National Medical College and Teaching Hospital

Bīrganj, Nepal

National Medical College and Teaching Hospital

Bīrganj, Nepal
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Deo S.P.,National Medical College and Teaching Hospital
Journal of the Nepal Medical Association | Year: 2011

Objective: This study was carried out to evaluate the effects of a single pre-operative sub-mucosal injection of dexamethasone after third molar surgery to see the effects on post-operative discomfort. Methods: This study was a prospective, double-blind, randomized, clinical trial. The subjects were forty patients who underwent surgical removal of the mandibular impacted third molar under local anesthesia and after being randomly assigned to receive either an 8 mg dexamethasone as submucosal injection or a normal saline injection into the lower buccal vestibule adjacent to the third molar. The maximum interincisal distance and facial contours were measured at the baseline and post-surgically on Day 2 and 7. Post-operative pain was evaluated subjectively using a visual analog scale and objectively by counting the number of analgesic tablets used. All subjects were operated upon by the same investigator to minimize the difference from inter-operator variability. Results: There was a significant difference in the measurements of the degree of swelling and trismus between the two groups on the 2 nd post-operative day. In contrast, there was no statistically significant difference between the groups on the 7 th post-operative day. The test group also used fewer analgesics post-operatively. Conclusions: Submucosal injection of dexamethasone after third molar surgery is effective in reducing postoperative swelling and trismus. It also delays the onset of post-operative pain.

Shidiki A.,National Medical College and Teaching Hospital | Pokhrel N.,National College
Research Journal of Pharmaceutical, Biological and Chemical Sciences | Year: 2013

This study determine the comparison of growth pattern and time required for isolation and drug susceptibility testing of Mycobacterium tuberculosis on blood agar (BA) and Lowenstein-Jensen (LJ) media.Mycobacterium tuberculosis was isolated from 250 sputum. The sputum samples were proceed for Mycobacterium tuberculosis by Ziehl-Neelsen method, culture on LJ and BA media followed by biochemical tests. Drug susceptibility test was performed on LJ and BA against 10 Mycobacterium tuberculosis isolates.Among 55·2% smear positive, growth of Mycobacterium tuberculosis was 71·7% on LJ and 82·6% on 10% blood agar media.Similarly, smear negative specimens, growth of Mycobacterium tuberculosis was 12·5% on LJ and 10·7% on blood agar. Statistically, there was no significant difference for isolation of Mycobacterium tuberculosis on both LJ and BA media (P=1·39). Growth of Mycobacterium tuberculosis (3+) was 34% on BA than 30·8% on LJ media. Time taken for Mycobacterium tuberculosis on blood agar (2-3 weeks) than for LJ (4-5 weeks).Drug susceptible test, 50% (5/10) were resistance to one or more drugs containing LJ and BA media. Blood agar slants may be a good substitute of LJ medium for rapid detection and drug susceptible test of Mycobacterium tuberculosis.

Adak M.,National Medical College and Teaching Hospital | Shivapuri J.N.,National Medical College and Teaching Hospital
Research Journal of Pharmaceutical, Biological and Chemical Sciences | Year: 2010

Since the liver performs a variety of functions like metabolic, synthetic, excretory etc. Therefore, no single test is sufficient to provide complete estimate of function of liver. Liver function tests (LFT) are a helpful screening tool, which are an effective modality to detect hepatic dysfunction. Some of the enzymes and the products of the metabolic pathway that are very sensitive for the abnormality occurred may be considered as biochemical marker of liver dysfunction. These markers are serum bilirubin, albumin, caeruloplasmin, α-fetoprotein, prothrombin time, alanine aminotransferase, aspartate aminotransferase, ratio of aminotransferases, alkaline phosphatase, γ-glutamyl transferase, and 5/- nucleotidase. An isolated or conjugated alteration of biochemical markers of liver damage in patients can challenge the clinicians during the diagnosis of disease related to liver directly or with some other organs. Often clinicians are faced with reports that do not tally with the clinical condition of the patient and they face difficulty in interpreting the LFT.

Adak M.,National Medical College and Teaching Hospital
Nepal Medical College journal : NMCJ | Year: 2010

