bluuebunny/crossref_metadata_2025 huggingface dataset:
Sacro-Coccygeal Tumours
Authors: Gongal D N , Bhattacharya S K
Published: September 2018

NA
Environmental Science
Authors: Joshi Ramkrishna L
Published: September 2018

NA
Experience With Typhoid Fever At Shanta Bhawan
Authors: Dorman Jane , Dickinson John
Published: September 2018

NA
Hyperventilation Syndromes As Seen Is Kathmandu
Authors: Sharma B P
Published: September 2018

NA
The Role of Block Grant Funding from International and Bilateral Agencies in organizing Basic Health Services for Developing Nations. ( Position paper : with particular reference to Nepal)
Authors: Shrestha Rudra Man
Published: September 2018

NA
Medical Assessment Of Air Crews-Civil And Military
Authors: Bhattarai Keshab Raj
Published: September 2018

NA
EMERGENCY CONTRACEPTION - AN UPDATE
Authors: Pradhan P
Published: September 2018

Abstract
Surgical Treatment Of Goitre
Authors: Sharma Anjani Kumar , Joshi N R , Joshi B B
Published: September 2018

NA
A Big Children's Hospital Is Needed, And How To Make One.
Authors: Shrestha Y B
Published: September 2018

NA
Nepal Medical Association Supplement
Authors: Author No
Published: September 2018

Contents1. Journal Commitee Report2. Constitution of the Nepal Medical Association
Oncoprevention in Gynecology
Authors: Dhakal S
Published: September 2018

Gynaecological cancers are one of the preventive cancers. There are some preventive factors like change in life style, food habits and some screening tests. Cancer can be prevented and premalignant conditions can be detected before invasion. Cervical cancer can be detected early by VIA, VILI, Pap smear, colposcopy and HPV testing. Identifying high risk population, transvaginal ultrasound to determine endometrial thickness and endometrial sampling by endocervical curettage, dilation and curettage, fractional curettage and hysteroscopy guided endometrial biopsy are the various modalities for earlier detection of endometrial cancers. For ovarian cancer, prevention or early diagnosis is done by identifying high risk factors, creating awareness in women, routine pelvic examination, ultrasonogram, checking tumour marker and prophylactic oophorectomy in indicated cases. The main screening methods for early detection of breast cancer are clinical breast examination and mammography. Oral contraceptive and HRT are associated with small increase in breast cancer risk. Vulval and vaginal carcinomas are not so common. All molar pregnancies should be followed after evacuation to look for malignant transformation. Hereditary/familial gynaecological cancer like ovarian and breast cancer are manifestation of genetic disorder. Mass screening for gene mutation is very expensive so it is not recommended.
Kala-Azar in Nepal: A Study from Siraha District
Authors: Devkota U N , Stinmann J P
Published: September 2018

Abstract
Patterns of Post Operative Wound Infection and their Antibiotic Sensitivity in Bir Hospital
Authors: Gongal D N , Shrestha B M , Gurubacharya V L , Shrestha Jyotsana
Published: September 2018

Abstract
Epilepsy In Children
Authors: Sharma B P
Published: September 2018

NA
Bladder Stone Dystocia
Authors: Anderson M W , Bernhard E , Coats R , Fischer P , Mack G J
Published: September 2018

NA
The Iodization Of The Dhankuta Water Supply
Authors: Ward J P
Published: September 2018

NA
Goitre Incidence In Workers And Their Families On The East/West Highway (British Section)
Authors: Cunningham J S
Published: September 2018

NA
Common E.N.T. Problems In Children
Authors: Rajbhandari P R
Published: September 2018

NA
Disaster Planning
Authors: Mack G J
Published: September 2018

NA
Incidence Of Urolithiasis In Bir Hospital
Authors: Shrestha S M , Shrestha Shobhana , Bahadur Sankhar
Published: September 2018

NA
The Role Of Child Health In Relation To The Family Planning Programming In Nepal
Authors: Shrestha Y B
Published: September 2018

NA
Medical Defence
Authors: Editor JNMA
Published: September 2018

NA
Efficacy of Endovascular Therapy for Direct Occlusion of Intracranial Aneurysms
Authors: Tamrakar K , Karki B , Duan C-Z , Li X-F , Zhang X
Published: September 2018

Introduction: Our purpose was to evaluate the effectiveness of endovascular therapy using detachable coils and balloons for the direct occlusion of intracranial aneurysms.

Methods: We retrospectively reviewed 563 patients undergoing digital subtraction angiography from January 2007 to July 2009. Two hundred and fi fty patients with 323 embolized intracranial aneurysms were studied.

Results: Among 250 patients, 66 % were female and 34 % male, the age ranging from 19 - 83 years (mean 50.66 ± 12.92). One hundred and seventy-seven had a single aneurysm while 73 showed multiple aneurysms. Seventeen (9.6 %) had giant aneurysms. Three hundred and eleven aneurysms were treated using detachable coils, and 12 giant aneurysms were embolized by detachable balloons for the parent vessel occlusion. Of 323 aneurysms treated via the endovascular approach, total occlusion was seen in 93 % of the aneurysms, near total occlusion in 5.2 % and incomplete embolization in 1.5 %. Among patients presenting with sub-arachnoid hemorrhage, 62 improved to the Glasgow outcome score (GOS) of 5, 93 improved to GOS 4, 14 improved to GOS 3, 10 improved to GOS 2 at the time of discharge and 5 patients died. Angiographic follow-up was scheduled between 6 - 12 months post-embolization. The aneurysm recurred in 1.2 % and were re-embolized using additional coils. Statistically, Hunt and Hess Grade and GOS indicated clinical signifi cance (P < 0.05). The patients, gender, clinical presentation and aneurysmal location did not show statistical signifi cance (P > 0.05).

Conclusions: Hunt and Hess VI and V are considered as poor clinical gradings in aneurysmal SAH. However, endovascular treatment has been established as an effective method to obliterate intracranial aneurysms allowing subsequent decrease in mortality and morbidity.

