Pub Date : 2022-06-29DOI: 10.3126/jonmc.v11i1.46066
M. Das, Rashmita Bhandari
Background: Cervical cancer is a leading health problem among women all over the world with significant mortality and morbidity in developing countries like Nepal. Pap smear is an effective and cost efficient diagnostic technique for cervical lesions. This study aims at histopathological correlation of cervical Pap smears. Materials and Methods: A cross sectional study was conducted from January 2020 to January 2022 in Pathology department of Nobel Medical College Teaching Hospital (NMCTH). 119 cases of cervical Pap smear were reported using the Bethesda system and correlated with histopathological examination findings for various epithelial cell abnormalities. Analysis was done using SPSS software version 20. Results: Out of 5110 smears examined, 119 were positive for epithelial cell abnormalities. Cellular abnormality was commonly seen between 31-60 years of age. Low grade Squamous Intraepithelial Lesion was the commonest lesion found. Pap smear findings had good concordance rates with histopathological findings for individual lesions. The overall sensitivity, specificity, positive predictive value, negative predictive value and diagnostic accuracy of Pap smear were 84%, 23.1%, 89.9%, 15% and 77.3% respectively. Conclusion: Pap smear has a good diagnostic accuracy, sensitivity and positive predictive value in diagnosing cervical lesions in comparison to histopathological examination
{"title":"Epithelial Cell Abnormality in Cervical Pap Smear with Histopathological Correlation among Patients of a Tertiary Care Centre in Eastern Nepal","authors":"M. Das, Rashmita Bhandari","doi":"10.3126/jonmc.v11i1.46066","DOIUrl":"https://doi.org/10.3126/jonmc.v11i1.46066","url":null,"abstract":"Background: Cervical cancer is a leading health problem among women all over the world with significant mortality and morbidity in developing countries like Nepal. Pap smear is an effective and cost efficient diagnostic technique for cervical lesions. This study aims at histopathological correlation of cervical Pap smears. \u0000Materials and Methods: A cross sectional study was conducted from January 2020 to January 2022 in Pathology department of Nobel Medical College Teaching Hospital (NMCTH). 119 cases of cervical Pap smear were reported using the Bethesda system and correlated with histopathological examination findings for various epithelial cell abnormalities. Analysis was done using SPSS software version 20. \u0000Results: Out of 5110 smears examined, 119 were positive for epithelial cell abnormalities. Cellular abnormality was commonly seen between 31-60 years of age. Low grade Squamous Intraepithelial Lesion was the commonest lesion found. Pap smear findings had good concordance rates with histopathological findings for individual lesions. The overall sensitivity, specificity, positive predictive value, negative predictive value and diagnostic accuracy of Pap smear were 84%, 23.1%, 89.9%, 15% and 77.3% respectively. \u0000Conclusion: Pap smear has a good diagnostic accuracy, sensitivity and positive predictive value in diagnosing cervical lesions in comparison to histopathological examination","PeriodicalId":52824,"journal":{"name":"Journal of Nobel Medical College","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2022-06-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"48919922","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 : 2022-06-29DOI: 10.3126/jonmc.v11i1.45782
M. Khadka
Background: Colonoscopy is the procedure of choice in investigations of suspected pathologies related to colon and terminal ileum and the standard practice for screening colonic polyps and cancer, especially in the elderly. Adequate bowel preparation is important for the efficacy of the procedure. As there is a lack of published data on colonoscopy preparation and findings in the Maldives, this study was conducted to share the single-center experience. Materials and Methods: This was a retrospective observational preliminary study carried out in the endoscopy center at ADK hospital, Maldives from April 2017 to March 2020. All patients were evaluated as per pre-designed Pro-forma. The procedure was performed after a pre-anesthetic check-up with intravenous sedation after bowel preparation as protocol. Findings were noted and Biopsies were taken as per need and sent for histopathologic examination. Results: Out of 129 patients who underwent lower gastrointestinal endoscopy, only 98 were included for the study analysis. Among them, 44% of patients were male and 56% were female. Young adults were more involved in the procedure. Bowel preparation was poor in the majority (52%). Bleeding per rectum was the most common indication (40%) and hemorrhoids were the most frequent finding (52%). In 86% of patients, colonoscopy was complete up to cecum with the majority of them up to terminal ileum. Conclusion: Per rectal bleeding was the most common indication for colonoscopy and hemorrhoids were the most common findings. Despite poor bowel preparation due to the lack of a standard cleansing regimen, the yield of the procedure was yet satisfactory.
