Pub Date : 2022-12-31DOI: 10.3126/jngmc.v20i2.51592
Roma Km, G. J. Shah, Shyam Nandan Sah
Introduction: The early presentation of bacterial meningitis and aseptic meningitis are similar however treatment and outcome are different. The Bacterial Meningitis Score helps to differentiate bacterial meningitis from aseptic meningitis. Aims: To evaluate bacterial meningitis score as clinical prediction rule in children with acute meningitis. Methods: This was a hospital based prospective study done at pediatric department of Nepalgunj Medical College, Nepalgunj, a tertiary care reference hospital in Nepal, conducted from September 2020- August 2021. All the patients who were suspected of meningitis during the study period between the ages of 29 days to 15 years were included in this study. Results: A total of 138 patients were included in our study with 86 patients as aseptic meningitis and 52 patients as bacterial meningitis. Taking cut-off point of bacterial meningitis scoreto be 1.5 it’s sensitivity and specificity was found to be 100%. Area under ROC curve was found to be 1 showing 100% predictivity of bacterial meningitis score . The outcome of aseptic meningitis group was significantly better than bacterial group. Conclusion: Bacterial meningitis had grave prognosis associated with high mortality. Bacterial meningitis score is helpful to differentiate aseptic meningitis from bacterial meningitis to plan appropriate management timely.
{"title":"Bacterial Meningitis Score as Clinical Prediction Rule in Children with Acute Meningitis","authors":"Roma Km, G. J. Shah, Shyam Nandan Sah","doi":"10.3126/jngmc.v20i2.51592","DOIUrl":"https://doi.org/10.3126/jngmc.v20i2.51592","url":null,"abstract":"Introduction: The early presentation of bacterial meningitis and aseptic meningitis are similar however treatment and outcome are different. The Bacterial Meningitis Score helps to differentiate bacterial meningitis from aseptic meningitis. \u0000Aims: To evaluate bacterial meningitis score as clinical prediction rule in children with acute meningitis. \u0000Methods: This was a hospital based prospective study done at pediatric department of Nepalgunj Medical College, Nepalgunj, a tertiary care reference hospital in Nepal, conducted from September 2020- August 2021. All the patients who were suspected of meningitis during the study period between the ages of 29 days to 15 years were included in this study. \u0000Results: A total of 138 patients were included in our study with 86 patients as aseptic meningitis and 52 patients as bacterial meningitis. Taking cut-off point of bacterial meningitis scoreto be 1.5 it’s sensitivity and specificity was found to be 100%. Area under ROC curve was found to be 1 showing 100% predictivity of bacterial meningitis score . The outcome of aseptic meningitis group was significantly better than bacterial group. \u0000Conclusion: Bacterial meningitis had grave prognosis associated with high mortality. Bacterial meningitis score is helpful to differentiate aseptic meningitis from bacterial meningitis to plan appropriate management timely.","PeriodicalId":166882,"journal":{"name":"Journal of Nepalgunj Medical College","volume":"11 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2022-12-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"128085280","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 : 2022-12-31DOI: 10.3126/jngmc.v20i2.51908
N. Chaudhary, B. Badhu, Barun Dev, Prabhat Deo
Introduction: Refractive errors remain the most important cause of visual impairment in childhood worldwide which contributes to about 19% of total blindness in the world. This can be further complicated by other ocular conditions like vernal keratoconjunctivitis, which is a chronic, recurrent bilateral inflammation of conjunctiva and cornea. Aims: To assess the pattern of refractive status in patients with Vernal keratoconjunctivitis. Methods: This was a cross sectional hospital-based study conducted in patients attending the Outpatient department of ophthalmology at Birat Medical college Teaching Hospital with the clinical diagnosis of Vernal Keratoconjuctivitis from July 2020 to June 2021.The vision and baseline refractive status of all patients were assessed accordingly. All the data was recorded in a specifically designed proforma which was then entered in MS excel for statistical analysis. Results: 80 patients were included in the study out of which 85% were male and 15 % were female. The most common presenting age group was 7 to 12 years. The most common type of Vernal Keratoconjunctivitis was found to be mixed type (58%), followed by limbal (22%) and papillary (20%). The most prevalent refractive error was found to be astigmatism (37.5%) followed by hypermetropia (16.25%) and myopia (11.25%). The remaining patients (35%)had a normal state of refraction. Conclusion: Refractive error was commonly seen in patients with Vernal Keratoconjuctivitis in our study. Hence, awareness among the people about the disease is very important.
