{"title":"DENTAL CLEARANCE PRIOR TO ANTI-NEOPLASTIC THERAPY","authors":"S. Thakur","doi":"10.54530/jcmc.1227","DOIUrl":"https://doi.org/10.54530/jcmc.1227","url":null,"abstract":"<jats:p>NA</jats:p>","PeriodicalId":265624,"journal":{"name":"Journal of Chitwan Medical College","volume":"40 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":"126915253","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. A. Khan, Ajeevan Gautam, S. Shakya, A. Shrestha
Background: The pelvis is a home to pelvic parts of the sympathetic and parasympathetic nervous systems, the sacral and coccygeal plexuses, and the lumbosacral trunk. The lower spine’s sciatic nerve is made up of a combination of motor and sensory fibers from spinal nerves fourth lumbar to third sacral segment (ventral rami). The objective of study was to determine morphological variations in origin and formation of branching pattern of sciatic nerve. Methods: A descriptive cross-sectional study was conducted on twenty-four (forty-eight lower limbs) cadavers available in the Department of Anatomy at School of Basic Sciences, Chitwan Medical College. All damaged cadavers were excluded. The cadavers for undergraduate first year medical students dissected as per Cunningham’s Manual. The branching pattern of the sciatic nerve was noted. All Variation of each sacral plexus was photographed. Statistical analysis was done using Microsoft Excel and SPSS version 20. Both gluteal regions were studied for the locations and variation of the sciatic nerve. Results: Forty-eight lower limbs were examined. Among them forty-two lower limbs (87.5 percent) showed a normal anatomy of the sciatic nerve. Six lower limbs (12.5 percent) showed variations in the sciatic nerve. Conclusions: The study concluded that there are variations in origin and formation of branches of sciatic nerve. Variations of sciatic nerve observed could be beneficial for various surgical interventions like nerve release and pain management in compressed nerve.
背景:骨盆是交感神经系统和副交感神经系统的骨盆部分、骶丛和尾骨丛以及腰骶干的所在地。下脊柱的坐骨神经是由从第四腰椎到第三骶节(腹支)的脊神经的运动纤维和感觉纤维组合而成。研究的目的是确定坐骨神经分支形态的起源和形成的形态学变化。方法:对奇旺医学院基础科学学院解剖学系提供的24具(48具下肢)尸体进行描述性横断面研究。所有损坏的尸体都被排除在外。根据《坎宁安手册》解剖的一年级医科本科生尸体。注意到坐骨神经的分支结构。每个骶神经丛的所有变异都被拍照。统计学分析采用Microsoft Excel和SPSS version 20进行。研究了两个臀区坐骨神经的位置和变化。结果:检查48例下肢。其中42个下肢(87.5%)的坐骨神经解剖正常。6个下肢(12.5%)表现出坐骨神经的变异。结论:研究表明，坐骨神经分支的起源和形成存在差异。观察到的坐骨神经变化可能有利于各种手术干预，如神经释放和压迫神经疼痛管理。
{"title":"STUDY OF A VARIATION OF LUMBOSACRAL PLEXUS: SCIATIC NERVE AND ITS CLINICAL SIGNIFICANCE","authors":"G. A. Khan, Ajeevan Gautam, S. Shakya, A. Shrestha","doi":"10.54530/jcmc.1130","DOIUrl":"https://doi.org/10.54530/jcmc.1130","url":null,"abstract":"Background: The pelvis is a home to pelvic parts of the sympathetic and parasympathetic nervous systems, the sacral and coccygeal plexuses, and the lumbosacral trunk. The lower spine’s sciatic nerve is made up of a combination of motor and sensory fibers from spinal nerves fourth lumbar to third sacral segment (ventral rami). The objective of study was to determine morphological variations in origin and formation of branching pattern of sciatic nerve.\u0000Methods: A descriptive cross-sectional study was conducted on twenty-four (forty-eight lower limbs) cadavers available in the Department of Anatomy at School of Basic Sciences, Chitwan Medical College. All damaged cadavers were excluded. The cadavers for undergraduate first year medical students dissected as per Cunningham’s Manual. The branching pattern of the sciatic nerve was noted. All Variation of each sacral plexus was photographed. Statistical analysis was done using Microsoft Excel and SPSS version 20. Both gluteal regions were studied for the locations and variation of the sciatic nerve.\u0000Results: Forty-eight lower limbs were examined. Among them forty-two lower limbs (87.5 percent) showed a normal anatomy of the sciatic nerve. Six lower limbs (12.5 percent) showed variations in the sciatic nerve. \u0000Conclusions: The study concluded that there are variations in origin and formation of branches of sciatic nerve. Variations of sciatic nerve observed could be beneficial for various surgical interventions like nerve release and pain management in compressed nerve.","PeriodicalId":265624,"journal":{"name":"Journal of Chitwan Medical College","volume":"178 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":"116100438","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}
