Rai P, Ackerman IN, O'Connor DA
… +2 more, Dangal G, Buchbinder R
JNMA J Nepal Med Assoc
· 2025 Mar · PMID 40656920
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INTRODUCTION: Nepal continues to face significant challenges with high maternal and neonatal mortality. To improve health and achieve the Sustainable Development Goals of reducing maternal and newborn mortality by 2030,...INTRODUCTION: Nepal continues to face significant challenges with high maternal and neonatal mortality. To improve health and achieve the Sustainable Development Goals of reducing maternal and newborn mortality by 2030, Nepal needs to focus on addressing high-burden maternal and neonatal disorders. The objective of the study was to examine the current burden of maternal and neonatal disorders in Nepal and to assess any changes over time. METHODS: We examined the annual Global Burden of Disease Study data on prevalence, deaths, Years Lived with Disability, and Disability-Adjusted Life Years for maternal and neonatal disorders in Nepal for the 1990-2019 period. Estimated annual percentage changes were also calculated to assess the trends of the age-standardised rates of these burden metrics. RESULTS: The analysis found that the prevalence of overall maternal disorder in Nepal decreased by 37% from 128,176 in 1990 to 80,724 in 2019 with Age-Standarised Ratio of 432.07 per 100,000 in 2019 and Estimated Annual Percentange Change of -4.34 (CI 95%: -4.49 to -4.18). Similarly, the overall prevalence of neonatal disorder increased by 57% from 303,146 in 1990 to 475,544 in 2019 with Age-Standarised Ratio of 1521.14 per 100,000 in 2019 and Estimated Annual Percentage Change of 0.98 (95% CI: 0.67-1.29). CONCLUSIONS: Our findings emphasise the need to address maternal haemorrhage, indirect maternal deaths, maternal abortion and neonatal disorders in Nepal in future national health programs.
Khanal U, Sah R, Mahato SK
… +2 more, Katwal S, Gurung G
JNMA J Nepal Med Assoc
· 2025 Mar · PMID 40656919
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INTRODUCTION: Magnetic Resonance Imaging is a common diagnostic tool used to evaluate various clinical conditions. Different fat suppression techniques such as Short Tau Inversion Recovery and Dixon are employed to enhan...INTRODUCTION: Magnetic Resonance Imaging is a common diagnostic tool used to evaluate various clinical conditions. Different fat suppression techniques such as Short Tau Inversion Recovery and Dixon are employed to enhance diagnostic accuracy. The choice of fat suppression sequence varies based on availability and performance. This study aimed to compare Contrast Ratio and Contrast-to-Noise Ratio of Short Tau Inversion Recovery and Dixon technique. METHODS: This observational cross-section study was performed in the Department of Radiology from 8 September 2023 to 7 September 2024 after the approval by the Institutional Review Committee (Reference number: 151/080/081(6-11)E2). Using a complete census method during the study period, MRI-lumbar spines of 384 adult patients were included in the study. Signal intensity values of the lesion, adjacent normal tissue, and noise were recorded for calculation of Contrast Ratio and Contrast-to-Noise Ratio. RESULTS: Among 384 cases, 191 (49.74%) were male and 193 (50.26%) were female with median age 46 (IQR: 35-60) years. The median value of contrast ratio and contrast-to-noise ratio were 0.31 (IQR: 0.14-0.50) and 8.74 (IQR: 3.82-15.50) respectively for STIR sequence while median value of contrast ratio and contrast-to-noise ratio were 0.44 (IQR: 0.19-0.74) and 11.95 (IQR: 5.38-23.18) respectively for Dixon sequence, higher than Short Tau Inversion Recovery. CONCLUSIONS: Contrast Ratio and Contrast to Noise Ratio were found higher and background noise lower for Dixon compared to Short Tau Inversion Recovery.
