bluuebunny/crossref_metadata_2025_split huggingface dataset:
Non endoscopic endonasal dacryocystorhinostomy versus external dacryocystorhinostomy
Authors: Sharma BR 
Published: April 2009

Aims and Objectives: To compare the success rates of non endoscopic endonasal dacryocystorhinostomy and conventional external dacryocystorhinostomy for the surgical management of primary acquired nasolacrimal duct obstruction. Materials and methods: A retrospective, nonrandomized, comparative interventional case series of 302 patients who underwent either endonasal or external dacryocystorhinostomy over a period of 2 years. All surgeries were performed by a single surgeon and patients with primary nasolacrimal duct obstruction with a minimum of 6 months post operative follow up were included in the study. While external dacryocystorhinostomy was performed using traditional technique, endonasal dacryocystorhinostomy was performed using direct method of nonendoscopic visualization. Results: Of the 302 cases included in the study 165 patients had endonasal dacryocystorhinostomy whereas 137 underwent external dacryocystorhinostomy. Success was defined by resolution of symptoms of tearing, a negative fluorescein dye disappearance test and patency of the canalicular system on lacrimal irrigation. In the external dacryocystorhinostomy group 124 (90.5%) patients had surgical success whereas 146 (88.5%) of the endonasal dacryocystorhinostomy patients had successful outcome. The overall success rate was 89.4%, and the difference of surgical success between the two groups was not statistically significant ( P=0.57). Conclusion: Non endoscopic endonasal dacryocystorhinostomy gives surgical results comparable to those of external dacryocystorhinostomy and is a viable alternative where dacryocystorhinostomy is indicated for primary acquired nasolacrimal duct obstruction. Key words: Endonasal Dacryocystorhinostomy (ENDCR), External Dacryocystorhinostomy (EXDCR), Primary acquired nasolacrimal duct obstruction (PANLDO) doi: 10.3126/kumj.v6i4.1731 Kathmandu University Medical Journal (2008), Vol. 6, No. 4, Issue 24, 437-442
Peripheral intravenous catheter related phlebitis and its contributing factors among adult population at KU Teaching Hospital
Authors: Singh R , Bhandary S , Pun KD 
Published: April 2009

Background: Peripheral intravenous catheter-related phlebitis is a common and significant problem in clinical practice. This study was carried out to determine the occurrence of peripheral intravenous catheter related phlebitis and to define the possible factors associated to its development. Materials and methods: Prospective observational study was carried out on 230 clients who were under first time peripheral infusion therapy during two months period: September - October, 2007. Peripheral infusion site was examined for signs of phlebitis once a day. Jackson Standard visual phlebitis scale was used to measure the severity of the phlebitis. SPSS software was used to enter, edit and analyze the data and t-test, chi-square test, binary logistic regression and ROC curve were used to draw the statistical inferences. Results: Phlebitis developed in 136/230 clients (59.1%). It was very mild in most cases. Increased incidence rates of infusion related phlebitis were associated with male sex, small catheter size (20 gauge), insertion at the sites of forearm, IV drug administration and blood product transfusions. The incidence rate of phlebitis rose sharply after 36 hours of catheter insertion. Conclusion: Peripheral Intravenous therapy related phlebitis at KUTH, Dhulikhel Hospital is a significant problem. Related risk factors as found in the present study were insertion site (forearm), size of catheter (20G) and dwell time (>= 36 hours). There were higher incident of phlebitis among the client with Intra venous drug administration and especially between ages 21 - 40 years. Therefore more attention and care are needed in these areas by the care provider. Key words: Phlebitis, Intravenous Therapy, Catheter, Risk Factors, KUTH, Nepal. doi: 10.3126/kumj.v6i4.1732 Kathmandu University Medical Journal (2008), Vol. 6, No. 4, Issue 24, 443-447
Outcome of pneumatic retinopexy at a tertiary eye care centre in Nepal
Authors: Thapa R , Shrestha MK , Gurung R , Ruit S , Paudyal G 
Published: April 2009