{"title":"Three Years of Colonoscopy Experience in a Tertiary Hospital in Maldives","authors":"M. Khadka","doi":"10.3126/jonmc.v11i1.45782","DOIUrl":"https://doi.org/10.3126/jonmc.v11i1.45782","url":null,"abstract":"Background: Colonoscopy is the procedure of choice in investigations of suspected pathologies related to colon and terminal ileum and the standard practice for screening colonic polyps and cancer, especially in the elderly. Adequate bowel preparation is important for the efficacy of the procedure. As there is a lack of published data on colonoscopy preparation and findings in the Maldives, this study was conducted to share the single-center experience. \u0000Materials and Methods: This was a retrospective observational preliminary study carried out in the endoscopy center at ADK hospital, Maldives from April 2017 to March 2020. All patients were evaluated as per pre-designed Pro-forma. The procedure was performed after a pre-anesthetic check-up with intravenous sedation after bowel preparation as protocol. Findings were noted and Biopsies were taken as per need and sent for histopathologic examination. \u0000Results: Out of 129 patients who underwent lower gastrointestinal endoscopy, only 98 were included for the study analysis. Among them, 44% of patients were male and 56% were female. Young adults were more involved in the procedure. Bowel preparation was poor in the majority (52%). Bleeding per rectum was the most common indication (40%) and hemorrhoids were the most frequent finding (52%). In 86% of patients, colonoscopy was complete up to cecum with the majority of them up to terminal ileum. \u0000Conclusion: Per rectal bleeding was the most common indication for colonoscopy and hemorrhoids were the most common findings. Despite poor bowel preparation due to the lack of a standard cleansing regimen, the yield of the procedure was yet satisfactory.","PeriodicalId":52824,"journal":{"name":"Journal of Nobel Medical College","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2022-06-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44285724","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 : 2022-06-29DOI: 10.3126/jonmc.v11i1.45717
Sunaina Adhikari
Background: Corona virus disease pandemic has hastened the adoption of digital technology and online classes have become part of nursing education. The transition from face-to-face learning towards online learning is full of challenges and it is very important to explore students’ viewpoints regarding online classes. Materials and Methods: A descriptive cross-sectional study was carried out at Nobel Medical College among undergraduate nursing students. Non-probability consecutive sampling technique was adopted to collect data and 117 students participated in the study. A self-structured online form was developed and data were collected by a self-administered questionnaire through an online survey method. Data was entered and analyzed by SPSS 22.0 version. A Chi-square test was performed to assess the association between background variables and attitude level. Results: The study revealed that 50.43% of the students had negative attitudes towards online classes. In total, two-thirds (67.5%) of students preferred face-to-face learning. Variables such as age, enrolled nursing program, and year of study was significantly associated (p ≤ 0.05) with students’ attitudes towards online classes. Conclusion: Despite being the alternative solution, almost half of nursing students relatively had negative attitudes towards online classes. Students were more inclined towards face-to-face learning in future days.
