Pub Date : 2018-06-04DOI: 10.3126/mjpahs.v1i1.22457
A. Nepal
Background: Dermatophytoses have a high prevalence worldwide and also in Nepal. Large scale studies with different antifungal agents for long fol¬low up periods to assess the long term outcome of treatments together with culture sensitivity testing are required to confirm the elimination of the fungi. Materials and Methods: Total of 97 patients were enrolled, 48 patients received treatment with terbinafine 1% cream for 2 weeks and 49 patients received clotrimazole 1% cream for 4 weeks. Clinical evaluation and microscopic examination of the potassium hydroxide (KOH) mount were done at presentation, at week 2 and at week 4. Clinical assessment scoring (CAS) and Mycological cure rate were compared between the study groups. Results: Terbinafine cured more cases of dermatophytoses compared to clotrimazole. The clinical cure rate was not statistically different among cases of tinea pedis. Terbinafine was better among cases of tinea cruris and tinea corporis only at the end of week 4. Mycological cure rate was higher for terbinafine both at the end of week 2 and week 4.
{"title":"Efficacy of topical terbinafine and clotrimazole in the treatment of dermatophytoses: a Clinical and Microbiological Comparision","authors":"A. Nepal","doi":"10.3126/mjpahs.v1i1.22457","DOIUrl":"https://doi.org/10.3126/mjpahs.v1i1.22457","url":null,"abstract":"Background: Dermatophytoses have a high prevalence worldwide and also in Nepal. Large scale studies with different antifungal agents for long fol¬low up periods to assess the long term outcome of treatments together with culture sensitivity testing are required to confirm the elimination of the fungi. \u0000Materials and Methods: Total of 97 patients were enrolled, 48 patients received treatment with terbinafine 1% cream for 2 weeks and 49 patients received clotrimazole 1% cream for 4 weeks. Clinical evaluation and microscopic examination of the potassium hydroxide (KOH) mount were done at presentation, at week 2 and at week 4. Clinical assessment scoring (CAS) and Mycological cure rate were compared between the study groups. \u0000Results: Terbinafine cured more cases of dermatophytoses compared to clotrimazole. The clinical cure rate was not statistically different among cases of tinea pedis. Terbinafine was better among cases of tinea cruris and tinea corporis only at the end of week 4. Mycological cure rate was higher for terbinafine both at the end of week 2 and week 4.","PeriodicalId":256896,"journal":{"name":"Medical Journal of Pokhara Academy of Health Sciences","volume":"302 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2018-06-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"122245953","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 : 2018-06-04DOI: 10.3126/mjpahs.v1i1.22459
S. Paudel, N. Gurung, Dhruva Bahadur Adhikari, A. Acharya, S. Shrestha, A. Gurung, D. Shrestha, A. Paudel
Introduction: Laparoscopic cholecystectomy is the choice of operation for symptomatic gallstones. Gallstone and bile spillage can occur during laparoscopic cholecystectomy during dissection by cautery or due to perforation of gall bladder by grasper. The complication of spilt stone and bile may range from simple superficial surgical site infection, adhesion, obstruction, abscess formation to none. Methods: This study was conducted at Western Regional Hospital (WRH), Pokhara from July 2015 to December 2016. A total of one hundred and twenty patients who underwent laparoscopic cholecystectomy were included. All patients’ age, sex, pre-operative ultrasound findings, intra operative spillage of stone and bile and post-operative superficial surgical site infection were noted. Statistical analysis was done using Microsoft Excel software and SPSS-21. Result obtained from the study was discussed with reference to current world literature. Results: Out of one hundred and twenty patients, one hundred and nine were female and eleven were male with mean age of 42.68 years. Spillage of stones and bile occurred in twelve patients (10%). Spillage of stone and bile was common with multiple stones. Only four patients (one male and three females) developed superficial port site infection (3.3%). Two patients among spillage and two among non spillage developed superficial surgical site infection (p<0.05). Most common organism was Staphylococcus aureus followed by Escherichia coli. Conclusion: The incidence of split stone or bile is 10 % and is common with multiple gallstones. The chance of superficial surgical site infection is more in male patients and with spillage of stone and bile.
