Journal Issue: Volume: 10, No 3, Issue 39, JUL-SEP, 2012
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Volume
Number
Issue Date
2012
Journal Title
Journal ISSN
1812-2027
Journal Volume
Articles
A Study of Prevalence of Taenia Infestation and Associated Risk Factors Among the School Children of Dharan
(Kathmandu University, 2012) Sah, RB; Pokharel, PK; Paudel, IS; Acharya, A; Jha, N; Bhattarai, S
ABSTRACT
Background
Taenia prevalence has remained high among certain ethnic groups and occupational
diseases in Nepal. Taenia saginata and Taenia solium species are worldwide in
distribution. Infection is found most often in rural areas of developing countries
with poor hygiene and living in close contact with pigs and eating undercooked
pork meats. This allows the tapeworm infection to be completed and its cycle to
continue.
Objectives
To measure the prevalence of taenia infestation and to identify risk factors
associated with taenia infestation among the school children of Dharan.
Methods
A cross sectional study was conducted among 935 Government and private school
going children of Grade VI, VII, and VIII of Dharan during 2007 to 2008. Stratified
random sampling method was applied to choose the schools and the study
subjects. The prevalence was calculated, Chi-square test was used to measure the
association of risk factors and taenia infestation.
Results
Taenia species was found to be high (5.5%) among the school children of Dharan.
Infection rate of taenia among the male children (6.0%) was slightly higher than
female (4.8%). There were no cases of taenia infestation found among children
washing hands with soap. Regarding meat consumption in the non-vegetarian
group, taenia infestation was found higher (6.5%) among pork eating than non-
pork eating (4.7%). No significant relationship was traced among the factors in the
causation of taenia infestation although slight indications present.
Conclusion
Taenia species was found very high among the school children of Dharan. No such
association was found with the risk factors.
KEY WORDS
Prevalence, risk factors, taenia infestation, school children, Dharan
Risk Factors for Stunting Among Children: A Community Based Case Control Study in Nepal
(Kathmandu University, 2012) Paudel, R; Pradhan, B; Wagle, RR,; Pahari, DP; Onta, SR
ABSTRACT
Background
Stunting, a chronic condition, is an underlying cause of child morbidity and mortality
in Nepal. This study intends to identify the factors causing stunting among children
that will help to prioritize the strategies at the district level.
Objective
The objective of the study was to identify the risk factors for stunting among
children of age between 6 to 59 months.
Methods
The study was based on community-based case control design in the mid-west,
Surkhet Nepal from August to September 2010. The cases were stunted children
and controls were the children without stunting. Data was collected by interviewing
those children’s mothers and measured length/height of 118 children as cases and
236 children as controls. Logistic regression analysis was performed to identify the
best model of factors leading to stunting. Odds ratio and 95% confidence interval
were used as a measure of association.
Results
Socio-economic risk factors for stunting comprised mothers without earning
(OR=3.11, 95% CI 1.26-7.65), food deficit families (OR=4.26, 95% CI 1.73-10.45)
and care taker of the children other than mother (OR=3.02, 95% CI 1.19-7.70).
Environmental risk factors for stunting consisted of kitchen without ventilation and
children exposed to pesticide. Inappropriate exclusive breast feeding (OR=6.90, 95%
CI 2.81-16.97), complementary feeding less than four times a day (OR=3.60, 95% CI
1.32-9.95) and dietary diversity below WHO standard (OR=4.06, 95% CI 1.70-9.67)
were factors of stunted children. Diarrhea was found significantly associated with
stunting (OR=7.46, 95% CI 2.98-18.65).
Conclusions
Stunting was found to be as a result of multiple factors such as socio-economic,
environmental and inappropriate feeding practices.
KEY WORDS
Children, community, case-control study, risk factors, stunting
Comparison of Ketamine, Fentanyl and Clonidine as an Adjuvant During Bupivacaine Caudal Anaesthesia in Paediatric Patients
(Kathmandu University, 2012) Singh, J; Shah, RS; Vaidya, N; Mahato, PK; Shrestha, S; Shrestha, BL
ABSTRACT
Background
Caudal epidural analgesia with bupivacaine is very popular in paediatric anaesthesia
for providing intra- and postoperative analgesia. Several adjuvants have been used
to prolong the action of bupivacaine.
