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Kathmandu University Medical Journal (KUMJ)

P K Pokharel, S S Budhathoki, M P Upadhyay
Community based education trains health professional students to deal with the community health problems. The attitude and skills they gain as planners for health care provision are applicable in both hospital and community settings. BP Koirala Institute of Health Sciences has implemented a model of Community based education which encompasses the health institutions, organisations and the communities of the sixteen districts in eastern Nepal and refers to this concept as the 'Teaching District" concept of B P Koirala Institute of Health Sciences...
July 2016: Kathmandu University Medical Journal (KUMJ)
B Nayak Satheesha, D Reghunathan, B M George, S Mishra
Occurrence of accessory lobes of liver and anomalies of gall bladder is quite common. A thorough knowledge of their variation can minimise diagnostic and surgical errors. We found concurrent variations of liver and gall bladder. A small accessory liver lobe was attached to the quadrate lobe through a stalk formed by peritoneum. The gall bladder was "bean shaped" due to the presence of a constriction in the middle of its body. Since the accessory lobe was quite close to gall bladder, it could compress the gall bladder and hinder normal functioning of it...
July 2016: Kathmandu University Medical Journal (KUMJ)
R Kumar, G Jaiswal, A Bhargava, J Kundu
Superior mesenteric artery syndrome is a life-threatening rare acquired upper gastrointestinal disorder due to mechanical compression of third part of duodenum by the acute angulation of Superior mesenteric artery, leading to obstruction. Acute loss of intervening mesenteric fat as a result of a variety of debilitating conditions is believed to be the etiologic factor causing the reduced aortomesenteric angle. Abdominal CT angiography showed the dilatation of second part of duodenum and vascular compression of the proximal third part of the duodenum between the aorta and superior mesenteric artery...
July 2016: Kathmandu University Medical Journal (KUMJ)
A Luitel, J Rimal, I K Maharjan, D Niroula, P Regmee
While impaction of a tooth or two in dentoalveolar region is common, ectopic presence of them in non-dentate area is less commonly reported. A 45-year-old female reported to the department with pain on right back teeth region since two days. On examination, grossly decayed 46, root stump 47, missing 48, with poor periodontal status were noted. Panoramic radiograph was advised for screening, which revealed an inverted impacted 48 at the right ramus just below subcondylar region. However, it was an incidental finding and the patient was asymptomatic, she was informed about the pros and the cons of her case and kept under close monitoring...
July 2016: Kathmandu University Medical Journal (KUMJ)
K Subedi, S Koirala, R Basnet, A Poudel
Paediatric stroke is an uncommon syndrome with even lesser annual incidence rates of arterial ischemic stroke in infants and children. In children the diagnosis of stroke is frequently delayed or missed. This is due to subtle and nonspecific clinical presentations, a complicated differential diagnosis and a lack of awareness by physicians and also delay in the seeking of medical attention as in our case. We report you a rare case of a four year old child from remote Nepal who presented to our Out Patient Department after a long gap of around four months after the sudden onset of loss of consciousness and decreased movement of right limbs who after detailed history examination and lab investigations and imaging revealed ischemic stroke due to iron deficiency anemia...
July 2016: Kathmandu University Medical Journal (KUMJ)
S Kc, L Khanal, A Ojha, D Karn
Nepal experienced a devastating earthquake measuring 7.8 Richter scale on 25th April 2015. Although the heightened effects were secondary to trauma, the indirect effects were also of prime importance. We came across different dermatoses, directly or indirectly secondary to earthquake. We here present an audit of the cutaneous effects following four months of the major shock presenting to a tertiary care center of central Nepal. A total of 7326 patients presented to the dermatology department over a period of four months following the major shock...
July 2016: Kathmandu University Medical Journal (KUMJ)
M Pokharel, I Shrestha, A Dhakal, R Cm Amatya
Background Head and neck cancer is a major public health problem worldwide. In spite of the increase in incidence, there has been paucity of research on socio demographic factors influencing head and neck cancer. Objective To study the influence of various socio demographic factors on late presentation of head and neck cancer. Method Prospective, analytical study conducted in 69 patients with Head and neck malignancies in Department of Otorhinolaryngology and Head and Neck surgery, Kathmandu University School of Medical sciences between January 2015 to January 2016...
