Introduction: Human skeleton shows variable degree of sexual dimorphism, but definitive inference can be obtained from only a few bones, sacrum being one of them. The morphometric differences of the bone will be helpful to obstetricians, as it shows special adaptations in females for child bearing. It is also important for physical anthropologists and forensic scientists for sex determination. The aim of this study was to find out whether sex could be determined by using sacral parameters from X-ray images of pelvis. Methods: The study included antero-posterior X-ray images of pelvis with clearly visible 680 sacra (311 of males and 369 of females) obtained by computer generated random numbers from records in the Department of Radiodiagnosis of a medical college in Nepal. X-ray images with the sacrum suspected for fractures and pathological diseases were excluded. Inbuilt software “CR Konica Minolta Aero DR/CR CS7” was used for measurements. Results: The mean sacral length and mean transverse diameter of S1 vertebra were higher in males; whereas, mean sacral breadth, mean left ala length, mean right ala length, mean ala length, mean sacral index and mean alar index were higher in females. These differences in sacral parameters between the two sexes were statistically significant (p<0.05). The percentage of bones identified by demarking points of sacral index was 15.17% and 0.32% respectively in the males and the females. Conclusion: The result of the present study supported determination of sex of an individual from radiological assessment of sacrum.
{"title":"Sex Determination from Radiological Assessment of the Sacrum in Nepalese Population: A Cross-sectional Study","authors":"Subina Shrestha, S. Kc, S. Acharya","doi":"10.22502/JLMC.V8I2.393","DOIUrl":"https://doi.org/10.22502/JLMC.V8I2.393","url":null,"abstract":"Introduction: Human skeleton shows variable degree of sexual dimorphism, but definitive inference can be obtained from only a few bones, sacrum being one of them. The morphometric differences of the bone will be helpful to obstetricians, as it shows special adaptations in females for child bearing. It is also important for physical anthropologists and forensic scientists for sex determination. The aim of this study was to find out whether sex could be determined by using sacral parameters from X-ray images of pelvis. Methods: The study included antero-posterior X-ray images of pelvis with clearly visible 680 sacra (311 of males and 369 of females) obtained by computer generated random numbers from records in the Department of Radiodiagnosis of a medical college in Nepal. X-ray images with the sacrum suspected for fractures and pathological diseases were excluded. Inbuilt software “CR Konica Minolta Aero DR/CR CS7” was used for measurements. Results: The mean sacral length and mean transverse diameter of S1 vertebra were higher in males; whereas, mean sacral breadth, mean left ala length, mean right ala length, mean ala length, mean sacral index and mean alar index were higher in females. These differences in sacral parameters between the two sexes were statistically significant (p<0.05). The percentage of bones identified by demarking points of sacral index was 15.17% and 0.32% respectively in the males and the females. Conclusion: The result of the present study supported determination of sex of an individual from radiological assessment of sacrum.","PeriodicalId":16109,"journal":{"name":"Journal of Lumbini Medical College","volume":"8 1","pages":"259-263"},"PeriodicalIF":0.0,"publicationDate":"2020-12-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"45936762","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}
In the past, journals were published only in the print, and the only way to access them was through the library. However, today we can easily access journals and articles with a click. There are more online journals which have made it possible and feasible for authors to submit their work. As an editor of a journal, I am often approached by younger aspiring authors for accelerated publication of their manuscripts. The journal is biannual and undergoes double-blind peer review process which in itself is time consuming. The authors also fear the reviewer’s comment about major corrections or even rejection of their article. The criteria of mandatory publication for academic promotion has compelled medical professionals to write and publish research articles. To get their articles published quick and easy, they sometimes fall prey to predatory journals. The ‘Publish or Perish’ trend should be discouraged and young researchers should be mentored and encouraged to publish in good impact journals.
