Introduction: Cervical cancer is killing Nepali women in gross even though cervical cancer is preventable with time-tested screening strategies in Nepal. Detection of premalignant lesions of cervix is preliminary step for early treatment and to minimise the tragedy of death. The aim of this research is to corelate the Pap smear, colposcopy and guided biopsy findings with histopathology to detect premalignant lesion of cervix.Methods: A prospective observational study conducted among 145 women attending gynaecology OPD with symptoms during reproductive age 21-65 years. Collection of Pap smear was conducted by conventional method, colposcopy and guided biopsy in selected women were performed and the sample was sent to pathology department for histopathological confirmation.Results:The pre-malignant lesions in cytology were ASCUS (Atypical Squamous Cells of Undetermined Significance) 11%, ASC-H (Atypical Squamous cell- cannot exclude High Grade)1.3 %, LSIL (Low Grade Intraepithelial Lesion)28.2 %, and HSIL (High Grade Intraepithelial Lesion) 7.5 %. The colposcopy detected 54.4% atypical transformation zone. The histopathology detected Cervical Intra-epithelial Neoplasia I (CIN I) 26.1%, CIN II 11.7%, and CIN III 7.5%. The sensitivity of Pap smear and colposcopy was 83%, the specificity of Pap smear was 88%, and colposcopy was 98%.The positive predictive value(PPV)were 89% and 98 %, negative predictive value(NPV) were 81%and 83%.and accuracy was 88 % and 98% in Cytology and Colposcopy.Conclusions:Pap smear and colposcopy were effective tools to detect premalignant lesions of cervix in comparison to histopathological findings.
简介:尽管在尼泊尔，宫颈癌是可以通过久经考验的筛查策略预防的，但总的来说，宫颈癌正在导致尼泊尔妇女死亡。宫颈癌前病变的检测是早期治疗的初步步骤，并尽量减少死亡的悲剧。本研究的目的是将巴氏涂片，阴道镜检查和引导活检结果与组织病理学联系起来，以检测宫颈癌前病变。方法:对145名育龄期21-65岁有症状的妇科门诊妇女进行前瞻性观察研究。常规方法收集宫颈抹片，择期行阴道镜检查和引导活检，送病理科进行组织病理确认。结果:细胞学上的癌前病变为ASCUS(未确定意义的非典型鳞状细胞)11%，ASC-H(非典型鳞状细胞-不能排除高级别)1.3%，LSIL(低级别上皮内病变)28.2%，HSIL(高级别上皮内病变)7.5%。阴道镜检出不典型转化带54.4%。组织病理学检出宫颈上皮内瘤变I (CIN) 26.1%， CIN II 11.7%， CIN III 7.5%。巴氏涂片和阴道镜检查的敏感性为83%，特异性为88%，阴道镜检查为98%。阳性预测值(PPV)为89%和98%，阴性预测值(NPV)为81%和83%。细胞学和阴道镜检查的准确率分别为88%和98%。结论:与组织病理学结果相比，巴氏涂片和阴道镜检查是检测宫颈癌前病变的有效工具。
{"title":"Pre-Malignant Lesions of Cervix in Female Attending a Tertiary Hospital of Nepal","authors":"Buddhi Kumar Shrestha, Chin Bahadur Pun, Subha Shrestha, Alok Chandra Mahato, Deeva Shrestha","doi":"10.3126/jcmsn.v19i2.55971","DOIUrl":"https://doi.org/10.3126/jcmsn.v19i2.55971","url":null,"abstract":"Introduction: Cervical cancer is killing Nepali women in gross even though cervical cancer is preventable with time-tested screening strategies in Nepal. Detection of premalignant lesions of cervix is preliminary step for early treatment and to minimise the tragedy of death. The aim of this research is to corelate the Pap smear, colposcopy and guided biopsy findings with histopathology to detect premalignant lesion of cervix.Methods: A prospective observational study conducted among 145 women attending gynaecology OPD with symptoms during reproductive age 21-65 years. Collection of Pap smear was conducted by conventional method, colposcopy and guided biopsy in selected women were performed and the sample was sent to pathology department for histopathological confirmation.Results:The pre-malignant lesions in cytology were ASCUS (Atypical Squamous Cells of Undetermined Significance) 11%, ASC-H (Atypical Squamous cell- cannot exclude High Grade)1.3 %, LSIL (Low Grade Intraepithelial Lesion)28.2 %, and HSIL (High Grade Intraepithelial Lesion) 7.5 %. The colposcopy detected 54.4% atypical transformation zone. The histopathology detected Cervical Intra-epithelial Neoplasia I (CIN I) 26.1%, CIN II 11.7%, and CIN III 7.5%. The sensitivity of Pap smear and colposcopy was 83%, the specificity of Pap smear was 88%, and colposcopy was 98%.The positive predictive value(PPV)were 89% and 98 %, negative predictive value(NPV) were 81%and 83%.and accuracy was 88 % and 98% in Cytology and Colposcopy.Conclusions:Pap smear and colposcopy were effective tools to detect premalignant lesions of cervix in comparison to histopathological findings.","PeriodicalId":15436,"journal":{"name":"Journal of College of Medical Sciences-nepal","volume":"6 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-06-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"136369301","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
