Showing papers in "Nepal Medical College journal in 2003"
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TL;DR: While significant progress has been achieved over the past 30 years in reducing the proportion of malnourished children in developing countries, nonetheless, malnutrition persists affecting large numbers of children.
Abstract: Approximately 70.0% of the world's malnourished children live in Asia, resulting in the region having the highest concentration of childhood malnutrition. About half of the preschool children are malnourished ranging from 16.0% in the People's Republic of China to 64.0% in Bangladesh. Prevalence of stunting and underweight are high especially in South Asia where one in every two preschool children is stunted. Besides protein-energy malnutrition, Asian children also suffer from micronutrient deficiency. Iron deficiency anaemia affects 40.0-50.0% of preschool and primary school children. Nearly half of all vitamin A deficiency and xeropthalmia in the world occurs in South and Southeast Asia, with large numbers of cases in India (35.3 million), Indonesia (12.6 million) and China (11.4 million). Another major micronutrient problem in the region is iodine deficiency disorders, which result in high goiter rates as manifested in India, Pakistan and parts of Indonesia. While under-nutrition problem persists, overweight problem in children has emerged in Asia, including Taiwan, Singapore and urban China and Malaysia. The etiology of childhood malnutrition is complex involving interactions of multiple determinants that include biological, cultural and socio-economic influences. Protein-energy malnutrition and micronutrient deficiency leading to early growth failure often can be traced to poor maternal nutritional and health care before and during pregnancy, resulting in intrauterine growth retardation and children born with low birth weight. While significant progress has been achieved over the past 30 years in reducing the proportion of malnourished children in developing countries, nonetheless, malnutrition persists affecting large numbers of children. The socio-economic cost of the malnutrition burden to the individual, family and country is high resulting in lower cognitive outcomes in children and lower adult productivity. Interventions that are cost-effective and culturally appropriate for the elimination of childhood malnutrition deserve the support of all.
89Ā citations
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TL;DR: It was seen that these school going girls needed education about the abnormalities of menstruation so that they can differentiate the normal phenomenon from abnormality and report in time in case of aberrance in the menstrual cycle.
Abstract: Puberty is the biological transition between the immature and adult reproductive function. This study has been carried out to find out the menstrual pattern, and awareness of the abnormalities in menstrual pattern among school going pubertal age group girls in Dharan. It has been carried out with the aim to follow it with school health education. Cross sectional study was done in 96 girls of two different school of Dharan of the age group ranging from 11 years to 17 years. The median age of menarche was 12 years. There were 6.9% cases of oligomennorhea and 10.0% of hypomenorhea. Menorrhagia was seen in 6.2% of the girls. Spasmodic dysmenorrhea was seen in 67.0% of the girls but the daily activity was hampered only in 20.0%. Out of the 96 students 73.0% were prepared psychologically beforehand. Very less students (8.0%) knew only very little about the abnormalities in menstruation, rest were ignorant about it. Thus, it was seen that these school going girls needed education about the abnormalities of menstruation so that they can differentiate the normal phenomenon from abnormality and report in time in case of aberrance in the menstrual cycle.
45Ā citations
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TL;DR: A small-scale cross sectional study on intestinal parasitosis was conducted in a remote hilly village in western Nepal in January 2001 and Dalits (the lower caste people) had highest prevalence than Tibeto-Burman and Indo-Arvan ethnic (P>0.05).
Abstract: A small-scale cross sectional study on intestinal parasitosis was conducted in a remote hilly village in western Nepal in January 2001. Stool samples collected from 115 inhabitants (M: 41 and F: 74; Aged: 1 to 89 years) were examined by direct smear method in duplicate. Overall positive rate was 27.0% with a marginally high positive rate in males (P>0.05). Dalits (the lower caste people) had highest prevalence (71.4%) than Tibeto-Burman and Indo-Arvan ethnic (P>0.05). Higher prevalence was observed in adults than in children. Eighty percent of subjects had single parasite infection. Altogether, six types of parasites were detected of which Ascaris lumbricoides was most common. People having toilet had marginally low positive rate. All subjects included in this study were drinking raw water. Occupation wise, farmers had marginally high prevalence.
