Pub Date : 2023-07-17DOI: 10.3126/jonmc.v12i1.56496
Y. Shakya, Samjhana Basnet, Latika Giri, Ajay K.C., R. Karmacharya
Background: Laparoscopic surgery, a minimally invasive procedure, has gained popularity due to early recovery rate and minimal incision. Port site infection following laparoscopic surgery is an infrequent complication, increasing patient's morbidity, and also damaging surgeon's reputation. It depends on sterilization and surgical techniques, which have improved with time. The aim of this study is to evaluate the role of prophylactic antibiotics in preventing port site infection after laparoscopic cholecystectomy. Materials and Methods: A comparative cross-sectional study on 200 patients undergoing elective laparoscopic cholecystectomy was conducted from November 2021 to February 2022 in tertiary care Hospital by using systematic random sampling.Among the 200 patients, 100 odd numbered patients were given antibiotics, and 100 even numbered patients were not. The outcome of the two groups was measured with regard to port site infection. Results: The mean age in prophylactic antibiotic receiving group and not receiving group was 42.13 (SD = 14.41) and 42.71(SD = 14.29) years, respectively. The female: male ratio for total patients was 2.77.There were three cases of port site infection in total, in group receiving antibiotics (Cefotaxime), there was one case, whereas in placebo group, there were two. Simple logistic regression was utilized to compare the results of two groups (p>0.05). Similarly, Chi-square test was applied to histopathology diagnosis, which showed no statistically significant difference (χ2 = 0.99, P = 0.80). Conclusion: Antibiotic prophylaxis does not lower the rate of infectious in patients undergoing elective laparoscopic cholecystectomy.
{"title":"Port Site Infection after Elective Laparoscopic Cholecystectomy with or without the Use of Prophylactic Antibiotics: A Comparative Cross-Sectional Study","authors":"Y. Shakya, Samjhana Basnet, Latika Giri, Ajay K.C., R. Karmacharya","doi":"10.3126/jonmc.v12i1.56496","DOIUrl":"https://doi.org/10.3126/jonmc.v12i1.56496","url":null,"abstract":"Background: Laparoscopic surgery, a minimally invasive procedure, has gained popularity due to early recovery rate and minimal incision. Port site infection following laparoscopic surgery is an infrequent complication, increasing patient's morbidity, and also damaging surgeon's reputation. It depends on sterilization and surgical techniques, which have improved with time. The aim of this study is to evaluate the role of prophylactic antibiotics in preventing port site infection after laparoscopic cholecystectomy. \u0000Materials and Methods: A comparative cross-sectional study on 200 patients undergoing elective laparoscopic cholecystectomy was conducted from November 2021 to February 2022 in tertiary care Hospital by using systematic random sampling.Among the 200 patients, 100 odd numbered patients were given antibiotics, and 100 even numbered patients were not. The outcome of the two groups was measured with regard to port site infection. \u0000Results: The mean age in prophylactic antibiotic receiving group and not receiving group was 42.13 (SD = 14.41) and 42.71(SD = 14.29) years, respectively. The female: male ratio for total patients was 2.77.There were three cases of port site infection in total, in group receiving antibiotics (Cefotaxime), there was one case, whereas in placebo group, there were two. Simple logistic regression was utilized to compare the results of two groups (p>0.05). Similarly, Chi-square test was applied to histopathology diagnosis, which showed no statistically significant difference (χ2 = 0.99, P = 0.80). \u0000Conclusion: Antibiotic prophylaxis does not lower the rate of infectious in patients undergoing elective laparoscopic cholecystectomy.","PeriodicalId":52824,"journal":{"name":"Journal of Nobel Medical College","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-07-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"47125561","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 : 2023-07-17DOI: 10.3126/jonmc.v12i1.56282
A. Giri, V. Sah, S. Yadav, Niraj S. Yadav
