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Participation of Community in Prevention and Control of Dengue Fever in Dharan Sub Metropolitan City of Province No 1, Nepal 尼泊尔第一省达兰市社区参与登革热防控工作
Pub Date : 2020-12-11 DOI: 10.3126/jonmc.v9i2.33355
D. Baral, A. Ghimire, S. Uprety, S. Pokharel, Siddhant Baral
Background: Dengue fever is known as a break-bone fever and its common symptoms are headaches, high grade fever, muscular, bone pains and decrease of platelets count. Community participation involving local government and household participants in controlling breeding areas of dengue mosquitoes is the only cost-effective and sustainable activities of ensuring prevention and control of Dengue fever. This study aimed to assess the perception of the general population regarding community participation in the prevention of dengue and to verify its effectiveness with the control practices observed at the homes in Dharan sub-metropolitan city of Province No 1. Material and Methods: A cross-sectional study was conducted among 250 households at the Dharan sub-metropolitan city of Province no. 1 in Nepal from August to October 2019. The technique of sample collection was done using purposive sampling and data were collected using a pretested close-ended questionnaire and observational checklists. Results: Slightly over half of the respondents 129 (51.6%) reported a positive attitude regarding community practice and almost three out of five 157 (62.8%) houses were observed to have good dengue control practices. The univariate results revealed attitude of households regarding community participation were significantly associated with the control practices observed in their homes (p
背景:登革热被称为骨折热,其常见症状是头痛、高烧、肌肉、骨痛和血小板计数下降。让地方政府和家庭参与者参与控制登革热蚊子繁殖区的社区参与是确保登革热预防和控制的唯一具有成本效益和可持续性的活动。本研究旨在评估普通人群对社区参与登革热预防的看法,并通过在1号省达兰次大都市的家庭中观察到的控制措施来验证其有效性。材料和方法:2019年8月至10月,在尼泊尔第一省达兰市的250户家庭中进行了一项横断面研究。样本收集技术是使用有目的的抽样进行的,数据是使用预先测试的封闭式问卷和观察检查表收集的。结果:略高于一半的受访者129(51.6%)表示对社区实践持积极态度,近五分之三的157(62.8%)家被观察到有良好的登革热控制实践。单变量结果显示,家庭对社区参与的态度与在家中观察到的控制实践显著相关(p
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引用次数: 0
Medico-Legal Findings in Victims and Accused of Sexual Assault 性侵犯受害者和被告的法医调查结果
Pub Date : 2020-12-11 DOI: 10.3126/jonmc.v9i2.33349
R. Karki, P. Singh, A. Khan
Background: Sexual assault is one of the heinous and barbarous crimes and continues to plague our nation. It is present in every countries cutting across boundaries of culture, race, gender, relationship, social standing and the extremes of ages. The current study aims to analyze the incidence of sexual assault cases, their socio-demographic parameters, incidence to reporting time and relationship of the assailant with the victim and pattern of injury for evaluation of sexual assault. Materials and Methods: The medico-legal reports of 102 sexual assaults cases were retrieved and analyzed retrospectively which was examined by Department of Forensic Medicine from October 2019 to September 2020 at Dhulikhel hospital. All the data were entered in SPSS version 25 and results were ascertained. Results: Out of 102 samples, 52 female victims and 48 accused were analyzed. Two were male victims of sodomy. The mean age was 20.54±10.78 and 27.67±11.08 for victim and accused respectively, the most vulnerable being unmarried teenagers. Most of the accused and victims were familiar with each other (81.25%) and the common incident locale was victim’s own house. Genital injury was seen in 53.85% and general injury in 32.7% of the victims. Only 13.46 % victims and 12.50% of accused were brought for examination on the same day. Genital injury had significant association with age (p=0.003) and day of examination (p=0.029). Four of the victims were positive for pregnancy test. Conclusion: Hence this study aims to highlight that sexual assault is a catastrophe and there is a dire need of educating the vulnerable groups.
