bluuebunny/crossref_metadata_2025 huggingface dataset:
Continuinig Medical Education- A Must
Authors: Bhatla P C
Published: September 2018

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

NA
The Surgical Treatment Of Retinal Detachment Modified By The Use OF Cryotherapy
Authors: Harris Dennis
Published: September 2018

NA
Combined Treatment of Alendronate and Low-Intensity Pulsed Ultrasound (LIPUS) Increases Bone Mineral Density at the Cancellous Bone Osteotomy Site in Aged Rats: A Preliminary Study.
Authors: Aonuma H , Miyakoshi N , Kasukawa Y , Kamo K , Sasaki H , Tsuchie H , Segawa T , Shimada Y
Published: September 2018

Introduction: During fracture healing, alendronate encourages callus volume by inhibiting bone resorption, whereas low-intensity pulsed ultrasound (LIPUS) enhances bone regeneration by promoting an anabolic response.

Methods: In the present study, 9-month-old Sprague-Dawley rats, with a unilateral proximal tibial osteotomy, were treated with alendronate (daily, 1 g/kg) plus sham-LIPUS (n = 14), saline plus LIPUS (20 min/day) (n = 18), alendronate plus LIPUS (n = 16), or saline plus sham- LIPUS as a control (n = 13) for 4 weeks. The rats were then examined for changes in bone mineral density (BMD) during metaphyseal bone repair.

Results: The combined therapy signi cantly increased BMD at the osteotomy site at 4 weeks (p < 0.001) compared with the control, without affecting the contralateral, non-osteotomized tibia. Both alendronate and LIPUS alone also exerted a positive, albeit less, effect on BMD in the affected limb (p < 0.001 and p = 0.006, respectively).

Conclusions: Alendronate and LIPUS cooperate to enhance BMD during metaphyseal bone healing.

Keywords: LIPUS, bisphosphonate, bone mineral density.
Tamoxifen for Breast Cancer
Authors: Karn A , Jha A K , Shrestha S , Acharya B , Poudel S , Bhandari R B
Published: September 2018

Breast cancer is one of the common cancers. Hormonal therapy along with surgery, chemotherapy, radiotherapy and targeted therapy are vital modalities for the management of breast cancer. Tamoxifen has been the most widely used hormonal therapy for more than two decades. In this article we review the benefits, dose, duration and timing of Tamoxifen therapy in patients with breast cancer.

Keywords: breast cancer, hormonal therapy, tamoxifen.
Erythrocyte Life Span And Sequestration Studies With 51chromium in Kala-azar
Authors: Shrestha I L , Ghose S , Bhattacharya K S , Bose A
Published: September 2018

NA
Rabies Or Hydrophobia
Authors: Mast Jeff
Published: September 2018

NA
Medical Philately
Authors: Mack Gordon
Published: September 2018

NA
Kathmandu Med. jour. Club Report
Authors: Author No
Published: September 2018

NA
List Of Medical Journals
Authors: Author No
Published: September 2018

NA
Refresher Courses
Authors: Editor JNMA
Published: September 2018

NA
Staph. Pneumonia Quartet
Authors: Dixit Hemang , Gyawali Bina
Published: September 2018

NA
Dextrocardia In two Brothers
Authors: Dixit Hemang , Gyawali Bina
Published: September 2018

NA
Risk Factors associated with Still Births
Authors: Shrestha S R , Yadav B K
Published: September 2018

INTRODUCTION:

Still birth is a common adverse outcome of pregnancy, associated with many risk factors like prematurity, infection, birth injury, eclamptic disorders.

METHODS:

A hospital based, retrospective study was conducted at Patan Hospital in the year 2064. The number of still births and their associated risk factors were assessed.

RESULTS:

There were three thousand and five hundred and eighty eight deliveries. Among all deliveries, still birth cases were counted forty seven with a rate of 14 per thousand deliveries. The major risk factors were prematurity, low birth weight, fetal distress and maternal jaundice.

CONCLUSIONS:

Prematurity was the commonest risk factor for still birth.
Social marketing of contraceptive in nepal.
Authors: Poudyal Ranjan L
Published: September 2018

NA
contraceptive Technology
Authors: Vaidya Kokila
Published: September 2018

NA
Education of Adolescents on Reproductive Health- Which way to Go
Authors: Roy S
Published: September 2018

INTRODUCTION:

The study was done to assess the educational needs of the adolescent girl students regarding their reproductive health.

METHODS:

The data were collected by administering an open-ended self-administered questionnaire to the participating students seeking their opinion on several issues related to adolescent reproductive health.

RESULTS:

The students preferred their teachers next only to doctors as health educator. Their health problems included menstrual problems, weakness, eye problems, headache and weight gain. Other problems were tension with studies, inability to concentrate, depression and irritability. Two most important areas of their concern are safe motherhood and AIDS.

CONCLUSIONS:

Need exists for reproductive health education.

Keywords: adolescent, reproductive health education, school.
incidence of Human Brucellosis in Kathmandu
Authors: Joshi D.D
Published: September 2018

NA
Enteric fever-a review of clinical records
Authors: Malla F.B , Shakya G.M
Published: September 2018

NA
Bacteriology and Antibiotic Susceptibility Pattern of Peitonsillar Abscess
Authors: Acharya A , Gurung R , Khanal B , Ghimire A
Published: September 2018

INTRODUCTION:

Peritonsillar abscess is a common complication of acute tonsillitis. Its management consists of aspiration or surgical drainage followed by appropriate antibiotics. Appropriate antibiotic treatment depends on the common organisms associated with infection and their antibioticsensitivity pattern in local scenario.

METHODS:

Pus samples aspirated from diagnosed cases of peritonsillar abscess and submitted for culture and sensitivity in last two years were included in this study. Identification of different microorganisms was made on the basis of the microscopic findings, observation of their colony morphology and standard biochemical reactions. Susceptibility pattern to commonly used antibiotics were determined by Clinical Laboratory Standards Institute (CLSI) guidelines.

