Journal of the Institute of Medicine最新文献_第8页

Comparison of Graft Uptake and Postoperative Hearing Results between Butterfly-Cartilage and Temporalis-Fascia Myringoplasty 蝶软骨与颞筋膜鼓膜成形术移植骨摄取及术后听力效果比较

Journal of the Institute of Medicine Pub Date : 2020-04-30 DOI: 10.3126/JIOM.V42I1.37416

A. K. Sah, P. Rayamajhi, H. Bhattarai

{"title":"Comparison of Graft Uptake and Postoperative Hearing Results between Butterfly-Cartilage and Temporalis-Fascia Myringoplasty","authors":"A. K. Sah, P. Rayamajhi, H. Bhattarai","doi":"10.3126/JIOM.V42I1.37416","DOIUrl":"https://doi.org/10.3126/JIOM.V42I1.37416","url":null,"abstract":"Introduction Myringoplasty is one of the commonest surgeries done in Otology for chronic otitis media- mucosal type (COM-mucosal type). The objective of this study was to compare the graft uptake and post-operative hearing status between butterfly-cartilage and temporalis-fascia myringoplasty.MethodsPatients of age ≥15 years with COM-mucosal type with dry, small to medium sized central perforation of pars tensa with clearly visible perforation margin were randomized into two groups of butterfly-cartilage myringoplasty and temporalis-fascia myringoplasty. Graft uptake and hearing results were assessed after six weeks and results were compared within and between the groups. ResultsThirty-one patients in butterfly cartilage group and twenty-nine patients in temporalis fascia group were analysed. Graft uptake rate was 93.5% (29/31) in butterfly group and it was 86.2% (25/29) in temporalis fascia group with no statistically significant difference (p= 0.344) between the two groups. The mean pre and post-operative air bone gap in butterfly cartilage group were 20.65dB±8.35 dB; 12.86dB±7.39dB and that in the temporalis fascia group were 19.72±6.14dB, 13.16dB±6.26dB respectively. The difference of preoperative and postoperative hearing status, obtained within the two groups was statistically highly significant (p< 0.001). However, there was no statistically significant difference in hearing results between the two groups (p= 0.593).ConclusionThe graft uptake rate and hearing results of butterfly-cartilage group and temporalis-fascia group were statistically significant within the group after myringoplasty but there was no statistically significant difference in between the two methods.","PeriodicalId":85033,"journal":{"name":"Journal of the Institute of Medicine","volume":"42 1","pages":"7-11"},"PeriodicalIF":0.0,"publicationDate":"2020-04-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41930901","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 Nepalese and Swedish Patients with Colorectal Cancer Regarding Tumor Suppressor Methylation in Tumor and Mucosa Samples 尼泊尔和瑞典结直肠癌患者肿瘤和粘膜样本中抑癌基因甲基化的比较

Journal of the Institute of Medicine Pub Date : 2020-04-30 DOI: 10.3126/JIOM.V42I1.37451

