bluuebunny/crossref_metadata_2025 huggingface dataset:
A comparison of outcomes of four ports versus three ports laparoscopic cholecystectomy
Authors: Koirala K. , Simkhada G. , Adhikari N. , Mukhia R. , Shakya S.
Published: September 2018

Background: Conventional laparoscopic cholecystectomy is performed using four ports. With increasing surgeon experience, there is a trend towards performing it using three ports. The aim of this study was to compare the three-port laparoscopic cholecystectomy with the conventional four-port technique in terms of safety, benefits and feasibility in a teaching hospital and private hospital setups.Materials & Methods: A retrospective review of medical records was performed on patients who underwent laparoscopic cholecystectomy at KIST Medical College and Teaching Hospital and Om Hospital & Research Center P. Ltd by a single laparoscopic surgeon. The review included demographics, operating time, analgesics requirement, post- operative hospital stay and intra-operative and post-operative complications. The data were tabulated in MS-Excel and statistically analyzed using SPSS statistics software, version 21.Results: There were 150 patients included in this study with 75 patients in each three and four-port groups. The demographics were comparable in both groups. 7.3% were diagnosed with acute calculous cholecystitis, 76.7% with chronic calculous cholecystitis and 3.3 % were gall bladder polyps. Four-port technique was generally required for the acute calculous cholecystitis which was statistically significant. The three-port group had a shorter mean operative time than the four-port group. There was no statistically significant difference in the doses of analgesics requirement and mean post-operative hospital stay in both groups. There were no major intra and post-operative complications in both groups. Four-port technique was commonly done in teaching hospital and the three-port in private hospital.Conclusions: There is significant number of laparoscopic cases being performed using three ports and we concluded that the three-port laparoscopic cholecystectomy is safe and feasible in experienced hand although there is no significant benefit. The study also showed an increasing use of four-port technique in the teaching institution which is better to clearly visualize the anatomy of the Calot’s triangle. So we recommend using the four-port technique for teaching the beginners and as the experience is gained, we can gradually shift to three-port technique and at the same time we shouldn’t hesitate to convert to four-port in difficult cases.JMMIHS.2018;4(1):66-71
Development and characterization of pomegranate and orange fruit peel extract based silver nanoparticles
Authors: Vinay C.H. , Goudanavar P. , Acharya A.
Published: September 2018

Background: Nanoparticles are those whose size ranges 1 nm to 100 nm. They are in different sizes and shape, such as triangular, spherical, irregular, etc. In recent years, nanoparticles synthesis has received considerable attention due to their unique properties and potential applications. Powdered sample (100gm)was extracted with 800ml ethanol by Soxhlet extraction method for 6 hours. The resultant extract was used to prepare nanoparticles.Methods: The main objective of the present work was to prepare pomegranate and orange peel extract based nano particles by chemical complexation method. Ethanolic extracts of pomegranate and orange peel were prepared by using Soxhlet apparatus and evaluated for phyto-chemical constituents.Results: Qualitative analysis of pomegranate peel showed positive results for Alkaloids, Anthraquinones, Saponins and Terpenoids, where as orange peel showed positive results for Alkaloids, Tannin and Saponins. The percentage moisture content obtained from the 2 fruits (pomegranate and orange) was 72% and 96.12% respectively. The pH was found to be 3.6 and 3.8 for pomegranate and orange respectively. A zeta potential of prepared nanoparticles for pomegranate extract was found in the range of -24.6 mV to -34.5 mV (P20 & P50) and -21.4 mV to 32.0 mV (O20 & O50) for orange extract, respectively. These values of nanoparticles having higher surface charge which indicates there is least chance of aggregation. The particle size for pomegranate extract was found in the range of 118.6 nm to 231.7 nm (P20 & P30) and 178.8 nm to 191.6 nm (O20 & O50) for orange extract, respectively. These range confirms that obtained particles were in nano range, i.e. <500 nm size. SEM results indicated the formation of nanoparticles and were relatively spherical in shape. Energy dispersive spectrometry (EDS) analysis confirms the presence of AgNPs.Conclusion: The silver nanoparticles were prepared by using fruit peels extract of pomegranate and orange. Computability study FT-IR showed no any change of functional groups of peel extracts in prepared nanoparticles. Zeta potential showed higher value hence less particle aggregation. Prepared nanoparticles were spherical in shape and having particle size of approximately 200±20nm. Further the study will be extended for anti-microbial and wound healing activities.JMMIHS,2018;4(1):72-85
Novel Swine Inﬂ uenza AH1N1 and the Phase Six Pandemic
Authors: Khadka M
Published: September 2018

The family Orthomyxoviridae consists of Influenza A virus which is negative sense single stranded virus. The genome of the virus is segmented and possesses a peculiar trait of genetic reassortment. The influenza virus on its envelop consists of the antigenic glycoprotein like haemagglutinin (HA) and neuraminidase (NA). The changes in those glycoprotein components due to antigenic shift and antigenic drift leads to the development of new strain of Influenza A viruses. Now the novel swine influenza A/H1N1 strain has been detected from different parts of the world which is causing pandemic. World Health Organization has declared the pandemic phase six and more than 60 countries have reported the cases of novel influenza A/H1N1 strain including Nepal. As the disease is spreading world wide, it is a major public health concern for all the countries. And especially the developing countries like Nepal should immediately respond to the situation and should be well prepared to combat the disease before the disease spreads to enough population.

