Pub Date : 2020-06-26DOI: 10.3126/mjsbh.v19i2.28285
A. Gurung, D. Shrestha, P. Budhathoki, Sachit Dhakal, Sagar Rajkarnikar, K. Thapa, R. Shrestha
Introduction: Uveitis is an inflammatory condition of uvea of eye. It is a sight threatening condition, so accurate and timely diagnosis and treatment is required. Acute anterior uveitis is characterised by eye pain or photophobia, circumlimbal redness and anterior chamber cells and flare. Methods: This is a cross-sectional descriptive hospital record-based study based on data record in eye department of a tertiary care level centre in Kathmandu, Nepal. All cases of anterior uveitis presented to our OPD over one-year duration (December 2017November 2018) were enrolled. Age, sex, co-morbidities and profile of uveitis like slit lamp findings were recorded. Results: Total 52 cases of acute uveitis were observed during the study period. There were total 34 males and 18 females with eye involvement. Age group of the patients ranged from 19 to 79 years with median age of 36 years. Forty eight cases (92.3%) had unilateral involvement whereas only four cases (7.7%) had bilateral involvement. Keratic precipitates were seen in 44 patients. Majority of the patients had good vision; 65.4% in right eye and 69.2% in left eye. Conclusions: Most of the anterior uveitis occur in male in third and fourth decade. The most common complaints of the patient were decreased vision, eye pain and red eye.
{"title":"Clinical and Demographic Profile of Acute Anterior Uveitis: A Hospital Based Study","authors":"A. Gurung, D. Shrestha, P. Budhathoki, Sachit Dhakal, Sagar Rajkarnikar, K. Thapa, R. Shrestha","doi":"10.3126/mjsbh.v19i2.28285","DOIUrl":"https://doi.org/10.3126/mjsbh.v19i2.28285","url":null,"abstract":"Introduction: Uveitis is an inflammatory condition of uvea of eye. It is a sight threatening condition, so accurate and timely diagnosis and treatment is required. Acute anterior uveitis is characterised by eye pain or photophobia, circumlimbal redness and anterior chamber cells and flare. Methods: This is a cross-sectional descriptive hospital record-based study based on data record in eye department of a tertiary care level centre in Kathmandu, Nepal. All cases of anterior uveitis presented to our OPD over one-year duration (December 2017November 2018) were enrolled. Age, sex, co-morbidities and profile of uveitis like slit lamp findings were recorded. Results: Total 52 cases of acute uveitis were observed during the study period. There were total 34 males and 18 females with eye involvement. Age group of the patients ranged from 19 to 79 years with median age of 36 years. Forty eight cases (92.3%) had unilateral involvement whereas only four cases (7.7%) had bilateral involvement. Keratic precipitates were seen in 44 patients. Majority of the patients had good vision; 65.4% in right eye and 69.2% in left eye. Conclusions: Most of the anterior uveitis occur in male in third and fourth decade. The most common complaints of the patient were decreased vision, eye pain and red eye.","PeriodicalId":33963,"journal":{"name":"Medical Journal of Shree Birendra Hospital","volume":"19 1","pages":"75-79"},"PeriodicalIF":0.0,"publicationDate":"2020-06-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.3126/mjsbh.v19i2.28285","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"45971961","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2020-06-26DOI: 10.3126/mjsbh.v19i2.27689
Satya Narayan Suwal, Sammodavardhana Kaundinnyayana, K. Prajapati, Reena Baidya
Introduction: Gram negative bacteria are commonly involved in wound infections and are significantly associated with morbidity and mortality because of increasing resistance to commonly used antibacterial agents. This study aims to evaluate the pattern of antibacterial sensitivity of the gram negative bacteria from wound swabs of accidental trauma cases. Methods: This retrospective study was done by collecting all the culture positive reports for wound swabs of accidental wounds from the microbiology laboratory and analyzing the reports showing growth of gram negative bacteria for frequency of sensitivity to commonly used antibacterial agents. Results: Culture positivity rate was 21.95% with growth of gram negative bacteria in 79.7% of cases. The most commonly isolated organism was Escherichia coli being 41.3% among gram negative isolates. Highly resistant bacteria were E. coli, Klebsiella pneumoniae and Acinetobacter spp. Conclusions: As there is low culture positivity rate for wound swabs obtained before washing the wounds inflicted by accidental trauma, prolonged routine use of prophylactic antibiotic is not justified. Thoroughly washing the wound is very likely to decrease the rate of wound infection further and reduces the need of antibacterial agents. Culture and sensitivity test should guide the treatment when wound is infected because highly resistant gram negative organism may be involved in such cases.