26Ā citations
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TL;DR: Seroprevalence of Toxoplasma infections in 272 patients with ocular diseases, malignancy, women with bad obstetric history (BOH) and others (patients with fever, lymphadenitis and encephalitis) have been studied.
Abstract: Seroprevalence of Toxoplasma infections in 272 patients with ocular diseases (uveitis, retinochoroiditis), malignancy (including leukemia), women with bad obstetric history (BOH) and others (patients with fever, lymphadenitis and encephalitis) have been was studied. Toxoplasma antibodies were detected by microlatex agglutination and IgM ELISA techniques. Overall, 50.7% (138/272) patients included in this study had Toxoplasma antibodies, out of which 5.7% (8/138) had IgM antibodies. Patients with malignancy had highest positive rate [68.7% (22/32)] followed by group of others. Of the different groups, women with BOH had highest Toxoplasma IgM positive rate [25.0%; (2/8)].
15Ā citations
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TL;DR: Routine pap smear screening in patients attending gynecological OPD is the good method of detecting precancerous cervical intraepithelial neoplasia (CIN) lesion and early cervical cancer, which would go undiagnosed otherwise with worst morbidity and mortality.
Abstract: This study was undertaken to evaluate the prevalence of Cervical precancerous and Cancer pick up by single pap smear test. A prospective study of pap smear test of three years duration 2000-2002 in Obstetrics and Gynecology department, NMCTH, Kathmandu. A total 800 cases were included Maximum number of patients are in the age group of active reproductive period (21-40 yr) with higher rate of an abnormal smear in Brahmin ethnic group. The main complaints are of lower abdominal pain and white discharge per vaginum. The main cervical pathology is cervicitis, cervical erosion and cervical hypertrophied with bleeding on touch. 4.8% of the patients had abnormal smear including three patients with invasive cervical squamous cell carcinoma detected on pap smear test. This study shows that routine pap smear screening in patients attending gynecological OPD is the good method of detecting precancerous cervical intraepithelial neoplasia (CIN) lesion and early cervical cancer, which would go undiagnosed otherwise with worst morbidity and mortality. We should try to cover 100% screening if possible in an institution at least to begin with.
14Ā citations
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TL;DR: Thyroid neoplasm was the commonest patients followed by tumour of larynx, oropharyngeal tumour and oral cavity tumour, which ranked number one, and all head and neck tumours were squamous cell carcinoma.
Abstract: This retrospective study was carried out to analyze the types of head and neck tumours on the basis of site and histopathological type. A total of 35 patients with head and neck tumours (M: 19 and F: 16; aged 15 to 68 years) were included. Thyroid neoplasm was the commonest (20.0%) patients followed by tumour of larynx (17.1%), oropharyngeal tumour and (14.3%), oral cavity tumour ranked number one (14.3%) followed by tumours of nose (11.4%) and others. All thyroid neoplasms were follicular type whereas all laryngeal tumours were squamous cell carcinoma.
12Ā citations
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TL;DR: The use of pessary is 25% among female with genital prolapse but only a few were following medical advice to change the ring, and 79% of women with genital Prolapse had all children born at home without help.
Abstract: Genital prolapse is one of the commonest reproductive morbidity in developing country Common predisposing factors are multiparity, early postpartum sternous activity, advanced age and menopause This study conducted in Bhaktapur district in five months included 1337 women aged 20 and above The prevalence of female genital prolapse found to be 755% Maximum numbers of women were having children eight and more (4851%) Only 19% of women with genital prolapse were nulliparous Home delivery is still common in Bhaktapur, 79% of women with genital prolapse had all children born at home without help Regarding post partum activity majority of them (643%) told that they took rest at least one month after delivery but 2673% started working in field in 2-3 weeks after delivery The use of pessary is 25% among female with genital prolapse but only a few were following medical advice to change the ring Nine women were having impacted ring in situ for years
12Ā citations
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TL;DR: The demographic status of vasectomy clients in Sankhuwasabha district in Eastern Nepal is presented based on the 427 face-sheets taken at camps in district during 3 consecutive years, with more than half of clients being Brahmin and Chhetri.
