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Ugwumadu C, Thapa R, Nepal K, Gautam A, Al-Majali Y, Trembly J, Drabold DA. Self-Assembly and the Properties of Micro-Mesoporous Carbon. J Chem Theory Comput 2024; 20:1753-1762. [PMID: 37326598 DOI: 10.1021/acs.jctc.3c00394] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/17/2023]
Abstract
This study introduces a new approach for constructing atomistic models of nanoporous carbon by randomly distributing carbon atoms and pore volumes in a periodic box and then using empirical and ab initio molecular simulation tools to find the suitable energy-minimum structures. The models, consisting of 5000, 8000, 12000, and 64000 atoms, each at mass densities of 0.5, 0.75, and 1 g/cm3, were analyzed to determine their structural characteristics and relaxed pore size distribution. Surface analysis of the pore region revealed that sp atoms exist predominantly on surfaces and act as active sites for oxygen adsorption. We also investigated the electronic and vibrational properties of the models, and localized states near the Fermi level were found to be primarily situated at sp carbon atoms through which electrical conduction may occur. Additionally, the thermal conductivity was calculated using heat flux correlations and the Green-Kubo formula, and its dependence on pore geometry and connectivity was analyzed. The behavior of the mechanical elasticity moduli (Shear, Bulk, and Young's moduli) of nanoporous carbons at the densities of interest was discussed.
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Affiliation(s)
- C Ugwumadu
- Department of Physics and Astronomy, Nanoscale and Quantum Phenomena Institute (NQPI), Ohio University, Athens, Ohio 45701, United States
| | - R Thapa
- Department of Physics and Astronomy, Nanoscale and Quantum Phenomena Institute (NQPI), Ohio University, Athens, Ohio 45701, United States
| | - K Nepal
- Department of Physics and Astronomy, Nanoscale and Quantum Phenomena Institute (NQPI), Ohio University, Athens, Ohio 45701, United States
| | - A Gautam
- Department of Physics and Astronomy, Nanoscale and Quantum Phenomena Institute (NQPI), Ohio University, Athens, Ohio 45701, United States
| | - Y Al-Majali
- Department of Mechanical Engineering, Institute for Sustainable Energy and the Environment (ISEE), Ohio University, Athens, Ohio 45701, United States
| | - J Trembly
- Department of Mechanical Engineering, Institute for Sustainable Energy and the Environment (ISEE), Ohio University, Athens, Ohio 45701, United States
| | - D A Drabold
- Department of Physics and Astronomy, Nanoscale and Quantum Phenomena Institute (NQPI), Ohio University, Athens, Ohio 45701, United States
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Ambarchi Z, Boulton KA, Thapa R, Thomas EE, DeMayo MM, Sasson NJ, Hickie IB, Guastella AJ. Evidence of a reduced role for circumscribed interests in the social attention patterns of children with Autism Spectrum Disorder. J Autism Dev Disord 2023; 53:3999-4011. [PMID: 35927513 PMCID: PMC10499676 DOI: 10.1007/s10803-022-05638-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/06/2022] [Indexed: 11/27/2022]
Abstract
Reduced social attention is characteristic of Autism Spectrum Disorder (ASD). It has been suggested to result from an early onset and excessive influence of circumscribed interests (CIs) on gaze behaviour, compared to typically developing (TYP) individuals. To date, these findings have been mixed. The current eye-tracking study utilised a visual preference paradigm to investigate the influence of CI versus non-CI objects on attention patterns in children with ASD (aged 3-12 years, n = 37) and their age-matched TYP peers (n = 30). Compared to TYP, social and object attention was reduced in the ASD group irrespective of the presence of CIs. Results suggest a reduced role for CIs and extend recent evidence of atypical attention patterns across social and non-social domains in ASD.
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Affiliation(s)
- Z Ambarchi
- Brain and Mind Centre, Children's Hospital Westmead Clinical School, Faculty of Medicine and Health, University of Sydney, 2050, Sydney, Australia
| | - K A Boulton
- Brain and Mind Centre, Children's Hospital Westmead Clinical School, Faculty of Medicine and Health, University of Sydney, 2050, Sydney, Australia
| | - R Thapa
- Brain and Mind Centre, Children's Hospital Westmead Clinical School, Faculty of Medicine and Health, University of Sydney, 2050, Sydney, Australia
| | - E E Thomas
- Brain and Mind Centre, Children's Hospital Westmead Clinical School, Faculty of Medicine and Health, University of Sydney, 2050, Sydney, Australia
| | - M M DeMayo
- Brain and Mind Centre, Children's Hospital Westmead Clinical School, Faculty of Medicine and Health, University of Sydney, 2050, Sydney, Australia
| | - N J Sasson
- Department of Psychology, School of Behavioral and Brain Sciences, The University of Texas at Dallas, Richardson, USA
| | - I B Hickie
- Brain and Mind Centre, Central Clinical School, Faculty of Medicine and Health, University of Sydney, Sydney, Australia
| | - Adam J Guastella
- Brain and Mind Centre, Children's Hospital Westmead Clinical School, Faculty of Medicine and Health, University of Sydney, 2050, Sydney, Australia.
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Thapa R, Garikipati A, Ciobanu M, Singh NP, Browning E, DeCurzio J, Barnes G, Dinenno FA, Mao Q, Das R. Machine Learning Differentiation of Autism Spectrum Sub-Classifications. J Autism Dev Disord 2023:10.1007/s10803-023-06121-4. [PMID: 37751097 DOI: 10.1007/s10803-023-06121-4] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/19/2023] [Indexed: 09/27/2023]
Abstract
PURPOSE Disorders on the autism spectrum have characteristics that can manifest as difficulties with communication, executive functioning, daily living, and more. These challenges can be mitigated with early identification. However, diagnostic criteria has changed from DSM-IV to DSM-5, which can make diagnosing a disorder on the autism spectrum complex. We evaluated machine learning to classify individuals as having one of three disorders of the autism spectrum under DSM-IV, or as non-spectrum. METHODS We employed machine learning to analyze retrospective data from 38,560 individuals. Inputs encompassed clinical, demographic, and assessment data. RESULTS The algorithm achieved AUROCs ranging from 0.863 to 0.980. The model correctly classified 80.5% individuals; 12.6% of individuals from this dataset were misclassified with another disorder on the autism spectrum. CONCLUSION Machine learning can classify individuals as having a disorder on the autism spectrum or as non-spectrum using minimal data inputs.