Keywords: detachable coils, detachable balloons, endovascular therapy, intracranial aneurysms.
Primary Heealth Care Development: Where is Nepal after 30 years of Alma Ata Declaration??
Authors: Karkee R , Jha N
Published: September 2018

The year 2008 has witnessed the global conversation to return to tenets of Alma-Ata and to review its 30 years of journey. We reviewed Nepal's journey on Primary Health Care development: policy formulation, structure development, progress and constraints. Though Nepal has institutionalised the PHC approach in health policy, strategy and health care delivery system, this has not been effectively translated into actions, and the results are mixed. Nepal has gained impressive achievements in selective primary health care markers: 45.43% maternal mortality and 62.34% child mortality reduction during 1990-2005. But gain in comprehensive health care markers is not impressive: 18.7% Skilled Birth Attendant (4% in poorest quintile and 45% in richest quintile), 39% having access to improved sanitation and 55.7% of females are literate as compared to males. Socio-political environment until recently was not favourable for comprehensive primary health care, allowing limited health sector decentralisation and community empowerment. Health activities were focussed more on selective health care strategy in the form of disease control, immunisation, vitamin A supplementation, oral rehydration solution use and contraceptive use. Nepal's rural hilly geography posed great challenge on logistic supply, communication and retention of health workers rendering public health centres of low quality with negative perceptions of consumers. Nepal is on the pathway to build equitable comprehensive primary health care.
Family Planning For The Individuals
Authors: Malla D Shree
Published: September 2018

NA
Journal Sub-committee
Authors: Editorial JNMA
Published: September 2018

NA
The Study Of Smears Of The Noseblow In All Types Of Leprosy
Authors: Pedley J C
Published: September 2018

NA
Inhalation Anaesthesia By "Open Method"
Authors: Singh B B
Published: September 2018

NA
Deodeno-Jejunal Tuberculosis
Authors: Gongal D N
Published: September 2018

NA
Receipts & Payments Kathmandu
Authors: Author No
Published: September 2018

NA
Hospital Desaster Planning
Authors: Malla M M
Published: September 2018

NA
Open Letter
Authors: Shah Moin
Published: September 2018

NA
NMA Supplement
Authors: Author No
Published: September 2018

Charity Begins At HomeInaugural Adress By Her Royal Highness Princess Sharada Shah
Evaluation of Rodent Infestations in Nepal- A Preliminary Report
Authors: Frantz Stephen C
Published: September 2018

NA
NMA News
Authors: Author No
Published: September 2018

Building CommitteeJournal Sub-committee
Journal of The Nepal Medical Association- Editorial
Authors: Editorial JNMA
Published: September 2018

Man And The MountainsHIgh Altitude Pulmonary Oedema And Acute Mountain Sickness
Malnutrition And Cell-Mediated Immunity - A Brief Review And Some Preliminary Results
Authors: Bang F B , Bang B G
Published: September 2018

NA
Sero-Epidemiology Of Influenza In Man And Animals
Authors: Graves I L , Sousa V O , Pyakural S
Published: September 2018

NA
Acute Altitude Sickness
Authors: Dickinson John
Published: September 2018

NA
Pattern Of Eye Diseases In Bir Hospital General Survey
Authors: Pradhan Y M , Malla B K
Published: September 2018

NA
Integrated Basic Health Services A Definition
Authors: Bart Kenneth J
Published: September 2018

NA
The Role of MIssion Hospitals in Nepal
Authors: Mack Gordon J
Published: September 2018

NA
Economic Aspects Of Health Manpower In Nepal
Authors: Shrestha B P
Published: September 2018

NA
स्वास्थ्य सेवाको कार्यक्रम तर्जुमाको कार्यपत्र
Authors: Author No
Published: September 2018

परिचय
Discussion on 5-Man Working Committee on Health Plan
Authors: Author No
Published: September 2018

Points of discussion:Basic Health ServicesDevelopment and Modernisation of Health InstitutionsEfficient and Effective Health ServicesHealth Man PowerInterpretation of Health Programmes From Intersectoral Viewpoint
Manpower Development For MAternal-Child Health And Family Planning Program A- Neplese Case Study
Authors: Thapa Rita
Published: September 2018

NA
अपराध संहिता माथि नेपाल मेडिकल एसोिशएसनको विचार
Authors: Author No
Published: September 2018

NA
Editorial
Authors: Editorial JNMA
Published: September 2018

Some Newer Concepts in Nephrotic Syndrome
Advanced Abdominal Malignant Disease
Authors: Ellis Harold
Published: September 2018

NA
Medical News
Authors: Author No
Published: September 2018

Heart Portfolio 2027Do you diagnose your Cancer patients early?
Heard, Seen & Spoken.
Authors: Raj Baidya
Published: September 2018

NA
The Neurosurgical Unit
Authors: Author No
Published: September 2018

NA
The Cutaneous Manifestations of Normocholesteremic Xanthomatoses
Authors: Moody J
Published: September 2018

Case ReportDiscussionSummaryReferences
Heard, Seen & Spoken.
Authors: Author No
Published: September 2018

NA
Clinical Trials Of Two New Drugs In The Field Of Anaesthesia
Authors: Nix Nelson
Published: September 2018

NA
Filariasis: Hematuria And Chyluria With Report of 3 Unusual Cases
Authors: Jones, Jr. H Leonard , Shrivastava Pramod , Shrestha Bihari Lal , Mack Gordon J
Published: September 2018

NA
Endemic Goiter In Nepal
Authors: Illany J
Published: September 2018

NA
Learning Pelvic Examination with Professional Patients
Authors: Shrestha S , Wijma B , Swahnberg K , Siwe K
Published: September 2018

Performing pelvic examination is a vital skill to learn during gynecological and obstetrical training. It's a difficult maneuver to master as there is very little to see and more to feel and interpret. In addition, learning PE in usual clinical set-up has been found to induce lot of stress and anxiety among both the patients and the students. Students fear of hurting the patients and being judged inept, whereas patients feel embarrassed having to expose their most intimate body parts for learning purpose. This hampers effective learning. Learning PE on sedated women before surgery or on mannequins has been practiced as alternative learning models. But, they have been found to miss out on teaching the communication skills, which are as important as the palpation skills. However, there exists another model of learning PE--the professional patients, who are specially trained to act as patients and also guide the students on how to make a proper PE. They provide stress-free environment for the students to learn PE and at the same time, provide immediate feedback on each of their maneuvers. They form a complete learning model and help students to see patients as partner and not just a person seeking help.