Abstract: This paper presents the demographic status of vasectomy clients in Sankhuwasabha district in Eastern Nepal based on the 427 face-sheets taken at camps in district during 3 consecutive years. More than half (55.0%) of the clients were Brahmin and Chhetri. Major occupation of clients was agriculture (73.7%) with a literacy rate of 83.0%. Mean age of vasectomy clients and their wives was 32.5 and 28.7 years respectively. Average number of children of a client was 3.2. Age of youngest male child was 4.7 years and youngest female child was 3.9 years. Of the total 55.8% couples have had used temporary contraceptives before having vasectomy. As a part screening procedure blood pressure of more than half clients (54.6%) was measured and found to be within normal range. (authors)
7Ā citations
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TL;DR: Ketamine reliably, safely, and quickly provided adequate sedation to effectively facilitate the reduction of children's fractures at the small clinic setup of rural Nepal.
Abstract: Recently there has been a resurgence in the utilization of ketamine, a unique anaesthetic, for emergency procedures requiring sedation. The purpose of the present study was to examine the safety and efficacy of ketamine for sedation in the treatment of children's fractures in the small clinic setup of rural Nepal. One hundred and fourteen children (average age, 5.3 years; range, twelve months to ten years and ten months) who underwent closed reduction of an isolated fracture or dislocation in the Orthopaedic & Trauma Clinic at Janakpurdham were prospectively evaluated. Ketamine hydrochloride was administered intravenously (at a dose of less than two milligrams per kilogram of body weight) in ninety-nine of the patients and intramuscularly (at a dose of four milligrams per kilogram of body weight) in the other fifteen. Adequate fracture reduction was obtained in 111 of the children. Ninety-nine percent (sixty-eight) of the sixty-nine parents present during the reduction were pleased with the sedation and would allow it to be used again in a similar situation. Minor side effects included nausea (thirteen patients), emesis (eight of the thirteen patients with nausea), clumsiness (evident as ataxic movements in ten patients), and dysphonic reaction (one patient). No long-term sequelae were noted, and no patients had hallucinations or nightmares. Ketamine reliably, safely, and quickly provided adequate sedation to effectively facilitate the reduction of children's fractures at our institution. Therefore, it was ideal for small clinic in our setup.
7Ā citations
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TL;DR: A case of solid and cystic tumor arising in the lesser Omentum of a 53 year old woman is presented and a well defined, encapsulated tumor was histologically characterized by a combination ofSolid and pseudo papillary growth patterns of tumor cells with pale to eosinophilic cytoplasm.
Abstract: A case of solid and cystic tumor arising in the lesser Omentum of a 53 year old woman is presented. A well defined, encapsulated tumor measuring 7.5 x 6.5 x 6 cms, weight 170 grams was histologically characterized by a combination of solid and pseudo papillary growth patterns of tumor cells with pale to eosinophilic cytoplasm. No pancreatic tissue was seen with or adjacent to the tumor. The patient was well with out recurrence 7 months after the diagnosis. It is important to include pseudo papillary solid cystic tumor in the differential diagnosis of omental tumors. The tumor is presented because of its rarity.
6Ā citations
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TL;DR: In anterior AMI, ST elevation in aVR, aVL and ST depression in inferior leads can predict the occlusion site in LAD proximal to first diagonal and first septal branch.
