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Biomedical subjects

N Sharma

Publications and source records attributed to N Sharma.

248 records · Page 14Linked to original sources
PubMedDate not supplied

Typhoid fever in Dhulikhel hospital, Nepal.

One hundred and twelve cases of typhoid fever presenting in outpatient and emergency department of Dhulikhel Hospital in Nepal were studied. In this study, it was found that 71% typhoid fever cases were less than 30 years of age group with male to female ratio of 3:1. Fever over 5 days followed by headache and chills were major presenting symptoms. Widal test and blood culture for Salmonella typhi were positive in 59% and 49% cases respectively. Two third of our study population had total leucocyte count of normal range. The fever clearance time was significantly better with ofloxacin compared to ciprofloxacin (p < 0.05) and ceftriaxone compared to chloramphenicol (p < 0.05). The release from treatment was significantly shorter with ceftriaxone compared to ofloxacin, ciprofloxacin and chloramphenicol (p < 0.01). Ceftriaxone was found to be 100% sensitive to salmonella typhi. Amoxicillin was only 52.1% sensitive to Salmonella typhi. Early diagnosis and institution of appropriate antibiotic therapy is of paramount importance in the management of typhoid patients.

Adolescent↗
PubMedDate not supplied

An outbreak of El Tor cholera in Kavre district, Nepal.

Outbreak of cholera still remains major public health problem in most of the developing countries including Nepal. A prospective study was carried out at Dhulikhel Hospital, Kathmandu University Teaching Hospital, Kavrepalanchok during 1st May 2004 to 31st October 2004. A total of 148 stool samples from patients with acute diarrhea were collected and further investigated for cholera. The study was conducted to establish the causes of the outbreak of acute diarrheal disease, antimicrobial profiles of the stool isolates and parasitic co-infection in cholera cases. The samples were subjected to standard recommended microbial procedures and confirmation of the isolates was done by seroagglutination using V.cholerae polyvalent O1 and 0139 antisera and monovalent Ogawa and Inaba antisera. Out of the 148 stool samples, 46 cases (31%) were found to be positive for V.cholerae serogroup O1, biotype ElTor, serotype Ogawa. Both sexes were equally affected. Young age group of less than 30 years were mostly affected. Brahmin was the most affected ethnic group. The isolates were sensitive to all the antibiotics tested except co-trimoxazole. Among the laboratory confirmed cholera cases 30% exhibited co-infection with other parasites among which Giardia lamblia and Ascaris lumbricoides were the most common.

Adolescent↗
PubMedDate not supplied

Prevalence of Helicobacter pylori in Dhulikhel Hospital, Kathmandu University Teaching Hospital: a retrospective histopathologic study.

OBJECTIVE: The main objective of this study was to determine prevalence of Helicobacter pylori infection in Dhulikhel Hospital, Kathmandu University Teaching Hospital. METHODOLOGY: Endoscopic antral biopsies from January 1, 2004 to August 31, 2005 were studied retrospectively. Hematoxylin and eosin and Giemsa stained histological sections were examined. RESULTS: Out of 224 patients (Male 125 and female 99) who underwent endoscopic biopsy and included in the study, a total of 76 (33.9%) patients (Male 50 and female 26) were infected by H. pylori. The mean age of the H. pylori infected patients was 40.2 years (SD 16.0). The infection by H. pylori was significantly higher in males than females (p<0.05) with male to female ratio of 1.9:1. The most common (31.3%) histopathologic finding was chronic superficial gastritis followed by normal histology (30.8%). A total of 10 cases (4.5%) of adenocarcinoma and 16 cases (7.1%) of intestinal metaplasia were detected and neither of them showed presence of H. pylori. Two cases (0.9%) were diagnosed as suspected malignancy and both were negative for H. pylori infection. Among gastritis, H. pylori was most frequently observed in chronic active gastritis (86.1%). Two of 69 cases (2.9%) of normal gastric mucosa showed H. pylori.