Keywords: pandemic, public health, reassortment, swine influenza A/H1N1.
Work At Pokhara: The Problems
Authors: Turner Gerald W.A.
Published: September 2018

NA
Go To Village
Authors: Editor JNMA
Published: September 2018

NA
A Review Of 100 New-born Infants
Authors: Rajbhandari P L
Published: September 2018

NA
MARCH OF MEDICINE
Authors: Pandey Shyam Bahadur
Published: September 2018

Abstract
PRIMARY HEALTH CARE DEVELOPMENT IN NEPAL
Authors: Karki B B
Published: September 2018

Abstract
TUBERCULOSIS CONTROL CONCEPT IN NEPAL
Authors: Giri Jaya N , Patterson D H
Published: September 2018

Abstract
REVIEW OF 100 INPATIENTS AT TCMH WITH HAEMOGLOBIN OF 10 GM. PERCENT OR LESS
Authors: Shrestha Khagendra Bahadur , Thapa Jung Bahadur
Published: September 2018

Abstract
ROTAVIRUS IN INFANTILE DIARRHOEA: A STUDY IN FIFTY CASES
Authors: Baral Manindra R , Dixit Hemang , Choudhary Brij N
Published: September 2018

Abstract
INCIDENCE AND CAUSES OF BLINDNESS AND PATTERN OF DISEASES IN JANAKPUR EYE RELIEF CAMP [1979]
Authors: Prasad L N , Malla B K
Published: September 2018

Abstract
Computed tomographic Assessment of Lateral Lamella of Cribiform Plate and Comparison of Depth of Olfactory Fossa
Authors: Bista M , Maharjan M , Shrestha S , KC T
Published: September 2018

INTRODUCTION:

Endoscopic sinus surgery is an upcoming branch in rhinological practice but with some major risks since it has to play around the skull base area. Lateral lamella of cribriform plate is the thinnest area of the skull base. Thus this study is undertaken to evaluate the height of lateral lamella of cribriform plate and the depth of olfactory fossae by the help of computed tomographic images.

METHODS:

Computed tomographic study of 50 patients was done in Advanced Imaging and Diagnostic center, Kathmandu Medical College. Coronal sections at the centre of infra-orbital foramina were taken as reference slide. The height of cribriform plate point was subtracted from the height of medial ethmoidal roof point to measure the length of lateral lamella of cribriform plates on both sides.

RESULTS:

The median height of LLCP in 100 slides was 2.8 mm. LLCP height was 0 to 3.9 mm in 86 slides, 4 to 7 mm in 12 slides and greater than 7mm in 2 slides. The LLCP length was greater in right side in 28 (56%) patients and was greater in left side in 19 (38%) patients. It was equal in both sides in only three patients (6%).

CONCLUSIONS:

As regards the length of LLCP; 0 to 3.9 mm length was most common. The olfactory fossa depth was more in the right side compared to the left side. Thus, right side is more vulnerable to injury during surgery. Thus adequate caution has to be exercised by the rhinological surgeon during endoscopic sinus surgery.

Keywords: lateral lamella of Cribriform plate, medical ethmoidal roof, olfactory fossa.
THE VALUE OF PAPER ELECTOPHORESIS IN DIAGNOSIS OF NEPHROTIC SYNDROME
Authors: Singh R P , Mishra N P
Published: September 2018

Abstract
Muluki Ain-On Medical Practice
Authors: Author No
Published: September 2018

NA
A Doctor's Dilemma
Authors: Editorial JNMA
Published: September 2018

NA
Notifiable Diseases
Authors: Editorial JNMA
Published: September 2018

NA
Paragonimiasis in Tansen
Authors: Iwamura Noboru
Published: September 2018

NA
Control And Prevention of Smallpox
Authors: Editorial JNMA
Published: September 2018

NA
Clinicopathologic Profile of Bronchogenic Carcinoma
Authors: Shrestha SG , Dhakhwa R , Chokhani R
Published: September 2018

INTRODUCTION:

Bronchogenic carcinoma is the most common cancer in the world. It can present in many ways. Accurate diagnosis and categorization into different types is important because of its effect on prognosis and management. We conducted this study to find out the frequency of various histological types of bronchogenic carcinoma and correlate with their clinicopathologic profile.

METHODS:

This is a retrospective study conducted in 174 histopathologically proven cases of bronchogenic carcinoma that were referred from different parts of the country to a private hospital in Kathmandu over a period of 4 years.

RESULTS:

The mean age of the patients developing bronchogenic carcinoma was 64 years. Squamous cell carcinoma was the commonest histologic subtype followed by small cell carcinoma. Adenocarcinoma was more common in females. Clinical history was available in 133 cases. Among them, almost all patients had a history of smoking, the average number of pack years being 39.99. Most of the patients consulted doctor for chief complaint of cough and shortness of breath, the average duration of symptoms being 117.53 days.

CONCLUSIONS:

The lung cancer must be ruled out in all patients who have persistent signs and symptoms of pulmonary disease with a history of smoking.

KEYWORDS:  bronchogenic, histopathology, smoking.
Journal Of The Nepal Medical Association
Authors: Author No
Published: September 2018

NEW MINISTER NEW DIRECTOR NEPAL MEDICAL COUNCIL WHO 18th ASSEMBLY Drs. EDGAR & ELIZABETH MILLER BIRTHDAY AWARDS REPRINT SERVICE KATHMANDU BRANCH NEWS BIRATNAGAR BRANCH NEWS RAJBIRAJ BRANCH NEWS NEPALGUNJ BRANCH NEWS RAPTI DOON JORE GANESH PRESS
Tuberculosis Control Plan For Nepal
Authors: Joshi Y R
Published: September 2018

NA
Child Care
Authors: Editorial JNMA
Published: September 2018

NA
Medical Certificates
Authors: Editorial JNMA
Published: September 2018

NA
Problem of Tuberculosis in Nepal
Authors: Dass N N
Published: September 2018

NA
Tuberculosis in the Upper Respiratory Tract
Authors: Prasad Laxmi Narayan
Published: September 2018

NA
Tuberculosis Control In China
Authors: Yiao Chu Tsung
Published: September 2018

NA
Domiciliary Treatment of Tuberculous Patients in China
Authors: Hui Li
Published: September 2018

NA
Control Of Tuberculosis
Authors: Author No
Published: September 2018

NA
Infectious Disease Act - 2020 B.S. (1964)
Authors: Author No
Published: September 2018

NA
Puberty menorrhagia Requiring Inpatient Admission
Authors: Khosla AH , Devi L , Goel P , Saha PK
Published: September 2018

INTRODUCTION:

Puberty menorrhagia is a significant health problem in adolescent age group and severe cases may require admission and blood transfusion. Aim of this study was to evaluate the causes, associated complications and management of puberty menorrhagia.

