Journal of Gandaki Medical College-Nepal最新文献

{"title":"Outcome of diagnosed cases of appendicitis and diagnostic accuracy of ultrasound of the appendix","authors":"B. Sharma, N. Paudel, S. Parajuli, Sushma Singh, M. Timilsina","doi":"10.3126/jgmcn.v13i1.27691","DOIUrl":"https://doi.org/10.3126/jgmcn.v13i1.27691","url":null,"abstract":"Background: Acute appendicitis is the most common condition requiring an emergency ultrasound scan as well as surgery. Several scoring systems for acute appendicitis has been suggested to improve diagnostic accuracy and decrease the negative appendectomy rate. In this study, we have evaluated the diagnostic performance of ultrasound on the diagnosis of acute appendicitis, other appendicular pathology, and correlate with surgical outcome. \u0000Material and methods: This retrospective study included 776 cases of ultrasound scan reports in which the appendix was visualized and not visualized or equivocal. Data were collected from October 2014 to April 2019 from different department and wards of Gandaki Medical College Teaching Hospital and Research Center (GMCTHRC). All the cases with diagnosed acute appendicitis, appendicular lump, and appendicular abscess were included and were followed for its surgical outcome. The surgical note or post-operative findings served as the reference standard for determining whether perforation was present or not. \u0000Result: There were 776 ultrasound scans for suspected appendicitis out of which 423 (54.5%) were diagnosed as appendicular pathology. Out of 423 diagnosed cases, 192 (45.4%) were males and 231 (54.6%) were females, with age ranging from 24 months to 87 years. Sonographic findings, in these positive subjects, suggested acute appendicitis, appendicular lump, abscess, and amount of free fluid in right iliac fossa (RIF) and pelvic cavity. Frank acute appendicitis was present in 378 (89.3%) cases, eight (1.9%) cases had an appendicular abscess, 23 (5.4%) had an appendicular lump and 14 (3.3%) had perforated appendicitis. \u0000Conclusion: We conclude that ultrasound is a good modality for visualization of appendicitis with other appendicular pathology. We could follow a structured report and identify pathology more specifically. Ultrasound is an easy and non-invasive test to investigate.  ","PeriodicalId":177622,"journal":{"name":"Journal of Gandaki Medical College-Nepal","volume":"122 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2020-06-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"131615922","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":"Prescription patterns of Antibiotics in Acute tonsillitis: Hospital-based study","authors":"Brihaspati Sigdel, T. Dubey, R. Nepali, N. Kc","doi":"10.3126/jgmcn.v13i1.27561","DOIUrl":"https://doi.org/10.3126/jgmcn.v13i1.27561","url":null,"abstract":"Introduction: Acute tonsillitis is caused by either viruses or bacteria and is characterized by a sore throat and painful swallowing. About 49% of cases are thought to be caused by Group A beta-hemolytic streptococci. Penicillin should be given empirically after the diagnosis of acute tonsillitis. This study was carried out to find out the prescription pattern of antibiotics among the admitted cases of acute tonsillitis. \u0000Materials and Methods: This study was conducted in the Department of Otorhinolaryngology and Head and Neck Surgery, Gandaki Medical College Teaching Hospital and Research Centre (GMCTH), Pokhara. All the patients who were admitted for acute tonsillitis in the ENT ward were enrolled in this study. Age, gender, the average number of drugs per prescription, and the most commonly prescribed drug was recorded. \u0000Results: There were 320 patients with acute tonsillitis and the mean age was 27.44 ± 11.1 years. Most of the cases were in their twenties. The average number of drugs per prescription was four while the total number of antibiotics used was 520. The single antibiotic was used in 170 (53%) cases and a two-drug combination was used in 91(28.4%) cases. Ceftriaxone was the most commonly prescribed drug. There were 78 (24.3%) cases under monotherapy and 69 (21%) in multitherapy. \u0000Conclusion: Among the various effective antimicrobials, ceftriaxone was the most commonly prescribed antimicrobial. The injectable route of antibiotics administration was a widely used method in hospitalized patients in our setting.  ","PeriodicalId":177622,"journal":{"name":"Journal of Gandaki Medical College-Nepal","volume":"27 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2020-06-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"122599407","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":"Light Weight Complete Denture Prosthesis - A Case Report","authors":"A. Khanal, I. Limbu, P. Parajuli, P. Suwal, R. K. Singh","doi":"10.3126/jgmcn.v12i1.22622","DOIUrl":"https://doi.org/10.3126/jgmcn.v12i1.22622","url":null,"abstract":"Retention, stability and support are the basic principles on which the success of a complete denture relies on. Extreme resorption of the maxillary denture-bearing area leads to a narrower, constricted residual ridge with decreased supporting tissues and a larger restorative space between the maxillary and mandibular residual ridge. Rehabilitation in such cases may result in increased weight and height of the prosthesis further compromising its retention, support and stability. So, to prevent further resorption of