RESULTS:

Altogether 24 pus samples were included in the study. Positive culture was obtained from 18 samples. Among them one organism was isolated from 13 samples whereas from five samples multiple organisms were isolated. From six samples no organisms could be cultured. Altogether Streptococcus pyogenes was isolated from 12 samples and Staphylococcus aureus from five samples. Other isolated organisms included Haemophlilus influenzae, Pseudomonas aeruginosa, Escherichia coli and Enterococcus species. Penicillin was effective for Streptococcus pyogenes whereas Staphylococcus aureus was resistant to it. Cloxacillin was found to be effective for Staphylococcus aureus. Ciprofloxacin and Ceftazidime were found to be effective for both organisms.

CONCLUSIONS:

Streptococcus pyogenes and Staphylococcus aureus were more commonly associated with peritonsillar abscess. Streptococcus pyogenes were sensitive to penicillin but all Staphylococcus aureus were resistant to it. This fact should be considered in clinical practice for management of peritonsillar abscess.

KEYWORDS: Bacteriology, Peritonsillar abscess, Susceptibility pattern.
Two cases of intraperitoneal haemorrhage of unusual Aetiology
Authors: Eldrige M.G
Published: September 2018

Na
Cerebral Malaria
Authors: Shrestha Dr.G.P , Rawal Dr.K.B. , Suvedi Dr.B.K.
Published: September 2018

NA
Oesophageal Perforation
Authors: Sharma A K , Sharma G , Shrestha J K
Published: September 2018

NA
EVidence of Leshmaniasis in Nepal
Authors: Joshi D D
Published: September 2018

NA
Impact of Abnormal foetal Heart Rate with Meconium Stained Liquor Amniion on Birth scores.
Authors: Sinha Radha Krishna , Singh Bharat Prasad , Pal Heera Lal
Published: September 2018

NA
Importance of serum copper 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
Madura Foot
Authors: Shafique Dr.M. , Sinha Dr.B.C.
Published: September 2018

NA
Ultrasound Versus the Landmark Technique: A Prospective Randomized Comparative Study of Internal Jugular Vein Cannulation in an Intensive Care Unit
Authors: Shrestha B R , Gautam B
Published: September 2018

OBJECTIVE:

The aim of this study is to find out if an ultrasound technique has advantages over the conventional landmark technique.

METHODS:

This is a prospective randomized comparative study on 120 patients requiring central venous cannulation of the right internal jugular vein. The study comprised of two groups: ultrasound and landmark groups, each consisting of 60 patients. The outcome measures were compared between the groups.

RESULTS:

Cannulation of the internal jugular vein was successful in 58 patients in the ultrasound group and in 53 in the landmark group. The number of attempts was 1.5 (1 - 3) and 2 (1 - 3) in the ultrasound and landmark group respectively (p = 0.001). The time taken for the successful cannulation was 4.9 +/- 1.7 minutes in the ultrasound approach and 8.0 +/- 2.8 minutes in the landmark approach (p = 0.00). The internal jugular vein diameter in the supine position was 11.2 +/- 1.5 mm which increased to 15.04 +/- 1.5 mm with a 15 degrees head-down position in the USG group (p = 0.001). The first attempt success rate was 39/60 (63%) in the ultrasound group and 19/60 (32%) with the landmark technique. The seven (12%) failure cases in the landmark group were rescued by the ultrasound technique. Inadvertent carotid artery puncture occurred in 2/60 (3%) and 6/60 (10%) of patients in the ultrasound and land mark group respectively.

CONCLUSIONS:

Ultrasound improves success rate, minimizes cannulation time and complications during internal jugular vein cannulation. It can be employed as a rescue technique in cases of a failed landmark technique.

Keywords:cannulation, central, landmark, technique, ultrasound.
Nepal Medical Association
Authors: NA NA
Published: September 2018

NA
A Comparitive study of Tetanus Neonatorum
Authors: Suvedi B K
Published: September 2018

NA
Dental Caries
Authors: Bahadur Basant , Kansakar Bina
Published: September 2018

NA
W.H.O. Goitre Team
Authors: Author No
Published: September 2018

NA
The Prevalance of Tuberculosis in Cattle and Buffalo in the Koshi Hills of Nepal
Authors: Morel AM
Published: September 2018

NA
Head injury in Bir HOspital
Authors: Gongal DN , Shrestha RK
Published: September 2018

NA
Traditional Beliefs from Nepalese culture in Relation to Obstetrics.
Authors: Dali Dr.Sanu Maiya
Published: September 2018

Na
Seasonal Prominence of Diabetes Mellitus
Authors: Singh Dr.Lakhan
Published: September 2018

NA
Creativity
Authors: Joshi Dr.Mohan P
Published: September 2018

NA
Supplement
Authors: Author No
Published: September 2018

Ministers of HealthExecutive Committee Of N.M.A.N.M.A Telephone No.N.M.A. Legal AdviserSubcommittee ReportsMedical NewsObituary
President's Address
Authors: Author No
Published: September 2018

NA
Role of Analgesia in Spinal Analgesia.
Authors: Kafle S K
Published: September 2018

NA
The Fecal Contamination of janakpurdham's Water supply on the Occasion of the ram Navani festival.
Authors: Burghart Richard
Published: September 2018

NA
Spinal Cord Injury Rehabilitation in Nepal
Authors: Shah Nabina , Shrestha Binav , Subba Kamana
Published: September 2018

