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  • 1
    Online-Ressource
    Online-Ressource
    Comparative Study of Clinical Profile and Outcome Among Variceal and Nonvariceal Bleeding in a Tertiary Referral Hospital of Nepal During Covid Pandemic
    Nepal Journals Online (JOL) ; 2022
    In:  Nepalese Medical Journal Vol. 5, No. 1 ( 2022-06-30), p. 506-509
    Details
    In: Nepalese Medical Journal, Nepal Journals Online (JOL), Vol. 5, No. 1 ( 2022-06-30), p. 506-509
    Kurzfassung: Introduction: Upper Gastrointestinal Bleeding is a common medical emergency that is broadly classified into variceal and non-variceal bleeding. Preendoscopicemperical treatment is based on clinical findings and laboratory parameters. The article aimed to compare these parameters among variceal and non-variceal bleeding. Materials and Methods: This is a retrospective descriptive study conducted in a tertiary level referral hospital after taking approval from the Institutional review board. The data included was from September 2020 to August 2021. All patients with relevant data who underwent upper GI endoscopy were enrolled. The clinical and laboratory parameters were compared using appropriate statistical tests. Results: A total of 85 patients were studied with 40 (47.06%) in the variceal and 45 (52/94%) in the non-variceal group. Significantly more patients in the variceal bleeding group had a history of alcohol consumption (85% vs 60%) and smoking history (52.50 % vs 31.10%) compared to the non-variceal group. Jaundice, ascites, splenomegaly, low platelet count, and high INR all were predictors of variceal bleeding (p 〈 0.005). In the variceal group, 39 (97.5%) needed endo therapy compared to only 4 (8.9%) in the non-variceal group. Conclusions: Clinical and laboratory parameters differ significantly in the variceal and non-variceal groups which can guide the pre-endoscopic management of the patients.
    Materialart: Online-Ressource
    ISSN: 2645-8586 , 2631-2093
    URL: Article
    DOI: 10.3126/nmj.v5i1.44527
    Sprache: Unbekannt
    Verlag: Nepal Journals Online (JOL)
    Publikationsdatum: 2022
    Standort Signatur Einschränkungen Verfügbarkeit
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  • 2
    Online-Ressource
    Online-Ressource
    Upper Gastrointestinal Bleeding among Patients Admitted in Department of Emergency in a Tertiary Care Centre: A Descriptive Cross-sectional Study
    Journal of Nepal Medical Association (JNMA) ; 2022
    In:  Journal of Nepal Medical Association Vol. 60, No. 248 ( 2022-04-15), p. 360-363
    Details
    In: Journal of Nepal Medical Association, Journal of Nepal Medical Association (JNMA), Vol. 60, No. 248 ( 2022-04-15), p. 360-363
    Kurzfassung: Introduction: Upper gastrointestinal bleeding is a common medical emergency with significant morbidity and mortality. Its causes can be classified under variceal bleeding or non-variceal bleeding. Peptic ulcer and variceal bleeding are common causes. Thus, this study aims to find the prevalence of upper gastrointestinal bleeding among patients attending the Department of Emergency in a tertiary care centre. Methods: This was a descriptive cross-sectional study conducted on patients admitted to the Department of Emergency a tertiary care centre from September 2020 to August 2021 among 3375 patients. The ethical approval was obtained from the Institutional Review Committee of the hospital (Reference number: 328). Patients presenting with the clinical features of upper gastrointestinal bleeding in the form of hematemesis or melena were enrolled after written informed consent. Data entry was done in Statistical Packages for the Social Sciences version 20.0. for descriptive analysis. Point estimate at 95% Confidence Interval was calculated along with frequency and percentage for binary data. Results: Out of 3375 admissions in the Department of Emergency, 85 (2.52%) (1.99-3.05 at 95% Confidence Interval) patients presented with upper gastrointestinal bleeding. Conclusions: The prevalence of upper gastrointestinal bleeding is lower in comparison to other studies done in similar settings.
