scholarly journals Histopathologic Analysis of Pancreaticoduodenectomy Specimen

2016 ◽  
Vol 55 (204) ◽  
pp. 79-85
Author(s):  
Ramesh Dhakhwa ◽  
Neeta Kafle
Keyword(s):  
Pancreatic Adenocarcinoma ◽  
Perineural Invasion ◽  
Surgical Margin ◽  
College Teaching ◽  
Distal Cholangiocarcinoma ◽  
Medical College ◽  
Periampullary Neoplasms ◽  
Significant Difference ◽  
Histopathologic Evaluation ◽  
Histopathologic Analysis

Introduction: Whipple’s Pancreaticoduodenectomy has increasingly been used as an appropriate resectional procedure for tumors of the periampullary region which are pancreatic, periampullary, ampullary and biliary tumors. Our aim was to study the distribution and histopathologic features of these tumors and to examine local trends of periampullary neoplasms resected with a PD.Methods: A descriptive study was conducted in the department of Pathology, Kathmandu Medical College Teaching Hospital from July 2013 to June 2016.Results: Thirty five patients underwent Whipple’s Pancreaticoduodenectomy procedure during a period of 36 months from July 2013 to June 2016. Malignant tumor was present in 31 (88.57%) cases where as four cases (11.43%) harboured benign lesions. Periampullary mixed carcinoma was the predominant tumor (34.28%) followed by periampullary duodenal (20%), ampullary (14.28%), pancreatic adenocarcinoma (11.42%) and distal cholangiocarcinoma (5.71%). There was no significant difference in tumor size among periampullary, ampullary, pancreatic and biliary carcinomas. Ampullary carcinomas were predominantly well differentiated (80%) where as the other tumors were mostly moderately differentiated. Lymphovascular and perineural invasion varied in different tumor types. Four pancreatic adenocarcinomas showed lymphovascular and perineural invasion. Adequate surgical margin clearance was achieved in most of the cases except in one case each of periampullary duodenal carcinoma and distal cholangiocarcinoma and two cases of pancreatic adenocarcinoma..Conclusions: Pancreaticoduodenectomy specimen requires thorough histopathological evaluation. Pathologists should also be aware of possibility of a benign diagnosis in PD specimens which have been resected presuming malignancy based on clinical judgement and radiological data. Keywords: histopathologic evaluation, pancreaticoduodenectomy, periampullary carcinoma. | PubMed

scholarly journals Perception of Nurses on Needs of Family Members of Patient Admitted to Critical Care Units of Teaching Hospital, Chitwan Nepal: A Cross-Sectional Institutional Based Study

2018 ◽  
Vol 2018 ◽  
pp. 1-7 ◽  
Author(s):  
Ishwori Khatri Chhetri ◽  
Bedantakala Thulung
Keyword(s):  
Critical Care ◽  
Teaching Hospital ◽  
Family Members ◽  
College Teaching ◽  
Patient Treatment ◽  
Family Needs ◽  
Cross Sectional ◽  
Critical Care Units ◽  
Medical College ◽  
Significant Difference

Background. Critical care units’ nurses should seek to develop collaborative relationships with patients’ family members based on their needs and help them to cope with their distress. The objective of this study was to find out the perception of nurses on needs of family members of patients admitted to critical care units.Methods. A descriptive cross-sectional study was conducted in Chitwan Medical College Teaching Hospital among all 65 nurses working in critical care units. Ethical clearance was obtained from Chitwan Medical College Institutional Review Committee. Data were collected from March 27 to April 25, 2016, using Critical Care Family Needs Inventory (CCFNI). Obtained data were analyzed using descriptive and inferential statistics.Results. This study found that mean age of the nurses was 23.98 ± 4.05 years. More than half of the nurses had completed PCL in nursing (52.3%) and had 1-5 years of experience in critical care units (58.5%). Nurses ranked the needs for assurance as most important needs with mean percent (86.25%) followed by needs for information (78.58%), need for comfort (69.59%), needs for closeness (69%), and needs for support (64.13%). Out of 45 family needs, 81.5% of nurses perceived that knowing about patient treatment is very important for family members. Married nurses perceived the needs for support to be more important than unmarried nurses (p=0.04) whereas unmarried nurses perceived the needs for information to be more important than married (p=<0.01). There was significant difference on perception of nurses on needs of assurance with ethnicity (p=0.009) and critical care experience (p=0.04).

scholarly journals Astigmatic change after pterygium excision with autologous limbal conjunctival graft

