Pub Date : 2023-12-31DOI: 10.3126/jcmsn.v19i4.60031
Harikala Soti, Nitu Kumari Singh, I. Sah, L. Paudyal
IntroductionCOVID-19 has emerged as a pandemic and started online education. Online education can play a vital role in the process of teaching and learning and parental satisfaction is extremely important in effective implementation of the online education in their children, especially at homes where newly adopted during COVID-19.The purpose of this study was to assess the parental satisfactions regarding online education of their children during COVID-19 pandemic. MethodsThis descriptive cross-sectional study was conducted from21st August 2021 to 25th January 2022 in a Phoolbari 11, Pokhara. Ethical approval was taken from the Gandaki Medical College Institutional Review Committee. Purposive sampling method was used. The data were collected using a questionnaire through face to face interview whose children had participated in online education. ResultsOut of 216 respondents, the study revealed that more than half of the respondents (52.8%) had low satisfaction. The highest satisfaction experienced by parents was social interaction (11.98±2.88) followed by instructional support (14.97±3.11). There was significant association between level of satisfaction with parental sex (p=<0.002), parents’ education (p<0.001), parents’ occupation (p=<0.005), monthly income (p=<0.011) and status of living (p=<0.020). Likewise, there was significant association between level of satisfaction with child sex (p<0.001), fast internet at home for online learning (p=<0.001) and children participate in online class with laptop/tab/mobile phone (p<0.001). Conclusions It is concluded that respondents have low level of satisfaction. Therefore, intervention for increasing satisfaction should be conducted by the concerned authority.
{"title":"Parental Satisfaction Regarding Online Education of Their Children During COVID-19 Pandemic","authors":"Harikala Soti, Nitu Kumari Singh, I. Sah, L. Paudyal","doi":"10.3126/jcmsn.v19i4.60031","DOIUrl":"https://doi.org/10.3126/jcmsn.v19i4.60031","url":null,"abstract":"IntroductionCOVID-19 has emerged as a pandemic and started online education. Online education can play a vital role in the process of teaching and learning and parental satisfaction is extremely important in effective implementation of the online education in their children, especially at homes where newly adopted during COVID-19.The purpose of this study was to assess the parental satisfactions regarding online education of their children during COVID-19 pandemic. MethodsThis descriptive cross-sectional study was conducted from21st August 2021 to 25th January 2022 in a Phoolbari 11, Pokhara. Ethical approval was taken from the Gandaki Medical College Institutional Review Committee. Purposive sampling method was used. The data were collected using a questionnaire through face to face interview whose children had participated in online education. ResultsOut of 216 respondents, the study revealed that more than half of the respondents (52.8%) had low satisfaction. The highest satisfaction experienced by parents was social interaction (11.98±2.88) followed by instructional support (14.97±3.11). There was significant association between level of satisfaction with parental sex (p=<0.002), parents’ education (p<0.001), parents’ occupation (p=<0.005), monthly income (p=<0.011) and status of living (p=<0.020). Likewise, there was significant association between level of satisfaction with child sex (p<0.001), fast internet at home for online learning (p=<0.001) and children participate in online class with laptop/tab/mobile phone (p<0.001). Conclusions It is concluded that respondents have low level of satisfaction. Therefore, intervention for increasing satisfaction should be conducted by the concerned authority.","PeriodicalId":15436,"journal":{"name":"Journal of College of Medical Sciences-nepal","volume":"27 14","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-12-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139130114","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-12-31DOI: 10.3126/jcmsn.v19i4.59869
Manoj Shrestha, Pramod Bhusal, Manohar Pradhan
IntroductionMyocardial Infraction is the leading cause of mortality and mortality globally. Thrombolysis with streptokinase is well established therapeutic intervention in Myocardial Infraction. Timely intervention with adequate myocardial reperfusion is associated with better clinical outcome whereas failed reperfusion due to incomplete or non-reopening of culprit artery is associated with complications. This study aims to compare diabetic and non-diabetic patients with acute myocardial infraction in term is culprit artery patency. MethodsThis analytical cross-sectional study was carried out in Cardiology Department, Collage of Medical Sciences, Bharatpur from 1st June 2023 to 30th October 2023. Total 80 patients with acute Myocardial Infarction were enrolled in the study. Blood sugar level and twelve leads ECG of each patients were recorded before giving intravenous 1.5 million units of streptokinase over one hour for acute ST elevation myocardial infarction. Coronary angiogram was done after 24 hours of thrombolysis. Patency of the culprit artery was assessed in each patients and compared between diabetics and non-diabetics. ResultsThe study included 57.5 % (n=46) male and 42.5 % (n=34) female patients. Mean random blood sugar level was 160.87 ±40.8 mg/dl. Mean age of the study population was 52.9 ±10.8 years. 40 % (n= 32) of patients were diabetics. The percentage of culprit artery patency was lower in diabetic patients as compared to non-diabetic patients (43.75 % vs 75%). Conclusions Among both male and female patients the success of thrombolysis in term of culprit artery patency was higher in non-diabetic patients as compared to diabetic patients.
