Journal of Gandaki Medical College-Nepal

Current Perspectives on Leishmaniasis

KR Reddy — Thu, 30 May 2019 08:32:41 +0000

DOI: https://doi.org/10.3126/jgmcn.v12i1.22598

No abstract available.

Keywords: Leishmania donovani

Pregnancy Outcome in Women Having Oligohydramnios in Gandaki Medical College Teaching Hospital, Pokhara, Nepal

Thu, 30 May 2019 08:33:48 +0000

DOI: https://doi.org/10.3126/jgmcn.v12i1.22599

Background: Amniotic fluid index is one of the most commonly used methods of amniotic fluid volume assessment and is a predictor of adverse maternal and perinatal outcome.

Objectives: To compare the maternal and perinatal outcome in women with singleton term pregnancies having amniotic fluid index (AFI) ≤5 cm to those having AFI ≥5 to 20 cm.

Methods: This is a prospective, case-control study which was conducted at Gandaki Medical College Teaching Hospital over a period of one year from July 2017 to July 2018. It included 60 pregnant women at term pregnancy with amniotic fluid index ≤5 cm. The control group included 60 pregnant women at term pregnancy with amniotic fluid index ≥5 cm. The two groups were compared. Statistical analysis was done using the Chi-square test to calculate the P- value.

Results: There was a significantly higher incidence of overall cesarean rates due to fetal distress, low birth weight babies and adverse neonatal outcome like 5 minute Apgar score ≤7, neonatal intensive care unit (NICU) admission rates, and meconium aspiration syndrome in the group with oligohydramnios as compared to the group with normal liquor volume.

Conclusion: Oligohydramnios adversely affects the perinatal outcome. However a favorable outcome can be expected by good antenatal and intrapartum surveillance and neonatal care.

Keywords: Amniotic fluid index, Pregnancy, outcome, term pregnancy

Dry Eye among Medical Students of Gandaki Medical College, Pokhara, Nepal

S Tuladhar, B Poudel, D Shahi — Thu, 30 May 2019 08:34:33 +0000

DOI: https://doi.org/10.3126/jgmcn.v12i1.22600

Introduction: Dry eye disease results from decreased tear production, increased evaporation of tears and inflammation. Medical students often have dry eyes due to use of projectors, computers for study and also due to use of mobiles.

Objective: The present study was undertaken to find out dry eye by Schirmer 1 test with local anesthesia and measurement of wetting of Schirmer test strip.

Methods: Schirmer 1 test with anesthesia was performed on 200 medical students from June 1, 2017 to June 1, 2018 after obtaining informed consent and after applying some exclusion criteria. The test was performed by first applying 4% topical lignocaine and then using Whatman filter paper no 41 and wetting of the filter paper measured after five minutes and time noted.

Results: 146 (73%) Among 200 Students, were males and 54 (27%) were females. Mean age of patients was 21.73 ±1.42 years. Mild dry eye was seen in 19.5%, moderate in 13% and severe dry eye in 13.5% of medical students

Conclusion: Dry eye is one of common ocular disease among medical students.

Keywords: Dry eye disease, Medical students, Schirmer test

Patterns of Cancer Occurrence in Nepal

A Dhungana, HP Ghimire — Thu, 30 May 2019 08:35:17 +0000

DOI: https://doi.org/10.3126/jgmcn.v12i1.22601

Background: Cancer is a public health problem throughout the world and Nepal is not an exception. Actual information on pattern of cancer morbidity and mortality is possible only from population-based registry, which unfortunately is lacking in Nepal.

Objectives: The objective of this study is to determine the pattern of cancer occurrence in Nepal with respect to different pertinent variables.

Methods: A descriptive cross sectional study was done among 198 admitted patients from Bhaktapur Cancer Hospital using semi-structured interview schedule. Data entry and analysis was done on IBM SPSS V20. Descriptive statistical measures were employed.

Results: This study showed that cancer was seen in advanced age group with no sex wise variations. Majority was married, literate, from rural area, of upper caste and upper lower socioeconomic status. Cancer of lung, rectum and bile duct were more frequent in males in contrary to that of breast, ovary and cervix in females. Malignant neoplasm of digestive organs in males and that of female genital organs in females were the commonest to occur according to ICD-10 classification.

Conclusions: Cancer is rapidly emerging non-communicable disease throughout the world. Despite lack of population based disease registry, patterns of disease from this hospital study emphasize prioritizing the health promotive activities against cancer in the general population.

Keywords: Bhaktapur, Cancer Hospital, Cancer, ICD-10, Sex-wise variation

Measurement of Length of Styloid Process by Orthopantomography

BR Sharma, S Singh, M Timilsina, P Sharma, K Sharma — Thu, 30 May 2019 08:36:37 +0000

DOI: https://doi.org/10.3126/jgmcn.v12i1.22606

Background: Styloid process (SP) is an anatomical structure whose elongation is not well understood. Proper clinical and radiological assessment is needed to detect an elongated SP. Anatomical variation is also common. SP is said to be elongated if longer than 30 mm. Orthopantomogram (OPG) is also an imaging modality by which we can view SP.