2020 ◽  
Vol 9 (1) ◽  
pp. 25-30
Author(s):  
Dikchhya Sharma ◽  
Gunjan Prasai ◽  
Om Krishna Malla
Keyword(s):  
Age Groups ◽  
College Teaching ◽  
Corneal Astigmatism ◽  
P Value ◽  
Ocular Surgery ◽  
Medical College ◽  
Corneal Scarring ◽  
Significant Difference ◽  
History Of ◽  
Pterygium Excision

Background: Pterygium induces a significant amount of astigmatism. Pterygium excision with conjunctival limbal autograft results in significant reduction in astigmatism by inducing a reversal of pterygium induced corneal flattening thereby improving the vision. Objectives: The aim of this study was to investigate the amount of corneal astigmatism in patients with pterygium before and one month (4 weeks) after surgery.  Methodology: The prospective observational study was conducted in 31 patients who underwent pterygium excision with limbal autograft in Kathmandu Medical College Teaching Hospital during the study period of 12 months duration. Patients with recurrent pterygium, pseudopterygium, history of ocular trauma, history of ocular surgery, corneal scarring were excluded from the study. After surgery, patients were followed for four weeks. Findings were recorded in the proforma and statistical analysis was done in SPSS version 19.   Results: Pterygium was seen in all age groups with majority being in the active age range of 41-50 yrs. Females were most commonly affected. Significant difference in corneal astigmatism was noted postoperatively with a p value being 0.01. Conclusion: The technique of pterygium excision with limbal conjunctival autograft not only reduces the chances of recurrence but also helps in reducing the induced corneal astigmatism which is responsible for decreased vision in patients with pterygium.

scholarly journals Pattern of superficial venous arrangement in cubital fossa among preclinical Nepalese MBBS students at Birat Medical College Teaching Hospital

2021 ◽  
Vol 12 (10) ◽  
pp. 152-156
Author(s):  
Sanjib Kumar Sah ◽  
Sidarth Timsinha ◽  
Raju Kumar Chaudhary ◽  
Rajesh Kumar Shah ◽  
Umesh Kumar Mehta
Keyword(s):  
College Teaching ◽  
Venous Access ◽  
Cross Sectional Study ◽  
Type I ◽  
Cross Sectional ◽  
Medical College ◽  
Significant Difference ◽  
Reconstructive Microsurgery ◽  
Cubital Fossa ◽  
The Right

Background: The superficial veins of the cubital fossa are frequently variable in existence and arrangement. Many clinical procedures, such as reconstructive microsurgery and arterial bypass surgery, as well as intravenous injections or therapy, require the use of superficial veins. Aims and Objective: The aim of the study was to observe and describe the variations in anatomical distribution of the superficial veins of the cubital fossa in Nepalese pre-clinical medical students. Materials and Methods: The cross-sectional study included a total of 98 students between 18 to 24 years of age. A total of 196 anterior aspects of both arms were examined for cubital venous pattern. A tourniquet was applied at the mid-arm and drawing of the pattern of veins was made on a separate unglazed paper. The venous patterns in the cubital fossa were then categorized based on their gender. Results: Six patterns of superficial veins of the cubital fossa were observed. The commonest pattern in both genders was type I pattern. No statistical significant difference was observed between patterns of superficial veins on the right and left cubital fossa (P = 0.728 and 0.825 respectively) in both male and female subjects. Conclusion: Our research showed six venous patterns of superficial veins at the cubital fossa in Nepalese population. Understanding the common anatomy, patterns and variations of superficial vein anastomosis is imperative as this knowledge would help those needing venous access for various medical procedures.

scholarly journals A Comparative Study of Oxytocin & Misoprostol in Active Management of Third Stage of Labour

2015 ◽  
Vol 12 (1) ◽  
pp. 22-24
Author(s):  
N Ansari ◽  
CR Das
Keyword(s):  
Blood Loss ◽  
College Teaching ◽  
Cross Sectional Study ◽  
Active Management ◽  
Cross Sectional ◽  
Medical College ◽  
Significant Difference ◽  
Third Stage ◽  
Group A ◽  
Group B

