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Search Results: 1 - 10 of 197936 matches for " N Maharjan "
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Intravitreal bevacizumab in macular edema secondary to branch retinal vein occlusion: 12-month results
Thapa R, Maharjan N, Paudyal G
Clinical Ophthalmology , 2012, DOI: http://dx.doi.org/10.2147/OPTH.S30555
Abstract: travitreal bevacizumab in macular edema secondary to branch retinal vein occlusion: 12-month results Original Research (1547) Total Article Views Authors: Thapa R, Maharjan N, Paudyal G Video abstract presented by Raba Thapa Views: 147 Published Date July 2012 Volume 2012:6 Pages 1057 - 1062 DOI: http://dx.doi.org/10.2147/OPTH.S30555 Received: 04 February 2012 Accepted: 10 May 2012 Published: 12 July 2012 Raba Thapa,1 Nhukesh Maharjan,2 Govinda Paudyal1 1Vitreo-retinal Service, Tilganga Institute of Ophthalmology, 2Research Department, Tilganga Institute of Ophthalmology, Kathmandu, Nepal Purpose: The purpose of this study was to evaluate the long-term safety, anatomical, and visual outcomes following intravitreal bevacizumab (Avastin; Genentech) on macular edema (ME) secondary to branch retinal vein occlusion (BRVO). Methods: A prospective, interventional case series study was conducted among patients with ME due to BRVO, from June 2008 to October 2011. Intravitreal bevacizumab (1.25 mg/0.05 mL) was given at 4–6 weekly intervals until the ME subsided, and cases were followed up for a year. Complete ophthalmic evaluations and measurement of central retinal thickness (CRT) by optical coherence tomography were performed at baseline and follow-up visits. Results: Sixty-three eyes of 63 patients were included in the study. The mean age was 58.22 years (standard deviation [SD], 12.3). The CRT at baseline was 515.3 ± 189.4 μm, and it significantly improved at each follow-up, with a CRT of 233.6 ± 101.5 μm at 12 months. The best-corrected visual acuity (BCVA) at baseline was 0.82 ± 0.54, and it significantly improved at each follow-up, with a BCVA of 0.40 ± 0.25 at 12 months (P < 0.001). The BCVA was better in 76% of the patients with a more than three-line increase in 55.5% of the eyes. The average number of intravitreal bevacizumab injections was 3.1 (range, 1–6 injections). Recurrent ME occurred in 30.2% of cases. There were no major ocular or systemic adverse events. Conclusion: Intravitreal bevacizumab appears to be a safe and effective drug for reducing ME and improving visual acuity secondary to BRVO at 12-month follow-up at a tertiary referral eye hospital in Nepal.
Intravitreal bevacizumab in macular edema secondary to branch retinal vein occlusion: 12-month results
Thapa R,Maharjan N,Paudyal G
Clinical Ophthalmology , 2012,
Abstract: Raba Thapa,1 Nhukesh Maharjan,2 Govinda Paudyal11Vitreo-retinal Service, Tilganga Institute of Ophthalmology, 2Research Department, Tilganga Institute of Ophthalmology, Kathmandu, NepalPurpose: The purpose of this study was to evaluate the long-term safety, anatomical, and visual outcomes following intravitreal bevacizumab (Avastin; Genentech) on macular edema (ME) secondary to branch retinal vein occlusion (BRVO).Methods: A prospective, interventional case series study was conducted among patients with ME due to BRVO, from June 2008 to October 2011. Intravitreal bevacizumab (1.25 mg/0.05 mL) was given at 4–6 weekly intervals until the ME subsided, and cases were followed up for a year. Complete ophthalmic evaluations and measurement of central retinal thickness (CRT) by optical coherence tomography were performed at baseline and follow-up visits.Results: Sixty-three eyes of 63 patients were included in the study. The mean age was 58.22 years (standard deviation [SD], 12.3). The CRT at baseline was 515.3 ± 189.4 μm, and it significantly improved at each follow-up, with a CRT of 233.6 ± 101.5 μm at 12 months. The best-corrected visual acuity (BCVA) at baseline was 0.82 ± 0.54, and it significantly improved at each follow-up, with a BCVA of 0.40 ± 0.25 at 12 months (P < 0.001). The BCVA was better in 76% of the patients with a more than three-line increase in 55.5% of the eyes. The average number of intravitreal bevacizumab injections was 3.1 (range, 1–6 injections). Recurrent ME occurred in 30.2% of cases. There were no major ocular or systemic adverse events.Conclusion: Intravitreal bevacizumab appears to be a safe and effective drug for reducing ME and improving visual acuity secondary to BRVO at 12-month follow-up at a tertiary referral eye hospital in Nepal.Keywords: branch retinal vein occlusion, bevacizumab, macular edema
