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Infusion therapy, as compared to bolus therapy, showed a significantly better diuresis (mean urinary output increment 483ml vs 243ml, p <0.001), natriuresis (mean urinary sodium excretion increment 35.2 mEq/L vs 16.6 mEq/L, p = 0.004),decrease in abdominal circumference (6.1cm vs 3.0cm, p<0.001) and decrease in body weight (5.53 Kg vs 2.86 Kg, p < 0.001). The complications of renal impairment were also lower in the Infusion group.

Infusion of furosemide and albumin is a potential safer and effective therapeutic option in the management of refractory ascites with better natriuresis, higher urine output, and higher decrement in abdominal circumference and body weight, and lesser side effects.

Infusion of furosemide and albumin is a potential safer and effective therapeutic option in the management of refractory ascites with better natriuresis, higher urine output, and higher decrement in abdominal circumference and body weight, and lesser side effects.

Establishment of accurate diagnosis of participants is vital before starting the development of diagnostic scale. The aim of this study was to develop psychometrically sound Attention Deficit Hyperactivity Disorder diagnostic scale for children.

Informed consent was taken. Initial diagnosis of Attention Deficit Hyperactivity Disorder was made by using Diagnostic and Statistical Manual-5. Socio-demographic data were obtained. Behavior observation, parental information and teacher's report were also analyzed. Then, Kiddie-Schedule for Affective disorders and Schizophrenia, Child and Adolescent Symptoms Inventory, Stroop Color and word test were done to obtain confirmatory data. Verbatim collection was done to develop the culture specific items. Likewise, standardization was done Results Accurate diagnosis was established with the help of various tools and techniques. Comorbid conditions were excluded. Diagnostic accuracy was assessed where reliability of each item was ? 0.90; whereas, sensitivity and specificity were 97.0% and 96.6%, respectively with cut off score of 38.5. All items are highly co-related with Attention Deficit Hyperactivity Disorder items of Child and Adolescent Symptoms Inventory-5.

Results clearly indicated that diagnostic accuracy values of this scale is high.

Results clearly indicated that diagnostic accuracy values of this scale is high.

Portal vein drains blood from the abdominal part of alimentary tract, spleen, pancreas and gall bladder to the liver. It is normally formed by the union of superior mesenteric and splenic veins behind the neck of pancreas. MAP4K inhibitor Knowledge of variations regarding the formation of portal vein is very useful for surgeons to perform pancreas and duodenum and liver surgeries and for the interventional radiologist for catheter-based interventions. The objectives of this study are to disclose the variations in formation of hepatic portal vein and to measure the length of portal vein in cadavers.

A descriptive cross sectional study was carried out on 40 embalmed cadavers in the Department of Human Anatomy, KIST Medical College, Lalitpur Nepal after taking ethical approval. The pattern of portal vein formation and its tributaries were identified and photographs were taken. The pattern of portal vein formation was classified as Type I Portal vein formed by the confluence of superior mesenteric and splenic vein ; Type II portal vein formed by the confluence of superior mesenteric, splenic and inferior mesenteric vein . Data was analyzed by using SPSS version 20.

Type I pattern of portal vein formation was observed in 31 cadavers (82.5%) while Type II pattern was observed in 5 cadavers (12.5%). Average length of portal vein was 50.58mm.

Portal vein shows variations in the pattern of formation which should be taken into consideration during pancreatico-duodenal surgeries and in the interpretation of abdominal angiographs.

Portal vein shows variations in the pattern of formation which should be taken into consideration during pancreatico-duodenal surgeries and in the interpretation of abdominal angiographs.

More than half of Central Nervous System tumors are benign; however, they can cause substantial morbidity. The classification of central nervous system is vital for their varied outcomes and management. The objective of this study is to provide the histopathological spectrum of central nervous system tumors in a central hospital in Nepal.

The present study is a retrospective cross-sectional study conducted at Department of Pathology, Kathmandu Model Hospital, Kathmandu, Nepal from January 2010 to December 2017 of 162 cases of clinically diagnosed cases of central nervous system tumors. All patients were classified according to the World Health Organization classification of central nervous system tumors.

Nine of these162 patients did not have any tumor. The most common categories of tumors were astrocytic and oligodendroglial tumors (39.2%), meningiomas (21.5%), cranial and para spinal tumors (15%), tumors of sellar region including pituitary adenoma (4.5%), and metastatic tumors (3.2%). Glioblastoma(51.6%) and diffuse astrocytoma (21.6%) were the most common astrocytic and oligodendroglial tumors. The most common site of tumors in the brain was frontal (14.37%) followed by temporal (10.45%) region in the brain and dorsal region in spine.

This study gives the current scenario of the epidemiology and clinicohistopathological aspects of different brain tumors as encountered in a tertiary level hospital in Kathmandu.

This study gives the current scenario of the epidemiology and clinicohistopathological aspects of different brain tumors as encountered in a tertiary level hospital in Kathmandu.

Laparoscopic cholecystectomy is responsible for 80-85% of the bileduct injury, and twice as frequentcompared to open cholecystectomy.Injury affects the quality of life and overall survival of the patient. The management of these injuries is complex and challenging. There are few locally published reports regarding management of bile duct injury. The objective of this study is to evaluate the management of bile duct injury and its outcome Methods This retrospective study includes patients bile duct injury following cholecystectomy who were managed at Dhulikhel Hospital, Nepal, during January 2014 to December 2016. The clinical features, type of injuries(Strasberg classification) management, outcome (as per McDonald and colleague grading system) and follow up were analyzed descriptively.

Out of 35 bile duct injuries,only 3 (8.57%)occurred following open cholecystectomy. Three (8.7%) cases of bile duct injury were diagnosed intraoperatively and had primary biliary anastomosis over T-tube. Five (14.28%) were diagnosed postoperatively and underwent Roux-en-y hepatojejunostomy 6 weeks after index surgery.

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