Nepal Medical College Journal

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Epigastric mass in a young girl: trichobezoar. Imaging diagnosis.
(2006-09-06) Sharma, Umesh Kumar; Sharma, Yubaraj; Chhetri, Raj Kumar; Makaju, Ram Kantha; Chapagain, Suman; Shrestha, Rohit
A 16-year old girl presented with a history of abdominal pain, lump in epigastrium since one year. The ultrasound examination showed an epigastric mass, which was delineated as a filling defect in the stomach on barium studies. Upper GI endoscopy showed a large intragastric mass composed of hair. The CT scan showed a gastric mass extending to the duodenum. She was managed by surgical removal. A large gastric trichobezoar extending upto the jejunum was found. This case highlights the characteristic radiological appearance on barium, ultrasound and computed tomography of a bezoar within the stomach and a trichobezoar with a long tail extending upto the jejunum without intestinal obstruction is unusual.
A study on efficacy of lamivudine therapy in decompensated cirrhosis of liver due to chronic hepatitis B virus infection.
(2004-12-22) Sharma, Yuba Raj; Miah, Abdur Rahim; Saha, Sushen Kumar; Mohammed, Samsuddin; Rahman, Mijanur; Roy, Projesh Kumar; Hasan, Mahamud
The prognosis of decompensated cirrhosis of liver resulting from chronic Hepatitis B Virus (HBV) infection is poor and liver transplantation is the only established mode of treatment. The benefits of treatment with interferon are outweighed by serious side effects and risks of fatal exacerbation of disease activity. Lamivudine rapidly reduces hepatitis B viral DNA in serum to undetectable levels. The purpose of this study was to evaluate effectiveness and safety of Lamivudine treatment in patients with advanced and end stage liver disease caused by Hepatitis B. This was a prospective observational study in which a total of 45 patients, 39 (87.0%) male and 6 (13.0%) female who had viral activity and child pugh score e" 8 were given Lamivudine 100 mg orally once daily. Among them 30 patients completed at least 6 months of therapy, majority (27 patients) showed improvement in liver function with decrease in serum ALT from mean (+/- SD) 118.8 +/- 106.5 to 50.2 +/- 57.1 U/L (p < 0.001), decrease in serum bilirubin from 73.9 +/- 80.5 to 44.7 +/- 62.9 micromol/l (p = 0.129), increase in serum albumin from 26.2 +/- 4.2 to 33.2 +/- 3.4 g/l (p < 0.05), decrease in prothrombin time from 8.3 +/- 4.0 to 3.9 +/- 2.9 seconds prolonged (p < 0.05) and reduction in child pugh score from 11.0 +/- 1.7 to 7.0 +/- 1.3 (p < 0.001). Seroconversion was found in 5 (11.1%) patients on Intention to treat analysis. Among the seroconverted group, 1 (2.2%) patient also lost HBsAg. Six (13.0%) patient had procore mutant virus, 2 (4.4%) of them showed virological response. Therefore, total 7 (15.5%) patients showed virological response by intention to treat analysis. We conclude that inhibition of viral replication with Lamivudine results in a significant improvement of liver function in patients with decompensated cirrhosis of liver due to HBV infection.
The prevalence of type 2 diabetes mellitus and impaired fasting glucose in semi-urban population of Nepal.