Dyslipidemia is one of the primary causes for coronary artery disease (CAD). Elevated total cholesterol (TC), triglycerides (TG), low-density lipoprotein-cholesterol (LDL-C) and lowered high-density lipoprotein-cholesterol (HDL-C) are conventional risk factor in myocardial infarction patients. The present study was undertaken with an objective to frame out the lipid and lipoprotein profile in non-diabetic patients attending OPD of NMCTH, Birgunj. Out of 599 total patients, 317 patients were male and 282 patients were female. The mean +/- SD (mg/dl) levels of lipid, lipoprotein and their ratio among different age group were found increased with increasing age and these were statistically significant when compared with healthy control group. Desirable TC level (<200 mg/dl) in 73.0%, normal TG level (<150 mg/dl) in 59.0%, optimal level of HDL-C (<40 mg/dl) in 82.0% and normal LDL-C (<129 mg/dl) in 32.0% were found of the total population. Nearly 16% population in total, male and female had normal (40-60 mg/dl) HDL-C respectively. Higher percentage of female (46.8%) than male (34.9%) had optimal level of LDL-C (<100 mg/dl). About 20.0% male had very high level of LDL-C (>160 mg/dl) while it was noted in 6.7% of female patients. Higher ratio of TC/HDL-C in both male and female patients was observed compared to controls and it was highest among >70 years age group. Higher ratio of LDL-C/HDL-C of all age group in male patients was observed when compared with control and it was statistically significant while in female patients the ratio was found increased significantly (p<0.05) after the age of 50 years. The study concludes that the importance of assessing the lipid profile and their ratio even in a normal individual as these are atherogenic factors for development of myocardial infarction and other coronary complications. The practice of computing the ratio should be practiced even in a normal health check up packages.

Upadhyay A.K.,National Medical College and Teaching Hospital | Parajuli P.,Mission Research
Asian Journal of Pharmaceutical and Clinical Research | Year: 2013

Introduction: Extended spectrum β- lactamases (ESBL) producing multidrug resistant (MDR) Klebsiella species resulting in limitation of therapeutic option. The present study has been undertaken to detect the presence of extended spectrum β- lactamases producing multidrug resistant Klebsiella species in various clinical specimens. Methodology: A total of 300 specimens including Urine, Pus and Blood were processed according to the standard methodology. Antibiotic susceptibility testing was done by Kirby Bauer disc diffusion method following Clinical and Laboratory standard institute (CLSI) guidelines. Combination disk method was done for the detection of extended spectrum β- lactamases producing isolates. Result: A total of 300 samples (200 urine, 45 bloods and 55 pus) were included in the study. Out of total samples proceed 110(36.7%) samples showed significant growth of Gram-negative bacteria. Amongst these significant growth of 65(59.1%) Klebsiella species, 45(69.2%) Klebsiella pneumonia and 20(30.8%) Klebsiella oxytoca were isolated. Amongst these total isolated Klebsiella species 30(66.7%) multidrug resistant Klebsiella pneumonia and 9(45.0%) multidrug resistant Klebsiella oxytoca were isolated. A total of 21(70.0%) Klebsiella pneumonia isolates and 4(44.4%) Klebsiella oxytoca isolates were found to be extended spectrum β- lactamases producers. Conclusion: This study shows that Klebsiella pneumonia and Klebsiella oxytoca recovered from clinical specimens in this region produces extended spectrum β- lactamases in much higher number. Such isolates are also resistant to Floroquinolones, Aminoglycosides, Tetracycline and Cotrimoxazole. Further studies to investigate the factors which determine the emergence and persistence of multidrug resistant extended spectrum β- lactamases producing Klebsiella species in this region and their impact on clinical and economic outcomes at such institutions would be useful.

Das N.,University of Dhaka | Goshwami D.,National Medical College and Teaching Hospital | Hasan M.S.,University of Dhaka | Raihan S.Z.,University of Dhaka | Subedi N.K.,University of Dhaka
Asian Pacific Journal of Tropical Disease | Year: 2015

Objective: To evaluate anthelmintic activity of methanolic extract of leaves of Terminalia citrina (. T. citrina) plant belonging to the Combretaceae family. Methods: The tests of phytochemical screening included alkaloids, flavonoids, tannins, saponins, quinines, anthocyanins, glycosides, carbohydrates and reducing sugars. The anthelmintic activity of methanolic extract of leaves of T. citrina was evaluated against Pheretima posthuma at three different concentrations (25 mg/mL, 50 mg/mL and 100 mg/mL) of extracts which involved determination of time of paralysis and time of death of worms. Results: The phytochemical screening of T. citrina leaves revealed the presence of flavonoids, tannins, alkaloids, carbohydrates and reducing sugars. The present study indicated that methanolic extract significantly exhibited paralysis and also caused death of worms especially at highest concentration of 100 mg/mL, as compared to standard reference Albendazole (10 mg/mL). Conclusions: This study suggests that the leaves of T. citrina possess potent anthelmintic activity. © 2015 Asian Pacific Tropical Medicine Press.

Adak M.,National Medical College and Teaching Hospital | Gabar M.A.,7th April University
Research Journal of Pharmaceutical, Biological and Chemical Sciences | Year: 2011

Tea is the most popular drink after water, consumed everyday by millions of people around the world. Tea is generally consumed in the forms of green, oolong, and black tea, all of which originate from the leaves of the plant Camellia sinensis. Tea consumption began about 5000 years ago in southwest China, where it was used medicinally to treat various illnesses. Health benefits are believed to be largely due to the presence of high levels of flavonoids. Recent human studies suggest that green tea may contribute to a reduction in the risk of cardiovascular disease and some forms of cancer, as well as to the promotion of oral health. In addition, green tea possesses significant antioxidant, anti-inflammatory, antimicrobial, antihypertensive, thermogenic properties. Increasing interest in its health benefits has led to the inclusion of green tea in the group of beverages with functional properties. The present review focuses on the beneficial effects of tea consumption on human health. © 2010 RJPBCS.

