Neuroleptic malignant syndrome (NMS) is a neurological emergency due to neuroleptic medications which is characterized by fever, muscle rigidity, autonomic instability, and altered mental status. Here we report a case of a 74 years old female who presented with complaints of fever, altered sensorium, restlessness, self-muttering, irritation, muscular rigidity, decreased mobility and diaphoresis. She was under medication olanzapine for schizoaffective disorder. It is a diagnosis of exclusion after detailed examinations and investigations. The patient was managed with bromocriptine and supportive measures. NMS may mimic acute encephalitis syndrome. Therefore, NMS should be included in differential diagnosis with presentation as in our case.
{"title":"Neuroleptic Malignant Syndrome: A potential mimic of acute encephalitis syndrome","authors":"Radhay Shyam Yadav, Anup Raj Upreti, Prabin Khatri, Bishal Bharati, Pingala Khadka, Ashryata Manandhar, Sammi Joshi, Khusboo Chaudhary","doi":"10.3126/nmcj.v25i3.59024","DOIUrl":"https://doi.org/10.3126/nmcj.v25i3.59024","url":null,"abstract":"Neuroleptic malignant syndrome (NMS) is a neurological emergency due to neuroleptic medications which is characterized by fever, muscle rigidity, autonomic instability, and altered mental status. Here we report a case of a 74 years old female who presented with complaints of fever, altered sensorium, restlessness, self-muttering, irritation, muscular rigidity, decreased mobility and diaphoresis. She was under medication olanzapine for schizoaffective disorder. It is a diagnosis of exclusion after detailed examinations and investigations. The patient was managed with bromocriptine and supportive measures. NMS may mimic acute encephalitis syndrome. Therefore, NMS should be included in differential diagnosis with presentation as in our case.","PeriodicalId":87122,"journal":{"name":"Nepal Medical College journal : NMCJ","volume":"2014 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-10-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135739423","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}
Apart from decreased visual acuity, amblyopia may be associated with alteration in color vision, contrast sensitivity and stereopsis. The study was conducted to assess visual functions among amblyopic patients. Cross sectional observational study was done with appropriate examination. Best corrected visual acuity, color vision, contrast sensitivity and stereopsis were done among 31 amblyopic patients of age 5-18 years, visiting Department of Ophthalmology in Kathmandu Medical College from October 2021 to March 2022. Among thirty-one patients, male is to female ratio was 1.81:1. Mean age of participants was 9.45±3.49 years. Among patients with stimulus deprivation amblyopia, visual acuity was <6/60, color vision and contrast sensitivity were decreased in 100% and moderate stereopsis (80-200 seconds of arc) was present. Among patients with strabismic amblyopia, visual acuity was decreased (6/12-6/18), color vision and contrast sensitivity were normal in 100% and good stereopsis (<60 seconds of arc) was seen. Among those with refractive amblyopia, visual acuity was 6/6-6/9 in 34.5%, 6/12-6/18 in 44.8% and 6/24-6/60 in 20.7%. Color vision was decreased in 27.3% in ametropic, 9.1% in meridional and normal in anisometropic type. Contrast sensitivity was decreased in 27.3% each in ametropic and anisometropic, and in 63.6% in meridional amblyopia. Good and poor (>200 seconds of arc) stereopsis was found in 24.1% each and moderate in 51.7% of refractive amblyopia. Contrast sensitivity was seen to be decreased with decrease in vision (40.0%, 42.8%, 50.0% and 100.0% in visual acuity 6/6-6/9, 6/12-6/18, 6/24-6/60 and<6/60 respectively). To conclude, visual functions are affected in different types of amblyopia.
