{"title":"Patient’s Involvement, Engagement, and Participation in Medical Research: Nepalese Perspective","authors":"A. Dhakal, D. Shrestha","doi":"10.3126/nmj.v5i1.47142","DOIUrl":"https://doi.org/10.3126/nmj.v5i1.47142","url":null,"abstract":"No abstract available.","PeriodicalId":52856,"journal":{"name":"Nepalese Medical Journal","volume":"16 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-06-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"81700384","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: Despite many advances in diagnosis, diagnosing appendicitis remains difficult. Various diagnostic scoring systems have been developed in an attempt to improve the diagnostic accuracy of acute appendicitis. The study aimed to determine the accuracy of the Modified Alvarado and Eskelinen score in diagnosing acute appendicitis and to correlate the histopathological findings with the severity of acute appendicitis. Materials and Methods: A prospective study was conducted in TUTH including 84 patients with a clinical diagnosis of acute appendicitis managed surgically for 10 months. Modified Alvarado and Eskelinen Score were calculated and histopathological findings were correlated for predicting the severity of appendicitis. Results: Out of 84 patients Modified Alvarado Score had sensitivity and specificity of 67.79% and 32% when the score was taken as 7 and Eskelinen Score had sensitivity and specificity of 70.17% and 29.62% when the score was taken as 55. However, the sensitivity of the Modified Alvarado Score increased to 92.85% and specificity to 14.28% when the cut-off score was taken as 6. Modified Alvarado Score predicted 67% and 63% of uncomplicated and complicated appendicitis respectively and Eskelinen Score predicted 72% of uncomplicated and 67% of complicated appendicitis when the score was taken as 7 and 55 respectively. Conclusions: Both Modified Alvarado and Eskelinen Scores have low sensitivity in diagnosing acute appendicitis. With cut off for Modified Alvarado Score taken as 6, sensitivity increased. There was no correlation between the severity of appendicitis with the increase in Modified Alvarado and Eskelinen Score.
{"title":"Comparative Study of Modified Alvarado Score and Eskelinen Score in Diagnosing Acute Appendicitis","authors":"Isha Dahal","doi":"10.3126/nmj.v5i1.42868","DOIUrl":"https://doi.org/10.3126/nmj.v5i1.42868","url":null,"abstract":"Introduction: Despite many advances in diagnosis, diagnosing appendicitis remains difficult. Various diagnostic scoring systems have been developed in an attempt to improve the diagnostic accuracy of acute appendicitis. The study aimed to determine the accuracy of the Modified Alvarado and Eskelinen score in diagnosing acute appendicitis and to correlate the histopathological findings with the severity of acute appendicitis.\u0000Materials and Methods: A prospective study was conducted in TUTH including 84 patients with a clinical diagnosis of acute appendicitis managed surgically for 10 months. Modified Alvarado and Eskelinen Score were calculated and histopathological findings were correlated for predicting the severity of appendicitis.\u0000Results: Out of 84 patients Modified Alvarado Score had sensitivity and specificity of 67.79% and 32% when the score was taken as 7 and Eskelinen Score had sensitivity and specificity of 70.17% and 29.62% when the score was taken as 55. However, the sensitivity of the Modified Alvarado Score increased to 92.85% and specificity to 14.28% when the cut-off score was taken as 6. Modified Alvarado Score predicted 67% and 63% of uncomplicated and complicated appendicitis respectively and Eskelinen Score predicted 72% of uncomplicated and 67% of complicated appendicitis when the score was taken as 7 and 55 respectively.\u0000Conclusions: Both Modified Alvarado and Eskelinen Scores have low sensitivity in diagnosing acute appendicitis. With cut off for Modified Alvarado Score taken as 6, sensitivity increased. There was no correlation between the severity of appendicitis with the increase in Modified Alvarado and Eskelinen Score.","PeriodicalId":52856,"journal":{"name":"Nepalese Medical Journal","volume":"13 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-06-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"78471513","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}
A. Shrestha, A. Adhikari, A. Poudel, B. Aryal, Ganesh Parajuli, S. Gurung, Shreejana Baskota, Ishu Shrestha
Introduction: Pap smear is a time-tested screening test to diagnose cervical carcinoma at an early stage. It allows clinicians to take intervention measures, prevent the progression of the disease to invasive forms and decrease the burden of carcinoma as a whole. The objective of this study is to determine the values regarding the diagnostic accuracy of Pap smear and establish its role in the health care setting of Nepal. Materials and Methods: This is a retrospective cross-sectional analysis of the records from April 14, 2018, to April 12, 2020, of the Department of Pathology in a tertiary care hospital in the capital city of Nepal. Ethical approval for the study was taken from the Institutional Review Board and the demographic and clinical data of patients were analyzed anonymously. The consecutive sampling technique as used for data collection and analysis was done in Microsoft Excel 2019 and Statistical Packages for Social Sciences Version 25. The diagnostic accuracy parameters were calculated from a contingency table prepared from the collected data. Results: Out of 3095 Pap smears, 72 had a positive finding of some sort. 74 cases had a positive finding in the form of a biopsy out of 573. The sensitivity, specificity, positive predictive value, and negative predictive value of Pap smear at the institution were found to be 0.70, 0.94, 0.78, and 0.91 respectively with an overall accuracy of 88.36%. Conclusions: Pap smear can still play a pivotal role in the diagnosis of cervical neoplastic lesions.
