The COVID-19 pandemic is still ongoing, it is imperative to vaccinate most people, including children, to achieve herd immunity against the pandemic. Since parents are the ones who ultimately decide whether to vaccinate their children, this viewpoint was conducted to determine parents' acceptance and reluctance to vaccinate their children against COVID-19. This viewpoint aims to identify the predictors and ethical considerations of childhood vaccination. Several predictive factors contribute to the decision to accept or refuse the COVID-19 vaccine for children. Predictor factors that influence the acceptance of the COVID-19 vaccine in children are citizen trust in government, conspiratorial beliefs, intention of parents, psychological reactance, and magical beliefs. Ethical considerations must also be considered, because this is very important. Ethical considerations that may be a dilemma for vaccine acceptance such as autonomy, beneficence, non-maleficence, and justice.
{"title":"COVID-19 VACCINATION IN CHILDREN: AN UPDATE FOR THE NEW ERA OF COVID-19","authors":"Aprianto Daniel Pailaha","doi":"10.54530/jcmc.1238","DOIUrl":"https://doi.org/10.54530/jcmc.1238","url":null,"abstract":"The COVID-19 pandemic is still ongoing, it is imperative to vaccinate most people, including children, to achieve herd immunity against the pandemic. Since parents are the ones who ultimately decide whether to vaccinate their children, this viewpoint was conducted to determine parents' acceptance and reluctance to vaccinate their children against COVID-19. This viewpoint aims to identify the predictors and ethical considerations of childhood vaccination. Several predictive factors contribute to the decision to accept or refuse the COVID-19 vaccine for children. Predictor factors that influence the acceptance of the COVID-19 vaccine in children are citizen trust in government, conspiratorial beliefs, intention of parents, psychological reactance, and magical beliefs. Ethical considerations must also be considered, because this is very important. Ethical considerations that may be a dilemma for vaccine acceptance such as autonomy, beneficence, non-maleficence, and justice.","PeriodicalId":265624,"journal":{"name":"Journal of Chitwan Medical College","volume":"4 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-03-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"115636711","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}
The esthetic concerns of patients have become an essential part of periodontal therapy. Gingival recession is one of the common esthetic concerns of periodontal tissue resulting in root exposure and may favor the initiation of tooth sensitivity. Different surgical techniques have been proposed in order to cover the area of recession and to prevent further recession by increasing the width of the attached gingiva. This paper reports a case in which a sub epithelial connective tissue graft was used to produce root coverage for Miller class II recession.
{"title":"COVERAGE OF GINGIVAL RECESSION USING SUB EPITHELIAL CONNECTIVE TISSUE GRAFT TECHNIQUE","authors":"Erika Shrestha, Shristi Kafle","doi":"10.54530/jcmc.1274","DOIUrl":"https://doi.org/10.54530/jcmc.1274","url":null,"abstract":"The esthetic concerns of patients have become an essential part of periodontal therapy. Gingival recession is one of the common esthetic concerns of periodontal tissue resulting in root exposure and may favor the initiation of tooth sensitivity. Different surgical techniques have been proposed in order to cover the area of recession and to prevent further recession by increasing the width of the attached gingiva. This paper reports a case in which a sub epithelial connective tissue graft was used to produce root coverage for Miller class II recession.","PeriodicalId":265624,"journal":{"name":"Journal of Chitwan Medical College","volume":"27 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-03-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"122103486","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}
D. Lama, R. Singh, Farhat Jahan, Bhawana Tiwari, Laxman Mandal
Tuberculosis may have wide range of clinical presentation. Here, we present one of atypical presentation of pulmonary tuberculosis. A 41 years male presented to Medical OPD of Chitwan Medical College & Teaching Hospital, tertiary level hospital located in central Terai region of Nepal with chief complaints of generalized body swelling for 4 days and failure to pass urine for 10 hours. Clinical findings revealed pulse 80 bpm, BP 110/70 mmHg and gross edema present all over body. On investigation, his urine examination showed protein +, pus cells plenty and serum albumin 1.4 gm/dl. So, initial diagnosis of Nephrotic syndrome and Urinary Tract Infection was made. 24 hour urinary protein was sent which didn’t suggest Nephrotic syndrome. Patient was treated initially with antibiotics for UTI, potassium supplement and diuretics. In addition, he developed fever on 3rd day of admission which did not subside even after 5 days of antibiotic therapy. His chest examination revealed crackles bilaterally on infraclavicular and subscapular regions. Initially chest X-ray and later on CECT chest were done which showed multiple enlarged intrathoracic lymph nodes. His initial clinical examination had not revealed any enlarged peripheral lymph nodes but after doing CECT, retrospective clinical examination revealed enlarged right supraclavicular lymph nodes, FNAC of which suggested tubercular lymphadenopathy. Anti-Tubercular Therapy was started on 2023/01/25 and after 5 days of treatment his fever subsided, appetite and general health being also improved. So, generalized intrathoracic lymphadenopathy can be atypical presenting feature of tuberculosis which is generally confused with malignancy and sarcoidosis.
