NepMed Repository :: Browsing by Author "Shrestha, S"

Browsing by Author "Shrestha, S"

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A comparison of haemodynamic responses with pethidine vs. butorphanol in open cholecystectomy cases
(Kathmandu University, 2004) Tabedar, S; Maharjan, SK; Shrestha, BR; Shrestha, S
Objective: 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.
Acute haemorrhagic conjunctivitis: an epidemic in august/ September 2003
(Kathmandu University, 2003) Karki, DB; Shrestha, CD; Shrestha, S
Objective: 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.
Admission Cardiotocography in Predicting Perinatal Outcome
(Kathmandu University, 2019) Shrestha, S; Shrestha, I
ABSTRACT Background Antepartum assessment of the fetus is very important to prevent intra-uterine demise, birth asphyxia, neurological defect of newborns and neonatal mortality. Cardiotocography is the best indicator for fetal surveillance during labour in low resource country. Objective To assess on admission cardiotocography and predict perinatal outcome of antenatal mothers admitted to labour room for delivery at Dhulikhel Hospital, Kathmandu University Hospital. Method A prospective, observational study was conducted from 1st January 2016 to 31st December 2017. Antenatal mothers were evaluated in admission cardiotocography for 20 minutes. Cardiotocography studies were interpreted and categorized according to the classification proposed by National Institute of Clinical Excellence (NICE)- clinical guidelines 2007. Result Total 204 mothers were enrolled, the mean age is 24.06±4.331. Cardiotocography interpretation shows, 81.4% of Normal, 13.7% suspected and only 4.9% accounts pathological. Mother having CTG of pathological had more operative delivery 80% compare to normal and suspicious (0.0001). Similarly, more meconium stained liquor fall in pathological group with p value of 0.002. Fetal distress in labour is seen in all groups, showing 13.3% in normal, 32.1% in suspicious and 80% in pathological with p value 0.000. The duration of on admission cardiotocography to occurrence of fetal distress found to be mean hour of 9.57. Conclusion The admission cardiotocography test is useful to detect fetal distress which is already present at the time of test and can predict fetal wellbeing during the next few hours of labour. This test might lead to higher incidence of operative delivery at low resource countries because of lack of fetal blood sampling test to confirm fetal hypoxia during labour. KEY WORDS Admission cardiotocography, Perinatal outcome, Obstetrical outcome
Adolescent Health Risk and Behavior Survey: A School Based Survey in Central Nepal
(Kathmandu University, 2017) Thapa, B; Powell, J; Yi, J; McGee, J; Landis, J; Rein, L; Kim, S; Shrestha, S; Karmacharya, B
ABSTRACT Background A comprehensive study of adolescent health risk specific to the Dhulikhel catchment area has not been performed. Objective This survey assesses trends in demographics, nutrition, hygiene and related infrastructure, causes of injury, violence, mental health, substance abuse, and menstrual hygiene. Method A 40 question survey was adapted from the Center for Disease Control (CDC) Youth Risk Behavior Surveillance System, translated into the Nepali language, and administered to 1200 students in eight different schools in central Nepal. Descriptive statistics were used to summarize the data. Result The data has identified nutrition, infrastructure, mental health, and menstrual hygiene as areas for improvement. The number of adolescents who reported going hungry some, most, or all of the time (30.5%, 25.8%, 13.9%) reveals a need for better food access. Approximately 44.5 % of students had no access to soap and water at school. Students who endorse dissatisfaction with themselves was 6.5% and those with suicidal ideation or attempt was 11.8% of the surveyed population. A significantly greater percentage of students who reported suicidal ideation also reported engaging in behaviors related to physical violence, substance abuse, being dissatisfaction with themselves, insomnia due to anxiety, and loneliness. Of the female students, 40.1% reported missing school at least once in the last three months due to their period. Conclusion This data shows a need for better food access, improved infrastructure in schools in central Nepal, and the need to address the prevalence of mental health issues through program interventions. KEY WORDS Adolescent health, School health, Survey
Analysis of 400 cases of posterior segment diseases visiting retina clinic of Nepal eye hospital
(Kathmandu University, 2003) Karki, DB; Malla, OK; Byanju, RN; Shrestha, S
Objective: 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.