{"title":"Pattern of Refractive Status in Patients with Vernal Keratoconjunctivitis at Birat Medical College Teaching Hospital","authors":"N. Chaudhary, B. Badhu, Barun Dev, Prabhat Deo","doi":"10.3126/jngmc.v20i2.51908","DOIUrl":"https://doi.org/10.3126/jngmc.v20i2.51908","url":null,"abstract":"Introduction: Refractive errors remain the most important cause of visual impairment in childhood worldwide which contributes to about 19% of total blindness in the world. This can be further complicated by other ocular conditions like vernal keratoconjunctivitis, which is a chronic, recurrent bilateral inflammation of conjunctiva and cornea. \u0000Aims: To assess the pattern of refractive status in patients with Vernal keratoconjunctivitis. \u0000Methods: This was a cross sectional hospital-based study conducted in patients attending the Outpatient department of ophthalmology at Birat Medical college Teaching Hospital with the clinical diagnosis of Vernal Keratoconjuctivitis from July 2020 to June 2021.The vision and baseline refractive status of all patients were assessed accordingly. All the data was recorded in a specifically designed proforma which was then entered in MS excel for statistical analysis. \u0000Results: 80 patients were included in the study out of which 85% were male and 15 % were female. The most common presenting age group was 7 to 12 years. The most common type of Vernal Keratoconjunctivitis was found to be mixed type (58%), followed by limbal (22%) and papillary (20%). The most prevalent refractive error was found to be astigmatism (37.5%) followed by hypermetropia (16.25%) and myopia (11.25%). The remaining patients (35%)had a normal state of refraction. \u0000Conclusion: Refractive error was commonly seen in patients with Vernal Keratoconjuctivitis in our study. Hence, awareness among the people about the disease is very important.","PeriodicalId":166882,"journal":{"name":"Journal of Nepalgunj Medical College","volume":"1 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2022-12-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"129759575","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: Several research have demonstrated the connection between lipid levels, diabetes mellitus (DM), and hypertension, but none have focused specifically on the association between lipid levels and essential hypertension in Nepal's non-diabetic population. Aims: To study the relationship between lipid profile, body mass index (BMI), and blood pressure (BP) in the nondiabetic hypertensive population. Methods: A hospital-based cross-sectional study was conducted among 150 participants. Anthropometric measurements including height, weight and BP were taken. Blood was collected in serum vial for lipid profile [total cholesterol (TC), triglyceride (TG) and low and high density lipoprotein cholesterol (LDLC and HDLC)] after an overnight fasting. Results: 44.7% were female, and 55.3% were male with the age ranging between 28-80 years. Among 48.67% of the overweight participants, 56.8% were male. 25.33% were obese, among which 52.6% were male. 56% of participants had systolic blood pressure (SBP) ≥140 mmHg and 58% had diastolic blood pressure (DBP) ≥90 mmHg and showed no significance among the gender. Borderline TG level was observed in 76.2% of participants with SBP ≥140 mmHg and in 74.7% with DBP ≥90 mmHg. HDLC vs gender showed significance. SBP and DBP had a significant relationship with LDLC and TC. The association of BMI with BP and lipid profile was not significant. Conclusion: Dyslipidemia is prevalent among non-diabetic hypertensive individuals. The majority of participants were overweight, however blood pressure and lipid profile did not correlate with BMI presumably because other anthropometric characteristics have better predictive values than BMI.
{"title":"Study of the Relationship of Lipid Profile, BMI and Blood Pressure among Non-diabetic Hypertensive Patients - A Hospital Based Study","authors":"Dristi Baskota, Bishow Raj Shrestha, S. Tiwari, Pragati Poudyel, Rachana Pandey, Richa Joshi","doi":"10.3126/jngmc.v20i2.51909","DOIUrl":"https://doi.org/10.3126/jngmc.v20i2.51909","url":null,"abstract":"Introduction: Several research have demonstrated the connection between lipid levels, diabetes mellitus (DM), and hypertension, but none have focused specifically on the association between lipid levels and essential hypertension in Nepal's non-diabetic population. \u0000Aims: To study the relationship between lipid profile, body mass index (BMI), and blood pressure (BP) in the nondiabetic hypertensive population. \u0000Methods: A hospital-based cross-sectional study was conducted among 150 participants. Anthropometric measurements including height, weight and BP were taken. Blood was collected in serum vial for lipid profile [total cholesterol (TC), triglyceride (TG) and low and high density lipoprotein cholesterol (LDLC and HDLC)] after an overnight fasting. \u0000Results: 44.7% were female, and 55.3% were male with the age ranging between 28-80 years. Among 48.67% of the overweight participants, 56.8% were male. 25.33% were obese, among which 52.6% were male. 56% of participants had systolic blood pressure (SBP) ≥140 mmHg and 58% had diastolic blood pressure (DBP) ≥90 mmHg and showed no significance among the gender. Borderline TG level was observed in 76.2% of participants with SBP ≥140 mmHg and in 74.7% with DBP ≥90 mmHg. HDLC vs gender showed significance. SBP and DBP had a significant relationship with LDLC and TC. The association of BMI with BP and lipid profile was not significant. \u0000Conclusion: Dyslipidemia is prevalent among non-diabetic hypertensive individuals. The majority of participants were overweight, however blood pressure and lipid profile did not correlate with BMI presumably because other anthropometric characteristics have better predictive values than BMI.","PeriodicalId":166882,"journal":{"name":"Journal of Nepalgunj Medical College","volume":"36 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2022-12-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"114664371","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 : 2022-12-31DOI: 10.3126/jngmc.v20i2.51834
