Kathmandu University Medical Journal最新文献

{"title":"Angiomyolipoma of Nasal Cavity - A rare clinical entity.","authors":"K S Shrestha, B L Shrestha, B Sapkota, S B Ghimire, P Shrestha","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>Angiomyolipomas (AML) are benign mesenchymal tumour with varying proportion of matured fat cells, thick walled vessels and smooth muscle cells. Nasal angiomyolipomas are exceedingly rare and usually present as small tumour in middle aged and old men. This is a case of 86 years old male who presented in the ENT OPD with the swelling in the right nasolabial fold for 2 months. He underwent excision of the mass under general anesthesia and the histopathological examination proved to be angiomyolipoma of nose.</p>","PeriodicalId":35493,"journal":{"name":"Kathmandu University Medical Journal","volume":"22 87","pages":"350-352"},"PeriodicalIF":0.0,"publicationDate":"2024-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144200167","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":"Current Understanding of Emergency Medicine and Knowledge, Practice, and Attitude toward Disaster Preparedness and Management among Healthcare Workers in Nepal.","authors":"Y R Shakya, J N Patel, R Shrestha, S Shakya Shrestha, R Dangal, B Pradhan, J Pandya, S Basnet","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>Background Disasters are serious disruptions to a community's functioning that exceed its capacity to cope using its resources. Natural, man-made, technological hazards and other factors may cause disasters and influence a community's exposure and vulnerability. Objective To assess the knowledge, practice, and attitude of healthcare workers in Nepal regarding disaster preparedness and management for emergencies. Method A retrospective study was conducted among healthcare workers in Nepal registered for the 1st World Academic Council of Emergency Medicine- Table-top Exercise and Communication in Disaster Medicine conference as participants or faculty. Information was collected using total enumeration sampling and a questionnaire developed from a literature review and the questionnaire was adapted from the Emergency Preparedness Information Questionnaire (EPIQ). Percentages, means, and medians were calculated for socio-demographic data, knowledge, practices, and attitudes toward emergency preparedness. A chi-square test assessed associations between socio-demographic characteristics, emergency procedures, and familiarity scores on the preparedness questionnaire. Result A total of 118 participants took part in the study, most with over six months of emergency department experience. There was a significant association between work experience and emergency procedure status ((ꭓ2=6.982, p=0.008), and between education level and familiarity with disaster management (ꭓ2=5.507, p=0.019). However, there was a low correlation (r=0.140, p=0.129) between emergency procedure status and disaster management familiarity. Conclusion Emergency preparedness is crucial for life-saving in disasters. The availability of emergency services and skills related to emergency preparedness and disaster management are crucial for saving lives in emergency conditions. The hospital should provide emergency preparedness and disaster management training to all healthcare workers. In addition, the hospital authority should perform disaster exercises/tabletop simulation exercises or drills periodically.</p>","PeriodicalId":35493,"journal":{"name":"Kathmandu University Medical Journal","volume":"22 87","pages":"290-295"},"PeriodicalIF":0.0,"publicationDate":"2024-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144200170","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 Hamular Notch-Incisive Papilla Plane as a Useful Reference in Establishing the Occlusal Plane.","authors":"P Ghimire, R K Singh, P Suwal, A H Rijal, B B Basnet","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>Background Establishment of occlusal plane with hamular notch- incisive papilla plane as a useful reference helps to reduce the chairside time taken for jaw relation during complete denture fabrication. Objective To determine the hamular notch-incisive papilla plane (HIP) as a useful reference plane in establishing the occlusal plane. Method This cross-sectional analytical study was conducted among 100 dental students by obtaining the maxillary cast from an impression made. The data collected were entered and analyzed using SPSS version 21. Paired t-test, Independent t-test and Pearson correlation was applied for statistical analysis. Result The vertical distance from hamular notch-incisive papilla plane and occlusal plane at the level of mesio-incisal line