Pub Date : 2021-06-22DOI: 10.3126/jonmc.v10i1.37981
A. Rai, Rajeev Yadav, S. Karki, M. Pradhan
Background: Out of many cause of non-scarring alopecia, alopecia areata is one the cause of non-scarring alopecia. Most study till now has shown autoimmunity to be pathogenesis of alopecia areata and has found to be frequently associated with abnormal thyroid function. The current study aims to early detection of thyroid dysfunction in AA patient and reduce morbidity related to thyroid disorder. Materials and Methods: This was a prospective observational study conducted over a period of 1 year from July 2018 to June 2019 in department of dermatology Nobel Medical College, Biratnagar. Any patient who presented with clinical features of alopecia areata were included in the study. Results: In our study, only 5 (7.1%) patients showed abnormal thyroid function tests, and other 65 (92.9%) had normal thyroid function. 3 patients (4.3%) had hypothyroidism and 2 patients (2.9%) had hyperthyroidism. In those presenting with thyroid dysfunction, 3 (10.3%) were females and 2 (4.9%) were males Mean age of onset of alopecia areata was 27.8 years. Conclusion: Our study did not show significant association of alopecia areata with thyroid dysfunction. However this study showed male preponderance in alopecia areata though thyroid dysfunction was seen more in female.
{"title":"Alopecia Areata and it’s Association with Thyroid Dysfunction","authors":"A. Rai, Rajeev Yadav, S. Karki, M. Pradhan","doi":"10.3126/jonmc.v10i1.37981","DOIUrl":"https://doi.org/10.3126/jonmc.v10i1.37981","url":null,"abstract":"Background: Out of many cause of non-scarring alopecia, alopecia areata is one the cause of non-scarring alopecia. Most study till now has shown autoimmunity to be pathogenesis of alopecia areata and has found to be frequently associated with abnormal thyroid function. The current study aims to early detection of thyroid dysfunction in AA patient and reduce morbidity related to thyroid disorder. \u0000Materials and Methods: This was a prospective observational study conducted over a period of 1 year from July 2018 to June 2019 in department of dermatology Nobel Medical College, Biratnagar. Any patient who presented with clinical features of alopecia areata were included in the study. \u0000Results: In our study, only 5 (7.1%) patients showed abnormal thyroid function tests, and other 65 (92.9%) had normal thyroid function. 3 patients (4.3%) had hypothyroidism and 2 patients (2.9%) had hyperthyroidism. In those presenting with thyroid dysfunction, 3 (10.3%) were females and 2 (4.9%) were males Mean age of onset of alopecia areata was 27.8 years. \u0000Conclusion: Our study did not show significant association of alopecia areata with thyroid dysfunction. However this study showed male preponderance in alopecia areata though thyroid dysfunction was seen more in female.","PeriodicalId":52824,"journal":{"name":"Journal of Nobel Medical College","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-06-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42406642","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 : 2021-06-22DOI: 10.3126/jonmc.v10i1.37986
S. Dhungana, Sanjib K Sharma
The clinical picture of infective endocarditis varies from the asymptomatic stage for a long duration to an acute fulminant course. A high index of suspicion is necessary whenever a patient presents with nonspecific symptoms and some peripheral clinical signs with a cardiac murmur. We report a case of sub-acute IE involving multiple left and right side cardiac valves with underlying rheumatic heart disease (RHD).