ridges, the weight of the prosthesis needs to be reduced which can be achieved by making hollow prosthesis. This case report describes a novel technique of fabricating maxillary hollow maxillary complete denture.","PeriodicalId":177622,"journal":{"name":"Journal of Gandaki Medical College-Nepal","volume":"39 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2019-02-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"117085253","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":"Epidemiology and Clinical Outcome of Snakebite in Western Nepal: A Retrospective Study","authors":"D. Karki, B. Sharma, R. Koirala, A. Nagila","doi":"10.3126/JGMCN.V12I1.22618","DOIUrl":"https://doi.org/10.3126/JGMCN.V12I1.22618","url":null,"abstract":"Introduction: Snakebite is an environmental hazard associated with significant morbidity and mortality. It is an important medical emergency and cause of significant numbers of hospital admissions in many parts of the Asian region. In this study, we assess the epidemiology and clinical outcome of snake bite. \u0000Methods: This was a retrospective study of all patients with snake bites admitted to the Department of Internal Medicine, Manipal Teaching Hospital, Pokhara, kaski, Nepal. A total numbers of 265 snake bite cases in the period of 2013 to 2016 were enrolled in this study. Snake bite cases by person, place and time along with month of snake bite and time of bite, were analyzed. We also identified the types of snake and site of the bite. Sign and symptoms were clinically observed and the management of the snake bite cases was clinically done. Prothrombin time (PT) test along with INR value was performed by Medical Technologist at the Department of Laboratory, Manipal Teaching Hospital. Data was entered in to the Microsoft excel and analyzed by SPPS version 21.0. Percentages were applied to find the results. \u0000Results: Total numbers of snake bite cases were 265. More than half, 60.4% of the snake bite cases were females. Regarding the age group, nearly half, 47.9% were in the age group of 20 - 40 years and 9.8% cases were in the age group of 60 years and above. In this study, 50.6% bite cases were held at the day time and most of the bites were reported/ observed in the limb, 53.6% in lower limb, and 43.4% in the upper limb. Very few bites were in the head, neck and trunk. Our result shows 49.1% were green snake and 30.9% snake were unidentified. When we observed the sign and symptoms, 153 (57.7%) cases showed local swelling, 83 (31.3%) showed fang mark. Hematological manifestation were 144 (54.3%) cases and complication observed in 145 (54.7%) cases. Snake bite cases were managed after PT/INR test, INR. Antibiotic were prescribed in 154 cases and in 135 (50.9%) cases blood was transfused. There were no fetal cases noticed among hospital admitted snake bite cases. \u0000Conclusion: There is gross disparity in the management and outcomes of snake bite in different hospitals. Snake bite cases should manage in tertiary care hospital as early as possible.","PeriodicalId":177622,"journal":{"name":"Journal of Gandaki Medical College-Nepal","volume":"20 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2019-02-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"123804745","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":"Teaching How to Teach: Microteaching (A Way to Build up Teaching Skills)","authors":"K. Reddy","doi":"10.3126/jgmcn.v12i1.22621","DOIUrl":"https://doi.org/10.3126/jgmcn.v12i1.22621","url":null,"abstract":"Microteaching is one of the most recent innovations in teacher training program which is used as a professional developmental tool in pre-service or in-service teacher training programs. Microteaching helps teachers to better understand the processes of teaching and learning and provides the opportunity to learn teaching skills, to study their own teaching, and to study the teaching of others. \u0000Microteaching is an organized, scaled-down teacher training program where a trainee teacher plans a short lesson, teaches it to a reduced group of students (Three to ten) in a 5 to 20 minute lesson, and then reflects on their teaching afterwards. The lesson is video recorded for either individual or peer review. The trainee teacher’s micro-lesson is reviewed, discussed, analyzed, and evaluated to give a feedback. Based on this feedback, the trainee teacher re-teaches the micro-lesson, incorporating those points raised during the discussion and analysis. \u0000The main objective of this article is to address and emphasize that microteaching has the potential to improve the teachers’ pedagogic skills, competencies, self-confidence, beliefs, and attitudes with minimum available facilities and to provide students with valuable teaching experiences and make them aware of the benefits and relationships between theory and practice.","PeriodicalId":177622,"journal":{"name":"Journal of Gandaki Medical College-Nepal","volume":"1 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2019-02-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"114792085","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":"Correlation of Ultrasound Parameters with Serum Creatinine in Renal Parenchymal Disease","authors":"H. Khadka, B. Shrestha, S. Sharma, A. Shrestha, S. Regmi, A. Ismail, G. Thapa, S. Pathak","doi":"10.3126/JGMCN.V12I1.22619","DOIUrl":"https://doi.org/10.3126/JGMCN.V12I1.22619","url":null,"abstract":"Introduction: