Kathmandu University Medical Journal最新文献_第6页

Central Pancreatectomy for Bilobed Solid Pseudopapillary Tumor of Pancreas. 胰腺双叶实性假乳头状瘤的中央胰腺切除术

Kathmandu University Medical Journal Pub Date : 2023-07-01

M K Jha, R Ramtel, B Adhikari, U Laudari, A Thapa, S B Rawal

引用次数: 0

Predicting Complicated Appendicitis Based on Neutrophil to Lymphocyte Ratio, A Study in University Hospital of Nepal. 根据中性粒细胞与淋巴细胞比率预测并发阑尾炎，尼泊尔大学医院的一项研究。

Kathmandu University Medical Journal Pub Date : 2023-07-01

B Shrestha, R Koju, S Makaju Shrestha, K Shrestha, G Hada, Y R Shakya, R M Karmacharya, B R Malla

{"title":"Predicting Complicated Appendicitis Based on Neutrophil to Lymphocyte Ratio, A Study in University Hospital of Nepal.","authors":"B Shrestha, R Koju, S Makaju Shrestha, K Shrestha, G Hada, Y R Shakya, R M Karmacharya, B R Malla","doi":"","DOIUrl":"","url":null,"abstract":"Background Acute appendicitis is one of the most common causes of acute abdomen requiring surgical treatment. Accurately diagnosing appendicitis and identifying complicated appendicitis can be difficult at times. Objective To evaluate the ability of the neutrophil-to-lymphocyte ratio (NLR) to differentiate between uncomplicated and complicated appendicitis. Method This was a prospective hospital-based observational study conducted at the Department of Surgery, Dhulikhel Hospital, Kathmandu University Hospital from July 2021 to December 2022. Patients with the clinical diagnosis of acute appendicitis who had undergone emergency appendectomy were included in the study. Informed consent was taken from each patient and data collection was done by filling the proforma. Result A total of 218 patients were included in the study. Male: female ratio was 1.18:1. Mean age of patients was 28.58 ± 16.65 (3-78) years. A significant correlation was found between increasing neutrophil count and neutrophil-to-lymphocyte ratio with complicated appendicitis. However, no significant correlation was found between White Blood Cell counts and complicated appendicitis. Neutrophil-to-lymphocyte ratio > 12.6 was found to be associated with complicated appendicitis. Conclusion A simple, cost-effective, and yet perfect test is not available for identifying complicated appendicitis. Increased Neutrophil count and neutrophil-to-lymphocyte ratio can indicate complicated appendicitis. Elevated WBC counts alone has no role in differentiating complicated appendicitis. According to the results of our study, an neutrophil-to-lymphocyte ratio of 12.6 can help to differentiate complicated from uncomplicated appendicitis.","PeriodicalId":35493,"journal":{"name":"Kathmandu University Medical Journal","volume":"21 83","pages":"270-274"},"PeriodicalIF":0.0,"publicationDate":"2023-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142112888","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

Restoration of Severely Damaged Tooth by Zirconia based Endocrown: Case Series. 用氧化锆内冠修复严重受损的牙齿：病例系列。

Kathmandu University Medical Journal Pub Date : 2023-07-01

C Q Huong, N M Duc, T D Hai

引用次数: 0

Thyroid Hormone Abnormalities and Associated Risk Factors among Acute Coronary Syndrome Patients at a Tertiary Care Hospital. 一家三级医院急性冠状动脉综合征患者的甲状腺激素异常及其相关风险因素

Kathmandu University Medical Journal Pub Date : 2023-07-01

R K Shreewastav, S P Dhungana, S Pokhrel, R Jayshwal, H Pandey

{"title":"Thyroid Hormone Abnormalities and Associated Risk Factors among Acute Coronary Syndrome Patients at a Tertiary Care Hospital.","authors":"R K Shreewastav, S P Dhungana, S Pokhrel, R Jayshwal, H Pandey","doi":"","DOIUrl":"","url":null,"abstract":"Background Thyroid dysfunction and associated factors like age, sex, diabetes mellitus, hypertension, smoking, family history of coronary artery disease and dyslipidemia contributes the risk for acute coronary syndrome. Objective To find out the prevalence of thyroid dysfunction and associated risk factors among acute coronary syndrome patients at this tertiary care hospital in eastern Nepal. Method A descriptive cross-sectional study was carried out prospectively among acute coronary syndrome patients at a tertiary care Hospital. Diagnosis of acute coronary syndrome was made based on the medical history, Electrocardiogram abnormalities, and cardiac markers. Thyroid function test and estimation of other blood parameters were done in the blood of the patients. Other relevant information and medical history of the patients were collected by using proforma. Result Out of 186 total acute coronary syndrome patients, 127 (68.28%) were male and mean age of all patients was 60.0 ± 13.7 years. Thyroid dysfunction was observed in 52 (27.95%) patients, out of that subclinical hypothyroidism was mostly seen in 30 (16.12%) patients followed by hypothyroidism in 13 (6.98%). The number of patients with hyperthyroidism and subclinical hyperthyroidism was 6 (3.23%) and 3 (1.62%) respectively. Associated factors like hypertension, diabetes mellitus, smoking, family history of coronary artery disease and dyslipidemia was observed in 80 (43.01%), 42 (22.58%), 83 (44.62%), 11 (5.91%) and 79 (42.47%) patients. Conclusion Acute coronary syndrome was predominantly seen in male and subclinical hypothyroidism was a major thyroid dysfunction observed among the patients. Hypertension, dyslipidemia, diabetes mellitus and smoking was found to be associated in a proportion of patients with acute coronary syndrome.","PeriodicalId":35493,"journal":{"name":"Kathmandu University Medical Journal","volume":"21 83","pages":"309-314"},"PeriodicalIF":0.0,"publicationDate":"2023-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142112906","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

