Introduction: Prostatic enlargement that may due to any cause may give rise to bladder outlet obstruction. Prostatic specific antigen is the enzyme that is responsible for liquefaction of semen within a few minutes after it has clotted. Prostatic specific antigen is a widely used tumor marker for prostatic cancer. Prostatic specific antigen levels in the blood go up if the barrier between the lining epithelium and the blood stream is damaged. This study was done to determine the correlation between serum Prostatic specific antigen level and histological diagnosis in prostatic biopsy.Material and Methods: This is a one year prospective study carried out in the Department of Pathology, Nobel Medical College from August 16, 2016 to August 15 2017. A total of 175 cases were included in the study. Patient Prostatic specific antigen level were noted and biopsy specimen was collected after operation. Histopathological examination was done and correlation between HPE diagnosis and serum Prostatic specific antigen level was done.Results: Benign Prostatic Hyperplasia was the most common diagnosis that was encountered. Majority of the cases had a serum Prostatic specific antigen level less than 10 ng/ml. Serum Prostatic specific antigen level of more than 30 ng/ml was seen only in prostatic carcinoma.Conclusions: Serum Prostatic specific antigen is organ specific but not a disease for prostate. It can be used to monitor the carcinoma of the prostate rather than the diagnosis of the carcinoma.
{"title":"Study on Correlation between Serum Prostate Specific Antigen and Various Prostatic Pathology","authors":"N. Mainali, N. Nepal, P. Chaudhary, Jit Shrestha","doi":"10.3126/NMJ.V1I2.21579","DOIUrl":"https://doi.org/10.3126/NMJ.V1I2.21579","url":null,"abstract":"Introduction: Prostatic enlargement that may due to any cause may give rise to bladder outlet obstruction. Prostatic specific antigen is the enzyme that is responsible for liquefaction of semen within a few minutes after it has clotted. Prostatic specific antigen is a widely used tumor marker for prostatic cancer. Prostatic specific antigen levels in the blood go up if the barrier between the lining epithelium and the blood stream is damaged. This study was done to determine the correlation between serum Prostatic specific antigen level and histological diagnosis in prostatic biopsy.Material and Methods: This is a one year prospective study carried out in the Department of Pathology, Nobel Medical College from August 16, 2016 to August 15 2017. A total of 175 cases were included in the study. Patient Prostatic specific antigen level were noted and biopsy specimen was collected after operation. Histopathological examination was done and correlation between HPE diagnosis and serum Prostatic specific antigen level was done.Results: Benign Prostatic Hyperplasia was the most common diagnosis that was encountered. Majority of the cases had a serum Prostatic specific antigen level less than 10 ng/ml. Serum Prostatic specific antigen level of more than 30 ng/ml was seen only in prostatic carcinoma.Conclusions: Serum Prostatic specific antigen is organ specific but not a disease for prostate. It can be used to monitor the carcinoma of the prostate rather than the diagnosis of the carcinoma.","PeriodicalId":52856,"journal":{"name":"Nepalese Medical Journal","volume":"13 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2018-12-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"82599722","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: Upper airway problems are frequently encountered in ENT practice. It is difficult to diagnose upper airway pathology by conventional methods. So use of fibreoptic flexible nasopharyngoscopy (NPL) is very helpful in both diagnosis and treatment of upper airway disorders. The aim of this study is to observe the usefulness of flexible NPL in patients with upper airway problems as an outpatient procedure. Materials and Methods: A cross sectional descriptive study was conducted in the department of ENT at KIST medical college teaching hospital during the period of 2years. A total of 138 patients who had persistent upper airway symptoms and underwent NPL were included in the study Detail history, clinical examination and required investigations were done. Data were recorded and analysed.Results: Total 138 patients suffering from upper airway disorders underwent NPL. Among them 65(47.1%) were males and 73(52.9%) were females. Age range was from 16 to 82 years. Most common problem observed was laryngopharyngeal reflux disease accounting for 41 percent of cases followed by vocal cord nodule and polyp.Conclusions: Flexible fiberoptic nasopharyngolaryngoscopy (NPL) is safe and noninvasive outpatient department procedure for the assessment of upper airway disorders.
