JNMA; journal of the Nepal Medical Association最新文献_第3页

Nepal Health Conclave 2024: Coordinating Diaspora for Healthcare Strengthening. 尼泊尔卫生秘密会议2024：协调侨民加强医疗保健。

JNMA; journal of the Nepal Medical Association Pub Date : 2025-02-01 Epub Date: 2025-02-28 DOI: 10.31729/jnma.8886

Madhusudan Subedi

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Giant Cell Tumor of Hoffa's Fat Pad: A Case Report. 霍法氏脂肪垫巨细胞瘤1例报告。

JNMA; journal of the Nepal Medical Association Pub Date : 2025-02-01 Epub Date: 2025-02-28 DOI: 10.31729/jnma.8888

Rupesh Kumar Vaidya, Prabal Pradhan, Karishma Malla Vaidya

引用次数: 0

Lymph node Yield in Apical Tissue During Triangle Operation While Doing Whipples Operation: An Observational Study. Whipples手术时三角手术中根尖组织淋巴结产量的观察研究。

JNMA; journal of the Nepal Medical Association Pub Date : 2025-02-01 Epub Date: 2025-02-28 DOI: 10.31729/jnma.8887

Dhiresh Kumar Maharjan, Prashanta Pudasaini, Bidur Prasad Acharya, Yugal Limbu, Roshan Ghimire, Prabin Bikram Thapa

{"title":"Lymph node Yield in Apical Tissue During Triangle Operation While Doing Whipples Operation: An Observational Study.","authors":"Dhiresh Kumar Maharjan, Prashanta Pudasaini, Bidur Prasad Acharya, Yugal Limbu, Roshan Ghimire, Prabin Bikram Thapa","doi":"10.31729/jnma.8887","DOIUrl":"10.31729/jnma.8887","url":null,"abstract":"Introduction: The \"TRIANGLE operation\" involves the en-bloc removal of the tumor and the entire \"mesopancreas\" from the triangle-shaped space bounded by the superior mesenteric artery, coeliac trunk, and portal vein. This study assessed lymph node yield in apical tissue during the triangle operation.Methods: An observational cross-section study was conducted for two years at the Department of Gastrointestinal and General Surgery at a tertiary care center of Nepal. from 15th March 2022 to 15th March 2024. The operative procedure included pancreaticoduodenectomy or Whipple's operation. Total sampling was done. Postoperative outcome and lymph node yeild of the surgeries were studied. Ethical approval was taken from the Institutional Review Committee (Reference No-1102202204).Results: A total of 56 patients underwent pancreaticoduodenectomy along with a triangle operation. The mean age of the patients was 56.38±14.79 years. Male: Female ratio was 1.2:1. Mean preoperative BMI was 24.41±4.72. The mean total lymph node yield was 20.95±8.57. Nineteen patients had a positive lymph node yield in the triangle tissue. The mean triangle lymph node yield was 10.59±4.92, and the mean positive lymph node was 2.58±1.64. Among 56 patients, nine patients had both apical margin and the rest of the triangle tissue margin positive. Ten patients had negative apical tissue margins, but the rest of the triangle tissue was positive, whereas, in thirty-seven patients, both the apical tissue and the rest of the triangle circumferential resection margin tissue were negative.Conclusions: This study emphasizes the importance of the inclusion of apical tissue dissection at the confluence of SMA and coeliac trunk to achieve R0 resection. However, a long-term follow is awaited.","PeriodicalId":520657,"journal":{"name":"JNMA; journal of the Nepal Medical Association","volume":"63 282","pages":"103-108"},"PeriodicalIF":0.0,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11930294/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144629373","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Prevalence of Osteoporosis in Patients with Distal Radius Fracture from Low-energy Trauma: An Observational Study. 低能量创伤桡骨远端骨折患者骨质疏松的发生率：一项观察性研究。

JNMA; journal of the Nepal Medical Association Pub Date : 2025-02-01 Epub Date: 2025-02-28 DOI: 10.31729/jnma.8884

