Tanvi Meshram, Darshana Rathod, Kamlesh K. Kumari, Arun Sahayraja M
This case is an anesthesia challenge and management of one-lung ventilation in a patient with pulmonary embolism of the ventilated lung. A 50 years old male with a history of pulmonary thromboembolism of segmental and subsegmental branches of the left pulmonary artery was posted for right decortication. He developed hypoxia (sp02~82-85% ) and PaC02-EtCO2 difference of ~30 mm Hg on initiation of one lung ventilation indicating significant shunting of blood and V/Q mismatch. We want to emphasize the importance of intraoperative arterial blood analysis to look for (PaCO2 –EtCO2) difference and periodic reinflation of the collapsed lung for management of patients in whom the blood supply to the dependent is compromised. The presence of pulmonary vascular compromise on the dependent side offers a great number of challenges during the management of one-lung ventilation.
本病例是一例经通气肺栓塞的单肺通气患者的麻醉挑战和处理。一位50岁男性，有左肺动脉节段和亚节段分支的肺血栓栓塞史。单肺通气开始时出现缺氧(sp02~82-85%)， PaC02-EtCO2差~30 mm Hg，提示明显的血液分流和V/Q错配。我们想强调术中动脉血分析的重要性，以寻找(PaCO2 -EtCO2)差异和肺萎陷的周期性再膨胀，以管理患者的血液供应受到损害的依赖。依赖侧肺血管损伤的存在给单肺通气的管理带来了许多挑战。
{"title":"Right-sided Decortication in a Patient with Left Pulmonary Artery Embolism – A Case Report","authors":"Tanvi Meshram, Darshana Rathod, Kamlesh K. Kumari, Arun Sahayraja M","doi":"10.3126/nmj.v5i1.44411","DOIUrl":"https://doi.org/10.3126/nmj.v5i1.44411","url":null,"abstract":"This case is an anesthesia challenge and management of one-lung ventilation in a patient with pulmonary embolism of the ventilated lung. A 50 years old male with a history of pulmonary thromboembolism of segmental and subsegmental branches of the left pulmonary artery was posted for right decortication. He developed hypoxia (sp02~82-85% ) and PaC02-EtCO2 difference of ~30 mm Hg on initiation of one lung ventilation indicating significant shunting of blood and V/Q mismatch. We want to emphasize the importance of intraoperative arterial blood analysis to look for (PaCO2 –EtCO2) difference and periodic reinflation of the collapsed lung for management of patients in whom the blood supply to the dependent is compromised. The presence of pulmonary vascular compromise on the dependent side offers a great number of challenges during the management of one-lung ventilation.","PeriodicalId":52856,"journal":{"name":"Nepalese Medical Journal","volume":"73 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-06-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"72716271","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}
Heterogeneity of symptoms within and among mild cognitive impairment individuals often makes it challenging to document case reports clinically. Additionally, data on the Indian population is also limited. Therefore, our study includes a case study of a 56-year-old male with mild cognitive impairment from our Institute. A patient had symptoms of mild cognitive impairment following a stroke that occurred 23 years back (vascular in origin). Both formal and informal assessments were carried out. Formal testing was done using the Montreal Cognitive Assessment. On assessment of memory, mild deficits in working memory, episodic memory, and procedural memory were noticed. Attention span and Word-finding difficulties with reduced use of words were observed in language assessment. Problems in reasoning, problem-solving, and decision-making skills, indicating deficits in executive functioning were evident. Linguistic deficits presenting secondary to cognitive deficits in our client could have led to communication breakdowns in speech, affecting his overall quality of life.