(2007-09-21) Ono, Kazuo; Limbu, Yuba Raj; Rai, Shiba Kumar; Kurokawa, Manabu; Yanagida, Jun-Ichiro; Rai, Ganesh; Gurung, Numaya; Sharma, Madhusudan; Rai, Chandra Kala
The increase in life expectancy in developing countries and as a result of increasing obesity and other life style changes, the global incidence of type 2 diabetes mellitus (T2DM) is increasing. The purpose of this study was to investigate the prevalence of T2DM and impaired fasting glucose (IFG) in semi-urban population of Nepal and to compare the prevalence between men and women and among different age groups. A total 740 adults (286 men and 454 women) aged 21 to 94 years (men +/- SD; 45.6 +/- 15.6 years) were included. The prevalence of T2DM and IFG was 9.5% and 19.2% in the whole population. Prevalence of T2DM was higher in men (11.8%) then in women (7.9%), similarly IFG was noted higher in men (25%) then in women (15.4%0). The prevalence of T2DM and IFG was seen to be increased with age in the whole population. Among women, the prevalence of T2DM and IFG was 2.9% and 12.8% in 21 to 40 years age group, 9.7% and 13.8% in 41 to 60 years age group and 15.4% and 27.7% in > 60 years age group. Among men, it was 4.7% and 22.6% in 21 to 40 years age group, 13.3% and 30.5% in 41 to 60 years age group and 23% and 17.3% in > 60 years age group. To conclude, the overall prevalence of T2DM and IFG increases with age. Prevalence of IFG is highest among middle age men where as the prevalence of T2DM is highest among older men.
A study of antibiotics used in adult respiratory disorders in Kathmandu and Bhaktapur.
(2007-06-29) Pradhan, Serena; Jauhari, Akhilesh Chandra
Respiratory tract infections (RTI) are one of the major causes of morbidity and mortality, in Nepal, because of the climate, living conditions and economic status of the people. This study was done to find out the pattern of respiratory tract infections in adults and pattern of antibiotics (AB) prescribed in them and to explore the most economical treatment of patients without compromising the quality of it. Three hospitals of Kathmandu valley and two hospitals of Bhaktapur were selected. Out of 118 patients of RTI in which AB were prescribed, 110 patients were randomly selected in this study. Among them 53.6% were male and 46.4% were female, 43.7% patients were smokers and 56.3% were non-smokers. The average costs of treatment of upper respiratory tract infections (URTI) were lower then lower respiratory tract infections (LRTI). The cost of treatment of chronic respiratory cases was highest.
Intramuscular ketamine pre-medication to separate children from their parents.
(2005-12-08) Bhatt, Shrikrishna; Neupane, Bhusan
Total of 68 cases (children of age ranging from 1-10 years) were analyzed to see the effect of intramuscular ketamine to separate them from their parents. Every case was injected ketamine 5mg/kg of body weight and atropine 0.02mg/kg of body weight. The result showed 56 (82.4%) of the cases to be asleep, 10 (14.7%) of the cases calmly separated, 2 (2.9%) of the cases sedated but tearing and none of them was found difficult to separate from the parents. Tolerance of face mask and IV opening showed, 60 (88.24%) of the cases easily tolerated the face mask and IV opening, 6 (8.8%) of the cases slightly moved and 2 (2.9%) of the cases had to be held by assistant during application of face mask and IV opening. The pulse rate slightly increased after 5 minutes of pre-medication and slowed down after 10 minutes more or less to the baseline, and after 15 minutes pulse rate slightly dropped beyond the base line showing that patients were more haemodynamically stable. As pulse rate before pre-medication was found slightly higher than after 15 minutes of pre-medication it may due to apprehension and anxiety. Average time taken to separate the patients was 7.1 minutes (Range, 5 to 10 minutes) which is very convenient for conducting the operation in time. From this study it was concluded that Intramuscular Ketamine for pre-medication in children to separate from the parents is effective, takes less time, keeps the patients haemodynamically stable and is very safe.
Gender difference in socio-epidemiological factors for leprosy in the most hyper-endemic district of Nepal.
