bluuebunny/crossref_metadata_2025_split huggingface dataset:
Clinico-radiological Aspects of Neurocysticercosis in Pediatric Population in a Tertiary Hospital
Authors: Shrestha Bandana , Mainali Prabha , Sayami Sujan , Shrestha Om Kumar 
Published: September 2018

Introduction: Neurocysticercosis (NCC) is common in developing countries including Nepal. Clinical presentations vary depending on the CT scan findings of head. Adequate information of NCC in children from Western Nepal is lacking. This study was conducted with an objective of evaluating the most common clinical and radiological picture in children suffering from NCC at a tertiary care teaching hospital in Western Nepal. Methods: Hospital records of all pediatric inpatients, admitted from 16th June 2010 to 15th December 2012, consistent with the diagnosis of Neurocysticercosis were reviewed.Results: Among the 217 patients that either presented seizure or other neurological deficit, 49 were diagnosed as Neurocysticercosis. Their age varied between 2.6 years and 14 years with the mean age of 10.6 years and the peak age of 12 years among diagnosed inpatients. It also showed slight male predominance with the ratio of male and female being 1.22:1. Sorted based on geographical distribution, the maximum of 14 (28.6%) patients were from Kaski district, closely followed by Tanahun district with 13 (26.5%). 38 (77.5%) of the presentations were seizures, partial seizures being most common. 44 (89.8%) of the lesions were single, with 20 (40.8%) predominantly residing in the parietal region, 30 (61.22%) were in transitional stage. However, number of lesions discovered from CT scan of head showed no significance in association with seizure types (p=0.84). In addition, perilesional edema and scolex within the lesion were noted in 67.34% and 18.36% of the cases respectively._______________________________________________________________________________________Keywords: clinico-radiological profile; neurocysticercosis; pediatric population._______________________________________________________________________________________
Asymptomatic Bacteriuria in Pregnant Women
Authors: Thakur Achala , Baral Ratna , Basnet Pritha , Rai Rubina , Agrawal Ajay , Regmi Mohan Chandra , Uprety Dhruba Kumar 
Published: September 2018

Introduction: Asymptomatic bacteriuria is the significant presence of bacteria in urine of an individual without symptoms. The aim of the study is to determine the prevalence of asymptomaticbacteriuria in pregnant women.
Methods: This study was a prospective study conducted in the department of Obstetrics and Gynaecology at B. P. Koirala Institute of Health Sciences. The duration of the study was six monthsfrom January to June 2012. A total of 600 pregnant women were enrolled. All women were clinically identified to have no signs and symptoms of UTI. Clean catch midstream urine sample was collectedfrom each patient into a sterile vial. The urine samples were examined for microscopic and culture sensitivity test.
Results: Out of 600 pregnant women, 52 were positive for significant bacteriuria with a prevalence rate of 8.7%. There was a significant difference in prevalence of asymptomatic bacteriuria withrespect to trimester (p=0.005). Age did not show any significant difference in the prevalence of asymptomatic bacteriuria (p=0.807). There was not any significant difference in the prevalence ofasymptomatic bacteriuria with respect to parity (p=0.864) and booking status (p=0.397). Escherichia coli (35%), Acinetobacter species (15%), Enterococcus species (12%) and Klebsiella pneumoniae (10%)were the common isolates. Most of the isolates were sensitive either to Nitrofurantoin, Norfloxacin or Amikacin.
Conclusions: Asymptomatic bacteriuria is common in pregnancy. Urine culture sensitivity should be carried out routinely on all pregnant patients in order to prevent the dangerous complicationsassociated with it.
Keywords: asymptomatic bacteriuria in pregnancy; urine culture and sensitivity.
Clinico-pathological Study of Colorectal Carcinoma
Authors: Thapa Rupendra , Lakhey Mamta , Yadav Pradeep Kumar 
Published: September 2018

