Probable systemic lupus erythematosus with cell-bound complement activation products (CB-CAPS)

Complement activation is a key feature of systemic lupus erythematosus (SLE). Detection of cell-bound complement activation products (CB-CAPS) occurs more frequently than serum hypocomplementemia in definite lupus. We describe a patient with normocomplementemic probable SLE who did not fulfill ACR classification criteria for lupus, but the diagnosis was supported by the presence of CB-CAPS.

Multiple simultaneous hypertensive supratentorial and infratentorial hemorrhages: A rare kind of hypertensive bleed

Multiple simultaneous intracranial hemorrhages are very uncommon and both supra- and infratentorial hemorrhages are even more rare. Here we report a case of 56 year old hypertensive male with no other significant medical history who presented with a hypertensive emergency. Emergency head computed tomography showed bilateral basal ganglia and midbrain hemorrhages extending to right cerebellar peduncle. The patient made a progressive recovery and finally achieved functional independence. This report shows that hypertension may cause multiple simultaneous supra- and infratentorial hemorrhages and have good prognosis. Journal of College of Medical Sciences-Nepal,2011,Vol-6,No-4, 53-56 DOI: http://dx.doi.org/10.3126/jcmsn.v6i4.6728

Early feeding and discontinuation of intravenous fluid after laparoscopic cholecystectomy

BACKGROUND

Common practice at most centers in the country is to continue intravenous (i.v.) fluid till morning round next day following laparoscopic cholecystectomy (LC), assess patient and gradually allow oral diet. However this seems unnecessary in view of fast recovery after minimal invasive LC. The aim of this study was to observe the prospects and assess the acceptability, safety and benefit of early oral feeding and discontinuing i.v. fluid after LC.

METHODS

This cross-sectional observational study was carried out prospectively from Oct 1, 2009 to Sep 31, 2010 at Patan Hospital, a university teaching hospital. All elective LC patients were included. Oral liquid was introduced after four hours and i.v. fluid was stopped after six hr of LC. I.v. cannula was kept locked in situ. Vomiting, abdomen distension and reasons for continuation or resumption of i.v. fluids were recorded.

RESULTS

During one year period 294 LC patients fulfilled study criteria. Average age was 40.8 years. Female accounted for 78.2%. Oral fluid was started in average of 5.5 hrs in 97%. In 3% (9/294) i.v. was continued. Postoperative nausea and vomiting was observed in 25.9% (76/294), of which 6.6% (5/76) required i.v.. There was no untoward affect after i.v. fluid was stopped.

CONCLUSIONS

Early oral feeding and discontinuing of intravenous fluid in laparoscopic cholecystectomy is safe, economic and well accepted by patients, family and nursing staff in Patan hospital.

Harvesting methods of Cinnamomum tamala leaves in private land: a case study from Udayapur district, Nepal

Tejpat (Cinnamomum tamala) leaf is commercially one of the important non-timber forest products of Nepal. This paper attempts to elaborate and analyze the harvesting methods and techniques of Tejpat grown by the farmers in their private land. The study was conducted in the villages of Udayapur district where Tejpat was widely cultivated and harvested for income generation and trading purposes. Almost all farmers with private land had planted Tejpat. Complete lopping of leaves once a year was the exclusive practice for harvesting. The collection period for leaf was from Ashoj (October) to Magh (February) but the period for bark varied greatly, i.e. from Kartik to Poush (November to January) and Baisakh / Jestha (May / June). Bark collection was done only from old, dying, diseased and low leaf producing trees. Average number of trees per household ranged from 10 to 155. The mean diameter at breast height (DBH) of the trees was 39.58 cm. There was high positive correlation between the DBH and fresh weight of leaf. Fitting of linear regression of fresh weight of leaf with DBH proved that the relationship was statistically significant at 5% level of significance. The minimum age and size of trees for leaf harvesting were found to be five years and 16.18 cm, respectively. Keywords: Fresh weight; harvesting; private land; Tejpat DOI: 10.3126/banko.v19i2.2981 Banko Janakari, Vol. 19, No.2 2009 pp.20-24