Kathmandu University Medical Journal最新文献

Vesicovaginal Fistula Following Trauma. 外伤后的膀胱阴道瘘

Kathmandu University Medical Journal Pub Date : 2024-04-01

S Shrestha, G Dangal, A Karki, H K Pradhan, R Shrestha, K Bhattachan, S Sah

引用次数: 0

Role of Intraoperative Cholangiogram in Major Liver Resection and Complex Bilio-enteric Bypass Surgery. 术中胆管造影在大肝切除术和复杂双肠旁路手术中的作用

Kathmandu University Medical Journal Pub Date : 2024-04-01

A Ranabhat, C Yang, G Zhanpeng

{"title":"Role of Intraoperative Cholangiogram in Major Liver Resection and Complex Bilio-enteric Bypass Surgery.","authors":"A Ranabhat, C Yang, G Zhanpeng","doi":"","DOIUrl":"","url":null,"abstract":"Background One of the most challenging intra-articular fractures to treat is tibial plateau fracture type V and VI because of its controversial treatment protocol. Surgical intervention is the most compatible modality to achieve stable internal fixation and early joint movements. Although the soft tissue is compromised and chance of infection is high due to long exposure time, but the outcome is good after surgery. Objective To evaluate the clinical and functional outcome treated with open reduction and internal fixation (ORIF) and factors effecting the outcome of the patients. Method We treated 52 cases of Schatzker type V and VI tibial plateau fracture from April 2018 to May 2020. All of them were managed surgically and the outcomes were evaluated with regular follow ups using oxford knee scoring (OKS) criteria. Result Forty-three cases (82.7%) had excellent Oxford Knee Scoring (OKS). Wound infections were seen in 5 cases resulting poor outcome (Mean 24.0 compared to 44.7, p = 0.007). Female patients had better outcome in comparison to male patients (Mean 45.0 compared to 41.5, p = 0.041). Older patients had poor outcomes with negative correlation of 0.371, p = 0.007. Conclusion Open Reduction and Internal fixation in Schatzker type V and VI tibial plateau fractures is an excellent treatment option to achieve good clinical and functional outcome within short period of time interval with very minimum chance of malunion and other complications improving the patients' quality of life. Age, gender and infection are some of the factors that alters the outcome.","PeriodicalId":35493,"journal":{"name":"Kathmandu University Medical Journal","volume":"22 86","pages":"139-143"},"PeriodicalIF":0.0,"publicationDate":"2024-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142355598","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}

引用次数: 0

Mirror Ear: A Rare Case of Polyotia. 镜面耳一个罕见的多耳症病例

Kathmandu University Medical Journal Pub Date : 2024-04-01

N Amatya, B L Shrestha, S Karmacharya, N Sapkota, S Subba

{"title":"Mirror Ear: A Rare Case of Polyotia.","authors":"N Amatya, B L Shrestha, S Karmacharya, N Sapkota, S Subba","doi":"","DOIUrl":"","url":null,"abstract":"Polyotia is an anomaly of the external auricle in which the accessory auricle is large enough to closely resemble an additional pinna rather than a skin remnant and cartilage. Polyotia, also known as mirror ear or accessory ear, is a type of ear anomaly in the tragus area, but the term refers to substantial anomalies which resemble an accessory ear, unlike a pre-auricular tag. It is an extremely rare condition and to date, less than 30 cases of polyotia have been reported according to a review of the literature. A variety of theories has been proposed for development of such abnormal external auricle. We report two cases of polyotia which presented to Dhulikhel Hospital ENT OPD that was successfully corrected surgically. An 8-year-old boy and a 14-year-old boy presented with a large accessory anomalous auricle on left and right ear respectively. The accessory auricle was composed of an elastic cartilaginous component covered with skin and was positioned anteriorly to the original auricle in both the cases. The anomaly was not as large as the patient's external auricle, rather it mirrored the external auricle. On the opposite ear both the cases presented with preauricular skin tag. Surgical correction was done by dissecting the skin free from the duplicated cartilage via an incision along the free edge of the helix the duplicated cartilage was contoured to fill the pre-tragal hollow and the tragus reconstructed with a free cartilage graft.","PeriodicalId":35493,"journal":{"name":"Kathmandu University Medical Journal","volume":"22 86","pages":"248-251"},"PeriodicalIF":0.0,"publicationDate":"2024-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142355590","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}