背景:性侵是令人发指的野蛮罪行之一,并继续困扰着我们的国家。它存在于每个跨越文化、种族、性别、关系、社会地位和年龄极端的国家。目前的研究旨在分析性侵案件的发生率、其社会人口学参数、报告时间的发生率以及袭击者与受害者的关系以及伤害模式,以评估性侵。材料和方法:检索并回顾性分析了2019年10月至2020年9月在Dhulikhel医院由法医科检查的102起性侵案件的法医报告。将所有数据输入SPSS 25版,并确定结果。结果:在102份样本中,对52名女性受害者和48名被告进行了分析。其中两人是鸡奸的男性受害者。受害者和被告的平均年龄分别为20.54±10.78和27.67±11.08,其中未婚青少年最为脆弱。大多数被告和受害者彼此熟悉(81.25%),常见的事件地点是受害者自己的房子。53.85%的受害者出现生殖器损伤,32.7%的受害者出现全身损伤。只有13.46%的受害者和12.50%的被告在同一天接受了检查。生殖器损伤与年龄(p=0.003)和检查日期(p=0.029)有显著相关性。其中4名受害者的妊娠测试呈阳性。结论:因此,本研究旨在强调性侵犯是一场灾难,迫切需要对弱势群体进行教育。
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引用次数: 1
Hepatitis B Virus Vaccination Status and Anti Hepatitis B Surface Antibody Titer among the Health Care Workers of a Hemodialysis Unit 某血液透析单位医护人员乙型肝炎疫苗接种状况及抗乙型肝炎表面抗体滴度
Pub Date : 2020-12-11 DOI: 10.3126/jonmc.v9i2.33354
S. Shrestha, P. Roy
Background: Health care workers are in high risk of getting infected with hepatitis B virus. A large proportion of them do not receive a 3-dose series of hepatitis B vaccination and have anti hepatitis B surface antibody titer 10 mIU/ml. Remaining 11 participants (36.7%), with either partial (6) or no hepatitis B vaccination (5), had antibody titer of 10 mIU/ml. Conclusion: Our study shows that a large proportion of health care workers of hemodialysis unit were either partially or not vaccinated with hepatitis B vaccination and were having anti hepatitis B antibody titer of
背景:卫生保健工作者是乙型肝炎病毒感染的高危人群。他们中的很大一部分人没有接受3剂系列乙型肝炎疫苗接种,抗乙型肝炎表面抗体滴度为10 mIU/ml。其余11名参与者(36.7%),部分(6)或未接种乙型肝炎疫苗(5),抗体滴度为10 mIU/ml。结论:血透单位医务人员部分或未接种乙型肝炎疫苗,抗乙型肝炎抗体滴度为
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引用次数: 0
Clinical Profile and Outcome of Obstetric Patients Requiring Critical Care Support in a Tertiary Care Centre 三级护理中心产科病人需要重症护理支持的临床概况和结果
Pub Date : 2020-12-11 DOI: 10.3126/jonmc.v9i2.33351
S. Pokhrel, R. Ghimire, A. Ghimire, Prajmi Shrestha, A. Chaudhary
Background: The maternal complications during pregnancy pose very serious challenge requiring multispeciality critical care approach. The objective of the study was to analyse clinical profile and outcome of these patients. Studies regarding above will add on existing knowledge that will help in improving patient outcome. Materials and Methods: This was a prospective observational study conducted over a period of 1 year from April 2017 to March 2018 in the department of obstetrics and gynecology of Nobel Medical College, Biratnagar. All the consecutive patients requiring ICU care were enrolled. Results: Among 7820 deliveries, 122 patients (1.56% of total deliveries) required critical care admission. Among them 61(50%) have causes related to obstetrics problems and 61 (50%) have non obstetric problems. Obstretic hemorrgage (24.59%) and hypertensive disorders (11.47%) of pregnancy were common obstetric complications whereas isolated renal failure 18(14.75%), cardiac disease 16 (13.1%), pulmonary disorders 11(9.1%) and sepsis 10 (8.19%) were common non obstetric complications. Maternal mortality rate was 24.59%.Renal failure 9(30%) was the commonest cause of death. Conclusion: Obstetric hemorrhage and hypertensive disorders of pregnancy were the commonest risk factors requiring critical care support. Other risk factors requiring ICU were renal failure, cardiac disease, pulmonary disorders and sepsis.
