Pub Date : 2024-04-02DOI: 10.3126/nmcj.v26i1.63886
J. Bajracharya, Bineet Thapa, Kaushal Oli, Deepika Lamichhane, Rit Shrestha
Phimosis is considered virtually universal in newborn males. Circumcision is mostly done for unresolved phimosis. There is a stream of evidence that suggests steroid cream application is effective in these children prior to any surgical decision. A cross-sectional descriptive study from October 2021 to November 2022, was designed to include all cases of phimosis in male children up to 15 years of age. Caregivers of the patients were counseled and advised for management with hydrocortisone 1.0% ointment twice a daily and follow up in 2 weeks. The resolution rates were noted in 2 weeks and 4 weeks and unresolved children were counseled for either continuation of medical management or circumcision. Electronic registry was used to enroll all the cases and note the outcomes. A total of 146 boys were evaluated. Median age of presentation was 4 years, 113 children (77.4%) were successfully treated with medical therapy and only 33 children (22.6%) had failed medical therapy requiring circumcision. A total of 66 children (58.4%) required only 1 followup for resolution of phimosis. By contrast, 47 children (41.6%) required more than 1 follow-up for resolution. Topical steroid in treatment of phimosis is a very safe, effective, inexpensive and easy approach that attenuates the need for surgical intervention. The response rate is very high and adverse effects are minimal. In the developing world, medical therapy can thus be more feasible of an option as compared to surgery.
{"title":"Evaluation of Medical Management of Phimosis in Pediatric Patients: A Descriptive Cross Sectional Study","authors":"J. Bajracharya, Bineet Thapa, Kaushal Oli, Deepika Lamichhane, Rit Shrestha","doi":"10.3126/nmcj.v26i1.63886","DOIUrl":"https://doi.org/10.3126/nmcj.v26i1.63886","url":null,"abstract":"Phimosis is considered virtually universal in newborn males. Circumcision is mostly done for unresolved phimosis. There is a stream of evidence that suggests steroid cream application is effective in these children prior to any surgical decision. A cross-sectional descriptive study from October 2021 to November 2022, was designed to include all cases of phimosis in male children up to 15 years of age. Caregivers of the patients were counseled and advised for management with hydrocortisone 1.0% ointment twice a daily and follow up in 2 weeks. The resolution rates were noted in 2 weeks and 4 weeks and unresolved children were counseled for either continuation of medical management or circumcision. Electronic registry was used to enroll all the cases and note the outcomes. A total of 146 boys were evaluated. Median age of presentation was 4 years, 113 children (77.4%) were successfully treated with medical therapy and only 33 children (22.6%) had failed medical therapy requiring circumcision. A total of 66 children (58.4%) required only 1 followup for resolution of phimosis. By contrast, 47 children (41.6%) required more than 1 follow-up for resolution. Topical steroid in treatment of phimosis is a very safe, effective, inexpensive and easy approach that attenuates the need for surgical intervention. The response rate is very high and adverse effects are minimal. In the developing world, medical therapy can thus be more feasible of an option as compared to surgery.","PeriodicalId":506882,"journal":{"name":"Nepal Medical College Journal","volume":"256 3","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-04-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140751432","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}
Dengue viral infection is a disease transmitted by mosquitoes of the Aedes genus, and it arises as a result of being bitten by mosquitoes that are carrying the virus. This infection induces a wide range of changes in the body’s immune system. Thus serological evaluation together with hematological and biochemical parameters in cases of dengue viral infection make an accurate clinical diagnosis. The main objective of this study was to study the serological, hematological, and biochemical parameters among patients infected with Dengue virus. A total of 102 blood samples were collected at Asrik Diagnostic Lab, Lalitpur during the period of August to October 2022. Samples were analyzed by following methods: hematological tests were done by coulter counter, Biochemical tests were done by fully automated analyzer and serological tests were done by ELISA. Of the 102 blood samples NS1 antigen was detected in 62 (60.9%) whereas anti-dengue IgM antibody was detected in 10 (9.8%). Leukopenia and thrombocytopenia were present in 33 (53.1%) and 32 (51.6%) of the 62 NS1 positive samples, respectively. Of the 62 cases, only 16 samples were tested for the alanine aminotransferase (ALT) and aspartate aminotransferase (AST). Out of 16 samples, ALT and AST level were significantly higher in 11 (68.8%) and 14 (87.5%) positive cases, respectively. The statistical analysis showed that there was no significant association between NS1 and IgM. It can be concluded that the investigation of leukocytes, thrombocytes, ALT, and AST helps to diagnose the dengue efficiently.
