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Pokhara, Nepal

Koirala K.,Manipal Teaching Hospital
Asian Pacific Journal of Cancer Prevention | Year: 2015

Background: Laryngeal malignancy is a common malignancy of the head and neck region. Affected patients usually present with features that are characteristic of certain subsites. The larynx is oncologically divided into three: supraglottis, glottis and subglottis. Studies from Western countries have shown that the glottis is the commonest subsite to harbour laryngeal malignancy. However, the supraglottis has been reported to be the commonest subsite in developing countries, including examples in the Indian subcontinent. To our knowledge, no study has been carried out in western Nepal about the epidemiology of laryngeal cancer to date. The purpose of this study was to analyse the epidemiology of laryngeal cancer in relation to its risk factors, age distribution,and preferred subsites and to see if there is any recent change in the subsite wise distribution of laryngeal malignancy in western Nepal. Materials and Methods: Patients of all ages and both sexes with suspected laryngeal malignancy were enrolled in the initial study. Detailed history taking and clinical examination was performed to find out the involved subsite in relation to the clinical features. Direct laryngoscopy was performed to further confirm the subsite and to take biopsy from the growth under general anesthesia. After confirmation of malignancy from the biopsy report, patients were finally included in the study. Data were analysed and observations were made to find out the distribution of laryngeal malignancy in different subsites. Results: The supraglottic larynx was the commonest subsite to harbor laryngeal malignancy. Smoking and alcohol were found to be the common risk factors. The mean age of the patients was in their sixties. Conclusions: Laryngeal malignancy is common in elderly individuals. Supraglottic laryngeal malignancy is the commonest laryngeal malignancy in people who smoke and drink alcohol in Nepal. Avoidance of alcohol use and smoking will be a milestone to reduce the incidence of laryngeal cancers and associated mortality.

Ranjeet N.,Manipal Teaching Hospital | Estrella E.P.,Philippine General Hospital
Journal of Clinical and Diagnostic Research | Year: 2012

Introduction: Distal radius fractures are common fractures which are treated by orthopaedic surgeons. However, they are complex injuries with a variable prognosis and if they are not treated optimally, they can be associated with various complications. Methods and Materials: We studied 80 cases of closed distal radius fractures. These patients were treated and their X-rays were evaluated to determine whether the reduction was radiologically acceptable or not. These patients were then followed up at 1.5 and 3 months to evaluate them both radiologically as well as functionally by using the Modified Mayo Scoring System and the Gartland and Werley's Functional Scoring System. Results: In our study, 68 patients had an acceptable reduction and 12 patients had an unacceptable reduction. All the fractures healed by the end of the study. The radiological parameters improved from the pre-operative to the immediate postoperative X-ray and all the parameters remained the same till 3 months of follow up. The grip strength improved during the 1.5 to the 3 months follow up. We observed that the trend of the final X-ray score correlated with the pre-treatment X-ray score: however, the functional outcome did not correlate with the X-ray scores. Conclusion: We could not find any correlation between an acceptable reduction to a better functional outcome according to the G and W and the MM scores. We believe that a longer follow up will give us the true functional outcome of these patients and thus a true picture of the correlation between them.

Batajoo H.,Manipal Teaching Hospital
Journal of Nepal Health Research Council | Year: 2013

Gallstone diseases being common disorder, multiple studies have shown an association between gallstones and abnormal lipids. This study is to compare the serum lipid abnormalities in females who have cholelithiasis with controls. A retrospective study of females who underwent cholecystectomy for gallstone disease was carried out. A total of 133 patients were divided into two age groups ≤ 40 and >40 years. In age group ≤ 40 years, there were 72 cases with no controls, whereas, in >40 years, 61 cases were compared with 67 controls. The serum lipid profile were collected and compared according to the age groups. The groups were compared by using Student's t-test, p<0.05 was considered statistically significant. In age group >40 years serum LDL of gallstone patients were statistically significantly raised (P<0.05) (95% CI -22.077; -850) compared with controls and serum total cholesterol and triglycerides were not statistically significantly high (P >0.05). Serum HDL and VLDL were lower in gallstone patients but not statistically significant (P >0.05) compared to control group. The study showed that serum LDL level was statistically significant in females >40 years of age, whereas other parameters were not statistically significantly different.

Allurkar V.M.,Manipal Teaching Hospital
Nepal Medical College journal : NMCJ | Year: 2010

Dilated cardiomyopathy (DCM) is a common cause of congestive cardiac failure all over the world. Most cases are idiopathic and sporadic. However, an increasing number are found to have a genetic basis which accounts for about 25.0-30.0% of cases all over the world. Different modes of inheritance and mutations have been implicated in these familial cases. Regardless of the type, they usually present in an advanced state with features of congestive cardiac failure or with complications like arrhythmia and sudden cardiac death and have a high mortality rate of 15.0-50.0% at 5 years. Hence in all DCM cases, detailed family history and if possible screening examination of the relatives is to be done so as to diagnose the familial cases in an early stage and prevent the likely complications. Here we present an interesting case of familial dilated cardiomyopathy (FDC) in which all four sons of the family are suffering from a heart disease while all the daughters are spared.

Banerjee I.,R G Kar Medical College | Chakraborty P.K.,Manipal Teaching Hospital
BMC Psychiatry | Year: 2013

Background: Currently a large number of atypical antipsychotics available in the market are endorsed as better option for treating schizophrenia than the typical antipsychotics. Information regarding the utilization pattern of antipsychotic drugs is lacking in Nepalese population particularly in Western Nepal. By means of this study one is expected to acquire an idea concerning clinician's preference to the antipsychotic drugs in actual clinical setup. The main objective of the study was to find the commonest antipsychotics prescribed in a tertiary care center among hospitalized patients in Western Nepal.Methods: This cross sectional study was carried out between 1st January 2009 and 31th December 2010 at Manipal Teaching Hospital, Nepal. The diagnosis of schizophrenia was based on ICD-10 (Tenth revision).The main outcome variables of the study was commonest antipsychotic drug prescribed. Z test, Chi square test and logistic regression were used for analytical purpose. P-value < 0.05 was considered to be statistically significant. This is the first study done on the utilization pattern of antipsychotics drugs among hospitalized patients in Nepal.Results: Out of 210 cases of schizophrenia, most of the patients were less than 40 yrs. 78.6%, male 61.9%, unemployed 86.7% and having their monthly income less than NPR 10000 /month 80.5%. As far as religion, 78.1% patients were the Hindus and ethnically schizophrenia was common among the Dalit 26.2%. The study revealed that 46.2% of patients were students followed by 25.2% of housewives. Olanzapine was the commonest antipsychotic drug to be prescribed 34.3%. It was observed that the psychiatrists had a tendency of using antipsychotic drugs by trade names [OR 3.3 (1.407, 8.031)] in male patients as compared to female patients.Conclusion: According to the utilization pattern of antipsychotics, it is concluded that atypical antipsychotics were used relatively more commonly than that of typical antipsychotics. Among the atypical antipsychotic drugs, there is a trend of using Olanzapine during Schizophrenia as compared to other atypical antipsychotic drugs in Western Nepal. © 2013 Banerjee et al.; licensee BioMed Central Ltd.

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