Abstract: The complications, therapy and prognosis are significantly determined by the exact location of occlusion site in left anterior descending (LAD) coronary artery in anterior acute myocardial infarction (AMI). This study assessed the role of Electrocardiogram (ECG) as a predictor of coronary artery occlusion site in anterior AMI. Sixty two patients of anterior AMI were divided into two groups according to the occlusion site in relation to first septal and first diagonal branches, proximal--group A and distal--group B. Their initial ECG were analyzed and interpreted. The number of patients having ST elevation in leads aVR and aVL (> or = 0.5 mm) were significantly higher in proximal group compared to distal ones (42.3% vs 2.8% and 73.1% vs 22.2%; p or = 1 mm), III (> or = 1 mm) and aVF (> or = 1 mm) were also significantly higher in proximal group (84.6% vs 22.2%, 88.5% vs 33.3% and 84.6% vs 22.2%; p or = 1 mm), III (> or = 1 mm) and aVF (> or = 1 mm) to predict the proximal lesion were 85.0%, 88.0% and 85.0% respectively, whereas specificity were 78.0%, 67.0% and 78.0% respectively. The ST elevation in a VR had 42.0% sensitivity and 97.0% specificity to predict proximal lesion. Similarly ST elevation in aVL (> or = 0.5 mm) had 73% sensitivity and 78% specificity. In anterior AMI, ST elevation in aVR, aVL and ST depression in inferior leads can predict the occlusion site in LAD proximal to first diagonal and first septal branch.
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TL;DR: The result showed that there is almost no difference in the age group of both case and control at the time of their consultation, and the menstrual pattern was not found to have changed in both groups excepts for those who had organic condition.
Abstract: Voluntary surgical contraception (VSC) is said to be one of the most popular, safe, effective and long term methods of birth control not only in Nepal but also in the world One of the very frequently suspected complication or effect of voluntary sterilization (female) is "post tubal sterilization syndrome" The term post tubal sterilization syndrome has been used variously to include abnormal menstrual bleeding, dysmenorrahoea, premenstrual distress, hysterectomy and miscellaneous other conditions like need for recanalisation, feeling of regret and menopausal syndrome Abnormal vaginal bleeding due to ovarian dysfunction has been a regular and common complaint of the female clients after their TS This study was carried out in a clinic setting to find out the level of satisfaction among the cases of VS Level of satisfaction was measured by whether the client regretted the procedure, whether their menstrual pattern was changed after the procedure, performed either by themselves or VSC by the husband and also by finding out how many of them needed hysterectomy and recanalisation procedure Women who had undergone TS were taken as the cases (group A) and those women whose husband has VSC were taken as control group (group B) The result showed that there is almost no difference in the age group of both case and control at the time of their consultation At the time of VS almost 60% (5653%) of cases were 70% (7123%) of the women were <29 years of age when their husbands were vasectomised 2615% of the women in group A were in the age group of 30-40 whereas this age group comprised of only 1538% in group B Average age at menarche was 14 years and average age at marriage 17 years The menstrual pattern was not found to have changed in both groups excepts for those who had organic condition Hysterectomy had been performed in only 5 cases at the age of 30, 34, 40, 42 and 43 years in group-A and in two case in group-B Indications of hysterectomy n these cases were (DUB) and fibroids Two patients in group-A had to undergo recanalisation but the indication in both the cases were loss of previous children
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TL;DR: The study carried out to assess whether Urinary Tract Infection (UTI) is a predisposing factor for Renal Stones (RS) formation found that males had higher incidence of RS than females with a prevalence of (p < 0.0001), and the higher occurrence of RS was observed in age group between 21-40 years for both genders.
Abstract: The study was carried out to assess whether Urinary Tract Infection (UTI) is a predisposing factor for Renal Stones (RS) formation. A total of 836 subjects (males 300; females 536) attending Surgery Out Patient Department (OPD) of which were either diagnosed of UTI or had been detected of RS for a period of two years from January 2001 to December 2002 were included. Of the 836, 240 had UTI and 596 were free from UTI. The prevalence of RS was higher without UTI (44.4%) than those with UTI (27.8%) in males. In case of females the result showed (17.6%) and (5.1%) in cases with and without UTI. Chi square test revealed statistically significant difference in the proportion of prevalence between subjects with and without UTI with (p < 0.01) in males and (p < 0.001) in females. Males had higher incidence of RS than females with a prevalence of (p < 0.0001). The higher occurrence of RS was observed in age group between 21-40 years for both genders.
