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JNMA; Journal of the Nepal Medical Association

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https://www.readbyqxmd.com/read/29453486/immune-system-and-kidney-transplantation
#1
Badri Man Shrestha
The immune system recognises a transplanted kidney as foreign body and mounts immune response through cellular and humoral mechanisms leading to acute or chronic rejection, which ultimately results in graft loss. Over the last five decades, there have been significant advances in the understanding of the immune responses to transplanted organs in both experimental and clinical transplant settings. Modulation of the immune response by using immunosuppressive agents has led to successful outcomes after kidney transplantation...
October 2017: JNMA; Journal of the Nepal Medical Association
https://www.readbyqxmd.com/read/29453485/oral-squamous-papilloma-of-edentulous-mouth-interfering-with-denture-retention
#2
Nashib Pandey, Shivalal Sharma, Ashish Shrestha, Vinay Marla
Soft tissue overgrowths inside oral cavity can present with wide range of clinical manifestations and some of them can asymptomatic. Oral squamous papilloma is one of that asymptomatic lesion described in the literature with extremely low virulence and infectivity rate. Soft tissue overgrowths can sometimes interfere with denture retention. Here we report a case of squamous papilloma in a 60 years old edentulous female who presented with loss of denture retention.
October 2017: JNMA; Journal of the Nepal Medical Association
https://www.readbyqxmd.com/read/29453484/late-presentation-of-post-diphtheritic-myocarditis-in-a-15-year-male
#3
Kutty Sharada Vinod, Nitin Gupta, Harsh Sahu, Naveet Wig
A 15-year old male patient presented to us with dyspnoea for four days. He had a history of fever, pseudo-membranous tonsillitis and cervical adenopathy twenty-five days prior to the presentation. On examination and laboratory investigations, he had features suggestive of myocarditis with biventricular failure. There was no reliable history of immunisation and he had a positive history of contact. He was planned for anti-diphtheria toxin but before the anti-toxin could be initiated, the patient succumbed to refractory cardiogenic shock...
October 2017: JNMA; Journal of the Nepal Medical Association
https://www.readbyqxmd.com/read/29453483/chorioangioma-of-placenta
#4
Rubby Das, Nilam Subedi, Gahana Gurung
Chorioangioma of placenta is the commonest benign tumour of the placenta. It consists of a benign angioma arising from chorionic tissue. We report a case of placental chorioangioma which was diagnosed in the post partum period in a patient with polyhydramnios who went into preterm labor and delivered a premature baby.
October 2017: JNMA; Journal of the Nepal Medical Association
https://www.readbyqxmd.com/read/29453482/identification-of-deceased-children-of-nepal-airlines-crash-through-dental-age-estimation
#5
Nitin Kumar Agrawal, Samarika Dahal, Harihar Wasti
Identification of victims in a disaster is a challenging process and requires use of both primary and secondary identifiers. Development of teeth is one of the routinely used methods of age estimation and helps in establishing deceased biological profile. Two children who lost their lives in 2014 in Nepal Airlines crash, were looked for the dental developmental status. One of the children had primary dentition, while the other had mixed dentition. This helped us in estimating age of these individuals reconciled with the chronological age provided by the relatives...
October 2017: JNMA; Journal of the Nepal Medical Association
https://www.readbyqxmd.com/read/29453481/ventilator-associated-pneumonia-and-role-of-nurses-in-its-prevention
#6
Chadani Osti, Deepa Wosti, Bimala Pandey, Qinghua Zhao
Ventilator-associated pneumonia (VAP) is one of the most frequent nosocomial infections among ventilated patients in ICUs, associated with an increase in days of ICU stay, morbidity, and mortality. Its prevention is a significant concern in every hospital. Most of the interventions and prevention strategies are part of routine nursing care. Nurses have different vital roles such as care provider, manager, educator, coordinator, and evaluator in preventing VAP. Lack of knowledge of infection prevention and proper nursing care among nurses may become a barrier in adhering to evidence-based guidelines for preventing ventilator-associated pneumonia...
