S. P. Wasti, P. Simkhada, Sudip Ale, Edwin Roland van Teijlingen
The novel coronavirus or COVID-19 is a new highly infectious virus affecting a large population across the globe. There is no specific therapeutic drug available against covid-19 hence the most effective public health measures need to strictly be adhered to without delay. Range of issues were reported to fight against COVID-19 in the current health system of Nepal which should be addressed and strengthened the full spectrum of the health system for its effective and sustainable response. It is crucial to understand the current health system at the local and provincial level and strictly adhere the federal government policies and plan as per the protocol for maintaining minimum infection prevention and control measures with having preventive and safety measures to both service providers and community people. To tackle those daily increasing number of COVID-19 cases, it provides an opportunity for the three tires of governments to reprioritize the health service in the national agenda for the effective prevention and response it. Although National health policy 2019 clearly articulated the need for equitable access and quality of health care services to all. Evidence shows that Nepal is in risk zone because of comparably weak health system that should be aware of all three tires of governments of Nepal and strengthen and control the present threat posed the daily increasing cases of pandemic.
{"title":"Nepalese Health System Response to Fight Against COVID-19 Pandemic","authors":"S. P. Wasti, P. Simkhada, Sudip Ale, Edwin Roland van Teijlingen","doi":"10.46405/EJMS.V3I1.262","DOIUrl":"https://doi.org/10.46405/EJMS.V3I1.262","url":null,"abstract":"The novel coronavirus or COVID-19 is a new highly infectious virus affecting a large population across the globe. There is no specific therapeutic drug available against covid-19 hence the most effective public health measures need to strictly be adhered to without delay. Range of issues were reported to fight against COVID-19 in the current health system of Nepal which should be addressed and strengthened the full spectrum of the health system for its effective and sustainable response. It is crucial to understand the current health system at the local and provincial level and strictly adhere the federal government policies and plan as per the protocol for maintaining minimum infection prevention and control measures with having preventive and safety measures to both service providers and community people. To tackle those daily increasing number of COVID-19 cases, it provides an opportunity for the three tires of governments to reprioritize the health service in the national agenda for the effective prevention and response it. Although National health policy 2019 clearly articulated the need for equitable access and quality of health care services to all. Evidence shows that Nepal is in risk zone because of comparably weak health system that should be aware of all three tires of governments of Nepal and strengthen and control the present threat posed the daily increasing cases of pandemic.","PeriodicalId":254508,"journal":{"name":"Europasian Journal of Medical Sciences","volume":"5 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2021-03-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"116932089","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}
Background: Chhaupadi is the old unscientific system in mid and far western parts of Nepal. Reproductive age women were considered unclean during the menstrual and delivery period. Invisible cultural taboos and practices were prevailing in each and every household. The objective of the study is to assess the associated factors affecting during Chhaupadi and delivery practice with their health outcome. Method: The cross-sectional descriptive study was conducted amongst 175 reproductive age women in Bajura districts of Nepal, by using multistage random sampling. Both qualitative and quantitative methods was used. All the data were entered in Ms excel and exported into SPSS 16.0. The necessary descriptive and inferential statistics was used for quantitative analysis and thematic analysis was done for qualitative analysis. Results: More than one third (38.9%) of the participants were in the age group 20-29 years. Almost all the participants were from Hindu religion. The majority (91%) of participants know about the Chhaupadi system. Almost (74%) of the participants were staying in the Chhaupadi hut during menstruation. Similarly, (78.3%) of the respondents were mentioned, they did not like the Chhau system and never like to continued. There is a significant association between health effect in women and the Chhaupadi system (p < 0.031). Conclusion: It shows that the larger proportion of women in Bajura District still believes in old unscientific tales and Chhaupadi practices which lead to the different health problems.