子宫颈抹片检查是一项久经考验的筛查试验，可在早期诊断宫颈癌。它使临床医生能够采取干预措施，防止疾病发展为侵袭性形式，并从整体上减少癌症的负担。本研究的目的是确定关于巴氏涂片诊断准确性的价值，并确定其在尼泊尔卫生保健环境中的作用。材料与方法:对尼泊尔首都某三级医院病理科2018年4月14日至2020年4月12日的记录进行回顾性横断面分析。该研究获得了机构审查委员会的伦理批准，患者的人口统计和临床数据进行了匿名分析。数据收集和分析使用的连续抽样技术在Microsoft Excel 2019和Statistical Packages for Social Sciences Version 25中完成。根据收集的数据编制的列联表计算诊断准确性参数。结果:在3095份巴氏涂片检查中，72份有某种阳性发现。573例中有74例活检呈阳性。该机构子宫颈抹片的敏感性、特异性、阳性预测值和阴性预测值分别为0.70、0.94、0.78和0.91，总体准确率为88.36%。结论:子宫颈抹片检查在宫颈肿瘤诊断中仍有重要作用。
{"title":"Pap Smear as a Screening Tool for Cervical Cancer in a Tertiary Care Centre in Nepal: A Retrospective Cross-sectional Analysis","authors":"A. Shrestha, A. Adhikari, A. Poudel, B. Aryal, Ganesh Parajuli, S. Gurung, Shreejana Baskota, Ishu Shrestha","doi":"10.3126/nmj.v5i1.46421","DOIUrl":"https://doi.org/10.3126/nmj.v5i1.46421","url":null,"abstract":"Introduction: Pap smear is a time-tested screening test to diagnose cervical carcinoma at an early stage. It allows clinicians to take intervention measures, prevent the progression of the disease to invasive forms and decrease the burden of carcinoma as a whole. The objective of this study is to determine the values regarding the diagnostic accuracy of Pap smear and establish its role in the health care setting of Nepal.\u0000Materials and Methods: This is a retrospective cross-sectional analysis of the records from April 14, 2018, to April 12, 2020, of the Department of Pathology in a tertiary care hospital in the capital city of Nepal. Ethical approval for the study was taken from the Institutional Review Board and the demographic and clinical data of patients were analyzed anonymously. The consecutive sampling technique as used for data collection and analysis was done in Microsoft Excel 2019 and Statistical Packages for Social Sciences Version 25. The diagnostic accuracy parameters were calculated from a contingency table prepared from the collected data.\u0000Results: Out of 3095 Pap smears, 72 had a positive finding of some sort. 74 cases had a positive finding in the form of a biopsy out of 573. The sensitivity, specificity, positive predictive value, and negative predictive value of Pap smear at the institution were found to be 0.70, 0.94, 0.78, and 0.91 respectively with an overall accuracy of 88.36%.\u0000Conclusions: Pap smear can still play a pivotal role in the diagnosis of cervical neoplastic lesions.","PeriodicalId":52856,"journal":{"name":"Nepalese Medical Journal","volume":"235 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-06-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"87506660","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}
Anticoagulants are medications that are administered to patients with clotting issues. Major issues include atrial fibrillation, venous thromboembolism/deep vein thrombosis, and pulmonary embolism. However, recent studies show the increased use of these medications in the treatment and management of COVID-19. This paper has been designed as a systematic Literature review based on PRISMA strategy. Data were collected by conducting exhaustive research on major electronic databases i.e., SCOPUS, Web of Science, EMBASE, ProQuest, ScienceDirect, and Google Scholar. A total of 52 studies were included in this review. These studies were selected from the period 2011-2021. The overall study revealed the advancements of DOACs or NOACs in comparison to Warfarin, revealed the findings of various food, drug, and another kind of products that interfere with oral anticoagulants, and advancements in terms of treatment of DVT/VTE, pulmonary embolism, and arterial fibrillation by use of oral anticoagulants and the role of anticoagulation in COVID-19.