Background: Pediatric poisoning is common emergency worldwide and represents major and preventable cause of morbidity and mortality in children. The study describes epidemiology and outcome of acute poisonings in children presenting to Nobel Medical College through Emergency and Outpatient department and determines causative agents and characteristics of acute poisoning in several pediatric age groups. Material and Methods: This was hospital based prospective cross-sectional study which included all acutely poisoned patients under 18yrs age of either sex who presented to Nobel Medical College Teaching Hospital during 1year period (January 2021 to December 2021). Various socio-demographic variables, poisoning details, clinical manifestations, treatment given, outcome and complications were entered in predesigned proforma. Data was entered in excel sheet and descriptive analysis was done using SPSS software (version 20). Results: During the study period total 56 children with poisoning were admitted and enrolled. The mean age (±SD) of children with poisoning was 8.18 ± 5.50 Years. Poisoning cases werepredominant in male children (n=56, 53.6%). The most common poison wasorganophosphates(OP) compounds (41.1%). More than three-fourth of cases (92.9%) were symptomatic where nausea/vomiting (78.6%) was most common clinical symptoms, About 83.9% children survived, 10.7% expired and 5.4% left against medical advice (LAMA). Complications were seen in about 37.5% where shock was most common complications Conclusion: Poisoning was common in adolescent age group.Overall nature of poisoning was accidental however, in adolescent age group majority of them were suicidal in nature.Organophosphates (OP) compounds was most common type of poisoning
{"title":"Clinico-Epidemiological Profile and Outcome of Poisoning in Children Presenting at a Tertiary Care Hospital of Eastern Nepal","authors":"A. Giri, V. Sah, S. Yadav, Niraj S. Yadav","doi":"10.3126/jonmc.v12i1.56282","DOIUrl":"https://doi.org/10.3126/jonmc.v12i1.56282","url":null,"abstract":"Background: Pediatric poisoning is common emergency worldwide and represents major and preventable cause of morbidity and mortality in children. The study describes epidemiology and outcome of acute poisonings in children presenting to Nobel Medical College through Emergency and Outpatient department and determines causative agents and characteristics of acute poisoning in several pediatric age groups. \u0000Material and Methods: This was hospital based prospective cross-sectional study which included all acutely poisoned patients under 18yrs age of either sex who presented to Nobel Medical College Teaching Hospital during 1year period (January 2021 to December 2021). Various socio-demographic variables, poisoning details, clinical manifestations, treatment given, outcome and complications were entered in predesigned proforma. Data was entered in excel sheet and descriptive analysis was done using SPSS software (version 20). \u0000Results: During the study period total 56 children with poisoning were admitted and enrolled. The mean age (±SD) of children with poisoning was 8.18 ± 5.50 Years. Poisoning cases werepredominant in male children (n=56, 53.6%). The most common poison wasorganophosphates(OP) compounds (41.1%). More than three-fourth of cases (92.9%) were symptomatic where nausea/vomiting (78.6%) was most common clinical symptoms, About 83.9% children survived, 10.7% expired and 5.4% left against medical advice (LAMA). Complications were seen in about 37.5% where shock was most common complications \u0000Conclusion: Poisoning was common in adolescent age group.Overall nature of poisoning was accidental however, in adolescent age group majority of them were suicidal in nature.Organophosphates (OP) compounds was most common type of poisoning","PeriodicalId":52824,"journal":{"name":"Journal of Nobel Medical College","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-07-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44301404","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 : 2023-07-17DOI: 10.3126/jonmc.v12i1.56340
K. Shrestha, P. Singh, K. R. Yadav, G. Singh
Background: Urinary tract infection (UTI) is defined as growth of micro-organisms >105 CFU/ml in mid-stream urine samples. [1] Globally, urinary tract infection is considered a major public health concern with the second most common bacterial infection affecting individuals of different ages. It is estimated that worldwide 150 million cases of UTI occur per year and bacteria are responsible for about 95% of all the cases with each year. [3, 4] This study was designed to describe the pattern of microorganisms causing UTI and their antibiotic sensitivity. Materials and Methods: This is a hospital based cross-sectional study conducted in the Department of Microbiology from January 2022 to June 2022 after taking ethical approval from Institutional Review Committee, Nobel Medical College and Teaching Hospital, Biratnagar, Nepal. The patient profiles or records visiting a tertiary care hospital