IntroductionThere is an increasing incidence of colorectal carcinoma (CRC) in developing countries like Nepal. The objective of this research is to study the CRC its demography, mode of presentation, type of surgery, complications and Histopathological evaluation (HPE) after surgery.MethodsThis was a retrospective descriptive observational study at College of Medical Sciences, Bharatpur, Nepal. Patients diagnosed with colorectal cancer admitted to gastrointestinal surgery department from July 2019 to June 2022 (3 years) were included. Data of patients were retrieved from hospital records. Pre-operative, intra-operative and post-operative diagnosis of CRC on HPE were also included in the study.ResultsOut of 52 CRC, males were 30 (57.7%) and females were 22 (42.3%), mean age was 52.7 years. Overall, left colon was affected in 33 (63.5%) and right in 19 (36.5%). More than one quarter of patients 14 (26.9%), had disease recurrence by 6 months follow-up. HPE revealed half of the disease condition as adenocarcinoma, moderately differentiated in (50%) cases.ConclusionsColorectal cancer is predominant in male patients and older age group. Incidence is high in younger people <40 years and low in extreme age group >80 years. Meticulous surgery is the only proven cure for malignancy.
{"title":"Clinicopathological Profile of Colorectal Cancers in a Tertiary Care Hospital of Central, Nepal","authors":"Sagar Khatiwada, Narayan Prasad Belbase, Binay Timilsina, Prasun Yadav, Sushim Bhujel, Nischal Shrestha, Hari Prasad Upadhyay","doi":"10.3126/jcmsn.v19i2.55980","DOIUrl":"https://doi.org/10.3126/jcmsn.v19i2.55980","url":null,"abstract":"IntroductionThere is an increasing incidence of colorectal carcinoma (CRC) in developing countries like Nepal. The objective of this research is to study the CRC its demography, mode of presentation, type of surgery, complications and Histopathological evaluation (HPE) after surgery.MethodsThis was a retrospective descriptive observational study at College of Medical Sciences, Bharatpur, Nepal. Patients diagnosed with colorectal cancer admitted to gastrointestinal surgery department from July 2019 to June 2022 (3 years) were included. Data of patients were retrieved from hospital records. Pre-operative, intra-operative and post-operative diagnosis of CRC on HPE were also included in the study.ResultsOut of 52 CRC, males were 30 (57.7%) and females were 22 (42.3%), mean age was 52.7 years. Overall, left colon was affected in 33 (63.5%) and right in 19 (36.5%). More than one quarter of patients 14 (26.9%), had disease recurrence by 6 months follow-up. HPE revealed half of the disease condition as adenocarcinoma, moderately differentiated in (50%) cases.ConclusionsColorectal cancer is predominant in male patients and older age group. Incidence is high in younger people <40 years and low in extreme age group >80 years. Meticulous surgery is the only proven cure for malignancy.","PeriodicalId":15436,"journal":{"name":"Journal of College of Medical Sciences-nepal","volume":"26 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-06-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"136369164","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Introduction: Oral cleanliness is important for all to maintain the overall health status. It is also important for the old aged edentulous people with dentures. The complete dentures are custom made device which are the replacement for the missing all tooth of mouth. Many microorganisms adhere to the surfaces of dentures and form denture plaque and calculus. They are there due to inadequate denture hygiene maintenance. This study was performed with the aim of assessing cleanliness of complete dentures among the denture wearers.Methods :A descriptive cross-sectional study conducted among 140 complete denture in the Department of Prosthodontics and Maxillofacial Prosthetics at Chitwan Medical College and Hospital. A convenience sampling method was used in this study. After taking the sociodemographic information and other information related to dentures, the participants dentures were evaluated with disclosing agent. The stained dentures were then assessed according to the Denture Cleanliness Index. Data was analyzed by using descriptive statistical tools in SPSS-16 and results were presented in form of tables.Results: The mean age of 140 patients was 71.39±5.80 years. There were 81 (57.9%) females and 59 (42.1) males. About 27 (19.3%) denture wearers did not remove dentures from their mouth at night. Among total, 81 (57.9%) of participants brushed their dentures with water. Denture Cleanliness Index scores of 2 was observed in 64 (45.8%) of denture wearers. Conclusions: It can be concluded that majority of participants had uncleaned dentures suggesting the need ofproper denture hygiene instructions and routinely follow-up for the cleanliness of dentures and their overall intraoral health status whether or not there were denture stomatitis.
