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JNMA; Journal of the Nepal Medical Association

J Robins, A Shrestha, J Hampton, B M Shrestha
Acute lower gastrointestinal bleeding (ALGIB) is a common cause for hospital admission that results in significant morbidity and mortality. The major objectives of all involved in the management of ALGBI patients are to reduce mortality and the need for major surgery. A secondary objective is to prevent unnecessary hospital admission for patients presenting with bleeding that is not life-threatening. The management of ALGBI has evolved over last decade with the changing modalities of diagnostic facilities. On review of the published literature, there is paucity of randomised control trials in relation to the diagnostic tools and management of ALGBI...
October 2015: JNMA; Journal of the Nepal Medical Association
R S Bhandari, P J Lakhey, P R Mishra
A 57 year old male presented to our outpatient clinic with history of on and off melena, weight loss and decreasing appetite for 10 months duration and a noticeable mass on the right upper quadrant. Abdominal examination revealed an intra-abdominal lump in right upper quadrant which was subsequently evaluated by colonoscopy, which revealed an ulcero-proliferative growth in the hepatic flexure and the biopsy from it confirmed well-differentiated adenocarcinoma. Contrast enhanced computed tomography demonstrated hepatic flexure mass with possible invasion into adjacent duodenum without features of advanced disease...
October 2015: JNMA; Journal of the Nepal Medical Association
S Parajuli, K R Dhital
We report a case of recalcitrant nodular vasculitis in a 23 years old male who was treated successfully with methotrexate. He presented to our Dermatology out Patient Department, Tribhuvan university teaching hospital with complaints of recurrent painful discharging ulcer over bilateral calf and lower legs of three years duration. The diagnosis of nodular vasculitis was made on the basis of the clinical presentation and the histopathological findings. The patient was treated with anti-tuberculosis treatment with initial good response; however the lesions persisted later on, despite completing the course of ATT...
October 2015: JNMA; Journal of the Nepal Medical Association
P Chalise, S Subedi, P Sharma
Shared psychotic disorderĀ is a rare psychiatric disorder. It is defined when a primary psychotic person imposes his/her delusional beliefs to the other person usually in a close relationship. Occurrence of this disorder among family members and close friends has been described. However, its exact incidence and prevalence is not known. Since such case has not been reported in Nepal to best of our knowledge, we present a case of shared delusional disorder along with brief review of literature. This case report describes a case of common shared persecutory delusion in husband and wife...
October 2015: JNMA; Journal of the Nepal Medical Association
S Sherchan, D Joshi
Delusional disorder is a relatively uncommon psychiatric condition in which patients present with non-bizarre delusions, but with no accompanying prominent perceptual disturbances, thought disorder or significant and sustained mood symptoms. Apart from their delusions, people with delusional disorder may continue to socialize and function in a normal manner and their behavior does not generally seem odd or bizarre to others for many years of the onset of their symptoms. Because of this, they are brought to the clinician many years after the onset of their symptoms, only when their delusional behavior becomes overt...
October 2015: JNMA; Journal of the Nepal Medical Association
B R Dawadi, M T Sherpa, R Shrestha
Myiasis occurs in humans and vertebrate animals mostly due to dipterous flies of the genera Chrysomyia and Cochliomyia. There have been reported cases of myiasis of skin, breast, intestine, eyes and ear but very few cases of vulvar myiasis have been reported in the medical literature. We report a case of a 20 years old female with vulvar myiasis. A 20-year old unmarried girl presented to our hospital with complains of vaginal discharge and vulvar irritation for 3 days with evidence of some worms around her vulvar region...
October 2015: JNMA; Journal of the Nepal Medical Association
K K Agrawaal
INTRODUCTION: Diabetes is a major cause of morbidity and cardiovascular related mortality along with a major cause of preventable blindness and foot amputation. There are limited studies on diabetes awareness, attitude, and prevalence. METHODS: Thus, we designed a study to seek the patients awareness about the complications associated with diabetes. It was a prospective observational study which included 123 patients with Diabetes Mellitus. RESULTS: The mean age of population studied was 53 years mainly from the Rupandehi and Nawalparasi districts in Nepal attending a clinic...