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Affiliation(s)
- R Thapa
- Montera, Inc dba Forta, 548 Market St, PMB 89605, San Francisco, CA, USA
| | - A Garikipati
- Montera, Inc dba Forta, 548 Market St, PMB 89605, San Francisco, CA, USA
| | - M Ciobanu
- Montera, Inc dba Forta, 548 Market St, PMB 89605, San Francisco, CA, USA
| | - N P Singh
- Montera, Inc dba Forta, 548 Market St, PMB 89605, San Francisco, CA, USA
| | - E Browning
- Montera, Inc dba Forta, 548 Market St, PMB 89605, San Francisco, CA, USA
| | - J DeCurzio
- Montera, Inc dba Forta, 548 Market St, PMB 89605, San Francisco, CA, USA
| | - G Barnes
- Montera, Inc dba Forta, 548 Market St, PMB 89605, San Francisco, CA, USA
| | - F A Dinenno
- Montera, Inc dba Forta, 548 Market St, PMB 89605, San Francisco, CA, USA
| | - Q Mao
- Montera, Inc dba Forta, 548 Market St, PMB 89605, San Francisco, CA, USA.
| | - R Das
- Montera, Inc dba Forta, 548 Market St, PMB 89605, San Francisco, CA, USA
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Thapa R, Nikolli K, McMahon D, Blakemore S, Tamang S, Bhatta S, Gautam P, Shrestha R, Rajbhandari R. Novel on-site follow-up and enhancement program (FEP) improves knowledge, clinical skills and enabling environment of skilled birth attendants in Nepal. PLoS One 2023; 18:e0285653. [PMID: 37607194 PMCID: PMC10443845 DOI: 10.1371/journal.pone.0285653] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2022] [Accepted: 04/27/2023] [Indexed: 08/24/2023] Open
Abstract
INTRODUCTION Although great strides have been made in maternal and newborn health in Nepal, the maternal mortality ratio (MMR) is still high at 186 per 100,000 births. Many maternal deaths are preventable if there is access to a skilled birth attendant (SBA). The Ministry of Health and Population of Nepal launched the in-service SBA training program in 2007 and has trained over 10,000 SBAs to date. Evidence shows that one episode of training is not enough to retain skills. Therefore, the Nick Simons Institute (NSI) in collaboration with National Health Training Center (NHTC) devised a Follow-Up and Enhancement Program (FEP) in 2011 where the knowledge, clinical skills, and working environment of SBA graduates were assessed directly at their worksites. FEP allows on-site coaching and feedback so that graduates may continue to improve upon any gaps in their knowledge, skills, and working environment. This study aims to assess the effectiveness of FEP. METHODS We used a mixed-methods research design. A total of 73 SBAs who had a pre-FEP assessment in 2016 were followed up for a post-FEP assessment in 2017. We also collected data from 3 additional districts (115 SBAs) that had not previously had FEP, to compare SBAs in FEP versus non-FEP districts. Qualitative data was collected from 16 health facilities on the perceptions, motivation, and satisfaction of stakeholders. RESULTS Of the total 188 SBAs that were sampled, a one-time FEP increased knowledge scores by 9%, clinical skills scores by 29%, and enabling environment scores by 7%. The number of deliveries conducted improved with a one-time FEP, although this increase was not statistically significant. We found a trickle-down effect of working in a facility that has had prior FEP, with SBAs that have never had FEP improving their clinical skills. FEP was found to be a highly accepted program and is beneficial to SBAs, trainers, and the Hospital Management Committee (HFOMC). However, a one-time FEP is not sufficient in retaining clinical skills and knowledge. CONCLUSION FEP is a highly effective program by both quantitative and qualitative evaluation. Our study suggests that FEP should be frequent and continuous to retain the knowledge and clinical skills of SBAs, motivate them through on-site coaching, and improve their working environment through direct feedback to the Ministry of Health and Population.
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Affiliation(s)
- R. Thapa
- Nick Simons Institute, Kathmandu, Nepal
| | - K. Nikolli
- Division of Global Health Equity, Brigham and Women’s Hospital, Boston, MA, United States of America
| | - D. McMahon
- Harvard Medical School, Boston, MA, United States of America
| | - S. Blakemore
- Division of Global Health Equity, Brigham and Women’s Hospital, Boston, MA, United States of America
| | - S. Tamang
- Nick Simons Institute, Kathmandu, Nepal
| | - S. Bhatta
- National Health Training Center, Kathmandu, Nepal
| | - P. Gautam
- Harvard T.H. Chan School of Public Health, Boston, MA, United States of America
| | | | - R. Rajbhandari
- Nick Simons Institute, Kathmandu, Nepal
- Division of Global Health Equity, Brigham and Women’s Hospital, Boston, MA, United States of America
- Harvard Medical School, Boston, MA, United States of America
- Mount Auburn Hospital, Cambridge, MA, United States of America
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Kelkar A, Rasmussen B, Thapa R. Not All That Flares is Gout: Calcineurin-Inhibitor Induced Pain Syndrome (CIPS) Post Heart Transplant. J Heart Lung Transplant 2023. [DOI: 10.1016/j.healun.2023.02.489] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/05/2023] Open
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Thapa R, Ugwumadu C, Nepal K, Trembly J, Drabold DA. Ab Initio Simulation of Amorphous Graphite. Phys Rev Lett 2022; 128:236402. [PMID: 35749197 DOI: 10.1103/physrevlett.128.236402] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/22/2022] [Revised: 04/06/2022] [Accepted: 05/31/2022] [Indexed: 06/15/2023]
Abstract
An amorphous graphite material has been predicted from molecular dynamics simulation using ab initio methods. Carbon materials reveal a strong proclivity to convert into a sp^{2} network and then layer at temperatures near 3000 K within a density range of ca. 2.2-2.8 g/cm^{3}. Each layer of amorphous graphite is a monolayer of amorphous graphene including pentagons and heptagons in addition to hexagons, and the planes are separated by about 3.1 Å. The layering transition has been studied using various structural and dynamical analyses. The transition is unique as one of partial ordering (long range order of planes and galleries, but topological disorder in the planes). The planes are quite flat, even though monolayer amorphous graphene puckers near pentagonal sites. Interplane cohesion is due partly to non-Van der Waals interactions. The structural disorder has been studied closely, especially the consequences of disorder to electronic transport. It is expected that the transition elucidated here may be salient to other layered materials.
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Affiliation(s)
- R Thapa
- Department of Physics and Astronomy, Nanoscale and Quantum Phenomena Institute (NQPI), Ohio University, Athens, Ohio 45701, USA
| | - C Ugwumadu
- Department of Physics and Astronomy, Nanoscale and Quantum Phenomena Institute (NQPI), Ohio University, Athens, Ohio 45701, USA
| | - K Nepal
- Department of Physics and Astronomy, Nanoscale and Quantum Phenomena Institute (NQPI), Ohio University, Athens, Ohio 45701, USA
| | - J Trembly
- Department of Mechanical Engineering, Institute for Sustainable Energy and the Environment, Ohio University, Athens, Ohio 45701, USA
| | - D A Drabold
- Department of Physics and Astronomy, Ohio University, Athens, Ohio 45701, USA
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Demetriou EA, Boulton KA, Bowden MR, Thapa R, Guastella AJ. An evaluation of homesickness in children: A systematic review and meta-analysis. J Affect Disord 2022; 297:463-470. [PMID: 34740026 DOI: 10.1016/j.jad.2021.09.068] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/30/2021] [Revised: 09/04/2021] [Accepted: 09/21/2021] [Indexed: 10/20/2022]
Abstract
OBJECTIVE To provide a systematic review and meta-analysis of the quantitative literature on homesickness in children, including how it is assessed and relationship to other negative states. STUDY SELECTION AND SYNTHESIS A literature search was conducted using Medline, PsychINFO and Scopus databases. Studies were included if they assessed homesickness in children under eighteen years of age and were published in peer reviewed journals in the English language between 1990 and December 2020. A total of 176 studies were screened for relevance and 17 met the inclusion criteria for the systematic review with five studies included in the meta-analysis. MAIN OUTCOMES AND MEASURES The primary outcome measure was homesickness severity, and it was examined in relation to measures of depression and anxiety. The literature in relation to known risk and protective factors was also reviewed. RESULTS Homesickness was reported in the majority of children who were separated from their home. It was associated with negative emotional states. A total of seventeen studies were included in the quantitative review. The meta-analysis showed a significant relationship between homesickness and depression r=0.431 (95% CI 0.344-0.510; p<0.001) and homesickness and anxiety r=0.426 (95% CI 0.369-0.479; p<0.001). Age was not a significant moderator of homesickness severity. Consideration of effective interventions to address homesickness was limited. CONCLUSIONS AND RELEVANCE Homesickness significantly impacts children's well-being regardless of age and is associated with overall distress, depression and anxiety. Future studies are required to examine homesickness interventions and supports to improve well-being in children.