{"title":"Multi-Valvular Endocarditis with Underlying Rheumatic Heart Disease: A Case Report","authors":"S. Dhungana, Sanjib K Sharma","doi":"10.3126/jonmc.v10i1.37986","DOIUrl":"https://doi.org/10.3126/jonmc.v10i1.37986","url":null,"abstract":"The clinical picture of infective endocarditis varies from the asymptomatic stage for a long duration to an acute fulminant course. A high index of suspicion is necessary whenever a patient presents with nonspecific symptoms and some peripheral clinical signs with a cardiac murmur. We report a case of sub-acute IE involving multiple left and right side cardiac valves with underlying rheumatic heart disease (RHD).","PeriodicalId":52824,"journal":{"name":"Journal of Nobel Medical College","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-06-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42679827","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 : 2021-06-22DOI: 10.3126/jonmc.v10i1.37980
Ashish Shrestha, Ang Dali Sherpa
Background: Facial Lacerations constitute an important reason for children (< 18 years) to visit emergency room. While bleeding and pain are the associated acute problems, the long term outcome in terms of a cosmetically acceptable scar is a matter of significant parental concern. The aim of the research is to study the profile of facial lacerations in children and to assess the outcome of repair. Materials and Methods: A retrospective review of children who underwent facial laceration repair between January 2018 and December 2020 was done. The deep ones underwent sutured repair in layers reinforced withtissue adhesive in operation room under intra-venous anesthesia and superficial ones in emergency room with only tissue adhesive following usual wound treatment protocol. Demographics, surgical details and outcomes were studied. All the repaired cuts were followed up at 1 year retrospectively and the cosmetic outcome was evaluated using modified stony brooke scoring system. Results: A total of 40 patients (24 males, 16 females) underwent facial laceration repair at a mean age of 4.7 years (range 1-13 years). Seventeen were deep and 23 were superficial cuts. Only1child in the superficial group with gross wound contamination at presentation developed wound infection. No dissatisfaction was reported in the deep group while parents of 4 children in the superficial group reported dissatisfaction with the final scar. Conclusion: While surface cuts can be treated with irrigations and tissue adhesive in the emergency room, the deeper cuts require layered repair aided by tissue adhesive for optimum scar outcome.
{"title":"Treating Facial Cuts to a Near Scar Less Outcome in Children","authors":"Ashish Shrestha, Ang Dali Sherpa","doi":"10.3126/jonmc.v10i1.37980","DOIUrl":"https://doi.org/10.3126/jonmc.v10i1.37980","url":null,"abstract":"Background: Facial Lacerations constitute an important reason for children (< 18 years) to visit emergency room. While bleeding and pain are the associated acute problems, the long term outcome in terms of a cosmetically acceptable scar is a matter of significant parental concern. The aim of the research is to study the profile of facial lacerations in children and to assess the outcome of repair. \u0000Materials and Methods: A retrospective review of children who underwent facial laceration repair between January 2018 and December 2020 was done. The deep ones underwent sutured repair in layers reinforced withtissue adhesive in operation room under intra-venous anesthesia and superficial ones in emergency room with only tissue adhesive following usual wound treatment protocol. Demographics, surgical details and outcomes were studied. All the repaired cuts were followed up at 1 year retrospectively and the cosmetic outcome was evaluated using modified stony brooke scoring system. \u0000Results: A total of 40 patients (24 males, 16 females) underwent facial laceration repair at a mean age of 4.7 years (range 1-13 years). Seventeen were deep and 23 were superficial cuts. Only1child in the superficial group with gross wound contamination at presentation developed wound infection. No dissatisfaction was reported in the deep group while parents of 4 children in the superficial group reported dissatisfaction with the final scar. \u0000Conclusion: While surface cuts can be treated with irrigations and tissue adhesive in the emergency room, the deeper cuts require layered repair aided by tissue adhesive for optimum scar outcome.","PeriodicalId":52824,"journal":{"name":"Journal of Nobel Medical College","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-06-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49302043","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 : 2021-06-20DOI: 10.3126/JONMC.V10I1.37944
B. Joshi, S. Rizal
Background: Low density lipoproteinforms a basis of decision making in treatment of hypercholesterolemic patients and primary target of intervention. Its cost effective and accurate measurementis a need for every clinical laboratories and different calculation methods has been adopted as a replacement to direct assays. This study aims to evaluate the Martin’s formula and Friedewald’s formula in a sample of Nepalese population compared against direct homogenous assay. Materials and Methods: This is a cross-sectional study conducted in Department of Biochemistry from Feb 2020 to January 2021. Serum samples of the participants were analysed for total cholesterol, triglyceride, high density lipoprotein and low density lipoprotein. Martin’s and Friedewald’s formula were applied to get calculated value of low density lipoprotein from both methods. Passing and Bablok regression analysis was used for methods comparison. Results: The mean age of participants was 54.2 ± 8.9 years. Passing-Bablok regression analysis showed Friedewald’s formula performed better than Martin’s formula as per systematic and proportional bias when compared with directassay. However at lowerserum low density lipoprotein level, underestimation of low density lipoprotein compared to direct assay was more common in Friedewald’s formula. At high triglyceride level more percentage error of difference of mean from direct assay was found for Friedewald’s formula. Conclusion: When compared to direct assay, Friedewald’s formula was found to be in better agreement than Martin’s formula. Martin’s formula had advantage over Friedewald’s formula at lower serum low density lipoprotein level and higher triglyceride level where Friedewald’s formula mostly underestimated low density lipoprotein.