抗凝剂是给有凝血问题的病人服用的药物。主要问题包括心房颤动，静脉血栓栓塞/深静脉血栓形成和肺栓塞。然而，最近的研究表明，在COVID-19的治疗和管理中，这些药物的使用有所增加。本文是一篇基于PRISMA策略的系统文献综述。通过对主要电子数据库(SCOPUS、Web of Science、EMBASE、ProQuest、ScienceDirect和Google Scholar)进行详尽的研究收集数据。本综述共纳入52项研究。这些研究选自2011-2021年。整体研究揭示了DOACs或NOACs与华法林相比的进展，揭示了各种食品、药物和其他类产品对口服抗凝药物的干扰，以及口服抗凝药物在治疗DVT/VTE、肺栓塞和动脉颤动方面的进展，以及抗凝在COVID-19中的作用。
{"title":"Recent Advancements in Oral Anticoagulants: A Systematic Review","authors":"Ramica Sharma","doi":"10.3126/nmj.v5i1.44920","DOIUrl":"https://doi.org/10.3126/nmj.v5i1.44920","url":null,"abstract":"Anticoagulants are medications that are administered to patients with clotting issues. Major issues include atrial fibrillation, venous thromboembolism/deep vein thrombosis, and pulmonary embolism. However, recent studies show the increased use of these medications in the treatment and management of COVID-19. \u0000This paper has been designed as a systematic Literature review based on PRISMA strategy. Data were collected by conducting exhaustive research on major electronic databases i.e., SCOPUS, Web of Science, EMBASE, ProQuest, ScienceDirect, and Google Scholar. A total of 52 studies were included in this review. These studies were selected from the period 2011-2021. The overall study revealed the advancements of DOACs or NOACs in comparison to Warfarin, revealed the findings of various food, drug, and another kind of products that interfere with oral anticoagulants, and advancements in terms of treatment of DVT/VTE, pulmonary embolism, and arterial fibrillation by use of oral anticoagulants and the role of anticoagulation in COVID-19.","PeriodicalId":52856,"journal":{"name":"Nepalese Medical Journal","volume":"54 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-06-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"83684571","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: With the aid of modern imaging procedures like ultrasonography and computed tomography, fine needle aspiration cytology of deeper structures, small and vaguely palpable swellings, and lesions that are in close proximity to major vasculature are feasible. This study aims to establish the prevalence of image-guided FNAC, evaluate its diagnostic utility, and assess the spectrum of disorders diagnosed with its usage. Materials and Methods: A retrospective descriptive study was performed in the Pathology department, Om Hospital, and Research Centre from May 2015 to November 2019. The study included all samples of image-guided FNACs which were received for cytological examination. Results: Image-guided FNAC accounted for 13.03% of all FNACs done during the study period. Female predominance with a male to female ratio of 1:1.4 was noted. The age of the patients ranged from 13 to 85 years with a mean age of 53.6 years. The majority of the FNACs were performed under USG guidance. The lung was the most commonest site followed by lymph nodes and liver. Cytological diagnosis was made in 225 (88.93%) of the total cases. 7 (2.77%) cases were suspicious for malignancy and 21 (8.3%) were inconclusive. The majority of the lesions were categorized as malignant. Conclusions: Image-guided FNAC has a good diagnostic yield for deeper structures and small and vaguely palpable swellings. A spectrum of lesions, both neoplastic and non-neoplastic can be diagnosed with its usage. The commonest site of aspiration was the lung followed by lymph nodes and liver.