Analysis of Post Earthquake Disease Pattern in a Camp at Gyampesal Gorkha
(Kathmandu University, 2016) Malla, T; Malla, KK; Singh, SK; Shrestha, S
ABSTRACT Background A major earthquake occurred in Nepal on 25th April 2015 with magnitude of 7.8 causing mass panic amongst people. Objective To analyze scenario, experience and disease pattern of Post Earthquake camp at Gyampesal, Gorkha. Method A prospective observational study done on 13th and 14th June 2015 in a population who attended the health camp at health post, Gyampesal Gorkha. Analysis was done for age, sex, and disease pattern. Medicines for their health problems was provided by Manipal Teaching Hospital, Pokhara, Nepal Pediatric Society and Children Welfare in Nepal, Kathmandu. Result Total 159 patients [80.5% children and 19.5% adults] had attended the health camp. The mean age of children was 6.18±4.27 SD with maximum between 2-5 years (39%) and mean age of adults was 37.87±14.07 SD. Among the children males were more (50.8%) than females but in adult group females (83.9%) were more. Most common complaints were earthquake related fear (Children- 60.23% / adults -71%), insect bite [children -25.8% /adults -35.5%], pain abdomen (children- 64.1% / adult -38.7%) and decreased appetite (children- 83.6% / adults - 16.1%). Pain abdomen and decreased appetite was significantly high in children with p <0.009 and 0.001 respectively. The common disease patterns noted in children were recurrent abdominal pain (25%), acute gastroenteritis (19.5%), upper respiratory tract infections (15.6%), Impetigo (15.6%), Dental caries(10%), Pityriasis alba (10%). In adults Acid peptic disease (51.6%), Headache (32.5%), hypertension, Upper respiratory infections, scabies and Urinary tract infection (16%), Acute gastroenteritis (13%) was common. Conclusion Earthquake related fear, insect bite and Communicable diseases both airborne and water borne were the commonest findings observed. Therefore basic needs and services like safe water and sanitation, adequate shelter, primary healthcare services and vector-control campaigns are crucial and essential for these displaced populations. KEY WORDS Children, disease pattern, earthquake
Anxiety on Primigravid Women Attending Antenatal Care: A Hospital Based Cross-sectional Study
(Kathmandu University, 2018) Shrestha, S; Pun, KD
ABSTRACT Background High levels of anxiety during pregnancy have adverse effects on mother and baby. Objective To assess anxiety on primigravid women attending Antenatal Care. Method Analytical cross-sectional study was carried out on the primigravid women attending Antenatal Care out-patient department of Dhulikhel Hospital. Perinatal Anxiety Screening Scale (PASS) was used to assess anxiety on 502 women. Data were collected through face-to-face interview using Systematic Random Sampling Technique from May 2017 to December 2017. Chi-square test was applied to test the association between selected variables. All p- values less than 0.05 were considered statistically significant. Result The mean (± Standard deviation [SD]) age of the participants was 23.17±3.9 years. More than half (57.6%) of the women were from the age group 20-25 years. Just above two-fifth (41.4%) of the participants were in the third trimester of pregnancy. Out of 502 pregnant women, nearly half (46.4%) of them were at high risk of anxiety. High risk of anxiety was significantly associated with age and type of family. However significant associations were not seen between high risk of anxiety during pregnancy and residence, educational status, occupation, husband’s occupation and gestational period of women. Conclusion The high risk of anxiety on primigravid women was quite up. Anxiety during pregnancy was more likely to fall on younger women (age <20 years) and joint families in comparison to those women from age twenty and above and nuclear families respectively. KEY WORDS Antenatal care, Anxiety, Primigravid women
Assessment of Health Service Delivery to Address Cardiovascular Diseases in Nepal
(Kathmandu University, 2021) Suwal, PS; Prajapati, D; Bajracharya, S; Shrestha, A; Maharjan, R; Shrestha, S; Jha, N; Koju, RP; Vaidya, A
ABSTRACT Background A health care delivery system is the organization of people, institutions, and resources designed to deliver health services. A comprehensive study to explore cardiovascular health service delivery in Nepal is lacking. Objective This study attempted to assess Nepal’s health system gap on organization and delivery of cardiovascular disease prevention and management services. Method This mixed-method study used the six building blocks of the World Health Organization health system framework: organization; access; coverage, utilization and demand; equity; quality of services; and outcomes. We conducted the desk reviews of national and international documents, performed several key informant interviews, calculated the relevant indicators, and assessed the Strengths, Weaknesses, Opportunities, and Threats of the cardiovascular health service