Datura stramonium is a common plant found all over Nepal. It contains alkaloids like atropine, hyoscyamine and scopolamine which can produce severe anti-cholinergic effects upon intoxication. It is mostly consumed during Mahashivaratri as a means of recreation and sacred blessing from lord Shiva. We would like to present a case of accidental poisoning in children by consuming sacred food mixed with D. stramonium during Mahashivaratri. Careful history taking and physical examination is important for early diagnosis. Presence of eye witness and early presentation to hospital contributes to favorable outcome. It may be more beneficial if we become more cautious and follow safety measures while performing cultural rituals and celebrating festivals. Also, we need to be aware of the possible fatal complications of Datura poisoning.
{"title":"ACCIDENTAL DATURA POISONING IN A CHILD, A CASE REPORT FROM CENTRAL NEPAL","authors":"Bibek Regmi, Sudhir Adhikari, Sagun Khatri, Anjana Lamichhane","doi":"10.54530/jcmc.672","DOIUrl":"https://doi.org/10.54530/jcmc.672","url":null,"abstract":"Datura stramonium is a common plant found all over Nepal. It contains alkaloids like atropine, hyoscyamine and scopolamine which can produce severe anti-cholinergic effects upon intoxication. It is mostly consumed during Mahashivaratri as a means of recreation and sacred blessing from lord Shiva. We would like to present a case of accidental poisoning in children by consuming sacred food mixed with D. stramonium during Mahashivaratri. Careful history taking and physical examination is important for early diagnosis. Presence of eye witness and early presentation to hospital contributes to favorable outcome. It may be more beneficial if we become more cautious and follow safety measures while performing cultural rituals and celebrating festivals. Also, we need to be aware of the possible fatal complications of Datura poisoning.","PeriodicalId":265624,"journal":{"name":"Journal of Chitwan 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":"122857855","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 sciatic nerve is formed in the pelvic cavity and leaves the cavity through the greater sciatic foramen below the piriformis muscle. It terminates by giving tibial and common peroneal (fibular) nerve near the superior angle of the popliteal fossa. Awareness of variations in bifurcation of sciatic nerve is significant during deep intramuscular gluteal injections, clinical conditions such as piriformis syndrome, sciatica, coccygodynia and muscle atrophy. The main objective of this study was to highlight the site of bifurcation of sciatic nerve. Methods: An observational cross–sectional study was performed in the Department of Anatomy of KIST medical college & Teaching Hospital, Lalitpur, Nepal. The data was collected after ethical approval from Institutional Review Committee. 50 specimens were taken in the study by convenient sampling method. Sciatic nerve was observed in respect to its site of bifurcation. Results: Out of 50 lower limbs, in 30 specimens (60%) the sciatic nerve showed bifurcation near the superior angle of popliteal fossa. 20 lower limbs (40%) showed variations,of which eight limbs (16%) showed division of nerve prior to its exit in the gluteal region, eight limb (16%) showed division in upper 2/3rd of back of thigh and four limbs (8%) showed division of the nerve in the popliteal fossa. Conclusions: This study concludes that the majority of sciatic nerve divides at the superior angle of the popliteal fossa while some divided into other regions such as pelvis, thigh & popliteal fossa.
