Pub Date : 2023-07-17DOI: 10.3126/jonmc.v12i1.56246
R. Baral
Not Available
不可用
{"title":"Hospital Waste Management- Are We Doing it in the Correct Way?","authors":"R. Baral","doi":"10.3126/jonmc.v12i1.56246","DOIUrl":"https://doi.org/10.3126/jonmc.v12i1.56246","url":null,"abstract":"Not Available","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":"44175499","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.v12i1.56392
R. Yadav, Rekha Shah
Background: Most elderly patients with high blood pressure have isolated systolic hypertension. Enalapril and amlodipine are respectively the most commonly prescribed ACE inhibitors and calcium channel blockers in Nepal. The goal of the current study was to compare the adverse drug reaction associated with amlodipine and enalapril in the study population as well as to compare the mean blood pressure and pulse rate reductions caused by amlodipine and enalapril in isolated systolic hypertensive patients. Materials and Methods: A comparative cross-sectional study was performed on 72 patients of both genders within the age group of 30 to 90 years; with isolated systolic hypertension; attending the out-patients department of Medicine of Nobel Medical College and Teaching Hospital; from December 2022 to February 2023. Mean reductions in systolic and diastolic blood pressure in the two treatment groups over the eight-weeks study period was calculated and then compared. Frequencies of patients developing different side effects was also calculated and compared between the two groups. Results: Systolic blood pressure was reduced by 16.1% in amlodipine group and by 18.8 % in enalapril group. Enalapril was slightly more efficacious in reducing the systolic blood pressure but such changes were found to be of no significant difference when compared between the two groups. (p > 0.05). The incidence of adverse effect was more in the amlodipine group in comparison to the enalapril group. Dry cough, dizziness, headache and fatigue with enalapril; and headache, peripheral edema, shortness of breath, fatigue, and flushing and dizziness with amlodipine were the common adverse effects. Conclusion: Both amlodipine and enalapril were equally effective in lowering systolic blood pressure without significantly lowering diastolic blood pressure. They were also generally well tolerated, though amlodipine was slightly more likely to cause side effects.
{"title":"A Comparative Study of the Safety and Efficacy of Amlodipine and Enalapril when Prescribed as Monotherapy in Patients with Isolated Systolic Hypertension","authors":"R. Yadav, Rekha Shah","doi":"10.3126/jonmc.v12i1.56392","DOIUrl":"https://doi.org/10.3126/jonmc.v12i1.56392","url":null,"abstract":"Background: Most elderly patients with high blood pressure have isolated systolic hypertension. Enalapril and amlodipine are respectively the most commonly prescribed ACE inhibitors and calcium channel blockers in Nepal. The goal of the current study was to compare the adverse drug reaction associated with amlodipine and enalapril in the study population as well as to compare the mean blood pressure and pulse rate reductions caused by amlodipine and enalapril in isolated systolic hypertensive patients. \u0000Materials and Methods: A comparative cross-sectional study was performed on 72 patients of both genders within the age group of 30 to 90 years; with isolated systolic hypertension; attending the out-patients department of Medicine of Nobel Medical College and Teaching Hospital; from December 2022 to February 2023. Mean reductions in systolic and diastolic blood pressure in the two treatment groups over the eight-weeks study period was calculated and then compared. Frequencies of patients developing different side effects was also calculated and compared between the two groups. \u0000Results: Systolic blood pressure was reduced by 16.1% in amlodipine group and by 18.8 % in enalapril group. Enalapril was slightly more efficacious in reducing the systolic blood pressure but such changes were found to be of no significant difference when compared between the two groups. (p > 0.05). The incidence of adverse effect was more in the amlodipine group in comparison to the enalapril group. Dry cough, dizziness, headache and fatigue with enalapril; and headache, peripheral edema, shortness of breath, fatigue, and flushing and dizziness with amlodipine were the common adverse effects. \u0000Conclusion: Both amlodipine and enalapril were equally effective in lowering systolic blood pressure without significantly lowering diastolic blood pressure. They were also generally well tolerated, though amlodipine was slightly more likely to cause side effects.","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":"43440578","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.v12i1.56391
Khushi Pokhrel, Kabita Dhami, N. Shah, Nyamika K.C., Mamta K.C., P. Shah
Background: In critical care units, ventilator-associated pneumonia is still a frequent and possibly fatal consequence of ventilator therapy. Choosing the most urgent care and knowing how to prevent ventilator-associated pneumonia may help nurses become more alert, which will improve the quality of care and prevent a serious problem in Nepal. Thus, this study aimed to assess the knowledge regarding evidence-based guidelines on ventilator-associated pneumonia prevention bundle among critical care nurses. Materials and Methods: Data were collected through a self-administered structured questionnaire using the non-probability total enumerative sampling technique among 132 critical care nurses. Data analysis was carried out using SPSS version 20. For descriptive statistics frequency, percentage, mean, and standard deviation were calculated. For inferential statistics, the Chi-square test was used to find out the association between the levels of knowledge regarding Evidence-Based Guidelines on the VAP Prevention Bundle among Critical Care Nurses. Results: One hundred and thirty-two critical nurses participated in this study. 51.5 % had a poor level of knowledge, whereas, 45.5 % had an average level of knowledge and only 3.0 % had a good level of knowledge. There was a statistically significant association between the level of knowledge and the respondents’ working experience. Conclusion: According to the study's findings, the majority of respondents had inadequate knowledge. Regular formal training and interactive educational sessions are required to evaluate knowledge of the VAP prevention bundle, particularly in light of the high nurse turnover rate.
