Nepalese Medical Journal最新文献_第3页

Comparative Study of Clinical Profile and Outcome Among Variceal and Nonvariceal Bleeding in a Tertiary Referral Hospital of Nepal During Covid Pandemic 新冠肺炎大流行期间尼泊尔某三级转诊医院静脉曲张和非静脉曲张出血的临床特征和结局比较研究

Nepalese Medical Journal Pub Date : 2022-06-30 DOI: 10.3126/nmj.v5i1.44527

Binod Karki, T. Sherpa, R. Deo, Egesh Aryal, B. Regmi, A. Adhikari, Srijana Katawal, S. K. Mandal

{"title":"Comparative Study of Clinical Profile and Outcome Among Variceal and Nonvariceal Bleeding in a Tertiary Referral Hospital of Nepal During Covid Pandemic","authors":"Binod Karki, T. Sherpa, R. Deo, Egesh Aryal, B. Regmi, A. Adhikari, Srijana Katawal, S. K. Mandal","doi":"10.3126/nmj.v5i1.44527","DOIUrl":"https://doi.org/10.3126/nmj.v5i1.44527","url":null,"abstract":"Introduction: Upper Gastrointestinal Bleeding is a common medical emergency that is broadly classified into variceal and non-variceal bleeding. Preendoscopicemperical treatment is based on clinical findings and laboratory parameters. The article aimed to compare these parameters among variceal and non-variceal bleeding.\u0000Materials and Methods: This is a retrospective descriptive study conducted in a tertiary level referral hospital after taking approval from the Institutional review board. The data included was from September 2020 to August 2021. All patients with relevant data who underwent upper GI endoscopy were enrolled. The clinical and laboratory parameters were compared using appropriate statistical tests.\u0000Results: A total of 85 patients were studied with 40 (47.06%) in the variceal and 45 (52/94%) in the non-variceal group. Significantly more patients in the variceal bleeding group had a history of alcohol consumption (85% vs 60%) and smoking history (52.50 % vs 31.10%) compared to the non-variceal group. Jaundice, ascites, splenomegaly, low platelet count, and high INR all were predictors of variceal bleeding (p<0.005). In the variceal group, 39 (97.5%) needed endo therapy compared to only 4 (8.9%) in the non-variceal group.\u0000Conclusions: Clinical and laboratory parameters differ significantly in the variceal and non-variceal groups which can guide the pre-endoscopic management of the patients.","PeriodicalId":52856,"journal":{"name":"Nepalese Medical Journal","volume":"43 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-06-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"90261743","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

Oral Gabapentin Pretreatment to Attenuate the Haemodynamic Response to Laryngoscopy and Tracheal Intubation 口服加巴喷丁预处理降低喉镜和气管插管后的血流动力学反应

Nepalese Medical Journal Pub Date : 2022-06-30 DOI: 10.3126/nmj.v5i1.45703

Tulsi Ram Shrestha, S. Podar, S. Ghimire, Dhiraj Tamrakar

{"title":"Oral Gabapentin Pretreatment to Attenuate the Haemodynamic Response to Laryngoscopy and Tracheal Intubation","authors":"Tulsi Ram Shrestha, S. Podar, S. Ghimire, Dhiraj Tamrakar","doi":"10.3126/nmj.v5i1.45703","DOIUrl":"https://doi.org/10.3126/nmj.v5i1.45703","url":null,"abstract":"Introduction: Laryngoscopy and intubation are associated with transient sympathetic responses manifesting as a rise in blood pressure and heart rate. This study was conducted to evaluate the role of oral gabapentin pretreatment in the attenuation of such haemodynamic response.\u0000Materials and Methods: Sixty-two patients aged 16 to 60 years weighing 50 to 75 kg undergoing elective surgeries requiring endotracheal intubation were randomized into two groups. group G received 900 mg oral gabapentin and group P received a placebo by mouth two hours before induction of anaesthesia. Patients were induced with propofol, fentanyl, and vecuronium. Laryngoscopy was attempted after four minutes and endotracheal intubation was done. Heart rate, systolic, diastolic, and mean arterial pressure at baseline, before intubation, one, three, five, and ten minutes after intubation were compared between two groups. Patients were observed for any adverse events peri-operatively and post-operatively for the first 24 hours.\u0000Results: There was significant attenuation of the rise in blood pressure and heart rate before and after intubation in both groups compared with their corresponding baseline parameters. A significant decrease in heart rate was observed in the gabapentin group only 10 minutes after laryngoscopy and intubation (p=0.022).\u0000Conclusions: Oral Gabapentin 900 mg two hours before induction is effective in attenuating the rise in blood pressure and heart rate following laryngoscopy and tracheal intubation, though a statistically significant difference was observed only at 10 minutes after intubation, compared with a placebo group. Besides the significant incidence of pre-induction somnolence, there were no serious perioperative adverse effects. ","PeriodicalId":52856,"journal":{"name":"Nepalese Medical Journal","volume":"11 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-06-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"88126796","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