{"title":"Sensitivity Pattern of Gram Negative Bacteria Contaminating Traumatic Wounds: A Retrospective Study in a Tertiary Care Hospital of Kathamandu Valley","authors":"Satya Narayan Suwal, Sammodavardhana Kaundinnyayana, K. Prajapati, Reena Baidya","doi":"10.3126/mjsbh.v19i2.27689","DOIUrl":"https://doi.org/10.3126/mjsbh.v19i2.27689","url":null,"abstract":"Introduction: Gram negative bacteria are commonly involved in wound infections and are significantly associated with morbidity and mortality because of increasing resistance to commonly used antibacterial agents. This study aims to evaluate the pattern of antibacterial sensitivity of the gram negative bacteria from wound swabs of accidental trauma cases. Methods: This retrospective study was done by collecting all the culture positive reports for wound swabs of accidental wounds from the microbiology laboratory and analyzing the reports showing growth of gram negative bacteria for frequency of sensitivity to commonly used antibacterial agents. Results: Culture positivity rate was 21.95% with growth of gram negative bacteria in 79.7% of cases. The most commonly isolated organism was Escherichia coli being 41.3% among gram negative isolates. Highly resistant bacteria were E. coli, Klebsiella pneumoniae and Acinetobacter spp. Conclusions: As there is low culture positivity rate for wound swabs obtained before washing the wounds inflicted by accidental trauma, prolonged routine use of prophylactic antibiotic is not justified. Thoroughly washing the wound is very likely to decrease the rate of wound infection further and reduces the need of antibacterial agents. Culture and sensitivity test should guide the treatment when wound is infected because highly resistant gram negative organism may be involved in such cases.","PeriodicalId":33963,"journal":{"name":"Medical Journal of Shree Birendra Hospital","volume":"19 1","pages":"103-107"},"PeriodicalIF":0.0,"publicationDate":"2020-06-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42336537","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2020-06-26DOI: 10.3126/mjsbh.v19i2.28666
Saurav Khetan, N. Agrawal, Prakash Rajoli
Anti-NMDA encephalitis is second commonest cause of autoimmune encephalitis among children; however, it is hardly diagnosed and often not considered as one of the differentials when a child presents with encephalitis-related symptoms. In children, it presents mostly with seizures or psychiatric symptoms without prodrome. Here we present a six years old girl who presented with seizures and inappropriate behaviour. We investigated her in the line of viral encephalitis such as Japanese Encephalitis, which is very common in our region. However, results were not suggestive of Japanese Encephalitis and further investigations subsequently lead to diagnosis of antiNMDA encephalitis. This is probably one of the first case report of this disease in our country. We want to highlight the significance of high index of suspicion for looking out for an organic cause in any child who presents with psychiatric symptoms, along with seizures.
