Journal Issue: Volume: 27, No. 2, August, 2005
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Volume
Number
Issue Date
2005
Journal Title
Journal ISSN
ISSN (Print) : 1993-2979 | ISSN (Online) : 1993-2987
Journal Volume
Articles
The need of a Clinical Skills Learning Centre (CSLC) at Institute of Medicine
(Institute of Medicine, 2005) Sharma, PR
NA.
Correlation of hearing impairment with site of tympanic membrane perforation
(Institute of Medicine, 2005) Bhusal, CL; Guragain, RPS; Shrivastav, RP
Abstract
Objective: This prospective study was done to assess the level of preoperative hearing impairment in different sites of pars tensa perforation in patients with chronic suppurative otitis media (CSOM) tubo-tympanic type undergoing myringoplasty.
Materials and Methods: A total of 50 patients were recruited from the outpatient Department of Otorhinolaryngology and Head and Neck Surgery from June 2003 to May 2004. Cases of CSOM tubo-tympanic type with dry central perforation, with conductive type of hearing loss were subjected to myringoplasty. Preoperative audiometric evaluations were done. Just prior to operation, examination under microscope was performed. Exact site of perforation was noted. During operation, those found to have ossicular discontinuity or fixation were excluded from this study.
Results: It was observed that the greatest hearing loss was found in big central (45dB) and posterior central (43dB); whereas least in those of anterior central (31dB) and central malleolar (34dB) perforations. The average hearing loss at 500Hz, 1000Hz and 2000Hz was 46.40 dB, 30.90 dB and 31.9 dB respectively. This showed that the hearing loss is maximum at the lowest frequencies and minimum as the frequencies increase.
Conclusion: This study shows that the posterior-central perforations cause more hearing loss than anterior-central ones. The hearing loss is maximum at the lowest frequencies and minimum as the frequencies increase.
Post cholecystectomy biliary gastritis and H. pylori infection
(Institute of Medicine, 2005) Shrestha, ML; Khakurel, M; Sayam, G
Abstract
Background: Post cholecystectomy abdominal pain is a significant problem in a group of patients with gall stone surgery. The pathogenesis of post cholecystectomy dyspepsia is still poorly understood and yet difficult to ascertain. H. Pylori have been associated with significant number of the cases with gastritis, gastric ulcer, duodenal ulcer and other gastro -duodenal disorders. Hence, post cholecystectomy biliary gastritis associated with H. pylori infection might be a major aetiological factor. This study aims to evaluate the association of bile reflux gastritis, the presence of H. pylori and dyspeptic symptoms in post choecystectomized patients.
Patients and Methods: This is a prospective non-randomized study carried out on 68 patients with post cholecystectomy dyspeptic symptoms during 2 years period through September 2002 to October 2004 in Tribhuvan University Teaching Hospital at the Department of Surgery.
Results: Two hundred and thirty eight patients who were having cholelithiasis and underwent cholecystectomy were prospectively studied non-randomized way. Out of 238, 68 (28.57%) patients presented with upper abdominal pain, belching water brass with or without nausea and vomiting. So only 68 cases were included in the study. Of 68 patients, dyspeptic symptoms were more common in Bile reflux positive group (BR +) and H. pylori infection was seen in 38% (14/36) when compared with Bile Reflux negative (BR-) patients 13.75% (4/32), which was statistically significant. Biliary gastritis was found on 32, more over reflux esophagitis in 3 cases, duodenal ulcer in 1 case was also found on BR (-) group. H. Pylori were positive on 18 cases detected by endoscopic biopsy by Giemsa stain, 14 in BR (+) and 4 in (BR-) group.
Conclusion: This study suggests that excessive bile reflux may be responsible for persistence of symptoms after cholecystectomy by causing gastric mucosal damage and that biliary gastritis might be a significant problem associated with H.pylori infection in our context.
Various presentations of Meckel’s Diverticulum
(Institute of Medicine, 2005) Kumar, S; Singh, YP; Vaidya, P
Abstract
Background – Meckel’s diverticulum is very difficult to diagnose. The aim of this study was to study the various presentations of Meckel’s diverticulum in TUTH in one year.
Methods – Retrospective study of nine patients admitted from emergency in one year data was done.
Result - In acute abdomen we have to think about Meckel’s diverticulum and its complications. The diagnosis of symptomatic Meckel’s diverticulum is difficult to make, especially in adults. The diagnosis must be considered in anyone with unexplained abdominal complaints, nausea and vomiting, or intestinal bleeding.
Bacterial vaginosis in Tribhuvan University Teaching Hospital
(Institute of Medicine, 2005) Manandhar, R; Sharma, J; Pokharel, BM; Shrestha, B; Pradhan, N
Abstract
Five hundred women of reproductive age group were screened for bacterial vaginosis (BV) using Amsel’s criteria from January 2004 to July 2004 at gynaecological out patient department of Tribhuvan University Teaching Hospital (TUTH). Bacterial vaginosis was found in 2.5%. Among all BV positive patients, 67.3% were symptomatic and 32.7% were asymptomatic. Brahmans were significantly least infected caste. Highly educated women were also significantly least infected group. Sexual exposure has significant association with BV. Smokers and people using alcohol suffered much from bacterial vaginosis but were not statistically significant.