{"title":"Attitude towards Online Classes among Nursing Students during COVID-19 Pandemic at Nobel Medical College Teaching Hospital","authors":"Sunaina Adhikari","doi":"10.3126/jonmc.v11i1.45717","DOIUrl":"https://doi.org/10.3126/jonmc.v11i1.45717","url":null,"abstract":"Background: Corona virus disease pandemic has hastened the adoption of digital technology and online classes have become part of nursing education. The transition from face-to-face learning towards online learning is full of challenges and it is very important to explore students’ viewpoints regarding online classes. \u0000Materials and Methods: A descriptive cross-sectional study was carried out at Nobel Medical College among undergraduate nursing students. Non-probability consecutive sampling technique was adopted to collect data and 117 students participated in the study. A self-structured online form was developed and data were collected by a self-administered questionnaire through an online survey method. Data was entered and analyzed by SPSS 22.0 version. A Chi-square test was performed to assess the association between background variables and attitude level. \u0000Results: The study revealed that 50.43% of the students had negative attitudes towards online classes. In total, two-thirds (67.5%) of students preferred face-to-face learning. Variables such as age, enrolled nursing program, and year of study was significantly associated (p ≤ 0.05) with students’ attitudes towards online classes. \u0000Conclusion: Despite being the alternative solution, almost half of nursing students relatively had negative attitudes towards online classes. Students were more inclined towards face-to-face learning in future days.","PeriodicalId":52824,"journal":{"name":"Journal of Nobel Medical College","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2022-06-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44083203","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 : 2022-06-29DOI: 10.3126/jonmc.v11i1.46166
Pratima Gautam, G. Sedain, Deependra Kumar Shrestha, M. Sharma
Intracranial aneurysms are sometimes associated with other vascular anomalies in extracranial location. Coarctation of aorta, a congenital vascular lesion can be associated with intracranial aneurysms. In patients with coarctation, evaluation of intracranial vasculature is essential. We encountered a 12-year kid with subarachnoid hemorrhage. On further evaluation, she had anterior communicating artery aneurysm. On further evaluation for secondary causes of aneurysm, she had coarctation of aorta. She was surgically managed successfully by clipping of the aneurysm.
{"title":"Subarachnoid Hemorrhage due to Ruptured Anterior Communicating Artery Aneurysm in a Child with Coarctation of Aorta","authors":"Pratima Gautam, G. Sedain, Deependra Kumar Shrestha, M. Sharma","doi":"10.3126/jonmc.v11i1.46166","DOIUrl":"https://doi.org/10.3126/jonmc.v11i1.46166","url":null,"abstract":"Intracranial aneurysms are sometimes associated with other vascular anomalies in extracranial location. Coarctation of aorta, a congenital vascular lesion can be associated with intracranial aneurysms. In patients with coarctation, evaluation of intracranial vasculature is essential. We encountered a 12-year kid with subarachnoid hemorrhage. On further evaluation, she had anterior communicating artery aneurysm. On further evaluation for secondary causes of aneurysm, she had coarctation of aorta. She was surgically managed successfully by clipping of the aneurysm. ","PeriodicalId":52824,"journal":{"name":"Journal of Nobel Medical College","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2022-06-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42743922","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 : 2022-06-29DOI: 10.3126/jonmc.v11i1.45962
V. Kaul, P. Rai
Backgroud: Depression is a common condition seen in Psychiatry outpatient department. The treatment data suggest that the drugs that modulate the serotonergic neurotransmission are effective in the treatment of depression. Serotonin and nor Epinephrine re uptake inhibitors are also being used to treat depression. This study is aimed at comparing the results of a selective serotonin re-Uptake inhibitor (Paroxetine) to that of both Serotonin and Nor-Adrenaline re-Uptake inhibitor (Venlafaxine). Comparative analysis between the effects of Controlled release Paroxetine and extended-release Venlafaxine for treatment of depression in eastern Nepal. Materials and Methods: It is a prospective, open and randomized comparison. One Hundred consecutive patients who attended the Psychiatry outpatient door of Nobel Medical College and Teaching Hospital and diagnosed as Depression were enrolled for this study after being divided into 2 groups: Group 1 also being named as Paroxetine group while Group 2 as Venelafaxine group. The 100 patients were enrolled after being followed all the required protocols including Montgomery Asberg rating Scale readings and data were recorded on Day 0, Week 1, 2,3,4,6,8. Results: According to the analysis of the Montgomery Asberg rating Scale scores at baseline and after completion of study at 8weeks, both Paroxetine Controlled Release and Venlafaxine Extended-release treated patients improved similarly. But, many of the Venlafaxine-treated patients had nausea and constipation (p<0.05). Conclusion: Paroxetine controlled released is better tolerated by patient though, the efficacy of both the drugs (paroxetine and venlafaxine) is similar for the treatment of Depression.