Introduction: The third stage of labour is the period which follows the completed delivery of the foetus and consists of delivery of the placenta and its attached membranes.Aims and objectives: Comparison of oxytocin & misoprostol in active management of third stage of labour.Material and Methods: This is a comparative cross-sectional study was conducted in Nepalgunj Medical College Teaching Hospital, Kohalpur from March 2013 to March 2014. Group A - Oxytocin 10 IU IV bolus in 100 patients and Group B - Misoprostol 600 micro gram rectally. The collected were subjected to statistical analysis using SPSS 15.Results: After active management with bolus oxytocin, the blood loss was grossly reduced being 40-100ml in 84% cases and only 7% had blood loss more than 100ml. blood loss between 200-300ml were only 6% and only 3% had PPH, after misoprostol 80% of cases had blood loss within 40 – 100 ml., 6% cases had blood loss within 100 – 200 ml. and larger amount of blood loss i.e. between 200 – 300 ml. was observed in 7% cases, in 3% cases blood loss was between 300 – 400 ml. and 4% of women in this group had PPH.Conclusion: There was no statistically significant difference in the efficacy of oxytocin and misoprostol in reducing amount of blood loss and duration of labour rd in 3 stage of labour.Journal of Nepalgunj Medical College Vol.12(1) 2014: 22-24

scholarly journals Histopathologic analysis of appendectomy specimens

1970 ◽  
Vol 2 (3) ◽  
pp. 215-219 ◽  
Author(s):  
R Shrestha ◽  
SR Ranabhat ◽  
M Tiwari
Keyword(s):  
Acute Appendicitis ◽  
Carcinoid Tumour ◽  
Perforated Appendicitis ◽  
College Teaching ◽  
Negative Appendectomy ◽  
Age Group ◽  
Chronic Appendicitis ◽  
Medical College ◽  
Incidental Appendectomy ◽  
Histopathologic Analysis

Background: Acute appendicitis is one of the common conditions requiring emergency surgery. A retrospective study was performed to determine various histopathological diagnoses, their demographics and the rates of perforated appendicitis, negative appendectomy and incidental appendectomy. Materials and Methods: Histopathological records of resected appendices submitted to histopathology department Chitwan medical college teaching hospital over the period of 2 yrs from May, 2009 to April 2011 were reviewed retrospectively. Results: Out of 930 specimens of appendix, appendicitis accounted for 88.8% with peak age incidence in the age group of 11 to 30 yrs in both sexes. Histopathologic diagnoses included acute appendicitis (45.6%), acute suppurative (20.8%), gangrenous (16.3%), perforated (1.7%), resolving /recurrent/non specific chronic appendicitis (2.5%), acute eosinophilic appendicitis (1.2%), periappendicitis (0.2%), and carcinoid tumour (0.1%). Other important coexisting pathologies were parasitic infestation (0.2%) and Meckel’s diverticulum (0.2%). Negative appendectomy rate was 10.8% and three times more common in females with peak occurrence in the age group of 21-30 yrs. There were 10 cases of acute appendicitis in incidental appendectomies (2.5%, 24 cases) with 7 times more common in females of age group of 31- 60 yrs. Conclusion: There is a high incidence of appendicitis in adolescents and young adults in central south region of Nepal. Negative appendectomy is also very common in females. Incidental appendectomy in elderly females may have preventive value. DOI: http://dx.doi.org/10.3126/jpn.v2i3.6025 JPN 2012; 2(3): 215-219

scholarly journals Evaluation of Breast Lump by Fine Needle Aspiration Cytology

2017 ◽  
Vol 9 (2) ◽  
pp. 38-42
Author(s):  
Suman Poudel ◽  
S Ranabhat ◽  
B Parajuli ◽  
G Pun
Keyword(s):  
Fine Needle Aspiration ◽  
Fine Needle Aspiration Cytology ◽  
College Teaching ◽  
Needle Aspiration ◽  
Breast Lump ◽  
Aspiration Cytology ◽  
Fine Needle ◽  
Medical College ◽  
Significant Difference ◽  
Needle Aspiration Cytology

Introduction: Fine needle aspiration cytology (FNAC) is the important part of triple assessment in diagnosing the palpable breast lump. It categorizes the lesion into benign, malignant and its subtypes. It can also identify the residual diseases after treatment.Methods: It was a cross sectional descriptive study of cases of breast lump carried out during June 2015 to May 2016 in the Department of Pathology, Gandaki Medical College Teaching Hospital, Pokhara, Nepal. All the patients presenting in Pathology Department with history of breast lump were examined in detail. FNAC was done by standard procedure; smears were prepared and stained with Giemsa and pap for evaluation. Histopathology slides were stained with hematoxylin and eosin stain and evaluated by pathologists in Gandaki Medical College Teaching Hospital.Results: The study showed that, fibroadenoma of breast is the commonest benign lesion among the young populations. Only 13.11% of breast lump is malignant in the elderly population.Conclusion: FNAC is one of the safest and cheapest procedure that can be done in outpatient department for the diagnosis of breast lump. And there is no significant difference in diagnosis made by FNAC and histopatholgy examination. Journal of Gandaki Medical CollegeVolume, 09, Number 2, July December  2016, Page: 38-42

scholarly journals Maternal and Fetal Outcome in Elective versus Emergency Cesarean Section