Introduction: Colorectal carcinoma (CRC) ranks as the fourth most frequent cancer in men (afterlung, prostate and stomach cancer), and third in women (after cancers of breast and uterine cervix).Adenocarcinoma of the colon is the most common malignancy of the GI tract and is a majorcause of morbidity and mortality worldwide. It is also one of the most common cancers in Nepal.Methods: A descriptive study was conducted in a Kathmandu based Hospital. This study included50 casesof colorectal carcinoma diagnosed on colonoscopic/sigmoidoscopic biopsies over a periodof two years.Results: A total of 50 patients were studied out of these, 29 (58%) patients were male, whereas21 (42%) were female with male:female ratio of 1.3:1. Age ranged was from 20 years to 80 years.Maximum number of cases were observed between the ages of 61-70 years. The most common histological type of colorectal carcinoma was moderately differentiated adenocarcinoma and seen in 37(74%) cases. Left sided tumor constituted 40 (80%) cases of all tumorsand rectum was the predominant site with 26 (52%) cases followed by sigmoid colon with 7 (14%) cases.Conclusions: Colorectal carcinoma (CRC) is not an uncommon disease in this part of the world. The use ofsigmoidoscopy and colonoscopy along with biopsy when required should be encouraged as a screeningprogram for colorectal carcinoma in an elderly age group for the detection of CRC at an earlier stage._______________________________________________________________________________________Keywords: biopsy; colonoscopy; colorectal carcinoma; histopathology; sigmoidoscopy._______________________________________________________________________________________
Anatomical and Visual Outcome following Macular Hole Surgery at a Tertiary Eye Care Centre in Nepal
Authors: Thapa R , Paudyal G 
Published: September 2018

Introduction: Macular hole (MH) leading to central vision loss is common in the elderly. This study aimed to explore the anatomical and functional outcome of MH surgery at a tertiary eye care setting in Nepal.
Methods: This retrospective, interventional case series study included patients who had undergone MH treatment with pars plana vitrectomy, membrane peeling and perfluoropropane gas (C3F8) from 2007 January to 2010 August and had completed three months of follow up. The best corrected visual acuity (BCVA) and anatomical status of MH assessed with bio-microscopy and optical coherence tomography (OCT) at six weeks, three months and at the last follow-up following surgery were recorded.
Results: A total of 36 cases with the age range of 11 - 73 years and the mean age of 53.2 years (19.3 S.D) were included in the study. The mean duration of decreased vision was 11.1 months (12.1 S.D). Idiopathic macular hole comprised of 31 cases (86.1 %) and traumatic of five cases (13.9 %). The mean follow-up period was 9.4 months. The MH closed in 27 cases (75 %) at six weeks and in 28 cases (77.8%) at three months and at the last follow-up. The vision had improved in 36 % of cases, with more than 2 lines in 27.8 %, and was stable in 27.7 % of cases during the the last follow-up. The anatomical success rate was higher in the idiopathic MH (80.65 %) than in the traumatic (60 %) and visual acuity improved in 45 % of cases in the idiopathic and 20 % in the traumatic cases.
Conclusions: The overall anatomic success rate was 78 % and improvement in visual acuity was seen in one -third of cases. The success rate was higher among idiopathic MH than in traumatic.
Keywords: Anatomical success, macular hole, perfluoropropane gas, visual acuity, vitrectomy
Clinical Profile and Outcome of Patients Presenting with Mushroom Poisoning in a Tertiary Care Center of Eastern Nepal
Authors: Chaudhary Shatdal , Chaurasia Ramesh Kumar , Patel Sushila , Agrawal Krishna Kumar , Aswani Rakesh , Jaiswal Niraj Kumar 
Published: September 2018

Introduction: Accidental mushroom poisoning is constantly seen and regularly reported from all over world. Exact magnitude of problem and its clinical profile in Nepal is not well known. This study was done to evaluate clinical profile and treatment outcome of patients presenting with mushroom poisoning in the department of internal medicine, BPKIHS, Dharan.
Methods: It is a prospective observational study conducted in department of internal medicine, BPKIHS, Dharan from 1st January 2008 to 31st December 2009. Informed consent was taken. All the patients were subjected to necessary laboratory investigation. They were followed up at 1 week and 1 month after discharge.
Results: All together 60 patients were analyzed. Majority of subjects 56 (93.3%) were from rural areas. Vomiting and diarrhea were the two most common presentations seen in 56 (93.3%) subjects. The latent period for the symptoms were > 6 hours in 4 (6.7%) and < 6 hours in 56 (93.3%) subjects. Fulminant hepatic failure was seen in 6 (10%) subjects and among them 4 (66.7%) expired. After admission 3 (5%) subjects developed GI bleeding. Average duration of hospital stay was 4.6 days. In follow up recovery was complete in all subjects who survived the acute phase of poisoning.
Conclusions: Especially in patients coming during rainy season mushroom poisoning should be considered in the differential diagnosis of acute gastroenteritis. Mortality is high in subjects with FHF whereas recovery is complete in subjects who survived the acute phase. Keywords: fulminant hepatic failure; gastroenteritis; mushroom poisoning; wild mushrooms.
Risk Factors Predicting Mortality in Patients with Lung Abscess in a Public Tertiary Care Center in Karachi, Pakistan
Authors: Ghazal Shaista , Kumar Ashok , Shrestha Binav , Sajid Sana , Malik Maria , Rizvi Nadeen 
Published: September 2018