delivery. Result We found that most of the cardiovascular services are concentrated in urban areas, and suffer from poor access, quality, utilization, and coverage in most of the areas resulting in poor health outcomes. Though the services have recently improved due to increased primary care interventions, there is scope for the development of competent human resources, advancement of technologies, development of national protocols, and improved monitoring and supervision. Improved disease system including the medical recording and reporting mechanism to incorporate and reflect the true burden of CVD in Nepal is lacking. Conclusion Despite having health facilities from grassroots to the central level, availability, access, and quality of cardiovascular health services are poor. Further improvement and equitable expansion of promotive, preventive, diagnostic, referral, and rehabilitative cardiovascular services are needed to ensure universal health coverage. KEY WORDS CVDs, Health-service delivery, Infrastructure, Needs-assessment, Nepal
Assessment of Level of Expectation and Awareness towards Dental Implants among Complete Denture Patients and Partial Denture Prostheses Wearers
(Kathmandu University, 2020) KC, Basnyat S; Sapkota, B; Shrestha, S; Rimal, U
ABSTRACT Background Among many options to replace missing teeth, dental implant is widely popular but willingness to have implant treatment and its success depends on patients’ knowledge and expectations as well as the care, skill, and judgment of clinicians. Objective The main objective of this study was to assess awareness, expectation and source of information about dental implant among complete and removable partial denture wearers and to find association between them. Method A questionnaire consisting of 6 close-ended questions was used to assess the level of knowledge and awareness among patients visiting Dental Outpatient Department of Dhulikhel Hospital regarding dental implants as a treatment option for replacing missing teeth. Chi-square test was used to study the association between demographic variables and awareness about implantation. Statistical software SPSS 20.0 was used for data analysis. Result Our results revealed significant difference in age (p=0.001), education level (p=0.03) and occupation (p=0.004) in awareness of dental implant and no significant difference in gender (p=0.567), compared between complete and removable partial denture wearers. Due to lack of awareness, lower educational status and advanced age the patients responded that they “did not know “ in answer to almost all the questions. Conclusion The awareness level of dental implant was low among complete and removable denture patients and this was associated with a low level of education and lack of accurate information about dental implants. KEY WORDS Awareness, Complete denture, Dental implant, Expectation, Partial dentures
Association Between use of Interdental Cleansing Aids Gingival Conditions in Fixed Dental Prosthesis Patients
(Kathmandu University, 2020) KC Basnyat, S; Sapkota, B; Shrestha, S; Rimal, U
ABSTRACT Background The fixed dental prosthesis are one of the most commonly used prosthesis which are difficult for cleansing in dental clinical practice especially the interproximal areas. As a result, periodontal disease most commonly develops in interproximal areas. The efficacy of using dental floss and interdental brushing in addition to tooth brushing reduce plaque and gingival inflammation. Objective To assess gingival condition in patients after placement of fixed dental prosthesis for a period of 3 months who regularly use or do not use dental floss and interdental brushing. Method Patients visiting the Dental Outpatient Department of Dhulikhel Hospital were selected for study. The examination was conducted using basic diagnostic tools (Mouth mirror, periodontal probe and explorer). The total number of patients involved in the study were 200. Teeth and gingiva were examined using the Plaque (Silness and Loe) and Gingiva Index (Löe and Silness). The examinations were conducted after 15 days and 3 months of placement of fixed dental prosthesis along with the oral hygiene instructions. Chi-square test and McNemar Bowker test were done to find statistical association using SPSS 20.0. Result Statistical analysis showed that there was association between frequency of interdental cleaning and plaque index (p=0.012) and gingival index (p=0.036) examined in 15 days and 3 months. Conclusion Use of Interdental cleansing aids was statistically significant to oral hygiene outcomes i.e. plaque index and gingival index. Oral hygiene instructions play a vital role in improving overall oral health. KEY WORDS Fixed partial denture, Gingival index, Oral hygiene, Plaque index
Association of Different Biochemical and Hemodynamic Characteristic with Type 2 Diabetes Mellitus and Hypertension in Nephrolithiasis Patients
(Kathmandu University, 2023) Katwal, BM; Gautam, N; Shrestha, S; Adhikari, R; Baral, H; Jha, SK; Jha, G
