Journal Issue: Vol 9 No 1 Issue 18 April 2011
Loading...
Volume
9
Number
1
Issue Date
2011
Journal Title
Journal ISSN
1999-6217
Journal Volume
Volume 9
(9)
Articles
Role of CaCO3 alone and CaCO3 plus Vitamin D3 in terms of Calcium Phosphorus Product in Chronic Kidney Diseases
(Nepal Health Research Council, 2011) Adhikary, L; Acharya, S; Acharya, L
Background: CaCO3 alone and CaCO3 plus vitamin D3 metabolites are commonly prescribed in CKD patients.
The objective of this study is to analyze the changes in Ca x P product, calcium level and phosphorus level in CKD patients receiving calcium carbonate alone and calcium carbonate with vitamin D3 in combination.
Methods: A prospective, cross sectionalstudy among CKD patients under maintenance hemodialysis two times a week were studied over a period of one year. The patients were divided into two groups receiving oral CaCO3 alone and CaCO3 plus vitamin D3 once a day. The patients were followed for 1 month and result of Ca x P product was analyzed accordingly.
Results: Mean decrease of Ca x P product in CaCO3 group is (50.42+/-8.85 to 47 +/-6.63) in one month, p value =0.001(0.6-5) and CI- 95%. There is also significant reduction of phosphorus level in CaCO3 group than CaCO3 plus vitamin D3 group. Mean decrease in phosphorus in CaCO3 group is (5.51+/-0.76 to 5.17+/- 0.05) in one month. P value =0.01(0.14-0.53) and CI 95%.
Conclusions: There is a significant decrease in Ca x P product and phosphorus level was observed in CKD patients taking CaCO3 alone.
Keywords: calcium carbonate, calcium phosphorus product, chronic kidney disease, vitamin.
Early Enteral Feeding in Intestinal Anastomosis
(Nepal Health Research Council, 2011) Thapa, P B; Nagarkoti, K; Lama, T; Maharjan, D K; Tuladhar, M
Background: Routine practice after major GI surgery has been to keep patient nil per oral till the return of bowel sound with a belief that this will prevent post operative nausea and vomiting and protect the anastomotic site where as the trend has been changing to encourage enteral feeding as soon as possible as various studies has shown early enteral feeding to be beneficial in terms of nutritional, immunological aspect and for faster recovery of patient.
Methods: Patients undergoing major elective GI surgery in department of Surgery, Kathmandu Medical College Teaching Hospital who were given early enteral feeding (within 24 hrs of operation) were studied prospectively and were compared retrospectively with historical control who underwent similar procedure .
Results: Early enteral feeding in patient undergoing major G.I surgery showed early return of bowel movement,decreased ICU and hospital stay with a significant reduction in postoperative cost.
Conclusions: Early enteral feeding promotes faster recovery while reducing hospital stay and treatment cost in patient undergoing major GI surgery.
Keywords: anastomosis, enteral feeding, intestine
Allergic Fungal Rhinosinusitis in Chronic Rhinosinusitis
(Nepal Health Research Council, 2011) Shrestha, S; Kafle, P; Akhter, J; Acharya, L; Khatri, R; KC, T
Background: Rhinosinusitis is the inflammation of nasal and paranasal sinus mucosa and is associated with mucosal alteration ranging from inflammatory thickening or gross nasal polyp formation.The main objective of this study is to etermine the prevalence of allergic fungal rhino sinusitis among the patients having chronic rhino sinusitis with or without polyps who under goes functional endoscopic sinus surgery.
Methods: The patient with chronic rhinosinusitis with or without polyp who FESS were studied. Surgical specimens were sent for mycology and histopathological analysis for identification of fungus.
Results: Headache 41(82%) and nasal block 45(90%) were the commonest clinical presentation. Out of 50 patients,fungal elements were detected by KOH in 8(16%) of cases and histopathological examination in 11(22%) of cases.
Conclusions: Allergic Fungal Rhinosinusitisis a common disorder in patients with chronic rhinosinusitis, it needdifferent specific tests for the diagnosis, a more specific diagnostic tests are fungus culture, and IgE to fungal antigen and skin test are needed for definite diagnosis.
Keywords: allergy, fungus, rhinosinusitis, sinusitis
Diagnostic Accuracy of Fine Needle Aspiration Cytology in Thyroid Swellings
(Nepal Health Research Council, 2011) Bista, M; KC, Toran; Regmi, D; Maharjan, M; Kafle, P; Shrestha, S
Background: Proper management of the disease depends upon accurate diagnosis. Fine Needle Aspiration Cytology
has become the investigation of choice because of its high accuracy, simplicity, minimal-invasiveness, quick result and
reliability.
Methods: All the patients with thyroid disease, irrespective of age and gender, who underwent thyroid werestudied. These patients had their fine needle aspiration Cytology was done in our centre. Detailed history, physical examination, routine investigations, radiological investigations (including CT scans when needed), hormonal assay, (T3, T4, TSH ), ultrasound of neck and FNAC were done. Pre- operative fine needle aspiration results were compared with histopathology results of operated specimen and then analyzed statistically to assess the sensitivity, specificity and accuracy of the result.
Results: There were total of 51 patients. Age ranges from 21 to 62 years. The study duration was from May 2006 to February 2011. Out of 51 patients, 82.35% (n=42) were females and 17.64% (n=9) were males. In 43 patients, FNAC showed benign lesions, of which 40 were true negative (TN) and three false negative (FN), which on histopathology reported malignancy. Remaining eight cases were diagnosed as malignancy on histopathology of which seven cases were true positive (TP), one case of false positive (FP) was detected in our study. Over all Sensitivity was 70% and specificity was 97.5% and accuracy of FNAC was 92.1%.
Conclusions: FNAC should be performed in all cases of thyroid nodules because of its high sensitivity and specificity to differentiate benign from malignant lesions and counsel the patient as well as plan surgery accordingly. Expenditure, time and the hassle of revision surgery is minimized by the pre operative FNAC report.
Keywords: fine needle aspiration cytology, histopathology, sensitivity, specificity, thyroid swellings.
Health Impacts and Research Ethics in Female Trafficking
(Nepal Health Research Council, 2011) Dhital, S R; Aro, R A
Female trafficking is a social and public health problem, associated with physical and sexual abuse, psychological
trauma, injuries from violence, sexually transmitted infections, adverse reproductive outcomes and substance misuse. It faces several challenges ranging from the hidden nature of the problem to ethical and human rights issues. The objectives of this paper are to analyze health impact of trafficking; ethical and research issues and anti-trafficking strategies in the Nepalese context. We collected published and unpublished data assessing the public health, ethical burden and research needs from different sources. Trafficked female involved in sex-industry that face grave situationas depicted and it might a reservoir of sexually transmitted diseases. Ethical issues related to survey of assessing the burden are difficult to carry out. The best ways to prevent and control these problems are to enhance anti- trafficking laws and raise awareness, empower and mobilize females and establish organizational capacity.
Keywords: empowerment, female trafficking, health issues, Nepal