of both sex and every age group who were having symptoms and clinical diagnosis of urinary tract infection were included. Results: A total of 2247 urine samples were collected, 501(22.29%) of the urine sample yielded significant growth of uropathogenes. The most common bacteria was found to be Escherichia coli (E. coli) that accounts for 73.05% followed by Enterococcus species 11.57%, Klebsiella pneumoniae 8.98% and amikacin and nitrofurantoin was found to be the most sensitive antibiotic to gram negative uropathogens. Conclusion: The prevalence of uropathogenes was found to be higher in our study. Significant bacteriuria was seen in the female than male. The total number of patient with culture positivity was higher in younger age groups with high frequency of antibiotic resistance
{"title":"Prevalence and Antibiogram of Bacterial Uropathogens from a Tertiary Care Hospital of Eastern Nepal","authors":"K. Shrestha, P. Singh, K. R. Yadav, G. Singh","doi":"10.3126/jonmc.v12i1.56340","DOIUrl":"https://doi.org/10.3126/jonmc.v12i1.56340","url":null,"abstract":"Background: Urinary tract infection (UTI) is defined as growth of micro-organisms >105 CFU/ml in mid-stream urine samples. [1] Globally, urinary tract infection is considered a major public health concern with the second most common bacterial infection affecting individuals of different ages. It is estimated that worldwide 150 million cases of UTI occur per year and bacteria are responsible for about 95% of all the cases with each year. [3, 4] This study was designed to describe the pattern of microorganisms causing UTI and their antibiotic sensitivity. \u0000Materials and Methods: This is a hospital based cross-sectional study conducted in the Department of Microbiology from January 2022 to June 2022 after taking ethical approval from Institutional Review Committee, Nobel Medical College and Teaching Hospital, Biratnagar, Nepal. The patient profiles or records visiting a tertiary care hospital of both sex and every age group who were having symptoms and clinical diagnosis of urinary tract infection were included. \u0000Results: A total of 2247 urine samples were collected, 501(22.29%) of the urine sample yielded significant growth of uropathogenes. The most common bacteria was found to be Escherichia coli (E. coli) that accounts for 73.05% followed by Enterococcus species 11.57%, Klebsiella pneumoniae 8.98% and amikacin and nitrofurantoin was found to be the most sensitive antibiotic to gram negative uropathogens. \u0000Conclusion: The prevalence of uropathogenes was found to be higher in our study. Significant bacteriuria was seen in the female than male. The total number of patient with culture positivity was higher in younger age groups with high frequency of antibiotic resistance","PeriodicalId":52824,"journal":{"name":"Journal of Nobel Medical College","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-07-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44218656","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 : 2023-07-17DOI: 10.3126/jonmc.v12i1.56263
N. K. Yadav, K. Kandel, R. Ghimire
Background: Chronic kidney disease affects the structure and function of the kidneys over a specific period of time. It is a worldwide public health related problem. It is usually associated with increasing age, hypertension, diabetes, cardiovascular disease and lack of exercise. Materials and Methods: It was a cross-sectional observational study conducted at Nobel Medical College Teaching Hospital. A total 150 patients were enrolled in this study from March 2021 to February 2022. Patients aged 18 years and above diagnosed with chronic kidney disease and treated with dialysis were included in this study. Statistical tools were used to describe the relevant data. Results: Chronic kidney disease was more predominant among males 90 (60%) than females 60 (40%). Thecommon co-morbid conditions were hypertension 51(34%) followed by hypertension & diabetes 40 (26.66%). 115 (76.66%) patients were receivinghemodialysis twice followed by 26 (17.33%) who were receiving it thrice a week. An average of 7.03 drugs per prescription was advised. Commonly used drugs were hydrocortisone 145 (96.66%), torsemide 90 (85.71%), and vitamin D3 105 (75%). Among the complications, the most commonly occurred were chills & rigor 15 (10%) followed by backache 12 (8%). Conclusion: Hydrocortisone, torsemide and Vit.D3, were prescribed medications in CKD patients maintained on hemodialysis. Hydrocortisone was commonly used at this tertiary care hospital. Chills & rigor and backache were complication occurred during hemodialysis.
