Cholesterol Gallstone among Patients with Cholelithiasis Admitted to the Department of Surgery of a Tertiary Care Center.

Introduction: Gallstone is one of the most common pathological conditions found mostly in females. The incidence of cholesterol gallstones is developing higher nowadays which is increasing the burden of cost in society. This study aimed to find out the prevalence of cholesterol gallstones among patients with cholelithiasis admitted to the Department of Surgery of a tertiary care centre. Methods: A descriptive cross-sectional study was conducted among patients with cholelithiasis who presented in the Department of Surgery of tertiary care centre for cholecystectomy (laparoscopic or open) from 23 December 2022 to 22 September 2023 after obtaining ethical approval from the Institutional Review Committee. Patients who were diagnosed by use of abdominal ultrasound or CT scan were included. Those patients with gallbladder polyps, cholangitis, and gallbladder tumours were excluded from the study. A convenience sampling method was used. The point estimate was calculated at a 95% Confidence Interval. Results: Among 190 patients, the prevalence of cholesterol gallstones was seen in 85 (44.74%) (37.67-51.81, 95% Confidence Interval). The female to male ratio was 6.72:1. Conclusions: The prevalence of cholesterol gallstones was found to be higher as compared to other studies done in similar settings. Keywords: cholesterol; gallbladder; gallstone; prevalence.

Mesorrhine Type of Nose among Medical Students of a Medical College.

Introduction: The nose is an attraction point in our face and one of the important sense organs of our body. The knowledge of the type of nose is essential for surgeons undertaking esthetic repair and reconstruction of noses The aim of this study was to find out the prevalence of the mesorhine type of nose among medical students of a medical college. Methods: A descriptive cross-sectional study was done among medical students of medical college after obtaining ethical approval from the Institutional Review Committee. Students of age groups 16-25 years from different religions with various castes/ethnicities were included. Those with craniofacial abnormalities, nasal deviation and a history of nasal trauma were excluded. All the nasal parameters were measured with the help of vernier's calliper and the nasal index was calculated. Convenience sampling method was used. The point estimate was calculated at a 95% Confidence Interval. Results: Among 215 medical students, the prevalence of mesorrhine type of nose was 130 (60.46%) (53.92-67, 95% Confidence Interval). Conclusions: The prevalence of mesorrhine type of nose among medical students was similar to other studies done in similar settings. Keywords: medical students; nose; prevalence; sexual dimorphism.

Sensitivity and Specificity of CT and Its signs for Diagnosis of Strangulation in Patients with Acute Small Bowel Obstruction.

INTRODUCTION: To perform a meta-analysis to review the sensitivity and specificity of computed tomography and different known computed yomography signs for the diagnosis of strangulation in patients with acute small bowel obstruction. METHODS: A comprehensive Pubmed search was performed for all reports that evaluated the use of CT and discussed different CT criteria for the diagnosis of acute SBO. Articles published in English language from January 1978 to June 2008 were included. Review articles, case reports, pictorial essays and articles without original data were excluded. The bivariate random effect model was used to obtain pooled sensitivity and pooled specificity. Summary receiver operating curve was calculated using Meta-Disc. Software Openbugs 3.0.3 was used to summarize the data. RESULTS: A total of 12 studies fulfilled the inclusion criteria. The pooled sensitivity and specificity of CT in the diagnosis of strangulation was 0.720 (95% CI 0.674 to 0.763) and 0.866 (95% CI 0.837 to 0.892) respectively. Among different CT signs, mesenteric edema had highest Pooled sensitivity of 0. 741 and lack of bowel wall enhancement had highest pooled specificity of 0.991. CONCLUSIONS: This review demonstrates that CT is highly sensitive as well as specific in the preoperative diagnosis of strangulation SBO which are in accordance with the published studies. Our analysis also shows that "presence of mesenteric fluid" is most sensitive, and "lack of bowel wall enhancement" is most specific CT sign of strangulation, and also justifies need of large scale prospective studies to validate the results obtained as well as to determine a clinical protocol.

Radiological techniques in the diagnosis of strangulating small bowel obstruction.

Early detection of signs of strangulation in case of acute small bowel obstruction is critical because it mandates an operation. Therefore the role of different radiological techniques used for diagnosing strangulating small bowel obstruction has been discussed here. Strangulation remains a major problem in patients with acute small bowel obstruction. Despite of having several radiological diagnostic tools, CT is the only method with established higher diagnostic sensitivity and specificity in patients with acute small bowel obstruction as well as strangulation.