(2004-12-22) Kumar, Rajendra; Singhasivanon, Pratap; Sherchand, Jeevan Bahadur; Mahaisavariya, Punkae; Kaewkungwal, Jaranit; Peerapakorn, Somchai; Mahotarn, Krisada
Leprosy which has caused stigma and social ostracism for millennium is nearing elimination worldwide as a public health problem, but the leprosy burden in Nepal is still 4.4 times greater than WHO's target level of less than one case per 10,000 population. Although leprosy affects both the sexes, in most parts of the world males are affected more than females at a ratio of 2:1. The general objective of the study was to investigate the gender difference in socio-epidemiological factors for leprosy. The analytic cross-sectional study was carried out in one of the most hyper endemic district- Dhanusa district of Nepal. Stratified random sampling method was applied for the selection of the patients. Chi-square/Fisher's exact test was applied to assess statistically significant differences in values between males and females. There were 580 leprosy patients (385 male and 195 female) aged above 15 years registered for multi drug therapy between April 1, 2001 to March 31,2002 in the 16 main health centers of the district. Out of 580 patients, 273 patients (183 males and 90 females) were included in the study in order to collect the data on socio-demographics, patient's knowledge on leprosy, treatment seeking behaviour, and social problems faced by the patients. Data were collected using a structured interview schedule. The mean age of the male patients was 45.1 years (range 15-77 years) and female patients were 40.3 years (range 15-75 years). Among male patients 93.4% were married while among female patients 70.0% were married. Among male patients 51.9% were illiterate whereas 71.1% were illiterate among female patients. Most of the patients (69.6%) lived in joint family and the rest in nuclear family. Among male patients, 86.9% had good knowledge about the disease compared to 73.3% among females. This study showed that among the female patients 12.2% were facing high level of social problems, while among male patients only 4.4% were facing the same. About 15% patients had poor treatment seeking behaviors (8.2% among males and 27.8% among females). A significant gender differences among leprosy patients have been found in age distribution, educational status, marital status, caste types, family members, and overall knowledge on the general aspect of leprosy, social problems faced by the patients and treatment seeking behaviour.
Study habits and attitude of medical students of basic sciences.
(2007-06-29) Dhungel, Kshitiz Upadhyay; Prajapati, Rajesh; Pramanik, Tapas; Ghosh, Arijit; Roychowdhury, Paresh
Study habits and attitude for learning of Basic Medical Sciences amongst 133 students of first and second year MBBS course were analyzed (through questionnaires). The study revealed that the most of the students desired to be physicians to serve the patient/society. They preferred to learn more through self study (48.0%) and lecture classes (43.0%), less through group discussion (8.0%) and PBL (1.0%). Only 5.0% use to surf the internet regularly for their study matter and 79.0% students had never consulted any medical journals.
Visual status of Nepalese national football and cricket players.
(2006-12-16) Sapkota, Kishor; Koirala, Shashank; Shakya, Suraj; Chaudhary, Meenu; Paudel, Prakash
This study was undertaken to assess the visual acuity, refractive status, stereopsis, colour vision and ocular morbidity of Nepalese national footballers and cricketers. Ninety-five national football and cricket players of different age group, who had at least played one international tournament representing Nepal, were included in the study. A thorough ocular examination of the players was done in the study period of six months, which revealed that higher-level professional players have significant visual problems. Among the players 70.0% had never had complete ocular examination, 8.0% were found with refractive error, 60.0% with stereo acuity equal or less than 40" of arc and 65.0% with ocular complaints.
LH/FSH ratio: a better marker of secondary amenorrhea in patients from eastern Nepal.
(2007-09-21) Lamsal, Madhab; Pokhrel, Subarna; Mahato, Ram Vinod; Baral, Nirmal; Upreti, Dhruba; Sridhar, Magadh Gopal
FSH, LH and prolactin (PRL) levels were assessed by ELISA in 50 cases with secondary amenorrhea and 52 age and sex-matched healthy controls from eastern Nepal. Cases were diagnosed by differential diagnosis, and data were analyzed using standard statistical tools. Early stage (3-6 months) and long standing (> 6 months) secondary amenorrhea had no effect (p > 0.05) in hormonal parameters studied. Pulse, SBP, DBP, weight, height, age of menarche, cycle interval and duration of flows were homogenous (p > 0.05) in patients and controls. Median age of menarche, median cycle interval and median duration of flows in healthy subjects were 14 years, 30 and 4 days respectively. FSH in cases (15.38 +/- 7.24 mU/ml) was significantly elevated (p < 0.01) as compared to controls (9.38 +/- 6.34 mU/ml). LH in cases (35.44 +/- 24.35 mU/ml, median 36.5 mU/ml) was significantly (p < 0.01) elevated by almost 5 times of its mean value and 9 times of its median value as compared to that of controls (7.58 +/- 6.604 mU/ml, median 4.2 mU/ml). LH/ FSH ratio in cases (2.44 +/- 1.73, median 2.00) was significantly higher (p < 0.01) as compared to controls (0.82 +/- 0.42, median 0.76). FSH e"12 mU/ml, LH e"10 mU/ml and LH/FSH ratio e"1 cut offs were significantly associated (p = 0.000 in each) with the cases as revealed by chi-square analysis, and LH/FSH ratio e"1 (Sensitivity = 84.0%, specificity = 77.0%) was found to be a stronger marker of secondary amenorrhea. As the elevation of LH was more pronounced than that of FSH, this study hints towards possible LH receptor mutation, which is generally found in premature ovarian failure (POF). Diagnosis of cases in this region may need a new cut off level for POF, as the elevation of FSH itself was not as pronounced as reported by other workers.