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TL;DR: The findings of nationwide outbreak of acute hemorrhagic conjunctivitis (AHC) epidemic occurred in Nepal during summer 2003 are presented, where only ten percent of samples showed bacterial and no fungus were grown.
Abstract: This rapid communication present the findings of nationwide outbreak of acute hemorrhagic conjunctivitis (AHC) epidemic occurred in Nepal during summer 2003. Only ten percent of samples showed bacterial and no fungus were grown. On the contrary, viruses were detected in 60.0% cases studied. Of the viruses detected, Adenovirus (ADV), Coxsackie virus (CA24v) and both accounted for 83.3% (30/36), 11.1% (4/36) and 5.5% (2/36), respectively. Interestingly, ADV was detected also from one of the ten a Rupees bill.
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TL;DR: It has been found that both the systolic and diastolic pressure increases in low ambient temperature, which may be due to sympathetic stimulation and increase secretion of catecholamines in response to cold.
Abstract: In this study, the variation of blood pressure in young normotensive medical students has been recorded in winter and summer. Daytime blood pressure of young normotensive medical students has been measured in supine position. It has been found that both the systolic and diastolic pressure increases in low ambient temperature. It may be due to sympathetic stimulation and increase secretion of catecholamines in response to cold. Both sympathetic stimulation and catecholamines causes vasoconstriction leading to increased peripheral resistance and thereby increases diastolic pressure. At the same time the above mention stimuli increases heart rate and force of contraction of cardiac muscle causing increased cardiac output and thereby increases the systolic pressure.
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TL;DR: Assessment of the relation between lower respiratory tract infection and feeding pattern in infancy found mixed feeding/artificial feeding had more incidence of LRTI than exclusively breast-fed children (1.7:1) and the mortality rate was 10 times more in mixed/Artificial fed infants than exclusively Breast fed infants.
Abstract: OBJECTIVE To assess the relation between lower respiratory tract infection and feeding pattern in infancy. SETTING Hospital based descriptive. METHODS Two hundred and five infants presenting with lower respiratory infection (LRTI) admitted in the ward were studied over a period of one year. Criteria for the clinical diagnosis of LRTI were based on the lines of TUCSON CHILDREN RESPIRATORY STUDY. RESULTS Forty three percent of LRTI in infancy were seen in age group of 0 to 3 months. Sixty percents of pre-lacteal feeding and 71% of bottle-feeding were observed. Late introduction of solid food was very commonly practiced. In 64.7% solid food was introduced at the age of 9 to 12 months. Fifty three percent of LRTI were associated with diarrhoea, which was the commonest factor associated with mortality due to LRTI. There was male preponderance with male:female = 2.8:1(P value <0.001), which is highly significant. Mixed feeding/artificial feeding had more incidence of LRTI than exclusively breast-fed children (1.7:1) and the mortality rate was 10 times more in mixed/artificial fed infants than exclusively breast fed infants.
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TL;DR: Clinico-histopathological correlation was done to see for the inconsistency between clinical and histopathological diagnosis and also to analyse for the false positive diagnosis of melanoma in such lesions.
Abstract: A total of 85 skin biopsies were analyzed to see the pattern of skin disorders in Kathmandu Valley. Clinico-histopathological correlation was done to see for the inconsistency between clinical and histopathological diagnosis and also to analyse for the false positive diagnosis of melanoma in such lesions. The age of the patients ranged from 10 to 88 years. No gender predominance was observed. Five percent of the lesions were located on head and neck region and rest were distributed over chest, back and extremities. Clinically 21 (24.7%) out of 85 cases showed hyperpigmentation and were diagnosed as melanocytic lesions. Intradermal nevus emerged as the single largest disorder with a total of 11 cases (12.9%). Capillary hemangioma cases constituted the second largest group with a total of 9 cases (10.6%). Seborrhoeic Keratosis (8.2%), Verrucous vulgaris (8.2%) Neurofibroma (7.1%), Nonspecific granulomatous lesions (4.7%) and melanoma (3.5%) formed the other major groups of disorders. Morphea (1.2%), Psoriasis (1.2%) and fungal lesions (1.2%) commonly seen in other studies were not found to be common among the skin disorders in the present study.