{"title":"Assessment of Denture Cleanliness among Complete Denture Wearer in Chitwan","authors":"Rajib Chaulagain, Smriti Narayan Thakur, Srijana Mishra Sapkota, Bibek Khanal, Anisha Pandey","doi":"10.3126/jcmsn.v19i2.55332","DOIUrl":"https://doi.org/10.3126/jcmsn.v19i2.55332","url":null,"abstract":"Introduction: Oral cleanliness is important for all to maintain the overall health status. It is also important for the old aged edentulous people with dentures. The complete dentures are custom made device which are the replacement for the missing all tooth of mouth. Many microorganisms adhere to the surfaces of dentures and form denture plaque and calculus. They are there due to inadequate denture hygiene maintenance. This study was performed with the aim of assessing cleanliness of complete dentures among the denture wearers.Methods :A descriptive cross-sectional study conducted among 140 complete denture in the Department of Prosthodontics and Maxillofacial Prosthetics at Chitwan Medical College and Hospital. A convenience sampling method was used in this study. After taking the sociodemographic information and other information related to dentures, the participants dentures were evaluated with disclosing agent. The stained dentures were then assessed according to the Denture Cleanliness Index. Data was analyzed by using descriptive statistical tools in SPSS-16 and results were presented in form of tables.Results: The mean age of 140 patients was 71.39±5.80 years. There were 81 (57.9%) females and 59 (42.1) males. About 27 (19.3%) denture wearers did not remove dentures from their mouth at night. Among total, 81 (57.9%) of participants brushed their dentures with water. Denture Cleanliness Index scores of 2 was observed in 64 (45.8%) of denture wearers. Conclusions: It can be concluded that majority of participants had uncleaned dentures suggesting the need ofproper denture hygiene instructions and routinely follow-up for the cleanliness of dentures and their overall intraoral health status whether or not there were denture stomatitis.","PeriodicalId":15436,"journal":{"name":"Journal of College of Medical Sciences-nepal","volume":"5 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-06-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"136369302","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-06-30DOI: 10.3126/jcmsn.v19i2.55960
None Sharmila Poudel
Didelphys uterus is a mullerian duct anomaly that is extremely rare and has unpredictable reproductive and gestational effects. Common genital tract congenital defects in women can have a wide range of implications. While some mullerian anomalies are easy to spot, others manifest in odd ways that make diagnosis and treatment difficult. For a thorough grasp of the pathophysiology and clinical characteristics of congenital defects, one should have a solid foundation in fundamental embryology. Uterus didelphys make up 8% of all congenital problems affecting the female reproductive system. About 0.3% of the population is affected. 2.1% of the population of women with a history of infertility and abortion experience this more frequently. This is a case report of a 19 years primigravida mother with uterine didelphys with the outcome being successful delivery with a live female via caesarian section at 32 weeks of gestation.
Keywords: Didelphys uterus; Mullerian duct anomaly; Successful pregnancy.
