scholarly journals Lumbosacral Transitional Vertebrae in patients attending a Tertiary Care Hospital of Nepal

2021 ◽  
Vol 6 (2) ◽  
pp. 1507-1511
Author(s):  
Sanzida Khatun ◽  
Diwakar Kumar Shah

Introduction: Lumbosacral Transitional vertebrae are congenital anomalies of lumbosacral vertebral junction. It may present either as sacralization of fifth lumbar vertebrae or lumbarization of first sacral vertebrae. Various secondary pathological spinal conditions such as intervertebral disc herniation and/or degeneration, facet joint arthrosis and spinal canal or foraminal stenosis are associated with the presence of LSTV. The failure in the identification may lead to clinical consequences such as errors in diagnosis of disease and lumbosacral procedures. Objective: The aim of this study was to determine the prevalence and patterns of LSTV in patients presenting to Department of Radiology of Nobel Medical College Teaching Hospital, Nepal.. Methodology: A descriptive cross-sectional study was conducted in Department of Radiology of Nobel Medical College Teaching Hospital, Nepal.Plain radiographs including Antero-posterior (AP) and Lateral views of lumbosacral spine of 343 patients referred for the scan were analyzed for the presence of lumbosacral vertebrae. Result: Out of 343 patients, LSTV was found in 61 (17.8%) subjects. Thirty-eight subjects (11.1%) exhibited sacralization and 23 (6.7%) showed lumbarization.Out of total LSTV subjects,  type I A was present in 8 (13.1%), type I B in 21 (34.4%), type II A in 10 (16.4%), type II B in 5 (8.2%) , type III A in 6 (9.8%) , type III B in 9 (14.8%) and type IV in 2 (3.3%). Conclusion: The LSTV is prevalent in almostone-fifth of subjects presenting to department of radiology of Nobel Medical College and Teaching Hospital, Biratnagar for lumbosacral scan.. Sacralization occurs more frequently than lumbarization, both of which alter the morphology of anatomical structures in spine. The presence of anomaly in this region may be related to occurrence of various pathological and clinical conditions.

2015 ◽  
Vol 53 (199) ◽  
pp. 188-191 ◽  
Author(s):  
Prabin Bikram Thapa ◽  
Dhiresh Kumar Maharjan ◽  
Theten Yonjan Tamang ◽  
Suman Kumar Shrestha

Introduction: Safe dissection of Calot’s Triangle is important during the performance of laparascopic cholucystectomy. The purpose of the study is to determine the frequency of demonstrable Rouviere’s sulcus in patients with symptomatic gall stones and its role in safe dissection in Calot’s triangle. Methods: This is a prospective descriptive study design done in Department of surgery, Kathmandu Medical College Teaching Hospital from Jan 2013 to Jan 2015. Patients who were posted for laparoscopic cholecystectomy were included. During laparoscopy, Rouviere’s sulcus was noted in the operative note and classified according to following: Type I: Open type was defined as a cleft in which the right hepatic pedicle was visualized and the sulcus was opened throughout its length. Type II: if the sulcus was open only at its lateral end. Type III If the sulcus was open only at its medial end. Type IV: Fused type was defined as one in which the pedicle was not visualized. Results: A total of 200 patients underwent laparoscopic cholecystectomy during period of 2 years. Out of which Rouviere’s sulcus was visualized in 150 patients (75 %).Type I (open type) was commoner in 54%, type II in 12%, Type III in 9% and type IV (fused type) in 25%. Conclusions: Rouviere’s Sulcus is an important extra biliary land mark for safe dissection of Calot’s triangle during laparoscopic cholecystectomy.  Keywords: Rouviere’s Sulcus, laparoscopic cholecystectomy, bile duct injury.


2013 ◽  
Vol 1 (1) ◽  
pp. 48-52
Author(s):  
S Shrestha ◽  
B Shakya ◽  
P Shrestha

Background and Objectives: Mycobacterial disease continues to cause high morbidity and mortality and is a major public health problem in Nepal. Bacteriological examination of sputum is the cornerstone in the diagnosis of pulmonary tuberculosis in the developing world. This prospective study was carried out with an objective to evaluate the prevalence of pulmonary tuberculosis among the patients visiting National Medical College Teaching Hospital by Ziehl- Neelsen (Zn) staining microscopy. Material and Methods: The study was cross-sectional study. Three consecutive early morning sputum collected from 626 patients were subjected to Zn staining and observed under oil immersion. Results: Among 626 patients, 85 (13.57%) were found to be Acid fast positive by Zn staining microscopy. Of total suspected patients,16.0% of male and 8.7% of female were infected, common among 41-60 years group (17.2%) followed by 21-40 years (12.6%) and multibacillary cases was 71.8%. Conclusion: The prevalence of pulmonary tuberculosis among National medical college teaching hospital was found to be higher than the Nation pulmonary tuberculosis detection rate, most commonly infecting males. DOI: http://dx.doi.org/10.3126/jmcjms.v1i1.7886 Janaki Medical College Journal of Medical Sciences (2013) Vol. 1 (1):48-52