Assessment of Genetic Diversity in Nepalese Populations of Swertia chirayita (Roxb. Ex Fleming) H. Karst Using RAPD-PCR Technique  [PDF]
J. K. Chhipi Shrestha, T. Bhattarai, J. Sijapati, N. Rana, J. Maharjan, D. S. Rawal, B. B. Raskoti, S. Shrestha
American Journal of Plant Sciences (AJPS) , 2013, DOI: 10.4236/ajps.2013.48196
Abstract:

Owing to the high demand, Swertia chirayita populations in the wild are being depleted beyond its regeneration capacity. S. chirayita is one of the most valuable medicinal plants of Nepal in trade. Present Molecular investigation was undertaken to understand the level of genetic diversity in five S. chirayita populations of Nepal using Polymerase Chain Reaction (PCR)-based Random amplified polymorphic DNA (RAPD) technique. Thirty four accessions of S. chirayita along with six outlier accessions were analyzed using 26 arbitrary primers. Of the total 285 amplified bands scored for S. chirayita, 263 bands (92.28%) were polymorphic. Two major clusters were revealed in the phenogram generated from cluster analysis using NTSYS-PC software (version 2.21i) for the geographic populations under study. Principal Coordinate Analysis further substantiated the results of the phenograms. Swertia chirayita populations from Sankhuwasabha and Terathum were

Microstrip Cross-coupled Interdigital SIR Based Bandpass Filter
R. K. Maharjan,B. Shrestha,N. Y. Kim
Radioengineering , 2012,
Abstract: A simple and compact 4.9 GHz bandpass filter for C-band applications is proposed. This paper presents a novel microstrip cross-coupled interdigital half-wavelength stepped impedance resonator (SIR) based bandpass filter (BPF).The designed structure is similar to that of a combination of two parallel interdigital capacitors. The scattering parameters of the structure are measured using vector network analyzer (VNA). The self generated capacitive and inductive reactances within the interdigital resonators exhibited in a resonance frequency of 4.9 GHz. The resonant frequency and bandwidth of the capacitive cross-coupled resonator is directly optimized from the physical arrangement of the resonators. The measured insertion loss (S21) and return loss (S11) were 0.3 dB and 28 dB, respectively, at resonance frequency which were almost close to the simulation results.
Inferior conjunctival autografting for pterygium surgery: an alternative way of preserving the glaucoma filtration site in far western Nepal
Shrestha A,Shrestha A,Bhandari S,Maharjan N
Clinical Ophthalmology , 2012,
Abstract: Arjun Shrestha1, Anand Shrestha2, Sujata Bhandari1, Nhukesh Maharjan3, Deepak Khadka1, Suresh Raj Pant1, Bidya Prasad Pant11Geta Eye Hospital, Dhangadhi, 2Tribhuvan University Teaching Hospital, Kathmandu, 3Tilganga Institute of Ophthalmology, Kathmandu, NepalBackground: The purpose of this study was to evaluate the outcome of pterygium excision with inferior conjunctival autografting for primary pterygium.Methods: This was a prospective noncomparative interventional case series study enrolling 50 eyes of 50 patients with primary pterygium between November 1, 2010 and October 30, 2011. All patients underwent the standard surgical technique for pterygium excision with inferior conjunctival autografting. The sampling method was purposive. The study variables were complications of surgery and recurrence rates during a follow-up period of 6 months.Results: The mean age of the patients was 43 ± 7.97 (range 26–64) years. Grade 1 pterygium comprised 64% while grade 2 pterygium comprised 36% of cases. The mean size of pterygium was 3.2 ± 0.60 mm. Minor complications did occur, but only 4% required resuturing. Recurrence occurred in two eyes (4%) which we detected 3 months after surgery in both cases. We observed conjunctival scarring at the donor site in four eyes (8%); however, there was no symblepharon formation or restriction of upgaze.Conclusion: Inferior conjunctival autografting is an effective technique with a low recurrence rate. This is a useful technique when it is not possible or desirable to use the superior conjunctiva as a donor source. It is an especially good option for preserving the glaucoma filtration site for the future.Keywords: inferior, conjunctival, autografting, pterygium surgery, recurrence
Influence of duration of symptoms over perioperative outcomes during emergency laparoscopic cholecystectomy
SK Sharma,PB Thapa,DK Maharjan,A Dhakal,N Baral
Kathmandu University Medical Journal , 2009, DOI: 10.3126/kumj.v7i2.2703
