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  • 1
    Online Resource
    Online Resource
    A Rare Presentation of Orbital Roof Blow-out Fracture with Intact Vision
    Nepal Journals Online (JOL) ; 2019
    In:  Eastern Green Neurosurgery Vol. 1, No. 2 ( 2019-09-23), p. 32-33
    Details
    In: Eastern Green Neurosurgery, Nepal Journals Online (JOL), Vol. 1, No. 2 ( 2019-09-23), p. 32-33
    Abstract: The orbital blowout fracture is most common in its inferior and medial wall; however we are presenting here a rare case of superior orbital wall blowout fracture with intact vision. This is a presentation of a 55 year-old right handed gentleman following road traffic accident had left orbital injury causing orbital roof fracture. Despite of such a huge injury there was no deterioration of his vision and his movements of the eye balls were also absolutely preserved.
    Type of Medium: Online Resource
    ISSN: 2705-4489 , 2705-4470
    URL: Article
    DOI: 10.3126/egn.v1i2.25732
    Language: Unknown
    Publisher: Nepal Journals Online (JOL)
    Publication Date: 2019
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  • 2
    Online Resource
    Online Resource
    Persistent Mullerian Duct Syndrome with Polysplenia and Short Pancreas: A Case Report
    Journal of Nepal Medical Association (JNMA) ; 2019
    In:  Journal of Nepal Medical Association Vol. 57, No. 216 ( 2019-04-30)
    Details
    In: Journal of Nepal Medical Association, Journal of Nepal Medical Association (JNMA), Vol. 57, No. 216 ( 2019-04-30)
    Abstract: Persistent Mullerian duct syndrome is a rare entity and usually presents with common symptoms of undescended testis and hernia. The syndrome is caused by an insufficient amount of Mullerian inhibiting substance or due to the insensitivity of the target organ to Mullerian inhibiting substance. Polysplenia is a rare congenital disease manifested by multiple small accessory spleens. The association of these two entities is rare and has not been reported in the literature. We reported a case of a 27 years old male presented with complains of right flank pain and nausea. Ultrasound showed right ureteric calculus with hydronephrosis and elongated soft tissue mass posterior to bladder. Contrast enhanced Computed Tomography showed soft tissue suggestive of infantile uterine structure with multiple splenculi and short pancreas. He was diagnosed as Persistent Mullerian duct syndrome with unilateral cryptorchidism, polysplenia and short pancreas, coincidentally detected while evaluating for ureteric colic.
    Type of Medium: Online Resource
    ISSN: 1815-672X , 0028-2715
    URL: Article
    DOI: 10.31729/jnma.4298
    Language: Unknown
    Publisher: Journal of Nepal Medical Association (JNMA)
    Publication Date: 2019
    detail.hit.zdb_id: 2209910-4
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  • 3
    Online Resource
    Online Resource
    Recent developments, challenges and future prospects in advanced drug delivery systems in the management of tuberculosis
    Elsevier BV ; 2022
    In:  Journal of Drug Delivery Science and Technology Vol. 75 ( 2022-09), p. 103690-
    Details
    In: Journal of Drug Delivery Science and Technology, Elsevier BV, Vol. 75 ( 2022-09), p. 103690-
    Type of Medium: Online Resource
    ISSN: 1773-2247
    URL: Article
    DOI: 10.1016/j.jddst.2022.103690
    Language: English
    Publisher: Elsevier BV
    Publication Date: 2022
    detail.hit.zdb_id: 2542935-8
    SSG: 15,3
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  • 4
    Online Resource
    Online Resource
    A Prospective Study on the Outcome of Semi-Closed Neurointensive Care in A Tertiary Care Hospital Located in A Rural Area of Eastern Nepal: A Lower-Income Developing Country
    Nepal Journals Online (JOL) ; 2020
    In:  Eastern Green Neurosurgery Vol. 2, No. 3 ( 2020-09-24), p. 7-13
    Details
    In: Eastern Green Neurosurgery, Nepal Journals Online (JOL), Vol. 2, No. 3 ( 2020-09-24), p. 7-13