Spinal cord injury is a major trauma, with its short and long term effects and consequences to the patient, his friends and family. Spinal cord injury is addressed in the developed countries with standard trauma care system commencing immediately after injury and continuing to the specialized rehabilitation units. Rehabilitation is important to those with spinal injury for both functional and psychosocial reintegration. It has been an emerging concept in Nepal, which has been evident with the establishment of the various hospitals with rehabilitation units, rehabilitation centres and physical therapy units in different institutions. However, the spinal cord injury rehabilitation setting and scenario is different in Nepal from those in the developed countries since spinal cord injury rehabilitation care has not been adequately incorporated into the health care delivery system nor its importance has been realized within the medical community of Nepal. To name few, lack of human resource for the rehabilitation care, awareness among the medical personnel and general population, adequate scientific research evidence regarding situation of spinal injury and exorbitant health care policy are the important hurdles that has led to the current situation. Hence, it is our responsibility to address these apparent barriers to successful implementation and functioning of rehabilitation so that those with spinal injury would benefit from enhanced quality of life.Keywords: rehabilitation; spinal injury.
Surgical Treatment Of Peptic Ulcer
Authors: Sharma A K
Published: September 2018

NA
Pathophysiology Of Diastolic Hypertension
Authors: Shrestha Y B
Published: September 2018

NA
Discussion On Vasectomy
Authors: Author No
Published: September 2018

NA
Accuracy of Triple Test Score in The Diagnosis of Palpable Breast Lump
Authors: Ghimire Bikal , Khan MI , Bibhusal T , Singh Y , Sayami P
Published: September 2018

Breast lump is a very sensitive issue for the patient so a reliable, non invasive and prompt diagnosishelps to lessen the associated anxiety and leads to early definitive treatment. The aim of this studywas to evaluate the acuracy of Triple Test Score (TTS) as a clinical tool for the diagnosis of a palpablebreast lump. This diagnostic test study was carried out in the Department of Surgery of TribhuvanUniversity Teaching Hospital. Of the 117 patients admitted with breast diseases from the breastclinic over thirteen months, 87 had breast lump. Fifty patients underwent Triple Test Score ( physicalexamination, mammography and fine needle aspiration cytology) and were categorized into benign,suspicious and malignant. This was later correlated with the histopathological findings. Nineteenpatients with breast lumps interpreted by TTS as benign correlated with the histopathologicalfindings whereas of 31 malignant lumps, 30 turned out to be malignant and one benign. This givesTTS an over all accuracy of 98% with 100% sensitivity, 95.2% specificity and positive predictive valueof 96.7%. Carcinoma was seen in 29 (58%) cases in the age group of 35 to 70 years. The mean age atdiagnosis of benign and malignant disease was 41.8 and 45.1 years respectively. In conclusion, TTS isan accurate and least invasive diagnostic test based on which definitive treatment can be initiated.Key words : breast lump, carcinoma breast, triple test score
surgical Aspect Of Family Planning
Authors: Sharma A K
Published: September 2018

NA
Food For Thought
Authors: Author No
Published: September 2018

NA
Journal of The Nepal Medical Association- Editorial
Authors: Small Michael L
Published: September 2018

Surgery In Tuberculosis Of The Lung, (VIII)
A Brief Study On The Epidemiology Of Filariasis In Nepal
Authors: Jung Rana Krishna
Published: September 2018

NA
Tuberculosis Case Finding And Treatment In Lalitpur Wards 1,2, & 3 From December 1970 through August 1973
Authors: Bomgars M R
Published: September 2018

NA
Escherichia Coli Culture Filtrate Includes Diarrhea Resembling Cholera
Authors: Nalin David R
Published: September 2018

NA
Peripartal Cardiomyopathy
Authors: Pandey M R , Tripathi B P , Suwal Y
Published: September 2018

NA
Medical Record And Its Value
Authors: Pradhan T M.S.
Published: September 2018

NA
A Preliminary Study On An Easy And Inexpensive Method For The Detection Of Tuberculosis In Cattle Using The Glutaraldehyde Test
Authors: Larsson Stig
Published: September 2018

NA
A Report On Knowledge, Attitude, Use-Pattern And Availability Of Jeevan Jal(Pre-Packaged Oral Rehydration Slts) In Baitadi
Authors: Suvedi B K
Published: September 2018

A Study regarding the knowledge, altitude, use pattern and availabity of Jeevan Jal JJ was undertaken in the remote hilly district of Baitadi of Far Western Development Region of Nepal. The study shows that the females are less aware(38.7% about Jeevan Jal than the males (76%). 57.3% of the total respondents had knowledge about Jeevan Jal, 42% know the use of it and 28.3% consider it should be given in diarrhoes accordingly as recommended. 64.5% of those, who have seen JJ (116/172) had prepared its solution, but only 27.6% (32/116) can make it correctly, (and the males leading again-17.3% versus 4% females, that is only 10.6% of the total,) and 62.9% know that it must be used within24 hours of preparation of the solution. 98% of the respondents found it is not available in the village panchayat office or worker (31.2%) and/or centrally located home in the village(29.5%).
Anaesthetic Circuits - Review Study
Authors: Shrivastava C P
Published: September 2018

NA
Model Village Health Camp By Nepal Medical Association
Authors: Author No
Published: September 2018

NA
Study of Breast Lump of 2246 Cases by Fine Needle Aspiration
Authors: Pradhan Manohar , Dhakal HP
Published: September 2018