{"title":"ATYPICAL PRESENTATION OF PULMONARY TUBERCULOSIS","authors":"D. Lama, R. Singh, Farhat Jahan, Bhawana Tiwari, Laxman Mandal","doi":"10.54530/jcmc.1275","DOIUrl":"https://doi.org/10.54530/jcmc.1275","url":null,"abstract":"Tuberculosis may have wide range of clinical presentation. Here, we present one of atypical presentation of pulmonary tuberculosis. A 41 years male presented to Medical OPD of Chitwan Medical College & Teaching Hospital, tertiary level hospital located in central Terai region of Nepal with chief complaints of generalized body swelling for 4 days and failure to pass urine for 10 hours. Clinical findings revealed pulse 80 bpm, BP 110/70 mmHg and gross edema present all over body. On investigation, his urine examination showed protein +, pus cells plenty and serum albumin 1.4 gm/dl. So, initial diagnosis of Nephrotic syndrome and Urinary Tract Infection was made. 24 hour urinary protein was sent which didn’t suggest Nephrotic syndrome. Patient was treated initially with antibiotics for UTI, potassium supplement and diuretics. In addition, he developed fever on 3rd day of admission which did not subside even after 5 days of antibiotic therapy. His chest examination revealed crackles bilaterally on infraclavicular and subscapular regions. Initially chest X-ray and later on CECT chest were done which showed multiple enlarged intrathoracic lymph nodes. His initial clinical examination had not revealed any enlarged peripheral lymph nodes but after doing CECT, retrospective clinical examination revealed enlarged right supraclavicular lymph nodes, FNAC of which suggested tubercular lymphadenopathy. Anti-Tubercular Therapy was started on 2023/01/25 and after 5 days of treatment his fever subsided, appetite and general health being also improved. So, generalized intrathoracic lymphadenopathy can be atypical presenting feature of tuberculosis which is generally confused with malignancy and sarcoidosis.","PeriodicalId":265624,"journal":{"name":"Journal of Chitwan Medical College","volume":"142 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-03-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"116339657","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}
Ashmita Adhikari, Dija Khanal, S. Shrestha, R. Joshi, J. Chaudhary, Prajita Bhandari
Molar pregnancy can occur outside the uterine cavity. Ectopic molar pregnancy although a rare entity does exist. The patient presents with features similar to ruptured or unruptured ectopic gestation. Management requires surgical removal of the conceptus and follow-up. Diagnosis with histopathological examination of the specimen is the gold standard. Here, we report an unusual case of 30 years female with a left tubal partial hydatidiform mole. The initial suspicion was made with preoperative raised serum beta Human Chorionic Gonadotropin levels and the diagnosis was confirmed with the histopathological examination of the specimen. The patient was followed up with serial weekly serum beta Human Chorionic Gonadotropin monitoring and remission was achieved. Therefore, sending samples for histopathological examination after surgical management of ectopic pregnancy is mandatory to detect molar ectopic pregnancy in order to make a proper follow-up and to prevent persistent gestational trophoblastic diseases.