引用次数: 0

Quality of Life and Associated Factors among Patients with Stroke at Tertiary Hospital, Nepal. 尼泊尔三级医院脑卒中患者的生活质量及相关因素。

Kathmandu University Medical Journal Pub Date : 2024-04-01

B Chaudhary, N Devkota, B R Kafle, S Pradhan, P L Maharjan, S Pradhan, H P Adhikari

{"title":"Quality of Life and Associated Factors among Patients with Stroke at Tertiary Hospital, Nepal.","authors":"B Chaudhary, N Devkota, B R Kafle, S Pradhan, P L Maharjan, S Pradhan, H P Adhikari","doi":"","DOIUrl":"","url":null,"abstract":"Background Stroke is the second leading cause of mortality globally, with 70% of cases occurring in low- and middle-income countries. Various risk factors for stroke have been identified as predictors of Health-Related Quality of Life (HRQoL). Objective This study aims to assess the impact of associated factors of stroke on the quality of life (QoL) of stroke patients at this tertiary hospital in Nepal. Method A descriptive cross-sectional study was conducted among 92 stroke patients at Annapurna Neurological Institute and Allied Sciences from June to December, 2022. Data were collected through a pre-designed and pre-tested SS-QoL questionnaire followed by a face-to-face interview. SPSS version 22 was employed for analysis, and Mann-Whitney U tests and Kruskal-Wallis H tests was applied to determine the association of variables at a 5% level of significance. Result About two-thirds of the participants were male, indicating a male predominance. Patients aged 45-55 exhibited higher quality of life in family roles and vision, possibly due to the adversity of stroke in older patients. Ischemic stroke was three times more prevalent than hemorrhagic stroke, and those individuals reported higher quality of life, particularly in work and productivity. However, other domains remained statistically insignificant. Among the studied comorbidities, hypertensive patients had the highest overall quality of life. Conclusion Conducting a comprehensive evaluation of the overall quality of life in individuals who have experienced a stroke can contribute to improved health outcomes, particularly in terms of their functioning and well-being in psychosocial aspects.","PeriodicalId":35493,"journal":{"name":"Kathmandu University Medical Journal","volume":"22 86","pages":"186-190"},"PeriodicalIF":0.0,"publicationDate":"2024-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142355597","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}

引用次数: 0

Prevalence of Renal and Urinary Tract Diseases among Pediatric Cases Admitted in a Tertiary Hospital in Developing Country. 发展中国家一家三级医院收治的儿科病例中肾病和泌尿道疾病的发病率。

Kathmandu University Medical Journal Pub Date : 2024-04-01

S Gautam, P Gautam, A Chaudhary, A Dahal, P Giri, S Poudel

{"title":"Prevalence of Renal and Urinary Tract Diseases among Pediatric Cases Admitted in a Tertiary Hospital in Developing Country.","authors":"S Gautam, P Gautam, A Chaudhary, A Dahal, P Giri, S Poudel","doi":"","DOIUrl":"","url":null,"abstract":"Background Kidney disease includes diseases of the glomerulus, tubular disorders, and conditions associated with hematuria or proteinuria. Urinalysis can be a reliable and easy tool to screen. Objective In this study, we aim to study the prevalence of renal and urinary tract diseases among the pediatric population in a tertiary hospital in Nepal. Method A single-center retrospective cross-sectional study was conducted from 2022 to 2023 in the pediatric department. Information was obtained regarding clinicalepidemiological profile, associated condition, investigations, diagnosis, and duration of hospital stay, management, and outcome. Result The prevalence of renal disease was 5.6%, with urinary tract infection being the most common diagnosis. Maximum cases presented between one and five years with a male-to-female ratio of 1.1:1 and 80.9% of the patients had new onset disease. The mean duration of hospital stay was six days. The mortality rate in renal diseases was 3.2%. Conclusion Renal diseases make up a significant portion of pediatric admissions. Renal diseases contribute to significant morbidity and mortality. A large number of cases of renal diseases are due to infective etiology hence they are preventable and curable. Renal disease in children presents with vague symptoms and signs. Routine screening of renal diseases is needed for early diagnosis and reduction in morbidity and mortality.","PeriodicalId":35493,"journal":{"name":"Kathmandu University Medical Journal","volume":"22 86","pages":"144-148"},"PeriodicalIF":0.0,"publicationDate":"2024-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142355595","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}