The Milan System for Reporting Salivary Gland Cytopathology: A 3-year Retrospective Analysis in Patan Hospital 米兰唾液腺细胞病理学报告系统:帕坦医院3年回顾性分析

Nepalese Medical Journal Pub Date : 2022-06-30 DOI: 10.3126/nmj.v5i1.46793

D. Gautam, Rojin Thapa

{"title":"The Milan System for Reporting Salivary Gland Cytopathology: A 3-year Retrospective Analysis in Patan Hospital","authors":"D. Gautam, Rojin Thapa","doi":"10.3126/nmj.v5i1.46793","DOIUrl":"https://doi.org/10.3126/nmj.v5i1.46793","url":null,"abstract":"Introduction: The characteristics of salivary gland lesions identified by fine-needle aspiration cytology are varied and may overlap, which makes diagnosis difficult for cytopathologists. To provide consistency in the reporting of salivary gland cytology and to enhance clinic-pathologic communication, the \"Milan system for reporting salivary gland cytopathology\" has been introduced, which offers guidelines for diagnosis and treatment based on various categories of malignancy risk.\u0000Material and Methods: In this retrospective study, Fine needle aspiration cytology was done for all salivary gland lesions for three years and were retrieved from the Department of pathology, Patan hospital. All the cases were recategorized according to the Milan system for reporting salivary gland cytology with histopathology follow-up wherever available. Consistency of the two different types of assessment techniques (Milan category and primary cytology diagnosis) were assessed and the k score was calculated\u0000Results: A total of 58 cases were included in the study of which histological follow-up was available in 27 cases. Out of 58 cases, maximum cases 32 (55.1%) were classified under IVA followed by 15.5% cases classified under II, 8.6% of cases under Category IVB), 6.8% under category Vand 5.1% cases under category VI. Kappa's score was 0.58 which represents a moderate agreement.\u0000Conclusions: Milan system for reporting salivary gland cytopathology is a recently proposed six-category scheme, which places salivary gland fine needle aspiration cytology into well-defined categories that limit the possibilities of false negative and false positive cases.","PeriodicalId":52856,"journal":{"name":"Nepalese Medical Journal","volume":"28 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-06-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"83543107","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: 1

Effect of Obstructive Sleep Apnea on Sleep Pattern and Blood Glucose Level in Type 2 Diabetes Patients 阻塞性睡眠呼吸暂停对2型糖尿病患者睡眠模式及血糖水平的影响

Nepalese Medical Journal Pub Date : 2022-06-30 DOI: 10.3126/nmj.v5i1.43223

Santosh Kumar Sah, Jay Prakash Singh Rajput, Dimpal Rochlani, R. S. Inamdar

{"title":"Effect of Obstructive Sleep Apnea on Sleep Pattern and Blood Glucose Level in Type 2 Diabetes Patients","authors":"Santosh Kumar Sah, Jay Prakash Singh Rajput, Dimpal Rochlani, R. S. Inamdar","doi":"10.3126/nmj.v5i1.43223","DOIUrl":"https://doi.org/10.3126/nmj.v5i1.43223","url":null,"abstract":"Introduction: Our physical, mental, and emotional well-being require normal sleep. Disturbances in sleep quality and quantity can result in metabolic disorders. Sleep fragmentation increases sympathetic activity which leads to decreased insulin sensitivity. Obstructive sleep apnea causes sleep fragmentation. That is why this study attempt is made to find the effect of obstructive sleep apnea on sleep pattern and blood glucose level in type 2 diabetes patients.\u0000Materials and Method: Depending on the severity of the Apnea-Hypopnea Index (AHI) recorded by polysomnography, each, volunteer were divided into two groups, a) AHI>10 groups, and b) AHI≤10 groups. Then the comparison of all the parameters between AHI>10 and AHI≤10 groups of diabetic participants was done.\u0000Results: In participants of AHI≤ 10 groups, Sleep efficiency%, Mean TBI SPo2%, sleep Stage III%, and REM% are significantly higher as compared to AHI>10 groups. In participants of the AHI>10 groups, sleep Stage I%, the score of ESS, and fasting blood glucose level are significantly higher as compared to AHI≤ 10 groups.\u0000Conclusions: Increasing AHI is associated with reduced sleep efficiency; a sleep stage of N3%, and a REM sleep phase, which lead to an increase in fasting blood glucose levels in the diabetic group.","PeriodicalId":52856,"journal":{"name":"Nepalese Medical Journal","volume":"8 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-06-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"75903673","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