METHODS:

Hospital records of all patients of puberty menorrhagia requiring admission were analyzed for etiology, duration since menarche, duration of bleeding, investigation profile and management.

RESULTS:

There were 18 patients of puberty menorrhagia requiring hospital admission. Etiology was anovulatory bleeding in 11 patients, bleeding disorders in five which included idiopathic thrombocytopenia purpura in three and one each with Von-Willebrand disease and leukemia. Two patients had hypothyroidism as the cause. Fourteen patients presented with severe anaemia and required blood transfusion. All except one responded to oral hormonal therapy.

CONCLUSIONS:

Puberty menorrhagia can be associated with severe complications and requiring blood transfusion. Although most common cause is anovulation but bleeding disorder, other medical condition and other organic causes must be ruled out in any patient of Puberty menorrhagia.KEYWORDS: anovulation, bleeding disorder, puberty, menorrhagia, anaemia.
March Of Medicine
Authors: Author No
Published: September 2018

1. The Ocular Manifestations Of Nutritional Disease. Mc Laren, D.S & Halasa, A. Postgraduate Med. J. 1964, Dec., v.40, No. 470, 711-16, 2 figs, (15 refs).2. Lead Intoxication And The Nervous System. Fazlullah S. and Ramamurthi B. J. Ind, Med. Asso. 1965, 44, 644-3. Neonatal Candidiasis. Sharma N.L., Gupta S.P., Philip Elsie, Goel K.M. Indian J. Pediat. 1965, 32, 157.4. Stress, Tobacco and Heart Disease. Russek H.I. JAMA, 1965, 192, 189.5. Autoimmune Addition' Disease. Koang N.K. & Hsing-Chiung C. Chinese M.J. 1965, 84;343.6. Metformin-Chlorpropamide Therapy. Clarke B.F., Duncan L.J.P. Lancet, (1965), i, 12487. Nutritional Vitamin B12 Deficiency among Hindus. Habib, G.G. Trop. & Geograph. Med. Haarlem. 1964, sept., v.16 no.3 206-15. (73 refs)
Diagnostic Accuracy of Computed Tomogram in the Evaluation of a Neck Mass
Authors: Shrestha M K , Ghartimagar D , Ghosh A
Published: September 2018

Introduction: The concept of dividing extracranial head and neck into different spaces is a notion that dates back to the 1800s. Various studies have led to detailed description of the soft tissue spaces that are contained within the fascial layers. This study was carried out to determine the accuracy of computed tomogram (CT) in differentiating malignant from benign lesions in the neck, to study the spatial distribution of different types of histological groups in the neck and the prevalence of malignant versus benign diseases involving the neck.

Methods: This was a hospital-based, prospective study conducted in the department of Radiodiagnosis, Kasturba Medical college, Mangalore, from 2005-2008. A hundred consecutive patients referred for CT scan examination presenting with complaints related to involvement of neck spaces or presence of palpable neck masses were enrolled in this study. The details of all the cases regarding their radiological fi ndings and histopathology were reviewed.

Results: Of the 100 patients studied, 53 % had malignant lesions, out of which 43 % were squamous cell carcinoma and 4 % were metastatic lymph nodal involvement. Twenty percent of the lesions were of an infective origin while 23 % were benign and congenital cystic lesions.

Conclusions: CT scan as an imaging modality has the ability to evaluate the malignant and benign tumors of the neck. Considering histopathology as the gold standard, the sensitivity of CT in detecting malignant/benign lesions was 96.5 % with a specifi city of 100 %. The positive predictive value was 100 % and the negative predictive value 95.2 %.

Keywords: CT scan, neck mass, neck spaces.
Family Planning in Nepal
Authors: Jha Pitambar
Published: September 2018

NA
Cardiovascular Autonomic Neuropathyin Chronic Kidney Diseases
Authors: Thapa L , Karki P , Sharma SK , Bajaj BK
Published: September 2018

INTRODUCTION:

This study was conducted to explore cardiovascular autonomic neuropathy and its pattern in chronic kidney disease patients.

METHODS:

Autonomic function using five standard tests was examined in 20 diabetic patients with CKD, 20 age and sex matched diabetic patients without CKD and 20 age and sex matched controls. Analysis of difference between the autonomic function was done in the three groups using Chi-square test or Fischer's test.

RESULTS:

Total 20 (100%) diabetic CKD patients were found to have autonomic neuropathy. Of these, 2 (10%) patients had early parasympathetic damage, 8 (40%) patients had definite parasympathetic damage, and 10 (50%) patients had combined damage. Heart rate response to standing was statistically significant (p = 0.014) among diabetic CKD patients when compared with diabetic patients without CKD. Combined form of autonomicdysfunction was more frequent in advanced stages of diabetic CKD. Three (42.85%) patients in stage 3 CKD, 4 (66.66%) patients in stage 4 CKD and 5 (71.42%) patients in stage 5 CKD, had combined autonomic failure.

CONCLUSIONS:

Autonomic neuropathy is common in native Nepalese diabetic CKD patients. Heart rate response to standing is significantly abnormal in diabetic CKD patients in comparison with diabetes mellitus patient without CKD. Severity of autonomic dysfunction increases with severity of CKD..

 KEYWORDS: cardiovascualr autonomic neuropathy, chronic kidney disease, diabetes mellitus.
Better Service Please
Authors: Editor JNMA
Published: September 2018

NA
Baidya Raj Column
Authors: Author No
Published: September 2018

NA
Osteosynthesis of Intercondylar Humerus Fracture Using Bryan and Morrey Approach
Authors: Lakhey S , Sharma S , Pradhan RL , Pandey BK , Manandhar RR , Rijal KP
Published: September 2018

INTRODUCTION:

The olecranon approach has been the gold standard for surgical approaches to fracture fixation of distal articular surface of humerus. Although it provides a good exposure, it also has disadvantages of delayed union, nonunion and implant related complications at the osteotomy site.