{"title":"Misconception and effect of Menstruation (Chhaupadi) and Delivery on Women’s Health in Bajura, District Nepal","authors":"Chetraj Pandit, Anil Kumar Singh, Ayuska Parajuli, Ashok Pandey","doi":"10.46405/EJMS.V3I1.123","DOIUrl":"https://doi.org/10.46405/EJMS.V3I1.123","url":null,"abstract":"Background: Chhaupadi is the old unscientific system in mid and far western parts of Nepal. Reproductive age women were considered unclean during the menstrual and delivery period. Invisible cultural taboos and practices were prevailing in each and every household. The objective of the study is to assess the associated factors affecting during Chhaupadi and delivery practice with their health outcome. Method: The cross-sectional descriptive study was conducted amongst 175 reproductive age women in Bajura districts of Nepal, by using multistage random sampling. Both qualitative and quantitative methods was used. All the data were entered in Ms excel and exported into SPSS 16.0. The necessary descriptive and inferential statistics was used for quantitative analysis and thematic analysis was done for qualitative analysis. Results: More than one third (38.9%) of the participants were in the age group 20-29 years. Almost all the participants were from Hindu religion. The majority (91%) of participants know about the Chhaupadi system. Almost (74%) of the participants were staying in the Chhaupadi hut during menstruation. Similarly, (78.3%) of the respondents were mentioned, they did not like the Chhau system and never like to continued. There is a significant association between health effect in women and the Chhaupadi system (p < 0.031). Conclusion: It shows that the larger proportion of women in Bajura District still believes in old unscientific tales and Chhaupadi practices which lead to the different health problems. ","PeriodicalId":254508,"journal":{"name":"Europasian Journal of Medical Sciences","volume":"5 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2021-02-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"127180300","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}
S. Bajracharya, D. Rajbhandari, B. Gurung, A. Rana
Background : Birth defects are defined as abnormalities of structure or function, which are present at birth. Major birth defects are abnormalities that lead to developmental or physical disabilities or require medical or surgical treatment and they're the leading cause of death in the first year of life. The objective of this study is to find the incidence of congenital abnormalities in this institution. Methods: This was a prospective study conducted in Institute of Medicine, Maharajgunj Medical Campus, Tribhuwan University Teaching Hospital from 14th April 2015 to 11th Feb ,2016 . All the delivered babies in this hospital during the study period were included. All the birth cases of gross congenital fetal malformation were identified and carefully studied and were classified according to the International Classification of diseases (ICD-10). Results: Total number of congenital fetal malformation abnormalities (CMF) delivered during this period was 94 (1.13%) in total 8300 birth /7868 live birth. CMF were categorized as, Musculoskeletal - 25.55%, CNS - 17.02%, Gastrointestinal -13.33%, Renal 14.25%, Cardiac -10.63%, Respiratory -10.6%, craniofacial - 9.57%, Genitouriary - 8.51%, and Miscellaneous - 9.57%. Conclusion: Birth abnormalities incompatible to life needs to be timely diagnosed and terminated, whereas as those compatible to life should be given a chance to be born and cared thereafter. All the mothers who have, had previous malformed babies must undergo preconceptional counseling, before planning next pregnancy in order to avoid recurrent mishap.
{"title":"Incidence of Congenital Fetal Malformation Abnormalities in Tribhuban University, Teaching Hospital, Kathmandu, Nepal: a Hospital Based Study","authors":"S. Bajracharya, D. Rajbhandari, B. Gurung, A. Rana","doi":"10.46405/EJMS.V3I1.285","DOIUrl":"https://doi.org/10.46405/EJMS.V3I1.285","url":null,"abstract":"Background : Birth defects are defined as abnormalities of structure or function, which are present at birth. Major birth defects are abnormalities that lead to developmental or physical disabilities or require medical or surgical treatment and they're the leading cause of death in the first year of life. The objective of this study is to find the incidence of congenital abnormalities in this institution. \u0000Methods: This was a prospective study conducted in Institute of Medicine, Maharajgunj Medical Campus, Tribhuwan University Teaching Hospital from 14th April 2015 to 11th Feb ,2016 . All the delivered babies in this hospital during the study period were included. All the birth cases of gross congenital fetal malformation were identified and carefully studied and were classified according to the International Classification of diseases (ICD-10). \u0000Results: Total number of congenital fetal malformation abnormalities (CMF) delivered during this period was 94 (1.13%) in total 8300 birth /7868 live birth. CMF