引用次数: 0

Morphological Variation of Lip Patterns among Nepali Adults. 尼泊尔成年人唇型的形态差异。

Kathmandu University Medical Journal Pub Date : 2024-04-01

A Atreya, P P Yadav, B Acharya, R G Menezes, S Nepal, K Khanal

{"title":"Morphological Variation of Lip Patterns among Nepali Adults.","authors":"A Atreya, P P Yadav, B Acharya, R G Menezes, S Nepal, K Khanal","doi":"","DOIUrl":"","url":null,"abstract":"Background Lip patterns are normal lines and fissures in the form of wrinkles and grooves present in the zone of transition of the human lip between the inner labial mucosa and the outer skin. Lip patterns are said to be unchangeable and unique. Objective To determine predominant lip patterns found among the Nepali population and to evaluate whether any sex difference exists. Method This study included 411 healthy adult Nepali comprising 215 males and 196 females in the age group of 18-27 years. The data was collected using an automated mode Canon EOS 3000D 18MP camera with an 18-55 mm lens. Lip patterns were then divided into four quadrants using Suzuki and Tsuchihashi's classification system. Result Lip pattern Type I (29.56%) was found to be the most common lip pattern in the study population. Sex-wise, Type I was the most common pattern with a prevalence of 28.72% in males and 30.48% in females. Applying the Chi-square test, a statistically significant difference (p 0.05) was not achieved in all the quadrants. Conclusion There is a marked variation observed between the findings of the present study when compared to previous Nepali studies. Being insignificant to sex differences, lip patterns should not be used as a useful resource in forensic casework for sex discrimination.","PeriodicalId":35493,"journal":{"name":"Kathmandu University Medical Journal","volume":"22 86","pages":"210-214"},"PeriodicalIF":0.0,"publicationDate":"2024-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142355591","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}

引用次数: 0

Accuracy of Transvaginal Ultrasound Parameters and Bishop Score as Predictors of Successful Induction of Labor in Term High-Risk Pregnancy. 经阴道超声参数和 Bishop 评分预测足月高危妊娠引产成功的准确性。

Kathmandu University Medical Journal Pub Date : 2024-04-01

S Shakya, A Shrestha

{"title":"Accuracy of Transvaginal Ultrasound Parameters and Bishop Score as Predictors of Successful Induction of Labor in Term High-Risk Pregnancy.","authors":"S Shakya, A Shrestha","doi":"","DOIUrl":"","url":null,"abstract":"Background Induction is one of the most common interventions in obstetrics practice, accounting for 1.4-35%. Cervical favorability is crucial for successful induction. The Bishop score is simple and assesses preinduction cervical favorability based on five components. However, it has high inter- and intra-observer variability. Alternative objective methods are transvaginal ultrasound parameters (e.g., cervical length, width, and funneling). Objective To assess and compare the predictive value of transvaginal ultrasound and bishop score for vaginal delivery. In addition, the time interval from induction to delivery in women undergoing induction of labor. Method This prospective cross-sectional study included 342 pregnant women, in whom induction of labor was performed at 38-42 weeks of gestation. Cervical length, funneling, and width from transvaginal sonography and bishop scores by digital examination are assessed prior to induction in high-risk cases according to standard protocol. Result In our study, both transvaginal cervical length and bishop score showed similar predictors of successful labor induction, i.e., vaginal delivery. The ROC curve for cervical length showed an optimal cut-off value of ≤ 32 mm, corresponding to a sensitivity of 64.2% and a specificity of 60.0%, whereas the optimal cut-off value for Bishop score was ≥ 5, with a sensitivity of 65.1% and a specificity of 62.0%. However, cervical width and the presence of cervical funneling did not correlate. Both cervical length and Bishop score had a significant correlation as predictors of successful induction, with an OR of 0.93 (95% CI 0.91-0.96), an AOR of 0.96 (955 CI 0.9-0.99), and an OR of 1.41 (95% CI 1.2-1.6) and an AOR 1.2 (95% CI 1.1-1.5), respectively. Conclusion Cervical length and bishop score are both good and equally predict of successful induction of labor.","PeriodicalId":35493,"journal":{"name":"Kathmandu University Medical Journal","volume":"22 86","pages":"202-209"},"PeriodicalIF":0.0,"publicationDate":"2024-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142355579","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}