{"title":"Speech, Language and Cognitive Profile of Mild Cognitive Impairment: A single Case Study","authors":"Biraj Bhattarai, Joanna K B, P Niranjana, A. B P","doi":"10.3126/nmj.v4i2.38759","DOIUrl":"https://doi.org/10.3126/nmj.v4i2.38759","url":null,"abstract":"Heterogeneity of symptoms within and among mild cognitive impairment individuals often makes it challenging to document case reports clinically. Additionally, data on the Indian population is also limited. Therefore, our study includes a case study of a 56-year-old male with mild cognitive impairment from our Institute. A patient had symptoms of mild cognitive impairment following a stroke that occurred 23 years back (vascular in origin). Both formal and informal assessments were carried out. Formal testing was done using the Montreal Cognitive Assessment. On assessment of memory, mild deficits in working memory, episodic memory, and procedural memory were noticed. Attention span and Word-finding difficulties with reduced use of words were observed in language assessment. Problems in reasoning, problem-solving, and decision-making skills, indicating deficits in executive functioning were evident. Linguistic deficits presenting secondary to cognitive deficits in our client could have led to communication breakdowns in speech, affecting his overall quality of life.","PeriodicalId":52856,"journal":{"name":"Nepalese Medical Journal","volume":"37 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-12-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"86871876","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}
P. Basnet, Deepanshu Sharma, Shravya Singh Karki, S. Karki, Hira Lal Bhandari, D. Shrestha
Introduction: The outbreak of coronavirus diseases 2019 (Covid-19) caused by SARS-COV-2 which started in Wuhan china led to an alarming level of spread and severity. In Nepal, the first case of COVID-19 was reported on 23.1.2020 and has become a global health crisis since then. The clinical presentation and outcome of patients with COVID-19 have been variable in different countries and therefore it is important to analyze as well as document the clinical behaviors of this disease in the local population so we have reported the clinic-epidemiological profile, outcome, and its association with conjunctivitis during the second wave of this pandemic which hit Nepal badly hoping this study will be helpful to tackle the future surges of COVID-19 as well. Materials and Methods: This was a prospective, single-center study where the data regarding epidemiology, demography, common clinical presentation as well as management and outcome of COVID-19 Patients were retracted and analyzed. Results: A total of 238 COVID-Positive patients were admitted out of which 60% were male and 39.9% people belonged to Dang valley itself with dyspnea (67.2%) was the commonest symptoms followed by fever in 59.7% of patients. Out of these patients 9 patients presented with ocular symptom conjunctivitis. Conclusions: Mild conjunctivitis manifesting as conjunctival congestion is common and one of the major ocular manifestations in COVID -19 positive patients.
{"title":"Clinico-Demographic Profile of Covid-19 Patients Admitted in COVID- HDU and its Association with Conjunctivitis","authors":"P. Basnet, Deepanshu Sharma, Shravya Singh Karki, S. Karki, Hira Lal Bhandari, D. Shrestha","doi":"10.3126/nmj.v4i2.41492","DOIUrl":"https://doi.org/10.3126/nmj.v4i2.41492","url":null,"abstract":"Introduction: The outbreak of coronavirus diseases 2019 (Covid-19) caused by SARS-COV-2 which started in Wuhan china led to an alarming level of spread and severity. In Nepal, the first case of COVID-19 was reported on 23.1.2020 and has become a global health crisis since then. The clinical presentation and outcome of patients with COVID-19 have been variable in different countries and therefore it is important to analyze as well as document the clinical behaviors of this disease in the local population so we have reported the clinic-epidemiological profile, outcome, and its association with conjunctivitis during the second wave of this pandemic which hit Nepal badly hoping this study will be helpful to tackle the future surges of COVID-19 as well.\u0000Materials and Methods: This was a prospective, single-center study where the data regarding epidemiology, demography, common clinical presentation as well as management and outcome of COVID-19 Patients were retracted and analyzed.\u0000Results: A total of 238 COVID-Positive patients were admitted out of which 60% were male and 39.9% people belonged to Dang valley itself with dyspnea (67.2%) was the commonest symptoms followed by fever in 59.7% of patients. Out of these patients 9 patients presented with ocular symptom conjunctivitis.\u0000Conclusions: Mild conjunctivitis manifesting as conjunctival congestion is common and one of the major ocular manifestations in COVID -19 positive patients.","PeriodicalId":52856,"journal":{"name":"Nepalese Medical Journal","volume":"285 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-12-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"75332419","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}