{"title":"Comparison of Culprit Artery Patency Between Diabetic and Non-Diabetic Patients Undergoing Thrombolysis with Streptokinase for ST Elevation Myocardial Infarction","authors":"Manoj Shrestha, Pramod Bhusal, Manohar Pradhan","doi":"10.3126/jcmsn.v19i4.59869","DOIUrl":"https://doi.org/10.3126/jcmsn.v19i4.59869","url":null,"abstract":"IntroductionMyocardial Infraction is the leading cause of mortality and mortality globally. Thrombolysis with streptokinase is well established therapeutic intervention in Myocardial Infraction. Timely intervention with adequate myocardial reperfusion is associated with better clinical outcome whereas failed reperfusion due to incomplete or non-reopening of culprit artery is associated with complications. This study aims to compare diabetic and non-diabetic patients with acute myocardial infraction in term is culprit artery patency. MethodsThis analytical cross-sectional study was carried out in Cardiology Department, Collage of Medical Sciences, Bharatpur from 1st June 2023 to 30th October 2023. Total 80 patients with acute Myocardial Infarction were enrolled in the study. Blood sugar level and twelve leads ECG of each patients were recorded before giving intravenous 1.5 million units of streptokinase over one hour for acute ST elevation myocardial infarction. Coronary angiogram was done after 24 hours of thrombolysis. Patency of the culprit artery was assessed in each patients and compared between diabetics and non-diabetics. ResultsThe study included 57.5 % (n=46) male and 42.5 % (n=34) female patients. Mean random blood sugar level was 160.87 ±40.8 mg/dl. Mean age of the study population was 52.9 ±10.8 years. 40 % (n= 32) of patients were diabetics. The percentage of culprit artery patency was lower in diabetic patients as compared to non-diabetic patients (43.75 % vs 75%). Conclusions Among both male and female patients the success of thrombolysis in term of culprit artery patency was higher in non-diabetic patients as compared to diabetic patients.","PeriodicalId":15436,"journal":{"name":"Journal of College of Medical Sciences-nepal","volume":"122 32","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-12-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139135013","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-12-31DOI: 10.3126/jcmsn.v19i4.60632
Sriyansu Piya, B. Pradhan, H. Upadhyay
IntroductionDepression is common among all population but even more in women going through menopause. It is due to hormonal changes during that period paired with certain behavioral as well as biological factors and even certain life events that can have devastating effects on the person. The objective of this research is to find the prevalence and associated factor of perimenopausal depression along with factors associated with it. MethodsA Cross sectional descriptive study was conducted in Ward no. 10 and 11 of Tokha Municipality among 205 perimenopausal women. Permission was taken from Research department of National Open College also from the ward offices of Tokha Municipality, Kathmandu. The collected data was entered in Microsoft excel and analyzed in SPSS version 22. ResultsThe prevalence of depression among perimenopausal women was more than one-third (39.2%), 28.7% of respondents having mild depression, 8.3% having moderate depression, 1.1% having moderately severe and 1.1% having severe depression. Depression was found to have significant association with loss of family members or peers and help seeking intention of the respondents. Conclusions The study identified prevalence of depression among perimenopausal women. Loss of closed ones and help seeking intentions were seen to be associated with depression during perimenopause.