ABSTRACT Background Although Nephrolithiasis is a common condition caused by a wide variety of metabolic or environmental disturbances, its being one of the major factor of morbidity. Incidence of kidney stone disease (KSD) is highly affected by metabolic disorders and change in blood pressure and glucose. Objective To find out association of different biochemical and hemodynamic parameters with various glycemic status and hypertension in kidney stone disease. Method A cross sectional study was conducted in patients diagnosed as nephrolithiasis by using re¬nal ultrasonography and underwent nephrectomy between January 2019 to January 2021 in Shahid Dharmabhakta National Transplant Centre (SDNTC). A total of 100 subjects with 60 male and 40 females were enrolled. Glycemic status was categorized based on criteria of American Diabetes Association (ADA) and hypertension was defined as BP ≥ 140/90 mm Hg in right arm supine position. All biochemical and hemodynamic profile was carried out following standard protocol. Result Out of 100 patients enrolled, pre-diabetes accounted for 31% followed by diabetes (4%). However, hypertension comprised of 66% in total subjects. Serum urea, cholesterol and triglyceride level were found to be increased by 84.6%, 67.7% and 64.7% respectively in diabetes followed by increase of 3.9%, 19.5% and 3.1% respectively in prediabetes when compared to normal glycemic condition in nephrolithiasis subjects. Serum fasting blood glucose, creatinine and uric acid level was observed significantly higher (p=0.003, p=0.004, p < 0.001 respectively) in hypertensive patients. Duration of hospital stay was also seen positively correlated with hypertension. Conclusion Not only diabetes, prediabetes also manifests the increased risk of kidney stone disease along with hypertension. There is significant impairment in renal function and lipid profile based on diabetes mellitus and hypertension. Early identifying these systemic diseases, different biochemical and hemodynamic parameters and proper treatment accordingly may minimize risk and prevent serious complication in these patients. KEY WORDS Diabetes mellitus, Hypertension, Nephrolithiasis
Awareness of Burn First Aid Management among Undergraduate Medical Students at a Medical College Teaching Hospital
(Kathmandu University, 2024) Thapa, S; Thapa, B; Shrestha, S
ABSTRACT Background First aid training, educational degree of health sector employee is linked to greater levels of knowledge, awareness and positive outcome in burn injury and its management but studies have shown insufficient level of awareness with unsatisfactory skills not only among professional healthcare workers but also in medical students. Objective To assess the knowledge and confidence of our medical students towards basic burn first aid and management. Method Cross sectional observational study was done using a structured, self-reported 16 multiple choice questionnaire with total marks of 30. Students was graded accordingly: more than 25 points: good, 16-25 points: satisfactory and less than 16 points: poor level of awareness about burn first aid management. Confidence in management of burn related victims, information on receiving of prior formal training in burns and sources of knowledge in students were also evaluated. Result Only a satisfactory level of awareness is seen in medical students 62.1%, 98.2% had not received any kind of formal training and the medical college curriculum was the main source of information (69.2%) followed by journals (47.1%) and internet (26%). 78.4% students felt that the curriculum provided to them was inadequate and only 5.3% students were confident in managing burn first aid. Conclusion There was inadequacy in the knowledge of burn first aid amongst undergraduate students therefore clinical course in managing burns into the undergraduate curriculum is vital. KEY WORDS Awareness, Burns, First aid management, Medical students, Perception
Awareness Regarding Preventive Measures of Avian Influ- enza Among the Adult People of Thimi Municipality, Nepal
(Kathmandu University, 2013) Manandhar, K; Chataut, J; Khanal, K; Shrestha, A; Shrestha, S; Shrestha, S
ABSTRACT Background Avian influenza is considered as a threat to global public health. Prevention and control depends on the awareness of the general population as well as high risk- groups. The avian influenza should be viewed more seriously because it may lead to pandemic influenza when the virus mutates its strain with the common human influenza. Thus, this study aims to explore the awareness regarding preventive measures of avian influenza among the adult population of Thimi Municipality. Objective The objective of this study was to explore awareness regarding preventive measures of avian influenza among the adult population of Thimi Municipality. Methods It is a cross-sectional, population based study. It was carried out in Thimi Municipality from May 15 to June 15, 2012. Pre tested structured questionnaire was used for face to face interview with randomly