Calculus Induced Hydroureteronephrosis Obstructive Syndrome in a Patient with Two Separate Pelvicalcyeal System in Right Side with Bifid Ureter: A Rare Clinical Entity
Anil Gautam1, Bijay Subedi1, Mukesh Dhital2, Janak Awasthi3, Suman Adhikari4, *Purushottam
1Pokhara University, Faculty of Health Science/Dr. Koirala Research Institute for Biotechnology and
2Nobel College, Pokhara University, Kathmandu
3Gandaki Medical College, Department of Anatomy
4Nepal Academy of Medical Sciences, Bir Hospital
5Gandaki Medical College Teaching Hospital and Research Center.
Hydroureteronephrosis is a clinical condition where the dilatation of renal calyces and ureter occur jointly due to obstruction. When two ureters arise from single kidney the situation is known as bifid ureter which may be complete or incomplete. The present study examines a congenital anomaly of bifid ureter and rare clinical presentation of calculus induced obstructive hydroureternephrosis in a adult male aged 38 by past 48 hours. The common symptoms of this condition were extreme intolerable pain in the abdomen, flank pain moderate to severe radiate to loin to groin, vomiting/nausea and haematuria. Diagnosis was done by injection of intravenous dye and computed tomography intravenous pyleogram was performed along with lab findings. In this case we found two incomplete ureters i.e. bifid nature arising from right kidney that unite as a single ureter before emptying into the urinary bladder. There was presence of single large calculus measuring approximately 8.6*8mm right at the junction of bifid ureter at the level of L3 vertebra inducing hydroureteronephrosis. Similarly marked upstream dilation of upper right ureter was found. The anomaly of bifid ureter occurs due to the untimely division of ureteric diverticulum. Unless some complication of ureter occurs, the duplication does not expose itself. Acute obstruction of ureter does not cause any significant alternation in renal function. Though the whole clinical presentation is rare itself, it further needs follow ups to avoid re-occurrence.
Assessment of Knowledge, Attitude and Practice of Emergency Contraceptive Pills among Medical and Paramedical Students
Bindu Malla1, Komal Malla2, Madan Sigdel1, Sanjeev Guragain1, Rajesh Kumar Yadav1, Sabita Paudel1, Bijay Aryal1
1Department of Clinical Pharmacology, Gandaki Medical College, Kaski, Nepal.
2Department of Pharmacy, School of Health and Allied Sciences. Pokhara University, Lekhnath-12, Kaski, Nepal
Emergency contraceptive pill (ECP) is also called as morning after pill which is indicated after unprotected coitus, sexual abuse and nonuse of regular contraception to avoid unwanted pregnancy. The present study was conducted to evaluate the knowledge, attitude and current use of emergency contraceptive pill among the medical and paramedical students. Institution based cross- sectional descriptive study was conducted at Gandaki medical college and The School of Health and Allied sciences from August 2015-Janawary 2016.Data was collected using structured questionnaire and analyzed using Microsoft excel 2007. Out of 181 respondents 40.9% were male and 59.1% were female students. 91.2% respondents were from urban area and 86.2% were Hindu. As compared to female students, male students have more knowledge about the ECPs. However, female students were more correct than male students regarding the proper administration time of ECP. Although recipients have positive attitude regarding ECPs, majority of them believed that ECPs have harmful effects to the body. Mainly due to the humiliation and lack of proper knowledge, male respondents and female respondents respectively felt challenges to use ECPs. It is concluded the misinformation regarding ECPs is high among the respondents. Therefore, effective awareness program should be lunched to educate them regarding the ECPs and to protect young females from the risk of unsafe abortion.
Epidemiological study of intestinal parasitosis in rural area of Nepal
Kalyan Sapkota MD1, Jiwan Thapa MD2, Amal Basnet MD2, Bijaya Dhakal 3
Department of Medicine, Bharatpur Hospital, Nepal1,
Department of Medicine, National Academy of Medical Sciences, Bir Hospital, Nepal2,
Balkumari College, Narayangarh, Chitwan3
Intestinal parasitosis is one of the major public health and socio-economic problems in Nepal. It is ranked among the top 10 morbidities in Nepal. Fecal samples were collected from the patients attending to different hospitals and private laboratories throughout the Myagdi district. A total of 985 participants were included in the study. The age ranged from 1 to 86 years. Commonly affected age group was of below 15 years. Male to female ratio was 1.3:1. The general prevalence of infection with different types of intestinal parasites was 14.7% (145). The fecal examination revealed different types of helminths (7.2%) and protozoan (7.5%). Giardia lamblia was the most common parasite (5.5%), followed by Entamoeba histolytica 2.0%, Ascaris lumbricoides 4.0%, Hookworm 1.8%, Trichuris trichiura 0.8%, Hymenolepis nana 0.4% and Taenia spp 0.2%. Multiple parasites were observed in 11 samples. Higher prevalence rates of parasitic infections were seen among children.
SIF : 0.74
IF : 0.432