cholesteatoma, sinus tympani