Biomedical subjects

S K Shrestha

Publications and source records attributed to S K Shrestha.

7 recordsLinked to original sources

PubMed2006

Molecular analysis of isolates from influenza B outbreaks in the U.S. and Nepal, 2005.

Currently circulating influenza B viruses can be divided into two antigenically and genetically distinct lineages referred to by their respective prototype strains, B/Yamagata/16/88 and B/Victoria/2/87, based on amino acid differences in the hemagglutinin surface glycoprotein. During May and July 2005, clinical specimens from two early season influenza B outbreaks in Arizona and southeastern Nepal were subjected to antigenic (hemagglutinin inhibition) and nucleotide sequence analysis of hemagglutinin (HA1), neuraminidase (NA), and NB genes. All isolates exhibited little reactivity with the B/Shanghai/361/2002 (B/Yamagata-like) vaccine strain and significantly reduced reactivity with the previous 2003/04 B/Hong Kong/330/2001 (B/Victoria-like) vaccine strain. The majority of isolates were antigenically similar to B/Hawaii/33/2004, a B/Victoria-like reference strain. Sequence analysis indicated that 33 of 34 isolates contained B/Victoria-like HA and B/Yamagata-like NA and NB proteins. Thus, these outbreak isolates are both antigenically and genetically distinct from the current Northern Hemisphere vaccine virus strain as well as the previous 2003-04 B/Hong Kong/330/2001 (B/Victoria lineage) vaccine virus strain but are genetically similar to B/Malaysia/2506/2004, the vaccine strain proposed for the coming seasons in the Northern and Southern Hemispheres. Since these influenza B outbreaks occurred in two very distant geographical locations, these viruses may continue to circulate during the 2006 season, underscoring the importance of rapid molecular monitoring of HA, NA and NB for drift and reassortment.

Cluster Analysis↗

PubMed1999

Alterations in the conjunctival bacterial flora following a single dose of azithromycin in a trachoma endemic area.

BACKGROUND/AIMS: The World Health Organisation has recommended repeated mass treatment of children in trachoma endemic areas with oral azithromycin. While chlamydia, the causative agent of trachoma, remains universally sensitive to azithromycin, there is concern that large scale programmes may alter the bacterial flora and induce resistance in streptococcal species. In this study the effect of a single dose of azithromcyin on the prevalence, species distribution, and resistance of conjunctival bacterial flora was determined. METHODS: Baseline and 14 day follow up bacterial cultures were taken from the conjunctivae of 121 children who reside in a trachoma endemic area of Nepal. 91 children were treated with azithromycin at baseline and 31 children received deferred treatment at the 14 day follow up. RESULTS: Although the prevalence of bacterial pathogens decreased significantly with azithromycin treatment, a significant change in the distribution of specific bacterial pathogens could not be demonstrated. Streptococcal resistance to azithromycin was found significantly more frequently after treatment. No change in the prevalence, distribution, or resistance pattern was found in the untreated control group. CONCLUSION: Repeated mass treatment of trachoma endemic areas with oral azithromycin will have an effect on bacterial flora. However, further work needs to be done to determine if this will have any clinical relevance.

Anti-Bacterial Agents↗

PubMed1998

Prevalence of blindness and cataract surgery in Nepal.

BACKGROUND: A national eye care programme was launched in Nepal in the early 1980s. The impact of this programme on blindness and cataract surgery prevalence was evaluated in two geographic zones. METHODS: People aged 45 years and older were sampled using a stratified cluster design. Within randomly selected clusters, door to door enumeration was followed by visual acuity measurement and eye examinations at conveniently located sites. The full survey was preceded by a pilot study where operational methods were refined and quality assurance measures carried out. RESULTS: Of the 5112 enumerated individuals 90% were examined. Blindness, defined as presenting visual acuity less than 6/60 in both eyes, was found in 5.3% (95% CI 3.6, 6.8) of individuals examined, with cataract being the principal cause in at least one eye in 78% of cases. Considering both cataract operated and unoperated cataract blind cases, surgical coverage was approximately 42%. CONCLUSION: The findings suggest that blindness prevalence may have decreased slightly from that estimated in a 1981 national survey, both overall and cataract related. Similarly, cataract surgical coverage may have increased somewhat. None of these changes, however, are at statistically significant levels. Accordingly, the blindness problem remains challengingly high.