{"title":"Diagnostic Role of Image-Guided Fine Needle Aspiration Cytology","authors":"P. Sherpa, Sudhamsu Koirala","doi":"10.3126/nmj.v5i1.46803","DOIUrl":"https://doi.org/10.3126/nmj.v5i1.46803","url":null,"abstract":"Introduction: With the aid of modern imaging procedures like ultrasonography and computed tomography, fine needle aspiration cytology of deeper structures, small and vaguely palpable swellings, and lesions that are in close proximity to major vasculature are feasible. This study aims to establish the prevalence of image-guided FNAC, evaluate its diagnostic utility, and assess the spectrum of disorders diagnosed with its usage.\u0000Materials and Methods: A retrospective descriptive study was performed in the Pathology department, Om Hospital, and Research Centre from May 2015 to November 2019. The study included all samples of image-guided FNACs which were received for cytological examination.\u0000Results: Image-guided FNAC accounted for 13.03% of all FNACs done during the study period. Female predominance with a male to female ratio of 1:1.4 was noted. The age of the patients ranged from 13 to 85 years with a mean age of 53.6 years. The majority of the FNACs were performed under USG guidance. The lung was the most commonest site followed by lymph nodes and liver. Cytological diagnosis was made in 225 (88.93%) of the total cases. 7 (2.77%) cases were suspicious for malignancy and 21 (8.3%) were inconclusive. The majority of the lesions were categorized as malignant.\u0000Conclusions: Image-guided FNAC has a good diagnostic yield for deeper structures and small and vaguely palpable swellings. A spectrum of lesions, both neoplastic and non-neoplastic can be diagnosed with its usage. The commonest site of aspiration was the lung followed by lymph nodes and liver.","PeriodicalId":52856,"journal":{"name":"Nepalese Medical Journal","volume":"41 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-06-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"81000186","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: Cholesterol has been blamed as the principal cause of cardiovascular diseases, however, it is a common observation that most coronary artery disease patients do not have strikingly high cholesterol values, often falling within the desirable range, and also many patients with high cholesterol levels do not have any atherosclerotic cardiovascular diseases. Therefore, we decided to investigate whether there is an association between cholesterol levels and coronary artery disease. Materials and Methods: This is a case-control study conducted on a total of 313 coronary heart disease patients and 369 controls diagnosed by coronary angiogram. Fasting lipid profile was analyzed for both cases and controls. The study extended for a period of three years from 2018 July to 2020 June. Results: Total cholesterol (p<0.05) and Low-Density Lipoprotein (p<0.05) levels were significantly lower among the cases, while triglyceride and High-Density Lipoprotein levels of cases were similar to the controls. Taking age into consideration, there was no significant difference in the total cholesterol and Low-Density Lipoprotein levels between cases and controls below the age of 60 years, however, above the age of 60 years, total cholesterol and Low-Density Lipoprotein were significantly lower in the cases (p<0.05). Conclusions: The findings of the present study indicated that either there was no association between cholesterol levels and coronary artery disease or an inverse association when age was taken into consideration, as above 60 years of age the cholesterol level was found to be significantly lower in the patients of coronary artery disease compared to controls.
