K C Mathura’s research while affiliated with Kathmandu Medical College and other places

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Publications (7)


Study of serum lipid profile in type 2 diabetic patients attending KMCTH
  • Article

January 2006

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48 Reads

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11 Citations

K C Mathura

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Dipesh Lal Gurbacharya

The study was aimed at identifying the association between two major risk factors for coronary artery disease (CAD), namely, type 2 diabetes and hyperlipidemia. Hyperlipidemia has a ocumented causative relation with CAD, but the major risk associated with diabetes may be due to the associated hyperlipidemia. Lipid profiles of 30 patients with type 2 diabetes were taken and a detailed clinical workup done, including estimation of the body mass index (BMI). The study revealed that dyslipidemia is very common in type 2 diabetics and the most common abnormality seen was increased serum triglyceride levels (73.3%). The next common abnormality was decreased serum high-density lipoprotein cholesterol (HDL-C) levels and increased serum low-density lipoprotein cholesterol (LDL-C) levels, both seen in 66.7% patients respectively. A high total serum cholesterol levels was seen in 46.7% patients. Forty percent of the patients examined were on the overweight side, 16.7% being overtly obese. Thus the study, despite having small number of patients, clearly shows the association between type 2 diabetes and hyperlipidemia, which may influence the mechanism by which type 2 diabetes is associated with increased CAD risk.


Correlation between serum-ascites albumin concentration gradient and endoscopic parameters of portal hypertension

October 2005

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106 Reads

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19 Citations

Kathmandu University Medical Journal

We sought to determine the correlation between the level of serum-ascites albumin concentration gradient (SAAG) and the complications of portal hypertension (PHTN), manifested by the presence and grade of esophageal varices (EV). Our study included 32 patients with ascites, demonstrated by ultrasonography, who had measurement of the SAAG. All had upper gastrointestinal endoscopy with assessment of the presence and size of EV. High SAAG was considered to be present when SAAG was >=1.1 g/dl and Low SAAG when it measured < 1.1 g/dl. We found that 25 of 32 (78.13%) patients had High SAAG and 7 of 32 (21.87%) had Low SAAG. Esophageal varices were present in 18 of 25 (72%) patients with High SAAG and in none of 7 (0%) patients with Low SAAG (p =<0.001). Among patients with High SAAG, EV were present in four of 8 patients (50%) with SAAG values of 1.10-1.49g/dl; in four of seven patients (57.1%) with SAAG values of 1.50-1.99g/dl; and in ten of ten (100%) with SAAG values of >=2.0g/dl (p = 0.037). The size of the esophageal varices had no association with the level of SAAG in patients with High SAAG (p = 0.426). In patients with ascites the presence of esophageal varices is associated only with patients with High SAAG. The presence of EV in patients with ascites and High SAAG is directly related to the degree of SAAG. The size of the EV in patients with ascites and High SAAG is not associated with the degree of SAAG.


Table 2 ] 
Study of clinical profile and antibiotic sensitivity pattern in culture positive typhoid fever cases
  • Article
  • Full-text available

October 2005

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234 Reads

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31 Citations

Kathmandu University Medical Journal

K C Mathura

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[...]

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D L Gurubacharya

The present study was designed to analyze the clinical profile and antibiotic sensitivity pattern in the cases of culture positive typhoid fever. The study was conducted over a period of 1 year. Total of 46 culture positive cases of Typhoid fever were included in the study. The sensitivity pattern of isolates from blood culture was recorded. The modes of presentation, clinical course, lab investigation reports were also recorded. Out of 46 cases, 33 (71.7%) were males and 13 (28.3%) were females. Average age of presentation was 26.17 years. Fever was present in all patients. Resistance of S .typhi to amoxycillin, chloramphenicol and co-trimoxazole were significantly high. Ciprofloxacin showed resistance in 2 (4.3%) cases. Sensitivity to ceftriaxone was 100% in our study. Typhoid fever is one of the most common health problem in Nepal. Various drugs are being used in the treatment of typhoid fever, in the mean time resistance to many of them are emerging. An appropriate antibiotic has to be initiated only after culture sensitivity in typhoid fever.