    Materialart: Online-Ressource
    ISSN: 1815-672X , 0028-2715
    URL: Article
    DOI: 10.31729/jnma.7409
    Sprache: Unbekannt
    Verlag: Journal of Nepal Medical Association (JNMA)
    Publikationsdatum: 2022
    ZDB Id: 2209910-4
    Standort Signatur Einschränkungen Verfügbarkeit
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  • 3
    Online-Ressource
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    An Echocardiographic Evaluation of Dilated Cardiomyopathy in a Tertiary Care Hospital
    Journal of Nepal Medical Association (JNMA) ; 2019
    In:  Journal of Nepal Medical Association Vol. 57, No. 215 ( 2019-02-28)
    Details
    In: Journal of Nepal Medical Association, Journal of Nepal Medical Association (JNMA), Vol. 57, No. 215 ( 2019-02-28)
    Kurzfassung: Introduction: Cardiomyopathies are diseases of heart muscle that may originate from genetic defects, cardiac myocyte injury or infiltration of myocardial tissues. Dilated cardiomyopathy is the most common phenotype and is often a final common pathway of numerous cardiac insults. Mostly it remains unknown in the absence of echocardiography, histopathology and genetic evaluation. Though common it is underdiagnosed with not much of data available in our setup.Methods: This study was analytical cross-sectional study of hospital data on Echocardiographic findings in 65 patients of DCM visiting cardiology unit for Echocardiographic evaluation from 1st of February to 31st July 2018 for the period of six months in Shree Birendra Hospital, a tertiary care military hospital at Chhauni, Kathmandu. Pediatric age group patients and those who refused to give consent were excluded. Data obtained were entered in Microsoft Excel 2010 and analyzed by IBM SPSS 21.Results: Among 65 patients enrolled 40 (61%) were male and 25 (39%) female with male to female ratio of 1.6:1. Elderly people (61-75 years) with an average age of 65 were commonly involved and they presented mostly with congestive heart failure, 32 (49%). Echocardiographic evaluation showed 36 (55%) with mildly dilated Left Ventricle (5.6-6.0cm). Majority had reduced Left ventricular systolic function with an average Ejection fraction (EF) of 39.6%. No significant difference between male and female with the average EF% (P=0.990) and there was no significant relation between age and average EF% (P=0.091).Conclusions: Dilated Cardiomyopathy is the commonest cardiomyopathy phenotype mostly presenting with congestive heart failure. It is often underdiagnosed in our part of the world, however echocardiography will easily detect the condition. Keywords: dilated cardiomyopathy; echocardiography; ejection fraction; left ventricle.
    Materialart: Online-Ressource
    ISSN: 1815-672X , 0028-2715
    URL: Article
    DOI: 10.31729/jnma.3992
    Sprache: Unbekannt
    Verlag: Journal of Nepal Medical Association (JNMA)
    Publikationsdatum: 2019
    ZDB Id: 2209910-4
    Standort Signatur Einschränkungen Verfügbarkeit
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  • 4
    Online-Ressource
    Online-Ressource
    Comparative Study of Colorectal Cancer Based on Tumor Location in Adolescent and Young Adult Population in Nepal
    Nepal Journals Online (JOL) ; 2020
    In:  Nepalese Medical Journal Vol. 3, No. 2 ( 2020-12-30), p. 370-374
    Details
    In: Nepalese Medical Journal, Nepal Journals Online (JOL), Vol. 3, No. 2 ( 2020-12-30), p. 370-374
    Kurzfassung: Introduction: Colorectal cancer in the Adolescent and Young Adult population are increasing and are characterized by a more advanced stage at diagnosis, poorer cell differentiation, higher signet ring histology, and left-sided colon location of the primary tumor. This study aims to compare colorectal cancer data in the Adolescent and Young Adult population-based on tumor location.Materials and Methods: This is a retrospective cross-sectional study of colorectal cancer in the Adolescent and Young Adult population from April 2017 to September 2020 in Shree Birendra Hospital. Data were collected for age, sex, clinical features, histology, TNM stage, colonoscopy finding, radiologic features, treatment, and follow-up status based on tumor location. Data were analyzed using Excel 2010 and SPSS v 17.Results: The total number of patients was 61 with the mean age of 32.36 ± 6.24 years. There was a male preponderance of 63.93%. Right-sided colorectal cancer was 24.59% while left-sided colorectal cancer was 75.41%. For right-sided colorectal cancers, the most common symptoms were pain abdomen (73.3%) and diarrhea (53.3%) while for left-sided colorectal cancers, it was pain abdomen (80.4%) and bleeding per rectum (45.7%). The most common histology was adenocarcinoma (95.08%) with moderately differentiated being most common in both locations. Surgery, radiation and chemotherapy for right-sided and left-sided colorectal cancer were 86.66%, 0.0%, 86.66% and 58.67%, 28.26%, 89.13% respectively.Conclusions: Left-sided colorectal cancer was more common in the Adolescent and Young Adult population in our study. There were signifi cant differences in the clinical presentation of colorectal cancer as per the tumor location.