Keywords: learning model, pelvic examination, stress, students.
Medical News From Britain(No 138) by Dr. W.A.R. Thomson, Medical Correspondent,"The Daily Telegraph",London
Authors: Author No
Published: September 2018

Transporting Contagious PatientsMicrobiological FiltersVentillator ResuscitatorTransparent CoverMiniature Heart RecorderDuring Normal Activities
Unusual Presentations of Amoebic Hepatitis
Authors: Pahari S K
Published: September 2018

NA
Antibiotic- Resistance Pattern Of Hospital Staphylococci*
Authors: Prasai B R , Gurubacharya V L
Published: September 2018

NA
Beginings Of Anaesthesia At Bir Hospital
Authors: Singh B B
Published: September 2018

NA
Contraceptive prevalance in a village of kathmandu.
Authors: Shrestha Purushottam N. , Bhattarai Kiran D.
Published: September 2018

N/A
Role of Areca Catechu (BETEL NUT) in the Treatment of Cerebrovascular Diseases
Authors: Mannan M.A
Published: September 2018

NA
An aid in diafnosis and management of acute abdomen-paracentesis peritonii (A study on 123 cases)
Authors: Shafique Dr.M , Sinha Dr.BC
Published: September 2018

NA
Pulseless Disease of japan in Nepal.
Authors: Koirala Madan
Published: September 2018

NA
Nepal Medical Association.
Authors: NA NA
Published: September 2018

NA
presidential Speech by the New President
Authors: Bhattacharya Dr.S.K.
Published: September 2018

NA
Farewell presidential speech
Authors: Vaidya Dr.B.B
Published: September 2018

NA
Pattern of Sexually Transmitted Diseases at Nepalgunj( A clinico-Epidemiological Study)
Authors: Shakya G R
Published: September 2018

NA
Experimental Investigation of Immuno Supression and Exolitonic dynamics in Thermal Burns Afflicted with Pseudomonas Aeruginosa and Klebsiella
Authors: Mishra S , Aryal S K , Bajaj M M , Bajaj S P
Published: September 2018

NA
Importance of serum Zinc in Pulmonary Tuberculosis of Childhood
Authors: Sinha Dr.Radha Krishna , Khan Dr.A.F.A. , Singh Dr.Bharat Prasad , Ram Prof.(Dr.)Sishupal
Published: September 2018

NA
Epidimilogical Situation of Human Plague in Nepal
Authors: Joshi Dr.D.D.
Published: September 2018

NA
Echocardiographic Findings in Chronic Corpulmonale
Authors: Dhungel Sanjib , Konishike Atsushi , Raut Kanak , Sayami Geeta , Shrestha Pramod Kumar , Singh Ramesh Man
Published: September 2018

NA
A Survey Of Pulmonary Thromboembolic Disease
Authors: Mast J W , Wilson L G
Published: September 2018

NA
Glaucoma For Practitioners
Authors: Author No
Published: September 2018

NA
Study on Factors Responsible for Subfertility
Authors: Rijal Dr.Bhola P. , Rai Dr.Shankar M , Karki Dr.Arjun B , Shrestha Dr.Krishna B
Published: September 2018

NA
Clinical Meetings
Authors: Editor JNMA
Published: September 2018

NA
Bio-assay of Chloramphenical in Enteric Fever Cases
Authors: Manandhar Mukunda Bahadur , Acharya I L , Shrestha Jyotshana , Shrestha M B , Gurubacharya V L
Published: September 2018

NA
Letter
Authors: Joshi B L , Acharya Achyut M
Published: September 2018

NA
Nepal And the Medical World
Authors: Author No
Published: September 2018

Twenty First World Health Assembly Geneva, May 1968Committee On Programme And BudgetDirector Health Services At The WHO-SEARO 20th Anniversary, New Delhi
Drug Abuse in Nepal
Authors: Shrestha Dhurba Man
Published: September 2018

na
Seventh Year Of JNMA
Authors: Author No
Published: September 2018

NA
Peptic Ulcer In Nepal
Authors: Editor JNMA
Published: September 2018

NA
Role of Non-Invasive Technique in Cardiology
Authors: Aziz MP
Published: September 2018

NA
Cleft lip Operation In Kosi
Authors: Ward J P
Published: September 2018

NA
ABO Incompatibility
Authors: Giri et al Kanti
Published: September 2018

NA
Medical History Of Nepal
Authors: Author No
Published: September 2018

Kanti HospitalParopakar Shree Panch Indra Rajya Laxmi Prasuti GrihaTribhuban Chandra Millitary Hospital
Gathering Above The Tundikhel
Authors: Author No
Published: September 2018

NA
Letter
Authors: Cash Richard A , Gordon C G.I. , Prasai B R
Published: September 2018

NA
An Epidemic Of Infectious Hepatitis In The Kathmandu Valley
Authors: Hillis A , Shrestha S M , Saha N K
Published: September 2018

NA
Patterns Of Disease In Community Genral Hospitals
Authors: Simpson Thomas W
Published: September 2018

NA
Prescription Writing Skills of Pre-Clinical Medical and Dental Undergraduate Students
Authors: Rauniyar GP , Roy RK , Das BP , Bhandari G , Bhattacharya SK
Published: September 2018