{"title":"‘Publish or Perish’ Trend: Fueling the Predatory Journals","authors":"A. Atreya","doi":"10.22502/JLMC.V8I2.409","DOIUrl":"https://doi.org/10.22502/JLMC.V8I2.409","url":null,"abstract":"In the past, journals were published only in the print, and the only way to access them was through the library. However, today we can easily access journals and articles with a click. There are more online journals which have made it possible and feasible for authors to submit their work. \u0000As an editor of a journal, I am often approached by younger aspiring authors for accelerated publication of their manuscripts. The journal is biannual and undergoes double-blind peer review process which in itself is time consuming. The authors also fear the reviewer’s comment about major corrections or even rejection of their article. The criteria of mandatory publication for academic promotion has compelled medical professionals to write and publish research articles. To get their articles published quick and easy, they sometimes fall prey to predatory journals. The ‘Publish or Perish’ trend should be discouraged and young researchers should be mentored and encouraged to publish in good impact journals.","PeriodicalId":16109,"journal":{"name":"Journal of Lumbini Medical College","volume":"8 1","pages":"183-184"},"PeriodicalIF":0.0,"publicationDate":"2020-12-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"48664682","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}
C. K. Garbuja, Sunita Rana, P. Thapa, Mohan Singh Rana
Introduction: Learners are key figures for whom the provision and perception of positive, progressive and encouraging interactive educational environment at any educational institution is very crucial. The study aimed to find the perception of nursing students of two different medical colleges regarding their educational environment. Methods: A cross-sectional descriptive study was conducted among 190 students through the use of internationally validated, non-culturally specific questionnaire. The responses were made on five points Likert scale scored from 0 to 4. The overall score was interpreted as very poor, plenty of problems, more positive than negative and excellent based on obtained score of 0-50, 51-100, 101-150 and 151-200 respectively. Descriptive statistics and one way analysis of variance test was used to analyze the collected data. Results: There were 98 (51.6%) participants from College of Medical Sciences and 92 (48.4%) from Lumbini Medical College and Teaching Hospital. The overall score of perception of educational environment were 142.13±14.90 (74.64%) and 144.34±15.59 (76.14%) in the two centers respectively which means more positive than negative perceptions. Only nature of accommodation was found statistically significant with students’ perception of teachers (p = 0.014). Conclusion: Majority opined a more positive than negative perception towards educational environment. Good communication skills of teachers, knowledgeable teachers, teaching to develop their competence level were some positive perceptions. Whereas, teachers being authoritarian, focus on short term and factual learning, lack of support system were the areas which could be improved.
{"title":"Perception of Educational Environment among Nursing Students of Different Colleges: A Cross- Sectional Study","authors":"C. K. Garbuja, Sunita Rana, P. Thapa, Mohan Singh Rana","doi":"10.22502/JLMC.V8I2.403","DOIUrl":"https://doi.org/10.22502/JLMC.V8I2.403","url":null,"abstract":"Introduction: Learners are key figures for whom the provision and perception of positive, progressive and encouraging interactive educational environment at any educational institution is very crucial. The study aimed to find the perception of nursing students of two different medical colleges regarding their educational environment. Methods: A cross-sectional descriptive study was conducted among 190 students through the use of internationally validated, non-culturally specific questionnaire. The responses were made on five points Likert scale scored from 0 to 4. The overall score was interpreted as very poor, plenty of problems, more positive than negative and excellent based on obtained score of 0-50, 51-100, 101-150 and 151-200 respectively. Descriptive statistics and one way analysis of variance test was used to analyze the collected data. Results: There were 98 (51.6%) participants from College of Medical Sciences and 92 (48.4%) from Lumbini Medical College and Teaching Hospital. The overall score of perception of educational environment were 142.13±14.90 (74.64%) and 144.34±15.59 (76.14%) in the two centers respectively which means more positive than negative perceptions. Only nature of accommodation was found statistically significant with students’ perception of teachers (p = 0.014). Conclusion: Majority opined a more positive than negative perception towards educational environment. Good communication skills of teachers, knowledgeable teachers, teaching to develop their competence level were some positive perceptions. Whereas, teachers being authoritarian, focus on short term and factual learning, lack of support system were the areas which could be improved.","PeriodicalId":16109,"journal":{"name":"Journal of Lumbini Medical College","volume":"8 1","pages":"251-258"},"PeriodicalIF":0.0,"publicationDate":"2020-12-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43515261","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}