{"title":"Comparative Analysis between Controlled Release Paroxetine and Extended-Release Venlafaxine for Treatment of Depression","authors":"V. Kaul, P. Rai","doi":"10.3126/jonmc.v11i1.45962","DOIUrl":"https://doi.org/10.3126/jonmc.v11i1.45962","url":null,"abstract":"Backgroud: Depression is a common condition seen in Psychiatry outpatient department. The treatment data suggest that the drugs that modulate the serotonergic neurotransmission are effective in the treatment of depression. Serotonin and nor Epinephrine re uptake inhibitors are also being used to treat depression. This study is aimed at comparing the results of a selective serotonin re-Uptake inhibitor (Paroxetine) to that of both Serotonin and Nor-Adrenaline re-Uptake inhibitor (Venlafaxine). Comparative analysis between the effects of Controlled release Paroxetine and extended-release Venlafaxine for treatment of depression in eastern Nepal. \u0000Materials and Methods: It is a prospective, open and randomized comparison. One Hundred consecutive patients who attended the Psychiatry outpatient door of Nobel Medical College and Teaching Hospital and diagnosed as Depression were enrolled for this study after being divided into 2 groups: Group 1 also being named as Paroxetine group while Group 2 as Venelafaxine group. The 100 patients were enrolled after being followed all the required protocols including Montgomery Asberg rating Scale readings and data were recorded on Day 0, Week 1, 2,3,4,6,8. \u0000Results: According to the analysis of the Montgomery Asberg rating Scale scores at baseline and after completion of study at 8weeks, both Paroxetine Controlled Release and Venlafaxine Extended-release treated patients improved similarly. But, many of the Venlafaxine-treated patients had nausea and constipation (p<0.05). \u0000Conclusion: Paroxetine controlled released is better tolerated by patient though, the efficacy of both the drugs (paroxetine and venlafaxine) is similar for the treatment of Depression.","PeriodicalId":52824,"journal":{"name":"Journal of Nobel Medical College","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2022-06-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43984899","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 : 2022-06-29DOI: 10.3126/jonmc.v11i1.45730
A. Koirala, M. Gautam, Sachidanand Shah, D. Adhikari, A. Bhattarai, Ajay Kumar Yadav
Background: Appendectomy is most common surgical procedure done for treatment of acute appendicitis. Both laparoscopic and open techniques are used for its removal. The aim of this study is to compare the outcome of laparoscopic appendectomy with open appendectomy. Materials and Methods: A retrospective study was conducted in Nobel Medical College And Teaching Hospital, Biratnagar, Nepal from April 2019 to February 2021.Total 90 patients were enrolled in the study of which 44 in laparoscopic appendectomy group and 46 in open appendectomy group. These two groups were compared for demographic profiles, operative time, postoperative pain, length of hospital stay and surgical site infections. Results: Ninety patients underwent appendectomy of which 44 were in Laparoscopic group and 46 in Open group with similar demographic profiles. The mean operative time in Laparoscopic group was 42.95±2.46 minutes where as in Open group it was 35.25±1.87 minutes [p<0.001].The mean postoperative pain at 8 hours in Laparoscopic group was 7.77±1.03 and in Open group 8.45±1.16 [p=0.002], at day one Laparoscopic group 5.01±0.88 and in Open group 5.80±0.99 [p<0.001],at day two Laparoscopic group 3.54 ±1.19 and in Open group 4.26±0.89[p<0.001]. Mean duration of hospital stay in Laparoscopic group was 2.02±0.26 and Open group was 2.52 ±0.54[p<0.001]. Surgical site infections was noted 1(2.27%) in Laparoscopic group and 6(13.04%) in Open group[p=0.029]. Conclusion: Laparoscopic appendectomy offers less postoperative pain, shorter hospital stay, less surgical site infections but prolonged operative time compared to open appendectomy.