Background: Rhegmatogenous retinal detachment is one of the commonly encountered retinal problems where timely treatment could prevent irreversible vision loss. Pneumatic retinopexy (PR) is a simple and minimally invasive procedure for retinal reattachment. Aim: This study aimed to assess the outcome of pneumatic retinopexy in primary rhegmatogenous retinal detachment at our facility. Study design: This was a retrospective- prospective, interventional case series. Materials and methods: All subjects with rhegmatogenous retinal detachment who underwent pneumatic retinopexy at Tilganga Eye Centre of Nepal from January 2002 to June 2007 were included in this study. Results: A total of 32 cases were included in the study. The mean age of patients was 55.2 year (SD=11.0). The majority of cases (62.5%) presented within two weeks of symptoms with blurring of vision in 90% of cases. Pre-operatively, 56.3% (18) patients had a best corrected distance visual acuity of < 6/60. Retinal detachment involving less than two quadrants consisted of 37.5% (12). A single retinal break was present in 78.1% (25) of cases and 87.5% (28) of the retinal breaks were located in the superotemporal quadrant. The macula was attached in 37.5% (12) of the cases. Sulfurhexafluoride and Perfluoropropane were used in 68.8% (22) and 31.3% (10) respectively. The average follow up period was 1.02 years (range one month to four years). The retina was completely attached in 81.3% (26) of cases at the last follow up. The best corrected distance visual acuity of 6/18-6/60 was found in 40.6% (13) of subjects in the last follow up. There was a transient rise in intraocular pressure in 6.3% (2) of subjects after the procedure. Conclusion: The anatomical success rate following pneumatic retinopexy is quite high (81.3%) with good visual recovery and less morbidity translating to higher productivity for the patient. This procedure, being quicker than the alternatives, will also save surgeon's time making PR a good choice for managing primary rhegmatogenous retinal detachment in countries like Nepal where resources are scarce. Key words: Rhegmatogenous retinal detachment, retinal break, pneumatic retinopexy, Nepal doi: 10.3126/kumj.v6i4.1737 Kathmandu University Medical Journal (2008), Vol. 6, No. 4, Issue 24, 466-471
Seroprevalence of anti HCV antibodies among blood donors in Kathmandu valley, Nepal
Authors: Karki S , Ghimire P , Tiwari BR , Rajkarnikar M 
Published: April 2009

Aims and objectives: To study the seroprevalence of anti HCV antibodies among Nepalese blood donors in relation to their age, sex, type of donation and times of donation. Materials and methods: Descriptive cross-sectional study conducted in Nepal Red Cross Society (NRCS), Central Blood Transfusion Service (CBTS), Kathmandu, from December 1, 2006 to September 1, 2007. A total of 33,255 blood donors were screened for anti HCV antibodies by ELISA. Donor's information was collected from blood donor's record form and statistical analysis was done using the software ‘SPSS 11.5' and ‘Winpepi ver. 3.8'. Result: The seroprevalence of anti HCV antibodies in blood donors was 0.66% (95% CI= 0.58-0.76). Higher seroprevalence was observed in male donors (0.7%, 95% CI= 0.6-0.8) than in female donors (0.4%, 95% CI= 0.2-0.6) (P < 0.05). The seroprevalence was highest (0.82%) in the age group of 21-30 years and there was significantly decreasing trends in seroprevalence with increasing age (P < 0.05). The highest seroprevalence among the male donors (0.88%) was also observed in the age group of 21-30 years (P < 0.001). Among female donors the seroprevalence (0.47 %) was highest in age group 41-50 years (P > 0.05). The seroprevalence of anti HCV was significantly higher in volunteer donors (0.7%) than in replacement donors (0.4%) (P < 0.05). Similar seroprevalence of anti HCV was observed in first time (0.65%) and repeat blood donors (0.67%) (P > 0.05). Conclusion: The seroprevalence of anti HCV antibodies among blood donors in this study was similar to the seroprevalence reported for general population by other studies. Similar seroprevalence in first time and repeat blood donors as well as higher seroprevalence in volunteer donors than in replacement donors are the potential threats to safe blood supply, which urges the need of more effective donor education and counselling of blood donors. Key words: . doi: 10.3126/kumj.v6i4.1741 Kathmandu University Medical Journal (2008), Vol. 6, No. 4, Issue 24, 491-496
Anterior dislocation of the shoulder with ipsilateral humerus shaft fracture
Authors: Pradhan I , Banskota AK 
Published: April 2009