{"title":"Flexible Nasopharyngolaryngoscopy for the Assessment of Upper Airway Disorders","authors":"Sangita Regmi Chalise, S. Khadka","doi":"10.3126/NMJ.V1I2.21590","DOIUrl":"https://doi.org/10.3126/NMJ.V1I2.21590","url":null,"abstract":"Introduction: Upper airway problems are frequently encountered in ENT practice. It is difficult to diagnose upper airway pathology by conventional methods. So use of fibreoptic flexible nasopharyngoscopy (NPL) is very helpful in both diagnosis and treatment of upper airway disorders. The aim of this study is to observe the usefulness of flexible NPL in patients with upper airway problems as an outpatient procedure. Materials and Methods: A cross sectional descriptive study was conducted in the department of ENT at KIST medical college teaching hospital during the period of 2years. A total of 138 patients who had persistent upper airway symptoms and underwent NPL were included in the study Detail history, clinical examination and required investigations were done. Data were recorded and analysed.Results: Total 138 patients suffering from upper airway disorders underwent NPL. Among them 65(47.1%) were males and 73(52.9%) were females. Age range was from 16 to 82 years. Most common problem observed was laryngopharyngeal reflux disease accounting for 41 percent of cases followed by vocal cord nodule and polyp.Conclusions: Flexible fiberoptic nasopharyngolaryngoscopy (NPL) is safe and noninvasive outpatient department procedure for the assessment of upper airway disorders.","PeriodicalId":52856,"journal":{"name":"Nepalese Medical Journal","volume":"350 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2018-12-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"79763972","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, Shova Kunwar, B. Aryal, A. Adhikari, A. Poudel
Introduction: Fine Needle Aspiration Cytology is a relatively simple, inexpensive and rapid diagnostic procedure for identifying cause of lymphadenopathy without need for surgical procedures. This study aims to explain the pattern of lymphadenopathy seen on fine needle aspiration cytology in a tertiary level hospital in KathmanduMaterials and Methods: This study was conducted at Shree Birendra Hospital Nepal. Cases of lymph node FNAC done in the years 2073 and 2074 BS were included in the study. The cases were classified into reactive lymphadenitis, granulomatous lymphadenitis, tubercular lymphadenitis, lymphomas, leukemias, and metastases.Results: A total of 215 patients were included in the study, ranging in age from 2 to 84 years, out of which 98 were female and 117 were male. Reactive lymphadenitis was the most common diagnosis (n=126; 58.6%), followed by granulomatous lymphadenitis (n=34; 15.8%) and tubercular lymphadenitis (n=18; 8.4%). There were 18 cases of metastatic malignancies, 15 cases of suppurative lymphadenitis, and 2 cases of Hodgkin lymphoma and 2 cases of non-Hodgkin lymphoma.Conclusions: Reactive lymphadenitis is the most common type of lymphadenopathy encountered in FNAC, while in the elderly, metastases are more common.