    Materialart: Online-Ressource
    ISSN: 2645-8586 , 2631-2093
    URL: Article
    DOI: 10.3126/nmj.v3i2.33087
    Sprache: Unbekannt
    Verlag: Nepal Journals Online (JOL)
    Publikationsdatum: 2020
    Standort Signatur Einschränkungen Verfügbarkeit
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  • 5
    Online-Ressource
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    Ceftriaxone, ofloxacin or both in the treatment of enteric fever
    Nepal Journals Online (JOL) ; 2013
    In:  Medical Journal of Shree Birendra Hospital Vol. 12, No. 1 ( 2013-11-04), p. 37-40
    Details
    In: Medical Journal of Shree Birendra Hospital, Nepal Journals Online (JOL), Vol. 12, No. 1 ( 2013-11-04), p. 37-40
    Kurzfassung: Introduction: Enteric fever is a common diagnosis in febrile patients admitting to the hospital of Nepal. The treatment of enteric fever, though looks straightforward, in recent times has been complicated by emerging resistance to various antibiotics including fluoroquinolones and cephalosporins.Methods: This was a randomized clinical study done at Shree Birendra Hospital from January 2011 to December 2011. Patients with with high grade fever, headache, relative bradycardia, abdominal pain, diarrhoea  or constipation with normal to low leukocyte count were clinically diagnosed as Enteric fever and were randomized to either ofloxacin or ceftriaxone group, both well accepted first line treatment for enteric fever and observed for at least five days before the addition of the second drug that is ceftriaxone in ofloxacin group and ofloxacin in ceftriaxonegroup and the response to the drug was noted in terms of defervescence of fever.Results: Total 50 patients were enrolled, 25 in each treatment group. After five days, six patients in Ceftriaxone group needed addition of Ofloxacin and two patients in Ofloxacin group needed Ceftriaxone. The average fever defervescence time in Ceftriaxone group was 3.88 days and in Ofloxacin group was 3.04 days. All patients were afebrile by 9 days of antibiotics.Conclusions: Fever defervescence time with Ofloxacin was lesser than ceftriaxone group and need of supplementary antibiotic is lesser in ofloxacine group. So, ofloxacin can be recommended as 1st line drug for enteric fever.Medical Journal of Shree Birendra Hospital; January-June 2013/vol.12/Issue1/37-40DOI: http://dx.doi.org/10.3126/mjsbh.v12i1.9092         
    Materialart: Online-Ressource
    ISSN: 2091-0193 , 2091-0185
    URL: Article
    DOI: 10.3126/mjsbh.v12i1.9092
    Sprache: Unbekannt
    Verlag: Nepal Journals Online (JOL)
    Publikationsdatum: 2013
    ZDB Id: 3030595-0
    Standort Signatur Einschränkungen Verfügbarkeit
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  • 6
    Online-Ressource
    Online-Ressource
    The Prognostic Value of Initial Tumor Size in Patients with Ewing Family of Tumors
    Nepal Journals Online (JOL) ; 2015
    In:  Medical Journal of Shree Birendra Hospital Vol. 12, No. 2 ( 2015-07-11), p. 31-35
    Details
    In: Medical Journal of Shree Birendra Hospital, Nepal Journals Online (JOL), Vol. 12, No. 2 ( 2015-07-11), p. 31-35
    Kurzfassung: Introduction: Ewing Family of Tumors (EFT) is a high grade embryonic malignancy, common in children andyoung adults (CYAs). The prognostic factors include initial tumor volume, site, presence of metastasis, and theEWS/FLI 1 mutation. Low volume disease is known to result in higher response rates and longer survival times.Methods: Twelve patients with non-metastatic EFT were managed with the intensive Ewing Family Tumor(EFT 2001) protocol. The patient characteristics studied were - age, sex, site, number of sites involved,bone marrow involvement and size (volume). Tumor volume was measured in non-metastatic tumors by tridimensionalvolume in MRI scans.Results: Progression free survival (PFS) of patients with initial tumor volume ????100 cc ranged from 30 monthsto 74 months (mean 56.4 months) while that for 〉 100 cc ranged from 19 months to 79 months (mean 40months) (p value: 0.701). However there was trend towards better survival in patients with initial tumor volume????100 cc.Conclusions: There is a trend towards better PFS in patients with smaller tumor volume at presentation. Thusinitial tumor volume is a prognostic factor in Ewing family of tumors.doi:http://dx.doi.org/10.3126/mjsbh.v12i2.12925 
    Materialart: Online-Ressource