{"title":"Lack of an Association or an Inverse Association Between Cholesterol and Coronary Artery Disease: A Case-Control Study","authors":"Sanjay Shrestha, Nikky Maharjan","doi":"10.3126/nmj.v5i1.46471","DOIUrl":"https://doi.org/10.3126/nmj.v5i1.46471","url":null,"abstract":"Introduction: Cholesterol has been blamed as the principal cause of cardiovascular diseases, however, it is a common observation that most coronary artery disease patients do not have strikingly high cholesterol values, often falling within the desirable range, and also many patients with high cholesterol levels do not have any atherosclerotic cardiovascular diseases. Therefore, we decided to investigate whether there is an association between cholesterol levels and coronary artery disease. \u0000Materials and Methods: This is a case-control study conducted on a total of 313 coronary heart disease patients and 369 controls diagnosed by coronary angiogram. Fasting lipid profile was analyzed for both cases and controls. The study extended for a period of three years from 2018 July to 2020 June.\u0000Results: Total cholesterol (p<0.05) and Low-Density Lipoprotein (p<0.05) levels were significantly lower among the cases, while triglyceride and High-Density Lipoprotein levels of cases were similar to the controls.\u0000Taking age into consideration, there was no significant difference in the total cholesterol and Low-Density Lipoprotein levels between cases and controls below the age of 60 years, however, above the age of 60 years, total cholesterol and Low-Density Lipoprotein were significantly lower in the cases (p<0.05).\u0000Conclusions: The findings of the present study indicated that either there was no association between cholesterol levels and coronary artery disease or an inverse association when age was taken into consideration, as above 60 years of age the cholesterol level was found to be significantly lower in the patients of coronary artery disease compared to controls.","PeriodicalId":52856,"journal":{"name":"Nepalese Medical Journal","volume":"40 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-06-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"89889916","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}
Head and Neck cancer is one of the most prevalent conditions in the world and so is in Nepal. Head and Neck cancer causes speech, language, and swallowing disorder that affects the quality of life of a patient. A multidisciplinary team is needed for the management of the cancer patient. A Speech Language Pathologist is one important team member involved in the rehabilitation of communication and swallowing issues. The role of Speech Language pathologists should be understood by other medical professionals and need to be integrated into the team to provide a holistic health care facility to an individual with head and cancer.
{"title":"Speech-language Pathologist: A Team Member for Management of Head and Neck Cancer Patients","authors":"Biraj Bhattarai","doi":"10.3126/nmj.v5i1.37741","DOIUrl":"https://doi.org/10.3126/nmj.v5i1.37741","url":null,"abstract":"Head and Neck cancer is one of the most prevalent conditions in the world and so is in Nepal. Head and Neck cancer causes speech, language, and swallowing disorder that affects the quality of life of a patient. A multidisciplinary team is needed for the management of the cancer patient. A Speech Language Pathologist is one important team member involved in the rehabilitation of communication and swallowing issues. The role of Speech Language pathologists should be understood by other medical professionals and need to be integrated into the team to provide a holistic health care facility to an individual with head and cancer.\u0000 ","PeriodicalId":52856,"journal":{"name":"Nepalese Medical Journal","volume":"14 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-06-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"80864930","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}
Tulsi Ram Shrestha, S. Podar, S. Ghimire, Dhiraj Tamrakar
Introduction: Laryngoscopy and intubation are associated with transient sympathetic responses manifesting as a rise in blood pressure and heart rate. This study was conducted to evaluate the role of oral gabapentin pretreatment in the attenuation of such haemodynamic response. Materials and Methods: Sixty-two patients aged 16 to 60 years weighing 50 to 75 kg undergoing elective surgeries requiring endotracheal intubation were randomized into two groups. group G received 900 mg oral gabapentin and group P received a placebo by mouth two hours before induction of anaesthesia. Patients were induced with propofol, fentanyl, and vecuronium. Laryngoscopy was attempted after four minutes and endotracheal intubation was done. Heart rate, systolic, diastolic, and mean arterial pressure at baseline, before intubation, one, three, five, and ten minutes after intubation were compared between two groups. Patients were observed for any adverse events peri-operatively and post-operatively for the first 24 hours. Results: There was significant attenuation of the rise in blood pressure and heart rate before and after intubation in both groups compared with their corresponding baseline parameters. A significant decrease in heart rate was observed in the gabapentin group only 10 minutes after laryngoscopy and intubation (p=0.022). Conclusions: Oral Gabapentin 900 mg two hours before induction is effective in attenuating the rise in blood pressure and heart rate following laryngoscopy and tracheal intubation, though a statistically significant difference was observed only at 10 minutes after intubation, compared with a placebo group. Besides the significant incidence of pre-induction somnolence, there were no serious perioperative adverse effects.