Khadka N, Suryabanshi A, Shrestha A
… +7 more, Paudel K, Aryal S, Jha B, Bhattarai SM, Rajbhandari B, Shrestha R, Jha R
JNMA J Nepal Med Assoc
· 2025 Mar · PMID 40656918
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Spinal cord tumors, though uncommon, pose significant challenges due to their potential for neurological disability and mortality. Intramedullary spinal cord tumors, particularly Long-level intramedullary spinal cord tum...Spinal cord tumors, though uncommon, pose significant challenges due to their potential for neurological disability and mortality. Intramedullary spinal cord tumors, particularly Long-level intramedullary spinal cord tumors, present challenging clinical scenarios. Contrast-enhanced Magnetic resonance imaging remains pivotal for radiological evaluation and surgical planning. Notably, aggressive resection is advocated to enhance prognosis, with meticulous attention to preserving neurological function. Advancements in spinal surgery techniques, coupled with intraoperative monitoring, offer promising avenues for improved patient outcomes. We presented three cases of long-level intramedullary tumors, emphasizing the significance of tailored management and presented details, including clinical presentations, radiological findings, and histopathological results.
Basnyat AB, Dangal G, Karki A
… +3 more, Pradhan HK, Shrestha R, Bhattachan K
JNMA J Nepal Med Assoc
· 2025 Mar · PMID 40656917
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Leiomyomas are a common gynaecological condition affecting 20-30% of women over the age of 35, with prevalence decreasing following menopause. Leiomyomas are most commonly found within the uterus. Rarer extra-uterine loc...Leiomyomas are a common gynaecological condition affecting 20-30% of women over the age of 35, with prevalence decreasing following menopause. Leiomyomas are most commonly found within the uterus. Rarer extra-uterine locations include the broad ligament, cervix, and vagina. We present an unusual case of multiple Left Broad Ligament Leiomyomata that extended from Left Iliac Fossa and Hypogastrium to Epigastric region in a 50-year-old female. Our case highlights the importance for extra-uterine leiomyoma to be considered as a differential diagnosis in patients presenting with huge abdominal mass suspicious of adnexal tumor or malignancy.
Sharma J, Shrestha D, Thapa D
… +2 more, Rawal S, Kafle R
JNMA J Nepal Med Assoc
· 2025 Mar · PMID 40656916
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INTRODUCTION: Infertility, defined as the inability to conceive after a year of regular unprotected sexual activity, is a significant global health concern. It affects couples across the world, with prevalence rates vary...INTRODUCTION: Infertility, defined as the inability to conceive after a year of regular unprotected sexual activity, is a significant global health concern. It affects couples across the world, with prevalence rates varying between 3.5-16.7% in developed countries and 6.9-9.3% in developing nations. This study aims to explore the sociodemographic profiles and contributing factors in both men and women among infertility patients at a tertiary care center. METHODS: An observational cross-section study was conducted at a tertiary care center and participants were between 18 and 42 years old with infertility for one year or longer, excluding those who had received treatment or were pregnant. The data was collected from December 2023 to May 2024. Ethical approval and informed consent were obtained. Data were collected using a structure proforma through in-person interviews or telephone calls and analyzed using Statistical Package for the Social Sciences with descriptive statistics. RESULTS: Among 170 couples with infertility, primary infertility was observed in 124 (72.94%) and secondary infertility in 46 (27.06%). The median duration of marriage was 5 years (IQR: 4-7). Among women, 37 (21.76%) had tubal blockages, 16 (9.41%) had polycystic ovarian disease, and 6 (3.53%) had fibroids. Among men, 58 (34.12%) had semen abnormalities, with oligospermia being the most common in 25 (14.71%). Hormonal analysis revealed that 68 (40%) of women had elevated anti-Müllerian hormone levels, frequently linked to polycystic ovarian syndrome. CONCLUSIONS: These findings show that infertility is rarely due to a single cause. It commonly involves both partners and requires a comprehensive approach to diagnosis and treatment.