selected 250 subjects. Results Out of 250 subjects, 123 (49.2 %) were males. The mean age of subjects was 36 ± 11.8 year. Among total subjects, 94.4 percent had heard about avian influenza. The main source of information was television (94.1%). Majority of subjects (84.9 %) thought that keeping infected birds and poultry as the mode of transmission followed by eating not well cooked poultry meat (82.8 %). Out of total study subjects, 165 (66.0 percent) mentioned fever and 138 (55.2 percent) thought fatigue as the signs and symptoms. As for knowledge about preventive measures, majority (85.6%) stated that cleaning the surfaces that had come in contact with the poultry could prevent the disease and 83.2 % had knowledge that the infection could be prevented by washing hands with soap and water after poultry handling. Awareness regarding preventive measures was found significantly low in females, middle adults, illiterates, and house wives. Conclusion The awareness regarding avian influenza was quite satisfactory among the adult people of Thimi Municipality. However level of awareness was seen lower in female, illiterate and middle adult. So that along with large scale mass education, there should be specific health education program for the specific group of population. KEY WORDS Awareness, avian influenza, preventive measures
Bacterial Isolates and its Antibiotic Susceptibility Pattern in NICU
(Kathmandu university, 2013) Shrestha, S; Shrestha, NC; Dongol Singh, S; Shrestha, RPB; Kayestha, S; Shrestha, M; Thakur, NK
ABSTRACT Background Neonatal sepsis is one of the major causes of morbidity and mortality among the newborns in the developing world. Objectives To determine the common bacterial isolates causing sepsis in neonatal intensive care unit and its antibiotic susceptibility pattern. Methods A one year discriptive prospective study was conducted in neonatal intensive care unit to analyse the results of blood culture and to look into the sensitivity of the commonly used antibiotics. Results The blood culture yield by conventional method was 44.13% with nosocomial sepsis accounting for 10.79%. 84.08% were culture proven early onset sepsis and 15.95% were late onset sepsis. Klebsiella infection was the commonest organism isolated in early, late and nosocomial sepsis but statistically not significant. Gram positive organisms were 39.36% in which Staphylococcus aureus was the leading microorganism followed by coagulase negative staphylococcus areus. Gram negative organisms were 60.64% amongst them Klebsiella was the most often encountered followed by Pseudomonas. The most common organism Klebsiella was 87.5% and 78.3% resistance to ampicillin and gentamycin respectively. Among gram negative isolates 87.5% and 77.2% were resistance to ampicillin and gentamycin respectively. Among gram positive isolates 58.5% and 31.5% resistance were noted to ampicillin and gentamycin respectively. Resistance to cefotaxim to gram negative and gram positive isolates were 87.34% and 59.35% respectively. Conclusion Klebsiella is most common organism which is almost resistance to first line antibiotics. Resistance to both gram negative and gram positive isolates among firstline antibiotics and even with cefotaxim is emerging and is a major concern in neonatal intensive care unit. KEY WORDS Antibiotic susceptibility, bacterial isolates, neonates
BK Virus Associated Nephropathy, a Cause of Early Renal Allograft Dysfunction: A Single Centre Study
(Kathmandu University, 2015) Shrestha, S; Kerr, PG; Kanellis, J; Polkinghorne, KR; Brown, F; Yii, M; Mulley, W
ABSTRACT Background BK virus associated nephropathy (BKVN) is an important cause of early graft dysfunction in renal transplant recipients. The present study was carried out to determine the burden of BKVN in a single renal transplant centre in Australia. Method A retrospective analysis of de novo renal transplant recipients from 2010 to 2013 was performed to identify biopsy proven BKVN. Estimated glomerular filtration rate (eGFR) was compared at baseline, at BKVN diagnosis and 3 and 12 months post- diagnosis. Result Of the 317 de novo renal transplants recipients in the study period, 20 (6.3%) developed BKVN. The mean age was 54.8 ± 13.1 years and 13 (65%) were male. The mean time from transplant to BKVN was 8.7 ± 6.7 months with 17 (85%) diagnosed within 12 months. Four recipients each were diagnosed BKVN on 3 and 12 month surveillance biopsy. Six (30%) had normal eGFR at diagnosis. Mean eGFR at diagnosis was 38.8 ± 19.2 ml/min/1.73 m2, which was significantly lower (p < 0.01) than that at baseline (50.3 ± 16.4 ml/min/1.73 m2). eGFR improved numerically at 3 and 12 months post-diagnosis, however the difference was not significant. One patient had graft failure, 19 months after diagnosis. Conclusion BKVN generally occurs in first post-transplant year and is an important cause of early graft dysfunction. Surveillance biopsy helps in detecting subclinical BKVN. KEY WORDS Immunosuppression, renal transplant, surveillance biopsy.