2013 ◽  
Vol 03 (03) ◽  
pp. 072-076
Author(s):  
Lydia S. Quadros ◽  
Arathy Babu ◽  
Antony Sylvan D'souza

Abstract Context: Facial artery is usually the main artery supplying the face. It gives three named branches on the face, the inferior labial, the superior labial and the lateral nasal and continues as the angular artery. Face is also supplied by the transverse facial artery and the arteries accompanying the cutaneous nerves. Aim: In the present study, variations of facial artery on face were observed. Settings & design: Department of Anatomy, Kasturba Medical College, Manipal. Material & method: The present study was performed on 38 males and 12 females' formalin-fixed hemi-faces. Diameter of facial artery was noted at two specific points using a fine microcaliper. Results: The variations were divided into 3 categories. Out of 38 male hemi-faces, 100% right and 78% left hemi-faces belonged to type I category; 22% left hemi-faces belonged to Type III category. Out of 12 female hemi-faces, 80% right and 80% left hemi-faces belonged to Type I category, 18% left hemi-faces belonged to Type II category and 20% right and 2% left hemi-faces belonged to Type III category. Premasseteric branch was observed in 4 hemi-faces; a duplex with a prominent lateral angular branch was observed in 4 hemi-faces and anenlarged transverse facial artery was seen in 2 hemi-faces. The diameter of facial artery at its origin and at the antero-inferior angle of masseter muscle was larger in males. Conclusion: This study shows that the variations in the branches and the diameter of the facial artery were relatively larger in males when compared to females.


2012 ◽  
Vol 6 (2) ◽  
pp. 37-43 ◽  
Author(s):  
H Tuladhar ◽  
N Dhakal

Aims: To identify the determinants of antenatal care (ANC) attendance and its impact on maternal / perinatal outcome. Methods: Prospective descriptive study of women delivered at Nepal Medical College Teaching Hospital (NMCTH), a 700 bedded tertiary care hospital situated at periphery of Kathmandu. Results: Among 322 women delivered during period of four months, majority (87%) reported of attending more than 4 antenatal visits, only 21 (6.5%) women had not attended ANC. The most preferred place of ANC was hospital (71.6%). Women with secondary education and above, business/service holders, 20-29 years age group, primigravida and Brahmin / Chhetri caste were more likely to attend ? 4 visits, while those living further than 6 km. from a health facility were less likely to attend. Financial problem (52.4%) followed by ignorance (28.6%) were the most commonly stated reasons for not attending ANC. Women attending more than 4 antenatal visits have more chance of full immunization with tetanus toxoid and iron supplementation. Most of the women started attending ANC from their second trimester (75.8%), only 21.9% had first ANC visit during first trimester. Overall Cesarean section rate was 17.4% and with increased rates in women who had attended ANC, because of the fact that all elective cesarean section were planned in these women only. Also, all inductions of labor (9.3%) were performed among them. Maternal complications like anemia and pregnancy induced hypertension occurred more commonly in women without ANC. The proportion of low birth weight and preterm babies was higher in women with inadequate or no ANC. Special care baby unit (SCBU) admission was also higher among them due to various reasons like neonatal sepsis, birth asphyxia, jaundice etc. While there were no neonatal deaths during the study period, 3 still births have occurred. Perinatal mortality rate was similar in no ANC and inadequate ANC groups; it was 16 times higher than that in the group with more than 4 visits. Maternal and perinatal outcomes were found to be better in women who attended regular ANC. Conclusions: Although attendance of ANC is quite encouraging, the proportion of women attending ANC from first trimester is low. The quality of antenatal care needs to be strengthened. The health system needs to ensure the availability of ANC in primary care level and to establish mobile clinics for those living far from the health facilities.NJOG 2011 Nov-Dec; 6 (2): 37-43 DOI: http://dx.doi.org/10.3126/njog.v6i2.6755


2014 ◽  
Vol 83 (4) ◽  
pp. 399-403 ◽  
Author(s):  
Iva Fialová ◽  
Michaela Paninárová ◽  
Alois Nečas ◽  
Ladislav Stehlík ◽  
Pavel Proks

