Pub Date : 2021-08-09DOI: 10.3126/jngmc.v18i2.38903
A. Shrestha, A. Kidwai, R. Shrestha, Suman Kc
Introduction: Organophosphorus (OP) compounds are the most commonly used pesticides worldwide and Organophosphorus poisoning has become the major public health problem especially in developing countries.The case fatality rate following ingestion of Organophosphorus pesticides in developing countries in Asia is 5-20%.Due to limited availability of facilities and resources in Nepal, it is important to prioritize treatment based on severity of poisoning as all patients can’t be managed in Intensive Care Unit. Aims: To study the correlation between serum cholinesterase level and clinical severity based on Peradenya organophosphorus poisoning scale in Organophosphorus poisoning. Methods: The study was conducted in the department of Medicine, Nepalgunj Medical College, Kohalpur, Banke from November 2019 to November 2020. It is based on the descriptive study of 66 patients with Organophosphorus poisoning attending to the emergency department. All patients with history of exposure to Organophosphorus poisoning were included in the study. Peradenya Organophosphorus Poisoning scale was used to assess the clinical severity as mild, moderate and severe. At the same time venous blood samples were collected for serum cholinesterase level. Results: Age group ranged from 16-60 years and majority of patients were in the age group of 20-29 years (34.85%). 53% were females. 74.2% of the patients were from lower socioeconomic status. 83.3% of the patients consumed poison with suicidal intention. Majority of the patients were from tharu ethinicity (40.9%) and were farmers (30.3%). It was observed that there is significant correlation between serum cholinesterase level and severity of poisoning based on Peradenya Organophosphorus Poisoning scale at initial presentation (p value <0.001). Conclusion: There is significant correlation between severity of poisoning and degree of derangement of serum cholinesterase level at the initial presentation. As the facility for the estimation of serum cholinesterase level is not available in all regions of Nepal.
{"title":"A Study on Correlation Between Serum Cholinesterase Level and Clinical Severity Based on Pop Scale in Organophosphorus Poisoning","authors":"A. Shrestha, A. Kidwai, R. Shrestha, Suman Kc","doi":"10.3126/jngmc.v18i2.38903","DOIUrl":"https://doi.org/10.3126/jngmc.v18i2.38903","url":null,"abstract":"Introduction: Organophosphorus (OP) compounds are the most commonly used pesticides worldwide and Organophosphorus poisoning has become the major public health problem especially in developing countries.The case fatality rate following ingestion of Organophosphorus pesticides in developing countries in Asia is 5-20%.Due to limited availability of facilities and resources in Nepal, it is important to prioritize treatment based on severity of poisoning as all patients can’t be managed in Intensive Care Unit. \u0000Aims: To study the correlation between serum cholinesterase level and clinical severity based on Peradenya organophosphorus poisoning scale in Organophosphorus poisoning. \u0000Methods: The study was conducted in the department of Medicine, Nepalgunj Medical College, Kohalpur, Banke from November 2019 to November 2020. It is based on the descriptive study of 66 patients with Organophosphorus poisoning attending to the emergency department. All patients with history of exposure to Organophosphorus poisoning were included in the study. Peradenya Organophosphorus Poisoning scale was used to assess the clinical severity as mild, moderate and severe. At the same time venous blood samples were collected for serum cholinesterase level. \u0000Results: Age group ranged from 16-60 years and majority of patients were in the age group of 20-29 years (34.85%). 53% were females. 74.2% of the patients were from lower socioeconomic status. 83.3% of the patients consumed poison with suicidal intention. Majority of the patients were from tharu ethinicity (40.9%) and were farmers (30.3%). It was observed that there is significant correlation between serum cholinesterase level and severity of poisoning based on Peradenya Organophosphorus Poisoning scale at initial presentation (p value <0.001). \u0000Conclusion: There is significant correlation between severity of poisoning and degree of derangement of serum cholinesterase level at the initial presentation. As the facility for the estimation of serum cholinesterase level is not available in all regions of Nepal.","PeriodicalId":166882,"journal":{"name":"Journal of Nepalgunj Medical College","volume":"9 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2021-08-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"114528861","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 : 2020-12-31DOI: 10.3126/jngmc.v18i1.35200
A. Shrestha