{"title":"Successful Pregnancy Outcome in Uterus Didelphys: A Rare Case Report","authors":"None Sharmila Poudel","doi":"10.3126/jcmsn.v19i2.55960","DOIUrl":"https://doi.org/10.3126/jcmsn.v19i2.55960","url":null,"abstract":"Didelphys uterus is a mullerian duct anomaly that is extremely rare and has unpredictable reproductive and gestational effects. Common genital tract congenital defects in women can have a wide range of implications. While some mullerian anomalies are easy to spot, others manifest in odd ways that make diagnosis and treatment difficult. For a thorough grasp of the pathophysiology and clinical characteristics of congenital defects, one should have a solid foundation in fundamental embryology. Uterus didelphys make up 8% of all congenital problems affecting the female reproductive system. About 0.3% of the population is affected. 2.1% of the population of women with a history of infertility and abortion experience this more frequently. This is a case report of a 19 years primigravida mother with uterine didelphys with the outcome being successful delivery with a live female via caesarian section at 32 weeks of gestation.
 Keywords: Didelphys uterus; Mullerian duct anomaly; Successful pregnancy.","PeriodicalId":15436,"journal":{"name":"Journal of College of Medical Sciences-nepal","volume":"44 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-06-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"136369298","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
The rectal foreign body is a rare presentation with rising incidence. We present a case of a 26-year-old heterosexual male with an alleged history of sexual assault with insertion of a large foreign body through the anus two days prior with peritonitis. After investigations, the patient underwent an exploratory laparotomy, foreign body removal, primary repair of perforation with a diverting colostomy. Diversion must be considered in cases where the extent of anal sphincter mechanism injury is in question. The patient had a good outcome. Assessment of the shape, size, nature, and location of the object through appropriate imaging is necessary. Exploratory laparotomy is inevitable in cases of perforation.
{"title":"Rectal Foreign Body Causing Perforation: A Case Report","authors":"Nischal Shrestha, N. Belbase, Sushim Bhujel, Sagar Khatiwada, Binaya Timilsina, Nishnata Koirala","doi":"10.3126/jcmsn.v19i1.54169","DOIUrl":"https://doi.org/10.3126/jcmsn.v19i1.54169","url":null,"abstract":"The rectal foreign body is a rare presentation with rising incidence. We present a case of a 26-year-old heterosexual male with an alleged history of sexual assault with insertion of a large foreign body through the anus two days prior with peritonitis. After investigations, the patient underwent an exploratory laparotomy, foreign body removal, primary repair of perforation with a diverting colostomy. Diversion must be considered in cases where the extent of anal sphincter mechanism injury is in question. The patient had a good outcome. Assessment of the shape, size, nature, and location of the object through appropriate imaging is necessary. Exploratory laparotomy is inevitable in cases of perforation.","PeriodicalId":15436,"journal":{"name":"Journal of College of Medical Sciences-nepal","volume":"1 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41341853","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-05-01DOI: 10.3126/jcmsn.v19i1.53465
R. Acharya, Pramod Kumar Chhetri, V. Natraj Prasad, K. Thapa, M. Mishra, Arati Ghimire
IntroductionSpine injury is one of the leading caused for disability in Nepal. Patients with trauma relatedspine injury leads to neurological dysfunction, focal deficits and even fatal life threating events.The timely intervention in acute spinal trauma injury could save the patients from disability andmortality risk. Imaging modalities like Xray, CT Scan and MRI helps in diagnosis and managementof spinal trauma. MRI plays crucial role in detection of spinal cord and soft tissue injuries. It issuperior than CT scan in evaluation of spinal cord injuries, ligament, soft issue structures, disc,and occult osseous injuries. The objective of this research is to evaluate MRI in acute spinal traumain tertiary center of Nepal. MethodsThis is descriptive hospital based observational study in those patients who were admitted andreferred in hospital for MRI with acute spinal trauma injury. Data were analysed by SPSS 2022. ResultsAcute spinal trauma is most common in male with ratio of 1.7 with the mean±SD of age was foundto be 50.98±19.26 years. Most common mode of injury were fall injury (76%). Most common spinalregion involved were lumbar (42%) followed by thoracic (36%), dorso-lumbar (14%) and cervical(8%) region respectively. Spinal cord contusion with edema, disc rupture, paravertebral collectionand ligament injury were seen. Most common type of fractures were simple compression fracture(72%), followed by burst fracture (16%), both (6%) and listhesis and sub/dislocations (6%). Spinalcord injury were seen in 22%, followed by disc rupture, paravertebral collection and ligamentinjury. ConclusionsMRI helps in evaluating vertebrae, spinal cord, ligament and disc injuries. We can assess the cordcontusion, edema and canal compression. It provides involvement, extension and severity of cordinjury. It endowed about outcome of surgery as well as conservative management in patient ofspinal injury.
