Bp Koirala Institute Of Health Science Bpkihs

Dharān Bāzār, Nepal

Bp Koirala Institute Of Health Science Bpkihs

Dharān Bāzār, Nepal

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Das M.L.,Bp Koirala Institute Of Health Science Bpkihs | Rowland M.,London School of Hygiene and Tropical Medicine | Austin J.W.,BASF | De Lazzari E.,University of Barcelona | Picado A.,University of Barcelona
PLoS ONE | Year: 2014

In the Indian subcontinent, Leishmania donovani, the parasite causing visceral leishmaniasis (VL) is transmitted by the sand fly vector Phlebotomus argentipes. Long lasting insecticide treated nets (LN) have been postulated as alternative or complement to Indoor Residual Spraying but there are few field studies evaluating the entomological efficacy of different nets against this vector. We conducted two crossover trials in a VL endemic area in Nepal to compare the barrier effect of (1) LN with different mesh sizes (156 holes/inch2 vs 625 holes/inch2) and (2) alpha-cypermethrin treated LN and untreated nets having the same mesh size (156 holes/inch2). Each crossover trial had two arms consisting of a sequence of two different nets for 8 nights. We used 10 cattle sheds per trial. A cow placed under the net was used as bait. CDC light traps placed inside the nets were used to evaluate the number of P. argentipes crossing the net barrier. Negative binomial generalized estimating equation (GEE) population-ave raged models adjusted by night and sequence were used to estimate the barrier effect of the different nets. The crossover trials conducted in a rural village in Morang district (Southeastern Nepal) demonstrated that reducing the size of the holes in treated nets (625 holes/inch2) increased the barrier effect of LN by 77% (95% confidence interval (CI): 56%-88%) compared with treated nets with larger holes (156 holes/inch2). Treating nets with alpha-cypermethrin reduced the number of P. argentipes captured inside the nets by 77% (95% CI: 27%-93%) compared with untreated nets. The effectiveness and acceptability of finer mesh pyrethroid treated LN should be tested for VL prevention in a randomized controlled trial.


Bhattarai S.,Bp Koirala Institute Of Health Science Bpkihs | Bhattarai S.,Ishan Children and Maternity Hospital | Kc S.,BPKIHS | Pradhan P.M.S.,Patan Academy of Health science | Rijal S.,Internal Medicine
BMC Research Notes | Year: 2014

Background: Hepatitis B is a dreadful infectious disease and a major global health problem. Health-care workers including clinical students are more vulnerable to such infections and non-sterile occupational exposures as their daily activities are closely related to patient's blood and body fluids. Methods: A descriptive cross sectional study was conducted at B.P. Koirala Institute of Health Sciences (BPKIHS), Dharan, Nepal from July till October 2012. All medical, dental and nursing students were surveyed for their Hepatitis B vaccination status and only those students in clinical rotations were surveyed for the prevalence and pattern of Needle-stick and Sharps-related Injuries (NSSIs) using a pre-tested, semi-structured, self-administered questionnaire. Descriptive and inferential statistics was used to analyze the data. Results: Majority (86.5%) of students were vaccinated against Hepatitis B of which 83.7% had completed full doses. Among non-vaccinated students, 43.2% reported the main reason for non-vaccination as lack of vaccination programs. Out of 210 respondents from clinical rotations, 90 students (42.8%) reported at least one injury. Among those injured, two students reported exposure to Human immunodeficiency virus (HIV) positive cases and four to Hepatitis B virus (HBV) positive cases. Most of the injuries (44%) occurred during Internal Medicine rotation and the most common sharp involved (56.3%) was Hypodermic needle. Most injuries (35.6%) occurred while manipulating needle into patients. Following exposure, only 11.4% took Post exposure prophylaxis and 19.54% went for a Post-exposure serology test. Conclusions: Needle-stick and Sharps-related Injuries occur frequently among health care workers including trainee students keeping them at high risk for acquiring dreadful infections like HBV, HCV and HIV. They need to be protected from unwarranted hazards by adopting routine Hepatitis B vaccination programs and by reinforcing education regarding universal precautions.