The purpose of this study was to analyze breast lesions causing breast lump with special referenceto patients younger and older than 30 years of age diagnosed by fine-needle aspiration (FNA) and toevaluate the histology of the cases diagnosed as suspicious of malignancy in FNA.All patients who underwent FNA during four years period (2000-2004) were included in this study.The FNA procedure was performed and interpreted by the experienced pathologists. Histologicalevaluation of the suspicious cases in FNA was done and was based on excisional biopsy or mastectomyspecimen.Out of 2246 FNA performed, 1840 were diagnosed as non-malignant, 6 atypical ductal hyperplasia,52 suspicious of malignancy and 348 as malignant. The most common non-malignant lesionsincluded 975 (43%) fibroadenosis, 180 (8%) fibroadenoma, 126 (6%) abscess and 96 (4%) fibrocysticchanges. The patients were further divided into two groups: group I consisted of 918 patients aged30 years and younger and group II consisted of 1328 patients above 30 years. In group I, 444 (48.4%)were diagnosed as fibroadenosis and only 15 (1.6%) cases were malignancies. In group II 531 (40%)were fibroadenosis and 333 (25%) were malignant. Patients more than 30 years old had significantlyhigher malignancy diagnoses (P <0.001). The odds of being diagnosed as malignant tumor amongthe higher age group patients (>30 years) is 21 times larger (confidence interval 12.4, 35.6) than theyounger patients (< 30 years). In 63% (27/43) of the suspicious cases, malignancy was diagnosed inhistological examination.Cancer and Fibroadenosis are two most common causes of breast lumps in Nepal. Incidence ofmalignancy is significantly lower in patients aged 30 years and younger than in patients aged olderthan 30 years. Suspicious FNA cases should be evaluated histologically to rule out malignancy.Key words: breast, cancer, fine needle aspiration
Female Sterilization Through Vaginal Tubectomy
Authors: Maskey C P
Published: September 2018

NA
A comparison of the approaches to assess the abdominal aortic stiffness using M-mode ultrasonography, tissue tracking and strain rate imaging
Authors: Zheng Xiao-Zhi , Yang Bin , Wu Jing
Published: September 2018

Introduction: Which kind of ultrasound imaging technique is suitable for the assessment of theabdominal aortic stiffness are seldom reported. The purposes of this study were to explore a reliablemethod to evaluate the abdominal aortic stiffness in patients with hypertension among the followingultrasound imaging techniques: M-mode ultrasonography (M-mode), tissue tracking and strain rateimaging.Methods: Fifty patients with hypertension and fifty age and sex-matched healthy volunteers wereinvolved in this study. The displacement (d), the peak strain (ε) and the peak strain rate (s) wereobtained from the long-axis images of the abdominal aorta using tissue tracking and strain rateimaging, respectively. The pressure strain elastic modulus (Ep), β stiffness index and distensibilitywere calculated according to the conventional formulas using M-mode combined with the bloodpressure.Results: Compared to the normal subjects, the difference between systolic diameters and diastolicdiameters (Δdiameter), the displacement of posterior wall (d-posterior), the difference of thedisplacement between anterior and posterior wall (Δ displacement), and the distensibility decreasedand the Ep and β stiffness index increased in the hypertension patients There were no significantdifferences between the patients with hypertension and the normal subjects according to the ε, s.Among Δdiameters, d-posterior, Δdisplacement, the ε and s, only Δdiameters significantly correlatedwith the Ep, β stiffness index and the distensibility in hypertension patients.Conclusions: Strain rate imaging cannot sensitively discriminate the difference of the abdominal aorticstiffness between patients with hypertension and the normal subjects. M-mode ultrasonography isstill a classical method for accessing the aortic elasticity._______________________________________________________________________________________Keywords: abdominal aortic elasticity; hypertension M-mode ultrasonography; strain rate imaging; tissuetracking._______________________________________________________________________________________
Loupe Magnification for Small Incision Cataract Surgery - an Alternative to Microscope Magnification?
Authors: Singh Sanjay Kumar , Winter I , Hennig A
Published: September 2018

A Prospective randomized controlled study was conducted to compare outcome of Small IncisionCataract Surgery (SICS) using microscope or loupe magnification.Two hundred fifty one patient with mature cataract were randomly allocated to SICS-FishhookTechnique with either microscope (127 eyes) or loupe (124 eyes) magnification. Intra- andpostoperative complications and immediate visual outcome were analyzed.Nearly two third (microscope 65% and magnifying loupe 62.9%) of all patients had good visualoutcome on first postoperative day. Poor outcome (<6/60) was recorded in 8% (microscope group)and 7% (magnifying loupe group). Mean visual acuity with Snellen was 0.39 (SD 0.2) in microscopegroup and 0.38 (SD 0.2) in magnifying loupe group. Intra operative complications were comparablein both groups. Mean surgery time with loupe magnification was significantly shorter.Comparatively equivalent good surgical outcome was achieved with loupe as well as with microscopemagnification. However performing SICS with loupe magnification is significantly faster. Smallincision cataract surgery with loupe magnification is safe and effective procedure for cataract surgeryso it can play a role in reducing cataract blindness in developing countries of the world.Key words: loupe, magnification, microscopic, cataract, surgery
Fahr’s Disease Presenting with Manic Symptoms
Authors: Subedi Sandip , Mukhi Sadan , Pandey Pradip
Published: September 2018

Bilateral striopallidodentate calcinosis (BSPDC), commonly known as Fahr’s disease, is a rare syndrome characterised by symmetrical calcification over the basal ganglion and dentate nucleus. No case of Fahr's disease with associated manic symptoms has been described in the literature to date. We report an unusual case of Fahr’s Disease in a 18 year old unmarried male who presented to the emergency department of Universal College of Medical Sciences – Teaching Hospital, Nepal with symptoms of mania. This rare case of Fahr’s disease has been reported to highlight this unusual condition and its differentiation from the commoner Fahr’s syndrome.
Acute Respiratory Infections in Infants and Children
Authors: Sharma Phuspa Raj
Published: September 2018

NA
Incidence Of Disease In Patan Hospital General Outpatient Department
Authors: Gsellman R
Published: September 2018