{"title":"Prevalence and Associated Factors of Depression among Perimenopausal Women of Tokha Municipality, Kathmandu","authors":"Sriyansu Piya, B. Pradhan, H. Upadhyay","doi":"10.3126/jcmsn.v19i4.60632","DOIUrl":"https://doi.org/10.3126/jcmsn.v19i4.60632","url":null,"abstract":"IntroductionDepression is common among all population but even more in women going through menopause. It is due to hormonal changes during that period paired with certain behavioral as well as biological factors and even certain life events that can have devastating effects on the person. The objective of this research is to find the prevalence and associated factor of perimenopausal depression along with factors associated with it. MethodsA Cross sectional descriptive study was conducted in Ward no. 10 and 11 of Tokha Municipality among 205 perimenopausal women. Permission was taken from Research department of National Open College also from the ward offices of Tokha Municipality, Kathmandu. The collected data was entered in Microsoft excel and analyzed in SPSS version 22. ResultsThe prevalence of depression among perimenopausal women was more than one-third (39.2%), 28.7% of respondents having mild depression, 8.3% having moderate depression, 1.1% having moderately severe and 1.1% having severe depression. Depression was found to have significant association with loss of family members or peers and help seeking intention of the respondents. Conclusions The study identified prevalence of depression among perimenopausal women. Loss of closed ones and help seeking intentions were seen to be associated with depression during perimenopause.","PeriodicalId":15436,"journal":{"name":"Journal of College of Medical Sciences-nepal","volume":"116 25","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-12-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139134184","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-12-31DOI: 10.3126/jcmsn.v19i4.60103
Hemant Kumar Gupta, R. R. Hamal, Suman Lamichhane
IntroductionFracture shaft of humerus is commonly seen fracture which is managed by nonoperative and operative methods. Operative fixation allows early return to daily work with ease in rehabilitation and less complication. This study was conducted to evaluate outcome of fracture shaft of humerus treated with plating by anteromedial approach on medial surface of humerus. MethodsA hospital based prospective study including 164 cases of humerus fracture shaft surgically managed with medial plating over a period 15th July 2017 to 14thJune 2022with the mean follow-up duration of 24 weeks was performed. The final outcome was evaluated on the basis of radiological union and Modified Stewart and Hundley Scoring criteria. ResultsFracture united in 49.39% of cases within 12 weeks, 28.65% case united in 12-24 weeks time and 19.61% cases united later than 24 weeks. Non union seen in 4 cases in our study treated with bone grafting healed. Functional outcome was measured as per Modified Stewart and Hundley Scoringcriteria, it was excellent in 67.08% of cases, good in 18.29%, satisfactory in 7.93 % of cases. Poor results were seen in 6.7 percent of cases. Conclusions Anterolateral approach with medial plating was found to be better option for fixation of fracture shaft of humerus as per our study as it has fewer complication with comparable results to other literature.
{"title":"Outcome of Medial Plating for Fracture Shaft of Humerus","authors":"Hemant Kumar Gupta, R. R. Hamal, Suman Lamichhane","doi":"10.3126/jcmsn.v19i4.60103","DOIUrl":"https://doi.org/10.3126/jcmsn.v19i4.60103","url":null,"abstract":"IntroductionFracture shaft of humerus is commonly seen fracture which is managed by nonoperative and operative methods. Operative fixation allows early return to daily work with ease in rehabilitation and less complication. This study was conducted to evaluate outcome of fracture shaft of humerus treated with plating by anteromedial approach on medial surface of humerus. MethodsA hospital based prospective study including 164 cases of humerus fracture shaft surgically managed with medial plating over a period 15th July 2017 to 14thJune 2022with the mean follow-up duration of 24 weeks was performed. The final outcome was evaluated on the basis of radiological union and Modified Stewart and Hundley Scoring criteria. ResultsFracture united in 49.39% of cases within 12 weeks, 28.65% case united in 12-24 weeks time and 19.61% cases united later than 24 weeks. Non union seen in 4 cases in our study treated with bone grafting healed. Functional outcome was measured as per Modified Stewart and Hundley Scoringcriteria, it was excellent in 67.08% of cases, good in 18.29%, satisfactory in 7.93 % of cases. Poor results were seen in 6.7 percent of cases. Conclusions Anterolateral approach with medial plating was found to be better option for fixation of fracture shaft of humerus as per our study as it has fewer complication with comparable results to other literature.","PeriodicalId":15436,"journal":{"name":"Journal of College of Medical Sciences-nepal","volume":" 1107","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-12-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139136463","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-12-31DOI: 10.3126/jcmsn.v19i4.60383
S. Parajuli, Heera Kc, Bikki Shah, Hom Bahadur Parajuli, Binod Kumar Yadav