July 2016: Kathmandu University Medical Journal (KUMJ)
S Upadhyay, R Shrestha, D Shrestha, S Poudyal
Background Population specific standards on the timing and sequence of emergence of permanent teeth are essential in planning dental care for children. There is only a single study on the emergence of permanent teeth in Nepalese children. Objective To determine the standards for permanent teeth emergence time and sequence in children of Kavre district, Nepal. Method A descriptive cross sectional study was conducted in 623 children of age 5 to 14 years from six different schools of Kavre district. The number of permanent tooth erupted except third molar was recorded along with age and gender...
July 2016: Kathmandu University Medical Journal (KUMJ)
A Risal, S Sanjel, P P Sharma
Nursing students pass through many stressful situations during their academic course. Depression is frequently observed in this student group. Objective To quantify and compare the level of depression among the students undertaking undergraduate and graduate level nursing education in Kathmandu University School of Medical Sciences, Nepal. Method A questionnaire based cross-sectional study was carried out among all the students of Proficiency Certificate Level, Bachelor in Nursing Sciences and B.Sc. Nursing in Kathmandu University School of Medical Sciences, studying in different years during the academic year (2013-14) using Beck Depression Inventory...
July 2016: Kathmandu University Medical Journal (KUMJ)
S Karki, S Suwal, S R Tamrakar, R Poudel
Background Fallopian tube and uterine abnormalities are the most common cause of female infertility, accounting for 30% of cases. Hysterosalpingography is the safe, minimal invasive radiographic technique for evaluation of uterine cavity and fallopian tubes defects. The purpose of the study was to assess the various uterine and tubal abnormalities leading to infertility Objective To assess the abnormalities in uterus and fallopian tubes detected on Hysterosalpingography (as causative factors of infertility in a tertiary care centre for proper decision making in treatment...
July 2016: Kathmandu University Medical Journal (KUMJ)
R Dhakal, R Makaju, S Sharma, S Bhandari, S Shrestha, R Bastakoti
Background Cervical cancer can be controlled to a greater extent by screening to improve morbidity and mortality. Pap smear is important screening method, which has proven to be highly effective in reducing the number of cases and the mortality from cervical carcinoma. Any abnormality detected in pap smear has to be confirmed with cervical biopsy, which remains the reference investigation. Objective To find the changes of cervical cytology by pap smear, to classify cervical lesions into malignant and benign groups on cytological and histopathological basis and to correlate the changes observed in cervical cytology with cervical biopsy...
July 2016: Kathmandu University Medical Journal (KUMJ)
T Malla, K K Malla, S K Singh, S Shrestha
Background A major earthquake occurred in Nepal on 25th April 2015 with magnitude of 7.8 causing mass panic amongst people. Objective To analyze scenario, experience and disease pattern of Post Earthquake camp at Gyampesal, Gorkha. Method A prospective observational study done on 13th and 14th June 2015 in a population who attended the health camp at health post, Gyampesal Gorkha. Analysis was done for age, sex, and disease pattern. Medicines for their health problems was provided by Manipal Teaching Hospital, Pokhara, Nepal Pediatric Society and Children Welfare in Nepal, Kathmandu...
July 2016: Kathmandu University Medical Journal (KUMJ)
S Kumar, A Jalan, B N Patowary, S Shrestha
Background Appendicitis is the most common cause for acute abdominal pain. Laparoscopic appendectomy is an effective alternative to open appendectomy. It is a minimally invasive results in less postoperative pain, less wound infection, early return to normal work and less morbidity compared to open appendectomy. Both surgical methods are safe but there has been a controversy about which surgical procedure is the most appropriate. Objective To compare the outcomes of laparoscopic versus open appendectomy. Method In this prospective study, from January 2015 to April 2016, 212 cases of acute appendicitis were included...