{"title":"Comparative Analysis between Martin’s Formula and Friedewald’s Formula with Direct Homogenous Assay for Estimating Low Density Lipoprotein Cholesterol Level in Nepalese Population","authors":"B. Joshi, S. Rizal","doi":"10.3126/JONMC.V10I1.37944","DOIUrl":"https://doi.org/10.3126/JONMC.V10I1.37944","url":null,"abstract":"Background: Low density lipoproteinforms a basis of decision making in treatment of hypercholesterolemic patients and primary target of intervention. Its cost effective and accurate measurementis a need for every clinical laboratories and different calculation methods has been adopted as a replacement to direct assays. This study aims to evaluate the Martin’s formula and Friedewald’s formula in a sample of Nepalese population compared against direct homogenous assay. \u0000Materials and Methods: This is a cross-sectional study conducted in Department of Biochemistry from Feb 2020 to January 2021. Serum samples of the participants were analysed for total cholesterol, triglyceride, high density lipoprotein and low density lipoprotein. Martin’s and Friedewald’s formula were applied to get calculated value of low density lipoprotein from both methods. Passing and Bablok regression analysis was used for methods comparison. \u0000Results: The mean age of participants was 54.2 ± 8.9 years. Passing-Bablok regression analysis showed Friedewald’s formula performed better than Martin’s formula as per systematic and proportional bias when compared with directassay. However at lowerserum low density lipoprotein level, underestimation of low density lipoprotein compared to direct assay was more common in Friedewald’s formula. At high triglyceride level more percentage error of difference of mean from direct assay was found for Friedewald’s formula. \u0000Conclusion: When compared to direct assay, Friedewald’s formula was found to be in better agreement than Martin’s formula. Martin’s formula had advantage over Friedewald’s formula at lower serum low density lipoprotein level and higher triglyceride level where Friedewald’s formula mostly underestimated low density lipoprotein.","PeriodicalId":52824,"journal":{"name":"Journal of Nobel Medical College","volume":"10 1","pages":"36-41"},"PeriodicalIF":0.0,"publicationDate":"2021-06-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41536556","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 : 2021-06-20DOI: 10.3126/jonmc.v10i1.37943
R. Ghimire, R. K. Shreewastav
Background: Prescription of rational drugs is needed to save critically ill patients. This study was conducted to assess the prescription patterns of drugs in the intensive care unit. Materials and Methods: A descriptive cross-sectional study among patients admitted in intensive care unit from March 2020 to February 2021 after approval from the Institutional Review Committee (ref no. 344 /2019). Demographic profile, prescription patterns, the average number of drugs used, route of administration, and duration of hospitalization were recorded based on the pre-structured questionnaires. Convenient sampling was chosen. Data were analyzed by SPSS, version 20. Results: Prescription patterns of 225 were analyzed. The mean age was 55.60 ± 20.16 years with a male predominance of 131(58.2%). Cardiac disorders 57(25.3%) were the most common admitting diagnosis followed by pulmonary, neurological, and kidney disorders. The average length of hospital stay was 4.14 days (range 1-38 days). A total of 887 drugs were prescribed. The mean number of drugs prescribed per patient was 7.71 ± 1.92. Parenteral drugs accounted for 81.39%. Antibiotics were prescribed to all patients. Intravenous fluids were given to 62.2% of patients, blood and blood products to 21.33%. Thromboprophylaxis was used in 15 (6.7%) patients. Seven hundred twenty-two (81.39%) drugs were injectables, 129(14.54%) were used by the oral or nasogastric route and 36 (4.05%) were inhaled drugs. Conclusion: Newer generations antibiotics were the most commonly prescribed drugs. Pantoprazole, Metoclopramide, and Hydrocortisone were the top three most commonly prescribed individual drugs. There was marked underuse of thromboprophylaxis, analgesics, and sedatives.
