Biomedical subjects

Narendra Bhatta

Publications and source records attributed to Narendra Bhatta.

5 recordsLinked to original sources

PubMed2006

Current status of inpatient HIV care at a tertiary care center in Nepal.

The success of the WHO's '3 by 5' programme will depend on the ability of developing countries to provide antiretroviral therapy. The purpose of this study was to determine the current status of HIV care at a major teaching hospital in eastern Nepal. A retrospective cohort study was conducted of admitted HIV-infected patients at BPKIHS between 1993 and 2003, evaluating reasons for admission and the care received. There were 2, 2, 2, 3, 5 and 18 admissions, respectively, from 1998 to 2003. Only 4 were female patients. Two were children, both admitted in the last y studied. 10 admissions (31% of the total) were for opportunistic infections (OIs). Seven patients were prescribed OI prophylaxis, with incorrect dosages in 6. Four patients were prescribed antiretroviral therapy, all in inappropriate dosages or combinations. 13 patients were rapidly discharged without further care as soon as a diagnosis of HIV was made. Hospital admissions of HIV-infected individuals are increasing rapidly. Important segments of the HIV-infected population such as women and children are not receiving medical services. Most admissions are not due to OIs. The care of HIV-infected patients even at a major tertiary care teaching hospital in Nepal is sub-optimal.

AIDS-Related Opportunistic Infections↗

PubMed2005

Melioidosis imported into Nepal.

This is a report of the first recognized case of melioidosis in Nepal. Illness began 1 month after returning from Malaysia after a 1 y stay. The case highlights the importance of ascertaining the travel history in any patient with a suspected infectious disease in this age of global travel.

Adult↗

PubMedDate not supplied

Outdoor air pollution and emergency room visits at a hospital in Delhi.

Several reports from large metropolitan cities have indicated significant association between acute morbidity and mortality from cardio-respiratory disorders and daily levels of major pollutants in the ambient air. Despite the wide-spread public concern about the adverse health effects of air pollution, there is substantial uncertainty regarding the effects of these pollutants at a concentration typical of Delhi, which is one of the ten most polluted cities in the world and the most polluted city in India. This study was undertaken to correlate the daily levels of various pollutants with the number of patients visiting the All India Institute of Medical Sciences (AIIMS, New Delhi) casualty for aggravation of certain defined cardiorespiratory disorders. Daily counts of patients visiting the emergency room of the AIIMS for acute asthma, acute exacerbation of chronic obstructive airway disease (COAD) and acute coronary event was obtained in prospective manner from January 1997 to December 1998. Daily mean levels of ambient CO, NOx and SO2 were monitored along with temperature and humidity. Data was analysed using one day time lag for events of interest. Time series analysis was undertaken using Poisson regression and population averaged general estimation equation, correcting for auto-correlation, days of the weak and season. The ambient levels of pollutants exceeded the national air quality standards on most of the days, over the two year period. Further, emergency room visits for asthma, COAD and acute coronary events increased by 21.30%, 24.90% and 24.30% respectively on account of higher than acceptable levels of pollutants. It is concluded that there is considerable burden of cardiorespiratory diseases in Delhi due to high levels of ambient air pollution.

Acute Disease↗

PubMedDate not supplied

Non-invasive ventilation: current status.

Mechanical ventilation is being increasingly used in many disciplines by specialists who manage critically ill patients. Non-invasive ventilation (NIV) refers to the method of providing assisted ventilation without endotracheal intubation. This technique requires a positive-pressure ventilator, connected by a tubing to an interface device that directs intermittent positive pressure through the upper airway and actively assists ventilation. The use of NIV is increasing for patients with acute and chronic respiratory failure, because of its convenience, lower cost and minimal complications. The greatest advantage of NIV is that endotracheal intubation is not required. Although it is an extremely useful technique, it cannot be used in all patients and correct patient selection is important. It has been extensively used in patients with chronic obstructive pulmonary disease with acute or acute-on-chronic respiratory failure. It has also been found to be useful in acute respiratory distress syndrome, acute cardiogenic pulmonary oedema and acute severe asthma. All patients with respiratory failure need to be considered for NIV if they fulfil the requisite criteria. Patients who are unable to protect the upper airway, those with severe life-threatening hypoxaemia, or major associated organ dysfunction are unlikely to benefit from this technique. Despite these limitations, NIV can be useful in many conditions that lead to respiratory failure. NIV is a relatively new technique and has not found a place in all intensive care units. It is expected that this modality will be used more frequently in the near future.

Humans↗

PubMedDate not supplied

Primary pulmonary lymphoma presenting as lung mass.

The commonest cause of lung mass in an elderly patient is bronchogenic carcinoma. We are reporting an unusual case of lung mass that was diagnosed following exploratory thoracotomy and pneumonectomy. Sputum examination, bronchoscopy and percutaneous fine needle aspiration cytology were inconclusive. On histopathology, a diagnosis of non-Hodgkin's lymphoma (NHL) was made. There was no involvement of any other site on detailed work up. The patient was advised chemotherapy.

Aged↗