Introduction: Lung abscess is a commonly encountered entity in South-East Asia but not much data regarding its outcome is available. The objective of this study was to identify the factors associated with increased mortality in patients diagnosed with lung abscess in a tertiary care center of Karachi, Pakistan.
Methods: A retrospective case analysis was performed via hospital records, on patients admitted with lung abscess between January 2009 and January 2011 at the largest state-owned tertiary care centre in Karachi, Pakistan. Out of the 41 patients hospitalized, 17 could not survive and were evaluated for clinical, radiological and microbiological factors to determine association with heightened mortality.
Results: Mortality due to lung abscess stood at 41.4% (17 of 41 cases). Adult male patients were found to have higher mortality with 13 out of 17 (43%) dead patients being male. A majority (21/41, 51.2%) of the cases belonged to the 41-60 year old age group. Highest mortality was seen in patients <20 years of age (3/4, 75%). Patients with blood sugar levels of >200 mg/dL (56%) succumb to disease. Patients with a positive history of smoking, diabetes mellitus, and alcohol intake expressed mortality rates of 44%, 56%, and 50% respectively; while 29.4% of the mortalities were positive for Pseudomonas aeruginosa on sputum culture. A significant association was found with elevated mortality and low haemoglobin levels at time of admission; mortality was 58% ( p=0.005) in patients with Hb less than or equal to 10 mg/dL.
Conclusions: The risk factors involved with heightened mortality included male gender and history of smoking, diabetes and alcohol intake. High blood sugar levels and detection of Pseudomonas aeruginosa on sputum cultures were also implicated. Anemia (Hb level less than or equal to 10mg/dl) was statistically significant predictive factor for increased mortality.
Keywords: lung abscess; mortality; risk factors.
CT Evaluation of Pelvic and Hip Fractures
Authors: Sharma Umesh Kumar , Basnyat Anjali , Rijal Keshab , Shrestha Babu Kaji , Banskota Bibek , Banskota Ashok Kumar 
Published: September 2018

Introduction: To analyze the spectrum of pelvic and hip joint injuries by computed tomography in patients attending to emergency.
Methods: CT evaluation with multiplanar and 3-D reformations of 62 patients done with pelvic and hip fractures during 18 months. The mode of injury and treatment were recorded.
Results: Forty four (70.9%) of the injuries were sustained in high speed vehicle accidents (automobile, motorcycle, autopedestrian), 14 patients (22.5%) had sustained fall injury and 4 patients (6.4%) sustained injury following slip on the ground. 31 patients underwent surgery for acetabular fractures. Associated injuries included spinal fractures (5), abdominal visceral injury (3), extremity fractures (13), chest injury (5), head injury (1), urethral injury (4), clavicle fracture (1). Forty patients (64.5%) had acetabular fractures, 25 (40.3%) patients had iliac bone fractures, 47 (75.8%) had pubic bone fracture. Sacral fracture was found in 17 (27.4%) patients. Associated femoral fracture was found in 4, hip joint dislocation was seen in 5 (2- central, 3-posterior). Sacroiliac joint diastasis was found in 13(20.9%) patients, pubic diastasis in 7 (11.2%), fracture ischium in 7(11.%) , protrusio acetabuli in 5 (8%).
Conclusions: Spiral CT with multiplanar and 3-D reformations has clinical values for precise diagnosis and treatment plan for the pelvic and hip fractures.
Keywords: pelvis; hip fractures; CT scan.
Managerial experiences on Pediatric surgical tumors in Tribhuvan University Teaching Hospital
Authors: Pokharel Rameshwar Prasad 
Published: September 2018