{"title":"Anti-NMDA Encephalitis: A Rare Encephalitis in a Child- A Case Report","authors":"Saurav Khetan, N. Agrawal, Prakash Rajoli","doi":"10.3126/mjsbh.v19i2.28666","DOIUrl":"https://doi.org/10.3126/mjsbh.v19i2.28666","url":null,"abstract":"Anti-NMDA encephalitis is second commonest cause of autoimmune encephalitis among children; however, it is hardly diagnosed and often not considered as one of the differentials when a child presents with encephalitis-related symptoms. In children, it presents mostly with seizures or psychiatric symptoms without prodrome. Here we present a six years old girl who presented with seizures and inappropriate behaviour. We investigated her in the line of viral encephalitis such as Japanese Encephalitis, which is very common in our region. However, results were not suggestive of Japanese Encephalitis and further investigations subsequently lead to diagnosis of antiNMDA encephalitis. This is probably one of the first case report of this disease in our country. We want to highlight the significance of high index of suspicion for looking out for an organic cause in any child who presents with psychiatric symptoms, along with seizures.","PeriodicalId":33963,"journal":{"name":"Medical Journal of Shree Birendra Hospital","volume":"19 1","pages":"108-111"},"PeriodicalIF":0.0,"publicationDate":"2020-06-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.3126/mjsbh.v19i2.28666","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43162496","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2020-06-26DOI: 10.3126/mjsbh.v19i2.28278
Sushil Rana Magar, P. Chand, B. B. Thapa, R. Sinha, R. Shah, D. Maharjan, Sushil Shrestha
Introduction: Stress fracture of neck of femur is known to occur in athletes and soldiers. From treatment perspective, this is still an unsolved fracture. The purpose of this study is to critically analyse the functional outcome of surgical treatment of stress fracture of neck of femur in military recruits performed by the same surgical team. Methods: This is a retrospective study of surgically treated femoral neck stress fracture from 1st December 2012 to 1st December 2013. All fractures were fixed with three 6.5 mm cancellous lag screws with washers. For failure of primary fixation or non-union, osteosynthesis with fibular strut graft was performed. Patients were evaluated at six weeks, 12 weeks, six months, 12 months and then yearly for three years. Functional outcome was evaluated by using Harris Hip Score at six months and at final follow-up. The outcome was followed up for six years up to Dec 2019. Results: There were eight males and one female patient. Mean age of patient was 20.7 years (Range, 19-23 years). Average follow-up period was 67.6 months (range 6-81). Lag screw fixation was done in five cases after closed reduction and in four cases after open reduction. Osteosynthesis with fibular graft was done in two cases. In six cases, fracture united at a mean duration of 9.8 months (Range 6-20). In three cases there was non-union of the fracture with added infection in one case. Avascular necrosis of femoral head developed in two cases. Conclusions: Successful surgical treatment of stress fracture of neck of femur requires anatomical reduction and stable interfragmentary compression with lag screws.
{"title":"Outcome of Surgical Treatment of Stress Fracture Neck of Femur in Military Recruits","authors":"Sushil Rana Magar, P. Chand, B. B. Thapa, R. Sinha, R. Shah, D. Maharjan, Sushil Shrestha","doi":"10.3126/mjsbh.v19i2.28278","DOIUrl":"https://doi.org/10.3126/mjsbh.v19i2.28278","url":null,"abstract":"Introduction: Stress fracture of neck of femur is known to occur in athletes and soldiers. From treatment perspective, this is still an unsolved fracture. The purpose of this study is to critically analyse the functional outcome of surgical treatment of stress fracture of neck of femur in military recruits performed by the same surgical team. Methods: This is a retrospective study of surgically treated femoral neck stress fracture from 1st December 2012 to 1st December 2013. All fractures were fixed with three 6.5 mm cancellous lag screws with washers. For failure of primary fixation or non-union, osteosynthesis with fibular strut graft was performed. Patients were evaluated at six weeks, 12 weeks, six months, 12 months and then yearly for three years. Functional outcome was evaluated by using Harris Hip Score at six months and at final follow-up. The outcome was followed up for six years up to Dec 2019. Results: There were eight males and one female patient. Mean age of patient was 20.7 years (Range, 19-23 years). Average follow-up period was 67.6 months (range 6-81). Lag screw fixation was done in five cases after closed reduction and in four cases after open reduction. Osteosynthesis with fibular graft was done in two cases. In six cases, fracture united at a mean duration of 9.8 months (Range 6-20). In three cases there was non-union of the fracture with added infection in one case. Avascular necrosis of femoral head developed in two cases. Conclusions: Successful surgical treatment of stress fracture of neck of femur requires anatomical reduction and stable interfragmentary compression with lag screws.","PeriodicalId":33963,"journal":{"name":"Medical Journal of Shree Birendra Hospital","volume":"19 1","pages":"90-96"},"PeriodicalIF":0.0,"publicationDate":"2020-06-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.3126/mjsbh.v19i2.28278","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"47103993","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2020-06-26DOI: 10.3126/mjsbh.v19i2.26640
B. Bhandari, B. Thapa, D. Ayer, S. Thapa, S. Bista
Introduction: The incidence of small and medium size renal stones is rising. Stone clearance, bleeding, urine leak and infectious complications are major concerns for urologist. Urologist chooses best technique from list of armamentarium available. Minimally invasive approach like Percutaneous Nephrolithotomy (PCNL) has significantly influenced the renal stone management since 1976. Miniaturisation of the instruments allow more effective and safer alternatives for urolithasis management. Methods: This is a retrospective study in which the outcome of mini PCNL (mPCNL) was compared with standard PCNL (sPCNL) in management of nephrolithiasis.