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TL;DR: Surgeons using the the Transverse Rectus Abdominis (TRAM) flap in autogenous breast constructive surgeries should be aware of such unusual patterns of intersections so as to design the TRAM flap accordingly.
Abstract: The objective of the present study was to note the different patterns of tendinous intersections of rectus abdominis muscle and its surgical importance. The tendinous intersections of rectus abdominis muscle were studied in dissected 46 human cadavers dissected over a span of 3 years. Only two unusual patterns of intersections; one with tendinous intersections arched, and the other with the intersections at different levels on the right and left sides of the same cadaver, were observed, in two different cadavers. The tendinous intersections are the sites of anastomosis of numerous blood vessels. Surgeons using the the Transverse Rectus Abdominis (TRAM) flap in autogenous breast constructive surgeries should be aware of such unusual patterns so as to design the TRAM flap accordingly. Biomechanics of rectus abdominis muscle may also be influenced by arched pattern of tendinous intersections instead of normal transverse pattern.
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TL;DR: Pre-drilled Kuntscher nail with good quality cortical screws for interlocking is recommended for any variety of femoral shaft fracture and it is cost effective and gives acceptable result as compared to standard interlocking intramedullary nail.
Abstract: A prospective and comparative study of 44 cases of close locked static intramedullary (IM) nailing of Femur shaft fracture with two nailing systems was done. Comparing the cheap predrilled Kuntscher nail with standard but expensive Variwall nail of Biomet Company England, we found almost equal result in both groups regarding complications and healing of the fracture. Average healing time in Variwall and Kuntscher nailing were 16.4 and 16.1 weeks respectively, P value being in-significant. In Variwall nailing, stable fractures healed at the average of 13.5 weeks and unstable fractures at 17.2 weeks; open fractures at 18.4 weeks and close ones at 14.2 weeks; fractures due to Road Traffic Accident (RTA) at 16.3 weeks, gunshot injury at 18.6 weeks and fractures due to fall at 14 weeks. Similarly in Kuntscher nailing these figures were 14 and 16.7 weeks; 19.6 and 14.5 weeks; 16.6, 22 and 13 weeks respectively. Pre-drilled Kuntscher nail with good quality cortical screws for interlocking is recommended for any variety of femoral shaft fracture. It is cost effective, at the same time gives acceptable result as compared to standard interlocking intramedullary nail.
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TL;DR: The levels of most of the serum components examined in this study were within normal ranges for Japanese and others, however, it seemed to be necessary to improve their living conditions as these serum components are related to hepatic or renal function and the infectious diseases.
Abstract: Serum aspartate aminotransferase (AST), alanine aminotransferase (ALT), gamma-glutamyltranspeptidase (gamma-GTP), lactate dehydrogenase (LDH), urea nitrogen (BUN), uric acid (UA) and creatinine (CRE) levels were examined in 183 people (98 males and 85 females aged 10 to 68 years) living in Terai region in Nepal The mean values of serum components examined did not differ by sex in the age group of 10-14 years The mean values of serum AST, ALT and gamma-GTP levels differed significantly between the sexes (P<001) The all physical measurements and serum parameters observed correlated well in males, but a few of them correlated in females The AST-ALT, AST-gamma-GTP, ALT-CRE and BUN-CRE correlated well in both sexes The UA correlated with ALT and gamma-GTP, CRE with gamma-GTP, LDH and UA in males, while only AST-LDH and gamma-GTP-BUN correlated in females The levels of most of the serum components examined in this study were within normal ranges for Japanese and others However, it seemed to be necessary to improve their living conditions as these serum components are related to hepatic or renal function and the infectious diseases
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TL;DR: In this paper, the authors have shown that an elevated blood cholesterol level is one of the major modifiable risk factors associated with the development of coronary heart disease and LDL cholesterol is the primary lipoprotein mediating atherosclerosis.