N. Paudel, Prasanna Ghimire, A. Jha, Pooja Baidya, P. Ghimire, Hom Nath Adhikari
Introduction: Transabdominal and transvaginal ultrasound can be used in distinguishing lesions of adnexa. Transvaginal ultrasound has higher diagnostic accuracy than transabdominal ultrasound when compared with gold standard histopathology. It also provides better resolution as compared to transabdominal ultrasound. Aims: To find the diagnostic accuracy and efficacy of transvaginal and transabdominal sonographic techniques in adnexal pathologies by comparing against the gold standard of biopsy. Methods: Hospital based cross sectional comparative study done in 108 cases who underwent transabdominal and transvaginal sonography and histopathological study post operatively. Diagnostic findings of transabdominal and transvaginal sonogram were compared with the diagnosis of histopathology. Results: Of total 108 cases, most cases were benign. Sensitivity, specificity, accuracy, positive predictive value and negative predictive value for transabdominal were 63.15 %, 95.5%, 89.8%, 75% and 92.3% respectively. Sensitivity, specificity, accuracy, positive predictive value and negative predictive values of transvaginal were 73.6%, 95.5%, 91.6%, 77.7% and 94.4% respectively. Conclusion: Transvaginal sonography has higher diagnostic accuracy as compared to transabdominal ultrasonography.
{"title":"Radiopathological Correlation in Diagnosis of Adnexal Lesions: A Hospital Based Comparative Study","authors":"N. Paudel, Prasanna Ghimire, A. Jha, Pooja Baidya, P. Ghimire, Hom Nath Adhikari","doi":"10.3126/jngmc.v20i2.51834","DOIUrl":"https://doi.org/10.3126/jngmc.v20i2.51834","url":null,"abstract":"Introduction: Transabdominal and transvaginal ultrasound can be used in distinguishing lesions of adnexa. Transvaginal ultrasound has higher diagnostic accuracy than transabdominal ultrasound when compared with gold standard histopathology. It also provides better resolution as compared to transabdominal ultrasound. \u0000Aims: To find the diagnostic accuracy and efficacy of transvaginal and transabdominal sonographic techniques in adnexal pathologies by comparing against the gold standard of biopsy. \u0000Methods: Hospital based cross sectional comparative study done in 108 cases who underwent transabdominal and transvaginal sonography and histopathological study post operatively. Diagnostic findings of transabdominal and transvaginal sonogram were compared with the diagnosis of histopathology. \u0000Results: Of total 108 cases, most cases were benign. Sensitivity, specificity, accuracy, positive predictive value and negative predictive value for transabdominal were 63.15 %, 95.5%, 89.8%, 75% and 92.3% respectively. Sensitivity, specificity, accuracy, positive predictive value and negative predictive values of transvaginal were 73.6%, 95.5%, 91.6%, 77.7% and 94.4% respectively. \u0000Conclusion: Transvaginal sonography has higher diagnostic accuracy as compared to transabdominal ultrasonography.","PeriodicalId":166882,"journal":{"name":"Journal of Nepalgunj Medical College","volume":"108 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2022-12-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"117252278","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 : 2022-12-31DOI: 10.3126/jngmc.v20i2.51598
K. Shrestha, Dhundi Raj Paduel, S. Bhandari, S. Mahaseth
Introduction: Tympanoplasty is the procedure of choice for surgical correction of tympanic membrane perforation triggered by either chronic otitis media or trauma. Various types of autologous grafts have been used to close tympanic membrane perforations among which temporalis fascia and tragal cartilage are preferred, due to their anatomic proximity, ease of harvesting and suppleness. Aims: To compare clinical and audiological outcomes of type 1 tympanoplasty where temporalis fascia and tragal cartilage were used as the graft material. Methods: A prospective study was conducted on 50 patients of ages ranging from 10 to 50 years with Chronic Otitis Media - Mucosal. All the patients underwent type 1 tympanoplasty and were categorized into Group-A (Temporalis fascia graft) and Group-B (Cartilage graft), each group comprising of 25 patients. Graft uptake rate, hearing gain and air bone gap closure were compared between the groups in 4 and 8 weeks after surgery. Results: Out of total 50 patients, 20 were male and 30 were female. The average age of the patients was 28.20 years. The total hearing gain in the whole series was 14.94 dB while the total air bone gap closure was 14.78 dB respectively. The difference between pre and post-operative hearing was statistically significant for both air bone gap and air conduction, (P<0.05) in the whole series. There was 15.56 dB improvement in mean hearing threshold and 15.64 dB mean air bone gap closure in the fascia group, compared to 14.32 dB improvement in mean hearing and 13.92 dB mean air bone gap closure in the cartilage group. Graft uptake rate in the temporalis fascia group was 84% and the cartilage group was 92 % with significant difference in the graft uptake rate between the groups. Conclusion: The graft uptake rate and hearing results of tragal cartilage are comparable to those of temporalis fascia. Cartilage tympanoplasty has a higher graft uptake rate with low failure rate and also shows a high degree of reliability in high risk cases. Both cartilage and fascia tympanoplasty provided similar improvements in the hearing outcome post-operatively. Thus, cartilage tympanoplasty is recommended as an alternative option.