were categorized as, Musculoskeletal - 25.55%, CNS - 17.02%, Gastrointestinal -13.33%, Renal 14.25%, Cardiac -10.63%, Respiratory -10.6%, craniofacial - 9.57%, Genitouriary - 8.51%, and Miscellaneous - 9.57%. \u0000Conclusion: Birth abnormalities incompatible to life needs to be timely diagnosed and terminated, whereas as those compatible to life should be given a chance to be born and cared thereafter. All the mothers who have, had previous malformed babies must undergo preconceptional counseling, before planning next pregnancy in order to avoid recurrent mishap. \u0000 ","PeriodicalId":254508,"journal":{"name":"Europasian Journal of Medical Sciences","volume":"1 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2021-01-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"129712503","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}
Background: The need for a professionalized and highly skilled public health workforce is essential to improving and protecting the health of populations, especially in Nepal. This study aimed to explore: (i) the current trends in public health in Nepal and (ii) the opportunities and barriers to the professionalization of the sector. Methods: We employed an exploratory qualitative research design and used a combination of semi-structured interviews with senior public health professionals and a small focus group discussion with more recently qualified public health practitioners in Nepal. A total of nine professional stakeholders were interviewed and five junior practitioners joined the focus group discussion. Data was collected via Skype due to COVID-19 restrictions. Thematic analysis was used to analyze the data. Results: Four core themes emerged from the research: understanding the public health approach; health priorities; federalization and the impact on public health practice; professionalization and workforce development. Conclusions: Political federalization and more recently COVID-19 have impacted the development, capacity, and employment of this often-neglected workforce. Public health graduates with their broad-ranging knowledge and skills are often overlooked in the health sector. This is related to a general lack of understanding of what public health is and what public health practitioners do amongst politicians and the general public.
{"title":"Professionalization of Public Health in Nepal","authors":"R. Khatri, Kamal Bishowkarma, T. Bhandari","doi":"10.46405/EJMS.V2I2.238","DOIUrl":"https://doi.org/10.46405/EJMS.V2I2.238","url":null,"abstract":"Background: The need for a professionalized and highly skilled public health workforce is essential to improving and protecting the health of populations, especially in Nepal. This study aimed to explore: (i) the current trends in public health in Nepal and (ii) the opportunities and barriers to the professionalization of the sector. \u0000Methods: We employed an exploratory qualitative research design and used a combination of semi-structured interviews with senior public health professionals and a small focus group discussion with more recently qualified public health practitioners in Nepal. A total of nine professional stakeholders were interviewed and five junior practitioners joined the focus group discussion. Data was collected via Skype due to COVID-19 restrictions. Thematic analysis was used to analyze the data. \u0000Results: Four core themes emerged from the research: understanding the public health approach; health priorities; federalization and the impact on public health practice; professionalization and workforce development. \u0000Conclusions: Political federalization and more recently COVID-19 have impacted the development, capacity, and employment of this often-neglected workforce. Public health graduates with their broad-ranging knowledge and skills are often overlooked in the health sector. This is related to a general lack of understanding of what public health is and what public health practitioners do amongst politicians and the general public.","PeriodicalId":254508,"journal":{"name":"Europasian Journal of Medical Sciences","volume":"20 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2020-12-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"130762294","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}
B. Bhattarai, Koshal Shrestha, Sushila Patel, Laxmi Devi Manandhar, R. Karki, N. Gurung
