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Browsing by Author "Adhikari, Bidur"

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    Measurement of Subcarinal Angle: A Cadaveric study
    (Institute of Medicine, 2019) Shrestha, Anusuya; Ranjit, Nirju; Bhandari, Rosha; Adhikari, Bidur; Gautam, Jyoti
    ABSTRACT Introduction The bifurcation of trachea into two primary bronchi at the level of fourth thoracic vertebra creates an angle at the bifurcation. This angle can be seen clearly in routine chest X-rays where the measurement can throw light on many medical conditions within the mediastinum. This study aimed at finding the subcarinal angle, which is the angle formed by inferior borders of two primary bronchi. Methods The measurements were taken from photographs of tracheal specimen of 92 cadavers, 63 male and 29 female. Angle was measured by photographic software and analysis of subcarinal angle was done in the study population. Results The mean subcarinal angle was found to be 41.090 with standard deviation of 17.140. This measurement was found to be significantly more in males (68.02± 15.720) than in females (60.14 ± 17.710). Conclusion The subcarinal angles in the study population were seen to be different among sexes. Also, the mean subcarinal angles from other studies, radiological or on specimen were close to the observations made in this study. Keywords: Bronchus, subcarinal angle, trachea
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    Morphology and Morphometry of Thyroid Gland in Cadavers: A Descriptive Cross-Sectional Study
    (Institute of Medicine, Tribhuvan University, 2024) Phuyal, Navindra; Shrestha, Anusuya; Bhandari, Rosha; Adhikari, Bidur; Gautam, Jyoti; Dhungel, Deepesh; Gautam, Subina; Ranjit, Nirju
    Abstract: Introduction Variations in anatomy of thyroid gland include the occasional presence of a pyramidal lobe and a fibromuscular band called levator glandulae thyroideae. These variations affect the gland's morphometry and morphology. This study aimed to study morphometry and variation prevalence of thyroid gland. Methods This descriptive study examined adult cadavers from the Department of Forensic Medicine at Maharajgunj Medical Campus. Measurements of the length, breadth, and thickness of both lateral lobes and the isthmus were taken. The presence or absence of the isthmus, pyramidal lobe, and levator glandulae thyroideae was recorded, along with the origin and dimensions of the pyramidal lobe, if present. Results The mean dimensions of the right lobe were 43.88±6.88 mm (length), 23.93±4.76 mm (breadth), and 12.28±3.30 mm (thickness). For the left lobe, the measures were 40.47±7.26 mm, 21.95±4.22 mm, and 12.84±3.61 mm, respectively. The isthmus had mean dimensions of 18.12±5.52 mm, 16.65±5.51 mm, and 5.10±1.76 mm. The isthmus was absent in 7.2% of cases. The pyramidal lobe, present in 27.8% of cases, had mean dimensions of 19.17±8.26 mm, 11.64±3.47 mm, and 4.60±1.33 mm, typically originating from the center of the isthmus. The average weight of the thyroid gland was 16.19±5.22 g. Conclusion The thyroid gland's weight was higher in males and positively correlated with the individual's height. Also, thyroid gland's dimensions and weight were less than those described in standard texts. The relationship between body weight and thyroid gland weight warrants further investigation.
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    Perception and Willingness Regarding Organ Transplantation/donation among Medical Students of Maharajgunj Medical Campus: A Cross-sectional Study
    (Nepal Health Research Council, 2024) Bhattarai, Amit Sharma; Adhikari, Bidur; Joshi, Deepak Raj; Yadav, Alisha; Joshi, Pankaj; Parajuli, Bashu Dev; Koirala, Megha; Karki, Kushal Jung; Subedi, Krishna Prasad; Shrestha, Gentle Sunder; Shrestha, Anil; Singh, Shreejana
    Background: Organ transplant is the procedure of replacing a failing or damaged organ with a functioning one. Positive attitude and awareness about donation are a must for donor organs to be available. This study explored the level of knowledge, perception and willingness regarding organ donation among medical students in Nepal. Methods: A descriptive cross-sectional study was conducted with 180 medical students using a self-administered questionnaire. Descriptive statistics were used, and Pearson correlation was applied to examine the relationship between knowledge and perception of organ transplantation. Independent samples t-test and ANOVA was used to compare scores among year of study and gender. Results: Results indicated that 86.1% of participants were aware of the need for organ donation, and 83.3% knew that both living and deceased individuals could be donors. While 93.9% believed in the need for effective laws, 72.8% perceived risks for donors. However, only 74.4% were willing to donate their organs, though 91.7% expressed willingness to promote organ donation among friends and family. Participants showed a positive perception towards organ donation. Conclusions: Despite a high level of awareness and knowledge regarding organ donation, participants exhibited a lower level of willingness to donate organs. Perceived risks for donors and a lack of robust laws and regulations presented significant barriers. Nevertheless, an inclination to promote organ donation was observed. This underlines the need for enhanced education and policy reform to increase organ donation rates. Keywords: Awareness; knowledge; organ donation; organ transplantation; perception.
