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Publication Child mortality in Jumla district of Nepal, 1971 through 1995: Trends and socio-economic differentials(Nepal Health Research Council, 2002) Geater, A; Ulstein, M; Thapa, N; Chongsuvivatowng, VPublication Cross-border collaboration on Vector-borne disease control in Bangladesh, Bhutan, India and Nepal(Nepal Health Research Council, 2002) Wijeyaratne, PPublication Visceral Lsishmanissis related knowledge, attitude and practices in rural endemic villages of Eastern Nepal(Nepal Health Research Council, 2002) Joshi, A BPublication Environmental factors associated with the distribution of Kala-azar in Nepal(Nepal Health Research Council, 2002) Bhatt, L R; Regmi, S; Joshi, A B; K.C., I SPublication An epidemiological study on acute zink phosphide poisoning in Nepal(2002) Adhikari, R P; Lohani, S P; B.C., R KPublication Quality survey of Raw milk samples in Eastern Nepal: A microbiological assessment in milk chain system(Nepal Health Research Council, 2002) Ranjit, D K; Adhikari, R P; Regmi, S; Shah, P KPublication Spectrum of Liver diseases in Liver clinic at Bir hospital(Nepal Health Research Council, 2002) Pradhan, B R; Mishara, A K; Shrestha, J KPublication Rapid immunochromatographic Optimal assay for detection of plasmodium vivax and plasmodium falciparum malaria from two endemic districts of Nepal(Nepal Health Research Council, 2002) Sherchand, J BPublication Profile and risk factors analysis on surgical outcome of rhegmatogenous retinal detachment(Nepal Health Research Council, 2002) Koirala, S; Shrestha, J K; Abdullah, ZPublication Causes of Neonatal deaths at Patan hospital(Nepal Health Research Council, 2002) Adhikari, N; Shrestha, SPublication The effect of improved cool-stove on the incidence of child-hood pneumonia in Jumla(Nepal Health Research Council, 2002) Pathak, R PPublication Dermatoglyphics: a study of finger tip patterns in bronchial asthma and its genetic disposition.(Kathmandu University, 2003) Gupta, UK; Prakash, SFinger tip patterns of sixty patients of Bronchial Asthma were compared with that of 50 control cases. Higher frequency of whorls was observed in first digit of both generations of bronchial asthma patients in comparison to controls. In all digits the frequency of arches was reduced in both generations of bronchial asthma patients as compared to controls. These findings proved highly significant statistically (P valve : < 0.001). There was no significant change in finger tip patterns in II, & III digit, but, IV & V digit showed significant reduction in frequency of loops in both generations of bronchial asthma patients as compared to controls. There is scope of more studies in this field and the significant findings can be included as part of clinical picture of bronchial asthma. Key words: Dermatoglyphics; Arch; Whorl; Loop; Triradius & Core.Publication Environmental noise induced hearing loss in Nepal(Kathmandu University, 2003) Joshi, SK; Devkota, S; Chamling, S; Shrestha, SIntroduction: 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 A profile of menstrual disorders in a private set up(2003) Padhye, S; Karki, C; Padhye, S BMenstruation and its disorders are still considered unholy & impure and are not yet recognised as significant reproductive health morbidity. Therefore a prospective study was carried out at a private clinic for a period of three months where total number of patients coming with current or past menstrual problems are 525. This number did not include pregnant women or those on any hormonal medications or having dysfunctional uterine bleeding. This study aimed to find out the incidence of Menstrual Morbidity and their mode of presentation. It has also tried to find out these women's age, parity, age of menarche and number, following discriminating traditional rituals during their 1st and regular menses, their family planning status and the districts from where they came to Kathmandu for their treatment. In this study, menstrual morbidity was found to be 43.75%. Approximately 60% of women having menstrual complaints had absolutely normal menstrual cycle; whereas 13% of them had irregular, 17% of them had prolonged and 6% had short menstrual cycle. A significant number (46%) of women although suffering from menstrual problems presented with other symptoms like vaginal discharge, pain lower abdomen, subfertility, urinary problems, abdominal lumps and for cuT check-ups. 3% of the women who presented with vague, non-specific complaints asking for a general check up had one or the other menstrual problem. Although approximately 69% of these women were from the age group of 20 - 39 years, 4% of them were adolescents and 27% above 40 years. It was observed that although approximately 78% of these women were primi and multiparous ladies, 22% were unmarried and nulliparous suffering from various menstrual morbidities. More than 55% of these women had their menarche at the age of 12-14 years. It was not surprising to note that more than 90% of women had to follow the traditional unhealthy and unsociable rituals during their first menstruation. More than 75% of them had to follow the discriminating traditional rituals which consider a menstruating woman “untouchable” for 5 days of every month throughout their active reproductive lives. 