N. Gautam, R. Ojha, S. Kharel, B. Gajurel, Sanjeeta Sitaula, R. Karn, R. Rajbhandari, A. Shrestha
Introduction: Idiopathic Intracranial Hypertension is characterized by headache, visual impairment, papilledema, and increased cerebrospinal fluid opening pressure. We aim to evaluate clinical manifestations, neuroimaging findings, and treatment of Idiopathic Intracranial Hypertension in a Nepalese tertiary center. Materials and Methods: We retrospectively included patients with the diagnosis of Idiopathic Intracranial Hypertension who were admitted to the Neurology department of Tribhuvan University Teaching Hospital from 2019 June to 2021 May and presented to the Neuro-ophthalmology outpatient clinic of the hospital for follow-up. Results: Out of 16 Idiopathic Intracranial Hypertension patients, 12(75%) patients had either headache or ocular pain. Reduced visual acuity and progressive visual loss were found in 44% of patients. Normal CSF opening pressure was found in 19%, 44% had CSF opening pressure at a range of 20-30 cm H20 and > 30 cm H20 in 37.5%. 15 Idiopathic Intracranial Hypertension patients (93.7%) were subtyped as Typical and 1 patient was diagnosed as Fulminant Idiopathic Intracranial Hypertension. Acetazolamide was used for treatment in 15 patients and 1 patient needed ventriculoperitoneal shunting. 56% Seven patients (44%) had some abnormal findings: partial empty sella (44%), and tortuous optic nerve (31%), flattened posterior eyeball (31%), and hypoplastic transverse sinus (19%). Conclusions: Idiopathic Intracranial Hypertension is an uncommon diagnosis but should be suspected in patients with chronic headaches with visual impairment. In low-resource settings, proper history along with neurological and ophthalmological examinations can even detect the early features and timely referral can save the vision and disability of Idiopathic Intracranial Hypertension patients.
特发性颅内高压以头痛、视力障碍、乳头水肿和脑脊液开口压力升高为特征。我们的目的是评估尼泊尔三级中心特发性颅内高压的临床表现、神经影像学发现和治疗。材料和方法:回顾性纳入2019年6月至2021年5月在特里布万大学教学医院神经内科就诊的特发性颅内高压患者，并在该院神经眼科门诊进行随访。结果:在16例特发性颅内高压患者中，12例(75%)患者出现头痛或眼痛。44%的患者发现视力下降和进行性视力丧失。19%脑脊液开口压力正常，44%脑脊液开口压力在20-30 cm H20范围内，37.5%脑脊液开口压力> 30 cm H20。特发性颅内高压15例(93.7%)亚型为典型，1例诊断为暴发性特发性颅内高压。15例患者使用乙酰唑胺治疗，1例患者需要脑室腹腔分流术。56% 7例(44%)患者有一些异常表现:部分鞍空(44%)，视神经扭曲(31%)，后眼球扁平(31%)，横窦发育不全(19%)。结论:特发性颅内高压是一种罕见的诊断，但在慢性头痛伴视力损害的患者中应予以怀疑。在资源匮乏的环境中，适当的病史配合神经学和眼科检查甚至可以发现早期特征，及时转诊可以挽救特发性颅内高压患者的视力和残疾。
{"title":"Clinical Manifestations, Neuroimaging Findings, and Treatment of Idiopathic Intracranial Hypertension in a Nepalese Tertiary Centre","authors":"N. Gautam, R. Ojha, S. Kharel, B. Gajurel, Sanjeeta Sitaula, R. Karn, R. Rajbhandari, A. Shrestha","doi":"10.3126/nmj.v4i2.40038","DOIUrl":"https://doi.org/10.3126/nmj.v4i2.40038","url":null,"abstract":"Introduction: Idiopathic Intracranial Hypertension is characterized by headache, visual impairment, papilledema, and increased cerebrospinal fluid opening pressure. We aim to evaluate clinical manifestations, neuroimaging findings, and treatment of Idiopathic Intracranial Hypertension in a Nepalese tertiary center.\u0000Materials and Methods: We retrospectively included patients with the diagnosis of Idiopathic Intracranial Hypertension who were admitted to the Neurology department of Tribhuvan University Teaching Hospital from 2019 June to 2021 May and presented to the Neuro-ophthalmology outpatient clinic of the hospital for follow-up.\u0000Results: Out of 16 Idiopathic Intracranial Hypertension patients, 12(75%) patients had either headache or ocular pain. Reduced visual acuity and progressive visual loss were found in 44% of patients. Normal CSF opening pressure was found in 19%, 44% had CSF opening pressure at a range of 20-30 cm H20 and > 30 cm H20 in 37.5%. 15 Idiopathic Intracranial Hypertension patients (93.7%) were subtyped as Typical and 1 patient was diagnosed as Fulminant Idiopathic Intracranial Hypertension. Acetazolamide was used for treatment in 15 patients and 1 patient needed ventriculoperitoneal shunting. 