Journal Issue: Vol 8 No 2 Issue 17 October 2010
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Volume
8
Number
2
Issue Date
2010-10
Journal Title
Journal ISSN
1999-6217
Journal Volume
Volume 8
(8)
Articles
Microalbuminuria and Macroalbuminuria in Type 2 Diabetes
(Nepal Health Research Council, 2010) Maharjan, B R; Bhandary, S; Risal, P; Sedhain, A; Gautam, M
Background: Type 2 diabetes is the leading cause of end stage renal disease worldwide. Prevalence of diabetic nephropathy (DN) varies in the different ethnic groups. Nepal is country with great ethnic diversity. This study has been done to find the prevalence of microalbuminuria and macroalbuminuria in the two ethnic groups Jyapu and Brahmin.
Methods: In our study we have included two ethnics groups Jyapu and Brahmin type 2 diabetic patients. Inclusion criteria: Age ≥ 30 years, clinically diagnosed type 2 diabetic patients. Exclusion criteria: Patients with a history of urinary tract infection, hematuria, renal failure, intercaste marriage and women with menstruation at the time of sample collection.
Results: The overall prevalence of albuminuria was 49.05%. The prevalence of microalbuminuria was 35.89% in Jyapu and 37.73% in Brahmin which was comparable. There was significantly higher prevalence of macroalbuminuria in Jyapu 20.75% and Brahmin 3.77%. Association of dietary habit was seen with microalbuminuria and macroalbuminuria in both ethnic groups.
Conclusions: The overall prevalence of albuminuria in type 2 diabetes of our study was high and there was significantly higher macroalbuminuria in Jyapu compared with Brahmin. It, therefore, predicts a higher risk of having kidney disease in Jyapu population.
An Unusual presentation of Acute Coronary Syndrome
(Nepal Health Research Council, 2010) Kohli, S C; Parajuli, M; Maskey, A; Acharya, C P
Acute coronary syndrome in elderly can manifest with a variety of atypical presentation and may be associated with other comorbid conditions. We present an atypical presentation of ACS in an elderly left handed female presenting with sudden onset of slurred speech preceded by dizziness and vomiting. After through clinical examination and investigation she was managed as a case of non ST elevation myocardial infarction and ischaemic stroke.
Dilemma of Medical Graduates in Nepal
(Nepal Health Research Council, 2010) Lamichhane, J
The medical education system is in infancy in Nepal. There are many constrains at various levels. The numbers of medical colleges are increasing every year without considering for its quality by the concerned authorities. Nepal Medical Council is the authorized body to look for medical professionals in the country. Even though, efforts have been made from various sectors but are insufficient. This article will mainly focus on the life of a medical graduate in Nepal. It will give an idea of how these graduates have to undergo various problems regarding their career, family, profession and social lives, right after their graduation.
Use of Ureterorenoscope as Choledochoscope
(Nepal Health Research Council, 2010) Joshi, M R
Background: Flexible Choledochoscope is used to remove the stones using accessories during exploration of the common bile duct and its use reduces the incidence of retained stones. The choledochoscope and accessories are expensive and not available in many General Hospitals. In comparison to this, semi-rigid ureterorenoscope is easily available in many minimally invasive centres and accessories are more useful to remove even the impacted stones. We have used this for exploration of the CBD and tried to analyse its efficacy and safety.
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Methods: All the patients who underwent Ureterorenoscopic intervention by single surgeon for common bile duct stones during 2007-2010 are included. The usefulness, efficacy and safety of the procedure are analysed.
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Results: There were total 71 patients. Age ranges from 10 years to 69 years. Forty one (57.7%) patients had undergone open procedure where as 30 (42.2%) underwent laparoscopic procedure. Most of them were females (69%) and majority had multiple stones (59%). Twenty five (35%) patients required the use of different accessories like dormia basket, forceps etc. Pneumatic lithotripsy was used in 3 patients to fragment large impacted stones. In one (3%) patient of laparoscopic group scope could not be negotiated. In 4 cases mild common bile duct tear observed and in one patient duodenal laceration occurred. In two patients (2.8%) there were retained small stone fragments which passed spontaneously within two weeks post-operatively.
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Conclusions: SemirigidUreterorenoscope is easily available, safe and effective instrument. It is useful even for large impacted stones.
Prostatic Abscess a Diagnostic Dilemma
(Nepal Health Research Council, 2010) Agarwal, A; Praveen, C R; Hirachan, S; Karmacharya, A; Belokar, W K
Abscess of the prostate has become increasingly rare due to modern antibiotics and a decreasing incidence of gonococcal infections. It is still difficult to diagnose the disorder on clinical grounds. Diagnosis is often made after Ultrasound examination. We report 2 cases of prostatic abscess and review etiopathogenic factors, clinical findings, diagnosis and treatment of this uncommon entity.