{"title":"Comparison Between Mini PCNL and Standard PCNL in Management of Nephrolithiasis","authors":"B. Bhandari, B. Thapa, D. Ayer, S. Thapa, S. Bista","doi":"10.3126/mjsbh.v19i2.26640","DOIUrl":"https://doi.org/10.3126/mjsbh.v19i2.26640","url":null,"abstract":"Introduction: The incidence of small and medium size renal stones is rising. Stone clearance, bleeding, urine leak and infectious complications are major concerns for urologist. Urologist chooses best technique from list of armamentarium available. Minimally invasive approach like Percutaneous Nephrolithotomy (PCNL) has significantly influenced the renal stone management since 1976. Miniaturisation of the instruments allow more effective and safer alternatives for urolithasis management. Methods: This is a retrospective study in which the outcome of mini PCNL (mPCNL) was compared with standard PCNL (sPCNL) in management of nephrolithiasis.","PeriodicalId":33963,"journal":{"name":"Medical Journal of Shree Birendra Hospital","volume":"40 25","pages":"80-83"},"PeriodicalIF":0.0,"publicationDate":"2020-06-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.3126/mjsbh.v19i2.26640","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41265453","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2020-06-26DOI: 10.3126/mjsbh.v19i2.29327
Raju Kafle
Journals are the essence of scholarly communication. They not only serve to disseminate latest scientific advancements but also provide a platform for archiving scholarly information for future reference, and allow a researcher to assert his or her scientific caliber. Selecting the most suitable journal to showcase one’s scholarly work is no mean feat. With more than 43,000 biomedical journals listed with PubMed1, the database maintained by United States National Library of Medicine (NLM), this exercise can easily baffle an inexperienced researcher. The huge risk of rejection of a paper from a journal that is not the right fit, and a widening web of dubious and predatory journals which publish almost everything sent to them, make this task particularly daunting. You may think that getting your paper into a journal with the highest possible impact factor is your only concern. However, this makes sense only if you think that you will be judged solely on the journal your paper is in rather than the quality and actual impact of the work. Although journal name and impact factor are still used to judge papers (or even researchers), the problems with this approach are becoming more widely known.2 Within one journal, papers can vary enormously in their quality and citations so it is unfair to judge a single paper by the mean number of citations in a whole journal.