Shrestha S.,National Medical College and Teaching Hospital
Nepal Medical College journal : NMCJ | Year: 2011

Vaginitis is the most prevalent disorder among the pregnant women. The objective of this study was to find out the prevalence of common types of vaginitis among the pregnant women visiting Paropakar Maternity and Women's Hospital in Kathmandu. Among 200 pregnant women included in the study, 78 (39.0%) had vaginitis. Of total 78 positive cases of vaginitis, 29.5% had candidiasis, 52.6% bacterial vaginosis and 1.3% trichomoniasis. Approximately 83% had monomicrobial infection and 16.7% had polymicrobial infection. Vaginitis was common in the age group of 20 to 29 years (41.8%) and 30-39 years (40.0%). Ethnically, Indo-Aryans (40.2%) were mostly infected. The infection rate was the highest among illiterate women (47.6%) and least among the women having education above secondary (23.0%). The positive infection rate was higher in women from rural area (45.2%) than those from urban area (37.3%). Nearly half of the women with agriculture occupation (48.4%) had vaginitis. Vaginitis was common in women with third pregnancy (52.6%). Among 78 vaginitis cases, 53 (67.9%) were asymptomatic cases.

Shakya B.,National Medical College and Teaching Hospital
Nepal Medical College journal : NMCJ | Year: 2010

Present study was conducted to assess the nasal carriage rate of methicilin resistant Staphylococcus aureus (MRSA) among patients, visitors/patient attendants and healthcare personnel at National Medical College Teaching Hospital, Birgunj, Nepal. A total of 112 nasal swabs (patients: 31, visitors/patient attendants: 61, and healthcare personnel: 20) were subjected to bacteriological investigation following standard protocol. S. aureus isolates were identified by mannitol fermentation and coagulase positivity. Antimicrobial susceptibility test was performed by Kirby-Bauer's disc diffusion method on Muller-Hinton agar medium. S. aureus was isolated in 14 (12.5%) of participants (M: 11.3%, F: 13.6%). Highest nasal colonization rate was found among healthcare personnel (25.0%) followed by the visitors/patient attendants (13.1%) and the patients (3.2%) (P>0.05). Highest positive rate was observed in the age group d"14 years (33.3%), followed by 15 to 50 years (13.2%) and >50 years (5.6%) (P>0.05). Out of 14 S. aureus isolates, 57.1% were methicillin resistant, prevalence rate of MRSA among total subjects being 7.1%. MRSA prevalence rate were 5.6% and 8.5% in total male and female participants, respectively (P>0.05). Highest MRSA prevalence rate was among health-care personnel (10.0%), followed by visitors/patient attendants (8.2%) and the patients (3.2%) (P>0.05). All MRSA isolates were resistant to Ampicillin, followed by Cephalexin (37.5%), Ciprofloxacin (37.5%), Tetracycline (37.5%), Gentamycin (25.0%), Erythromycin (0.0%) and Vancomycin (0.0%). High rate of nasal MRSA carriage rate found in this study indicates the need for standard infection control to prevent MRSA transmission.

Shakya B.,National Medical College and Teaching Hospital
Journal of Nepal Health Research Council | Year: 2012

Intestinal parasitosis is a major public health problem of developing countries, children being major victims. Higher prevalence has been reported among school children, mostly in hilly regions of Nepal. This study aims at assessing prevalence of intestinal parasitosis among school children of a school in a border town of Nepal and the associated factors. Fecal samples from the students were examined by direct smear technique and result was correlated with their socioeconomic status and hygienic behavior. The chi-square test was used for analytical assessment. The prevalence rate was 13.9%, girls being highly infected (19.1%) than boys (10.3%) (P>0.05). Entamoeba histolytica (36.0%) was the commonest parasite followed by A. lumbricoides (28.0%). The highest positive rate was found among children of 5 years and less age (29.2%) and least among those above 12 years (5.3%) (P>0.05). Those from family size 5 and less than 5 were least infected (10.5%). Children of illiterate parents (16.7%) and farmers (17.1%) were more infected than literate ones and non-farmers (P>0.05). 8.7% of positive children had multi-parasitic infection. Children drinking untreated water (15.0%) were more infected than those drinking treated water (5.5%) (P>0.05). Intestinal parasitic infection was found among 17% school children. Awareness on infectious diseases, improving hygiene, and application of supportive programs for parents to elevate socioeconomic conditions may reduce the burden of infection.

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