Manoj Kandel, Sarik Kumar Shrestha, Krishna Prasad Paudel, Sunil Panta, Deepak Banjade, Ramesh Syangtan, Sushil Thapa

{"title":"Prevalence of Osteoporosis in Patients with Distal Radius Fracture from Low-energy Trauma: An Observational Study.","authors":"Manoj Kandel, Sarik Kumar Shrestha, Krishna Prasad Paudel, Sunil Panta, Deepak Banjade, Ramesh Syangtan, Sushil Thapa","doi":"10.31729/jnma.8884","DOIUrl":"10.31729/jnma.8884","url":null,"abstract":"Introduction: Osteoporosis is characterized by low bone mass, leading to enhanced bone fragility. Low-energy fractures of distal radius are related to osteoporosis and is therefore related to increased risk of subsequent hip fractures. The objective of this study was to study the prevalence of osteoporosis in patients with distal radius fracture from low-energy trauma. This will emphasise the need to investigate these patients for osteoporosis and make practitioners should be aware of the possibility of osteoporosis in such patients.Methods: This observational cross-section study evaluated the prevalence of osteoporosis in patients with distal radius fracture from low-energy trauma among patients presenting to tertiary level hospital of Nepal from October 2022 to September 2023. The participants' demographic data, mechanism of injury, BMD values and T-score values were recorded and diagnosis of osteoporosis and osteopenia was made according to WHO diagnostic criteria. Ethical approval was taken from Institutional Review Committee (Reference Number: 079/80-015).Results: The study involved 96 patients with mean age of 68.27±4.09 years. The mean BMD among the participants was 0.69±0.02 and the mean T-score was -2.75±0.23. Diagnosis of osteoporosis was made in 88 (91.67%) patients and diagnosis of osteopenia was made in 8 (8.33%) patients based on the T-score using the WHO criteria. Of the 88 (91.67%) patients who met the diagnosis of osteoporosis, only 45 (46.88%) patients had started treatment with bisphosphonates for osteoporosis.Conclusions: We have found a high prevalence of osteoporosis among patients with low-energy distal radius fracture.","PeriodicalId":520657,"journal":{"name":"JNMA; journal of the Nepal Medical Association","volume":"63 282","pages":"93-97"},"PeriodicalIF":0.0,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11930303/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144629377","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Klippel-Trenaunay Syndrome in the Distal Part of the Unilateral Upper Limb and Venous Deficiency: A Case Report. 单侧上肢远端Klippel-Trenaunay综合征及静脉缺乏1例报告。

JNMA; journal of the Nepal Medical Association Pub Date : 2025-02-01 Epub Date: 2025-02-28 DOI: 10.31729/jnma.8892

Beenu Maharjan, Lian Liu, Xu Liu, Qingfeng Liu, Xian Jiang

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Pediatric Appendicitis Score and Ultrasound in children with Acute Appendicitis: An Observational Study. 急性阑尾炎儿童阑尾炎评分和超声：一项观察性研究。

JNMA; journal of the Nepal Medical Association Pub Date : 2025-02-01 Epub Date: 2025-02-28 DOI: 10.31729/jnma.8889