{"title":"VARIATIONS OF SCIATIC NERVE BIFURCATION: A CADAVERIC STUDY","authors":"Tinku Kumari Pandit, Shanta Hada, Muna Kadel","doi":"10.54530/jcmc.1160","DOIUrl":"https://doi.org/10.54530/jcmc.1160","url":null,"abstract":"Background: The sciatic nerve is formed in the pelvic cavity and leaves the cavity through the greater sciatic foramen below the piriformis muscle. It terminates by giving tibial and common peroneal (fibular) nerve near the superior angle of the popliteal fossa. Awareness of variations in bifurcation of sciatic nerve is significant during deep intramuscular gluteal injections, clinical conditions such as piriformis syndrome, sciatica, coccygodynia and muscle atrophy. The main objective of this study was to highlight the site of bifurcation of sciatic nerve.\u0000Methods: An observational cross–sectional study was performed in the Department of Anatomy of KIST medical college & Teaching Hospital, Lalitpur, Nepal. The data was collected after ethical approval from Institutional Review Committee. 50 specimens were taken in the study by convenient sampling method. Sciatic nerve was observed in respect to its site of bifurcation.\u0000Results: Out of 50 lower limbs, in 30 specimens (60%) the sciatic nerve showed bifurcation near the superior angle of popliteal fossa. 20 lower limbs (40%) showed variations,of which eight limbs (16%) showed division of nerve prior to its exit in the gluteal region, eight limb (16%) showed division in upper 2/3rd of back of thigh and four limbs (8%) showed division of the nerve in the popliteal fossa.\u0000Conclusions: This study concludes that the majority of sciatic nerve divides at the superior angle of the popliteal fossa while some divided into other regions such as pelvis, thigh & popliteal fossa.","PeriodicalId":265624,"journal":{"name":"Journal of Chitwan Medical College","volume":"219 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":"114154510","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: Radiology services are vital part of health care service and as a service provider one needs to understand the quality of service being delivered, from the patients’ perspective. This study objectively evaluates the expectation and perception of patients towards the quality of service offered by the department using SERVQUAL questionnaire. Methods: This was a descriptive cross-sectional study from September to November, 2018 with 219 patients subjected to different services of the department and participated in the self-administered SERVQUAL questionnaire survey in terms of the dimensions of tangibles, reliability, responsiveness, assurance and empathy. The mean gap score between perception and expectation for each of the dimension were determined, and the obtained overall scores were compared. Data MP Version 14 software was used for data processing and analysis. Results: The overall average score was negative (-0.03). Particularly, the modern look of equipment, the displayed information at the department (tangibles) and promptness of the services provided were perceived to be less than expected (score -0.33). With regard to reliability (+0.27), responsiveness (-0.0004), assurance (+0.19) and empathy (-0.30), the positive behavior of the staff instilled confidence in the patients in undergoing the procedures and they kept the patients’ best interest in mind during the services provided. Conclusions: There exists a service quality gap in the patients’ expectations and the actual perception of services in the department. The institute is now better able to recognize the gap, and hence can design and implement strategies that can improve the quality of services for increasing the patients’ satisfaction and propensity.