{"title":"Oral Gabapentin Pretreatment to Attenuate the Haemodynamic Response to Laryngoscopy and Tracheal Intubation","authors":"Tulsi Ram Shrestha, S. Podar, S. Ghimire, Dhiraj Tamrakar","doi":"10.3126/nmj.v5i1.45703","DOIUrl":"https://doi.org/10.3126/nmj.v5i1.45703","url":null,"abstract":"Introduction: Laryngoscopy and intubation are associated with transient sympathetic responses manifesting as a rise in blood pressure and heart rate. This study was conducted to evaluate the role of oral gabapentin pretreatment in the attenuation of such haemodynamic response.\u0000Materials and Methods: Sixty-two patients aged 16 to 60 years weighing 50 to 75 kg undergoing elective surgeries requiring endotracheal intubation were randomized into two groups. group G received 900 mg oral gabapentin and group P received a placebo by mouth two hours before induction of anaesthesia. Patients were induced with propofol, fentanyl, and vecuronium. Laryngoscopy was attempted after four minutes and endotracheal intubation was done. Heart rate, systolic, diastolic, and mean arterial pressure at baseline, before intubation, one, three, five, and ten minutes after intubation were compared between two groups. Patients were observed for any adverse events peri-operatively and post-operatively for the first 24 hours.\u0000Results: There was significant attenuation of the rise in blood pressure and heart rate before and after intubation in both groups compared with their corresponding baseline parameters. A significant decrease in heart rate was observed in the gabapentin group only 10 minutes after laryngoscopy and intubation (p=0.022).\u0000Conclusions: Oral Gabapentin 900 mg two hours before induction is effective in attenuating the rise in blood pressure and heart rate following laryngoscopy and tracheal intubation, though a statistically significant difference was observed only at 10 minutes after intubation, compared with a placebo group. Besides the significant incidence of pre-induction somnolence, there were no serious perioperative adverse effects. ","PeriodicalId":52856,"journal":{"name":"Nepalese Medical Journal","volume":"11 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-06-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"88126796","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: The characteristics of salivary gland lesions identified by fine-needle aspiration cytology are varied and may overlap, which makes diagnosis difficult for cytopathologists. To provide consistency in the reporting of salivary gland cytology and to enhance clinic-pathologic communication, the "Milan system for reporting salivary gland cytopathology" has been introduced, which offers guidelines for diagnosis and treatment based on various categories of malignancy risk. Material and Methods: In this retrospective study, Fine needle aspiration cytology was done for all salivary gland lesions for three years and were retrieved from the Department of pathology, Patan hospital. All the cases were recategorized according to the Milan system for reporting salivary gland cytology with histopathology follow-up wherever available. Consistency of the two different types of assessment techniques (Milan category and primary cytology diagnosis) were assessed and the k score was calculated Results: A total of 58 cases were included in the study of which histological follow-up was available in 27 cases. Out of 58 cases, maximum cases 32 (55.1%) were classified under IVA followed by 15.5% cases classified under II, 8.6% of cases under Category IVB), 6.8% under category Vand 5.1% cases under category VI. Kappa's score was 0.58 which represents a moderate agreement. Conclusions: Milan system for reporting salivary gland cytopathology is a recently proposed six-category scheme, which places salivary gland fine needle aspiration cytology into well-defined categories that limit the possibilities of false negative and false positive cases.