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Fig. 1 Vegetation in Tricuspid Valve 
Injection drug use and tricuspid valve endocarditis

January 2005

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124 Reads

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6 Citations

Kathmandu University Medical Journal

Tricuspid valve endocarditis is more common in injection drug users. Pulmonary valve and Eustachian valve endocarditis have been reported but are very rare. Earlier reports of endocarditis in injection drug users emphasized the dominance of right sided involvement. In a series of 105 patients 86 % were right sided and 14 % had left sided involvement. We report a case of isolated tricuspid valve endocarditis in an injection drug user affecting a structurally normal heart and review of the literature on this subject. Key Words: injection drug use, tricuspid valve endocarditis.


Diagnostic Efficacy of Electrocardiography in Determining Left Ventricular Hypertrophy in Patients with Essential Hypertension

September 2004

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15 Reads

JNMA; journal of the Nepal Medical Association

A total of 37 hypertensive patients of both sexes over 18 years of age and more than four years of duration after diagnosis and only those having evidence of left ventricular hypertrophy (LVH) by echocardiography (ECHO) were enrolled to analyze the diagnostic efficacy of electrocardiography in determining left ventricular hypertrophy in patients with essential hypertension. Electrocardiograhpy (ECG) of 37 LVH diagnosed cases were analysed and 31 of them were found to have LVH on voltage criteria. Thus, the sensitivity of ECG in diagnosing LVH is 83%.Key Words: Left Ventricular Hypertrophy (LVH), Electrocardiography (ECG), Echocardiography (ECHO).


Clinical profile of typhoid patients

April 2003

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32 Reads

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15 Citations

Kathmandu University Medical Journal

The present study was undertaken to determine the clinical profile of typhoid fever in hospitalised patients. Prospective cross-sectional study. Kathmandu Medical College and Teaching Hospital. Total of thirty patients above fifteen years of age who had clinical features strongly suggestive of typhoid fever and on blood culture found to be positive for Salmonella typhi were analysed for clinical features. Among total of thirty cases, there were 17 (57%) males and 13 (43%) females. 86% of cases of typhoid fever clustered around 15-30 years of age. Predominant symptoms were fever (100%), headache (90%), abdominal Pain (37%) and constipation (33%). Common clinical signs were splenomegaly (37%), relative bradycardia (27%) and hepatomegaly (17%). None of the patients presented with complications. The clinical profile of typhoid fever in our study revealed not much difference from that of other studies on typhoid fever. Rose spots were not noticed and we did not find a single case of complication of typhoid fever. Probably early initiation of antibiotics prevented the complications.


Knowledge, attitude and practices among health care workers on needle-stick injuries

April 2003

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1,865 Reads

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113 Citations

Kathmandu University Medical Journal

This study aimed to assess the knowledge, attitude and practices among health care workers on needle stick injuries. A 15-item questionnaire was administered to seventy health care workers including nurses and paramedical staffs from different departments of Kathmandu Medical College and Teaching Hospital to measure knowledge, attitude and practices on needle stick injuries. Results showed that 4% and 61% of health care workers, respectively, were unaware of the fact that hepatitis B and hepatitis C can be transmitted by needle-stick injuries. 52 subjects (74%) had a history of needle-stick injuries and only 21% reported the injuries to the hospital authority. Only 23% were in the habit of using gloves for phlebotomy procedures all the time. 79% were of the impression that needle should be recapped after use. Only 66% were aware of Universal Precaution Guidelines. 16 subjects (23%) were negative for HBsAg, Anti-HCV and Anti-HIV and 54 subjects (77%) do not know about their immune status. 42 subjects (60%) had been vaccinated against hepatitis B, while 28 subjects (40%) were not vaccinated against hepatitis B. Only 6 subjects (14%) had been tested for Anti-HBs antibody after hepatitis B vaccination. The survey revealed that knowledge of health care workers about the risk associated with needle-stick injuries and use of preventive measures was inadequate. A standing order procedure (SOP) should be formulated regarding needle-stick injuries in all the health institutions. It should outline precautions to be taken when dealing with blood and body fluids. It should also contain reporting of all needle-stick injuries. Health care workers should be made aware of hazards, preventive measures and post-exposure prophylaxis to needle-stick injuries. A hospital-wide hepatitis immunization programme should also be started.