56% Seven patients (44%) had some abnormal findings: partial empty sella (44%), and tortuous optic nerve (31%), flattened posterior eyeball (31%), and hypoplastic transverse sinus (19%).\u0000Conclusions: Idiopathic Intracranial Hypertension is an uncommon diagnosis but should be suspected in patients with chronic headaches with visual impairment. In low-resource settings, proper history along with neurological and ophthalmological examinations can even detect the early features and timely referral can save the vision and disability of Idiopathic Intracranial Hypertension patients.","PeriodicalId":52856,"journal":{"name":"Nepalese Medical Journal","volume":"12 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-12-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"74661436","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}
D. Paudel, H. Regmi, U. Bajracharya, G. K. Shrestha
Introduction: Urinary bladder cancers are heterogeneous diseases consisting of a divergent group of tumors. Diseases of the urinary bladder, both neoplastic and nonneoplastic contribute to notable mortality and morbidity. Histopathology remains the gold standard of diagnosis. Bladder transurethral resection of the tumor is a therapeutic procedure that ensures the material necessary for histopathological diagnosis because it allows assessment of the degree of differentiation, depth of tumor invasion, parameters useful in the elaboration of diagnosis and prognosis assessment Material and Methods: All the urinary bladder biopsies submitted in the pathology laboratory during 1 year time period were included in the study. Results: Among the 51 total cases in the study, the male to female ratio was 4.67:1 with the age group of 22-96 years. Among the study population, 30 (52.7%) presented with hematuria, 10 (19.2%) with burning micturition, frequent urination, and lower abdominal pain. In the study, 44 (86%) showed neoplastic lesions while 7(14%) remaining were non-neoplastic lesions. Infiltrative urothelial carcinoma with low and high grades was diagnosed in 23% (12/51) Conclusions: This study has revealed that neoplastic lesions are more common than non-neoplastic lesions. A great majority of neoplastic lesions are of urothelial origin. Majority of which are invasive urothelial neoplasm. All urothelial neoplasms are more common in males. Cystoscopic studies and biopsies help in the early detection of bladder neoplasms and they form the mainstay of the diagnosis and follow-up.
{"title":"Spectrum and Presentation of Urinary Bladder Growth: a Single-Center Retrospective Study","authors":"D. Paudel, H. Regmi, U. Bajracharya, G. K. Shrestha","doi":"10.3126/nmj.v4i2.42055","DOIUrl":"https://doi.org/10.3126/nmj.v4i2.42055","url":null,"abstract":"Introduction: Urinary bladder cancers are heterogeneous diseases consisting of a divergent group of tumors. Diseases of the urinary bladder, both neoplastic and nonneoplastic contribute to notable mortality and morbidity. Histopathology remains the gold standard of diagnosis. Bladder transurethral resection of the tumor is a therapeutic procedure that ensures the material necessary for histopathological diagnosis because it allows assessment of the degree of differentiation, depth of tumor invasion, parameters useful in the elaboration of diagnosis and prognosis assessment \u0000Material and Methods: All the urinary bladder biopsies submitted in the pathology laboratory during 1 year time period were included in the study. \u0000Results: Among the 51 total cases in the study, the male to female ratio was 4.67:1 with the age group of 22-96 years. Among the study population, 30 (52.7%) presented with hematuria, 10 (19.2%) with burning micturition, frequent urination, and lower abdominal pain. In the study, 44 (86%) showed neoplastic lesions while 7(14%) remaining were non-neoplastic lesions. Infiltrative urothelial carcinoma with low and high grades was diagnosed in 23% (12/51) \u0000Conclusions: This study has revealed that neoplastic lesions are more common than non-neoplastic lesions. A great majority of neoplastic lesions are of urothelial origin. Majority of which are invasive urothelial neoplasm. All urothelial neoplasms are more common in males. Cystoscopic studies and biopsies help in the early detection of bladder neoplasms and they form the mainstay of the diagnosis and follow-up.","PeriodicalId":52856,"journal":{"name":"Nepalese Medical Journal","volume":"43 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-12-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"78949087","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}