{"title":"Evaluation of Drug Use Patterns in Intensive Care Unit of Tertiary Care Hospital: A Descriptive Cross-Sectional Study","authors":"R. Ghimire, R. K. Shreewastav","doi":"10.3126/jonmc.v10i1.37943","DOIUrl":"https://doi.org/10.3126/jonmc.v10i1.37943","url":null,"abstract":"Background: Prescription of rational drugs is needed to save critically ill patients. This study was conducted to assess the prescription patterns of drugs in the intensive care unit. \u0000Materials and Methods: A descriptive cross-sectional study among patients admitted in intensive care unit from March 2020 to February 2021 after approval from the Institutional Review Committee (ref no. 344 /2019). Demographic profile, prescription patterns, the average number of drugs used, route of administration, and duration of hospitalization were recorded based on the pre-structured questionnaires. Convenient sampling was chosen. Data were analyzed by SPSS, version 20. \u0000Results: Prescription patterns of 225 were analyzed. The mean age was 55.60 ± 20.16 years with a male predominance of 131(58.2%). Cardiac disorders 57(25.3%) were the most common admitting diagnosis followed by pulmonary, neurological, and kidney disorders. The average length of hospital stay was 4.14 days (range 1-38 days). A total of 887 drugs were prescribed. The mean number of drugs prescribed per patient was 7.71 ± 1.92. Parenteral drugs accounted for 81.39%. Antibiotics were prescribed to all patients. Intravenous fluids were given to 62.2% of patients, blood and blood products to 21.33%. Thromboprophylaxis was used in 15 (6.7%) patients. Seven hundred twenty-two (81.39%) drugs were injectables, 129(14.54%) were used by the oral or nasogastric route and 36 (4.05%) were inhaled drugs. \u0000Conclusion: Newer generations antibiotics were the most commonly prescribed drugs. Pantoprazole, Metoclopramide, and Hydrocortisone were the top three most commonly prescribed individual drugs. There was marked underuse of thromboprophylaxis, analgesics, and sedatives. ","PeriodicalId":52824,"journal":{"name":"Journal of Nobel Medical College","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-06-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42405410","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 : 2021-06-20DOI: 10.3126/jonmc.v10i1.37946
P. Kafle, M. Sharma, S. Shilpakar, G. Sedain, Amit Pradhanang, A. Thapa, R. Shrestha, B. Rajbhandari, B. Khanal
Background: There are limited studies pertaining to management of encephalocele in Nepal. So the present study seems justifiable to bridge the gap in the literature on encephalocele from Nepal on its clinical profile and early outcome. This study aims to characterize the clinical profile, management and outcome of largest series of encephalocele at tertiary care center in Nepal. Materials and Methods: A retrospective analysis of encephalocele, managed surgically at two tertiary care centers between 2015 and 2020, was performed. Results: Total of 25 cases was surgically managed in the present study. The median age of study population was 2.5 months. There were 11 male and 14 female with male to female ratio of 1:1.26. Occipital encephalocele was the most common variant. Lump in the head (n=11) was the commonest clinical presentation followed by hyperteliorism (n=10). One patient presented with cleft lip and one had CSF discharge in a case of occipital encephalocele. Bony defect was the common radiological findings. Excision and repair was the most common mode of surgery leading to good outcome. Mortality rate was 4% with morbidity of 20%. Conclusion: Early surgical excision and tight dural closure with repair of bony defect is the standard treatment with relatively good outcome.