{"title":"Incidence of Superficial Port Site Infection in Laparoscopic Cholecystectomy in relation to Spilt Stone and Bile Spillage","authors":"S. Paudel, N. Gurung, Dhruva Bahadur Adhikari, A. Acharya, S. Shrestha, A. Gurung, D. Shrestha, A. Paudel","doi":"10.3126/mjpahs.v1i1.22459","DOIUrl":"https://doi.org/10.3126/mjpahs.v1i1.22459","url":null,"abstract":"Introduction: Laparoscopic cholecystectomy is the choice of operation for symptomatic gallstones. Gallstone and bile spillage can occur during laparoscopic cholecystectomy during dissection by cautery or due to perforation of gall bladder by grasper. The complication of spilt stone and bile may range from simple superficial surgical site infection, adhesion, obstruction, abscess formation to none. \u0000Methods: This study was conducted at Western Regional Hospital (WRH), Pokhara from July 2015 to December 2016. A total of one hundred and twenty patients who underwent laparoscopic cholecystectomy were included. All patients’ age, sex, pre-operative ultrasound findings, intra operative spillage of stone and bile and post-operative superficial surgical site infection were noted. Statistical analysis was done using Microsoft Excel software and SPSS-21. Result obtained from the study was discussed with reference to current world literature. \u0000Results: Out of one hundred and twenty patients, one hundred and nine were female and eleven were male with mean age of 42.68 years. Spillage of stones and bile occurred in twelve patients (10%). Spillage of stone and bile was common with multiple stones. Only four patients (one male and three females) developed superficial port site infection (3.3%). Two patients among spillage and two among non spillage developed superficial surgical site infection (p<0.05). Most common organism was Staphylococcus aureus followed by Escherichia coli. \u0000Conclusion: The incidence of split stone or bile is 10 % and is common with multiple gallstones. The chance of superficial surgical site infection is more in male patients and with spillage of stone and bile.","PeriodicalId":256896,"journal":{"name":"Medical Journal of Pokhara Academy of Health Sciences","volume":"72 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2018-06-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"121492276","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}
Background: Stillbirth (SB) incidents are one of the most common adverse outcomes to occur during pregnancy. Studies indicate that approximately 3.3 million stillbirths are reported annually across the developing world. Institutional registration and under reporting of still birth to an authorized centre is a common problem. Objective: The objective of this study is to find out the incidence of SB after 28 weeks gestation and to find out the associated risk factors at Western Regional Hospital of Nepal. Materials and Methods: This is a cross sectional study carried out at Western Regional Hospital. Stillbirth babies born after 28 weeks of gestation or birth weight ≥ 1 kilogram and their mothers were recruited for the study. Intrapartum stillbirths were included despite of their ages, races or socio-economic status. Descriptive analysis was done on the data. Results: There were 3380 deliveries during the period of study. Among them, 50 cases were stillborn babies with a rate of 14 per thousand deliveries. The major risk factors associated were oligohydramnios, decreased fetal movement, growth restriction, meconium stained liquor and cord prolapse. Conclusion: Oligohydramnios (amniotic fluid index < 5cm) was the most common risk factor for stillbirth. Early identification and appropriate perinatal management could help to promote perinatal health.
{"title":"Profile of Risk Factors Associated with Stillbirth at Western Regional Hospital","authors":"Rashmi Regmi, Shyam Sundar Parajuly, Dela Singh, Nabin Shrestha, Srijana Sharma","doi":"10.3126/MJPAHS.V1I1.22453","DOIUrl":"https://doi.org/10.3126/MJPAHS.V1I1.22453","url":null,"abstract":"Background: Stillbirth (SB) incidents are one of the most common adverse outcomes to occur during pregnancy. Studies indicate that approximately 3.3 million stillbirths are reported annually across the developing world. Institutional registration and under reporting of still birth to an authorized centre is a common problem. \u0000Objective: The objective of this study is to find out the incidence of SB after 28 weeks gestation and to find out the associated risk factors at Western Regional Hospital of Nepal. \u0000Materials and Methods: This is a cross sectional study carried out at Western Regional Hospital. Stillbirth babies born after 28 weeks of gestation or birth weight ≥ 1 kilogram and their mothers were recruited for the study. Intrapartum stillbirths were included despite of their ages, races or socio-economic status. Descriptive analysis was done on the data. \u0000Results: There were 3380 deliveries during the period of study. Among them, 50 cases were stillborn babies with a rate of 14 per thousand deliveries. The major risk factors associated were oligohydramnios, decreased fetal movement, growth restriction, meconium stained liquor and cord prolapse. \u0000Conclusion: Oligohydramnios (amniotic fluid index < 5cm) was the most common risk factor for stillbirth. Early identification and appropriate perinatal management could help to promote perinatal health.","PeriodicalId":256896,"journal":{"name":"Medical Journal of Pokhara Academy of Health Sciences","volume":"42 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2018-06-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"133058855","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 : 2018-06-04DOI: 10.3126/mjpahs.v1i1.22448
B. Thapa
It gives me great pleasure to know that Pokhara Academy of Health Sciences, (PAHS) has come out with its first publication of medical journal of Pokhara Academy of Health Sciences (MJPAHS). This can be a beginning of implementation of the policy of federal Government of Nepal to set at least one government medical college in each province. PAHS has been established in the year 2016 (2072 B.S) with an aim to begin postgraduate medical education in province number 4 and provide quality care and affordable medical service to all, in general, poor and marginalized people in particular. It also aims to carry out scientific research and study in different health related areas of this region. Accordingly we have formed IRC, Medical Education Department and Journal Editorial Board to carry out all its activities. This journal publication has been possible only because of collaborative, cooperative and untiring efforts of editorial board. I congratulate Dr. Bhogendra Bahadur KC and all other members of Editorial Board for this great job. I am sure this journal will fulfil the academic needs of all faculties and students and academics of different health institutes of this region.