S. Thapa, A.R. Ghosh, Dilasma Ghartimagar, S. Regmi, A. Jhunjhunwala
Introduction: The incidence of skin cancer is increasing exponentially around the world. This study aims to analyze different malignant skin tumors concerning age pattern, gender, and site-wise distribution. Materials and Methods: This is a descriptive cross-sectional hospital-based study carried out in the Department of Pathology, a tertiary care center for over ten years from April 2011 to March 2021. All malignant skin tumors arising from the epidermis along with melanocytic and adnexal tumors were included in the study. Results: A total of 208 cases of skin malignancies among which 117 (56.3%) cases were males and 91 (43.8%) females with a male to female ratio of 1.3:1. Overall, the majority were seen in the sixth decade 49 (23.6%) with head and neck region 113 (54.3%) being the commonest site of involvement. Basal cell carcinoma 79 (38%) was the most frequent non-melanoma skin cancer followed by squamous cell carcinoma 75 (36.1%). A maximum number of basal cell carcinoma were observed in the sixth decade 19 (24.1%) whereas squamous cell carcinoma in the seventh decade 21 (28%) cases. Other skin cancers were malignant melanoma 31 (14.9%), verrucous carcinoma 13 (6.3%), trichilemmal carcinoma five (2.4%), sebaceous carcinoma two (1%), and one case each of eccrine carcinoma, malignant nodular hidradenoma, and malignant proliferating trichilemmal tumor. Conclusions: Skin malignancies were seen in the sixth decade with male preponderance. Overall, the head and neck region was the commonest site of involvement. Basal cell carcinoma was the most frequent non-melanoma skin cancer followed by squamous cell carcinoma.
{"title":"Histomorphological Pattern of Malignant Skin Tumors – A Cross-sectional Study in a Teaching Hospital","authors":"S. Thapa, A.R. Ghosh, Dilasma Ghartimagar, S. Regmi, A. Jhunjhunwala","doi":"10.3126/nmj.v4i2.41335","DOIUrl":"https://doi.org/10.3126/nmj.v4i2.41335","url":null,"abstract":"Introduction: The incidence of skin cancer is increasing exponentially around the world. This study aims to analyze different malignant skin tumors concerning age pattern, gender, and site-wise distribution. \u0000Materials and Methods: This is a descriptive cross-sectional hospital-based study carried out in the Department of Pathology, a tertiary care center for over ten years from April 2011 to March 2021. All malignant skin tumors arising from the epidermis along with melanocytic and adnexal tumors were included in the study. \u0000Results: A total of 208 cases of skin malignancies among which 117 (56.3%) cases were males and 91 (43.8%) females with a male to female ratio of 1.3:1. Overall, the majority were seen in the sixth decade 49 (23.6%) with head and neck region 113 (54.3%) being the commonest site of involvement. Basal cell carcinoma 79 (38%) was the most frequent non-melanoma skin cancer followed by squamous cell carcinoma 75 (36.1%). A maximum number of basal cell carcinoma were observed in the sixth decade 19 (24.1%) whereas squamous cell carcinoma in the seventh decade 21 (28%) cases. Other skin cancers were malignant melanoma 31 (14.9%), verrucous carcinoma 13 (6.3%), trichilemmal carcinoma five (2.4%), sebaceous carcinoma two (1%), and one case each of eccrine carcinoma, malignant nodular hidradenoma, and malignant proliferating trichilemmal tumor. \u0000Conclusions: Skin malignancies were seen in the sixth decade with male preponderance. Overall, the head and neck region was the commonest site of involvement. Basal cell carcinoma was the most frequent non-melanoma skin cancer followed by squamous cell carcinoma.","PeriodicalId":52856,"journal":{"name":"Nepalese Medical Journal","volume":"17 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-12-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"82341792","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}
