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  • 1
    Online Resource
    Online Resource
    Inflammatory myo-fibroblastic tumor of appendix: A rare clinical entity
    Elsevier BV ; 2021
    In:  International Journal of Surgery Case Reports Vol. 89 ( 2021-12), p. 106607-
    Details
    In: International Journal of Surgery Case Reports, Elsevier BV, Vol. 89 ( 2021-12), p. 106607-
    Type of Medium: Online Resource
    ISSN: 2210-2612
    URL: Article
    DOI: 10.1016/j.ijscr.2021.106607
    Language: English
    Publisher: Elsevier BV
    Publication Date: 2021
    detail.hit.zdb_id: 2558001-2
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  • 2
    Online Resource
    Online Resource
    A Huge Mesenteric Lymphangioma Presenting as a Small Bowel Volvulus in a Paediatric Patient: A Case Report
    Hindawi Limited ; 2022
    In:  Case Reports in Pathology Vol. 2022 ( 2022-5-17), p. 1-5
    Details
    In: Case Reports in Pathology, Hindawi Limited, Vol. 2022 ( 2022-5-17), p. 1-5
    Abstract: Lymphangioma is a benign tumor characterized by proliferation of thin-walled lymphatic spaces. Lymphangioma of the small-bowel mesentery is rare, with an incidence of 1 : 250,000, representing less than 1% of all lymphangiomas. The predilection of the tumor is in the head and neck (70%), axillary (20%), and internal organs (10%). They are usually asymptomatic but can cause acute abdominal symptoms due to complications such as volvulus, bleeding, or lymphangioma rupture that require emergent surgery. Here, we report a case of mesenteric lymphangioma (ML) of a small bowel in a paediatric patient who presented with pain abdomen on and off which increased in severity and later had features of subacute intestinal obstruction. He underwent explorative laparotomy, and the mass was excised completely along with the part of small intestine. Pathological analysis of the surgical specimen confirmed the diagnosis of ML of the small intestine. The postoperative recovery was uneventful, and the patient was discharged after ten days of hospital stay. Though benign in nature, ML may cause acute abdominal symptoms that require emergent surgery. Therefore, it has to be kept in differential diagnosis of the acute abdominal condition.
    Type of Medium: Online Resource
    ISSN: 2090-679X , 2090-6781
    URL: Article
    DOI: 10.1155/2022/3033705
    Language: English
    Publisher: Hindawi Limited
    Publication Date: 2022
    detail.hit.zdb_id: 2648758-5
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  • 3
    Online Resource
    Online Resource
    Clinicopathological profile of colorectal carcinoma in a tertiary care teaching hospital in Pokhara, Nepal
    Nepal Journals Online (JOL) ; 2021
    In:  Journal of Gandaki Medical College-Nepal Vol. 14, No. 1 ( 2021-07-03), p. 14-18
    Details
    In: Journal of Gandaki Medical College-Nepal, Nepal Journals Online (JOL), Vol. 14, No. 1 ( 2021-07-03), p. 14-18
    Abstract: Introduction: Colorectal cancer is the most common malignancy of the gastrointestinal tract. They are common after 50 years of age and present with bleeding per rectum, altered bowel habits, anemia, pain abdomen, and weight loss. The objective of this study was to evaluate the demographic profile, clinical presentation, colonoscopy and histopathology findings of colorectal cancer. Methods: A descriptive cross-sectional study was conducted. Cases were studied from the departmental records. Clinical presentation, CT abdomen, colonoscopy, and histopathology findings of colorectal carcinoma were studied. Data entry was done in SPSS version 20. Results: The mean age of subjects was 56 ± 11.42 years (range of 34 – 80 years) with male predominance (M: F=3:2). Changes in bowel habits (92.3%), chronic abdominal pain (84.6%), generalized weakness (80.7%), rectal bleeding (46.2%), and significant weight loss (42.3%) were the most common presenting symptoms. Rectal carcinoma was the most common (35%) followed by carcinomas of ascending colon (14%) and descending colon (10 %). The most common morphology was proliferative growth (61.5%). All colorectal carcinomas were adenocarcinoma, and the majority was moderately differentiated (51.9%). Conclusion: Colorectal cancers are seen above 50 years of age and common in males. Changes in bowel habits, chronic abdominal pain, generalized weakness, rectal bleeding, and weight loss are the most common form of presentations. These patients usually present late with advanced disease and unfavorable histopathology. Screening colonoscopy 〉 50 years is strongly recommended.
