Journal Issue: Volume 14: No 3, Issue 55, JULY-SEPT, 2016
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Volume
Number
Issue Date
2016
Journal Title
Journal ISSN
1812-2027
Journal Volume
Articles
Cosmetic/Surgical Dermatology: Should it be an Integrated Part of Medical Dermatology?
(Kathmandu University, 2016) Agrawal, S
NA
A Hospital Based Study of Pterygium in Tertiary Care Hospital of Nepal
(Kathmandu University, 2016) Shrestha, P; Kaiti, R
ABSTRACT
Background
Pterygium, a triangular fibrovascular subepithelial growth of degenerative bulbar
conjunctival tissue over the limbus onto the cornea, is one of the common ocular
conditions that may result in discomfort, tearing, photophobia and significant visual
impairment. Little is known about its epidemiology in Nepalese context.
Objective
The current study aims to analyze the epidemiology of pterygium in a hospital-based
population in Kavre District, a mid hilly region of central Nepal.
Method
This was a prospective hospital based study carried out in the Department of
Ophthalmology in Dhulikhel Hospital, Kathmandu University Hospital for a period of
one year from January to December 2013. All the patients with pterygium, aged 21
years and above attending the outpatients department were included into the study.
The epidemiological data was collected using a standard questionnaire and complete
ocular examination was performed by the Ophthalmologist.
Result
A total of 7925 patients were seen in the Ophthalmology outpatient department
during a one year period, out of which 5622 patients (age range 20-80 years) were
eligible for the study. A total of 137 patients, 43(31.4%) males and 94 females (68.6%)
had different grades of pterygium with mean age of 48.6± 12.8 years. The overall
prevalence of pterygium was 2.4 %. Majority of the patients with pterygium were
between 41-60 years. Fifty-eight percent of pterygium were of grade I followed by
41% of grade II. Unilateral and nasal pterygia were common.
Conclusion
The prevalence of pterygium is low in this hospital based population, majority of
cases affecting females and old age population.
KEY WORDS
Prevalence, pterygium, risk-factors
Sex Determination From the Bicondylar Width of the Femur: A Nepalese Study Using Digital X-ray Images
(Kathmandu University, 2016) Singh, PK; Karki, RK; Palikhe, AK; Menezes, RG
ABSTRACT
Background
One of the important components of forensic identification is sex determination. The
prediction of sex becomes easy with a complete skeleton. The problem arises with
mutilated and incomplete skeletal remains. The skull and pelvis are preferred for sex
prediction, but not uncommonly, long bones are brought for forensic examination.
The femur out stands as the most dimorphic long bone. The literature on sex
determination from the femur in different population groups is in abundance. The
forensic anthropology literature suggests that longitudinal dimensions are often less
discriminating than the breadth and circumference of long bones. Many researchers
have suggested that the bicondylar width of the femur is the most dimorphic
dimension.
Objective
To evaluate the sexing potential of the bicondylar width of the femur in the Nepalese
population using digital X-ray images.
Method
A sample of 200 digital X-ray images of the knee belonging to 100 males and
100 females was used to measure the bicondylar width of the right femur. These
digital X-ray images were those of Nepalese patients who visited the Department
of Radiology at the affiliate hospital of Kathmandu University School of Medical
Sciences, Dhulikhel, Nepal for diagnostic and treatment purposes.
Result
The resent study reveals a statistically significant difference for the bicondylar width
of the femur between males and females. A regression equation was derived with
sectioning point 77.84. Using the regression equation the prediction of sex was 68%
with an overlapping of 32%. Having a low prediction in comparison to other studies
in different populations, 95% confidence interval for the mean was used to get a
range of measurements of the bicondylar width for males and females. The range
stated in the present study is 79.47 mm to 82.20 mm for males and 73.75 mm to
75.93 mm for females.