Right-sided Decortication in a Patient with Left Pulmonary Artery Embolism – A Case Report 左肺动脉栓塞患者右侧去皮1例

Nepalese Medical Journal Pub Date : 2022-06-30 DOI: 10.3126/nmj.v5i1.44411

Tanvi Meshram, Darshana Rathod, Kamlesh K. Kumari, Arun Sahayraja M

引用次数: 0

Histopathological Study of Endometrial Changes in Hysterectomy Specimens with Cystic Lesion of Ovary 子宫切除术伴卵巢囊性病变子宫内膜改变的组织病理学研究

Nepalese Medical Journal Pub Date : 2022-01-11 DOI: 10.3126/nmj.v4i2.41661

P. Pillai

{"title":"Histopathological Study of Endometrial Changes in Hysterectomy Specimens with Cystic Lesion of Ovary","authors":"P. Pillai","doi":"10.3126/nmj.v4i2.41661","DOIUrl":"https://doi.org/10.3126/nmj.v4i2.41661","url":null,"abstract":"Introduction: Some of the ovarian lesions become functional and secrete hormones that bring endometrial changes like hyperplasias and polyps. This study aimed to find endometrial changes associated with different types of cystic lesions of the ovary.\u0000Materials and Methods: A histopathological study done from 2010 -2013 on all the total abdominal hysterectomy specimens with bilateral oophorectomy having cyst size more than 3cms, with a detailed clinical history received in the Department of Pathology, Sri Manakula Vinayagar Medical College and Hospital, Pondicherry. A total of 112 cases were collected analyzed and statistically correlated.\u0000Results: Out of the 112 cases of cystic lesions of the ovary 67% showed endometrium within normal limits, 33% of cystic lesions of ovary showed polyps, simple hyperplasia without atypia, complex hyperplasia without atypia. Among non-neoplastic lesions, follicular cyst produced the most endometrial changes, followed by benign surface epithelial lesions. Granulosa cell tumor was found to induce polyp as well as simple hyperplasia without atypia. Two out of three malignant lesions showed endometrial changes followed by benign lesions. The majority of the cystic lesions of the ovary encountered are non-neoplastic lesions (59%) and follicular cysts were more common (97%). Endometrial hyperplasia of both simple and complex types without atypia was found with serous cystadenoma.\u0000Conclusions: From the current study it implicates the necessity of assessing cystic lesions of the ovary like a follicular cyst, luteal cyst, granulosa cell tumors as they can become functional leading to endometrial changes that can form a fertile ground for carcinomas.","PeriodicalId":52856,"journal":{"name":"Nepalese Medical Journal","volume":"1 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-01-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"82852531","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

Speech, Language and Cognitive Profile of Mild Cognitive Impairment: A single Case Study 轻度认知障碍的言语、语言和认知特征:一个个案研究

Nepalese Medical Journal Pub Date : 2021-12-31 DOI: 10.3126/nmj.v4i2.38759

Biraj Bhattarai, Joanna K B, P Niranjana, A. B P

引用次数: 0

Clinico-Demographic Profile of Covid-19 Patients Admitted in COVID- HDU and its Association with Conjunctivitis 新冠肺炎HDU住院患者的临床人口学特征及其与结膜炎的关系