Abstract: Background: Laparoscopic cholecystectomy is a gold standard treatment for gall stone diseases. Early surgical intervention in acute calculus cholecystitis is feasible and duration of onset of symptoms does not influence the conversion rate. Objective : To compare the safety and feasibility between urgent and delayed laparoscopic cholecystectomy in patients with acute calculus cholecystitis. Materials and methods: This is a comparative study conducted in Department of Surgery, Kathmandu Medical College, during the period of January 2006 to January 2008. Altogether, 436 patients were analysed out of which 55 were selected as urgent laparoscopic cholecystectomy and were included in the study. Among 55 patients presented with acute calculus cholecystitis were divided into two groups. Group 1 underwent laparoscopic cholecystectomy within 72 hours of onset of pain abdomen and Group 2 after 72 hours of onset of pain abdomen. Results : Conversion rate in Group 1 was 19.44% whereas it was 263% in Group 2 (p = .693). There was no statistically significant difference in mean operating time (p = .412), total hospital stay (p = .626), bile duct injury and postoperative complications. Conclusion : Urgent laparoscopic cholecystectomy is safe and duration of onset of pain abdomen does not influence conversion rate. Key words: Urgent laparoscopic cholecystectomy; Conversion rate; acute calculus cholecystitis DOI: 10.3126/kumj.v7i2.2703 Kathmandu University Medical Journal (2009) Vol.7, No.2 Issue 26, 120-124
Demographics and awareness of diabetic retinopathy among diabetic patients attending the vitreo-retinal service at a tertiary eye care center in Nepal
R Thapa,G Paudyal,N Maharjan,PS Bernstein
Nepalese Journal of Ophthalmology , 2012, DOI: 10.3126/nepjoph.v4i1.5844
Abstract: Introduction: Diabetic retinopathy (DR) is one of the leading causes of blindness in Nepal. Objective: To investigate the demographic characteristics and awareness of diabetic retinopathy among new cases of diabetes mellitus (DM) attending the vitreo-retinal service of a tertiary eye care centre in Nepal. Materials and methods: A hospital-based, cross-sectional study including all consecutive new cases of DM was carried out. Detailed demographics of the subjects and their awareness of potential ocular problems from diabetes mellitus were noted. Results: A total of 210 patients with a mean age of 57 ± 10.4 years were included. Brahmins (34.8 %) and Newars (34.3 %) were the predominant ethnic groups. Housewives (38.6 %) and office workers (18.6 %) were the major groups affected. Two-fifths (37 %) of the cases were unaware of DR and its potential for blindness. Awareness was significantly higher among literate patients (P = 0.006). Fundus evaluation was done for the first time in 48.6 %, although almost four-fifths had a duration of diabetes of five years or more. DR was found in 78 % of the cases, with 16.7 % already at the proliferative stage and about 40 % exhibiting clinically significant diabetic macular edema. Conclusion: A lack of awareness of DR coupled with a high proportion of cases already at a sight-threatening stage of retinopathy at their first presentation reflects the need for improved awareness programs to reduce the burden of blindness from DR in Nepal. DOI: http://dx.doi.org/10.3126/nepjoph.v4i1.5844 NEPJOPH 2012; 4(1): 10-16
Optical coherence tomographic assessment of macular thickness and morphological patterns in diabetic macular edema: Prognosis after modified grid photocoagulation
A Shrestha,N Maharjan,A Shrestha,R Thapa,G Poudyal
Nepalese Journal of Ophthalmology , 2012, DOI: 10.3126/nepjoph.v4i1.5864
Abstract: Introduction : The topographic mapping is useful for monitoring patients for the development of macular edema and following the resolution of edema after laser treatment. Objectives : To evaluate the usefulness of optical coherence tomography (OCT) for mapping of macula after laser therapy in clinically significant macular edema (CSME). Materials and methods : A prospective study was carried out enrolling 60 eyes of 35 patients with the diagnosis of CSME. OCT was performed at first visit and every successive follow up visit. The retinal thickness was measured automatically using OCT retinal mapping software. Statistics : Correlation between vision status and central macular thickness (CMT) was done using the Spearman’s correlation test. The analysis of variance (ANOVA) and independent t-test were used for comparison of groups. Results: The OCT revealed sponge like thickening pattern (ST) in 67.4 % followed by cystoid macular edema (CME) in 19.6 %. Best corrected visual acuity (BCVA) improved in 89.1 % after 6 months of treatment. There was high correlation between vision status and CMT (P =<0.001). The mean values of baseline CMT were 301.68 (±134.738), 434.83 (±180.758), 518.67 (±275.184), 327 (±108.393) and 334.85 (±158.91) microns for the OCT patterns of ST, CME, sub-foveal detachment (SFD), vitreo-macular interface abnormality (VMIA) and average CMT respectively (p=0.042). Conclusion: OCT is a useful tool for evaluating CSME. It can show the various morphological variants of CSME while the BCVA and CMT are fairly different. DOI: http://dx.doi.org/10.3126/nepjoph.v4i1.5864 NEPJOPH 2012; 4(1): 128-133