October 2015: JNMA; Journal of the Nepal Medical Association
S Bhattarai, A Saha
INTRODUCTION: Several studies have shown that there several unintentional causes for the unwanted childhood accidents. In addition, Nepal demographic health survey via West University of England revealed at 2006 A.D, 11% death casualties of under- five aged children are due to unintentional injuries 1. This particular study is extremely useful to health care planner, provider and researcher to have grand design to be produced by government of Nepal, such that; there shall be minimal rate of casualties of deceased children due to accidents...
October 2015: JNMA; Journal of the Nepal Medical Association
S K C, D Sharma, S Khadka, N Karki, B Jaishi, K Regmi, D Khadka
INTRODUCTION: Increased incidence and prevalence of gallstones in liver cirrhosis has already been reported by many studies. This study aimed to investigate the prevalence of gallstone disease in Nepali patients with LC and to identify risk factors for gallstone formation. METHOD: Consecutive patients of LC presenting to liver clinic from January, 2010 to December, 2012 were evaluated for GS by ultrasonography at their first visit. Liver cirrhosis was diagnosed on the basis of clinical features, laboratory parameters, ultrasonography, and/or histopathology...
October 2015: JNMA; Journal of the Nepal Medical Association
A A Talpur, A A Shaikh, M I Arain, A J Siddiqui
INTRODUCTION: Hydatid disease is a significant health problem with their location at Extrahepatic Intra abdominal sites is a very rare disease. Disease in these sites usually found concurrently with liver hydatid disease. Diagnosis is based blood tests & imaging studies. Surgery is the mainstay of treatment. This study will help us in determining the frequency of Extra Hepatic Intra Abdominal Hydatid Disease. Also different methods to diagnose & treat the disease will be evaluated. METHODS: It includes patients of extra hepatic intra abdominal Hydatid cyst above 13 years and underwent surgery from 2009 to 2014...
October 2015: JNMA; Journal of the Nepal Medical Association
R K Shrestha, G S Shrestha
INTRODUCTION: Color vision is one of the important attribute of visual perception. The study was conducted at different schools of Kathmandu to compare the findings of the Ishihara Pseudoisochromatic test and the Farnsworth D-15 test. METHOD: A cross-sectional study was conducted among 2120 students of four schools of Kathmandu. Assessment included visual acuity measurement, slit lamp examination of anterior segment and fundus examination with direct ophthalmoscopy...
October 2015: JNMA; Journal of the Nepal Medical Association
M Ansari
INTRODUCTION: Sleep is an important determinant of keeping healthy physically and mentally. Deviation in sleep is a common problem among students during examinations. The purpose of this study is to determine students' sleep pattern during night preceding viva examination and its correlation with performance. METHODS: This was a cross-sectional prospective study conducted between January and February 2014 among 1st and 2nd year MBBS students of National Medical College, Birgunj, Nepal who appeared in University's final practical examinations...
October 2015: JNMA; Journal of the Nepal Medical Association
A S Joshi, M Namba, T Pokharela
INTRODUCTION: The objective of this study is to identify relationships between three components of organizational commitment and organizational characteristics of nurses in the western and the eastern region of Nepal. METHODS: A self-administrated questionnaire was used to collect data from 310 nurses currently working at various hospitals in the eastern and the western region of the country. The questionnaire included three sections namely 1) personal characteristics 2) organizational characteristics and 3) organizational commitments scale...
October 2015: JNMA; Journal of the Nepal Medical Association
N Ojha
INTRODUCTION: Low birth weight and preterm birth are the major community health problems in developing countries. They are the major determinants of perinatal survival and infant morbidity and mortality. The aim of this study was to determine the proportion and the maternal risk factors for low birth weight and preterm birth among hospital deliveries in Tribhuvan University Teaching Hospital. METHODS: A cross sectional retrospective study was carried out in the Department of Obstetrics and Gynecology of TUTH...
