Journal Issue: Vol 8 No 1 Issue 16 April 2010
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Volume
8
Number
1
Issue Date
2010-04
Journal Title
Journal ISSN
1999-6217
Journal Volume
Volume 8
(8)
Articles
Scenario of Extrapulmonary Tuberculosis in a Tertiary Care Center
(Nepal Health Research Council, 2010) Thakur, N K; Mohammad, A; Makaju, R
Background: Tuberculosis is  a worldwide disease and one of the major health problems of Nepal. Extrapulmonary tuberculosis is increasing all over the world. The main aim of this study was to assess the frequency of extrapulmonary tuberculosis in various organ systems of the body and to assess the pattern of disease in different age groups and gender.
Methods: This observational retrospective study was carried out from December 2003 to October 2009 at the Department of Pathology, Kathmandu University Hospital, Kavre, Nepal. A total of 259 extrapulmonary tuberculosis cases diagnosed by fine needle aspiration cytology and biopsy were included. Frequency of extrapulmonary tuberculosis in the lymph nodes in relation to age and sex were studied.
Results: Lymph nodes tuberculosis was present in 179 (69.11%) cases. Among all extrapulmonary tuberculosis, 132 (50.56%) cases were in males and 127 (49.04%) were in females. Out of total 179 tuberculosis of lymph nodes, 116 (74.35%) were seen in age group of 25 years and above (p=0.018)Â and 86 (48.04%) in males and 93 (51.95%) in females (p=0.18).
Conclusions: Extrapulmonary tuberculosis is common in lymph nodes, equally in both sexes and more in age group of 25 and above. Therefore, this age group should be focused upon more for investigation and management of extrapulmonary tuberculosis.
Key words: biopsy, fine needle aspiration cytology, lymph nodes, tuberculosis
Primary Salivary Gland Tumors in Eastern Nepal Tertiary Care Hospital
(Nepal Health Research Council, 2010) Joshi, R R; Nepal, A; Chettri, S T; Bhattarai, M; Ghimire, A; Karki, S
Methods: A retrospective observational study of all the salivary gland tumors treated in the department of Otolaryngology, B. P. Koirala Institute of Health Sciences during April 2004 to March 2009 was done. Age, sex, presenting features, radiological findings, histopathological type of the tumor and type of surgery were recorded and descriptive analysis was done to calculate frequencies, percentage and their relations.                      Â
Background: The knowledge of the distribution and pattern of salivary gland tumors in the tertiary care center can provide overview of the disease pattern in the region. It also helps in planning the strategies to treat the disease and launch the awareness program in the community to this largely curable disease.
Results: Out of total 51 cases, 81% (n=41) were benign and 19% (n=10) malignant tumors. Male to female ratio was 1:2.1.Mean age for benign and malignant tumors were 32.3 and 46.5 years respectively. Parotid tumor outnumbered all other sites comprising 69%, followed by submandiibular 18% and minor glands 13%. Pleomorphic adenoma was the commonest tumor (76%) of all primary salivary gland tumors. Benign to malignant tumor ratio of parotid, submandibular and minor glands were 6:1,3.5:1 and 1.3:1respectively. Adenoid cystic carcinoma (40%) and mucoepidermoid carcinoma (30%) were commonest malignant tumors.
Conclusions: The principal site for salivary gland tumors in eastern Nepal population was the parotid and the pleomorphic adenoma outnumbered all other tumors. Most of the cases in both benign and malignant group presented with painless lump often misleading the gravity of disease.                   Â
Key words: parotid, pleomorphic, salivary, submandibular, tumor
Maternal and Infant Mortality in Mahottari District of Nepal
(Nepal Health Research Council, 2010) Maskey, M K; Shah, R; Shah, R
Background: Reducing maternal mortality by three quarters and under-five mortality by two-thirds between 1990 and 2015 are the targets of UN Millennium Development Goals as well as of the national safe motherhood programme of Nepal. This study was undertaken by Nepal Health Research Council mainly to identify the maternal and infant mortalities in Mahottari district.
Methods: A descriptive observational study was carried out of maternal and child death over two year period before the time of survey was carried out in eleven VDCs of Mahottari District and two wards of the Jaleshwor municipality. Data were collected in three stages: first, FCHVs collected the information regarding birth, maternal and infant death, which were cross-checked later.      Â
Results: Maternal mortality ratio was estimated at 380 per 100,000 live births, and early neonatal mortality rate, neonatal mortality rate and infant mortality rate were found 32, 39 and 52per 1,000 live births respectively. The highest deaths in infants were among Dalits, whereas it was among Muslims for maternal mortality. All maternal deaths occurred at a distance of more than 2 hours. Male-to-female ratio for infant mortality was 1:3. The major cause of maternal deaths was post-partum haemorrhage, while it was sepsis among infant deaths.
Conclusions: Both maternal mortality ratio and infant mortality rate of the district were higher than the national average and appeared commensurate with the socio-economic  status and health facilities of the district when compared with another similar Terai district of Bara.
Key words: infant mortality rate, maternal mortality ratio, millennium development goals
Environmental Burden of Acute Respiratory Infection and Pneumonia due to Indoor Smoke
(Nepal Health Research Council, 2010) Dhimal, M; Baral, K; Shrestha, N; Dhakal, P; Maskey, M K
Background: ARI and pneumonia is one of the major public health problems in Nepal which always ranks highest position among the top ten diseases. One of the risk factor of ARI and pneumonia is indoor smoke from kitchen where primary source of cooking is solid biomass fuel. This study was carried out in order to estimate the burden of ARI and pneumonia due to indoor smoke. ARI and pneumonia was chosen as it is one of the significant public health problem among under five children in Nepal and responsible for high number of premature deaths.
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Methods: A cross-sectional study was conducted in Dhading district. Multistage cluster sampling technique was used for data collection considering ward as a cluster. The environmental burden of ARI and pneumonia due to indoor smoke was calculated using the WHO Environmental Burden of Disease Series.
Results: About 87 percent of households were using solid biomass fuel as a primarysource of fuel. The under five children exposed to solid fuel use was 41313. The total 1284 Disability Adjusted Life Years were lost due to ARI and pneumonia and about 50 percent of it was attributed by Indoor smoke in household.
Conclusions: The solid biomass fuel was primary source of energy for cooking in Dhading district which is attributing about 50 percent of burden of ARI and pneumonia among under  five children.
Key words: acute respiratory infection,environmental burden of disease, indoor smoke, pneumonia, solid fuel us
Intrauterine Condom Tamponade in Management of Post Partum Haemorrhage
(Nepal Health Research Council, 2010) Pandey, S; Amatya, S; Thapa, K; Malla, B
Background: Uterine tamponade is often used to control post partum hemorrhage. Among various methods, condom Foley’s catheter  tamponade is simple, easy to use and is believed to be effective. The study evaluates outcome of condom Foley’s catheter tamponade.
Results: The condom tamponade stopped bleeding in all the cases. Average amount of blood loss was 1221ml. No complications were noted.
Methods: In this prespective observational study, condom tamponade was applied to fourteen cases with varying degrees of PPH, not controlled with pharmacologic measures. The efficacy on control of bleeding was assessed along with the total amount of blood loss and any complications.
Conclusions: Thus, condom tamponade is an effective method to control intractable PPH.  It’s simple and does not require expertise to use, so, it can have a wide application even in resource poor settings.   Â
Key words: condom tamponade, intrauterine, post partum haemorrhage