Introduction: Pediatric tumors are least prioritized but serious problems. Multidisciplinary management improves survival. Incidences, types and follow up results on Nepalese pediatric tumors have not yet been studied. To highlight our center’s experiences on pediatric tumors management and follow up is aimed.
Methods: All pediatric surgical tumors admitted in pediatric surgery unit from 2065-2070 BS werer studied. Patients evaluated with or without chemo / radiotherapy pre or post surgery. Total of 22 cases from age four months to 13 years were studied.
Results: Tumor detection shown highest in age group below 3 years, followed by 5-10 years. Mean age was 54 months. Most common problem (22.7 %) was Saccrococcygeal teratoma (histologically matured). 13% Nephroblastoma, 9% ovarian tumor, 9% Neuroblastoma and various others each were 4.45 %. Majority underwent surgical excision of tumors. Three cases pre surgery and 5 post-surgery, received chemotherapy. Rest had only excision of tumor mass.Follow up were from three weeks to five years period. During this period, two patients expired (one due to complication of second cycle of chemotherapy and second one died with severe aspiration after second laparotomy for intestinal obstruction one year after initial Nephroblastoma excision.) One patient lost for follow up after excision of stage V Nephroblastoma and first cycle of chemotherapy.
Conclusions: Management of pediatric tumors is complicated. Thus it needs better multidisciplinary centre of excellence for satisfactory results. Management is directed according to incidence, types, standard management protocol, which is not studied yet in Nepal. Research on pediatric tumors is virgin area. Large scale studies need to conduct in detail and a center of excellence is essential to provide better services.
Keywords: follow ups; management; Nepalese population; pediatric tumors; types.
Primary Cutaneous Angiosarcoma on the Nose in a Patient with Multiple Nonmelanoma Skin Cancers
Authors: Basak Kayhan , Basak Pinar Yuksel , Demirel Hakan , Karadayi Nimet 
Published: September 2018

Cutaneous angiosarcoma is an uncommon, potentially metastatic and highly aggressive vascular tumor that may arise as de novo or be associated with previous radiotherapy. A 70-year-old female with a solitary lesion on the nose was initially diagnosed as actinic keratosis. However, when the recurring lesion at the same region within 6 months was reexcised, the histological diagnosis was definitively established as well-differentiated angiosarcoma. This case was presented in order to increase awareness of this rare malignancy in an uncommon localisation, especially in the light of pathological findings. Moreover, occurrence of cutaneous angiosarcoma within a short period following a previous excision in a patient with a history of multiple nonmelanoma skin cancers was interestingly pointed out.
Keywords: angiosarcoma; face; nonmelanoma skin cancers.
PBL Implementation of Kathmandu University Curriculum – Is It Quo Vadis?
Authors: Dixit Hemang , Vaidya Sujan , Pradhan Binita 
Published: September 2018

The history of the implementation of PBL which started in 1978 is long and there have been many ups and downs in the process of getting it to work. Of course there are many reasons for this, starting with the fact that basically it is a method of learning of medicine that is being tried out in various parts of the world. What is envisaged by KU is a hybrid form of the process to be implemented for the MBBS course that KUSMS conducts at its campus at Chaukot, Kavre and at its seven affiliated medical colleges. Various points regarding this are discussed in this article. The information provided in the MBBS curriculum of KU was analysed and comments made there on. The syllabi of IoM, BPKIHS and PAHS were also referred to, to note the existing differences.
Keywords: BPKIHS; ICM; IIME; IoM; KU; NMC; PAHS; SDL; WFME.
Effect of Submucosal Injection of Dexamethasone on Post-operative Sequelae of Third Molar Surgery
Authors: Deo S P , Shetty P 
Published: September 2018

Introduction: This study was carried out to evaluate the effects of a single pre-operative sub-mucosal injection of dexamethasone after third molar surgery to see the effects on post-operative discomfort.
Methods: This study was a prospective, double-blind, randomized, clinical trial. The subjects were forty patients who underwent surgical removal of the mandibular impacted third molar under local anesthesia and after being randomly assigned to receive either an 8 mg dexamethasone as submucosal injection or a normal saline injection into the lower buccal vestibule adjacent to the third molar. The maximum interincisal distance and facial contours were measured at the baseline and post-surgically on Day 2 and 7. Post-operative pain was evaluated subjectively using a visual analog scale and objectively by counting the number of analgesic tablets used. All subjects were operated upon by the same investigator to minimize the difference from inter-operator variability.
Results: There was a signicant difference in the measurements of the degree of swelling and trismus between the two groups on the 2nd post-operative day. In contrast, there was no statistically signicant difference between the groups on the 7th post-operative day. The test group also used fewer analgesics post-operatively.
Conclusions: Submucosal injection of dexamethasone after third molar surgery is effective in reducing postoperative swelling and trismus. It also delays the onset of post-operative pain.
Keywords: dexamethasone, submucosal injection, third molar, third molar surgery, third molar extraction
Vulvar Endometrioma: A Case Report
Authors: Turan V , Ergenoglu M , Yeniel O , Emiroglu G , Ulukus M , Zekioglu O 
Published: September 2018