{"title":"Visual Functions among amplyopic patients","authors":"Sabina Shrestha, Dikchhya Sharma, Aparajita Manoranjan, Subee Joshi, Yuliya Shrestha","doi":"10.3126/nmcj.v25i3.58710","DOIUrl":"https://doi.org/10.3126/nmcj.v25i3.58710","url":null,"abstract":"Apart from decreased visual acuity, amblyopia may be associated with alteration in color vision, contrast sensitivity and stereopsis. The study was conducted to assess visual functions among amblyopic patients. Cross sectional observational study was done with appropriate examination. Best corrected visual acuity, color vision, contrast sensitivity and stereopsis were done among 31 amblyopic patients of age 5-18 years, visiting Department of Ophthalmology in Kathmandu Medical College from October 2021 to March 2022. Among thirty-one patients, male is to female ratio was 1.81:1. Mean age of participants was 9.45±3.49 years. Among patients with stimulus deprivation amblyopia, visual acuity was <6/60, color vision and contrast sensitivity were decreased in 100% and moderate stereopsis (80-200 seconds of arc) was present. Among patients with strabismic amblyopia, visual acuity was decreased (6/12-6/18), color vision and contrast sensitivity were normal in 100% and good stereopsis (<60 seconds of arc) was seen. Among those with refractive amblyopia, visual acuity was 6/6-6/9 in 34.5%, 6/12-6/18 in 44.8% and 6/24-6/60 in 20.7%. Color vision was decreased in 27.3% in ametropic, 9.1% in meridional and normal in anisometropic type. Contrast sensitivity was decreased in 27.3% each in ametropic and anisometropic, and in 63.6% in meridional amblyopia. Good and poor (>200 seconds of arc) stereopsis was found in 24.1% each and moderate in 51.7% of refractive amblyopia. Contrast sensitivity was seen to be decreased with decrease in vision (40.0%, 42.8%, 50.0% and 100.0% in visual acuity 6/6-6/9, 6/12-6/18, 6/24-6/60 and<6/60 respectively). To conclude, visual functions are affected in different types of amblyopia.","PeriodicalId":87122,"journal":{"name":"Nepal Medical College journal : NMCJ","volume":"12 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-10-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135739521","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}
Diabetes mellitus (DM) is a glucose metabolism disorder with diabetic ketoacidosis (DKA) being the most common complication associated with significant morbidity and mortality. Unlike other patients with typical symptoms of abdominal discomfort, pain, nausea and emesis of DKA, our patient presented with atypical symptoms such as cough, runny nose and fast breathing. This symptoms would have initially misled with diagnosis of respiratory tract infection, which would have caused delay in the treatment of DKA. In our patient DKA was treated with intravenous fluid replacement followed by intravenous insulin infusion, along with monitoring of blood glucose and electrolyte levels. We would like to emphasize that DKA can be precipitated by simple upper respiratory tract infection in toddlers with undiagnosed type 1 DM. Hence, random blood sugar measurement and urine for ketone bodies test should be performed if feasible in sick patients presenting with respiratory tract illness-like symptoms.
{"title":"New-onset severe Diabetic Ketoacidosis in a 13-months old Nepali Toddler: a case report","authors":"Bijay Basnet, Chaitanya Darshan Bhattarai, Rohit Bhatt, Romila Chimoriya, Kushal Adhikari, Birendra Kumar Yadav","doi":"10.3126/nmcj.v25i3.59022","DOIUrl":"https://doi.org/10.3126/nmcj.v25i3.59022","url":null,"abstract":"Diabetes mellitus (DM) is a glucose metabolism disorder with diabetic ketoacidosis (DKA) being the most common complication associated with significant morbidity and mortality. Unlike other patients with typical symptoms of abdominal discomfort, pain, nausea and emesis of DKA, our patient presented with atypical symptoms such as cough, runny nose and fast breathing. This symptoms would have initially misled with diagnosis of respiratory tract infection, which would have caused delay in the treatment of DKA. In our patient DKA was treated with intravenous fluid replacement followed by intravenous insulin infusion, along with monitoring of blood glucose and electrolyte levels. We would like to emphasize that DKA can be precipitated by simple upper respiratory tract infection in toddlers with undiagnosed type 1 DM. Hence, random blood sugar measurement and urine for ketone bodies test should be performed if feasible in sick patients presenting with respiratory tract illness-like symptoms.","PeriodicalId":87122,"journal":{"name":"Nepal Medical College journal : NMCJ","volume":"9 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-10-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135739547","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}
Family support is an essential factor among the elderly to maintain health and wellbeing. Most of the elderly are living with the family and depend on them for care. However support from family has been decreasing with the increasing age. The objective of the study was to assess perceived family support among elderly residing in Gokarneshwor, Kathmandu. A descriptive cross-sectional research design was used for conducting this study among 216 elderly residing in Gokarneshwor Municipality of Kathmandu over a period of July 2022 to October 2022 through non-probability purposive sampling technique. Data collection was done by using face to face interview using valid standard tool for family support scale (FSS). Data was analyzed by using SPSS version 16. The results of this study showed that more than half (55.1%) respondents perceived low family support from their family members. Only 44.9% had high family support. Respondents who had chronic disease were financially dependent perceived low family support. There was significant association between perceived family support and age (p=0.015), educational level (p=0.013) and working elderly (0.001). The study concluded that family support perception from elderly was low and some elderly was perceived high support from their family members. However sleep related care, information and decision making support was perceived less than other variables. Family members should be encouraged to build positive family relationship with elderly and involve them in wise decision making.