PubMed | Bp Koirala Institute Of Health Science Bpkihs
Type: Comparative Study | Journal: Indian journal of pediatrics | Year: 2014

To measure the normal range of dimensions of liver in children of various age groups and to compare the liver measurement obtained by palpation-percussion, auscultation and ultrasonography.This was a cross-sectional comparative study in which 500 normal (weight for height between 2 SD of WHO standards for children aged less than 5y and BMI between 2 SD of WHO standards for children aged more than 5y) children (0-15y) divided in 5 age groups (100 in each age group). Subjects were enroled from normal hospital delivery neonates, children visiting immunization and well baby clinics, children visiting outpatient and inpatient department with minor illnesses and healthy school children.The normal range of dimensions of liver in children were estimated and percentile tables of liver size were established. Though the measurements obtained by clinical methods were significantly (P<0.001) lower than those obtained by ultrasonography, there was a strong correlation between clinical and ultrasonographic measurement. Palpation-percussion method could estimate the liver size within 1.0cm of what was obtained by ultrasonography in 88% of cases. In more than half of the study children (54.2%), this estimation was within 0.5cm.Clinical methods of liver span estimation strongly correlate with ultrasonographic measurement. The performance of palpation-percussion method is better than that of auscultation. Clinical methods should continue to be used for the estimation of liver size.


PubMed | BP Koirala Institute of Health science BPKIHS
Type: | Journal: International journal of oral and maxillofacial surgery | Year: 2017

An oral synechia is an adhesion between the maxilla and the mandible; these adhesions can be found at various locations in the oral cavity. The presence of oral synechiae associated with cleft palate represents a rare congenital deformity. Oral synechiae with cleft palate can have serious implications for airway management and feeding in babies, and hence requires early intervention to reduce morbidity. Two cases of congenital oral synechiae accompanied by cleft palate, in which the synechiae veiled the oral cavity restricting a detailed intraoral examination, are reported here.


PubMed | Bp Koirala Institute Of Health Science Bpkihs
Type: Journal Article | Journal: BMC complementary and alternative medicine | Year: 2016

Ficus benghalensis L. (Banyan) is a commonly found tree in Eastern Nepal. Its different plant parts are used for various neurological ailments. This study was performed in mice to see its effects in various neuropharmacological parameters.Passive-avoidance (memory), Open-field (anxiety), Pentobarbital-induced Sleep potentiation (sleep), Rota-rod (muscle-co-ordination), Pentylenetetrazol-Induced and Maximal Electroshock Seizure Tests were performed. Sample size was calculated using G*Power 3.1.9.2. Aqueous root extracts (Soxhlet method) of Ficus benghalensis 100mg/kg and 200mg/kg with negative and positive controls were used. The experimental results were represented as MeanSD. P-value was set at <0.05. Oneway analysis of variance (ANOVA) or Mann-Whitney U test was appropriately used.Passive-avoidance test showed 200mg/kg group spent significantly less. Time (0.00s+0.00s) in shock-zone than Normal Saline-group (9.67s+14.36s, P=0.000) or Diazepam-group (41.07s+88.24s, P=0.000). Open-field test showed 200mg/kg group spent significantly longer Time (24.77s + 12.23s) in central-square than either Normal Saline group (15.08s+6.81s, P=0.000) or Diazepam-group (15.32s+5.12s, P=0.000). In Rota-rod test, 200mg/kg group fell off the rod significantly (P=0.000) earlier (33.01s+43.61s) than both Normal Saline (>120s) and Diazepam (62.07s+43.83s) PTZ model showed that 100mg/kg significantly (P=0.004) delayed seizure-onset (184.40s+36.36s) compared to Normal Saline (101.79s+22.81s), however, in MES model 200mg/kg significantly (P=0.000) prolonged tonic hind-limb extension (17.57s + 2.15s) compared to Normal Saline (13.55s+2.75s) or Phenytoin (00.00s+00.00s).Aerial roots of Ficus benghalensis have memory-enhancing, anxiolytic, musclerelaxant, and seizure-modifying effect.