背景:阑尾切除术是治疗急性阑尾炎最常见的手术方法。腹腔镜和开放式技术均可用于切除。本研究的目的是比较腹腔镜阑尾切除术与开放式阑尾切除术的效果。材料与方法:回顾性研究于2019年4月至2021年2月在尼泊尔比拉特纳格尔诺贝尔医学院和教学医院进行。本研究共纳入90例患者,其中腹腔镜阑尾切除术组44例,开放式阑尾切除术组46例。比较两组患者的人口学特征、手术时间、术后疼痛、住院时间和手术部位感染。结果:90例患者行阑尾切除术,其中腹腔镜组44例,开放组46例,人口学特征相似。腹腔镜组平均手术时间为42.95±2.46 min,开放组平均手术时间为35.25±1.87 min [p<0.001]。腹腔镜组术后8 h平均疼痛为7.77±1.03,开放组为8.45±1.16 [p=0.002];第1天腹腔镜组为5.01±0.88,开放组为5.80±0.99 [p<0.001];第2天腹腔镜组为3.54±1.19,开放组为4.26±0.89[p<0.001]。腹腔镜组平均住院时间为2.02±0.26,开放组平均住院时间为2.52±0.54[p<0.001]。腹腔镜组手术部位感染1例(2.27%),开放组6例(13.04%)[p=0.029]。结论:与开放式阑尾切除术相比,腹腔镜阑尾切除术术后疼痛小,住院时间短,手术部位感染少,手术时间长。
{"title":"A Comparative Study of Laparoscopic Appendectomy with Open Appendectomy at a Tertiary Care Hospital","authors":"A. Koirala, M. Gautam, Sachidanand Shah, D. Adhikari, A. Bhattarai, Ajay Kumar Yadav","doi":"10.3126/jonmc.v11i1.45730","DOIUrl":"https://doi.org/10.3126/jonmc.v11i1.45730","url":null,"abstract":"Background: Appendectomy is most common surgical procedure done for treatment of acute appendicitis. Both laparoscopic and open techniques are used for its removal. The aim of this study is to compare the outcome of laparoscopic appendectomy with open appendectomy. \u0000Materials and Methods: A retrospective study was conducted in Nobel Medical College And Teaching Hospital, Biratnagar, Nepal from April 2019 to February 2021.Total 90 patients were enrolled in the study of which 44 in laparoscopic appendectomy group and 46 in open appendectomy group. These two groups were compared for demographic profiles, operative time, postoperative pain, length of hospital stay and surgical site infections. \u0000Results: Ninety patients underwent appendectomy of which 44 were in Laparoscopic group and 46 in Open group with similar demographic profiles. The mean operative time in Laparoscopic group was 42.95±2.46 minutes where as in Open group it was 35.25±1.87 minutes [p<0.001].The mean postoperative pain at 8 hours in Laparoscopic group was 7.77±1.03 and in Open group 8.45±1.16 [p=0.002], at day one Laparoscopic group 5.01±0.88 and in Open group 5.80±0.99 [p<0.001],at day two Laparoscopic group 3.54 ±1.19 and in Open group 4.26±0.89[p<0.001]. Mean duration of hospital stay in Laparoscopic group was 2.02±0.26 and Open group was 2.52 ±0.54[p<0.001]. Surgical site infections was noted 1(2.27%) in Laparoscopic group and 6(13.04%) in Open group[p=0.029]. \u0000Conclusion: Laparoscopic appendectomy offers less postoperative pain, shorter hospital stay, less surgical site infections but prolonged operative time compared to open appendectomy.","PeriodicalId":52824,"journal":{"name":"Journal of Nobel Medical College","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2022-06-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43465933","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 : 2022-06-29DOI: 10.3126/jonmc.v11i1.45957
R. Jha, D. Giri
Background: Oral cancer is one of the most common life-threatening conditions. Lack of awareness, knowledge, risk factors and early sign and symptom of oral cancer .Thus the aim of present study was to to evaluate the awareness and knowledge about oral cancer among patients. Materials and Methods: The descriptive cross-sectional study was done in Nobel Medical College Teaching Hospital, Biratnagar, Nepal from December 2020 to February 2021. Approval was acquired from Institutional Review Committee. A total of 300 patients above 25years of age group were included in the study. Self -administered questionnaire was prepared and distributed to obtain information about patient’s age, gender, education level and occupation. The questions regarded habits, awareness of oral cancer, knowledge of the risk factors, signs and symptoms and source of information about oral cancer. Results: A total of 300 patients participated in this study out of which male was 70%, and the female was 30%. The result of awareness questionnaire showed that 65% of the respondents were heard about oral cancer. The study revealed that 70.3% and 62.6% respectively patients were sable to correctly identify tobacco and smokeless tobacco as risk factor and 64% and 53.5% respectively was able to correctly identify white patch and red patch as signs and symptom of oral cancer. Majority of the respondent 46% yielded awareness and knowledge of oral cancer from media. Conclusion: The present study shows the dental patients had lack of awareness and knowledge about the risk factors and signs and symptom of oral cancer.