背景:放射学服务是医疗保健服务的重要组成部分，作为服务提供者，需要从患者的角度了解所提供的服务质量。本研究采用SERVQUAL问卷，客观评价患者对科室服务质量的期望和感知。方法:采用描述性横断面研究方法，于2018年9月至11月对219例在该科接受不同服务的患者进行问卷调查，从有形维度、信度维度、响应性维度、保证度维度和共情维度进行问卷调查。确定每个维度的感知和期望之间的平均差距得分，并比较所获得的总体得分。使用Data MP Version 14软件进行数据处理和分析。结果:整体平均得分为负(-0.03)。特别是，设备的现代化外观、部门显示的信息(有形)和所提供服务的及时性被认为低于预期(得分-0.33)。在可靠性(+0.27)、响应性(-0.0004)、保证性(+0.19)和共情性(-0.30)方面，工作人员的积极行为为患者在接受治疗过程中注入了信心，并在提供服务时牢记患者的最佳利益。结论:患者对该科服务的期望与实际感知存在一定的服务质量差距。该研究所现在能够更好地认识到差距，因此可以设计和实施能够提高服务质量的战略，以提高患者的满意度和倾向。
{"title":"EVALUATION OF PATIENTS’ SATISFACTION USING THE SERVQUAL QUESTIONNAIRE MODEL","authors":"Pradesh Ghimire, N. Bista, Maghn R. Collao","doi":"10.54530/jcmc.650","DOIUrl":"https://doi.org/10.54530/jcmc.650","url":null,"abstract":"Background: Radiology services are vital part of health care service and as a service provider one needs to understand the quality of service being delivered, from the patients’ perspective. This study objectively evaluates the expectation and perception of patients towards the quality of service offered by the department using SERVQUAL questionnaire.\u0000Methods: This was a descriptive cross-sectional study from September to November, 2018 with 219 patients subjected to different services of the department and participated in the self-administered SERVQUAL questionnaire survey in terms of the dimensions of tangibles, reliability, responsiveness, assurance and empathy. The mean gap score between perception and expectation for each of the dimension were determined, and the obtained overall scores were compared. Data MP Version 14 software was used for data processing and analysis.\u0000Results: The overall average score was negative (-0.03). Particularly, the modern look of equipment, the displayed information at the department (tangibles) and promptness of the services provided were perceived to be less than expected (score -0.33). With regard to reliability (+0.27), responsiveness (-0.0004), assurance (+0.19) and empathy (-0.30), the positive behavior of the staff instilled confidence in the patients in undergoing the procedures and they kept the patients’ best interest in mind during the services provided.\u0000Conclusions: There exists a service quality gap in the patients’ expectations and the actual perception of services in the department. The institute is now better able to recognize the gap, and hence can design and implement strategies that can improve the quality of services for increasing the patients’ satisfaction and propensity.","PeriodicalId":265624,"journal":{"name":"Journal of Chitwan 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":"129145987","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. Jha, Sanjeev Nirala, M. K. Sah, Kamaluddin Rain
Background: Chronic otitis media is usually complicated due to perforation of tympanic membrane and ultimately leading to hearing loss. The objective of this study was to compare the results of myringoplasty alone with myringoplasty with cortical mastoidectomy in COM (Chronic Otitis Media) mucosal inactive type in terms of graft uptake. Methods: This was a descriptive, prospective, qualitative type of study. A total of thirty patients of COM mucosal inactive type were included in the study of which 15 patients were selected alternatively for myringoplasty alone while another 15 patients were selected for myringoplasty with cortical mastoidectomy. Pure tone audiometry was done within 1 week prior to surgery. Graft uptake was assessed after 6 weeks and results were compared within and between the groups using Chi-square test. Results: Graft uptake rate of myringoplasty alone and myringoplasty with cortical mastoidectomy done using temporalis fascia graft and underlay technique was same 86.66% (n=26) and failure rate was 13.33% (n=4).The graft take was higher 88.9%(n=8) in small perforation worsened in medium (85 %) and then in subtotal perforation (79%). Graft uptake rate was highest in central perforation (86.9%) followed by posterior perforation (84.6%) and least in anterior perforation (77.7%). Mean age of presentation was 27.7 years, ranging from 15 to 60 years. Most common approach was permeatal in myringoplasty and postaural in case of myringoplasty with cortical mastoidectomy. Conclusions: The graft uptake rate myringoplasty alone are comparable to those of myringoplasty with cortical mastoidectomy. The choice of surgery is based on surgeon’s preference.