Lumbosacral transitional vertebra is a common congenital anomaly of the spine in dogs. It is a predisposing factor for degeneration of the lumbosacral spine and development of cauda equina syndrome or hip dysplasia in affected dogs. The aim of the study was to determine breed predisposition, types, and prevalence of lumbosacral transitional vertebrae in the canine population in the Czech Republic. The value of laterolateral radiographs of the lumbosacral junction in the diagnosis of LTV was also evaluated. Prevalence of lumbosacral transitional vertebrae was determined by reviewing ventrodorsal radiographs of pelvis with an extended hip of 1,878 dogs. Lumbosacral transitional vertebrae were detected in 188 dogs (10%). German Shepherd, Alaskan Malamute and Bohemian Shepherd were found to be highly predisposed breeds. The most common type of lumbosacral transitional vertebra was type II with separation of the first sacral vertebra from sacrum and presence of rudimentary intervertebral space between S1 and the sacral median crest (37.8% of the lumbosacral transitional vertebrae). Type I was detected in 29.2% and the asymmetric type of the lumbosacral transitional vertebra (type III) in 33%. Laterolateral radiograph of the lumbosacral spine was evaluated in 126 dogs from 188 with lumbosacral transitional vertebrae. Rudimentary intervertebral disc space between S1 and S2 in laterolateral radiographs was detected in 100% of lumbosacral transitional vertebrae with type II and III, and was not detected in type I. The findings on lumbosacral transitional vertebrae in the Czech Republic will extend knowledge about the disease. Both ventrodorsal hip-extended and laterolateral radiographs should be recommended for routine screening and reliable differentiation among the three different types of lumbosacral transitional vertebra.


2013 ◽  
Vol 34 (1) ◽  
pp. 13-17 ◽  
Author(s):  
S Pandey ◽  
MS Raza ◽  
CP Bhatta

Introduction: Staphylococcus aureus is found to be a major source of community as well as hospital acquired infection. Staphylococcal isolates from tertiary care hospital are found to be resistant to commonly used antimicrobial agents. Methicillin resistant S. aureus (MRSA) with intrinsically developed antimicrobial resistance has been associated with an increase in morbidity and mortality of the patients in the hospital. This study was undertaken to know the antibiotic sensitivity pattern of staphylococcal isolates with special reference to Methicillin resistant S. aureus. Methods: Clinical specimens received from July 2009 to July 2010 in Kathmandu Medical college-Teaching Hospital were processed and all S. aureus isolates were included in the study. The isolates were identified by standard laboratory procedure. The antibiotic susceptibility pattern of all staphylococcal strain was determined by modified Kirby Bauer antibiotic sensitivity method. Results: Of 111 S .aureus isolates 29(26.12%) were identified to be MRSA. The rate of multi drug resistance was 75.86% for MRSA and 6.09% for MSSA. All the staphylococcal isolates were resistant to penicillin. However, all strains were sensitive to vancomycin. Conclusions: This study showed a high prevalence of MRSA in tertiary care hospital of Kathmandu valley. Regular surveillance of hospital-associated infection and monitoring of antibiotic sensitivity pattern is mandatory to reduce MRSA prevalence in hospital and its spread to community as well. Present study conclusively shows that vancomycin remains the first choice of treatment for MRSA infection. To preserve its value, use of vancomycin should be limited to those cases where there are clearly needed. DOI: http://dx.doi.org/10.3126/joim.v34i1.9117 Journal of Institute of Medicine, April, 2012; 34:1 13-17


2019 ◽  
Vol 57 (219) ◽  
Author(s):  
Anu Kushwaha ◽  
Anuj Raj Kadel

Introduction: Family medicine is a relatively overlooked specialty in Nepalese medical education. It is unclear how many interns are actually interested in Family medicine as a career and how many non-medical individuals are aware of its existence. The aim of this study is to assess information, expectation and perception among interns regarding family medicine and its choice as a career. Methods: This is a descriptive-cross sectional study carried out in Kathmandu Medical College Teaching Hospital from July 2018 to December 2018. Whole sampling was done. All interns of Kathmandu Medical College Teaching Hospital posted in different departments during the time period was the inclusion criteria. Chronic absentees was the exclusion criteria. Factor like age, sex, their residency of choice, and whether they consider family medicine as a potential career were considered. Data was entered in with Statistical Package for Social Services version 16 and necessary calculations were done. Results: Thirty three interns preferred internal medicine as their career of choice, 20 preferred surgery while only three preferred in family medicine. Eighty eight interns, including the three who had family medicine as their career of choice, said that they could consider family medicine as a potential career. Eighty eight out of the 100 interns in the study mentioned that their family had knowledge that a specialty called family medicine existed. Conclusions: Despite being the career of choice of only a few, majority considered family medicine as a potential career for them. And the knowledge about existence of family medicine was high among families of interns.