背景:在重症监护病房，呼吸机相关性肺炎仍然是呼吸机治疗的常见且可能致命的后果。选择最紧急的护理和了解如何预防呼吸机相关肺炎可能有助于护士提高警惕，这将提高护理质量并防止尼泊尔出现严重问题。因此，本研究旨在评估重症护理护士关于呼吸机相关肺炎预防束循证指南的知识。材料与方法:采用非概率全枚举抽样方法对132名危重病护理人员进行问卷调查。数据分析采用SPSS version 20。对于描述性统计，计算频率、百分比、平均值和标准差。对于推论统计，采用卡方检验来找出重症护理护士对VAP预防包循证指南的知识水平之间的关联。结果:132名重症护士参与了本研究。51.5%的人知识水平差，45.5%的人知识水平一般，只有3.0%的人知识水平好。知识水平与被调查者的工作经验之间存在显著的统计学相关性。结论:根据研究结果，大多数受访者的知识不足。需要定期进行正式培训和互动教育课程，以评估VAP预防方案的知识，特别是考虑到护士的高流动率。
{"title":"Knowledge Regarding Evidence-Based Guidelines on Ventilator-Associated Pneumonia Prevention Bundle among Critical Care Nurses","authors":"Khushi Pokhrel, Kabita Dhami, N. Shah, Nyamika K.C., Mamta K.C., P. Shah","doi":"10.3126/jonmc.v12i1.56391","DOIUrl":"https://doi.org/10.3126/jonmc.v12i1.56391","url":null,"abstract":"Background: In critical care units, ventilator-associated pneumonia is still a frequent and possibly fatal consequence of ventilator therapy. Choosing the most urgent care and knowing how to prevent ventilator-associated pneumonia may help nurses become more alert, which will improve the quality of care and prevent a serious problem in Nepal. Thus, this study aimed to assess the knowledge regarding evidence-based guidelines on ventilator-associated pneumonia prevention bundle among critical care nurses. \u0000Materials and Methods: Data were collected through a self-administered structured questionnaire using the non-probability total enumerative sampling technique among 132 critical care nurses. Data analysis was carried out using SPSS version 20. For descriptive statistics frequency, percentage, mean, and standard deviation were calculated. For inferential statistics, the Chi-square test was used to find out the association between the levels of knowledge regarding Evidence-Based Guidelines on the VAP Prevention Bundle among Critical Care Nurses. \u0000Results: One hundred and thirty-two critical nurses participated in this study. 51.5 % had a poor level of knowledge, whereas, 45.5 % had an average level of knowledge and only 3.0 % had a good level of knowledge. There was a statistically significant association between the level of knowledge and the respondents’ working experience. \u0000Conclusion: According to the study's findings, the majority of respondents had inadequate knowledge. Regular formal training and interactive educational sessions are required to evaluate knowledge of the VAP prevention bundle, particularly in light of the high nurse turnover rate.","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":"48752525","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.v12i1.56344
R. Tamrakar, A. Rai, R. Maskey
Background: Hyperprolactinemia and subclinical hypothyroidism may be associated and are usually accompanied by menstrual disorders in female patients. The objective of this study is to determine the prevalence and association of hyperprolactinemia in subclinical hypothyroidism and the associated clinical features. Materials and Methods: This is a hospital-based descriptive cross-sectional study conducted from 1 July 2022 to 31 December 2022. Serum Prolactin level was measured in subclinical hypothyroid patients who met the inclusion criteria.Descriptive statistics such as frequency and percentage for categorical variables and mean with standard deviation for quantitative variables were calculated. Pearson’s Chi-square test was used for statistical analysis and the p-value <0.05 was considered statistically significant for analysis. Results: One hundred and forty-four newly diagnosed subclinical hypothyroid patients were enrolled; the mean age of the patients was 36.95±12.58 years. Female patients comprised 89.6% of the study participants. Hyperprolactinemia was prevalent in 23.6% of subclinical hypothyroid patients (23.4% in TSH 4.5-10 µIU/mL group and 24.3% in TSH >10 µIU/mL group). There was no significant association between subclinical hypothyroidism and prolactin levels.Menstrual irregularities were the most common clinical manifestations which account for 44.2% of female subclinical hypothyroid patients and menstrual irregularities were significantly associated with hyperprolactinemia. Conclusion: The number of patients with hyperprolactinemia in subclinical hypothyroidism was substantial even though the association between them was not significant. Assessment of serum prolactin may be considered in subclinical hypothyroid patients who present with menstrual irregularities