{"title":"Surgical Management and Early Outcome of Encephalocele","authors":"P. Kafle, M. Sharma, S. Shilpakar, G. Sedain, Amit Pradhanang, A. Thapa, R. Shrestha, B. Rajbhandari, B. Khanal","doi":"10.3126/jonmc.v10i1.37946","DOIUrl":"https://doi.org/10.3126/jonmc.v10i1.37946","url":null,"abstract":"Background: There are limited studies pertaining to management of encephalocele in Nepal. So the present study seems justifiable to bridge the gap in the literature on encephalocele from Nepal on its clinical profile and early outcome. This study aims to characterize the clinical profile, management and outcome of largest series of encephalocele at tertiary care center in Nepal. \u0000Materials and Methods: A retrospective analysis of encephalocele, managed surgically at two tertiary care centers between 2015 and 2020, was performed. \u0000Results: Total of 25 cases was surgically managed in the present study. The median age of study population was 2.5 months. There were 11 male and 14 female with male to female ratio of 1:1.26. Occipital encephalocele was the most common variant. Lump in the head (n=11) was the commonest clinical presentation followed by hyperteliorism (n=10). One patient presented with cleft lip and one had CSF discharge in a case of occipital encephalocele. Bony defect was the common radiological findings. Excision and repair was the most common mode of surgery leading to good outcome. Mortality rate was 4% with morbidity of 20%. \u0000Conclusion: Early surgical excision and tight dural closure with repair of bony defect is the standard treatment with relatively good outcome.","PeriodicalId":52824,"journal":{"name":"Journal of Nobel Medical College","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-06-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41799578","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 : 2021-06-19DOI: 10.3126/jonmc.v10i1.37929
M. Yadav, S. Subedi
Background: Congenital disorders (birth defects) are structural or functional abnormalities, which are present from birth, whether recognized at birth or later and constitute a major health problem worldwide. Congenital anomalies occur in 3 to 5 % of all pregnancies and 2 to 3 % of all births. The exact magnitude of birth defect related events is still unrevealed. Prevalence is high in Nepal but true magnitude is still unknown. Materials and Methods: This is a prospective cross sectional study of all antenatal women who had an ultrasound revealing congenital anomalies as well who delivered with a fetal congenital malformation at department of Obstetrics and Gynecology, Nobel Medical College Teaching Hospital. Maternal variables like age, parity, period of gestation at detection, medical history, mode of delivery and complications were recorded. Fetal outcomes and details of anomalies were analyzed. Consanguinity and history of use of folic acid was also inquired. Results: Our institutional prevalence of congenital anomalies was 1.25%. The mean age of the mother is 25.88 years. Anencephaly was seen in 5 live birth among the mothers of consanguineous marriage. The predominant system involved was central nervous system 37(37%) followed by Musculoskeletal system 13 (13%). Most of them 38/56 (68%) were pre diagnosed by antenatal ultrasound only in the third trimester. Majority of them didn’t give history of the use of folic acid. Vaginal delivery was the preferred choice of the termination of pregnancy. Conclusion: Congenital anomaly rate was 1.25% and Central Nervous System was the predominant system involved with Anencephaly being common in consanguineous marriage.