    Type of Medium: Online Resource
    ISSN: 2070-4259 , 2070-4240
    URL: Article
    DOI: 10.3126/jgmcn.v14i1.30966
    Language: Unknown
    Publisher: Nepal Journals Online (JOL)
    Publication Date: 2021
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  • 4
    Online Resource
    Online Resource
    Intestinal stomas: A clinical study in a Teaching Hospital, our experience
    Nepal Journals Online (JOL) ; 2020
    In:  Journal of Kathmandu Medical College Vol. 9, No. 1 ( 2020-03-31), p. 37-42
    Details
    In: Journal of Kathmandu Medical College, Nepal Journals Online (JOL), Vol. 9, No. 1 ( 2020-03-31), p. 37-42
    Abstract: Background: An intestinal stoma is an opening of the intestine on anterior abdominal wall made with an intention of either decompression of an obstructed colon or diversion of stool. Intestinal stomas may be temporary or permanent, depending on their role.   Objectives: The objective of this study was to determine the common indications and types of intestinal stomas, and outcomes of patients operated at Manipal Teaching Hospital, Pokhara, Nepal. Methodology:  A retrospective cross-sectional study was conducted in 105 patients of intestinal stomas from February 2017 to March   2020 in a teaching hospital after approval from institutional review committee. Data were derived from medical records of patients and operation logbooks with the consecutive sampling method. Data were analyzed with the help of the Statistical Package for Social Sciences (SPSS) version20 and p value 〈 0.05 was considered significant.  Results: Total of 105 patients with intestinal stomas was included for the study of which 82.9% (n=63) were emergency operations and 17.1% (n=13) were elective. There were 46 (43.80%) cases of ileostomy, 9(8.5%) jejunostomy and 50(47.6%) colostomy patients. Major indications of stoma formation were trauma 33.3% (n=35) and intestinal obstruction 22.8% (n=24). Complications were observed in 39 (37.14%) of the patients, with wound infection 11.8% (n=9) and peristomal dermatitis 11.8% (n=9) for ostomates being the commonest. Higher complications were seen with ileostomy as compared to colostomy (p=0.02) and loop ileostomy still higher than end ileostomy (p=0.00).  Conclusion: Common indications for intestinal stomas were abdominal trauma, enteric perforation, intestinal obstruction and colorectal carcinoma. Main complications included local skin problems, wound infection and retraction.
    Type of Medium: Online Resource
    ISSN: 2091-1793 , 2091-1785
    URL: Article
    DOI: 10.3126/jkmc.v9i1.33543
    Language: Unknown
    Publisher: Nepal Journals Online (JOL)
    Publication Date: 2020
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  • 5
    Online Resource
    Online Resource
    The Role of Computed Tomography in Blunt Abdominal Trauma
    Journal of Nepal Medical Association (JNMA) ; 2015
    In:  Journal of Nepal Medical Association Vol. 53, No. 200 ( 2015-12-31), p. 227-230
    Details
    In: Journal of Nepal Medical Association, Journal of Nepal Medical Association (JNMA), Vol. 53, No. 200 ( 2015-12-31), p. 227-230
    Abstract: Introduction: Blunt injury trauma is regularly encountered in the emergency department. Diagnostic tools that help in optimum management of blunt abdominal trauma include; Focussed Assessment Sonography for Trauma scan, Diagnostic peritoneal lavage and Computed Tomography scan. The aim of this study is to determine the validity of CT scan as an accurate diagnostic tool and its role in management of patients with blunt abdominal trauma. Methods: A prospective analysis of 80 patients of blunt abdomen trauma who were admitted in Manipal Teaching Hospital, Pokhara, Nepal within a span of 15 months was done. Demographic data, mechanism of trauma, management and outcomes were studied. Organ injuries were graded using the Organ Injury Scale guidelines. Results: Most of the patients in our study were in the age group of 21-40 years with an M: F ratio of 2.3:1. Road traffic accident (47.5%) was the most common mechanism of injury. Spleen (27.5%) was the commonest organ injured. CT scan was superior to FAST scan and had sensitivity of 97.3% specificity 75% positive predictive value 98.6%. FAST scan had sensitivity of 78.9%, specificity 50%, positive predictive value 96% with p- value of 0.0034. 81% of patients were conservatively managed. Conclusions: In conjunction with close clinical monitoring, CT scan is reliable in the evaluation and management of blunt abdominal trauma patients. Our study also shows CT as a superior diagnostic modality compared to FAST scan. Keywords: blunt abdominal trauma; CT scan; FAST scan; road traffic accident.