{"title":"Goodwill message from the Vice Chancellor","authors":"B. Thapa","doi":"10.3126/mjpahs.v1i1.22448","DOIUrl":"https://doi.org/10.3126/mjpahs.v1i1.22448","url":null,"abstract":"It gives me great pleasure to know that Pokhara Academy of Health Sciences, (PAHS) has come out with its first publication of medical journal of Pokhara Academy of Health Sciences (MJPAHS). This can be a beginning of implementation of the policy of federal Government of Nepal to set at least one government medical college in each province. PAHS has been established in the year 2016 (2072 B.S) with an aim to begin postgraduate medical education in province number 4 and provide quality care and affordable medical service to all, in general, poor and marginalized people in particular. It also aims to carry out scientific research and study in different health related areas of this region. Accordingly we have formed IRC, Medical Education Department and Journal Editorial Board to carry out all its activities. This journal publication has been possible only because of collaborative, cooperative and untiring efforts of editorial board. I congratulate Dr. Bhogendra Bahadur KC and all other members of Editorial Board for this great job. I am sure this journal will fulfil the academic needs of all faculties and students and academics of different health institutes of this region.","PeriodicalId":256896,"journal":{"name":"Medical Journal of Pokhara Academy of Health Sciences","volume":"6 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2018-06-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"127984824","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 : 2018-06-04DOI: 10.3126/MJPAHS.V1I1.22456
L. Vaidya, Rajan Sharma
Background: The referral rates of psychiatric patients in Nepal are very low, considering the higher rates of psychiatric morbidity in patients who attend various departments of a general hospital. Studying the pattern of psychiatric referrals may facilitate the management of the mentally ill in a comprehensive and holistic manner. Materials and methods: The study was conducted at Western Regional Hospital (WRH) over the period of one year. The patients referred from different departments were assessed by the consultant psychiatrists. Result: A total of 816 patients were referred for psychiatric consultation out of which majority was from department of medicine and the most common reason for referral was anxiety disorder. Conclusion: Multi-disciplinary interaction is beneficial to identify the psychiatric morbidity in the patients who attend general hospital.
{"title":"Psychiatric Referral Pattern in a General Hospital","authors":"L. Vaidya, Rajan Sharma","doi":"10.3126/MJPAHS.V1I1.22456","DOIUrl":"https://doi.org/10.3126/MJPAHS.V1I1.22456","url":null,"abstract":"Background: The referral rates of psychiatric patients in Nepal are very low, considering the higher rates of psychiatric morbidity in patients who attend various departments of a general hospital. Studying the pattern of psychiatric referrals may facilitate the management of the mentally ill in a comprehensive and holistic manner. \u0000Materials and methods: The study was conducted at Western Regional Hospital (WRH) over the period of one year. The patients referred from different departments were assessed by the consultant psychiatrists. \u0000Result: A total of 816 patients were referred for psychiatric consultation out of which majority was from department of medicine and the most common reason for referral was anxiety disorder. \u0000Conclusion: Multi-disciplinary interaction is beneficial to identify the psychiatric morbidity in the patients who attend general hospital.","PeriodicalId":256896,"journal":{"name":"Medical Journal of Pokhara Academy of Health Sciences","volume":"8 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2018-06-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"116591720","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 : 2018-06-04DOI: 10.3126/mjpahs.v1i1.22452
Rohini Sigdel, M. Lama, Sanish Gurung, S. Timilsina
Background: Regional anesthesia is being utilized as the preferred anesthetic technique for cesarean delivery worldwide. This study was performed to review cesarean delivery anesthetic practice in our institute which represents a tertiary care regional hospital. Methods: Data was collected regarding the number of cesarean delivery performed during the period of six months from January 2017 to June 2017 at Western Regional Hospital. Number of elective versus emergency cesarean delivery, mode of anesthesia and the reason for general anesthesia and complications was recorded. Results: The number of cesarean delivery was found to be 1174(26.41%) of total deliveries during the study period. Out of which, 64.82% were for emergency indication and 35.18% were elective cesarean delivery. Spinal anesthesia was utilized in 99.03% of elective cesarean section and 97.63% of emergency cesarean section. The percentage of cases performed under general anesthesia was 1.87%. Reasons for general anesthesia included inadequate subarachnoid block, fetal malpresentation, eclampsia and maternal comorbidities. Complications related to general anesthesia like failed intubation, airway difficulty related to general anesthesia and anesthesia related mortality was not encountered. Conclusion: Spinal anesthesia is utilized widely and safely in obstetric practice at our hospital. Use of labour epidural analgesia should be introduced and encouraged in our setting to minimize the side effects of single shot spinal anesthesia and to avoid general anesthesia when indicated.
