Journal Issue: Volume: 19, No 2, Issue 74, APRIL-JUNE 2021
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Volume
Number
Issue Date
2021
Journal Title
Journal ISSN
1812-2027
Journal Volume
Articles
Vaccination Against COVID-19 in Pregnant and Lactating Women
(Kathmandu University, 2021) Shrestha, A
NA
Laparoscopic Surgeries in Urology: Initial Burgeoning Experience at National Transplant Centre, Nepal
(Kathmandu University, 2021) Katwal, BM; Koju, S; Kunwar, KJ; Shrestha, D; Verma, R; Shrestha, PC
ABSTRACT
Background
This study focuses on experience of laparoscopic surgery at Shahid Dharma Bhakta
National Transplant Centre (SDNTC), Nepal; which could enable us to gain knowledge
regarding its benefits over conventional surgery. The present study revealed the
frequency of various forms of laparoscopic surgeries done at our centre. Moreover,
this study accomplishes laparoscopic donor nephrectomy “a historical milestone
achieved in Nepal for kidney transplantation on 18th November 2018” which was the
first Laparoscopic donor nephrectomy done in Nepal by Nepalese team.
Objective
The present study assesses the feasibility and safety of laparoscopic surgery at
government hospital of Nepal.
Method
This hospital based cross-sectional study included all patients of age group 10 to 60
years, coming to outpatient department of SDNTC and those having indications for
nephrectomy. We excluded patient having previous history of open surgeries of kidney,
bleeding disorders, uncontrolled Diabetes Mellitus and uncontrolled Hypertension.
The study duration was 15 months from November 2017 to January 2019. The total
number of patients enrolled in the study was fifty where transperitoneal laparoscopic
surgery was performed in all 50 patients. The demographic data, indications for
surgery, duration of surgery, complications of surgery and perioperative outcomes
were analyzed.
Result
Out of 50 cases, 34 (68%) underwent simple lap nephrectomy, 6 (12%) were lap
pyeloplasty, 6 (12%) lap nephrectomy along with ureterectomy of long segment of
diseased ureter, 1 (2%) lap radical nephrectomy, 1 (2%) lap donor nephrectomy for
kidney transplantation, 1 (2%) lap heminephrectomy and 1 (2%) lap nephrectomy
for hydronephrotic non functioning left crossed ectopia. Amongst all nephrectomies,
27 (54%) patients were operated on right side while 23 (46%) patients on left. The
median age of the patient was 38.56 years. Out of total cases 32 (64%) were male
and 18 (36%) female. The median operative time and hospital stay was 122.3 minutes
and 5 days respectively. The median estimated blood loss was 74.1 cc. Only one
patient required blood transfusion intra-operatively. 2 (4%) patients were converted
to open surgery.
Conclusion
Laparoscopic surgery is feasible and safe procedure in government setup hospital
with less cumbersome procedure and minimum complications associated with it.
KEY WORDS
First donor nephrectomy, Laparoscopic surgery, Nephrectomy, Transplantation
Functional Outcome of Pediatric Monteggia Fracture Dislocation Treated Surgically in a Tertiary Care Centre of Nepal
(Kathmandu University, 2021) Dhoju, D; Parajuli, B
ABSTRACT
Background
Monteggia fracture dislocation may need operative management. The fracture of
ulna is reduced by closed or open reduction followed by stabilization of ulna with
Rush pin, K-wires or Dynamic compression plate.
Objective
To evaluate the Mayo Elbow Performance Score of patients with Monteggia fracture
dislocation treated operatively.
Method
It is a retrospective study conducted at Dhulikhel Hospital, Kathmandu University
Hospital. All the pediatric patients with Monteggia fracture dislocation managed
operatively from January 2011- December 2019 were included in the study. The
functional outcome scoring of the effected elbow using Mayo Elbow Performance
Score was done in the last follow up.
Result
Forty eight surgically managed Monteggia patients had a mean age of 7.23 ± 2.9
years with male predominance. Left side was the dominant side of involvement with
29 patients. Bado type 1 was the most common type (81.3%). Most of the patient
underwent closed reduction and fixation with Rush pin (n=40). All of the patient has
excellent (89.6%) to good (10.4%) functional outcome.