Introduction: Adolescent pregnancy is a major public health concern in low- and middle-income countries. Nepal ranks among the twenty countries with the highest child marriage rates in the world. Adolescent mothers are at higher risk for poorer maternal and neonatal outcomes. This study intended to find the reproductive health issues and use of family planning methods among married adolescent mothers at a tertiary care center in a western part of Nepal. Methods: This was a cross-sectional study conducted among adolescent mothers who attended the family planning counseling session at Community Medicine Out-patient Department at a tertiary care center. Pre-tested semi-structured questionnaire was used for data collection and variables were entered in SPSSTM version 16. Descriptive statistics were presented in terms of mean and percentage. Results: Among 235 adolescent mothers, the mean age of adolescent mothers was 18.02 years (SD = 1.13). Almost 93.2% had not used any kind of contraceptive methods previously. Limited knowledge, uncomfortable talking about contraception and spousal denial were common reasons for not using contraception. Obstetric related complications were observed in 13.6% and one in ten neonates required neonatal intensive care unit admission during the study period. After the counseling session, six out of ten expressed current choice of long-acting reversible contraceptives method in which Jadelle implant was preferred. Conclusion: Our study among the adolescent mothers showed that use of family planning methods before pregnancy had been very low. Policies need to focus on meeting the unmet need for family planning among married adolescent girls.
{"title":"Reproductive Health Issues and Use of Family Planning Methods among Married Adolescent Mothers","authors":"S. Nepal, S. Aryal","doi":"10.22502/JLMC.V8I2.404","DOIUrl":"https://doi.org/10.22502/JLMC.V8I2.404","url":null,"abstract":"Introduction: Adolescent pregnancy is a major public health concern in low- and middle-income countries. Nepal ranks among the twenty countries with the highest child marriage rates in the world. Adolescent mothers are at higher risk for poorer maternal and neonatal outcomes. This study intended to find the reproductive health issues and use of family planning methods among married adolescent mothers at a tertiary care center in a western part of Nepal. Methods: This was a cross-sectional study conducted among adolescent mothers who attended the family planning counseling session at Community Medicine Out-patient Department at a tertiary care center. Pre-tested semi-structured questionnaire was used for data collection and variables were entered in SPSSTM version 16. Descriptive statistics were presented in terms of mean and percentage. Results: Among 235 adolescent mothers, the mean age of adolescent mothers was 18.02 years (SD = 1.13). Almost 93.2% had not used any kind of contraceptive methods previously. Limited knowledge, uncomfortable talking about contraception and spousal denial were common reasons for not using contraception. Obstetric related complications were observed in 13.6% and one in ten neonates required neonatal intensive care unit admission during the study period. After the counseling session, six out of ten expressed current choice of long-acting reversible contraceptives method in which Jadelle implant was preferred. Conclusion: Our study among the adolescent mothers showed that use of family planning methods before pregnancy had been very low. Policies need to focus on meeting the unmet need for family planning among married adolescent girls.","PeriodicalId":16109,"journal":{"name":"Journal of Lumbini Medical College","volume":"8 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2020-12-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42048442","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}
Introduction: Diabetes is one of the major burdens of non-communicable disease causing morbidity and mortality. Glycated hemoglobin (HbA1c) has been used as a tool to monitor glycemic control in patients with type 2 diabetes mellitus and elevated HbA1c value is considered an independent risk factor for dyslipidemia. Methods: A total of 120 patients with type 2 diabetes mellitus were enrolled in this cross-sectional study. Means with standard deviation were used for age, height, weight and fasting blood sugar and Pearson correlation test was applied to identify correlation between Glycated hemoglobin (HbA1c) and lipid profile. Comparison of means was done by Z test in parametric data within the two groups. P value less than 0.05 was considered significant. Results: The mean HbA1c of male and female patients were 8.35±1.77 and 8.65±1.95 respectively. Among patients with good glycemic control, mean total cholesterol and mean high density lipoprotein were higher than poor glycemic control patients. Patients with poor glycemic control had higher mean triglyceride and low density lipoprotein than good glycemic control patients. Correlation coefficient for various components of lipid profile and HbA1c were: total cholesterol (r=0.189, p=0.038, n=120), triglyceride (r=0.418, p<0.01, n=120), low density lipoprotein (r=0.673,p<0.01,n=120) and high density lipoprotein ( r=-0.683, p<0.01, n=120). Conclusion: There was a significant moderate correlation between HbA1c and lipid profile. Lipid profile values were significantly higher in poor glycemic control than good glycemic control patients. Hence, HbA1c can be considered as a surrogate marker for dyslipidemia in type 2 DM patients.