{"title":"Anesthesia practice in cesarean delivery in tertiary care hospital: a retrospective observational study","authors":"Rohini Sigdel, M. Lama, Sanish Gurung, S. Timilsina","doi":"10.3126/mjpahs.v1i1.22452","DOIUrl":"https://doi.org/10.3126/mjpahs.v1i1.22452","url":null,"abstract":"Background: Regional anesthesia is being utilized as the preferred anesthetic technique for cesarean delivery worldwide. This study was performed to review cesarean delivery anesthetic practice in our institute which represents a tertiary care regional hospital. \u0000Methods: Data was collected regarding the number of cesarean delivery performed during the period of six months from January 2017 to June 2017 at Western Regional Hospital. Number of elective versus emergency cesarean delivery, mode of anesthesia and the reason for general anesthesia and complications was recorded. \u0000Results: The number of cesarean delivery was found to be 1174(26.41%) of total deliveries during the study period. Out of which, 64.82% were for emergency indication and 35.18% were elective cesarean delivery. Spinal anesthesia was utilized in 99.03% of elective cesarean section and 97.63% of emergency cesarean section. The percentage of cases performed under general anesthesia was 1.87%. Reasons for general anesthesia included inadequate subarachnoid block, fetal malpresentation, eclampsia and maternal comorbidities. Complications related to general anesthesia like failed intubation, airway difficulty related to general anesthesia and anesthesia related mortality was not encountered. \u0000Conclusion: Spinal anesthesia is utilized widely and safely in obstetric practice at our hospital. Use of labour epidural analgesia should be introduced and encouraged in our setting to minimize the side effects of single shot spinal anesthesia and to avoid general anesthesia when indicated.","PeriodicalId":256896,"journal":{"name":"Medical Journal of Pokhara Academy of Health Sciences","volume":"20 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2018-06-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"130024462","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 : 2018-06-04DOI: 10.3126/mjpahs.v1i1.22454
Dhurba Adhikari, D. Shrestha, S. Poudel
Objective: To evaluate the efficacy of tamsulosin in the treatment of distal ureteric calculi. Materials and Methods: Forty patients, who meet the inclusion criteria, were selected for the prospective study. All these patients received tamsulosin 0.4 mg once before bed time for fourteen days to observe the effectiveness, side effects and stone expulsion rate. Results: The average time of stone expulsion was 8.03±2.80 days. The successful medical expulsion was seen in 82.50%. About 7.5% complained of dizziness and headache, 2.5% complained of fatigue and postural hypotension. Conclusion: The use of tamsulosin was safe, effective and was associated with fewer side effects. Successful stone expulsion rate was observed in in selected cases.
