Kathmandu University Medical Journal最新文献_第4页

Sinonasal Mucormycosis Amidst the Second Wave of COVID-19 Pandemic; Clinical Spectrum and Outcome in a Tertiary Care Center in Nepal. 第二波新冠肺炎大流行中的鼻毛霉菌病尼泊尔三级保健中心的临床谱和结果。

Kathmandu University Medical Journal Pub Date : 2024-10-01

U Gurung, K Dongol, S Paudel, N M Thapa, R B Pradhananga, B R Gyawali, G S Shrestha

{"title":"Sinonasal Mucormycosis Amidst the Second Wave of COVID-19 Pandemic; Clinical Spectrum and Outcome in a Tertiary Care Center in Nepal.","authors":"U Gurung, K Dongol, S Paudel, N M Thapa, R B Pradhananga, B R Gyawali, G S Shrestha","doi":"","DOIUrl":"","url":null,"abstract":"Background Mucormycosis is an angioinvasive opportunistic fungal infection which surged during the second wave of COVID-19 pandemic. Objective This study assessed patient demographics, risk factors, clinical characteristics, and outcomes of sinonasal mucormycosis during the second wave of COVID-19 pandemic. Method The clinical records of patients with histologically proven sinonasal mucormycosis, admitted between May 2021 to October 2021, in a tertiary center were reviewed. Result There were 25 patients (18 males, 7 females). The age ranged from 16 to 70 years (mean 51 ± 9.5 years). Uncontrolled diabetes mellitus detected in 23 patients was the most common co-morbidity. COVID-19 infection was documented in 20 patients. The mean time of diagnosis was 12 days after the onset of COVID-19 infection. Based on the disease extent, six patients had sino-nasal, seven had rhino-orbital, and 12 had rhino-orbital-cerebral involvement. The most common first presenting symptom was orbital (17/25) followed by facial (5/25) and orodental (3/25). All patients received intravenous amphotericin B for 2 to 8 weeks. Maintenance with posaconazole ranged from 3 to 9 months. Sixteen patients underwent surgical debridement. Out of the 25 patients, 14 (56%) had good recovery. Poor outcome was observed mostly with intracranial involvement. Conclusion Uncontrolled diabetes mellitus was a common risk factor. Advanced disease at presentation was frequently encountered due to rapid extrasinus spread. Nearly 50% of patients had good recovery whilst poor outcome was observed, mostly with intracranial involvement. Adequate blood sugar control, early administration of antifungals, and aggressive surgical debridement are the mainstay of treatment.","PeriodicalId":35493,"journal":{"name":"Kathmandu University Medical Journal","volume":"22 88","pages":"419-425"},"PeriodicalIF":0.0,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144209725","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

Effects of Bauxite and Alumina Exposure on Mortality due to Cancer - Meta-analysis. 接触铝土矿和氧化铝对癌症死亡率的影响-荟萃分析。

Kathmandu University Medical Journal Pub Date : 2024-10-01

T Thevi, A L Abas

引用次数: 0

A Rare Case of Sporadic Optic Pathway Glioma in a 7-year-old Female. 罕见的散发性视神经通路胶质瘤1例7岁女性。

Kathmandu University Medical Journal Pub Date : 2024-10-01

S Gupta, U Sinha, A Raj

引用次数: 0

Prevalence of Depression and Associated Factors among Cervical Cancer Patients Attending Tertiary Center in Bhaktapur, Nepal. 尼泊尔巴克塔普尔三级医疗中心宫颈癌患者抑郁患病率及相关因素

Kathmandu University Medical Journal Pub Date : 2024-10-01

M Dhakal, P Basel

引用次数: 0

Stress Anxiety and Depression among Adolescents of Schools in Godawari Municipality, Lalitpur. 拉利特普尔戈达瓦里市学校青少年的压力、焦虑和抑郁