Introduction Injuries have a significant proportion in the global burden of diseases and are in increasing trend. Nepal being an agrarian country had frequent reporting of injuries among rural communities whose major occupation is agriculture. So, we had this study with the objective to assess clinico epidemiological profile of agricultural work related injuries in the rural agrarian community of Nepal. Methods A community based cross sectional study was conducted among 362 farmers of rural agrarian communities of Budhiganga Rural Municipality of Nepal from 20 December 2022 to 20 June 2023 after getting ethical clearance from institutional review committee (IRC-PA 254/2022). A specially designed pro forma was used to collect data through convenient sampling techniques. Collected data was entered in Microsoft Excel and analyzed by SPSS version 23. Results The annual prevalence of agricultural work related injury was 48.6%. The most common primary causes were Sickle cut injury 43(24.4%), followed by Oxen/Cow hit injury 33 (18.8%), Traditional Plough cut injury 15 (8.5%), Spade cut injury 15 (8.5%) etc. Injury typically occurs in lower extremities 71 (40.3%). Among them 102 (58%), 82 (46.6%), 28 (15.9%) and 147 (83.5%) had a disability, bedridden, hospitalized and received some sort of treatment. Twenty two (12.5%), 36 (20.5%) and 32 (18.2%) reported stress, self reported decreased vision and self reported hearing loss at the time of injury respectively. Only 9 (5.1%) had used personal protective equipment (PPE) during agricultural work and about 36 (20.5%) had helping hands at the time of injury. Conclusions About half of farmers experienced agricultural work related injury with significant days of disability from daily activities and regular work. Use of personal protective equipment during work is miserable.
{"title":"Clinicoepidemiological Profile of Agricultural Work Related Injuries in Rural Agrarian Community of Nepal: A Cross Sectional Study","authors":"S. Parajuli, Heera Kc, Bikki Shah, Hom Bahadur Parajuli, Binod Kumar Yadav","doi":"10.3126/jcmsn.v19i4.60383","DOIUrl":"https://doi.org/10.3126/jcmsn.v19i4.60383","url":null,"abstract":"Introduction Injuries have a significant proportion in the global burden of diseases and are in increasing trend. Nepal being an agrarian country had frequent reporting of injuries among rural communities whose major occupation is agriculture. So, we had this study with the objective to assess clinico epidemiological profile of agricultural work related injuries in the rural agrarian community of Nepal. Methods A community based cross sectional study was conducted among 362 farmers of rural agrarian communities of Budhiganga Rural Municipality of Nepal from 20 December 2022 to 20 June 2023 after getting ethical clearance from institutional review committee (IRC-PA 254/2022). A specially designed pro forma was used to collect data through convenient sampling techniques. Collected data was entered in Microsoft Excel and analyzed by SPSS version 23. Results The annual prevalence of agricultural work related injury was 48.6%. The most common primary causes were Sickle cut injury 43(24.4%), followed by Oxen/Cow hit injury 33 (18.8%), Traditional Plough cut injury 15 (8.5%), Spade cut injury 15 (8.5%) etc. Injury typically occurs in lower extremities 71 (40.3%). Among them 102 (58%), 82 (46.6%), 28 (15.9%) and 147 (83.5%) had a disability, bedridden, hospitalized and received some sort of treatment. Twenty two (12.5%), 36 (20.5%) and 32 (18.2%) reported stress, self reported decreased vision and self reported hearing loss at the time of injury respectively. Only 9 (5.1%) had used personal protective equipment (PPE) during agricultural work and about 36 (20.5%) had helping hands at the time of injury. Conclusions About half of farmers experienced agricultural work related injury with significant days of disability from daily activities and regular work. Use of personal protective equipment during work is miserable.","PeriodicalId":15436,"journal":{"name":"Journal of College of Medical Sciences-nepal","volume":"120 14","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-12-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139133164","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-12-31DOI: 10.3126/jcmsn.v19i4.58869
K. Sapkota, D. Pokharel, Shailesh Basel, Bijaya Dhakal
Introduction. Antibiotics are most abundantly used drugs of major global concern for rapid ongoing emergence of resistant strains, increase overall cost of treatment and impact on national economy. Optimized use of antibiotic on the basis of proper diagnosis, prescriber’s attention about the problem and antimicrobial stewardship programs may become a way to rationalize the use. Methods. This is a cross-sectional descriptive study done in patients visiting to various OPD of tertiary referral hospital. Prescriptions were randomly selected and Antibiotics utilization was assessed by WHO prescribing Indicator form. Prescribed drugs were checked for adherence to guidelines and essential medicine list. Results. Among 731 sampled prescriptions, 384 (52.53%) were found with at least one antibiotic; 214 prescriptions (55.72%) were of female patients. Mean age was 37.71 years with SD 25.01. Highest numbers of patients (21.09%) belong to the 15-29 age group. Highest number of patients 158 (41.15%) treated with antibiotics were seen in patient attending Medicine department, 30 antibiotics were prescribed for 577 times. Amoxicillin-Clavulanate 70 (12.13%) was the most frequently prescribed followed by Azithromycin and Metronidazole with frequency of 39 (6.76%). Drug availability is 50.36%, in the facility and only 2.4 % of drugs were prescribed in generic. Conclusions. More than half of the patients were prescribed with antibiotics and all antibiotics were prescribed empirically. Newer generation antibiotics with broad spectrum efficacy were used in remarkable frequency. This study provides evidence for antibiotic stewardship, drug use review and establishment of institutional guidelines.