{"title":"SURGICAL OUTCOME OF MYRINGOPLASTY WITH AND WITHOUT CORTICAL MASTOIDECTOMY IN CHRONIC OTITIS MEDIA MUCOSAL INACTIVE TYPE","authors":"A. Jha, Sanjeev Nirala, M. K. Sah, Kamaluddin Rain","doi":"10.54530/jcmc.1216","DOIUrl":"https://doi.org/10.54530/jcmc.1216","url":null,"abstract":"Background: Chronic otitis media is usually complicated due to perforation of tympanic membrane and ultimately leading to hearing loss. The objective of this study was to compare the results of myringoplasty alone with myringoplasty with cortical mastoidectomy in COM (Chronic Otitis Media) mucosal inactive type in terms of graft uptake.\u0000Methods: This was a descriptive, prospective, qualitative type of study. A total of thirty patients of COM mucosal inactive type were included in the study of which 15 patients were selected alternatively for myringoplasty alone while another 15 patients were selected for myringoplasty with cortical mastoidectomy. Pure tone audiometry was done within 1 week prior to surgery. Graft uptake was assessed after 6 weeks and results were compared within and between the groups using Chi-square test.\u0000Results: Graft uptake rate of myringoplasty alone and myringoplasty with cortical mastoidectomy done using temporalis fascia graft and underlay technique was same 86.66% (n=26) and failure rate was 13.33% (n=4).The graft take was higher 88.9%(n=8) in small perforation worsened in medium (85 %) and then in subtotal perforation (79%). Graft uptake rate was highest in central perforation (86.9%) followed by posterior perforation (84.6%) and least in anterior perforation (77.7%). Mean age of presentation was 27.7 years, ranging from 15 to 60 years. Most common approach was permeatal in myringoplasty and postaural in case of myringoplasty with cortical mastoidectomy.\u0000Conclusions: The graft uptake rate myringoplasty alone are comparable to those of myringoplasty with cortical mastoidectomy. The choice of surgery is based on surgeon’s preference.","PeriodicalId":265624,"journal":{"name":"Journal of Chitwan Medical College","volume":"61 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":"127878689","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: Under-reporting of suspected adverse drug reactions by health professionals is a widespread problem. To strengthen the pharmacovigilance program, medical students should be well trained about adverse drug reaction reporting from the very beginning. The objective of present study was to assess knowledge, attitude, and practice of pharmacovigilance among undergraduate medical and dental students of a tertiary care teaching hospital. Methods: A cross-sectional study was conducted among first and second-year medical and dental students on March 2021. An online questionnaire was used to collect data. The frequency of different measures mentioned by respondents was noted. The total score was compared among different subgroups using Mann–Whitney test. Results: Out of 238 students, 204 students (85.7 %) responded. Among them, medical students were 157 (77%) and dental students were 47 (23%). The medians for total knowledge, total attitude and total practice scores were 4, 7 and 2 respectively. Thus, respondents had good attitude towards pharmacovigilance but their knowledge and practice were not adequate. When MBBS students were compared with the BDS students, it was found that the median for total scores for knowledge and attitude were not significantly different (p > 0.05) but there was statistically significant difference (p < 0.05) between median for total practice scores. Conclusions: Positive attitude was noted among undergraduate medical and dental students towards pharmacovigilance, but knowledge and practice were not adequate. Thus, the study indicates the need for integrating interventions and education related to pharmacovigilance in undergraduate medical curricula to prepare them for future practice.