{"title":"EXTRAUTERINE MOLAR PREGNANCY: A CASE OF TUBAL PARTIAL MOLAR PREGNANCY","authors":"Ashmita Adhikari, Dija Khanal, S. Shrestha, R. Joshi, J. Chaudhary, Prajita Bhandari","doi":"10.54530/jcmc.1277","DOIUrl":"https://doi.org/10.54530/jcmc.1277","url":null,"abstract":"Molar pregnancy can occur outside the uterine cavity. Ectopic molar pregnancy although a rare entity does exist. The patient presents with features similar to ruptured or unruptured ectopic gestation. Management requires surgical removal of the conceptus and follow-up. Diagnosis with histopathological examination of the specimen is the gold standard. Here, we report an unusual case of 30 years female with a left tubal partial hydatidiform mole. The initial suspicion was made with preoperative raised serum beta Human Chorionic Gonadotropin levels and the diagnosis was confirmed with the histopathological examination of the specimen. The patient was followed up with serial weekly serum beta Human Chorionic Gonadotropin monitoring and remission was achieved. Therefore, sending samples for histopathological examination after surgical management of ectopic pregnancy is mandatory to detect molar ectopic pregnancy in order to make a proper follow-up and to prevent persistent gestational trophoblastic diseases.","PeriodicalId":265624,"journal":{"name":"Journal of Chitwan Medical College","volume":"16 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-03-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"114144886","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. Thakur, R. Thakur, Apar Adhikari, Tekendra Khanal, R. Yadav, N. Ghimire
Background: Tympanoplasty is done in cases of chronic otitis media. Middle Ear Risk Index (MERI) Scale is used to predict the outcome of tympanoplasty, based on various risk factors like otorrhoea, perforation, ossicular chain status, cholesteatoma, smoking and middle ear granuation/effusion. The objective of the study was to report the success rate of graft uptake, postoperative gain in hearing threshold and to find out the association of success to the different categories of MERI scale. Methods: A prospective study of 75 cases of chronic otitis media who underwent tympanoplasty, was done over one year. Convenience sampling method was done. Clinical and audiological evaluation was done pre- and post- operatively. Risk categorization based on MERI scale was done. Data were recorded and analyzed using SPSS 16. Results: Out of 75 cases, 39 (52%) cases were male and 36 (48%) were female. The mean age was 24.55 years±11.545. Overall, 53 (70.66%) cases had successful graft uptake. MERI 1-3 group had 82.6 % (38/46), MERI 4-7 group had 64.7 % (11/17) and MERI 8-12 group had only 33.33% (4/12) graft uptake, (p-value 0.003). Above-10-year age group had higher graft uptake rate and hearing gain. Graft acceptance was seen equal in dry or wet ear, and in unilateral or bilateral perforation. Conclusions: Tympanoplasty done in cases with lower MERI scale and more than 10 years age group was associated with higher graft acceptance. More than 10 years age group had better hearing gain. The status of middle ear, dry or wet and laterality of perforation had no association for graft acceptance.