Adolescent↗
PubMedDate not supplied

Definitive proton beam radiation therapy for inoperable gastric cancer: a report of two cases.

Proton beam radiation therapy using 250 MeV protons was carried out on two patients with early gastric cancer (T1, N0, M0). One patient was an 85-year-old man with early gastric cancer of type IIa + IIc. The other one was a 70 year old man with early gastric cancer of type IIc. In both cases histological examination of biopsy specimens showed differentiated adenocarcinoma; distant metastasis was not found by other examinations. Both patients were considered inoperable due to their poor cardiac and/or respiratory functions. Therefore, it was decided to treat them by definitive proton irradiation, delivering total doses of 86 Gy and 83 Gy, respectively. In both patients, skin erythema that did not require any special treatment was found in the irradiation field. Hematobiological examinations did not show any abnormality. Although endoscopic examination at two years after irradiation in the former case and at seven months in the latter case showed persistent gastric ulcer at the site of the cancerous lesions, cancer cells were not found histologically. Therefore, we concluded that proton irradiation therapy was useful for inoperable early gastric cancers.

Adenocarcinoma↗
PubMedDate not supplied

Therapeutic penetrating keratoplasty in nonhealing corneal ulcer.

Results of penetrating keratoplasty in 443 eyes of 439 patients of active infective corneal ulcers, from a period of 10 years, were analyzed. All these eyes were proven refractory to maximal medical therapy for extended periods of time, in some cases more than 6 weeks. As the surgery was performed during the active stage, the outcome was not favorable functionally. Clinical cure was obtained, however, by therapeutic penetrating keratoplasty in all but 27 of these eyes. Of unsuccessful cases, 16 could be saved with additional medical therapy, two led to phthisis bulbi, and nine required repeat therapeutic penetrating keratoplasty. Complications encountered included disturbances in intraocular dynamics such as extrusion of the lens and vitreous during surgery, secondary rise of intraocular pressure leading to damage of the optic nerve, loss of the eye due to above factors, and reinfection. The anatomical success achieved was 97% with graft clarity of 2+ or more in 39% of eyes. Useful vision, ie, better than or equal to 6/60, was possible in 33% of eyes. Thus, therapeutic keratoplasty in refractory corneal ulcer still has scope in a Third-World country.

Adolescent↗
PubMedDate not supplied

Retinopathy after solar eclipse, 1995.

BACKGROUND: Visual damage following direct sighting of the solar eclipse is a well established clinical entity. In spite of warnings in the media, a number of people attempted to observe the solar eclipse. Consequently, some developed visual damage. METHODS: Twenty-one patients were referred to the Solar Eclipse Cell at our centre. Their demographic and clinical features were evaluated. RESULTS: Foveal findings correlated with the duration of exposure and frequency of watching the eclipse. Six patients had used protective devices for viewing the eclipse. More than 47% eyes had discernible fundus lesions. CONCLUSION: Lasting visual damage can follow a solar retinal burn with little or no protection from the viewing devices. Prevention remains the best treatment and there is a need to educate the public in this regard.

Adolescent↗
PubMedDate not supplied

Health and nutritional status of boys aged 6 to 12 years in a children observation home.

One hundred and ninety two boys in the age group 6 to 12 years, living in a Children Observation Home in Delhi were studied for their nutritional status and morbidity profile. Body Mass Index (BMI), an age-independent index was used to grade the nutritional status according to which, 36.7% of the boys were found to be malnourished. Signs of specific nutritional deficiencies were observed in 13.5% of the boys. Morbidity in some form or the other was present in 148 (60%) boys. Skin disease was the commonest morbidity (31.7%), followed by diseases of the oral cavity (16.1%), acute respiratory infections (8.6%) and diseases of the ear (9.9%). Need for health promotional activities is stressed to reduce the morbidity and improve the health status of these children.

Body Mass Index↗