The article a month by month survey of the diagnoses made in the general outpatient department of Patan Hospital in Lalitpur District. The survey began in Poush 2043 and ended in Mangsir 2044.A total of 79,404 diagnoses were made over the tweleve month period by the Doctor's Assistants, The greatest number of disgnoses were in the category of infectious disease (49%), followed by the category of preventive/ family planning (18%). within the category of infectious disease, the leading system involvement was gastro-intestinal (40%), followed by respiratory (34%) and skin (13%).Seasonal fluctuations were found for the diarrhoeal disease (peak incidence Jestha-Shrawan), acute respiratory infections (two peaks: one in Chaitra-Baishak, the other in Bhadra-Asoj), and skin infections (peak in Shrawan-Asoj). The hepatitis epidemic in Kathmandu Valley was also documented, with a peak in Bhadra. Enteric Fever was found to peak in Asoj.
Giant Common Bile Duct Stones Without Jaundice And A Shrivelled Gall Bladder
Authors: Joshi Bhola Raj , Khakurel Mahesha , Upadhya Prakash
Published: September 2018

NA
Case of Intestinal Myiasis In Darchula
Authors: Marasini B R
Published: September 2018

A case of Intestinal Myiasis in a 21 year old male patient is reported along with brief review of te subject and possible management.
Comparison of Pre and Post-operative Hearing Results in Canal Wall Down Mastoidectomy with Type III Tympanoplasty
Authors: Shrestha Bikash Lal , Bhusal CL , Bhattarai H
Published: September 2018

This study was done to compare the pre and post-operative hearing results in patients undergoingcanal wall down mastoidectomy with classical type III tympanoplasty using temporalis fasciaalone.Patients of ≥5 years age with the diagnosis of Chronic otitis media (squamous) with conductive ormixed hearing loss, needing canal wall down mastoidectomy and with intact and mobile stapessuprastructure at surgery who underwent classical type III tympanoplasty were included in thestudy. The pre and post-operative PTA was performed and evaluated. The post-operative hearingwas assessed in terms of average ABG and size of ABG closure.Mean pre and post-operative air bone gap in classical type III tympanoplasty were 37.8 dB and 29.8dB respectively and these differences were statistically significant. The postoperative PTA-ABGranged from 15-61.2 dB.Hearing results after type III tympanoplasty varied widely showing statistically significantimprovement in mean post-operative PTA-ABG but there was a great variation.Key words: air bone gap, chronic otitis media, mastoidectomy, tympanoplasty
Acquired Immuno Deficiency Syndrome (AIDS)
Authors: Shrestha Chandrika Devi , Pradhan Suvarna
Published: September 2018

NA
Bedside Differential Diagnosis In Clinical Medicine
Authors: K R K
Published: September 2018

NA
Laurence-Moon-Bardet-Biedl Syndrome
Authors: Sahu JK , Jain Vandana
Published: September 2018

Laurence-Moon-Bardet-Biedl syndrome is a rare, genetically heterogeneous, autosomal recessiveinherited disorder with wide variability in expression. We report a case of Laurence-Moon-Bardet-Biedl syndrome with typical phenotype in conjunction with nonalcoholic steatohepatitis. Thediagnosis had been missed until the patient presented at our hospital.Key words: laurence-moon-bardet-biedl syndrome, obesity, polydactyly, retinitis pigmentosa
MORBIDITY PROFILE OF PATIENTS ATTENDING NEUROPSYCHIATRIC OPD AT THE WESTERN REGIONAL HOSPITAL, POKHARA
Authors: Upadhayay K D , Dutta S , Singh G
Published: September 2018

ABSTRACT
PREVALENCE OF HBV INFECTION AMONG THE HEALTHY NEPALESE MALES: A SEROLOGICAL SURVEY
Authors: Manandhar Kishor
Published: September 2018

ABSTRACT
PERITONEAL DIALYSIS IN NEPAL-A REVIEW
Authors: Kafle RK , Suvedi BK , Satyal PR
Published: September 2018

ABSTRACT
ANTILEPROTICS, LEPROSY AND THE PROFESSION
Authors: Soldenhoff Richard De
Published: September 2018

ABSTRACT
A Comparative Study Between Laproscopic and Mini Laproscopy Cholecystectomy
Authors: Christian L B , Charles N
Published: September 2018

Abstract
The pattern of anti-tuberculosis drug resistance in patients traeted at an urban tuberculosis clinic Kathmandu valley
Authors: Shrestha Bhawana , Neher A. , Breyer O. , Feldmann K.
Published: September 2018

Abstract
Arthroscopy in Tuberculosis of the Knee Joint
Authors: Shrivastava M P
Published: September 2018

Abstract
VOGT, KOYANAGI, HARADA (VKH) SYNDROME
Authors: Shah D N , Karmacharya PCD , Koirala S , Upadhayay M P
Published: September 2018

ABSTRACT
A Rare Case of Small Intestinal Leiomyosarcoma Presenting As An Acute Intestinal Obstruction
Authors: Christian Lynden B , Charles N , Ray D , Joshi B R
Published: September 2018

ABstract
STRENGTHENING GENERAL PRACTICE TRAINING IN NEPAL
Authors: Allison David J , Gupta Shatendra K
Published: September 2018

ABSTRACT
Tuberculin surveys conducted by National Tuberculosis Control Project (Phase I and II)
Authors: Hoshino Hitoshi
Published: September 2018

Abstract
Management of HIV-infected tuberculosis in national tuberculosis programmes
Authors: Kumaresan Jacob
Published: September 2018

Abstract
Current Status in The Management of HCV
Authors: Shrestha R
Published: September 2018

Abstract
COMPUTERIZING THE ATTENDANCE REGISTER FROM A RURAL HOSPITAL OUTPATIENT DEPARTMENT
Authors: Chadwell Ian
Published: September 2018

ABSTRACT
Tuberculosis control: In The context of the increasing AIDS epidemic
Authors: Bhattarai M D
Published: September 2018

Abstract
THIS ISSUE'S MEDICAL QUIZ
Authors: Zimmerman Mark
Published: September 2018

abstract
Tuberculosis (TB) control programme in Nepal
Authors: Bam Dirgh Singh
Published: September 2018