Conclusion
Operative management of Monteggia fracture dislocation with complete ulna
fracture has excellent to good outcome.
KEY WORDS
Functional outcome, Monteggia fracture dislocation, Operative management, Rush
pin
Self-confidence Level among Intern Dentists in Performing Endodontic Treatment Procedures in Nepal
(Kathmandu University, 2021) Chakradhar, A; Humagain, M; Acharya, N; Pradhan, S; Poudel, P
ABSTRACT
Background
Endodontics is considered as one of the most difficult and stressful disciplines in
dentistry. This might be due to the complex anatomical variations, recent advances
in equipment, technology, materials and lack of self-confidence.
Objective
To determine the self-confidence level among the intern dentists in performing
endodontic procedures from six different colleges of Kathmandu University, Nepal.
Method
A descriptive cross-sectional study was conducted among 145 intern dentists. The
online questionnaire regarding confidence level (5 point Likert scale) in different
endodontic procedures and difficulty level (easy, ok and difficult) with respect to
teeth was distributed. For descriptive purpose, frequency and percentage for each
response were calculated.
Result
Dental interns were confident in performing majority of the normal endodontic
procedures, however, they showed less confidence in performing difficult steps like
rubber dam application for anterior (74, 51%) and posterior tooth (91, 62.7%), use
of electronic apex locator (89, 61.4%), using rotary files (114, 78.6%), management
of flare-ups (86, 59.4%), assessment of quality of post-endodontic treatment (85,
58.5%), recall periods (75, 51.6%) and performing post and core (82, 56.6%). Likewise,
upper first molars (84, 57.9%) and second molars (104, 71.7%) were found to be the
most difficult teeth to treat.
Conclusion
It can be concluded that majority of the dental interns were confident in performing
basic endodontic procedures, however, they were found to have low confidence in
performing difficult steps. Further training and exposure should be incorporated to
increase their confidence level.
KEY WORDS
Confidence level, Endodontic procedures, Intern dentists, Kathmandu University
Prevalence of Loss of Smell and/or Taste and other Otorhinolaryngology Symptoms in COVID-19 Patients
(Kathmandu University, 2021) Shrestha, I; Mishra, A; Mishra, A; Bista, M; Acharya, J
ABSTRACT
Background
Loss of smell and/or taste have been described in COVID-19 patients. Studies have
not been conducted to evaluate the loss of smell and/or taste in the context of Nepal.
Objective
To investigate the prevalence of Ear, Nose and Throat related symptoms and assess
smell and taste disorders in laboratory-confirmed SARS-CoV-2 patients.
Method
This prospective cross-sectional study evaluated patients from September 2020 to
March 2021 with preceding COVID-19 diagnosis from a tertiary centre in Kathmandu.
COVID-19 positive patients visiting out-patient department, quarantined or admitted
were included. Patients were given questionnaire consisting of demographic data,
history of smoking and evaluation of presenting symptoms. Loss of smell and taste
were subjectively tested and followed up via telephone for ten weeks to evaluate for
recovery time and degree of recovery.
Result
A total of 226 patients participated in the study, 18-92 years old (mean age, 36.77 ±
15.23 years; 53.5% males, 69% non-smokers). Majority of the patients had Myalgia (n
= 128, 56.6%) as their presenting symptoms followed by fever (n = 122, 53.9%), loss
of smell (n = 117, 51.7%), cough (n = 107, 47.34) and sore throat (n = 102, 45.1%).
Loss of sense of smell and taste was reported in 51.8% and 42% respectively. The
association between loss of sense of smell and taste was statistically significant (p
< .001). All patients had some degree of recovery with 64.1% recovery of smell and
64.2% recovery of taste within 14 days of onset of symptoms. The mean recovery
time for sense of smell and taste was 14.34 ± 9.82 days and 15.03 ± 10.06 days,
respectively.
Conclusion
Olfactory and gustatory dysfunctions are cardinal features of COVID-19. They recover
spontaneously along with other symptoms within few weeks. The absence of smell or
taste in times of pandemic can be suggestive of potential COVID-19 infection and be
used as a screening tool for early diagnosis and reduce transmission of the infection.
KEY WORDS
COVID-19, SARS-CoV-2, Loss of smell, Loss of taste