{"title":"An Author’s Dilemma: Where to Publish?","authors":"Raju Kafle","doi":"10.3126/mjsbh.v19i2.29327","DOIUrl":"https://doi.org/10.3126/mjsbh.v19i2.29327","url":null,"abstract":"Journals are the essence of scholarly communication. They not only serve to disseminate latest scientific advancements but also provide a platform for archiving scholarly information for future reference, and allow a researcher to assert his or her scientific caliber. Selecting the most suitable journal to showcase one’s scholarly work is no mean feat. With more than 43,000 biomedical journals listed with PubMed1, the database maintained by United States National Library of Medicine (NLM), this exercise can easily baffle an inexperienced researcher. The huge risk of rejection of a paper from a journal that is not the right fit, and a widening web of dubious and predatory journals which publish almost everything sent to them, make this task particularly daunting. You may think that getting your paper into a journal with the highest possible impact factor is your only concern. However, this makes sense only if you think that you will be judged solely on the journal your paper is in rather than the quality and actual impact of the work. Although journal name and impact factor are still used to judge papers (or even researchers), the problems with this approach are becoming more widely known.2 Within one journal, papers can vary enormously in their quality and citations so it is unfair to judge a single paper by the mean number of citations in a whole journal.","PeriodicalId":33963,"journal":{"name":"Medical Journal of Shree Birendra Hospital","volume":"19 1","pages":"57-59"},"PeriodicalIF":0.0,"publicationDate":"2020-06-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.3126/mjsbh.v19i2.29327","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44795280","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2020-06-26DOI: 10.3126/mjsbh.v19i2.28380
S. Bhatta, M. Pradhan, Alina Singh, R. Chaudhary, Y. I. Singh
Introduction: Pseudomonas aeruginosa (P. aeruginosa) is one of the major cause of nosocomial infection. Multi-drug-resistant P. aeruginosa (MDR PA) are increasingly encountered in clinical samples .Therefore, this study was undertaken to know the sensitivity pattern of P. aeruginosa and to detect MDR PA from clinical samples. Methods: This was a laboratory based retrospective-cross sectional study conducted at Department of Microbiology at a tertiary care referral centre in Kathmandu, Nepal from December 2018 to December 2019. Total of 200 isolates of P. aeruginosa were isolated from clinical samples. Non repetitive sample per patient was included in the study. Samples were processed according to standard methodology and antimicrobial sensitivity testing (AMST) was carried out by Modified Kirby Bauer disk diffusion test as per Clinical Laboratory Standard Institute guideline. MDR was defined as strains resistant to one or more agent of ≥ 3 groups of antimicrobial categories. Results: Highest number of P. aeruginosa were isolated from sputum (93), followed by wound swab (35), and pus (29). AMST revealed the most sensitive drug to be Amikacin (91.51%) followed by Meropenem (78.5%) and Piperacillin/Tazobactam (77.50%). Out of 200 isolates, 69 (34.5%) were MDRPA. Conclusions: The information regarding sensitivity pattern of P. aeruginosa will help clinicians to choose most effective antimicrobials for the treatment of patients thus saving the time duration and total cost of patient management and also it will play a key role in setting antimicrobial stewardship policy.
{"title":"Antimicrobial Sensitivity Pattern of Pseudomonas Aeruginosa Isolated from a Tertiary Care Hospital","authors":"S. Bhatta, M. Pradhan, Alina Singh, R. Chaudhary, Y. I. Singh","doi":"10.3126/mjsbh.v19i2.28380","DOIUrl":"https://doi.org/10.3126/mjsbh.v19i2.28380","url":null,"abstract":"Introduction: Pseudomonas aeruginosa (P. aeruginosa) is one of the major cause of nosocomial infection. Multi-drug-resistant P. aeruginosa (MDR PA) are increasingly encountered in clinical samples .Therefore, this study was undertaken to know the sensitivity pattern of P. aeruginosa and to detect MDR PA from clinical samples. Methods: This was a laboratory based retrospective-cross sectional study conducted at Department of Microbiology at a tertiary care referral centre in Kathmandu, Nepal from December 2018 to December 2019. Total of 200 isolates of P. aeruginosa were isolated from clinical samples. Non repetitive sample per patient was included