Introduction: Diabetic mellitus is a chronic metabolic disease characterized by hyperglycemia. Type 2 diabetes mellitus accounts for more than 90% of cases worldwide. Elevated HbA1c and dyslipidemia proportionately increases the risk of development of cardiovascular disease (CVD) which is the major cause of morbidity and mortality worldwide. Aims: To Study the correlation between glycated hemoglobin (HbA1c) and serum lipid profile in type 2 diabetic patients. Methods: This is a hospital based cross sectional study conducted at Nepalgunj medical college teaching hospital, which included 104 type 2 diabetic patients (54 males and 50 females).Venous blood samples were collected from all patients and serum was used for analyzing HbA1c, lipid profile panel and fasting blood glucose (FBG). DM was defined as per American diabetic association (ADA) criteria. Dyslipidemia was defined as per the National Cholesterol Education Program (NCEP) Adult Treatment Panel (ATP) III Guidelines. The data were analyzed using standard statistical methods, including SPSS 21. Results : Abnormal lipid parameters were demonstrated with increased Total Chloseterol (TC), Triglyceride (TG), Low density lipoprotein (LDL),Very low density lipoprotein (VLDL) and low High density lipoprotein (HDL) suggestive of dyslipidemia.HbA1c showed direct and significant correlation with TC,LDL,TG and VLDL. Patients with HbA1c > 7.0% had a significantly higher value of TC, LDL, TG and VLDL as compared to patients with HbA1c ≤7.0%.However, the significant difference in value of HDL-C was not found between two groups. Conclusion: Due to the strong correlation with lipid profile, HbA1c could be the ideal marker for predicting dyslipidemia in type 2 DM . Patients with higher HbA1c value and dyslipidemia should be considered as a very high risk group for CVD.
{"title":"Study of Correlation Between Glycated Hemoglobin (Hba1c) and Serum Lipid Profile in Type 2 Diabetic Patients","authors":"A. Shrestha","doi":"10.3126/jngmc.v18i1.35200","DOIUrl":"https://doi.org/10.3126/jngmc.v18i1.35200","url":null,"abstract":"Introduction: Diabetic mellitus is a chronic metabolic disease characterized by hyperglycemia. Type 2 diabetes mellitus accounts for more than 90% of cases worldwide. Elevated HbA1c and dyslipidemia proportionately increases the risk of development of cardiovascular disease (CVD) which is the major cause of morbidity and mortality worldwide.\u0000Aims: To Study the correlation between glycated hemoglobin (HbA1c) and serum lipid profile in type 2 diabetic patients.\u0000Methods: This is a hospital based cross sectional study conducted at Nepalgunj medical college teaching hospital, which included 104 type 2 diabetic patients (54 males and 50 females).Venous blood samples were collected from all patients and serum was used for analyzing HbA1c, lipid profile panel and fasting blood glucose (FBG). DM was defined as per American diabetic association (ADA) criteria. Dyslipidemia was defined as per the National Cholesterol Education Program (NCEP) Adult Treatment Panel (ATP) III Guidelines. The data were analyzed using standard statistical methods, including SPSS 21.\u0000Results : Abnormal lipid parameters were demonstrated with increased Total Chloseterol (TC), Triglyceride (TG), Low density lipoprotein (LDL),Very low density lipoprotein (VLDL) and low High density lipoprotein (HDL) suggestive of dyslipidemia.HbA1c showed direct and significant correlation with TC,LDL,TG and VLDL. Patients with HbA1c > 7.0% had a significantly higher value of TC, LDL, TG and VLDL as compared to patients with HbA1c ≤7.0%.However, the significant difference in value of HDL-C was not found between two groups.\u0000Conclusion: Due to the strong correlation with lipid profile, HbA1c could be the ideal marker for predicting dyslipidemia in type 2 DM . Patients with higher HbA1c value and dyslipidemia should be considered as a very high risk group for CVD.","PeriodicalId":166882,"journal":{"name":"Journal of Nepalgunj Medical College","volume":"2011 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2020-12-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"121503778","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 : 2020-12-31DOI: 10.3126/jngmc.v18i1.35190
Anshu Sharma, Ravi Saxena, D. Paudel, K. Shrestha
Introduction: Hearing impairment is the most common congenital abnormality that occurs in 1 to 4/1000 newborns. It has a profound effect on their optimal development of language, speech and cognitive skill. Early detection in order to achieve effective treatment is essential. An association between low birth weight and hearing loss is commonly associated with multiple risk factors that can alter hearing in a synergistic fashion. Universal neonatal hearing screening programs have become widely implemented aiming for the screening, confirmation of the diagnosis and intervention by 1, 3 and 6 months respectively. Transient Evoked Otoacoustic emissions is one of the test found to be a quick, objective, non-invasive, accurate and easy test for early detection of this problem. Aims: Early detection of hearing loss in neonates focusing on low birth weight for early optimum rehabilitation. Methods: A comparative case control study conducted in 100 neonates under 2 groups. 50 neonates with low birth weight and 50 with normal birth weight who were born at NGMCTH, Kohalpur. Their hearing evaluation was done with Transient Evoked Oto Acoustic Emission (TEOAE). Results: The total referral rate was 12 % and pass rate was 88 %. The referral rate in LBW group was 20 % and 4 % in normal weight neonates. The pass rate in low birth weight was 80 % and 96 % in normal weight babies. Conclusion: Hearing impairment is a severe consequence in neonates with low birth weight. To decrease the economic and social burden of effects of hearing loss, it is assumed that newborn screening can immeasurably improve the future of newborn with early rehabilitation.