{"title":"Hematological and Biochemical Profiles of Patients with Dengue Virus Infection in Lalitpur, Nepal","authors":"Indira Rai, Subash Paudel, Santosh Shrestha, Debbie Manandhar, Shiba Kumar Rai","doi":"10.3126/nmcj.v26i1.63877","DOIUrl":"https://doi.org/10.3126/nmcj.v26i1.63877","url":null,"abstract":"Dengue viral infection is a disease transmitted by mosquitoes of the Aedes genus, and it arises as a result of being bitten by mosquitoes that are carrying the virus. This infection induces a wide range of changes in the body’s immune system. Thus serological evaluation together with hematological and biochemical parameters in cases of dengue viral infection make an accurate clinical diagnosis. The main objective of this study was to study the serological, hematological, and biochemical parameters among patients infected with Dengue virus. A total of 102 blood samples were collected at Asrik Diagnostic Lab, Lalitpur during the period of August to October 2022. Samples were analyzed by following methods: hematological tests were done by coulter counter, Biochemical tests were done by fully automated analyzer and serological tests were done by ELISA. Of the 102 blood samples NS1 antigen was detected in 62 (60.9%) whereas anti-dengue IgM antibody was detected in 10 (9.8%). Leukopenia and thrombocytopenia were present in 33 (53.1%) and 32 (51.6%) of the 62 NS1 positive samples, respectively. Of the 62 cases, only 16 samples were tested for the alanine aminotransferase (ALT) and aspartate aminotransferase (AST). Out of 16 samples, ALT and AST level were significantly higher in 11 (68.8%) and 14 (87.5%) positive cases, respectively. The statistical analysis showed that there was no significant association between NS1 and IgM. It can be concluded that the investigation of leukocytes, thrombocytes, ALT, and AST helps to diagnose the dengue efficiently.","PeriodicalId":506882,"journal":{"name":"Nepal Medical College Journal","volume":"15 15","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-04-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140753992","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 : 2024-04-02DOI: 10.3126/nmcj.v26i1.63873
Mohan Khadka, K. K. Bhomi, Bineet Thapa, Anup Gautam, Mansi Ghimire, Adwitiya Jha
In patients undergoing fixed orthodontic therapy, favorable conditions for plaque stagnation as well as difficulty in performing usual oral hygiene measures have been associated with poorer periodontal health among orthodontic patients. So this study aims to assess the effect of the duration of fixed orthodontic treatment on presence of gingival enlargement in adolescents and young adults. This cross sectional descriptive study was conducted in the dental hospital of Nepal Medical College Teaching Hospital. Patients under fixed orthodontic therapy for at least 3 months were examined for the presence of gingival enlargement (GE). Demographic variables and the details of duration of the fixed orthodontic therapy was recorded along with presence of gingival enlargement and its grading. The oral hygiene habits like frequency of brushing, use of interdental cleaning aids were recorded along with plaque index. Gingival enlargement was present in 204 (63.7%) out of total 320 patients taken, among which 124 patients (38.8%) had gingival enlargement of score 1 and 80 (25.0%) patients had gingival enlargement of score 2. Gingival enlargement was observed in 101 (73.2%) in 20-30 years old patients which was more prevalent in this age group. Oral hygiene habits like frequency of brushing and use of interdental aids also seem to affect the occurrence of gingival enlargement in patients. Among those who were undergoing orthodontic therapy for more than 2 years, 48 (82.8%) had presence of gingival enlargement. Mean of plaque index was seen to be statistically associated with presence of gingival enlargement. Thus, this study showed that the duration of orthodontic treatment duration significantly influenced the occurrence of GE. Therefore, oral hygiene instructions and motivations should be reinforced for patients undergoing orthodontic treatment.