Subedi B, Bhandari S, Timilsina S
… +2 more, Pokhrel S, Neupane S
JNMA J Nepal Med Assoc
· 2025 Mar · PMID 40656915
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Methotrexate is a widely used medication in dermatology, rheumatology, and oncology. However, patient misunderstandings or attempts to expedite symptom relief can lead to overuse, resulting in severe toxicity. This case...Methotrexate is a widely used medication in dermatology, rheumatology, and oncology. However, patient misunderstandings or attempts to expedite symptom relief can lead to overuse, resulting in severe toxicity. This case series presents five instances of methotrexate toxicity due to daily dosing and excessive use for underlying disorders. All patients exhibited fever, skin, and mucosal lesions, alongside abnormal hematological parameters. Management involved immediate cessation of methotrexate, administration of leucovorin rescue therapy, and supportive care. Three patients fully recovered with the resolution of lesions and improved hematological profiles, while two succumbed to the illness. These cases underscore the critical need for early recognition of methotrexate toxicity symptoms and comprehensive patient counseling on proper dosing schedules to prevent such adverse outcomes.
JNMA J Nepal Med Assoc
· 2025 Mar · PMID 40656914
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INTRODUCTION: Child health is crucial in low and middle-income countries. Pediatric healthcare in tertiary-level hospitals addresses complex medical conditions. This study aimed to describe the sociodemographic and clini...INTRODUCTION: Child health is crucial in low and middle-income countries. Pediatric healthcare in tertiary-level hospitals addresses complex medical conditions. This study aimed to describe the sociodemographic and clinical profiles of pediatric patients admitted to Kanti Children's Hospital in Nepal. METHODS: An observational cross-section study was conducted including all the inpatients under 15 years of age. The data were collected from the hospital medical record section from July 17, 2023 to July 15, 2024, after the ethical approval from Institutional Review Review Committee, (Reference number 2168). The statistical analysis included descriptive statistics to assess demographic characteristics, case types, admission patterns, and outcomes using Microsoft Excel and Statistical Package for Social Sciences (SPSS) 2024. RESULTS: A total of 9682 pediatric cases were included, of which 6389 (65.99%) of the patients were male, with 3305 (34.13%) being aged 1 to 5 years. Among the admitted patietns 2194 (22.66%) had respiratory cause and 1520 (15.70%) had infectious disease. Mortallity rate was 203 (2.09%) and it was 82 (12.06%) in pediatric intensive care unit and 48(10.62%) in neonatal intensive care unit. CONCLUSIONS: Respiratory and infectious diseases were the most common cause of admission in pediatric settings with a higher prevalence in younger children. The majority of cases were residing outside the capital city. This study highlighted higher mortality rates in critical care units.
Maharjan B, Liu L, Liu X
… +2 more, Liu Q, Jiang X
JNMA J Nepal Med Assoc
· 2025 Feb · PMID 40656831
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Klippel-Trenaunay Syndrome is a rare congenital disorder characterized by a triad of symptoms-capillary malformations, venous abnormalities, and hypertrophy of bones and soft tissues. The syndrome often presents with por...Klippel-Trenaunay Syndrome is a rare congenital disorder characterized by a triad of symptoms-capillary malformations, venous abnormalities, and hypertrophy of bones and soft tissues. The syndrome often presents with port wine stains, varicose veins, and limb hypertrophy, which can lead to significant complications such as venous thromboembolism and bleeding. We present a case of a 13 ' year female, with erythema in left upper limb and shoulder since birth.. An effective treatment method was employed, which incorporated a multidisciplinary team of experts specialized in various fields of dermatology and vascular surgery, all working collaboratively with the patient's well-being at the core of their efforts. This approach emphasized a personalized strategy based on the patient's preferences.
