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Dhakal S.S.,B P Koirala Institute Of Health Science
Saudi journal of kidney diseases and transplantation : an official publication of the Saudi Center for Organ Transplantation, Saudi Arabia | Year: 2011

To determine the clinical profile and patterns of lupus nephritis patients in Eastern Nepal, we studied 38 patients fulfilling the 1982 revised criteria of American College of Rheumatology for systemic lupus erythematous (SLE), followed up from January 2004 to January 2008. Arthritis was a common initial feature in addition to variable cutaneous, cardiac, pulmonary and neuropsychiatric manifestations. Renal biopsy showed grade 1 changes in 5 (13.5%) patients, grade 2 changes in 13 (35.1%) patients, grade 3 changes in 9 (24.3%) patients, grade 4 changes in 7 (18.9%) patients, grade 5 changes in 2 (5.4%) patients, and grade 6 changes in 2.7% patients. Antinuclear antibody (ANA) assay and anti-ds DNA were positive in 78.4 and 81.1%, respectively. We conclude that mesangial proliferative glomerulonephritis (grade 2) was the most common pattern of lupus nephritis encountered in our study. Timely diagnosis and treatment may improve the overall patients' survival. Source


Alirol E.,University of Geneva | Sharma S.K.,B P Koirala Institute Of Health Science | Bawaskar H.S.,Bawaskar Hospital and Research Center | Kuch U.,Biodiversity and Climate Research Center | Chappuis F.,University of Geneva
PLoS Neglected Tropical Diseases | Year: 2010

Snake bite is one of the most neglected public health issues in poor rural communities living in the tropics. Because of serious misreporting, the true worldwide burden of snake bite is not known. South Asia is the world's most heavily affected region, due to its high population density, widespread agricultural activities, numerous venomous snake species and lack of functional snake bite control programs. Despite increasing knowledge of snake venoms' composition and mode of action, good understanding of clinical features of envenoming and sufficient production of antivenom by Indian manufacturers, snake bite management remains unsatisfactory in this region. Field diagnostic tests for snake species identification do not exist and treatment mainly relies on the administration of antivenoms that do not cover all of the important venomous snakes of the region. Care-givers need better training and supervision, and national guidelines should be fed by evidence-based data generated by well-designed research studies. Poorly informed rural populations often apply inappropriate first-aid measures and vital time is lost before the victim is transported to a treatment centre, where cost of treatment can constitute an additional hurdle. The deficiency of snake bite management in South Asia is multi-causal and requires joint collaborative efforts from researchers, antivenom manufacturers, policy makers, public health authorities and international funders. © 2010 Alirol et al. Source


Agrawaal K.K.,B P Koirala Institute Of Health Science
Saudi journal of kidney diseases and transplantation : an official publication of the Saudi Center for Organ Transplantation, Saudi Arabia | Year: 2014

The reported prevalence of systemic lupus erythematosus (SLE) in the general population is 20-150 cases per 100,000 population. The female to male ratio ranges from 7-15:1. An estrogen effect has been suggested by a number of observations for this difference. In children, sex hormonal effects are presumably minimal and, thus, the female to male ratio is 3:1. We report a series of three male patients who presented at the B. P. Koirala Institute of Health Sciences and were diagnosed to have lupus nephritis (LN). This is probably the first case series from Nepal on adult male LN. Male patients with SLE present mainly with renal involvement and seizures rather than photophobia and skin manifestations. The outcome also seems to be more serious in males. Thus, we believe that although male patients with lupus are not commonly seen, the manifestations are life threatening and early detection of the disease will lead to better outcome of these patients. Source


Nepal A.,B P Koirala Institute Of Health Science
Nepal Medical College journal : NMCJ | Year: 2010

Penetrating neck injuries by traditional weapons are rare entity in the modern era of sophisticated weapons. We report an unusual case of penetrating neck injury by a metallic arrow entering anterior neck in zone II and its tip coming out of neck posteriorly causing difficulty for patient to lie down as well as posing challenge to intubate. Arrows are low velocity projectile and from a close proximity they can cause penetrating trauma similar to a low powered handgun. Management of the case was discussed. Source


Lavaju P.,B P Koirala Institute Of Health Science
Nepalese journal of ophthalmology : a biannual peer-reviewed academic journal of the Nepal Ophthalmic Society : NEPJOPH | Year: 2010

Rhinosporidiosis is endemic in India and Sri Lanka and parts of East Africa and South America. Cases of ocular rhinosporidiosis have also been reported from Nepal. Ocular rhinosporidiosis usually involves the conjunctiva and the lacrimal sac. It usually presents as a polypoidal mass. Cystic mode of presentation has not yet been reported in the literature. We herein report an unusual mode of presentation of ocular rhinosporidiosis presenting as a huge conjunctival cystic mass. © Nepal Ophthalmic Society. Source

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