Nepalese Medical Journal Pub Date : 2021-12-31 DOI: 10.3126/nmj.v4i2.41492

P. Basnet, Deepanshu Sharma, Shravya Singh Karki, S. Karki, Hira Lal Bhandari, D. Shrestha

{"title":"Clinico-Demographic Profile of Covid-19 Patients Admitted in COVID- HDU and its Association with Conjunctivitis","authors":"P. Basnet, Deepanshu Sharma, Shravya Singh Karki, S. Karki, Hira Lal Bhandari, D. Shrestha","doi":"10.3126/nmj.v4i2.41492","DOIUrl":"https://doi.org/10.3126/nmj.v4i2.41492","url":null,"abstract":"Introduction: The outbreak of coronavirus diseases 2019 (Covid-19) caused by SARS-COV-2 which started in Wuhan china led to an alarming level of spread and severity. In Nepal, the first case of COVID-19 was reported on 23.1.2020 and has become a global health crisis since then. The clinical presentation and outcome of patients with COVID-19 have been variable in different countries and therefore it is important to analyze as well as document the clinical behaviors of this disease in the local population so we have reported the clinic-epidemiological profile, outcome, and its association with conjunctivitis during the second wave of this pandemic which hit Nepal badly hoping this study will be helpful to tackle the future surges of COVID-19 as well.\u0000Materials and Methods: This was a prospective, single-center study where the data regarding epidemiology, demography, common clinical presentation as well as management and outcome of COVID-19 Patients were retracted and analyzed.\u0000Results: A total of 238 COVID-Positive patients were admitted out of which 60% were male and 39.9% people belonged to Dang valley itself with dyspnea (67.2%) was the commonest symptoms followed by fever in 59.7% of patients. Out of these patients 9 patients presented with ocular symptom conjunctivitis.\u0000Conclusions: Mild conjunctivitis manifesting as conjunctival congestion is common and one of the major ocular manifestations in COVID -19 positive patients.","PeriodicalId":52856,"journal":{"name":"Nepalese Medical Journal","volume":"285 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-12-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"75332419","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 Manifestations, Neuroimaging Findings, and Treatment of Idiopathic Intracranial Hypertension in a Nepalese Tertiary Centre 尼泊尔三级中心特发性颅内高压的临床表现、神经影像学发现和治疗

Nepalese Medical Journal Pub Date : 2021-12-31 DOI: 10.3126/nmj.v4i2.40038

N. Gautam, R. Ojha, S. Kharel, B. Gajurel, Sanjeeta Sitaula, R. Karn, R. Rajbhandari, A. Shrestha

{"title":"Clinical Manifestations, Neuroimaging Findings, and Treatment of Idiopathic Intracranial Hypertension in a Nepalese Tertiary Centre","authors":"N. Gautam, R. Ojha, S. Kharel, B. Gajurel, Sanjeeta Sitaula, R. Karn, R. Rajbhandari, A. Shrestha","doi":"10.3126/nmj.v4i2.40038","DOIUrl":"https://doi.org/10.3126/nmj.v4i2.40038","url":null,"abstract":"Introduction: Idiopathic Intracranial Hypertension is characterized by headache, visual impairment, papilledema, and increased cerebrospinal fluid opening pressure. We aim to evaluate clinical manifestations, neuroimaging findings, and treatment of Idiopathic Intracranial Hypertension in a Nepalese tertiary center.\u0000Materials and Methods: We retrospectively included patients with the diagnosis of Idiopathic Intracranial Hypertension who were admitted to the Neurology department of Tribhuvan University Teaching Hospital from 2019 June to 2021 May and presented to the Neuro-ophthalmology outpatient clinic of the hospital for follow-up.\u0000Results: Out of 16 Idiopathic Intracranial Hypertension patients, 12(75%) patients had either headache or ocular pain. Reduced visual acuity and progressive visual loss were found in 44% of patients. Normal CSF opening pressure was found in 19%, 44% had CSF opening pressure at a range of 20-30 cm H20 and > 30 cm H20 in 37.5%. 15 Idiopathic Intracranial Hypertension patients (93.7%) were subtyped as Typical and 1 patient was diagnosed as Fulminant Idiopathic Intracranial Hypertension. Acetazolamide was used for treatment in 15 patients and 1 patient needed ventriculoperitoneal shunting. 56% Seven patients (44%) had some abnormal findings: partial empty sella (44%), and tortuous optic nerve (31%), flattened posterior eyeball (31%), and hypoplastic transverse sinus (19%).\u0000Conclusions: Idiopathic Intracranial Hypertension is an uncommon diagnosis but should be suspected in patients with chronic headaches with visual impairment. In low-resource settings, proper history along with neurological and ophthalmological examinations can even detect the early features and timely referral can save the vision and disability of Idiopathic Intracranial Hypertension patients.","PeriodicalId":52856,"journal":{"name":"Nepalese Medical Journal","volume":"12 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-12-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"74661436","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

Pseudoeosinophilia with Abnormal WBC Scattergram: an Important Diagnostic Clue on Hematology Analyzer 假性嗜酸性粒细胞增多伴白细胞散点图异常:血液分析仪诊断的重要线索

Nepalese Medical Journal Pub Date : 2021-12-31 DOI: 10.3126/nmj.v4i2.41920

Swathi C. Prabhu, A. Tahlan, Shreya Sharma, S. Lehl

引用次数: 0