Med Phoenix最新文献

{"title":"Assessment of Hyperbilirubinemia in Acute Appendicitis","authors":"Sanjiv Kumar Sahi, B. Rai, Ajit Singh, Sujit Singh","doi":"10.3126/medphoenix.v8i1.54931","DOIUrl":"https://doi.org/10.3126/medphoenix.v8i1.54931","url":null,"abstract":"Introduction: Acute appendicitis is the most common cause of ‘acute abdomen’ in young adults. Appendicectomy is the most common surgery performed by a surgeon.However, sometime diagnosis is difficult to make in such case either the diagnosis is missed or patients with normal appendix are operated which lead to increase in morbidity and mortality. The aim of this study was to assess the relationship between hyperbilirubinemia and acute appendicitis and to see whether elevated bilirubin levels have a predictive potential for the diagnosis of appendicular perforation.\u0000Methods: This prospective study was carried out in Department of Surgery of National Medical College and Teaching Hospital. A total of 85 patients were included in this study. Data analysis was done using SPSS (Statistical Package for social sciences), version 26.\u0000Results: In this study, mean age was 28.86 year. Males (68.23%) outnumbered females (31.76%). Of the 85 patients, 62 patients were diagnosed as simple appendicitis while 23 patients were diagnosed with appendicular perforation. Out of 23 patients of appendicular perforation, 19 patients (82.60%) had raised bilirubin levels. The sensitivity, specificity, positive predicative value and negative predicative value of serum bilirubin as a marker in predicting acute appendicitis and appendicular perforation was 82.60%, 88.70%, 73.07%, 93.22% respectively.\u0000Conclusion: Serum bilirubin level appear to be a new laboratory marker in helping to diagnose a case of acute appendicitis.","PeriodicalId":123544,"journal":{"name":"Med Phoenix","volume":"506 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-07-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"115809299","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}

{"title":"Single Dose of Tolvaptan In The Management of Intracranial Haemorrhage Induced Syndrome of Inappropriate Antidiuretic Hormone- A Case Report","authors":"N. Keyal, P. Shah, M. K. Sah, R. Mahato","doi":"10.3126/medphoenix.v8i1.56840","DOIUrl":"https://doi.org/10.3126/medphoenix.v8i1.56840","url":null,"abstract":"Hyponatraemia is a common manifestation of a syndrome of inappropriate antidiuretic hormone secretion in neurological patients admitted to the intensive care unit. We present a case of 62-years old male who presented with loss of consciousness, seizure, and altered mental status and was diagnosed to have right-sided intracranial haemorrhage. The patient underwent evacuation of hematoma and developed persistent hyponatremia secondary to the syndrome of inappropriate antidiuretic hormone. Patient was treated with 3%sodium chloride, loop diuretics, and fluid restriction. There was no improvement in hyponatremia after initial correction and we started on 7.5 milligrams of Tolvaptan. The patient responded within 4 days of starting Tolvaptan. There was no hyponatraemic episode during the follow-up. From this, we want to emphasize that refractory hyponatremia secondary to intracranial haemorrhage should be treated with Tolvaptan.","PeriodicalId":123544,"journal":{"name":"Med Phoenix","volume":"102 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-07-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"117338697","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}