{"title":"Outcome of Real Time Self-visualization of Rigid Cystoscopy Procedure on Procedural Pain in Male Patients","authors":"Mohan Khadka, K. K. Bhomi, Bineet Thapa, Anup Gautam, Mansi Ghimire, Adwitiya Jha","doi":"10.3126/nmcj.v26i1.63873","DOIUrl":"https://doi.org/10.3126/nmcj.v26i1.63873","url":null,"abstract":"In patients undergoing fixed orthodontic therapy, favorable conditions for plaque stagnation as well as difficulty in performing usual oral hygiene measures have been associated with poorer periodontal health among orthodontic patients. So this study aims to assess the effect of the duration of fixed orthodontic treatment on presence of gingival enlargement in adolescents and young adults. This cross sectional descriptive study was conducted in the dental hospital of Nepal Medical College Teaching Hospital. Patients under fixed orthodontic therapy for at least 3 months were examined for the presence of gingival enlargement (GE). Demographic variables and the details of duration of the fixed orthodontic therapy was recorded along with presence of gingival enlargement and its grading. The oral hygiene habits like frequency of brushing, use of interdental cleaning aids were recorded along with plaque index. Gingival enlargement was present in 204 (63.7%) out of total 320 patients taken, among which 124 patients (38.8%) had gingival enlargement of score 1 and 80 (25.0%) patients had gingival enlargement of score 2. Gingival enlargement was observed in 101 (73.2%) in 20-30 years old patients which was more prevalent in this age group. Oral hygiene habits like frequency of brushing and use of interdental aids also seem to affect the occurrence of gingival enlargement in patients. Among those who were undergoing orthodontic therapy for more than 2 years, 48 (82.8%) had presence of gingival enlargement. Mean of plaque index was seen to be statistically associated with presence of gingival enlargement. Thus, this study showed that the duration of orthodontic treatment duration significantly influenced the occurrence of GE. Therefore, oral hygiene instructions and motivations should be reinforced for patients undergoing orthodontic treatment.","PeriodicalId":506882,"journal":{"name":"Nepal Medical College Journal","volume":"28 15","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-04-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140754128","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 : 2024-04-02DOI: 10.3126/nmcj.v26i1.63893
Arnija Rana, D. P. Thapa, Shristi Shrestha, Prabin Adhikari, Asim Shrestha
Rowell’s syndrome (RS) is a rare disorder characterized by Erythema multiforme (EM)-like lesions in a patient with lupus erythematosus, either systemic lupus erythematosus (SLE) or cutaneous lupus erythematosus (CLE). A 35 years old female presented in our dermatology outpatient department (OPD) with complaint of hemorrhagic crusting of lips and multiple discrete targetoid lesions over the chest, upper limb, and gluteal region. Investigations revealed a speckled pattern of antinuclear antibody (ANA), anti-Smith antibody, anti-ds DNA antibody, and strongly positive anti-Ro antibody. According to the clinical evaluation and investigations, the diagnosis of drug induced RS was made. The likely role of proton pump inhibitors, namely esomeprazole as a triggering factor is discussed. After stopping esomeprazole and starting medications with oral steroids and hydroxychloroquine, her good response to treatment was noted.