Kathmandu University Medical Journal Pub Date : 2024-10-01

R Ghimire, T Adhikari Mishra, P Sharma

{"title":"Stress Anxiety and Depression among Adolescents of Schools in Godawari Municipality, Lalitpur.","authors":"R Ghimire, T Adhikari Mishra, P Sharma","doi":"","DOIUrl":"","url":null,"abstract":"Background Adolescence is a critical phase of life marked by various physical, emotional, and intellectual changes. Emotional aspects of adolescents are often undetected, unaddressed, and untreated. Objective To find out the level and factors associated with stress, anxiety, and depression among adolescent students. Method A descriptive cross-sectional study among 513 adolescents from grades 9 and 10 in the Public Secondary Schools of Godawari Municipality was carried out using cluster sampling techniques. The participants were administered a validated Nepali version of the Depression, Anxiety, and Stress Scale 21. Descriptive statistics was used to assess the level of stress, anxiety, and depression, while binary logistic regression was used to identify predictors of these conditions among adolescent students. Result Findings revealed that mild level of stress (10.1%), moderate level of anxiety (21.2%) and mild level of depression (19.5%) were more prevalent among adolescent students. In a multivariate model, it was found that female adolescents were more likely to have symptoms of stress, anxiety, and depression. Similarly, witnessing domestic violence and experiencing abuse ever were significantly associated with stress; family health problems and witnessing domestic violence were significantly associated with anxiety and passed in previous examination, family history of mental illness, experiencing abuse ever and bedtime use of electronic devices were significantly associated with depression in adolescent students. Conclusion The severity of stress, anxiety and depression are increasing among adolescent students. Hence routine mental health screening, adolescent mental health awareness programs and counselling sessions should be conducted in schools.","PeriodicalId":35493,"journal":{"name":"Kathmandu University Medical Journal","volume":"22 88","pages":"426-432"},"PeriodicalIF":0.0,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144209727","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

Incidence of Accidental Awareness with Recall during General Anaesthesia: A Prospective Observational Study in a Tertiary Care Hospital. 全麻期间意外意识与回忆的发生率：三级医院的前瞻性观察研究。

Kathmandu University Medical Journal Pub Date : 2024-10-01

S L Moktan, R Pradhan, A Pradhan

{"title":"Incidence of Accidental Awareness with Recall during General Anaesthesia: A Prospective Observational Study in a Tertiary Care Hospital.","authors":"S L Moktan, R Pradhan, A Pradhan","doi":"","DOIUrl":"","url":null,"abstract":"Background Accidental awareness during general anaesthesia, though rare, is a serious issue. It could lead to potential harmful psychological consequences. It has been reported that general surgical population has an incidence of awareness ranging from 0.1 to 0.2%. Objective To determine the incidence of awareness with recall under general anaesthesia by using modified Brice questionnaire in post-operative care unit. Method This was an observational study conducted on adult patients in a tertiary care hospital. A modified Brice questionnaire was used for the post-operative interview in 1,120 patients following the written informed consent. They were of American society of anaesthesiologists' physical status I to III and had surgeries under general anaesthesia. The incidence of intraoperative awareness with recall was the primary outcome of the study. Result Among the total 1,120 patients, 678 patients were female and 442 were males. Most patients, 785 were of American society of anaesthesiologists' physical status I, while 316 were II and 19 were III. While 1071 (95.6%) patients underwent elective surgery, 49 (4.3%) patients had emergency surgeries. The mean age of the study population was 40.31years with standard deviation of 12.12. Of the 1120 patients, two of them had definitive awareness. Conclusion The incidence of intraoperative awareness with recall after general anaesthesia in patients from a tertiary care hospital was 0.13%.","PeriodicalId":35493,"journal":{"name":"Kathmandu University Medical Journal","volume":"22 88","pages":"441-446"},"PeriodicalIF":0.0,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144209714","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