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Affiliation(s)
- E A Demetriou
- Brain and Mind Centre, Children's Hospital Westmead Clinical School, Faculty of Medicine and Health, University of Sydney, 2050
| | - K A Boulton
- Brain and Mind Centre, Children's Hospital Westmead Clinical School, Faculty of Medicine and Health, University of Sydney, 2050
| | - M R Bowden
- Mental Health Branch, NSW Health; Sydney Children's Hospitals Network; Discipline of Psychiatry, Westmead Clinical School and The Children's Hospital at Westmead Clinical School, Faculty of Medicine and Health, University of Sydney
| | - R Thapa
- Brain and Mind Centre, Children's Hospital Westmead Clinical School, Faculty of Medicine and Health, University of Sydney, 2050
| | - A J Guastella
- Brain and Mind Centre, Children's Hospital Westmead Clinical School, Faculty of Medicine and Health, University of Sydney, 2050.
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Baral P, Hann K, Pokhrel B, Koirala T, Thapa R, Bijukchhe SM, Khogali M. Annual consumption of parenteral antibiotics in a tertiary hospital of Nepal, 2017-2019: a cross-sectional study. Public Health Action 2021; 11:52-57. [PMID: 34778016 PMCID: PMC8575388 DOI: 10.5588/pha.21.0043] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2021] [Accepted: 08/10/2021] [Indexed: 11/11/2022] Open
Abstract
SETTING Patan Hospital, a tertiary care hospital in Lalitpur District, Nepal. OBJECTIVES To describe the annual parenteral antibiotic consumption in 1) defined daily dose (DDD) and DDD per 100 admissions; 2) calculate DDD per 100 admissions and proportions by pharmacological subgroup, chemical subgroup and AWaRe categories; and 3) describe patient expenditure on parenteral antibiotics as a proportion of the total patient expenditure on drugs and consumables between 2017 and 2019. DESIGN This was a cross-sectional study. RESULTS Total DDD of parenteral antibiotics increased by 23% from 39,639.7 in 2017 to 48,947.7 in 2019. DDD per 100 admissions increased by 10% from 172.1 in 2017 to 190.2 in 2019. Other beta-lactam antibacterials comprised the most frequently consumed pharmacological subgroup. The chemical substance most often consumed was ceftriaxone, with an increasing trend in the consumption of vancomycin and meropenem. Parenteral antibiotics in 'Watch' category were the most consumed over the study period, with a decreasing trend in 'Access' and increasing trend in 'Reserve' categories. CONCLUSION We aimed to understand the consumption of parenteral antibiotics at a tertiary care hospital and found that Watch antibiotics comprised the bulk of antibiotic consumption. Overconsumption of antibiotics from the 'Watch' and 'Reserve' categories can promote antimicrobial resistance; recommendations were therefore made for their rational use.
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Affiliation(s)
- P Baral
- Department of Pharmacy, Modern Technical College, Sanepa, Lalitpur, Nepal
| | - K Hann
- Sustainable Health System, Freetown, Sierra Leone
| | - B Pokhrel
- Department of Paediatrics, Patan Academy of Health Sciences, Lalitpur, Nepal
| | - T Koirala
- Dasharathpur Primary Health Centre, Department of Health Services, Ministry of Health and Population, Surkhet, Nepal
| | - R Thapa
- Department of Pharmacy, Patan Academy of Health Sciences, Lalitpur, Nepal
| | - S M Bijukchhe
- Department of Paediatrics, Patan Academy of Health Sciences, Lalitpur, Nepal
| | - M Khogali
- UNICEF/UNDP/World Bank/WHO Special Programme for Research and Training in Tropical Diseases (TDR), World Health Organization, Geneva, Switzerland
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Liveringhouse C, Wilson C, Mills M, Thapa R, Fridley B, Robinson T, Diaz R. PH-0224 Association between the genomic immune response and locoregional control in ER- breast cancer. Radiother Oncol 2021. [DOI: 10.1016/s0167-8140(21)07276-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Mills M, Liveringhouse C, Lee F, Nanda R, Ahmed K, Washington I, Thapa R, Fridley B, Blumencranz P, Extermann M, Balducci L, Diaz R. THE PREVALENCE OF LUMINAL B SUBTYPE IS HIGHER IN OLDER POSTMENOPAUSAL WOMEN WITH ER+/HER2– BREAST CANCER AND IS ASSOCIATED WITH INFERIOR OUTCOMES. J Geriatr Oncol 2019. [DOI: 10.1016/s1879-4068(19)31150-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
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Dulal S, Paudel B, Shah A, Neupane P, Acharya B, Chapagain S, Karn A, Shilpakar R, Thapa R, Gautam B, Brustugun O, Leighl N. EP1.01-40 Outcome of EGFR-Mutated and Non-Mutated Lung Adenocarcinoma Receiving Standard Therapy - A Nepalese Cohort. J Thorac Oncol 2019. [DOI: 10.1016/j.jtho.2019.08.2013] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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Puri S, Guadalupe NR, Niyongere S, Boyle T, Thapa R, Chen D, Noyes D, Chatwal M, Antonia S, Gray J. P2.01-06 Phase I Study of Nivolumab and Ipilimumab Combined with Nintedanib in Advanced Non-Small Cell Lung Cancer. J Thorac Oncol 2019. [DOI: 10.1016/j.jtho.2019.08.1350] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Dulal S, Paudel B, Shah A, Neupane P, Acharya B, Chapagain S, Rayamajhi A, Thapa R, Brustugun O, Leighl N. EP1.01-30 Clinico-Pathological Profile of Adenocarcinoma of the Lung – A Prospective Study in a Nepalese Population. J Thorac Oncol 2019. [DOI: 10.1016/j.jtho.2019.08.2007] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Scott J, Sedor G, Peacock J, Kattan M, Waller A, Grass D, Mellon E, Thapa R, Schell M, Poppen S, Andl G, Eschrich S, Dilling T, Dalton W, Harrison L, Fox T, Torres-Roca J. Quantifying Inefficiencies in Empiric Radiation Dosing: The Clinical Cost of Ignoring Biological Heterogeneity. Int J Radiat Oncol Biol Phys 2019. [DOI: 10.1016/j.ijrobp.2019.06.192] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
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Chiappori A, Williams C, Creelan B, Tanvetyanon T, Gray J, Haura E, Chen D, Thapa R, Beg A, Boyle T, Sangani M, Morris E, Tao A, Hurtado F, Manenti L, Castro J, Antonia S. P1.04-32 Phase I/II Study of the A2AR Antagonist NIR178 (PBF-509), an Oral Immunotherapy, in Patients (pts) with Advanced NSCLC. J Thorac Oncol 2018. [DOI: 10.1016/j.jtho.2018.08.747] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
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Thompson A, Thapa R, Galoforo S, Hang X, Buelow K, Wilson G. Targeting Stem Cells in Head and Neck Cancer Using Superparamagnetic Iron Oxide Nanoparticles. Int J Radiat Oncol Biol Phys 2017. [DOI: 10.1016/j.ijrobp.2017.06.2098] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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17
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Thapa R, Lakhey M, Bhatta AD. Spectrum of histomorphological diagnosis in cystoscopic bladder biopsies. J Pathol Nep 2017. [DOI: 10.3126/jpn.v7i1.16913] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
Abstract
Background: Urinary bladder lesions are the main source of significant clinical symptoms which are more disabling than lethal. Bladder tumors constitute one of the most common urological pathology. Urothelial carcinoma accounts for 90% of all primary tumors of the bladder. This study aimed to determine the frequency of different types of lesions of the urinary bladder and to determine the grade and stage of urothelial tumors.Materials and Methods: This is a 2 years cross sectional study of cystoscopic biopsies carried out in the Department of Pathology, Medicare National Hospital and Research Centre, Kathmandu, Nepal.Results: Out of 87 cases, 58 (66.67%) cases were neoplastic lesions and 29(33.33%) cases were non- neoplastic lesions. Majority of neoplastic lesions 96.55% were urothelial (transitional cell) tumors comprising predominantly of low grade papillary urothelial carcinoma 50.91%. Muscle invasion was seen only in high grade papillary urothelial carcinomas.Conclusion: Among bladder tumors low grade papillary urothelial carcinoma is the most common.
