An 83‐year‐old‐male patient presented with obstructive jaundice, whose imagings were consistent with the cholangiocarcinoma of the distal common bile duct. The tumor markers were within normal limits. IgG4 level was raised; therefore, IgG4‐sclerosing cholangitis was made as the provisional diagnosis. Steroid therapy was started to which he responded well.
Background Hepatocellular carcinoma (HCC) is the most common primary
liver cancer. Liver cancer is one of the commonest cancers worldwide in
terms of incidence and mortality. Viral hepatitis, alcohol abuse, and
autoimmune hepatitis are the common causes of HCC. Usually patients
present at advanced stages where curative treatment is no longer
possible. This study aims to analyze the demographic, clinical, and
radiological profiles and treatment patterns of HCC patients. Methods We
studied patients with HCC from March 2020 to August 2022 and analyzed
their risk factors, clinical characteristics, and treatment modalities.
Patients with at least one clinical, radiological, or biochemical
evidence of HCC were considered for the study. Data were collected using
predetermined proformas. Results Our study included 54 patients with a
mean age of 57.17 years, and male: female ratio of 5:1. Of them, 68.52%
consumed alcohol and 74.07% smoked cigarettes. At the time of
diagnosis, 88.89% of them were symptomatic, weight loss (64.81%) being
the most common symptom. The majority of the participants belonged to
Barcelona Clinic Liver Cancer (BCLC) terminal stage (38.89%) and had
more than three liver lesions (35.19%) involving the right lobe
(55.56%). Only four patients underwent curative surgical resection. As
most were in the terminal stage (BCLC D), supportive care was provided.
Conclusion Alcohol-related liver cirrhosis is the most common cause of
HCC in Nepal. Despite the significant progress in diagnostic methods,
most of the patients are diagnosed at advanced and terminal stages.
These patients are unsuitable for curative treatment and are treated
with supportive methods. Keywords Autoimmune hepatitis, hepatitis,
hepatocellular carcinoma, treatment.
An 83-year-old-male presented with obstructive jaundice, whose imaging
was consistent with the cholangiocarcinoma of the distal common bile
duct. The tumor markers were within normal limits. IgG4 level was
raised, therefore, IgG4-sclerosing cholangitis was made as the
provisional diagnosis. Steroid therapy was started to which he responded
well.
The adenosquamous carcinoma of the gallbladder is a rare variant accounting for only 1-4% of all primary gallbladder carcinoma. Regardless of the histological types, all gallbladder carcinomas have silent and rapid progression resulting in delayed diagnosis and poor prognosis. Even with medical and/or surgical interventions, the median survival of patients with adenosquamous carcinoma, one of the histological variants, is less than a year. However, we present a case of adenosquamous carcinoma with an unusually better prognosis. A 70-year-old female patient, after being diagnosed with gallbladder carcinoma was suggested for surgical resection but was lost to follow-up since then. Two years later, the patient presented and was managed with extended cholecystectomy. The slow progression and non-recurrence of the tumour during follow-up for two years after the surgery indicates a better prognosis in this case.
Introduction The lack of awareness on the appropriate use of antibiotics, its dose and duration is one of the leading causes of global antimicrobial resistance (AMR). AMR poses a growing threat to public health, as infections from resistant strains of microbes become increasingly difficult to treat, resulting in prolonged illness and greater risk of death. Hence, this study would be an important reference for determining the scope of the problem which will be essential for formulating and monitoring an effective response to antibiotic use and its problem of resistance.
MethodsA descriptive cross-sectional study was done among higher secondary level students from selected schools in Kathmandu valley. Baseline data was collected after a tutorial session through semi-structured questionnaires which was based on past researches and verified using expert consultation. Ethical consideration was maintained throughout the study. Descriptive statistics was used to find out the KAP level including knowledge score and attitude-practice score of the selected population.
ResultsAmong 465 participants conducted in our research, the overall average knowledge score of the participants was found to be 73.3% while the attitude-practice score was 60.53%. It was found that 80.86% of the participants had heard the term “antibiotic resistance”. The knowledge score percentage among the students of grade 10 and 11 had no significant difference (p value= 0.592).
ConclusionOur study concludes that if topics like antibiotics and their judicial use is well covered in school curriculum, it can produce measurable change in knowledge, attitude and practice level of the students.
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