{"title":"Hearing Loss in Low Birth Weight Neonates: A Comparative Study at Nepalgunj Medical College and Teaching Hospital","authors":"Anshu Sharma, Ravi Saxena, D. Paudel, K. Shrestha","doi":"10.3126/jngmc.v18i1.35190","DOIUrl":"https://doi.org/10.3126/jngmc.v18i1.35190","url":null,"abstract":"Introduction: Hearing impairment is the most common congenital abnormality that occurs in 1 to 4/1000 newborns. It has a profound effect on their optimal development of language, speech and cognitive skill. Early detection in order to achieve effective treatment is essential. An association between low birth weight and hearing loss is commonly associated with multiple risk factors that can alter hearing in a synergistic fashion. Universal neonatal hearing screening programs have become widely implemented aiming for the screening, confirmation of the diagnosis and intervention by 1, 3 and 6 months respectively. Transient Evoked Otoacoustic emissions is one of the test found to be a quick, objective, non-invasive, accurate and easy test for early detection of this problem. \u0000Aims: Early detection of hearing loss in neonates focusing on low birth weight for early optimum rehabilitation.\u0000Methods: A comparative case control study conducted in 100 neonates under 2 groups. 50 neonates with low birth weight and 50 with normal birth weight who were born at NGMCTH, Kohalpur. Their hearing evaluation was done with Transient Evoked Oto Acoustic Emission (TEOAE).\u0000Results: The total referral rate was 12 % and pass rate was 88 %. The referral rate in LBW group was 20 % and 4 % in normal weight neonates. The pass rate in low birth weight was 80 % and 96 % in normal weight babies.\u0000Conclusion: Hearing impairment is a severe consequence in neonates with low birth weight. To decrease the economic and social burden of effects of hearing loss, it is assumed that newborn screening can immeasurably improve the future of newborn with early rehabilitation.","PeriodicalId":166882,"journal":{"name":"Journal of Nepalgunj Medical College","volume":"11 6","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2020-12-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"133085647","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 : 2020-12-31DOI: 10.3126/jngmc.v18i1.35151
G. Dc
Introduction: Lateral epicondylitis or Tennis elbow is one of the most common causes of lateral elbow pain. Local steroid injection is a time tested treatment for providing symptomatic relief. Local injection of autologous blood in a case of lateral epicondylitis provides pain relief due to its cellular and humoral factor and triggers a healing cascade. Aims: This study aims to compare the outcomes of the autologous blood injection and local corticosteroid injection in the treatment of tennis elbow. Methods: This is a Hospital based study on conducted in the Department of Orthopedics at Nepalgunj Medical College from July 2018 to June 2019. 42 patients with unilateral tennis elbow were divided into two groups-Group A-21 patients (Autologous Blood Injection) and Group B-21 patients (Steroid Injection). Group A received 2 ml of autologous venous blood and mixed with 1 ml of 2% lignocaine solution; Group B patients received 80 mg (in 2 ml) of methyl Prednisolone acetate and 1ml of 2% lignocaine solution. Visual Analogue Scale pain score and Nirschl stage of patients were evaluated before injection and at 2, 6, and 12 weeks of injection were noted and analyzed. Results: Preinjection mean VAS pain score was - 7.48±0.75, 7.52±0.68 in Group A, and Group B respectively while the Nirschl stage was 5.62±0.59 and 5.6±0.5 in group A and B, these scores among two group was not statistically significant. At 2 weeks follow up both groups showed improvement without any significant difference between two groups (p=0.84 and 0.549), while group A had better improvement in VAS pain score at 6 weeks (p=0.001). At 12 weeks follow-up within each group, there was significant VAS pain and Nirschl stage improvement (p=0.001) but there was no significant difference between the two groups. Conclusion: Injection of autologous blood and corticosteroid injection is equally effective in the treatment of Tennis elbow at 12 weeks final follow-up.