October 2015: JNMA; Journal of the Nepal Medical Association
R Dwivedi, R Joshi, S Panthi, S Byanjankar, R Shrestha
INTRODUCTION: Forearm fractures are common upper limb injuries among children and usually treated non-operatively. Failure of non-operative treatment, open injuries and multiple fractures are the indications for surgery in paediatric both bone forearm fractures. Intramedullary nailing is considered as minimally invasive procedure with excellent to fair outcomes but it is not free of complications. We reviewed the results and evaluated the outcomes of IM fixation of forearm fractures in children by Rush nails to understand the risks and complications associated with these procedures...
October 2015: JNMA; Journal of the Nepal Medical Association
S Dahal, B P Rijal, K N Yogi, J B Sherchand, K Parajuli, N Parajuli, B M Pokhrel
INTRODUCTION: Inadequate empirical antibiotic therapy for HAP is a common phenomena and one of the indicators of the poor stewardship. This study intended to analyze the efficacy of empirical antibiotics in the light of microbiological data in HAP cases. METHODS: Suspected cases of HAP were followed for clinico-bacterial evidence, antimicrobial resistance and pre and post culture antibiotic use. The study was taken from February,2014 to July 2014 in department of Microbiology and department of Respiratory medicine prospectively...
October 2015: JNMA; Journal of the Nepal Medical Association
A Shrestha, N Rajbhandari, A Shrestha, B Pun
INTRODUCTION: Cerebral ventricular enlargement occurs as a natural aging process but also has been associated with many neurological disorders. Whether this enlargement is primary or secondary to these pathological conditions remains controversial. Objective of the study was to tabulate and create normal references values for maximum width of third ventricle in Nepalese population according to age group and gender. METHODS: MTW was determined in two hundred (112 males and 88 females) and age ranging between 1- 93 years who had normal Computed tomography scan of the head ...
October 2015: JNMA; Journal of the Nepal Medical Association
S Dhakal, T Acharya, S Gautam, N Upadhyay, S Dhakal
INTRODUCTION: Lateral Epicondylitis has been found to be the second most frequently diagnosed musculoskeletal disorder. A wide range of symptomatic treatments are available such as use of anti-inflammatory analgesic drugs, steroids, physiotherapy. This study aims to know about the diagnosis, prescription pattern and current practice on management of tennis elbow in Nepal. METHODS: This is a hospital based observational study carried out at Bir Hospital, Kathmandu, Nepal...
October 2015: JNMA; Journal of the Nepal Medical Association
O B Karki
INTRODUCTION: Blunt injury trauma is regularly encountered in the emergency department. Diagnostic tools that help in optimum management of blunt abdominal trauma include; Focussed Assessment Sonography for Trauma scan, Diagnostic peritoneal lavage and Computed Tomography scan. The aim of this study is to determine the validity of CT scan as an accurate diagnostic tool and its role in management of patients with blunt abdominal trauma. METHODS: A prospective analysis of 80 patients of blunt abdomen trauma who were admitted in Manipal Teaching Hospital, Pokhara, Nepal within a span of 15 months was done...
October 2015: JNMA; Journal of the Nepal Medical Association
M R Joshi, T P Bohara, S Rupakheti, A Parajuli, D K Shrestha, D Karki, U Laudari
INTRODUCTION: Laparoscopic cholecystectomy is one of the most common operation performed. Though LC have become safer and easier at times it can be difficult. Difficult cases can result in prolonged operative time, bleeding, bile spillage, conversion to open technique and bile duct injury resulting in unplanned prolonged hospital stay, increase in estimated cost to the patients and for the surgeon it leads to increased stress during operation and time pressure to complete the operative list...
October 2015: JNMA; Journal of the Nepal Medical Association
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