OBJECTIVE:

The aim of this study was to determine the functional outcome of displaced intra-articular distal humerus fracture fixation using an alternative approach: the Bryan and Morrey approach.

MATERIALS AND METHODS:

Twenty patients with twenty AO type C1 and C2 intercondylar fractures of the distal humerus had bicolumnar fixationof the distal humerus with two contoured reconstruction plates and screws on the dorsal surface or various combinations of a single reconstruction plate, screws and K-wires using a Bryan and Morrey approach. Twelve of the patients were male and eight were female. The average age of the patients was 44.8 years. Eleven patients had sustained the injury as result of fall and nine of the patients had sustained it in road traffic accidents. Right elbow was involved in fifteen patients and left in five. All patients were followed up for 12 months post operatively.

RESULTS:

All twenty fractures had united at 4 months follow-up. The mean fixed flexion deformity was 9.0º (range 0º-15º) and the mean arc of motion was 115.0 º (range 85 º- 130º). All patients had grade 4 triceps strength and stable elbows at the end of 12 months follow up. One patient had deep seated wound infection resulting in necrosis of the triceps tendon requiring a second operative procedure.

CONCLUSIONS:

Bryan and Morrey approach is a simpler, easier and better approach as compared to the other posterior approaches to the elbow joint, and therefore, can be used as the approach of choice for fixation of fractures of the distal articular surface of humerus.

KEYWORDS: fracture, Humerus, intercondylar, osteosynthesis.
Longivity
Authors: Editor JNMA
Published: September 2018

NA
Spot Diagnosis
Authors: Author No
Published: September 2018

NA
Clinico-demography Profile in Obsessive Compulsive Disorders
Authors: Shakya D R
Published: September 2018

INTRODUCTION:

Obsessive compulsive disorder (OCD) is one of the most prevalent and debilitating mental illnesses. The present study was conducted to find out the clinico-demographic profiles of Nepalese OCD patients in the local set up.

METHODS:

We used the criteria of OCD as per the ICD-10: Classification of Mental and Behavioral Disorders' as a diagnostic and 'Yale Brown Obsessive Compulsive Scale' as a rating tool. Patients diagnosed as OCD were included and related information collected with their consent.

RESULTS:

Of 60 cases, 39 (65%) were male. The most common age groups were 20-29 (43%) and 30-39 (28%). Most of the subjects were relatively better educated. About half were married. More than half presented after more than five years of onset of illness. Seventy percent had some precipitating stressors. The most common obsessions were doubt (62%) and ruminations (57%); and compulsions checking (35%) and washing (28%). Somatic (28%) and mood symptoms (22%) were other common presenting complaints. About 7% had high suicidal intents. Nearly two thirds presented when they had YBOC Score of severe ranges, mean YBOC score being in the severe range (24).

CONCLUSIONS:

Most of the OCD patients present late only when severely affected. This indicates need for public awareness program in our set up.

KEYWORDS: behavioral disorder, compulsion, mental, obsession, obsessive compulsive disorder
LEPROSY CONTROL PROJECT PLAN AND ITS ACHIEVEMENTS
Authors: Mali I B
Published: September 2018

Abstract
INTESTINAL PARASITISM IN POKHARA: A PRELIMINARY SURVEY
Authors: Sousa V O
Published: September 2018

Abstract
FERTILITY AND MORTALITY IN NEPAL
Authors: Gubhaju B B
Published: September 2018

Abstract
CHINA-THE SECOND TIME
Authors: Dixitt Hemang
Published: September 2018

Abstract
PROTECTOR CAN BECOME A "KILLER"
Authors: Satyal P R
Published: September 2018

Abstract
PREVALENCE OF VARIOUS TYPES OF HEART DISEASES IN KATHMANDU- A SIX YEARS SURVEY OF ADMITTED CASES
Authors: Pandey M R , Ghimire Madhu
Published: September 2018

Abstract
SELECTIVE VAGOTOMY WITH PYLOROPLASTY IN TREATMENT OF PEPTIC ULCER PERFORATIONS, TOTAL OF 30 CASES
Authors: Kothari Anandlal B
Published: September 2018

Abstract
VIRAL A HEPATITIS IN PREGNANCY DURING KATHMANDU EPIDEMIC- REPORT OF HIGH INCIDENCE OF FULMINANT HEPATIC FAILURE
Authors: Shrestha Santosh M , Malla Dibya Shree
Published: September 2018

Abstract
Obitaury
Authors: Author No
Published: September 2018

NA
Acute Fenthion(Dalf) Poisoning
Authors: Shrestha Santosh Man
Published: September 2018

NA
EXPERIENCE WITH 100 DIARRHOEA CASES TREATED AT NARAYANI ZONAL HOSPITAL REHYDRATION THERAPY CENTRE, BIRGUNJ
Authors: Baral M R
Published: September 2018

Abstract
STUDY OF PHYSICAL COMPOSITION AND BACTERIOLOGICAL ANALYSIS OF SOLID WASTE OF KATHMANDU CITY
Authors: Shrestha S , Sharma AP
Published: September 2018

ABSTRACT
ELECTOCARDIOGRAPHIC INTERVALS, DURATIONS AND AXIS OF HEALTHY NEPALESE DOCTORS WITH NORMAL ELECTROCARDIOGRAM
Authors: Karki DB , Lohani S
Published: September 2018

ABSTRACT
Incidence Of Leprosy Detection In Skin And V.D. Dept. And The Importance Of Knowing The Differential Diagnosis
Authors: Adiga R B
Published: September 2018

NA
Schick Test Survey At Two Urban Primary Schools Of Kathmandu
Authors: Amatya Sevika Joshi
Published: September 2018

NA
PATTERN OF BLINDNESS IN MECHI- A HOSPITAL BASED STUDY IN MECHI EYE CARE CENTRE
Authors: KC RM , Ale JB , Singh SK
Published: September 2018

ABSTRACT
Paropakar And The Maternity Hospital
Authors: Sakya Asha Ram
Published: September 2018