{"title":"Comparative Study of Temporalis Fascia Graft versus Cartilage Shield Tympanoplasty in Chronic Otitis Media - Mucosal Type","authors":"K. Shrestha, Dhundi Raj Paduel, S. Bhandari, S. Mahaseth","doi":"10.3126/jngmc.v20i2.51598","DOIUrl":"https://doi.org/10.3126/jngmc.v20i2.51598","url":null,"abstract":"Introduction: Tympanoplasty is the procedure of choice for surgical correction of tympanic membrane perforation triggered by either chronic otitis media or trauma. Various types of autologous grafts have been used to close tympanic membrane perforations among which temporalis fascia and tragal cartilage are preferred, due to their anatomic proximity, ease of harvesting and suppleness. \u0000Aims: To compare clinical and audiological outcomes of type 1 tympanoplasty where temporalis fascia and tragal cartilage were used as the graft material. \u0000Methods: A prospective study was conducted on 50 patients of ages ranging from 10 to 50 years with Chronic Otitis Media - Mucosal. All the patients underwent type 1 tympanoplasty and were categorized into Group-A (Temporalis fascia graft) and Group-B (Cartilage graft), each group comprising of 25 patients. Graft uptake rate, hearing gain and air bone gap closure were compared between the groups in 4 and 8 weeks after surgery. \u0000Results: Out of total 50 patients, 20 were male and 30 were female. The average age of the patients was 28.20 years. The total hearing gain in the whole series was 14.94 dB while the total air bone gap closure was 14.78 dB respectively. The difference between pre and post-operative hearing was statistically significant for both air bone gap and air conduction, (P<0.05) in the whole series. There was 15.56 dB improvement in mean hearing threshold and 15.64 dB mean air bone gap closure in the fascia group, compared to 14.32 dB improvement in mean hearing and 13.92 dB mean air bone gap closure in the cartilage group. Graft uptake rate in the temporalis fascia group was 84% and the cartilage group was 92 % with significant difference in the graft uptake rate between the groups. \u0000Conclusion: The graft uptake rate and hearing results of tragal cartilage are comparable to those of temporalis fascia. Cartilage tympanoplasty has a higher graft uptake rate with low failure rate and also shows a high degree of reliability in high risk cases. Both cartilage and fascia tympanoplasty provided similar improvements in the hearing outcome post-operatively. Thus, cartilage tympanoplasty is recommended as an alternative option.","PeriodicalId":166882,"journal":{"name":"Journal of Nepalgunj Medical College","volume":"583 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2022-12-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"126443578","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 : 2022-12-31DOI: 10.3126/jngmc.v20i2.51907
S. Bhandari, D. Paudel, S. Mahaseth
Introduction: Chronic otitis media is chronic inflammation of middle ear cleft followed by permanent abnormality of tympanic membrane. As mastoid a part of temporal bone is in close relation to middle ear; its pneumatization plays an important role in pathogenesis and prognosis of chronic otitis media. Aims: To study the pneumatization pattern of mastoid in unilateral chronic otitis media and its relationship with contralateral mastoid, diseased side tympanic membrane and ossicular status. Methods: Forty patients of 10-65 year of age diagnosed as unilateral chronic otitis media squamous type were selected. They were otoscopically evaluated for retraction and perforation of tympanic membrane and were subjected to high-resolution computed tomography of temporal bone. High resolution computed tomographies were analyzed for mastoid status of bilateral ear and ossicular involvement. During mastoidectomy ossicular status was noted and correlated with high resolution computed tomography. Results: Forty cases were enrolled in the study. Age ranged from10-65 years. On radiological analysis of temporal bones, 21(52.5%) mastoids were sclerotic, 15(37.5 %) mastoid diploic and 4(10%) were pneumatized in the diseased sides. Contralateral side showed pneumatization in 23(57.5%), diploic in 11(27.5%) and sclerotic in 6(15%) Amongst 21 sclerotic mastoid, 11(52.3%) patient had retraction in pars tensa and 9(42.8 %) had retraction of pars flaccida. In total 15 diploic mastoids retraction of pars tensa was in 8(53.3%) and pars flaccid retraction in 8(53.3%) All three ossicles were involved in 8(38%), Malleus and incus were eroded in 3(14%), incus were eroded in 7(33.3%), malleus were eroded in 3(14%) and ossicles were intact in 3(14%)of 21 sclerosed mastoids on high resolution computed tomography. In remaining 19 non sclerotic mastoids all 3 ossicles were eroded in 4 (21%), malleus plus incus eroded in 8 (16%), incus were eroded in 5(26.3%) andossicular chain was intact in 2(10%). Conclusion: Mastoid pneumatization pattern not only effect to the pressure of middle ear leading to chronic otitis media but also alter the pathogenesis and outcome of chronicotitismedia. Contralateral mastoid pneumatization is not altered in unilateral Chronic otitis media.