{"title":"The Efficacy of Medical Expulsion Therapy in Distal Ureteric Calculi","authors":"Dhurba Adhikari, D. Shrestha, S. Poudel","doi":"10.3126/mjpahs.v1i1.22454","DOIUrl":"https://doi.org/10.3126/mjpahs.v1i1.22454","url":null,"abstract":"Objective: To evaluate the efficacy of tamsulosin in the treatment of distal ureteric calculi. \u0000Materials and Methods: Forty patients, who meet the inclusion criteria, were selected for the prospective study. All these patients received tamsulosin 0.4 mg once before bed time for fourteen days to observe the effectiveness, side effects and stone expulsion rate. \u0000Results: The average time of stone expulsion was 8.03±2.80 days. The successful medical expulsion was seen in 82.50%. About 7.5% complained of dizziness and headache, 2.5% complained of fatigue and postural hypotension. \u0000Conclusion: The use of tamsulosin was safe, effective and was associated with fewer side effects. Successful stone expulsion rate was observed in in selected cases.","PeriodicalId":256896,"journal":{"name":"Medical Journal of Pokhara Academy of Health Sciences","volume":"10 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2018-06-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"115172317","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 : 2018-06-04DOI: 10.3126/mjpahs.v1i1.22450
S. Shrestha, J. Ghimire, R. Bastola, R. Gurung
Background: Neonatal sepsis is leading cause of mortality in neonates. The organism responsible for sepsis differed depending on the site of Neonatal care unit and country. In this study, we aimed to look at cause of sepsis and antibiotic sensitivity. Materials and Methods: Neonates admitted in the neonatal care unit of western regional hospital from 14th August 2012 to 14th July 2014were included in the study. Septic workup was done and culture was sent. Results of culture sensitivity were noted along with the sensitivity pattern. Results: Neonatal sepsis accounted for 38 percent of total admission in the neonatal unit. Staphylococcus aureus was the most common organism isolated which was followed by Escherichia coli (E coli). Staphylococcus aureus isolated was sensitive to Cloxacillin in 97% of cases. There were 5 % mortalities during the study period. Conclusion: Neonatal sepsis was the most common reason for admission and staphylococcus aureus was the most common organism.
{"title":"Clinical and bacteriological profile of neonates admitted in the neonatal care unit of western regional hospital","authors":"S. Shrestha, J. Ghimire, R. Bastola, R. Gurung","doi":"10.3126/mjpahs.v1i1.22450","DOIUrl":"https://doi.org/10.3126/mjpahs.v1i1.22450","url":null,"abstract":"Background: Neonatal sepsis is leading cause of mortality in neonates. The organism responsible for sepsis differed depending on the site of Neonatal care unit and country. In this study, we aimed to look at cause of sepsis and antibiotic sensitivity. \u0000Materials and Methods: Neonates admitted in the neonatal care unit of western regional hospital from 14th August 2012 to 14th July 2014were included in the study. Septic workup was done and culture was sent. Results of culture sensitivity were noted along with the sensitivity pattern. \u0000Results: Neonatal sepsis accounted for 38 percent of total admission in the neonatal unit. Staphylococcus aureus was the most common organism isolated which was followed by Escherichia coli (E coli). Staphylococcus aureus isolated was sensitive to Cloxacillin in 97% of cases. There were 5 % mortalities during the study period. \u0000Conclusion: Neonatal sepsis was the most common reason for admission and staphylococcus aureus was the most common organism.","PeriodicalId":256896,"journal":{"name":"Medical Journal of Pokhara Academy of Health Sciences","volume":"15 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2018-06-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"128213156","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 : 2018-06-04DOI: 10.3126/MJPAHS.V1I1.22460
Swasti Sharma
Background: Chronic otitis media (COM) squamous type is commonly associated with cholesteatoma. In COM squamous type with active disease, there is retraction of pars flaccida or pars tensa with retention of squamous epithelial debris and is associated with inflammation and production of pus. It is potentially dangerous because it can cause resorption of bone, leading to ossicular erosion and destruction of bony plates of middle ear. The objective of this study is to determine the effect of chronic otitis media squamous type on the ossicular chain as well as to observe the types of pathology in this disease. Methods and materials: Fifty cases of chronic otitis media squamous type who underwent surgical management were included. The status of ossicular chain was evaluated intraoperatively. The type of pathology involving middle ear was also studied. Cases admitted for revision surgery were excluded from the study. Results: Of the total fifty cases, ossicular changes were observed in forty eight cases and in two cases all ossicles were intact. Long process of incus is the most frequently involved ossicle. The most common pathology was found to be mixed type (52%). Conclusion: The conclusion of this study is that ossicular chain is commonly involved in chronic otitis media squamous type and mixed pathology consisting of cholesteatoma and granulation tissue is the most frequent pathology.