    Abstract: Background: High mortality and morbidity in neurological patients are found due to lack of closed ICU (Intensive Care Unit), neurointensivist, and training in neurocritical care in most of the developing countries. Therefore, this study was conducted to evaluate the outcome of the neurological patient managed by neurointensivist in a semi-closed ICU. Materials and methods: It was a prospective, descriptive observational cross-sectional study in a level three Neuro-intensive care unit of a tertiary care hospital of Eastern Nepal, for one year in 191 patients. All patients above 18 years admitted to the Neuro-intensive care unit were included in this study. Demographic data was collected for all patients at the time of presentation to the ICU. The outcome of the patient was defined as transferred to Neuro-Ward, leave against medical advice (LAMA), do not resuscitate (DNR) and death. Statistical analysis was done by using SPSS. The result was presented as frequency and percentage. Results: Out of 191 patients, Males (71.7%) was more common than females (28.2%). There were 107 (56%) patients were admitted after 24 hours of injury or illness. 28.2% of patients had a hemorrhagic stroke and was the most common diagnosis for admission in the ICU. This study showed that 58(82.72%) patients survived and were discharged, 23(12%) expired, 7(3.66%) went in LAMA) and 3(1.57%) gave do not resuscitate orders (DNR). Mean days on a mechanical ventilator was 3.17 ± 2.12 days. Mortality in the intubated patient was 19%. Conclusion: A semi-closed Neuro-intensive care unit that includes full-time neurointensivist may have a better outcome than the open ICU.
    Type of Medium: Online Resource
    ISSN: 2705-4489 , 2705-4470
    URL: Article
    DOI: 10.3126/egn.v2i3.31445
    Language: Unknown
    Publisher: Nepal Journals Online (JOL)
    Publication Date: 2020
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  • 5
    Online Resource
    Online Resource
    Types of Neurosurgical Patients Requiring Tracheostomy- Institution Based Study
    Nepal Journals Online (JOL) ; 2020
    In:  Eastern Green Neurosurgery Vol. 2, No. 1 ( 2020-01-29), p. 27-29
    Details
    In: Eastern Green Neurosurgery, Nepal Journals Online (JOL), Vol. 2, No. 1 ( 2020-01-29), p. 27-29
    Abstract:  Background and purpose: Tracheostomy is common surgical procedure among neurosurgical patients who are ventilater dependent for prolonged period of time in neuro ICU. With the objective to analyzed various type of neurosurgical patients requiring tracheostomy this study was performed. Material and method: This is a Crossectional , Analytical stydt with Non probability consecutive sampling over the duration of 2 years. Association between age vs categories of different pathologies and Gender is categories of different neurological pathologies were analysed using Chi square test/fishers exact test wherever applicable using SPSS20.  Result: There were total of 85 patients who underwent tracheostomy for various types of pathologies in our institute over the duration of two years. Mean age of patients who undergone tracheostomy was 45.26 ( SD 18.9) years and they ranged between 8 and 86 years. Among all these categories head injuries accounted for 45% of cases followed by ICH (28%).  Conclusion: Head Injury and intracerebral hemorrhage seems to be the common pathology requiring tracheostomy in tertiary neurosurgical centre. Young and male patients are more predominant in this study.
    Type of Medium: Online Resource
    ISSN: 2705-4489 , 2705-4470
    URL: Article
    DOI: 10.3126/egn.v2i1.27458
    Language: Unknown
    Publisher: Nepal Journals Online (JOL)
    Publication Date: 2020
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  • 6
    Online Resource
    Online Resource
    Massive Temporalis Muscle Swelling after Decompressive Craniectomy: Case Report
    Nepal Journals Online (JOL) ; 2020
    In:  Eastern Green Neurosurgery Vol. 2, No. 3 ( 2020-09-24), p. 32-34
    Details
    In: Eastern Green Neurosurgery, Nepal Journals Online (JOL), Vol. 2, No. 3 ( 2020-09-24), p. 32-34
    Abstract:  Background: Decompressive Craniectomy is a surgical procedure in neurosurgery to handle brain swelling subsequent to trauma, vascular insult, or tumor. There are different techniques and measurements of decompressive craniectomy performed worldwide. We follow the regular trauma flap involving fronto-temporo-parietal craniectomy. There have been many complications seen in these procedures, like brain herniation, malignant swelling, hydrocephalus, infection, etc. But we have encountered quite rare complications of decompressive craniectomy which had massive swelling of the temporalis muscle leading to significant mass effect and midline shift.