{"title":"Pattern of Lymphadenopathy on Fine Needle Aspiration Cytology in a Tertiary Level Hospital in Kathmandu","authors":"A. Shrestha, Shova Kunwar, B. Aryal, A. Adhikari, A. Poudel","doi":"10.3126/nmj.v1i2.21592","DOIUrl":"https://doi.org/10.3126/nmj.v1i2.21592","url":null,"abstract":"Introduction: Fine Needle Aspiration Cytology is a relatively simple, inexpensive and rapid diagnostic procedure for identifying cause of lymphadenopathy without need for surgical procedures. This study aims to explain the pattern of lymphadenopathy seen on fine needle aspiration cytology in a tertiary level hospital in KathmanduMaterials and Methods: This study was conducted at Shree Birendra Hospital Nepal. Cases of lymph node FNAC done in the years 2073 and 2074 BS were included in the study. The cases were classified into reactive lymphadenitis, granulomatous lymphadenitis, tubercular lymphadenitis, lymphomas, leukemias, and metastases.Results: A total of 215 patients were included in the study, ranging in age from 2 to 84 years, out of which 98 were female and 117 were male. Reactive lymphadenitis was the most common diagnosis (n=126; 58.6%), followed by granulomatous lymphadenitis (n=34; 15.8%) and tubercular lymphadenitis (n=18; 8.4%). There were 18 cases of metastatic malignancies, 15 cases of suppurative lymphadenitis, and 2 cases of Hodgkin lymphoma and 2 cases of non-Hodgkin lymphoma.Conclusions: Reactive lymphadenitis is the most common type of lymphadenopathy encountered in FNAC, while in the elderly, metastases are more common.","PeriodicalId":52856,"journal":{"name":"Nepalese Medical Journal","volume":"27 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2018-12-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"78949785","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, M. Al‐Mahtab, S. Rahman, J. Sarkar, T. Lama
Congenital hepatic fibrosis is a rare condition characterized by extensive fibrosis of liver but with preserved normal lobular architecture inherited as autosomal recessive trait. We report a 19 year-old-female admitted to Bangabandhu Sheikh Mujib Medical University with the complaints of lump in upper abdomen since last 13 years and episodes of fever and abdominal pain for same duration. She was diagnosed with hepatic TB on hepatic histology. Congenital hepatic fibrosis is a rare cause of portal hypertension that presents during childhood. Prognosis of congenital hepatic fibrosis is good. Life threatening events in these patients are related with variceal bleeding and episodes of cholangitis. Owing to relatively good liver function these patients tolerate portosystemic shunt surgeries quite well.Though rare, congenital hepatic fibrosis should be included in the differential diagnosis of portal hypertension in early life.
{"title":"Its Congenital Hepatic Fibrosis; Not Cirrhosis At All","authors":"A. Shrestha, M. Al‐Mahtab, S. Rahman, J. Sarkar, T. Lama","doi":"10.3126/NMJ.V1I2.21624","DOIUrl":"https://doi.org/10.3126/NMJ.V1I2.21624","url":null,"abstract":"Congenital hepatic fibrosis is a rare condition characterized by extensive fibrosis of liver but with preserved normal lobular architecture inherited as autosomal recessive trait. We report a 19 year-old-female admitted to Bangabandhu Sheikh Mujib Medical University with the complaints of lump in upper abdomen since last 13 years and episodes of fever and abdominal pain for same duration. She was diagnosed with hepatic TB on hepatic histology. Congenital hepatic fibrosis is a rare cause of portal hypertension that presents during childhood. Prognosis of congenital hepatic fibrosis is good. Life threatening events in these patients are related with variceal bleeding and episodes of cholangitis. Owing to relatively good liver function these patients tolerate portosystemic shunt surgeries quite well.Though rare, congenital hepatic fibrosis should be included in the differential diagnosis of portal hypertension in early life.","PeriodicalId":52856,"journal":{"name":"Nepalese Medical Journal","volume":"4 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2018-12-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"88543469","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}
Clostridium difficile ; a group of spore forming, toxin forming, gram positive anerobel is implicated in hospital associated diarrhea and is the causative agent of infectious diarrhea. It is the most common hospital associated infection in Europe and North America, and is presumed to be as prevalent in the rest of the world.There has been emergence of new virulent strain of C. difficile, identified as BI, NAP1, and toxinotype III and ribotype 027 (subsequently known as BI/NAP1/027) by various typing method in recent years, implicated in dramatic increase in C. difficile infections.Diagnosis is established by presence of C. difficile toxin or C. difficile toxin gene in stool. Lab testing does not distinguish C. difficile infection and asymptomatic carriage. Clinical suspicion and positive stool study confirms a diagnosis.Clostridium Difficile infection, is most common health care associated infection in Europe and North America, and the available studies show it may have similar prevalence in Nepal. Literature review does not reveal any significant study being conducted in Nepal as of now. It warrants further study to exactly determine the incidence/prevalence and its impact in current health care in Nepal. Clinicians need increased awareness and prompt diagnosis to reduce morbidity and further prevention of transmission.Nepalese Medical Journal, vol.1, No. 1, 2018, page: 43-47