Maharjan DK, Pudasaini P, Acharya BP
… +3 more, Limbu Y, Ghimire R, Thapa PB
JNMA J Nepal Med Assoc
· 2025 Feb · PMID 40656830
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INTRODUCTION: The "TRIANGLE operation" involves the en-bloc removal of the tumor and the entire "mesopancreas" from the triangle-shaped space bounded by the superior mesenteric artery, coeliac trunk, and portal vein. Thi...INTRODUCTION: The "TRIANGLE operation" involves the en-bloc removal of the tumor and the entire "mesopancreas" from the triangle-shaped space bounded by the superior mesenteric artery, coeliac trunk, and portal vein. This study assessed lymph node yield in apical tissue during the triangle operation. METHODS: An observational cross-section study was conducted for two years at the Department of Gastrointestinal and General Surgery at a tertiary care center of Nepal. from 15th March 2022 to 15th March 2024. The operative procedure included pancreaticoduodenectomy or Whipple's operation. Total sampling was done. Postoperative outcome and lymph node yeild of the surgeries were studied. Ethical approval was taken from the Institutional Review Committee (Reference No-1102202204). RESULTS: A total of 56 patients underwent pancreaticoduodenectomy along with a triangle operation. The mean age of the patients was 56.38±14.79 years. Male: Female ratio was 1.2:1. Mean preoperative BMI was 24.41±4.72. The mean total lymph node yield was 20.95±8.57. Nineteen patients had a positive lymph node yield in the triangle tissue. The mean triangle lymph node yield was 10.59±4.92, and the mean positive lymph node was 2.58±1.64. Among 56 patients, nine patients had both apical margin and the rest of the triangle tissue margin positive. Ten patients had negative apical tissue margins, but the rest of the triangle tissue was positive, whereas, in thirty-seven patients, both the apical tissue and the rest of the triangle circumferential resection margin tissue were negative. CONCLUSIONS: This study emphasizes the importance of the inclusion of apical tissue dissection at the confluence of SMA and coeliac trunk to achieve R0 resection. However, a long-term follow is awaited.
JNMA J Nepal Med Assoc
· 2025 Feb · PMID 40656829
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Uterine Arteriovenous malformation is an abnormal connection between artery and veins in the uterus. Although rare, it is an important cause of abnormal uterine bleeding in women and can lead to life threatening torrenti...Uterine Arteriovenous malformation is an abnormal connection between artery and veins in the uterus. Although rare, it is an important cause of abnormal uterine bleeding in women and can lead to life threatening torrential hemorrhage. Traditionally such cases have been managed with medical therapy and hysterectomy. However, selective uterine artery embolization and hysteroscopy guided procedures are the treatment of choices. We hereby report a case of 25 years lady who presented with irregular heavy vaginal bleeding and diagnosed to have uterine arteriovenous malformation by magnetic resonance imaging. She was managed conventionally with condom tamponade during bleeding due to intrauterine procedure and later with hormonal therapy. The patient later had regular cycles avoiding hysterectomy at a young age. The objective of this case report is to share the successful application of uterine balloon tamponade (UBT) for the active management of bleeding uterine arteriovenous malformation which has not been reported so far which can be applied especially in a resource limited setup.
Malla N, Poudel L, Pokhrel S
… +2 more, Chaudhary V, Mali P
JNMA J Nepal Med Assoc
· 2025 Feb · PMID 40656828
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INTRODUCTION: Depression is an important public health issue responsible for considerable morbidity and mortality among elderly. There were very few studies related with depression among elderly from rural community of N...INTRODUCTION: Depression is an important public health issue responsible for considerable morbidity and mortality among elderly. There were very few studies related with depression among elderly from rural community of Nepal. The objectives were to assess depression among elderly in Chhayanath Rara municipality. METHODS: An observational cross-section study was conducted among 387 elderly through face-to-face interviews by using Geriatric Depression Scale-short scale (GSD 15) in a municipality of Nepal. Ethical Approval was taken from Institutional Review Committee (Reference Number: 079/80-015 ). Data were entered and analyzed into SPSS version 20. Descriptive statistics was employed to assess the prevalence of elderly depression. RESULTS: The prevalence of depression among elderly was found to be 282 (72.87%; 95% CI: 68.44%-77.30%). Of those, 124 (32.04%) experienced mild depression, 115 (29.72%) had moderate depression, and 43 (11.11%) suffered from severe depression. CONCLUSIONS: The prevalence of depression in elderly was found higher compared to previous studies and other population.
