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Browsing by Author "Yadav, DK"

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    Assessment of Sexual Dimorphism in Mandibular Ramus: An Orthopanoramic Study
    (Kathmandu University, 2021) Koju, S; Maharjan, N; Rajak, RRK; Yadav, DK; Bajracharya, D; Ojha, B
    ABSTRACT Background Mandible is the largest and strongest bone of the face, is very durable, and hence remains well preserved than many other bones. In cases of mass disasters where an intact skull is not found, the mandible may play a vital role in sex determination as it is the most dimorphic bone of the skull. Morphometric analysis of mandibular ramus provides highly accurate data to discriminate sex. This can be accomplished by the use of panoramic radiography which is widely available and is used routinely to assess the mandibular structures. Objective To evaluate and compare the various parameters of the mandibular ramus and to determine the usefulness of the mandibular ramus as an aid in sex determination. Method Orthopantomograms of 140 samples (70 males and 70 females) were collected from the archives and traced manually on matte acetate tracing paper. Various parameters of mandibular ramus were measured on the right and left sides. The obtained measurements were subjected to discriminant function analysis. Result Mandibular measurements on the right side were greater than on the left side. However, only the ramus breath (minimum and maximum) and projective height of ramus were statistically significant (p < 0.05). All the measurements were higher for males than females. F-statistic values indicated that the highest sexual dimorphism was seen with the projective height of ramus and least with minimum ramus breath. Conclusion Mandibular ramus measurements can be a useful tool for gender determination and can be an essential tool in forensic science especially when there is damaged or partially preserved mandibles and may be helpful for medico-legal purpose in Nepal. KEY WORDS Dimorphism, Discriminant analysis, Gender, Mandible, Panoramic, Ramus
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    Laparoscopic Adrenalectomy for Adrenal Mass
    (Kathmandu University, 2025) Adhikari, MB; Yadav, DK; Maharjan, B; Gautam, RK; Mishra, P; Basnet, B; Khadga, A
    ABSTRACT Adrenal gland tumors, including both benign and malignant forms, are increasingly detected due to advancements in imaging techniques. This prospective study, conducted at Nepal Mediciti Hospital evaluated thirteen patients diagnosed with adrenal masses, all confirmed benign via contrast-enhanced computed tomography. Functional assessment, preoperative endocrinological and anesthesiological evaluations and pharmacological preparations were conducted as needed. All patients underwent successful lateral transperitoneal laparoscopic adrenalectomy, performed by a single surgeon. The study population had a female predominance (9 females, 4 males), with tumor sizes ranging from 2 to 9 cm. No surgeries required conversion to open procedures, and postoperative outcomes were favorable, with no mortality or re-operations. Complications were minimal, including transient blood pressure elevation in one pheochromocytoma case and one postoperative chest infection. Histopathological findings included aldosterone-producing adenomas, cortisol-producing adenomas, and pheochromocytomas. The study supports the continued use of laparoscopic adrenalectomy as the preferred surgical method for adrenal tumors. KEY WORDS Adrenal gland, Adrenal tumor, Laparoscopic surgery
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    Outbreak of Cholera in Tilathi VDC Saptari Nepal
    (Kathmandu University, 2012) Yadav, DK; Tamrakar, D; Baral, R; Jha, P; Gautam, S; Pokharel, PK
    ABSTRACT Background On 2011, Cluster of cholera cases was reported in the Tilathi VDC of Saptari, Nepal. Objective The outbreak was investigated to identify the etiological agent and possible source of infection and guiding the prevention and control measures. Methods Demographic and clinical details were collected from the suspected case-patients, and the outbreak was described by time, place, and person. Focus group discussion and Key informant interview were conducted to assess the practice of sanitation, source of drinking water and probable cause of diarrheal disease. Five stool samples and 10 water samples of tube well and ponds were collected and microbiological study was done in BPKIHS Dharan. Results A total of 111 persons suffered with diarrhea and 02 died of it (attack rate 3.05%, case fatality rate 1.8%). All age groups were affected with disease (median age 26 yrs) and males were affected more than females. Descriptive epidemiology suggested the clustering of cases were around the pond where they clean utensils, take bath and wash clothes. The Vibrio cholerae 01 El Tor, Ogawa serotype was isolated in 03 out of 05 suspected stool samples and in all three of the pond water samples. They reported that most of the houses do not have the toilet and people do not wash their hands regularly with soap and water after defecation. Conclusion Vibrio cholerae was the causative agent behind the outbreak and probable source of infection was the problematic pond water which they used for different purpose. Immediate chlorination of the pond was recommended to halt further spread of the epidemics. KEY WORDS Cholera, outbreak, tilathi, saptari

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