Background: Depressive disorder is frequently found as a comorbidity among patients with substance abuse. Most of the time it is reported as underdiagnosed and a majority of patients go untreated. Many studies have indicated that comorbid depressive symptoms play a major role in the prognosis of substance use disorder and the relapse has been found to be greater in patients who have a comorbid depression. The present study seeks to determine the comorbidity of depression in cases with substance abuse and their sociodemographic characteristics. Objective: The current study is aimed to determine the relationship between various drug abusing patterns and comorbidity of depression with substance use disorders. Methods: This was a cross-sectional study. The study was carried out in 42 patients, who were consecutively admitted in psychiatric ward of Kathmandu Medical College Teaching Hospital and Punarjeevan Hospital with the diagnosis of mental and behavioural disorder due to use of psychoactive substances, according to ICD-10. The study was carried out from 1st January 2010 to 30th December 2010. All patients were rated using Hamilton Depression Rating Scale. Results: Among all subjects, 31 (73.8 %) were found to be suffering from Depression among which 19 (45.2%) had mild to moderate depression and 12 (28.6%) had severe depression. Depression was seen among 80% of unemployed subjects, followed by 75% employed subjects and 68.8% students. In method of drug intake, 21 (50%) subjects used oral drugs, 12 (28.6%) subjects used intravenous route and 5 (11.9%) subjects used inhalational drugs. All patients using intravenous drugs were found to have depression. Among drugs abused, 22 (52.4%) patients used multiple substances like alcohol and cannabis, 11 (26.2%) patients used Heroin, 6 (14.3%) patients used drugs like Diazepam, Dextropropoxyphene, Nitrazepam and Promethazine, followed by 3 (7.1%) patients using Buprenorphine. Depression was found in 6 (54.54%) out of 11 subjects who used Heroin followed by 19 (86.63%) out of 22 subjects who were dependent on alcohol, cannabis and other substances. Conclusion: The result showed strong correlation between depressive symptoms and substance abuse, which draws attention to the need of taking into consideration the comorbidity and its management. Clinicians should routinely assess for depression in patients with substance abuse disorders. DOI: http://dx.doi.org/10.3126/jkmc.v1i2.8145 Journal of Kathmandu Medical College, Vol. 1, No. 2, Oct.-Dec., 2012: 96-99
Introduction: Pathology of the rotator cuff is the cause of most common problems at the shoulder joint and accurate diagnosis is essential for appropriate management. High-resolution real-time ultrasonography and MRI are successful imaging modalities for both rotator cuff and non–rotator cuff disorders and have important implications in the management of rotator cuff pathologies. This study was conducted to Compare the results obtained after the evaluation of rotator cuff injuries of shoulder joint by high resolution Ultrasonography and Magnetic Resonance Imaging. Methods: 50 patients with suspected rotator cuff injuries of the shoulder joint were included in this study over a period of 2years. Patients had presented with various complaints like prolonged pain in the shoulder joint with stiffness, restriction and difficulty in movement of the shoulder joint, traumatic injuries and recurrent dislocations of the shoulder joints. Results: Mean age was 41.6years ( range 15-80 ).Maximum patients were between 41-50 years (24%). 29 were males and 21 were females. In our study diagnostic accuracy of ultrasound in rotator cuff tears was 57. 14% for full thickness tears and 58.33 for partial thickness tears. The diagnostic accuracy of ultrasound in detection of complete tear of the supraspinatus muscle was 57.14% while that of MRI was 100%. Conclusion: High resolution Ultrasound being a dynamic study can be used as the first-line investigation for rotator cuff tear. Full-thickness rotator cuff tears can be identified using ultrasound and MRI with comparable accuracy. DOI: http://dx.doi.org/10.3126/mjsbh.v10i1.6443 Medical Journal of Shree Birendra Hospital Jan-June 2011 10(1) 9-14
We report a case of torsion of a pedunculated uterine leiomyoma. A 56-year-old married Chinese female presented at the emergency department with complaints of severe lower abdominal pain on July 27, 2010. A transabdominal sonogram revealed multiple uterine masses, including a pedunculated mass. With a preoperative diagnosis of torsion of a pedunculated subserosal leiomyoma, the patient underwent a total abdominal hysterectomy with bilateral salpingo-oophorectomy. On gross inspection, the resected myoma was ischemic, and both focal hemorrhage and necrosis were noted in the pathology report. In conclusion, torsion of a pedunculated uterine myoma is rare but represents a surgical emergency to improve symptoms and avoid consumptive coagulopathy.
We report a case of 21 Yrs old female patient referred to the radiology department at Shree Birndra Hospital, to investigate primary infertility. She underwent hysterosalpingogram, both transabdominal & transvaginal ultrasound and MRI of the pelvis. The final diagnosis was Uterus Didelphys, which is a type of lateral fusion disorder of mullerian ducts. According to the American Fertility Society Classification of Mullerian Anomalies, Uterus Didelphys is a class III anomaly.
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