Yadav AK, Yadav N, Dev B
… +4 more, Dahal S, Yadav RP, Taparia S, Patahak H
JNMA J Nepal Med Assoc
· 2025 Feb · PMID 40656827
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INTRODUCTION: Intussusception is common cause of acute emergency responsible for bowel obstruction in infants and toddlers with peak age of incidence between 6-9 months. Ultrasound is imaging modality of choice for diagn...INTRODUCTION: Intussusception is common cause of acute emergency responsible for bowel obstruction in infants and toddlers with peak age of incidence between 6-9 months. Ultrasound is imaging modality of choice for diagnosis of intussusception and ultrasound guided hydrostatic enema reduction is standard, nonsurgical, internationally preferred treatment modality for uncomplicated pediatric intussusceptions. This study was aimed to find the outcome of the procedure. METHODS: An observational cross-section was carried in a tertiary care center in children presenting with intussusception. Ultrasoud guided hydrostatic reduction was done in all radiologically confirmed intussusception in children presenting to our tertiary hospital from February 2023 to July 2024 fulfilling the inclusion criteria after proper resuscitation. Patients having marked abdominal distension with features of peritonitis were excluded from the study. Ethical approval was obtained from Institutional Review Committee (Reference number: 287/2023). RESULTS: Total 81 patients with 84 intussusceptions underwent ultrasound guided hydrostatic reduction with male to female ratio of 2.86 and mean age 9.49±8.43 months. Hydrostatic reduction was successful in 78 (92.85%) cases. Among successful reductions, 3 (3.84%) patients had recurrence and repeat successful hydrostatic reduction was done. Presenting complain seen were abdominal pain 81 (100%) , vomiting 72 (88.89%). Ileocolic intussusception was seen in 74 (88.09%). CONCLUSIONS: The success rate of ultrasound-guided hydrostatic reduction using normal saline for uncomplicated intussusception was consistent with findings from previous studies conducted in similar settings, which utilized both hydrostatic and pneumatic reduction methods.
JNMA J Nepal Med Assoc
· 2025 Feb · PMID 40656826
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This case series highlights four pediatric patients with coinfection of dengue fever and scrub typhus, presenting at Patan Hospital. Dengue fever is caused by flavivirus transmitted by Aedes mosquitoes, and scrub typhus...This case series highlights four pediatric patients with coinfection of dengue fever and scrub typhus, presenting at Patan Hospital. Dengue fever is caused by flavivirus transmitted by Aedes mosquitoes, and scrub typhus is caused by Orientia tsutsugamushi transmitted by Leptotrombidium mites, which share overlapping symptoms such as fever, headache, and abdominal pain, complicating the diagnosis. The cases were from different geographical regions of Nepal with varied presentation: from febrile illness to severe manifestations like meningoencephalitis and raised intracranial pressure. Two patients presented with hepatosplenomegaly, one with severe rash, and another with pneumonia-like symptoms. Laboratory findings confirmed coinfection, and management included IV antibiotics, antipyretics, and supportive management. Complications such as thrombocytopenia, transaminitis, and allergic reactions required interventions. This case series highlights the importance of early suspicion and treatment of coinfection to reduce prolonged hospitalization and prevent end-organ dysfunction, and mortality, especially in endemic regions.