Abstract
KALA-AZAR CONTROL IN THE FRAMEWORK OF PRIMARY HEALTH CARE A DISTRICT LEVEL PLANNING
Authors: Devkota Uma N , Steinmann J P
Published: September 2018

ABSTRACT
UTERINE RUPTURE FOLLOWING INDUCED ABORTION A CASE REPORT
Authors: Rana Ashma , Dongol Hira , Gautam Gajeswar
Published: September 2018

ABSTRACT
HELICOBACTER PYLORI INFECTION IN CHILDREN
Authors: Jain N K , Mangal V
Published: September 2018

ABSTRACT
Incidence of Wound Infection after cholecystectomy with or without appendicectomy
Authors: Gongal D N , Sharma G
Published: September 2018

From the 1st of September 1978 to the end of August 1979 one hundred and one patients undrewent laprotomy for gall-stones and gall-bladder diseases in the Department of Surgery, Bir Hospital, All operations were performed by one team. Among-them seventeen were males (16.8%) and eighty four females (83.2%). Cholecystectomy and appendicectomy were performed in fortyseven patients, among them nine patients underwent choledochotomy as well. Postoperative wound infection after cholecystectomy. cholecystectomy with choledochotomy and removal of the gall bladder with appendicectomy was 5.9, 10 and 10.6 percent respectively. Despite high incidence of wound sepsis after biliary surgery with appendicectomy the later procedure is advocated during routine cholecystectomy, because there are very few hospitals in Nepal where facilities for laparotomy exist, and review of English literature has revealed a number of references to concomitant cholecystic - appendiceal disease. These reports refer to the high incidence of unsuspected pathological process within the appendex as a indication for its removal at the time of elective cholecystectomy.
Penetrating Cardiac Injury By A Piece of Metallic Plate
Authors: Gongal D N , Sharma Govind
Published: September 2018

NA
Influenza virus and its zoonotic significance
Authors: Pyakural S
Published: September 2018

NA
Epilepsy in Childhood
Authors: Etheridge Jr. James E
Published: September 2018

NA
Prosthetic Replacement For Femoral Neck Fractures
Authors: Banskota A K
Published: September 2018

Prosthetic replacement of the femoral head was performed in series of five selected patients at Shanta Bhawan Hospital, Kathmandu. Although prosthetic replacement surgery is common place in most parts of the globe, this was the first time we had undertaken this type of treatment at our hospital. We used fenestrated stem Austin Moore prosthesis in all our patients. Bone cement (methyl-methacrylate) is not readily available to us at the present and we have not yet used prosthesis with cement at our hospital. One of our patients expired in the immediate post operative period. The remaining four patients were rapidly rehabilitated and left hospital on their feet after an average in-hospital stay of about three weeks.       Although it is too early right now to draw conclusions, we feel that given the selected patient, there are definite indications for this type of procedure even in the Nepalese socio-economic context.                             TABLE 1.Case    Age    Sex    Side    Associated conditions   1        63      M      (R)      ASHD, Diabetes mellitus.  2        63      M      (R)                ----  3        65      M      (R)                ----  4        72      F       (R)      Duodenal ulcer disease.  5        70      M      (R)
Environmental Health Priorities With Some References To Jumla
Authors: Shrestha Mathura P
Published: September 2018

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Secretary's Report
Authors: Author No
Published: September 2018

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ENDO-TRACHEAL-ANESTHESIA AT BIR HOSPITAL, KATHMANDU, NEPAL
Authors: Singh B B
Published: September 2018

ABSTRACT
Behavioral Risk Factors for Non-Communicable Disease among Factory Employees in Faridabad; Haryana
Authors: Jamatia Biplab , Anand K , Kapoor S K , Pandey R M
Published: September 2018

Introduction: In developing countries like India, in addition to the infectious diseases, noncommunicablediseases are emerging as signifi cant causes of morbidity and mortality. Workplacespresent a setting which is appropriate for intervention for adults in a community. The aim of this studyis to assess the knowledge, attitude and prevalence of selected risk factors for non-communicablediseases.Methods: A cross sectional study was conducted among the regular employees of the factories.Smoking, alcohol consumption, dietary intake and physical activity were measured through interviewschedules and height, weight and blood pressure were also measured by standard instrument. Anawareness generation program was pre-tested.Results: A total of 545 employees were interviewed. Among them 307 (56.3%) and 238 (43.7%)were manual and non-manual workers respectively. Most of the employees knew [smoking asa risk factor for hypertension (55.2%), heart attack (61.1%) and cancer (78.7%); Alcohol as a riskfactor for hypertension (72.1%), heart attack (73.9%), cancer ( 54.9%); Physical inactivity as a riskfactor for hypertension (82.6%), heart attack (78.5%), diabetes (60.4%) and high fat diet as a riskfactor for hypertension (67.2%), heart attack (64.8%)] that these risk factors lead to different noncommunicablediseases. The prevalence (95% CI) of the risk factors is as follows: male currentsmoker [40.7% (36.4-45.3)], current alcohol consumption [31.0 % (27.2 – 35.1)], sedentary activity[41.2% (37.0 – 45.5)], high fat intake [93.7% (90.2 - 95.5)], over weight [26.9% (23.2 – 30.9)] ; andhypertension [21.0% (17.62 - 24.6)]Conclusions: This study showed that the risk factors for non-communicable diseases are prevalentin factory employees. Implementation of the risk factors control programme is desirable and there isan interest among employees and management.Key Words: alcohol consumption, diet, over weight, physical activity, risk factor, smoking
A NOTICE FROM 4TH ALL NEPAL MEDICAL CONFERENCE
Authors: Nepal Birgunj,
Published: September 2018

ABSTRACT
A Study of Injuries and Violence Related Articles in Nepal
Authors: Joshi Sunil Kumar , Shrestha S
Published: September 2018

