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Shrestha M, Boaz K, Srikant N, Shakya A. An assessment of candidal colonization and species differentiation in head and neck cancer patients receiving radiation. JOURNAL OF NEPAL HEALTH RESEARCH COUNCIL 2014; 12:156-161. [PMID: 26032051] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/04/2023]
Abstract
BACKGROUND Oral colonization with Candida species has been observed in upto 93% of patients receiving radiation for head and neck cancer. With immunosuppression there is a trend of emergence of rare species. The present study aimed to assess species and colonization of candida at different stages of radiation therapy for head and neck cancer. METHODS Oral rinses of thirty cancer patients receiving a six weeks course of radiation therapy for head and neck cancer were taken at two intervals; first at the start of radiation (0 Grays), and second at completion of radiation (60 Grays). The oral rinse was streaked onto a differential media (CHROMagar®) plates and incubated at 37ºC for 48 hours. Colony forming units (CFU) were counted and species were differentiated. Fifteen healthy controls were compared. RESULTS The candida albicans colony count (CFU/ml) at baseline, 0 Grays radiation ranged from 50 to 1820 CFU/ml in cases and from 0 to 300 CFU/ml in controls. C. albicans was seen in all cases (100%) and most of the controls (86.66%). Other species such as C. Krusei, C. parapsilosis, C .tropicalis, and C. glabrata were observed with a frequency of 10%, 6.66%, 3.33%, and 3.33% respectively in the cases. However, no species other than C. albicans was observed in controls. CONCLUSIONS Immunosupression of radiation therapy patients led to the development of species other than Candida albicans, which is the most prevalent species. Thus it can be inferred that there is emergence of the opportunistic fungal pathogens in patients with immunosupression.
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Shrestha M, Sarikouch S, Maeding I, Przybilla K, Zimmermann S, Bara C, Koigeldiyev N, Haverich A. Aortic valve replacement in elderly patients with rapid-deployment aortic valve system: 3 years later. Thorac Cardiovasc Surg 2014. [DOI: 10.1055/s-0034-1367329] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
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Arar M, Rotärmel A, Knoefel AK, Baraki H, Kutschka I, Shrestha M, Haverich A, Martens A. Sternal bone marrow is a suitable autologous cell source for cardiac stem cell therapies. Thorac Cardiovasc Surg 2014. [DOI: 10.1055/s-0034-1367453] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
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Shakya A, Rao A, Shenoy R, Shrestha M. Oral Health Related Knowledge And Attitude Of Anganwadi of Mangalore City, India. ACTA ACUST UNITED AC 2014. [DOI: 10.3126/jcmc.v3i4.9545] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
Dental caries is a common childhood disease. Its prevalence can be reduced by integrating dental strategies into primary health care approach. Knowledge, attitude and practice of anganwadi workers in the subject of oral health is imperative in achieving this goal. This study was therefore conducted to assess the knowledge and attitude towards oral health among anganwadi workers of Mangalore city. A questionnaire study, using convenience samples was conducted among 159 anganwadi workers of Mangalore city. A close ended questionnaire consisting of 20 questions was used. Details of age and qualification were recorded. The data was analyzed using SPSS 11.5. Only 45.9% of the anganwadi workers knew that dental caries was a disease, 57.2% knew that the best time to eat sweets was during meal time, 58.5% workers stated dentists as their source of oral health information. Almost all of the Anganwadi workers were positive towards the importance of oral health education and expressed their willingness to teach children how to brush properly and obliged to advise a child needing dental care to go to dentist. An anganwadi worker can be a vital link in the health care delivery system. There is a need to educate them on oral health in order to reach children at an early and receptive age. It is very important on the part of the health department to carry out effective programmes on oral health for anganwadi workers. Journal of Chitwan Medical College 2013; 3(4); 6-8 DOI: http://dx.doi.org/10.3126/jcmc.v3i4.9545