B. Ghimire, G. Kurlberg, Yogendra Pratap Singh, Y. Wettergren

{"title":"Comparison of Nepalese and Swedish Patients with Colorectal Cancer Regarding Tumor Suppressor Methylation in Tumor and Mucosa Samples","authors":"B. Ghimire, G. Kurlberg, Yogendra Pratap Singh, Y. Wettergren","doi":"10.3126/JIOM.V42I1.37451","DOIUrl":"https://doi.org/10.3126/JIOM.V42I1.37451","url":null,"abstract":"IntroductionColorectal cancer (CRC) is common with wide variation in incidence. However, the incidence in younger adults is showing an increasing trend with rectal preponderance. Such cases appear to present in advanced stage with poorly differentiated histopathology and the trend is stronger in developing countries. The aim of the study was to compare the MLH1 and in matched mucosa and tumor samples obtained from the large gut of Nepalese and Swedish patients with CRC.MethodsPatients diagnosed and operated for CRC at Tribhuvan University Teaching Hospital, Nepal (n=39) matched for age with those operated at Sahlgrenska University Hospital, Sweden (n=39) were included in the study. Demographics and clinicopathological data were compared. The tissue methylation status was compared in the Nepalese and Swedish populations and correlated to clinicopathological data.ResultsThere were 56% men and 44% women in the study. Their mean age was 53 years with a range of 20 to 78 years. Colon cancer amounted to 70% and 60% in the Nepalese and Swedish patients respectively and the majority of lesions were on the right colon. The colorectal cancer was commonly of stage III (52% and38%) in the Nepalese and Swedish group respectively. Most of the tumors were well differentiated (41%) in the Nepalese population where as in Swedish patients it the differentiation was medium to low (52% and 11%). Methylation of MLH gene, in different CpG sites, when analyzed independently, showed that inabout 18-20% of the cases, the degree of methylation is significantly higher in tumor tissue as compared to sites at least 10 cm away from the lesion.ConclusionColon cancer is more common in men in Nepal with predominantly more on the right colon. Most of them present in advanced stage with higher MLH1 methylation.Keywords: Colorectal cancer, MLH1, p14ARF, methylation, MSI","PeriodicalId":85033,"journal":{"name":"Journal of the Institute of Medicine","volume":"42 1","pages":"73-73"},"PeriodicalIF":0.0,"publicationDate":"2020-04-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"69288405","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: 2

Adnexal Torsion in Ovarian Hyperstimulation Syndrome in Early Pregnancy: A Diagnostic Challenge 早期妊娠卵巢过度刺激综合征的附件扭转:一个诊断挑战

Journal of the Institute of Medicine Pub Date : 2020-04-30 DOI: 10.3126/JIOM.V42I1.37446

P. Regmi, I. Amatya, A. Poudel

引用次数: 0

Japan: What to Do with Dead Bodies? A Burning Issue 日本：如何处理尸体？一个亟待解决的问题

Journal of the Institute of Medicine Pub Date : 2020-04-30 DOI: 10.3126/JIOM.V42I1.37415

A. Crump

{"title":"Japan: What to Do with Dead Bodies? A Burning Issue","authors":"A. Crump","doi":"10.3126/JIOM.V42I1.37415","DOIUrl":"https://doi.org/10.3126/JIOM.V42I1.37415","url":null,"abstract":"Death, the passing of a loved one, friend, colleague or just someone we may have known, is virtually always sad and often traumatic. However, it is a part of life and has to be coped with. Each year around 60 million people worldwide die from a wide and diverse number of causes. The problem of what to do with all those dead bodies is becoming a major conundrum for the families involved as well as for policy makers and governments. Natural and anthropogenic disasters, together with increasing incidence of major pandemics of infectious diseases is making finding a solution ever more difficult. A problem which is made worse by ever-increasing draconian rules about what can and cannot be done when disposing of a body. Currently, there are two basic choices, either bury the body in the ground where such action is permitted or cremate it and dispose of the ashes in a culturally and legally acceptable fashion. Generally, both options are becoming prohibitively expensive. The cost of land and the burgeoning demand for land to be used for industry, agriculture, urbanised centres or leisure activities is making burial no longer an option for most people. Japan has long led the world in incineration technology and it has also led the world for many years in cremating its dead. Virtually all Japanese are now cremated, the funeral process involving a mixture of high technology and unique routines steeped in history. Despite widespread concerns that cremation can cause environmental pollution and may damage public health as a result, it is still deemed less polluting than burial. It is likely that countries around the globe will increasingly adopt a policy of cremating their deceased citizens and would do well to follow the lead in this respect being shown by Japan.","PeriodicalId":85033,"journal":{"name":"Journal of the Institute of Medicine","volume":"42 1","pages":"1-6"},"PeriodicalIF":0.0,"publicationDate":"2020-04-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"45596711","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

Experience of Hydatid Cyst Management in a Tertiary Care Center in Kathmandu Nepal 尼泊尔加德满都三级保健中心包虫病管理的经验

Journal of the Institute of Medicine Pub Date : 2020-04-30 DOI: 10.3126/JIOM.V42I1.37421