angle of maxillary central incisor and mesio-palatal cusp tips of maxillary first molar showed statistically significant difference (p < 0.001) on both right and left sides. There was statistically significant difference (p < 0.05) between hamular notch-incisive papilla plane and occlusal plane on right and left sides, between right and left mesio-palatal cusp tips of maxillary central incisors from hamular notch-incisive papilla plane. Hamular notch-incisive papilla plane, mesioincisal line angle of right maxillary central incisor and mesio-incisal line angle of left maxillary central incisor had mild but significant correlation with age. The parallelism between hamular notch-incisive papilla plane and occlusal plane within the range of 2 mm was 62% on right side and 75% on left side. Conclusion Hamular notch-incisive papilla plane can be used as a practical method for establishing the occlusal plane tentatively.</p>","PeriodicalId":35493,"journal":{"name":"Kathmandu University Medical Journal","volume":"22 87","pages":"325-330"},"PeriodicalIF":0.0,"publicationDate":"2024-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144200183","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":"Unilateral Pheochromocytoma in Von Hippel-Lindau Syndrome Revealed by a Hemangioblastoma.","authors":"S Kc, H Poudyal, S Baral","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>Von Hippel-Lindau (VHL) syndrome is characterized by the occurrence of both benign and malignant tumors, with typical manifestations such as cerebellar hemangioblastoma, Renal cell carcinoma (RCC) and pheochromocytomas.1 Additional tumors that may be associated include pancreatic cysts; neuroendocrine tumours; epididymal cysts and endolymphatic sac tumors.1 This case report details a 29-year-old male who arrived at the Emergency Department (ED) with a one-month history of headaches accompanied by dizziness and vomiting. A Computed Tomography (CT) scan of the head followed by Magnetic Resonance Imaging (MRI) suggested cerebellar hemangioblastoma. Further workup showed multiple tumors, including unilateral pheochromocytoma and pancreatic cysts, which aligned with a diagnosis of von Hippel-Lindau (VHL) syndrome. Notably, the patient's catecholamine and vanillylmandelic acid (VMA) levels were within normal limits. The patient underwent surgical intervention for the cerebellar hemangioblastoma, and the postoperative recovery was uneventful. This case is noteworthy due to its characteristic findings and the rarity of the condition.</p>","PeriodicalId":35493,"journal":{"name":"Kathmandu University Medical Journal","volume":"22 87","pages":"353-355"},"PeriodicalIF":0.0,"publicationDate":"2024-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144200193","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":"Hashimoto's Thyroiditis with Squamous Metaplasia.","authors":"S Dahal, R Makaju, D Basnet, B Dhakal, B Shrestha, P B Maharjan","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>Hashimoto's thyroiditis is an autoimmune inflammatory disease. Although rare, squamous metaplasia can be seen in Hashimoto's thyroiditis. We present a case of 19 years female who presented with chief complaint of anterior neck swelling for three months. Thyroid Stimulating Hormone (TSH) was 3.93 mIU/L. Ultrasonography neck showed TIRADS (Thyroid Imaging Reporting and Data Systems) 5 lesion. Fine Needle Aspiration Cytology showed Papillary Thyroid Carcinoma. Histopathological examination revealed numerous lymphoid follicles of variable size with clusters of squamous metaplastic cells within the germinal centers of lymphoid follicles and surrounding fibrosis. Some cells showed nuclear clearing. Diagnosis of Hashimoto's thyroiditis with squamous metaplasia was further confirmed by immunohistochemistry. The case presented here is rare and there are very few cases reported in literature so far.</p>","PeriodicalId":35493,"journal":{"name":"Kathmandu University Medical Journal","volume":"22 87","pages":"356-358"},"PeriodicalIF":0.0,"publicationDate":"2024-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144200184","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":"A Comprehensive Approach to Juvenile Angiofibroma:Diagnosis, Staging, and Surgical Management.","authors":"B L Shrestha, P Shrestha","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>Juvenile angiofibroma of nasopharynx is a benign but locally aggressive tumor predominantly affecting adolescent males, characterized by hypervascular growth in the nasopharynx. Early diagnosis and appropriate management are crucial to prevent complications. Symptoms typically include nasal obstruction, epistaxis, and hearing loss. Imaging