Assessment of Range of Motion of Temporomandibular Joint among Dental Students of Dhulikhel Hospital. Dhulikhel医院牙科学生颞下颌关节活动度的评估。

Kathmandu University Medical Journal Pub Date : 2024-10-01

A Luitel, H Bali, P Gautam, R Shrestha, N Singh, K Gurung

{"title":"Assessment of Range of Motion of Temporomandibular Joint among Dental Students of Dhulikhel Hospital.","authors":"A Luitel, H Bali, P Gautam, R Shrestha, N Singh, K Gurung","doi":"","DOIUrl":"","url":null,"abstract":"Background Restriction in mandibular range of motion (ROM) is one of the main signs of mandibular dysfunction and an important criterion for evaluation of functional state of the masticatory system. Objective The objective of this study was to evaluate the normal ROM of Temporomandibular Joint (TMJ) among dental students of tertiary care hospital at central region of Nepal. Method After ethical clearance, cross- sectional study was conducted between August to September 2022 among all dental students who gave consent. The inter-incisal opening, bilateral lateral excursion and protrusion were measured thrice using 15 cm metallic scale and an average was considered to reduce ambiguity. The data was entered in Microsoft excel and transferred to SPSS version 20 for statistical analysis. The descriptive statistics was calculated and independent t test was applied to compare the mean between genders. Result Total of 145 students (25 males and 120 females) were included with the mean age of 21.32 ± 1.29 years. The overall mean inter-incisal opening was 44.82 ± 5.80 mm, right lateral excursion was 8.23 ± 2.11 mm, left lateral excursion was 8.70 ± 1.80 mm and protrusion was 5.65 ± 1.87 mm. There was statistically significant difference in right and left lateral excursion and protrusion among genders. Conclusion The inter-incisal opening of participants in our study appeared towards lower range of normal mouth opening while lateral excursion appeared consistent with those described in the literature. The protrusive movement of our participants was decreased, compared to those recorded in the literature.","PeriodicalId":35493,"journal":{"name":"Kathmandu University Medical Journal","volume":"22 88","pages":"404-407"},"PeriodicalIF":0.0,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144209707","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

Magic of Intravitreal Triamcinolone and Dexamethasone in a Patient with Uveitic Macular Edema with Treated Ocular Tuberculosis. 玻璃体内注射曲安奈德和地塞米松治疗葡萄膜性黄斑水肿合并眼结核的疗效。

Kathmandu University Medical Journal Pub Date : 2024-10-01

A Agrawal, R Kharel Sitaula

引用次数: 0

Platelet Count-to-platelet Distribution Width Ratio and other Platelet Indices as Cost-effective Markers of Preeclampsia: a case control study. 血小板计数与血小板分布宽度比和其他血小板指标作为子痫前期的成本效益指标：一项病例对照研究。