{"title":"Correlation of Mastoid Pneumatization with Middle Ear Pathology in Unilateral Squamous Type of Chronic Otitis Media","authors":"S. Bhandari, D. Paudel, S. Mahaseth","doi":"10.3126/jngmc.v20i2.51907","DOIUrl":"https://doi.org/10.3126/jngmc.v20i2.51907","url":null,"abstract":"Introduction: Chronic otitis media is chronic inflammation of middle ear cleft followed by permanent abnormality of tympanic membrane. As mastoid a part of temporal bone is in close relation to middle ear; its pneumatization plays an important role in pathogenesis and prognosis of chronic otitis media. \u0000Aims: To study the pneumatization pattern of mastoid in unilateral chronic otitis media and its relationship with contralateral mastoid, diseased side tympanic membrane and ossicular status. \u0000Methods: Forty patients of 10-65 year of age diagnosed as unilateral chronic otitis media squamous type were selected. They were otoscopically evaluated for retraction and perforation of tympanic membrane and were subjected to high-resolution computed tomography of temporal bone. High resolution computed tomographies were analyzed for mastoid status of bilateral ear and ossicular involvement. During mastoidectomy ossicular status was noted and correlated with high resolution computed tomography. \u0000Results: Forty cases were enrolled in the study. Age ranged from10-65 years. On radiological analysis of temporal bones, 21(52.5%) mastoids were sclerotic, 15(37.5 %) mastoid diploic and 4(10%) were pneumatized in the diseased sides. Contralateral side showed pneumatization in 23(57.5%), diploic in 11(27.5%) and sclerotic in 6(15%) Amongst 21 sclerotic mastoid, 11(52.3%) patient had retraction in pars tensa and 9(42.8 %) had retraction of pars flaccida. In total 15 diploic mastoids retraction of pars tensa was in 8(53.3%) and pars flaccid retraction in 8(53.3%) All three ossicles were involved in 8(38%), Malleus and incus were eroded in 3(14%), incus were eroded in 7(33.3%), malleus were eroded in 3(14%) and ossicles were intact in 3(14%)of 21 sclerosed mastoids on high resolution computed tomography. In remaining 19 non sclerotic mastoids all 3 ossicles were eroded in 4 (21%), malleus plus incus eroded in 8 (16%), incus were eroded in 5(26.3%) andossicular chain was intact in 2(10%). \u0000Conclusion: Mastoid pneumatization pattern not only effect to the pressure of middle ear leading to chronic otitis media but also alter the pathogenesis and outcome of chronicotitismedia. Contralateral mastoid pneumatization is not altered in unilateral Chronic otitis media.","PeriodicalId":166882,"journal":{"name":"Journal of Nepalgunj Medical College","volume":"30 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2022-12-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"122296796","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 : 2022-12-31DOI: 10.3126/jngmc.v20i2.51832
Sugam Shrestha, S. Gurung, Binus Bhandari
Introduction: Clinical forensic medical services play crucial role in emergency department followed by all other specialty. Aims: The preliminary survey was undertaken to assess the knowledge about the clinical forensic medicine among the medical students during their clinical posting in forensic medicine, Nepalgunj Medical College. Methods: The questionnaire was used in this study to evaluate the student’s knowledge. Results: As many as 108 medical students were included in the survey (70 male and 38 female). The maximum participants were 23 years old 38(35.2%) and youngest participant was 21 years old 6(5.6%). Maximum students were able to perform clinical forensic skills except traffic accident cases 27(25%) followed by gunshot wounds cases 46(42.6%). The students stated that they could master forensic pathology skills in asphyxia cases 80(74.07%) followed by dead victims in blunt and sharp violence cases 76(70.4%) and least in sudden death cases 31(28.7%), criminal abortion 43(39.8%), infanticide 45(41.7%) and sexual offences 49(45.3%). The students were able to issue medical certificate 99(91.7%) followed by issue a death certificate 98(90.7%) and provide information to the police 96(88.9%) but least could give expert statement 30(27.8%). Conclusion: In this survey, found the validity of student self-assessment in determining the ability of clinical knowledge, it is influenced by several factors of objectivity and subjectivity of assessment in terms of students.