Challenges and Opportunities of Public Health Research in Nepal
(Kathmandu University, 2014) Shrestha, S
NA
Clinical and Laboratory Profile of Children with Eosinophilia at Dhulikhel Hospital
(Kathmandu University, 2012) Shrestha, S; Dongol Singh, S; Shrestha, NC; Shrestha, RPB
ABSTRACT Background Eosinophilia in children is commonly caused by or parasitic, allergic and immunologic problems. Objectives To study clinical and laboratory profile of patients with eosinophilia and to identify possible causes. Method A prospective and descriptive study was conducted from January 2009- December 2011. All the cases of eosinophilia with symptoms and signs of single or multiple organ were included. The known caused of eosinophilia like allergy, asthma and drugs were excluded. Results During three years period, 84(2.41%) cases had eosinophilia with single or multiple organ involment. 14.3%, 39.3% and 46.4% had mild, moderate and severe eosinophilia respectively, with cases of hypereosinophilia comprising 85.7%. Eosinophilia is seen predominantly in tamang caste with overall age ranging from 1-14 years. Most common symptoms and signs are abdominal pain (67.9%) hepatomegaly (59.5%) respectively. Gastrointestinal system was most commonly involved organ followed by respiratory system. Nineteen percent had polyserositis involving pleural, pericardial effusion and ascites at presentation. Out of 84 patients only nine serum samples were able to be sent for parasitological analysis. sixteen had identifiable and/ or possible causes. Serum sample for parasitological analysis revealed fascilosis, filariasis, strongylosis stercoralis and toxocariasis. Conclusion Eosinophilia is more common among tamang poulation in our study. Most common symptoms and signs are abdominal pain and hepatomegaly respectively. Parasitic infection seems to be the most common cause however further study has to be done to reach final conclusion. KEY WORDS Children, eosinophilia
Clinical Profile and Knowledge, Attitude and Practice of Patients Presenting with Headache
(Kathmandu University, 2023) Ghimire, MR; Thapa, M; Shrestha, AM; Bhattrai, S; Ghimire, S; Sharma, N; Soti, B; Dutta, Ashish; Shrestha, S; Pokharel, M; Poudel, R; Thapa, LJ
ABSTRACT Background Headache disorders are among the most prevalent and disabling conditions worldwide. People, however, do not seek early advice in developing countries. Objective To study clinical profile of patients with headache and their existing knowledge, attitude, and practice regarding primary headaches. Method Descriptive cross-sectional study conducted among 196 patients. Patients were selected using purposive sampling technique fulfilling inclusion criteria. Patients were interviewed based on semi-structural headache questionnaire and data was collected from 4th October to 21st December 2021. Descriptive statistics was used for analysis and interpretation. Result Among 196 participants, 74% were females, 29.6% of patients were between (31 to 40) years of age. The majority were Hindu and belongs to province 3; 36.7% were homemakers, and 32.2% were literate. Migraine headache was the most common type with 14.3% reporting aura. Most reported headache within 1 to 5 years. The commonest triggers were sunlight 64.8%, crowd 54.7%, stress 39.8%, fasting state 31.7%, cold 26.3%. Almost 39% believed that headache could be a chronic neurologic disorder. Majority had knowledge of the causes, triggers, and the relieving factors. Fifty-five percent seek help of a doctor for first time, and the rest seek help of a pharmacist or self-medication. Only 19% tried to manage the headache triggers; 66.8% felt that lifestyle modification is the best treatment for headache comparing drugs. Conclusion Migraine headache was the commonest headache occurring at middle age group with sunlight being the most common trigger factor. Lifestyle modification was perceived to be the best for headache management. KEY WORDS Attitude, Clinical profile, Headache, Knowledge, Practice