{"title":"Drug Induced Rowell’s Syndrome: A Rare Presentation","authors":"Arnija Rana, D. P. Thapa, Shristi Shrestha, Prabin Adhikari, Asim Shrestha","doi":"10.3126/nmcj.v26i1.63893","DOIUrl":"https://doi.org/10.3126/nmcj.v26i1.63893","url":null,"abstract":"Rowell’s syndrome (RS) is a rare disorder characterized by Erythema multiforme (EM)-like lesions in a patient with lupus erythematosus, either systemic lupus erythematosus (SLE) or cutaneous lupus erythematosus (CLE). A 35 years old female presented in our dermatology outpatient department (OPD) with complaint of hemorrhagic crusting of lips and multiple discrete targetoid lesions over the chest, upper limb, and gluteal region. Investigations revealed a speckled pattern of antinuclear antibody (ANA), anti-Smith antibody, anti-ds DNA antibody, and strongly positive anti-Ro antibody. According to the clinical evaluation and investigations, the diagnosis of drug induced RS was made. The likely role of proton pump inhibitors, namely esomeprazole as a triggering factor is discussed. After stopping esomeprazole and starting medications with oral steroids and hydroxychloroquine, her good response to treatment was noted.","PeriodicalId":506882,"journal":{"name":"Nepal Medical College Journal","volume":"42 12","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-04-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140755619","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 : 2024-04-02DOI: 10.3126/nmcj.v26i1.63874
Alina Acharya, Meera Bista
Tonsillectomy is the complete removal of a tonsil from its bed and is one of the most common procedures in Otorhinolaryngology. The intensity of post-operative pain is severe enough to cause dysphagia which subsequently leads to infection of the fossa and other complications. Several studies on pain management have been conducted but not a single standard protocol currently exist. This study aims to evaluate the intensity of post tonsillectomy pain and to assess the efficacy of infiltration of Bupivacaine on the tonsillar fossa following tonsillectomy. A comparative study was conducted at Kathmandu Medical College, ENT-HNS department for a period of 18 months (January 2018 to June 2019). Ninety three patients were included. 2.5 ml of 0.5% Bupivacaine was infiltrated in right tonsillar fossa after tonsillectomy in all patients. The lateralization and intensity of pain at various post-operative period was assessed using visual analogue scale. The requirement of extra analgesics at various post-operative period was recorded. The pain score on the Bupivacaine side on the first and second post-operative day was decreased as compared to the other side. The pain score on the fourth hour and third post-operative day on Bupivacaine side was more than that of the other side. Infiltration of Bupivacaine over the tonsillar fossa has provided a good result with a significant reduction of pain in first post-operative day and in early post-operative period. However, other multi-centered and double blinded study is requires to provide better results.
{"title":"Comparison of Post-operative Pain with and without Infiltration of Bupivacaine Hydrochloride in Tonsillectomy","authors":"Alina Acharya, Meera Bista","doi":"10.3126/nmcj.v26i1.63874","DOIUrl":"https://doi.org/10.3126/nmcj.v26i1.63874","url":null,"abstract":"Tonsillectomy is the complete removal of a tonsil from its bed and is one of the most common procedures in Otorhinolaryngology. The intensity of post-operative pain is severe enough to cause dysphagia which subsequently leads to infection of the fossa and other complications. Several studies on pain management have been conducted but not a single standard protocol currently exist. This study aims to evaluate the intensity of post tonsillectomy pain and to assess the efficacy of infiltration of Bupivacaine on the tonsillar fossa following tonsillectomy. A comparative study was conducted at Kathmandu Medical College, ENT-HNS department for a period of 18 months (January 2018 to June 2019). Ninety three patients were included. 2.5 ml of 0.5% Bupivacaine was infiltrated in right tonsillar fossa after tonsillectomy in all patients. The lateralization and intensity of pain at various post-operative period was assessed using visual analogue scale. The requirement of extra analgesics at various post-operative period was recorded. The pain score on the Bupivacaine side on the first and second post-operative day was decreased as compared to the other side. The pain score on the fourth hour and third post-operative day on Bupivacaine side was more than that of the other side. Infiltration of Bupivacaine over the tonsillar fossa has provided a good result with a significant reduction of pain in first post-operative day and in early post-operative period. However, other multi-centered and double blinded study is requires to provide better results.","PeriodicalId":506882,"journal":{"name":"Nepal Medical College Journal","volume":"98 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-04-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140751656","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 : 2024-04-02DOI: 10.3126/nmcj.v26i1.63891
B. Gorkhali, M. Amatya
Cervical cancer is considered a cancer that is preventable by means of vaccination against human papilloma virus (HPV) and early detection by screening. Its incidence is decreasing in developed countries but not in developing countries, including Nepal. Disease ignorance and low awareness about available preventive health services are the main causes for cervical cancer still being a leading cause of death by cancer. We evaluated the effectiveness of a health educational intervention in improving women’s knowledge about cervical cancer and its prevention in a semi-urban community of Kathmandu. Health education was provided in an interactive lecture for women of reproductive age in various wards of Shankarapur Municipality, Kathmandu. Its effectiveness was assessed by comparing the level of knowledge before and four weeks after the intervention, by interviewing participants based on a questionnaire consisting of 48 questions. The study was completed in 126 women (mean age 33.5 years). The mean pre-test and post-test correct scores were 10.2 and 42.13 respectively (p <0.001). Initially, 96.8% had poor knowledge (score <60.0% of total); post-intervention, 87.3% had good knowledge (score ≥80.0%, p <0.001). Knowledge before intervention was especially poor among older age, less educated, housewives or doing small business, and married women (p <0.001). Knowledge of cervical cancer and its prevention is poor among community women. A health education is very effective in improving women’s knowledge and should be implemented as a policy to achieve the goal of eliminating cervical cancer as a public health issue.