Arterio-Venous (AV) Fistula: Surgical outcome in College of Medical Sciences Teaching Hospital, Bharatpur, Chitwan
S Shah,N Maharjan,D Chapagain,KG Shrestha,DJ Reddy
Journal of College of Medical Sciences-Nepal , 2012, DOI: 10.3126/jcmsn.v8i4.8693
Abstract: Aims Arteriovenous fistula is considered as reliable form of vascular access for hemodialysis in Chronic Kidney Disease (CKD) patients. We aim to evaluate prospectively, the outcome and primary failure rate of Arteriovenous fistula in 30 Chronic kidney Disease patients with Glomerular Filtration Rate (GFR) <30ml/min. Materials and methods This prospective study was conducted at the department of cardiothoracic and vascular surgery (CTVS), College of Medical Sciences, Bharatpur from May 2011 to May 2012. Thirty patients ranging from age 25 to 76 years with stage IV and V CKD, i.e. GFR below 30ml/min, were included in this study. Detailed physical examination including arterial pulses i.e. axillary, brachial, radial and ulnar and blood pressure in both upper limbs was recorded. Allens test was performed on every patient and left upper limb was used for AV fistula formation. Brachiocephalic fistula was made in 19 (63.33%), while radiocephalic fistula was made in 11 (36.67%) patients. Patients were evaluated post operatively, on outdoor basis, weekly for 6weeks. All patients were evaluated for the presence or absence of complications i.e. infection, hematoma, thrombosis, aneurysms and steal syndrome. Results The complication was primary failure in two patients. One male patient got secondary infection and one female patient got post operative hematoma leading to 6.66% primary failure of fistula. No other complications were noted. Conclusion Arteriovenous fistula is the gold standard for vascular access for hemodialysis in patients with deteriorating renal function and end-stage renal disease. It is designed to improve the effectiveness of dialysis with fewer risks and complications than other vascular accesses. This study gives the higher success rate of 93.33% and concludes that age should not be a limiting factor when determining candidacy for arteriovenous fistula creation and is the safe procedure. Journal of College of Medical Sciences-Nepal, 2012, Vol-8, No-4, 1-6 DOI: http://dx.doi.org/10.3126/jcmsn.v8i4.8693
Need of Improvement in Timing of Prophylactic Antibiotic in Elective Surgery
J N Shah, S B Maharjan, K Manandhar
Asian Journal of Medical Sciences , 2011, DOI: 10.3126/ajms.v2i3.5610
Abstract: Objective: Infections in surgery are major concern of morbidity, mortality, and costs. Timely antibiotic prophylaxis (AP) before incision ensures optimum concentration of AP in blood and tissues to prevent surgical site infections (SSIs). However, proper timing of AP remains problematic as reported by various studies, though none so far from? local institutions in Nepal. Aim of this cross sectional observation study was to assess and address the issues of timing of AP and need for improvements. Material & Methods: Convenient sample target of 100 cases of preoperative AP were studied from Oct 1 to Oct 30, 2010. Data were prospectively entered in predesigned ‘AP form’ for all major elective surgeries, except obstetric cases, who received AP of intravenous Cefazoline 1 g as per existing hospital protocol. Time of AP administration in respect to incision time was analyzed. Results: There were 125 cases during study period. Majority, 81% received AP before incision, while 19% had AP after the incision. Only 1% of patients received AP within recommended period within 60 to 30 minutes before incision. Conclusion: Current practice of antibiotic prophylaxis (AP) at our institutions needs improvement as per standard guidelines of AP within 60 to 30 minutes before incision. DOI: http://dx.doi.org/10.3126/ajms.v2i3.5610 Asian Journal of Medical Sciences 2 (2011) 207-211 ?
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