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Yan TD, Tian DH, LeMaire SA, Misfeld M, Elefteriades JA, Chen EP, Chad Hughes G, Kazui T, Griepp RB, Kouchoukos NT, Bannon PG, Underwood MJ, Mohr FW, Oo A, Sundt TM, Bavaria JE, Di Bartolomeo R, Di Eusanio M, Roselli EE, Beyersdorf F, Carrel TP, Corvera JS, Della Corte A, Ehrlich M, Hoffman A, Jakob H, Matalanis G, Numata S, Patel HJ, Pochettino A, Safi HJ, Estrera A, Perreas KG, Sinatra R, Trimarchi S, Sun LZ, Tabata M, Wang C, Haverich A, Shrestha M, Okita Y, Coselli J. The ARCH Projects: design and rationale (IAASSG 001). Eur J Cardiothorac Surg 2013; 45:10-6. [DOI: 10.1093/ejcts/ezt520] [Citation(s) in RCA: 27] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
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Fleissner F, Ius P, Martens A, Koigeldiyev N, Stiefel P, Beckmann E, Haverich A, Shrestha M. 118 * TOTAL AORTIC ARCH REPLACEMENT WITH THE FROZEN ELEPHANT TRUNK TECHNIQUE IN ACUTE TYPE A AORTIC DISSECTION: ARE WE PUSHING THE LIMITS TOO FAR? Interact Cardiovasc Thorac Surg 2013. [DOI: 10.1093/icvts/ivt372.118] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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Martens A, Rotaermel A, Rojas SV, Baraki H, Shrestha M, Martin U, Haverich A, Kutschka I. 051 * CD133 POSITIVE BONE MARROW-DERIVED STEM CELLS ARE LOST WITHIN MINUTES AFTER INTRAMYOCARDIAL INJECTION. Interact Cardiovasc Thorac Surg 2013. [DOI: 10.1093/icvts/ivt372.51] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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Shrestha M, Martens A, Kruger H, Maeding I, Ius F, Fleissner F, Haverich A. Total aortic arch replacement with the elephant trunk technique: single-centre 30-year results. Eur J Cardiothorac Surg 2013; 45:289-95; discussion 295-6. [DOI: 10.1093/ejcts/ezt359] [Citation(s) in RCA: 49] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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Shrestha M, Martens A, Behrendt S, Maeding I, Koigeldiyev N, Haverich A. Is the branched graft technique better than the en bloc technique for total aortic arch replacement? Eur J Cardiothorac Surg 2013; 45:181-6; discussion 186-7. [DOI: 10.1093/ejcts/ezt357] [Citation(s) in RCA: 30] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
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Martens A, Stiefel P, Beckmann E, Bleeker-Kohlsaat V, Haverich A, Shrestha M. Combined aortic valve and ascending aortic replacement (Bentall Procedure) with a tissue-valved conduit: Single center experience with over two hundred fifty patients. Thorac Cardiovasc Surg 2013. [DOI: 10.1055/s-0032-1332435] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
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Martens A, Engelke H, Rojas SV, Reitz M, Stiefel P, Haverich A, Shrestha M, Kutschka I. Total arterial revascularisation with left internal thoracic artery and radial artery T-Grafts results in excellent long term survival and quality of life. Thorac Cardiovasc Surg 2013. [DOI: 10.1055/s-0032-1332247] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
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Martens A, Beckmann E, Abd Alhadi F, Stiefel P, Haverich A, Shrestha M. Is aortic valve sparing re-implantation (David procedure) in patients with acute type A aortic dissection (AADA) acceptable? Thorac Cardiovasc Surg 2013. [DOI: 10.1055/s-0032-1332542] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
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Shrestha M, Martens A, Li Y, Leone A, Haverich A. Minimally access aortic root and ascending aortic surgery: Are we pushing the limits too far? Thorac Cardiovasc Surg 2013. [DOI: 10.1055/s-0032-1332436] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
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Peterß S, Pichlmaier M, Hoeffler K, Martens A, Shrestha M, Haverich A, Hagl C, Khaladj N. The impact of ventricular unloading using cardiopulmonary bypass in a rodent model of acute myocardial infarction. Thorac Cardiovasc Surg 2013. [DOI: 10.1055/s-0032-1332477] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
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Shakya D, Lama S, Shrestha M, Pandey A, Shyangwa P, Deo B. 1278 – Psychological problems among nursing students: study from a nepalese health institute. Eur Psychiatry 2013. [DOI: 10.1016/s0924-9338(13)76341-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/26/2022] Open