{"title":"Perceived Family Support among elderly residing in Gokarneshwor Municipality, Kathmandu","authors":"Mithu Saud, Shrijana Pandey, Ishwori Lama, Shova Shrestha","doi":"10.3126/nmcj.v25i3.58709","DOIUrl":"https://doi.org/10.3126/nmcj.v25i3.58709","url":null,"abstract":"Family support is an essential factor among the elderly to maintain health and wellbeing. Most of the elderly are living with the family and depend on them for care. However support from family has been decreasing with the increasing age. The objective of the study was to assess perceived family support among elderly residing in Gokarneshwor, Kathmandu. A descriptive cross-sectional research design was used for conducting this study among 216 elderly residing in Gokarneshwor Municipality of Kathmandu over a period of July 2022 to October 2022 through non-probability purposive sampling technique. Data collection was done by using face to face interview using valid standard tool for family support scale (FSS). Data was analyzed by using SPSS version 16. The results of this study showed that more than half (55.1%) respondents perceived low family support from their family members. Only 44.9% had high family support. Respondents who had chronic disease were financially dependent perceived low family support. There was significant association between perceived family support and age (p=0.015), educational level (p=0.013) and working elderly (0.001). The study concluded that family support perception from elderly was low and some elderly was perceived high support from their family members. However sleep related care, information and decision making support was perceived less than other variables. Family members should be encouraged to build positive family relationship with elderly and involve them in wise decision making.","PeriodicalId":87122,"journal":{"name":"Nepal Medical College journal : NMCJ","volume":"9 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-10-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135738535","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}
Clinical assessment, chest X-ray (CXR) and chest high-resolution computed tomography (HRCT) are used in the management of Corona virus disease-19 (COVID-19). This retrospective cross sectional study included 251 patients admitted to Nepal Medical College Teaching Hospital (NMCTH) with a diagnosis of COVID‑19 infection confirmed by Reverse Transcriptase- Polymerase Chain Reaction (RT‑PCR). These patients underwent chest HRCT within the first two weeks of hospital admission. Images were evaluated for various HRCT findings & semi- quantitative CT Severity Score (CT –SS) was calculated based on the extent of lobar involvement. Out of 251 patients with positive RT PCR test, 127 were male (50.6%) and 124 female (49.4%). Typical bilateral peripheral subpleural ground glass opacities were demonstrated in 98.8% of patients; followed by thoracic lymphadenopathy (80.8%), interlobular septal thickening (80.4%),vascular changes (44.2%), focal consolidation (28.6%), consolidation with ground glass opacity (15%), pleural effusion (13.1%) bronchiectasis (3.8%), fibrotic changes (3.1%) and reversed halo pattern (0.7%). Calculated CT- SS showed moderate score in 130 patients (51.7%) followed by severe score in 67 patients (26.6%) and mild score in 51 patients (20.3%). HRCT can be used as a one stop radiological investigation for the diagnosis and prognosis of corona virus disease and CT -SS might be beneficial for diagnostic workflow in symptomatic cases.