Chronic kidney disease (CKD) is common cause of renal failure. It involves a progressive loss in the structure and function of the kidneys over the course of months, with or without decreased glomerular filtration rate (GFR). CKD can be diagnosed by its pathological abnormalities, changes in the levels of renal function markers in the blood or urine, or by imaging investigations (E.g. USG etc). \u0000Objectives: The purpose of our study is 1) To correlate renal echogenicity with serum creatinine in order to determine the significance of renal echogenicity for identifying the progression of chronic kidney disease (CKD) and for the sonographic grading of CKD, 2) To study association of blood pressure, renal cortical cysts and renal size with grade of chronic renal disease. \u0000Methods: This hospital based cross sectional study was carried out at National Kidney Centre, Banasthali Kathmandu. Two hundred patients above 20 years, diagnosed with CKD according to the guidelines of the National Kidney Foundation and referred for USG, were included in the study. Patients with kidney transplant, on dialysis, with liver disease and renal tumors were excluded. Ultrasound of kidneys was performed by senior consultant radiologist who was blind to the patients’ serum creatinine levels. The relationship between grade of CKD with serum creatinine, kidney size, blood pressure and cortical cysts were assessed. Statistical analysis was performed by Kruskal wallis test using SPSS version 17. P values less than 0.05 were considered statistically significant. \u0000Results: Mean serum creatinine was 1.7 mg/dl for Grade 1 (range: 1.1- 4.7 mg/dl, STD 0.44), 2.38 mg/dl for Grade 2 (range: 1.8-3.9 mg/dl STD 0.40), 4.18 mg/dl for Grade 3 (range: 2.6-6.0 mg/dl, STD 0.88), and 5.65 mg/dl for Grade 4 (range: 3.1-12 mg/dl, STD 2.0. \u0000Conclusion: Renal echogenicity and its grading correlates better with serum creatinine in CKD than other sonographic parameters. Hence, renal echogenicity is a better parameter than serum creatinine for estimating renal function in CKD, and has the added advantage of irreversibility.","PeriodicalId":177622,"journal":{"name":"Journal of Gandaki Medical College-Nepal","volume":"33 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2019-02-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"114304716","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":"District Health Service Management","authors":"S. Poudel, Sushil Subedi, S. Khadka, S. Timilsina, Sanjay Sharma, Syamal Roy, S. Gaire, S. Poudel, S. Shrestha, V. Jha, V. Yadav, Y. Thapa","doi":"10.3126/JGMCN.V12I1.22623","DOIUrl":"https://doi.org/10.3126/JGMCN.V12I1.22623","url":null,"abstract":"District Health System Management is a comprehensive study of the health system of the district as a unit of national health system. The report of District Health System Management has been prepared as per the MBBS 4th year (Third phase) curriculum of Tribhuvan University (TU), Institute of Medicine (IOM), Nepal after the field placement of our group in Gorkha and Kaski districts. \u0000We prepared regional health directorate profile, regional tuberculosis center profile, district profile, district health profile of Kaski, hospital profile of Western Regional Hospital, Kaski, and critical analysis on human resources of the Aampipal hospital. We prepared five year plan on ICU services of Gorkha District Hospital and conducted epidemiological study on COPD in WRH, Pokhara. \u0000The techniques used in this study were observation, interviews, interactions, participation, secondary data retrieval, analysis and presentation using specific tools and guidelines devised for the same. \u0000The field practice proved to be a milestone in enabling the students to develop aptitude in the fields of management, administration and communication in different health set-ups of the country. It is in fact once-in-a lifetime opportunity for the medical students to imbibe the practicality of management skills at various levels.","PeriodicalId":177622,"journal":{"name":"Journal of Gandaki Medical College-Nepal","volume":"116 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2019-02-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"123156630","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":"Histopathological Analysis of Endometrial Biopsy in Gandaki Medical College Teaching Hospital, Pokhara, Nepal","authors":"B. Parajuli, G. Pun, S. Ranabhat, S. Poudel","doi":"10.3126/JGMCN.V12I1.22608","DOIUrl":"https://doi.org/10.3126/JGMCN.V12I1.22608","url":null,"abstract":"Objective: To study the spectrum of histopathological diagnosis of endometrial lesions and their distribution according to age. \u0000Methods: All the endometrium samples obtained by the procedure of dilatation and curettage and hysterectomy sent for histopathological examination at Pathology Department of Gandaki Medical College Teaching Hospital, Pokhara, Nepal. The study duration was total 12 months ranging from July 2016 to June 2017. All the endometrial samples were processed, sectioned at 4 - 6 μm and stained with routine H & E stain. Patient’s data including age, sex, procedure of the biopsy taken and histopathological diagnosis were noted. A pathologist, using Olympus microscope, reported the slides. Cases were reviewed by a second pathologist whenever necessary. \u0000Results: A total of 128 cases were