{"title":"Hyperprolactinemia in Subclinical Hypothyroid Patients at BPKIHS, Dharan","authors":"R. Tamrakar, A. Rai, R. Maskey","doi":"10.3126/jonmc.v12i1.56344","DOIUrl":"https://doi.org/10.3126/jonmc.v12i1.56344","url":null,"abstract":"Background: Hyperprolactinemia and subclinical hypothyroidism may be associated and are usually accompanied by menstrual disorders in female patients. The objective of this study is to determine the prevalence and association of hyperprolactinemia in subclinical hypothyroidism and the associated clinical features. \u0000Materials and Methods: This is a hospital-based descriptive cross-sectional study conducted from 1 July 2022 to 31 December 2022. Serum Prolactin level was measured in subclinical hypothyroid patients who met the inclusion criteria.Descriptive statistics such as frequency and percentage for categorical variables and mean with standard deviation for quantitative variables were calculated. Pearson’s Chi-square test was used for statistical analysis and the p-value <0.05 was considered statistically significant for analysis. \u0000Results: One hundred and forty-four newly diagnosed subclinical hypothyroid patients were enrolled; the mean age of the patients was 36.95±12.58 years. Female patients comprised 89.6% of the study participants. Hyperprolactinemia was prevalent in 23.6% of subclinical hypothyroid patients (23.4% in TSH 4.5-10 µIU/mL group and 24.3% in TSH >10 µIU/mL group). There was no significant association between subclinical hypothyroidism and prolactin levels.Menstrual irregularities were the most common clinical manifestations which account for 44.2% of female subclinical hypothyroid patients and menstrual irregularities were significantly associated with hyperprolactinemia. \u0000Conclusion: The number of patients with hyperprolactinemia in subclinical hypothyroidism was substantial even though the association between them was not significant. Assessment of serum prolactin may be considered in subclinical hypothyroid patients who present with menstrual irregularities","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":"48051755","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.v12i1.56283
Saraswata Neupane, Indira Pokhrel, R. Singh, Ram Prasad Dhakal
Background: Pregnancy and childbirth are momentous events, with deeply personal and social significance in the lives of women, families, and communities. Around the world, in every country and community, pregnancy and childbirth are immensely important events in the lives of women and families. So, the study aimed to assess the perception regarding respectful maternity care among postnatal mothers. Materials and Methods: A cross-sectional study was conducted among postnatal mothers at Tertiary Centre Hospital in Koshi Province. The study was started after acquiring approval from the Institutional Review Committee of Nobel Medical College. Data was collected using a face-to-face interview technique with a standardized tool from June 2022 to September 2022. A total of 102 postnatal mothers were taken as a sample by using a non-probability purposive sampling technique. Data analysis was done by descriptive study. Results: A total of 102 respondents participated in the study of which 62.7% had received overall dimensions of experienced Respectful Maternity Care (RMC) with a mean score ± SD (51.91 ± 5.56). Likewise, among the four dimensions of RMC, the highest average mean score of 81.96 is observed in the discrimination-free care with an SD of 11.08, where 100 % of the women claimed being received discrimination-free care. Conclusion: There was a significant association of RMC with residence and the number of ANC visits. Even though RMC prioritizes removing disrespectful and abusive settings from healthcare facilities, one-half of participants felt that they had not utilized all of RMC's offerings.