{"title":"Awareness and Knowledge of Oral Cancer in Patients Visiting Nobel Medical College Teaching Hospital","authors":"R. Jha, D. Giri","doi":"10.3126/jonmc.v11i1.45957","DOIUrl":"https://doi.org/10.3126/jonmc.v11i1.45957","url":null,"abstract":"Background: Oral cancer is one of the most common life-threatening conditions. Lack of awareness, knowledge, risk factors and early sign and symptom of oral cancer .Thus the aim of present study was to to evaluate the awareness and knowledge about oral cancer among patients. \u0000Materials and Methods: The descriptive cross-sectional study was done in Nobel Medical College Teaching Hospital, Biratnagar, Nepal from December 2020 to February 2021. Approval was acquired from Institutional Review Committee. A total of 300 patients above 25years of age group were included in the study. Self -administered questionnaire was prepared and distributed to obtain information about patient’s age, gender, education level and occupation. The questions regarded habits, awareness of oral cancer, knowledge of the risk factors, signs and symptoms and source of information about oral cancer. \u0000Results: A total of 300 patients participated in this study out of which male was 70%, and the female was 30%. The result of awareness questionnaire showed that 65% of the respondents were heard about oral cancer. The study revealed that 70.3% and 62.6% respectively patients were sable to correctly identify tobacco and smokeless tobacco as risk factor and 64% and 53.5% respectively was able to correctly identify white patch and red patch as signs and symptom of oral cancer. Majority of the respondent 46% yielded awareness and knowledge of oral cancer from media. \u0000Conclusion: The present study shows the dental patients had lack of awareness and knowledge about the risk factors and signs and symptom of oral cancer. ","PeriodicalId":52824,"journal":{"name":"Journal of Nobel Medical College","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2022-06-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"48971906","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 : 2022-06-29DOI: 10.3126/jonmc.v11i1.46082
N. Vaidya, Nishan Bhattarai, Prabhat Gami, B. Tamang, Sahil Bade, S. Bade
Background: It is universally recommended that blood pressure should be measured on bare arm for accurate reading. However, this is seldom done in busy clinical schedules. This study aims to see if clothing adjustments should be a concern while measuring blood pressure under suboptimal conditions. Materials and Methods: This was a cross sectional study conducted at medicine department of Kathmandu University Hospital, Dhulikhel Hospital among conveniently selected 100 patients. After getting informed consent, consecutive blood pressure measurements were done over rolled-up sleeve arm, sleeve arm and bare arm in seated position. Socio-demographic information were obtained through an interview using a semi-structured questionnaire. Data were entered in Microsoft Excel and analyzed using descriptive and inferential statistics in Statistical Software for Social Sciences version 20. Results: The median of differences between sleeved arm and bare arm was 0 for both systolic and diastolic blood pressure and the median value for differences between rolled up arm and bare arm was 2 units for both systolic and diastolic blood pressure. Although the differences looked statistically significant, the size of the differences was not clinically significant. Conclusion: Meticulous clothing adjustment has clinically insignificant differences in measurement of blood pressure if patient is wearing thin sleeves. Therefore, in suboptimal conditions, blood pressure can be measured on rolled-up sleeve arm and sleeve arm if patient is wearing thin sleeve clothes.