Anterior dislocation of the shoulder joint with ipsilateral humerus shaft fracture is a very rare injury. Until July 2006 only 18 cases have been reported in the literature. Here we report a case of Anterior Shoulder dislocation with greater tuberosity and shaft of humerus fracture. The patient was treated by Open reduction and internal fixation of the shaft fracture followed by closed reduction of the dislocation. A post-operative rehabilitation program was instituted for complete rehabilitation of the shoulder function. Key words: Shoulder dislocation, Ipsilateral, Humerus, Fracture, Open reduction. doi: 10.3126/kumj.v6i4.1743 Kathmandu University Medical Journal (2008), Vol. 6, No. 4, Issue 24, 502-504
An unusual presentation of hydatid cyst in anterior abdominal wall
Authors: Srivastava P , Gangopadhyay AN , Upadhyaya VD , Sharma SP , Jaiman R 
Published: April 2009

Hydatid disease is a parasitic infestation caused by the larval form of the cestode worm Echinococcus. The most commonly encountered form of the disease is visceral hydatid cyst caused by Echinococcus granulosus or dog tapeworm. Muscular involvement has been reported in only 3-4% cases. We are reporting this case because of its rarity, difficulty to diagnose clinically, dramatic response to medical treatment and to alert the reader of this rare infestation so that open biopsy will be avoided. Key words: Hydatid cyst, parietal wall, medical treatment doi: 10.3126/kumj.v6i4.1746 Kathmandu University Medical Journal (2008), Vol. 6, No. 4, Issue 24, 511-513
Retrograde intubation: An alternative way for the management of difficult airway
Authors: Lama P , Shrestha BR 
Published: April 2009

Inserting a retrograde wire into the pharynx through a cricothyroid puncture can facilitate tracheal intubation in difficult situations where either a flexible fiber-optic bronchoscope or an expert user of such a device is not available. Even in cases when fibropric can not be negotiated for the purpose,this method has been claimed to be useful to manage the airway. Some mouth opening is essential for the oral or nasal retrieval of the wire from the pharynx. Here, a case of post mandibular reconstructed wound infection required surgical debridement and plate removal from reconstructed lower mandible under general anesthesia. We retrieved the guide wire passed through a cricothyroid puncture and subsequently accomplished wire-guided oro-tracheal intubation. In the absence of a flexible fiber-optic bronchoscope, this technique is a very useful aid to intubate patients with limited mouth opening. Key words: cricothyrotomy, guide wire, retrograde endotracheal intubation (REI), surgery. doi: 10.3126/kumj.v6i4.1748 Kathmandu University Medical Journal (2008), Vol. 6, No. 4, Issue 24, 516-519
Community participation in health: A brief review and the experience of Kathmandu Medical College with the Duwakot community
Authors: Vaidya A , Pradhan B 
Published: April 2009

One of the principles of Primary Health Care (PHC), Community Participation is a process through which the stakeholders influence and share control over development initiatives and the decisions and resources which affect them. It is a complex issue that has been studied widely and continues to be of great interest among community health workers. This paper presents a brief review of various aspects of community participation. It then illustrates how it is practiced at Duwakot Community Hospital, Kathmandu Medical College, Duwakot, Bhaktapur, Nepal in collaboration with the local community. Key words: Primary Health Care, Community Participation doi: 10.3126/kumj.v6i4.1750 Kathmandu University Medical Journal (2008), Vol. 6, No. 4, Issue 24, 526-532
Regarding the article “Irrational fixed dose combinations in Nepal: Need for intervention” (KUMJ, Vol 6, No. 3, Issue 23, p. 399-405)
Authors: Poudel A , Khanal S , Alam K , Palaian S 
Published: April 2009

doi: 10.3126/kumj.v6i4.1753 Kathmandu University Medical Journal (2008), Vol. 6, No. 4, Issue 24, 537-538
A comparative study of early vs. delayed laparoscopic cholecystectomy in acute cholecystitis
Authors: Yadav RP , Adhikary S , Agrawal CS , Bhattarai B , Gupta RK , Ghimire A 
Published: April 2009