    Type of Medium: Online Resource
    ISSN: 2705-4489 , 2705-4470
    URL: Article
    DOI: 10.3126/egn.v2i3.31465
    Language: Unknown
    Publisher: Nepal Journals Online (JOL)
    Publication Date: 2020
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  • 7
    Online Resource
    Online Resource
    Successful Mechanical Thrombectomy of Middle Cerebral Artery Occlusion 14 Hours after Stroke Onset
    Nepal Journals Online (JOL) ; 2021
    In:  Eastern Green Neurosurgery Vol. 3, No. 01 ( 2021-08-08), p. 42-44
    Details
    In: Eastern Green Neurosurgery, Nepal Journals Online (JOL), Vol. 3, No. 01 ( 2021-08-08), p. 42-44
    Abstract: A 45-year-old patient with no significant past medical history presented to out-patient department with aphasia and right hand weakness with a National Institutes of Health Stroke Scale (NIHSS) of 10 and occlusion of the left middle cerebral artery (MCA) in the M1 segment. Last known normal time was 14hrs (wake up stroke). Immediate endovascular thrombectomy was performed 14 hours after symptom onset with complete recanalization and complete clinical recovery. Although mechanical thrombectomy is generally considered an effective alternative strategy up to 8 hours after stroke onset, selected patients with a large diffusion/perfusion mismatch and small infarct cores may benefit from an expanded therapeutic window.
    Type of Medium: Online Resource
    ISSN: 2705-4489 , 2705-4470
    URL: Article
    DOI: 10.3126/egn.v3i01.38980
    Language: Unknown
    Publisher: Nepal Journals Online (JOL)
    Publication Date: 2021
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  • 8
    Online Resource
    Online Resource
    MR Imaging Evaluation of Perianal fistulae
    Nepal Journals Online (JOL) ; 2022
    In:  Medical Journal of Eastern Nepal Vol. 1, No. 1 ( 2022-06-17), p. 1-6
    Details
    In: Medical Journal of Eastern Nepal, Nepal Journals Online (JOL), Vol. 1, No. 1 ( 2022-06-17), p. 1-6
    Abstract: Background: Perianal fistula is a troublesome condition both for patient and surgeon with significant morbidity and challenging treatment. MRI is considered as the technique of choice for preoperative evaluation of perianal fistulae, as it provides accurate anatomical information for appropriate surgical treatment, decreasing the incidence of recurrence and allowing side effects such as fecal incontinence to be avoided. The study aimed to describe the role of magnetic resonance imaging (MRI) in the diagnosis and classification of perianal fistulae. Methods: This retrospective study looked at 52 patients referred to the radiology department with a clinical diagnosis of perianal fistula. MRI grading of anal fistula done according to St. James’s University Hospital classification. Results: The MRI showed 46 internal openings in 44 patients; two patients had more than one. The internal opening was mostly at the 6 o’clock position in 59.9% patients, followed by 7 o’clock and 5 o’clock position in 11.3% of patients. According to the St. James’s University Hospital classification, 21 (47.7%) patients had grade 1, 11 (25%) patients had grade 2, 2 (4.5%) had grade 3, 7 (15.9%) had grade 4, and 4 (9%) had grade 5 fistulae. Twenty-five patients had associated abscesses. The most common location of the abscess was in the perianal region (8 patients). Conclusions: MR imaging examinations is a highly accurate imaging method for preoperative evaluation perianal fistula. It provides precise information of the fistulous track, along with its relationship to pelvic structures and plays crucial role for surgical planning.