Ghimire S, Ghimire S, Dahal S
… +3 more, Dahal S, Paudel N, Paudel P
JNMA J Nepal Med Assoc
· 2025 Feb · PMID 40656825
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INTRODUCTION: Dentinal hypersensitivity is a widespread condition characterized by a brief, sharp pain arising from exposed dentin in response to external stimuli, which cannot be linked to any other dental conditions. T...INTRODUCTION: Dentinal hypersensitivity is a widespread condition characterized by a brief, sharp pain arising from exposed dentin in response to external stimuli, which cannot be linked to any other dental conditions. This study aimed to estimate the prevalence of dentinal hypersensitivity among patients attending a tertiary health care center. METHODS: A observational cross-section study was conducted, involving 376 patients aged 10-70 years who visited a tertiary care center. Convenience sampling was employed to select participants, and the prevalence of dentinal hypersensitivity was assessed through a questionnaire. Data were collected from the Department of Oral Medicine and Radiology after obtaining ethical approval Institutional Review Committee (Reference number: 385 (6-11) E2 079/80). The analysis was performed using Microsoft Excel, and descriptive statistics were reported . RESULTS: There were 376 patients in the study and the prevlence of dentin hypersensitivity wasa 236 (62.77%; CI 95%: 57.66%-67.67%). Among those diagnosed, 138 (73.02%) were male, and 98 (52.41%) were female. The age-specific prevalence was found to be 30 (50.85%) in patients aged 10-19 years, 73 (63.48%) in those aged 20-29 years, 42 (53.16%) in patients aged 30-39 years, 23 (51.11%) in those aged 40-49 years. CONCLUSIONS: This study identified a high prevalence of dentin hypersensitivity among the patient population, with variations observed across different age and sex groups.
Kandel M, Shrestha SK, Paudel KP
… +4 more, Panta S, Banjade D, Syangtan R, Thapa S
JNMA J Nepal Med Assoc
· 2025 Feb · PMID 40656824
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INTRODUCTION: Osteoporosis is characterized by low bone mass, leading to enhanced bone fragility. Low-energy fractures of distal radius are related to osteoporosis and is therefore related to increased risk of subsequent...INTRODUCTION: Osteoporosis is characterized by low bone mass, leading to enhanced bone fragility. Low-energy fractures of distal radius are related to osteoporosis and is therefore related to increased risk of subsequent hip fractures. The objective of this study was to study the prevalence of osteoporosis in patients with distal radius fracture from low-energy trauma. This will emphasise the need to investigate these patients for osteoporosis and make practitioners should be aware of the possibility of osteoporosis in such patients. METHODS: This observational cross-section study evaluated the prevalence of osteoporosis in patients with distal radius fracture from low-energy trauma among patients presenting to tertiary level hospital of Nepal from October 2022 to September 2023. The participants' demographic data, mechanism of injury, BMD values and T-score values were recorded and diagnosis of osteoporosis and osteopenia was made according to WHO diagnostic criteria. Ethical approval was taken from Institutional Review Committee (Reference Number: 079/80-015). RESULTS: The study involved 96 patients with mean age of 68.27±4.09 years. The mean BMD among the participants was 0.69±0.02 and the mean T-score was -2.75±0.23. Diagnosis of osteoporosis was made in 88 (91.67%) patients and diagnosis of osteopenia was made in 8 (8.33%) patients based on the T-score using the WHO criteria. Of the 88 (91.67%) patients who met the diagnosis of osteoporosis, only 45 (46.88%) patients had started treatment with bisphosphonates for osteoporosis. CONCLUSIONS: We have found a high prevalence of osteoporosis among patients with low-energy distal radius fracture.
JNMA J Nepal Med Assoc
· 2025 Feb · PMID 40656822
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INTRODUCTION: Pelvis and acetabular fractures are complex, high-energy trauma and are often associated with life threatening injuries. The majority of them require surgical intervention and extensive rehabilitation. The...INTRODUCTION: Pelvis and acetabular fractures are complex, high-energy trauma and are often associated with life threatening injuries. The majority of them require surgical intervention and extensive rehabilitation. The epidemic figures are necessary to make plan for their management and its complications. We aim to analyze epidemiological profile of patients presented with pelvis and acetabular fracture in our center. METHODS: This was observational cross-section study, analyzed on patients admitted with pelvis and acetabular fracture at a tertiary care center through emergency and outpatient department between January to December 2023. The collected parameters were age, gender, mechanism of injury, site of injury, classification of fracture, associated other injuries, management operative or non-operative, early post-operative complications, duration of hospital stay, mortality and Intensive Care Unit admission and they were analyzed. Ethical approval was obtained from Institutinal Review Committee (Reference number: 19/2024). RESULTS: There were 48 (7.27%) pelvis and/or acetabular fracture amongst 660 patient with traumatic fractures. Pelvic fracture was 29 (4.39%) and acetabular fracture was 16 (2.42%). The median age was 38 years (IQR: 25.25-46.75) and 36 (75%) were male. Thirty three (69%) patients required surgery, 17 (35%) patients had additional surgery for associated injury and 14 (29%) required intensive care unit admission. The median hospital stay was 12.5 days and mortality rate were 2%. CONCLUSIONS: The proportion of pelvis fracture was comparable to other studies while the proportion of actebular was comparatively higher in this study.