Bijendra Dhoj Joshi, Udaya Koirala, A. Joshi, S. Dhital, Prativa Dhoubadhel

{"title":"Experience of Hydatid Cyst Management in a Tertiary Care Center in Kathmandu Nepal","authors":"Bijendra Dhoj Joshi, Udaya Koirala, A. Joshi, S. Dhital, Prativa Dhoubadhel","doi":"10.3126/JIOM.V42I1.37421","DOIUrl":"https://doi.org/10.3126/JIOM.V42I1.37421","url":null,"abstract":"Introduction Hydatid cyst is a common disease in Asian subcontinent produced by the larval stage of Echinococcus granulosus. The most common site of involvement is the liver. The mode of presentation can vary. The management of hydatid cyst includes medical treatment with albendazole, ultrasound guided aspiration and instillation of scolicidal agents as well as surgical treatment. Surgery can be perfomed by open or laparoscopic approach. The aim of this study is to analyze the cases of hydatid cyst of liver managed in our set up. Methods This is a retrospective study of 45 patients with hydatid cyst managed in Kathmandu Model Hospital over the last five years. Data were collected from the patients hospital records. Demographic parameters, chief complains, radiological findings, anti echinococcal immunglobulin findings, mode of management,complications of surgery were evaluated. Results Majority of our patients were female (66.7%). Mean age of the patients were 39±17.2 years (16 to 89 years).Most common symptom of presentation was pain in right upper quadrant of abdomen.Most common site of involvement was liver (93.33%)followed by spleen (4.4%). There was one case of ruptured pulmonary hydatid cyst which was referred.Operative management was done in patients (17.77%) out of which five patients (62.5%) underwent laparoscopic partial pericystectomy and omentoplasty.No major complications were encountered in any of the cases managed surgically. Conclusion Majority of cases occured in liver. Most cases were managed conservatively. Laparoscopic management of hydatid cyst is effective.","PeriodicalId":85033,"journal":{"name":"Journal of the Institute of Medicine","volume":"42 1","pages":"26-30"},"PeriodicalIF":0.0,"publicationDate":"2020-04-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"69288396","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

Palliative Care Services at a Cancer Center in Janakpur Nepal 尼泊尔Janakpur癌症中心的姑息治疗服务

Journal of the Institute of Medicine Pub Date : 2020-04-30 DOI: 10.3126/JIOM.V42I1.37454

Sanjay Gupta, Anshul Thakur, R. Mishra, P. Jha

{"title":"Palliative Care Services at a Cancer Center in Janakpur Nepal","authors":"Sanjay Gupta, Anshul Thakur, R. Mishra, P. Jha","doi":"10.3126/JIOM.V42I1.37454","DOIUrl":"https://doi.org/10.3126/JIOM.V42I1.37454","url":null,"abstract":"Introduction Palliative care is one of the essential components of cancer care in Nepal. Most of our cancer patients present to the hospital quite late. In our everyday practice, we encounter many progressive incurable cancer patients who need palliative care. The goal of the palliative care is to relieve the pertinent symptoms or to improve quality of life (QoL) for patients with advanced cancer. We reviewed the palliative care services to the cancer patients at our center.MethodsRetrospective analysis of the cancer patients who received palliative care alone or in adjunct to curative treatment in Binayatara Cancer Center since its establishment in December 2018 was done.ResultsA total of 108 patients received palliative care of which most were at advanced stage of disease (Stage IV). The male to female ratio was 1:1.45. The most common complaints for their visit was pain (62%) followed by nause and vomiting (32%), constipation (28%), anorexia (22%), shortness of breath, abdominal distension, seizure. Most of the patients with pain needed morphine (65%) for pain management followed by tramadol (25%) and NSAIDs (10%). Few of them were also supplemented with TCAs and anticonvulsants.Abdominal distension due to ascites was managed by ascitic tapping, Albumin supplementation while shortness of breath due to pleural effusion was managed by pleural fluid tapping. In one patient with pleural effusion, chest tube was inserted. Three patients with seizure due to brain metastasis were managed with anticonvulsant. A patient of prostate cancer with bony metastasis was managed with surgical orchidectomy.ConclusionWhile considering the appropriate and effective use of palliative care, a palliative care physician is often confronted with a full range of multidisciplinary treatment options, and technical considerations that could potentially relieve some symptoms of advanced cancer in our settings.","PeriodicalId":85033,"journal":{"name":"Journal of the Institute of Medicine","volume":"42 1","pages":"76-76"},"PeriodicalIF":0.0,"publicationDate":"2020-04-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44322391","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