{"title":"Effectiveness of Autologous Blood and Steroid Injection in Tennis Elbow Based on Visual Analog Score Pain Score and Nirschl Stage","authors":"G. Dc","doi":"10.3126/jngmc.v18i1.35151","DOIUrl":"https://doi.org/10.3126/jngmc.v18i1.35151","url":null,"abstract":"Introduction: Lateral epicondylitis or Tennis elbow is one of the most common causes of lateral elbow pain. Local steroid injection is a time tested treatment for providing symptomatic relief. Local injection of autologous blood in a case of lateral epicondylitis provides pain relief due to its cellular and humoral factor and triggers a healing cascade. \u0000Aims: This study aims to compare the outcomes of the autologous blood injection and local corticosteroid injection in the treatment of tennis elbow. \u0000Methods: This is a Hospital based study on conducted in the Department of Orthopedics at Nepalgunj Medical College from July 2018 to June 2019. 42 patients with unilateral tennis elbow were divided into two groups-Group A-21 patients (Autologous Blood Injection) and Group B-21 patients (Steroid Injection). Group A received 2 ml of autologous venous blood and mixed with 1 ml of 2% lignocaine solution; Group B patients received 80 mg (in 2 ml) of methyl Prednisolone acetate and 1ml of 2% lignocaine solution. Visual Analogue Scale pain score and Nirschl stage of patients were evaluated before injection and at 2, 6, and 12 weeks of injection were noted and analyzed. \u0000Results: Preinjection mean VAS pain score was - 7.48±0.75, 7.52±0.68 in Group A, and Group B respectively while the Nirschl stage was 5.62±0.59 and 5.6±0.5 in group A and B, these scores among two group was not statistically significant. At 2 weeks follow up both groups showed improvement without any significant difference between two groups (p=0.84 and 0.549), while group A had better improvement in VAS pain score at 6 weeks (p=0.001). At 12 weeks follow-up within each group, there was significant VAS pain and Nirschl stage improvement (p=0.001) but there was no significant difference between the two groups. \u0000Conclusion: Injection of autologous blood and corticosteroid injection is equally effective in the treatment of Tennis elbow at 12 weeks final follow-up.","PeriodicalId":166882,"journal":{"name":"Journal of Nepalgunj Medical College","volume":"8 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2020-12-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"133518826","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 : 2020-12-31DOI: 10.3126/jngmc.v18i1.35180
R. Shrestha, Kavita Sinha, N. Sharma, A. Shrestha
Introduction: Cervical cancer is the second most common cancer in females worldwide and third most common cancer in Nepal. Conventional Pap smear is the most widely used screening tool for detecting premalignant and malignant lesions of cervix. Cytohistological correlation of Pap smear is a widely accepted method for analysis of various factors leading to discrepancies in diagnosis and internal quality assurance. Aims: To study the cytohistological correlation of epithelial cell abnormality in Pap smear in Nepalgunj Medical College Teaching Hospital, Kohalpur, Banke, Nepal. Methods: This is a hospital based prospective cross sectional study carried out at Department of Pathology, NGMC, Kohalpur, Nepal from August 2018 to January 2020. The study included 137 cases of Pap smear with epithelial cell abnormality and correlated with corresponding histopathological findings. Results: The age of patients ranged from 20-80 years with the number of cases seen in the range of 30-39 years (n=44; 32.1%). Whitish discharge per vaginum was most common presenting symptom. High grade squamous intraepithelial lesion (HSIL) was the most common abnormal finding in Pap smear with a frequency of 40 (29.1%) cases. Out of 137 cases of Pap smear 57 (41.6%) cases showed discrepancies in cervical biopsy. All cases of Squamous Cell Carcinoma (SCC) were correctly diagnosed by Pap smear. The overall sensitivity of smear test was 84%. After evaluating cytohistological correlation, the Positive Predictive Value (PPV) was found to be 100% for SCC, 52% for HSIL and 59% for Low grade squamous intraepithelial lesion (LSIL). Conclusion: The current study revealed a good correlation between cervical cytology and biopsy in Pap smear showing epithelial cell abnormalities. Thus, cytology and histology are complementary to each other and helps to reduce discrepancies.