Retrospective study of chest wall tumors at a cancer hospital in Nepal.
(2005-06-22) Thakur, Binay; Bo, Tan Zhen; Lamichhane, Nirmal; Shrestha, Bhakta Man; Neupane, Prakash Raj; Dudani, Rajesh
Primary and metastatic tumors of both soft tissues and bony skeleton, and primary tumors of adjacent organs invading the chest wall constitute chest wall tumors. A retrospective review of all the patients with chest wall tumors was done at BP Koirala Memorial Cancer Hospital (BPKMCH). Primary tumors of breast were excluded. Surgical treatment consisted of wide local excision (WLE). Chest wall reconstruction, if needed, was achieved by a muscular flap +/- prolene mesh +/- omental transposition. Thirty one patients were treated in the period from October 1999 to October 2003. Age of the patients varied from 3 years to 72 years (mean age--38 years). Presenting complaint was mass in 96.8% and pain in 48.4% cases. The mass was 5 cm or less in 34.4%, from 5 to 10 cm in 32.3%, and more than 10 cm in 32.3% cases. The lesions were located in sternal region, anterior, lateral, posterior, and vertebral chest wall in 6.5%, 32.3%, 41.9%, 16.1% and 3.2% respectively. WLE was done in 29 cases. Chest wall reconstruction using both muscular flaps and prolene mesh (15x15 cm) was done in 8 cases. In three of them, where concomitant wedge resection of the lung was done, omental transposition was added. In rest of the cases, primary closure, muscular/myocutaneous flap or skin grafting was done. Minor complications were observed in 31.0% cases, which were managed conservatively. Two patients received adjuvant radiotherapy and four patients--adjuvant chemotherapy. There were no postoperative deaths. The rate of malignancy was 48.4%.
Epidemiological survey of intestinal parasitic infections of diarrhoeal patients in Nepal and Lao PDR.
(2004-06-29) Takemasa, Kaoru; Kimura, Kenji; May, Sithat Insisien; Rai, Shiba Kumar; Ohyama, Fumio; Wu, Zhiliang; Kimura, Daisuke; Uga, Shoji
Intestinal parasitological survey was conducted to clarify the distribution of intestinal parasites in Nepal and Lao Peoples' Democratic Republic (Lao PDR) from 2001 to 2003. A total of 401 diarrheal fecal specimens were collected from patients aged one to 75 years (250 from Nepal and 151 from Lao PDR). The specimens were examined using the formalin-ether sedimentation (FES) and sucrose centrifugal flotation (SCF) techniques. Nine species (3 Nematoda, 1 Cestoda, and 5 Protozoa) of parasites were recovered from Nepal, whereas seven species (3 Nematoda, 1 Trematoda, and 3 Protozoa) from Lao PDR. Of the parasites detected, (14.4%) was the most common in Nepal, and was Opisthorchis viverrini (29.8%) in Lao PDR. Infection rates were markedly different among age groups in both countries; higher rates were observed in age groups of 10-29 years than in 0-9 years group. Scanning electron microscopic observation revealed that trematoda eggs recovered from Lao PDR were identified as O. viverrini, which could not be done by a light microscope.