Background: Chalazion is a common eyelid disease caused by plugged meibomian glands and chronic lipogranulomatous inflammation. It can affect individuals of all ages and may cause local eye symptoms such as irritation and inflammation and cosmetic disfigurement. There are mainly three methods of treating chalazion: Intralesional Triamcinolone Acetonide (0.1-0.3 ml of 40mg/ml), Incision and Curettage and Conservative Treatment (hot compression +lid hygiene + antibiotic ointment) to the affected eyelid. To comparing which method is the best this study has been carried out Methodology: Patients with chalazion presenting to OPD from 15 March to 15 July 2017 were included in the study. They underwent any of the three procedures according to their choice. Follow up visit was done at two weeks to determine effectiveness in terms of reduction of size or complete resolution of the chalazion. Results: Out of 112 patients enrolled in study 65(58%) were females and 47(42%) were male with a male: female ratio of (0.7:1). The mean age of involvement was 25.7years (SD 10.3). At 2 weeks follow up there was complete resolution in incision and curettage (I and C) group 77 %( 41/53) and in Triamcinolone Acetonide (TA) injection group 63 %( 20/32). Pearsons correlations showed that I and C were superior to any other forms of intervention for any size of chalazion followed by intralesional injection of TA. Conclusion: Among the three methods, Incision and Curettage remained the best choice for treatment of chalazion followed by triamcinolone acetonide injection but may need multiple injections. Keywords: Chalazion, Intralesional Triamcinolone, Incision and Curettage, Meibomian Gland
{"title":"Treatment of Chalazian: a Comparative Cross-sectional Study","authors":"B. Bhattarai, Koshal Shrestha, Sushila Patel, Laxmi Devi Manandhar, R. Karki, N. Gurung","doi":"10.46405/EJMS.V1I1.3","DOIUrl":"https://doi.org/10.46405/EJMS.V1I1.3","url":null,"abstract":"Background: Chalazion is a common eyelid disease caused by plugged meibomian glands and chronic lipogranulomatous inflammation. It can affect individuals of all ages and may cause local eye symptoms such as irritation and inflammation and cosmetic disfigurement. There are mainly three methods of treating chalazion: Intralesional Triamcinolone Acetonide (0.1-0.3 ml of 40mg/ml), Incision and Curettage and Conservative Treatment (hot compression +lid hygiene + antibiotic ointment) to the affected eyelid. To comparing which method is the best this study has been carried out Methodology: Patients with chalazion presenting to OPD from 15 March to 15 July 2017 were included in the study. They underwent any of the three procedures according to their choice. Follow up visit was done at two weeks to determine effectiveness in terms of reduction of size or complete resolution of the chalazion. Results: Out of 112 patients enrolled in study 65(58%) were females and 47(42%) were male with a male: female ratio of (0.7:1). The mean age of involvement was 25.7years (SD 10.3). At 2 weeks follow up there was complete resolution in incision and curettage (I and C) group 77 %( 41/53) and in Triamcinolone Acetonide (TA) injection group 63 %( 20/32). Pearsons correlations showed that I and C were superior to any other forms of intervention for any size of chalazion followed by intralesional injection of TA. Conclusion: Among the three methods, Incision and Curettage remained the best choice for treatment of chalazion followed by triamcinolone acetonide injection but may need multiple injections. Keywords: Chalazion, Intralesional Triamcinolone, Incision and Curettage, Meibomian Gland","PeriodicalId":254508,"journal":{"name":"Europasian Journal of Medical Sciences","volume":"35 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2020-12-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"125211850","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}
R. K. Sangroula, Subash Khatiwada, Maginsh Dahal, Kushalata Baral, Bhuwan Thakurathi, R. Barakoti, Menuka Sangroula, S. Khanal, R. Subedi
Background: The government of Nepal aims to improve the health of mothers and newborns by providing quality safe motherhood services. Increasing access and utilization of antenatal care (ANC) services are the first steps towards improving maternal and neonatal health outcomes, particularly those of the marginalized communities.Objective: The aim of this study is to assess the prevalence and factors associated with the antenatal care visits among the marginalized community of Nepal.Methods: A mixed-method study was conducted among 202 reproductive aged females of marginalized community in Nepal having childbirth during the last 2 years. Pre-tested semi-structured questionnaires and key informant interview guidelines were used for the collection of data. Bivariate and multiple regression analysis were carried out to find out the factors associated with the antenatal care visits. For qualitative data, thematic analysis was done. Results: More than half (56.9%) of the participants had completed four or more antenatal care visits. Mothers with primary level of education were 2.7 times more likely to complete four or more ANC visits (AOR: 2.7, CI: 1.09-7.07). Age at marriage (AOR: 2.3, CI: 1.08-5.22), women who took decisions alone for their health (AOR: 2.9, CI: 1.22-6.96),exposure to FCHV (AOR:2.5, CI: 1.1-5.9), knowledge about safe delivery incentive program (AOR: 3.6, CI: 1.46-9.0) and perception of “good quality” ANC service(AOR:7.5, CI: 3.3-17.1)were significantly associated with the number of ANC visits. Conclusion: The overall utilization of antenatal health services was low. So, there is a need of different community based maternal health programs especially targeting the marginalized females.