{"title":"Study of Association Between Glycated Hemoglobin and Lipid Profile in Type 2 Diabetes Mellitus in Tertiary Care Center","authors":"Tilchan Pandey, Jivan Khanal, Krishna Chandra Godar","doi":"10.22502/JLMC.V8I2.387","DOIUrl":"https://doi.org/10.22502/JLMC.V8I2.387","url":null,"abstract":"Introduction: Diabetes is one of the major burdens of non-communicable disease causing morbidity and mortality. Glycated hemoglobin (HbA1c) has been used as a tool to monitor glycemic control in patients with type 2 diabetes mellitus and elevated HbA1c value is considered an independent risk factor for dyslipidemia. Methods: A total of 120 patients with type 2 diabetes mellitus were enrolled in this cross-sectional study. Means with standard deviation were used for age, height, weight and fasting blood sugar and Pearson correlation test was applied to identify correlation between Glycated hemoglobin (HbA1c) and lipid profile. Comparison of means was done by Z test in parametric data within the two groups. P value less than 0.05 was considered significant. Results: The mean HbA1c of male and female patients were 8.35±1.77 and 8.65±1.95 respectively. Among patients with good glycemic control, mean total cholesterol and mean high density lipoprotein were higher than poor glycemic control patients. Patients with poor glycemic control had higher mean triglyceride and low density lipoprotein than good glycemic control patients. Correlation coefficient for various components of lipid profile and HbA1c were: total cholesterol (r=0.189, p=0.038, n=120), triglyceride (r=0.418, p<0.01, n=120), low density lipoprotein (r=0.673,p<0.01,n=120) and high density lipoprotein ( r=-0.683, p<0.01, n=120). Conclusion: There was a significant moderate correlation between HbA1c and lipid profile. Lipid profile values were significantly higher in poor glycemic control than good glycemic control patients. Hence, HbA1c can be considered as a surrogate marker for dyslipidemia in type 2 DM patients.","PeriodicalId":16109,"journal":{"name":"Journal of Lumbini Medical College","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2020-12-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"45657804","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}
Introduction: Salivary gland tumor accounts for about 5% of all the neoplasms of the head and neck. 75% of such tumors occur in the parotid glands. Pleomorphic adenoma is the most common type of benign salivary gland tumor. It tends to recur after inappropriate treatment. Surgery of parotid tumor includes enucleation, superficial parotidectomy and total parotidectomy. Identification and preservation of facial nerve trunk and its branches are very important in parotid surgery. Advancement of microsurgical technique has helped in better visualization, identification and preservation of the facial nerve. Methods: This prospective study included twenty-seven patients. Preoperative ultrasonography and fine needle aspiration cytology were done for all cases. Computed tomography/magnetic resonance imaging were performed in some cases when needed. Standard microsurgical technique with the help of microscope was performed for antegrade parotidectomy. Data analysis was done using SPSS version 26.0. Results: The patients' age ranged from 12 to 78 years. Fifteen (55.6%) patients were female and 12 (44. 4%) were males. Sixteen (59.3%) tumors were located on the right side whereas 11 (40.7%) were on the left side. Most of the tumors (n=18, 66.7%) were pleomorphic adenoma. Two (7.4%) of the patients had temporary facial paralysis which improved with time. Two (7.4%) patients had developed hematoma. Frey’s syndrome was not found in follow-up. Conclusion: This study showed low morbidity in parotidectomy using microsurgical techniques. No permanent injury to the facial nerve was found.