Introduction: Nepal lacks suffi cient data on injury and violence. Studies have been done in differentregions but there is not a nationwide study on this topic. So, we have designed this systematic reviewto get a cumulative picture of injury and violence status in Nepal.Methods: We searched Medline database, Google scholar database and also all the national medicaljournals for relevant studies on injuries and violence. Our eligibility criteria included studies donein Nepal, evaluating the incidence of different forms of injuries, and their causes and effects. Weexcluded case reports, editorials and reviews. All together, we had 23 studies. We made cumulativeanalysis wherever possible.Results: All the studies were descriptive. In overall, the incidence of injuries was twice as commonin male as in female with the ratio of 2.1:1. The economically active population between 20-50 yearsof age was mostly involved in injuries. Road traffi c injuries were the most common form of injuries,most of which (42.5%) involved motorcycles. Pedestrians (48.6%) were the most vulnerable group ofpopulation. Falls (48.9%) were the most common cause of neuro traumatic accidents.Conclusions: Our systematic review suggests that injuries and violence pose a big problem; roadtraffi c accidents make the most part of it.Key Words: burn, falls, injury, ocular trauma, road traffi c accident
Proposal For Postgraduate Education in Medicine in Nepal
Authors: Prasai B R
Published: September 2018

abstract
Joint Tribhuwan University and University of Calgary Postgraduate Training Programme in Nepal; General Practice in Nepal
Authors: Kerr Melville G
Published: September 2018

abstract
Obstetric Performance of Young Adolescent Primipara
Authors: Prasad Vedawati
Published: September 2018

abstract
Pterocarpus marsupium Roxb and Alloxan-induced Diabetes Mellitus in Experimental Rabbits
Authors: Pathak U G , Mishra M , Dubey K M
Published: September 2018

abstract
Voluntary Organisations and Health Care
Authors: Srider Kenneth
Published: September 2018

abstract
Echocardiographic Evaluation of Diastolic Function in Asymptomatic Type 2 Diabetes
Authors: Shrestha Nikesh Raj , Sharma SK , Karki P , Shrestha NK , Acharya P
Published: September 2018

INTRODUCTION:Diabetes mellitus is an established risk factor for congestive cardiac failure in which the diastolic function is impaired earlier than the systolic function and majority of these patients maybe asymptomatic without signs of overt heart failure.METHODS:A cross sectional hospital based study was done which included 100 asymptomatic patients with type 2 diabetes without evidence of coronary artery disease, congestive heart failure, thyroid or overt renal disease. LVDD was evaluated by Doppler echocardiography, which included the valsalva maneuver to unmask the pseudonormal pattern of left ventricular filling. The prevalence of LVDD and the associated risk factors were assessed.RESULTS:LVDD was found in 71 subjects (71%), of whom 60 had impaired relaxation and 11 had a pseudonormal pattern of ventricular filling. Systolic function was normal in all subjects, and there was no correlation between LVDD and indexes of metabolic control. It was also found that age > or =45 years was associated with an almost three times higher risk for the development of diastolic dysfunction in type 2 diabetes. Females were at a two times higher risk of developing diastolic dysfunction than when compared to men. Duration of diabetes > or = two years was associated with a two times higher risk for developing diastolic dysfunction.CONCLUSIONS:LVDD is much more common than previously reported in subjects with well-controlled type 2 diabetes who are free of clinically detectable heart disease. The high prevalence of this phenomenon in this high-risk population suggests that screening for LVDD in type 2 diabetes should include procedures such as the valsalva maneuver to unmask a pseudonormal pattern of ventricular filling.Keywords:diabetes mellitus, diastolic dysfunction, echocardiography, impaired relaxation, pseudonormal
Omphalocele with Dextrocardia - A Rare Association
Authors: Shakya Vikal Chandra , Agrawal C S , Shrestha N R , Dhungel K , Adhikary S
Published: September 2018

Omphalocele is frequently associated with many other congenital malformations. In cardiacanomalies, association of omphalocele with dextrocardia has been rarely noticed before. We presenthere a child with dextrocardia and omphalocele alongwith a brief review of the literature on this rareassociation.Key Words: congenital malformations, dextrocardia, omphalocele
Management of Breast Cancer in Nepal
Authors: Singh Yogendra P , Sayami P
Published: September 2018

Breast cancer is the second most common malignancy among women in Nepal. It is more commonin young premenopausal women. Breast cancer continues to increase in incidence due to lifestylechanges in Nepalese women despite constant remarkable development in the management of thisdisease over the past three decades. Breast cancer was diagnosed solely clinically and surgery wasthe only treatment option until fi fty years ago. Multidisciplinary approach has been adopted fordiagnosis and treatment of breast cancer in Nepal. Imaging is required for the diagnosis, appropriatetreatment decision and proper follow up. Treatment modality depends upon the extent of thedisease and tumor biology. However, there is a strong need for standard guidelines for the propermanagement of breast cancer in Nepal so that surgeries, chemotherapy, hormone therapy andradiotherapy are standardized in the country. Palliative care has been initiated to provide to somepatients with metastatic breast cancer recently.The breast cancer management in Nepal is a little different when compared with the centers in thedeveloped countries. The reasons are socioeconomic status, lack of education and lack of facilities.Although cancer care is on the rise in Nepal, the optimal facility for centers managing breast cancerhas to be improved signifi cantly.Cancer education, screening and early detection are the keyelements to infl uence the diagnosis, treatment and prognosis of breast cancer in Nepal. Breast cancerawareness and clinical breast examination are important tools for early detection in our resourcelimited context. Breast cancer can be cured in majority of the cases if diagnosed in early stages.This review will focus on relevant patient data along with future recommendation regarding breastcancer treatment in Nepal.Key Words: Breast cancer, cancer education, chemotherapy, imaging, radiotherapy, surgery
Oxidative Stress in BPH
Authors: Savas Murat , Verit A , Ciftci H , Ciftci E , Aktan E , Topal U , Erel O
Published: September 2018