{"title":"Self-Assessment of Undergraduate Medical Students Regarding the Clinical Knowledge in Forensic Medicine","authors":"Sugam Shrestha, S. Gurung, Binus Bhandari","doi":"10.3126/jngmc.v20i2.51832","DOIUrl":"https://doi.org/10.3126/jngmc.v20i2.51832","url":null,"abstract":"Introduction: Clinical forensic medical services play crucial role in emergency department followed by all other specialty. \u0000Aims: The preliminary survey was undertaken to assess the knowledge about the clinical forensic medicine among the medical students during their clinical posting in forensic medicine, Nepalgunj Medical College. \u0000Methods: The questionnaire was used in this study to evaluate the student’s knowledge. \u0000Results: As many as 108 medical students were included in the survey (70 male and 38 female). The maximum participants were 23 years old 38(35.2%) and youngest participant was 21 years old 6(5.6%). Maximum students were able to perform clinical forensic skills except traffic accident cases 27(25%) followed by gunshot wounds cases 46(42.6%). The students stated that they could master forensic pathology skills in asphyxia cases 80(74.07%) followed by dead victims in blunt and sharp violence cases 76(70.4%) and least in sudden death cases 31(28.7%), criminal abortion 43(39.8%), infanticide 45(41.7%) and sexual offences 49(45.3%). The students were able to issue medical certificate 99(91.7%) followed by issue a death certificate 98(90.7%) and provide information to the police 96(88.9%) but least could give expert statement 30(27.8%). \u0000Conclusion: In this survey, found the validity of student self-assessment in determining the ability of clinical knowledge, it is influenced by several factors of objectivity and subjectivity of assessment in terms of students.","PeriodicalId":166882,"journal":{"name":"Journal of Nepalgunj Medical College","volume":"28 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2022-12-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"128719004","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 : 2022-12-31DOI: 10.3126/jngmc.v20i2.51913
M. Shrestha, Rupak K.C., Prabesh Luintel, Anjali Joshi, Rajendra K. Mahat
Introduction: Medical science is one of the most advance and modern technology over the course of time period with extensive research and scientific knowledge of human body and health care to make incredible changes enabling the population remain healthy with mere absence of disease or infirmity. Research is considered as one of the useful measures to track the scientific advancement of a country. Promoting research skills in undergraduate and post graduate medical students help to develop scientific advancement in medical field of a country. Aims: To assess knowledge, attitude, and perceived barriers among undergraduate and postgraduate medical students. Methods: An institutional based cross sectional analytical study covering total 224 undergraduate and postgraduate medical students of Nepalgunj Medical College was from January 2022 to April 2022. A pre tested, pre designed, sets of questionnaire were provided to all recruited participants after obtaining informed written consent. Then informations generated by the study were analyzed for scientific result by using descriptive analysis and independent T- test. Results: Male students were 135(60.3%) whereas female students were 89(39.7%) only. The mean knowledge score was 33.69 ± 3.8 and mean attitude score was 19.67 ± 2.34. The average 100(44.6%) had good knowledge and 118(52.7%) had positive attitude towards medical research. Most common perceived barrier was not having proper mentoring and research familiarity. Seventy Six(39.6%) undergraduate students had behavioral hesitation to participate in research while 21(65.6%) post graduate students showed social factor as one of the hesitancy to involve in research. Conclusion: Most of the participants had good knowledge regarding research and expressed positive attitude toward involvement in research activity. Some of barriers were lack of funds, awareness and research skills. This study would improve scientific knowledge and research skills for academicians and clinicians too.
