Journal Issue: Volume: 15, No 3, Issue 59, JULY-SEPT, 2017
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Volume
Number
Issue Date
2017
Journal Title
Journal ISSN
1812-2027
Journal Volume
Articles
Diet and Health – What Should We Eat ?
(Kathmandu University, 2017) Shrestha, Archana; Spiegelman, Donna
NA
Role of Endoscopic Modified Inlay Butterfly Cartilage Perichondrium Myringoplasty in Hearing Outcome and Graft Uptake
(Kathmandu University, 2017) Shrestha, BL; Dhakal, A; Pradhan, A; Rajbhandari, P
ABSTRACT
Background
The endoscopes have better optics and magnification with wide angle of view due
to angled lenses. It provides the excellent resolution of image in surgeries having
many difficult anatomic nooks and corners like; antero-inferior recess of external
auditory canal, middle ear cavity and difficult areas to visualize under microspore
like sinus tympani. Likewise, the use of cartilage has very low metabolic rate, provide
support to prevent retraction and reacts minimally to inflammatory reaction, so it
has advantageous role in closure of tympanic membrane perforations.
Objective
The main objective of our study is to see the graft uptake rate and hearing results
after endoscopic cartilage myringoplasty with our own modification.
Method
This is a prospective, cohort study conducted among 37 patients who underwent
endoscopic modified inlay butterfly cartilage perichondrium myringoplasty using
tragal cartilage. The hearing was assessed by comparing pre with post-operative ABG
(Air bone gap) and ABG closure in speech frequencies (500Hz, 1KHz, 2KHz, 4KHz).
Result
Among 42 patients, 37 (88.09%) had graft uptaken. Other five patients had residual
perforation because of infection. The post-operative ABG was smaller than pre-
operative ABG.(26.41±8.47dB and 36.57±12.13dB respectively). The mean ABG
closure was 10.15±10.23dB. The ABG closure was ≤ 10dB in 28(75.6%) patients.
Conclusion
Endoscopic modified inlay butterfly cartilage perichondrium myringoplasty has
advantages in terms of hearing results and graft uptake rate as it is comparable or
even better than others. So, it is advisable to perform this technique without any
difficulty.
KEY WORDS
Air bone gap, cartilage, endoscope, myringoplasty
Comparative Study to Determine the efficacy of Zinc Oxide Eugenol and Alveogyl in Treatment of Dry Socket
(Kathmandu University, 2017) Chaurasia, NK; Upadhyaya, C; Dixit, S
ABSTRACT
Background
Dry socket is one of the most common complications following permanent tooth
extraction, especially mandibular third molar. Management remains controversial
and different authors have shown different results with the use of zinc oxide eugenol
and AlveogylTM, some preferring AlveogylTM over zinc oxide eugenol.
Objective
To determine the incidence, possible risk factors and compare the effectiveness of two
most commonly used agents (Zinc oxide eugenol and AlveogylTM) for management of
dry socket.
Method
Dry socket patients were randomly divided into two groups. Various risk factors
were recorded through proper history. After thorough irrigation with normal saline,
zinc oxide eugenol paste mixed with cotton pellet was placed in one group whereas
AlveogylTM was placed in another group. Intensity of pain was recorded on visual
analogue scale of Zero to ten. Pain score was recorded at the time of diagnosis, thirty
and sixty minutes after placement of medication and on second, fifth, seventh and
tenth day. The medication was changed every day until the pain subsided. The data
were collected and analyzed using SPPS software (version 20).
Result
Incidence of dry socket was 4.70%, more common in males (59.09%). It was more
common after extraction mandibular third molar. Initial and final pain relief on visual
analogue scale was better with use of zinc oxide eugenol.
Conclusion
Zinc oxide Eugenol paste is more effective in management of dry socket for early as
well as final pain relief compared to AlveogylTM.
KEY WORDS
Alveogyl, dry socket, visual analogue scale, zinc oxide eugenol
Intramedullary Nailing System in Unstable Both Bone Diaphyseal Fractures in Children
(Kathmandu University, 2017) KC, BB; Lamichhane, N; Parajuli, SP; Maharjan, S
ABSTRACT
Background
Forearm fractures in pediatric population is usually managed conservatively. Unstable
fractures need operative intervention like closed or open intramedullary nailing or
open reduction and internal fixation with plates and screws. However, there is no
consensus regarding the method of treatment according to age group.
Objective
To standardize the use of elastic nailing system as effective form of treatment in
terms of function, cost and lower complications as compared to widely used titanium
nails in developed countries.
Method
Sixty eight pediatric patients with both bone forearm diaphyseal fractures were
managed with closed reduction and intramedullary fixation with rush nail or k-wire
and followed at least for 6 months for evaluation of radiological and functional
outcome.
Result
Patients were divided into two age groups, Group A for age of 5 to 9 years (26
patients) and Group B for age of 10-15 years (42 patients). The mean time for union
for Group A patient was 7.31 weeks which was significantly lower than that of Group
B patients of 9.33 weeks (p-value <0.05). All the patients in Group A had excellent
outcome and 36 (85.7%) patients had excellent outcome and 6 (14.3%) had good
outcome in Group B. 5 out of 68 cases (7.35 %) had minor complications (2 in Group
A and 3 in Group B). The mean time for implant removal was 17.9 weeks in Group A
and 22.9 in Group B.
Conclusion
Intramedullary fixation for unstable diaphyseal both bone fractures of forearm is safe
and cost effective method of treatment with good to excellent functional outcome
with union time being significantly lower in younger age group.
KEY WORDS
Children, diaphyseal forearm fracture, intramedullary nail
Prevalence of Diastolic Dysfunction in Type 2 Diabetes Mellitus
(Kathmandu University, 2017) Yadava, SK; Dolma, N; Lamichhane, G; Poudel, N; Barakoti, M; Karki, DB
ABSTRACT
Background
Diastolic dysfunction is an inability of the ventricle to fill to a normal end-diastolic
volume, both during exercise as well as at rest. Diabetes mellitus increases the risk of
heart failure even in the absence of other co-morbidities.
Objective
To find the prevalence of diastolic dysfunction in patients with type 2 diabetes
mellitus and its association with age, gender, duration, glycosylated hemoglobin
levels, dyslipidemia, tobacco smoking and alcohol consumption.
Method
Ninety patients with type 2 diabetes mellitus of both genders, aged 30 to 60 years,
were included in this study. Doppler echocardiography was performed to evaluate
diastolic dysfunction.
Result
The mean age of the study population was 46.21 ± 9.20 yrs. The overall prevalence of
diastolic dysfunction in the study population was 47.8%. The prevalence of diastolic
dysfunction increases with age: 23.1% in patients of age 30 – 39 yrs to 65.8% in
patients of age 50 – 60 yrs (adjusted OR 0.16, 95% CI 0.04 - 0.64, P = 0.010) and with
the duration of diabetes: 32.8% in patients with diabetes for <5 yrs to 75% in patients
with diabetes for >10 yrs (adjusted OR 0.31, 95% CI 0.08 - 1.00, P = 0.05). There
was no significant association between diastolic dysfunction and dyslipidaemia, BMI,
tobacco smoking, alcohol consumption, HbA1c and gender.
Conclusion
Prevalence of diastolic dysfunction in type 2 diabetes mellitus was 47.8% in our study.
A rising trend of prevalence of diastolic dysfunction with the duration of diabetes and
increasing age of patients was observed.
KEY WORDS
Diastolic dysfunction, Prevalence, Type 2 diabetes mellitus