Conclusion
The bicondylar width of the femur cannot be individually recommended for sex
determination in the Nepalese population, but could be considered if analyzed along
with the other morphometric traits for sex determination.
KEY WORDS
Bicondylar width, dimorphism, femur, forensic anthropology, identification, sex
determination
Awareness on Hypertension and its Self-Management Practices Among Hypertensive Patients Attending Outreach Clinics of a Medical College in South India
(Kathmandu University, 2016) Joseph, N; Chiranjeevi, M; Sen, S; Singh, P; Saini, M; Beg, S
ABSTRACT
Background
Recent data suggest that hypertension is a significant public health problem in
India. The success strategies for hypertension management depend upon clients’
awareness on hypertension and its self-management practices.
Objective
To determine awareness, self-management practices and compliance with treatment
among hypertensive patients.
Method
This cross-sectional study was done in January 2012 at four health centres in
Mangalore. All confirmed cases of hypertension attending the outpatient department
were interviewed using a semi-structured interview schedule.
Result
Majority (58.7%) of the 315 participants were of the age group 41 to 60 years and
majority (53.6%) were males. Most patients (69.5%) were educated up to high school
level. The awareness level about hypertension was average or good in majority
(52.4%) of the participants. Self-management practices were found to be average
or good among 60.6% cases. Good compliance with treatment was seen in 78.7%
cases and blood pressure was in control in 72.4% cases. Quality of self-management
practices was found to influence control of blood pressure (p=0.021). Awareness,
self-management practices and compliance were found to be significantly poor
among aged (above 50 years), males, less educated, unemployed, unskilled or retired
patients.
Conclusion
Awareness on hypertension and self-management practices were average or above
among majority of the studied population. However this study identified groups
who need to be better educated and further monitored to achieve universal blood
pressure control among hypertensive population during the routine health care
services in this settings.
KEY WORDS
Awareness, compliance, hypertension, self-management
Safe and Feasible Time Limit for Early Appendectomy in Appendiceal Mass
(Kathmandu University, 2016) Pandit, RK
ABSTRACT
Background
Early appendectomy in appendiceal mass is gaining popularity among some surgeons.
However, it is endowed with increasing operative difficulty with time, and safe and
feasible timing is not yet clear.
Objective
To know safe and feasible time limit for early appendectomy in appendiceal mass.
Method
This is a retrospective study. Between May 2009 and July 2014, 114 patients of
appendiceal mass who underwent early surgical intervention by a single surgeon
were studied. Group I included 98 patients operated within seven days of onset of
pain and group II included 16 patients operated between 8th and 15 days of pain.
Type of operative procedure, difficulties and complications were analyzed.
Result
There were 58 men and 56 women. Their mean age was 24.27 ± 8.7 years. In group
I, 98 (100%) patients had appendectomy and adhesiolysis was safe and feasible. In
group II, 5(31.25%) patients had extra-peritoneal drainage of abscess without attempt
for appendectomy. Remaining 11 patients had attempt for appendectomy, but only
3(18.75%) out of 4 patients operated on the 8th day could have appendectomy. Six
(37.5%) patients had just drainage of abscess. Two (12.5%) patients, operated on
the 12th and 15th days of pain had just open-closed due to dense adhesion and both
resolved. One patient operated on the 10th day sustained ileal injury. Surgical site
infection occurred in 16.6% (14 in 86) in group I and 33.3% (5 in 15) in group B (P=
0.001). Mean operative time was 34.4 ± 9.23 minutes and 43.7 ± 16.38 minutes for
group I and group II respectively. Mean hospital stay after surgery was 2.9 ± 1.1 days
and 5.5 ± 1.37 days in group I and group II respectively.
Conclusion
Early appendectomy in appendiceal mass seems safe and feasible up to 7th day
since onset of pain in my experience. However, this limit may vary with surgeon’s
experience, and further studies are required to better clarify this issue.
KEY WORDS
Appendiceal mass, early appendectomy, safe and feasible timing