{"title":"Perception Regarding Respectful Maternity Care among Postnatal Mothers at Tertiary Centre Hospital, Koshi Province","authors":"Saraswata Neupane, Indira Pokhrel, R. Singh, Ram Prasad Dhakal","doi":"10.3126/jonmc.v12i1.56283","DOIUrl":"https://doi.org/10.3126/jonmc.v12i1.56283","url":null,"abstract":"Background: Pregnancy and childbirth are momentous events, with deeply personal and social significance in the lives of women, families, and communities. Around the world, in every country and community, pregnancy and childbirth are immensely important events in the lives of women and families. So, the study aimed to assess the perception regarding respectful maternity care among postnatal mothers. \u0000Materials and Methods: A cross-sectional study was conducted among postnatal mothers at Tertiary Centre Hospital in Koshi Province. The study was started after acquiring approval from the Institutional Review Committee of Nobel Medical College. Data was collected using a face-to-face interview technique with a standardized tool from June 2022 to September 2022. A total of 102 postnatal mothers were taken as a sample by using a non-probability purposive sampling technique. Data analysis was done by descriptive study. \u0000Results: A total of 102 respondents participated in the study of which 62.7% had received overall dimensions of experienced Respectful Maternity Care (RMC) with a mean score ± SD (51.91 ± 5.56). Likewise, among the four dimensions of RMC, the highest average mean score of 81.96 is observed in the discrimination-free care with an SD of 11.08, where 100 % of the women claimed being received discrimination-free care. \u0000Conclusion: There was a significant association of RMC with residence and the number of ANC visits. Even though RMC prioritizes removing disrespectful and abusive settings from healthcare facilities, one-half of participants felt that they had not utilized all of RMC's offerings.","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":"48299982","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Background: Professional values are the basis to professional nursing practices. Professional values can be challenged by the variety of situation due to increasing globalization, diversity and health variance and can generate ethical dilemmas in health care delivery. Nursing students must be familiar to the professional value of the profession in which they are enrolled to imply the effective care to the patients. Material and Methods: A descriptive cross sectional study design was done to assess the Professional values among undergraduate Nursing students in Nobel Medical College Teaching Hospital. A total of 119 nursing students were included in the study using total enumerative sampling techniques. Nurses Professional Values Scale (NPVS-3) was used to assess professional values among the Nursing Students. The data were analysed using SPSS version 23. For descriptive statistics frequency, percentage, mean and standard deviation was calculated and for inferential statistics Pearson’s correlation test was used. Results: The total mean score of professional values from the nursing student’s outlook was high (115.24 ± 13.50) and also it reveals that 51.3% of the nursing students were conscious of professional values about nursing profession. The mean score was high (42.34 ±5.11) on caring sub-dimension than Activism and Professionalism. There was statistically significant relationship between the total score of professional values with Age. Conclusion: Findings of the study showed that the overall nursing professional value was high and the mean score was high on caring sub-dimension whereas professionalism and activism has been given less importance by the nursing students in comparison with caring domain.
