Journal Issue: Volume: 29, No. 1, April, 2007
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Volume
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Issue Date
2007
Journal Title
Journal ISSN
ISSN (Print) : 1993-2979 | ISSN (Online) : 1993-2987
Journal Volume
Articles
Rising demand for comprehensive abortion care services in Nepal
(Institute of Medicine, 2007) Rana, A
NA.
Comparison between the conventional methods and Glasgow Benefit Plot in evaluating subjective hearing results after myringoplasty
(Institute of Medicine, 2007) Rayamajhi, P; Bhattarai, H; Sinha, BK; Shrivastav, RP
Abstract
Background: To compare the Conventional methods with Glasgow Benefit Plot in evaluating subjective hearing results after myringoplasty.
Materials and Methods: Patients above 17 years of age with the diagnosis of Chronic Suppurative Otitis Media-tubotympanic type undergoing Myringoplasty at TU Teaching Hospital from January 2004 to July 2005 were included in the study. The pre and postoperative Pure Tone Audiometry (PTA) was performed and evaluated. The postoperative subjective hearing status of the patients was recorded as improved, same or worsened. Objectively, the postoperative hearing was assessed in terms of Air Bone Gap closure, Air Conduction Threshold improvement and Glasgow Benefit Plot. The objective methods were then compared with the postoperative subjective hearing status of the patients.
Results: The association between the Air Bone gap closure and the postoperative subjective hearing status was not statistically significant. The association between the Air Conduction threshold improvement and the postoperative subjective hearing status was statistically significant. The association between the Glasgow Benefit Plot and the postoperative subjective hearing status was also statistically significant.
Conclusion: The study showed that the Air Conduction threshold improvement and the Glasgow Benefit plot are better parameters for evaluating subjective hearing results after myringoplasty than the Air Bone gap closure.
Keywords: Glasgow Benefit Plot, myringoplasty, Pure Tone Audiometry (PTA)
An epidemiological study of Cyclospora cayetanensis in Nepalese people
(Institute of Medicine, 2007) Sherchand, JB; Sherchand, JB; Cross, JH
Abstract
Background: Cyclospora cayetanensis is a coccidian parasite that causes recurrent gastroenteritis among children living under poor sanitary condition and adults from industrialized countries who lived or traveled in endemic developing countries.
Materials and Methods: A total of 1842 stool specimens from gastroenteritis patients were examined between March 2005 to February 2006 and collected various types of faecal specimens from human, animals and samples of water and green leafy vegetables.
Results: Of 1842 stool specimens collected from different areas of Nepal, 146 (7.9 %) were found to be positive for Cyclospora cayetanensis with the majority were from children 2-9 years of age. The highest rate of infections was found in the month of June; (31.6%). Cyclospora cayetanensis were found to be contaminated in green vegetables including leaves of basil, mint leaves, water sources and feces of domestic animals and these findings were presented in the paper.
Conclusion: Cyclospora-like oocysts were isolated for the first time from the leaves of basil, a holy plant of Nepal and the study indicated that vegetarian people were also found highest rate (65.1%) of Cyclosporiasis. However, to obtain more evidence on the source of infection, specimens from rodents, birds, insects and domestic animals are need for an extensive study.
Keywords: oocysts, Cyclospora cayetanensis
Effectiveness of episiotomy in preventing third and fourth degree perineal tear
(Institute of Medicine, 2007) Devkota, AR; Rana, A; Gurung, G; Amatya, A
Abstract
Background: To verify effectiveness of episiotomy in preventing third and fourth degree perineal tear.
Materials and Methods: Retrospective analysis of obstetric variables in 30 women who had sustained third and fourth degree perineal tear, compared with remaining 9632 vaginal deliveries during the same period. Obstetric department of Tribhuwan University Teaching Hospital, Institute of Medicine, Kathmandu, Nepal. This study identified 9662 vaginal deliveries over 42 months period from April 2003 to October 2006 from obstetric records. Thirty cases who sustained third and fourth degree perineal tear were further analyzed.
Results: Overall rate of third and fourth degree perineal tear was 0.22% (n=21) and 0.09% (n=9), respectively. Episiotomy was given to 49.0% (n=4250) of the total vaginal delivery that occurred during that period. Among women who were given episiotomy 0.42% (n=18) had severe degree perineal tear. Among women who were not given episiotomy 0.22% (n=12) had severe degree perineal tear. Among cases who had severe degree perineal tear 76.7% (n=23) were primi, compared to 23.3% multipara. Women who had sustained third degree perineal tear had slightly smaller babies of average birth weight 3.22 kg compared to 3.31 kg in those who had fourth degree tear. Post dated delivery occurred in 46.7% (n=14) cases. 15.4% (n=4) cases were induced with prostaglandins and 46.2% (n=12) were augmented with syntocinon. Forceps was used in 3.33% (n=1) and vacuum was used in 10.0% (n=3) cases.
Conclusion: Severe degree perineal tear occurred in almost double cases who were epitomized than those who were not. Large birth weight of baby, primiparity, postdated delivery and instrumentation were related to severe degree perineal tear.
Keywords: Episiotomy, perineal tear, vaginal deliveries
Accuracy of otoscopy, tympanic membrance mobility and tympanometry in the diagnosis of otitis media with effusion
(Institute of Medicine, 2007) KC, S; Guragain, RPS; Sinha, BK
Abstract
Background: To determine the accuracy of otoscopy, pneumatic otoscopy and tympanometry in the diagnosis of otitis media with effusion.
Materials and Methods: A total of 71 patients (121 ears) suffering from Otitis Media with Effusion (OME) diagnosed clinically were subjected to myringotomy and ventilation tube insertion (VTI). The finding of presence of fluid in middle ear after myringotomy was correlated with Tympanic Membrane (TM) color, fluid level, air bubble, TM mobility and tympanometric curve recorded preoperatively.
Results: Otoscopic findings revealed pink TM in 78.5%, prominent landmarks in 98.3%, generalized retraction 73.6%, fluid level in 14% and air bubble in 2.5% of cases. On pneumatic otoscopy, decreased or absent mobility was found in 85.1%. Tympanometry with ‘B’ curve was the most sensitive finding
(98.9%), whereas pneumatic otoscopy was found to be the most specific amongst all the three tools. Combination of tympanometry with either otoscopy or pneumatic otoscopy or combination of all
three modalities was found to be highly significant .
Conclusion: Tympanometry is the most sensitive tool for the diagnosis of OME and combination of tympanometry with either otoscopy or pneumatic otoscopy is highly significant.
Keywords: otitis media with effusion (OME), pneumatic otoscopy, tympanometry