Prevention of hypotension during propofol induction: a comparison of preloading with 3.5% polymers of degraded gelatin (Haemaccel) and intravenous ephedrine.
(2008-03-15) Dhungana, Y; Bhattarai, B K; Bhadani, U K; Biswas, B K; Tripathi, M
The present study compared the efficacy of preloading with colloid "Haemaccel" with vasoconstrictor (intravenous ephedrine sulphate) in preventing hypotension during propofol induction. This prospective, randomized study included 120 patients of Amercan Society of Anaesthesiologists (ASA) physical status I and II ageing 21 to 50 years of both gender coming for routine surgery. Patients were randomly allocated into three groups with 40 patients in each. Group A (control) did not receive any study medication, group B received Haemaccel (10 ml/kg intravenously over 10-15 minutes) and group C received injection ephedrine (0.2 mg/kg iv) prior to induction of anaesthesia. Propofol (2.5 mg/kg iv) was used for induction of anaesthesia. Heart rate and blood pressure were recorded before induction (baseline) and then every minute for 5 minutes after administering propofol. Anaesthesia was continued with standard technique thereafter. Hypotension was defined as fall in systolic blood pressure more than 20% from the basal value. The incidence of hypotension in Haemaccel (23.1%) or ephedrine group (22.5%) was significantly less than the control group (67.5%, P<0.01). We conclude that though preloading with colloid (Haemaccel) or prior injection of sympathomimetic (ephedrine) are not fully efficacious in preventing hypotension caused by propofol induction, both decrease the incidence in significant number of patients with heart rate less than baseline value in the colloid group.
Awareness and practice of family planning methods in women attending gyne OPD at Nepal Medical College Teaching Hospital.
(2008-09-04) Tuladhar, H; Marahatta, R
A cross sectional descriptive study of awareness and practice of family planning methods among 200 women of reproductive age attending gynecology out patient department (GOPD) of Nepal Medical College Teaching Hospital from 14th May 2008 to 14th July, 2008 was carried out. Most of the respondents (93.0%) were aware of at least one of family planning methods out often methods, but only 65.0% had ever used it and contraceptive prevalence rate was 33.5% which was slightly higher than the national data as 28.5%. The best known method of temporary contraception was depo provera (78.0%) followed by oral contraceptive pills (74.0%) and condom (71.0%) and least known methods were vaginal foam tablets/jelly (34.0%) and natural methods (16.0%). Among permanent family planning methods, awareness about female sterilization (81.0%) was more than male sterilization (77.0%) which was in accordance with studies done in other countries. Knowledge about emergency coritraception was quite low (12.0%) as it was newly introduced in the country. Regarding current use of contraception depo provera (11.0%) was the most widely used followed by oral contraceptive pills (4.5%) and condom (4.5%). 5.5% had undergone female sterilization while only 2.5% of male partner had sterilization Knowledge of non contraceptive benefits of family planning methods was claimed by only 35.0% of the respondents, 27.0% reported awareness that condoms protect from HIV/AIDS and sexually transmitted diseases (STD) while knowledge about various adverse effects was widespread (52.5%). The most common source of information on contraception was media (55.5%), both printed and electronic. This study also observed that with increase in level of education, awareness also increased. Although most of the women were aware about the methods, they were ignorant about the details like duration of protection, return of fertility on discontinuation and non contraceptive benefits. The most common reason for discontinuation of FP methods was stated as side effects. A wide knowledge practice gap was evident in this study, which was similar to the findings of studies done in other developing countries. Improved female education strategies and better access to services are needed to solve these problems. The use of communication media suitable for the audience and adequate message is important in conducting effective family planning awareness activities. Efforts should be made to educate the public about the safety and convenience of modern, long-term, reversible methods of contraception among both healthcare professionals and the public.
Percutaneous transvenous mitral commissurotomy.
