scholarly journals Laparoscopic Management of Benign Ovarian Masses

2013 ◽  
Vol 52 (192) ◽  
Author(s):  
Rachana Saha ◽  
Chanda Karki
Keyword(s):  
Laparoscopic Surgery ◽  
College Teaching ◽  
Operative Techniques ◽  
Medical College ◽  
Laparoscopic Assisted Vaginal Hysterectomy ◽  
Endometriotic Cyst ◽  
Operative Findings ◽  
A Prospective Study ◽  
Laparoscopic Assisted ◽  
Ovarian Masses

Introduction: Laparoscopic surgery is one of the most common procedures performed for benign ovarian masses. The aim of the study was to analyze all benign ovarian masses treated laparoscopically to assess safety, feasibility and outcome.Methods: A prospective study was carried out at Kathmandu Medical College Teaching Hospital, Sinamangal, Nepal. All the patients undergoing laparoscopic surgery for benign ovarian masses from 1st January 2012 to 31st December 2012 were included in the study. The pre-operative findings, intra-operative findings, operative techniques and post-operative complications were analyzed.Results: Thirty-six patients were taken for the study. Two cases were excluded since intra-operatively they were tubo-ovarian masses. The most common tumor was dermoid cyst (n=13; 38.23%) and endometriotic cyst (n=14; 41.17%). Out of 34 cases, five cases of endometriotic cyst (14.70%) were converted to laparotomy due to severe adhesions and four cases of endometriotic cyst underwent deroofing surgery. Two cases underwent laparoscopic assisted vaginal hysterectomy with bilateral salphingo-oopherectomy. Successful cystectomies were carried out in 22 cases. None were malignant. Major complications were not noted while minor complications like port-site infection (n=3; 8.82%) and subcutaneous emphysema (n=1; 2.9%) were present.Conclusions: Laproscopic management of benign ovarian masses is safe and feasible.

scholarly journals Nutritional Status of Under-Five Children in Western Nepal

2014 ◽  
Vol 34 (2) ◽  
pp. 119-124 ◽  
Author(s):  
Bandana Shrestha
Keyword(s):  
Who Classification ◽  
College Teaching ◽  
Standard Technique ◽  
Tertiary Hospital ◽  
Major Health Problem ◽  
Under Five ◽  
Under Five Children ◽  
Medical College ◽  
High Prevalence ◽  
A Prospective Study

Introduction: Undernutrition is a major health problem in developing countries which may have adverse effects on growth and development of an individual. The objectives of this study were to assess the prevalence and grades of malnutrition in children below 60 months of age, attending outpatient department at Gandaki Medical College teaching hospital.Materials and Methods: A prospective study was conducted among 556 children below 60 months of age from August to December 2013. Weight and length/height were measured using standard technique and were plotted on WHO centiles curves and severity determined based on WHO classification. The prevalence of underweight, stunting and wasting were determined by anthropometry.Results: Based on WHO classification, out of 556 children, 20.2% were underweight, 34% were stunted and 15.1% were wasted respectively. Of them, severe underweight were 4.7%, severe stunted were 14.1% and severe wasted were 7.2% respectively.Conclusion: A high prevalence of undernutrition exists in under- five children attending a tertiary hospital in a western region of Nepal.DOI: http://dx.doi.org/10.3126/jnps.v34i2.10566J Nepal Paediatr Soc 2014;34(2):119-124      

scholarly journals Gastric Cancer in Nepal A Locally Advanced Disease

2019 ◽  
Vol 21 (3) ◽  
pp. 199-203
Author(s):  
Rabin Koirala ◽  
N. Acharya ◽  
S. Khanal ◽  
A. Rajbhandary
Keyword(s):  
Gastric Cancer ◽  
Locally Advanced ◽  
College Teaching ◽  
Albumin Level ◽  
Curative Intent ◽  
Duration Of Symptoms ◽  
Medical College ◽  
Duration Of Illness ◽  
Long Duration ◽  
Operative Findings

The goal of this study is to describe the distribution of gastric cancer by age, gender, duration of symptoms, nutritional status and staging of the disease based on operative findings and correlation between the data. This was an observational study. The study was conducted at Department of Surgery, Nepal Medical College Teaching Hospital from December 2012 to December 2017. All patients who were admitted to the department with a diagnosis of stomach cancer and underwent palliative or curative intent procedure were reviewed and analyzed. Out of the 80 patients, 51(63.7%) were male and 29 (36.3%) patients were female. The disease was commonest in the 6th and 7th decades of life. Majority of the patients were of Tibetoburmese (Mongolian) origin with 44 (55%). Majority of patients, 60 (75%) patients had long duration of illness of more than 6 months. Most of the patients had albumin level less than 3gm/dl. Gastric carcinoma is a male predominant malignancy usually of old age and commonly observed in the Tibeto-Burman group of people. Overwhelming majority diagnosed at an advanced stage and had poor prognosis.

