Authors’ conflicts of interest in Nepalese healthcare journals

Most biomedical journals now require authors to declare their conflicts of interest (COI), especially financial ones, before they accept the manuscript for submission. This study aims to examine the COI policies of Nepalese healthcare journals. The sample constituted journals indexed in Nepal Journals Online (NepJOL) as of June 2021. Of the 68 that met our inclusion criteria, 38(55.9%) journals endorsed the COI policy of the International Committee of Medical Journal Editors. Thirty-six (52.9%) journals had a policy for reporting the COI. Financial COI was the only type of COI mentioned. All journals in Nepal are encouraged to request the authors to declare the COI for better transparency.

Intraoperative Findings during Canal Wall Down Mastoidectomy in Children.

Objective: The main objective of this study is to assess the intraoperative finding during canal wall down mastoidectomy in paediatric patients undergoing surgery for unsafe type of chronic suppurative otitis media (CSOM) attending ENT OPD of Kathmandu Medical College. Materials and Methods: Fifty patients of age group 4 to 13 years who were suffering from unsafe type of CSOM with or without cholesteatoma were taken for the study. The study period was two years from April 2007 to March 2009. The operative findings like extent of cholesteatoma in different location of middle ear cleft, mastoid bony landmarks, and ossicular chain condition and otogenic complication were identified during canal wall down mastoidectomy. Result: Of the 50 patients 32 (64%) were boys and 18(36%) were girls. The age ranged from 4 years to 13 years. Majority of patients had cholesteatoma with granulation diseases (72%) followed by granulation diseases (16%). Involvement of disease in attic, aditus, antrum and mesotympanum were found to be high in majority of cases (82%) with high percentage of necrosis of incus (56%). Conclusion: The primary disease found in patients undergoing canal wall down mastoidectomy (CWDM) was cholesteatoma combined with granulation in72%, granulation in 16% and cholesteatoma in 12%.

Comparison of sub mucosal diathermy and partial resection of Inferior turbinate in the treatment of symptomatic nasal valve blockage.

OBJECTIVES: to evaluate the efficacy of sub mucosal diathermy (SMD) and partial resection of inferior turbinate (PRIT) in the treatment of symptomatic enlarged inferior turbinates. STUDY DESIGN: prospective. METHODS: Forty patients of age group 18 -56 yrs with symptomatic enlarged inferior turbinates had given choices for SMD and PRIT. All the patients had history of failed medical treatment. RESULTS: Each twenty patients underwent SMD (group I), PRIT (group II), five pt of gr. I had to have anterior nasal packing after surgery for bleeding. Three pt complained of excessive rhinorrhoea for first 2 weeks while 3 pt of Group 1 complained of nasal blockage for 1 week even after intervention. In group 2, 5 pt had to have re-anterior nasal packing after pack removal. Both groups followed up for 6 months. Nine patients were lost in follow up, so excluded from the study. Following 6 months of follow up, 6 patient of gr. I had recurrence with nasal blockage and in gr. II none had recurrence. CONCLUSION: PRIT is better than SMD in long course; nevertheless it should be reserved for failed SMD, not as a primary option.

Comparison of chemical cautery (AgNo3) and steroid spray against SMD (submucosal diathermy) in the treatment of symptomatic inferior turbinate hypertrophy (ITH).

OBJECTIVE: To compare the efficacy of chemical cautery (AgNo3) and steroid nasal spray against SMD (submucosal diathermy) in the treatment of symptomatic Inferior Turbinate Hypertrophy (ITH). MATERIALS AND METHODS: Patients attending OPD in the department of ENT &HNS at KMCTH with symptomatic Inferior turbinate Hypertrophy were taken with their approval included for the study. Patients were divided into 2 Groups: in the first Group 25 patients were included and treated with chemical cautery (AgNo3) under Local Anaesthesia (LA), followed by steroid nasal spray for 3 months; in the second Group 25 patients were included and were treated with SMD (submucosal diathermy) under General Anaesthesia (GA).They all had history of use of topical nasal decongestant for different time period. Patients were followed up for 6 months. RESULTS: In Group 1, 16 patients complain of burning sensation for first week and 8 patients complain of continuous nasal blockage for 6 weeks.1 patient complain about inosmia for 2 weeks. In Group 2, nasal pain was complained by 17 patient for 2 weeks. 3 patients complain of persistent nasal blockage for 4 weeks. 3 patients complain of anosmia for 4 weeks. After completion of 6 months in Group 1, 20 patient has recurrent nasal blockage, whereas in Group 2, 10 patient has recurrent nasal blockage. Besides these, other symptoms noticed during initial phase did not appear. CONCLUSION: Chemical cautery (AgNo3) and steroid nasal spray is easy to follow, has less complication ,but failure rate is high, whereas SMD is procedure with less failure rate, but has to carried out under GA and has more discomfort postoperatively. For symptomatic inferior turbinate hypertrophy, where topical nasal decongestant has little role SMD is the choice of treatment for longer relief.

Surgical management of sinus tympani cholesteatoma.

OBJECTIVE: the aim of this study is to describe the extension of unsafe middle ear disease in the sinus tympani and to review the methods of surgical access to remove the disease from this area. METHODS: Of the 164 operated ears with unsafe chronic suppurative otitis media 64(39%) ears had variable disease extension into the sinus tympani and were included in the study. Sixty two ears underwent canal wall down (CWD) procedure while remaining two underwent tympanoplasty with bone work. RESULT: Five operated ears had deeper extension of the disease into the sinus tympani. And despite of different maneuver the complete removal of the disease could not be confirmed. Six ears (9.4%) had recidivism. CONCLUSION: The study emphasizes on the greater incidence of this disease extension into this difficult anatomical area and their complete removal may not be always possible. But one should require thorough knowledge and surgical expertise to work in this difficult area of posterior mesotympanum.