{"title":"Antibiotics Prescribing Pattern of Outpatients in a Tertiary Level Hospital in Nepal","authors":"K. Sapkota, D. Pokharel, Shailesh Basel, Bijaya Dhakal","doi":"10.3126/jcmsn.v19i4.58869","DOIUrl":"https://doi.org/10.3126/jcmsn.v19i4.58869","url":null,"abstract":"Introduction. Antibiotics are most abundantly used drugs of major global concern for rapid ongoing emergence of resistant strains, increase overall cost of treatment and impact on national economy. Optimized use of antibiotic on the basis of proper diagnosis, prescriber’s attention about the problem and antimicrobial stewardship programs may become a way to rationalize the use. Methods. This is a cross-sectional descriptive study done in patients visiting to various OPD of tertiary referral hospital. Prescriptions were randomly selected and Antibiotics utilization was assessed by WHO prescribing Indicator form. Prescribed drugs were checked for adherence to guidelines and essential medicine list. Results. Among 731 sampled prescriptions, 384 (52.53%) were found with at least one antibiotic; 214 prescriptions (55.72%) were of female patients. Mean age was 37.71 years with SD 25.01. Highest numbers of patients (21.09%) belong to the 15-29 age group. Highest number of patients 158 (41.15%) treated with antibiotics were seen in patient attending Medicine department, 30 antibiotics were prescribed for 577 times. Amoxicillin-Clavulanate 70 (12.13%) was the most frequently prescribed followed by Azithromycin and Metronidazole with frequency of 39 (6.76%). Drug availability is 50.36%, in the facility and only 2.4 % of drugs were prescribed in generic. Conclusions. More than half of the patients were prescribed with antibiotics and all antibiotics were prescribed empirically. Newer generation antibiotics with broad spectrum efficacy were used in remarkable frequency. This study provides evidence for antibiotic stewardship, drug use review and establishment of institutional guidelines.","PeriodicalId":15436,"journal":{"name":"Journal of College of Medical Sciences-nepal","volume":" 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-12-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139136150","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
IntroductionHematoma expansion after hemorrhagic stroke can lead to devastating consequences. An important factor associated with this is high blood pressure. This study was carried out to find out what proportion of patients with hemorrhagic stroke develop hematoma expansion and whether blood pressure during presentation could be associated with it.MethodsThis prospective observational study was carried out over a period of one year in patients who were admitted with the diagnosis of hemorrhagic stroke. The collected data were entered into and analyzed by using the Statistical Package for the Social Sciences version 26 after obtaining approval from the Institutional Review Committee of the Institute of Medicine, Tribhuvan University. ResultsOut of 83 patients included in the study, history of hypertension was present in 72 (86.7%). Hematoma expansion occurred in 11 (13.3%). There was no statistically significant associations between mean systolic, diastolic, and mean blood pressures between patients with and without hematoma expansion [(168.9±35.6, 164.5±28.5, t(81)=0.47, p=0.64), (101.8±18.9, 101.2±19.6, t(81)=0.10, p=0.92) and (124.2±23.6, 122.3±21.5, t(81)=0.27, p=0.79) respectively (values in mmHg)]. Majority of patients with hematoma expansion had high absolute systolic blood pressure (27.3% vs 26.4%) and high absolute diastolic blood pressure (54.5% vs 38.9%); however, the associations were not statistically significant (p= 1.00 and 0.33 respectively).Conclusions High blood pressure is highly prevalent but hematoma expansion is not common in patients with hemorrhagic stroke. There was no statistically significant association between history of hypertension, gender, patient age, absolute and mean blood pressures, and hematoma expansion in our study.