{"title":"Comparison of Blood Pressure Readings on a Bare Arm, over a Sleeve Arm and over a Rolled-Up Sleeve Arm in Outpatient Department of Medicine in Dhulikhel Hospital, Kathmandu University Hospital","authors":"N. Vaidya, Nishan Bhattarai, Prabhat Gami, B. Tamang, Sahil Bade, S. Bade","doi":"10.3126/jonmc.v11i1.46082","DOIUrl":"https://doi.org/10.3126/jonmc.v11i1.46082","url":null,"abstract":"Background: It is universally recommended that blood pressure should be measured on bare arm for accurate reading. However, this is seldom done in busy clinical schedules. This study aims to see if clothing adjustments should be a concern while measuring blood pressure under suboptimal conditions. \u0000Materials and Methods: This was a cross sectional study conducted at medicine department of Kathmandu University Hospital, Dhulikhel Hospital among conveniently selected 100 patients. After getting informed consent, consecutive blood pressure measurements were done over rolled-up sleeve arm, sleeve arm and bare arm in seated position. Socio-demographic information were obtained through an interview using a semi-structured questionnaire. Data were entered in Microsoft Excel and analyzed using descriptive and inferential statistics in Statistical Software for Social Sciences version 20. \u0000Results: The median of differences between sleeved arm and bare arm was 0 for both systolic and diastolic blood pressure and the median value for differences between rolled up arm and bare arm was 2 units for both systolic and diastolic blood pressure. Although the differences looked statistically significant, the size of the differences was not clinically significant. \u0000Conclusion: Meticulous clothing adjustment has clinically insignificant differences in measurement of blood pressure if patient is wearing thin sleeves. Therefore, in suboptimal conditions, blood pressure can be measured on rolled-up sleeve arm and sleeve arm if patient is wearing thin sleeve clothes.","PeriodicalId":52824,"journal":{"name":"Journal of Nobel Medical College","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2022-06-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41473290","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 : 2022-06-29DOI: 10.3126/jonmc.v11i1.45731
B. Thapa, P. Sitoula, Ranjib Kumar Jha, Santosh Thapa, S. Kunwar, Ashish Rajthala
Background: Open tibia fractures are high energy injuries often associated with large soft defects, extensive soft tissue stripping and contamination requiring multiple debridement procedures. Collective ortho-plastic approach helps us achieve proper debridement, adequate fixation and early soft tissue coverage. Due to fairly high incidence of failure, steep learning curve, time consuming procedure and the cost of treatment for those tedious free flaps, non-microvascular flaps are being preferred to cover the soft tissue defects or exposed hardware in open tibia fractures. Materials and Methods: A prospective study was carried out in 19 patients to assess the outcome of soft tissue coverage in open tibia fractures with non-microvascular flap. Out of these patients, 6 patients were treated with medial gastrocnemius flap, 5 patients with medial hemi-soleus, 5 patients with reverse sural fasciocutaneous flap, and 3 patients with local rotational random flaps. Outcome measures included bony union, deep surgical infection and flap failure. Results: 84% patients were male whereas 16% patients were female. Road traffic accident was the major cause of the defect among the patients (74%). Complications in the form of deep infection (10%), non-union (21%), delayed union (10%) and marginal flap necrosis (21%) were observed. Conclusion: In our study, early soft tissue coverage with appropriate non-microvascular flaps in management of severe open fractures of tibia was associated with more favourable outcomes.