{"title":"High Resolution Computed Tomography chest findings among people affected by corona virus disease in a tertiary hospital of Nepal","authors":"Rumita Kayastha, Riwaz Acharya, Sunil Pradhan, Abhushan Siddhi Tuladhar, Amit Shrestha","doi":"10.3126/nmcj.v25i3.58712","DOIUrl":"https://doi.org/10.3126/nmcj.v25i3.58712","url":null,"abstract":"Clinical assessment, chest X-ray (CXR) and chest high-resolution computed tomography (HRCT) are used in the management of Corona virus disease-19 (COVID-19). This retrospective cross sectional study included 251 patients admitted to Nepal Medical College Teaching Hospital (NMCTH) with a diagnosis of COVID‑19 infection confirmed by Reverse Transcriptase- Polymerase Chain Reaction (RT‑PCR). These patients underwent chest HRCT within the first two weeks of hospital admission. Images were evaluated for various HRCT findings & semi- quantitative CT Severity Score (CT –SS) was calculated based on the extent of lobar involvement. Out of 251 patients with positive RT PCR test, 127 were male (50.6%) and 124 female (49.4%). Typical bilateral peripheral subpleural ground glass opacities were demonstrated in 98.8% of patients; followed by thoracic lymphadenopathy (80.8%), interlobular septal thickening (80.4%),vascular changes (44.2%), focal consolidation (28.6%), consolidation with ground glass opacity (15%), pleural effusion (13.1%) bronchiectasis (3.8%), fibrotic changes (3.1%) and reversed halo pattern (0.7%). Calculated CT- SS showed moderate score in 130 patients (51.7%) followed by severe score in 67 patients (26.6%) and mild score in 51 patients (20.3%). HRCT can be used as a one stop radiological investigation for the diagnosis and prognosis of corona virus disease and CT -SS might be beneficial for diagnostic workflow in symptomatic cases.","PeriodicalId":87122,"journal":{"name":"Nepal Medical College journal : NMCJ","volume":"216 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-10-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135739143","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}
Overt hypothyroidism usually leads to dyslipidemia. The relationship between overt hypothyroidism and dyslipidemia is well established, to that of subclinical hypothyroidism is controversial. Also, Subclinical hypothyroidism if untreated can lead to overt hypothyroidism. So, the present study was conducted to investigate dyslipidema in patients with subclinical hypothyroidism. The study population comprised of total 111 cases having subclinical hypothyroidism and 111 cases of healthy controls. Those with normal T3 and T4 with thyroid stimulating hormone above 4.68 IU/ml were considered subclinical hypothyroidism and were further evaluated for lipid profile. Highest number of participants in the cases belonged to age group 60-71 (36.0%) whereas in control group it was 40-49 years (32.4%). No significant differences were found between lipid parameters between case and control (p >0.05). Serum triglyceride, high density lipoprotein, very low-density lipoprotein was positively correlated with thyroid stimulating hormone (r=0.152, r=0.056, r=0.152, respectively and p=0.110, p=0.560, p=0.110, respectively) whereas total cholesterol, low density lipoprotein was negatively correlated with thyroid stimulating hormone in the cases (r=-0.089, r=-0.118, respectively) and the relation was not statistically significant (p=0.351, p=0.216, respectively). Among control group, serum total cholesterol, high density lipoprotein, low density lipoprotein were positively correlated with thyroid stimulating hormone (r=0.197, r=0.196, r=0.132, respectively) whereas triglyceride, very low density lipoprotein were negatively correlated with thyroid stimulating hormone (r=-0.009, r=-0.025, respectively). Subclinical hypothyroidism may or may not lead to dyslipidemia. Even euthyroid group can have lipid abnormalities. So, screening for hyperlipidemia in general population is more useful rather than patients with subclinical hypothyroidism.