    Type of Medium: Online Resource
    ISSN: 1815-672X , 0028-2715
    URL: Article
    DOI: 10.31729/jnma.2735
    Language: Unknown
    Publisher: Journal of Nepal Medical Association (JNMA)
    Publication Date: 2015
    detail.hit.zdb_id: 2209910-4
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  • 6
    Online Resource
    Online Resource
    Cancellation of Elective General Surgical Operations on the Day of Surgery
    Nepal Health Research Council ; 2020
    In:  Journal of Nepal Health Research Council Vol. 18, No. 2 ( 2020-09-07), p. 201-204
    Details
    In: Journal of Nepal Health Research Council, Nepal Health Research Council, Vol. 18, No. 2 ( 2020-09-07), p. 201-204
    Abstract: Background: Unanticipated cancellation of scheduled elective operations decreases theatre efficiency and is inconvenient to the patients, their families and the medical teams. It creates logistic and financial burden associated with extended hospital stay and repetitions of pre-operative preparations. The aim of this study is to determine the incidence and causes of cancellation of surgical operations in our centre and make recommendations to reduce it.Methods: This was a prospective cross-sectional study carried out over a period of one year in Manipal Teaching Hospital, Pokhara from July 12017 to June 2018. Consecutive sampling method was used. All patients booked for elective surgical procedures were enrolled in the study. The age, gender, diagnosis, proposed surgery and reasons for cancellation were documented and analysed.Results: A total of 794 patients were scheduled for elective surgical operations during the study period and 86 (10.83%) patients’ operations were cancelled. There were 54(62.79%) males and 32 (37.20%) females. Recent change in the medical status of the patient (n=18; 20.9%) was the main reason for cancellation of operation followed by overbooking (n=11; 12.7%), change in plan of management (n=9,10.4%).Conclusions: Avoidable factors are mainly responsible for cancellation of surgeries. Efficient management, pre-operative assessment, utilization of the few available hospital resources, improvement in communication between medical teams and patients would reduce the rate of cancellation of booked surgical procedures.Keywords: Cancellation; efficient management; elective operation.
    Type of Medium: Online Resource
    ISSN: 1999-6217 , 1727-5482
    URL: Issue
    URL: Article
    DOI: 10.33314/jnhrc.v18i2
    DOI: 10.33314/jnhrc.v18i2.1951
    Language: Unknown
    Publisher: Nepal Health Research Council
    Publication Date: 2020
    detail.hit.zdb_id: 2551251-1
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  • 7
    Online Resource
    Online Resource
    Postoperative Surgical Site Infections in the Department of General Surgery of 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. 249 ( 2022-05-05), p. 439-443
    Details
    In: Journal of Nepal Medical Association, Journal of Nepal Medical Association (JNMA), Vol. 60, No. 249 ( 2022-05-05), p. 439-443
    Abstract: Introduction: Surgical site infection is defined by the Centres for Disease Control and Prevention as a wound infection that occurs within 30 days of an operative procedure or within a year if an implant is left in place and the infection is thought to be secondary to surgery. It occupies 20% to 39% of all the infections acquired in hospitals. The aim of this study is to find out the prevalence of postoperative surgical site infections in the Department of General Surgery of a tertiary care centre. Methods: A descriptive cross-sectional study on a total of 384 post-operative patients of abdominal surgery was conducted in the Department of General Surgery of a tertiary care centre from August 1, 2020 to July 30, 2021 with ethical approval from the Institutional Review Committee (Reference number: 267). Convenience sampling was done. Post-operative patients fulfilling the inclusion and exclusion criteria were included in the study. Data were entered in Microsoft Excel and analyzed using the Statistical Package for the Social Sciences version 21.0. Point estimate was done at a 95% Confidence Interval along with frequency and percentages for binary data and mean with standard deviation for continuous data. Results: Among 384 patients, the prevalence of surgical site infection was found to be 65 (16.92%) (13.15-20.65 at a 95% Confidence Interval). The patients had a mean age of 42.06±21.92 years. Conclusions: The prevalence of surgical site infection was higher in our study in comparison to other similar studies conducted in similar settings.