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Shrestha M, Shrestha L, Basnet S, Shrestha PS. Trends in Perinatal Mortality in Tribhuvan University Teaching Hospital: 13 Years Review. JOURNAL OF NEPAL PAEDIATRIC SOCIETY 2012. [DOI: 10.3126/jnps.v32i2.6898] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
Abstract
Introduction: The perinatal mortality rate (PMR) in Nepal is still very high. In major hospitals of Nepal, it is still ranging from 20-30 per thousand births. This study was carried out with the objective to review PMR and classifying it according to Wigglesworth classification to identify the causes of perinatal deaths at Tribhuvan University Teaching Hospital (TUTH), Kathmandu, Nepal over the past 13 years and assess need for improvement in care. Material and Methods: It was a retrospective study carried out in TUTH. Data of all stillbirths from 28 weeks of pregnancy and neonatal deaths within first seven days of life in the hospital was taken from monthly perinatal audit and annual mortality review. All the perinatal deaths were then classified according to Wigglesworth classification. Results: Over a 13 year period, there were total 42,746 births and 921 perinatal deaths giving a perinatal mortality of 21.5 per thousand births. Over this period PMR has decreased from 31 to 18 per thousand births. Still births contributed almost 50% of the perinatal deaths; deaths related to prematurity show an increasing trend and have increased by almost 70% in past 5 years. Deaths due to perinatal asphyxia were static. Conclusion: PMR over the years has shown declining trend at TUTH. There is need to improve antenatal, obstetric as well as intrapartum services to further reduce the still birth as well as deaths due to prematurity and perinatal asphyxia. J. Nepal Paediatr. Soc. 32(2) 2012 150-153 doi: http://dx.doi.org/10.3126/jnps.v32i2.6898
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Shrestha M, Adhikari RK. Comparison of Pain Response to Venepuncture Versus Heel Lance Blood Sampling in Term Neonates. JOURNAL OF NEPAL PAEDIATRIC SOCIETY 2012. [DOI: 10.3126/jnps.v32i2.5477] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
Abstract
Introduction: Pain in neonates is largely underestimated and neglected. Pain experience can alter clinical outcome, brain development and subsequent behavior in newborns. Numerous newborns undergo blood sampling routinely in nurseries/NICUs and these procedures are often done without pain relieving measures. Heel lancing and venepuncture are two common procedures for blood sampling in neonates. The objective of this study was to compare pain response to venepuncture versus heel lance in full term neonates. Materials and Methods: A comparative observational study was conducted among 200 term neonates who were undergoing blood sampling for bilirubin or glucose estimation. Neonates were randomly assigned to heel lance (HL) and venepuncture (VP) groups with 100 babies in each group. During the procedure, pain was assessed by Neonatal/Infant pain Scale (NIPS). Heart rate (HR) and oxygen saturation (SpO2) were continuously monitored 5 minutes prior to procedure and upto 5 minutes after the procedure. Results: The median NIPS score in HL and VP were 7 and 3.5 respectively which showed statistically significant (p= 0.0001) higher level of pain experience in HL than in VP. During the procedure, both the groups (HL and VP) showed significant changes in heart rate and oxygen saturation i.e., increase in HR (p= 0.0001) and decrease in SpO2 (p= 0.0001), however the increase in heart rate and decrease in oxygen saturation were significantly more in HL than in VP (p= 0.0001). Conclusion: Neonates perceive pain as demonstrated by Neonatal Pain Scale and venepuncture is the less painful procedure than heel lancing for blood sampling in neonates. J. Nepal Paediatr. Soc. 32(2) 2012 99-104 doi: http://dx.doi.org/10.3126/jnps.v32i2.5477
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Driscoll C, Chestin I, Jungius H, Pereladova O, Darman Y, Dinerstein E, Seidensticker J, Sanderson J, Christie S, Luo S, Shrestha M, Zhuravlev Y, Uphyrkina O, Jhala Y, Yadav S, Pikunov D, Yamaguchi N, Wildt D, Smith J, Marker L, Nyhus P, Tilson R, Macdonald D, O’Brien S. A postulate for tiger recovery: the case of the Caspian Tiger. JOURNAL OF THREATENED TAXA 2012. [DOI: 10.11609/jott.o2993.2637-43] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022] Open