{"title":"Prevalence and Pattern of Birth Defects in a Tertiary Referral Center","authors":"M. Yadav, S. Subedi","doi":"10.3126/jonmc.v10i1.37929","DOIUrl":"https://doi.org/10.3126/jonmc.v10i1.37929","url":null,"abstract":"Background: Congenital disorders (birth defects) are structural or functional abnormalities, which are present from birth, whether recognized at birth or later and constitute a major health problem worldwide. Congenital anomalies occur in 3 to 5 % of all pregnancies and 2 to 3 % of all births. The exact magnitude of birth defect related events is still unrevealed. Prevalence is high in Nepal but true magnitude is still unknown. \u0000Materials and Methods: This is a prospective cross sectional study of all antenatal women who had an ultrasound revealing congenital anomalies as well who delivered with a fetal congenital malformation at department of Obstetrics and Gynecology, Nobel Medical College Teaching Hospital. Maternal variables like age, parity, period of gestation at detection, medical history, mode of delivery and complications were recorded. Fetal outcomes and details of anomalies were analyzed. Consanguinity and history of use of folic acid was also inquired. \u0000Results: Our institutional prevalence of congenital anomalies was 1.25%. The mean age of the mother is 25.88 years. Anencephaly was seen in 5 live birth among the mothers of consanguineous marriage. The predominant system involved was central nervous system 37(37%) followed by Musculoskeletal system 13 (13%). Most of them 38/56 (68%) were pre diagnosed by antenatal ultrasound only in the third trimester. Majority of them didn’t give history of the use of folic acid. Vaginal delivery was the preferred choice of the termination of pregnancy. \u0000Conclusion: Congenital anomaly rate was 1.25% and Central Nervous System was the predominant system involved with Anencephaly being common in consanguineous marriage.","PeriodicalId":52824,"journal":{"name":"Journal of Nobel Medical College","volume":"1 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-06-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"69307941","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 : 2021-06-19DOI: 10.3126/jonmc.v10i1.37931
Praman Sharma, L. Yadav, A. Shahbaz, Jyotindra Sharma, Rajesh Nepal, S. Khanal, S. Agrawal, V. Kattel
Background: Cardiac surgical procedures like coronary artery bypass graft surgery and aortic or mitral valve replacements are commonly performed worldwide. In the developing world, Cardio-Thoracic and Vascular Surgery are not adequately accessible except in a few major cities. We established the department to fill that gap at a tertiary center in the eastern part of Nepal. The main objective of the study was to evaluate the short-term outcome of all major cardiac surgeries. Materials and Methods: This is a retrospective study including all cardiac surgery cases operated over 18 months of the establishment. Demographics, various cardiac diseases, co-morbidities, pre-specified peri-operative, and postoperative outcomes were noted in pre-structured questionnaires. The ethical clearance was taken from the hospital ethical committee. Results: There were 67 major cardiac surgery cases performed. Among those 50.7% and 49.3% were males and females respectively with a median age of 50 years. The most common etiology was coronary artery disease (43.28%) followed by rheumatic heart disease (28.35%) and congenital heart diseases (23.88%). The mean cardiopulmonary bypass and aortic cross-clamp times were 93 min and 58 min respectively. The mean intensive care unit and hospital stays were 1.9 and 5.87 days respectively. One (1.5%) patient underwent reexploration and 6(8.9%) patients developed acute kidney injury. Peri-operative survival was 100% whereas the first and third-month survivals were 97% and 95% respectively. Conclusion: Major cardiac surgeries are feasible and safe in newly established cardiac surgery department with acceptable short-term morbidity and mortality.
{"title":"Short-Term Outcome of Cardiac Surgeries in a Tertiary Care Hospital at the Eastern Part of Nepal","authors":"Praman Sharma, L. Yadav, A. Shahbaz, Jyotindra Sharma, Rajesh Nepal, S. Khanal, S. Agrawal, V. Kattel","doi":"10.3126/jonmc.v10i1.37931","DOIUrl":"https://doi.org/10.3126/jonmc.v10i1.37931","url":null,"abstract":"Background: Cardiac surgical procedures like coronary artery bypass graft surgery and aortic or mitral valve replacements are commonly performed worldwide. In the developing world, Cardio-Thoracic and Vascular Surgery are not adequately accessible except in a few major cities. We established the department to fill that gap at a tertiary center in the eastern part of Nepal. The main objective of the study was to