{"title":"Microscopic Antegrade Parotidectomy for Different Types of Parotid Tumor","authors":"Brihaspati Sigdel, T. Dubey","doi":"10.22502/JLMC.V8I2.338","DOIUrl":"https://doi.org/10.22502/JLMC.V8I2.338","url":null,"abstract":"Introduction: Salivary gland tumor accounts for about 5% of all the neoplasms of the head and neck. 75% of such tumors occur in the parotid glands. Pleomorphic adenoma is the most common type of benign salivary gland tumor. It tends to recur after inappropriate treatment. Surgery of parotid tumor includes enucleation, superficial parotidectomy and total parotidectomy. Identification and preservation of facial nerve trunk and its branches are very important in parotid surgery. Advancement of microsurgical technique has helped in better visualization, identification and preservation of the facial nerve. Methods: This prospective study included twenty-seven patients. Preoperative ultrasonography and fine needle aspiration cytology were done for all cases. Computed tomography/magnetic resonance imaging were performed in some cases when needed. Standard microsurgical technique with the help of microscope was performed for antegrade parotidectomy. Data analysis was done using SPSS version 26.0. Results: The patients' age ranged from 12 to 78 years. Fifteen (55.6%) patients were female and 12 (44. 4%) were males. Sixteen (59.3%) tumors were located on the right side whereas 11 (40.7%) were on the left side. Most of the tumors (n=18, 66.7%) were pleomorphic adenoma. Two (7.4%) of the patients had temporary facial paralysis which improved with time. Two (7.4%) patients had developed hematoma. Frey’s syndrome was not found in follow-up. Conclusion: This study showed low morbidity in parotidectomy using microsurgical techniques. No permanent injury to the facial nerve was found.","PeriodicalId":16109,"journal":{"name":"Journal of Lumbini Medical College","volume":"8 1","pages":"233-237"},"PeriodicalIF":0.0,"publicationDate":"2020-11-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43525821","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}
Introduction: Wound infection due to various pathogenic microorganisms and the development of resistance to antibiotics is one of the major problems in medical sector. This study aimed to identify the etiological agents of wound infection along with their antibiotic susceptibility. Methods: A total of 400 wound swab specimens were collected from the patients visiting a tertiary center in western Nepal over a period of six months. Thus, collected specimens were processed in Microbiology laboratory for isolation of causative agents. Antibiotic susceptibility test was performed for entire isolates by Kirby Baur disc diffusion method. Methicillin-Resistant Staphylococcus aureus was detected by cefoxitin disc diffusion test and Extended- Spectrum Beta-Lactamases producing Enterobacteriaeae by Phenotypic confirmatory disc diffusion test as recommended by Clinical and Laboratory Standards Institute. Results: Two hundred and fifty-nine (64.7%) of specimens were infected, giving rise to 269 different isolates. Among these, 166 (61.7%) were gram positive and 101 (37.6%) were gram negative bacteria. Staphylococcus aureus (n = 130, 48.3%) was the most predominant bacteria followed by Escherichia coli (n=44, 16.3%), and Klebsiella pneumoniae (n=23, 8.5%). Gentamicin followed by co-trimoxazole was the most effective among the tested antibiotics for Staphylococcus aureus. Gentamicin and ciprofloxacin were shown effective for isolated gram-negative bacteria. Conclusion: Fifty-eight (44.6%) of total Staphylococcus aureus were Methicillin-Resistant Staphylococcus aureus positive and 16 (20.7%) of total Enterobacteriaceae were Extended-Spectrum Beta-Lactamases producers. The increased prevalence of Methicillin-Resistant Staphylococcus aureus and Extended-Spectrum Beta-Lactamase suggest rational use of antibiotics on the basis of antibiotic sensitivity results.