{"title":"TYMPANOPLASTY AND ITS OUTCOME IN VARIOUS AGE GROUPS USING THE MIDDLE EAR RISK INDEX SCALE AT A TERTIARY CARE CENTRE IN EASTERN NEPAL","authors":"S. Thakur, R. Thakur, Apar Adhikari, Tekendra Khanal, R. Yadav, N. Ghimire","doi":"10.54530/jcmc.1188","DOIUrl":"https://doi.org/10.54530/jcmc.1188","url":null,"abstract":"Background: Tympanoplasty is done in cases of chronic otitis media. Middle Ear Risk Index (MERI) Scale is used to predict the outcome of tympanoplasty, based on various risk factors like otorrhoea, perforation, ossicular chain status, cholesteatoma, smoking and middle ear granuation/effusion. The objective of the study was to report the success rate of graft uptake, postoperative gain in hearing threshold and to find out the association of success to the different categories of MERI scale.\u0000Methods: A prospective study of 75 cases of chronic otitis media who underwent tympanoplasty, was done over one year. Convenience sampling method was done. Clinical and audiological evaluation was done pre- and post- operatively. Risk categorization based on MERI scale was done. Data were recorded and analyzed using SPSS 16.\u0000Results: Out of 75 cases, 39 (52%) cases were male and 36 (48%) were female. The mean age was 24.55 years±11.545. Overall, 53 (70.66%) cases had successful graft uptake. MERI 1-3 group had 82.6 % (38/46), MERI 4-7 group had 64.7 % (11/17) and MERI 8-12 group had only 33.33% (4/12) graft uptake, (p-value 0.003). Above-10-year age group had higher graft uptake rate and hearing gain. Graft acceptance was seen equal in dry or wet ear, and in unilateral or bilateral perforation.\u0000Conclusions: Tympanoplasty done in cases with lower MERI scale and more than 10 years age group was associated with higher graft acceptance. More than 10 years age group had better hearing gain. The status of middle ear, dry or wet and laterality of perforation had no association for graft acceptance.","PeriodicalId":265624,"journal":{"name":"Journal of Chitwan Medical College","volume":"42 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-03-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"114265267","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: Mandibular third molar is unique as relatively large number are either malposed, impacted or underdeveloped. This characteristic often leads to higher prevalence of dental caries, periodontal diseases and pathological lesions such as cysts, tumours or space infections leading to extraction of mandibular third molars. The objective of this study was to assess the reasons for mandibular third molar extraction. Methods: A descriptive cross-sectional study was conducted on 146 patients from 1st August 2021 to 31st July 2022 in the department of Dental surgery of Birat medical college and teaching hospital. Data were analysed by Statistical Package for Social Sciences (SPSS) version 22. Results: Out of 146 patients 90 (61.6%) were females and 56 (38.4%) were males. Reasons for mandibular third molar extraction were dental caries (n=67; 45.9%), impaction (n=62; 42.5%), periodontitis (n=10; 6.8%) and others (n=; 4.8%) which included traumatic ulcer on the tongue (n=3; 2%), angle fracture of the mandible (n=2; 1.4%), dentigerous cyst (n=1; 0.7%) and fascial space infection (n=1; 0.7%). Conclusions: The most common reasons for extraction of mandibular third molar was dental caries. Most common reason for extraction in age ≤ 25 years was impaction and it gradually shifted to dental caries as age progressed. Impaction was the most common reason for extraction of mandibular third molar in males however it was dental caries in females.
{"title":"REASONS FOR EXTRACTION OF MANDIBULAR THIRD MOLAR AT TERTIARY CARE CENTRE IN EASTERN NEPAL","authors":"Gopal Gurung, Arun Kumar Mahat, Mona Pokharel","doi":"10.54530/jcmc.1195","DOIUrl":"https://doi.org/10.54530/jcmc.1195","url":null,"abstract":"Background: Mandibular third molar is unique as relatively large number are either malposed, impacted or underdeveloped. This characteristic often leads to higher prevalence of dental caries, periodontal diseases and pathological lesions such as cysts, tumours or space infections leading to extraction of mandibular third molars. The objective of this study was to assess the reasons for mandibular third molar extraction.\u0000Methods: A descriptive cross-sectional study was conducted on 146 patients from 1st August 2021 to 31st July 2022 in the department of Dental surgery of Birat medical college and teaching hospital. Data were analysed by Statistical Package for Social Sciences (SPSS) version 22.\u0000Results: Out of 146 patients 90 (61.6%) were females and 56 (38.4%) were males. Reasons for mandibular third molar extraction were dental caries (n=67; 45.9%), impaction (n=62; 42.5%), periodontitis (n=10; 6.8%) and others (n=; 4.8%) which included traumatic ulcer on the tongue (n=3; 2%), angle fracture of the mandible (n=2; 1.4%), dentigerous cyst (n=1; 0.7%) and fascial space infection (n=1; 0.7%). \u0000Conclusions: The most common reasons for extraction of mandibular third molar was dental caries. Most common reason for extraction in age ≤ 25 years was impaction and it gradually shifted to dental caries as age progressed. Impaction was the most common reason for extraction of mandibular third molar in males however it was dental caries in females.","PeriodicalId":265624,"journal":{"name":"Journal of Chitwan Medical College","volume":"1 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-03-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"130335273","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}