    ISSN: 2091-0193 , 2091-0185
    URL: Article
    DOI: 10.3126/mjsbh.v12i2.12925
    Sprache: Unbekannt
    Verlag: Nepal Journals Online (JOL)
    Publikationsdatum: 2015
    ZDB Id: 3030595-0
    Standort Signatur Einschränkungen Verfügbarkeit
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  • 7
    Online-Ressource
    Online-Ressource
    Acute intermittent porphyria presenting as recurrent limb weakness
    Nepal Journals Online (JOL) ; 2013
    In:  Medical Journal of Shree Birendra Hospital Vol. 11, No. 2 ( 2013-04-06), p. 44-45
    Details
    In: Medical Journal of Shree Birendra Hospital, Nepal Journals Online (JOL), Vol. 11, No. 2 ( 2013-04-06), p. 44-45
    Kurzfassung: Acute intermittent porphyria is a rare autosomal dominant condition of porphyrin metabolism resulting from the half-normal Hydroxy methyl bilane synthase activity. The disorder can present with protean manifestation ranging from acute abdomen, psychosis to gross peripheral neuropathy thus making the diagnosis challenging and misled most of the times. A case of Acute intermittent porphyria with extreme neurological involvement in form of acute onset quadriparesis is presented in this paper.Medical Journal of Shree Birendra Hospital; July-December 2012/vol.11/Issue2/44-45 DOI: http://dx.doi.org/10.3126/mjsbh.v11i2.7910 
    Materialart: Online-Ressource
    ISSN: 2091-0193 , 2091-0185
    URL: Article
    DOI: 10.3126/mjsbh.v11i2.7910
    Sprache: Unbekannt
    Verlag: Nepal Journals Online (JOL)
    Publikationsdatum: 2013
    ZDB Id: 3030595-0
    Standort Signatur Einschränkungen Verfügbarkeit
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  • 8
    Online-Ressource
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    Oral Cancer Awareness among Dental Patients
    Nepal Journals Online (JOL) ; 2021
    In:  Medical Journal of Shree Birendra Hospital Vol. 20, No. 2 ( 2021-09-06), p. 162-169
    Details
    In: Medical Journal of Shree Birendra Hospital, Nepal Journals Online (JOL), Vol. 20, No. 2 ( 2021-09-06), p. 162-169
    Kurzfassung: Introduction: The incidence of oral cancer in South Asian countries, including Nepal is increasing despite the fact that all of its risk factors are modifiable. This can be attributed to lack of awareness regarding oral cancer and its risk factors among general public. This study was conducted among subjects attending Dental OPD of a tertiary hospital to assess the knowledge and attitude regarding oral cancer and also practices of risk factors associated with it.  Methods: This is a questionnaire based cross-sectional study conducted from July 2020 to October 2020. Subjects attending Dental OPD of a tertiary hospital in Kathmandu were asked to fill a structured close-ended Questionnaire. Section one of the questionnaire focused on the demographic data of the subjects, second part elicited information pertaining to knowledge of oral cancer, third part focused on attitude and fourth part on practices of participants towards risk factors of oral cancer. Result: Out of 300 subjects, 65% were males. Most were in the age group 41 - 50 years and 75.6% were literate. Majority mentioned smokeless tobacco as the risk factor, followed by smoking and alcohol. Regarding signs and symptoms, most of the participants mentioned non-healing ulcer, followed by lump and pain. Most of the participants responded tongue as the most common site of oral cancer. Majority answered that oral cancer can be prevented by not chewing tobacco. Among the total, 55.3% said oral cancer is non-contagious. Only 25% had undergone oral examination in the last one year. 31.7% had habit of tobacco and / or alcohol. Conclusions: The awareness level and knowledge about risk factors and early signs of oral cancer in this cross-section of dental patients were satisfactory. Key words: awareness; oral cancer; risk factors; tobacco
    Materialart: Online-Ressource
    ISSN: 2091-0193 , 2091-0185
    URL: Article
    DOI: 10.3126/mjsbh.v20i2.33507
    Sprache: Unbekannt
    Verlag: Nepal Journals Online (JOL)
    Publikationsdatum: 2021
    ZDB Id: 3030595-0
    Standort Signatur Einschränkungen Verfügbarkeit
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  • 9
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    Online-Ressource
    Prevalence of Atrial Fibrillation in Patients with Ischemic Stroke and its Effect on Functional Outcome.