导言出血性脑卒中后血肿扩大可导致破坏性后果。与此相关的一个重要因素是高血压。本研究旨在了解出血性脑卒中患者中发生血肿扩大的比例，以及发病时的血压是否与此有关。方法 本前瞻性观察研究对确诊为出血性脑卒中的住院患者进行了为期一年的观察。在获得特里布万大学医学研究所机构审查委员会批准后，使用社会科学统计软件包 26 版对所收集的数据进行了输入和分析。结果 在纳入研究的 83 名患者中，72 人（86.7%）有高血压病史。11例（13.3%）患者出现血肿扩大。有血肿扩张和没有血肿扩张的患者的平均收缩压、舒张压和平均血压之间没有明显的统计学差异[（168.9±35.6，164.5±28.5，t（81）=0.47，p=0.64）、（101.8±18.9，101.2±19.6，t（81）=0.10，p=0.92）和（124.2±23.6，122.3±21.5，t（81）=0.27，p=0.79）（单位：mmHg）]。大多数血肿扩大患者的绝对收缩压较高（27.3% vs 26.4%），绝对舒张压较高（54.5% vs 38.9%），但两者之间的关系无统计学意义（P= 1.00 和 0.33）。在我们的研究中，高血压病史、性别、患者年龄、绝对血压和平均血压与血肿扩大之间没有统计学意义。
{"title":"Blood Pressure and Hematoma Expansion in Hemorrhagic Stroke","authors":"Bikram Prasad Gajurel, Pukar Ghimire, Pradeep Panthee, Sumit Shahi, Rajeev Ojha, Reema Rajbhandari, Ragesh Karn","doi":"10.3126/jcmsn.v19i4.59506","DOIUrl":"https://doi.org/10.3126/jcmsn.v19i4.59506","url":null,"abstract":"IntroductionHematoma expansion after hemorrhagic stroke can lead to devastating consequences. An important factor associated with this is high blood pressure. This study was carried out to find out what proportion of patients with hemorrhagic stroke develop hematoma expansion and whether blood pressure during presentation could be associated with it.MethodsThis prospective observational study was carried out over a period of one year in patients who were admitted with the diagnosis of hemorrhagic stroke. The collected data were entered into and analyzed by using the Statistical Package for the Social Sciences version 26 after obtaining approval from the Institutional Review Committee of the Institute of Medicine, Tribhuvan University. ResultsOut of 83 patients included in the study, history of hypertension was present in 72 (86.7%). Hematoma expansion occurred in 11 (13.3%). There was no statistically significant associations between mean systolic, diastolic, and mean blood pressures between patients with and without hematoma expansion [(168.9±35.6, 164.5±28.5, t(81)=0.47, p=0.64), (101.8±18.9, 101.2±19.6, t(81)=0.10, p=0.92) and (124.2±23.6, 122.3±21.5, t(81)=0.27, p=0.79) respectively (values in mmHg)]. Majority of patients with hematoma expansion had high absolute systolic blood pressure (27.3% vs 26.4%) and high absolute diastolic blood pressure (54.5% vs 38.9%); however, the associations were not statistically significant (p= 1.00 and 0.33 respectively).Conclusions High blood pressure is highly prevalent but hematoma expansion is not common in patients with hemorrhagic stroke. There was no statistically significant association between history of hypertension, gender, patient age, absolute and mean blood pressures, and hematoma expansion in our study.","PeriodicalId":15436,"journal":{"name":"Journal of College of Medical Sciences-nepal","volume":"18 24","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-12-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139130197","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-12-31DOI: 10.3126/jcmsn.v19i4.59827
Manisha Shrestha
Background Strabismus/squint is an ocular misalignment in which the eyes are not properly aligned with each other. Amblyopia is a serious visual impairment resulting from abnormal visual stimulation during early childhood. It can be easily prevented or treated if detected early. This study aimed to assess the knowledge and attitude of school nurses and primary school teachers of Government schools toward children suffering from strabismus and amblyopia. Method This was a cross-sectional study among the participating school nurses and primary school teachers of Government school which was organized to raise awareness regarding strabismus and amblyopia among them. It was conducted using a questionnaire which contained 22 items divided into three sections. First section consisted of demographic parameters, second regarding knowledge of strabismus and the third the knowledge of Amblyopia. Data were analysed using Epi info version 7.02 (Centers for Disease Control, Atlanta, Georgia, United States). P-values of <0.05 was used for clinical