{"title":"Clostridium Difficile","authors":"S. Adhikari","doi":"10.3126/nmj.v1i1.20400","DOIUrl":"https://doi.org/10.3126/nmj.v1i1.20400","url":null,"abstract":"Clostridium difficile ; a group of spore forming, toxin forming, gram positive anerobel is implicated in hospital associated diarrhea and is the causative agent of infectious diarrhea. It is the most common hospital associated infection in Europe and North America, and is presumed to be as prevalent in the rest of the world.There has been emergence of new virulent strain of C. difficile, identified as BI, NAP1, and toxinotype III and ribotype 027 (subsequently known as BI/NAP1/027) by various typing method in recent years, implicated in dramatic increase in C. difficile infections.Diagnosis is established by presence of C. difficile toxin or C. difficile toxin gene in stool. Lab testing does not distinguish C. difficile infection and asymptomatic carriage. Clinical suspicion and positive stool study confirms a diagnosis.Clostridium Difficile infection, is most common health care associated infection in Europe and North America, and the available studies show it may have similar prevalence in Nepal. Literature review does not reveal any significant study being conducted in Nepal as of now. It warrants further study to exactly determine the incidence/prevalence and its impact in current health care in Nepal. Clinicians need increased awareness and prompt diagnosis to reduce morbidity and further prevention of transmission.Nepalese Medical Journal, vol.1, No. 1, 2018, page: 43-47","PeriodicalId":52856,"journal":{"name":"Nepalese Medical Journal","volume":"7 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2018-06-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"75664641","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: Dry eye is a disorder of the tear film which occurs due to tear deficiency or excessive tear evaporation. It causes damage to the interpalpebral ocular surface and is associated with a variety of symptoms reflecting ocular discomfort.Materials and Methods: This was a hospital-based retrospective descriptive study conducted to study the demography of dry eye patients and associated attributable risk factors for the disease. Every patient presenting with symptoms suggestive of dry eye was given a questionnaire, as per Salisbury Eye Evaluation Study and thorough ocular examination was done along with two tests for dry eye i.e Schirmer test I measuring less than 10mm and Tear film break up time measuring less than 10 sec. Final data analysis was done using statistical tool SPSS.Results: Demographic profile revealed a female preponderance in the patients with a ratio of 1.9:1. Amongst them, prevalence of premenopausal age was 53%. Dry eye was found to be more common in age group between 30 to 40 years (29%). The modifiable attributable risk factors were urban residence (67%), exposure to air condition and computer user (52%), indoor workers (59%), and environmental pollutants (60%).Conclusions: This study revealed the patients who presented with dry eye were mostly female of premenopausal age group, and exposed to modifiable risk factors which included residing at urban areas, indoor work, and exposure to environmental pollutants. Nepalese Medical Journal. vol.1, No. 1, 2018, page: 9-11
{"title":"Demographic Profile and Risk Factors for Dry Eye","authors":"P. Basnet, Anjila Basnet, Poojyashree Karki","doi":"10.3126/NMJ.V1I1.20391","DOIUrl":"https://doi.org/10.3126/NMJ.V1I1.20391","url":null,"abstract":"Introduction: Dry eye is a disorder of the tear film which occurs due to tear deficiency or excessive tear evaporation. It causes damage to the interpalpebral ocular surface and is associated with a variety of symptoms reflecting ocular discomfort.Materials and Methods: This was a hospital-based retrospective descriptive study conducted to study the demography of dry eye patients and associated attributable risk factors for the disease. Every patient presenting with symptoms suggestive of dry eye was given a questionnaire, as per Salisbury Eye Evaluation Study and thorough ocular examination was done along with two tests for dry eye i.e Schirmer test I measuring less than 10mm and Tear film break up time measuring less than 10 sec. Final data analysis was done using statistical tool SPSS.Results: Demographic profile revealed a female preponderance in the patients with a ratio of 1.9:1. Amongst