{"title":"Thyroid Function Status in Patient with Iron Deficiency Anaemia in A Tertiary Care Hospital of Lalitpur, Nepal","authors":"B. Bhattarai, M. Bataju, A. Niraula","doi":"10.3126/medphoenix.v8i1.56877","DOIUrl":"https://doi.org/10.3126/medphoenix.v8i1.56877","url":null,"abstract":"Introduction: Studies have found that iron deficiency anaemia (IDA) impairs thyroid hormone metabolism. The prevalence of thyroid dysfunction in adults in the general population ranges from 1 to 10 percent, and is even higher in selected groups. Thus, in this study we would like to see thyroid function status in people with IDA.\u0000Materials and Methods: It was Laboratory based cross sectional study conducted in the Department of Biochemistry of a tertiary care hospital of KIST Medical College and Teaching Hospital, Lalitpur, Nepal. Secondary data of 162 patients available in laboratory database of 3 years’ duration from August 2018 to August 2021 were taken. All Patients diagnosed with IDA whose thyroid profile was also done were included in the study. Data were entered in Microsoft Excel. Statistical analysis was performed using version 29 of the Statistical Package for Social Sciences (SPSS Inc, Chicago IL, USA).\u0000Results: Among 162 IDA patients, 86.4% (n=140) were females and 13.62% (n=22) were males. Age ranged widely from 19 to 88 years and median age was 38 years. Out of 162 patients most of the patients 68.5% were euthyroid, 8.7% had euthyroid hypothyroxinemia, 7.4% had primary hypothyroidism,3.7% had subclinical hypothyroidism, 3.1% had secondary hypothyroidism, 1.2% had primary hyperthyroidism, 1.2% had T3 toxicosis, 0.6% had euthyroid hyperthyroxinemia. Based on multiple independent KW test, relationship between category of thyroid disorders and iron profile as well as thyroid disorder and Hb level were found not to be statistically significant. No category of thyroid dysfunction was associated with value of haemoglobin level or severity of anaemia.   Irrespective of category of thyroid profile including euthyroid, hypothyroid and hyperthyroid, no category is particularly associated with IDA.\u0000Conclusion: In patients with IDA, there is no significant association between Hb level or severity of iron deficiency irrespective of patient being euthyroid, hypothyroid or hyperthyroid.","PeriodicalId":123544,"journal":{"name":"Med Phoenix","volume":"5 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-07-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"121809445","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}

{"title":"Sonographic Measurement of The Splenic Length in Adults and its Correlation with Different Parameters","authors":"Dambar Sah, Md. Kalim Akthar, A. Jha, S. Shah, Rajan Kumar Mahato, Vandana Mourya, Chandan Chaurasiya, R. Jha, Trayush Adhikari, A. Thakur","doi":"10.3126/medphoenix.v8i1.56923","DOIUrl":"https://doi.org/10.3126/medphoenix.v8i1.56923","url":null,"abstract":"Introduction: Splenic length is an important parameter for many splenic pathologies. Ultrasonography has been an efficient tool for the measurement of different splenic parameters including the splenic length. The objective of this prospective study was to determine the splenic length in healthy adults without any hematological, oncologic or traumatic condition and to correlate it with age, sex, height, weight, body surface area of the body. \u0000Materials and Methods: A total of 360 healthy subjects were included in this study conducted for a period of 6 months. Informed written consent and ethical approval were taken. A detailed clinical history of all the patients were taken. Basic investigations, clinical and ultrasonography examination were performed. Then the data collected was analyzed by MS Excel and SPSS 25 program. \u0000Results: The study included 360 participants (180 male & 180 female) with mean age of the 40.39 ±11.51 years. The mean splenic length was found to be 9.11±1.16 cm. There was significant correlation of splenic length with age, weight, height and body surface area. The splenic length was higher in male compared to female ineach age group. \u0000Conclusion: The study aimed to establish the normal range of spleen length and to examine its correlation with body height, weight, and surface area in male and female subjects. The researchers found that spleen length decreases with age in both sexes. Additionally, spleen length increases with body height, weight, and body surface area. Female spleen length is less than male spleen length for corresponding ages.","PeriodicalId":123544,"journal":{"name":"Med Phoenix","volume":"26 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-07-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"125954937","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}

{"title":"Intrapleural Streptokinase in Management of Multiloculated Pleural Effusion as a Complication of Frequent Relapse Nephrotic Syndrome - A Case Report","authors":"Manoj Gupta, Md. Ashfaque Ansari, Sijan Kharel, R. Maharjan, P. Shrestha, Anjan K.C.","doi":"10.3126/medphoenix.v8i1.53871","DOIUrl":"https://doi.org/10.3126/medphoenix.v8i1.53871","url":null,"abstract":"Treatment of pleural effusion with intrapleural administration of fibrinolytic drugs has proven to be efficient and secure. Patients with pleural effusion who receive streptokinase instillations in conjunction with chest tube draining avoid surgery and have better outcomes. Its application in multiloculated pleural effusion, which develops as a nephrotic syndrome consequence, has only occasionally been documented. We describe a case of multiloculated pleural effusion that did not react to conventional chest tube drainage but resolved completely and dramatically in response to intrapleural streptokinase.","PeriodicalId":123544,"journal":{"name":"Med Phoenix","volume":"20 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-07-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"127095806","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}