Objective of this prospective study was to assess the acquisition of prescribing skill of preclinicalmedical and dental undergraduate students. Prescription writing skills of 258 students of both firstand second year of MBBS and BDS students were analyzed through an objective structured practicalexamination. MBBS student of second year scored 85.01% and 92.82% respectively in physician anddrug related component whereas first year MBBS students scored 89.9% and 83.4%. BDS studentof first year scored 91.96% and 86.33% in physician and drug related components which is betterthan second year that scored 83.33% and 77.94% respectively. This study revealed that the studentsof both courses acquire prescribing skills to a limited extent during preclinical phase. Prescribingerrors were found both in physician and drug related components. To minimize the different form ofprescribing errors vigorous training in the internship period will help to minimize prescribing errorsand improve rational prescribing too.Key words: dental, examination, medical, objective, prescription, student
Bir Hospital Stastistics
Authors: Author No
Published: September 2018

NA
Percutaneous Adductor Release in Nonambulant Children with Cerebral Palsy
Authors: Sahu Ramji Lal
Published: September 2018

Introduction: Adductor spasticity at hips is the main barrier in functional activities and rehabilitation of spastic cerebral palsy patients. The aim of this study is to evaluate the results of percutaneous adductor release under general anesthesia.Methods: From July 2005 to July 2010, 64 hips in 32 patients (19 males and 13 females) were recruited from outpatient department having adductor contracture at hips in cerebral palsy children. All children were operated under general anesthesia. All children were followed for twenty-four months. The clinical results were evaluated radiologically, including measurement of CE- angle, AC-index and femoral head coverage and in terms of activity level of children.  Results: Of the thirty-two children, twenty-eight showed marked and immediate improvement. None of our children was functionally worse at follow-up. The CE-angle and femoral head coverage did not change significantly. The AC-index improved significantly (p = 0.01).The results were excellent in 12.5% children, good in 50%, fair in 25% and poor in 12.5%. Conclusions: Bilateral mini-invasive adductor release can be an effective treatment for children suffering from adductor contracture refractory to nonoperative management and early adductor release can prevent subluxation and possibly the need for future bony procedure on the proximal femur and pelvis.Keywords: Adductor contracture, Percutaneous, Cerebral palsy, Minimal invasive procedure.
Screening of Syphilis in Abroad Job Seeking Healthy Males
Authors: Shrestha Bidya
Published: September 2018

This study was carried out to find out the prevalence of syphilis is healthy male populations. Testfor Syphilis is mandatory for those who apply for overseas employment, especially in Middle Eastcountries. From randomly selected Nepalese male population (16-50 years) seeking jobs abroad, 2585blood samples were collected and tested by nontreponemal test, the Rapid Plasma Reagin test andby treponemal test, the Treponema pallidum haemagglutination test. Confirmed cases of syphilis were22 (0.85%). No association of syphilis with any age groups (X2 = 6.6465, P>0.05) and developmentregions were observed (X2 = 1.8782, P>0.05). Syphilis occurrence was almost equal in terai (0.94%)and hilly region (0.9%) and was none in mountainous region showing no association (X2 = 1.5334,P>0.05). In eastern development region, all the cases were from terai region showing significantlygreater occurrence of syphilis in terai region (X2 = 4.334, P<0.05). In the contrary, all the cases ofsyphilis in mid-western development region were from hilly region, however this finding was notstatistically significant (X2 = 0.5497, P>0.05). Asymptomatic stage of syphilis may lead to tertiarysyphilis; hence, People should be educated about the disease; they should be screened and treatedwhen required.Key Words: asymptomatic, latent stage, rapid plasma reagin, syphilis, screening
Association Of Cerebrospinal Fluid Lactic Acid In Various Types Of Meningitis
Authors: Kumar Binay
Published: September 2018

NA
Depression: Its Detection And Management In General Practice
Authors: Nepal Mahendra K
Published: September 2018

NA
Approved Essential Drugs For Nepal
Authors: Author No
Published: September 2018

NA
Thiacetazone Reactions In Patan Hospital
Authors: Piya M K
Published: September 2018

A 4 year retrospective study (August 1983- August 1987) of adverse reactions produced by thiacetazone in 1250 pulmonary tuberculosis (T.B.) patients over 15 years of age is reported. Thiacetazone was used in combination with isonizid and rifampicin or streptomycin. The reactions were commoner in younger patients, females and mongoloid races and mostly occured early in treatment. The overall reaction rate was relatively low (4.16%) and continued use of thiacetazone under supervision in areas where cost is important is recommended.
Oral Health Problems in Lalitpur District - Nepal a survey report
Authors: Cox Stephen C
Published: September 2018

This paper reports the results of a "pilot" survey undertaken in 1986 in the region of Lalitpur district, prior to the commencement of a primary oral health programme in the area. Rural areas, and urban schools were the venue for this survey, and were chosen at random.The results show a "low" to "very low" prevalence of dental decay with a rising incidence. On the other hand the area has a "high incidence" of periodental disease. Recommendations are that a fluoride supplement should be added to the diet to maintain a low prevalance of dental decay (especially in the urban area), and that widespread educational programmes should be started with the aim of promoting good oral hygiene practices.
Management of Severe Pancreaticoduodenal Injuries
Authors: Bohara Tanka Prasad , Joshi Mukund Raj , Parajuli Anuj , Bajracharya Gausan Ratna
Published: September 2018

Severe pancreaticoduodenal injuries are rare and no surgeon and institute get enough number of cases to acquire expertise. Hence the management of such injuries remains controversial. We report a case of 28 years male who sustained a severe pancreaticoduodenal injury and was managed with emergency pancreaticoduodenectomy with immediate reconstruction. Various approach has been described in literature with variable outcome. Damage control strategy seems to be most useful approach and major resection should be a part of debridement whenever required. Immediate reconstruction can be carried out safely if patient remain hemodynamically and metabolically stable.
Need of Expansion of Special Adolescent Clinic
Authors: Karki Chandra , Shrestha NS
Published: September 2018