{"title":"Professional Values among Undergraduate Nursing Students in Nobel Medical College Teaching Hospital","authors":"Indira Pokhrel, Saraswata Neupane, Dilliram Niroula","doi":"10.3126/jonmc.v12i1.56372","DOIUrl":"https://doi.org/10.3126/jonmc.v12i1.56372","url":null,"abstract":"Background: Professional values are the basis to professional nursing practices. Professional values can be challenged by the variety of situation due to increasing globalization, diversity and health variance and can generate ethical dilemmas in health care delivery. Nursing students must be familiar to the professional value of the profession in which they are enrolled to imply the effective care to the patients. \u0000Material and Methods: A descriptive cross sectional study design was done to assess the Professional values among undergraduate Nursing students in Nobel Medical College Teaching Hospital. A total of 119 nursing students were included in the study using total enumerative sampling techniques. Nurses Professional Values Scale (NPVS-3) was used to assess professional values among the Nursing Students. The data were analysed using SPSS version 23. For descriptive statistics frequency, percentage, mean and standard deviation was calculated and for inferential statistics Pearson’s correlation test was used. \u0000Results: The total mean score of professional values from the nursing student’s outlook was high (115.24 ± 13.50) and also it reveals that 51.3% of the nursing students were conscious of professional values about nursing profession. The mean score was high (42.34 ±5.11) on caring sub-dimension than Activism and Professionalism. There was statistically significant relationship between the total score of professional values with Age. \u0000Conclusion: Findings of the study showed that the overall nursing professional value was high and the mean score was high on caring sub-dimension whereas professionalism and activism has been given less importance by the nursing students in comparison with caring domain.","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":"41446700","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.v12i1.56498
Ipsa Shakya, Bishomber Neupane, Ritul Agrawal, Arun Bajgain, C.N. Darshan
A short femur length (FL) has been defined as the presence of a biometric value of fetal FL below the 5th percentile or −2 standard deviations (SD) for gestational age at ultrasound examination. A short FL was also defined as a biparietal diameter to FL ratio above 1.5 SD for gestational age or as observed to expected FL ratio ≤0.91 for gestational age. Short FL was considered isolated when both the estimated fetal weight and abdominal circumference were >10th percentile for GA. Here, we report a case of a pregnant patient with isolated short FL of fetus in third trimester ultrasound exam.
{"title":"Isolated Short Femur Length in the Third Trimester","authors":"Ipsa Shakya, Bishomber Neupane, Ritul Agrawal, Arun Bajgain, C.N. Darshan","doi":"10.3126/jonmc.v12i1.56498","DOIUrl":"https://doi.org/10.3126/jonmc.v12i1.56498","url":null,"abstract":"A short femur length (FL) has been defined as the presence of a biometric value of fetal FL below the 5th percentile or −2 standard deviations (SD) for gestational age at ultrasound examination. A short FL was also defined as a biparietal diameter to FL ratio above 1.5 SD for gestational age or as observed to expected FL ratio ≤0.91 for gestational age. Short FL was considered isolated when both the estimated fetal weight and abdominal circumference were >10th percentile for GA. Here, we report a case of a pregnant patient with isolated short FL of fetus in third trimester ultrasound exam.","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":"46763534","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.v12i1.56265
R. Ghimire, Anjil Kc, R. K. Shreewastav
Background: Rational use of analgesic drugs is needed for immediate relief of pain. This study was conducted to find out the prescribing pattern of analgesics in the emergency department. Materials and Methods: A descriptive cross-sectional study among patients attending the emergency department of a tertiary care hospital from March 2022 to February 2023 after approval from the Institutional Review Committee. Demographic profile, indications for analgesics use, route, and frequency of administration were recorded based on the pre-structured questionnaires. Convenient sampling was done. Data were analyzed by using SPSS, version 20. Results: Prescription patterns of analgesics were analyzed in 325 patients. The mean age was 46.93 ± 17.79 years with a male predominance of 196 (60.6%). Orthopedic problems 99(30.5%) due to trauma were the most common indications followed by medical and surgical indications for analgesic use. Non-steroidal anti-inflammatory drugs were used in 46.6%, opioids in 26.8%, combinations in 23%, and antispasmodics in 3.6%. Commonly prescribed analgesic was ketorolac (27.4%), tramadol (19.7%), and diclofenac (11.4%). The most common combination was ketorolac and tramadol (14.5%). Paracetamol alone was used in 16 (4.9%). A prescription with a generic name was 149 (45.8%). Parenteral use accounted for 86.8%. Co-administration of gastroprotective drugs was used in 93.2%. A fixed-dose combination was used in 1.2%. Conclusion: Non-steroidal anti-inflammatory drugs are the commonly used analgesics for various indications, including acute pain and fever. The choice of analgesics and their prescription pattern varied depending on indications, medical history, and the presence of co-morbidities. Ketorolac and tramadol were the most commonly prescribed analgesics.