scholarly journals Retrospective analysis of elective hysterectomy cases in a tertiary care centre

2018 ◽  
Vol 7 (9) ◽  
pp. 3714
Author(s):  
Divya R. Prasad ◽  
Neelima V. Nair
Keyword(s):  
Retrospective Analysis ◽  
Vaginal Hysterectomy ◽  
Tertiary Care ◽  
Abdominal Hysterectomy ◽  
Care Centre ◽  
Tertiary Care Centre ◽  
Medical College ◽  
Fibroid Uterus ◽  
Laparoscopic Assisted Vaginal Hysterectomy ◽  
Laparoscopic Assisted

Background: Often hysterectomy remains the only option available in many gynaecological conditions, though it is resented by most women. This study aims to analyse the cases of hysterectomy performed in a tertiary care centre in India, with a view to modify and improve health care provided to women.Methods: A retrospective analysis of 500 cases of elective hysterectomy in Sree Gokulam Medical College and Research Foundation from January 2016 to December 2017 was done from hospital records. The observations according to age, indications of hysterectomy, route of hysterectomy and preservation of ovaries were statistically analysed.Results: 35.2% (176 cases) were between 45 and 50 years. Mean age was 48±2 years. 90.4% (452 cases) were done in women above 40 years of age. The commonest indication for hysterectomy was symptomatic fibroid uterus 59.4% (297 cases). 81.8% (409 cases) women underwent abdominal hysterectomy while 18.2 % (91 cases) women underwent vaginal hysterectomy or laparoscopic assisted vaginal hysterectomy. 84.6% (77 of 91 cases) of vaginal hysterectomy was done for prolapse uterus. Preservation of one or both ovaries was done in 47.2% (236 cases).Conclusions: Hysterectomy is usually done after the age of 40 years with the mean age being 48±2 years. Symptomatic fibroid uterus was the most common indication. The rates of vaginal hysterectomy were lower for indications other than prolapse uterus. Ovaries were preserved in several cases.

scholarly journals A clinical study of intestinal stomas in emergency laparotomy: its complications

2017 ◽  
Vol 5 (1) ◽  
pp. 273
Author(s):  
Jawahar Krishnaswamy ◽  
Senthil Kumar ◽  
Mukesh K. ◽  
Khalilur Rahman
Keyword(s):  
Loop Ileostomy ◽  
Tertiary Hospital ◽  
Common Type ◽  
Emergency Laparotomy ◽  
Time Duration ◽  
Female Ratio ◽  
Medical College ◽  
Careful Clinical Examination ◽  
Operative Findings ◽  
A Prospective Study

Background: Intestinal stoma is an opening for fecal diversion. The purpose of the present study was to identify indications for emergency laparotomy, commonly performed intestinal stomas and to study complications related to it.Methods: This is a prospective study was carried out in a surgical unit of Saveetha Medical College & Hospital, Chennai, Tamilnadu, from August 2012 to August 2013. Data was collected by meticulous history taking including age, gender, indication, type of stoma, type of surgery, careful clinical examination, appropriate operative findings and follow up of the cases. The results were collected, analyzed and compared.Results: A total of 74 patients were evaluated age ranged between 16 to 78 years. Male to female ratio was 7:2. The most common type of stoma made was loop ileostomy (60%) followed by end ileostomy (30%) and loop colostomy (9%). Main indication for emergency laparotomy was intestinal obstruction (44%). The most common type of stoma performed was loop ileostomy (60%). The most dreaded complication of stomal closure is anastomotic leakage.Conclusions: Early referral to the tertiary hospital, early diagnosis, proper preoperative management like intravenous fluids, antibiotics, etc., early detection and prevention of hypotension, reduction of time duration for emergency laparotomy, close post-operative monitoring definitely reduce the morbidity and mortality of stomal closure, when intestinal stomas kept for emergency cases.

scholarly journals A prospective study on emergency laparoscopic or open cholecystectomy in acute cholecystitis in a tertiary care hospital

2019 ◽  
Vol 6 (7) ◽  
pp. 2525
Author(s):  
Hari Babu M. A. ◽  
Hareesh G. S. R. ◽  
Praneeth Reddipogu ◽  
Venkata Ramanaiah Nannam
Keyword(s):  
Acute Cholecystitis ◽  
Open Cholecystectomy ◽  
Tertiary Care ◽  
Gallbladder Wall ◽  
Good Prognosis ◽  
Care Hospital ◽  
Medical College ◽  
Single Centre Study ◽  
Operative Findings ◽  
A Prospective Study