引用次数: 0

Feasibility, Safety and Acceptance of Buccal Mucosa Harvest Under Local Anesthesia for Substitution Urethroplasty:Prospective Observational Study in a Tertiary Centre. 在局部麻醉下采集颊黏膜用于替代尿道成形术的可行性、安全性和接受度：一家三级医疗中心的前瞻性观察研究。

Kathmandu University Medical Journal Pub Date : 2024-04-01

A Pandey, P M Shrestha, A Shrestha, R B Basnet, B Adhikari, A K Shah, U Mishra

{"title":"Feasibility, Safety and Acceptance of Buccal Mucosa Harvest Under Local Anesthesia for Substitution Urethroplasty:Prospective Observational Study in a Tertiary Centre.","authors":"A Pandey, P M Shrestha, A Shrestha, R B Basnet, B Adhikari, A K Shah, U Mishra","doi":"","DOIUrl":"","url":null,"abstract":"Background Urethral stricture is a challenging condition with significant socioeconomic impacts, often requiring surgical intervention such as urethroplasty. Buccal mucosa grafts (BMG) are a popular choice for substitution urethroplasty due to their favorable outcomes. This study evaluates the feasibility, safety, and acceptance of harvesting buccal mucosa grafts under local anesthesia. Objective To assess feasibility, safety and acceptance of Buccal mucosa harvest under local anesthesia. Method A prospective observational hospital based study to evaluate outcomes of substitution urethroplasty using buccal mucosa grafts (BMG) under local anesthesia. Result Of the 40 patients, 28 had unilateral graft harvests, while 12 had bilateral procedures. The mean graft length obtained was 5.65 cm. Postoperatively, patients experienced a quick recovery, with full mouth opening achieved within an average of 2.78 days and resumption of normal eating within 2.6 days. Minor complications included oral swelling in 15% of cases and food residue in 12.5%. Although 87.5% of patients reported pain at the perineal wound site, the overall pain score averaged 3.58, indicating manageable discomfort. Importantly, 92.5% of patients expressed a willingness to undergo the procedure again if necessary. Conclusion These findings suggest that buccal mucosa graft harvest under local anesthesia is both feasible and well-tolerated. The procedure appears to be a safe alternative to regional or general anesthesia, with minimal complications and a high level of patient acceptance. Future randomized controlled trials comparing local anesthesia to regional or general anesthesia could provide additional insights and further validate these findings. This study contributes to the growing body of evidence supporting the use of local anesthesia in urethral stricture surgery, offering a practical approach to managing this condition effectively.","PeriodicalId":35493,"journal":{"name":"Kathmandu University Medical Journal","volume":"22 86","pages":"197-201"},"PeriodicalIF":0.0,"publicationDate":"2024-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142355588","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}

引用次数: 0

Clinical and Pathological Features of Primary Cutaneous Lymphomas in Nepal: A retrospective cohort study from a dermatology referral centre. 尼泊尔原发性皮肤淋巴瘤的临床和病理特征：一项来自皮肤科转诊中心的回顾性队列研究。