{"title":"Pattern of Drug Prescription in Patients with Chronic Kidney Disease Maintained on Hemodialysis in a Tertiary Care Hospital","authors":"N. K. Yadav, K. Kandel, R. Ghimire","doi":"10.3126/jonmc.v12i1.56263","DOIUrl":"https://doi.org/10.3126/jonmc.v12i1.56263","url":null,"abstract":"Background: Chronic kidney disease affects the structure and function of the kidneys over a specific period of time. It is a worldwide public health related problem. It is usually associated with increasing age, hypertension, diabetes, cardiovascular disease and lack of exercise. \u0000Materials and Methods: It was a cross-sectional observational study conducted at Nobel Medical College Teaching Hospital. A total 150 patients were enrolled in this study from March 2021 to February 2022. Patients aged 18 years and above diagnosed with chronic kidney disease and treated with dialysis were included in this study. Statistical tools were used to describe the relevant data. \u0000Results: Chronic kidney disease was more predominant among males 90 (60%) than females 60 (40%). Thecommon co-morbid conditions were hypertension 51(34%) followed by hypertension & diabetes 40 (26.66%). 115 (76.66%) patients were receivinghemodialysis twice followed by 26 (17.33%) who were receiving it thrice a week. An average of 7.03 drugs per prescription was advised. Commonly used drugs were hydrocortisone 145 (96.66%), torsemide 90 (85.71%), and vitamin D3 105 (75%). Among the complications, the most commonly occurred were chills & rigor 15 (10%) followed by backache 12 (8%). \u0000Conclusion: Hydrocortisone, torsemide and Vit.D3, were prescribed medications in CKD patients maintained on hemodialysis. Hydrocortisone was commonly used at this tertiary care hospital. Chills & rigor and backache were complication occurred during hemodialysis.","PeriodicalId":52824,"journal":{"name":"Journal of Nobel Medical College","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-07-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"48322891","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 : 2023-07-17DOI: 10.3126/jonmc.v12i1.56390
B. Khanal, Sunilkumar. Yadav, S. Pokhrel, S. Singh, G. Baral, P. Kafle
Background: Neonatal mortality rate is very high in developing countries despite of advancement in perinatal and neonatal care with reduced neonatal mortality rate in many developed countries. This study aims to identify the reasons of admitting neonates for intensive care after vaginal delivery and their outcome. Materials and Methods: This is an observational descriptive study conducted for over a year at Nobel Medical College Teaching Hospital which included newborns delivered vaginally within the hospital. Demographic data of newborn and mother was obtained, birth weight, reason for admission and final outcome were documented. Outcomes were classified as improved with recovery, mortality and discharge on request prior to recovery. Descriptive statistics such as mean, percentage and standard deviation were obtained. Results: Total 117 neonates were admitted to intensive care out of 3452 vaginal deliveries with male to female ratio of 1.9:2. There were 60 (51.3%) preterm, 55 (47%) full term and 2 (1.7%) post term; and 68 (58.1%) were low birth weight. Prematurity with respiratory distress syndrome was the most common cause of admission (34.2%) along with birth asphyxia (29, 24.8%) and meconium aspiration syndrome (20, 17.1%). Positive Airway Pressure was required in 42 (35.9%). Blood Culture positive growth was seen in 17.9% with most common organism being Staphylococcus aureus. Mean stay was 3.75±2.49 days andmortality in the study population was 6.8%. Conclusion: Prematurity with respiratory distress syndrome, birth asphyxia and meconium aspiration syndrome were major indications for admission of newborns delivered via vaginal deliveries to neonatal intensive care unit. One-fourth required mechanical ventilation.
