Journal Issue: Volume: 40 No. 3 (2018) December
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Issue Date
2017
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ISSN (Print) : 1993-2979 | ISSN (Online) : 1993-2987
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Articles
Does stenting improve the surgical outcome of Endoscopic Dacryocystorhinostomy? A prospective randomized study
(Institute of Medicine, 2018) Gurung, U; Rauniyar, N; Pradhan, B; Thapa, N
Abstract
Introduction: The objective of this study was to compare the surgical outcome of endoscopic dacyrocystorhinostomy with or without stenting. It was a prospective, randomized study conductedfrom October 2011 to September 2013. Ganesh Man Singh Memorial Academy for ENT-Head and Neck Studies,Tribhuvan University Teaching Hospital, Maharajgunj Medical Campus, Institute of Medicine, Kathmandu, Nepal.
Methods: Patients aged 15 years and above of all genders with primary acquired nasolacrimal duct obstruction (PANDO) were included in the study. Forty patients were randomly allocated into two groups, 20 each in Endoscopic Dacyrocystorhinostomy with stenting (EwS) and Endoscopic Dacyrocystorhinostomy without stenting (EoS). Post-operative assessment was done at 8 weeks. In the subjective assessment using with 5-point Likert Scale of degree of epiphora, a score of 1,2 or 3 was considered a success. Objective assessment with syringing and endoscopic evaluation of patency of rhinostome considered patent and partly patent lacrimal system on syringing and patent rhinostome as success.
Results: Both the subjective and objectivesuccess rate was 95% in EwS and 90% in EoS.However, there was no significant statistical difference between the two groups (p value =1.00).
Conclusion: The success rate of EwS was comparable to that of EoS with no added benefit in our study. In addition, EoS avoided the complications associated with stenting. So, we recommend EoS for PANDO.
Keywords: Endoscopic Dacryocystorhinostomy, Primary acquired nasolacrimal duct obstruction, silicon stent
Indications of Cesarean Section in a rural referral Hospital
(Institute of Medicine, 2018) Aryal, B; Shrestha, U
Abstract
Introduction: There is a huge difference in cesarean section rate between rural (3.5%) and urban (15%) areas of Nepal. The national CS rate is around 5% whereas global CS rate is 26%. The objective of this study is to find out the delivery profile and rate and indications of CS in a rural university hospital.
Methods: This is a three -year’s retrospective cross-sectional study done from January 2016 to January 2019 (Magh 2072 to Poush 2075) at Karnali Academy of Health Sciences, Jumla. The data was retrieved from hospital birth profile records and analyzed using SPSS 20. Permission was taken from Institutional review committee (IRC) to conduct the study.
Results: Total number of delivery during this period was 1841 out of which 172 were Cesarean delivery giving a CS rate of 9.3%. The most common indication of CS were fetal distress (33.7%), previous CS (9.3%), failed induction of labor (9.3%). Non progress of Labor (8.1%) and post term pregnancy (8.1%). Majority of the CS were done as an emergency procedure.
Conclusion: The CS rate at KAHS teaching hospital was within WHO recommendation of between 5-15% and was very low in comparison to other centers situated in urban areas of the country. The indications of CS was also similar to the other national and international statistics.
Key words: Cesarean section, Indications, Nepal, Maternal health, rural area, Global trends
The Prevalence of Overweight and Obesity in Medical and Nursing Students of Institute of Medicine, Kathmandu
(Institute of Medicine, 2018) Mahotra, NB; Shrestha, L; Pradhan, S; Bajimaya, M; Malla, N; Aryal, V; Bhat, N
Abstract
Introduction:Obesity has become one of the important global public health issues. It is significantly associated with the prevalence of diabetes, hypertension and coronary artery disease. Body Mass Index (BMI) assesses overweight and obesity based on statistical criteria.
Methods:A cross-sectionaldescriptive study was carried out in young male medical and female nursing students in the department of Clinical Physiology, Maharajgunj Medical Campus, Institute of Medicine, Kathmandu from January 2019 to March 2019. Subjects were selected by convenient sampling and BMI was calculated in 116 medical and nursing students.
Results:Out of 60 male medical students, 7(11.7%) were underweight, 48 (80%) were normal weight and 5(8.3%) were overweight. Similarly, out of 56 female nursing students, 1(1.8%) was underweight, 46(82.1%) were normal weight, 7(12.5%) were overweight and 2(3.6%) were obese.
Conclusion:The prevalence of overweight and obesity is increasing worldwide in all age groups. Young Nepalese people are also affected and are at risk of developing non-communicable diseases. Adaptation of healthy life styles and healthy diets could prevent overweight and obesity.
Key words: Body Mass Index (BMI), Obesity, overweight
Measurement of Renal Arteries Using Multi detector Computed Tomography: A Study in Tertiary Care Hospital in Nepal
(Institute of Medicine, 2018) Khanal, UP; Ansari, M; Humagain, M; Dhakal, S
Abstract
Introduction: The purpose of this study was to determine the dimensions ofthe renal arteries (length and diameter), among the patients referred for Contrast Enhanced CT(CECT) of abdomen in department of Radiology and Imaging, Tribhuwan University, Teaching Hospital.
Methods: This prospective study was performed in Department ofRadiology and Imaging TUTH with A total of 135 (73 male and 62 female) patients underwent CECT abdomen from June to September 2018. In this study the diameter of right and left renal arteries, the length of right and left renal arteries were determined.
Results: The mean values of right renal artery diameter were found to be(0 .5706 ± 0.09861 cm) in males and (0.5061 ± 0.08384 cm) in females respectively. The mean values of left renal arteries diameter were found to be (0.5889 ± 0.10351 cm) in males and (0.5354 ± 0.10552 cm) in females respectively. The mean values of right renal artery length were found to be (4.568751 ± 0.83128cm) in males and (4.0318 ± 0.87575cm) in females respectively. The mean values of left renal arteries length were found to be (3.5990 ± 0.79567cm) in males and (3.2002 ± 0.59207cm) in females respectively. The diameter of renal artery diameter exhibited statistically significant differences in relation to age of the patients (p<0.05) with peak values in 55- 64 years age group where the mean right and left renal arteries diameters were found to be 5.801 mm and 6.012 mm respectively.
Conclusion: This study concluded that the diameter of the renal arteries variessignificantly with the age of the patients.
Keywords: Multi detector computed tomography, renal artery dimensions