Kathmandu University Medical Journal Pub Date : 2024-04-01

U Paudel, S Parajuli

{"title":"Clinical and Pathological Features of Primary Cutaneous Lymphomas in Nepal: A retrospective cohort study from a dermatology referral centre.","authors":"U Paudel, S Parajuli","doi":"","DOIUrl":"","url":null,"abstract":"Background Primary cutaneous lymphomas (PCLs) are rare diagnoses in Nepal and are not well characterized till date. Objective To evaluate clinical and pathological features of Primary cutaneous lymphomas in Nepal. Method We retrospectively reviewed outpatient and inpatient records of a dermatology referral centre of Kathmandu, Nepal for clinical and pathological findings of cases diagnosed as cutaneous lymphomas from July 2010 through July 2020. The final diagnosis was made based on 2008 World Health Organization classification and its update 2018. Result There were 12 cases of Primary cutaneous lymphomas diagnosed during this period. The age of presentation ranged from 19 years to 81 years (Mean: 53.4 years ± 21.5 years, SD). There were ten cases of cutaneous T-cell lymphoma (CTCLs) and two cases of cutaneous B- cell lymphomas (CBCLs). Among cutaneous T-cell lymphoma, there were four cases of primary cutaneous anaplastic large- cell Lymphoma (PCALCL), two cases of classic (patch/plaque) mycosis fungoides (MF), two cases of folliculotropic mycosis fungoides (FMF), and one case each of primary cutaneous aggressive epidermotropicCD8+ T-cell lymphoma and lymphomatoid papulosis. Among cutaneous B- cell lymphomas, there was one case of primary cutaneous marginal zone B- cell lymphoma, and one case of primary cutaneous follicle centre lymphoma. Most cases of MF presented at stage IB (75%), and three patients of primary cutaneous lymphomas died during this period. Conclusion Primary cutaneous lymphomas appear to be very rare in this study and presentations ranged from classic Mycoses Fungoides to aggressive T-cell lymphomas. Cutaneous T-cell lymphomas appeared to be more common than cutaneous B- cell lymphomas in this study.","PeriodicalId":35493,"journal":{"name":"Kathmandu University Medical Journal","volume":"22 86","pages":"154-159"},"PeriodicalIF":0.0,"publicationDate":"2024-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142355584","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}

引用次数: 0

Cone-Beam Computed Tomographic Study of the Internal Anatomy of Lower Anterior Teeth. 下前牙内部解剖的锥形束计算机断层扫描研究。

Kathmandu University Medical Journal Pub Date : 2024-04-01

M Nepal, A Chakradhar, S P Pradhan, J Khadka, R Tripathi, H Bali

{"title":"Cone-Beam Computed Tomographic Study of the Internal Anatomy of Lower Anterior Teeth.","authors":"M Nepal, A Chakradhar, S P Pradhan, J Khadka, R Tripathi, H Bali","doi":"","DOIUrl":"","url":null,"abstract":"Background A thorough knowledge of the root and canal morphology and their possible variations are essential for successful endodontic treatment. Methods like staining and clearing techniques, cross sectional method can provide precise information on root canal systems, however, these methods are invasive. Cone-beam computed tomography (CBCT) is the 3-dimensional scans of the maxillofacial skeleton that best visualizes canal morphology and helps in identifying additional canals and roots in vivo. Objective To investigate the root canal configuration of mandibular anterior teeth using Conebeam computed tomography. Method A total of 2910 CBCT images, comprising 970 central incisors, lateral incisors, and canines each from 485 patients were assessed. The following assessments were made: (1) The number of roots and root canals (2) Canal configuration according to Vertucci's classification (3) Bilateral occurrences for variations. Also, the gender and age of patients were noted. Result The study revealed mandibular anterior teeth predominantly had 1 root with Type I (79.79%, 77.11%, 91.34%) canal configuration followed by type III (20.2%, 22.67%, 5.15%) in central, lateral and canine respectively. Almost 90% incisors had symmetry in the canal configurations. No statistical correlation was found between the gender and root canal configurations. Type III canal configurations in canines were present more in elder age group. Conclusion Clinicians must be aware that each tooth may display a different number of roots and types of canal configurations. During endodontic treatment, presuming lower anterior teeth with single root and single canal may lead to missed canals and consequently, treatment failure.","PeriodicalId":35493,"journal":{"name":"Kathmandu University Medical Journal","volume":"22 86","pages":"221-227"},"PeriodicalIF":0.0,"publicationDate":"2024-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142355585","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}

引用次数: 0