Suyog Simkhada, Bijay Thapa, Anupama Thapa Basnet, Sijan Karki

{"title":"Pediatric Appendicitis Score and Ultrasound in children with Acute Appendicitis: An Observational Study.","authors":"Suyog Simkhada, Bijay Thapa, Anupama Thapa Basnet, Sijan Karki","doi":"10.31729/jnma.8889","DOIUrl":"10.31729/jnma.8889","url":null,"abstract":"Introduction: Acute appendicitis is a common surgical emergency encountered in pediatric population. Differential diagnosis in this age group present with similar signs and symptoms. Clinical scoring system and Ultrasound imaging are helpful in diagnosing acute appendicitis and ruling out its differential diagnosis. This study was done to assess the findings of presence or absence of appendicitis in children based on the Pediatric Appendicitis Score (PAS) and ultrasound scan.Methods: An observational cross-section study was done from November 2023 to May 2024, in a tertiary level hospital, Kathmandu. All children between the ages of five and 14 years undergoing surgery for the provisional diagnosis of acute appendicitis were included in the study. The provisional diagnosis was based on a Pediatric appendicitis score and ultrasound. The diagnosis was confirmed by histopathology. Ethical approval was taken from Institutional Review Committee (Reference number: 811/2080/81).Results: A total of 50 children were included during the study period. A pediatric appendicitis score of more than seven, which is considered a high risk, was observed in 43 (86%) patients, and a score between four and six, which was considered an intermediate risk, was observed in 6 (12%) patients Similarly, 39 (78%) of the patient had appendix diameter more than six mm and 10 (20%) had less than six in ultrasound measurement.Conclusions: Both Pediatric Appendicitis Score and Ultrasonography can be used to diagnose acute appendicitis in children.","PeriodicalId":520657,"journal":{"name":"JNMA; journal of the Nepal Medical Association","volume":"63 282","pages":"109-113"},"PeriodicalIF":0.0,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11930293/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144629375","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Primary Intracranial Adenoid Cystic Carcinoma: A Case Report. 原发性颅内腺样囊性癌1例报告。

JNMA; journal of the Nepal Medical Association Pub Date : 2025-02-01 Epub Date: 2025-02-28 DOI: 10.31729/jnma.8890

Pralisha Maharjan, Gopi Aryal, Reena Rana

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Selective Conventional Approach for Management of Bleeding Uterine Arteriovenous Malformation: A Case Report. 选择性常规入路治疗出血性子宫动静脉畸形1例。

JNMA; journal of the Nepal Medical Association Pub Date : 2025-02-01 Epub Date: 2025-02-28 DOI: 10.31729/jnma.8891

Jyoti Dahal, Suman Raj Tamrakar, Rupesh Singh Basnyat

{"title":"Selective Conventional Approach for Management of Bleeding Uterine Arteriovenous Malformation: A Case Report.","authors":"Jyoti Dahal, Suman Raj Tamrakar, Rupesh Singh Basnyat","doi":"10.31729/jnma.8891","DOIUrl":"10.31729/jnma.8891","url":null,"abstract":"Uterine Arteriovenous malformation is an abnormal connection between artery and veins in the uterus. Although rare, it is an important cause of abnormal uterine bleeding in women and can lead to life threatening torrential hemorrhage. Traditionally such cases have been managed with medical therapy and hysterectomy. However, selective uterine artery embolization and hysteroscopy guided procedures are the treatment of choices. We hereby report a case of 25 years lady who presented with irregular heavy vaginal bleeding and diagnosed to have uterine arteriovenous malformation by magnetic resonance imaging. She was managed conventionally with condom tamponade during bleeding due to intrauterine procedure and later with hormonal therapy. The patient later had regular cycles avoiding hysterectomy at a young age. The objective of this case report is to share the successful application of uterine balloon tamponade (UBT) for the active management of bleeding uterine arteriovenous malformation which has not been reported so far which can be applied especially in a resource limited setup.","PeriodicalId":520657,"journal":{"name":"JNMA; journal of the Nepal Medical Association","volume":"63 282","pages":"120-122"},"PeriodicalIF":0.0,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11930300/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144629390","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Dengue and Scrub Typhus Co-infection at a Tertiary Care Centre in Nepal: A Case Series in Pediatric Patients. 尼泊尔三级保健中心的登革热和恙虫病合并感染：儿科患者病例系列。

JNMA; journal of the Nepal Medical Association Pub Date : 2025-02-01 Epub Date: 2025-02-28 DOI: 10.31729/jnma.8893