Aged↗

PubMedDate not supplied

Stripping without a stripper.

Varicose veins afflict some 10 to 20% of the population in the west. It is believed to be less prevalent in the developing nations. Though there are absolute indications of surgery for varicose veins, people in Nepal come for treatment of the varicose veins either to join the army or to work abroad. Not all hospitals in Nepal are equipped with a vein stripper. In KMCTH, we studied 29 patients who had their long Saphenous veins stripped either with a stripper or by tunnelling around the Saphenous vein. We found that the long Saphenous vein could be stripped via the tunnelling method with an additional incision above the knee joint which is cosmetically accepted by our patients Moreover the patients were much satisfied because of minimal or no bruises in the post operative period as compared to those who had the long Saphenous vein stripped with a stripper.

Adolescent↗

PubMedDate not supplied

Total thyroidectomy: the treatment of choice in differentiated thyroid carcinoma.

INTRODUCTION: Clinically detectable thyroid carcinoma constitutes less than 1% of human cancers. Ninety percent of all thyroid malignancies are differentiated papillary and follicular carcinoma. Surgery plays a key role in differentiated thyroid carcinoma as it carries excellent prognosis, lower recurrence rate and low mortality rate but controversy persists for extent of surgery and optimal surgical management of lymph node metastasis. PATIENT AND METHOD: A retrospective analysis was done for the cases that underwent total thyroidectomy with lymph node dissection for differentiated carcinoma of thyroid in Kathmandu Medical College during two year periods (Oct 2001 to Oct 2003). RESULT: In our experience with 18 cases of Differentiated Thyroid Carcinoma (DTC) treated with total thyroidectomies and lymph node dissection, papillary carcinoma was predominant with 83% incidence. Disease was prevalent in 50 to 60 year age group. Except two cases of transient hypocalcaemia and few wound related complications, there have been no other complications. CONCLUSION: Total thyroidectomy with lymph node dissection is safe and effective, so, the treatment of choice in cases of differentiated thyroid carcinoma.

Adult↗

PubMedDate not supplied

Thyroglossal duct remnant: seven years analysis.

To analyze the clinico-pathological findings and surgical outcome in a patient population that underwent surgical procedures for the excision of the thyroglossal duct remnant (TGDR) i.e., cyst or sinus. A retrospective descriptive study was performed to include all patients of thyroglossal duct remnant who underwent the surgical procedures at National Academy of Medical Sciences, Nepal form April, 1998 to April, 2005 A.D. Age, sex, position of the thyroglossal duct remnant, histopathology of the lesion, type of surgery and its outcome with particular emphasis on recurrence were noted. All data were obtained from the patients' admission charts. Thirty clinically diagnosed thyroglossal duct remnant were enrolled in this study. Twenty-seven were histopathologically confirmed thyroglossal duct remnant and remaining three patients were dermoid cyst and tuberculous lymphadenopathy and were excluded from the study. The sex distribution was almost equal. The commonest age group affected by TGDR was less than twenty years (70.38 %) and commonest site was midline subhyoid (85.19 %). The post-operative complication rate of thyroglossal duct remnant was 18.51 % in the present study. Thyroglossal duct remnant is the commonest congenital cervical lesion in the pediatric population. Other clinical conditions of neck can masquerade as thyroglossal duct remnant so histopathological confirmation is mandatory. Sistrunk operation is the standard treatment to minimize recurrence.

Adolescent↗

PubMedDate not supplied

Foreign body in the rectosigmoid colon.

A 55 years old male presented with history of assault and insertion of a "glass object" through his anus. Examination and investigation of the patient revealed a bottle in the rectosigmoid colon. The bottle was manipulated and delivered out transanally under general anesthesia.

Anesthesia, General↗