{"title":"Correlation of Epithelial Cell Abnormality in Cervical Cytology with Cervical Histology","authors":"R. Shrestha, Kavita Sinha, N. Sharma, A. Shrestha","doi":"10.3126/jngmc.v18i1.35180","DOIUrl":"https://doi.org/10.3126/jngmc.v18i1.35180","url":null,"abstract":"Introduction: Cervical cancer is the second most common cancer in females worldwide and third most common cancer in Nepal. Conventional Pap smear is the most widely used screening tool for detecting premalignant and malignant lesions of cervix. Cytohistological correlation of Pap smear is a widely accepted method for analysis of various factors leading to discrepancies in diagnosis and internal quality assurance.\u0000Aims: To study the cytohistological correlation of epithelial cell abnormality in Pap smear in Nepalgunj Medical College Teaching Hospital, Kohalpur, Banke, Nepal.\u0000Methods: This is a hospital based prospective cross sectional study carried out at Department of Pathology, NGMC, Kohalpur, Nepal from August 2018 to January 2020. The study included 137 cases of Pap smear with epithelial cell abnormality and correlated with corresponding histopathological findings.\u0000Results: The age of patients ranged from 20-80 years with the number of cases seen in the range of 30-39 years (n=44; 32.1%). Whitish discharge per vaginum was most common presenting symptom. High grade squamous intraepithelial lesion (HSIL) was the most common abnormal finding in Pap smear with a frequency of 40 (29.1%) cases. Out of 137 cases of Pap smear 57 (41.6%) cases showed discrepancies in cervical biopsy. All cases of Squamous Cell Carcinoma (SCC) were correctly diagnosed by Pap smear. The overall sensitivity of smear test was 84%. After evaluating cytohistological correlation, the Positive Predictive Value (PPV) was found to be 100% for SCC, 52% for HSIL and 59% for Low grade squamous intraepithelial lesion (LSIL).\u0000Conclusion: The current study revealed a good correlation between cervical cytology and biopsy in Pap smear showing epithelial cell abnormalities. Thus, cytology and histology are complementary to each other and helps to reduce discrepancies.","PeriodicalId":166882,"journal":{"name":"Journal of Nepalgunj Medical College","volume":"28 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2020-12-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"115332894","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 : 2020-12-31DOI: 10.3126/jngmc.v18i1.35224
B. Thapa, J. Neupane, Sunil Moktan
Introduction: Glioblastoma multiforme is the most common primary malignant brain tumor, with a very poor prognosis. Direct compression of any structure in the visual pathway or chronic papilloedema is the cause of loss of vision in these patients. Case Report: 30 years old male from Dailekh was brought by his elder brother with the complaint of complete vision loss in both eyes for 45 days. He also had hearing difficulty on right side, headache, right sided weakness and abnormal body movement. His Visual acuity was no perception of Light in both eyes. Pupil was mid-dilated and not reacting to light. Fundus examination revealed bilateral Pallid disc edema. MRI brain revealed left fronto-temporal GBM compressing optic chiasm. Neurosurgical consultation was obtained and counseling was done regarding disease and its treatment. Due to poor prognosis and poverty patient choose palliative conservative treatment. Conclusion: This case highlights the possibility of bilateral Blindness in unilateral GBM. GBM has very poor outcome even after treatment.