{"title":"A hospital-based study of dyslipidemia in patients with subclinical hypothyroidism","authors":"Richa Bhattarai, Asmita Pokhrel, Bishesh Sah, Pragya Malla, Madhav Khanal, Dristi Banskota, Manish Prasad Paudel","doi":"10.3126/nmcj.v25i3.58711","DOIUrl":"https://doi.org/10.3126/nmcj.v25i3.58711","url":null,"abstract":"Overt hypothyroidism usually leads to dyslipidemia. The relationship between overt hypothyroidism and dyslipidemia is well established, to that of subclinical hypothyroidism is controversial. Also, Subclinical hypothyroidism if untreated can lead to overt hypothyroidism. So, the present study was conducted to investigate dyslipidema in patients with subclinical hypothyroidism. The study population comprised of total 111 cases having subclinical hypothyroidism and 111 cases of healthy controls. Those with normal T3 and T4 with thyroid stimulating hormone above 4.68 IU/ml were considered subclinical hypothyroidism and were further evaluated for lipid profile. Highest number of participants in the cases belonged to age group 60-71 (36.0%) whereas in control group it was 40-49 years (32.4%). No significant differences were found between lipid parameters between case and control (p >0.05). Serum triglyceride, high density lipoprotein, very low-density lipoprotein was positively correlated with thyroid stimulating hormone (r=0.152, r=0.056, r=0.152, respectively and p=0.110, p=0.560, p=0.110, respectively) whereas total cholesterol, low density lipoprotein was negatively correlated with thyroid stimulating hormone in the cases (r=-0.089, r=-0.118, respectively) and the relation was not statistically significant (p=0.351, p=0.216, respectively). Among control group, serum total cholesterol, high density lipoprotein, low density lipoprotein were positively correlated with thyroid stimulating hormone (r=0.197, r=0.196, r=0.132, respectively) whereas triglyceride, very low density lipoprotein were negatively correlated with thyroid stimulating hormone (r=-0.009, r=-0.025, respectively). Subclinical hypothyroidism may or may not lead to dyslipidemia. Even euthyroid group can have lipid abnormalities. So, screening for hyperlipidemia in general population is more useful rather than patients with subclinical hypothyroidism.","PeriodicalId":87122,"journal":{"name":"Nepal Medical College journal : NMCJ","volume":"11 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-10-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135739297","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-10-03DOI: 10.3126/nmcj.v25i3.58729
Urmila Bharati, Upashana Regmi
Medico-legal cases are essential component of medical practice and comprise important cases in emergencies.The objectives of this study was to assess the frequency and pattern of medico-legal cases and to identify the vulnerable gender, age group, outcome and the duration of stay in the Emergency Department of Nepal Medical College Teaching Hospital in Kathmandu. Medico-legal cases visiting emergencies from 1st March 2020 to 28th February 2021 were recorded using a proforma. During this period, a total of 1,176 medico-legal cases were registered (10.5% of the total emergency attendance; n=11,212) with 68.0% males and 32.0% females. Maximum number of cases belonged to the age group of 21 - 30 years (n=378; 32.1%) followed by 31 - 40 years (n=271; 23.0%). Most common medico-legal diagnosis was physical assault (n=389; 33.1%) followed by road traffic accidents (n=379; 32.2%). Majority of cases were accidental in nature (47.5%). Most of cases (56.1%) were discharged, 13.8% cases were admitted in different specialties for further management, 8.3% cases were referred to other centers and 21.7% cases left against medical advice. The length of stay was 15 minutes to 24 hours (mean 2.58 hours, SD 1.61). Most of the cases needed surgical consultation.