{"title":"MRI Evaluation in Acute Spinal Trauma in Tertiary Center of Nepal","authors":"R. Acharya, Pramod Kumar Chhetri, V. Natraj Prasad, K. Thapa, M. Mishra, Arati Ghimire","doi":"10.3126/jcmsn.v19i1.53465","DOIUrl":"https://doi.org/10.3126/jcmsn.v19i1.53465","url":null,"abstract":"IntroductionSpine injury is one of the leading caused for disability in Nepal. Patients with trauma relatedspine injury leads to neurological dysfunction, focal deficits and even fatal life threating events.The timely intervention in acute spinal trauma injury could save the patients from disability andmortality risk. Imaging modalities like Xray, CT Scan and MRI helps in diagnosis and managementof spinal trauma. MRI plays crucial role in detection of spinal cord and soft tissue injuries. It issuperior than CT scan in evaluation of spinal cord injuries, ligament, soft issue structures, disc,and occult osseous injuries. The objective of this research is to evaluate MRI in acute spinal traumain tertiary center of Nepal.\u0000MethodsThis is descriptive hospital based observational study in those patients who were admitted andreferred in hospital for MRI with acute spinal trauma injury. Data were analysed by SPSS 2022.\u0000ResultsAcute spinal trauma is most common in male with ratio of 1.7 with the mean±SD of age was foundto be 50.98±19.26 years. Most common mode of injury were fall injury (76%). Most common spinalregion involved were lumbar (42%) followed by thoracic (36%), dorso-lumbar (14%) and cervical(8%) region respectively. Spinal cord contusion with edema, disc rupture, paravertebral collectionand ligament injury were seen. Most common type of fractures were simple compression fracture(72%), followed by burst fracture (16%), both (6%) and listhesis and sub/dislocations (6%). Spinalcord injury were seen in 22%, followed by disc rupture, paravertebral collection and ligamentinjury.\u0000ConclusionsMRI helps in evaluating vertebrae, spinal cord, ligament and disc injuries. We can assess the cordcontusion, edema and canal compression. It provides involvement, extension and severity of cordinjury. It endowed about outcome of surgery as well as conservative management in patient ofspinal injury.","PeriodicalId":15436,"journal":{"name":"Journal of College of Medical Sciences-nepal","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42484658","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-05-01DOI: 10.3126/jcmsn.v19i1.53460
B. Jha, H. Upadhyay, S. Mahadevamurthy, J. Sudisha
IntroductionMoraxella catarrhalis is a gram negative, oxidase positive, cocci mainly causing upper and lowerrespiratory tract infections. The RND family efflux pumps lead to multidrug resistance in most ofthe gram negative bacteria. One of the well- known pumps in M. catarrhalis is arcAB and oprMsystem. The objective of this study was to investigate the antibiotic resistance in M. catarrhalis andto determine its resistance dependence on the efflux pump. MethodsIn this study, 283 different respiratory tract infection samples processed out of that 73 were confirmedby biotyping and molecular characterization as a M. catarrhalis. The antibiotic susceptibility testswere performed by disc diffusion method according to CLSI. Molecular characterization formultidrug resistance isolates was also done along with genes responsible for efflux pumps. PCRwas done M. catarrhalis and acrAB and oprM genes. The factor for association of efflux pump withantibiotic resistance was investigated using phenylalanine argine β-naphthylamide. ResultsThe antibiotics susceptibility result showed 12 out of 73 isolates were MDR, selectively takenfor PCR using 16SrRNA specific primer. The MDR isolates were further confirmed by PCR. Theamplification results of acra, acrb and oprm genes for the M. catarrhalis having multidrug resistancegenes by PCR band size products seen on 2% agrose gel. The highest resistance towards the drugsviz penicillin, ampicillin, amoxicillin, amoxiclave, cotrimoxazole, cefazolin, cefuroxime, ceftrixoneand cefepime were seen in M. catarrhalis. ConclusionsThe result showed that Moraxella catarrhalis is one of the major causes for respiratory tract infection.The drug resistance in this species is increasing day by day. The 90% of isolates have acrAB andoprM genes for efflux pump responsible for multiple drug resistance. The efflux pump inhibitorhas important clinical significance for the proper treatment.