JNMA J Nepal Med Assoc
· 2025 Feb · PMID 40656821
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Tenosynovial giant cell tumor (GCT) is a rare, benign disorder involving the joint's synovial lining, tendon sheath or bursa. It can be classified as localized or diffuse based on its pattern and behavior. Localized form...Tenosynovial giant cell tumor (GCT) is a rare, benign disorder involving the joint's synovial lining, tendon sheath or bursa. It can be classified as localized or diffuse based on its pattern and behavior. Localized form is extremely rare in knee joint. We present an unusual case of localized form of GCT in Hoffa's fat pad in a young female, treated with arthroscopic resection and monitored for over two years with no recurrence. Despite its rarity, GCT of Hoffa's fat pad should be considered in cases of non-traumatic knee pain.
JNMA J Nepal Med Assoc
· 2025 Feb · PMID 40656820
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INTRODUCTION: Acute appendicitis is a common surgical emergency encountered in pediatric population. Differential diagnosis in this age group present with similar signs and symptoms. Clinical scoring system and Ultrasoun...INTRODUCTION: Acute appendicitis is a common surgical emergency encountered in pediatric population. Differential diagnosis in this age group present with similar signs and symptoms. Clinical scoring system and Ultrasound imaging are helpful in diagnosing acute appendicitis and ruling out its differential diagnosis. This study was done to assess the findings of presence or absence of appendicitis in children based on the Pediatric Appendicitis Score (PAS) and ultrasound scan. METHODS: An observational cross-section study was done from November 2023 to May 2024, in a tertiary level hospital, Kathmandu. All children between the ages of five and 14 years undergoing surgery for the provisional diagnosis of acute appendicitis were included in the study. The provisional diagnosis was based on a Pediatric appendicitis score and ultrasound. The diagnosis was confirmed by histopathology. Ethical approval was taken from Institutional Review Committee (Reference number: 811/2080/81). RESULTS: A total of 50 children were included during the study period. A pediatric appendicitis score of more than seven, which is considered a high risk, was observed in 43 (86%) patients, and a score between four and six, which was considered an intermediate risk, was observed in 6 (12%) patients Similarly, 39 (78%) of the patient had appendix diameter more than six mm and 10 (20%) had less than six in ultrasound measurement. CONCLUSIONS: Both Pediatric Appendicitis Score and Ultrasonography can be used to diagnose acute appendicitis in children.
JNMA J Nepal Med Assoc
· 2025 Feb · PMID 40656819
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Adenoid cystic carcinoma (ACC) is a rare slow-growing but aggressive malignant tumor arising from the epithelial cells of mucous-secreting glands. Primary intracranial ACC is one of the rarest entity. We report a case of...Adenoid cystic carcinoma (ACC) is a rare slow-growing but aggressive malignant tumor arising from the epithelial cells of mucous-secreting glands. Primary intracranial ACC is one of the rarest entity. We report a case of a 61 years old male presenting with difficulty in swallowing, slurring of speech, generalized body weakness. Patient had residual right cerebellopontine angle (CPA) mass causing midline shift and fourth ventricular obstruction on MRI. Patient underwent right retrosigmoid craniotomy with excision of CPA mass. Histopathological examination confirmed the case as primary intracranial ACC.