them, prevalence of premenopausal age was 53%. Dry eye was found to be more common in age group between 30 to 40 years (29%). The modifiable attributable risk factors were urban residence (67%), exposure to air condition and computer user (52%), indoor workers (59%), and environmental pollutants (60%).Conclusions: This study revealed the patients who presented with dry eye were mostly female of premenopausal age group, and exposed to modifiable risk factors which included residing at urban areas, indoor work, and exposure to environmental pollutants. Nepalese Medical Journal. vol.1, No. 1, 2018, page: 9-11","PeriodicalId":52856,"journal":{"name":"Nepalese Medical Journal","volume":"44 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2018-06-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"90654940","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: Occupational dermatosis is defined as any pathological condition of the skin for which job exposure can be shown to be a major direct or contributory factor. The commonest occupational dermatosis is a work-related contact dermatitis. The aim of the study was to find the pattern and diagnosis of occupational dermatosis in our community as no such study has been carried out in Nepal.Materials and Methods: This was a prospective study of 70 ambulatory patients with work-related dermatoses presented to the Dermatology Department of Kist medical. Data on socio-demographic characteristics, on lifestyle and temporal factor, the type of contact dermatitis, location and etiological factors were gathered through a structured questionnaire.Results: More females (n=39; 60%) cases were affected by contact dermatitis compared to men (n=31; 40%), without a significant difference (p=0.5). Most of our patients belonged to the age group of 20-39 years accounting to 38 cases (54%). The mean age of patients was 34 years old (16 – 70 year), with 49 (70%) of them living in urban area and 21 (30%) living in rural area, (p<0.05). Regarding the dermatological diagnosis the most common occupational disease was irritant contact dermatitis (n=29; 41.4%), allergic dermatitis (n=19; 27.1%), dermatophytosis (n=13; 18.6 %), photoallergic (n=6; 8.6%) and miscellaneous in 3 (4.3%) cases.Conclusions: Irritant contact dermatitis is more common than allergic contact dermatitis. Occupational dermatitis can cause significant morbidity and most cases are encountered in the younger age group. Therefore use of protective clothes, gloves should be advised to those vulnerable occupations.Nepalese Medical Journal, vol.1, No. 1, 2018, Page: 24-28
{"title":"Occupational Dermatosis","authors":"R. Shrestha, M. Basukala","doi":"10.3126/nmj.v1i1.20395","DOIUrl":"https://doi.org/10.3126/nmj.v1i1.20395","url":null,"abstract":"Introduction: Occupational dermatosis is defined as any pathological condition of the skin for which job exposure can be shown to be a major direct or contributory factor. The commonest occupational dermatosis is a work-related contact dermatitis. The aim of the study was to find the pattern and diagnosis of occupational dermatosis in our community as no such study has been carried out in Nepal.Materials and Methods: This was a prospective study of 70 ambulatory patients with work-related dermatoses presented to the Dermatology Department of Kist medical. Data on socio-demographic characteristics, on lifestyle and temporal factor, the type of contact dermatitis, location and etiological factors were gathered through a structured questionnaire.Results: More females (n=39; 60%) cases were affected by contact dermatitis compared to men (n=31; 40%), without a significant difference (p=0.5). Most of our patients belonged to the age group of 20-39 years accounting to 38 cases (54%). The mean age of patients was 34 years old (16 – 70 year), with 49 (70%) of them living in urban area and 21 (30%) living in rural area, (p<0.05). Regarding the dermatological diagnosis the most common occupational disease was irritant contact dermatitis (n=29; 41.4%), allergic dermatitis (n=19; 27.1%), dermatophytosis (n=13; 18.6 %), photoallergic (n=6; 8.6%) and miscellaneous in 3 (4.3%) cases.Conclusions: Irritant contact dermatitis is more common than allergic contact dermatitis. Occupational dermatitis can cause significant morbidity and most cases are encountered in the younger age group. Therefore use of protective clothes, gloves should be advised to those vulnerable occupations.Nepalese Medical Journal, vol.1, No. 1, 2018, Page: 24-28","PeriodicalId":52856,"journal":{"name":"Nepalese Medical Journal","volume":"97 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2018-06-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"90815706","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