in the study. Samples were processed according to standard methodology and antimicrobial sensitivity testing (AMST) was carried out by Modified Kirby Bauer disk diffusion test as per Clinical Laboratory Standard Institute guideline. MDR was defined as strains resistant to one or more agent of ≥ 3 groups of antimicrobial categories. Results: Highest number of P. aeruginosa were isolated from sputum (93), followed by wound swab (35), and pus (29). AMST revealed the most sensitive drug to be Amikacin (91.51%) followed by Meropenem (78.5%) and Piperacillin/Tazobactam (77.50%). Out of 200 isolates, 69 (34.5%) were MDRPA. Conclusions: The information regarding sensitivity pattern of P. aeruginosa will help clinicians to choose most effective antimicrobials for the treatment of patients thus saving the time duration and total cost of patient management and also it will play a key role in setting antimicrobial stewardship policy.","PeriodicalId":33963,"journal":{"name":"Medical Journal of Shree Birendra Hospital","volume":"19 1","pages":"70-74"},"PeriodicalIF":0.0,"publicationDate":"2020-06-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.3126/mjsbh.v19i2.28380","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"48346350","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2020-06-26DOI: 10.3126/mjsbh.v19i2.27735
Binaya Shrestha, M. Pradhan
Introduction: Paediatric dentistry is the branch of dentistry dealing with children from birth to adolescence. Children tend to suffer from various dental conditions which can be primarily infective in nature and hence requires drugs that can be expensive. Drug utilisation data are needed for developing and monitoring policies because data on drug expenditure are not sufficient. Methods: This was a prospective cross-sectional study conducted in the Department of Pedodontics (paediatric dentistry) of a tertiary care teaching institute in Kathmandu, Nepal from July 2019 to December 2019. During the study period a total of 200 prescriptions were collected. Analysis was conducted using MS excel 2016 and further required analysis was done using Statistical Package for the Social Sciences v22.0. Results: A total of 200 prescriptions were analysed during the study period, of which 126 were males whereas 74 were females. The most common drug prescribed was paracetamol whereas amoxicillin was the most commonly prescribed antibiotics. Most common condition was periapical abscess but space infection was the most expensive condition.There was no statistically significance between the cost of drugs prescribed for the male and female patients. Conclusions: The drug prescription pattern was found to be rational. Every institution must have their own Drugs and Therapeutics Committee as has been suggested by WHO, so that patients will be benefited through decreasing economical burden, and adverse drug reactions and that by this, therapeutic effect will be increased.
儿科牙科是牙科的一个分支，治疗从出生到青春期的儿童。儿童往往患有各种各样的牙齿疾病，这些疾病本质上主要是传染性的，因此需要昂贵的药物。药物使用数据对于制定和监测政策是必要的，因为关于药物支出的数据并不充分。方法:这是一项前瞻性横断面研究，于2019年7月至2019年12月在尼泊尔加德满都的一家三级保健教学机构的儿科学(儿科牙科)部门进行。研究期间共收集处方200张。使用MS excel 2016进行分析，使用Statistical Package for the Social Sciences v22.0进行进一步必要的分析。结果:研究期间共分析处方200张，其中男性126张，女性74张。最常开的药物是扑热息痛，而阿莫西林是最常开的抗生素。最常见的是根尖周围脓肿，但最昂贵的是间隙感染。男女患者用药费用差异无统计学意义。结论:处方模式合理。正如世卫组织所建议的那样，每个机构都必须有自己的药物和治疗委员会，以便通过减少经济负担和药物不良反应使患者受益，从而提高治疗效果。
{"title":"A Prospective Drug Utilisation Study and Pharmacoeconomic Analysis in Paediatric Dentistry at a Tertiary Hospital","authors":"Binaya Shrestha, M. Pradhan","doi":"10.3126/mjsbh.v19i2.27735","DOIUrl":"https://doi.org/10.3126/mjsbh.v19i2.27735","url":null,"abstract":"Introduction: Paediatric dentistry is the branch of dentistry dealing with children from birth to adolescence. Children tend to suffer from various dental conditions which can be primarily infective in nature and hence requires drugs that can be expensive. Drug utilisation data are needed for developing and monitoring policies because data on drug expenditure are not sufficient. Methods: This was a prospective cross-sectional study conducted in the Department of Pedodontics (paediatric dentistry) of a tertiary care teaching institute in Kathmandu, Nepal from July 2019 to December 2019. During the study period a total of 200 prescriptions were collected. Analysis was conducted using MS excel 2016 and further required analysis was done using Statistical Package for the Social Sciences v22.0. Results: A total of 200 prescriptions were analysed during the study period, of which 126 were males whereas 74 