Dharān Bāzār, Nepal

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PubMed | Koirala Institute of Health science
Type: | Journal: Italian journal of pediatrics | Year: 2012

Perinatal asphyxia leading to hypoxic-ischemic encephalopathy (HIE) is a common problem causing multi organ dysfunction including myocardial involvement which can affect the outcome.To evaluate the myocardial dysfunction in neonates having HIE by electrocardiographic(ECG) and cardiac enzymes (CK Total, CK-MB and Troponin I) and find out the relationship with HIE and outcome.This was a hospital based prospective study. Sixty term neonates who had suffered perinatal asphyxia and developed HIE were enrolled. Myocardial involvement was assessed by clinical, ECG, and CK Total, CK-MB and Troponin I measurements.Of 60 cases, 13(21.7%) were in mild, 27(45%) in moderate and 20(33.3%) belonged to severe,HIE. ECG was abnormal in 46 (76.7%); of these 19 (41.3%) had grade I, 13 (28.2%) grades II and III each and 1 (2.1%) with grade IV changes. Serum levels of CK Total, CK- MB and Troponin I were raised in 54 (90%), 52 (86.6%) and 48 (80%) neonates, respectively. ECG changes and enzymatic levels showed increasing abnormalities with severity of HIE, and the differences among different grades were significant (p=0.002, 0.02, <0.001 and 0.004, respectively). Nineteen (32%) cases died during hospital stay. The non- survivors had high proportion of abnormal ECG (p=0.024), raised levels of CK-MB (p=0.018) and Troponin I (p=0.008) in comparison to survivors.Abnormal ECG and cardiac enzymes levels are found in HIE and can lead to poor outcome due to myocardial damage Early detection can help in better management and survival of these neonates.


PubMed | Koirala Institute of Health science
Type: | Journal: BMC research notes | Year: 2013

Poisoning is a common presentation in the emergency department. Oral exposures to organophosphorus compounds are especially frequent in rural and agricultural regions of South Asia and throughout the developing world.Here we report a case of deliberate self-harm with an organophosphorus pesticide via the relatively uncommon parenteral route. A young woman injected herself with chlorpyriphos. Although the cholinergic effects were mild, cellulitis and abscess development were noted as a result.Resource limited agricultural countries like Nepal present health care workers with numerous challenges in poisoning management. This case represents a rare but potentially morbid method of agrochemical poison exposure.


PubMed | Koirala institute of health science
Type: Journal Article | Journal: Reproductive health | Year: 2014

Son preference is predominant in developing countries especially South Asian countries and its effect is most visible when the fertility is on transition. Nepal is a country in South Asia where the fertility has declined and son is valued highly. This study examines the parents gender preference for children and its effect on fertility and reproductive behaviors.Study was conducted in Sonapur village development committee of Sunsari district among women of Tharu community of reproductive age (15-49) currently in union and having at least one child. Data was collected by house to house survey. Data was analyzed with IBM SPSS 20 version. Multinomial and binary logistic regression were used to analyze the relationship among variables.Three hundred women of reproductive age were included in the study. Current average age of the respondents was 31.97years and mean age at marriage was 18.87 (SD +/-2.615). Child Sex ratio (male: female) of the respondents who didnt want any more children was 1.41. The birth spacing following male baby was 3.09years whereas the average birth spacing following female baby was 2.71years. Age of the respondents and education status of the respondents were also significantly associated with contraceptive practice. Presence of only female children in family significantly increased the desire of other children (AOR=10.153, 95% CI=2.357-43.732).This study finds that the gender preference affects the fertility and reproductive behavior of the respondents and it is necessary to reduce son preference for the health and well being of children and women.


PubMed | Koirala Institute of Health science
Type: | Journal: Cases journal | Year: 2010

Tuberculosis affecting the anorectum is an uncommon extra-pulmonary form of the disease, and its association with malignancy is highly unusual.A 35 year lady presented with lower gastrointestinal bleed, altered bowel habit and significant weight loss. On examination, she had nodular stricture in the lower rectum, with friable mucosa, bleeding easily on touch. With the diagnosis of carcinoma lower rectum, she underwent abdomino-perineal resection of the growth. The histopathological examination revealed carcinoma rectum with coexisting tuberculosis.The aetiological association between the tuberculosis and anorectal cancer is a matter of debate. However, the treating surgeon should be aware of this association, to avoid confusion and delay in the management.

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