{"title":"Bacteriological Profile of Wound Infection and Antibiotic Susceptibility Pattern of Various Isolates in a Tertiary Care Center","authors":"Nabina Maharjan, B. S. Mahawal","doi":"10.22502/JLMC.V8I2.367","DOIUrl":"https://doi.org/10.22502/JLMC.V8I2.367","url":null,"abstract":"Introduction: Wound infection due to various pathogenic microorganisms and the development of resistance to antibiotics is one of the major problems in medical sector. This study aimed to identify the etiological agents of wound infection along with their antibiotic susceptibility. Methods: A total of 400 wound swab specimens were collected from the patients visiting a tertiary center in western Nepal over a period of six months. Thus, collected specimens were processed in Microbiology laboratory for isolation of causative agents. Antibiotic susceptibility test was performed for entire isolates by Kirby Baur disc diffusion method. Methicillin-Resistant Staphylococcus aureus was detected by cefoxitin disc diffusion test and Extended- Spectrum Beta-Lactamases producing Enterobacteriaeae by Phenotypic confirmatory disc diffusion test as recommended by Clinical and Laboratory Standards Institute. Results: Two hundred and fifty-nine (64.7%) of specimens were infected, giving rise to 269 different isolates. Among these, 166 (61.7%) were gram positive and 101 (37.6%) were gram negative bacteria. Staphylococcus aureus (n = 130, 48.3%) was the most predominant bacteria followed by Escherichia coli (n=44, 16.3%), and Klebsiella pneumoniae (n=23, 8.5%). Gentamicin followed by co-trimoxazole was the most effective among the tested antibiotics for Staphylococcus aureus. Gentamicin and ciprofloxacin were shown effective for isolated gram-negative bacteria. Conclusion: Fifty-eight (44.6%) of total Staphylococcus aureus were Methicillin-Resistant Staphylococcus aureus positive and 16 (20.7%) of total Enterobacteriaceae were Extended-Spectrum Beta-Lactamases producers. The increased prevalence of Methicillin-Resistant Staphylococcus aureus and Extended-Spectrum Beta-Lactamase suggest rational use of antibiotics on the basis of antibiotic sensitivity results.","PeriodicalId":16109,"journal":{"name":"Journal of Lumbini Medical College","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2020-10-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44766573","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}
Introduction: There are controversies regarding the benefit of open reduction and internal fixation with volar locking plates over closed reduction and external fixation along with supplementary Kirschner wires fixation for intra-articular distal end radius fracture. Therefore, this study aimed to compare the outcomes between external fixation along with supplementary Kirschner wires with volar locking plate in the treatment of intra-articular distal end radius fractures. Methods: This prospective, observational and analytical study was conducted over one and a half years. Forty-seven adults with displaced intra-articular distal end radius fracture were included in the study. Twenty-one cases were treated with closed reduction and external fixation along with supplementary Kirschner wires, whereas 26 patients were treated with open reduction and volar locking plate fixation. Results: At the end of three months, as per the Green and O’Brien scoring, the mean functional outcome score in the volar plate group was significantly better 80.77(±11.46) than the external fixation group 70.24(±10.66) (p=0.002). However, at the end of six months, the mean score in the volar plate group 86.15(±7.39) was not significantly different from the external fixation group 81.43(±9.63) (p= 0.63). Fracture reduction was achieved and maintained better in the volar locking plate group. Conclusion: Functional outcome of closed reduction and external fixation along with supplementary Kirschner wires is comparable with open reduction and internal fixation by volar locking plate in treatment of displaced intra-articular distal radius fractures. Radiological correction is achieved and maintained better with volar locking plates.