背景:孕妇在怀孕期间的并发症构成了非常严重的挑战,需要多专业的重症监护方法。本研究的目的是分析这些患者的临床特征和结果。上述研究将增加现有知识,有助于改善患者的预后。材料和方法:这是一项前瞻性观察性研究,于2017年4月至2018年3月在比拉特纳格尔诺贝尔医学院妇产科进行,为期1年。所有需要ICU护理的连续患者都被纳入。结果:在7820例分娩中,122名患者(占分娩总数的1.56%)需要接受重症监护。其中61人(50%)的病因与产科问题有关,61人(50%)有非产科问题。妊娠期常见的产科并发症有产科出血(24.59%)和高血压疾病(11.47%),而常见的非产科并发症有孤立性肾功能衰竭18例(14.75%)、心脏病16例(13.1%)、肺部疾病11例(9.1%)和败血症10例(8.19%)。孕产妇死亡率为24.59%,肾功能衰竭9例(30%)是最常见的死亡原因。结论:产科出血和妊娠期高血压疾病是需要重症监护支持的最常见的危险因素。其他需要ICU的危险因素包括肾功能衰竭、心脏病、肺部疾病和败血症。
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引用次数: 0
Gender Differences in the Clinical Characteristics of Patients with Acute Coronary Syndrome in the Eastern Region of Nepal 尼泊尔东部地区急性冠状动脉综合征患者临床特征的性别差异
Pub Date : 2020-12-09 DOI: 10.3126/jonmc.v9i2.33320
S. Dhungana, Roshna Adhikari, S. Khatiwada
Background: Studies from other regions show gender-based differences in the clinical characteristics of patients with the acute coronary syndrome (ACS) with conflicting results. There is a lack of definite data from our population. Materials and Methods: This is a hospital-based cross-sectional study in patients with ACS admitted to the tertiary care center from January 2019 to June 2020. Risk factors, co-morbidities, clinical symptoms, duration of symptoms onset, modalities of treatment offered, complications, and in-hospital outcome were noted in the pre-structured questionnaire by convenient sampling. Data were analyzed by using Microsoft excel 2007 and SPSS 20. Results: Among 384 participants, 65.9% were male and 34.1% were female. The mean age of males was 60.6 ± 12.1 and females 62.3 ± 11.1 years (P=0.21). Females had a higher prevalence of dyslipidemia (p<0.001). The prevalence of hypertension, diabetes, and smoking was similar. The mean hemoglobin level was higher in males (11.8 ± 2.2 gm/dl vs. 11.1 ± 4.57 gm/dl, P = 0.01). The majority presented with chest pain (94.9%) in males and 87.8% in females, P=0.44), and sweating (76.7% in males and 80.2% in females, P=0.43). Non-anginal symptoms were almost similar in both the genders except nausea which was more common in males (P=0.03). The timing of presentation, treatment with reperfusion therapy, and arterial territory involved were not significantly different. Prevalence of mechanical and arrhythmic complications as well as mortality was similar. Conclusion: Our study did not show significant gender-based differences in clinical profile, treatment modalities, in-hospital complications, and mortality.