Background: Gallstones are among one of the most common diseases affecting the digestive system requiring hospitalisation with a prevalence of 11% to 36%. Until 2 decades ago, patients presenting with acute cholecystitis were treated conservatively and a delayed interval cholecystectomy was performed after 6 weeks, now a days laparoscopic cholecystectomy was gaining popularity in acute cholecystitis. It cannot be said with certainty preoperatively whether the cholecystectomy is going to be easy or difficult. The aim of the study was to evaluate safety and outcomes of emergency laparoscopic or open cholecystectomy in acute cholecystitis.Methods: This is a prospective, observational, single centre study conducted in the Department of General Surgery, S.V. Medical College/ SVRRGG hospital, Tirupati, for a period of one year from the time of approval of IEC. All patients undergoing emergency laparoscopic or open cholecystectomy for acute cholecystitis and its related complications are studied for various clinical, radiological and other variables.Results: Total 100 patients who presented with acute cholecystitis and undergone cholecystectomy are studied. Age, sex, BMI, comorbities, clinical and usg criteria and intra-operative findings and post-operative complications are analysed.Conclusions: Difficult dissection in cholecystectomy can be predicted using pre-operative parameters like increasing age, male gender, multiple attacks in the past, gallbladder wall thickness >3 mm, and presence of pericholecystic fluid. Surgery performed within 72 hrs had good prognosis and few intra op complications due to good place of dissection due to inflammation.

scholarly journals Single incision multiport laparoscopic appendectomy using a 2 mm alligator forceps: our experience of 60 cases

2020 ◽  
Vol 7 (8) ◽  
pp. 2714
Author(s):  
Srikant Patro ◽  
Ashish K. Sahoo ◽  
Nikhil Muduli ◽  
Ashish K. Mishra ◽  
Tapan Kumar ◽  
...  
Keyword(s):  
Laparoscopic Surgery ◽  
Prospective Study ◽  
Laparoscopic Appendectomy ◽  
General Surgery ◽  
Operative Time ◽  
Single Incision ◽  
Single Incision Laparoscopic Surgery ◽  
Medical College ◽  
Post Operative Pain ◽  
A Prospective Study

Single incision laparoscopic surgery is an emerging branch of minimally assess surgery to reduce scar and post-operative pain. Appendicitis is a common general surgical problem encountered in day to day practice. Different methods of appendectomy have been described by different surgeons from open to laparoscopic and now single incision laparoscopic surgery has been practised. This is a prospective study carried out in our Department of General Surgery SCB Medical College, Cuttack from February 2019 to March 2020; 60 patients had undergone the procedure and the results are published noted under headings of post-operative pain at (6 hours, 12 hours, 24 hours and 48 hours), post-operative requirement of analgesia (diclofenac) at (6 hours, 12 hours, 24 hours and 48 hours), operative time, days to resume bowel activity, days of hospital stay, post-operative complication in accordance to Clavien-Dindo classification.

scholarly journals Importance of Routine Histopathological Examination of Gallbladder Specimen in Detecting Incidental Malignancies

2016 ◽  
Vol 4 (1) ◽  
pp. 15
Author(s):  
Archana Tiwari ◽  
Ramji Rai ◽  
Surendra Kumar Jain
Keyword(s):  
Gall Bladder ◽  
Gallbladder Carcinoma ◽  
Histopathological Examination ◽  
College Teaching ◽  
Biliary Tree ◽  
Epidemiological Studies ◽  
Medical College ◽  
Common Location ◽  
Incidental Gallbladder Cancer ◽  
A Prospective Study