{"title":"Knowledge, Attitude and Perceived barrier towards Medical Research among Undergraduates and Postgraduates Medical Students of Nepalgunj Medical College","authors":"M. Shrestha, Rupak K.C., Prabesh Luintel, Anjali Joshi, Rajendra K. Mahat","doi":"10.3126/jngmc.v20i2.51913","DOIUrl":"https://doi.org/10.3126/jngmc.v20i2.51913","url":null,"abstract":"Introduction: Medical science is one of the most advance and modern technology over the course of time period with extensive research and scientific knowledge of human body and health care to make incredible changes enabling the population remain healthy with mere absence of disease or infirmity. Research is considered as one of the useful measures to track the scientific advancement of a country. Promoting research skills in undergraduate and post graduate medical students help to develop scientific advancement in medical field of a country. \u0000Aims: To assess knowledge, attitude, and perceived barriers among undergraduate and postgraduate medical students. \u0000Methods: An institutional based cross sectional analytical study covering total 224 undergraduate and postgraduate medical students of Nepalgunj Medical College was from January 2022 to April 2022. A pre tested, pre designed, sets of questionnaire were provided to all recruited participants after obtaining informed written consent. Then informations generated by the study were analyzed for scientific result by using descriptive analysis and independent T- test. \u0000Results: Male students were 135(60.3%) whereas female students were 89(39.7%) only. The mean knowledge score was 33.69 ± 3.8 and mean attitude score was 19.67 ± 2.34. The average 100(44.6%) had good knowledge and 118(52.7%) had positive attitude towards medical research. Most common perceived barrier was not having proper mentoring and research familiarity. Seventy Six(39.6%) undergraduate students had behavioral hesitation to participate in research while 21(65.6%) post graduate students showed social factor as one of the hesitancy to involve in research. \u0000Conclusion: Most of the participants had good knowledge regarding research and expressed positive attitude toward involvement in research activity. Some of barriers were lack of funds, awareness and research skills. This study would improve scientific knowledge and research skills for academicians and clinicians too.","PeriodicalId":166882,"journal":{"name":"Journal of Nepalgunj Medical College","volume":"32 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2022-12-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"128102202","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 : 2022-12-31DOI: 10.3126/jngmc.v20i2.51906
A. Bist, R. Jha, Meeta Singh, Kanchan Devkota, Divya Das, Neha Das
Introduction: Emergency contraception is a contraceptive method used to prevent unwanted pregnancy in the first few days after unprotected sexual intercourse or contraceptive failure/accident. Many women are unaware of the existence of emergency contraception, misunderstand its use and safety, or do not use it when needed. Especially, residents of the rural regions of Nepal are deprived of family planning services and measures, which cover a major percent of our hospital patients. Aims: To assess the knowledge regarding emergency contraceptive pills, family planning and their prevalence. Methods: A descriptive cross-sectional study with a population size of 392 was performed at Nepalgunj medical college teaching hospital, Kohalpur, starting from January to April 2022. A pre-tested questionnaire containing structural, semi-structural, and open-ended questions in printed form was made as a data collection tool. All the people in this study were interviewed after receiving their consent. Results: 363 out of 392(92.6%) people in our study have known about contraceptives. Only 74.93% responded to having used some sort of contraceptive measure. Oral contraceptive pills were found to be the most used measure in 265 (73%). 222(61.6%) of 363 have heard about emergency contraceptive pills but only 71(31.98%) of them have ever used them. Out of 222 respondents who were aware of emergency contraceptive pills, only 129(58.10%)correctly identified 72 hours as the time limit for the methods to be used. Nineteen respondents (8.56%) believed that emergency contraceptive pills could be used as regular pills. None of them were aware of the use of the intrauterine contraceptive device as an emergency contraception. Conclusion: Despite having knowledge, only two-third population was found using any of the contraceptive measures. Among those having knowledge about emergency contraceptive pills, more than a half people preferred emergency contraceptive pills for any unplanned event. Emergency contraception awareness is essential to prevent unwanted pregnancy.
{"title":"Knowledge and Prevalence of Emergency Contraceptive Pills among the General Population Visiting a Tertiary Care Centre","authors":"A. Bist, R. Jha, Meeta Singh, Kanchan Devkota, Divya Das, Neha Das","doi":"10.3126/jngmc.v20i2.51906","DOIUrl":"https://doi.org/10.3126/jngmc.v20i2.51906","url":null,"abstract":"Introduction: Emergency contraception is a contraceptive method used to prevent unwanted pregnancy in the first few days after unprotected sexual intercourse or contraceptive failure/accident. Many women are unaware of the existence of emergency contraception, misunderstand its use and safety, or do not use it when needed. Especially, residents of the rural regions of Nepal are deprived of family planning services and measures, which cover a major percent of our hospital patients. \u0000Aims: To assess the knowledge regarding emergency contraceptive pills, family planning and their prevalence. \u0000Methods: A descriptive cross-sectional study with a population size of 392 was performed at Nepalgunj medical college teaching hospital, Kohalpur, starting from January to April 2022. A pre-tested questionnaire containing structural, semi-structural, and open-ended questions in printed form was made as a data collection tool. All the people in this study were interviewed after receiving their consent. \u0000Results: 363 out of 392(92.6%) people in our study have known about contraceptives. Only 74.93% responded to having used some sort of contraceptive measure. Oral contraceptive pills were found to be the most used measure in 265 (73%). 