{"title":"KNOWLEDGE, ATTITUDE AND PRACTICE OF PHARMACOVIGILANCE AMONG UNDERGRADUATE MEDICAL AND DENTAL STUDENTS OF A TERTIARY CARE TEACHING HOSPITAL","authors":"T. Manandhar","doi":"10.54530/jcmc.1205","DOIUrl":"https://doi.org/10.54530/jcmc.1205","url":null,"abstract":"Background: Under-reporting of suspected adverse drug reactions by health professionals is a widespread problem. To strengthen the pharmacovigilance program, medical students should be well trained about adverse drug reaction reporting from the very beginning. The objective of present study was to assess knowledge, attitude, and practice of pharmacovigilance among undergraduate medical and dental students of a tertiary care teaching hospital.\u0000Methods: A cross-sectional study was conducted among first and second-year medical and dental students on March 2021. An online questionnaire was used to collect data. The frequency of different measures mentioned by respondents was noted. The total score was compared among different subgroups using Mann–Whitney test.\u0000Results: Out of 238 students, 204 students (85.7 %) responded. Among them, medical students were 157 (77%) and dental students were 47 (23%). The medians for total knowledge, total attitude and total practice scores were 4, 7 and 2 respectively. Thus, respondents had good attitude towards pharmacovigilance but their knowledge and practice were not adequate. When MBBS students were compared with the BDS students, it was found that the median for total scores for knowledge and attitude were not significantly different (p > 0.05) but there was statistically significant difference (p < 0.05) between median for total practice scores.\u0000Conclusions: Positive attitude was noted among undergraduate medical and dental students towards pharmacovigilance, but knowledge and practice were not adequate. Thus, the study indicates the need for integrating interventions and education related to pharmacovigilance in undergraduate medical curricula to prepare them for future practice.","PeriodicalId":265624,"journal":{"name":"Journal of Chitwan Medical College","volume":"114 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":"126925517","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 growth of a child is the most important requirements for mental and physical development as well as social integrity. Knowledge of developmental milestones is essential for assessing normal development and to identify any delay in development. Mothers, who are usually taking care of the child, must have adequate knowledge regarding growth and development of child. The objective of this study was to assess the awareness regarding developmental milestones of under 3 years children among mothers at a teaching hospital, Chitwan. Methods: A descriptive, cross-sectional research was conducted among 104 mothers attending different pediatric departments of Chitwan Medical College & Teaching Hospital. Non-probability, convenience sampling technique was used to select the sample. Structured interview schedule was used for data collection and data were analyzed by using descriptive and inferential statistics. Results: The study revealed that more than half (52.95%) of respondents belonged to 20-29 years, 74% were Hindu, 58.7% belonged to urban area. Only 25% of the respondents had adequate level of awareness. Most of the mothers had awareness regarding social development & play (66.67%) followed by motor development (57.14%), physical development (50%), cognitive development (50%), & language development (50%). Conclusions: Majority of mothers have inadequate level of awareness regarding developmental milestones.