significance. Result There were 67 participants and the mean age was 32.67±7.71 years, range 21 to 55 years, the majority being female 66 (98.51%). Training on eye health was received by 13 (19.40%). Forty-four (65.67%) participants had knowledge of strabismus and amblyopia, out of them 30 were school nurses. The majority of school nurses 23 (76.67%) and primary teachers 13 (92.86%) had good knowledge scores (6 to 10). Conclusion The majority of participants had good knowledge about strabismus and amblyopia. As the school nurses and primary school teachers are the first link to the children at risk, improving their awareness level on strabismus and amblyopia will help in early referral, timely intervention and prevent the risk of vision loss.
{"title":"Knowledge and Awareness regarding Strabismus and Amblyopia among School Nurses and Primary School Teachers of Government Schools at Bharatpur","authors":"Manisha Shrestha","doi":"10.3126/jcmsn.v19i4.59827","DOIUrl":"https://doi.org/10.3126/jcmsn.v19i4.59827","url":null,"abstract":"Background Strabismus/squint is an ocular misalignment in which the eyes are not properly aligned with each other. Amblyopia is a serious visual impairment resulting from abnormal visual stimulation during early childhood. It can be easily prevented or treated if detected early. This study aimed to assess the knowledge and attitude of school nurses and primary school teachers of Government schools toward children suffering from strabismus and amblyopia. Method This was a cross-sectional study among the participating school nurses and primary school teachers of Government school which was organized to raise awareness regarding strabismus and amblyopia among them. It was conducted using a questionnaire which contained 22 items divided into three sections. First section consisted of demographic parameters, second regarding knowledge of strabismus and the third the knowledge of Amblyopia. Data were analysed using Epi info version 7.02 (Centers for Disease Control, Atlanta, Georgia, United States). P-values of <0.05 was used for clinical significance. Result There were 67 participants and the mean age was 32.67±7.71 years, range 21 to 55 years, the majority being female 66 (98.51%). Training on eye health was received by 13 (19.40%). Forty-four (65.67%) participants had knowledge of strabismus and amblyopia, out of them 30 were school nurses. The majority of school nurses 23 (76.67%) and primary teachers 13 (92.86%) had good knowledge scores (6 to 10). Conclusion The majority of participants had good knowledge about strabismus and amblyopia. As the school nurses and primary school teachers are the first link to the children at risk, improving their awareness level on strabismus and amblyopia will help in early referral, timely intervention and prevent the risk of vision loss.","PeriodicalId":15436,"journal":{"name":"Journal of College of Medical Sciences-nepal","volume":"49 4","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-12-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139132512","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Extra hepatic portal vein obstruction is one of the commonest cause of portal hypertension and upper gastrointestinal bleed in the third world. Portal vein cavernous transformation is one of the hallmarks of EHPVO. Despite various lesser invasive interventional approaches for management of EHPVO, surgical shunts still play an important role in long term treatment of patients with EHPVO. Here we present a case of 23 years old female who presented to the OPD with complains of dull aching abdominal pain for a year which was insidious on onset and gradually progressive. The pain was non-radiating, localized to the left upper quadrant of the abdomen which aggravated on lying on the left side. She underwent lieno-adrenal shunt for porto-systemic decompression and management of EHPVO. This case aims to highlight the use of leino-adrenal shunt as a feasible alternative to Linton’s shunt.