背景:来自其他地区的研究显示,急性冠脉综合征(ACS)患者的临床特征存在性别差异,但结果相互矛盾。我们的人口中缺乏明确的数据。材料和方法:这是一项基于医院的横断面研究,研究对象是2019年1月至2020年6月在三级医疗中心住院的ACS患者。风险因素、合并症、临床症状、症状发作持续时间、提供的治疗方式、并发症和住院结果均通过方便抽样的方式记录在预先编制的问卷中。采用Microsoft excel 2007和SPSS 20对数据进行分析。结果:384名参与者中,男性占65.9%,女性占34.1%。男性平均年龄60.6±12.1岁,女性平均年龄62.3±11.1岁(P=0.21)。女性的血脂异常患病率较高(p<0.001)。高血压、糖尿病和吸烟的患病率相似。男性平均血红蛋白水平较高(11.8±2.2 gm/dl vs 11.1±4.57 gm/dl, P = 0.01)。以胸痛(男性94.9%,女性87.8%,P=0.44)和出汗(男性76.7%,女性80.2%,P=0.43)为主。除恶心在男性中更为常见外,男女的非心绞痛症状几乎相似(P=0.03)。出现时间、再灌注治疗和动脉受累范围无显著差异。机械和心律失常并发症的患病率以及死亡率相似。结论:我们的研究在临床表现、治疗方式、住院并发症和死亡率方面没有显示出显著的性别差异。
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引用次数: 0
The Facts behind the Emergence of Nobel Coronavirus Disease, 2019 and Consequences thereof 2019年诺贝尔冠状病毒病出现的事实及其后果
Pub Date : 2020-12-09 DOI: 10.3126/jonmc.v9i2.33319
Arambam Giridhari Singh
Not available
不适用
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引用次数: 0
Outcome of Endoscopic Retrograde Cholangio-Pancreatography at Nobel Medical College Teaching Hospital: A Single Centre Experience 诺贝尔医学院教学医院内镜逆行胰胆管造影的结果:单中心经验
Pub Date : 2020-12-09 DOI: 10.3126/jonmc.v9i2.33323
R. Yadav, K. Subedi, B. Purbey, M. Gautam, A. Bhattarai, A. Koirala
Background: Endoscopic retrograde cholangiopancreatography is a technically demanding endoscopic procedure for both diagnostic and therapeutic purpose in treating various pancreaticobiliary diseases. This service is very limited in tertiary care center of our country Nepal mostly limited to Kathmandu valley and Dhulikhel hospital. Materials and Methods: This is a descriptive cross-sectional study patients who underwent ERCP with therapeutic intent in Nobel Medical College Teaching Hospital, Biratnagar from April 2019 to April 2020. Total 148 patients were included in this study for analysis. Results: The most common finding was choledocholithiasis in 132(89.2%) patients. Benign biliary stricture was found in 7 (4.7%). Biliary obstruction due to periampullary growth was found in 7 (4.7%) patients. Bile duct injury was found in 1(0.7%) and chronic pancreatitis in 1 (0.7%) patient. The therapeutic success of ERCP was for choledocholithiasis, Stone Clearance in 1st attempt 68.9%, in multiple attempts18.2%, failed stone extraction in 3 cases (2.0%) only biliary stenting was done in 15 (10.3%) patients of various biliary disease for therapeutic and palliative reason. Pancreatic stenting was done in1 (0.7%) patient. The most common complication was Acute Pancreatitis in 6(4.1%), Post-Sphincterotomy bleeding in 1 (0.7%), biliary septic shock in 1 (0.7%) and 1 death (0.7%). Conclusion: ERCP can be continued in Nobel Medical College Teaching Hospital as it has lots of benefits with minimal acceptable complications.
背景:内镜逆行胰胆管造影是一项技术要求很高的内镜手术,对各种胰胆道疾病的诊断和治疗都有一定的要求。这项服务在我国尼泊尔的三级保健中心非常有限,主要局限于加德满都谷地和杜利赫勒医院。材料和方法:这是一项描述性横断面研究,患者于2019年4月至2020年4月在比拉特纳格尔诺贝尔医学院教学医院接受ERCP治疗。本研究共纳入148例患者进行分析。结果:132例(89.2%)患者以胆总管结石最为常见。良性胆道狭窄7例(4.7%)。7例(4.7%)患者因壶腹周围生长导致胆道梗阻。胆管损伤1例(0.7%),慢性胰腺炎1例(0.7%)。ERCP治疗胆总管结石的成功率为第一次结石清除率68.9%,多次结石清除率18.2%,结石取出失败3例(2.0%),仅因治疗和缓解原因对各种胆道疾病行胆道支架植入术15例(10.3%)。1例(0.7%)患者行胰腺支架植入术。最常见的并发症是急性胰腺炎6例(4.1%),括约肌切开后出血1例(0.7%),胆道感染性休克1例(0.7%)和死亡1例(0.7%)。结论:ERCP疗效显著,并发症少,可在诺贝尔医学院教学医院继续应用。
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引用次数: 0
A Review Literature on Efficacy and Comparison between the Drugs Used in Influenza 流感药物疗效及疗效比较综述
Pub Date : 2020-06-21 DOI: 10.3126/jonmc.v9i1.29552
R. Ashraf, Hira Pervez, Munis M Ahmed, Fawad Ahmed, K. Neupane
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引用次数: 0
An Unusual Case of Spontaneous Pneumomediastinum 一例罕见的自发性纵隔肺炎
Pub Date : 2020-06-20 DOI: 10.3126/jonmc.v9i1.29544
B. Bista, R. Ghimire, D. R. Mishra
Spontaneous pneumomediastinum is rare condition with free air in the mediastinum. There are some controversies to consider spontaneous pneumomediastinum in patients with predisposing factors like asthma, interstitial lung disease, illicit drug users and irritant inhalations. It generally occurs due to sudden increase in intrathoracic pressure causing rupture of alveoli and movement of air to the mediastinum. Here we present a case of a 20 years old male patient with few bouts of cough as precipitating factor and development of spontaneous pneumomediastinum and subcutaneous emphysema.