Introduction: Perinatal deaths are potentially preventable and reflect the quality of care provided in the prenatal period, during labor, and to a newborn. The purpose of this study was to assess the causes and avoidable factors contributing to perinatal deaths in the year 2018-19 and compare these with the previous two years at Tertiary Care Hospital.Materials and Methods: This study was conducted from a retrospective analysis of all stillbirths and early neonatal deaths in the year July 2018 to July 2019. The Perinatal Mortality Rate, causes, and avoidable factors leading to perinatal deaths were analysed during this year and were compared with that of the previous two years at KIST Medical College and Teaching hospital.Results: PMR was 16.09 per 1000 births in the year 2018-19. Previous two studies at this hospital in the year 2017-18 and 2016-17 showed a Perinatal Mortality Rate of 14.61 and 16.27/1000 births respectively. The commonest primary cause of perinatal deaths was intrapartum hypoxia 6 (30%), preterm delivery 5 (31.25%), and congenital anomalies4 (19%) during the year 2018-19, 2017-18, and 2016-17 respectively. The most common avoidable factors identified were a maternal delay to seek health care, inadequate antenatal checkups, and inadequate antenatal counseling of danger signs by a service provider over the last three years.Conclusions: Maternal delay to seek health care and lack of maternal knowledge of danger signs during pregnancy were the common avoidable factors identified. More efforts should be made to raise awareness of pregnant women during antenatal care visits regarding early healthcare-seeking behavior when needed.
{"title":"An Analysis of Causes and Avoidable Factors of Perinatal Deaths at Tertiary Care Hospital","authors":"Sunita Bhandari, Y. Dwa, Riya Sharma","doi":"10.3126/nmj.v4i1.36994","DOIUrl":"https://doi.org/10.3126/nmj.v4i1.36994","url":null,"abstract":"Introduction: Perinatal deaths are potentially preventable and reflect the quality of care provided in the prenatal period, during labor, and to a newborn. The purpose of this study was to assess the causes and avoidable factors contributing to perinatal deaths in the year 2018-19 and compare these with the previous two years at Tertiary Care Hospital.Materials and Methods: This study was conducted from a retrospective analysis of all stillbirths and early neonatal deaths in the year July 2018 to July 2019. The Perinatal Mortality Rate, causes, and avoidable factors leading to perinatal deaths were analysed during this year and were compared with that of the previous two years at KIST Medical College and Teaching hospital.Results: PMR was 16.09 per 1000 births in the year 2018-19. Previous two studies at this hospital in the year 2017-18 and 2016-17 showed a Perinatal Mortality Rate of 14.61 and 16.27/1000 births respectively. The commonest primary cause of perinatal deaths was intrapartum hypoxia 6 (30%), preterm delivery 5 (31.25%), and congenital anomalies4 (19%) during the year 2018-19, 2017-18, and 2016-17 respectively. The most common avoidable factors identified were a maternal delay to seek health care, inadequate antenatal checkups, and inadequate antenatal counseling of danger signs by a service provider over the last three years.Conclusions: Maternal delay to seek health care and lack of maternal knowledge of danger signs during pregnancy were the common avoidable factors identified. More efforts should be made to raise awareness of pregnant women during antenatal care visits regarding early healthcare-seeking behavior when needed.","PeriodicalId":52856,"journal":{"name":"Nepalese Medical Journal","volume":"46 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-06-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"83736188","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}
Introduction: Dyslipidemia is a risk factor for coronary artery disease, a leading cause of mortality in patients with type 2 diabetes mellitus. This study aims to study the dietary pattern and dyslipidemia of type 2 diabetes mellitus patients visiting Tribhuvan University Teaching Hospital. Materials and Methods: Quantitative study was done to find out the dietary pattern and dyslipidemia of type 2 diabetes mellitus patients visiting Tribhuvan University Teaching Hospital. Patients with type 2 diabetes mellitus diagnosed for more than one year were included in the study. Results: The percentage of dyslipidemia in type 2 diabetes mellitus was found to be 88.5%. Dyslipidemia was found to be significantly associated (p<0.05) with alcohol consumption, regular dietary management, sedentary behavior, waist-hip ratio, body mass index, glycated hemoglobin, and hypertension. Dyslipidemia was also found to be significantly associated (p<0.05) with the dietary habit (vegetarian and non-vegetarian), consumption of cereals and its product, consumption of fruits, consumption of fast foods and street foods, consumption of red meat, and consumption of oilseeds. Conclusions: This study indicates the importance of dietary awareness and lifestyle modification for the management of dyslipidemia among type 2 diabetes mellitus.