{"title":"Bilateral Blindness Due to Left Fronto-Temporal Lobe Glioblastoma Multiforme","authors":"B. Thapa, J. Neupane, Sunil Moktan","doi":"10.3126/jngmc.v18i1.35224","DOIUrl":"https://doi.org/10.3126/jngmc.v18i1.35224","url":null,"abstract":"Introduction: Glioblastoma multiforme is the most common primary malignant brain tumor, with a very poor prognosis. Direct compression of any structure in the visual pathway or chronic papilloedema is the cause of loss of vision in these patients. \u0000Case Report: 30 years old male from Dailekh was brought by his elder brother with the complaint of complete vision loss in both eyes for 45 days. He also had hearing difficulty on right side, headache, right sided weakness and abnormal body movement. His Visual acuity was no perception of Light in both eyes. Pupil was mid-dilated and not reacting to light. Fundus examination revealed bilateral Pallid disc edema. MRI brain revealed left fronto-temporal GBM compressing optic chiasm. Neurosurgical consultation was obtained and counseling was done regarding disease and its treatment. Due to poor prognosis and poverty patient choose palliative conservative treatment. \u0000Conclusion: This case highlights the possibility of bilateral Blindness in unilateral GBM. GBM has very poor outcome even after treatment.","PeriodicalId":166882,"journal":{"name":"Journal of Nepalgunj Medical College","volume":"55 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2020-12-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"122867081","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 : 2020-12-31DOI: 10.3126/jngmc.v18i1.35222
K. Sinha, Amrendra Kushwaha, H. Adhikari
An outbreak of novel coronavirus pneumonia occurred worldwide since December 2019, which had been named COVID-19 subsequently. It is extremely transmissive that infection in pregnant women were unavoidable. The delivery process will produce large amount of contaminated media, leaving a challenge for medical personnel to ensure both the safety of the mother and infant and good self-protection. Here, we report a 27 year woman had reverse transcription polymerase chain reaction-confirmed COVID-19 at 37 weeks 2 days of gestation. An emergency caesarean section at 38 weeks 2 days of gestation under spinal anaesthesia was performed for oligohydramnios with scar tenderness with strict protection for all personnel.
{"title":"Caesarean Section in Confirmed COVID-19 Patient at Nepalgunj Medical College: Case Report","authors":"K. Sinha, Amrendra Kushwaha, H. Adhikari","doi":"10.3126/jngmc.v18i1.35222","DOIUrl":"https://doi.org/10.3126/jngmc.v18i1.35222","url":null,"abstract":"An outbreak of novel coronavirus pneumonia occurred worldwide since December 2019, which had been named COVID-19 subsequently. It is extremely transmissive that infection in pregnant women were unavoidable. The delivery process will produce large amount of contaminated media, leaving a challenge for medical personnel to ensure both the safety of the mother and infant and good self-protection. Here, we report a 27 year woman had reverse transcription polymerase chain reaction-confirmed COVID-19 at 37 weeks 2 days of gestation. An emergency caesarean section at 38 weeks 2 days of gestation under spinal anaesthesia was performed for oligohydramnios with scar tenderness with strict protection for all personnel.","PeriodicalId":166882,"journal":{"name":"Journal of Nepalgunj Medical College","volume":"11 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2020-12-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"122561858","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 : 2020-12-31DOI: 10.3126/jngmc.v18i1.35213
N. M. Shrestha
Introduction: Percutaneous Nephrolithotripsy (PCNL) is one of the most accepted surgical modality for removal of renal stone. Placement of a nephrostomy tube at the end of PCNL is a standard procedure for PCNL, however many reports have showed the safety and efficacy of tubeless PCNL for the removal of renal stone. Aims: The present study aimed to report the outcomes of PCNL with or without nephrostomy tube. Methods: It is Prospective Hospital Study conducted from June 2017 to April 2020 in the Department of Urology Nepalgunj Medical College. Total 153 patients under inclusion criteria were divided into two groups. Group 1 (75 patients) was allocated to patients who were being treated under standard PCNL procedure while Group 2 (78 patients) was allocated for patients who were being treated under Tubeless PCNL procedure. The two groups were compared for operation time (minutes), hospital stay (days), post operative dose of analgesic (mg), post operative complications such as, leakage (%), bleeding (%) and infection (%). Data were analyzed from SPSS and p-value less than 0.5 was considered as significant. Results: In Group II the mean hospital stay, analgesic dose and rate of leakage was significantly lesser than Group I (p<0.05) whereas, the mean operation time, rate of infection and bleeding were not significantly different between two groups (p>0.05). Conclusion: Tubeless PCNL procedure causes more rapid recovery and earlier discharge from the hospital, reduction in postoperative pain and no leakage when compared to standard tubless PCNL.