A cross sectional study has been done over a period of one year to find out the total number of youngpeople, adolescents and youth attending at general gynaecological OPD and special adolescent clinic andto analyse them in terms of their sex, ethnicity, address, marital status, education, occupation and theirhealth problems in a teaching hospital at Kathmandu.Of the total 2480 patients 31.29% were young people, 18.34% of them were adolescents and 30.52% ofthem were youth. Male attendance was insignificant. Majority (91%) of the young people were Brahmins,Newars and Chhetriyas. Most (91%) of them were from Kathmandu valley, 73% were already married and60% had experienced pregnancy. Approximately 12% of these people were illiterate, 24.85% of them hadnot completed the primary level education. Only 19%of them had completed the SLC examination Lackof education, trend of early marriage has been reflected on to their occupation. 64% of them are engagedin routine household work as housewives. Few (4.3%) of these young people were not doing anything at all.Majority (59%) of them presented with pregnancy related problems and rest of them came for problemslike Pelvic infection, urinary tract infection, sub fertility, breast problems and others.This study conclude that good number of young people from different parts of the country attend specialadolescent clinic with different needs. Therefore adolescent friendly services in the hospital need to bestrengthened to provide special care for them.Key words: Young people, adolescents, youth, substance abuse, illiterate
Staphylococcal Infections And Urticaria:
Authors: Witherington Katherine A
Published: September 2018

NA
Cancer of the Breast - Recent Trends
Authors: Upadhya Prakash
Published: September 2018

NA
Effects Of Intravenous Verapamil On Ventricular Rate And 'R-R' Interval In Cases Of Atrial Fibrillation
Authors: Kumar Binay
Published: September 2018

NA
Cervical Spondylosis in Nepalese Porters
Authors: Bista Prakash , Roka YB
Published: September 2018

Neck pain with or without radiculopathy and myelopathy is a very common problem in clinicalpractice. The incidence is believed to be higher in subgroups carrying load on their head. It has beenreported in literature that radiographic spondylosis is appreciable in 25% to 50% of population by theage of 50 years and 75% to 85% by the age of 65 years.One hundred and nineteen lateral X-rays of cervical spine were analyzed as case-control studyin patients between 40 and 50 years age with the objective of finding out proportion of cervicalspondylosis in this age group and difference in the prevalence between porters and non-porters.Out of the 119 cases 54 (45.4.2%) were porters and 65 (54.6%) were non-porters. There were 98(82.4%) males and 21 (17.6%) females. The overall prevalence of radiological cervical spondylosiswas 69 (58%). The prevalence of cervical spondylosis was significantly lower (x2 = 14.795, p=0.0001)in porters in comparison to non-porters. The odds ratio was found to be 0.23 (0.10, 0.53) at 95%confidence interval indicating that portering significantly prohibited development of spondylosis.This study concludes that the overall prevalence of cervical spondylosis in the Nepalese populationis slightly higher than in the Caucasian and contrary to other studies there is significantly lowerprevalence of such degeneration among the Nepalese porters.Key words: cervical Spine, cervical spondylosis, head Injury, Nepalese porters
S.I. UNIT
Authors: Shrestha G. B
Published: September 2018

NA
Oral Health Problems in Jumla Area
Authors: Ulenius Kalas U
Published: September 2018

So far there have been very few oral health surveys done in Nepal. This survey was requested from Karnali Techinical School in Jumla to get a picture of the oral health status among the students at the schools as well as the people in Jumla area. Altogether 317 persons were examined.The results show a "very low" (37% 0:8 DMFT for 12 year olds) prevalance of dental caries. It is likely that this will rise the future, due to worse food habits. The incidence of periodontal disease is, however, "high" (97.1% and an average of 3.2 sextants affected by calculus at 16-19 years of age). Prophylactic fluoride and an oral health programme to improve the oral hygiene habits are recommended to maintain the low rate of dental caries and to reduce the rate of periodontal disease.
Experiences In The Management Of Urinary Incontinence In T.U. Teaching Hospital
Authors: Maskey C P , Shrestha M L , Thapa Komal
Published: September 2018

NA
Ruptured Aneurysm of Extracranial Carotid Artery
Authors: Shrestha Uttam Krishna
Published: September 2018

Aneurysm of extracranial carotid artery is an uncommon clinical disease and that presenting as aruptured aneurysm is extremely rare. This entity represents a challenge to treatment strategy. A 54year old hypertensive male presented with painful, pulsatile mass in left neck. Duplex scan revealedthe ruptured left carotid artery at its bifurcation. Angiogram depicted clear picture of rupturedcarotid artery aneurysm. Resection of aneurysm was performed with placement of external carotidshunt. Continuity was maintained with interposition of Dacron graft.Key words: aneurysm, angiography, carotid artery, dacron graft
Studies On The Infestation Rate Of Human Intestinal Parasites Of Kirtipur
Authors: Gupta Ranjana , Gupta H N
Published: September 2018

NA
B-Thalassaemia: A Case Report
Authors: Shrestha H G , Hamal P , Singh B.K. Man , Nakanishi N , Sada D T
Published: September 2018

A case report of B-thalassaemia intermedia was diagnosed in a 22 years women old Nepalese on the basis of the investigations of blood, bone marrow, haemoglobin electrophoresis and X-rays with clinical findings.
Agreement of Co-operation Between Dharma Chitra Guthi and Nepal Medical Association
Authors: Author No
Published: September 2018

NA
Surgical Management of Odontoid Fracture in Elderly
Authors: Nadeem Muhammad , Noon Muhammad Jawad , Daraz Khan Rana Muhammad Omar , Khan Inayatullah
Published: September 2018

Odontoid type II fractures are associated with high mortality in the elderly. Their management can be done either conservatively or surgically, however, surgical treatment is technically demanding and relatively new.