{"title":"Diet Pattern and Dyslipidemia Among Type II Diabetes Mellitus Patients Diagnosed More Tthan One Year Visiting Tribhuvan University Teaching Hospital","authors":"Samiksha Niroula, Rama Subba, Aarem Karkee","doi":"10.3126/nmj.v4i1.37495","DOIUrl":"https://doi.org/10.3126/nmj.v4i1.37495","url":null,"abstract":"Introduction: Dyslipidemia is a risk factor for coronary artery disease, a leading cause of mortality in patients with type 2 diabetes mellitus. This study aims to study the dietary pattern and dyslipidemia of type 2 diabetes mellitus patients visiting Tribhuvan University Teaching Hospital.\u0000Materials and Methods: Quantitative study was done to find out the dietary pattern and dyslipidemia of type 2 diabetes mellitus patients visiting Tribhuvan University Teaching Hospital. Patients with type 2 diabetes mellitus diagnosed for more than one year were included in the study.\u0000Results: The percentage of dyslipidemia in type 2 diabetes mellitus was found to be 88.5%. Dyslipidemia was found to be significantly associated (p<0.05) with alcohol consumption, regular dietary management, sedentary behavior, waist-hip ratio, body mass index, glycated hemoglobin, and hypertension. Dyslipidemia was also found to be significantly associated (p<0.05) with the dietary habit (vegetarian and non-vegetarian), consumption of cereals and its product, consumption of fruits, consumption of fast foods and street foods, consumption of red meat, and consumption of oilseeds.\u0000Conclusions: This study indicates the importance of dietary awareness and lifestyle modification for the management of dyslipidemia among type 2 diabetes mellitus.","PeriodicalId":52856,"journal":{"name":"Nepalese Medical Journal","volume":"39 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-06-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"82660729","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}
Introduction: Nepal is a developing country where most of the population does not have access to proper health care services and on top of that eye care services do not reach the entire population. This study aimed to determine the pattern of ocular morbidity in patients attending the ophthalmic OPD of Rapti Academy of Health Sciences. Materials and Methods: This was a prospective cross-sectional study conducted in the Department of Ophthalmology of Rapti Academy of Health Science, Dang. The study period was Poush 2077 to Chaitra 2077. All the patients visiting the OPD of the Ophthalmology department with an ocular problem were included in the study. Results: A total of 1000 patients were examined during the study period. The patient's ages below 1 year were excluded so a total of 970 samples was selected. In which 625 (64.4%) were female and 345 (35.6%) were male. Most patients 92.9% were from Dang followed by Rolpa 4.1%, Rukum 1.4%, Pyuthan 0.9%, and Salyan 0.6%. Patients were examined from all age groups except for 1 year which was excluded. Out of the total patients, a maximum number of patients were female and the maximum number of patients were in the age group of 21- 30 years and followed by more than or equal to 60 years age group. Conclusions: This study will help in obtaining epidemiology of Ocular disease for proper planning and management in the hospital.