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Shrestha M, Höffler K, Marsch G, Siemeni T, Maeding I, Koigeldiev N, Sarikouch S, Haverich A. Isolated aortic valve replacement (AVR) with sutureless valves compares well against conventional biological aortic valves in Patients with small aortic-roots. Thorac Cardiovasc Surg 2012. [DOI: 10.1055/s-0031-1297532] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/14/2022]
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Martens A, Rojas SV, Baraki H, Reitz M, Khaladj N, Hagl C, Haverich A, Shrestha M, Kutschka I. Total arterial revascularization with composite T-grafts: Is outcome related to surgical experience? Thorac Cardiovasc Surg 2012. [DOI: 10.1055/s-0031-1297697] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/14/2022]
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Shrestha M, Haverich A. Total aortic arch replacement with 4-branched frozen elephant trunk graft. Thorac Cardiovasc Surg 2012. [DOI: 10.1055/s-0031-1297641] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/14/2022]
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Roka Y, Shrestha M, Puri PR, Adhikari H. High cervical nondysraphic intradural extramedullary lipoma. Neurol India 2012; 60:350-1. [DOI: 10.4103/0028-3886.98540] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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Paudel PK, Giri S, Shrestha PS, Shrestha L, Thapa SB, Shrestha M. A case of precocious puberty in a setting with limited resources. Kathmandu Univ Med J (KUMJ) 2011; 9:315-317. [PMID: 22710547 DOI: 10.3126/kumj.v9i4.6353] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/01/2023]
Abstract
Precocious puberty is a rare condition characterized by the development of secondary sexual characteristics before the median age for the sex. It is either gonadotropin dependent also called as central or gonadotropin independent also known as peripheral type. Hypothalamamic Hamartoma is a common cause of the central or precocious puberty due to organic brain lesion. Here we present a two year male who presented us with precocious puberty due to a hypothalamic Hamartoma.
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Sharma P, Neupane S, Shrestha M, Dwivedi R, Paudel K. An ultrasonographic evaluation of solitary muscular and soft tissue cysticercosis. Kathmandu Univ Med J (KUMJ) 2011; 8:257-60. [PMID: 21209548 DOI: 10.3126/kumj.v8i2.3571] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
BACKGROUND Cysticercosis in humans is infection with the larval form (cysticercus cellulosae) of the pork tapeworm T. solium. Encystment of larvae can occur in almost any tissue. The location of cysts in order of frequency is the central nervous system, subcutaneous tissue and striated muscle, vitreous humour of the eye and, rarely, other tissues. High resolution ultrasound can be used in the diagnosis of muscular and soft tissue cysticercosis. OBJECTIVE The aim of this study is to evaluate the ultrasonographic findings in cases of muscular and soft tissue cysticercosis. MATERIALS AND METHODS It was a retrospective review of the cases of muscular and soft tissue cysticercosis which were diagnosed by ultrasound during June 2007 to May 2009 in the department of Radiology and Imaging, Nepalgunj Medical College Teaching Hospital. A total of six patients were evaluated. RESULT There were four males and two females. Age of the patient ranged from 18 to 50 years. All of the patients presented with a swelling with pain in fi ve of them. There was a wide variation in the location of the cysts. In all cases ultrasound revealed a cystic lesion with an echogenic eccentric pedunculated nodule attached to the wall. The mean diameter of the cyst was 6mm. Smooth wall was present in fi ve cases whereas one of the cysts revealed irregular wall. Pericystic inflammatory changes were seen in the adjacent muscles. CONCLUSION Ultrasound is a safe and non-invasive method that can be used in the diagnosis of muscular and soft tissue cysticercosis.
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Peterss S, Khaladj N, Pichlmaier M, Hoeffler K, Wasielewski RV, Shrestha M, Haverich A, Hagl C. Hypothermic Circulatory Arrest with “Low Flow” Lower Body Perfusion: An Experimental Feasibility Study of Microcirculatory Parameters. Thorac Cardiovasc Surg 2011; 59:335-41. [DOI: 10.1055/s-0030-1250727] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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