Endometriosis is a benign and common disorder that is characterized by ectopic endometrium outside the uterus. Extrapelvic endometriosis, like of the vulva, is rarely seen. We report a case of a 47-year-old woman referred to our clinic due to complaints of a vulvar mass and periodic swelling of the mass at the time of menstruation. During surgery, the cyst ruptured and a chocolate-colored liquid escaped onto the surgical eld. The cyst was extirpated totally. Hipstopathological examination showed ndings compatible with endometriosis. She was asked to follow-up after three weeks. The patient had no complaints and the incision eld was clear at the follow-up.
Keywords: cystic mass, endometriosis, vulva.
Bilateral, Mirror-imaged, Postero-inferior Cerebellar Artery Aneurysms: Report of a Rare Case
Authors: Sharma G R , Jha R , Khadka N , Adhikari D R , Bista P , Sultaniya P K 
Published: September 2018

A 60-year-old right-handed lady presented with the features of subarachnoid haemorrhage. The CT angiogram showed a pair of very rare bilateral, mirror-imaged distal postero-inferior cerebellar artery aneurysms. Both aneurysms were clipped via the midline posterior fossa craniectomy under general anaesthesia. The literatures is reviewed on the incidence, presentation, management and outcome of bilateral distal posterior-inferior cerebellar artery aneurysms. Keywords: bilateral mirror image, distal postero-inferior cerebellar artery aneurysms, posterior fossa craniectomy, microsurgical clipping
Clinical Profile of Idiopathic Epistaxis in a Hospital
Authors: Bhatta R 
Published: September 2018

Introduction: Epistaxis is a common otolaryngological emergency but most of the cases are idiopathic. This study was done to assess clinical profile in patients with idiopathic epistaxis.
Methods: Patients presenting in ENT outpatient department or emergency with epistaxis and no definite cause were selected. Patients demographic data, present and past history was recorded. All patients underwent anterior rhinoscopy and rigid nasal endoscopy.
Results: There were 142 patients with epistaxis without definite cause. Age ranged from 11 to 84 years with mean 32.8 years. Approximately two-third were male. Bleeding from right side was seen in 64 (45.0%) patients. Past history of bleeding was given by 79 (55.6%) patients and out of them 60 (75.9) % had bleeding from same side. Presentation was mostly in months of January to March. Bleeding point was seen in 65 patients. Most of them (37/65) was in Little’s area. Deviated nasal septum was seen in 102 patients. More than half of patients with unilateral bleeding were having bleeding from convex side of deviation. Blood pressure was found to be equal or more than 140/90 mm Hg in 55 (38.7%) patients at the time of presentation. Antihypertensive was required in less than half of these patients.
Conclusion: Idiopathic epistaxis is common in male, in winter season and in right side and from nasal septum. Hypertension may be found at presentation but most of them don’t need antihypertensive.
Keywords: deviated nasal septum; epistaxis; hypertension.
Maternal Near-Miss: A Multicenter Surveillance in Kathmandu Valley
Authors: Rana Ashma , Baral Gehanath , Dangal Ganesh 
Published: September 2018

Introduction: Multicenter surveillance has been carried out on maternal near-miss in the hospitals with sentinel units. Near-miss is recognized as the predictor of level of care and maternal death. Reducing maternal mortality ratio is one of the challenges to achieve Millennium Development Goal. Objective was to determine the frequency and the nature of near-miss (severe acute maternal morbidity) events and analysis of near-miss morbidities among pregnant women.Methods: Prospective surveillance was done for a year in 2012 in nine hospitals in Kathmandu valley. Cases eligible by definition recorded as a census based on WHO near-miss guideline. Similar questionnaire and dummy tables were used to present the result by non-inferential statistics. Results: Out of 157 cases identified with near-miss rate of 3.8, severe complications were PPH (40%) and preeclampsia-eclampsia (17%). Blood transfusion (65%), ICU admission (54%) and surgery (32%) were the common critical intervention. Oxytocin was the main uterotonic used both prophylactically (86%) and therapeutically (76%), and 19% arrived health facility after delivery or abortion. MgSO4 was used in all cases of eclampsia. All of the laparotomies were performed within 3 hours of arrival. Near-miss to mortality ratio was 6:1 and MMR 62.Conclusions: Study result yields similar pattern amongst developing countries and same near-miss conditions as the causes of maternal death reported by national statistics. Process indicators qualify the recommended standard of care. The near-miss event can be used as a surrogate marker of maternal death and a window for system level intervention. Keywords: abortion, eclampsia, hemorrhage, near-miss, surveillance