{"title":"Outcomes of Percutaneous Nephrolithotripsy With or Without Nephrostomy Tube: A Comparative Study","authors":"N. M. Shrestha","doi":"10.3126/jngmc.v18i1.35213","DOIUrl":"https://doi.org/10.3126/jngmc.v18i1.35213","url":null,"abstract":"Introduction: Percutaneous Nephrolithotripsy (PCNL) is one of the most accepted surgical modality for removal of renal stone. Placement of a nephrostomy tube at the end of PCNL is a standard procedure for PCNL, however many reports have showed the safety and efficacy of tubeless PCNL for the removal of renal stone.\u0000Aims: The present study aimed to report the outcomes of PCNL with or without nephrostomy tube.\u0000Methods: It is Prospective Hospital Study conducted from June 2017 to April 2020 in the Department of Urology Nepalgunj Medical College. Total 153 patients under inclusion criteria were divided into two groups. Group 1 (75 patients) was allocated to patients who were being treated under standard PCNL procedure while Group 2 (78 patients) was allocated for patients who were being treated under Tubeless PCNL procedure. The two groups were compared for operation time (minutes), hospital stay (days), post operative dose of analgesic (mg), post operative complications such as, leakage (%), bleeding (%) and infection (%). Data were analyzed from SPSS and p-value less than 0.5 was considered as significant.\u0000Results: In Group II the mean hospital stay, analgesic dose and rate of leakage was significantly lesser than Group I (p<0.05) whereas, the mean operation time, rate of infection and bleeding were not significantly different between two groups (p>0.05).\u0000Conclusion: Tubeless PCNL procedure causes more rapid recovery and earlier discharge from the hospital, reduction in postoperative pain and no leakage when compared to standard tubless PCNL.","PeriodicalId":166882,"journal":{"name":"Journal of Nepalgunj Medical College","volume":"1 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2020-12-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"127454690","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 : 2020-12-31DOI: 10.3126/jngmc.v18i1.35202
Jyoti Adhikari, Rajesh Kc, Shristi Kharel
Introduction: Birth weight <2500 grams, <1500 grams and <1000 grams irrespective of gestational age is low birth weight, very low birth weight and extremely low birth weight respectively. Low birth weight is associated with high morbidity and mortality. Aims: To find out the possible maternal risk factors associated with low birth weight babies, morbidities and mortalities seen in them during their hospital stay. Methods: Hospital based cross sectional observational study was performed in 200 newborns <2500 grams in Nepalgunj Medical College, Kohalpur, Banke, Nepal. Results: Out of 200 neonates 8 (4%), 40 (20%) and 152 (76%) were extremely low birth weight, very low birth weight and low birth weight respectively with Male:Female ratio of 1.12:1. Most common maternal risk factors for low birth weight was Illiterate mothers (88%) followed by preterm delivery (68%). Inadequate antenatal visit was associated with low birth weight (P<0.05). Most common morbidity seen in low birth weight was neonatal sepsis (96%) followed by neonatal jaundice (87%). 44 (22.0%) neonates expired and 156 (78.0%) survived. Neonatal sepsis was most common (36.4%) cause of mortality followed by respiratory distress syndrome (22.7%). Conclusion: Certain measures could be taken to prevent low birth weight deliveries: discouraging delivery at teenage, adequate antenatal visits, avoiding smoking and alcohol during pregnancy. Well trained staffs and better facilities in neonatal intensive care unit could improve the survival and minimize the morbidities in low birth neonates.
{"title":"Risk Factors and Outcomes of Low Birth Weight Neonates Admitted In a Tertiary Care Center","authors":"Jyoti Adhikari, Rajesh Kc, Shristi Kharel","doi":"10.3126/jngmc.v18i1.35202","DOIUrl":"https://doi.org/10.3126/jngmc.v18i1.35202","url":null,"abstract":"Introduction: Birth weight <2500 grams, <1500 grams and <1000 grams irrespective of gestational age is low birth weight, very low birth weight and extremely low birth weight respectively. Low birth weight is associated with high morbidity and mortality.\u0000Aims: To find out the possible maternal risk factors associated with low birth weight babies, morbidities and mortalities seen in them during their hospital stay.\u0000Methods: Hospital based cross sectional observational study was performed in 200 newborns <2500 grams in Nepalgunj Medical College, Kohalpur, Banke, Nepal.\u0000Results: Out of 200 neonates 8 (4%), 40 (20%) and 152 (76%) were extremely low birth weight, very low birth weight and low birth weight respectively with Male:Female ratio of 1.12:1. Most common maternal risk factors for low birth weight was Illiterate mothers (88%) followed by preterm delivery (68%). Inadequate antenatal visit was associated with low birth weight (P<0.05). Most common morbidity seen in low birth weight was neonatal sepsis (96%) followed by neonatal jaundice (87%). 44 (22.0%) neonates expired and 156 (78.0%) survived. Neonatal sepsis was most common (36.4%) cause of mortality followed by respiratory distress syndrome (22.7%).\u0000Conclusion: Certain measures could be taken to prevent low birth weight deliveries: discouraging delivery at teenage, adequate antenatal visits, avoiding smoking and alcohol during pregnancy. Well trained staffs and better facilities in neonatal intensive care unit could improve the survival and minimize the morbidities in low birth neonates.","PeriodicalId":166882,"journal":{"name":"Journal of Nepalgunj Medical College","volume":"6 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2020-12-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"125596410","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 : 2020-12-31DOI: 10.3126/jngmc.v18i1.35175