October 2017: JNMA; Journal of the Nepal Medical Association
https://www.readbyqxmd.com/read/29453480/limited-open-reduction-and-percutaneous-plate-osteosynthesis-alternative-option-to-minimally-invasive-plate-osteosynthesis-in-management-of-distal-tibia-fractures
#7
Shambhu Sah, Bikash Kc, Sailoj Jung Dangi, Rem Kumar Rai, Roshan Yadav
INTRODUCTION: The management of distal tibia fracture is challenging because of the limited soft tissue coverage and poor vascularity around the bone in that area. Minimally invasive percutaneous plate osteosynthesis is a novel technique in this regard but needs fluoroscopy. In unavailability of fluoroscopy or its technical malfunction, limited open reduction percutaneous plate osteosynthesis becomes useful. The aim of this study is to compare the outcomes of distal tibia fractures treated by LORPPO and MIPPO techniques in terms of duration of hospital stay, full weight bearing, union time and complications...
October 2017: JNMA; Journal of the Nepal Medical Association
https://www.readbyqxmd.com/read/29453479/blood-pressure-and-its-association-with-body-mass-index-among-the-people-attending-in-a-hospital
#8
Dinesh Kumar Lamsal
INTRODUCTION: Systolic and diastolic hypertension has been increasing trend and different factors are associated such as body mass index, diabetes etc. Obesity and overweight are generally associated with high blood pressure. This study aims to identify the prevalence of blood pressure level and its association to body mass index among people attending in civil service hospital, Kathmandu. METHODS: A cross-sectional descriptive study was conducted among all 1002 study subjects aged above 20 years...
October 2017: JNMA; Journal of the Nepal Medical Association
https://www.readbyqxmd.com/read/29453478/endoscopic-sinus-surgery-for-sinonasal-polyposis-microdebrider-or-conventional-instruments
#9
Nabin Lageju, Bibhu Pradhan, Narmaya Thapa
INTRODUCTION: Sinonasal polyposis is one of the commonest causes of nasal obstruction. Surgical management is treatment of choice. Microdebrider offers more advantage to conventional instruments. We aimed to find out outcome using microdebrider versus conventional instruments in endoscopic sinus surgery of sinonasal polyposis. METHODS: The cross sectional descriptive study carried out in patients aged 13 years and above with diagnosis of sinonasal polyposis. Total of 51 patients were operated on the right side with microdebrider and left side with conventional instruments...
October 2017: JNMA; Journal of the Nepal Medical Association
https://www.readbyqxmd.com/read/29453477/effects-of-bilateral-nasal-packing-on-oxygen-saturation-and-blood-pressure
#10
Meera Bista
INTRODUCTION: Nasal packing is one of the most common rhinological procedures in ENT practice exerting local in nose and systemic effects. Systemic effects may be due to poor sleep quality, respiratory difficulty, decreased oxygen saturation, circulatory problems and toxic shock syndrome which can threaten the life of a person.The study was done to investigate the effect on bilateral nasal packing on blood oxygen saturation and blood pressure changes. METHODS: A cross-sectional prospective study was undertaken in Kathmandu Medical College from January 2017 to June 2017...
October 2017: JNMA; Journal of the Nepal Medical Association
https://www.readbyqxmd.com/read/29453476/postoperative-outcome-in-patients-with-pulmonary-hypertension-undergoing-elective-non-cardiac-surgery
#11
Vikas Pathak, Kriti Suwal
INTRODUCTION: The impact of pulmonary artery hypertension on post-operative outcome in elective, non-cardiac surgery is incompletely understood. This study was designed to evaluate the post-operative outcome of patients undergoing elective, non-cardiac surgery with and without pulmonary hypertension. METHODS: The study was conducted in an inner-city hospital in Bronx, New York. A retrospective chart review was conducted on all patients who underwent elective, non- cardiac surgery from January 2000 to December 2010 and had echocardiogram within 30 days of surgery...