{"title":"Effectiveness of Health Education Intervention on Knowledge Regarding Prevention of Cervical Cancer among Women in a Selected Community of Kathmandu, Nepal","authors":"B. Gorkhali, M. Amatya","doi":"10.3126/nmcj.v26i1.63891","DOIUrl":"https://doi.org/10.3126/nmcj.v26i1.63891","url":null,"abstract":"Cervical cancer is considered a cancer that is preventable by means of vaccination against human papilloma virus (HPV) and early detection by screening. Its incidence is decreasing in developed countries but not in developing countries, including Nepal. Disease ignorance and low awareness about available preventive health services are the main causes for cervical cancer still being a leading cause of death by cancer. We evaluated the effectiveness of a health educational intervention in improving women’s knowledge about cervical cancer and its prevention in a semi-urban community of Kathmandu. Health education was provided in an interactive lecture for women of reproductive age in various wards of Shankarapur Municipality, Kathmandu. Its effectiveness was assessed by comparing the level of knowledge before and four weeks after the intervention, by interviewing participants based on a questionnaire consisting of 48 questions. The study was completed in 126 women (mean age 33.5 years). The mean pre-test and post-test correct scores were 10.2 and 42.13 respectively (p <0.001). Initially, 96.8% had poor knowledge (score <60.0% of total); post-intervention, 87.3% had good knowledge (score ≥80.0%, p <0.001). Knowledge before intervention was especially poor among older age, less educated, housewives or doing small business, and married women (p <0.001). Knowledge of cervical cancer and its prevention is poor among community women. A health education is very effective in improving women’s knowledge and should be implemented as a policy to achieve the goal of eliminating cervical cancer as a public health issue.","PeriodicalId":506882,"journal":{"name":"Nepal Medical College Journal","volume":"129 ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-04-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140755172","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 : 2023-12-22DOI: 10.3126/nmcj.v25i4.60932
Maryada Malla, Sandesh Poudel
Bladder stones are rare and account for approximately 5.0% of all urinary tract stones. The presence of bladder stones places the pregnancy at risk for adverse outcomes including recurrent urinary tract infections, preterm labour, and obstructed labour. Prompt and accurate diagnosis requires a high degree of suspicion and judicious use of diagnostic imaging given the higher risks of radiation exposure. Treatment ranges from conservative to more invasive approaches. Thus, management needs to be individualized to the patient with careful consideration of the potential adverse effects. We report a case of bladder stone in mid-pregnancy that was treated by open cystolithotomy.