{"title":"Prevalence of Antenatal Care Practice among Marginalized Community of Nepal","authors":"R. K. Sangroula, Subash Khatiwada, Maginsh Dahal, Kushalata Baral, Bhuwan Thakurathi, R. Barakoti, Menuka Sangroula, S. Khanal, R. Subedi","doi":"10.46405/EJMS.V2I2.197","DOIUrl":"https://doi.org/10.46405/EJMS.V2I2.197","url":null,"abstract":"Background: The government of Nepal aims to improve the health of mothers and newborns by providing quality safe motherhood services. Increasing access and utilization of antenatal care (ANC) services are the first steps towards improving maternal and neonatal health outcomes, particularly those of the marginalized communities.Objective: The aim of this study is to assess the prevalence and factors associated with the antenatal care visits among the marginalized community of Nepal.Methods: A mixed-method study was conducted among 202 reproductive aged females of marginalized community in Nepal having childbirth during the last 2 years. Pre-tested semi-structured questionnaires and key informant interview guidelines were used for the collection of data. Bivariate and multiple regression analysis were carried out to find out the factors associated with the antenatal care visits. For qualitative data, thematic analysis was done. Results: More than half (56.9%) of the participants had completed four or more antenatal care visits. Mothers with primary level of education were 2.7 times more likely to complete four or more ANC visits (AOR: 2.7, CI: 1.09-7.07). Age at marriage (AOR: 2.3, CI: 1.08-5.22), women who took decisions alone for their health (AOR: 2.9, CI: 1.22-6.96),exposure to FCHV (AOR:2.5, CI: 1.1-5.9), knowledge about safe delivery incentive program (AOR: 3.6, CI: 1.46-9.0) and perception of “good quality” ANC service(AOR:7.5, CI: 3.3-17.1)were significantly associated with the number of ANC visits. Conclusion: The overall utilization of antenatal health services was low. So, there is a need of different community based maternal health programs especially targeting the marginalized females.","PeriodicalId":254508,"journal":{"name":"Europasian Journal of Medical Sciences","volume":"115 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2020-12-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"123462355","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}
At present, we are in the middle of a global pandemic due to COVID 19 disease caused by SARS-CoV-2 viral infection. It has now spread virtually to every corner of the globe. Medical professionals are faced with the challenge of managing diverse clinical manifestations and multisystem involvement of this infection. Although respiratory system is mainly involved COVID-19 disease, there have been diverse manifestations within the cardiovascular (CV) system that posing unique therapeutic challenges. Clinically, a patient may have features of myocarditis, heart failure, acute myocardial infarction, arrhythmia, and vascular thrombosis. Of these manifestations, the most common mechanism implicated is direct myocardial injury, whereas systemic inflammation, oxygen supply-demand mismatch, plaque rupture have also been suggested. Furthermore, current available data suggest cardiovascular related manifestations lead to increased morbidity and mortality. Also, patients with underlying cardiac conditions are more prone for severe disease and death. Although there are limited treatment options available for COVID-19 currently, it is imperative that the potential cardiovascular implications of these therapies are to be considered in these patients. There is need to review current available information regarding the implication of cardiovascular co-morbidity in COVID-19 disease so that we have uptodate and better understanding in this global problem. This review highlights the manifestations, pathophysiological mechanisms for cardiovascular manifestations of COVID-19 and address specific concerns of cardiac patients regarding medications and further management.