July 2016: Kathmandu University Medical Journal (KUMJ)
A Joshi, R Pb Shrestha, P S Shrestha, S Dangol, N C Shrestha, P Poudyal, A Shrestha
Background Congenital Heart Disease and Rheumatic Heart Disease are the most common childhood cardiac disease encountered in developing countries. Objective To study the pattern and the prevalence of cardiac diseases, its age wise distribution and to determine their risk factors for mortality in children presented to Dhulikhel Hospital, Kathmandu University Hospital. Method A study of cardiac diseases in children, since birth to 16 years of age attending the department of pediatrics in Dhulikhel Hospital, Kathmandu University Hospital was done over a period of 30 months (Jan 2014 to June 2016)...
July 2016: Kathmandu University Medical Journal (KUMJ)
M P Barakoti, A Karki, M K Chaulagain, D B Karki
Background The finding of persistent Junction point elevation of 1 mm or more in adjacent leads in electrocardiogram is considered to be due to early repolarization. This condition was considered benign in the past but presently it is believed to be the rare cause of idiopathic ventricular fibrillation and sudden death. Objective The main objective of the study is to find out the prevalence of early repolarization pattern in subjects having electrocardiogram at Kathmandu Medical College Teaching Hospital. Method Twelve lead electrocardiograms of patients attending Kathmandu Medical College Teaching Hospital were studied...
July 2016: Kathmandu University Medical Journal (KUMJ)
S Shrestha, R M Shrestha
Background Health problems like high body weight and oral diseases have the same essential risk factors as the inflammatory nature of obesity and periodontal disease are widely recognized. Body Mass Index and oral health indices are correlated and may be a confounder of disease status. Objective To assess oral health status and Body Mass Index of school teachers of Kathmandu valley and to find the correlation between them. Method A cross sectional study with purposive sampling was done on 100 Nepalese teachers to assess Body Mass Index, Community Periodontal Index and Decayed Missing Filled Teeth index...
July 2016: Kathmandu University Medical Journal (KUMJ)
H Rimal, A Pokharel
Attention Deficit Hyperactivity Disorder is the most common neuro- developmental disorders of childhood characterized by the core symptoms including inattentiveness and distractibility and frequently involve impairments in executive functioning, increased impulsivity, and restlessness. Objective To find out the prevalence of Attention Deficit Hyperactivity Disorder among school aged children Presented to Pediatric clinic and also to investigate associated comorbidities. Method This study was conducted at Nobel Medical College Teaching Hospital, Biratnagar during April 2014 - March 2015...
July 2016: Kathmandu University Medical Journal (KUMJ)
K Manikantan, B Bang, R Sharan, I Mallick, S Chatterjee, P Arun
Background Selective neck dissection in multimodality treatment protocols is slowly being accepted for the management of N+ neck in many centers. This is because the functional disability is lower than modified radical neck dissection. Objective This study compares the regional recurrence rates between patients who underwent selective neck dissection and patients underwent comprehensive neck dissection for node positive oral squamous cell carcinoma. Method A retrospective study comparing patients with node positive oral squamous cell carcinoma who underwent either selective neck dissection or comprehensive neck dissection between August 2011 and January 2014 was done, with a mean follow up period of 12 months...
July 2016: Kathmandu University Medical Journal (KUMJ)
R B Sah, B Pradhan, L Subedi, P Karki, N Jha
Background Tobacco use is still a serious public health problem in the world and represents a major cause of morbidity and mortality in most parts of the world. Objective To measure the prevalence of tobacco use and to identify the factors associated with tobacco use among the residents of Dhankuta Municipality. Method The cross-sectional study was conducted among the residents of the Dhankuta Municipality where 205 households were taken as subjects. Pretested semistructured questionnaire was used for data collection and face to face interview was conducted...
July 2016: Kathmandu University Medical Journal (KUMJ)
R K Pandit
Background Early appendectomy in appendiceal mass is gaining popularity among some surgeons. However, it is endowed with increasing operative difficulty with time, and safe and feasible timing is not yet clear. Objective To know safe and feasible time limit for early appendectomy in appendiceal mass. Method This is a retrospective study. Between May 2009 and July 2014, 114 patients of appendiceal mass who underwent early surgical intervention by a single surgeon were studied. Group I included 98 patients operated within seven days of onset of pain and group II included 16 patients operated between 8th and 15 days of pain...
July 2016: Kathmandu University Medical Journal (KUMJ)
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