Browsing by Author "Sharma, R"
Now showing 1 - 6 of 6
Results Per Page
Sort Options
Publication Common pathogens isolated in diabetic foot infection in Bir Hospital(Kathmandu University, 2006) Sharma, VK; Khadka, PB; Joshi, A; Sharma, RAim: Foot ulcers are a frequent complication of patients suffering with diabetes mellitus, accounting for up to 20% of diabetes-related hospital admission6. Secondary infection of these ulcers is by far the leading cause of amputation of feet and legs and the polymicrobial nature of diabetic foot infection has been well documented in the literature. The present study sought to reveal the bacterial etiology of diabetic foot ulcer in patients presenting to Bir Hospital. Method: A 1 year retrospective study was carried out to analyse the bacterial isolates of all patients admitted with diabetic foot infection presented with Wagner grade 2 -5 ulcers. Bacteriological diagnosis and antibiotic sensitivity profiles were carried out and analysed using standard procedures. Results: Diabetic polyneuropathy was found to be common in (51.1%) and gram positive bacteria were isolated more often than gram-negative ones in the patients screened. The most frequent bacterial isolate were Staphylococcus aureus (38.4%), Pseudomonas aeruginosa (17.5%), and Proteus (14%). Imipenem was the most effective agent against gram-negative organisms. Vancomycine was found to be most effective against gram- positive organisms. 13 Conclusion: Staph aureus and Pseodomonas aeruginosa were the most common causes of diabetic foot infections in Bir Hospital. Theses wounds require use of combined antimicrobial therapy for initial management, repeated dressing and wound debridements were done.Publication Effect of preloading on haemodynamic of the patient undergoing surgery under spinal anaesthesia(Kathmandu University, 2010) Singh, J; Ranjit, S; Shrestha, S; Sharma, R; Marahatta, SBAbstract Background: Hypotension and bradycardia after conduction of spinal anaesthesia are common side effects because of sympathetic blockade. Efforts to prevent these complications have been attempted like preloading with crystalloids, colloids or use of vasopressors. The role of volume preloading to prevent haemodynamic changes associated with spinal anaesthesia has been recently questioned. Objective: The objective of the study was to investigate the effects of volume preload on changes of patient’s hemodynamic. Materials and methods: A Quasi- experimental design was used to conduct the study. Taking written informed consent, 40 patients of age group 18-45 years and ASA grade I and II undergoing surgery under spinal anaesthesia in operation theatre of Dhulikhel Hospital were selected as the sample of the study and allocated randomly to 2 groups. Group I did not receive volume preload and Group II received preload of 1000 ml of Ringer’s lactate solution within 30 minutes immediately before giving the spinal anaesthesia. An observational checklist was used to collect demographic, intra- operative and post-operative records of systolic blood pressure (SBP), diastolic blood pressure (DBP), mean arterial pressure (MAP) and heart rate (HR). Results: The findings revealed that the haemodynamic changes occurred in all patients. The decrease in SBP, MBP and DBP from baseline was statistically significant at all points of time (p=0.000). The decrease in HR from baseline was not statistically significant at all points of time (p>0.05). The overall incidence of hypotension was 50%, among which 9 (45%) were from without preload group and 11 (55%) were from with preload group. The incidence of hypotension was similar in groups, sexes and surgical conditions (General Surgery, Gynae/Obs and Orthopaedics). There were no signifi cant differences in haemodynamic changes among groups. Conclusion: On the basis of findings, it is concluded that volume preloading had no effect on the incidence of hypotension and bradycardia after spinal anaesthesia. Key words: Preload, Haemodynamics, Spinal Anaesthesia, CrystalloidPublication Incidence of Simian Crease in Normal Nepalese Children(Kathmandu University, 2010) Malla, T; Malla, KK; Gauchan, E; Brijesh, S; Sharma, RABSTRACT Backgroud Simian crease is usually associated with some chromosomal anomalies and syndromes but it is also seen in some populations without any chromosomal defects. Objective To see the incidence of simian crease in children without chromosomal anomalies and to detect