October 2017: JNMA; Journal of the Nepal Medical Association
https://www.readbyqxmd.com/read/29453475/basal-cell-carcinoma-in-cases-with-or-without-xeroderma-pigmentosum
#12
Dilasma Ghartimagar, Arnab Ghosh, Sushil Ram Shrestha, Sachet Shrestha, Sushma Thapa, Raghavan Narasimhan, O P Talwar
INTRODUCTION: Basal cell carcinoma is the most common form of cancer in humans and comprises the vast majority of skin cancers. It predominantly affects fair-skinned individuals, and its incidence is rapidly increasing. The objective of the study is to identify the epidemiology, its topography and different histological subtypes of basal cell carcinoma in patients with or without Xeroderma Pigmentosum. METHODS: A cross-sectional descriptive study was conducted at Manipal Teaching Hospital, Pokhara from Jan 2009 to Dec 2016...
October 2017: JNMA; Journal of the Nepal Medical Association
https://www.readbyqxmd.com/read/29453474/fingerprints-as-an-alternative-method-to-determine-abo-and-rh-blood-groups
#13
Sonam Chaudhary, Sajana Deuja, Munna Alam, Poonam Karmacharya, Monami Mondal
INTRODUCTION: Blood grouping is conventionally done with invasive method by taking blood samples. The objective of this study is to determine blood group with uninvasive procedure by taking fingerprints of the participants and know the associations between their fingerprints and blood groups. METHODS: Seven hundred participants of both genders with no any age limitation from Manipal Teaching Hospital and Manipal College of Medical Sciences were randomly selected...
October 2017: JNMA; Journal of the Nepal Medical Association
https://www.readbyqxmd.com/read/29453473/prehospital-events-in-st-elevation-myocardial-infarction-undergoing-primary-angioplasty
#14
Sachin Dhungel, Rabi Malla, Chandramani Adhikari, Arun Maskey, Rajeeb Rajbhandari, Ranjit Sharma, Deewakar Sharma, Man Bhadhur Kc, Ajay Adhikari, Binaya Rauniyar, Dipak Limbu, Milan Gautam
INTRODUCTION: Pre-hospital delay includes time from onset of symptoms of myocardial infarction till arrival to emergency room of the hospital. This defines time from symptom onset to first medical contact and first medical contact to emergency room. This study aims to study the prehospital events and determining factors in patients undergoing primary angioplasty. METHODS: This was a cross sectional study in Shahid Gangalal National Heart Centre for three months...
October 2017: JNMA; Journal of the Nepal Medical Association
https://www.readbyqxmd.com/read/29453472/prevalence-of-hepatitis-d-among-patients-with-hepatitis-b-viral-infection-attending-a-tertiary-care-centre-of-nepal
#15
Kiran Regmi, Jeetendra Kaji Shrestha, Sudhamshu Kc, Bikash Jaishi, Niyanta Karki, Dipendra Khadka, Sandip Khadka
INTRODUCTION: Worldwide there is variation in prevalence of Hepatitis D viral infection. Superinfection and co infection with hepatitis B viral infection is known to occur in 15-20 million people. METHODS: This was a descriptive cross-sectional hospital based study carried out in NAMS, Bir hospital, Kathmandu, Nepal from period of January 2017 to June 2017. Consecutive patients of chronic hepatitis B viral infection of HBsAg positive with more than two-time upper normal limit of ALT were enrolled and tested for HDV IgG...
