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NepMed is a Nepal MEDLINE(Medical Literature Analysis and Retrieval System Online) by Nepal Health Research Council(NHRC). It includes bibliographic information for articles from academic biomedical journals covering medicine, dentistry, nursing, pharmacy, dentistry veterinary medicine, and allied health sciences.

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Article

Association between shape of sella turcica and class of malocclusion

(Nepal Medical College Pvt. Ltd., 2024) Nagar, Richa; Mehta, Siddharth; Gupta, Puneet; Mankad, Hitesh; Bansal, Amrita; Gupta, Shilpi Gilra

Abstract: The sella turcica, a saddle-shaped depression in the sphenoid bone, houses the pituitary gland and shares a common embryonic origin with teeth and facial structures, making it a valuable tool in orthodontic diagnosis and treatment planning. This study aims to analyse the association between sella turcica morphology and malocclusion using lateral cephalograms. A hospital-based cross-sectional study was conducted at the Department of Orthodontics, Mahatma Gandhi Dental College and Hospital, Jaipur, India. A total of 137 pre-treatment lateral cephalograms of patients aged 10 to 30 years were included in the study. The morphology of the sella turcica was assessed using Axelsson’s classification, and malocclusion was categorized using Angle’s classification. Statistical analysis was performed using descriptive statistics and the chi-square test, with SPSS version 27. Among the 137 cephalograms analysed, the normal shape of the Sella turcica was the most prevalent (n=55), followed by pyramidal (n=30) and oblique (n=20) shapes. Bridging (n=6) and irregular (n=12) shapes were the least observed. The results suggest an association between certain Sella turcica shapes and specific types of malocclusions. The findings of this study highlight the potential of lateral cephalograms for early diagnosis and intervention in patients with malocclusion, especially in cases with abnormal Sella turcica morphology. Identifying such associations could aid in improving orthodontic treatment outcomes.

Article

Single-stage total earlobe reconstruction in a young male: a case report

(Nepal Medical College Pvt. Ltd., 2024) Giri, Piyush; Pokhrel, Shrinkhala; Pandey, Pratishtha; Kunwar, Sushma; Khadka, Karuna

Abstract: This case report details a young male patient’s successful single-stage total earlobe reconstruction. The patient, a 24-year-old male, presented with a near complete earlobe loss following a traumatic injury. Utilizing an innovative surgical technique, the reconstruction achieved excellent cosmetic and functional outcomes, demonstrating the efficacy of single-stage procedures in such cases.

Article

A case report on endoscopic removal of ingested open Safety Pin

(Nepal Medical College Pvt. Ltd., 2024) Shrestha, Ramila; Kafle, Roshan; Rajbhandari, Sabin; Shrestha, Milan

Abstract: Safety pin ingestion is a problem in gastrointestinal practice. Non - organic foreign bodies like needle, pin, coin and button are commonly ingested foreign bodies among the pediatric population. It may lead to severe morbidity and mortality. Most of the ingested foreign bodies are passed spontaneously without any endoscopic and surgical removal. Remaining foreign bodies can be retrieved and removed endoscopically or surgically.

Article

Adult-Onset nevus lipomatosis cutaneous superficialis: a case report authors

(Nepal Medical College Pvt. Ltd., 2024) Khanal, Sushna; Rana, Arnija; Shrestha, Chanda; Pudasaini, Sujata; Ojha, Nirav

Abstract: Nevus lipomatosis cutaneous superficialis (NLCS) is an uncommon benign hamartomatous condition characterized by mature ectopic adipocytes in the dermis. Here we present a case of a 34 years female with a four years history of multiple, skin coloured, painless nodules over the inner side of the right upper thigh. The lesion was excised and sent for histopathological examination and was found to be nevus lipomatosis cutaneous superficialis. Such a case is rare and only few cases have been reported in context of Nepal hence the recognition of the condition is important.

Article

Evaluation of postoperative analgesic efficacy of intraperitoneal ketamine plus bupivacaine in laparoscopic surgery

(Nepal Medical College Pvt. Ltd., 2024) Gautam, Shailendra Nath; Poudel, Anju; Agrawal, Ankit; Shah, Jyoti; Koju, Srijana

Abstract: Laparoscopic surgery is considered as the gold standard for minimally invasive procedures for abdominal and pelvic surgeries and thought to be less painful compared to open surgeries. Local anesthetic instillation alone addresses parietal pain relief; therefore, the use of adjuvants has been investigated to augment pain relief. To evaluate the change in hemodynamic parameters and analgesic effect of intraperitoneal ketamine plus bupivacaine in patients undergoing laparoscopic general and gynecological surgery, to evaluate pain by using Visual Analog Scale (VAS), time for first rescue analgesia demand, total analgesic consumption in first postoperative day and any drug-related complications during the postoperative period. Fifty seven patients scheduled for laparoscopic general or gynecological surgery were randomly assigned to receive intraperitoneal ketamine 0.5mg/kg plus bupivacaine (0.5% 15ml) diluted in 15 ml of normal saline to make 0.25% bupivacaine. This solution was installed intraperitoneal and infiltrated at incision site at the end of surgery. Then the patients were tilted according to surgeries; Trendelenburg’s position to target the hepatodiaphragmatic space in the gall bladder bed and reverse Trendelenburg’s position in gynecological surgery to target the pelvic floor. The patients received intraperitoneal ketamine plus bupivacaine reported lower pain scores throughout the postoperative period with VAS scores observed lower on arrival in the postoperative ward, with less demand of supplemental rescue analgesia. No postoperative complications were observed. Intraperitoneal instillation of ketamine plus bupivacaine at the end of laparoscopic surgery was an effective and safe method for pain relief during the postoperative period with less demand for supplemental systemic analgesia, high patient satisfaction and no complications.

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