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Bari R, Thapa R, Bao J, Li Y, Zheng J, Leung W. KIR2DL2/2DL3-E(35) alleles are functionally stronger than -Q(35) alleles. Sci Rep 2016; 6:23689. [PMID: 27030405 PMCID: PMC4814820 DOI: 10.1038/srep23689] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/12/2015] [Accepted: 03/09/2016] [Indexed: 11/26/2022] Open
Abstract
KIR2DL2 and KIR2DL3 segregate as alleles of a single locus in the centromeric motif of the killer cell immunoglobulin-like receptor (KIR) gene family. Although KIR2DL2/L3 polymorphism is known to be associated with many human diseases and is an important factor for donor selection in allogeneic hematopoietic stem cell transplantation, the molecular determinant of functional diversity among various alleles is unclear. In this study we found that KIR2DL2/L3 with glutamic acid at position 35 (E35) are functionally stronger than those with glutamine at the same position (Q35). Cytotoxicity assay showed that NK cells from HLA-C1 positive donors with KIR2DL2/L3-E35 could kill more target cells lacking their ligands than NK cells with the weaker -Q35 alleles, indicating better licensing of KIR2DL2/L3+ NK cells with the stronger alleles. Molecular modeling analysis reveals that the glutamic acid, which is negatively charged, interacts with positively charged histidine located at position 55, thereby stabilizing KIR2DL2/L3 dimer and reducing entropy loss when KIR2DL2/3 binds to HLA-C ligand. The results of this study will be important for future studies of KIR2DL2/L3-associated diseases as well as for donor selection in allogeneic stem cell transplantation.
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Affiliation(s)
- Rafijul Bari
- Department of Bone Marrow Transplantation and Cellular Therapy, St. Jude Children's Research Hospital, Memphis, Tennessee, USA
| | - Rajoo Thapa
- Department of Bone Marrow Transplantation and Cellular Therapy, St. Jude Children's Research Hospital, Memphis, Tennessee, USA
| | - Ju Bao
- Department of Structural Biology, St. Jude Children's Research Hospital, Memphis, Tennessee, USA
| | - Ying Li
- Department of Bone Marrow Transplantation and Cellular Therapy, St. Jude Children's Research Hospital, Memphis, Tennessee, USA
| | - Jie Zheng
- Department of Structural Biology, St. Jude Children's Research Hospital, Memphis, Tennessee, USA
| | - Wing Leung
- Department of Bone Marrow Transplantation and Cellular Therapy, St. Jude Children's Research Hospital, Memphis, Tennessee, USA.,Department of Pediatrics, University of Tennessee Health Science Center, Memphis, Tennessee, USA
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Mallick D, Thapa R, Biswas B. Co-occurrence of biphenotypic acute leukaemia, glucose 6-phosphate dehydrogenase deficiency and haemoglobin E trait in a single child. BMJ Case Rep 2016; 2016:bcr-2015-212714. [PMID: 26833952 DOI: 10.1136/bcr-2015-212714] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022] Open
Abstract
Acute leukaemias occur as the result of clonal expansion subsequent to transformation and arrest at a normal differentiation stage of haematopoietic precursors, which commit to a single lineage, such as myeloid or B-lymphoid or T-lymphoid cells. Biphenotypic acute leukaemia (BAL) constitutes a biologically different group of leukaemia arising from a precursor stem cell and co-expressing more than one lineage specific marker. The present report describes a child with unusual co-occurrence of biphenotypic (B-precursor cell and Myeloid) acute leukaemia, haemoglobin E trait and glucose 6-phosphate dehydrogenase (G6-PD) deficiency. To the best of our knowledge, this constellation of haematological conditions in a single child has never been described before.
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Affiliation(s)
| | - Rajoo Thapa
- Department of Pediatrics, Golisano Children's Hospital, Syracuse, New York, USA
| | - Biswajit Biswas
- Department of Pediatrics, Institute of Child Health, Kolkata, West Bengal, India
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Thapa R, Bajimaya S, Sharma S, Rai BB, Paudyal G. Systemic association of newly diagnosed proliferative diabetic retinopathy among type 2 diabetes patients presented at a tertiary eye hospital of Nepal. Nepal J Ophthalmol 2015; 7:26-32. [DOI: 10.3126/nepjoph.v7i1.13163] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
Abstract
Introduction: Proliferative diabetic retinopathy (PDR) is the leading cause of blindness among the diabetics. Objective: to study the systemic association of proliferative diabetic retinopathy. Materials and methods: A prospective, case-series study was conducted among the newly diagnosed proliferative diabetic retinopathy cases presenting at the Tilganga Institute of Ophthalmology (TIO) from January 2012 to January 2013. Diabetic retinopathy was classi¿ed using the Early Treatment Diabetic Retinopathy Study criteria. Blood pressure, fasting and postprandial blood sugar, glycosylated hemoglobin, lipid pro¿le, urine for microalbumin, urea, and creatinine were evaluated at the time of diagnosis.Results: A total of 104 type 2 diabetic patients with newly diagnosed PDR presented during the study period. Concurrent macular edema was present in 93 cases (89.42 %). The mean age was 56.96 ± 9.394 (range 32 - 78) years. Males and females comprised of 75.7 % and 24.3 % respectively. The majority (37.5 %) were involved in business, followed by government service (17.30 %), and housewives (16.34 %). Mean duration of diabetes was 11.42 ± 5.356 years (range 1 month - 26 years). Concurrent hypertension was found in 55.76 %, uncontrolled fasting and or postprandial blood sugar in 72.54 %, poor glycemic control (HbA1C > 7 %) in 73.97 %, abnormal lipid profile in 52.56 %, microalbuminuria in 67.85 %, and positive urine albumin in 50 % of the cases.Conclusion: Despite the short duration of diabetes, the concurrent hypertension, poor glycemic control, proteinuria and dyslipidemia were the main systemic associations for PDR at our clinical set-up. Awareness, identification and management of these systemic problems could reduce the rapid progression to PDR.