Kathmandu University Medical Journal Pub Date : 2024-10-01

R Bashyal, A Singh, S Maharjan, S Tuladhar, B Bhattarai, P K Sharma

{"title":"Platelet Count-to-platelet Distribution Width Ratio and other Platelet Indices as Cost-effective Markers of Preeclampsia: a case control study.","authors":"R Bashyal, A Singh, S Maharjan, S Tuladhar, B Bhattarai, P K Sharma","doi":"","DOIUrl":"","url":null,"abstract":"Background Platelet indices, like platelet count (PC), plateletcrite, mean platelet volume (MPV) and platelet distribution width (PDW), and their ratios have shown to be costeffective and better predictors of preeclampsia (PE). However, platelet count/platelet distribution width ratio was not studied. Objective To compare platelet indices and their ratios between pregnant women with and without predictors of preeclampsia. Method An analytical, comparative, case-control study. Two groups were compared; pregnant women with preeclampsia (case, n=24) and without preeclampsia (control, n=72). Multivariable linear regression analysis for hematological parameters was performed to assess the effect of gestational age. Logistic regression was performed to calculate odds ratio. Receiver operating characteristic curve was used to determine sensitivity, specificity and cutoff values. P < 0.05 was considered significant. Result There was statistically significant reduction in values of platelet count, plateletcrit, platelet count/mean platelet volume, and platelet count/platelet distribution width among the pregnant women with preeclampsia compared to control group, while significant increase was noticed in platelet distribution width and mean platelet volume. platelet count/platelet distribution width had the highest area under the curve (AUC) of 0.767, followed by platelet distribution width (AUC=0.752). At the cutoff of 15.1 (p<0.001) for platelet count/platelet distribution width, sensitivity was 70.8%, and specificity was 81.9%. The odds of diagnosing true positive cases of preeclampsia was 11.02 (95% CI =3.79-31.99, p=<0.001) times higher compared to values below it at this cutoff. Conclusion Platelet indices are economical tests that can act as indicators of risk of preeclampsia. Among these, platelet count/platelet distribution width has the highest sensitivity and specificity in the detection of preeclampsia at the cutoff of 15.1 and has emerged as better predictor of preeclampsia.","PeriodicalId":35493,"journal":{"name":"Kathmandu University Medical Journal","volume":"22 88","pages":"367-372"},"PeriodicalIF":0.0,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144209721","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

Comparison of Ultrasonography with Computed Tomography in Diagnosis and Staging of Lung Cancer. 超声与ct在肺癌诊断与分期中的比较。

Kathmandu University Medical Journal Pub Date : 2024-10-01

S Paudel, P Kayastha, S Suwal, B Nepal, K R Bhusal, S Katwal, P R Regmi

{"title":"Comparison of Ultrasonography with Computed Tomography in Diagnosis and Staging of Lung Cancer.","authors":"S Paudel, P Kayastha, S Suwal, B Nepal, K R Bhusal, S Katwal, P R Regmi","doi":"","DOIUrl":"","url":null,"abstract":"Background Ultrasound (US) can aid in lung cancer diagnosis and staging in peripheral-based lesions by demonstrating chest wall invasion, aiding as a guide to biopsy, and detecting supraclavicular lymph nodes which are often missed by computed tomography (CT). Objective This study is to compare the ultrasound with computed tomography in the diagnosis and staging of lung cancer. Method This was an observational prospective study conducted from October 2020 to April 2023 in patients with or suspected lung cancer sent for imaging assessment to the Department of Radiology and Imaging. Out of 306 patients who underwent computed tomography scan, a total of 234 patients with proven lung cancer were subjected to ultrasound of the chest, liver, bilateral adrenal, and supraclavicular regions for the evaluation of lung mass, pleural effusion, and metastasis in lung, adrenal, and supraclavicular lymph nodes. Diagnostic values of ultrasound to detect peripheral lung lesions, chest wall invasion, pleural effusion, liver and adrenal metastasis, and supraclavicular lymph nodes were compared with contrast-enhanced computed tomography scans. Ultrasound's performance was evaluated against computed tomography scans as the gold standard, using the chi-square test, z-test, and area under the curve for comparison (p < 0.05 for significance). Result The majority of patients (53.8%, n=126) were aged 61-75, with 53% being male and 89% smokers. Ultrasound was superior in detecting pleural effusion (sensitivity 80.3%, NPV 92.2%, AUC 0.860) and supraclavicular lymph nodes (sensitivity 72.2%, NPV 91.6%, AUC 0.817). Conclusion In resource-constrained settings like Nepal, where advanced imaging may be limited, integrating ultrasound with contrast-enhanced computed tomography significantly improves lung cancer diagnosis. This non-radiation approach is particularly beneficial for peripheral lesions, patients with renal function impairment and aiding effective staging of lung cancer.","PeriodicalId":35493,"journal":{"name":"Kathmandu University Medical Journal","volume":"22 88","pages":"361-366"},"PeriodicalIF":0.0,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144209710","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