evaluate the short-term outcome of all major cardiac surgeries. \u0000Materials and Methods: This is a retrospective study including all cardiac surgery cases operated over 18 months of the establishment. Demographics, various cardiac diseases, co-morbidities, pre-specified peri-operative, and postoperative outcomes were noted in pre-structured questionnaires. The ethical clearance was taken from the hospital ethical committee. \u0000Results: There were 67 major cardiac surgery cases performed. Among those 50.7% and 49.3% were males and females respectively with a median age of 50 years. The most common etiology was coronary artery disease (43.28%) followed by rheumatic heart disease (28.35%) and congenital heart diseases (23.88%). The mean cardiopulmonary bypass and aortic cross-clamp times were 93 min and 58 min respectively. The mean intensive care unit and hospital stays were 1.9 and 5.87 days respectively. One (1.5%) patient underwent reexploration and 6(8.9%) patients developed acute kidney injury. Peri-operative survival was 100% whereas the first and third-month survivals were 97% and 95% respectively. \u0000Conclusion: Major cardiac surgeries are feasible and safe in newly established cardiac surgery department with acceptable short-term morbidity and mortality.","PeriodicalId":52824,"journal":{"name":"Journal of Nobel Medical College","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-06-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49466914","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 : 2021-06-17DOI: 10.3126/jonmc.v10i1.37825
A. Yadav, M. Thakur, S. B. Gharti
Background: Low-income countries like Nepal experience a double disease burden infectious diseases risk as well as rising incidence of non-communicable diseases .The present cross sectional study assesses the prevalence of overweight and associated factors in ward no. 1 and 3 of Tankisinuwari VDC, Morang. Materials and Methods: A Community based cross sectional study was conducted in ward no. 1 and 3 of Tankisinuwari VDC, Morang. Total 152 (10%) households were selected by systematic random sampling technique and then 590 individuals (male 323 and female 267), with the age ranging from 10 to 70 years were included in the study. Measurement of weight and height was done by calibrated standard weighing scale and measuring tape. Results: The prevalence of overweight was 16.1% which was significantly more among male (11.5%) than in female ( 4.6%) while prevalence of obesity was 2.5% , which was significantly more among female (2.2%), than male (0.3)%, P<0.05.The prevalence of overweight was seen more in the age group ≥50 years (7.1%) and obesity was seen more in age group 30-49 years ((2.0%). The prevalence of overweight (13.9%) and obesity (2.4%) among married group were found significantly more than unmarried population where the prevalence of overweight and obesity were (2.2%) and (0.2%) respectively, P<0.05. Prevalence of obesity among those who had short sleep of 6 hours (1.4%) and overweight (3.9%) was observed which significantly more than among those who slept 7 hour or 8 hour. P=0.013. Conclusion: The role of risk factors in development of obesity like short sleep and long sleep duration, physical inactivity and mode of transport were observed to be associated with overweight and obesity. Demographic factors like age, gender and marital status was found to be associated with overweight and obesity.
{"title":"Study of Prevalence and Associated Risk Factors of Overweight and Obesity among the Residents of Semi Urban Region of Eastern Nepal","authors":"A. Yadav, M. Thakur, S. B. Gharti","doi":"10.3126/jonmc.v10i1.37825","DOIUrl":"https://doi.org/10.3126/jonmc.v10i1.37825","url":null,"abstract":"Background: Low-income countries like Nepal experience a double disease burden infectious diseases risk as well as rising incidence of non-communicable diseases .The present cross sectional study assesses the prevalence of overweight and associated factors in ward no. 1 and 3 of Tankisinuwari VDC, Morang. \u0000Materials and Methods: A Community based cross sectional study was conducted in ward no. 1 and 3 of Tankisinuwari VDC, Morang. Total 152 (10%) households were selected by systematic random sampling technique and then 590 individuals (male 323 and female 267), with the age ranging from 10 to 70 years were included in the study. Measurement of weight and height was done by calibrated standard weighing scale and measuring tape. \u0000Results: The prevalence of overweight was 16.1% which was significantly more among male (11.5%) than in female ( 4.6%) while prevalence of obesity was 2.5% , which was significantly more among female (2.2%), than male (0.3)%, P<0.05.The prevalence of overweight was seen more in the