Showing papers by "Dhulikhel Hospital published in 2013"

Prevalence of Hypertension in Semi-Urban area of Nepal

Abstract: Hypertension is one of the major cardiovascular problems in middle and low income countries. There are few studies conducted in Nepal which shows significant number of hypertensive popu­lation in suburban area. Systematic random sampling from voter lists of all the members more than 18 years of age of Dhulikhel Municipality was done. 796 among 1150 sampled population were interviewed and their blood pressure was measured twice using mercury sphygmomanom­eter in standard method in their home. The average blood pressure was taken for study. Hyper­tension was defined as systolic blood pressure ≥ 140 mmHg and/or diastolic blood pressure ≥ 90 mmHg, and/or on antihypertensive treatment. Total number of study population was 796. Among them 490 (61.6%) were female and 306 (38.4%) were male with age ranging from 18 years to 88 years (mean 48.41±17.38). Overall prevalence of hypertension was 28.9% (male 28.8%, female 29%). The prevalence was increasing with age (11.1% in 70 years). Ac­cording to JNC 7, 29.1% were in Pre-hypertensive group. This study shows that Hypertension is significant in suburban area of Nepal. Nepalese Heart Journal | Volume 7 | No.1 | November 2010 (special issue) | Page 35-39 DOI: http://dx.doi.org/10.3126/njh.v7i1.8500

Training non-neurologists to diagnose epilepsy

Abstract: Purpose Narrowing the epilepsy treatment gap in the world's poorest countries is one of the greatest challenges that the epilepsy community faces. The reliable diagnosis of epilepsy is the first step in this. In well-off countries, doctors, often neurologists, carry this out but this is unrealistic in the developing world where there are often no neurologists, particularly in the rural areas where most people live. Other health professionals therefore need to acquire the skills to diagnose epilepsy. Method A trainee doctor and a nurse accompanied an experienced neurologist on epilepsy camps in Nepal. Answers to a defined set of about 50 questions were obtained from each patient. The two participants made the diagnosis, of epilepsy or not epilepsy, independently of each other and of the neurologist. Their diagnoses were then compared with those of the neurologist who then explained the reasons for his diagnosis. Results Agreement between each participant and the neurologist increased from about 50% at the start to over 90% after 20 patients. In one of the participants a high level of agreement was maintained 12 months later. Conclusion It is possible to train non-neurologists to diagnose epilepsy like a neurologist after exposure to only 20 patients in the company of that neurologist. This is a way in which experienced neurologists can help narrow the treatment gap in poorer parts of the world.

Study of the Side effects profile of different antihypertensive drugs among the Hypertensive patient

Abstract: Background Hypertension is the leading cause of morbidity and mortality worldwide. Because hypertension is usually asymptomatic yet requires long term therapy, consideration of potential of undesirable effects of drugs used for its treatment is important for making the appropriate choice. In this context, a precise understanding typical adverse reaction profile of the different drugs is essential. Objective This study was done to assess the side effects profile of different antihypertensive drugs (calcium channel blocker, beta blocker, ACE inhibitor) among the hypertensive patient. Methods A mixed retrospective & prospective cross sectional study of 61 patients was done at Medical Out Patient Department of Dhulikhel Hospital KUTH were included in the study. Result Dry cough was experienced by most of the patients (66.7%) and both dry cough and dizziness was reported by only one patient (6.7%) taking enalapril. In case of atenolol, bradycardia, dizziness and insomnia were experienced by same number of patients (14.3%) separately. Among amlodipine users, side effects experienced were peripheral edema (23%), flushing (2.6%), dyspnoea (2.6%), headache (5.1%), dizziness (2.6%), palpitation (2.6%) and insomnia (2.6%).Patients on enalapril had significantly more complaints regarding side effects (73.3%) compared to those taking amlodipine (41%) (OR=4, p =0.033) and atenolol (42.9%).There was no significant difference in the occurrence of side effects between enalapril- atenolol ( p >0.05) and amlodipine- atenolol ( p >0.05). Conclusion Although all three drugs were well tolerated, more side effects were seen in case of enalapril. Enalapril has 4 times higher rate of side effects than amlodipine. DOI: http://dx.doi.org/10.3126/njh.v9i1.8344 Nepalese Heart Journal Vol.9(1) 2012 pp.25-29

Pathological diagnosis of peritoneal loose body: a case report

Abstract: Peritoneal loose bodies are usually incidental findings at laparotomy. Their sizes range from that of a pea to giant loose bodies. We report a case of giant loose peritoneal body measuring 5x 4 cm found incidentally in a 67 year old man. Mobile pelvic masses are extremely rare findings. They are usually located in the pelvic cavity due to the fact that they gravitate to the most dependent part of the pelvic cavity. Usually these peritoneal loose bodies are left untreated until complications arise. DOI: http://dx.doi.org/10.3126/jpn.v3i6.9005 Journal of Pathology of Nepal (2013) Vol. 3 , 512-514

Comparison of Primary Hip Spica with Crossed Retrograde Intramedullary Rush Pins for the Management of Diaphyseal Femur Fractures in Children: A Prospective, Randomized Study

Abstract: Introduction: Femoral fractures are common in children between 2 and 12 years of age, and 75% of the lesions affect the femoral shaft. We compared primary hip spica with closed reduction and fixation with retrogradely crossed Rush pins for diaphyseal femur fracture in 25 children of age group 3 to 13 years randomly distributed in each group. Methods: Fifty children with femoral fractures were evaluated; 25 of them underwent conservative treatment using immediate hip spica (group A) and 25 were treated with crossed retrograde Rush pins (group B). The patients ages ranged from 3 to 13 years (mean age 5.6±3.57 yrs). Results: Mean clinico-radiological consolidation was within 15 weeks in group A and 12 weeks in group B. Mean duration of weight bearing 7 weeks in group B and 14 weeks in group A. Mean hospital stay were 8 days in group B and 4 days in group A. Mean follow up period in group A was 16 months and group B was 17 months. Complications like angulation, shortening, infection were compared. Bursitis and penetration of pins at the site of Rush pin insertion is complication associated with this method of treatment. Conclusions: Intra-medullary crossed Rush pinning is an effective method of paediatric diaphyseal femur fracture fixation as compared to primary hip spica in terms of early weight bearing and restoration of normal anatomy.