{"title":"Analysis of Neonatal Admission Patterns and Clinical Profiles in a Tertiary Care Center: Focus on Neonates Transferred from the Delivery Room to the Neonatal Intensive Care Unit","authors":"B. Khanal, Sunilkumar. Yadav, S. Pokhrel, S. Singh, G. Baral, P. Kafle","doi":"10.3126/jonmc.v12i1.56390","DOIUrl":"https://doi.org/10.3126/jonmc.v12i1.56390","url":null,"abstract":"Background: Neonatal mortality rate is very high in developing countries despite of advancement in perinatal and neonatal care with reduced neonatal mortality rate in many developed countries. This study aims to identify the reasons of admitting neonates for intensive care after vaginal delivery and their outcome. \u0000Materials and Methods: This is an observational descriptive study conducted for over a year at Nobel Medical College Teaching Hospital which included newborns delivered vaginally within the hospital. Demographic data of newborn and mother was obtained, birth weight, reason for admission and final outcome were documented. Outcomes were classified as improved with recovery, mortality and discharge on request prior to recovery. Descriptive statistics such as mean, percentage and standard deviation were obtained. \u0000Results: Total 117 neonates were admitted to intensive care out of 3452 vaginal deliveries with male to female ratio of 1.9:2. There were 60 (51.3%) preterm, 55 (47%) full term and 2 (1.7%) post term; and 68 (58.1%) were low birth weight. Prematurity with respiratory distress syndrome was the most common cause of admission (34.2%) along with birth asphyxia (29, 24.8%) and meconium aspiration syndrome (20, 17.1%). Positive Airway Pressure was required in 42 (35.9%). Blood Culture positive growth was seen in 17.9% with most common organism being Staphylococcus aureus. Mean stay was 3.75±2.49 days andmortality in the study population was 6.8%. \u0000Conclusion: Prematurity with respiratory distress syndrome, birth asphyxia and meconium aspiration syndrome were major indications for admission of newborns delivered via vaginal deliveries to neonatal intensive care unit. One-fourth required mechanical ventilation.","PeriodicalId":52824,"journal":{"name":"Journal of Nobel Medical College","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-07-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"47641342","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 : 2023-07-17DOI: 10.3126/jonmc.v12i1.56524
Dan Singh Budal, R. Bhatt, Chen Ling, C. Jing, Chunwei Ma, Xujun Ye
We present a case of 80 years woman chronic smoker (10 cigarettes)/ per day for 50 years diagnosed with adenocarcinoma in the upper left lobe of her lungs in a geriatric clinic. She has no history of diabetes but taking medicine for hypertension and dyslipidemia. She was admitted and operated on for partial pneumonectomy and discharged after 11 days of care with all essential drugs, and instructions. After 4 weeks of treatment, she complained of unusual polyuria, diagnosed in the department of Geriatrics, Zhongnan Hospital of Wuhan University, China.
{"title":"Asymptomatic Diabetes Insipidus Detected after Partial Pneumonectomy of Upper Left Lobe of Lung Diagnosed with Adenocarcinoma: An Unusual Case Report","authors":"Dan Singh Budal, R. Bhatt, Chen Ling, C. Jing, Chunwei Ma, Xujun Ye","doi":"10.3126/jonmc.v12i1.56524","DOIUrl":"https://doi.org/10.3126/jonmc.v12i1.56524","url":null,"abstract":"We present a case of 80 years woman chronic smoker (10 cigarettes)/ per day for 50 years diagnosed with adenocarcinoma in the upper left lobe of her lungs in a geriatric clinic. She has no history of diabetes but taking medicine for hypertension and dyslipidemia. She was admitted and operated on for partial pneumonectomy and discharged after 11 days of care with all essential drugs, and instructions. After 4 weeks of treatment, she complained of unusual polyuria, diagnosed in the department of Geriatrics, Zhongnan Hospital of Wuhan University, China.","PeriodicalId":52824,"journal":{"name":"Journal of Nobel Medical College","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-07-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"47659340","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 : 2023-07-17DOI: 10.3126/jonmc.v12i1.56345
Madhab Bista, S. Parajuli, R. K. Mehta, P. Shah, Raju Jayshwal, Sinet Pokharel, Himal Pandey