{"title":"Molecular Characterization of Moraxella Catarrhalis and it's Antibiotics Susceptibility Patterns from Different Respiratory Tract Infection Patient's Clinical Samples","authors":"B. Jha, H. Upadhyay, S. Mahadevamurthy, J. Sudisha","doi":"10.3126/jcmsn.v19i1.53460","DOIUrl":"https://doi.org/10.3126/jcmsn.v19i1.53460","url":null,"abstract":"IntroductionMoraxella catarrhalis is a gram negative, oxidase positive, cocci mainly causing upper and lowerrespiratory tract infections. The RND family efflux pumps lead to multidrug resistance in most ofthe gram negative bacteria. One of the well- known pumps in M. catarrhalis is arcAB and oprMsystem. The objective of this study was to investigate the antibiotic resistance in M. catarrhalis andto determine its resistance dependence on the efflux pump.\u0000MethodsIn this study, 283 different respiratory tract infection samples processed out of that 73 were confirmedby biotyping and molecular characterization as a M. catarrhalis. The antibiotic susceptibility testswere performed by disc diffusion method according to CLSI. Molecular characterization formultidrug resistance isolates was also done along with genes responsible for efflux pumps. PCRwas done M. catarrhalis and acrAB and oprM genes. The factor for association of efflux pump withantibiotic resistance was investigated using phenylalanine argine β-naphthylamide.\u0000ResultsThe antibiotics susceptibility result showed 12 out of 73 isolates were MDR, selectively takenfor PCR using 16SrRNA specific primer. The MDR isolates were further confirmed by PCR. Theamplification results of acra, acrb and oprm genes for the M. catarrhalis having multidrug resistancegenes by PCR band size products seen on 2% agrose gel. The highest resistance towards the drugsviz penicillin, ampicillin, amoxicillin, amoxiclave, cotrimoxazole, cefazolin, cefuroxime, ceftrixoneand cefepime were seen in M. catarrhalis.\u0000ConclusionsThe result showed that Moraxella catarrhalis is one of the major causes for respiratory tract infection.The drug resistance in this species is increasing day by day. The 90% of isolates have acrAB andoprM genes for efflux pump responsible for multiple drug resistance. The efflux pump inhibitorhas important clinical significance for the proper treatment.","PeriodicalId":15436,"journal":{"name":"Journal of College of Medical Sciences-nepal","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"48038427","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-05-01DOI: 10.3126/jcmsn.v19i1.53464
B. Kalakheti, Brajesh Raj Chaudhary, H. Upadhyay
Introduction Post infectious glomerulonephritis (PIGN) is the most common renal disease in children causing significant morbidity. The affected children present with features of acute nephric syndrome (hematuria, hypertension, edema and oliguria. The objective of this study was to determine the prevalence, clinical characteristics, complications, and outcomes of children presenting with post infectious glomerulonephritis in paediatric ward of tertiary care hospital. Methods This was a prospective observational study conducted at a tertiary care hospital in Chitwan, Nepal from March 1st 2020 to February 28th 2021. Children aged 4 – 15 years satisfying 2 out of 4 features of acute nephritic syndrome were included in the study. After discharge, patients were followed up at 4 weeks and 8 weeks. Data entry was done in statistical packages for the social science version 20. Results Among 63 children recruited with acute nephritic syndrome, 73% had Post infectious glomerulonephritis. The most common etiology of PIGN was Post streptococcal glomerulonephritis (63%). The mean age of children was 11.2 (±3.2) years. Males to females’ ratio was 1.5:1. The most common presenting feature was edema (100%). The most common complication was acute kidney injury (41.3%). Conclusion Post infectious glomerulonephritis was the most common cause of acute nephritic syndrome in children. High incidence of life-threatening complications like CCF, retinopathy, encephalopathy and renal insufficiency occur that require close monitoring and timely intervention to prevent morbidity and mortality.