{"title":"Evaluation of Prescription Pattern of Analgesics at Emergency Department of Tertiary Care Hospital: A Descriptive Cross-Sectional Study","authors":"R. Ghimire, Anjil Kc, R. K. Shreewastav","doi":"10.3126/jonmc.v12i1.56265","DOIUrl":"https://doi.org/10.3126/jonmc.v12i1.56265","url":null,"abstract":"Background: Rational use of analgesic drugs is needed for immediate relief of pain. This study was conducted to find out the prescribing pattern of analgesics in the emergency department. \u0000Materials and Methods: A descriptive cross-sectional study among patients attending the emergency department of a tertiary care hospital from March 2022 to February 2023 after approval from the Institutional Review Committee. Demographic profile, indications for analgesics use, route, and frequency of administration were recorded based on the pre-structured questionnaires. Convenient sampling was done. Data were analyzed by using SPSS, version 20. \u0000Results: Prescription patterns of analgesics were analyzed in 325 patients. The mean age was 46.93 ± 17.79 years with a male predominance of 196 (60.6%). Orthopedic problems 99(30.5%) due to trauma were the most common indications followed by medical and surgical indications for analgesic use. Non-steroidal anti-inflammatory drugs were used in 46.6%, opioids in 26.8%, combinations in 23%, and antispasmodics in 3.6%. Commonly prescribed analgesic was ketorolac (27.4%), tramadol (19.7%), and diclofenac (11.4%). The most common combination was ketorolac and tramadol (14.5%). Paracetamol alone was used in 16 (4.9%). A prescription with a generic name was 149 (45.8%). Parenteral use accounted for 86.8%. Co-administration of gastroprotective drugs was used in 93.2%. A fixed-dose combination was used in 1.2%. \u0000Conclusion: Non-steroidal anti-inflammatory drugs are the commonly used analgesics for various indications, including acute pain and fever. The choice of analgesics and their prescription pattern varied depending on indications, medical history, and the presence of co-morbidities. Ketorolac and tramadol were the most commonly prescribed analgesics.","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":"46833675","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 : 2022-12-31DOI: 10.3126/jonmc.v11i2.50445
R. Shrestha, M. Gautam
Background: Corona Virus Disease 2019came into existence in December 2019, as a sudden outbreak inthe city of Wuhan, China. Early identification of the patient is vitalto control disease transmission.This study is aimed at estimatingthe sensitivity, specificity, and practicability of Highresolution computed tomography chest in detecting Corona Virus Disease 2019 compared with a Reverse transcriptase-polymerase chain reaction. Materials and Methods: This was a retrospective single-center analytical study conducted at Nobel Medical Collegefor5 months during the second wave of Covid 19 from Feb 2021 to June 2021 after ethical approval from the Institutional Review Committee of Nobel Medical College Teaching Hospital. All clinically suspected patients who had undergoneHigh-resolution computed tomography chest and Reverse transcriptase-polymerase chain reaction within a 1-week time difference were included. High-resolution computed tomography chest scan was reported before Reverse transcriptase-polymerase chain reaction results became available. Results: Among 342 consecutive patients (195 male and 147 females, mean age 64), Reverse transcriptase-polymerase chain reaction was positive in 183 (53.5%) cases. Common High-resolution computed tomography chest features significantly more common in Reverse transcriptase-polymerase chain reaction positive patients were bilateral subpleural and peripheral ground-glass opacities with septal thickening(crazy paving). In comparison with Reverse transcriptase-polymerase chain reaction, the sensitivity was 91.8% and specificity 67.2%. Conclusion: This study revealed the high sensitivity of high-resolution computed tomography chest scansin accurately diagnosingCorona Virus Disease 2019.