Variation of Arteries Forming Circle of Willis in Adult Human Cadavers 成人尸体威利斯动脉形成圈的变化

Journal of the Institute of Medicine Pub Date : 2020-04-30 DOI: 10.3126/JIOM.V42I1.37419

J. Gautam, Bidur Adhikari, Roshna Bhandari, A. Shrestha, N. Ranjit

{"title":"Variation of Arteries Forming Circle of Willis in Adult Human Cadavers","authors":"J. Gautam, Bidur Adhikari, Roshna Bhandari, A. Shrestha, N. Ranjit","doi":"10.3126/JIOM.V42I1.37419","DOIUrl":"https://doi.org/10.3126/JIOM.V42I1.37419","url":null,"abstract":"Introduction Circle of Willis is a large arterial anastomosis between internal carotid and vertebrobasilar arterial system. It is the principal collateral channel for constant blood flow to brain. Any changes in its morphology may cause vascular insufficiency of variable severity. Knowledge about its anomalies may elucidate occurrence of cerebrovascular disorders, its presentation, treatment, prognosis and prevention.MethodsAn observational study on 107 fresh cadavers was conducted at Maharajgunj Medical Campus from September 2016 to August 2017. After dissection of the scalp and removal of the vault and dura mater, the brain was obtained. Then the Circle of Willis was identified and observed for its completeness, symmetry, presence, origin and number of arteries forming it and the obtained data were documented, photographed and analyzed.ResultsOut of 107 cadavers, variations were noted among 15 (14%): out of which 10 were male and 5 female. Twelve cadavers had single variation while 3 had two variations. Accessory anterior cerebral artery was found in 7 (38.90%), fetal origin of right posterior communicating artery in 2 (11.10%), fetal origin of left posterior communicating artery in 4 (22.20%), early bifurcation of left posterior cerebral artery in 1 (5.60%), variant anterior communicating artery in 2 (11.10%), fused anterior cerebral artery in 1 (5.60%) and aneurysm in 1(5.60%) subjects were found.ConclusionVariations were noted among 15 cadavers (14%), 12 cadavers had single variation while 3 had two variations. The most common variation seen was accessory anterior cerebral artery found in 7 cadavers (38.90%). Most of the variations were found in midline anteriorly followed by right side.","PeriodicalId":85033,"journal":{"name":"Journal of the Institute of Medicine","volume":"42 1","pages":"17-20"},"PeriodicalIF":0.0,"publicationDate":"2020-04-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43664928","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

Clinicopathological Review of Resectable Gastric Cancer at a Tertiary Level Teaching Hospital of Nepal 尼泊尔某三级教学医院可切除胃癌的临床病理分析

Journal of the Institute of Medicine Pub Date : 2020-04-30 DOI: 10.3126/JIOM.V42I1.37452