Pagetoid Squamous Cell Carcinoma In-Situ of Esophagus. 食管鳞状细胞原位癌（Pagetoid Squamous Cell Carcinoma In-Situ of Esophagus）。

Kathmandu University Medical Journal Pub Date : 2023-07-01

A Priyadarshinee, B Bhattacharya

{"title":"Pagetoid Squamous Cell Carcinoma In-Situ of Esophagus.","authors":"A Priyadarshinee, B Bhattacharya","doi":"","DOIUrl":"","url":null,"abstract":"Squamous cell carcinoma (SCC) is the most common malignant tumor of the esophagus, however, pagetoid SCCIS is an extremely rare condition in esophagus.1 Pagetoid Squamous Cell Carcinoma In-Situ (SCCIS) has been described in skin and external genitalia frequently.2 Herein we report a case of pagetoid squamous cell carcinoma in-situ in a 50-year-old male with clinical information, histopathological and immunohistochemical findings. The patient was a 50 years male with dyspepsia,refractory to proton pump inhibitors (PPIs). In upper gastroduodenal endoscopy, there was no obvious lesion in the esophagus and only mild erythema was noted. Biopsy showed a surprising finding of full thickness high grade squamous dysplasia in the lining squamous epithelium with scattered single large atypical cells. These cells were present away from the foci of dysplasia. The cells were large and showed marked pleomorphism, vesicular nuclei, prominent nucleoli and abundant pale to eosinophilic cytoplasm. Immunohistochemistry (IHC) was positive for p63 and p53, which confirmed the diagnosis of pagetoid SCCIS. Pagetoid squamous cell carcinoma in-situ is one of the rare entities with subtle clinical presentation and endoscopic findings. Evaluation of this case signifies the importance of taking biopsies in the lesions which shows minimal mucosal change in the endoscopy.","PeriodicalId":35493,"journal":{"name":"Kathmandu University Medical Journal","volume":"21 83","pages":"340-341"},"PeriodicalIF":0.0,"publicationDate":"2023-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142112886","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

Public Awareness and Attitude towards COVID-19 Infection and Vaccines: A cross-sectional national survey in Nepal. 公众对 COVID-19 感染和疫苗的认识和态度：尼泊尔全国横断面调查。

Kathmandu University Medical Journal Pub Date : 2023-07-01

S Pant, S Bhattarai, K Ranabhat, S P Dumre, B Rajbhandari, A Mudvari, B Bista, R Bhandari, S K Adhikari, M Dhimal, P Gyanwali

{"title":"Public Awareness and Attitude towards COVID-19 Infection and Vaccines: A cross-sectional national survey in Nepal.","authors":"S Pant, S Bhattarai, K Ranabhat, S P Dumre, B Rajbhandari, A Mudvari, B Bista, R Bhandari, S K Adhikari, M Dhimal, P Gyanwali","doi":"","DOIUrl":"","url":null,"abstract":"Background To combat COVID-19, high vaccination rates are essential. However, challenges such as vaccine denial, lack of knowledge, and negative attitudes hinder progress. Assessing public understanding of vaccination is crucial to promote acceptance and reducing reluctance. Objective To understand people's awareness and attitude regarding COVID-19 infection and vaccines in Nepal. Method A cross-sectional web-based survey was conducted among the Nepali population of age 18 years and above in April 2021 during the early phase of vaccination deployment. A structured questionnaire was used to collect awareness data, and a five-point Likert scale was employed to assess participants' attitudes. The survey categorized participants into two groups based on whether their awareness level or attitude score was above or below the mean. The secondary outcome was the association between socio-demographic factors and COVID-19 awareness or attitude. Result Of 475 eligible participants, 46% had a low level of awareness on COVID-19 infection whereas 56% had low awareness on COVID-19 vaccines. Every six out of ten participants had a positive attitude towards the national COVID-19 vaccination program. Most of the participants had high awareness of COVID-19 symptoms and preventive measures (hand hygiene, physical distancing, mask), but two-thirds had a false perception of vaccine safety and contraindications. People's education status, occupation, province, and current/prior COVID-19 infection status were found to be significantly associated with their awareness regarding COVID-19 disease or vaccines. Conclusion The study revealed limited COVID-19 awareness among the Nepali population but a positive attitude toward the national vaccination program. Regular updates on COVID-19 and vaccines are important as new variants and vaccines emerge.","PeriodicalId":35493,"journal":{"name":"Kathmandu University Medical Journal","volume":"21 83","pages":"286-292"},"PeriodicalIF":0.0,"publicationDate":"2023-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142112891","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