NA
Heard, Seen And Spoken
Authors: Author No
Published: September 2018

NA
Regionalization Of The Health Services
Authors: Shrestha S M
Published: September 2018

NA
DOCTORS AND NURSES- NEPAL'S HRH POSITION
Authors: Dixit H
Published: September 2018

ABSTRACT
Delayed Retrograde Type A Aotic Dissection After Endografting of Descending Thoracic Aorta
Authors: Tiwari K K , Mariani M , Murzi M , Glauber M
Published: September 2018

We report a case of a delayed retrograde dissection occurred after endovascular repair of ruptured type B aortic dissection. A 75-year-old male, presented with acute hemothorax and aortic arch fissuration. He was successfully treated with descending aorta and aortic arch stenting. After six days, he developed retrograde type A dissection with aortic root involvement and aortic valve incompetence. The entire ascending aorta and the ventral part of the arch were successfully replaced by a composite graft; in addition, aortic valve was replaced with prosthesis. Patient had an uncomplicated course and radiologic follow-up at one month revealed a sealed fissuration and no signs of endoleak. Endovascular repair of acute ruptured aorta, although life saving may be associated with potentially lethal complications, and it requires close monitoring with prolonged hospital stay to recognize and treat promptly these fatal complications.
PRUNE- BELLY SYNDROME- A CASE REPORT
Authors: Singh R
Published: September 2018

ABSTRACT
STEROID INDUCED CATARACT IN A CHILD WITH NEPHROTIC SYNDROME A CASE REPORT
Authors: Gami FC , Koirala S
Published: September 2018

ABSTRACT
RATIONAL OF COMBINATION ANTIMICROBIAL THERAPY FOR BACTERIAL INFECTIONS
Authors: Jain A , Sehgal A , Sehgal R
Published: September 2018

ABSTRACT
Medical Humanities in Nepal: Present scenerio
Authors: Dhakal Ajaya Kumar , Shankar P Ravi , Dhakal Sanjaya , Shrestha Devendra , Piryani Rano Mal
Published: September 2018

Medical Humanities is a relatively new concept even in developed countries, and is at the infancy stage in low income countries like Nepal. Medical humanities modules in Nepal are being conducted in a few medical schools. Humanities have an essential role in medical education, the gap between the humanities and medicine has to be bridged and there should be continuous and vigorous debate about the theory and practice of medical humanities
Abdominal Wall Endometriosis
Authors: Upadhyaya P , Karak AK , Sinha AK , Kumar B , Karki S , Agarwal CS
Published: September 2018

Endometriosis of abdominal wall scar following operation on uterus and tubes is extremely rare. The late onset of symptoms after surgery is the usual cause of misdiagnosis. Scar endometriosis is a rare disease which is difficult to diagnose and should always be considered as a differential diagnosis of painful abdominal masses in women. The diagnosis is made only after excision and histopathology of the lesion. Preoperative differentials include hernia, lipoma, suture granuloma or abscess. Hence an awareness of the entity avoids delay in diagnosis, helps clinicians to a more tailored treatment and also avoids unnecessary referrals. We report a case of abdominal endometriosis. The definitive diagnosis of which was established by histopathological studies.

KEYWORDS: abdominal wall endometriosis, cesarean scar, cyclical symptoms.
Schistoma Mansoni like Eggs Detected in Stool of Inhabitants in Southern Nepal
Authors: Shrechand JB , Ohara H
Published: September 2018

Abstract
Rhabdomyolysis and Acute Renal Failure
Authors: Wig Naveet , Aggarwal P , Handa R , Walil J P
Published: September 2018

abstract
Bancroftian Filariasis: Chyluria/Hematuria (Report of 42 cases)
Authors: Shrestha Santosh M , Shrestha Sobhana
Published: September 2018

NA
Preliminary Report Of Comparison Of Glybenclamide And Chlorpropamide In The Treatment Of Maturity Onset Diabetes Mellitus
Authors: Pandey Mrigendra Raj , Dixit S M
Published: September 2018

NA
Recent Advances In The Control Of Bancroftian Filariasis
Authors: Sasa Manabu
Published: September 2018

NA
Reduction of Maternal Mortality and Morbidity in Nepal
Authors: Pathak L R , Malla D S , Rajlawat R , Pradhan A , Lama D B , Kwast B , Compbell B B
Published: September 2018

Abstract
Practices and Results of Two Years Service from a single UK Renal Transplant Center
Authors: Shrestha P C , Dominguez-Escrig J , Gowardhan B , Rix D , Talbot D
Published: September 2018

INTRODUCTION:

End stage renal failure is a common condition requiring renal replacement therapy in the form of haemodialysis or peritoneal dialysis as a short-term measure with renal transplantation as a more definitive treatment option. The aim of this study was to evaluate the set up of arenal transplant unit in a developed country and compare its results with other centers of the world.

METHODS:

A retrospective observational study was conducted to see the results of two years activities of a well known renal transplant unit in the United Kingdom. A description of the setup of a renal transplant unit has been made and its results have been discussed.

RESULTS:

Of the total patients, who had transplants in the renal transplant unit in year 2006 and 2007, 209 were renal, 14 were simultaneous kidneypancreas and two were pancreas after kidney transplants. Our one year graft survival rate was 93%, delayed graft function was 15%, early rejection rate was 11% and mortality rate was 3% in one year follow up.

CONCLUSIONS:

To attain good results in renal transplantation surgery, a multi-disciplinary team approach is crucial. Our set up is an example where the results are comparable to published and unpublished data from other established units world-wide.

Keywords: complications, immunosuppression, renal transplant.
Common Eye Problems In Tropics
Authors: Pokhrel R P
Published: September 2018

NA
A Retrospective Study of 461 Patients Treated for Cholelithiasis
Authors: Charles Neelam R , Christian L B , Mahapatra S , Sen T , Joshi B R
Published: September 2018

abstract
On Medical Practice.
Authors: Dixit Hemang
Published: September 2018

NA
Health Services
Authors: Ghei P N
Published: September 2018

NA
Trend of Complete Hydatidiform Mole
Authors: Thapa K , Shrestha M , Sharma S , Pandey S
Published: September 2018

INTRODUCTION:

Complete Hydatidiform mole is one of the most frequent abnormal pregnancies. This review studies the trend of complete mole in Paropakar Maternity and Women's hospital and clinical ability to detect it.