    Nepal Journals Online (JOL) ; 2015
    In:  Medical Journal of Shree Birendra Hospital Vol. 12, No. 2 ( 2015-07-11), p. 1-4
    Details
    In: Medical Journal of Shree Birendra Hospital, Nepal Journals Online (JOL), Vol. 12, No. 2 ( 2015-07-11), p. 1-4
    Kurzfassung: Introduction: Stroke is third most common cause of death worldwide characterized by rapidly progressiveclinical symptoms and signs of focal or global loss of cerebral functions. Among various risk factors, atrialÞ brillation is one which affects the functional outcome. The objective of this study was to Þ nd out the prevalenceof atrial Þ brillation in patients with ischemic stroke in Nepalese context and its effect on the functional outcomeusing modiÞ ed Barthel index.Methods: Cross sectional analytical study was conducted in a tertiary level hospital over a period of oneyear from July 2011 to June 2011. All the patients who were admitted with the diagnosis of ischemic strokeduring the study period were included in the study. Presence of atrial Þ brillation was conÞ rmed by 12 leadelectrocardiograms. The parameters of patients with and without atrial Þ brillation were compared.Results: Total of 75 cases of ischemic stroke was identiÞ ed, out of which nine had atrial Þ brillation in the ECGwhich makes a prevalence of 12%. Among 75 patients, 41% were female and 59% were male with the meanage of presentation was 63. Majority of patients (62.8%) were above 60 years of age. The functional severityas assessed from Barthel index (mean) was 36.11 and 55.83 respectively in those having ischemic stroke withatrial Þ brillation and without atrial Þ brillation with 88.9% of patients with AF below the score of 40 ( p 〈 0.0001).Conclusions: In our population, the prevalence of atrial Þ brillation in patients with ischaemic stroke is 12%and Barthel index of patiens with stroke and atrial Þ brillation is signiÞ cantly lower than the patients withoutatrial Þ brillation.doi: http://dx.doi.org/10.3126/mjsbh.v12i2.12916
    Materialart: Online-Ressource
    ISSN: 2091-0193 , 2091-0185
    URL: Article
    DOI: 10.3126/mjsbh.v12i2.12916
    Sprache: Unbekannt
    Verlag: Nepal Journals Online (JOL)
    Publikationsdatum: 2015
    ZDB Id: 3030595-0
    Standort Signatur Einschränkungen Verfügbarkeit
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  • 10
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    Online-Ressource
    Cardiotoxicity Caused by 5 Fluorouracil in a Patient with Adenocarcinoma of Colon
    Nepal Journals Online (JOL) ; 2013
    In:  Medical Journal of Shree Birendra Hospital Vol. 12, No. 1 ( 2013-11-04), p. 43-46
    Details
    In: Medical Journal of Shree Birendra Hospital, Nepal Journals Online (JOL), Vol. 12, No. 1 ( 2013-11-04), p. 43-46
    Kurzfassung: From the time of inception, various chemotherapeutic agents are known to cause cardiotoxicity. The cardiotoxicity ranges from mild transient abnormality to irreversible cardiac tissue damage. Certain classes of drugs like anthracyclines are known to be cardiotoxic while some newer drugs like Transtuzumab also cause cardiotoxicity. 5 Fluorouracil is known to be cardiotoxic though the incidence is low. We present a case of cardiotoxicity due to prolonged 5 Fluorouracil infusion in a patient with adenocarcinoma of colon.Medical Journal of Shree Birendra Hospital; January-June 2013/vol.12/Issue1/43-46DOI: http://dx.doi.org/10.3126/mjsbh.v12i1.9094           
    Materialart: Online-Ressource
    ISSN: 2091-0193 , 2091-0185
    URL: Article
    DOI: 10.3126/mjsbh.v12i1.9094
    Sprache: Unbekannt
    Verlag: Nepal Journals Online (JOL)
    Publikationsdatum: 2013
    ZDB Id: 3030595-0
    Standort Signatur Einschränkungen Verfügbarkeit
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