techniques, such as contrast-enhanced CT and MRI, play a pivotal role in assessing tumor size, vascularity, and involvement of surrounding structures. Angiography, followed by embolization, is commonly used to reduce intraoperative bleeding risk. The treatment of choice is surgical resection, which can be performed via an endonasal, transpalatal, or combined approach, depending on tumor extent. In cases of inoperable tumors or recurrence, radiation therapy may be considered. Although nasopharyngeal juvenile angiofibroma has a favorable prognosis when treated early, close monitoring for recurrence is necessary, as it can reappear even years after surgery. Multidisciplinary management involving otolaryngologists, radiologists, and oncologists is essential for optimal outcomes.</p>","PeriodicalId":35493,"journal":{"name":"Kathmandu University Medical Journal","volume":"22 87","pages":"340-345"},"PeriodicalIF":0.0,"publicationDate":"2024-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144200165","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":"Aberrant Shape of the Heart, \"Gourd Shaped\": A Rare Case of Localized Constrictive Pericarditis.","authors":"S Rajbhandari, S Joshi, N Bhattarai, P Kc, P Rajthala, S Khadka, N P Neupane, M Aryal, K Rajlawot","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>Calcific constrictive pericarditis results commonly from the tubercular lesions in developing countries. The localized calcifications associated with the calcific constrictive pericarditis on its own is rare and the calcification along the atrioventricular groove distorting the heart to a shape of gourd is extremely rare. We present a case to highlight the importance of the early diagnosis of the condition. We have approached the patient with echocardiography and commuted tomography for the diagnosis and hemodynamic evaluation. Early treatment is equally important for this condition, as the calcific constrictive pericarditis is curable with pericardiectomy. However, there lacks a clear consensus for the pericardiectomy in patients with localized calcification and medical therapy can be initiated.</p>","PeriodicalId":35493,"journal":{"name":"Kathmandu University Medical Journal","volume":"22 87","pages":"346-349"},"PeriodicalIF":0.0,"publicationDate":"2024-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144200166","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":"Co-infection of COVID-19 with Malaria and Dengue -A Hospital based Study in Kathmandu, Nepal.","authors":"B Bajracharya, P Shrestha, D Shrestha, A K Karna, R K Mahato, S Shrestha, B Baral, P Bhandari, P Sah, A Bastola, B D Pandey","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>Background In tropical countries like Nepal, the COVID-19 pandemic unfolded within a population already grappling with various tropical infectious diseases. Co-infection with malaria and dengue holds clinical significance when managing COVID-19 patients in regions endemic to these diseases. Objective To identify malaria and dengue infections in febrile or symptomatic patients suspected of COVID-19 at the Sukraraj Tropical and Infectious Disease Hospital, Kathmandu. Method Over two months, a prospective study was conducted on febrile or symptomatic patients suspected of COVID-19 visiting Sukraraj Tropical and Infectious Disease Hospital, Kathmandu. One hundred and twenty-three patients suspected of COVID-19 were tested for SARS-CoV-2 through RT-PCR as well as for malaria and dengue infection using rapid diagnostic test kits. Result Out of 123 patients suspected of COVID-19, 64 were confirmed to have COVID-19. No evidence of SARS-CoV-2 and malaria co-infection was found among the 123 tested patients. However, two patients admitted for COVID-19 tested positive for dengue virus infection. The patients with co-infections with dengue or scrub typhus were likely to have a longer hospital stays (OR 2.5; 95% CI: 0.22-29.26), though lacking a significant association. Conclusion The two patients diagnosed with dengue virus and SARS-CoV-2 were identified during their hospital visit and both recovered after receiving treatment. Given that COVID-19 patients manifest symptoms resembling many tropical infectious diseases, the study underscores the clinical importance of testing for multiple circulating infections in patients from endemic areas. This approach ensures appropriate and timely management reducing the risk of severity or mortality.