METHODS:

This is a retrospective study of 504 cases of complete hydatidiform mole recorded at Paropakar maternity and women's hospital, Kathmandu, during 2058-2065 B.S. Medical records were reviewed and incidence, clinical presentation and method of diagnosis were studied.

RESULTS:

During the study period, there were 13,9117 births and 504 complete moles, 12 partial moles, 48 persistent gestational tumours, six choriocarcinoma and four invasive moles recorded in the hospital. The incidence of complete mole was one per 276 births. It was prevalent among women younger than 29 years (80%) and among the primigravidae (36.7%). More than 90% women presented in the first half of their pregnancy and vaginal bleeding was the main complaint (68.3%). Suction evacuation, dilation and evacuation followed by sharp curettage and abdominal hysterectomy were performed in 80.6%, 17.6% and 1.2% of the women respectively. Persistent mole and choriocarcinoma developed in 9.5% and 0.4% respectively.

CONCLUSIONS:

Complete mole has the highest incidence. It affects mostly younger women and presents with vaginal bleeding most of the time, usually in the first half of their pregnancy.

Keywords: complete hydatidiform mole, gestational trophoblastic disease, persistent gestational tumours.
Nepal Medical Association
Authors: Author No
Published: September 2018

NA
Medical Discussion Group Report
Authors: Author No
Published: September 2018

NA
Hospital Management Board
Authors: Editorial JNMA
Published: September 2018

NA
Chronic Cough in Thymoma
Authors: Agrawal K K , Dhakal SS , Bhatta N , Pradhan B , Chaurasia RK , Rijal S , Karki P
Published: September 2018

Cough is one of the most common symptom for which patients seek medical attention from primary care physicians and pulmonologists. Although tuberculosis and other lung infections are common throughout the developing world, they are not among the most common causes of chronic cough. We report a case of a 23 years old male who presenting to the outpatient clinic with chronic cough not responding to regular and symptomatic treatment that was diagnosed to have thymoma. After all the common causes for chronic cough have been ruled out, unusual causes should also be considered in the differential diagnosis.

KEYWORDS: Chronic cough, Thymoma, Anterior Mediastinum.
Retinal Findings In Severe Anemia
Authors: Yoder P R
Published: September 2018

NA
Helicobacter pylori Infection in Children
Authors: Jain N K , Mangal V
Published: September 2018

Abstract
Stress, Autonomic Reactivity and Blood Pressure among Undergraduate Medical Students
Authors: Khaliq F , Gupta K , Singh P
Published: September 2018

INTRODUCTION:

Medical training is highly stressful particularly for those who are beginning their medical education. The present study was undertaken to find out the level of stress, hypertension and its etiological factors among undergraduate medical students.

METHOD:

One hundred and seventeen undergraduate medical students between 17-21 years of age got examined for blood pressure and stress level. Twelve hypertensives selected from the above subjects and twenty normotensives underwent cold pressure test to assess autonomic reactivity to laboratory induced stress.

RESULTS:

10.25% of the subjects were found to be hypertensive and 6.83% pre hypertensive. On the stress scale 53% had mild stress, 7% showed moderate stress while none had stress as a major problem. There was no correlation between BP and stress score. On CPT, BP increased significantly in both the hypertensive and normotensive group but came back to basal levels within 5 minutes indicating normal autonomic response. Rise of BP was higher in hypertensive group. The diastolic and mean BP increased significantly on CPT in subjects having family history of hypertension. The subjects taking more of junk and oily foods had a higher systolic BP. Forty percent of normotensive subjects had more than 20 mm Hg rise in systolic BP on CPT.

CONCLUSIONS:

Adolescents must be routinely screened to detect asymptomatic hypertension. Advice on risk factor modification by appropriate lifestyle changes may prevent long term effects of hypertension on target organs.

Keywords: autonomic reactivity, blood pressure,  cold pressor test, medical students, stress.
Acute Renal Failure Treated With Peritoneal Dialysis
Authors: Shrestha Santosh Man , Rajlawot G P , Shrestha Shobhana
Published: September 2018

NA
Closed Mitral Valvotomy During Pregnancy
Authors: Koirala R R , Singh BM , Koirala B , Rana A , Shad S K , Sayami P , Gurung G , Jha R , Sharma G P
Published: September 2018

Abstract
Drugs- Use, Abuse And Misuse
Authors: Editorial JNMA
Published: September 2018

NA
Lumbar Disc Injury : A Retrospective Study of 150 cases
Authors: Baskota A K , Rajbhandari S , Rijal S
Published: September 2018

Abstract
The Relevance Of A.T.S. and Betamethasone in the Conservative Treatment Of Tetanus.
Authors: Sanders R K.M
Published: September 2018

Experience of a Rural Hospital on the Nepal Bihar Border
Seasonal Distribution of Phlebotomine Sand Flies-Vector of Visceral Leishmaniasis
Authors: Shrestha S L , Pant S K
Published: September 2018

Abstract
Anaemia In Pregnancy
Authors: Fleming A F
Published: September 2018

NA
A Review of Viral Hepatitis Infection in Nepal
Authors: Bista M B
Published: September 2018

Abstract
Unsafe Abortion- A Tragic Saga of Maternal Suffering
Authors: Regmi M C , Rijal P , Subedi S S , Uprety D , Budathoki B , Agrawal A
Published: September 2018

INTRODUCTION:

Unsafe abortion is a significant cause of maternal morbidity and mortality in developing countries despite provision of adequate care and legalization of abortion. The aim of this study was to find out the contribution of unsafe abortion in maternal mortality and its other consequences.

METHODS:

A retrospective study was carried out in the Department of Obstetrics and Gynecology in BPKIHS between 2005 April to 2008 September analyzing all the unsafe abortion related admissions.