2016 ◽  
Vol 3 (2) ◽  
pp. 84-88
Author(s):  
Susmita Saha ◽  
Neelam Vasudeva ◽  
Shipra Paul ◽  
Virender Kumar Gautam

Objetivos: El propósito del estudio era evaluar la morfología de acromion adulto en la población India y correlacionar su asociación con varias patologías del hombro. Materiales y métodos: La evaluación morfológica fue realizada en 200 omóplatos secos adultos obtenidos del museo de osteología del Departamento de Anatomía, Maulana Azad Medical College, Nueva Delhi. Se calculó la altura del arco acromial, ángulo anterior y posterior del arco y su índice, usando el método objetivo de Getz et al  (1996) para demarcar forma acromial. La presencia o la ausencia de entesofitos fue observada en la superficie inferior de la cara anterior del acromion. Resultados: 28% de los omóplatos fueron el acromion de tipo I, 67% fueron el tipo II y el 5% fueron el tipoIII. La presencia de entesofitos en la superficie inferior de la cara anterior del acromion también fue estudiada; los enthesofitos fueron observados en 3.5% en el tipo acromial I, 15.67% en el tipo II y el 40% en el proceso acromial de tipoIII. Conclusiones: La asociación entre el síndrome subacromial de compresión y el tipo acromial está bien establecida. Les asistirá a los clínicos para decidir la modalidad del tratamiento: conservador o quirúrgico. Se debe tener en cuenta la asociación de entesofitos subacromiales con la morfología acromial y los desgarros del manguito rotador al interpretar opacidades en las radiografías.  Objectives: The purpose of the study was to asses the morphology of adult acromion  processes in Indian population and correlate its association with various shoulder pathologies. Materials and methods: Morphologic evaluation was conducted on 200 adult dry scapulae obtained from osteology museum of Department of Anatomy, Maulana Azad Medical College, New Delhi. The height of the acromial arch, anterior and posterior angle of arch and their ratio were measured by using objective method of Getz et al (1996) for determining acromial shape. Presence or absence of enthesophyte was noted on the undersurface of the anterior aspect of the acromion process. Results: 28% scapulae exhibited type I acromion, 67% exhibited type II and 5% exhibited type III. The presence of enthesophytes on the anterior undersurface of the acromion was also studied; enthesophytes were observed in 3.5% in type I acromion, 15.67% in type II and 40% in type III acromion process. Conclusions: Association between subacromial impingement syndrome and acromial type is well established. This will assist the clinicians in deciding the modality of treatment: conservative or operative. Association of subacromial enthesophytes with acromial morphology and rotator cuff tears should be borne in mind when interpreting opacities on radiographs.


Author(s):  
G. D. Gagne ◽  
M. F. Miller ◽  
D. A. Peterson

Experimental infection of chimpanzees with non-A, non-B hepatitis (NANB) or with delta agent hepatitis results in the appearance of characteristic cytoplasmic alterations in the hepatocytes. These alterations include spongelike inclusions (Type I), attached convoluted membranes (Type II), tubular structures (Type III), and microtubular aggregates (Type IV) (Fig. 1). Type I, II and III structures are, by association, believed to be derived from endoplasmic reticulum and may be morphogenetically related. Type IV structures are generally observed free in the cytoplasm but sometimes in the vicinity of type III structures. It is not known whether these structures are somehow involved in the replication and/or assembly of the putative NANB virus or whether they are simply nonspecific responses to cellular injury. When treated with uranyl acetate, type I, II and III structures stain intensely as if they might contain nucleic acids. If these structures do correspond to intermediates in the replication of a virus, one might expect them to contain DNA or RNA and the present study was undertaken to explore this possibility.


2020 ◽  
Vol 9 (2) ◽  
pp. 45-49
Author(s):  
Pramod Sharma Gautam ◽  
Uday Chandra Prakash ◽  
Subreena Dangol

Background: The eye and vision related problems that results from continuous use of computers and other visual display terminals for extended period of time leads to computer vision syndrome. Due to rapid digitalization in human life, the risk of developing it has also increased in many folds. So, with an aim of determining the prevalence and level of awareness of computer vision syndrome among computer users along with their attitude and practices to prevent it, this study was conducted in the office employees who use computer for a considerable period of time. Materials and Methods: A hospital based observational descriptive study was conducted in the out-patient department of Ophthalmology in Nobel Medical College and Teaching Hospital, Biratnagar, where 105 employees working in different work stations of same institution were enrolled. A questionnaire and the clinical findings were used to collect data. Results: About 80% of the employees were using computer for about (8-11) hours per day. Prevalence of computer vision syndrome noted was (92.4%) with low level of knowledge (85.7%) about it. About 45% of them wore glasses for their refractive errors but attitude and practices in work place to prevent the bad effects of using visual display terminals were found to be lacking (53.3%). Burning sensation in the eye, headache, ocular irritation and itching and neck, shoulder or back pain were the common symptoms. Around (60-70)% of the eyes tested positive for dry eye. Conclusion: Lack of awareness of computer vision syndrome and lack of personal protective measures were associated with its high level of prevalence.  


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