Apar Adhikari, Tekendra Khanal, R. Yadav, M. Basnet, B. Ghimire, S. Thakur
Epistaxis is a common ENT emergency. Various causes are mucosal trauma, anticoagulants and bleeding disorders. Vascular causes and trauma accounts for less than 5% causes. A 25-year-old man presented to emergency with intractable epistaxis. He had sustained road traffic accident 5 months back. His previous CT scan showed multiple facial bones fracture along with sinuses (frontal, maxillary and sphenoid sinus on right para clinoid area) fracture. Initial CT angiography showed no vascular defects. The latest episode of epistaxis was massive and he underwent nasal endoscopy and packing of nose. Pulsatile sphenoidal polyp was visualized, along with transmitted pulsations in the sphenoid sinus on the right side. Subsequent Magnetic Resonance Angiography (MRA) showed a 12x4 mm pseudoaneurysm of clinoidal portion of Internal Carotid Artery on the right side. Post-traumatic Pseudoaneurysm of the Internal Carotid Artery may be the differential diagnosis in traumatic epistaxis, especially the delayed type. If pseudoaneurysm is suspected, CT or MRI angiography should be performed immediately.
{"title":"A RARE PRESENTATION OF DELAYED EPISTAXIS: POST TRAUMATIC INTERNAL CAROTID ARTERY PSEUDOANEURYSM AT A TERTIARY CARE CENTRE IN EASTERN NEPAL","authors":"Apar Adhikari, Tekendra Khanal, R. Yadav, M. Basnet, B. Ghimire, S. Thakur","doi":"10.54530/jcmc.1278","DOIUrl":"https://doi.org/10.54530/jcmc.1278","url":null,"abstract":"Epistaxis is a common ENT emergency. Various causes are mucosal trauma, anticoagulants and bleeding disorders. Vascular causes and trauma accounts for less than 5% causes. A 25-year-old man presented to emergency with intractable epistaxis. He had sustained road traffic accident 5 months back. His previous CT scan showed multiple facial bones fracture along with sinuses (frontal, maxillary and sphenoid sinus on right para clinoid area) fracture. Initial CT angiography showed no vascular defects. The latest episode of epistaxis was massive and he underwent nasal endoscopy and packing of nose. Pulsatile sphenoidal polyp was visualized, along with transmitted pulsations in the sphenoid sinus on the right side. Subsequent Magnetic Resonance Angiography (MRA) showed a 12x4 mm pseudoaneurysm of clinoidal portion of Internal Carotid Artery on the right side. Post-traumatic Pseudoaneurysm of the Internal Carotid Artery may be the differential diagnosis in traumatic epistaxis, especially the delayed type. If pseudoaneurysm is suspected, CT or MRI angiography should be performed immediately.","PeriodicalId":265624,"journal":{"name":"Journal of Chitwan Medical College","volume":"1 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-03-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"124322800","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}
G. B. Nepal, Archana Bhaila, Hari Sundar Shrestha, Niroj Maharjan, Bijaya Adhikari
Background: Body mass index (BMI) remains widely used parameter to assess obesity. However, it does not account for the fat and lean body mass. Amidst different methods of estimation of body fat, skinfold measurement remains the most feasible. This study was conducted to explore the correlation between BMI and body fat percentage (BF %) measured through skin-fold measurements. Methods: This cross-section study includes 207 healthy subjects (100 male and 107 female) aged 17-25 years. Anthropometric variables, waist and hip circumference were measured. Skinfold was measured using a caliper at triceps, biceps, iliac crest, and subscapular areas. BMI was derived from height and weight. Body density was calculated using the Durnin and Womersley formula and BF% was estimated by Siri equation. Group means for BMI and body fat percentage was calculated, the association between BF % and BMI, waist-hip ratio (WHR) and waist circumference (WC) was established using a Pearson Correlation analysis and Pearson correlation coefficient was reported. Results: The mean BMI and BF% was 21.77 ± 2.986 kg/m2 and 23.25 ± 6.693 respectively. Overall correlation between BMI and BF% was 0.325. The correlation of BF% with BMI was (0.811, 0.790) and with waist circumference was (0.668, 0.558) in male and female respectively. Similarly, correlation between BF% and WHR was 0.30 in male and 0.266 in female. The results were statistically significant at p<0.01. Conclusions: There is a strong correlation between BF% and BMI. This study also showed that WC better correlates with BF% as compared to WHR in both sexes.