{"title":"Prevalence and pattern of medico-legal cases in emergency department of a tertiary care Centre in Kathmandu, Nepal","authors":"Urmila Bharati, Upashana Regmi","doi":"10.3126/nmcj.v25i3.58729","DOIUrl":"https://doi.org/10.3126/nmcj.v25i3.58729","url":null,"abstract":"Medico-legal cases are essential component of medical practice and comprise important cases in emergencies.The objectives of this study was to assess the frequency and pattern of medico-legal cases and to identify the vulnerable gender, age group, outcome and the duration of stay in the Emergency Department of Nepal Medical College Teaching Hospital in Kathmandu. Medico-legal cases visiting emergencies from 1st March 2020 to 28th February 2021 were recorded using a proforma. During this period, a total of 1,176 medico-legal cases were registered (10.5% of the total emergency attendance; n=11,212) with 68.0% males and 32.0% females. Maximum number of cases belonged to the age group of 21 - 30 years (n=378; 32.1%) followed by 31 - 40 years (n=271; 23.0%). Most common medico-legal diagnosis was physical assault (n=389; 33.1%) followed by road traffic accidents (n=379; 32.2%). Majority of cases were accidental in nature (47.5%). Most of cases (56.1%) were discharged, 13.8% cases were admitted in different specialties for further management, 8.3% cases were referred to other centers and 21.7% cases left against medical advice. The length of stay was 15 minutes to 24 hours (mean 2.58 hours, SD 1.61). Most of the cases needed surgical consultation.","PeriodicalId":87122,"journal":{"name":"Nepal Medical College journal : NMCJ","volume":"11 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-10-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135738990","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-10-03DOI: 10.3126/nmcj.v25i3.58731
Bal Krishna Bhatta, Manisha Karki, Maginsh Dahal, Basanta Pokhrel
Nutrition plays an important role in the overall well- being of human beings more so in the elderly. Elderly living at old age homes have a different nutritional status as compared to those living with their families. Thus, this study was conducted to assess the nutritional status of the elderly living in old age homes of Kathmandu Metropolitan City (KMC). A descriptive cross-sectional study was carried among 133 elderly residing in all six old age homes of KMC by using Nepali-translated Nestle’s Mini Nutritional Assessment Tool (MNA). Further collected information was analyzed using chi square test. Regarding nutritional status, 30.8% of the participants had normal nutritional status, whereas 52.7% were at risk of malnutrition and 16.5% were malnourished. Lifestyle related factors such as smoking and physical activity were found to be the factors affecting the nutritional status of elderly people. Significant association was seen between nutritional status and age (p =0.001) and past occupation (p =0.021). A significant proportion of elderly people living in old age homes are at risk of malnutrit ion or are malnourished.
{"title":"Nutritional status and its associated factors of elderly population living in old age homes of Kathmandu Metropolitan City","authors":"Bal Krishna Bhatta, Manisha Karki, Maginsh Dahal, Basanta Pokhrel","doi":"10.3126/nmcj.v25i3.58731","DOIUrl":"https://doi.org/10.3126/nmcj.v25i3.58731","url":null,"abstract":"Nutrition plays an important role in the overall well- being of human beings more so in the elderly. Elderly living at old age homes have a different nutritional status as compared to those living with their families. Thus, this study was conducted to assess the nutritional status of the elderly living in old age homes of Kathmandu Metropolitan City (KMC). A descriptive cross-sectional study was carried among 133 elderly residing in all six old age homes of KMC by using Nepali-translated Nestle’s Mini Nutritional Assessment Tool (MNA). Further collected information was analyzed using chi square test. Regarding nutritional status, 30.8% of the participants had normal nutritional status, whereas 52.7% were at risk of malnutrition and 16.5% were malnourished. Lifestyle related factors such as smoking and physical activity were found to be the factors affecting the nutritional status of elderly people. Significant association was seen between nutritional status and age (p =0.001) and past occupation (p =0.021). A significant proportion of elderly people living in old age homes are at risk of malnutrit ion or are malnourished.","PeriodicalId":87122,"journal":{"name":"Nepal Medical College journal : NMCJ","volume":"45 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-10-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135739542","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-10-03DOI: 10.3126/nmcj.v25i3.58732
Sanskriti Khanal, Priyanka Shah, Anju Khapung
Dental treatment can cause anxiety in a child further leading to physiological changes that affects the success of dental care. This cross-sectional study was carried out to assess the changes in the pulse rate and peripheral oxygen saturation in children undergoing routine dental treatment. Total 80 patients of 6 to 12 years old were included in the study who were divided into four groups according the dental treatment they receive. Data was analyzed using SPSS-16. It was observed that the patients undergoing extraction (group IV) had higher mean pulse rate before, during and after the procedures; 100.25±9.33, 101.85±13.52, 98.85±7.63 respectively. Lowest SpO2 was recorded in the patients undergoing pulp therapy before the procedure (96.90±3.66). Pulse rate was higher in females compared to males but it was not statistically significant. The children in extraction group selecting facial image scale 4 had more mean pulse rate before during and after the procedure. The mean pulse rate was high in patients undergoing extraction in both first visit (103.00±9.21) and subsequent visits (101.36±15.28). It was concluded that physiological changes occur during routine dental treatment therefore monitoring should be done in order to prevent any dental emergencies.