were females. The most common drug prescribed was paracetamol whereas amoxicillin was the most commonly prescribed antibiotics. Most common condition was periapical abscess but space infection was the most expensive condition.There was no statistically significance between the cost of drugs prescribed for the male and female patients. Conclusions: The drug prescription pattern was found to be rational. Every institution must have their own Drugs and Therapeutics Committee as has been suggested by WHO, so that patients will be benefited through decreasing economical burden, and adverse drug reactions and that by this, therapeutic effect will be increased.","PeriodicalId":33963,"journal":{"name":"Medical Journal of Shree Birendra Hospital","volume":"19 1","pages":"60-64"},"PeriodicalIF":0.0,"publicationDate":"2020-06-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.3126/mjsbh.v19i2.27735","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43390968","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2020-06-26DOI: 10.3126/mjsbh.v19i2.27535
B. Rayamajhi, A. Khadka, N. Thapa
Introduction: There are various international guidelines for the surgical treatment of upper ureteral calculi. For upper ureteral stone of less than 10 mm size, ESWL and URS are regarded as first line treatment. However, there is lack of national guidelines for appropriate surgical options for such stone in our settings. Methods: The study was prospective comparative type involving 100 patients who were divided into ESWL and URS groups comprising 50 patients in each. ESWL and URS were performed after confirmation of stone size with ultrasonography and non-contrast enhanced computed tomography. All patients underwent X-ray KUB at one week and six weeks post procedure for confirmation of stone clearance. Those with residual calculi of size < 5 mm were considered stone free. Statistical analysis was done using Graph pad prism version 6. Results: The mean age of patients in ESWL and URS groups were 41.28 ± 15.3 years and 42.84 ± 16.1 years respectively. The male to female ratio was higher in ESWL group. The mean size of the stone pre ESWL was 8.58 mm and pre URS was 8.44 mm. The percentage of stone clearance at one week and six weeks for ESWL was 56% and 90% respectively whereas for URS, it was more than 90% at both one week and six weeks. The complications were higher with URS (20%) than ESWL (8%). Conclusions: The ESWL and URS are equally effective in stone clearance. The duration is longer with ESWL and the complications were more in URS group.
导读:输尿管上段结石的手术治疗有各种国际指南。对于小于10mm的输尿管上段结石，ESWL和URS被视为一线治疗。然而，在我们的环境中，缺乏适当的手术选择的国家指南。方法:采用前瞻性比较法，将100例患者分为ESWL组和URS组，每组各50例。超声和非增强计算机断层扫描确认结石大小后行ESWL和URS检查。所有患者在术后1周和6周接受x线KUB检查以确认结石清除。残余结石小于5mm者认为无结石。使用graphpad prism版本6进行统计分析。结果:ESWL组和URS组患者的平均年龄分别为41.28±15.3岁和42.84±16.1岁。ESWL组的男女比例较高。ESWL前的平均粒径为8.58 mm, URS前的平均粒径为8.44 mm。ESWL在1周和6周时结石清除率分别为56%和90%，而URS在1周和6周时结石清除率均超过90%。URS的并发症发生率(20%)高于ESWL(8%)。结论:ESWL和URS在清除结石方面同样有效。ESWL组持续时间更长，URS组并发症较多。
{"title":"A Prospective Study to Assess the Effectiveness of Extracorporeal Shock Wave Lithotripsy Versus Ureteroscopy for Proximal Ureteral Calculi Between Sizes 5 to 10 mm","authors":"B. Rayamajhi, A. Khadka, N. Thapa","doi":"10.3126/mjsbh.v19i2.27535","DOIUrl":"https://doi.org/10.3126/mjsbh.v19i2.27535","url":null,"abstract":"Introduction: There are various international guidelines for the surgical treatment of upper ureteral calculi. For upper ureteral stone of less than 10 mm size, ESWL and URS are regarded as first line treatment. However, there is lack of national guidelines for appropriate surgical options for such stone in our settings. Methods: The study was prospective comparative type involving 100 patients who were divided into ESWL and URS groups comprising 50 patients in each. ESWL and URS were performed after confirmation of stone size with ultrasonography and non-contrast enhanced computed tomography. All patients underwent X-ray KUB at one week and six weeks post procedure for confirmation of stone clearance. Those with residual calculi of size < 5 mm were considered stone free. Statistical analysis was done using Graph pad prism version 6. Results: The mean age of patients in ESWL and URS groups were 41.28 ± 15.3 years and 42.84 ± 16.1 years respectively. The male to female ratio was higher in ESWL group. The mean size of the stone pre ESWL was 8.58 mm and pre URS was 8.44 mm. The percentage of stone clearance at one week and six weeks for ESWL was 56% and 90% respectively whereas for URS, it was more than 90% at both one week and six weeks. The complications were higher with URS (20%) than ESWL (8%). Conclusions: The ESWL and URS are equally effective in stone clearance. The duration is longer with ESWL and the complications were more in URS group.","PeriodicalId":33963,"journal":{"name":"Medical Journal of Shree Birendra Hospital","volume":"19 1","pages":"65-69"},"PeriodicalIF":0.0,"publicationDate":"2020-06-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.3126/mjsbh.v19i2.27535","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44395157","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2020-01-14DOI: 10.3126/mjsbh.v19i1.26671