{"title":"ESTIMATION OF BODY FAT PERCENTAGE IN ADULT POPULATION IN NEPAL AND ASSESS ITS CORRELATION WITH BODY MASS INDEX","authors":"G. B. Nepal, Archana Bhaila, Hari Sundar Shrestha, Niroj Maharjan, Bijaya Adhikari","doi":"10.54530/jcmc.699","DOIUrl":"https://doi.org/10.54530/jcmc.699","url":null,"abstract":"Background: Body mass index (BMI) remains widely used parameter to assess obesity. However, it does not account for the fat and lean body mass. Amidst different methods of estimation of body fat, skinfold measurement remains the most feasible. This study was conducted to explore the correlation between BMI and body fat percentage (BF %) measured through skin-fold measurements.\u0000Methods: This cross-section study includes 207 healthy subjects (100 male and 107 female) aged 17-25 years. Anthropometric variables, waist and hip circumference were measured. Skinfold was measured using a caliper at triceps, biceps, iliac crest, and subscapular areas. BMI was derived from height and weight. Body density was calculated using the Durnin and Womersley formula and BF% was estimated by Siri equation. Group means for BMI and body fat percentage was calculated, the association between BF % and BMI, waist-hip ratio (WHR) and waist circumference (WC) was established using a Pearson Correlation analysis and Pearson correlation coefficient was reported.\u0000Results: The mean BMI and BF% was 21.77 ± 2.986 kg/m2 and 23.25 ± 6.693 respectively. Overall correlation between BMI and BF% was 0.325. The correlation of BF% with BMI was (0.811, 0.790) and with waist circumference was (0.668, 0.558) in male and female respectively. Similarly, correlation between BF% and WHR was 0.30 in male and 0.266 in female. The results were statistically significant at p<0.01.\u0000Conclusions: There is a strong correlation between BF% and BMI. This study also showed that WC better correlates with BF% as compared to WHR in both sexes.","PeriodicalId":265624,"journal":{"name":"Journal of Chitwan Medical College","volume":"26 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":"117023371","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}
Amit Dhungana, P. Baral, Satyendra N. Singh, B. Sah, A. Subedi, P. Thapa, Y. Trikhatri
Background: Sevoflurane and propofol are considered to be the agents of choice in laparoscopic surgery due to their smooth induction of anesthesia, hemodynamic stability, better recovery profile and less postoperative complications. The aim of study is to compare hemodynamic changes and recovery profile of propofol with sevoflurane-based anesthesia in laparoscopic cholecystectomy. Methods: Single blind comparative study was conducted among 132 patients aged 18-65 years, ASA-PS I & II undergoing laparoscopic cholecystectomy, randomized by computer generated random number table into two groups, 66 patients each- Group A patients induced with propofol 1.5-2.5 mg/kg IV and maintained with propofol 100-200 mcg/kg/min IV and Group B induced with sevoflurane and maintained with sevoflurane at minimum alveolar concentration of 0.7-1.3. Primary outcome were hemodynamic parameters (heart rate, systolic and diastolic blood pressure, mean arterial pressure) and recovery profile. Results: Intraoperative heart rate and diastolic blood pressure were comparable between two groups at all times while there was a significantly lower systolic blood pressure only at 3 and 5 minutes after intubation in group B compared to group A (p < 0.05). Recovery profiles assessed in terms of time of eye opening (657.89 ± 172.30 s vs 453.58 ± 157.49 s), obeying command (696.79 ± 192.44s vs 481.06±164.96s), and time of extubation (706.41±166.27s vs 483.38±160.62s) were significantly faster in group B (p value < 0.001). Conclusions: Hemodynamic changes were comparable between propofol group and sevoflurane group while sevoflurane group had faster recovery.