Aims and Objectives: To compare the outcome in early vs. delayed laparoscopic cholecystectomy in terms of frequency of intra-operative and postoperative complications and to determine the rate and reasons for conversion. Materials and methods: A prospective randomized clinical trial was performed in the Department of Surgery at BP Koirala Institute of Health Sciences from February 2003 to June 2004 in all patients with the diagnosis of acute calculus cholecystitis. Results: Out of 145 cases, 50 cases were included in our study where 12 (24%) patients were males and 38 (76%) were females (M:F=1:3.16). The mean (SD) age of patients in early and delayed groups were 42.68 yrs. (14.18) and 40.26 yrs. (11.62) respectively. The mean (SD) duration of symptoms in early successful and converted groups were 109.24 hrs. (43.66) and 132 hrs. (49.96) respectively and the mean (SD) duration of symptoms in delayed successful and converted groups were 15.36 months (13.88) and 41 months (40.73) respectively. In early group, 17 (68%) patients had total leukocyte count more than 10,000/cmm and they had ultrasound findings suggestive of acute cholecystitis. Out of 25 patients in early group, seven had jaundice and ten had deranged liver function in the preoperative period. In early group 4 (16%) patients; and in delayed group 3 (12%) had to be converted to open cholecystectomy (P=1.00). In early group 10 (40%) and in delayed 5 (20 %) cases had intra-operative complications (P=0.122). The total hospital stay was longer in the delayed group. The postoperative hospital stay in early and delayed converted groups were higher than early and delayed successful group (P=0.081, P=0.082). Conclusion: Both early and delayed laparoscopic cholecystectomy is possible and safe in the treatment of acute cholecystitis. Key words: Acute cholecystitis, Laparoscopic cholecystectomy, Conversion doi: 10.3126/kumj.v7i1.1759 Kathmandu University Medical Journal (2009), Vol. 7, No. 1, Issue 25, 16-20
Causes of vision impairment and assessment of need for low vision services for students of blind schools in Nepal
Authors: Kansakar I , Thapa HB , Salma KC , Ganguly S , Kandel RP , Rajasekaran S 
Published: April 2009

Background: The present study is first of its kind to evaluate causes of visual impairment of blind students in Nepal and assess their need for low vision rehabilitation services. Aim: To evaluate causes of vision impairment of students enrolled in blind schools in Nepal and assess the need for low vision rehabilitation services in these students. Materials and methods: A survey was conducted in 12 blind schools in Nepal, which were registered with Nepal Association for Welfare of Blindness (NAWB).It was conducted by a team of an ophthalmologist and an optometrist, by using standard eye examination protocols of the World Health Organization Prevention of Blindness Program (WHO/ PBL). Results: Of the 345 students enrolled in 12 schools, 285 students were examined (response rate of 82.61%). The students were in the 5 - 29 years age group. Nearly three-fourth of the children had become blind within one year of age and 52.3% visually impaired at birth and 20.7% developed vision impairment within one year of age. After refraction, 26 students (9.12%) had mild visual impairment, 21 students (7.37%) had severe visual impairment and 238 students (83.51%) were blind. The main cause of vision impairment was found to be corneal 35.79% and retina diseases, mainly dystrophy, 20.35% followed by problems with the whole globe, lens and optic nerve, accounting for 13.33%, 12.63% and 12.98% respectively. The major etiological factors were those of childhood such as Vitamin A deficiency, measles and similar causes (42.11%) followed by hereditary causes (25.26%). Of the total students examined, 48.07% were visually impaired due to preventable causes and 16.14% treatable aggregating to 64.21% of avoidable blindness. Fifty seven (28.22%) students could read smaller than 2 M print size after low vision assessment for near and 33(15.78%) students benefited with telescopic trial for distance low vision. Conclusion: In Nepal, renewed focus on providing best possible quality of life for visually impaired children by proper low vision assessment and eye health education focusing on, general public and community health workers, with governmental and institutional support is required to achieve Vision 2020 objectives to decrease childhood blindness. Key words: childhood blindness, Nepal, blind school study, low vision, vision impairment doi: 10.3126/kumj.v7i1.1764 Kathmandu University Medical Journal (2009), Vol. 7, No. 1, Issue 25, 44-49
Intraperitoneal and periportal injection of bupivacaine for pain after laparoscopic cholecystectomy
Authors: Maharjan SK , Shrestha S 
Published: April 2009