age group ≥50 years (7.1%) and obesity was seen more in age group 30-49 years ((2.0%). The prevalence of overweight (13.9%) and obesity (2.4%) among married group were found significantly more than unmarried population where the prevalence of overweight and obesity were (2.2%) and (0.2%) respectively, P<0.05. Prevalence of obesity among those who had short sleep of 6 hours (1.4%) and overweight (3.9%) was observed which significantly more than among those who slept 7 hour or 8 hour. P=0.013. \u0000Conclusion: The role of risk factors in development of obesity like short sleep and long sleep duration, physical inactivity and mode of transport were observed to be associated with overweight and obesity. Demographic factors like age, gender and marital status was found to be associated with overweight and obesity.","PeriodicalId":52824,"journal":{"name":"Journal of Nobel Medical College","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-06-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"47807208","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 : 2021-06-17DOI: 10.3126/jonmc.v10i1.37832
Madhab Bista, Rajesh Nepal, Manoj Aryal, Sushant Katwal, M. Thakur
Background: Pericardial effusion (PE) is one of the common pericardial diseases in our population with its associated morbidity and mortality. Our study aims to evaluate the clinical characteristics of patients with PE from eastern region of Nepal. Materials and Methods: A descriptive cross-sectional study carried out in tertiary care center in eastern region of Nepal from March 2019 to February 2020. A total of 45 cases of PE were enrolled by convenient sampling method. Diagnosis was made based on clinical history, examination, and relevant laboratory investigations. Data was entered in Microsoft excel 2007 and converted into IBM SPSS data editor, version 20. Results: Forty five patients were included with mean age of 55.36 ± 16.38 years. Twenty seven patients (60%) were male and 18 (40%) were female. Hypertension was present in 12 (26.7%) and diabetes mellitus in 13 (28.9%). Mean serum hemoglobin was 10.85 ± 2.09 gm/dl. Chronic kidney disease (Uremia), tuberculosis and hypothyroidism were the common causes of PE. Common clinical symptoms were dyspnea, fever, and cough and chest pain. Moderate to large pericardial effusion was noted in 21 (46.7%) of patients. Cardiac tamponade was present in 6 (13.3%). Twenty seven patients (60%) patients underwent pericardiocentesis. Conclusion: Chronic kidney disease, tuberculosis and hypothyroidism were the common causes of PE with male predominance. Dyspnea was the most common presenting symptom. Cardiac tamponade was relatively less common.
{"title":"Clinical Characteristics of Patients with Pericardial Effusion","authors":"Madhab Bista, Rajesh Nepal, Manoj Aryal, Sushant Katwal, M. Thakur","doi":"10.3126/jonmc.v10i1.37832","DOIUrl":"https://doi.org/10.3126/jonmc.v10i1.37832","url":null,"abstract":"Background: Pericardial effusion (PE) is one of the common pericardial diseases in our population with its associated morbidity and mortality. Our study aims to evaluate the clinical characteristics of patients with PE from eastern region of Nepal. \u0000Materials and Methods: A descriptive cross-sectional study carried out in tertiary care center in eastern region of Nepal from March 2019 to February 2020. A total of 45 cases of PE were enrolled by convenient sampling method. Diagnosis was made based on clinical history, examination, and relevant laboratory investigations. Data was entered in Microsoft excel 2007 and converted into IBM SPSS data editor, version 20. \u0000Results: Forty five patients were included with mean age of 55.36 ± 16.38 years. Twenty seven patients (60%) were male and 18 (40%) were female. Hypertension was present in 12 (26.7%) and diabetes mellitus in 13 (28.9%). Mean serum hemoglobin was 10.85 ± 2.09 gm/dl. Chronic kidney disease (Uremia), tuberculosis and hypothyroidism were the common causes of PE. Common clinical symptoms were dyspnea, fever, and cough and chest pain. Moderate to large pericardial effusion was noted in 21 (46.7%) of patients. Cardiac tamponade was present in 6 (13.3%). Twenty seven patients (60%) patients underwent pericardiocentesis. \u0000Conclusion: Chronic kidney disease, tuberculosis and hypothyroidism were the common causes of PE with male predominance. Dyspnea was the most common presenting symptom. Cardiac tamponade was relatively less common.","PeriodicalId":52824,"journal":{"name":"Journal of Nobel Medical College","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-06-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42456943","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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