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    Self-Assessment of Non-communicable Diseases related Competencies among Interns of a Medical Institute of Nepal
    (Institute of Medicine, 2022) Pradhan, Pranil MS; Adhikari, Bidur; Pant, Sagun B; Ranjit, Nirju; Rawal, Suniti; Basnet, Sudha
    ABSTRACT Introduction: One of the essential strategies to tackle rising burden of non-communicable diseases (NCD) is development of competent local human resource. Assessing the level of competencies in pre-service curriculum is the first step towards building an NCD-ready health workforce. This study aimed to assess perception of competence in delivering World Health Organization Package of Essential Non-communicable diseases (WHO-PEN) interventions among interns of Maharajgunj Medical Campus of Institute of Medicine (IOM). Methods: A survey was conducted at Maharajgunj Medical Campus of Institute of Medicine among interns using online questionnaire. The questionnaire contained seven sections on different competencies to prevent and manage NCDs. Ethical approval was obtained from Institutional Review Committee of IOM. Descriptive analysis was done to identify the level of competencies. Statistical analysis was performed using Microsoft Excel and IBM SPSS version 20. Results: Majority of the interns expressed low to moderate confidence in managing patients with presenting complaints of major NCDs. Most interns could perform diagnostic procedures and screening related to NCDs and mental disorders under supervision only (56.9%-68.6%), and one third felt they were unable to perform spirometry and visual inspection of cervix with acetic acid. Most interns could provide counseling on major NCD risk factors, self-care and palliative care only under supervision. Majority could not identify key NCD service performance measures and their data sources. Conclusion: Skills of independently diagnosing and screening for NCDs, counselling on healthy lifestyle, alcohol and tobacco cessation and conduct motivational interviewing, self-care and palliative care were limited. Keywords: Competency based education, non-communicable disease, undergraduate medical education
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    Variation of Arteries Forming Circle of Willis in Adult Human Cadavers
    (Institute of Medicine, 2020) Gautam, Jyoti; Adhikari, Bidur; Bhandari, Rosha; Shrestha, Anusuya; Ranji, Nirju
    ABSTRACT Introduction: Circle of Willis is a large arterial anastomosis between internal carotid and vertebrobasilar arterial system. It is the principal collateral channel for constant blood flow to brain. Any changes in its morphology may cause vascular insufficiency of variable severity. Knowledge about its anomalies may elucidate occurrence of cerebrovascular disorders, its presentation, treatment, prognosis and prevention. Methods: An observational study on 107 fresh cadavers was conducted at Maharajgunj Medical Campus from September 2016 to August 2017. After dissection of the scalp and removal of the vault and dura mater, the brain was obtained. Then the Circle of Willis was identified and observed for its completeness, symmetry, presence, origin and number of arteries forming it and the obtained data were documented, photographed and analyzed. Results: Out of 107 cadavers, variations were noted among 15 (14%): out of which 10 were male and 5 female. Twelve cadavers had single variation while 3 had two variations. Accessory anterior cerebral artery was found in 7 (38.90%), fetal origin of right posterior communicating artery in 2 (11.10%), fetal origin of left posterior communicating artery in 4 (22.20%), early bifurcation of left posterior cerebral artery in 1 (5.60%), variant anterior communicating artery in 2 (11.10%), fused anterior cerebral artery in 1 (5.60%) and aneurysm in 1(5.60%) subjects were found. Conclusion: Variations were noted among 15 cadavers (14%), 12 cadavers had single variation while 3 had two variations. The most common variation seen was accessory anterior cerebral artery found in 7 cadavers (38.90%). Most of the variations were found in midline anteriorly followed by right side. Keywords: Aneurysm, cerebrovascular disorder, circle of Willis, stroke, variant

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