The toxicity of Baclofen is extremely unusual. However, its predominant renal clearance makes its vulnerable in patients with impaired renal function. Clinical manifestations may begin as early as 2-3 days after starting the drug, even with a smaller dosage.A 73-year-old man with end-stage renal disease on maintenance hemodialysis was admitted to our emergency department with progressive confusion, hallucination and a generalized decrease in muscular tone. There was no significant metabolic or infectious etiology that could have clarified his condition. A thorough laboratory and imaging workup was negative too. A detailed history of his medication revealed that he had recently been prescribed baclofen for neck muscular spasm (10mg twice daily). He was then diagnosed with baclofen toxicity and was treated with intensive hemodialysis. During his admission, few sessions of hemodialysis on consecutive days, eventually produced expected clinical improvement and a complete return to his previous baseline mental status.Nepalese Medical Journal, vol.1, No. 1, 2018, page: 54-56
{"title":"Baclofen Toxicity in a Chronic Kidney Disease Stage 5D Patient","authors":"Sarju Raj Singh, M. Dhakal, S. Thapa, S. Khakurel","doi":"10.3126/NMJ.V1I1.20403","DOIUrl":"https://doi.org/10.3126/NMJ.V1I1.20403","url":null,"abstract":"The toxicity of Baclofen is extremely unusual. However, its predominant renal clearance makes its vulnerable in patients with impaired renal function. Clinical manifestations may begin as early as 2-3 days after starting the drug, even with a smaller dosage.A 73-year-old man with end-stage renal disease on maintenance hemodialysis was admitted to our emergency department with progressive confusion, hallucination and a generalized decrease in muscular tone. There was no significant metabolic or infectious etiology that could have clarified his condition. A thorough laboratory and imaging workup was negative too. A detailed history of his medication revealed that he had recently been prescribed baclofen for neck muscular spasm (10mg twice daily). He was then diagnosed with baclofen toxicity and was treated with intensive hemodialysis. During his admission, few sessions of hemodialysis on consecutive days, eventually produced expected clinical improvement and a complete return to his previous baseline mental status.Nepalese Medical Journal, vol.1, No. 1, 2018, page: 54-56","PeriodicalId":52856,"journal":{"name":"Nepalese Medical Journal","volume":"72 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2018-06-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"74392431","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: Malnutrition is common among patients on chronic hemodialysis and is a risk factor. Nutritional assessment ensures early recognition and appropriate intervention. Dietary interview, physical and anthropometric measurements, biochemical assessment, bio-impedance, and structured assessment tools like subjective global assessment are modalities for identifying and monitoring of nutritional assessment of hemodialysis patients. This study was conducted to assess the nutritional status of hemodialysis patients and identify various factors related to malnutrition.Materials and Methods: A cross-sectional study of 72 chronic hemodialysis patients at a hemodialysis unit in Lalitpur was done. Detailed dietary and personal interview, anthropometric measurements, biochemical assessment, and subjective global assessment were used to collect the data to determine the prevalence of malnutrition among the hemodialysis patients as well as identify various factors related.Results: Malnutrition was prevalent among the respondents. The respondents were mostly male with average age of 50.2 1.9 years and majority being on hemodialysis for more than two years. Though severe malnutrition was absent among the hemodialysis patients assessed, mild to moderate malnutrition was seen in 52.78%. Most of these patients were female and were of older age group. Patients who had malnutrition had experienced a significant weight loss in previous six months. Anthropometric profile, dietary habits, and biochemical profile did not correlate with occurrence of malnutrition in hemodialysis patients.Conclusions: Malnutrition is fairly prevalent in chronic hemodialysis patients which can be identified by subjective global assessment. Elderly patients and patients who are losing weight are risk factors for mild to moderate malnutrition.Nepalese Medical Journal, vol.1, No. 1, 2018, Page: 12-16