{"title":"Analysis of Intrapartum Cardiotocography Findings in Labour, its Correlation with Umbilical Arterial Blood pH and Neonatal Outcome","authors":"R. Mushtaq, R. Shrestha, S. Ansari, R. Shah, Pravin Shah, J. Deep","doi":"10.3126/medphoenix.v8i1.52810","DOIUrl":"https://doi.org/10.3126/medphoenix.v8i1.52810","url":null,"abstract":"Background: Cardiotocography (CTG) is being used in all labouring women to detect intrapartum hypoxemia which further requires confirmatory tests. But in a setting where these facilities are not available, umbilical artery pH analysis can help not only in identifying neonates with intrapartum hypoxemia but can also help in anticipating neonatal adverse outcomes. The aim of the study was to analyse intrapartum cardiotocography and its correlation with umbilical artery pH and neonatal outcome.\u0000Methods: Total of 317 consecutive single, term, labouring women were included in the present study. After taking CTG, it was classified into normal, non-reassuring and abnormal groups according to National Institute of Clinical Excellence (NICE) guideline 2017. At birth umbilical cord arterial blood was taken to detect neonatal hypoxemia. At the same time, APGAR score at 5 minute of birth, NICU admission and neonatal mortality was also recorded. Neonates with umbilical artery blood pH of ≤7.2 were considered as asphyxiated.\u0000Results: Among 317 women 48.8% had normal CTG, 35% had non-reassuring and 15.4% had abnormal CTG. APGAR score was found to be <7 in 17.3%, and same number of neonates had NICU admission. Out of 113 non-reassuring CTG, 5.9% had acidosis. This number was much higher in abnormal CTG group where 11% had acidosis. There were 6 neonatal mortalities. A statistically significant association was found between intrapartum CTG and umbilical artery pH and neonatal outcomes.\u0000Conclusion: Cardiotocography is an effective screening tool that is routinely used in all labouring women for screening of fetal hypoxia. By doing that timely intervention can be under taken to avoid neonatal morbidity and mortality. ","PeriodicalId":123544,"journal":{"name":"Med Phoenix","volume":"2 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-07-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"130916636","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}

{"title":"Rise of Artificial Intelligence in Laboratory Medicine","authors":"S. K. Sah, Brijesh Shrestha, Pradeep Kumar Chaudhary","doi":"10.3126/medphoenix.v8i1.56931","DOIUrl":"https://doi.org/10.3126/medphoenix.v8i1.56931","url":null,"abstract":"<jats:p>N/A</jats:p>","PeriodicalId":123544,"journal":{"name":"Med Phoenix","volume":"21 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-07-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"132358180","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}

{"title":"Diprosopus Tetrophthalmus Including Radiological and Post-Partum Images- A Case Report","authors":"Dambar Sah, A. Jha, R. Jha, Madhu Sah","doi":"10.3126/medphoenix.v8i1.56839","DOIUrl":"https://doi.org/10.3126/medphoenix.v8i1.56839","url":null,"abstract":"Introduction: Conjoint twinning is very uncommon with an incidence of approximately 1:50,000 to 1:100,000. Diprosopus tetrophthalmus is the rarest variant of conjoined twinning which results from incomplete monozygotic, monochorionic and monoamniotic twin division associated with multiple congenital malformations.  A 25 years old female patient at 26 weeks of gestation having single gravida (primi) and no significant family history was referred to our radiology department for anomalies scan. Transabdominal obstetric ultrasound showed the fetus with one head, two faces, two legs, two hands, one thorax, one abdomen and a single spinal cord with deformed spine. The aim of this case report was to present and discuss a case of Diprosopus tetrophthalmus (craniofacial duplication) a rare variant of conjoined twins resulted from incomplete monozygotic, monochorionic and monoamniotic twin division which help in prenatal counseling to the patient and its management.","PeriodicalId":123544,"journal":{"name":"Med Phoenix","volume":"24 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-07-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"114234098","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}