背景:七氟醚和异丙酚被认为是腹腔镜手术的首选药物，因为它们诱导麻醉平稳，血流动力学稳定，恢复情况好，术后并发症少。本研究的目的是比较异丙酚与七氟醚麻醉在腹腔镜胆囊切除术中的血流动力学变化和恢复情况。方法:对132例18 ~ 65岁ASA-PS I、II期腹腔镜胆囊切除术患者进行单盲比较研究，采用计算机生成的随机数字表随机分为两组，每组66例，A组为异丙酚1.5 ~ 2.5 mg/kg IV，异丙酚100 ~ 200 mcg/kg/min IV, B组为七氟醚诱导，七氟醚维持肺泡最低浓度0.7 ~ 1.3。主要终点是血流动力学参数(心率、收缩压和舒张压、平均动脉压)和恢复情况。结果:两组患者术中心率和舒张压在任何时间均具有可比性，B组患者仅在插管后3、5分钟收缩压明显低于a组(p < 0.05)。B组患者睁眼时间(657.89±172.30 s vs 453.58±157.49 s)、服从命令时间(696.79±192.44s vs 481.06±164.96s)、拔管时间(706.41±166.27s vs 483.38±160.62s)均显著快于B组(p值< 0.001)。结论:异丙酚组与七氟醚组血流动力学变化相当，七氟醚组血流动力学恢复较快。
{"title":"COMPARISON BETWEEN TOTAL INTRAVENOUS ANESTHESIA (TIVA) WITH PROPOFOL – FENTANYL AND BALANCED ANESTHESIA WITH SEVOFLURANE – FENTANYL IN TERMS OF HEMODYNAMIC CHANGES AND RECOVERY PROFILES DURING LAPAROSCOPIC CHOLECYSTECTOMY","authors":"Amit Dhungana, P. Baral, Satyendra N. Singh, B. Sah, A. Subedi, P. Thapa, Y. Trikhatri","doi":"10.54530/jcmc.1109","DOIUrl":"https://doi.org/10.54530/jcmc.1109","url":null,"abstract":"Background: Sevoflurane and propofol are considered to be the agents of choice in laparoscopic surgery due to their smooth induction of anesthesia, hemodynamic stability, better recovery profile and less postoperative complications. The aim of study is to compare hemodynamic changes and recovery profile of propofol with sevoflurane-based anesthesia in laparoscopic cholecystectomy.\u0000Methods: Single blind comparative study was conducted among 132 patients aged 18-65 years, ASA-PS I & II undergoing laparoscopic cholecystectomy, randomized by computer generated random number table into two groups, 66 patients each- Group A patients induced with propofol 1.5-2.5 mg/kg IV and maintained with propofol 100-200 mcg/kg/min IV and Group B induced with sevoflurane and maintained with sevoflurane at minimum alveolar concentration of 0.7-1.3. Primary outcome were hemodynamic parameters (heart rate, systolic and diastolic blood pressure, mean arterial pressure) and recovery profile.\u0000Results: Intraoperative heart rate and diastolic blood pressure were comparable between two groups at all times while there was a significantly lower systolic blood pressure only at 3 and 5 minutes after intubation in group B compared to group A (p < 0.05). Recovery profiles assessed in terms of time of eye opening (657.89 ± 172.30 s vs 453.58 ± 157.49 s), obeying command (696.79 ± 192.44s vs 481.06±164.96s), and time of extubation (706.41±166.27s vs 483.38±160.62s) were significantly faster in group B (p value < 0.001).\u0000Conclusions: Hemodynamic changes were comparable between propofol group and sevoflurane group while sevoflurane group had faster recovery.","PeriodicalId":265624,"journal":{"name":"Journal of Chitwan 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":"124620185","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}
Sudeep K.C., S. Giri, H. Upadhyay, B. Timilsina, Khagandra Ojha
Background: Management of renal trauma has evolved over past decades from surgical exploration to renal preservation. Conservative management of high-grade renal trauma is possible due to advancement in imaging modality, dedicated critical care and availability of selective embolization. The objective to this research was to analyze the demographics, characteristics and management of renal trauma in our institution. Methods: All patient who were admitted to College of Medical Sciences Teaching Hospital with diagnosis of renal trauma from 2017 to 2022 were retrospectively analyzed. Ethical approval was taken from institutional review committee