2013 ◽  
Vol 52 (192) ◽  
Author(s):  
Anupama Suwal ◽  
Veena R Shrivastava ◽  
Amrita Giri
Keyword(s):  
Cesarean Section ◽  
Teaching Hospital ◽  
College Teaching ◽  
Fetal Outcome ◽  
Elective Cesarean Section ◽  
Emergency Cesarean Section ◽  
Medical College ◽  
Emergency Cesarean ◽  
Significant Difference ◽  
Elective Cesarean

Introduction: The complications of cesarean section are seen more commonly in emergency than in elective cases. The aim of this study was to find out the incidence of cesarean section in Nepal Medical College Teaching Hospital and to compare the maternal and fetal outcome in elective and emergency cesarean section. Methods: A prospective study of all the cases undergoing cesarean section in Nepal Medical College Teaching Hospital was carried out during the period of six months from Asar 2069 to Mangsir 2069. Results: The incidence of cesarean section was 254 (22.30%) out of which emergency cesarean section accounted for 167 (65.7%) and elective cesarean section for 87 (34.3%). The usual indications of emergency cesarean section were fetal distress, previous cesarean section in labour, non progress of labour and prolonged second stage of labour. The usual indications of elective cesarean section were previous cesarean section, breech, cephalopelvic disproportion and cesarean section on demand. There was found to be no significant difference in age, period of gestation, blood loss and blood transfusion in emergency vs. elective cesarean section. There was significant difference seen in the length of hospital stay, fever, urinary tract infection, wound infection and low APGAR in five minutes indicating that these were more common in emergency cesarean section. Significant difference was also seen in the incidence of postpartum haemorrhage indicating that it was seen more in elective cesarean section. Conclusions: The incidence of cesarean section in Nepal Medical College Teaching Hospital is high and the overall complication rate is higher in emergency cesarean section than in elective cesarean section.Keywords: cesarean section; fetal and maternal outcome.

scholarly journals Morphology of Dorsal Venous Arch of Hand: A Cadaveric Study

2019 ◽  
Vol 15 (2) ◽  
pp. 139-143
Author(s):  
Nripendra Tiwari ◽  
Deepesh Budhathoki ◽  
Iju Shrestha ◽  
Ram Timsina ◽  
Santosh Kumar Shah ◽  
...  
Keyword(s):  
College Teaching ◽  
Cephalic Vein ◽  
Basilic Vein ◽  
Medial Aspect ◽  
Lateral Aspect ◽  
Cross Sectional ◽  
Medical College ◽  
Significant Difference ◽  
Male Cadaver ◽  
The Mean

Background: Venous network of hand is superficially placed and is easy to trace for clinical purposes. Ce-phalic vein on lateral aspect and basilic vein on medial aspect of the hand are clinically important for inva-sive and surgical procedures. Thus the study of cephalic and basilic veins at dorsal venous arch of hand was dissected to observe for length of dorsal venous arch and the diameter and thickness of cephalic and basilic veins. Methods: This is a cross-sectional observational study conducted in 50 hands of cadavers (36 hands of male cadavers, 14 hands of female cadavers) in Department of Anatomy, Kathmandu Medical College Teaching Hospital, Duwakot. Cadavers were performed to measure the length of dorsal venous arch, diame-ter and thickness of cephalic and basilic vein on dorsum of hands. Results: The mean±s.d. length of dorsal venous arch in male cadaver (19.03±2.84 cm.) was significantly greater than in female (16.51±1.36 cm.).There was no significant difference in length of dorsal venous arch on right (18.22 ±2.47 cm.) and left side (18.42±3.05 cm.) in either sex. The mean±s.d thickness of basilic vein (0.10±0.01mm) in either sex was significantly greater than that of cephalic vein (0.09±0.01mm). Conclusions: The length of the dorsal ve-nous arch in male cadavers was found significantly greater than in female cadavers. The diameters based on external and internal circumference of basilic veins was found to be more than diameter of cephalic veins in both male and female cadavers. The thickness of basilic vein was found to be more (0.10±0.01mm) than that of cephalic vein (0.09±0.01mm) in cadaver of both sexes.