Clinical Profile of Invasive Pneumococcal Disease in Patan Hospital, Nepal
(Kathmandu University, 2011) Chhetri, UD; Shrestha, S; Pradhan, R; Shrestha, A; Adhikari, N; Thorson, S; Pollard, AJ; Murdoch, DR; Kelly, DF
ABSTRACT Background Pneumococcal infection is one of the leading causes of pneumonia, meningitis and septicemia in developing countries. It accounts for one million deaths each year in children. Objectives The objective of this study is to see the clinical profile of invasive pneumococcal disease, antibiotics sensitivity pattern and prevalent serotypes in children admitted at Patan Hospital. Methods This is a retrospective analytical study conducted in the department of Paediatrics, Patan hospital. The lab data of those children who grew pneumococci in their blood, cerebrospinal fluid or body fluids over a period of 3 years (January 2007 to Dec 2009) were collected and the case files were then studied. Results Out of 42 cases of invasive pneumococcal diseases studied admitted diagnoses included pneumonia, febrile seizure, bacteremia or septicemia, meningitis, acute gastroenteritis and glomerulonephritis. Twenty seven of them were children under five. The male to female ratio was 1.7:1. On investigation 64%, 52% and 5% of the patients had leucocytosis, anaemia, and leucopenia respectively. Twenty six of them had radiological changes suggestive of pneumonia. Streptococcus pneumoniae grew in 38 blood samples, 5 cerebrospinal fluid and 3 pleural fluids. Almost all of these isolates were sensitive to penicillin, cefotaxime, amoxycillin, choloramphenicol, erythromycin and ofloxacin and resistant to cotrimoxazole and gentamicin.Pneumococcal serotypes found in our study were 1, 14, 5, 23B, 6B, 8, 9A, 9V, 10A, 15 and 23F (11 serotypes). Conclusions Penicillin is still the most effective antibiotic for streptococcal infection in our study. Of the pneumococcal serotypes identified; 36% were covered by the 7-valent pneumococcal conjugate vaccine, 54% each by PCV-10 and PCV-13, and 72% by the e 23 valent vaccines. KEY WORDS Invasive Pneumococcal Disease, Serotypes, Streptococcus pneumoniae,
Clinico-Pathological Correlation of Colorectal Diseases by Colonoscopy and Biopsy
(Kathmandu University, 2017) Makaju, R; Amatya, M; Sharma, S; Dhakal, R; Bhandari, S; Shrestha, S; Gurung, R; Malla, BR
ABSTRACT Background Colonoscopy is a simple, safe and well tolerated procedure, the visualization of the mucosa of the entire colon and terminal ileum to detect intestinal abnormalities and obtain biopsy leads to the early detection of the pathologic process and institution of appropriate therapy. Objective To find out the correlation between clinical and histopathological diagnosis of colorectal diseases. Method A cross-sectional study was conducted at Department of Pathology, Dhulikhel Hospital, Kathmandu University Hospital from Jan. 2015 - Jan. 2016. Altogether, 95 colonoscopic biopsies were examined and recorded clinical data using pre-designed pro forma. The specimens were grossed, processed and embedded using standard procedures, stained with Hematoxylin and Eosin stain and were analyzed using light microscope. Special stains Ziehl Neelsen, and Periodic Acid-Schiff were used whenever necessary. Result Analyses of 95 cases of colonoscopic biopsies were done. The most common clinical diagnosis was polyp in 49 cases (51.57%) and the common histopathological diagnosis was non-neoplastic polyps 31(32.63%). There was no correlation in cases for suspected infectious colitis, microscopic colitis and hemorrhoids. Conclusion Colonoscopy is incomplete without biopsy and histopathology is the gold standard for the diagnosis of colorectal lesions. The clinico-pathological correlation for neoplastic lesions was excellent. However, correlation was poor in non-neoplastic lesion. KEY WORDS Colonoscopy, colorectal lesions, histopathology

Browsing by Author "Shrestha, S"

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