(2006-09-06) Rajbhandari, Rajib; Kc, Man Bahadur; Bhatta, Yadav; Regmi, Shyam; Malla, Rabi; Rajbhandari, Sujeeb; Sharma, Deewakar; Sharma, Ranjit; Kansakar, Subodh; Mishra, Sundeep; Koirala, Bhagwan
Two hundred patients underwent Percutaneous transvenous mitral commissurotomy (PTMC) from January 2003 to July 2004. Seventy four percent of the patients were female. Age ranged from 10 years old to 61 years and mean age was 29 years. Twenty three percent of the patients were under 21 years of age. Atrial fibrillation was present in 32.0% of the cases. Mean mitral valve area increased from 0.90cm2 (+/- 0.14) to 1.82cm2 (+/- 0.21) (p = 0.018). Left atrial mean pressure decreased from 21 mmHg mean to 7 mmHg. Subjective improvement was reported in 98.0% of the patients immediately after the procedure. There was no mortality during the hospital stay or within the first month of the procedure. Significant mitral regurgitation of grade 3 was noted in 5 patients. Two developed severe mitral regurgitation. The complications were negligible. One had systemic embolisation during the procedure which recovered over a period of time. One developed deep vein thrombosis which recovered after treatment.
Perforation of oesophagus and aorta by an unusual migratory fish bone: case report.
(2005-12-08) Alam, Ansari Mukhtar; Shuaib, Ibrahim Lutfi; Hock, Lee Cheng; Bah, Eng Ji
This report describes a migratory fish bone which was not found during 1st surgery causing perforation to the superior part of the arch of aorta. The patient presented with feeling of something stucked in her throat after eating fish subsequently followed by progressive excruciating pain in the neck. During 2nd surgery the fish bone was found to have migrated from the superior aspect of the arch of aorta to the anterolateral aspect of the arch of aorta after piercing the aortic lumen. We report a case of migratory fish bone which was not found during 1st surgery. The clinical examination of the throat revealed no foreign body. The CT scan of the neck and upper thorax demonstrated a 1cm linear foreign body part of which had perforated into the superior part of the arch of aorta with mediastinal hematoma. The most likely cause was a fish bone. The patient's condition slowly deteriorated, median sternotomy and exploration of mediastinum then followed. Unfortunately no fish bone was found and only mediastinal hematoma was discovered. After the first operation the patient condition did not improve and repeat CT scan of the neck and upper thorax was done 3 days later. A similar foreign body has now moved from the superior aspect of the arch of aorta to the anterolateral aspect of arch of aorta. Exploration was done again and this time the fish bone was found.
ST-deviation, C-reactive protein and CPK-MB as mortality predictors in acute myocardial infarction.
(2006-09-06) Beg, Mujahid; Singhal, Krishna Chand; Wadhwa, Jyoti; Akhtar, Nishat
Prognosis varies widely in patients with acute coronary syndromes because of the heterogeneous nature of this condition. Successful outcome depends upon early risk stratification and an early decision regarding the approach of management of these patients. We studied 120 patients admitted with acute myocardial infarction, who were subsequently divided into two groups based on their final outcome (improvement or expiry). C-reactive protein and CPK-MB were quantitatively estimated at the time of hospital admission. Also, the number of ECG leads showing ST deviation and its sum was calculated and correlated with the biochemical markers. Differences in these variables were analysed between the two groups of patients. Significant differences were found in the mean levels of CRP, CPK-MB, the number of ECG leads with ST deviation and its sum between the two groups. Also, significant correlation was found between the levels of biochemical markers and the sum of ST deviation at admission in all patients of acute myocardial infarction.
Effect of prenatal exposure of alcohol in the morphology of developing rat embryo.