Objective: The objective of this study was to assess the SP on OPG and identify eagle syndrome.

Materials and Methods: The study was conducted on archived OPG radiographs available in the Department of Oral Radiology, Gandaki Medical College Teaching hospital and Research Centre. These radiographs were from patients who were subjected to radiographic examination for other dental problems. The length of SP was measured on both sides using the measurement tool bars on the accompanying analysis software.

Results: Average length of SP on males was 26.5 mm ±14.4 mm in right and 25.5 mm ±6.19 mm in left; and on females was 23.78 mm ±5.93 mm on right and 24.7 mm ±10.44 mm in left. Elongated SP was more on males compared to females. Elongated styloid process (ESP) was more prevalent in 21 - 30 years of age group, similarly unilateral and bilateral elongation was also predominant on males compared to females.

Conclusion: OPG is also useful for detection of an ESP in patients with or without symptoms and helps to avoid misdiagnosis of tonsillar pain or pain of dental, pharyngeal or muscular origin as well as Eagle syndrome (ES).

Keywords: Eagle syndrome, Elongated styloid process, Ortopantomogram, Styloid process

Profile of Hypertensive Retinopathy in a Tertiary Centre in Western Nepal

CB Pun, S Tuladhar — Thu, 30 May 2019 08:37:24 +0000

DOI: https://doi.org/10.3126/jgmcn.v12i1.22607

Objective: The present study was done to find out prevalence of hypertensive retinopathy among patients attending in OPD in GMC.

Methods: A hospital based cross-sectional study was performed among 200 hypertensive patients visiting eye OPD from Dec 2016 to Dec 2017. Detailed eye examination including fundus evaluation under mydriasis was done on all subjects and hypertensive retinopathy was graded according to Keith, Wagner and Barker classification by ophthalmologist using 90 dioptre lens. Patient having diabetes and other retinal diseases were excluded from the study. Data analysis was done using spss software.

Results: The mean age of the patients was 60.58 ±12.26 standard deviation. In our study 56.5% patients had hypertensive retinopathy. Of which 31% had grade I, 19% had grade II, 6% had grade III and 0.5% had grade IV hypertensive retinopathy. The ratio of hypertensive retinopathy among male and female was 1.7:1.

Conclusion: Hypertensive retinopathy is common among hypertensives and males are more prone to retinopathy than females.

Keywords: Fundus, Hyperactive retinopathy, Tertiary centre

Histopathological Analysis of Endometrial Biopsy in Gandaki Medical College Teaching Hospital, Pokhara, Nepal

B Parajuli, G Pun, S Ranabhat, S Poudel — Thu, 30 May 2019 08:38:06 +0000

DOI: https://doi.org/10.3126/jgmcn.v12i1.22608

Objective: To study the spectrum of histopathological diagnosis of endometrial lesions and their distribution according to age.

Methods: All the endometrium samples obtained by the procedure of dilatation and curettage and hysterectomy sent for histopathological examination at Pathology Department of Gandaki Medical College Teaching Hospital, Pokhara, Nepal. The study duration was total 12 months ranging from July 2016 to June 2017. All the endometrial samples were processed, sectioned at 4 - 6 μm and stained with routine H & E stain. Patient’s data including age, sex, procedure of the biopsy taken and histopathological diagnosis were noted. A pathologist, using Olympus microscope, reported the slides. Cases were reviewed by a second pathologist whenever necessary.

Results: A total of 128 cases were studied. The most common histopathological diagnosis was proliferative endometrium (28.9%) followed by disorder proliferative endometrium (15.65%). Most of the patients were in age group 36 - 45 years comprising 32.03%. Hydatidiform mole comprised of 7.03% and among Hydatidiform mole, partial mole was more common. Dilatation and curettage (82.8%) was the common procedure in compare to hysterectomy for the evaluation of endometrial lesions.

Conclusions: In this study, we observed a variety of endometrial lesions. Most of them are benign; among benign, proliferative endometrium was the common histopathological diagnosis followed by disorder proliferative endometrium. Most common presenting age group was found to be at 36 - 45 years. In evaluation of hydatidiform mole, partial mole was more frequent in compare to complete mole. Conventional dilatation and curettage is the preferred method in developing countries with limited resource to screen endometrial lesion and therefore biopsy should be sent for histopathological examination. Thus histopathological examination of routinely stained hematoxylin and eosin is readily available and widely accepted standard technique for evaluation of the endometrial lesions.

Keywords: Endometrial biopsy, Histopathological diagnosis, Disorder Proliferative Endometrium