Background: Modern healthcare delivery needs to take care of the quality of life of patients. The burden of cardiovascular disease is increasing each year affecting the quality of life. So, we aimed to examine the quality of life of patients with cardiovascular diseases (CVD) at Birat Medical College Teaching Hospital. Materials and Methods: A hospital based cross sectional study was conducted among cardiovascular disease patients at Birat Medical College Teaching Hospital from 2023 Jan 27 to 2023 March 27. Ethical clearance was taken from the institutional review committee. The collected data was entered in Microsoft Excel 2019 and analyzed by IBM SPSS statistics 2025. Results: Among 256 patients, the majority 67(26.2%) were in the age of 61-70 years and male 156(60.9%). Majority 91(35.5%) had coronary artery diseases. The quality of life domains ranging from least to most affected were bodily pain (81.04±26.02), mental health (76.4±15.18), social functioning (68.1±24.2), role limitation due to emotional problems (67.9±43.56), physical functioning (59.02± 28.9), vitality (53.67±15.45), general perception of health (50.19±15.7) and role limitation due to physical health (46.39± 44). Conclusion: Patients with cardiovascular disease had their quality of life affected based on their physical health, general perception of health, energy and vitality, physical functioning, role limitation due to emotional problems, social functioning, mental health and bodily pain
{"title":"Quality of Life among Patients with Cardiovascular Diseases at Birat Medical College Teaching Hospital","authors":"Madhab Bista, S. Parajuli, R. K. Mehta, P. Shah, Raju Jayshwal, Sinet Pokharel, Himal Pandey","doi":"10.3126/jonmc.v12i1.56345","DOIUrl":"https://doi.org/10.3126/jonmc.v12i1.56345","url":null,"abstract":"Background: Modern healthcare delivery needs to take care of the quality of life of patients. The burden of cardiovascular disease is increasing each year affecting the quality of life. So, we aimed to examine the quality of life of patients with cardiovascular diseases (CVD) at Birat Medical College Teaching Hospital. \u0000Materials and Methods: A hospital based cross sectional study was conducted among cardiovascular disease patients at Birat Medical College Teaching Hospital from 2023 Jan 27 to 2023 March 27. Ethical clearance was taken from the institutional review committee. The collected data was entered in Microsoft Excel 2019 and analyzed by IBM SPSS statistics 2025. \u0000Results: Among 256 patients, the majority 67(26.2%) were in the age of 61-70 years and male 156(60.9%). Majority 91(35.5%) had coronary artery diseases. The quality of life domains ranging from least to most affected were bodily pain (81.04±26.02), mental health (76.4±15.18), social functioning (68.1±24.2), role limitation due to emotional problems (67.9±43.56), physical functioning (59.02± 28.9), vitality (53.67±15.45), general perception of health (50.19±15.7) and role limitation due to physical health (46.39± 44). \u0000Conclusion: Patients with cardiovascular disease had their quality of life affected based on their physical health, general perception of health, energy and vitality, physical functioning, role limitation due to emotional problems, social functioning, mental health and bodily pain","PeriodicalId":52824,"journal":{"name":"Journal of Nobel Medical College","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-07-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43952133","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 : 2023-07-17DOI: 10.3126/jonmc.v12i1.56266
P. Koirala, R. K. Mehta, Swastik Raj Koirala, Gajendra Prasad Yadav, S. Parajuli, Santosh Chaudhary
Background: Novel coronavirus infection has myriad clinical manifestations, such as headache, respiratory failure, and long coronavirus disease syndrome. A common cause for admission is pneumonia, and such patients have shown longer periods of respiratory symptoms and exercise intolerance after discharge. The study aimed to determine short-term and long-term lung function outcomes in coronavirus disease patients. Materials and Methods: The prospective, cross-sectional study was conducted in coronavirus disease facility of Birat Medical College Teaching Hospital. A structured proforma including symptoms, modified medical research council dyspnea scale, 6-minute walk test and portable spirometry were recorded during 3 months follow up. Results: A total of 58 coronavirus disease patients were admitted, 4 expired. Common symptoms were dyspnea (98.28%), fever (94.8%), dry cough (86.2%), myalgia (17.2%). Mean Forced expiratory volume in 1 second to forced vital capacity ratio was normal. The mean forced vital capacity was 46.52% at admission, 53.33% at 3 months. The mean forced expiratory flow at 25% to 75% of forced vital capacity was 56.91% at admission, 59.31% at 3 months. Mean values of forced expiratory volume predicted was 47.40% at admission, 51.69% at 3 months. Mean 6-minute walk test distance did not improve during follow-up (240.09m at 1 month, 239.35m at 3 months) and there was no improvement in oxygen saturation at 3 months compared to the first month. Conclusion: Short-term lung function outcome demonstrated persistent dyspnea and development of mixed airways disease in all the survivors. Long-term lung function outcome observed was persistence of dyspnea, mixed airways disease, and low exercise capacity.