{"title":"Bladder stone in pregnancy: a rare encounter","authors":"Maryada Malla, Sandesh Poudel","doi":"10.3126/nmcj.v25i4.60932","DOIUrl":"https://doi.org/10.3126/nmcj.v25i4.60932","url":null,"abstract":"Bladder stones are rare and account for approximately 5.0% of all urinary tract stones. The presence of bladder stones places the pregnancy at risk for adverse outcomes including recurrent urinary tract infections, preterm labour, and obstructed labour. Prompt and accurate diagnosis requires a high degree of suspicion and judicious use of diagnostic imaging given the higher risks of radiation exposure. Treatment ranges from conservative to more invasive approaches. Thus, management needs to be individualized to the patient with careful consideration of the potential adverse effects. We report a case of bladder stone in mid-pregnancy that was treated by open cystolithotomy.","PeriodicalId":506882,"journal":{"name":"Nepal Medical College Journal","volume":"33 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-12-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139164681","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 : 2023-12-22DOI: 10.3126/nmcj.v25i4.60925
Anshumala Joshi, Nishchal Dhakal
The world witnessed the introduction of the COVID -19 virus in December 2019. This caused a pandemic for the next two to three years causing 7,67,984,989 deaths worldwide. A hospital based cross sectional descriptive study conducted in the Obstetrics and Gynecology department of Nepal Medical College Teaching Hospital, which is located in a suburban area of Kathmandu. The objective of the study was to assess the knowledge, attitude and practice of the pregnant women regarding the COVID pandemic pre and post-vaccination and its correlation with socio-demographic factors like age and educational level. A total of 418 women participated in the study. In each phase there were 209 women. In the pre-vaccination phase, 8.1% women had good knowledge, 37.8% had positive attitude, and 37.3% good practice. In the post-vaccination phase, 44.5% had good knowledge, 65.5% had positive attitude, and 84.7% had good practices.
{"title":"Knowledge, attitude and practice of pregnant women attending a health facility regarding the COVID -19 pandemic: pre and post-vaccination","authors":"Anshumala Joshi, Nishchal Dhakal","doi":"10.3126/nmcj.v25i4.60925","DOIUrl":"https://doi.org/10.3126/nmcj.v25i4.60925","url":null,"abstract":"The world witnessed the introduction of the COVID -19 virus in December 2019. This caused a pandemic for the next two to three years causing 7,67,984,989 deaths worldwide. A hospital based cross sectional descriptive study conducted in the Obstetrics and Gynecology department of Nepal Medical College Teaching Hospital, which is located in a suburban area of Kathmandu. The objective of the study was to assess the knowledge, attitude and practice of the pregnant women regarding the COVID pandemic pre and post-vaccination and its correlation with socio-demographic factors like age and educational level. A total of 418 women participated in the study. In each phase there were 209 women. In the pre-vaccination phase, 8.1% women had good knowledge, 37.8% had positive attitude, and 37.3% good practice. In the post-vaccination phase, 44.5% had good knowledge, 65.5% had positive attitude, and 84.7% had good practices.","PeriodicalId":506882,"journal":{"name":"Nepal Medical College Journal","volume":"5 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-12-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139164961","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 : 2023-12-22DOI: 10.3126/nmcj.v25i4.60874
Niraj Shrestha, Leepy Paudel, Prakriti Baral
Population ageing is a global phenomenon and proportion of elderly people is also increasing in Nepal. However, the increased burden of chronic disease as a result of population ageing, along with medical cost incurred during hospital stay is yet to be explored in Nepal. With the aim of studying these, data of 527 patients 70 years of age and above admitted to Nepal Medical College Teaching hospital, the largest tertiary care center in Gokarneshwor Municipality, was collected from November 2021 to November 2022 and analyzed. Seventy-four percent of the patients were of 70-80 years of age and male: female ratio was almost equal to 1:1. The most common cause of admission was respiratory problems. The cost was not more than Nepali rupees 19,200 for 82% of the patients and the duration of stay was less than 6 days for 75% of the patients. No significant association was found between duration of hospital stay and the age group or the gender. Similarly, no significant association was found between the medical cost incurred during hospital stay and the age group. However, association was found between the hospital cost and gender with males more likely to have higher cost.