{"title":"Outcome of Soft Tissue Coverage in Open Tibia Fractures with Non-Microvascular Flap at a Tertiary Care Hospital","authors":"B. Thapa, P. Sitoula, Ranjib Kumar Jha, Santosh Thapa, S. Kunwar, Ashish Rajthala","doi":"10.3126/jonmc.v11i1.45731","DOIUrl":"https://doi.org/10.3126/jonmc.v11i1.45731","url":null,"abstract":"Background: Open tibia fractures are high energy injuries often associated with large soft defects, extensive soft tissue stripping and contamination requiring multiple debridement procedures. Collective ortho-plastic approach helps us achieve proper debridement, adequate fixation and early soft tissue coverage. Due to fairly high incidence of failure, steep learning curve, time consuming procedure and the cost of treatment for those tedious free flaps, non-microvascular flaps are being preferred to cover the soft tissue defects or exposed hardware in open tibia fractures. \u0000Materials and Methods: A prospective study was carried out in 19 patients to assess the outcome of soft tissue coverage in open tibia fractures with non-microvascular flap. Out of these patients, 6 patients were treated with medial gastrocnemius flap, 5 patients with medial hemi-soleus, 5 patients with reverse sural fasciocutaneous flap, and 3 patients with local rotational random flaps. Outcome measures included bony union, deep surgical infection and flap failure. \u0000Results: 84% patients were male whereas 16% patients were female. Road traffic accident was the major cause of the defect among the patients (74%). Complications in the form of deep infection (10%), non-union (21%), delayed union (10%) and marginal flap necrosis (21%) were observed. \u0000Conclusion: In our study, early soft tissue coverage with appropriate non-microvascular flaps in management of severe open fractures of tibia was associated with more favourable outcomes.","PeriodicalId":52824,"journal":{"name":"Journal of Nobel Medical College","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2022-06-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42025149","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 : 2022-06-29DOI: 10.3126/jonmc.v11i1.45734
Amar Kumar Yadav, A. Acharya, Rimu Mishra
Background: Knowledge of contraceptive methods is nearly universal in Nepal, with almost all women and men knowing at least one method of contraception. The contraceptive prevalence rate among currently married women age 15-49 is 53%, with 43% using modern methods. This implies that Nepal needs to strengthen its family planning program to achieve the country’s commitments to global family planning goals and to reach a modern contraceptive prevalence rate of 52% by 2020. Materials and Methods: The study was descriptive cross sectional community based conducted in kharji, biratnagar municipality ward number 4, semi urban area or Eastern zone of Nepal. Total female of reproductive age 15 -49 married women 473 taken as a sample size. The data were collected by interview by predesigned and pretested questionnaire. Analysis of the data was done by SPSS. Results: Among all the respondents, 453 (95.77%) had the knowledge about the family planning. The majority of the study population 430 (90.90%) had positive attitude towards contraceptives. Among the all respondents, 210 (44.39%) were practice the different types of contraceptives methods. Most of the respondents 75(35.71%) practiced condom. Conclusion: The study concludes that the married women of reproductive age group had good knowledge and positive attitude towards family planning even though the practiced of family planning were low (44.39%).
{"title":"Knowledge, Attitude and Practice towards Family Planning among the Reproductive Age Group of Married Women in Semi Urban Area","authors":"Amar Kumar Yadav, A. Acharya, Rimu Mishra","doi":"10.3126/jonmc.v11i1.45734","DOIUrl":"https://doi.org/10.3126/jonmc.v11i1.45734","url":null,"abstract":"Background: Knowledge of contraceptive methods is nearly universal in Nepal, with almost all women and men knowing at least one method of contraception. The contraceptive prevalence rate among currently married women age 15-49 is 53%, with 43% using modern methods. This implies that Nepal needs to strengthen its family planning program to achieve the country’s commitments to global family planning goals and to reach a modern contraceptive prevalence rate of 52% by 2020. \u0000Materials and Methods: The study was descriptive cross sectional community based conducted in kharji, biratnagar municipality ward number 4, semi urban area or Eastern zone of Nepal. Total female of reproductive age 15 -49 married women 473 taken as a sample size. The data were collected by interview by predesigned and pretested questionnaire. Analysis of the data was done by SPSS. \u0000Results: Among all the respondents, 453 (95.77%) had the knowledge about the family planning. The majority of the study population 430 (90.90%) had positive attitude towards contraceptives. Among the all respondents, 210 (44.39%) were practice the different types of contraceptives methods. Most of the respondents 75(35.71%) practiced condom. \u0000Conclusion: The study concludes that the married women of reproductive age group had good knowledge and positive attitude towards family planning even though the practiced of family planning were low (44.39%).","PeriodicalId":52824,"journal":{"name":"Journal of Nobel Medical College","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2022-06-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"48673503","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}