{"title":"Outcome of Lung Functions in Covid-19 Patients at a Tertiary Care Center of Eastern Nepal","authors":"P. Koirala, R. K. Mehta, Swastik Raj Koirala, Gajendra Prasad Yadav, S. Parajuli, Santosh Chaudhary","doi":"10.3126/jonmc.v12i1.56266","DOIUrl":"https://doi.org/10.3126/jonmc.v12i1.56266","url":null,"abstract":"Background: Novel coronavirus infection has myriad clinical manifestations, such as headache, respiratory failure, and long coronavirus disease syndrome. A common cause for admission is pneumonia, and such patients have shown longer periods of respiratory symptoms and exercise intolerance after discharge. The study aimed to determine short-term and long-term lung function outcomes in coronavirus disease patients. \u0000Materials and Methods: The prospective, cross-sectional study was conducted in coronavirus disease facility of Birat Medical College Teaching Hospital. A structured proforma including symptoms, modified medical research council dyspnea scale, 6-minute walk test and portable spirometry were recorded during 3 months follow up. \u0000Results: A total of 58 coronavirus disease patients were admitted, 4 expired. Common symptoms were dyspnea (98.28%), fever (94.8%), dry cough (86.2%), myalgia (17.2%). Mean Forced expiratory volume in 1 second to forced vital capacity ratio was normal. The mean forced vital capacity was 46.52% at admission, 53.33% at 3 months. The mean forced expiratory flow at 25% to 75% of forced vital capacity was 56.91% at admission, 59.31% at 3 months. Mean values of forced expiratory volume predicted was 47.40% at admission, 51.69% at 3 months. Mean 6-minute walk test distance did not improve during follow-up (240.09m at 1 month, 239.35m at 3 months) and there was no improvement in oxygen saturation at 3 months compared to the first month. \u0000Conclusion: Short-term lung function outcome demonstrated persistent dyspnea and development of mixed airways disease in all the survivors. Long-term lung function outcome observed was persistence of dyspnea, mixed airways disease, and low exercise capacity.","PeriodicalId":52824,"journal":{"name":"Journal of Nobel Medical College","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-07-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43603634","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 : 2023-07-17DOI: 10.3126/jonmc.v12i1.56264
Jwala Kandel, Samjhana Ghimire, Rashmita Bhandari
Background: Determination of sex is an important parameter other than age, race and stature during forensic identification and crime scene investigation. Females tend to have finer and denser ridges on their fingertips than males. Present study aims at differentiating gender from fingerprint ridge density. Material and Methods: This is a cross sectional study conducted from March 2022 to March 2023 in Nobel Medical College Teaching Hospital, Nepal. Seven hundred fingerprints samples (350 males and 350 females), from 70 Nepalese medical students were collected and analyzed for gender differences. Comparative analysis was done using Student’s t-test (p<0.05). Likelihood ratio and posterior probability using Baye’s theorem were calculated to interpret the possibility of gender differentiation from various fingerprint ridge densities. Results: Students t-test revealed significant difference (p < 0.001) between the fingerprint ridge density of male and female (t= -16.733). The results showed ridge density <14/25mm2and >15/25mm2 are “more likely than not” from males and females respectively. Posterior probability using Baye’s theorem further revealed ridge density <13/25mm2 (C/C1=5.75,P=0.86) and >16/25mm2 (C1/C=4.29, P1=0.84) have higher probability of originating from males and females respectively. No any male and female had ridge density >16/25mm2 and <13/25mm2 respectively. Conclusion: The study revealsstatistically significantlygreater fingerprint ridge densities in female than in male Nepalese medical students.