{"title":"Evaluation of Genitourinary Infection in Preterm Labour: A Descriptive Cross-Sectional Study","authors":"R. Shrestha, R. Mushtaq, R. Shah, Himadrija Moktan, Sana Ansari, Pravin Shah, S. Choudhary, Arushi Jaiswal, J. Deep","doi":"10.3126/medphoenix.v8i1.56925","DOIUrl":"https://doi.org/10.3126/medphoenix.v8i1.56925","url":null,"abstract":"Introduction: Preterm labour is defined as the occurrence of regular uterine contractions (≥ 4 in 20 minutes or ≥ 8 in 1 hour) and cervical changes (effacement ≥ 80% and dilatation ≥ 1cm) in women with intact fetal membrane and gestational age less than 37 weeks. Genitourinary infection is the most important cause of preterm labour. The aim of this study was to determine the role of Genitourinary infection in causation of preterm labour.\u0000Methods: This is a descriptive cross sectional study done at National Medical College Teaching Hospital from 10 November 2021 to 9 November 2022 after obtaining IRC (F-NMC/549/078-79). Total of 90 patients in preterm labour fulfilling the inclusion criteria were enrolled in this study after taking informed consent. Clinical examination was done, vaginal swab, endocervical swab and urine samples were sent to microbiological department for examination. Preformed proforma were used to record the demographic, clinical finding and result of investigation. The data was analyzed statistically using SPSS 22 and mean age, frequency and prevalence of genitourinary infection were calculated.\u0000Results: In this study, 90 patients of preterm labour were enrolled. The mean age group of patients was 23.61 ± 4.25 years. Genital infection compromised of 41%, high vaginal swab showed 30% prevalence and endocervical swab showed 20% prevalence. The most common organism identified in genital infection was Gardenella vaginalis 55.55%. The prevalence of Urinary tract infection was 40% where E.coli was the most common organism 66.66%.\u0000Conclusions: Genitourinary tract infection plays an important role in causation of preterm labour and can easily be diagnosed with routine urine examination, urine culture and vagino-cervical swab. The prevalence of genital infections and urinary tract infection was 41% and 40% respectively. Gardnerella vaginalis was the most common pathogen identified in genital tract whereas E.coli was leading cause of UTI in Preterm labour patients.","PeriodicalId":123544,"journal":{"name":"Med Phoenix","volume":"2 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-07-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"114896324","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}

{"title":"Factor Responsible for Surgical Site Infection Following Emergency Non-Traumatic Abdominal Surgery","authors":"A. Yadav, Chandrika Sah Rauniyar, M. Joshi, Ajit Singh, Brijesh Shrestha","doi":"10.3126/medphoenix.v8i1.56871","DOIUrl":"https://doi.org/10.3126/medphoenix.v8i1.56871","url":null,"abstract":"Introduction: Surgical Site Infection (SSI) have always been a major complication of surgery. It results from microbialinfection during or after the surgical procedure. According to CDC, SSI can be classified as superficial,deep and organ/ space. It increases morbidity and also increases cost to the patient and healthcare system. The aim of this study is to determine the factors responsible for surgical site infection following emergency non- traumatic abdominal surgery.\u0000Materials and Methods: This prospective study was carried out in Department of Surgery of National Medical College and Teaching Hospital. A total of 90 patients were included in this study. Data analysis was done using SPSS (Statistical Package for social sciences), version 26.\u0000Results: Mean age of the study population was 42.74 years. The majority of the subjects were in the age group of 31-40 years. Most of the patients were males (68.8%). The commonest pathology for undertaking operation was Perforated Duodenal ulcer (42.2%).Preoperative serum albumin level, Smoking, comorbidity like COPD, Hypertension, DM, BMI showed statistical relation to surgical site infection.\u0000Conclusion: Numerous host factors like malnutrition, obesity, co-morbidity, type of wounds, time of presentation, personal habit contribute to increased incidence of SSI.","PeriodicalId":123544,"journal":{"name":"Med Phoenix","volume":"164 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-07-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"122435725","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}