Objectives
To compare the efficacy of ketamine, fentanyl and clonidine in terms of quality and
duration of analgesia they produce when added with caudal bupivacaine by single
shot technique in children.
Methods
Eighty children, age one to ten years, undergoing sub-umbilical surgery, were
prospectively randomized to one of four groups: caudal analgesia with 0.75 ml/
kg of 0.25% bupivacaine in normal saline (Group B) or caudal analgesia with 0.75
ml/kg of 0.25% bupivacaine with 1 μg/kg of clonidine in normal saline (Group BC)
or caudal analgesia with 0.75ml/kg of 0.25% bupivacaine with ketamine 0.5mg/kg
(Group BK) or caudal analgesia with 0.75ml/kg of 0.25% bupivacaine with fentanyl
1mcg/kg (Group BF). Post-operative pain was assessed for 24 hours using the FLACC
scale.
Results
The mean duration of analgesia was significantly longer in Group BC (629.06 ± 286.32
min) than other three groups P < 0.05. The pain score assessed using FLACC scale
was compared between the four groups, and children in Group BC had lower pain
scores, which was statistically significant. The requirement of rescue medicine was
lesser in Group BC. Clonidine in a dose of 1 μg/kg added to 0.25% bupivacaine for
caudal analgesia, during sub-umbilical surgeries, prolongs the duration of analgesia
of bupivacaine, without any side effects in compare to fentanyl or ketamine.
Conclusion
We conclude that clonidine in a dose of 1 μg/kg, added to 0.25% bupivacaine for
caudal analgesia and administered as a 0.75 ml/kg mixture in children, for sub-
umbilical surgery, significantly prolongs the duration of post-operative analgesia
when compared to 0.75 ml/kg of 0.25% bupivacaine in normal saline than 0.75
ml/kg of 0.25% bupivacaine with ketamine 0.5 mg/kg or 0.75 ml/kg of 0.25%
bupivacaine with fentanyl 1 mcg/kg or 0.75 ml/kg of 0.25% bupivacaine alone,
without any side effects.
KEY WORDS
Bupivacaine, caudal analgesia, clonidine, fentanyl, ketamine, post-operative
analgesia, sub-umbilical surgery
Clinical Profile of Patients Presenting with Breast Cancer in Nepal
(Kathmandu University, 2012) Acharya, SC; Jha, AK; Manandhar, T
ABSTRACT
Background
Breast cancer is the second most common cancer in women in Nepal. Even though
the evaluation and treatment of patients is done as per western guidelines, there are
considerable variations in risk factors, presenting stage and prognostic factors such as
receptor status.
Objective
To evaluate the clinical profile of patients presenting with breast cancer in Nepal.
Method
The study was conducted at Department of Radiotherapy and Oncology, Bir Hospital
and Department of Radiation Oncology, BP Koirala Memorial Cancer Hospital, Bharatpur
from 16th July 2007 to 15th June 2008 for a period of one year and 114 patients were
enrolled. Detailed history, clinical examination and necessary investigations performed.
Histological features including receptor status were recorded. Tumor Node Metastasis
(TNM) staging system was as per American Joint Committee on Cancer (AJCC), fifth
edition. Data was collected in preformed case report form and was managed using
SPSS version 13.
Results
The incidence was high (34.2%) among perimenopausal women age ranging from
41 to 50. The majority of women presented with lump (98.2%) and others with pain
(21.9%), nipple retraction (16.7%), ulceration (7.9%), discharge (7%), or symptoms
of metastasis (6.1%). Regarding receptor status, the majority (64.0%) were Estrogen
receptor (ER) and Progesterone receptor (PR) negative with 21.9 percent. ER+PR+,
Younger women were more likely to be both ER and PR negative. Where available, Her-
2 immunohistochemistry showed that 45.0 % of post menopausal women were Her-2
neative, compared to 64.0 % of premenopausal women. Incidence of Triple negative
disease was 41.3 %. The most common stage at presentation was stage III (26.3%).
Conclusion
Majority of patients were perimenopausal, presenting with locally advanced disease
(Stage III and Stage II) and with average tumor size two to five cm and were hormonal
receptor negative. These findings are similar to other South Asian population but is
inverse than profile reported in Western populations.
KEY WORDS
Breast Cancer, Estrogen Recepter (ER), Progesterone Recepter (PR), Human Epidermal
Growth Factor Receptor - 2 (Her-2/neu)