{"title":"Prevalence of Post Infectious Glomerulonephritis (PIGN) and Associated Complication","authors":"B. Kalakheti, Brajesh Raj Chaudhary, H. Upadhyay","doi":"10.3126/jcmsn.v19i1.53464","DOIUrl":"https://doi.org/10.3126/jcmsn.v19i1.53464","url":null,"abstract":"Introduction \u0000Post infectious glomerulonephritis (PIGN) is the most common renal disease in children causing significant morbidity. The affected children present with features of acute nephric syndrome (hematuria, hypertension, edema and oliguria. The objective of this study was to determine the prevalence, clinical characteristics, complications, and outcomes of children presenting with post infectious glomerulonephritis in paediatric ward of tertiary care hospital. \u0000Methods \u0000This was a prospective observational study conducted at a tertiary care hospital in Chitwan, Nepal from March 1st 2020 to February 28th 2021. Children aged 4 – 15 years satisfying 2 out of 4 features of acute nephritic syndrome were included in the study. After discharge, patients were followed up at 4 weeks and 8 weeks. Data entry was done in statistical packages for the social science version 20. \u0000Results \u0000Among 63 children recruited with acute nephritic syndrome, 73% had Post infectious glomerulonephritis. The most common etiology of PIGN was Post streptococcal glomerulonephritis (63%). The mean age of children was 11.2 (±3.2) years. Males to females’ ratio was 1.5:1. The most common presenting feature was edema (100%). The most common complication was acute kidney injury (41.3%). \u0000Conclusion \u0000Post infectious glomerulonephritis was the most common cause of acute nephritic syndrome in children. High incidence of life-threatening complications like CCF, retinopathy, encephalopathy and renal insufficiency occur that require close monitoring and timely intervention to prevent morbidity and mortality.","PeriodicalId":15436,"journal":{"name":"Journal of College of Medical Sciences-nepal","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43791857","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-05-01DOI: 10.3126/jcmsn.v19i1.53482
P. Basnet, H. Upadhyay, R. Chaulagain
IntroductionMastoid process is one of the most important landmark of the skull. It is a part of temporal boneand contains air filled space which is called mastoid air cells. It is also an attachment of differentneck muscles. Normal measurement of the mastoid process is very important for surgeons' pointof view. This study was aimed to assess the normal dimension of mastoid process. MethodsThe study was a descriptive cross-sectional study conducted on 104 patients, at Department ofRadiology and Imaging, College of medical sciences, Bharatpur, Nepal. All CT examinations wereperformed using Toshiba 160 slice CT scanner. The data was analyzed using Statistical Packagefor the Social Sciences (SPSS) version 16 (SPSS, Inc., an IBM Company, Chicago, IL). Descriptivestatistics was used to analyze the data. ResultsAmong the 104 patients who participated in the study, 38 (36.5%) were male and 66 (63.5%) werefemale. All the measurements of mastoid process taken in males were higher than in femalesexcept the anterior inclination angle which was more in female on both right and left side. Thevolume of mastoid process in males was 14.16±5.3 and 14.69±6.6 on right and left side respectivelywhile in female it was less. ConclusionsThe present study estimated the normal dimension of mastoid process. The normal dimension ofmastoid process in male is larger than in females.