{"title":"Comparison of External Fixation and Supplementary Kirschner-Wires Fixation With Volar Locking Plate for the Treatment of Intra- Articular Distal End Radius Fractures","authors":"R. Dwivedi, M. Khatri, Arjun Kc","doi":"10.22502/JLMC.V8I2.397","DOIUrl":"https://doi.org/10.22502/JLMC.V8I2.397","url":null,"abstract":"Introduction: There are controversies regarding the benefit of open reduction and internal fixation with volar locking plates over closed reduction and external fixation along with supplementary Kirschner wires fixation for intra-articular distal end radius fracture. Therefore, this study aimed to compare the outcomes between external fixation along with supplementary Kirschner wires with volar locking plate in the treatment of intra-articular distal end radius fractures. Methods: This prospective, observational and analytical study was conducted over one and a half years. Forty-seven adults with displaced intra-articular distal end radius fracture were included in the study. Twenty-one cases were treated with closed reduction and external fixation along with supplementary Kirschner wires, whereas 26 patients were treated with open reduction and volar locking plate fixation. Results: At the end of three months, as per the Green and O’Brien scoring, the mean functional outcome score in the volar plate group was significantly better 80.77(±11.46) than the external fixation group 70.24(±10.66) (p=0.002). However, at the end of six months, the mean score in the volar plate group 86.15(±7.39) was not significantly different from the external fixation group 81.43(±9.63) (p= 0.63). Fracture reduction was achieved and maintained better in the volar locking plate group. Conclusion: Functional outcome of closed reduction and external fixation along with supplementary Kirschner wires is comparable with open reduction and internal fixation by volar locking plate in treatment of displaced intra-articular distal radius fractures. Radiological correction is achieved and maintained better with volar locking plates.","PeriodicalId":16109,"journal":{"name":"Journal of Lumbini Medical College","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2020-10-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"48718412","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}
Introduction: Benign prostate hyperplasia is one of the most common diseases and a common cause of lower urinary tract symptoms in aging men. Various disease management approaches to optimize the patient’s long life and efficient status where patient adherence to the prescribed treatment plays a vital role. This study evaluated the medication adherence pattern of the patients to obtain successful treatment outcomes. Methods: A cross-sectional study was conducted in out-patient department of urology in a tertiary care hospital. Patients diagnosed with benign prostate hyperplasia were interviewed using a structured questionnaire. Results: The high expenses of medicine, fear of medication, lack of symptomatic relief were factors that showed statistically significant (p < 0.05) difference between adherent and non-adherent group. Similarly, the duration of diagnosis of the adherent group was significantly less than the non-adherent group including the pattern of physical activities (p < 0.05). Adherent group also had more participants working in business and services occupation compared to the non-adherent group. Conclusion: The general attitude (such as fear of medication and lack of symptomatic relief) is seen as major factors that affect adherent pattern in benign prostate hyperplasia patients. These issues can be solved using proper guidance. However, the cost of medicines also posts an immense issue for the non-adherent group.