RESULTS:

There were 70 unsafe abortion patients. Majority of them (52.8%) were of high grade. Most of them recovered but there were total 8maternal deaths.

CONCLUSIONS:

Unsafe abortion is still a significant medical and social problem even in post legalization era of this country.

Keywords: abortion, legalization, maternal death, unsafe.
2. Building Subcommittee Report and Receipts and Payments Account, from 8th Falgun 2027 to 32nd Ashadh,2028
Authors: Author No
Published: September 2018

NA
Cancer In Nepal
Authors: Prasai B R , Gurubacharya V L
Published: September 2018

NA
Comparison of Bolus Phenylephrine, Ephedrine and Mephentermine for Maintenance of Arterial Pressure during Spinal Anesth
Authors: Bhattarai B , Bhat S Y , Upadya M
Published: September 2018

INTRODUCTION:

Hypotension is common following spinal anesthesia. Various vasopressors have been indicated to prevent it. The study compares three such agents namely phenylephrine, ephedrine and mephentermine.

METHODS:

The study included 90 patients undergoing elective and emergency cesarean section who developed hypotension following subarachnoid blockade. Parturient were randomly divided into three groups each group had 30 patients. Group P received bolus of Phenylephrine 25 microgram, where as group E received Ephedrine 5mg and Group M received Mephentermine 6mg.

RESULTS:

It was found that rise of blood pressure was significantly higher in case of phenylephrine group in first six minutes, after the bolus, there was significant reduction in the heart rate in phenylephrine group, but there was tachycardia following administration of bolus ephedrine and mephenteramine. Neonatal APGAR score were similar in all three groups.

CONCLUSIONS:

All three drugs maintained hemodynamics within 20 percent of the baseline values on intravenous administration.

Keywords: APGAR, ephedrine, hypotension, mephentermine, phenylephrine, spinal anesthesia.
Eye Work in Nepal
Authors: Perkins E S
Published: September 2018

NA
10+2 Agenda for Public Health in Nepal
Authors: Gautam K C
Published: September 2018

Public health has come a long way in Nepal, but there is still a long way to go. Over the past years some remarkable achievements have been made in millennium development goals, such as reduction of child mortality, maternal mortality and fertility. However, there still exist wide gaps in healthcoverage among different ethnic groups, geographic regions and gender. In this context, a 10+2 agenda is recommended for scaling-up essentialhealth care in Nepal. These focus on equity, tackling malnutrition, prioritizing non-communicable diseases, preventing accidents, injuries and disabilities, promoting environmental health, harnessing the power of education and communication for behavior change, strengthening healthsystems, fostering public-private partnership, capitalizing on international health partnerships, as well as institutionalizing a culture of non-violence, and consolidating genuine democracy. 

KEYWORDS: 10+2 agenda, Nepal, public health
Role Of Nutrition In A Developing Country
Authors: Upadhyaya Vijaya
Published: September 2018

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School Health Service In Nepal
Authors: Pandey Badri R
Published: September 2018

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Giardiasis In Nepal : Its Treatment with Furazolidine
Authors: Pandey Mrigendra Raj , Acharya I L
Published: September 2018

NA
Some Thoughts On Children's Education
Authors: Singh Renu Lal
Published: September 2018

NA
The Health-Factor In The Concept Of An S.O.S. Children's Village
Authors: Pohl Edith
Published: September 2018

NA
UNICEF And Nepal
Authors: Mathema Keshab B
Published: September 2018

NA
Journal of The Nepal Medical Association- Editorial
Authors: Shrestha S M
Published: September 2018

Sixth All Nepal Medical ConferenceEndemic Goitre In Nepal
Male Sterilisation (Vasectomy) and Reversal of Vasectomy
Authors: Hai-Khan A
Published: September 2018

IntroductionAnatomical ConsiderationThe Operative ProcedureGeneral Effects Of VasectomyReversal Of Vasectomy Or Recontruction Of VASReference
Ocular Morbidity among Orphanages
Authors: Shrestha M K , Wolf L , Shrestha U , Gurung K , Chansi B S , Dhungana P , Gurung R , Ruit S
Published: September 2018

INTRODUCTION:

The study assesses the spectrum of ocular morbidity and predictors of morbidity in children living in orphanages in the Kathmandu Valley.

METHODS:

A descriptive, cross-sectional survey was performed at 12 orphanages over a period of three months. The survey included a questionnaire and a complete eye examination, which included measurement of refraction, ocular deviation, and a fundus exam. Prevalence of ocular morbidity was calculated. Factors associated with ocular morbidity were examined using logistic regression.

RESULTS:

A total of 660 children were included in the study (median age nine years [range 0.25-15]; 53% male). The prevalence of ocular morbiditywas 17.9% (118). Of those with ocular morbidity, 88.1% (104) had similar ocular problems bilaterally. The most common type of morbidity was refractive error, found in 70.3% (83) of those with ocular morbidity (12.6% overall).

CONCLUSIONS:

Refractive errors, which are largely correctable, are the greatest source of morbidity. In order to reduce childhood blindness, children living in orphanages are an appropriate group to target for future ocular screening in Nepal.

Keywords: children, Nepal, ocular morbidity, ocular screening, orphanage
An Easy Way To Successful Colon Surgery
Authors: Lohr Berthold
Published: September 2018

NA
Heard, Seen and Spoken
Authors: Author No
Published: September 2018

The Greatest Paesiatrician of NepalThe 'Guvaju'The 'Bhagvati'The 'Jhankri'Hot bricks and Hot ashes Pain Killer for Lumbago-sciaticaToward off the evil eye
Community Health Aspect Of Disaster Planning
Authors: Bomgaars Mona R
Published: September 2018

NA
Editorial
Authors: Editorial JNMA
Published: September 2018

Laudable-Attempt
News
Authors: Author No
Published: September 2018

Control of Goitre in NepalAdvance Course in Clinical ChemistryWorld Health DayDicussion on Medical Care in Countries of South East Region of WHoApril 1973: Who Assistant to Nepal for 1975
The Pattern Of Occlusive Arterial Disorders Affecting The Lower Extermities In India
Authors: Joshi Manohar J , Kanetkar A V , Gondhalekar A G
Published: September 2018

NA
Some Aspects Of Infants Nutrition
Authors: Shrestha Devi Bahadur
Published: September 2018

NA
Editorial
Authors: Editorial JNMA
Published: September 2018

Priority For Children
Refractive Error, Srabismus and Amblyopia in Congenital Ptosis
Authors: Thapa R
Published: September 2018

INTRODUCTION:

Congenital ptosis is often associated with visual impairment. The aim of the study is to find out the pattern of refractive error,strabismus and amblyopia in patients with congenital ptosis in a hospital setting.