自发性纵隔气肿是一种罕见的纵隔内有游离空气的情况。对于哮喘、间质性肺病、非法药物使用者和刺激性吸入等易感因素的患者,考虑自发性纵隔气肿存在一些争议。它通常是由于胸腔内压力突然增加,导致肺泡破裂和空气进入纵隔。本文报告一例20岁男性患者,其咳嗽次数较少,为诱发因素,并发展为自发性纵隔气肿和皮下气肿。
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引用次数: 0
The Influencing Role of Diabetes Mellitus and Hypertension in the Establishment of Benign Prostatic Hyperplasia 糖尿病和高血压在良性前列腺增生形成中的影响作用
Pub Date : 2020-06-20 DOI: 10.3126/jonmc.v9i1.29543
R. Shah, R. Tamang
Background: Benign prostatic hyperplasia is regarded as non-malignant growth of prostatic tissueIt is the most common benign tumor in men, and the incidence is age related. In men aged more than 50 years, it is the fourth most prevalent disease. This study aim to determine the association of benign prostatic hyperplasia with diabetes mellitus and/or hypertension and this may help to bring out new dimensions in management of benign prostatic hyperplasia, hypertension and diabetes mellitus. Materials and Methods: Five hundred forty patients, diagnosed as benign enlargement of prostate with control group 270 at Urology out patient door between May 2018 to February 2019 with approval of Institutional review committee, were included. Patient with history of prostate cancer, neurogenic bladder, those who had undergone surgical intervention for prostate, not willing to take part in study were excluded. Results: Age range in cases and control were from 41–94 years. Diabetes was present in 14.63% of cases and 11.85% of controls. The positive association was established between prostatic hyperplasia and Diabetes (P-0.27). Hypertension was present in 37.96% of cases and 29.63% of controls (P-0.019). Diabetes and Hypertension were present in 56.48% in cases and 43.33% in control (P-0.000). Conclusion: Study suggests that benign prostatic hyperplasia is associated with diabetes mellitus and hypertension and may help to bring out new dimensions in management of benign prostatic hyperplasia.
背景:良性前列腺增生被认为是前列腺组织的非恶性生长,是男性最常见的良性肿瘤,其发病率与年龄有关。在50岁以上的男性中,它是第四大流行疾病。本研究旨在探讨良性前列腺增生与糖尿病和/或高血压的关系,为良性前列腺增生、高血压和糖尿病的治疗提供新的思路。材料与方法:纳入2018年5月至2019年2月经机构审查委员会批准在泌尿外科门诊诊断为前列腺良性肿大的540例患者,对照组270例。排除有前列腺癌病史、神经源性膀胱癌、前列腺手术干预史、不愿参加研究的患者。结果:病例与对照组年龄均为41 ~ 94岁。14.63%的病例和11.85%的对照组存在糖尿病。前列腺增生与糖尿病呈正相关(p = 0.27)。高血压发生率为37.96%,对照组为29.63% (p = 0.019)。糖尿病和高血压发生率为56.48%,对照组为43.33% (p = 0.000)。结论:研究提示良性前列腺增生与糖尿病、高血压有关,为良性前列腺增生的治疗提供了新的思路。
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引用次数: 1
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Journal of Nobel Medical College
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