{"title":"Cardiovascular Co-morbidity in COVID-19 Pandemic","authors":"R. Tamrakar, K. Amgain, Ahmad Naeem Sajed","doi":"10.46405/EJMS.V2I0.314","DOIUrl":"https://doi.org/10.46405/EJMS.V2I0.314","url":null,"abstract":"At present, we are in the middle of a global pandemic due to COVID 19 disease caused by SARS-CoV-2 viral infection. It has now spread virtually to every corner of the globe. Medical professionals are faced with the challenge of managing diverse clinical manifestations and multisystem involvement of this infection. Although respiratory system is mainly involved COVID-19 disease, there have been diverse manifestations within the cardiovascular (CV) system that posing unique therapeutic challenges. Clinically, a patient may have features of myocarditis, heart failure, acute myocardial infarction, arrhythmia, and vascular thrombosis. Of these manifestations, the most common mechanism implicated is direct myocardial injury, whereas systemic inflammation, oxygen supply-demand mismatch, plaque rupture have also been suggested. Furthermore, current available data suggest cardiovascular related manifestations lead to increased morbidity and mortality. Also, patients with underlying cardiac conditions are more prone for severe disease and death. Although there are limited treatment options available for COVID-19 currently, it is imperative that the potential cardiovascular implications of these therapies are to be considered in these patients. There is need to review current available information regarding the implication of cardiovascular co-morbidity in COVID-19 disease so that we have uptodate and better understanding in this global problem. This review highlights the manifestations, pathophysiological mechanisms for cardiovascular manifestations of COVID-19 and address specific concerns of cardiac patients regarding medications and further management.","PeriodicalId":254508,"journal":{"name":"Europasian Journal of Medical Sciences","volume":"48 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2020-12-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"124392089","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}
P. Kayastha, S. Paudel, S. Suwal, Binaya Adhikari, M. Humagain, Bhawan Thapa Magar, K. Adhikary
Background: Aortic knob enlarges in many cardiovascular disorders including hypertension. It can be easily evaluated in chest radiographs. The study was carried out to document and analyze measurements of aortic knob in normal and hypertensive population in chest radiograph.Methods: This descriptive cross-sectional study was performed in the Department of Radiology and Imaging, Tribhuvan University Teaching Hospital (TUTH) and Manmohan Cardiothoracic Vascular and Transplant Center (MCVTC) from July to October 2019. Postero-anterior (PA) chest radiographs of 200 individuals (100 normal and 100 hypertensives) between the age of 18 to 70 years were evaluated. Width of aortic knob (AKW), straight length of aortic knob (AKS), curved length of aortic knob (AKC) and aortic knob index (AKI) were measured. Aortic knob index (AKI) was determined from AKC divided by AKS.Results: The mean aortic knob index (AKI) for male and female were 1.24±0.06 and 1.20±0.07 respectively and the total mean aortic knob index (AKI) was 1.22±0.07 in normal population. In hypertensive population, aortic knob index (AKI) was 1.49±0.095 and 1.42±0.04 in male and female respectively. Total aortic knob index (AKI) for hypertensive population was 1.45±0.083. Aortic knob index in hypertensive population was significantly higher than that of normal population. Mean aortic knob index (AKI) in male was significantly higher than that in female in both normal and hypertensive population (p<0.05).Conclusion: Aortic knob index (AKI), the index for aortic diameter, was higher in hypertensive population and male. Thus, simple measurement of aortic knob in PA chest x-ray may help in predicting cardiovascular disorder.
{"title":"Variations in Measurements of the Aortic Knob in the Chest Radiograph in Normal and Hypertensive Subjects","authors":"P. Kayastha, S. Paudel, S. Suwal, Binaya Adhikari, M. Humagain, Bhawan Thapa Magar, K. Adhikary","doi":"10.46405/EJMS.V2I2.212","DOIUrl":"https://doi.org/10.46405/EJMS.V2I2.212","url":null,"abstract":"Background: Aortic knob enlarges in many cardiovascular disorders including hypertension. It can be easily evaluated in chest radiographs. The study was carried out to document and analyze measurements of aortic knob in normal and hypertensive population in chest radiograph.Methods: This descriptive cross-sectional study was performed in the Department of Radiology and Imaging, Tribhuvan University Teaching Hospital (TUTH) and Manmohan Cardiothoracic Vascular and Transplant Center (MCVTC) from July to