METHODS:

This is a hospital based prospective and descriptive study conducted at Tribhuvan University, B P Koirala Lion's Centre for Ophthalmic studies in Nepal from February 2003 to July 2004. All the consecutive cases with congenital ptosis were included and cases with pseudoptosis were excluded from the study.

RESULTS:

Among the 78 cases (95 eyes) of congenital ptosis, refractive error was present in 13 cases (16.7%) with astigmatism as the commonestrefractive error (8.9%). Strabismus was found in 23 cases (26.9%) of congenital ptosis. Among the strabismus, combined exotropia with hypotropia was found in the majority of cases (16.7%). Visual impairment due to amblyopia was found in 15 cases (19.2%) of congenital ptosis with mixed strabismic and refractive etiology as the commonest one (46.7%) followed by pure strabismic (26.7%), pure refractive (20%) and stimulus deprivationamblyopia (6.7%).

CONCLUSIONS:

Patients with congenital ptosis have higher rate of amblyopia due to greater prevalence of strabismus and refractive errors although stimulus deprivation amblyopia is less common. Early ophthalmic evaluation and timely treatment of these conditions may help prevent the irreversible visual impairment in case of congenital ptosis.

Keywords: amblyopia, congenital ptosis, refractive error, strabismus.
Molluscum contagiosum involving an epidermoid cyst – a rare association and potential source of clinical misdiagnosis
Authors: Ghosh Prithwijit , Saha Kaushik
Published: September 2018

Molluscum contagiosum (MC) is a viral infection of skin and mucous membrane commonly affecting the adolescents and young adults. Extensive lesions are usually common in immunocompromised patients. We herein report a rare case of MC in an epidermoid cyst (EC) in a 24-year-old immunocompetent male. The provisional clinical diagnosis was inflammed EC or lipoma. On histopathological examination the lesion displayed a unilocular EC in the deep dermis, the lining of which was infected by MC virus with characteristic inclusions.  The overlying epidermis was absolutely normal having no attachment with the cyst.
The Viral Flora Of Village Children From Birth To Two And Half Years Of Age
Authors: Cooper-Dastur M , Bang F B
Published: September 2018

NA
Endoscopic Grading of Adenoid in Otitis Media with Effusion
Authors: Acharya K , Bhusal C L , Guragain R P
Published: September 2018

INTRODUCTION:

Adenoid is thought to be one of the causes of otitis media with effusion, though it is controversial. Grading the adenoid by rigid nasal endoscope in patients with otitis media with effusion may justify adenoidectomy in otitis media with effusion in the future.

METHODS:

A prospective study was carried out at GMS Memorial Academy of ENT and head neck studies from 15th December 2005-April 2007. Study group comprised of 32 children with otitis media with effusion and control group of 28 children with clinically normal ear and nose. Rigid nasal endoscope was used for grading of adenoid in study and control group. The severity of otitis media with effusion was assessed by preoperative air-bone gap and thickness of the fluid aspirated from middle ear during ventilation tube insertion.

RESULTS:

In the study group 13 out of 32 had grade 4 adenoid hypertrophy. This grade 4 adenoid hypertrophy was found to be statistically significant in children with otitis media with effusion (P < 0.0002). In control group 15 out of 28 had grade 1 adenoid hypertrophy which was significant in the same group (P < 0.002). Air-bone gap and thickness of fluid did not correlate with the increasing grade of adenoid hypertrophy.

CONCLUSIONS:

Grade 4 adenoid hypertrophy was statistically found to be significant with otitis media with effusion but severity of hypertrophy were not reflected by hearing loss and thickness of fluid.

Keywords: adenoid hypertrophy, myringotomy , otitis media with effusion, ventilaiton tube insertion.
Nepal's Five-Year Health Plan (1970-1975) And Its Achievement
Authors: Shrestha Rudra Man
Published: September 2018

The Bara and Kaski pilot projects testing the feasibilities of integrated basic health services as a method of health care delivery.
NMA News - Sixth All Nepal Medical Conference, Scientific Session 21st March 1973
Authors: Shrestha Santosh M
Published: September 2018

Welcome Speech
Inaugural Address To The Scientific Session, Sixth All Nepal Medical Conference
Authors: Sama Shree Bal Krishna
Published: September 2018

NA
Journal of The Nepal Medical Association- Editorial
Authors: Dixit Hemang
Published: September 2018

Health Man Power
Ovarian Pregnancy- A Rare Ectopic Pregnancy
Authors: Thapa M , Rawal S , Jha R , Singh M
Published: September 2018

Primary ovarian pregnancy is a rare entity, the incidence being 1 in 25,000 to 40,000 pregnancies. The diagnosis is difficult and still continues to challenge the clinicians. A case of ovarian pregnancy is reported here. The patient underwent laparotomy with right sided oophorectomy. Histopathological examination confirmed it to be an ovarian pregnancy.

Keywords: ectopia pregnancy, oophorectomy, ovarian pregnancy.
Planning, Selection, Training And Placement Of The Health Personnel
Authors: Prasad Laxmi Narayan
Published: September 2018

NA
Questions to JNMA Readers
Authors: Cunningham J S
Published: September 2018

NA
Educate All People On Health Activities
Authors: Dixit Kalyanmani Acharya
Published: September 2018

NA