{"title":"The Milan System for Reporting Salivary Gland Cytopathology: A 3-year Retrospective Analysis in Patan Hospital","authors":"D. Gautam, Rojin Thapa","doi":"10.3126/nmj.v5i1.46793","DOIUrl":"https://doi.org/10.3126/nmj.v5i1.46793","url":null,"abstract":"Introduction: The characteristics of salivary gland lesions identified by fine-needle aspiration cytology are varied and may overlap, which makes diagnosis difficult for cytopathologists. To provide consistency in the reporting of salivary gland cytology and to enhance clinic-pathologic communication, the \"Milan system for reporting salivary gland cytopathology\" has been introduced, which offers guidelines for diagnosis and treatment based on various categories of malignancy risk.\u0000Material and Methods: In this retrospective study, Fine needle aspiration cytology was done for all salivary gland lesions for three years and were retrieved from the Department of pathology, Patan hospital. All the cases were recategorized according to the Milan system for reporting salivary gland cytology with histopathology follow-up wherever available. Consistency of the two different types of assessment techniques (Milan category and primary cytology diagnosis) were assessed and the k score was calculated\u0000Results: A total of 58 cases were included in the study of which histological follow-up was available in 27 cases. Out of 58 cases, maximum cases 32 (55.1%) were classified under IVA followed by 15.5% cases classified under II, 8.6% of cases under Category IVB), 6.8% under category Vand 5.1% cases under category VI. Kappa's score was 0.58 which represents a moderate agreement.\u0000Conclusions: Milan system for reporting salivary gland cytopathology is a recently proposed six-category scheme, which places salivary gland fine needle aspiration cytology into well-defined categories that limit the possibilities of false negative and false positive cases.","PeriodicalId":52856,"journal":{"name":"Nepalese Medical Journal","volume":"28 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-06-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"83543107","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}
Santosh Kumar Sah, Jay Prakash Singh Rajput, Dimpal Rochlani, R. S. Inamdar
Introduction: Our physical, mental, and emotional well-being require normal sleep. Disturbances in sleep quality and quantity can result in metabolic disorders. Sleep fragmentation increases sympathetic activity which leads to decreased insulin sensitivity. Obstructive sleep apnea causes sleep fragmentation. That is why this study attempt is made to find the effect of obstructive sleep apnea on sleep pattern and blood glucose level in type 2 diabetes patients. Materials and Method: Depending on the severity of the Apnea-Hypopnea Index (AHI) recorded by polysomnography, each, volunteer were divided into two groups, a) AHI>10 groups, and b) AHI≤10 groups. Then the comparison of all the parameters between AHI>10 and AHI≤10 groups of diabetic participants was done. Results: In participants of AHI≤ 10 groups, Sleep efficiency%, Mean TBI SPo2%, sleep Stage III%, and REM% are significantly higher as compared to AHI>10 groups. In participants of the AHI>10 groups, sleep Stage I%, the score of ESS, and fasting blood glucose level are significantly higher as compared to AHI≤ 10 groups. Conclusions: Increasing AHI is associated with reduced sleep efficiency; a sleep stage of N3%, and a REM sleep phase, which lead to an increase in fasting blood glucose levels in the diabetic group.
{"title":"Effect of Obstructive Sleep Apnea on Sleep Pattern and Blood Glucose Level in Type 2 Diabetes Patients","authors":"Santosh Kumar Sah, Jay Prakash Singh Rajput, Dimpal Rochlani, R. S. Inamdar","doi":"10.3126/nmj.v5i1.43223","DOIUrl":"https://doi.org/10.3126/nmj.v5i1.43223","url":null,"abstract":"Introduction: Our physical, mental, and emotional well-being require normal sleep. Disturbances in sleep quality and quantity can result in metabolic disorders. Sleep fragmentation increases sympathetic activity which leads to decreased insulin sensitivity. Obstructive sleep apnea causes sleep fragmentation. That is why this study attempt is made to find the effect of obstructive sleep apnea on sleep pattern and blood glucose level in type 2 diabetes patients.\u0000Materials and Method: Depending on the severity of the Apnea-Hypopnea Index (AHI) recorded by polysomnography, each, volunteer were divided into two groups, a) AHI>10 groups, and b) AHI≤10 groups. Then the comparison of all the parameters between AHI>10 and AHI≤10 groups of diabetic participants was done.\u0000Results: In participants of AHI≤ 10 groups, Sleep efficiency%, Mean TBI SPo2%, sleep Stage III%, and REM% are significantly higher as compared to AHI>10 groups. In participants of the AHI>10 groups, sleep Stage I%, the score of ESS, and fasting blood glucose level are significantly higher as compared to AHI≤ 10 groups.\u0000Conclusions: Increasing AHI is associated with reduced sleep efficiency; a sleep stage of N3%, and a REM sleep phase, which lead to an increase in fasting blood glucose levels in the diabetic group.","PeriodicalId":52856,"journal":{"name":"Nepalese Medical Journal","volume":"8 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-06-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"75903673","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}
京公网安备 11010802042870号
京ICP备2023020795号-1
扫码关注我们
求助内容：
应助结果提醒方式：