PubMed | BP Koirala Institute of Health science BPKIHS
Type: Journal Article | Journal: Indian journal of community medicine : official publication of Indian Association of Preventive & Social Medicine | Year: 2016

The rising geriatric population is facing significant health and social problems in the developing world that are impacting the quality of their lives.The study describes the general health status and the socioeconomic characteristics of the elderly people of Pakhribas village development committee (VDC) of Eastern Nepal.Descriptive cross-sectional study was carried out targeting the people aged 60 years and above in the sample area using a semi-structured questionnaire and convenient sampling to get the required sample size. A total of 189 elderly people who consented were interviewed in May 2010.The major part of the elderly population was in the age group of 60-69 years. Seventy-two percent were illiterate and 75% were still earning with the majority involved in farming. Nine out of ten were living with their families and still made decisions for the household, Eighty-two percent did not feel lonely and 88.4% did not report any misbehavior by the house members. Regarding health, 69% had some diagnosed health issue with 36% suffering from gastritis and 20.4% from chronic lung disease. Using the ICD 10 criteria, depression was found among 18%. The most prevalent geriatric problem was a dental problem as found in 61% even though 87% claimed to brush their teeth regularly. More than half were suffering from visual difficulty and the proportions suffering from memory and hearing issues were also substantive. Smoking habit was found in 60%, and the relation between smoking and chronic respiratory diseases had a statistical association (The results of the study show that employment, family support, and pension schemes have a positive impact on the social status of the elderly. Health screening clinics should be established in the community to detect health-related disorders. Elderly populations need health education to emphasize the importance of personal and dental hygiene and to abstain from smoking and alcohol.


PubMed | Bp Koirala Institute Of Health Science Bpkihs
Type: Journal Article | Journal: Kathmandu University medical journal (KUMJ) | Year: 2013

Proper antenatal care and good delivery practice helps to prevent the complications of childbirth and ensures a wholesome maternal and child health in the future. Almost half of the births in the developing countries take place without a skilled birth attendant.To assess the antenatal care (ANC) and delivery practices in the Village Development Committees (VDC) of Ilam district, Nepal and to identify the relationship with the socio-demographic factors.Cross sectional study of 262 mothers of reproductive age group having at least one child of less than five years of age, selected by simple random sampling, was carried out over different VDCs of Ilam by face to face interview using semi-structured questionnaire.Among 262 mothers, 34.7% were married before the age of 18 years. 69.5% of the mothers had attended four antenatal care visits. Nearly 47% of the deliveries were conducted at home out of which only 33.6% were conducted by skilled birth attendant. Number of children and maternal education were found to significantly affect the ANC visit and place of delivery. Age at marriage and age at first pregnancy were significantly associated with the place of delivery.Large proportion of mothers still do not have adequate antenatal visits and this is supported by the fact that nearly half of the deliveries were conducted at home. Motivation and incentives are required for pregnant mothers especially in rural areas regarding importance of adequate antenatal visits and delivery in health institutions. Population policies should be aimed at reducing proportion of women marrying and giving birth in their teens.


PubMed | BASF, Bp Koirala Institute Of Health Science Bpkihs, University of Barcelona and London School of Hygiene and Tropical Medicine
Type: Journal Article | Journal: PloS one | Year: 2016

In the Indian subcontinent, Leishmania donovani, the parasite causing visceral leishmaniasis (VL) is transmitted by the sand fly vector Phlebotomus argentipes. Long lasting insecticide treated nets (LN) have been postulated as alternative or complement to Indoor Residual Spraying but there are few field studies evaluating the entomological efficacy of different nets against this vector. We conducted two crossover trials in a VL endemic area in Nepal to compare the barrier effect of (1) LN with different mesh sizes (156 holes/inch2 vs 625 holes/inch2) and (2) alpha-cypermethrin treated LN and untreated nets having the same mesh size (156 holes/inch2). Each crossover trial had two arms consisting of a sequence of two different nets for 8 nights. We used 10 cattle sheds per trial. A cow placed under the net was used as bait. CDC light traps placed inside the nets were used to evaluate the number of P. argentipes crossing the net barrier. Negative binomial generalized estimating equation (GEE) population-averaged models adjusted by night and sequence were used to estimate the barrier effect of the different nets. The crossover trials conducted in a rural village in Morang district (South-eastern Nepal) demonstrated that reducing the size of the holes in treated nets (625 holes/inch2) increased the barrier effect of LN by 77% (95% confidence interval (CI): 56%-88%) compared with treated nets with larger holes (156 holes/inch2). Treating nets with alpha-cypermethrin reduced the number of P. argentipes captured inside the nets by 77% (95% CI: 27%-93%) compared with untreated nets. The effectiveness and acceptability of finer mesh pyrethroid treated LN should be tested for VL prevention in a randomized controlled trial.


