Journal Issue: No 4, Issue 12, OCT-DEC, 2005
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Volume
Number
Issue Date
2005
Journal Title
Journal ISSN
1812-2027
Journal Volume
Articles
Developing paediatric cardiology in the developing countries
(Kathmandu University, 2005) MC, Sivaprakasam; JJ, Vettukattil
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Clinical study of sentinel lymph node biopsy in early uterine cervical carcinoma
(Kathmandu University, 2005) Ying, Wu Hong; B, Thakur
Background: Radical hysterectomy and complete pelvic lymphadenectomy is the standard treatment for early
cervical carcinoma. But the rate of pelvic and paraaortic nodal metastasis is found to be low, pointing that most of
the patients possibly undergo unnecessary nodal dissection.
Aim: To study the value of sentinel lymph nodes (SLNs) in prediction of the pelvic lymph node status and to
determine the significance of SLN detection in pelvic lymph node dissection in patients with early stage cervical
carcinoma.
Settings and design: Retrospective study.
Methods: From August 2002 to August 2004, 20 patients with early stage cervical carcinoma, planned to undergo
radical hysterectomy and extensive pelvic lymph node dissection received an intracervical injection of a blue dye to
identify and perform resection of SLN. The SLNs were pathologically compared with non-SLNs with frozen
section, paraffin section, and anti-cytokeratin immunohistochemical staining.
Results: Out of 20 patients, SLNs were detected in 15 patients. A total of 46 SLNs were identified and the mean
was 3 per patient. The detection rate of SLN was 75%. Sensitivity, specificity and accuracy of the SLN biopsy were
75%, 100% and 95%, respectively.
Conclusion: SLN detection can predict the pelvic lymph node status in early stage cervical carcinoma, but the
feasibility and safety of this technique to substitute conventional surgical modality should be evaluated by large
series of prospective studies.
Keywords: Cervical cancer; Sentinel lymph node biopsy; Lymph node excision
Correlation between serum-ascites albumin concentration gradient and endoscopic parameters of portal hypertension
(Kathmandu University, 2005) DL, Gurubacharya; Mathura, KC; DB, Karki
Objective: We sought to determine the correlation between the level of serum-ascites albumin concentration
gradient (SAAG) and the complications of portal hypertension (PHTN), manifested by the presence and grade of
esophageal varices (EV).
Material and methods: Our study included 32 patients with ascites, demonstrated by ultrasonography, who had
measurement of the SAAG. All had upper gastrointestinal endoscopy with assessment of the presence and size of
EV. High SAAG was considered to be present when SAAG was >= 1.1 g/dl and Low SAAG when it measured < 1.1
g/dl.
Results: We found that 25 of 32 (78.13%) patients had High SAAG and 7 of 32 (21.87%) had Low SAAG.
Esophageal varices were present in 18 of 25 (72%) patients with High SAAG and in none of 7 (0%) patients with
Low SAAG (p =< 0.001). Among patients with High SAAG, EV were present in four of 8 patients (50%) with
SAAG values of 1.10-1.49g/dl; in four of seven patients (57.1%) with SAAG values of 1.50-1.99g/dl; and in ten of
ten (100%) with SAAG values of >= 2.0g/dl (p = 0.037). The size of the esophageal varices had no association with
the level of SAAG in patients with High SAAG (p = 0.426).
Conclusions: In patients with ascites the presence of esophageal varices is associated only with patients with High
SAAG. The presence of EV in patients with ascites and High SAAG is directly related to the degree of SAAG. The
size of the EV in patients with ascites and High SAAG is not associated with the degree of SAAG.
Keywords: Ascites, Serum-ascites albumin concentration gradient (SAAG), Esophageal varices (EV), Portal
Hypertension (PHTN)
Lipid peroxidation and antioxidant enzyme status in oral carcinoma patients
(Kathmandu University, 2005) R, Khanna; PB, Thapa; HD, Khanna; S, Khanna; AK, Khanna; HS, Shukla
Objective: To measure the lipid peroxidation and endogenous antioxidant enzyme status in oral carcinoma and the
protective role of exogenous antioxidants.
Meterial and methods: 20 new cases of histologically proven oral squamous cell carcinoma, 20 of leukoplakia and
20 age and sex matched healthy conrols were included. Intra oral pH of patients and controlled were measured by
quantitative litmus paper test and serum was analysed for malonialdehyde (MDA), super oxide bismutase (SOD),
catalase and glutathione peroxidase (GP). Patients with leukoplakia were treated with exogenous antioxidants for 3
months and the same were reassessed.
Results: Oral pH of oral cancer patients was neutral (PH-7) but that of leukoplakia and controls were mildly acidic
(6.64 and 6.58 respectively). Serum malonialdehyde levels were highest in oral cancer group. With antioxidant
enzymes super oxide bismutase, catalase and glutathione peroxidase different pattern was noticed. Antioxidant
enzymes remained almost the same (P > 0.005 each) in patients with leukoplakia after 3 months of vitamin A,C
and E. but there was marginal increase in catalase level (P<0.05).
Conclusion: This study shows the positive benefit of vitamin (A,C,E) and nutrition supplementation on the
antioxidant enzyme defense system hence prevention of oral carcinogenesis in patients with leukoplakia.
Keywords: Lipid peroxidation, malonialdehyde, catalase, glutathione peroxidase, superoxide dismutase, oral cancer
Pattern of intraocular pressure changes following manual small incision cataract surgery
(Kathmandu University, 2005) H, Das; BP, Badhu; A, Panda
Objectives:
To find out the pattern of changes in intraocular pressure after manual small incision cataract surgery.
Methods: Consecutive patients (291 eyes of 291 patients) undergoing manual small incision cataract surgery were
prospectively evaluated for change in IOP. Patients were further divided into two groups based on whether or not
sutures were used to close the scleral tunnel. IOP was serially measured at day 1, 1st, 2 nd, 4 th
, 6 th, 8 th and 12th week.
Results: The mean post operative IOP in eyes where sutures were not applied (12.59± 3.02 mmHg,
12.59±2.34mmHg, 12.54±2.19mmHg and 12.40±2.99 mm Hg at day1, 2week and 4weeks respectively) was lower
than that where sutures were used to close the wound (15.57± 3.86mmHg, 14.05±2.52mmHg, 14.43±3.39mmHg at
day1, 2weeks and 4 weeks respectively). There was a drop of IOP from the preoperative IOP in both suture
(1.15±3.29mm Hg) and non suture (3.29±3.07mm Hg) group at 3 months of follow up. Conclusion: There is a small
drop of IOP following sutureless MSICS during long term follow up. Eyes where sutures are applied are more likely
to have higher IOP than those without sutures at the initial post operative period.
Key Words:
Small incision cataract surgery, suture less cataract surgery, intraocular pressure.