Citations (6)


... Out of these 163 studied cases there were 89 males (54.60%) and 74 females (45.40%). Similar male preponderance was reported by Malik GM et al 10 and Mathura KC et al 11 Though the exact cause of this male preponderance is not known the authors such as Khan M et al proposed that there are sex-linked differences in the degree of natural exposure of Peyer's patches to S. typhi as well as sexual dimorphism in host inflammatory response patterns which may be responsible for increased incidence and complications (perforation) of enteric fever in males as compared to females 12 . ...

Reference:

Enteric fever -Clinical presentation, lab parameters, Complications and Sensitivity pattern in a tertiary care centre in Rural Maharashtra
Clinical profile of typhoid patients
  • Citing Article
  • April 2003

Kathmandu University Medical Journal

... Similar comparatively lower coverage of doctors was observed by Punia et al., although only 7.4% lacked coverage [12]. Studies by Gurubacharya et al. [22], Singh et al. [23], and Makade et al. [8] reported lower proportions, i.e. 60%, 69%, and 69% of Hepatitis B vaccine coverage among HCWs of tertiary hospitals, respectively. ...

Knowledge, attitude and practices among health care workers on needle-stick injuries
  • Citing Article
  • April 2003

Kathmandu University Medical Journal

... Поражение правых отделов сердца встречается значительно реже (у 10-16 % больных) и преобладает только у инъекционных наркоманов (до 92,3 %) или при ИЭ электрокардиостимулятора (ЭКС) [4,5]. Доля наркоманов среди больных ИЭ правых отделов сердца варьирует от 46 до 86 % и отражает локальные различия в распространенности наркомании [4,6,7]. Кроме того, вовлечение правых отделов сердца изредка наблюдается в рамках многоклапанного ИЭ в сочетании с поражением митрального или аортального клапанов у пациентов, не злоупотребляющих наркотиками, либо развивается вторично у больных с врожденными пороками сердца, в том числе после хирургической коррекции [8]. ...

Injection drug use and tricuspid valve endocarditis

Kathmandu University Medical Journal

... Since its introduction in 1948, Chloramphenicol has been the gold standard drug in the treatment of typhoid fever in most parts of the world 19 . However, the indiscriminate use of the drug and acquisition of plasmid mediated R factor has led to the development of resistance of Salmonella Typhi against the drug 20 . ...

Study of clinical profile and antibiotic sensitivity pattern in culture positive typhoid fever cases

Kathmandu University Medical Journal

... All the study subjects with absence of varices had SAAG values less than 1.1. Similar results were reported by studies done by Gurubacharya et al. (2005) [22] and Bibhuti B. Das (2001). [23] High SAAG (>1.1) with varices was found in 72% and 91% of the study population, respectively. ...

Correlation between serum-ascites albumin concentration gradient and endoscopic parameters of portal hypertension
  • Citing Article
  • October 2005

Kathmandu University Medical Journal

... This finding is in line with the reports from our region and other countries. [26][27][28][29][30][31][32] There are variations in the frequency and phenotype of dyslipidemia patterns among studies in the literature that could be attributed to different populations' characteristics, studies design, racial differences, lifestyle patterns, therapeutic approaches and investigation methods across these studies. 33,34 ...

Study of serum lipid profile in type 2 diabetic patients attending KMCTH
  • Citing Article
  • January 2006