Introduction: Gallbladder carcinoma is the most common cancer of biliary tree and the 5th most common gastrointestinal malignancy.  An early diagnosis is essential as this malignancy progresses silently with a late diagnosis and poor prognosis. Epidemiological studies have identified striking geographic and ethnic variation with high occurrence in Southeast Asia, yet low elsewhere in the world. Gallbladder carcinoma, in 15-30% of patients, show  no preoperative  or intraoperative evidence and are detected only on histopathological examination. They are called as incidental gallbladder cancer (IGBC). The objective of this study was to find out the occurrence of IGBC in cholecystectomy specimens received in our histopathology laboratory and to analyze their clinico-pathological features.   Methods: This was a prospective study carried out in the Department of Histopathology, Lumbini Medical College Teaching Hospital during a period of two years from May 2014 to April 2016. The study included 800 cases of cholecystectomized Gall bladder specimens.   Result: Ninety seven percent of the specimens (n=776) revealed benign pathology. Malignancy was detected incidentally in 8 cases (1.25%). The mean age of patients with incidental Gall bladder carcinoma was 69 years (SD=4.1) and F:M ratio was 9:1. Out of 10 incidental malignancies, cholelithiesis was found in 8 (80%) cases. Fundus was the most common location (n=5, 50%) and focal fragile necrotic area was most common (n=3, 30%) gross morphology. On pathological staging, all the incidentally detected malignancies (n=10) were found to be in surgically resectable stages.   Conclusion: IGBC was found in 1.25% of the gallbladder specimen. Detailed gross and histopathological examination of gallbladder specimen is mandatory for every cholecystectomy specimen, even for benign diseases, to detect incidental carcinoma at potentially curable stage.

scholarly journals Misoprostol Versus Oxytocin for Induction of Labour at Term and Post Term Pregnancy of Primigravida

2018 ◽  
Vol 6 (2) ◽  
pp. 56-59
Author(s):  
Malati Tripathi ◽  
Ayushma Adhikari ◽  
Bibhushan Neupane
Keyword(s):  
College Teaching ◽  
Induction Of Labour ◽  
Delivery Time ◽  
Term Pregnancy ◽  
Time Duration ◽  
Medical College ◽  
Obstetrics And Gynaecology ◽  
Sublingual Misoprostol ◽  
A Prospective Study ◽  
Post Term Pregnancy

Introduction: To compare effectiveness and safety of sublingually administered misoprostol and intravenously infused 10 units of oxytocin for labor induction at term and post term pregnant women in Gandaki Medical College Teaching Hospital (GMCTH). Materials and methods: This is a prospective study conducted in Department of Obstetrics and Gynaecology in Gandaki Medical College and performed on 120 patients of primigravida with cephalic presentation at term and post-term pregnancy. Patients were given 50µg sublingual misoprostol 6 hourly (two doses) and 5 units of oxytocin in 500ml RL started from 10 drops up to 60 drops till effective contraction occur with maximum of 10 units oxytocin. Maternal and fetal outcomes were observed. Collected data were analyzed using SPSS and MS Excel.  Results: There were no significant differences between the groups concerning time duration between inductions to delivery time, indications of caesarean section, different modes of delivery and for the Apgar score at one and five minutes.  Conclusion:  Both oxytocin and misoprostol are effective and safe for induction of labour.

scholarly journals Pattern and Etiology of Mandibular Fractures Reported at Nepalgunj Medical College: A Prospective Study

2017 ◽  
Vol 13 (2) ◽  
pp. 21-24
Author(s):  
Niva Kansakar ◽  
Bikram Budhathoki ◽  
Namdev Prabhu ◽  
Anjani Kumar Yadav
Keyword(s):  
Prospective Study ◽  
Traffic Accidents ◽  
Road Traffic ◽  
College Teaching ◽  
Mandibular Fracture ◽  
Mandibular Fractures ◽  
Age Group ◽  
Road Traffic Accidents ◽  
Medical College ◽  
A Prospective Study

Background: Mandibular fracture is one of the most common fractures of the maxillofacial region. The pattern of mandibular fractures varies from country to country and these variations can be due to social, cultural, and environmental factors. Objectives: This study was conducted to evaluate the etiology, incidence and pattern of mandibular fractures in western region of Nepal, reported at Nepalgunj Medical College Teaching Hospital.Methodology: A prospective study of 130 patients with mandibular  fractures  was  conducted  in  Department  of  Dentistry,  Nepalgunj  Medical  College  Teaching  Hospital  from  November  2013  to November 2014. These patients were examined both using clinical and radiographic parameters for mandibular fracture. Data concerning age, gender, causes of fracture and sites of fracture were analyzed.Result: Out of 130 patients, 104(80%) were male patients and 26(20%) were female patients. Most common age group was between 21-30 years. Most common cause of mandibular fracture was road traffic accidents accounting for 66(50.77%) cases followed by fall injury in 30(23.08%) cases. Most common site involved was parasymphysis 46(30.47%) followed by angle 27(17.89%).  Road traffic  accidents due to alcohol  consumption 40(68.97%) was the leading cause followed by assault 10(17.24%) and fall 8(13.79%).Conclusion: Mandibular fractures are more frequent  in  male  than  female  with  higher  frequency  in  21-30  years  age  group.  The most commonly fractured site was the parasymphysis. Road traffic accidents were the most common etiology and significantly associated with alcoholism. JNGMC Vol. 13 No. 2 December 2015

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