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Background: Amongst all the modalities of treatment for renal stones, percutaneous nephrolithotomy is preferred treatment for large volume renal stone disease. However, percutaneous nephrolithotomy is associated with the risk of postoperative complications and the problem of stone free status. So, a preoperative classification is necessary to grade the complexity of percutaneous nephrolithotomy and STONE (stone size, tract length, degree of obstruction, number of involved calices, and stone essence) nephrolithometry score is one of such kind. Materials and Methods: This is analytical study conducted at the Department of Urology and Kidney Transplant, Nobel Medical College and Teaching Hospital, Biratnagar, Nepal from January 2020 to July 2020. Total 115 patients were included in the study. These patients were subjected for percutaneous nephrolithotomy. Stone clearance was documented at the end of the surgery; on first postoperative day and at 4 weeks. Results: In our study the stone – free rate was 89.6%. 32 patients experienced complications (27.8%). The STONE (stone size, tract length, degree of obstruction, number of involved calices, and stone essence) score correlated with the postoperative stone – free status (P=0.001). The patients rendered stone free had statistically significant lower scores than the patients with residual stones (6.83 ± 1.83 vs 9.83 ± 2.08, P = 0.001). Conclusion: The STONE (stone size, tract length, degree of obstruction, number of involved calices, and stone essence) nephrolithometry score is a simple and easy tool to apply system for predicting complexity in stone clearance with percutaneous nephrolithotomy.
背景:在所有治疗肾结石的方式中，经皮肾镜取石术是大体积肾结石疾病的首选治疗方法。然而，经皮肾镜取石术与术后并发症的风险和无结石状态的问题有关。因此，术前有必要对经皮肾镜取石术和结石的复杂性进行分级(结石大小、尿路长度、阻塞程度、受累肾盏数、结石实质)，肾结石测量评分就是其中一种。材料和方法:这是一项分析性研究，于2020年1月至2020年7月在尼泊尔比拉特纳格尔诺贝尔医学院和教学医院泌尿外科和肾脏移植科进行。研究共纳入115例患者。这些患者接受经皮肾镜取石术。手术结束时记录结石清除情况;术后第一天和第4周。结果:本组结石清除率为89.6%。32例出现并发症(27.8%)。结石(结石大小、尿路长度、梗阻程度、受累肾盏数和结石实质)评分与术后无结石状态相关(P=0.001)。结石清除组得分低于结石残留组(6.83±1.83 vs 9.83±2.08,P = 0.001)。结论:结石(结石大小、尿路长度、梗阻程度、受累肾盏数、结石实质)肾结石测量评分是预测经皮肾镜取石术后结石清除复杂性的一种简单易行的工具。
{"title":"Prediction of Stone Free Rate after Standard Percutaneous Nephrolithotomy using Stone Nephrolithometry Score in Nobel Medical College Teaching hospital – A Prospective Study","authors":"Ram Sagar Shah, Niraj Thapa, Jit Prakash Shrestha, A. Koirala, Kartikesh Mishra, Raju Jayshwal, Sinet Pokharel, Himal Pandey","doi":"10.3126/jonmc.v12i1.56247","DOIUrl":"https://doi.org/10.3126/jonmc.v12i1.56247","url":null,"abstract":"Background: Amongst all the modalities of treatment for renal stones, percutaneous nephrolithotomy is preferred treatment for large volume renal stone disease. However, percutaneous nephrolithotomy is associated with the risk of postoperative complications and the problem of stone free status. So, a preoperative classification is necessary to grade the complexity of percutaneous nephrolithotomy and STONE (stone size, tract length, degree of obstruction, number of involved calices, and stone essence) nephrolithometry score is one of such kind. \u0000Materials and Methods: This is analytical study conducted at the Department of Urology and Kidney Transplant, Nobel Medical College and Teaching Hospital, Biratnagar, Nepal from January 2020 to July 2020. Total 115 patients were included in the study. These patients were subjected for percutaneous nephrolithotomy. Stone clearance was documented at the end of the surgery; on first postoperative day and at 4 weeks. \u0000Results: In our study the stone – free rate was 89.6%. 32 patients experienced complications (27.8%). The STONE (stone size, tract length, degree of obstruction, number of involved calices, and stone essence) score correlated with the postoperative stone – free status (P=0.001). The patients rendered stone free had statistically significant lower scores than the patients with residual stones (6.83 ± 1.83 vs 9.83 ± 2.08, P = 0.001). \u0000Conclusion: The STONE (stone size, tract length, degree of obstruction, number of involved calices, and stone essence) nephrolithometry score is a simple and easy tool to apply system for predicting complexity in stone clearance with percutaneous nephrolithotomy.","PeriodicalId":52824,"journal":{"name":"Journal of Nobel Medical College","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-07-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44181124","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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