20% of these women were using non-hormonal contraceptive methods, out of which >50% had undergone permanent sterilisation. It was a matter of pride to note that this clinic was providing the health care services to the adolescents and women of 13 zones and more than 52 districts of the country. Key words: Menstrual morbidity, traditional rituals, Menarche, subfertility, nulliparousPublication Inter pleural catheter technique for perioperative pain management(Kathmandu University, 2003) Shrestha, BR; Tabadar, S; Maharjan, S; Amatya, SRNA.Publication Evaluation of undergraduate medical students: need for a change(Kathmandu University, 2003) Karki, DBNA.Publication Generalized anxiety disorder and personality traits(Kathmandu University, 2003) SC, SharmaThere are an increasing number of studies which show that certain personality traits predispose an individual to develop psychiatric disorders. The current study tried to examine whether neuroticism is more associated to generalized anxiety disorder. Methodology: A sample of 28 cases of Generalized Anxiety Disorder (GAD) was selected in the study and the degree of neuroticism was measured using Eysenck’s Personality Questionnaire (EPQ). Result: It was found that neuroticism correlated significantly with GAD than other parameters of EPQ. Conclusion: Neuroticism and its inherent traits were more prevalent in patients suffering from GAD. Keywords: EPQ, BAI, Anxiety, GADPublication Publication Epilepsy in children: an epidemiological study at Kathmandu(Kathmandu University, 2003) Shakya, KN; Shrestha, R; Baral, MRObjectives: To analyze the relative frequencies of various epileptic seizures and to study the age at onset ofdifferent seizure types in Nepalese children. Design: Prospective study. Setting: Hospital outpatient based inKathmandu, Nepal, between November 2001 to October 2002. Participants: 50 children diagnosed as epilepsyexcluding neonatal and febrile seizures. Main outcome measure: Diagnosis and classification of casesaccording to the International Classification of Epilepsy of the International League Against Epilepsy [ILAE]and number of patients in each category with various ages at first seizure. Result: Generalized seizures (78%)were 3.54 times commoner than partial seizures (22%). Most frequent seizure types were generalized tonicclonic (36%), tonic (16%), complex partial (14%), atonic (12%) and absence (10%). Generalized clonic, simplepartial and partial with secondary generalization, each had less than 5% frequencies. In 40% cases the firstseizure occurred when aged between 2-5 years. In partial seizures the peak age at onset was observed below 6years while primary generalized seizure was more frequently seen in age group 2-10 years. Conclusion: Morepaediatric patients with primary generalized seizures (78%) were observed than with partial seizures (22%). Inthis age group, the most frequent seizure type was generalized tonic clonic (36%) with the peak frequency ofage at onset of seizures in 2-5 years.Key words: Epilepsy, Frequency, Age at onset.Publication Study of patients presenting with symptoms of peripheral neuropathy and thickened greater auricular nerve(2003) Neopane, A; Upadhyaya, B; Dungana, S; Karki, DBObjective: To analyze symptoms and make a clinical diagnosis of leprosy in patients presenting with symptoms of peripheral neuropathy and found to have thickened greater auricular nerve. Design: Cross- sectional study Setting: Kathmandu Medical College Teaching Hospital, Sinamangal, Kathmandu. Patients attending the medical out patient department of this hospital were taken in the study. Materials and methods: 40 patients presenting with symptoms of peripheral neuropathy and are found to have thickened greater auricular nerve were included. Results: Thickened greater auricular nerve and sensory symptoms showed male predominance (97.5%). Mean age of involvement was 28.65 years. The symptom most frequently complained of was chest pain (75%), followed by pins and needle sensation 67.5%, burning of the upper extremities, nape of the neck and chest 57.5%, palpitation 45%, disturbed sleep mostly said to be due to burning 35%, sweating 20%, dizziness17.5%, shortness of breath 7.5%, and numbness of the limbs in 2.5%. None of the patients had somatic neuropathy. Autonomic neuropathy was present in 42.5 %. Conclusions: 1. In endemic areas patients with thickened peripheral nerve and sensory symptoms should be diagnosed clinically as primary neuritic leprosy. 2. In absence of objective loss of somatic sensation autonomic neuropathy may be the only early indicator of neuritis. 3. Close follow up of these patients is necessary. Key words: peripheral neuropathy, primary neuritic leprosy, autonomic neuropathy, follow up