{"title":"Hospital admissions and the financial cost incurred by the elderly patients at a tertiary care centre in Gokarneshwor Municipality, Kathmandu, Nepal","authors":"Niraj Shrestha, Leepy Paudel, Prakriti Baral","doi":"10.3126/nmcj.v25i4.60874","DOIUrl":"https://doi.org/10.3126/nmcj.v25i4.60874","url":null,"abstract":"Population ageing is a global phenomenon and proportion of elderly people is also increasing in Nepal. However, the increased burden of chronic disease as a result of population ageing, along with medical cost incurred during hospital stay is yet to be explored in Nepal. With the aim of studying these, data of 527 patients 70 years of age and above admitted to Nepal Medical College Teaching hospital, the largest tertiary care center in Gokarneshwor Municipality, was collected from November 2021 to November 2022 and analyzed. Seventy-four percent of the patients were of 70-80 years of age and male: female ratio was almost equal to 1:1. The most common cause of admission was respiratory problems. The cost was not more than Nepali rupees 19,200 for 82% of the patients and the duration of stay was less than 6 days for 75% of the patients. No significant association was found between duration of hospital stay and the age group or the gender. Similarly, no significant association was found between the medical cost incurred during hospital stay and the age group. However, association was found between the hospital cost and gender with males more likely to have higher cost.","PeriodicalId":506882,"journal":{"name":"Nepal Medical College Journal","volume":"123 3","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-12-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139163955","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 : 2023-12-22DOI: 10.3126/nmcj.v25i4.60922
Y. Limbu, S. Regmee, Spandan Darshan Adhikari, Bidur Prasad Acharya, R. Ghimire
The worldwide trend of appendectomy is shifting from conventional open to the laparoscopic technique. The study’s objective was to compare laparoscopic and open appendectomy in terms of various operative and postoperative parameters to find the best operative technique. A prospective comparative study was conducted on 142 patients undergoing laparoscopic (n=43) or open appendectomy (n=99) from 1st February 2022 to 30th January 2023 under the Department of Surgery of Kathmandu Medical College Teaching Hospital (KMCTH). In five patients, laparoscopic appendectomy was later converted to open and excluded from the study. The mean operating time for the open appendectomy group was 44.1±13.1 minutes while for the laparoscopic appendectomy group, it was 48.4±14.0 minutes (p=0.047). Visual analogue score taken on 1st, 7th and 30th post-operative day for open and laparoscopic appendectomy were 4.0±2.2 vs 3.6±1.9 (p=0.160); 1.4±1.3 vs 0.6±0.9 (p<0.001) and 0.2±0.5 vs 0.02±0.15 (p=0.107) respectively. The total days of postoperative hospital stay were 1.57±0.96 for open appendectomy and 1.58±1.07 for laparoscopic appendectomy (p=0.843). However, laparoscopic appendectomy group had an earlier return to normal activity (7.30±1.15 days) when compared to the open appendectomy group (8.05±2.42 days) (p=0.023). The laparoscopic appendectomy group also had fewer postoperative complications than the open appendectomy group (18.6% vs 24.2%) (p=0.411). Thus, laparoscopy is a safe and effective method of removal of appendix for acute appendicitis.
全球阑尾切除术的趋势正从传统的开腹手术转向腹腔镜技术。本研究的目的是比较腹腔镜阑尾切除术和开腹阑尾切除术的各种手术和术后参数，以找出最佳手术技术。自2022年2月1日至2023年1月30日，加德满都医学院教学医院（KMCTH）外科对142名接受腹腔镜阑尾切除术（43人）或开腹阑尾切除术（99人）的患者进行了前瞻性比较研究。有五名患者的腹腔镜阑尾切除术后来转为开腹手术，并被排除在研究之外。开腹阑尾切除术组的平均手术时间为（44.1±13.1）分钟，而腹腔镜阑尾切除术组为（48.4±14.0）分钟（P=0.047）。开腹和腹腔镜阑尾切除术后第1天、第7天和第30天的视觉模拟评分分别为4.0±2.2 vs 3.6±1.9（p=0.160）；1.4±1.3 vs 0.6±0.9（p<0.001）和0.2±0.5 vs 0.02±0.15（p=0.107）。开腹阑尾切除术的术后住院总天数为1.57±0.96天，腹腔镜阑尾切除术为1.58±1.07天（P=0.843）。然而，与开腹阑尾切除术组（8.05±2.42 天）相比，腹腔镜阑尾切除术组恢复正常活动的时间更早（7.30±1.15 天）（P=0.023）。腹腔镜阑尾切除术组的术后并发症也少于开腹阑尾切除术组（18.6% vs 24.2%）（P=0.411）。因此，腹腔镜是一种安全有效的急性阑尾炎阑尾切除方法。
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