Abstract: Hyperlipidaemia is one of the major contributors to atherosclerosis and Coronary Heart Disease (CHD) in our society. Numerous clinical and epidemiological studies have shown repeatedly that an elevated blood cholesterol level is one of the major modifiable risk factors associated with the development of CHD. In particular, these studies have demonstrated that low- density lipoprotein (LDL) cholesterol is the primary lipoprotein mediating atherosclerosis. Non-pharmacological therapy especially dietary therapy and exercise remains the first line of treatment in hyperlipidaemia, with pharmacotherapy reserved for use in patients at high risk of coronary heart disease or patients who do not respond to non-pharmacological therapy.
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TL;DR: The present study shows significant relationship of mental retardation and age in both the year and the higher rate ofmental retardation in the 0 to 5 years age group in both of the year.
Abstract: The study of etiological factors on mental retardation was conducted at family counselling and resource school of Association of Welfare of Menta+lly Retarded (AWMR), Hattisar, Kathmandu. A total of 91 mental retarded cases were studied in the year 2000 and 2001 for etiological factors. The present study shows significant relationship of mental retardation and age in both the year. The higher rate of mental retardation in the 0 to 5 years age group in both the year. About 70.0% with mental retardation (MR) are first born babies in both the year. Majority of the families have unfavourable attitude towards the mentally retarded individual.
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TL;DR: This articular branch originated mostly from the lateral aspect of second part of the axillary artery below to the origin of the lateral thoracic artery and is of importance to clinicians dealing with the shoulder joint.
Abstract: Origin and course of the articular branch of the axillary artery was recorded in 151 (43.9%) out of 344 axilla during the routine dissection. The branch was observed in 60.5% right side and 39.4% left side of male axilla, whereas in 55.5% right and 44.4% left side of female axilla and the difference was found significant (P < 0.001) among the gender. The orientation of the articular branch on right and left side was of similar proportion in both the sexes. The articular branch entered into the shoulder joint either upper, middle or lower part of the capsule of joint. This articular branch originated mostly from the lateral aspect of second part of the axillary artery below to the origin of the lateral thoracic artery. This is a rare observation and is of importance to clinicians dealing with the shoulder joint.
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TL;DR: A 12-year old girl presented 6 months after a forehead injury due to fall from height with a deformed forehead with a rectangular bone defect and a rectangular bicortical bone fragment impacted into the lower edge of the defect.
Abstract: A 12-year old girl presented 6 months after a forehead injury due to fall from height. She had a deformed forehead with a rectangular bone defect and a rectangular bicortical bone fragment impacted into the lower edge of the defect. There was no obvious skin or dural injury. The deformed forehead was exposed through a bi-coronal scalp flap. The bone fragment was reposited back into the defect. The forehead of the patient healed with a smooth contour.
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TL;DR: Patients with myocardial infarction studied using Hamilton Depression Rating Scale (HDRS) during first visit, and after one month, three months and six months period showed that most of the symptoms were somatic type and psychological category, whereas 7.0 to 12.0% of the Symptoms constituted motor.
Abstract: Depression is common clinical manifestation following myocardial infarction (MI), the prevalence being 20.0-30.0% in different studies. Both biological factors and problems related to life threatening condition have been blamed as risk factors of depression following MI. Although the profile of symptomatology of depression after life threatening physical illnesses is similar in many aspects to that of depressive disorder in other individuals, there are substantial differences between them. Fifty-one patients with MI were studied using Hamilton Depression Rating Scale (HDRS) during first visit, and after one month, three months and six months period. The result showed that most of the symptoms were somatic type (45.0-57.0%), psychological category being the next (36.0-44.0%), whereas 7.0 to 12.0% of the symptoms constituted motor.