We report a case of 75 years old man who presented to our clinical setting, following a history of fall. The CT scan and MRI showed odontoid type II fracture. With time, the neurological deficit got marked and he underwent transoral odontoidectomy and occipitocervical fixation using rods and screws via posterior approach. Patient’s neurological condition improved dramatically and on the short term follow up, he had no motor deficit. Our experience suggests that occipitocervical fixation via posterior approach is a viable option for the management of odontoid type II fracture in the geriatric population.
Assessing quality of care in the integrated tuberculosis control programme in Surkhet District
Authors: Weakliam David , Hamlet Neil
Published: September 2018

Abstract
PRESCRIBING TRENDS AT IN-PATIENT DEPARTMENTS OF TU TEACHING HOSPITAL, KATHMANDU*
Authors: Srivastava Kalpana , Joshi Mohan P , Maeda Kyoko
Published: September 2018

ABSTRACT
Operative procedure options in tuberculosis of dorsal spine with neurological deficit
Authors: Bajracharya Ashok R
Published: September 2018

Abstract
KNOWLEDGE, SKILL AND APPROACH IN POSTGRADUATE EDUCATION
Authors: Bhattarai M D
Published: September 2018

ABSTRACT
The effect of height and weight adjusted dose of intrathecal hyperbaric bupivacaine for elective caesarean section
Authors: Subedi A , Tripathi M , Bhattarai BK , Gupta PK , Pokharel K , Regmi MC
Published: September 2018

Introduction: The study compared spinal anesthesia using intrathecal hyperbaric bupivacaine between height and weight adjusted dose and fi xed dose during caesarean section.

Methods: A hundred parturients, who had given their consent and were scheduled for elective caesarean section under spinal anesthesia, were randomly assigned into two groups. We adjusted the intrathecal dose of heavy bupivacaine (0.5 %) according to the height and weight of patients (Group AD) from Harten’s dose chart developed from the Caucasian parturients and the fi xed dose (2.2 ml) was used in Group FD patients. Keeping the observer blinded to the study groups, the onset time to sensory block up to T5, haemodynamic changes, side effects, and fetal outcome were observed.

Results: The median onset time of spinal block in Group FD was faster than in Group AD (6 min vs. 4 min; p = 0.01). The spinal block level extended above T3 level in a signifi cantly (p < 0.05) larger number of patients 12 (24 %) in Group FD than in one (2 %) patient in Group AD. A signifi cantly (p < 0.05) larger number of patients, 32, (64 %) in Group FD had hypotension than in 15 (30 %) patients in Group AD. The lowest recorded SAP (101 ± 6 mm Hg) in Group AD was higher than in Group FD (96 ± 6.7 mm Hg). Nausea and vomiting were more pronounced in Group FD patients.

Conclusions: The bupivacaine dose was signifi cantly reduced on its dose adjustment for the body weight and height of patients for cesearean section. This adjusted-dose use suitably restricted spinal block level for cesarean section with a distinct advantage of less hypotension and with a similar neonatal outcome as fi xed compared with the dose use.

keywords: caesarean section; low-dose hyperbaric bupivacaine; spinal anesthesia.
Nurititional Status of Children Under Five Years Age in Social Perspective : A Case Study of Bishankhu Narayan Village
Authors: Bhatta K , Mishra S , Gurung G M
Published: September 2018

Abstract
Femoral Diaphyseal Fractures in Children Treated by Intramedullary Nailing
Authors: Singh S , Rajbhandari A P , Mehata A
Published: September 2018

Abstract
BRACHIAL PLEXUS INJURY? AFTER BRACHIAL PLEXUS BLOCK
Authors: Shrestha Bisharad M , Basnyat Narendra B
Published: September 2018

ABSTRACT
Prospective Study of 100 cases of Pap Smear
Authors: Shrivastava V , Bhanot U K
Published: September 2018

Abstract
Cataract Due to Lighting a Case Report
Authors: Khatry S K , Malla O K , Karki D B , Adhikari K P
Published: September 2018

Abstract
Recent Trends in Chemotherapy in Malaria
Authors: Rehan H S
Published: September 2018

Abstract
Gender and Tuberculosis in Nepal
Authors: Smith Ian
Published: September 2018

Abstract
Gullian Barre Syndrome- Current Concepts
Authors: Agrawal J P
Published: September 2018

Abstract
Epidemiological aspect of Tuberculosis in Nepal
Authors: Sharma Nam Raj , Smith Ian
Published: September 2018

Abstract
OF CADAVERIC PARTICLES AND REVERSE TRANSCRIPTASE LESSONS IN THE CONTROL OF HOSPITAL INFECTION
Authors: Zimmerman Mark D
Published: September 2018

ABSTRACT
Management of Full Thickness Corneal Injury with Traumatic Cataract
Authors: Singh SK
Published: September 2018

Abstract
FAITH HEALERS IN NEPAL
Authors: Shrestha Nirakar Man
Published: September 2018

ABSTRACT
Drug treatment for patient with tuberculosis in the National Tuberculosis Programme
Authors: K.C. Naresh Pratap
Published: September 2018

Abstract
DETERMINANTS OF MATERNAL MORTALITY-A HOSPITAL BASED CASE CONTROL STUDY FROM INDIA
Authors: Anandalakshmy P N , Talwar P P , Buckshee K , Hingorani V
Published: September 2018

ABSTRACT
Tuberculosis and its control in SAARC Countries
Authors: Kumar Prahlad , Bam Drigh Singh
Published: September 2018

Abstract
THE PREVALENCE OF ANAEMIA AMONG PREGNANT AND LACTATING WOMEN, AND AMONG THEIR INFANTS IN SARLAHI DISTRICT
Authors: Dreyfuss Michele L , Shrestha Jay Bahadur , Khatry Subarna Kumar , Shrestha Sharada Ram , Dali Sanu Maya , Adhikari Ramesh Kant , Pokhrel Ram Prasad
Published: September 2018

ABSTRACT
ROAD TRAFFIC ACCIDENT CASES AT BPKIHS, DHARAN, NEPAL: ONE YEAR IN RETROSPECT
Authors: Jha Nilambar
Published: September 2018