{"title":"Medication Adherence Pattern for Benign Prostatic Hyperplasia: A Cross-Sectional Study","authors":"J. Shrestha, H. Joshi, P. Neupane","doi":"10.22502/JLMC.V8I2.386","DOIUrl":"https://doi.org/10.22502/JLMC.V8I2.386","url":null,"abstract":"Introduction: Benign prostate hyperplasia is one of the most common diseases and a common cause of lower urinary tract symptoms in aging men. Various disease management approaches to optimize the patient’s long life and efficient status where patient adherence to the prescribed treatment plays a vital role. This study evaluated the medication adherence pattern of the patients to obtain successful treatment outcomes. Methods: A cross-sectional study was conducted in out-patient department of urology in a tertiary care hospital. Patients diagnosed with benign prostate hyperplasia were interviewed using a structured questionnaire. Results: The high expenses of medicine, fear of medication, lack of symptomatic relief were factors that showed statistically significant (p < 0.05) difference between adherent and non-adherent group. Similarly, the duration of diagnosis of the adherent group was significantly less than the non-adherent group including the pattern of physical activities (p < 0.05). Adherent group also had more participants working in business and services occupation compared to the non-adherent group. Conclusion: The general attitude (such as fear of medication and lack of symptomatic relief) is seen as major factors that affect adherent pattern in benign prostate hyperplasia patients. These issues can be solved using proper guidance. However, the cost of medicines also posts an immense issue for the non-adherent group.","PeriodicalId":16109,"journal":{"name":"Journal of Lumbini Medical College","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2020-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"45325952","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}
Introduction: Non-invasive strategies to predict variceal from non-variceal bleeding will be highly beneficialfor preemptive management of Upper Gastrointestinal Bleeding (UGIB). This study aimed to assess the roleof aspartate aminotransferase (AST) to platelet ratio index (APRI) as a non-invasive predictor of varicealetiology of UGIB. Methods: This was a retrospective descriptive study conducted at Endoscopy Departmentof Dhulikhel Hospital between January 2017 and December 2019 in patients presenting with acute UGIB.We assessed the diagnostic utility of the APRI score relative to other objective measures by Area Under theReceiver Operating Characteristic (AUROC) curve analysis. Results: A total of 158 patients with historyof UGIB were included in the study. There were total 123 males (77.8%) and the mean age of the patientswas 50.3±16.1 years. The APRI score performed well in predicting a variceal etiology of acute UGIB, withAUROC 0.9. When APRI was used at cut-off of 1.3, it had a sensitivity of 84.1% and specificity of 76.8%,a positive predictive value of 70.7% and a negative predictive value of 89.9% while predicting varicealetiology of UGIB at presentation. The relative risk of varices at an APRI cut-off of 1.3 is 17.5 with a p-valueof <0.0001. Conclusion: The present study highlighted that APRI score can be used as an objective metricthat helps to predict a variceal etiology of acute UGIB.
{"title":"The Role of Aspartate Aminotransferase to Platelet Ratio Index as a Non-Invasive Predictor of Variceal Etiology of Upper Gastrointestinal Bleeding","authors":"A. Shrestha, P. Sharma, A. Lama, R. Gurung","doi":"10.22502/JLMC.V8I2.376","DOIUrl":"https://doi.org/10.22502/JLMC.V8I2.376","url":null,"abstract":"Introduction: Non-invasive strategies to predict variceal from non-variceal bleeding will be highly beneficialfor preemptive management of Upper Gastrointestinal Bleeding (UGIB). This study aimed to assess the roleof aspartate aminotransferase (AST) to platelet ratio index (APRI) as a non-invasive predictor of varicealetiology of UGIB. Methods: This was a retrospective descriptive study conducted at Endoscopy Departmentof Dhulikhel Hospital between January 2017 and December 2019 in patients presenting with acute UGIB.We assessed the diagnostic utility of the APRI score relative to other objective measures by Area Under theReceiver Operating Characteristic (AUROC) curve analysis. Results: A total of 158 patients with historyof UGIB were included in the study. There were total 123 males (77.8%) and the mean age of the patientswas 50.3±16.1 years. The APRI score performed well in predicting a variceal etiology of acute UGIB, withAUROC 0.9. When APRI was used at cut-off of 1.3, it had a sensitivity of 84.1% and specificity of 76.8%,a positive predictive value of 70.7% and a negative predictive value of 89.9% while predicting varicealetiology of UGIB at presentation. The relative risk of varices at an APRI cut-off of 1.3 is 17.5 with a p-valueof <0.0001. Conclusion: The present study highlighted that APRI score can be used as an objective metricthat helps to predict a variceal etiology of acute UGIB.","PeriodicalId":16109,"journal":{"name":"Journal of Lumbini Medical College","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2020-09-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46568188","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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