Journal of Lumbini Medical College (JLMC)
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Adult Onset Best Vitelliform Macular Dystrophy: A Case Report
Get PDFIntroduction: Best disease or vitelliform macular dystrophy is a rare autosomal dominant disorder with bilateral presentation characterized by subretinal accumulation of yellowish material in the macular area. Macular findings range from a small yellow spot, multiple vitelliform or atrophic lesions to a chorio-retinal scar. Case report: A 35 years male presented to our outpatient department with chief complaint of blurring of vision of both eyes for the past three months. His visual acuity was 6/12 in both right and left eyes. On slit-lamp bio-examination anterior segments of both eyes were normal. On fundus examination, both eyes revealed a single, circular, yellow-opaque egg yolk-like macular lesion with no other abnormalities. Optical coherence tomography of both eyes revealed deposits of homogenous hyper- reflective material beneath retinal pigment epithelium at fovea. Fundus fluorescence angiography showed blocked fluorescence at the site of vitelliform lesion of both eyes. Conclusion: Best vitelliform macular dystrophy is a rare genetic disorder with incomplete penetrance. Optical coherence tomography and fundus fluorescence angiography support the diagnosis
COVID-19 And Nepal: A Gender Perspective
Get PDFThe ongoing Corona Virus Disease 19 (COVID-19) pandemic is in its height, the measures taken to control the spread of this pandemic is acute and harsh. With the increasing new cases every hour it has caused a panic among every individual. Economy of the countries are equally affected. However, the direct and indirect impactof this pandemic on gender related needs are least prioritized and discussed. Evidences so far reveal the mortality being proportionately higher in males.This fact may not remain the same in Nepalese context becausewomen are more vulnerable in this low-income country where limited resources are allotted to women’s health. Majority of the workforce at frontline health care are women in the form of nurses, midwives and female community health volunteers (FCHV). Government of Nepal has decided to mobilize FCHVs for COVID-19 response in the community and these FCHVs who provide services at ground levels are at occupational risk of acquiring the infection
Coping with COVID-19
Get PDFSevere acute respiratory syndrome corona virus (SARS-CoV-2) virus made its first appearance in Wuhan, China in December 2019. It has since spread like a wild fire across the globe with over five million corona virus disease (COVID-19) confirmed cases and almost three hundred fifty thousand deaths at the time of writing this article. This could however be only the tip of the iceberg considering the contagious nature of the SARS-CoV-2 virus and the rate at which it is spreading across the globe. China did well to contain the virus with strict lockdown measures, sealing the affected areas, active case finding, tracing, tracking and treating the COVID-19 cases at an astonishing speed. In the absence of specific treatment available as yet, treatment consists of mainly symptomatic management with some experimental medications. Antivirals, specifically Remdesivir has been a strong candidate for the treatment of COVID-19. However, it has yet to receive universal acceptance for the treatment of COVID-19. Chloroquine and Hydroxychloroquine seem to be effective in limiting the replication of SARS-CoV-2 virus in vitro. COVID-19 is highly pandemic in countries where malaria is least prevalent and least pandemic in countries where malaria is highly prevalent. These findings suggest the hypothesis that anti-malarial drugs have efficacy in the treatment of COVID-19
Threat of Dengue Outbreak in Nepal in Context of COVID-19 Pandemic
Get PDFThe world has been chained with Corona Virus Disease (COVID-19) pandemic today. It has affected more than 200 countries in just about a few months since December 2019. The virus has engulfed the world at a momentum never seen before. Considering the chances of disease being spread through asymptomatic transmission, social distancing has become a norm. This has brought a huge shift in how we live, work or interact with each other. It is feared that after the pandemic is over, the world would suffer a period of economic loss, as huge as the greatest depression of the 1930s or even more. With the world making medievalinventions and science doing wonders, we seem helpless to fight this pandemic. It has also drawn usto a realization that pandemic response cannot be extemporaneous
Fine Needle Aspiration versus Fine Needle Capillary Sampling Technique in Cyto-diagnosis of Thyroid Lesions
Get PDFIntroduction: In diagnosis of thyroid lesions, the negative pressure applied during fine needle aspirationcytology (FNAC) frequently produces bloody smears. This results in a compromise in cellular concentrationand architecture which may lead to improper interpretation. Fine needle capillary sampling cytology(FNCC), on the other hand, avoids active aspiration as it depends on capillary tension to collect tissuesamples in the needle bore. This study evaluated the diagnostic performance of FNAC and FNCC in thyroidlesions. Methods: A total of 120 patients were included in this study conducted over a duration of 19months. All thyroid swellings advised for cyto-diagnosis were sampled by both fine-needle aspiration(FNAC) and non-aspiration (FNCC) techniques. The slides were assessed according to the Mair et al.scoring system. Results: In the FNCC group, 72 (60%) smears were diagnostically superior while 54 (45%)smears were diagnostically superior in the FNAC group. Blood contamination (p=0.003), cellular trauma(p=0.019), and degree of cellular degeneration (p=0.026) were less and cellular architecture (p=0.047) waspreserved more in FNCC in comparison to FNAC groups. Conclusion: This study showed the superiority ofFNCC for the interpretation and diagnosis of thyroid lesions. However, the combination of both FNAC andFNCC could maximize the diagnostic yield
Comparison of External Fixation and Supplementary Kirschner-Wires Fixation With Volar Locking Plate for the Treatment of Intra- Articular Distal End Radius Fractures