ABSTRACT
DOTS-A BREAKTHROUGH IN TB CONTROL
Authors: Bam D S
Published: September 2018

ABSTRACT
The Role of Sedation and Pulse Oximetry During Upper Gastrointestinal Endoscopy
Authors: Sharma Sunil Kumar , Maharjan D K , Thapa P B , Adhikari S B , Byenjankar B , Khadka S , Gurung R
Published: September 2018

Introduction: To determine the changes in oxygen saturation, blood pressure and pulse rate during endoscopic procedure and to evaluate – oesophagogastroduodenoscopy (OGD) related discomfort assessed by the patient. Methods:It is observational case control study. Baseline pulse, blood pressure and oxygen saturation were monitored before procedure, at one minute of procedure, at fi ve minute and soon after procedure. Patients were randomly selected according to lottery system (1: without sedation and 2: with sedation) and divided into two groups; without and with sedation. Before leaving department they were asked about level of discomfort during and after procedure. Results:Patient’s mean age ± SD: 36.65, ± 11.42 years and 53.3% were men. Base line mean oxygen saturation among sedated patient were 96.77 ±1.56 % and 97.23, ± 2.26 % respectively (P=0.358). Mild to moderate hypoxia was noted more in sedated patient than in non sedated patient. Severe hypoxia was noted in 3.3% of sedated patient. No statistically signifi cant change was noticed in pulse and blood pressure in both the group. None or only slight discomfort was experienced by 9.4% in non sedated group and 90.6% in sedated group. Severe discomfort by 96.4% in non sedated group and 3.6% in sedated group .Conclusions:There is slight more incidence of mild hypoxia in sedated group than in non sedated group but no change in pulse and blood pressure. However, sedated patient have significant less level of discomfort than in non sedated group. Though routine use of pulse oxymeter is not necessary, routine use of sedation during endoscopy is recommended. Key Words: discomfort, gastroscopy, oxygen saturation, pulse oximeter
EMERGENCY CONTRACEPTION- AN UPDATE
Authors: Pradhan P
Published: September 2018

ABSTRACT
HIV/AIDS Prevention and Control
Authors: Acharya RP , Bhattarai MD
Published: September 2018

Abstract
Femoral Neck Stress Fractures in Military Personnel
Authors: Joshi Amit , KC B R , Shah B C , Chand P , Thapa B B , Kayastha N
Published: September 2018

Introduction: Stress fractures are common during military training but femoral neck stress fractures are uncommon and sometimes pose diagnostic and therapeutic challenges. An incomplete stress fracture with excellent prognosis, if left unprotected, can lead to displaced femoral neck fracture with almost 63% complication rate even with best of the treatment. The aim of this study was to analyze various aspects of the femoral neck stress fracture so that early diagnosis can be made to prevent devastating complications like osteonecrosis and non-union. Methods: The four year army hospital record of 16 patients with femoral neck stress fracture were studied. Their demographic profi le, type of fracture, presentation delay, on set of clinical symptoms and complication of femoral neck stress fracture were critically analyzed. Results: The mean age of the patient was 19.94 years. Total 74% of them developed fi rst symptoms of stress fracture between four to seven weeks of training. There was 3.4 weeks delay from the clinical onset of symptoms to the diagnosis of stress fracture. The type of femoral neck stress fracture were compression (31.25%), tension (18.75%) and displaced (50%). Out of eight displaced type of fractures, 5 (62.5%) had developed complications (3 osteonecrosis and 2 nonunion).Conclusions: Femoral neck stress fracture occurs in initial four to seven weeks of training. The high index of suspicion in initial period of training can help to detect and decreases significant morbidity.Key Words: displaced stress fractures, non-union, osteonecrosis, recruits
Role of broad spectrum antibiotics in chest infections in infants.
Authors: Sharma Pushpa Raj
Published: September 2018

50 patients with chest infections admitted in the Kanti Childrens Hospital were studied to assess the effectiveness of the broad spectrum antibiotics in altering the course of the disease. These infants were graded to assess the daily improvement in their conditions and were followed up to 7 days. Altogether 12 patients were grouped in grade 2 and 38 were grouped in grade 1. There were no change in the condition of these patients up to the fifth day of admision inspite of the costly drugs used.These findings confirm that routine use of antibiotics in chest infections in infants without secondary complications does not alter the prognosis. Moreover it increases the economic burden to family whose daily income can hardly afford nutretious diet.
Development of Health Services Research in Nepal.
Authors: Joshi D D , Pande B R
Published: September 2018

NA
BRAIN'S OWN OPIATES
Authors: Devkota Upendra Prasad
Published: September 2018

NA
Paediatric Care (0-5 Age Group) In Developing Countries (With Special Reference to India)
Authors: Bhatla P C
Published: September 2018

NA
Best Scientific Papers Read in The Tenth All Nepal Medical Conference Held in February 19--22, 1981 at Kathmandu
Authors: Author No
Published: September 2018

NA
The Pluripotent Doctor
Authors: D U P
Published: September 2018

NA
Shakespeare And Medicine
Authors: Prasad Ram Shakal
Published: September 2018

NA
Selected Abstracts
Authors: Author No
Published: September 2018

NA
Effects Of Durabolin On Pulmonary Tuberculosis
Authors: Rijal P P , Karki D B
Published: September 2018

NA
Present Status of Malaria in Nepal
Authors: Sakya G M
Published: September 2018

NA
Obituary
Authors: Author No
Published: September 2018

NA
Adequacy of hemodialysis in Nepalese patients undergoing maintenance hemodialysis
Authors: Sultania P , Sharma Sanjib Kumar , Sharma SK
Published: September 2018