Purpose: to study the analgesic efficacy of intraperitoneal and periportal injection of bupivacaine following laparoscopic cholecystectomy. Materials and methods: 40 patients undergoing laparoscopic cholecystectomy were randomized into two groups of 20 each. Group A (study group) received 40 ml of intraperitoneal injection of 0.25% bupivacaine and 20 ml of same concentration in 4 ports, 5 ml each at the end of surgery. Group B (control) received no treatment. Post operative patient monitoring and pain assessment was done by another doctor blinded to the procedure using VAS score at 1,2,3,6,9 and 24 hours after surgery. Pethidine 50 mg intramuscular was given as rescue analgesic when demanded by patient within first 24 hours. Results: when VAS score was analyzed in the two groups, the study group had less scores compared to control group though it was statistically not significant (p > 0.05). The rescue analgesic requirement was significantly less in study group (p < 0.00). Conclusion: Intraperitoneal and periportal injection of bupivacaine is effective in decreasing pain after laparoscopic cholecystectomy. Key words: Laparoscopic surgery, intraperitoneal bupivacaine, analgesia, VAS score doi: 10.3126/kumj.v7i1.1765 Kathmandu University Medical Journal (2009), Vol. 7, No. 1, Issue 25, 50-53
Anterior clinoidal meningiomas: functional outcome after microsurgical resection in a consecutive series of 106 patients
Authors: Bassiouni Hischam , Asgari Siamak , Sandalcioglu I. Erol , Seifert Volker , Stolke Dietmar , Marquardt Gerhard 
Published: April 2009

Object
In this study, the authors' goal was to analyze a series of patients treated microsurgically for an anterior clinoid process (ACP) meningioma in regard to long-term functional outcome.

Methods
The authors retrospectively analyzed clinical data in a consecutive series of 106 patients who underwent microsurgical treatment for an ACP meningioma at 2 neurosurgical institutions between 1987 and 2005. The main presenting symptoms of the 84 female and 22 male patients (mean age 56 years) were visual impairment in 54% and headache in 28%. Physical examination revealed decreased visual acuity in 49% and a visual field deficit in 26%. Tumors were primarily resected via a pterional approach. Meningioma extensions invading the cavernous sinus, present in 29% of the patients, were not removed. Complete tumor resection (Simpson Grade I and II) was achieved in 59% of the cases.

Results
Postoperatively, visual acuity improved in 40%, was unchanged in 46%, and deteriorated in 14%. A new oculomotor palsy was observed in 8 patients (8%). Clinical and MR imaging data were available in 95 patients for a mean postsurgical period of 6.9 years (1.5–18 years) and revealed tumor recurrence in 10% and tumor progression after subtotal resection in 38%. Clinical deterioration on long-term follow-up consisting primarily of ophthalmological deficits was observed in 14% of the cases.

Conclusions
Acceptable functional results can be achieved after microsurgical resection of ACP meningiomas; however, long-term treatment remains challenging due to a high tumor recurrence and progression rate.
Decreased brain edema after collagenase-induced intracerebral hemorrhage in mice lacking the inducible nitric oxide synthase gene
Authors: Kim Dong Wook , Im So-Hyang , Kim Jeong-Yeon , Kim Dong-Eog , Oh Goo Taeg , Jeong Sang-Wuk 
Published: April 2009

Object
Hematoma size and brain edema after intracerebral hemorrhage (ICH) are important prognostic factors. Inducible nitric oxide synthase (iNOS) is induced after cerebral ischemia and is known to be involved in secondary neuronal injury, but its significance in ICH is unknown. The authors tested whether iNOS would influence hematoma size and brain edema after ICH.

Methods
The authors used C57BL/6 and iNOS knockout mice for all the experiments. Experimental ICH was induced by the intrastriatal stereotactic administration of bacterial collagenase. Brain tissue was obtained at 72 hours after ICH. The volume of hematoma was quantified by spectrophotometric assay, and the brain water content was measured. The investigators also measured blood-brain barrier permeability using Evans blue dye.

Results
There was no significant difference in hematoma size between the 2 groups. The brain water content of the lesional hemisphere was higher in C57BL/6 mice than in iNOS knockout mice. More Evans blue leakage in the brain was observed in C57BL/6 control mice than in iNOS knockout mice. Immunohistochemistry showed iNOS immunoreactivity in the perihematoma areas of C57BL/6 mice but not in the iNOS knockout mice.

Conclusions
When hematoma size was similar, iNOS knockout mice had significantly less brain edema than their littermates. These results suggest that iNOS modulation might become an antiedematous therapy for ICH.