of college of Medical Sciences. Data was collected from hospital medical records. Data was analyzed using descriptive statistical tools. For the categorical variable frequency and percentage was calculated while for continuous variables mean and standard deviation was calculated. Results: Sixty-three patients were included in this study and Median age of patient admitted with renal trauma was 31 years with male to female ratio of 7:3. Blunt renal trauma was the most common type (96.8 %) with Road traffic accidents responsible for the majority of mechanisms of injury 66.7% (42) followed by fall 11(17.5%). Majority of Renal trauma was in AAST Grade III 26(41.3%). Right sided renal injury was common 33 (52.4%) than left sided renal injury 30 (47.6%). Intervention was required in 9 patients. Conclusions: High-grade renal trauma can be managed conservatively in selected cases with close monitoring in critical care unit and with use of minimally invasive technique such as Selective angioembolization, Double J Ureteric stenting or Nephrostomy Insertion. But hemodynamically unstable patient after resuscitation warrants immediate surgical exploration.
{"title":"OUTCOME OF RENAL TRAUMA IN A TERTIARY CARE CENTER OF NEPAL: A RETROSPECTIVE STUDY","authors":"Sudeep K.C., S. Giri, H. Upadhyay, B. Timilsina, Khagandra Ojha","doi":"10.54530/jcmc.1225","DOIUrl":"https://doi.org/10.54530/jcmc.1225","url":null,"abstract":"Background: Management of renal trauma has evolved over past decades from surgical exploration to renal preservation. Conservative management of high-grade renal trauma is possible due to advancement in imaging modality, dedicated critical care and availability of selective embolization. The objective to this research was to analyze the demographics, characteristics and management of renal trauma in our institution.\u0000Methods: All patient who were admitted to College of Medical Sciences Teaching Hospital with diagnosis of renal trauma from 2017 to 2022 were retrospectively analyzed. Ethical approval was taken from institutional review committee of college of Medical Sciences. Data was collected from hospital medical records. Data was analyzed using descriptive statistical tools. For the categorical variable frequency and percentage was calculated while for continuous variables mean and standard deviation was calculated.\u0000Results: Sixty-three patients were included in this study and Median age of patient admitted with renal trauma was 31 years with male to female ratio of 7:3. Blunt renal trauma was the most common type (96.8 %) with Road traffic accidents responsible for the majority of mechanisms of injury 66.7% (42) followed by fall 11(17.5%). Majority of Renal trauma was in AAST Grade III 26(41.3%). Right sided renal injury was common 33 (52.4%) than left sided renal injury 30 (47.6%). Intervention was required in 9 patients.\u0000Conclusions: High-grade renal trauma can be managed conservatively in selected cases with close monitoring in critical care unit and with use of minimally invasive technique such as Selective angioembolization, Double J Ureteric stenting or Nephrostomy Insertion. But hemodynamically unstable patient after resuscitation warrants immediate surgical exploration.","PeriodicalId":265624,"journal":{"name":"Journal of Chitwan Medical College","volume":"49 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":"128010417","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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