PubMed | Bp Koirala Institute Of Health Science Bpkihs and Jn Medical College
Type: Journal Article | Journal: Indian journal of otolaryngology and head and neck surgery : official publication of the Association of Otolaryngologists of India | Year: 2014

Studies with ovarian hormones on auditory brainstem response (ABR) have conflicting reports although women have ABR shorter than men. This study compared ABR between pre- and postovulatory phases of menstrual cycle in consenting 40 healthy female volunteers (age 192.35years). The study was conducted under standard laboratory conditions (room temperature 262C) using Neuropack (Nihon Kohden machine, NM-420S; H636, Japan) and earphone dynamic receiver ELEGA (Type DR-531; no.237, Japan) in sound proof room. Ears were stimulated simultaneously using standard protocol. ABR was recorded in pre- and postovulatory phases. Ovulation was estimated by measuring basal body temperature. The ABR wave latencies (WLs) I, II, III, IV, V and inter-peak latencies (IPLs) I-III, III-V, I-V were compared between the two phases of menstrual cycle using paired t test. The postovulatory phase had shorter WL V (5.710.18ms vs. 5.810.19ms, p<0.01), IPL III-V (1.890.16ms vs. 1.940.19ms, p<0.05), and I-V (3.880.16ms vs. 3.950.18ms, p<0.05) than in preovulatory. Other WLs and IPLs showed decreasing trend in postovulatory phase. ABR is better in postovulatory phase as compared to preovulatory phase probably due to progesterone hormone which might be involved in modulating auditory hearing pathway at postovulatory phase.


PubMed | Bp Koirala Institute Of Health Science Bpkihs, Professor, B P Koirala Institute Of Health Science Bpkihs and Nepal Medical College
Type: Journal Article | Journal: Journal of clinical and diagnostic research : JCDR | Year: 2015

Oxidative stress and malnutrition are shown to have pathogenic effect in Chronic Obstructive Pulmonary Disease (COPD).This study was done to assess the burden of oxidative stress in COPD and to determine its relation to their nutritional status.In this cross-sectional study, 100 COPD cases from emergency and medical ward and meeting inclusion criteria, along with age, sex and occupation (mainly farmers, housewives and drivers) matched 100 controls without COPD and meeting inclusion criteria were enrolled. Oxidative stress was assessed by measuring lipid peroxidation product, Malondialdehyde (MDA) and antioxidants, like Vitamin C, E and Red Blood Cell Catalase (RBCC). Mini Nutritional Assessment (MNA) tool and Body Mass Index (BMI) were used to assess nutritional status.Chi-square test was applied for categorical variable. Student t-test was applied for comparison of means. Analysis of Variance (ANOVA) was applied for comparison between groups followed by Bonferroni post hoc analysis. Pearson correlation method was used for quantitative variables. Statistical significance was defined as p< 0.05 (two tailed).COPD cases had significantly high MDA level with low level of Vitamin E and catalase as compared to controls (p < 0.001). Most of the COPD cases were underweight (BMI 18.5 Kg/m(2)) and malnourished (MNA score less than 7). Bonferroni post-hoc analysis, showed significantly high burden of oxidative stress in underweight and malnourished cases as compared to normal weight (p < 0.05) among COPD cases. Highly significant correlation was seen between BMI and plasma MDA level (r = -0.27, p = 0.008) in COPD cases.This study shows impaired oxidant/antioxidant balance along with malnutrition and underweight in COPD, which signals for considering antioxidant therapy along with nutritional management.

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