{"title":"Clinical Profile of Ocular Diseases at a Tertiary Eye Care Centre in Mid-Western Nepal","authors":"P. Basnet, Sagun Malla, Deepa Sharma, R. Gautam","doi":"10.3126/nmj.v4i1.37847","DOIUrl":"https://doi.org/10.3126/nmj.v4i1.37847","url":null,"abstract":"Introduction: Nepal is a developing country where most of the population does not have access to proper health care services and on top of that eye care services do not reach the entire population. This study aimed to determine the pattern of ocular morbidity in patients attending the ophthalmic OPD of Rapti Academy of Health Sciences.\u0000Materials and Methods: This was a prospective cross-sectional study conducted in the Department of Ophthalmology of Rapti Academy of Health Science, Dang. The study period was Poush 2077 to Chaitra 2077. All the patients visiting the OPD of the Ophthalmology department with an ocular problem were included in the study.\u0000Results: A total of 1000 patients were examined during the study period. The patient's ages below 1 year were excluded so a total of 970 samples was selected. In which 625 (64.4%) were female and 345 (35.6%) were male. Most patients 92.9% were from Dang followed by Rolpa 4.1%, Rukum 1.4%, Pyuthan 0.9%, and Salyan 0.6%. Patients were examined from all age groups except for 1 year which was excluded. Out of the total patients, a maximum number of patients were female and the maximum number of patients were in the age group of 21- 30 years and followed by more than or equal to 60 years age group.\u0000Conclusions: This study will help in obtaining epidemiology of Ocular disease for proper planning and management in the hospital.","PeriodicalId":52856,"journal":{"name":"Nepalese Medical Journal","volume":"129 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-06-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"90608657","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}
Introduction: This study was done to find out the causes of visual impairment in students studying in schools for the blind in the central development region of Nepal. Materials and Methods: The study was done in six schools for the blind in the central development region of Nepal. It was conducted by a team of Eye care professionals using standard eye examination protocols of the World Health Organization Prevention of Blindness Program in the year 2009. Results: A total of 133 students (5 - 21 years age group) enrolled in six schools for the blind were examined. 52.6% of children were visually impaired at birth and 12% developed vision impairment within one year of age. Twenty-one students (15.8%) had mild visual impairment, 5 students (3.8%) had severe visual impairment and 101 students (76%) were blind. The main cause of vision impairment was found to be lens-related anomaly 23.3% and retinal diseases, 18% followed by corneal lesions, 16.5%, and problems with the whole globe, optic nerve, and glaucoma accounting for 12.03%, 11.3%, and 7.5% respectively. The etiology could not be identified in 48.1% followed by hereditary causes (31.6%) and childhood factors (12%). Of the total students examined, 37.6% were visually impaired due to avoidable causes; preventable in 22.6% and treatable in 15% of cases. Conclusions: A high proportion of childhood blindness in schools for the blind in the central development region of Nepal is avoidable.
{"title":"Causes of Blindness and Visual Impairment Among Children Studying in Schools for the Blind in Central Development Region of Nepal","authors":"J. Shrestha, Pragati Gautam Adhikari, G. Shrestha","doi":"10.3126/nmj.v5i1.42151","DOIUrl":"https://doi.org/10.3126/nmj.v5i1.42151","url":null,"abstract":"Introduction: This study was done to find out the causes of visual impairment in students studying in schools for the blind in the central development region of Nepal.\u0000Materials and Methods: The study was done in six schools for the blind in the central development region of Nepal. It was conducted by a team of Eye care professionals using standard eye examination protocols of the World Health Organization Prevention of Blindness Program in the year 2009.\u0000Results: A total of 133 students (5 - 21 years age group) enrolled in six schools for the blind were examined. 52.6% of children were visually impaired at birth and 12% developed vision impairment within one year of age. Twenty-one students (15.8%) had mild visual impairment, 5 students (3.8%) had severe visual impairment and 101 students (76%) were blind. The main cause of vision impairment was found to be lens-related anomaly 23.3% and retinal diseases, 18% followed by corneal lesions, 16.5%, and problems with the whole globe, optic nerve, and glaucoma accounting for 12.03%, 11.3%, and 7.5% respectively. The etiology could not be identified in 48.1% followed by hereditary causes (31.6%) and childhood factors (12%). Of the total students examined, 37.6% were visually impaired due to avoidable causes; preventable in 22.6% and treatable in 15% of cases.\u0000Conclusions: A high proportion of childhood blindness in schools for the blind in the central development region of Nepal is avoidable.","PeriodicalId":52856,"journal":{"name":"Nepalese Medical Journal","volume":"23 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-06-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"76370286","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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