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Wongsiri S, Lekprayoon C, Thapa R, Thirakupt K, Rinderer TE, Sylvester HA, Oldroyd BP, Booncham U. Comparative biology ofApis andreniformisandApis floreain Thailand. ACTA ACUST UNITED AC 2015. [DOI: 10.1080/0005772x.1997.11099328] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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Debnath A, Thapa R, Chattopadhyay KK, Saha B. Spectroscopic Studies on Interaction of Congo Red with Ferric Chloride in Aqueous Medium for Wastewater Treatment. SEP SCI TECHNOL 2015. [DOI: 10.1080/01496395.2014.978474] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
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Biswas B, Mondal M, Thapa R, Mallick D. Childhood hepatitis A virus infection associated with immune thrombocytopenic purpura: Report of two cases. Med J DY Patil Univ 2015. [DOI: 10.4103/0975-2870.160827] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
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Abstract
Cayler cardiofacial syndrome is characterised by congenital unilateral hypoplasia of the depressor anguli oris muscle (DAOM) in association with congenital cardiac defects. Hypoplasia of this muscle causes inability to move one corner of the mouth downward and outward while crying or grimacing, giving rise to an 'asymmetric crying face' appearance. A variety of congenital cardiac defects have been described. Occasionally, other organ system anomalies may be additionally present. We present an instance of right-sided hypoplasia of the DAOM in a male newborn, which additionally had dextrocardia as a component of situs inversus totalis. To our knowledge, situs inversus totalis has not been previously documented as a part of this syndrome. Additionally, we reiterate that paediatricians need to be aware that this minor facial anomaly may be associated with severe internal organ system anomalies, with cardiac being most common.
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Affiliation(s)
- Birendra Rai
- Department of Pediatrics, Midland Regional Hospital, Mullingar, Ireland,
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Biswas B, Mondal M, Thapa R, Mallick D, Datta AK. Neonatal Brain Abscess due to Extended-Spectrum Beta-Lactamase Producing Klebsiella pneumoniae. J Clin Diagn Res 2014; 8:PD01-2. [PMID: 25584278 DOI: 10.7860/jcdr/2014/10160.5198] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2014] [Accepted: 09/20/2014] [Indexed: 11/24/2022]
Abstract
Klebsiella pneumoniae (K. pneumoniae) causing brain abscess in newborn infants is rare. Presented herein, is a 27-day-old male neonate who developed two frontal lobe abscesses in association with K. pneumoniae sepsis and meningitis. Antibiotic susceptibility testing utilizing the double-disk synergy method (Cefotaxime and Amoxycillin-Clavulanate) confirmed the extended spectrum beta-lactamase (ESBL) production by the isolate. He was treated simultaneously with antibiotics (Meropenem and Amikacin) and abscess aspiration through the anterior fontanelle, with less than satisfactory outcome. ESBL producing K. pneumoniae brain abscess in neonates is extremely rare in the English literature. Emperical carbapenems and aminoglycoside coverage in neonates with K. pneumoniae sepsis and brain abscess, especially in areas with high rate of ESBL producing bacteria may be warranted.
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Affiliation(s)
- Biswajit Biswas
- Assistant Professor, Departments of Pediatrics, Burdwan Medical College and Hospital , Burdwan, West Bengal, India
| | - Monojit Mondal
- Resident, Departments of Pediatrics, Burdwan Medical College and Hospital , Burdwan, West Bengal, India
| | - Rajoo Thapa
- Resident, Department of Pediatrics, Golisano Children's Hospital, Upstate Medical University, 750, E. Adams Street , Syracuse, New York 13210, USA
| | - Debkrishna Mallick
- Resident, Department of Pediatrics, St.Mary's Hospital, PO30 5TG Newport , Wales, UK
| | - Asok Kumar Datta
- Professor and Head of the Deptartment, Departments of Pediatrics, Burdwan Medical College and Hospital , Burdwan, West Bengal, India
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Thapa R, Joshi DM, Rizyal A, Maharjan N, Joshi RD. Prevalence, risk factors and awareness of diabetic retinopathy among admitted diabetic patients at a tertiary level hospital in Kathmandu. Nepal J Ophthalmol 2014; 6. [PMID: 25341843 DOI: 10.3126/nepjoph.v6i1.10760] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
Abstract
INTRODUCTION Diabetic retinopathy (DR) is one of the commonest causes of visual impairment and blindness in Nepal. OBJECTIVES The study aims to explore the prevalence, risk factors and awareness of DR among admitted diabetic patients. MATERIALS AND METHODS A non-interventional case series study was conducted among the inpatient diabetic cases referred for ophthalmic consultation. The patients' detailed demographics, awareness on DR, concurrent systemic problems, and glycemic control status were recorded. DR was graded using the Early Treatment Diabetic Retinopathy Study Criteria. MAIN OUTCOME MEASURES The prevalence, risk factors and awareness of diabetic retinopathy among the study participants was analyzed. RESULTS A total of 277 diabetic patients were enrolled in the study. The mean age was 62.25 ± 13.26 years. Only one-third (34.6 %) of the cases were admitted for sugar control and newly diagnosed cases comprised of 19.49 %. Nearly half of the cases (46.6 %) were not aware of diabetic retinopathy and dilated fundus evaluation was done for the first time in 44.4 %. DR was found in 38.26 % of the cases and was diagnosed in 13 % of the new cases. Almost four-fifths (78 %) of the diabetics had had the disease for a duration of 16 to 20 years. Clinically significant macular edema was found in 5.78 % and proliferative DR in 2.52 %. DR was significantly associated with the duration of diabetes (P value = 0.001) and concurrent hypertension (P value = 0.004). CONCLUSION The prevalence of DR was 38 % among the admitted diabetic cases and the DR was significantly associated with the duration of diabetes and systemic hypertension. Almost half of the cases had been unaware of DR before referral. This emphasizes the importance of the collaboration of the physician and the ophthalmologist for an early DR detection.
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Affiliation(s)
- R Thapa
- Tilganga Institute of Ophthalmology
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Thapa R, Paudyal G. Clinico-microbiological Profile and Visual outcome in Traumatic Endophthalmitis following Pars Plana Vitrectomy at a Tertiary Eye Care Centre of Nepal. JNMA J Nepal Med Assoc 2014; 52:886-891. [PMID: 26982661] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/05/2023] Open
Abstract
INTRODUCTION Endophthalmitis is a potentially devastating ocular complication of perforating eye injury (PEI) where prompt intervention can save some vision. This study aims to explore the clinico-microbiologic profile and visual outcome following pars plana vitrectomy (PPV) in traumatic endophthalmitis. METHODS This is a retrospective interventional case series study conducted at a tertiary eye care centre of Nepal. A total of 49 consecutive cases (49 eyes) of endophthalmitis following PEI, who underwent PPV from January 2007 to June 2010 were included in the study. RESULTS Mean age was 14.7 years (S.D. 14.27). Twenty seven patients (55%) were of age group below 10 years. Male to female ratio was 2.75:1. Mean duration of presentation was 8.9 days. Nineteen eyes (36.73%) had injuries with wooden sticks, followed by injury with metallic objects in 16 patients (32.56%). PEI involving zone I was found in 31 eyes (63.25%). The retained intraocular foreign body was found in seven patients (14.2%). The post operative vision improved in almost 24 cases (49%) with visual recovery of 20/200 and better in six cases (12.24%). The vitreous culture was positive in five cases (12.8%) with predominant streptococcus pneumonia in four cases (10.25%). CONCLUSIONS Children were the mostly affected group with males outnumbering females. Wooden sticks and metallic objects were the commonest insulting agents. Despite the late presentation and predominant zone I injury, eye could be salvaged in majority with visual recovery of 20/200 and better in six cases (12.24%).