(2008-03-15) Ghimire, S R; Dhungel, S; Rai, D; Jha, C B; Saxena, A K; Maskey, D
The objective this study was to observe the morphological changes in developing rat embryo exposed to alcohol in utero. Virgin female Wistar rats in experimental group (n=15) were given 20% (v/v) alcohol two weeks before mating and throughout the gestational period through oral route. The controls (n=15) were also maintained and were given the tap water. On gestational day 15 (GD15) and 19 (GD19), five rats from each group were sacrificed by cervical dislocation and the abdomen was incised to expose the uterine horn. The number of implantation sites and resorptions were counted and recorded. The body weight and length of the fetuses were also recorded. The litter size and body weight of the newborn were also recorded at the time of birth from the remaining dam. The incidence of resorption was higher in alcohol treated group than in control which was found to be 25% and 8.7% at days 15 and 19 respectively. The body weight and length of fetuses were found to be decreased and was significant at GD15 (p<0.001 for weight and p<0.05 for length). Similarly, the litter size and body weight of newborn were also found to be decreased significantly (p<0.05 for litter size and p<0.01 for body weight). The present study shows that the maternal consumption of alcohol during pregnancy has adverse effect on fetal viability and development of growing embryo.
Comparative study on a homemade rapid urease test with gastric biopsy for diagnosis of Helicobacter pylori infection.
(2006-06-05) Makaju, Ramesh Kumar; Tamang, Migma Dorji; Sharma, Yubaraj; Sharma, Nastu; Koju, Rajendra; Bedi, Tikka Ramesh Singh; Khanal, Sharad
The main objective of this study was to determine whether a homemade rapid urease test was reliable when compared to histology in the diagnosis of Helicobacter pylori infection. Endoscopic antral biopsies from 15th August 2004 to 15th July 2005 were studied prospectively. Rapid urease test and histological examination were done on all specimens. Among 160 biopsies, 56 cases showed H. pylori in histological section and 59 cases were rapid urease test positive. Among 56 H. pylori infected patients, the sensitivity, specificity, positive and negative predictive values, percentage of false positive, and percentage of false negative values of rapid urease test were 96.4%, 95.2%, 91.5%, 98.0%, 4.8% and 3.5% respectively. Rapid urease test is positive in significantly higher number (p < 0.001) in histological positive cases. In conclusion our homemade rapid urease test is a test with good sensitivity and specificity for detection of H. pylori infection.
Profile of blindness in Nepal: a hospital based study.
(2005-06-22) Rizyal, Aparna; Karmacharya, Purna Chandra; Koirala, Shashank
A hospital based prospective study was conducted at B P Koirala Lions Center for Ophthalmic Studies to determine the causes of blindness. A total of 701 patients were enrolled for this study during a one and a half year time period. Four main diseases in the order of prevalence--cataract, corneal diseases, trauma and posterior segment diseases--were identified as the major causes of blindness. The prevalence of blindness increased with age and showed a male preponderance. Cataract and corneal diseases were the leading causes of bilateral blindness and unilateral blindness respectively.
Plasticity of myenteric neurons.
(2008-06-03) Saini, N; Gupta, M
The nervous system exerts a profound influence on all digestive processes. The wall of digestive system is endowed with its own, local nervous system referred to as the enteric or intrinsic nervous system which is responsible for the modulation of the rhythmic gastrointestinal peristaltic activities along with other functions. The principal components of the enteric nervous system are two neuronal networks: myenteric and submucosal, embedded in the wall of the digestive tract and extend from esophagus to anus. The musculature of different parts of gastrointestinal tract is differently disposed to perform different functions. Thus the aim of present study was to demonstrate the presence of neurons and to quantify the number of collections of neurons, number of neurons in each collection and area of the neurons of the plexus. One cm piece from all the parts of GIT containing entire wall was taken from the same region of 5 adult cadavers of postmortem cases which were embalmed in the Department ofAnatomy, Postgraduate Institute of Medical Sciences and Research, Chandigarh and were processed for paraffin sectioning. 5 and 10 micro thick serial sections were obtained and 6th and 7th slides were stained with: Hematoxylin and Eosin and Marsland, Glees and Erikson's silver stain. The slides were photomicrographed using digital camera. The morphometrical analysis was done using Image Pro Express software. Aggregations of 1-31 neurons present in myenteric network located between longitudinal and circular muscle layers of the GIT whose size varied from 10.263-259.660 microm2. They were oval or round; multipolar, arranged in two rows and dispersed in groups in connective tissue of muscularis propria. The collections of neurons were appeared to be more numerous in appendix and ileoceacal valve.

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