Anuria, an Atypical Presentation of Leptospirosis: A Case Report

Leptospirosis, an underreported disease, is a highly prevalent spirochaetal zoonotic disease in both tropical and temperate climates. Symptoms can range from mild illness to potentially life-threatening infection. Laboratory tests are nonspecific. Microbiological confirmation is not widely available in endemic developing countries like Nepal. We need to rely on the serologic test, which has its own pitfalls in the initial days of illness. Here, we report a case of 56 years old female from the western region of Nepal who presented with fever, jaundice and anuria. She initially tested negative for leptospirosis but was later found to be positive in the second week of illness. Unlike the usual non-oliguric renal failure in leptospirosis, she presented with anuria requiring haemodialysis and subsequently had a good recovery with treatment. We highlight the importance of clinical suspicion and logical interpretation of serologic tests based on its timing from the onset of illness.

Fine needle aspiration cytology of thyroid swellings: Experience in a tertiary care hospital of Nepal

Introduction: Fine Needle Aspiration Cytology (FNAC) being a minimally invasive technique, is particularly suitable in the sensitive neck area. FNAC can obviate the need for surgery if the lesion is shown to be non neoplastic or if it confirms suspected recurrent tumor. A preoperative cytological diagnosis of a primary neoplasm of thyroid may allow more rational    planning of surgery.Method: This descriptive observational study was carried out at the Department of ENT- Head & Neck Surgery, Gandaki Medical College and Charak Hospital, Pokhara, Nepal, from August 2010 to November 2011. A total of 154 consecutive FNAC of thyroid swellings was included.Results: Out of 154 patients female were 142 (92%) and men were 12 (8%). In this series of 154 thyroid swellings on FNAC one hundred and thirty six (88%) were non neoplastic and eighteen (12%) neoplastic. Among non neoplastic thyroid swelling, adenoma was the most common sixty two (40%), followed by colloid cyst, Hashimoto thypoiditis, subacute thyroiditis, adenoma, cystic lesion, Graves’s disease, thyroglossal cyst and lymphocytic thyroiditis. Among neoplastic thyroid swelling papillary carcinoma was the commonest nine (5.8%) followed by follicular neoplasm six (3.9%).Conclusion: It is concluded from the present study that female in our region were more affected, non-neoplastic lesions of the thyroid were more common (colloid goiter being the commonest) than neoplastic lesions (papillary carcinoma being the commonest). DOI:http://dx.doi.org/10.3329/bjo.v18i2.11984 Bangladesh J Otorhinolaryngol 2012; 18(2): 119-123    

Pattern of Ear Diseases among Paediatric ENT Patient: An Experience from Tertiary Care Centre, Pokhara, Nepal

Introduction: Ear diseases are common in children mainly due to altered anatomy of Eustachian tube which is straighter in children as compared to that in adults. However, the cause of hearing loss in children is more varied, including the etiologies. This study was done to find out the pattern of ear diseases in paediatric age group attending ear, nose and throat OPD in a tertiary care centre in Pokhara, Nepal. Materials and Methods: This is a prospective study done in paediatric patients attending ENT OPD over a period of one year from January 2010 to January 2011. The diagnoses were made on the basis of history and clinical examination. Results were expressed in numbers and percentages. Results: Out of 1632 Pediatric ENT patients, 944 had ear diseases, 59.2% were males and 40.8% females. Wax (33.4%) was the commonest diagnosis followed by Chronic suppurative otitis media (24.3%) and Acute ottitis media (13%). Conclusion: Ear diseases are most common condition in ENT OPD among paediatric age group. Wax, CSOM and ASOM were the three most common ear diseases. J. Nepal Paediatr. Soc. 32(2) 2012 142-145 doi: http://dx.doi.org/10.3126/jnps.v32i2.5673

Symptomatology and allergen types in patients presenting with allergic rhinitis

Allergic rhinitis, despite its complex patho-physiology, is a global health problem with the increasing prevalence. The current study which was conducted at one of the tertiary care center in the country comprised of 548 diagnosed cases of allergic rhinitis and thus treated during the period extending from January 2010 to June 2011. In the study, males and females were almost equally distributed, constituting the ratio of 1:0.9. Among them, the patients from 20 –29 year of age group was the most commonly affected (38.1%). In our study most of the patients were housewives (30.3%) and the house dusts mites (76.3%), was the most common etiological factors. Majority of the patients presented with sneezing (86.7%) as the chief complaint. Of the total subjects, 18.6% presented with co-morbidity of allergic conjunctivitis and 8.9% with that of sinusitis. DOI: http://dx.doi.org/10.3329/bjo.v18i1.10411  Bangladesh J Otorhinolaryngol 2012; 18(1): 30-35