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Affiliation(s)
- R Thapa
- Tilganga Institute of Ophthalmology, Gaushala, Kathmandu, Nepal
| | - G Paudyal
- Tilganga Institute of Ophthalmology, Gaushala, Kathmandu, Nepal
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Yee S, Ionascu D, Thapa R, Wilson G. SU-E-T-558: An Exploratory RF Pulse Sequence Technique Used to Induce Differential Heating in Tissues Containing Iron Oxide Nanoparticles for a Possible Hyperthermic Adjuvant Effect to Radiotherapy. Med Phys 2014. [DOI: 10.1118/1.4888893] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
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Thapa R, Poudyal G. Short term results of intra-vitreal bevacizumab for the treatment of macular edema secondary to retinal vein occlusion. Nepal J Ophthalmol 2014; 5:63-8. [PMID: 23584649 DOI: 10.3126/nepjoph.v5i1.7824] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
Abstract
INTRODUCTION Macular edema (ME) is the leading cause of visual impairment in retinal vein occlusion (RVO). OBJECTIVE To evaluate the efficacy and safety of intravitreal bevacizumab (Avastin; Genentech) on ME secondary to RVO. MATERIALS AND METHODS A prospective, interventional study was conducted among patients with ME due to RVO from June 2008 to February 2010. Intravitreal bevacizumab (1.25 mg/0.05 ml) was given at 4 to 6 weekly intervals until the ME subsided. Complete ophthalmic evaluation and measurement of central retinal thickness (CRT) by optical coherence tomography (OCT) were performed at baseline and follow up visits. RESULTS Thirty four eyes (18 CRVO and 16 BRVO) were included in the study. The mean duration of visual symptoms and follow up period were 5.1 months (range 0.3 - 24 months) and 7.5 ± 4.8 months respectively. In CRVO, the CRT improved from 652 ± 206 ?m at the baseline to 257 ± 132 ?m (p less than 0.0001) at the final follow up, and in BRVO, the CRT improved from 540 ±197 ?m to 219 ± 135 ?m (p 0.0001). The improvement in BCVA was significant at each follow up interval for BRVO; in CRVO, there was only a significant improvement between the baseline and the 6 weeks' follow up. BCVA was improved in 75 % cases of BRVO and in 61.6 % in CRVO at the final follow up. There were no ocular or systemic adverse effects. CONCLUSION Intravitreal bevacizumab is an effective and safe drug for reducing ME and improving visual acuity secondary to RVO in the short term follow up.
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Affiliation(s)
- R Thapa
- Vitreo-retinal Service, Tilganga Institute of Ophthalmology, Kathmandu, Nepal
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Hirachand S, Maharjan M, Lakhey M, Thapa R, Kafle S. Accuracy of fine needle aspiration cytology in diagnosis of thyroid swelling. J Pathol Nep 2013. [DOI: 10.3126/jpn.v3i6.8988] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
Abstract
Background: Fine needle aspiration cytology has been shown to be simple, safe, cost effective and quick to perform procedure with excellent patient compliance. It is a well established technique for preoperative investigation of thyroid gland swellings with high sensitivity, specificity and accuracy. The aim of this study was to determine the accuracy of fine needle aspiration cytology of thyroid swellings performed at our institution. Materials and Methods: This study was carried out at Kathmandu Medical College and Teaching hospital, department of Pathology over a period of 3 years (January 2010 to December 2012). Two hundred and seventy three patients of all age groups and both sexes who underwent fine needle aspiration cytology for thyroid swelling were evaluated. Out of 273 patients, histopathological diagnosis was available in 45 patients. Results: Fine needle aspiration cytology result revealed 245 cases (89.7%) as non-neoplastic, 21 cases (7.7%) as neoplastic and 7 cases (2.6%) inadequate due to lack of cellularity. The commonest lesion in the thyroid gland was colloid goiter. Among the malignant neoplasms the commonest was papillary carcinoma. Out of 273 patients, histopathological diagnosis was available in 45 patients. Statistical analysis of our data shows the diagnostic accuracy of fine needle aspiration cytology to be 95.7%. Fine needle aspiration cytology showed a sensitivity of 96.4% and a specificity of 94.4%. Conclusion: Fine needle aspiration cytology is a well established technique for pre operative investigation of thyroid gland swellings with high sensitivity, specificity and accuracy. DOI: http://dx.doi.org/10.3126/jpn.v3i6.8988Journal of Pathology of Nepal (2013) Vol. 3, 433-436
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Morrison J, Thapa R, Hartley S, Osrin D, Manandhar M, Tumbahangphe K, Neupane R, Budhathoki B, Sen A, Pace N, Manandhar DS, Costello A. Understanding how women's groups improve maternal and newborn health in Makwanpur, Nepal: a qualitative study. Int Health 2013; 2:25-35. [PMID: 24037047 DOI: 10.1016/j.inhe.2009.11.004] [Citation(s) in RCA: 59] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022] Open
Abstract
Women's groups, working through participatory learning and action, can improve maternal and newborn survival. We describe how they stimulated change in rural Nepal and the factors influencing their effectiveness. We collected data from 19 women's group members, 2 group facilitators, 16 health volunteers, 2 community leaders, 21 local men, and 23 women not attending the women's groups, through semi-structured interviews, group interviews, focus group discussions and unstructured observation of groups. Participants took photographs of their locality for discussion in focus groups using photoelicitation methods. Framework analysis procedures were used, and data fed back to respondents. When group members were compared with 11 184 women who had recently delivered, we found that they were of similar socioeconomic status, despite the context of poverty, and caste inequalities. Four mechanisms explain the women's group impact on health outcomes: the groups learned about health, developed confidence, disseminated information in their communities, and built community capacity to take action. Women's groups enable the development of a broader understanding of health problems, and build community capacity to bring health and development benefit.
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Affiliation(s)
- J Morrison
- UCL Centre for International Health and Development, Institute of Child Health, University College London, 30 Guilford Street, London WC1N 1EH, UK
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Abstract
INTRODUCTION Nepal has many mountains including the highest one in the world. People living in high altitude are often involved in climbing mountains. OBJECTIVE To explore the pattern of vitreo-retinal disorders at high altitude in Nepal. MATERIALS AND METHODS Consecutive patients aged 40 years and older who presented at the micro-surgical eye camp at Lukla of Solukhumbu district (2,860 metres) were included. Detailed ocular and systemic histories and ocular examination including dilated fundus evaluation were done. RESULTS There were a total 81 patients with the mean age of 56.7 years (S.D 11.15). Females (51.9 %) outnumbered males. Sherpa comprised of 76.5 % followed by Rai (9.8 %). The main occupation was agriculture (51.9 %) followed by mountain trekking (28.4 %). Smokers comprised of 13.5 %. Hypertension was the predominant systemic problem (28 %). The best corrected visual acuity of 6/18 and better was found in 86.4 % of cases and less than 3/ 60 in 3.6 % of cases. Age-related macular degeneration (AMD) was found in 19.6 % of cases with a predominant mild AMD (16 %), hypertensive retinopathy in 12.2 %, with grade I hypertensive change in 8.6 %, retinal vein occlusion (RVO) in 7.1 % of cases and with a branch RVO in 4.9 %. Dilated and tortuous retinal vessels were present in 25.9 % of cases; out of this, 9.8 % of the cases had concurrent AMD and/or hypertensive retinopathy. Other retinal problems were macular hole (2.46 %), solar retinopathy (2.46 %) and choroidal tear (1.2 %). CONCLUSION AMD, hypertensive retinopathy, and RVO are the main vitreo-retinal disorders besides the dilated and tortuous retinal vessels in people living at high altitude in Nepal.