Get PDF Introduction: There are controversies regarding the benefit of open reduction and internal fixation with volar locking plates over closed reduction and external fixation along with supplementary Kirschner wires fixation for intra-articular distal end radius fracture. Therefore, this study aimed to compare the outcomes between external fixation along with supplementary Kirschner wires with volar locking plate in the treatment of intra-articular distal end radius fractures. Methods: This prospective, observational and analytical study was conducted over one and a half years. Forty-seven adults with displaced intra-articular distal end radius fracture were included in the study. Twenty-one cases were treated with closed reduction and external fixation along with supplementary Kirschner wires, whereas 26 patients were treated with open reduction and volar locking plate fixation. Results: At the end of three months, as per the Green and O’Brien scoring, the mean functional outcome score in the volar plate group was significantly better 80.77(±11.46) than the external fixation group 70.24(±10.66) (p=0.002). However, at the end of six months, the mean score in the volar plate group 86.15(±7.39) was not significantly different from the external fixation group 81.43(±9.63) (p= 0.63). Fracture reduction was achieved and maintained better in the volar locking plate group. Conclusion: Functional outcome of closed reduction and external fixation along with supplementary Kirschner wires is comparable with open reduction and internal fixation by volar locking plate in treatment of displaced intra-articular distal radius fractures. Radiological correction is achieved and maintained better with volar locking plates
India Amidst COVID-19 Crisis: The Good, The Bad and The Ugly
Get PDFBeating the statistics: With a population of over a billion, high population density with overcrowding especially in metropolis and underdeveloped health infrastructure, the projections for corona virus disease (COVID-19) pandemic were not in favour of India. Most statistical models had predicted over 5 lakh cases and more than 38,000 deaths and warned that India must prepare for a tsunami of COVID-19 cases. The situation appeared to be grimmer given that the incidence of diabetes, hypertension and respiratory diseases due to tuberculosis andair pollution is higher amongst Indians which are known risk factors for severe disease and death due to COVID-19
Knowledge Regarding Blood Donation among Students of a College in Western Nepal
Get PDFIntroduction: Blood can save millions of lives, and young people are the hope and future of safe blood supply worldwide. This study was conducted with an objective to assess knowledge level regarding blood donation among college students. Methods: A cross sectional study was conducted at Shree Mandavya Multiple Campus, Palpa, among all years of Bachelor in Business Studies students. Census sampling technique was used and the sample size was 78. A structured questionnaire was used for data collection. Descriptive and inferential statistics (Chi-square) was used for analysis. The level of significance (p) was set at 0.05. Results: The mean age of the participants was 19.5 years. Majority (67.9%) of the participants were male and the remaining 32.1% were female. Most (87.2%) of them had never donated blood. Few (38.5%) of them had history of blood requirement in the family whereas, 23.1% had blood donation in family. More than half (51.3%) of participants had inadequate level of knowledge regarding blood donation. The study showed that sex (p=0.04), history of self-blood donation (p=0.03) and history of blood requirement in the family (p=0.01) were found statistically significant with level of knowledge regarding blood transfusion. Conclusion: This study showed that majority of the students had inadequate knowledge regarding blood donation. Thus, it is very important to adopt strategies to sensitize and motivate them towards voluntary blood donation
Dermatoglyphic Patterns Among Undergraduate Students of a Medical College: A Descriptive Cross-sectional Study
Get PDFIntroduction: Dermatoglyphics is the science that deals with the study of dermal ridge patterns on the digits, palms and soles as a whole. The present study is based on fingerprints related with the dermatoglyphic patterns of digits of hands. Apart from individual identification in institutions, it is also useful in forensic investigations to identify the criminals or dead bodies in accidental cases. This study aimed to find out the fingerprint patterns in right and left hands of undergraduate medical students. Methods: The study was performed in 200 students (97 males and 103 females) from first and second years of MBBS and B.Sc. nursing streams. The fingerprints were collected individually by pressing each of the finger tips on the stamp pad and then pressing it on A4 sized plain paper until the best finger print was observed. Results: Out of 2000 fingerprints, 1218(60.9%) were loops, 581 (29.05%) were whorls, 134(6.7%) were arches, and 67(3.35%) were composites. In males, there were 620 loops, 226 whorls, 98 arches and 26 composites whereas 602 loops, 351 whorls, 36 arches and 41 composites were found in females. Conclusion:The loop patterns were more common than other fingerprint patterns. Comparatively arches and loops were more common in males and whorls and composites in female
COVID-19 Pandemic: A Surgical Perspective from Japan
Get PDFJapan reported its first COVID-19 case after a returnee from Wuhan, China tested positive for the virus on 16 January, 2020. On April 8, the Japanese government declared emergency in Tokyo and six other prefectures of the country; a nationwide emergency was declared on April 16. The total reported cases were 15,477 and total deaths 755 as of May 7, 2020.Japan Surgical Society (JSS) and Japanese Society of Gastroenterological Surgery (JSGS) have published recommendations for surgery and appropriate measures of safety. Patients are triaged based on the severity of their disease and level of outbreak. The Elective Surgery Acuity Scale (ESAS) by American College of Surgeons is recommended to triage the patients. The guidelines consider the risk of infection during the interventions that generate aerosol such as tracheal intubation, extubation, tracheostomy, mask ventilation, bronchoscopy,chest drainage, gastrointestinal endoscopy etc