INTRODUCTION:In the present study, we investigated the relationship between potency of oxidative stress and BPH and this may assist to contribute to the realistic explanation of the ethiopathogenesis of BPH.METHODS:Seventy four newly diagnosed men with BPH (mean age: 54+/-11.2), who had not undergone any previous treatment for BPH, and 62 healthy volunteers (mean age: 55+/-14) were enrolled in the present study. To determine the antioxidative status of plasma, total antioxidant capacity (TAC) was calculated, and to determine the oxidative status of plasma (TOS) total peroxide levels were measured. The ratio of TAC to total peroxide was accepted as an indicator of oxidative stress (OSI). Data are presented as mean SD +/- unless specified. Student t-test and correlation analyses were used to evaluate the statistical significance differences in the median values recorded for all parameters between BPH and control group.RESULTS:Plasma TAC TOS were found in patients and controls (1.70 +/- 0.32, 1.68 +/- 0.19 micromol Trolox Equiv./L), (12.48 +/- 1.98, 12.40 +/- 1.14 micromol / L) respectively. OSI was calculated as 7.57 +/- 1.91, 7.48 +/- 1.33, respectively. Plasma TAC, TOS and OSI levels were not found to be significantly difference between patients and control subjects (p>0.05, p>0.05, p>0.05).CONCLUSIONS:The present study has shown that there were not relationship between potency of oxidative stress and BPH. Further well designed studies should be planned to find out whether the oxidative stress-related parameters play role in BPH as an interesting pathology in regard of the etiopathogenesis.Keywords: benign prostatic hyperplasia, oxidative stress, prostate
Acute Pancreatitis in acute viral hepatitis
Authors: K.C. S , Khadka S , Sharma D , Chataut SP
Published: September 2018

Introduction: The association of acute viral hepatitis and acute pancreatitis is well described. This study was conducted to find out the frequency of pancreatic involvement in acute viral hepatitis in the Nepalese population.

Methods: Consecutive patients of acute viral hepatitis presenting with severe abdominal pain between January 2005 and April 2010 were studied. Patients with history of significant alcohol consumption and gall stones were excluded. Acute viral hepatitis was diagnosed by clinical examination, liver function test, ultrasound examination and confirmed by viral serology. Pancreatitis was diagnosed by clinical presentation, biochemistry, ultrasound examination and CT scan.

Results: Severe abdominal pain was present in 38 of 382 serologically-confirmed acute viral hepatitis patients. Twenty five patients were diagnosed to have acute pancreatitis. The pancreatitis was mild in 14 and severe in 11 patients. The etiology of pancreatitis was hepatitis E virus in 18 and hepatitis A virus in 7 patients. Two patients died of complications secondary to shock. The remaining patients recovered from both pancreatitis and hepatitis on conservative treatment.

Conclusions: Acute pancreatitis occurred in 6.5 % of patients with acute viral hepatitis. Cholelithiasis and gastric ulcers are the other causes of severe abdominal pain. The majority of the patients recover with conservative management.

Keywords: acute viral hepatitis, acute pancreatitis, pain abdomen, hepatitis E, hepatitis A, endemic zone
Correlation of Severity of ST Segment Elevation with Respect to the Site of Right Coronary Artery Lesion
Authors: Simkhada Rabindra
Published: September 2018

Introduction: Electrocardiogram a widely available tool may predict infarct related artery in acute inferior wall myocardial infarction. Severity of ST segment elevation may correlate with proximity of lesion in right coronary artery.Methods: Patient with acute ST segment elevation inferior wall myocardial infarction who underwent coronary angiogram was studied. Differences in electrocardiogram among right coronary and left circumflex groups were evaluated. Severity of ST segments elevation in relation to site of lesion in right coronary was studied.Results: The mean age of presentation was 59.52 ± 11.01 years. Total 36 (72%) were men. A total of 42 (84%) had lesion in right and 8 (16%) in left circumflex. Age, sex,diabetes,hypertension, smoking, dyslipidemia and physical activity showed no correlation with lesion in right or circumflex coronary artery. ST segment elevation in III>II (P=0.01), ST segment depression in AVL> I (P<0.01) and ST elevation in V4R (P=0.04), correlated with right coronary lesion. Sum of ST elevation in inferior leads were 10.90 ±1.30 mm for proximal, 7.38±1.19 mm for mid and 5.50± 0.53 mm for distal right coronary with significant correlation (P<0.01).Conclusions: Electrocardiogram was reliable tool to difference right and left circumflex lesion. Severity of sum of ST segment elevations in inferior leads correlated with the proximity of lesion in right coronary._______________________________________________________________________________________Keywords: acute inferior myocardial infarction; electrocardiogram; infarct related artery._______________________________________________________________________________________
Subperiosteal Osteoid Osteoma of the Neck of Talus
Authors: Khan Javed Ahmad , Vaidya S , Devkota P , Acharya BM , Pradhan NMS , Shrestha S
Published: September 2018

Juxta-articular, subperiosteal osteoid osteomas arising around the ankle are unusual. Tumors arising on the neck of the talus commonly produce symptoms mimicking monoarticular arthritis. Patients are usually treated for arthritis or ankle sprain, which often leads to a delay in definitive diagnosis. Here we present a case of osteoid osteoma of neck of talus which was presented as ankle pain. It puzzled us until MRI was done. Diagnostic dilemma and delay can be avoided by high index of suspicion. The patient was treated with open removal of the tumor. We also present brief review of literature about juxta-articular, subperiosteal osteoid osteoma which is uncommon from the typical osteoid osteoma occurring elsewhere in the body.Keywords: juxta-articular, subperiosteal, osteoid osteoma, talus neck