Sriram Kc, Bulbul Pradhan, Inesh Khanal, Aakripa Rani Shrestha

{"title":"Dengue and Scrub Typhus Co-infection at a Tertiary Care Centre in Nepal: A Case Series in Pediatric Patients.","authors":"Sriram Kc, Bulbul Pradhan, Inesh Khanal, Aakripa Rani Shrestha","doi":"10.31729/jnma.8893","DOIUrl":"10.31729/jnma.8893","url":null,"abstract":"This case series highlights four pediatric patients with coinfection of dengue fever and scrub typhus, presenting at Patan Hospital. Dengue fever is caused by flavivirus transmitted by Aedes mosquitoes, and scrub typhus is caused by Orientia tsutsugamushi transmitted by Leptotrombidium mites, which share overlapping symptoms such as fever, headache, and abdominal pain, complicating the diagnosis. The cases were from different geographical regions of Nepal with varied presentation: from febrile illness to severe manifestations like meningoencephalitis and raised intracranial pressure. Two patients presented with hepatosplenomegaly, one with severe rash, and another with pneumonia-like symptoms. Laboratory findings confirmed coinfection, and management included IV antibiotics, antipyretics, and supportive management. Complications such as thrombocytopenia, transaminitis, and allergic reactions required interventions. This case series highlights the importance of early suspicion and treatment of coinfection to reduce prolonged hospitalization and prevent end-organ dysfunction, and mortality, especially in endemic regions.","PeriodicalId":520657,"journal":{"name":"JNMA; journal of the Nepal Medical Association","volume":"63 282","pages":"127-131"},"PeriodicalIF":0.0,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11930301/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144629369","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Ultrasound-guided Hydrostatic Reduction of Acute Intussusception in Children at a Tertiary Care Center: An Observational Study. 超声引导下静水复位三级护理中心儿童急性肠套叠：一项观察性研究。

JNMA; journal of the Nepal Medical Association Pub Date : 2025-02-01 Epub Date: 2025-02-28 DOI: 10.31729/jnma.8878

Ajay Kumar Yadav, Neha Yadav, Binit Dev, Sonia Dahal, Rohit Prasad Yadav, Sushil Taparia, Hiramani Patahak

{"title":"Ultrasound-guided Hydrostatic Reduction of Acute Intussusception in Children at a Tertiary Care Center: An Observational Study.","authors":"Ajay Kumar Yadav, Neha Yadav, Binit Dev, Sonia Dahal, Rohit Prasad Yadav, Sushil Taparia, Hiramani Patahak","doi":"10.31729/jnma.8878","DOIUrl":"10.31729/jnma.8878","url":null,"abstract":"Introduction: Intussusception is common cause of acute emergency responsible for bowel obstruction in infants and toddlers with peak age of incidence between 6-9 months. Ultrasound is imaging modality of choice for diagnosis of intussusception and ultrasound guided hydrostatic enema reduction is standard, nonsurgical, internationally preferred treatment modality for uncomplicated pediatric intussusceptions. This study was aimed to find the outcome of the procedure.Methods: An observational cross-section was carried in a tertiary care center in children presenting with intussusception. Ultrasoud guided hydrostatic reduction was done in all radiologically confirmed intussusception in children presenting to our tertiary hospital from February 2023 to July 2024 fulfilling the inclusion criteria after proper resuscitation. Patients having marked abdominal distension with features of peritonitis were excluded from the study. Ethical approval was obtained from Institutional Review Committee (Reference number: 287/2023).Results: Total 81 patients with 84 intussusceptions underwent ultrasound guided hydrostatic reduction with male to female ratio of 2.86 and mean age 9.49±8.43 months. Hydrostatic reduction was successful in 78 (92.85%) cases. Among successful reductions, 3 (3.84%) patients had recurrence and repeat successful hydrostatic reduction was done. Presenting complain seen were abdominal pain 81 (100%) , vomiting 72 (88.89%). Ileocolic intussusception was seen in 74 (88.09%).Conclusions: The success rate of ultrasound-guided hydrostatic reduction using normal saline for uncomplicated intussusception was consistent with findings from previous studies conducted in similar settings, which utilized both hydrostatic and pneumatic reduction methods.","PeriodicalId":520657,"journal":{"name":"JNMA; journal of the Nepal Medical Association","volume":"63 282","pages":"73-77"},"PeriodicalIF":0.0,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11930295/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144629392","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0