A. Jha, N. Paudel, Sabin Nepal, Rajesh Nayak
Introduction: The pituitary gland is regarded as the master endocrine gland of the body. Subtle alterations in the size can cause significant changes to other endocrine glands and hormonal status. Magnetic Resonance Imaging (MRI) is the investigation of choice to examine pituitary gland. It is important to know the range of normal size and variations according to age and gender to enable radiologists to suggest what might be an abnormal pituitary gland. Aims: This study aims to examine normal size, volume and shape of pituitary gland and to establish a normal reference value for pituitary size in different age groups and genders. Methods: MRI Brain of 137 patients were studied retrospectively and patients with endocrinal abnormalities were excluded from the study. Images were acquired in General Electronics 1.5 Tesla MRI machine and mid-sagittal T1WI and coronal T2WI were selected for accurate measurement of the gland. Height, AP diameter, Transverse diameter, and volume were calculated for each individual and the collected data was categorized based on age and sex for analysis. Pearson’s correlation test was done to establish a relation between age and volume of the gland and a p-value of <0.05 was considered as significant. Results: Our study included 137 patients (57 males, 80 females) with age ranging from 3 to 86 years. The study was divided into six age groups. Mean pituitary height, AP diameter, transverse diameter and volume of the gland were 6mm, 8.9mm, 12.3 mm, and 354.5 mm3 respectively. The gland observed a gradual increase in size up to the third decade and was more pronounced in the female population. A steady decline in the size of the gland was noted after 30 years for both populations. Conclusion: Good understanding of the normal size and shape of pituitary gland and its variation with age and gender is a must for every radiologist to compare with an abnormal increase in size.
{"title":"Normal Pituitary Gland Size and Morphology and Its Variations Related To Age and Gender: An MRI Evaluation","authors":"A. Jha, N. Paudel, Sabin Nepal, Rajesh Nayak","doi":"10.3126/jngmc.v18i1.35175","DOIUrl":"https://doi.org/10.3126/jngmc.v18i1.35175","url":null,"abstract":"Introduction: The pituitary gland is regarded as the master endocrine gland of the body. Subtle alterations in the size can cause significant changes to other endocrine glands and hormonal status. Magnetic Resonance Imaging (MRI) is the investigation of choice to examine pituitary gland. It is important to know the range of normal size and variations according to age and gender to enable radiologists to suggest what might be an abnormal pituitary gland.\u0000Aims: This study aims to examine normal size, volume and shape of pituitary gland and to establish a normal reference value for pituitary size in different age groups and genders.\u0000Methods: MRI Brain of 137 patients were studied retrospectively and patients with endocrinal abnormalities were excluded from the study. Images were acquired in General Electronics 1.5 Tesla MRI machine and mid-sagittal T1WI and coronal T2WI were selected for accurate measurement of the gland. Height, AP diameter, Transverse diameter, and volume were calculated for each individual and the collected data was categorized based on age and sex for analysis. Pearson’s correlation test was done to establish a relation between age and volume of the gland and a p-value of <0.05 was considered as significant.\u0000Results: Our study included 137 patients (57 males, 80 females) with age ranging from 3 to 86 years. The study was divided into six age groups. Mean pituitary height, AP diameter, transverse diameter and volume of the gland were 6mm, 8.9mm, 12.3 mm, and 354.5 mm3 respectively. The gland observed a gradual increase in size up to the third decade and was more pronounced in the female population. A steady decline in the size of the gland was noted after 30 years for both populations.\u0000Conclusion: Good understanding of the normal size and shape of pituitary gland and its variation with age and gender is a must for every radiologist to compare with an abnormal increase in size.","PeriodicalId":166882,"journal":{"name":"Journal of Nepalgunj Medical College","volume":"33 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2020-12-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"134235067","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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