P. Kansakar, P. Vaidya

{"title":"Clinicopathological Review of Resectable Gastric Cancer at a Tertiary Level Teaching Hospital of Nepal","authors":"P. Kansakar, P. Vaidya","doi":"10.3126/JIOM.V42I1.37452","DOIUrl":"https://doi.org/10.3126/JIOM.V42I1.37452","url":null,"abstract":"IntroductionAccording to available data, gastric carcinoma is the most common malignancy arising from the gastrointestinal tract in Nepal. Our objective was to analyze the pathological features of gastric carcinoma in patients undergoing curative resection.MethodsRetrospective analysis of histopathological reports of patients who underwent curative surgery for gastric cancer was performed at Department of Surgery, Tribhuvan University Teaching Hospital for a period of two years. Demographic characteristics, symptoms, site of tumor, type of surgery performed, macroscopic and microscopic characteristics including number of harvested lymph nodes, number of positive lymph nodes and tumor stage were analyzed.ResultsA total of 36 patients underwent curative resection. Mean age of the patients was 61.6 years with range of 21-82 years. Male:female ratio was 7:4. Pain abdomen was the predominant presenting symptom. Vomiting, hematemesis and malena were the other frequent symptoms. Endoscopy Borrmann type II tumor wasseen in 27 (75%) of patients. Most patients underwent subtotal gastrectomy. In 25 patients, tumor was located in antrum. Lymphovascular and perineural invasion was seen in 21 and 20 patients respectively. Sixteen patients had poorly differentiated tumors. All but two patients had microscopic negative distalmargin whereas proximal margin was negative in all patients. A mean of 15 lymph nodes were harvested. Twenty three patients had node positive disease. Pathological staging revealed Stage IA in 3 patients, Stage IB in in 5 patients , stage IIA in 4 patients stage IIB in 6 patients, stage IIIA in 6 patients, stage IIIBin 8 patients and IIIC in 4 patients.ConclusionGastric carcinoma was common in seventh and eighth decade of life with male preponderance. Most of the patients presented with locally advanced gastric cancer. Tumors located in antrum requiring subtotal gastrectomy was the predominant finding.Keywords: Gastric cancer, pathological report, resectable tumor","PeriodicalId":85033,"journal":{"name":"Journal of the Institute of Medicine","volume":"42 1","pages":"74-74"},"PeriodicalIF":0.0,"publicationDate":"2020-04-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"48524946","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

Fracture Nasal Bone: Causes, Presentation and Management in a Tertiary Care Center in Nepal 鼻骨骨折：尼泊尔一家三级医疗中心的病因、表现和治疗

Journal of the Institute of Medicine Pub Date : 2020-04-30 DOI: 10.3126/JIOM.V42I1.37420

R. Mahaseth, U. Gurung, N. Thapa, B. Pradhan, B. Kharel

{"title":"Fracture Nasal Bone: Causes, Presentation and Management in a Tertiary Care Center in Nepal","authors":"R. Mahaseth, U. Gurung, N. Thapa, B. Pradhan, B. Kharel","doi":"10.3126/JIOM.V42I1.37420","DOIUrl":"https://doi.org/10.3126/JIOM.V42I1.37420","url":null,"abstract":"Introduction Fracture of nasal bone, the commonest facial fracture is frequently encountered in ENT practice. This study was conducted to assess the causes, presentation and management of fracture nasal bone in a tertiary care center. MethodsA retrospective chart review was done of patients admitted from August 2017 to July 2019 for management of isolated nasal bone fracture in the department of ENT and Head and Neck Surgery, Tribhuvan University Teaching Hospital. ResultsThirty-five patients (31 males and 4 females) of 13 to 86 years (mean age 26 years) underwent closed reduction of fracture nasal bone. The injury was sustained following physical assault in 13/35 (37%), fall from height in 10/35 (29%), road traffic accident in 8/35 (23%) and sports injury in 4/35 (11%). Pain, epistaxis, swelling over nasal dorsum, nasal deformity and wound were the presenting symptoms which most often occurred in combination. Close reduction was done under local anesthesia in 28/35 (80 %) and under general anesthesia in 7/35 (20%). The time between trauma and closed reduction ranged from 1 to 16 days with a mean of 6.2 days. ConclusionNasal bone fracture needing reduction was common following physical assault in males predominently of 21 to 30 years. A combination of pain, epistaxis and nasal deformity was the commonest presentation. Closed reduction of fracture under local anesthesia within 16 days of trauma was the usual practice.","PeriodicalId":85033,"journal":{"name":"Journal of the Institute of Medicine","volume":"42 1","pages":"21-25"},"PeriodicalIF":0.0,"publicationDate":"2020-04-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44261037","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

Thyroglossal Duct Fistula with an Unusual Presentation: A Case Report 甲状舌管瘘的异常表现:1例报告

Journal of the Institute of Medicine Pub Date : 2019-12-05 DOI: 10.3126/jiom.v41i2.26558

B. Gyawali, H. Dutta, P. Tripathi

引用次数: 0