{"title":"Sensitivity and Specificity of High Resolution Computed Tomography Chest in Diagnosing Corona Virus Disease 2019: A Retrospective Correlation with Reverse Transcriptase Polymerase Chain Reaction","authors":"R. Shrestha, M. Gautam","doi":"10.3126/jonmc.v11i2.50445","DOIUrl":"https://doi.org/10.3126/jonmc.v11i2.50445","url":null,"abstract":"Background: Corona Virus Disease 2019came into existence in December 2019, as a sudden outbreak inthe city of Wuhan, China. Early identification of the patient is vitalto control disease transmission.This study is aimed at estimatingthe sensitivity, specificity, and practicability of Highresolution computed tomography chest in detecting Corona Virus Disease 2019 compared with a Reverse transcriptase-polymerase chain reaction. \u0000Materials and Methods: This was a retrospective single-center analytical study conducted at Nobel Medical Collegefor5 months during the second wave of Covid 19 from Feb 2021 to June 2021 after ethical approval from the Institutional Review Committee of Nobel Medical College Teaching Hospital. All clinically suspected patients who had undergoneHigh-resolution computed tomography chest and Reverse transcriptase-polymerase chain reaction within a 1-week time difference were included. High-resolution computed tomography chest scan was reported before Reverse transcriptase-polymerase chain reaction results became available. \u0000Results: Among 342 consecutive patients (195 male and 147 females, mean age 64), Reverse transcriptase-polymerase chain reaction was positive in 183 (53.5%) cases. Common High-resolution computed tomography chest features significantly more common in Reverse transcriptase-polymerase chain reaction positive patients were bilateral subpleural and peripheral ground-glass opacities with septal thickening(crazy paving). In comparison with Reverse transcriptase-polymerase chain reaction, the sensitivity was 91.8% and specificity 67.2%. \u0000Conclusion: This study revealed the high sensitivity of high-resolution computed tomography chest scansin accurately diagnosingCorona Virus Disease 2019.","PeriodicalId":52824,"journal":{"name":"Journal of Nobel Medical College","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2022-12-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44883276","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 : 2022-12-31DOI: 10.3126/jonmc.v11i2.50463
K. Shrestha, K. R. Yadav, G. Singh, S. Bhattacharjee
Background: Candida albicans is one of the most frequently isolated yeast in clinical laboratories and studies have shown that it accounts for up to 80% of the yeast recovered from the site of infection. Candida species have emerged as significant opportunistic fungal pathogens and the conventional methods of yeast identification are reported to be cumbersome with delayed diagnosis and initiation of treatment. Thus rapid identification and speciation of Candida species is essential in clinical laboratories. Materials and Methods: A hospital based cross sectional study was carried out in the department of microbiology, Nobel medical college from January 2020 to December 2020. Approval was acquired from the Institutional Review Committee. Various clinical specimens were obtained and identification as per the standard microbiological procedures. Data were analyzed by SPSS, version 20. Results: A total of 62 Candida species were isolated out of which 65% were from male and 35% were from female patients. Candida albicans was found to be the most common species with 68%. The highest incidence was seen in the age group below 20 years and 21 – 40 years with 32.25% cases each followed by 41-60 years with 20.96% cases. Among 62 specimens, urine samples yielded the highest number of Candida species 48.38% followed by sputum samples with 29.03% Candida species. High vaginal swab (HVS) yielded 12.9% Candida species and blood samples yielded 9.67% Candida species. Conclusion: Candida albicans is still the most significant clinically but other non albicans are also emerging significant pathogens and warrant routine discrimination in clinical laboratories.
{"title":"Phenotypic Characterization of Candida species in Tertiary Care Hospital of Eastern Nepal","authors":"K. Shrestha, K. R. Yadav, G. Singh, S. Bhattacharjee","doi":"10.3126/jonmc.v11i2.50463","DOIUrl":"https://doi.org/10.3126/jonmc.v11i2.50463","url":null,"abstract":"Background: Candida albicans is one of the most frequently isolated yeast in clinical laboratories and studies have shown that it accounts for up to 80% of the yeast recovered from the site of infection. Candida species have emerged as significant opportunistic fungal pathogens and the conventional methods of yeast identification are reported to be cumbersome with delayed diagnosis and initiation of treatment. Thus rapid identification and speciation of Candida species is essential in clinical laboratories. \u0000Materials and Methods: A hospital based cross sectional study was carried out in the department of microbiology, Nobel medical college from January 2020 to December 2020. Approval was acquired from the Institutional Review Committee. Various clinical specimens were obtained and identification as per the standard microbiological procedures. Data were analyzed by SPSS, version 20. \u0000Results: A total of 62 Candida species were isolated out of which 65% were from male and 35% were from female patients. Candida albicans was found to be the most common species with 68%. The highest incidence was seen in the age group below 20 years and 21 – 40 years with 32.25% cases each followed by 41-60 years with 20.96% cases. Among 62 specimens, urine samples yielded the highest number of Candida species 48.38% followed by sputum samples with 29.03% Candida species. High vaginal swab (HVS) yielded 12.9% Candida species and blood samples yielded 9.67% Candida species. \u0000Conclusion: Candida albicans is still the most significant clinically but other non albicans are also emerging significant pathogens and warrant routine discrimination in clinical laboratories.","PeriodicalId":52824,"journal":{"name":"Journal of Nobel Medical College","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2022-12-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46401650","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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