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Affiliation(s)
- R Thapa
- Vitreo-retinal Unit, Tilganga Institute of Ophthalmology, Kathmandu, Nepal
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Thapa R, Poudyal G, Maharjan N, Bernstein PS. Demographics and awareness of diabetic retinopathy among diabetic patients attending the vitreo-retinal service at a tertiary eye care center in Nepal. Nepal J Ophthalmol 2013; 4:10-6. [PMID: 22343990 DOI: 10.3126/nepjoph.v4i1.5844] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
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.
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Affiliation(s)
- R Thapa
- Tilganga Institute of Ophthalmology, Kathmandu, Nepal.
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Abstract
BACKGROUND The Age related Macular Degeneration (AMD) is a common cause of visual impairment and blindness worldwide in elderly. OBJECTIVE This study aimed to explore the demographic characteristics, pattern and risk factors for AMD at a tertiary referral eye centre in Nepal. METHODS This is a hospital-based prospective study, conducted at Tilganga Institute of Ophthalmology, Nepal from September 2008 to May 2009. All the consecutive cases of AMD diagnosed at the institute were included. RESULTS A total of 141 patients (266 eyes) with AMD recruited for the study. The mean age was 69.5 years (9.1SD) with three fifth males (58.9%). Housewives and occupations like agriculture comprised of 38.3% and 42.5% respectively. Three fourth (75.6%) of the patients were illiterate. The proportion of dry and wet AMD were found in 62.4% and 37.6% respectively. Bilateral involvement was seen in 88.7% of the subjects. Three fourth (71.4%) of the AMD eyes had presenting visual acuity less than 6/18. History of smoking was found in 69.9% of patients. Hypertension was the predominant systemic problem (45.4%) followed by diabetes mellitus (12.8%). CONCLUSION AMD is correlated with ageing in our study as well. Dry AMD is more in age groups 45-64 years and wet AMD at 65 years and older. Bilateral involvement with one eye dry and fellow eye wet AMD is more predominant (44%). Smoking and occupations like agriculture and housewife are significant risk factors for AMD. Likewise male sex, illiteracy and hypertension are other risk factors for AMD in hospital settings.
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Affiliation(s)
- R Thapa
- Tilganga Institute of Ophthalmology, Gaushala, Kathnmandu, Nepal.
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Thapa R, Maiti S, Rana T, Maiti U, Chattopadhyay K. Anatase TiO2 nanoparticles synthesis via simple hydrothermal route: Degradation of Orange II, Methyl Orange and Rhodamine B. ACTA ACUST UNITED AC 2012. [DOI: 10.1016/j.molcata.2012.06.013] [Citation(s) in RCA: 50] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
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Abstract
INTRODUCTION Endophthalmitis following cataract surgery is a rare but devastating ocular complication where delay in treatment not only results in vision loss but also in difficulty to save the eye ball. OBJECTIVE To explore the clinical profile and visual outcome following pars plana vitrectomy (PPV) in acute endophthalmitis after cataract surgery. MATERIALS AND METHODS This is a retrospective interventional case series study conducted at Tilganga Institute of Ophthalmology (TIO), Nepal. All consecutive cases of acute endophthalmitis following cataract surgery treated with PPV from January 2005 to August 2010 were included in the study. RESULTS There were a total of 34 cases (34 eyes) treated with PPV. The age range was 8 - 93 years with mean age of 56.9 ± 19.5 years. The mean duration of presentation and duration following cataract surgery was 7.7 ± 8.1 days and 13 ± 11.6 days respectively. Small incision cataract surgery was done in 75 % of cases followed by phacoemulsification (15.6 %). The mean duration of the last follow -up was 4.3 months. Vision was improved in two-thirds of cases (67.67 %) with a good vision of 6/18 or better in 17.6 %. Among the available vitreous samples of 22 cases, 36.36 % had an abnormality in Gram and Giemsa stains and culture was positive in 13.6 % of cases. CONCLUSION Despite the late presentation, the majority of eyes were salvaged with improvement of vision in 67.67 %, with a good vision of 6/18 or better in 17.6 4 % of cases following PPV in acute post operative endophthalmitis.
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Affiliation(s)
- R Thapa
- Tilganga Institute of Ophthalmology, Kathmandu, Nepal.
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Thapa R, Paudyal G. Anatomical and visual outcome following macular hole surgery at a tertiary eye care centre in Nepal. JNMA J Nepal Med Assoc 2011; 51:122-127. [PMID: 22922858] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/01/2023] Open
Abstract
INTRODUCTION Macular hole (MH) leading to central vision loss is common in the elderly. This study aimed to explore the anatomical and functional outcome of MH surgery at a tertiary eye care setting in Nepal. METHODS This retrospective, interventional case series study included patients who had undergone MH treatment with pars plana vitrectomy, membrane peeling and perfluoropropane gas (C3F8) from 2007 January to 2010 August and had completed three months of follow up. The best corrected visual acuity (BCVA) and anatomical status of MH assessed with bio-microscopy and optical coherence tomography (OCT) at six weeks, three months and at the last follow-up following surgery were recorded. RESULTS A total of 36 cases with the age range of 11 - 73 years and the mean age of 53.2 years (19.3 S.D) were included in the study. The mean duration of decreased vision was 11.1 months (12.1 S.D). Idiopathic macular hole comprised of 31 cases (86.1 %) and traumatic of five cases (13.9 %). The mean follow-up period was 9.4 months. The MH closed in 27 cases (75 %) at six weeks and in 28 cases (77.8%) at three months and at the last follow-up. The vision had improved in 36 % of cases, with more than 2 lines in 27.8 %, and was stable in 27.7 % of cases during the the last follow-up. The anatomical success rate was higher in the idiopathic MH (80.65 %) than in the traumatic (60 %) and visual acuity improved in 45 % of cases in the idiopathic and 20 % in the traumatic cases. CONCLUSIONS The overall anatomic success rate was 78 % and improvement in visual acuity was seen in one -third of cases. The success rate was higher among idiopathic MH than in traumatic.
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Affiliation(s)
- R Thapa
- Tilganga Institute of Ophthalmology, Gaushala, Kathmandu, Nepal.
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Thapa R, Paudyal G. Anatomical and Visual Outcome following Macular Hole Surgery at a Tertiary Eye Care Centre in Nepal. JNMA J Nepal Med Assoc 2011. [DOI: 10.31729/jnma.24] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/01/2022] Open
Abstract
Introduction: Macular hole (MH) leading to central vision loss is common in the elderly. This study aimed to explore the anatomical and functional outcome of MH surgery at a tertiary eye care setting in Nepal.
