Journal Issue: Volume: 39, No. 3 (2017) December
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Volume
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Issue Date
2017
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Journal ISSN
ISSN (Print) : 1993-2979 | ISSN (Online) : 1993-2987
Journal Volume
Articles
Use of reverse sural artery flap for reconstruction of defects of distal leg, ankle and foot
(Institute of Medicine, 2017) Shrestha, JM; Rayamajhi, S; Lohani, I; Manandhar, K; Sharma, S
Abstract
Introduction: Reverse sural artery flap has been used effectively to cover defects of distal leg, ankle and foot. This flap is easier and quick to harvest and is a versatile flap in terms of extensive mobility and reliable vascularity and, in many instances it has obviated the need for free tissue transfer.
Methods: This is a retrospective study of sural flaps done at the Department of Plastic Surgery and Burns in Tribhuvan University Teaching Hospital over a period of 4 years from April 2011 to March 2015. It included 21 flaps carried out in 21 patients with soft tissue defects at distal lower leg, ankle and foot.
Results: Among 21 patients, 10 were men and 11 were women with an average age of 41 years (17 – 81). Successful flap coverage was obtained in 16 cases out of 21 (76%) which included 10 cases of complete survival (48%) and 6 cases (28%) of marginal flap necrosis. Four cases (19%) had partial flap loss and one case (5%) lost flap completely.
Conclusion: we found that reverse sural artery flap has good reliability with low incidence of complications and is a versatile flap for the reconstruction of defects in distal leg, ankle and foot
Key words: sural flap, distal leg, ankle, foot, flap survival, flap necrosis, skin strip
Visual outcome in Keratoconus with spherical rigid gas permeable contact lens
(Institute of Medicine, 2017) Chaudhary, M; Kandel, H; Adhikari, P
Abstract
Introduction: Keratoconus is a bileteral asymetric progressive ecteria of cornea commonly associated with vernal keratoconjunctivitis and Atopic dermatitis. Rigid gas permeable (RGP) contact lens is the first choice for refractive correction in keratoconic eyes. The visual outcome in Keratoconus with spherical RGP contact lens along with the mean age of presentation, gender predominance, ethnicity, associated conditions, refractive error and corneal astigmatism was evaluated.
Methods: The records of the Keratoconus patients attending cornea and contact lens clinic for last 6 years were reviewed and analyzed using SPSS-14 software. Data on laterality, race, age, gender, refractive error, visual acuity (VA), associated conditions and contact lens parameters were obtained. A total of 22 patients with 38 keratoconic eyes were included in the study.
Results: The mean age of Keratoconus presentation was 18.11 ± 4.45 years. Sixteen cases (72.73 %) were bilateral; 6 (27.27 %) were unilateral. Mean uncorrected visual acuity (UCVA) was 0.86 ± 0.40 Log MAR. Mean spectacle visual acuity was 0.54 ± 0.38 Log MAR. Mean visual acuity with spherical RGP contact lenses was 0.08 ± 0.14 Log MAR. The difference between mean spectacle visual acuity and mean VA with spherical RGP contact lens was statistically significant (p < 0.001).
Conclusion: In all stages of Keratoconus, improvement in visual acuity with spherical RGP contact lens was highly significant.
Key words: Contact Lenses, Keratoconus, Visual Acuity
Nasolabial cyst: Clinical presentation and surgical outcome of 14 cases with literature review
(Institute of Medicine, 2017) Gurung, U; Tamang, N; Tripathi, P
Abstract
Introduction: Nasolabial cyst is a rare, developmental, non-odontogenic cyst in the nasal alar region. The study aimed to assess the clinical characteristics, intra-operative findings, complications and recurrence following sublabial excision of nasolabial cyst and review the related literature.
Methods: It was a retrospective chart review of 14 cases of nasolabial cysts who underwent excision via sublabial approach in a tertiary center from December 2014 to May 2017. The data on clinical characteristics, intra-operative findings, complications and recurrence were assessed.
Results: Fourteen patients consisted of 9 females and 5 males. The age ranged from 22 to 73 years. Alar fullness was common presentation for all while 3 patients had associated pain. Two patients noted nasal obstruction. The cyst was located on left in 8 and on right side in 6 patients. The size ranged from 1.5 x1.5 to 4 x 4 cm2. All patients had the cyst excised totally via sublabial approach. Post-operatively, 8 patients developed cheek swelling which subsided within 2 weeks. None of the patients had gingival or tooth numbness or wound gape. There was no recurrence noted in follow up ranging from 3 to 30 months.
Conclusions: Nasolabial cyst is a slow growing, unilateral cyst in the nasal alar region, common in female in the fourth and fifth decade. Sublabial excision is the standard treatment with no recurrence however it has risk of intra-operative rupture of cyst and complications like cheek swelling, bruising, facial pain, facial numbness, numbness of teeth or gingiva. Transnasal endoscopic marsupialization is a new treatment modality.
Keywords: Nasolabial cyst, rare, sublabial excision, transnasal endoscopic marsupialization
Colour vision deficiency in Nepalese Medical and Nursing Students of different ethnicity
(Institute of Medicine, 2017) Mahotra, NB; Shrestha, L
Abstract
Introduction: Colour vision deficiency is a common but unnoticed condition. Medical students must be aware of their congenital colour vision deficiency and its effects on their work, so that color vision deficient student may not choose the discipline such as pathology and radiology, where colour vision is very important.
Methods: This is a cross-sectional study conducted in the Department of Clinical Physiology, Maharajgunj Medical Campus, Institute of Medicine, Kathmandu from February 2013 to January 2016. Total of 556 medical and nursing students selected by convenient sampling, underwent color vision evaluation by using Ishihara chart.
Results: Out of 302 male students, 20 (6.6%) were color vision deficient. Similarly, out of 254 female students, two (0.8%) were colour vision deficient. Among the male students, two (10%) were total colour blind, eight (40%) were suffering from deuteranomaly and 10 (50%) were suffering from deuteranopia. Colour vision deficiencies were observed more in Chhetri (9.5%), followed by Brahmin (7.1%) and Madhesi ethnicity (6.9%).
Conclusion: The prevalence of colour vision deficiency in Nepalese medical students is significant. Therefore, they should be screened for colour vision deficiency, so that the students with colour vision defect can choose appropriate discipline as their future carrier where colour vision defect may not affect their work.
Key words: colour vision deficiency, Ishihara chart, ethnicity