October 2019. Postero-anterior (PA) chest radiographs of 200 individuals (100 normal and 100 hypertensives) between the age of 18 to 70 years were evaluated. Width of aortic knob (AKW), straight length of aortic knob (AKS), curved length of aortic knob (AKC) and aortic knob index (AKI) were measured. Aortic knob index (AKI) was determined from AKC divided by AKS.Results: The mean aortic knob index (AKI) for male and female were 1.24±0.06 and 1.20±0.07 respectively and the total mean aortic knob index (AKI) was 1.22±0.07 in normal population. In hypertensive population, aortic knob index (AKI) was 1.49±0.095 and 1.42±0.04 in male and female respectively. Total aortic knob index (AKI) for hypertensive population was 1.45±0.083. Aortic knob index in hypertensive population was significantly higher than that of normal population. Mean aortic knob index (AKI) in male was significantly higher than that in female in both normal and hypertensive population (p<0.05).Conclusion: Aortic knob index (AKI), the index for aortic diameter, was higher in hypertensive population and male. Thus, simple measurement of aortic knob in PA chest x-ray may help in predicting cardiovascular disorder.","PeriodicalId":254508,"journal":{"name":"Europasian Journal of Medical Sciences","volume":"63 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2020-12-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"116316047","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}
A. Sharma, S. Khadka, B. Kunwar, K. Amgain, R. Joshi, Sadhana Dahal, S. Acharya, M. Magar
Background: Drug-drug interactions (DDIs) are one of the significant drug related problems encountered in clinical settings. Better understanding of the mechanisms, severity, and likely consequences of clinically significant DDIs are essential for proper medication therapy management (MTM). This study is conducted with the aim to aware clinical practitioners about clinically significant DDIs that occur in clinical settings and to help them manage such events with the accurate knowledge and technique. Methods: A descriptive cross-sectional study was conducted in Shree Birendra Hospital, Kathmandu on the prescription of medical out-patient department from June to November 2020. Total 483 prescriptions were selected randomly. A panel of physicians, pharmacologists and clinical pharmacists under the supervision of a consultant physician using MICROMEDEX DRUG-REAX, Evaluation of Drug Interactions, Drug Interaction Facts, Drug Interactions: Analysis and Management was conducted. Main outcome measure was obtained by the supervisor’s endorsement on panelists' opinion about clinical importance of DDIs. Results: A total of 2006 medicines were prescribed in 483 prescription samples. The number of drugs per prescription was in a range from 2 to 11 with 4.15 on average. DDIs were found in 21.53% prescriptions (n=104). 168 DDIs were identified with major, moderate, and minor types in 32 (19%), 85 (51%), and 51 (30%) respectively. As per occurrence, the panel determined that 13 interactions were clinically important. Conclusion: The drug interactions identified by a panel of expert using standard evaluation tool are considered to be clinically important and likely to occur in the clinical settings. Clinically significant DDIs can be preventable and can also be used for the beneficial effects in MTM. Adequate knowledge regarding nature of DDIs, inclusion of automated system in prescribing and dispensing area, and inter-professional collaboration of a clinical team is liable to prevent and manage such events and help in rational drug therapy.
背景:药物-药物相互作用(ddi)是临床环境中遇到的重要药物相关问题之一。更好地了解临床显著性ddi的机制、严重程度和可能的后果对于适当的药物治疗管理(MTM)至关重要。本研究的目的是让临床医生了解在临床环境中发生的具有临床意义的ddi，并帮助他们用准确的知识和技术来管理这些事件。方法:对加德满都Shree Birendra医院2020年6 - 11月门诊处方进行描述性横断面研究。随机抽取处方483张。在一名咨询医师的指导下，由医师、药理学家和临床药师组成的小组使用MICROMEDEX Drug - reax、药物相互作用评价、药物相互作用事实、药物相互作用分析和管理进行了研究。主要结果测量是通过督导对小组成员关于ddi临床重要性的意见的认可来获得的。结果:处方样本483份，共检出药品2006种。每张处方的药品数量在2 ~ 11种之间，平均4.15种。处方中使用ddi的占21.53% (n=104)。168例ddi分别有32例(19%)、85例(51%)和51例(30%)被鉴定为重度、中度和轻度ddi。根据发生情况，专家组确定13种相互作用具有临床重要性。结论:由专家小组使用标准评估工具确定的药物相互作用被认为具有临床重要性，并且可能在临床环境中发生。临床上显著的ddi是可以预防的，也可以用于MTM的有益效果。充分了解ddi的性质，在处方和配药领域纳入自动化系统，以及临床团队的跨专业合作，有责任预防和管理此类事件，并有助于合理的药物治疗。
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{"title":"Privacy Policy","authors":"Ejms Journals","doi":"10.46405/ejms.v1i1.229","DOIUrl":"https://doi.org/10.46405/ejms.v1i1.229","url":null,"abstract":"Privacy Policy","PeriodicalId":254508,"journal":{"name":"Europasian Journal of Medical Sciences","volume":"8 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2020-11-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"123714957","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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