{"title":"AWARENESS REGARDING DEVELOPMENTAL MILESTONES OF UNDER 3 YEARS CHILDREN AMONG MOTHERS AT A TEACHING HOSPITAL, CHITWAN","authors":"Rojina Marahatta, Subina Bajracharya","doi":"10.54530/jcmc.1165","DOIUrl":"https://doi.org/10.54530/jcmc.1165","url":null,"abstract":"Background: The growth of a child is the most important requirements for mental and physical development as well as social integrity. Knowledge of developmental milestones is essential for assessing normal development and to identify any delay in development. Mothers, who are usually taking care of the child, must have adequate knowledge regarding growth and development of child. The objective of this study was to assess the awareness regarding developmental milestones of under 3 years children among mothers at a teaching hospital, Chitwan.\u0000Methods: A descriptive, cross-sectional research was conducted among 104 mothers attending different pediatric departments of Chitwan Medical College & Teaching Hospital. Non-probability, convenience sampling technique was used to select the sample. Structured interview schedule was used for data collection and data were analyzed by using descriptive and inferential statistics.\u0000Results: The study revealed that more than half (52.95%) of respondents belonged to 20-29 years, 74% were Hindu, 58.7% belonged to urban area. Only 25% of the respondents had adequate level of awareness. Most of the mothers had awareness regarding social development & play (66.67%) followed by motor development (57.14%), physical development (50%), cognitive development (50%), & language development (50%).\u0000Conclusions: Majority of mothers have inadequate level of awareness regarding developmental milestones.","PeriodicalId":265624,"journal":{"name":"Journal of Chitwan Medical College","volume":"04 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":"130235363","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. Wagley, S. Adhikari, M. Bhattarai, Basanta Gauli, S. Gurung, Sunil Patel, Niraj Puri, Sharmila Chapagain, Pragyik Pandey
Background: Risk stratification of Community acquired pneumonia (CAP) is challenging for physicians. Though various biomarkers are available, they are costly or not readily available in all health care settings. This study aimed to analyze the prognostic value of routinely available clinical and blood parameters in relation to the outcome of patients admitted with community acquired pneumonia. Methods: This was a hospital-based observational study of the patients admitted to Chitwan Medical College (CMC), Nepal between August 2021 and December 2021. We enrolled patients 18 years old and above with the diagnosis of CAP in the study and excluded patients with COVID and active pulmonary tuberculosis. The outcomes of the patients were recorded as improved, not-improved, or dead. Fischer exact, Kruskal-Wallis or Mann-Whitney tests were used for analysis wherever appropriate. Results: Total 92 patients with mean age 58.2 years were enrolled in the study. Patients who were not improved or were dead had higher age (p=0.029), respiratory rate (p<0.001), shock index (p=0.013), total leukocyte count (TLC) (p=0.019), urea (p=0.046), creatinine (p<0.01), potassium (p<0.001), bilirubin (p=0.029), and lactate (P<0.05) and lower SpO2 (p<0.01), SpO2/FiO2 (p=0.018), pH (p=0.0497), and PaCO2 (p<0.001). Patients with nervous (p<0.001), cardiovascular (p=0.032) and renal system (p=0.019) involvement were also found to be associated with poor outcome. Conclusions: CAP patients with higher TLC, urea, creatinine, bilirubin and lactate, with lower SpO2, SpO2/FiO2, pH and PaCO2 and with involvement of more than one organ systems were found to have unfavorable prognosis. Higher potassium level was also found to be a potential marker of CAP severity.
{"title":"CLINICAL AND BLOOD PARAMETERS IN RELATION TO THE OUTCOMES OF COMMUNITY ACQUIRED PNEUMONIA","authors":"P. Wagley, S. Adhikari, M. Bhattarai, Basanta Gauli, S. Gurung, Sunil Patel, Niraj Puri, Sharmila Chapagain, Pragyik Pandey","doi":"10.54530/jcmc.681","DOIUrl":"https://doi.org/10.54530/jcmc.681","url":null,"abstract":"Background: Risk stratification of Community acquired pneumonia (CAP) is challenging for physicians. Though various biomarkers are available, they are costly or not readily available in all health care settings. This study aimed to analyze the prognostic value of routinely available clinical and blood parameters in relation to the outcome of patients admitted with community acquired pneumonia.\u0000Methods: This was a hospital-based observational study of the patients admitted to Chitwan Medical College (CMC), Nepal between August 2021 and December 2021. We enrolled patients 18 years old and above with the diagnosis of CAP in the study and excluded patients with COVID and active pulmonary tuberculosis. The outcomes of the patients were recorded as improved, not-improved, or dead. Fischer exact, Kruskal-Wallis or Mann-Whitney tests were used for analysis wherever appropriate.