the Ethnic group variations. Methods A prospective study in children attending the paediatric outpatient department of Manipal Teaching Hospital, Pokhara. –2,067 children were screened randomly from the 1st June 2007 to the 31st December 2007. Palm crease and axial triradius angle were detected in every child. Axial Triradius angle was compared between those who have simian crease to those who do not simian crease.Children who were found with simian crease underwent IQ testing. The exclusion criteria were children with Down syndrome, other chromosomal and minor anomalies, plus or any other chronic disease condition. Results 2,067children (1,084 boys & 983 girls) were screened. Among them four were cases of Down syndrome so were excluded from the study. Finally total of 2,063 (1,082 boys & 981 girls) were the study group. There were a total 14 ethnic groups who attended the outpatient department of Manipal Hospital during a seven months period. Among the seven ethnic groups Brahaman, Gurung, Tamang, Lama, Newar, Chettri and Dalit had single palmar crease. The incidence of simian crease was14.6%.This incidence was highly significant (p<0001) in Lama population (71.2%). In these seven ethnic groups axial triradius angle was compared between those who had simian crease and with those who did not have simian crease. Comparisons were made statistically and found to be significant. Conclusion Incidence of simian crease in Nepalese children was 14.6% and was observed only in certain ethnic groups. It was significantly high in the Lama population (71.2%0. Key Words Simian crease, single palmer crease, incidence, Down syndrome, ATD anglePublication 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 Refractive Errors and Visual Anomalies in Schoolchildren in the Kavrepalanchowk District(Kathmandu University, 2010) Marasini, S; Sharma, R; Sthapit, PR; Sharma, D; Koju, U; Thapa, G; Nepal, BPABSTRACT Background Schoolchildren form an important target group for a nation, as any ocular morbidity in this age group has huge physical, psychological and socio-economical implications. Childhood eye disorders can contribute to the burden of blindness in any society. This study aims to highlight the prevalence of ocular morbidity in governmental schools in a sub-urbanised area of Nepal, in relation to ethnic variation. Methods A descriptive study, and the study population used were schoolchildren who were examined in their schools and afterwards referred to the hospital if required. Presenting and best corrected visual acuity, refraction, binocularity assessment, anterior and posterior segment evaluation was carried out. Data was analysed statistically using SPSS software, version 14. Results We examined 1,802 school children. The mean age was 10.78±3.61 years. Ocular abnormality was detected in 11.7%. Low vision and blindness was rare (0.11% and 0.05%). Ocular morbidities were more common in Newar communities (3.71%) followed by Brahamans (3.38%). Lid abnormalities were the most common (3.55%), and morbidities in each ethnicity were followed by refractive errors (3%), conjunctival abnormalities (1.10%), strabismus (0.88%) and amblyopia (0.33%). Refractive errors were most common among Newar communities (1.16%) at almost twice as many Brahamans (0.61%) followed by Mongolians (0.49%). Convergence insufficiency was detected in 2.49% (p<0.01). Conclusions Ocular morbidities are common in children in Kavhrepalanchowk District with lid abnormalities being the most common issue, probably due to a lack of hygienic practice. Ethnic variation of ocular morbidities is an important observation mostly for refractive error and strabismus. Key Words blepharitis, blindness, ethnicity, oculo-visual, visual acuityPublication Tubercular scleritis(Kathmandu University, 2010) Sharma, R; Marasini, S; Nepal, BPABSTRACT Scleritis is a severe painful inflammatory process centred in the sclera. A scleritis may be a harbinger of many systemic diseases so that it is important to exclude multisystem disease. We describe a case of unilateral tubercular anterior nodular non-necrotizing scleritis. Anterior nodular non-necrotizing scleritis is relatively an uncommon manifestation of tuberculosis. It may be difficult to diagnose and manage the disease. However, good history, detail clinical evaluation, appropriate and timely management shows a good response to the disease. Key Words mantoux test, nodular scleritis, ocular tuberculosis