INTRODUCTION:Inadequate dialysis accounts for the high mortality in patients with end stage renal disease (ESRD). In Nepal, due to various factors including financial and logistic limitations, hemodialysis is mostly performed twice-a-week. This study was undertaken to look at adequacy of dialysis in patients undergoing maintenance hemodialysis in Nepal where the patients profile, in terms of diet, body muscle mass, nutritional status etc are different from western world.METHODS:In this cross sectional observational study, 40 patients on maintenance hemodialysis in the dialysis unit were evaluated and enrolled if patients were regularly undergoing twice-a-week hemodialysis in preceding 6 months with each session of dialysis prescription consisting of 4 hours (240 minutes). Patients were excluded if they were admitted in the hospital for some acute problems or had received acute hemodialysis in preceding 6 months. Only 14 patients fulfilled the inclusion criteria. Hemodialysis adequacy was measured using well established urea kinetic modeling.RESULTS:The mean age of the patients was 49 +/- 24 years. Mean predialysis urea and post dialysis urea were 163.7 +/- 60.05 mg/dL, and 73.7 mg/dL +/- 30.55 respectively. Mean URR was 65.3%. Mean Kt/v as assessed by Jindals equation was 0.99.CONCLUSIONS:Our study showed that twice-a-week of maintenance hemodialysis did not achieve recommended adequacy of hemodialysis in our patients.Key words: Adequacy of dialysis, end stage renal disease, hemodialysis.
Prevalence of Dental Caries in 5 – 6 Years and 12 – 13 Years Age Group of School Children of Kathmandu Valley
Authors: Subedi B , Shakya P , KC U , Janawali M , Paudyal BD , Acharya A , Koirala S , Singh A
Published: September 2018

Introduction: Dental caries is one of the most common conditions affecting the general health of children. The present study was carried out among school children of Kathmandu valley to determine the prevalence of dental caries in two age groups.

Methods: The study was conducted from December 2007 to May 2008. The age of the school children of the study was divided into two group: 5 - 6 years and 12 - 13 years. A stratifi ed cluster sampling with proportional allocation was used while grouping the subjects. The dental status examination was done with the help of trained dentists. Decayed, missed and fi lled teeth index and decayed, missed and fi lled surfaces index (dmft for primary dentition and DMFT for permanent dentition) were used as the standard tools for the determination of prevalence.

Results: A total of 638 students (325 of age group 12 - 13 years and 313 of age group 5 - 6 years) from 30 different schools of the Kathmandu valley were included in the study. The caries status was found higher in the age group of 5 - 6 years than in the 12 - 13 years and it was found to be statistically signifi cant (p < 0.001). The dmfs and caries percentage of the age group 5 - 6 years and the DMFS and caries percent of the 12 - 13 years was found to be 3.79, 69 % and 1.6, 53.23 % respectively. The dmft/dmfs value was found to be signifi cant according to the districts in the 5 - 6 years age group whereas the DMFS was found statistically signifi cant among the sexes of the 12 - 13 years age group.

Conclusions: The caries percentage was found to be above the recommended level of the World Health Organization. However, the DMFS and DMFT values were within the WHO level.

Keywords: Children, dental caries, DMF index.
SOMENTHING WORHT-REMEMBERING
Authors: Black A K
Published: September 2018

SOLUTIONS FOR INTRAVENOUS INFUSION
Assignment Report on Maternal andv Child Health(WHO project:Nepal 0008)
Authors: Van Dijk Ida J.
Published: September 2018

Abstract
PUERPERAL PSYCHOSIS
Authors: Sharma B P
Published: September 2018

abstract
URINARY TRACT INFECTION
Authors: Gurubacharya V L , Prashai B R
Published: September 2018

ABSTRACT
USEFUL THERAPY TO REMEMBER THERAPY AFTER PARTIAL GASTRECTOMY
Authors: Leonard-jones J E
Published: September 2018

Abstract
Artificial Blood
Authors: Singh Rajan
Published: September 2018

abstract
Auditor's Report for fiscal year 2039-40
Authors: Pradhan P P
Published: September 2018

abstract
NEW DIRECTIONS IN MEDICINE
Authors: Author Author
Published: September 2018

BIRTH DEFECTS OFTEN LINKED TO ENVIRONMENTAL INFLUENCES
Study of Leprosy Patients in Routine Skin Outdoor of Bheri Zonal Hospital-Nepalgunj
Authors: Shakya G Raj
Published: September 2018

abstract
Proposed Constitutional Amendment
Authors: Pradhan Sitaram BS
Published: September 2018

abstract
Diagnosis of Tubercular Lymphadenopathy by Fine Needle Aspiration Cytology, Acid-Fast Staining and Mantoux Test
Authors: Lakhey Mamta , Bhatta C P , Mishra S
Published: September 2018

Introduction: This study was undertaken to evaluate the role of Ziehl-Neelsen stain (for acid-fastbacilli), and Mantoux test in diagnosing tubercular lymphadenopathy on FNAC.Methods: FNAC was performed on patient with superfi cial lymphadenopathy. Ziehl-Neelsen stainfor acid fast bacilli was done in all cases where cheesy or purulent material was aspirated and smearsshowed granulomatous lymphadenitis. A Mantoux test was also done in these patients. A Mantouxtest was further done in patients of reactive lymphadenopathy where the lymph node size was morethan 1 cm. If the result was positive, a repeat FNAC was performed. When the repeat FNAC showedill-defi ned granulomas, excision biopsy was done.Results: Tubercular lymphadenopathy was seen in 122 (48.2%) cases. Acid- fast bacilli were found in71 (58.1%) cases. Mantoux test was positive in 112 (91.8%) cases. A repeat FNAC was done in sevenof 11 patients where the cytologic features of tuberculosis were not seen but the lymph node size wasmore than 1 cm and Mantoux test was positive. The repeat FNAC showed ill-defi ned granulomaswithout necrosis. Excision biopsy done in these patients diagnosed them as tubercular lymphadenitisin fi ve of the seven cases, the remaining two cases being diagnosed as reactive lymphadenitis.Conclusions: FNAC coupled with Ziehl – Neelsen staining for AFB and Mantoux test improves thediagnostic effi ciency for tubercular lymphadenopathy.Key Words: FNAC, lymphadenopathy, mantoux test, tuberculosis, Ziehl-Neelsen stain