scholarly journals The subjective acceptance in presbyopic patient receiving correction based on conventional method of age v/s amplitude of accommodation

2019 ◽  
Vol 16 (2) ◽  
pp. 88-91
Author(s):  
Neha Priyadarshani Chaudhary ◽  
Pramod Sharma Gautam
Keyword(s):  
Conventional Method ◽  
College Teaching ◽  
Cross Sectional Study ◽  
Age Group ◽  
Sectional Study ◽  
Cross Sectional ◽  
Patient’S Satisfaction ◽  
Medical College ◽  
Department Of Ophthalmology ◽  
Significant Difference

Objective: To observe the subjective acceptance in presbyopic patients following prescription of spectacles. Material and method: This is a hospital based cross sectional study which was conducted in 100 presbyopic patients in age group of 35 to 60 years at outpatient department of ophthalmology in Nobel Medical College Teaching Hospital, kanchanbari from 1 August 2018 to 30November 2018. The patients were divided into two groups, First group received the presbyopic correction according to conventional method of age and the second group received the prescription according to their amplitude of accommodation. Patient's satisfaction in terms of symptoms like eyestrain, headache or difficulty with the usage of glasses was noted. The data collected were subjected to statistical analysis. Conclusion: When presbyopic correction is given according to amplitude of accommodation in patients belonging to 36-45 years age group, it is tolerated better and patients are more satisfied in terms of symptoms like eyestrain and headache than getting the simple correction as per their age. However after the age of 45 years, presbyopic correction given according to age is equally tolerated well among all refractive error groups. Results: 100 patients in this study who visited our OPD with presbyopic symptoms were divided into two groups, each of 50 patients. Patient's satisfaction and tolerance was better when presbyopic correction was given on the basis of their amplitude of accommodation in age group 36-45, in comparison to the prescription given according to conventional method of their age. However, there was no statistically significant difference in the patient's satisfaction level in the two groups after the age of 45.

Efficacy of Oral Azithromycin versus Doxycycline in the Treatment of Acne Vulgaris

2021 ◽  
Vol 18 (2) ◽  
pp. 59-62
Author(s):  
Abhishek Arjel ◽  
Kumar Pokhrel ◽  
Sapana Sharma
Keyword(s):  
Acne Vulgaris ◽  
College Teaching ◽  
Medical College ◽  
Significant Difference ◽  
Common Skin ◽  
Group A ◽  
Efficacy Assessment ◽  
Grade Ii ◽  
Group B ◽  
Oral Azithromycin

Introduction: Acne vulgaris is one of the most common skin disease affecting adolescence of either sex, globally. Antibiotics like macrolides and tetracycline have been used with good results, studies comparing their efficacy are lacking. The present study compare the efficacy of Azithromycin v/s Doxycycline in acne vulgaris. Aims: To compare the efficacy of Azithromycin and Doxycycline in the treatment of acne vulgaris. Methods: This is a prospective hospital based comparative study, conducted on 80 patients attending outpatient department of Dermatology, Nepalgunj Medical College Teaching Hospital with acne vulgaris from July 2019 to April 2020. Patient were divided alternately into two groups, Group A received Azithromycin (n=40) and Group B Doxycycline (n=40) and compared the effects of treatment at 6 and 12 weeks. Efficacy assessment was done according to simple acne grading system. Results: Acne was predominant in female (62.5%) as compared to male (37.5%). Patient between 16 to 20 years age group were more prone to acne (47.5%). Most of the patients had Grade II acne before treatment in both groups (Azithromycin 52.5%, Doxycycline 55%). After the treatment most of them improve to Grade I at 6 weeks (Azithromycin 50%, Doxycycline 55%) and to Grade zero at 12 weeks (Azithromycin 42.5%, Doxycycline 67.5%).There was no statistically significant difference in treatment efficacy between the two groups at 6 weeks but at 12 weeks efficacy of Doxycycline was significantly better than Azithromycin. Conclusion:  Both oral Azithromycin and Doxycycline when given for treatment of acne vulgaris the analysis showed good improvement after 6 weeks of treatment but there was no statistically significant difference in the improvement in both groups (p 0.771). However after 12 weeks patient receiving Doxycycline showed statistically significant improvement (p 0.035) in comparison to the patients receiving Azithromycin.

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