October 2017: JNMA; Journal of the Nepal Medical Association
https://www.readbyqxmd.com/read/29453471/significance-of-non-invasive-markers-as-predictor-of-esophageal-varices-in-liver-cirrhosis
#16
Dipendra Khadka, Sushil Prajapati, Sudhamshu Kc, Jeetendra Kaji Shrestha, Niyanta Karki, Bikash Jaishi, Kiran Regmi, Sandip Khadka
INTRODUCTION: Upper gastro-intestinal endoscopy remains the gold standard for screening for esophageal varices but it has its own limitations. It is an invasive, expensive and uncomfortable procedure and needs clinical expertise. Accordingly, this study was conducted to establish the role of non-invasive markers for prediction of esophageal varices in liver cirrhosis. METHODS: A hospital based descriptive cross-sectional study was carried out in Liver unit of National Academy of Medical Sciences, Bir Hospital, from October 2016 to September 2017...
October 2017: JNMA; Journal of the Nepal Medical Association
https://www.readbyqxmd.com/read/29453470/nerve-conduction-and-heart-rate-variability-in-patients-with-hypothyroidism-at-a-tertiary-care-centre-in-eastern-nepal
#17
Shital Gupta, Rita Khadka, Dilip Thakur, Robin Maskey, K D Mehta, B H H Paudel
INTRODUCTION: Thyroid hormone effects on many organs including central and peripheral nervous systems. However, these hormones do not affect all systems/organs to a similar extent. Thus, we conducted this study to explore the effect of thyroid hormones on somatic nervous system assessed by Nerve conduction study and cardiac autonomic activity assessed by heart rate variability. METHODS: The study included newly diagnosed hypothyroid patients and healthy controls...
October 2017: JNMA; Journal of the Nepal Medical Association
https://www.readbyqxmd.com/read/29453469/demographic-and-clinical-profile-in-patients-with-liver-cirrhosis-in-a-tertiary-care-hospital-in-central-nepal
#18
Subash Bhattarai, Merina Gyawali, Khus Raj Dewan, Gaurav Shrestha
INTRODUCTION: Liver cirrhosis is an important health problem worldwide and is a common disease in Nepal. The profile of cirrhosis may vary due to different factors. This study was undertaken to see the demographic and clinical profiles of patients with cirrhosis of liver attending a tertiary care hospital in Central Nepal. METHODS: Six hundred patients with clinical features, laboratory and sonological findings suggestive of chronic liver dysfunction and endoscopic evidence of portal hypertension were included in the study...
October 2017: JNMA; Journal of the Nepal Medical Association
https://www.readbyqxmd.com/read/29453468/prevention-of-shivering-during-spinal-anesthesia-comparison-between-tramadol-ketamine-and-ondansetron
#19
Gajal Lakhe, Krishna Murari Adhikari, Kiran Khatri, Anil Maharjan, Akriti Bajracharya, Himdip Khanal
INTRODUCTION: Shivering is an unpleasant experience after spinal anesthesia. We conducted this study to evaluate the efficacy of ondansetron, ketamine and tramadol for prevention of shivering. METHODS: In this randomized controlled study, 120 patients aged 18-65 years of American Society of Anesthesiologist (ASA) physical status I and II undergoing various surgical procedures were included and allocated alternately to one of the 4 groups; Normal saline (Group1), Ondansetron 4mg (Group2), Ketamine 0...
October 2017: JNMA; Journal of the Nepal Medical Association
https://www.readbyqxmd.com/read/29453467/loading-dose-only-versus-standard-dose-magnesium-sulfate-seizure-prophylaxis-in-severe-pre-eclamptic-women
#20
Surya Prasad Rimal, Pappu Rijal, Rabindra Bhatt, Kriti Thapa
INTRODUCTION: Magnesium sulfate is the drug of choice for prevention of seizures in the pre-eclamptic woman. There is no agreement in the published randomized trials regarding the optimal time to initiate magnesium sulfate, the dose to use (both loading and maintenance) as well as the duration of therapy. The objective of this study is to determine whether magnesium sulfate prophylaxis is needed for up to 24 hours postpartum in all patients with severe pre-eclampsia for the prevention of seizure...
October 2017: JNMA; Journal of the Nepal Medical Association
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