Journal Issue: No 4, Issue 24, OCT-DEC, 2008
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Volume
Number
Issue Date
2008
Journal Title
Journal ISSN
1812-2027
Journal Volume
Articles
Need for community-based primary prevention of coronary heart disease in Nepal
(Kathmandu University, 2008) Vaidya, A
NA
Non endoscopic endonasal dacryocystorhinostomy versus external dacryocystorhinostomy
(Kathmandu University, 2008) Sharma, BR
Abstract
Aims and Objectives: To compare the success rates of non endoscopic endonasal dacryocystorhinostomy and
conventional external dacryocystorhinostomy for the surgical management of primary acquired nasolacrimal duct
obstruction.
Materials and methods: A retrospective, nonrandomized, comparative interventional case series of 302 patients who
underwent either endonasal or external dacryocystorhinostomy over a period of 2 years. All surgeries were performed
by a single surgeon and patients with primary nasolacrimal duct obstruction with a minimum of 6 months post operative
follow up were included in the study. While external dacryocystorhinostomy was performed using traditional technique,
endonasal dacryocystorhinostomy was performed using direct method of nonendoscopic visualization.
Results: Of the 302 cases included in the study 165 patients had endonasal dacryocystorhinostomy whereas 137 underwent
external dacryocystorhinostomy. Success was de ned by resolution of symptoms of tearing, a negative uorescein dye
disappearance test and patency of the canalicular system on lacrimal irrigation. In the external dacryocystorhinostomy
group 124 (90.5%) patients had surgical success whereas 146 (88.5%) of the endonasal dacryocystorhinostomy patients
had successful outcome. The overall success rate was 89.4%, and the difference of surgical success between the two
groups was not statistically signi cant ( P=0.57).
Conclusion: Non endoscopic endonasal dacryocystorhinostomy gives surgical results comparable to those of external
dacryocystorhinostomy and is a viable alternative where dacryocystorhinostomy is indicated for primary acquired
nasolacrimal duct obstruction.
Key words: Endonasal Dacryocystorhinostomy (ENDCR), External Dacryocystorhinostomy (EXDCR), Primary
acquired nasolacrimal duct obstruction (PANLDO)
Peripheral intravenous catheter related phlebitis and its contributing factors among adult population at KU Teaching Hospital
(Kathmandu University, 2008) Singh, R; Bhandary, S; Pun, KD
Abstract
Background: Peripheral intravenous catheter-related phlebitis is a common and signi cant problem in clinical practice.
This study was carried out to determine the occurrence of peripheral intravenous catheter related phlebitis and to de ne
the possible factors associated to its development.
Materials and methods: Prospective observational study was carried out on 230 clients who were under rst time
peripheral infusion therapy during two months period: September – October, 2007. Peripheral infusion site was examined
for signs of phlebitis once a day. Jackson Standard visual phlebitis scale was used to measure the severity of the phlebitis.
SPSS software was used to enter, edit and analyze the data and t-test, chi-square test, binary logistic regression and ROC
curve were used to draw the statistical inferences.
Results: Phlebitis developed in 136/230 clients (59.1%). It was very mild in most cases. Increased incidence rates of
infusion related phlebitis were associated with male sex, small catheter size (20 gauge), insertion at the sites of forearm,
IV drug administration and blood product transfusions. The incidence rate of phlebitis rose sharply after 36 hours of
catheter insertion.
Conclusion: Peripheral Intravenous therapy related phlebitis at KUTH, Dhulikhel Hospital is a signi cant problem.
Related risk factors as found in the present study were insertion site (forearm), size of catheter (20G) and dwell time (>=
36 hours). There were higher incident of phlebitis among the client with Intra venous drug administration and especially
between ages 21 - 40 years. Therefore more attention and care are needed in these areas by the care provider.
Key words: Phlebitis, Intravenous Therapy, Catheter, Risk Factors, KUTH, Nepal.
Retrospective analysis of management of patients presenting with acute urinary retention due to benign prostatic hyperplasia: A hospital based study
(Kathmandu University, 2008) Pandit, RK; Agrawal, CS; Chalise, PR; Sapkota, G
Abstract
Objectives: To analyze current practice of management of acute urinary retention (AUR) in men above 40 years of age
at B.P.Koirala Institute of Health Sciences, Nepal.
Materials and methods: A total of 68 patients (aged 50-91 years) presenting with indwelling catheter for AUR were
included in the study. Because of lack of clear guideline and limited health care facility in our setup trial without catheter
(TWOC) was given selectively depending mainly on preexisting symptoms. AUR presumed to be due to urinary tract
infection received only antibiotic and others diagnosed of benign prostatic hyperplasia (BPH) received alfa1 blocker
prior to TWOC. TWOC was given 3-15 days after such treatment. Those satis ed without catheter for at least a week
were considered successful TWOC.
Results: The data was available for 68 patients (mean age 66.1 years). Of 15 patients treated with antibiotic alone, 11
(73.3 %) had successful TWOC. Of 57 with presumptive diagnosis of BPH, 68.9% (31 of 45) had successful TWOC.
Mean age, symptom score and prostate volume were higher for patients with unsuccessful TWOC.
Conclusion: Selective TWOC may be imperative to minimize unnecessary suffering from AUR in less easily accessible
health care facilities like ours. It may also reduce total cost of treatment.
Key words: Acute urinary retention, benign prostatic hyperplasia, trial without catheter