\u0000Results: Total 92 patients with mean age 58.2 years were enrolled in the study. Patients who were not improved or were dead had higher age (p=0.029), respiratory rate (p<0.001), shock index (p=0.013), total leukocyte count (TLC) (p=0.019), urea (p=0.046), creatinine (p<0.01), potassium (p<0.001), bilirubin (p=0.029), and lactate (P<0.05) and lower SpO2 (p<0.01), SpO2/FiO2 (p=0.018), pH (p=0.0497), and PaCO2 (p<0.001). Patients with nervous (p<0.001), cardiovascular (p=0.032) and renal system (p=0.019) involvement were also found to be associated with poor outcome.\u0000Conclusions: CAP patients with higher TLC, urea, creatinine, bilirubin and lactate, with lower SpO2, SpO2/FiO2, pH and PaCO2 and with involvement of more than one organ systems were found to have unfavorable prognosis. Higher potassium level was also found to be a potential marker of CAP severity.","PeriodicalId":265624,"journal":{"name":"Journal of Chitwan Medical College","volume":"136 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":"131921669","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}
Restoration of endodontically treated teeth (ETT) is distinct from root canal treatment although they are mutually dependent in planning, treatment and prognosis. The fabrication of full coverage crowns with or without the use of posts remains the long-established means of restoration of endodontically treated teeth. Despite all the clinical success achieved with intraradicular posts, they have been criticized for removal of sound tissue and risk of root perforation. With the amelioration of adhesive techniques and invention of newer materials, the concept of endocrown has been considered as an alternative and viable method for restoration of root canal treated molars. It is an indirect monoblock restoration aimed to achieve a bonded biomimetic reconstruction. The preparation is simple following minimally invasive principles of adhesive dentistry compared to conventional crowns with post and core. They have the advantage of removing lower amounts of sound tissue compared to other techniques, and with much lower chair time needed. Also, the masticatory stresses received at the tooth/ restoration interface are more properly dissipated along the overall restored tooth structure when endocrowns are placed. The rationale of the preparation was to use surface area available in the pulp chamber to gain stability and retention through adhesive cementation. The supragingival positioning of restorative margins prevents interferences with periodontal tissues. This article highlights a case report where a porcelain fused to metal endocrown is fabricated to effectively manage a grossly mutilated endodontically treated tooth and was followed up for one year.
{"title":"ENDOCROWN: A SUBSTITUTE APPROACH TO POST AND CORE FOR REHABILITATION OF ENDODONTICALLY TREATED TOOTH","authors":"Sujan Thapa, S. Shubham","doi":"10.54530/jcmc.1229","DOIUrl":"https://doi.org/10.54530/jcmc.1229","url":null,"abstract":"Restoration of endodontically treated teeth (ETT) is distinct from root canal treatment although they are mutually dependent in planning, treatment and prognosis. The fabrication of full coverage crowns with or without the use of posts remains the long-established means of restoration of endodontically treated teeth. Despite all the clinical success achieved with intraradicular posts, they have been criticized for removal of sound tissue and risk of root perforation. With the amelioration of adhesive techniques and invention of newer materials, the concept of endocrown has been considered as an alternative and viable method for restoration of root canal treated molars. It is an indirect monoblock restoration aimed to achieve a bonded biomimetic reconstruction. The preparation is simple following minimally invasive principles of adhesive dentistry compared to conventional crowns with post and core. They have the advantage of removing lower amounts of sound tissue compared to other techniques, and with much lower chair time needed. Also, the masticatory stresses received at the tooth/ restoration interface are more properly dissipated along the overall restored tooth structure when endocrowns are placed. The rationale of the preparation was to use surface area available in the pulp chamber to gain stability and retention through adhesive cementation. The supragingival positioning of restorative margins prevents interferences with periodontal tissues. This article highlights a case report where a porcelain fused to metal endocrown is fabricated to effectively manage a grossly mutilated endodontically treated tooth and was followed up for one year.","PeriodicalId":265624,"journal":{"name":"Journal of Chitwan Medical College","volume":"22 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":"133268506","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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