{"title":"Ossicular Involvement and Types of Pathology in Chronic Otitis Media Squamous Active Disease","authors":"Swasti Sharma","doi":"10.3126/MJPAHS.V1I1.22460","DOIUrl":"https://doi.org/10.3126/MJPAHS.V1I1.22460","url":null,"abstract":"Background: Chronic otitis media (COM) squamous type is commonly associated with cholesteatoma. In COM squamous type with active disease, there is retraction of pars flaccida or pars tensa with retention of squamous epithelial debris and is associated with inflammation and production of pus. It is potentially dangerous because it can cause resorption of bone, leading to ossicular erosion and destruction of bony plates of middle ear. The objective of this study is to determine the effect of chronic otitis media squamous type on the ossicular chain as well as to observe the types of pathology in this disease. \u0000Methods and materials: Fifty cases of chronic otitis media squamous type who underwent surgical management were included. The status of ossicular chain was evaluated intraoperatively. The type of pathology involving middle ear was also studied. Cases admitted for revision surgery were excluded from the study. \u0000Results: Of the total fifty cases, ossicular changes were observed in forty eight cases and in two cases all ossicles were intact. Long process of incus is the most frequently involved ossicle. The most common pathology was found to be mixed type (52%). \u0000Conclusion: The conclusion of this study is that ossicular chain is commonly involved in chronic otitis media squamous type and mixed pathology consisting of cholesteatoma and granulation tissue is the most frequent pathology.","PeriodicalId":256896,"journal":{"name":"Medical Journal of Pokhara Academy of Health Sciences","volume":"55 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2018-06-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"126556489","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 : 2018-06-04DOI: 10.3126/mjpahs.v1i1.22451
M. Lama, Rohini Sigdel, Sanish Gurung, S. Timilsina
Background: Dreaming during anaesthesia is a common phenomenon. Dreams can occur with both inhalational agents as well as intravenous agents (IVA) like propofol and ketamine. But there are concerns like patient awareness, dreams and other untoward effects that may be associated with IVA. We have conducted this study to quantify the incidence of dreaming during IVA with propofol or ketamine. Methods: Sixty-nine patients aged 18 to 60 years scheduled for short procedures lasting from 5 to 25 minutes under IVA were randomized into two groups – group propofol or group ketamine. All the patients received midazolam and fentanyl intravenously. Then, patients in group propofol received propofol and those in ketamine group received ketamine for induction and maintenance of anaesthesia. After the end of surgery, when the patient were fully recovered from anaesthesia, patients were interviewed about occurrence of dreams and their ability to recall the dreams. Results: There were 35 patients in group propofol and 34 patients in group ketamine. The incidence of dreaming during anaesthesia was greater in patients of ketamine group, 23 (67.65%), when compared to propofol group, 7 (20%) (p < 0.001). Among the dreamers, 6 patients in the ketamine group and only 1 patient in the propofol group were able to recall their dream. Conclusion: Dreaming is quite common during IVA for short surgical procedure, more so following ketamine than propofol anaesthesia.
{"title":"Dreams and ability to recall: Comparison between propofol and ketamine in patients undergoing surgery under IVA","authors":"M. Lama, Rohini Sigdel, Sanish Gurung, S. Timilsina","doi":"10.3126/mjpahs.v1i1.22451","DOIUrl":"https://doi.org/10.3126/mjpahs.v1i1.22451","url":null,"abstract":"Background: Dreaming during anaesthesia is a common phenomenon. Dreams can occur with both inhalational agents as well as intravenous agents (IVA) like propofol and ketamine. But there are concerns like patient awareness, dreams and other untoward effects that may be associated with IVA. We have conducted this study to quantify the incidence of dreaming during IVA with propofol or ketamine. \u0000Methods: Sixty-nine patients aged 18 to 60 years scheduled for short procedures lasting from 5 to 25 minutes under IVA were randomized into two groups – group propofol or group ketamine. All the patients received midazolam and fentanyl intravenously. Then, patients in group propofol received propofol and those in ketamine group received ketamine for induction and maintenance of anaesthesia. After the end of surgery, when the patient were fully recovered from anaesthesia, patients were interviewed about occurrence of dreams and their ability to recall the dreams. \u0000Results: There were 35 patients in group propofol and 34 patients in group ketamine. The incidence of dreaming during anaesthesia was greater in patients of ketamine group, 23 (67.65%), when compared to propofol group, 7 (20%) (p < 0.001). Among the dreamers, 6 patients in the ketamine group and only 1 patient in the propofol group were able to recall their dream. \u0000Conclusion: Dreaming is quite common during IVA for short surgical procedure, more so following ketamine than propofol anaesthesia.","PeriodicalId":256896,"journal":{"name":"Medical Journal of Pokhara Academy of Health Sciences","volume":"9 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2018-06-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"132383389","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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