{"title":"Lieno-Adrenal Shunt a Rescue for Porto-Systemic Decompression in 23-Year-Old Female","authors":"Khagendra Ojha, Prasun Yadav, Binaya Timilsina, Vipul Bhusan Mallik, Sagar Khatiwada, N. Belbase","doi":"10.3126/jcmsn.v19i4.56905","DOIUrl":"https://doi.org/10.3126/jcmsn.v19i4.56905","url":null,"abstract":"Extra hepatic portal vein obstruction is one of the commonest cause of portal hypertension and upper gastrointestinal bleed in the third world. Portal vein cavernous transformation is one of the hallmarks of EHPVO. Despite various lesser invasive interventional approaches for management of EHPVO, surgical shunts still play an important role in long term treatment of patients with EHPVO. Here we present a case of 23 years old female who presented to the OPD with complains of dull aching abdominal pain for a year which was insidious on onset and gradually progressive. The pain was non-radiating, localized to the left upper quadrant of the abdomen which aggravated on lying on the left side. She underwent lieno-adrenal shunt for porto-systemic decompression and management of EHPVO. This case aims to highlight the use of leino-adrenal shunt as a feasible alternative to Linton’s shunt.","PeriodicalId":15436,"journal":{"name":"Journal of College of Medical Sciences-nepal","volume":"29 7","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-12-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139132579","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-12-31DOI: 10.3126/jcmsn.v19i4.56590
R. Shah, Tika Devi Kandel, Deepak Adhikari
Introduction: Renal stones are one of the common urological problems. The optimal management of lower calyceal renal calculi of 1-2 cm is still debatable. The objective of this research is to assess the safety, efficacy, and stone-free rate of retrograde intrarenal surgery and mini-percutaneous nephrolithotomy for the management of lower calyceal stones of 1-2 cm. Methods: A prospective comparative study was conducted among 30 patients which were divided in two group (A and B) prospectively with lower calyceal stones of 1-2 cm. Group A were treated with retrograde intra renal surgery while Group B were treated with mini percutaneous nephrolithotomy. Results: The mean age of patient in Group-A was 44.27±17.10 year and in Group-B was 45.27±16.11 year. The hospital stay in Group-A was 3.47±0.62 and in Group-B was 4.50±0.73 days. The stone size in Group-A was 13.30±2.21 mm and in Group-B was 15.60±2.55 with p-value of 0.381. The duration of operation time in Group-A was79.37±13.96 minutes and in Group-B was 62.53±7.41 minutes with p value of 0.091. Conclusions: Both retrograde intrarenal surgery and mini-percutaneous nephrolithotomy procedure are comparable. Mini percutaneous nephrolithotomy has a better stone free rate and haematuria is more common but retrograde intrarenal surgery has less hospital stay and post operative pyrexia is more common.
{"title":"Retrograde Intrarenal Surgery versus Mini-Percutaneous Nephrolithotomy for Lower Calyceal Stones of ≤ 2 cm","authors":"R. Shah, Tika Devi Kandel, Deepak Adhikari","doi":"10.3126/jcmsn.v19i4.56590","DOIUrl":"https://doi.org/10.3126/jcmsn.v19i4.56590","url":null,"abstract":"Introduction: Renal stones are one of the common urological problems. The optimal management of lower calyceal renal calculi of 1-2 cm is still debatable. The objective of this research is to assess the safety, efficacy, and stone-free rate of retrograde intrarenal surgery and mini-percutaneous nephrolithotomy for the management of lower calyceal stones of 1-2 cm. Methods: A prospective comparative study was conducted among 30 patients which were divided in two group (A and B) prospectively with lower calyceal stones of 1-2 cm. Group A were treated with retrograde intra renal surgery while Group B were treated with mini percutaneous nephrolithotomy. Results: The mean age of patient in Group-A was 44.27±17.10 year and in Group-B was 45.27±16.11 year. The hospital stay in Group-A was 3.47±0.62 and in Group-B was 4.50±0.73 days. The stone size in Group-A was 13.30±2.21 mm and in Group-B was 15.60±2.55 with p-value of 0.381. The duration of operation time in Group-A was79.37±13.96 minutes and in Group-B was 62.53±7.41 minutes with p value of 0.091. Conclusions: Both retrograde intrarenal surgery and mini-percutaneous nephrolithotomy procedure are comparable. Mini percutaneous nephrolithotomy has a better stone free rate and haematuria is more common but retrograde intrarenal surgery has less hospital stay and post operative pyrexia is more common.","PeriodicalId":15436,"journal":{"name":"Journal of College of Medical Sciences-nepal","volume":"100 20","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-12-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139131627","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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