Methods: This retrospective, interventional case series study included patients who had undergone MH treatment with pars plana vitrectomy, membrane peeling and perfluoropropane gas (C3F8) from 2007 January to 2010 August and had completed three months of follow up. The best corrected visual acuity (BCVA) and anatomical status of MH assessed with bio-microscopy and optical coherence tomography (OCT) at six weeks, three months and at the last follow-up following surgery were recorded.
Results: A total of 36 cases with the age range of 11 - 73 years and the mean age of 53.2 years (19.3 S.D) were included in the study. The mean duration of decreased vision was 11.1 months (12.1 S.D). Idiopathic macular hole comprised of 31 cases (86.1 %) and traumatic of five cases (13.9 %). The mean follow-up period was 9.4 months. The MH closed in 27 cases (75 %) at six weeks and in 28 cases (77.8%) at three months and at the last follow-up. The vision had improved in 36 % of cases, with more than 2 lines in 27.8 %, and was stable in 27.7 % of cases during the the last follow-up. The anatomical success rate was higher in the idiopathic MH (80.65 %) than in the traumatic (60 %) and visual acuity improved in 45 % of cases in the idiopathic and 20 % in the traumatic cases.
Conclusions: The overall anatomic success rate was 78 % and improvement in visual acuity was seen in one -third of cases. The success rate was higher among idiopathic MH than in traumatic.
Keywords: Anatomical success, macular hole, perfluoropropane gas, visual acuity, vitrectomy
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Thapa R, Biswas B, Mallick D. Classic Hemorrhagic Disease of the Newborn Presenting with Bilateral Vitreous Hemorrhage. J Emerg Med 2011; 41:84-5. [DOI: 10.1016/j.jemermed.2009.05.020] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2009] [Revised: 05/24/2009] [Accepted: 05/30/2009] [Indexed: 11/25/2022]
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Abstract
Luxation of the eye globe is a rare event but it carries a risk of threat to permanent vision loss if appropriate intervention is not initiated on time. Although a rare presentation following minor trauma, it is usually associated with other ocular conditions like shallow orbital socket, oppy eyelid syndrome, and exophthalmos. Prompt reduction results in restoration of full anatomical and visual recovery in otherwise healthy eyes. We herein report a case of luxation of the eye ball following trauma in a 15-year-old girl, who recovered completely after the surgrical correction and a review of the relevant literature.
Keywords: eye ball, luxation, trauma
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Thapa R. Luxation of eye ball following trauma--a rare case presentation. JNMA J Nepal Med Assoc 2011; 51:79-82. [PMID: 22916517] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/01/2023] Open
Abstract
Luxation of the eye globe is a rare event but it carries a risk of threat to permanent vision loss if appropriate intervention is not initiated on time. Although a rare presentation following minor trauma, it is usually associated with other ocular conditions like shallow orbital socket, floppy eyelid syndrome, and exophthalmos. Prompt reduction results in restoration of full anatomical and visual recovery in otherwise healthy eyes. We herein report a case of luxation of the eye ball following trauma in a 15-year-old girl, who recovered completely after the surgical correction and a review of the relevant literature.
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Affiliation(s)
- R Thapa
- Tilganga Institute of Ophthalmology, Gaushala, Kathmandu, Nepal.
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Roka YB, Thapa R, Puri PR, Aryal S. Van Gogh syndrome. J Nepal Health Res Counc 2011; 9:79-81. [PMID: 22929720] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/01/2023]
Abstract
Self injury is the intentional and direct injury to self that include bite, burn, ulceration and head banging. These injuries are rarely fatal and are usually not suicidal in nature. This behavior is common among adolescents, psychiatric patients and in females. Bipolar disorder, drug abuse and metabolic syndromes like LeschNyhan and Munchausen's syndrome are often associated with this disorder. Repetitive self mutilation is termed the Van Gogh syndrome after the famous painter who cut off his ear and gave it to a prostitute. We describe two such cases of self mutilation in schizophrenic patients.
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Affiliation(s)
- Y B Roka
- Department of Neurosurgery, Neuro Hospital, Biratnagar, Nepal.
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Thapa R, Mallick D, Biswas B. Necrotizing fasciitis following BCG vaccination. Indian Pediatr 2011; 48:235-237. [PMID: 21478557] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/30/2023]
Abstract
We report a newborn with methicillin-resistant Staphylococcus aureus mediated necrotizing fasciitis after Bacilli-Calmette-Guerin vaccination. Radical debridement of the affected area coupled with twice daily surgical honey dressing and intravenous vancomycin and clindamycin resulted in satisfactory healing.
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Affiliation(s)
- Rajoo Thapa
- Department of Pediatrics, The Institute of Child Health 2, 11, Dr Biresh Guha Street, Kolkata 700 017, India.
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Thapa R. Facial palsy in a 2-month-old infant with Kawasaki disease. Rheumatol Int 2011; 31:277-8. [DOI: 10.1007/s00296-009-1361-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2009] [Accepted: 12/29/2009] [Indexed: 11/30/2022]
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Maiti UN, Maiti S, Thapa R, Chattopadhyay KK. Flexible cold cathode with ultralow threshold field designed through wet chemical route. Nanotechnology 2010; 21:505701. [PMID: 21098936 DOI: 10.1088/0957-4484/21/50/505701] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/30/2023]
Abstract
A flexible cold cathode based on a uniform array of ZnO nanowires over carbon fabrics was designed via a simple wet chemical route. The structural parameters of the nanowires (i.e. length, diameter) as well as their arrangement over the carbon fibers were tailored by adjusting nutrient solution composition and growth duration. The optimized arrays of ZnO nanowires exhibit excellent electron emission performance with ultralow turn-on as well as threshold fields of 0.27 and 0.56 V µm(-1). This threshold field value is the lowest compared to any of the previous zinc-oxide-based cold cathodes realized through either chemical or vapor phase processes. In addition, the current density can reach an exceptionally high value of ∼ 11 mA cm(-2) at an applied electric field of only 0.8 V µm(-1). Flexible electronic devices based on a field emitter cold cathode may thus be realized through chemical processing at low budget but having high efficiency.
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Affiliation(s)
- U N Maiti
- Thin Films and Nanoscience Laboratory, Department of Physics, Jadavpur University, Kolkata 700032, India
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Abstract
Falciparum malaria is occasionally associated with multiple organ system complications. However, acute pancreatitis rarely occurs as a part of the spectrum. A 13-year-old boy presented with falciparum malaria complicated predominantly by acute pancreatitis. He recovered satisfactorily with supportive measures. To our knowledge, there are less than 10 such documented instances in the literature and they are mostly adults. Acute abdomen in Plasmodium falciparum infection may reveal pancreatitis which should be detected at the earliest.
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Affiliation(s)
- Rajoo Thapa
- Department of Pediatrics, Upstate Medical University Hospitals 1, 750, E Adams Street, Syracuse, New York 13210, USA.
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Affiliation(s)
- Rajoo Thapa
- Upstate Medical University Hospitals, Syracuse, NY, USA.
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Thapa R, Ghosh A, Dhar S. Keratitis, ichthyosis, and deafness (KID) syndrome associated with ventricular septal defect. Int J Dermatol 2010; 49:107-8. [PMID: 20465629 DOI: 10.1111/j.1365-4632.2009.04103.x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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