{"title":"Nutritional Status of Out-patient Hemodialysis Patients in a Hospital-based Hemodialysis Centre in Nepal","authors":"R. Khadka, N. Basnet, R. Kafle","doi":"10.3126/nmj.v1i1.20392","DOIUrl":"https://doi.org/10.3126/nmj.v1i1.20392","url":null,"abstract":"Introduction: Malnutrition is common among patients on chronic hemodialysis and is a risk factor. Nutritional assessment ensures early recognition and appropriate intervention. Dietary interview, physical and anthropometric measurements, biochemical assessment, bio-impedance, and structured assessment tools like subjective global assessment are modalities for identifying and monitoring of nutritional assessment of hemodialysis patients. This study was conducted to assess the nutritional status of hemodialysis patients and identify various factors related to malnutrition.Materials and Methods: A cross-sectional study of 72 chronic hemodialysis patients at a hemodialysis unit in Lalitpur was done. Detailed dietary and personal interview, anthropometric measurements, biochemical assessment, and subjective global assessment were used to collect the data to determine the prevalence of malnutrition among the hemodialysis patients as well as identify various factors related.Results: Malnutrition was prevalent among the respondents. The respondents were mostly male with average age of 50.2 1.9 years and majority being on hemodialysis for more than two years. Though severe malnutrition was absent among the hemodialysis patients assessed, mild to moderate malnutrition was seen in 52.78%. Most of these patients were female and were of older age group. Patients who had malnutrition had experienced a significant weight loss in previous six months. Anthropometric profile, dietary habits, and biochemical profile did not correlate with occurrence of malnutrition in hemodialysis patients.Conclusions: Malnutrition is fairly prevalent in chronic hemodialysis patients which can be identified by subjective global assessment. Elderly patients and patients who are losing weight are risk factors for mild to moderate malnutrition.Nepalese Medical Journal, vol.1, No. 1, 2018, Page: 12-16","PeriodicalId":52856,"journal":{"name":"Nepalese Medical Journal","volume":"2014 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2018-06-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"82722638","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: Hypertensive disorders complicating pregnancy contribute significantly to maternal and perinatal morbidity and mortality. Since placenta is the functional unit between the mother and fetus examination of placenta can give an idea about prenatal experience of fetus. The aim is to observe the morphology and histopathology of placenta in pregnancy with severe preeclampsia / eclampsia between 20-42 weeks of gestation.Materials and Methods: This was a prospective, descriptive study carried out in the Department of Obstetrics and Gynaecology and Department of Pathology at Institute of Medicine, Tribhuwan University Teaching Hospital, TUTH for one year, starting from 15th May 2015 - 14th May 2016. A total 55 placentas, 48 of severe preeclampsia and 7 of eclampsia were collected and placental morphometric parameters, gross and histopathological features were examined.Results: It was found that placental morphometric parameters were significantly reduced. Histopathological study showed significant number of syncytial knots, areas of fibrinoid necrosis, hyalinization and calcification. These placental findings were associated with significantly decreased weight of fetus at birth.Conclusions: Preeclampsia and eclampsia cause significant placental morphometric and histological changes which in turn adversely affects neonatal birth weight.Nepalese Medical Journal, vol.1, No. 1, 2018, page: 32-35
{"title":"Placental Pathology in Severe Pre-eclampsia and Eclampsia","authors":"K. Ojha, S. Rawal, A. Jha","doi":"10.3126/NMJ.V1I1.20397","DOIUrl":"https://doi.org/10.3126/NMJ.V1I1.20397","url":null,"abstract":"Introduction: Hypertensive disorders complicating pregnancy contribute significantly to maternal and perinatal morbidity and mortality. Since placenta is the functional unit between the mother and fetus examination of placenta can give an idea about prenatal experience of fetus. The aim is to observe the morphology and histopathology of placenta in pregnancy with severe preeclampsia / eclampsia between 20-42 weeks of gestation.Materials and Methods: This was a prospective, descriptive study carried out in the Department of Obstetrics and Gynaecology and Department of Pathology at Institute of Medicine, Tribhuwan University Teaching Hospital, TUTH for one year, starting from 15th May 2015 - 14th May 2016. A total 55 placentas, 48 of severe preeclampsia and 7 of eclampsia were collected and placental morphometric parameters, gross and histopathological features were examined.Results: It was found that placental morphometric parameters were significantly reduced. Histopathological study showed significant number of syncytial knots, areas of fibrinoid necrosis, hyalinization and calcification. These placental findings were associated with significantly decreased weight of fetus at birth.Conclusions: Preeclampsia and eclampsia cause significant placental morphometric and histological changes which in turn adversely affects neonatal birth weight.Nepalese Medical Journal, vol.1, No. 1, 2018, page: 32-35","PeriodicalId":52856,"journal":{"name":"Nepalese Medical Journal","volume":"18 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2018-06-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"88996345","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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