studied. The most common histopathological diagnosis was proliferative endometrium (28.9%) followed by disorder proliferative endometrium (15.65%). Most of the patients were in age group 36 - 45 years comprising 32.03%. Hydatidiform mole comprised of 7.03% and among Hydatidiform mole, partial mole was more common. Dilatation and curettage (82.8%) was the common procedure in compare to hysterectomy for the evaluation of endometrial lesions. \u0000Conclusions: In this study, we observed a variety of endometrial lesions. Most of them are benign; among benign, proliferative endometrium was the common histopathological diagnosis followed by disorder proliferative endometrium. Most common presenting age group was found to be at 36 - 45 years. In evaluation of hydatidiform mole, partial mole was more frequent in compare to complete mole. Conventional dilatation and curettage is the preferred method in developing countries with limited resource to screen endometrial lesion and therefore biopsy should be sent for histopathological examination. Thus histopathological examination of routinely stained hematoxylin and eosin is readily available and widely accepted standard technique for evaluation of the endometrial lesions.","PeriodicalId":177622,"journal":{"name":"Journal of Gandaki Medical College-Nepal","volume":"46 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2019-02-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"124949391","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":"Patterns of Cancer Occurrence in Nepal","authors":"A. Dhungana, Hp Ghimire","doi":"10.3126/JGMCN.V12I1.22601","DOIUrl":"https://doi.org/10.3126/JGMCN.V12I1.22601","url":null,"abstract":"Background: Cancer is a public health problem throughout the world and Nepal is not an exception. Actual information on pattern of cancer morbidity and mortality is possible only from population-based registry, which unfortunately is lacking in Nepal. \u0000Objectives: The objective of this study is to determine the pattern of cancer occurrence in Nepal with respect to different pertinent variables. \u0000Methods: A descriptive cross sectional study was done among 198 admitted patients from Bhaktapur Cancer Hospital using semi-structured interview schedule. Data entry and analysis was done on IBM SPSS V20. Descriptive statistical measures were employed. \u0000Results: This study showed that cancer was seen in advanced age group with no sex wise variations. Majority was married, literate, from rural area, of upper caste and upper lower socioeconomic status. Cancer of lung, rectum and bile duct were more frequent in males in contrary to that of breast, ovary and cervix in females. Malignant neoplasm of digestive organs in males and that of female genital organs in females were the commonest to occur according to ICD-10 classification. \u0000Conclusions: Cancer is rapidly emerging non-communicable disease throughout the world. Despite lack of population based disease registry, patterns of disease from this hospital study emphasize prioritizing the health promotive activities against cancer in the general population.","PeriodicalId":177622,"journal":{"name":"Journal of Gandaki Medical College-Nepal","volume":"35 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2019-02-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"128339283","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":"Measurement of Length of Styloid Process by Orthopantomography","authors":"B. Sharma, S. Singh, M. Timilsina, P. Sharma, K. Sharma","doi":"10.3126/jgmcn.v12i1.22606","DOIUrl":"https://doi.org/10.3126/jgmcn.v12i1.22606","url":null,"abstract":"Background: Styloid process (SP) is an anatomical structure whose elongation is not well understood. Proper clinical and radiological assessment is needed to detect an elongated SP. Anatomical variation is also common. SP is said to be elongated if longer than 30 mm. Orthopantomogram (OPG) is also an imaging modality by which we can view SP. \u0000Objective: The objective of this study was to assess the SP on OPG and identify eagle syndrome. \u0000Materials and Methods: The study was conducted on archived OPG radiographs available in the Department of Oral Radiology, Gandaki Medical College Teaching hospital and Research Centre. These radiographs were from patients who were subjected to radiographic examination for other dental problems. The length of SP was measured on both sides using the measurement tool bars on the accompanying analysis software. \u0000Results: Average length of SP on males was 26.5 mm ±14.4 mm in right and 25.5 mm ±6.19 mm in left; and on females was 23.78 mm ±5.93 mm on right and 24.7 mm ±10.44 mm in left. Elongated SP was more on males compared to females. Elongated styloid process (ESP) was more prevalent in 21 - 30 years of age group, similarly unilateral and bilateral elongation was also predominant on males compared to females. \u0000Conclusion: OPG is also useful for detection of an ESP in patients with or without symptoms and helps to avoid misdiagnosis of tonsillar pain or pain of dental, pharyngeal or muscular origin as well as Eagle syndrome (ES).","PeriodicalId":177622,"journal":{"name":"Journal of Gandaki Medical College-Nepal","volume":"1045 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2019-02-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"133842927","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}