{"title":"Anthropometric Measurement of Mastoid Process Using Multidetector Computed Tomography","authors":"P. Basnet, H. Upadhyay, R. Chaulagain","doi":"10.3126/jcmsn.v19i1.53482","DOIUrl":"https://doi.org/10.3126/jcmsn.v19i1.53482","url":null,"abstract":"IntroductionMastoid process is one of the most important landmark of the skull. It is a part of temporal boneand contains air filled space which is called mastoid air cells. It is also an attachment of differentneck muscles. Normal measurement of the mastoid process is very important for surgeons' pointof view. This study was aimed to assess the normal dimension of mastoid process.\u0000MethodsThe study was a descriptive cross-sectional study conducted on 104 patients, at Department ofRadiology and Imaging, College of medical sciences, Bharatpur, Nepal. All CT examinations wereperformed using Toshiba 160 slice CT scanner. The data was analyzed using Statistical Packagefor the Social Sciences (SPSS) version 16 (SPSS, Inc., an IBM Company, Chicago, IL). Descriptivestatistics was used to analyze the data.\u0000ResultsAmong the 104 patients who participated in the study, 38 (36.5%) were male and 66 (63.5%) werefemale. All the measurements of mastoid process taken in males were higher than in femalesexcept the anterior inclination angle which was more in female on both right and left side. Thevolume of mastoid process in males was 14.16±5.3 and 14.69±6.6 on right and left side respectivelywhile in female it was less.\u0000ConclusionsThe present study estimated the normal dimension of mastoid process. The normal dimension ofmastoid process in male is larger than in females.","PeriodicalId":15436,"journal":{"name":"Journal of College of Medical Sciences-nepal","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42999917","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-05-01DOI: 10.3126/jcmsn.v19i1.52792
A. Giri, Anjan Palikhey, A. Sah, H. Upadhyay, Bijaya Laxmi Giri
Introduction Postoperative pain management is essential post-extraction for early mobilization and rehabilitation to enhance recovery and to reduce morbidity. Diclofenac and Ibuprofen and Paracetamol combination are two most common NSAIDs used in the postoperative pain control. Methods Two hundred fifteen patients (n=215) of age group 20-60 years who underwent extraction of upper or lower third molar impacted teeth were divided randomly into two groups (T1 and T2). T1 group (n=105) received Tab. Diclofenac 100mg and T2 group (n=110) received Tab Ibuprofen and Paracetamol combination. Analgesic efficacy of Diclofenac was compared with that of Ibuprofen and Paracetamol combination at post-op day 1, day 3 and day 5. Analgesic efficacy was measured using Visual Analogue Scale (VAS) and Verbal Rating Scale (VRS). Results Pain intensity decreased significantly at all the time points in both the groups. The analgesic efficacy of Diclofenac was significantly higher than Ibuprofen and paracetamol combination as estimated by VAS mean score at day 1 and day 3 post-operative period (p<0.001).But based upon the VRS mean score at post-opearative day 1, day 3 and day 5, there was no statistically significant difference between two treatment groups. Conclusions This study showed that Diclofenac potassium was more effective than Ibuprofen and Paracetamol combination for reducing postoperative pain associated with extraction of third molar impaction. Few number of patients in both treatment groups developed gastrointestinal upset.
{"title":"Analgesic Efficacy of Diclofenac and Ibuprofen/Paracetamol Combination in Post Extraction Cases","authors":"A. Giri, Anjan Palikhey, A. Sah, H. Upadhyay, Bijaya Laxmi Giri","doi":"10.3126/jcmsn.v19i1.52792","DOIUrl":"https://doi.org/10.3126/jcmsn.v19i1.52792","url":null,"abstract":"Introduction\u0000Postoperative pain management is essential post-extraction for early mobilization and rehabilitation to enhance recovery and to reduce morbidity. Diclofenac and Ibuprofen and Paracetamol combination are two most common NSAIDs used in the postoperative pain control.\u0000Methods\u0000Two hundred fifteen patients (n=215) of age group 20-60 years who underwent extraction of upper or lower third molar impacted teeth were divided randomly into two groups (T1 and T2). T1 group (n=105) received Tab. Diclofenac 100mg and T2 group (n=110) received Tab Ibuprofen and Paracetamol combination. Analgesic efficacy of Diclofenac was compared with that of Ibuprofen and Paracetamol combination at post-op day 1, day 3 and day 5. Analgesic efficacy was measured using Visual Analogue Scale (VAS) and Verbal Rating Scale (VRS). \u0000 \u0000Results\u0000Pain intensity decreased significantly at all the time points in both the groups. The analgesic efficacy of Diclofenac was significantly higher than Ibuprofen and paracetamol combination as estimated by VAS mean score at day 1 and day 3 post-operative period (p<0.001).But based upon the VRS mean score at post-opearative day 1, day 3 and day 5, there was no statistically significant difference between two treatment groups.\u0000Conclusions\u0000This study showed that Diclofenac potassium was more effective than Ibuprofen and Paracetamol combination for reducing postoperative pain associated with extraction of third molar impaction. Few number of patients in both treatment groups developed gastrointestinal upset.","PeriodicalId":15436,"journal":{"name":"Journal of College of Medical Sciences-nepal","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43949552","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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