Simple Oncoplastic Breast Conserving Surgery for Breast Cancer in a University Hospital. 一家大学医院针对乳腺癌的简单肿瘤整形保乳手术。

Kathmandu University Medical Journal Pub Date : 2023-07-01

S Khanal, N Singh, Y P Singh

引用次数: 0

Fahr's Disease: A Rare Neurological Disorder Associated with Secondary Cause. 法尔氏病：一种罕见的继发性神经系统疾病。

Kathmandu University Medical Journal Pub Date : 2023-07-01

Y Bhatta, A Malla, A K Chaurasiya, B R Pokharel

引用次数: 0

Outcome Analysis of Termination of Pregnancy in Second Trimester. 第二孕期终止妊娠的结果分析。

Kathmandu University Medical Journal Pub Date : 2023-07-01

H Rijal, P Koirala

{"title":"Outcome Analysis of Termination of Pregnancy in Second Trimester.","authors":"H Rijal, P Koirala","doi":"","DOIUrl":"","url":null,"abstract":"Background Second-trimester abortions, constitute 10-15% of global annual abortions, leading to two-thirds of major abortion-related complications. Recognizing the elevated risk, the WHO recommends diverse methods for safe termination. Surgical and medical approaches, particularly using drugs like Mifepristone and Misoprostol, show promising success rates. Objective To analyze the outcomes of second-trimester termination using Mifepristone or PG analogues alone or in combination. Method This is a one-year retrospective study at Tribhuvan University Teaching Hospital analyzing second-trimester terminations, collecting data on demographics, medical history, period of gestation, doses of abotificient drugs, complications, and management. Result In a study of 66 second-trimester abortions, mean age was 28.8±4.96 years, gestational age 20.07±4.3 weeks. Mifepristone and Misoprostol combination succeeded in 66.7% of cases, while 42.2% required repeated Mifepristone doses. Misoprostol use was significantly higher in patients without medical comorbidities (p=0.018), but Mifepristone requirement didn't differ significantly based on medical conditions. Combined Mifepristone and Misoprostol were used more for fetal indications. Notably, the use of Mifepristone and Misoprostol didn't significantly differ for live and intrauterine fetal death cases. Conclusion Mifepristone and Misoprostol effectively terminate second-trimester pregnancies. In high-risk cases, cautious Prostaglandin use is crucial and Mifepristone alone, in divided doses, reduces complications with high success.","PeriodicalId":35493,"journal":{"name":"Kathmandu University Medical Journal","volume":"21 83","pages":"315-319"},"PeriodicalIF":0.0,"publicationDate":"2023-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142112884","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

Outcomes of Microvascular Free Flap Reconstruction after Major Head and Neck Ablative Surgery at a Tertiary Teaching Hospital in Eastern Nepal. 尼泊尔东部一家三级教学医院头颈部大面积消融手术后的微血管游离皮瓣重建效果。

Kathmandu University Medical Journal Pub Date : 2023-07-01

B P Sah, D Paudel, D P Sarraf

{"title":"Outcomes of Microvascular Free Flap Reconstruction after Major Head and Neck Ablative Surgery at a Tertiary Teaching Hospital in Eastern Nepal.","authors":"B P Sah, D Paudel, D P Sarraf","doi":"","DOIUrl":"","url":null,"abstract":"Background Reconstruction with free flaps has significantly changed the outcome of patients with head and neck cancer. Microsurgery is still considered a specialized procedure and is not routinely performed in the resource-constrained environment of developing country like Nepal. Objective To evaluate the clinical outcomes in patients who underwent different microvascular free flap reconstructions of head and neck defects after major ablative surgery. Method A retrospective study was conducted to review and analyze the data of patients with head and neck cancer who underwent microvascular free flap reconstruction after major ablative surgery from November 2017 to April 2021. The descriptive statistics were calculated using Microsoft Excel 2010. Result Out of 207 patients, 129 (62.32%) were males. Mean age was of 55.17±13.44 years. About 133 (64.25%) tumors were on gingivobuccal complex. Anterolateral thigh flap was the most common flap 112, (54.11%) used for the reconstruction. Facial artery was used in 174 (84.06%) patients for anastomosis. The overall success rate was 97.5%. Re-exploration was done in 22 (10.63%) cases out of which 11 (50%) cases were having flap compromise. Delayed flap failure occurred in 5 cases (2.5%) and salvage surgery was done with pectoralis major myocutanuos flap with a salvage rate of 54%. Minor complications were observed in 39 cases (18.84%) out of which donor site graft loss was observed in 19 (9.18%) patients. Conclusion In spite of advanced set up, with trained dedicated manpower the microvascular free flap reconstruction of head and neck defects is safe with high success rate even in resource constrained country like Nepal.","PeriodicalId":35493,"journal":{"name":"Kathmandu University Medical Journal","volume":"21 83","pages":"265-269"},"PeriodicalIF":0.0,"publicationDate":"2023-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142112885","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