Sagar Mani Jha, N. Shakya, S. Shakya, M. Maharjan
Introduction: Leprosy is responsible for disability and deformity among patients. Nerve damage is one of the main features of leprosy and it is the main cause of disability in the patients. Developing deformity leads to restriction in professional work and hence reduced income as well as it also acts adversely on social wellbeing. The aim of this study was to study the spectrum of Grade 2 disability among all leprosy patients attending outpatient and inpatient according to WHO grading and to find the association with Ridley Jopling classification. Methods: It was an observational cross sectional hospital based study. All the inpatients and outpatients of leprosy getting treatment and were on follow up in the Department of Dermatology between December 2017 to November 2019 were included. Details of disability and deformity were recorded and were Classified as per WHO grading and Ridley Jopling classification. Cross tab was used in descriptive analysis to compare between different variables and data was analysed in percentage. Results: A total of 88 patients were included in the study. Maximum number of patients 41 (46.7%) belonged to 30 to 50 years of age group. Various degrees of loss of sensation was seen in all patients and total number of patients with Grade 1 disability were 68 (77.3%) and Grade 2 disability were 20 (22.7%). Maximum number of patients 11 (12.5%) with Grade 2 disability was seen in Lepromatous Leprosy. Conclusions: Disability and deformity can occur in any spectrum of disease and intervention as early as possible will help reduce the incidence.
{"title":"Disability and Deformity in Patients of Hansen’s Disease Attending a Tertiary Care Center in Nepal","authors":"Sagar Mani Jha, N. Shakya, S. Shakya, M. Maharjan","doi":"10.3126/mjsbh.v19i1.26671","DOIUrl":"https://doi.org/10.3126/mjsbh.v19i1.26671","url":null,"abstract":"Introduction: Leprosy is responsible for disability and deformity among patients. Nerve damage is one of the main features of leprosy and it is the main cause of disability in the patients. Developing deformity leads to restriction in professional work and hence reduced income as well as it also acts adversely on social wellbeing. The aim of this study was to study the spectrum of Grade 2 disability among all leprosy patients attending outpatient and inpatient according to WHO grading and to find the association with Ridley Jopling classification. Methods: It was an observational cross sectional hospital based study. All the inpatients and outpatients of leprosy getting treatment and were on follow up in the Department of Dermatology between December 2017 to November 2019 were included. Details of disability and deformity were recorded and were Classified as per WHO grading and Ridley Jopling classification. Cross tab was used in descriptive analysis to compare between different variables and data was analysed in percentage. Results: A total of 88 patients were included in the study. Maximum number of patients 41 (46.7%) belonged to 30 to 50 years of age group. Various degrees of loss of sensation was seen in all patients and total number of patients with Grade 1 disability were 68 (77.3%) and Grade 2 disability were 20 (22.7%). Maximum number of patients 11 (12.5%) with Grade 2 disability was seen in Lepromatous Leprosy. Conclusions: Disability and deformity can occur in any spectrum of disease and intervention as early as possible will help reduce the incidence.","PeriodicalId":33963,"journal":{"name":"Medical Journal of Shree Birendra Hospital","volume":"19 1","pages":"26-30"},"PeriodicalIF":0.0,"publicationDate":"2020-01-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.3126/mjsbh.v19i1.26671","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44262146","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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