</p>","PeriodicalId":35493,"journal":{"name":"Kathmandu University Medical Journal","volume":"22 87","pages":"254-259"},"PeriodicalIF":0.0,"publicationDate":"2024-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144200168","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":"What's Shaping Medical Student's Attitude Towards Lesbian, Gay, Bisexual, And Transgender (LGBT) Community?","authors":"S Roy, L Bandyopadhyay, A Chakraborty, M Sahu, B Paul, R Kumar","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>Background Lesbian, Gay, Bisexual, and Transgender (LGBT) people form the basis of sexual and gender minority groups who face discrimination in their daily lives, including in healthcare facilities even though they are quite vulnerable to certain health problems. Medical student's attitudes towards the Lesbian, Gay, Bisexual, And Transgender community greatly shape the healthcare service delivery as well as service utilization by them, thus influencing their health status in the long run. Objective To find out the knowledge, attitude, judgment, and experience of a medical student regarding the Lesbian, Gay, Bisexual, And Transgender community and its associated factors. Method This institution-based Cross-Sectional study approved by the Institutional Ethics Committee was conducted among 216 medical undergraduates of a medical college from October 2022 to February 2023 after a pilot study. Sampling was done by Stratified Random Sampling. Data were collected anonymously by using an online questionnaire. Data were analyzed via Statistical Package for Social Sciences (SPSS) software using univariate and multivariable logistic regression. Result Only 37.5% of medical students had sufficient knowledge regarding the Lesbian, Gay, Bisexual, And Transgender community (mean knowledge score 69.26 ± 14.6). Upper socio-economic class students had a more positive judgment (p-value: 0.012) and positive experience (p-value: 0.040). The presence of personal contact made a significant difference in attitude (p-value: 0.001), judgment (p-value: 0.012), and experience (p-value < 0.001). Conclusion The overall attitude of medical students regarding the Lesbian, Gay, Bisexual, And Transgender community was inadequate. Their knowledge and attitude were most positively affected by any personal contact with the Lesbian, Gay, Bisexual, And Transgender community thus peer-to-peer counseling among medical students might be helpful to shed conservative attitudes and be more open-minded.</p>","PeriodicalId":35493,"journal":{"name":"Kathmandu University Medical Journal","volume":"22 87","pages":"331-336"},"PeriodicalIF":0.0,"publicationDate":"2024-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144200211","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":"Root Canal Morphology of Mandibular Premolars in a Nepalese Population: A Cone-Beam Computed Tomographic Study.","authors":"A Chakradhar, M Nepal, S P Pradhan, H Bali, R Napit","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>Background Mandibular premolars are the most challenging teeth to treat endodontically because of their variability in morphological and internal anatomical features. The knowledge of root canal morphology and its variation is crucial for the endodontic success. Objective To evaluate the root and canal morphology of mandibular premolars in a Nepalese population by using Cone Beam Computed Tomography. Method A total of 1924 mandibular first and second premolar teeth from 481 patients were evaluated. The number of roots and canal configuration were identified and categorized according to Vertucci's classification. An association between number of roots and root canal configuration with gender and ethnic group was evaluated. Also, the bilateral symmetrical occurrence of root and canal configuration were investigated. Result Majority of mandibular first premolars (86.7%) and second premolars (98.7%) were single rooted with type I root canal configuration followed by type V (8.6%) in first premolars and type III (0.6%) in second premolars while 3.8% of first premolars and 0.6% of second premolars were two rooted. In first premolars, there was an association between gender with number of roots (p-value = 0.007) and root canal configuration (p-value < 0.001). High degree of bilateral symmetry was seen in both first (85.4%) and second premolars (96.9%) in terms of the number of roots and canal configuration. Conclusion Most of the mandibular premolars were single rooted with Type I canal configuration. However, clinicians should be aware of the variations that may be encountered during routine endodontics which may influence the success behind treatment.</p>","PeriodicalId":35493,"journal":{"name":"Kathmandu University Medical Journal","volume":"22 87","pages":"265-270"},"PeriodicalIF":0.0,"publicationDate":"2024-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144200189","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}