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D B Karki

Publications and source records attributed to D B Karki.

At least 19 recordsLinked to original sources
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Field investigaton of an outbreak of epidemic dropsy in eastern Nepal.

About 17 cases with clinical syndrome suggestive of epidemic dropsy attended to the B P Koirala Institute of Health Sciences, Dharan, for treatment. These cases were from three villages of Saptari district in eastern Nepal. Some of the mustard oil samples were tested positive with Nitric acid test. In the wake of this, an extensive field investigation was conducted covering a wider area in these villages.

Adolescent↗
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Imaging in medicine.

Explore the source record for details and available documents.

Aortic Valve Insufficiency↗
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Study of patients presenting with symptoms of peripheral neuropathy and thickened greater auricular nerve.

OBJECTIVE: 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%, dizziness 17.5%, 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.

Adolescent↗
PubMedDate not supplied

Knowledge, attitude and practices among health care workers on needle-stick injuries.

OBJECTIVE: This study aimed to assess the knowledge, attitude and practices among health care workers on needle stick injuries. METHODS: A 15-item questionnaire was administered to seventy health care workers including nurses and paramedical staffs from different departments of Kathmandu Medical College and Teaching Hospital to measure knowledge, attitude and practices on needle stick injuries. RESULTS: Results showed that 4% and 61% of health care workers, respectively, were unaware of the fact that hepatitis B and hepatitis C can be transmitted by needle-stick injuries. 52 subjects (74%) had a history of needle-stick injuries and only 21% reported the injuries to the hospital authority. Only 23% were in the habit of using gloves for phlebotomy procedures all the time. 79% were of the impression that needle should be recapped after use. Only 66% were aware of Universal Precaution Guidelines. 16 subjects (23%) were negative for HBsAg, Anti-HCV and Anti-HIV and 54 subjects (77%) do not know about their immune status. 42 subjects (60%) had been vaccinated against hepatitis B, while 28 subjects (40%) were not vaccinated against hepatitis B. Only 6 subjects (14%) had been tested for Anti-HBs antibody after hepatitis B vaccination. CONCLUSION: The survey revealed that knowledge of health care workers about the risk associated with needle-stick injuries and use of preventive measures was inadequate. A standing order procedure (SOP) should be formulated regarding needle-stick injuries in all the health institutions. It should outline precautions to be taken when dealing with blood and body fluids. It should also contain reporting of all needle-stick injuries. Health care workers should be made aware of hazards, preventive measures and post-exposure prophylaxis to needle-stick injuries. A hospital-wide hepatitis immunization programme should also be started.

Adult↗
PubMedDate not supplied

Clinical profile of typhoid patients.

OBJECTIVE: The present study was undertaken to determine the clinical profile of typhoid fever in hospitalised patients. DESIGN: Prospective cross-sectional study. SETTING: Kathmandu Medical College and Teaching Hospital. METHOD: Total of thirty patients above fifteen years of age who had clinical features strongly suggestive of typhoid fever and on blood culture found to be positive for Salmonella typhi were analysed for clinical features. RESULT: Among total of thirty cases, there were 17 (57%) males and 13 (43%) females. 86% of cases of typhoid fever clustered around 15-30 years of age. Predominant symptoms were fever (100%), headache (90%), abdominal Pain (37%) and constipation (33%). Common clinical signs were splenomegaly (37%), relative bradycardia (27%) and hepatomegaly (17%). None of the patients presented with complications. CONCLUSION: The clinical profile of typhoid fever in our study revealed not much difference from that of other studies on typhoid fever. Rose spots were not noticed and we did not find a single case of complication of typhoid fever. Probably early initiation of antibiotics prevented the complications.

Adolescent↗
PubMedDate not supplied

Analysis of 400 cases of posterior segment diseases visiting retina clinic of Nepal Eye hospital.

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.

Adolescent↗
PubMedDate not supplied

Lipid levels in Nepalese population.

OBJECTIVE: To study the lipid pattern of Nepalese population. DESIGN: Retrospective study Setting: Patients attending Temple of Healing for consultation. METHODS: Fasting lipid profile of 2218 blood samples was analyzed. RESULTS: Abnormal total cholesterol (TC) was found in 7.7%. High LDL cholesterol (LDL-C) was found in 5% of cases. 70% of subjects had triglyceride(TG) level more than the upper level of normal. All abnormal lipid level was found in the age group 49 to 60 years. 23% of the study group had low level of HDL cholesterol. CONCLUSIONS: abnormal triglyceride level is the commonest lipid abnormality in our population. High total cholesterol and LDL cholesterol is not very common except in the age group 40 to 49 where it is significantly high in comparison to other age groups. HDL cholesterol level did not decrease significantly with increasing age. KEYWORDS: Lipids, Nepalese population.

Adult↗
PubMedDate not supplied

Intermediate uveitis: a hospital based study.

UNLABELLED: Intermediate uveitis affecting pars plana, peripheral retina and underlying choroid affects primarily healthy children and young adults. OBJECTIVE: To study the components of intermediate uveitis at Nepal Eye Hospital in the year 2003 August to 2004 March. MATERIALS AND METHODS: A prospective study was done in patients with intermediate uveitis visiting Nepal Eye Hospital. Sample size was 50. Specially designed proforma of intermediate uveitis was used to collect particulars of the patients, history, clinical examination findings, investigation reports, management protocols used and the final visual outcome. RESULTS: Intermediate uveitis was seen more in 20 to 29 years age group (38%) and more prevalent in males (52%). Among the study population farmers constituted maximum proportion (36%) and Mongoloid origin was mostly affected (30%). High number of patients were from the central development region with highest proportion from Dhading district (34%). Anterior segment affection with keratic precipitates and anterior chamber cells were noted in 72% of involved eyes. Vitreous cells were noted in all affected eyes while 4% had vitreous snow banking and 3% had vitreous snow balls. Most of the patients (52%) received between topical steroid and posterior subtenon injection of Triamcinolone. Visual Acuity was improved in 52% of cases and remained static in 46%.while deteriorated in 2%. CONCLUSION: Significantly high number of patients with intermediate uveitis has been reported from the central development region mainly from Dhading Kathmandu and Nuwakot districts People in their third decade were found to be commonly involved and Mongloid origin were more commonly affected Anterior chamber spill over was seen in higher percentage of patients than described in literature As the patients presented in milder forms visual acuity improved is of cases with the treatment protocol followed.

Adolescent↗
PubMedDate not supplied

Acute haemorrhagic conjunctivitis: an epidemic in August/September 2003.

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.

Adolescent↗