222(61.6%) of 363 have heard about emergency contraceptive pills but only 71(31.98%) of them have ever used them. Out of 222 respondents who were aware of emergency contraceptive pills, only 129(58.10%)correctly identified 72 hours as the time limit for the methods to be used. Nineteen respondents (8.56%) believed that emergency contraceptive pills could be used as regular pills. None of them were aware of the use of the intrauterine contraceptive device as an emergency contraception. \u0000Conclusion: Despite having knowledge, only two-third population was found using any of the contraceptive measures. Among those having knowledge about emergency contraceptive pills, more than a half people preferred emergency contraceptive pills for any unplanned event. Emergency contraception awareness is essential to prevent unwanted pregnancy.","PeriodicalId":166882,"journal":{"name":"Journal of Nepalgunj Medical College","volume":"3 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2022-12-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"125978733","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 : 2022-12-31DOI: 10.3126/jngmc.v20i2.51915
Durga Bc, R. Jha, R. Das
Introduction: Instrumental vaginal delivery is performed in second stage of labor to expedite delivery with aim to decrease cesarean section rate. Worldwide 10-20% of laboring women need obstetrics intervention for delivery. Aims: To evaluate the indication and fetomaternal outcome of instrumental vaginal delivery. Methods: This is a hospital based cross-sectional study conducted at the department of obstetrics and gynecology. The study was done from July 2021 to July 2022 for a period of one year. Data were collected, recorded in standard proforma and analyzed by using SPPS version 20. Results: The out of 6123 deliveries, 149(2.4%) had instrumental vaginal delivery. Out of 149 participants, 41.6% were between 20-24 years, 10.7% were of age group 15-19 years and 4% ladies were of >35 years. Instrument delivery was more frequently applied in primigravida in comparison to multigravida (57.3% vs 42.3%) p=0.046. The most common indication for instrumentation was poor maternal effort (41%) followed by fetal distress (33.6%). About 14.1% had postpartum haemorrhage, 3.4% had vulval hematoma, and 38.3% babies had Neonatal Intensive Care unit admission. Conclusion: Poor maternal effort and fetal distress were the common indications for instrumental delivery with some fetomaternal complications. Inspite of the complications, if used by an expertise, instrumental delivery can reduce the need of cesarean section.
导言:辅助阴道分娩在第二产程进行，以加快分娩，目的是降低剖宫产率。全世界10-20%的分娩妇女需要产科干预。目的:探讨阴道辅助分娩的适应证及结局。方法:这是一项在妇产科进行的以医院为基础的横断面研究。该研究于2021年7月至2022年7月进行，为期一年。收集数据，以标准形式记录，并使用SPPS version 20进行分析。结果:6123例分娩中，器械阴道分娩149例(2.4%)。在149名参与者中，41.6%的人年龄在20-24岁之间，10.7%的人年龄在15-19岁之间，4%的人年龄在50 - 35岁之间。与多胎孕妇相比，初产妇使用器械的频率更高(57.3% vs 42.3%) p=0.046。最常见的器械指征是产妇努力不足(41%)，其次是胎儿窘迫(33.6%)。14.1%发生产后出血，3.4%发生外阴血肿，38.3%进入新生儿重症监护病房。结论:产妇用力差和胎儿窘迫是器械分娩的常见指征，并伴有一些母婴并发症。尽管有并发症，如果由专业人员使用，器械分娩可以减少剖宫产的需要。
{"title":"Fetomaternal Outcome of Instrumental Vaginal Delivery at Nepalgunj Medical College Teaching Hospital Kohalpur","authors":"Durga Bc, R. Jha, R. Das","doi":"10.3126/jngmc.v20i2.51915","DOIUrl":"https://doi.org/10.3126/jngmc.v20i2.51915","url":null,"abstract":"Introduction: Instrumental vaginal delivery is performed in second stage of labor to expedite delivery with aim to decrease cesarean section rate. Worldwide 10-20% of laboring women need obstetrics intervention for delivery. \u0000Aims: To evaluate the indication and fetomaternal outcome of instrumental vaginal delivery. \u0000Methods: This is a hospital based cross-sectional study conducted at the department of obstetrics and gynecology. The study was done from July 2021 to July 2022 for a period of one year. Data were collected, recorded in standard proforma and analyzed by using SPPS version 20. \u0000Results: The out of 6123 deliveries, 149(2.4%) had instrumental vaginal delivery. Out of 149 participants, 41.6% were between 20-24 years, 10.7% were of age group 15-19 years and 4% ladies were of >35 years. Instrument delivery was more frequently applied in primigravida in comparison to multigravida (57.3% vs 42.3%) p=0.046. The most common indication for instrumentation was poor maternal effort (41%) followed by fetal distress (33.6%). About 14.1% had postpartum haemorrhage, 3.4% had vulval hematoma, and 38.3% babies had Neonatal Intensive Care unit admission. \u0000Conclusion: Poor maternal effort and fetal distress were the common indications for instrumental delivery with some fetomaternal complications. Inspite of the complications, if used by an expertise, instrumental delivery can reduce the need of cesarean section.","PeriodicalId":166882,"journal":{"name":"Journal of Nepalgunj Medical College","volume":"7 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2022-12-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"132901105","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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