    Type of Medium: Online Resource
    ISSN: 1815-672X , 0028-2715
    URL: Article
    DOI: 10.31729/jnma.7316
    Language: Unknown
    Publisher: Journal of Nepal Medical Association (JNMA)
    Publication Date: 2022
    detail.hit.zdb_id: 2209910-4
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  • 8
    Online Resource
    Online Resource
    Magnetic Resonance Imaging Findings in Spondylodiscitis
    Nepal Health Research Council ; 2018
    In:  Journal of Nepal Health Research Council Vol. 15, No. 3 ( 2018-01-01), p. 217-221
    Details
    In: Journal of Nepal Health Research Council, Nepal Health Research Council, Vol. 15, No. 3 ( 2018-01-01), p. 217-221
    Abstract: Background: Magnetic Resonance Imaging is the imaging modality of choice for imaging spinal infection due to its high sensitivity and specificity. This study aims to study the magnetic resonance imaging changes in patients with spondylodiscitis.Methods: The study was a retrospective study carried in a multimodality imaging centre in Kathmandu. Magnetic resonance imaging records and clinical record of 3 years duration were reviewed and patients with clinical and radiological diagnosis of spondylodiscitis were included in the study. Three radiologists interpreted Magnetic Resonance Imaging with mutual consensus in disputed issues. Data analysis was done with Statistical Package for Social Sciences21.0.Results: A total of 52 patients were included in the study. The mean age of the patients was 43.9 ± 17.6 years. Spondylodiscitis involved lumbar spine in 26(50%) case, cervical and thoracic spine in 13(25%) cases each. Multiple IV discs were involved in 24(46.2%) cases, which was most common in cervical spine and least common in thoracic spine. Only one vertebral end plate was involved in 16(30.8%) cases. Epidural collection was seen in 23(44.2%) cases and paravertebral collection was noted in 63(33.5%) cases. Statistical significant difference in region of spine involved (p=0.02) and epidural collection (p=0.04) was noted between genders.Conclusions: Lumbar spine was the most common level involved with spondylodiscitis, perivertebral enhancing soft tissue was present in all cases, and involvement of disc and the endplates were the most common pattern.
    Type of Medium: Online Resource
    ISSN: 1999-6217 , 1727-5482
    URL: Article
    DOI: 10.3126/jnhrc.v15i3.18843
    Language: Unknown
    Publisher: Nepal Health Research Council
    Publication Date: 2018
    detail.hit.zdb_id: 2551251-1
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  • 9
    Online Resource
    Online Resource
    Screening and characterization of potent poly glutamic acid producing Bacillus sp. isolated from Kinema, water and soil samples
    Elsevier BV ; 2021
    In:  Heliyon Vol. 7, No. 8 ( 2021-08), p. e07715-
    Details
    In: Heliyon, Elsevier BV, Vol. 7, No. 8 ( 2021-08), p. e07715-
    Type of Medium: Online Resource
    ISSN: 2405-8440
    URL: Article
    DOI: 10.1016/j.heliyon.2021.e07715
    Language: English
    Publisher: Elsevier BV
    Publication Date: 2021
    detail.hit.zdb_id: 2835763-2
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  • 10
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    Online Resource
    Microbial quality of poultry meat in an ISO 22000:2005 certified poultry processing plant of Kathmandu valley
    Springer Science and Business Media LLC ; 2019
    In:  International Journal of Food Contamination Vol. 6, No. 1 ( 2019-12)
    Details
    In: International Journal of Food Contamination, Springer Science and Business Media LLC, Vol. 6, No. 1 ( 2019-12)
    Abstract: Poultry meat can be contaminated by different types of microorganisms during processing in processing plant. The microbiological quality of chicken carcasses and along with processing steps and environmental condition was analyzed in this study in an ISO 22000:2005 certified poultry processing plant of Kathmandu. Standard plate count method was applied for the enumeration and detection of total mesophilic bacteria, total coliform, total faecal coliform, Staphylococcus load along with selected pathogens like Salmonella spp., S. aureus , Escherichia coli , Clostridium perfringens , and Listeria spp. in chicken meat at four processing step (evisceration, final washing, frozen and market). It was observed that the level of microbial load decreased with subsequent processing phases in poultry processing plant where high level of bacteria were reduced during final washing and frozen phase. After processing poultry meat in an ISO 22000:2005 certified meat processing plant, total aerobic mesophilic count, total coliform count, total faecal coliform count, total Staphylococcus count were decreased from 6.92 to 4.45 log CFU/g, 3.49 to 2.19 log CFU/g, 2.41 to nil log CFU/g, and 3..43 to 1.99 log CFU/g respectively. Pathogenic bacteria like Salmonella spp., C. perfringens , and Listeria spp. were absent in chicken meat at the fourth processing step. Prevalence of E. coli was reduced from 37.4% to 10.2%, whereas S. aureus was decreased from 18.57% to 17.1%. It was concluded that the final washing and freezing steps were the Critical Control Point (CCP) to control microbial hazards in poultry processing phase.
    Type of Medium: Online Resource
    ISSN: 2196-2804
    URL: Article
    DOI: 10.1186/s40550-019-0078-5
    Language: English
    Publisher: Springer Science and Business Media LLC
    Publication Date: 2019
    detail.hit.zdb_id: 2798646-9
    detail.hit.zdb_id: 3149513-8
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