    Type of Medium: Online Resource
    ISSN: 2822-2040 , 2822-2032
    URL: Article
    DOI: 10.3126/mjen.v1i1.45853
    Language: Unknown
    Publisher: Nepal Journals Online (JOL)
    Publication Date: 2022
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  • 9
    Online Resource
    Online Resource
    Universal Access to Essential Medicines: An Evaluation of Nepal’s Free Health Care Scheme
    Nepal Health Research Council ; 2018
    In:  Journal of Nepal Health Research Council Vol. 16, No. 1 ( 2018-03-18), p. 36-42
    Details
    In: Journal of Nepal Health Research Council, Nepal Health Research Council, Vol. 16, No. 1 ( 2018-03-18), p. 36-42
    Abstract: Background: Access to medicine for the poor is recognized to be difficult task and one of the major challenges in achieving universal health coverage, particularly in low-and- middle income countries. In order to ensure the availability of essential medicines free of cost in public health facilities, Nepal has also commenced Free Health Care Services (FHCS). So, this study aims to evaluate availability, expiry, and stock-out duration of essential medicines at front line service providers in Nepal.Methods: Cross-sectional survey was conducted 28 public health facilities, 7 district warehouses, and 14 private pharmacies in 7 districts of Nepal. The survey was conducted during the March and April 2014. Survey tools recommended by the WHO operational package for assessing, monitoring and evaluating country pharmaceutical situations was used with slight modification as per Nepal’s situation.Results: The availability of medicine was found to be 92.44% in this study. The percentage of expired medicines in district warehouse was found to be 8.40. The average stock-out duration in district warehouse was 0.324 days.Conclusions: Although the availability of essential medicines at peripheral health facilities was found to be satisfactory with lesser proportion of expired medicines, a strong monitoring and evaluation of expired and stock medicines are desirable to maintain and improve the access to essential medicines.
    Type of Medium: Online Resource
    ISSN: 1999-6217 , 1727-5482
    URL: Article
    DOI: 10.3126/jnhrc.v16i1.19361
    Language: Unknown
    Publisher: Nepal Health Research Council
    Publication Date: 2018
    detail.hit.zdb_id: 2551251-1
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  • 10
    Online Resource
    Online Resource
    Clival canal Angle and Basal Angle in Nepalese Population- A Computed Tomography Based Study
    Nepal Journals Online (JOL) ; 2020
    In:  Eastern Green Neurosurgery Vol. 2, No. 3 ( 2020-09-24), p. 25-28
    Details
    In: Eastern Green Neurosurgery, Nepal Journals Online (JOL), Vol. 2, No. 3 ( 2020-09-24), p. 25-28
    Abstract: Background: Clival canal angle is an angle formed by the clivus and the posterior longitudinal ligament of the cervical spine and Welcher basal angle formed between the line joining the nasion to tuberculumSella and the line joining the tuberculum sellae to basion along the plane of clivus. With the aim to review the normal distribution of clival canal angle and basal angle in the Nepalese population this study was performed. Methods and materials: This is a cross-sectional analytical study with non- probability consecutive sampling technique done over the duration of 3 months. A reconstructed image of a bone window in the midsagittal plane was selected and measurement of the angles was done in CT console. Results: There was a total of 60 patients in this study with male predominance (figure 3). The mean age of the population was 49.8 (SD 18.8) years. The clival canal angle reference range was 130.8 to 168.8 degrees with a mean 149.8(SD 9.5) degree. Similarly, the reference range of Welcher basal angle in the study population was 115.49 to 140.29 degree with a mean of 127.89(SD: 6.4) degrees. Conclusion: The mean clival canal angle in the Nepalese population is 149.8 (SD: 9.5) degrees and the mean basal angle is 127.89(SD: 6.4) degree.
    Type of Medium: Online Resource
    ISSN: 2705-4489 , 2705-4470
    URL: Article
    DOI: 10.3126/egn.v2i3.31454
    Language: Unknown
    Publisher: Nepal Journals Online (JOL)
    Publication Date: 2020
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