{"title":"Effect of Routine dental procedures on the pulse rate and peripheral oxygen saturation in pediatric patients","authors":"Sanskriti Khanal, Priyanka Shah, Anju Khapung","doi":"10.3126/nmcj.v25i3.58732","DOIUrl":"https://doi.org/10.3126/nmcj.v25i3.58732","url":null,"abstract":"Dental treatment can cause anxiety in a child further leading to physiological changes that affects the success of dental care. This cross-sectional study was carried out to assess the changes in the pulse rate and peripheral oxygen saturation in children undergoing routine dental treatment. Total 80 patients of 6 to 12 years old were included in the study who were divided into four groups according the dental treatment they receive. Data was analyzed using SPSS-16. It was observed that the patients undergoing extraction (group IV) had higher mean pulse rate before, during and after the procedures; 100.25±9.33, 101.85±13.52, 98.85±7.63 respectively. Lowest SpO2 was recorded in the patients undergoing pulp therapy before the procedure (96.90±3.66). Pulse rate was higher in females compared to males but it was not statistically significant. The children in extraction group selecting facial image scale 4 had more mean pulse rate before during and after the procedure. The mean pulse rate was high in patients undergoing extraction in both first visit (103.00±9.21) and subsequent visits (101.36±15.28). It was concluded that physiological changes occur during routine dental treatment therefore monitoring should be done in order to prevent any dental emergencies.","PeriodicalId":87122,"journal":{"name":"Nepal Medical College journal : NMCJ","volume":"91 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-10-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135695865","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}
The primary source of blood supply for long bones comes from the nutrient arteries that pass through the nutrient foramen. Understanding the location and structure of these foramens is important in surgical procedures to ensure that the bone’s blood supply is not disrupted. To study the morphology and topography of nutrient foramina and to determine the foraminal index of the upper and lower limb long bones. The long bones of the upper and lower limbs including 47 humeri, 38 radii, 38 ulnae, 53 femurs, 57 tibiae, and 44 fibulae were studied. The number and position of primary nutrient foramina were noted and the foraminal index was calculated. Results showed that 82.9% of the humeri had a single nutrient foramen, and 17.0% had double foramina. For the radii, 97.4% had single nutrient foramen and 2.6% had double foramina. A single nutrient foramen was observed in all the ulnae. In the lower limb bone, the femurs had 41.5% of single nutrient foramen, 56.6% had double foramina and only 1.9% had triple nutrient foramina. The tibiae showed 93.0% of the single nutrient foramen and only 7.0% had double foramen. In fibulae, only one nutrient foramen was seen. The mean foraminal index was 57.26 for the humerus, 34.82 for the radius, and 39.32 for the ulna. Similarly, the mean foraminal index of the femur was 44.73, the tibia was 32.32 and the ulna was 46.18. Understanding the location of foramina is crucial inmaintaining bone vasculature during surgical procedures, which can improve the success rates of bone grafting, fracture fixation, and replacement surgeries involving the shoulder, elbow, and knee joints.
{"title":"Topography and indexing of the nutrient foramina of the adult long bones","authors":"Umeshwar Prasad Thakur, Pranav Kumar Yadav, Brijendra Kumar Sah, Ram Jiban Prasad, Tirtha Narayan Shah","doi":"10.3126/nmcj.v25i3.58733","DOIUrl":"https://doi.org/10.3126/nmcj.v25i3.58733","url":null,"abstract":"The primary source of blood supply for long bones comes from the nutrient arteries that pass through the nutrient foramen. Understanding the location and structure of these foramens is important in surgical procedures to ensure that the bone’s blood supply is not disrupted. To study the morphology and topography of nutrient foramina and to determine the foraminal index of the upper and lower limb long bones. The long bones of the upper and lower limbs including 47 humeri, 38 radii, 38 ulnae, 53 femurs, 57 tibiae, and 44 fibulae were studied. The number and position of primary nutrient foramina were noted and the foraminal index was calculated. Results showed that 82.9% of the humeri had a single nutrient foramen, and 17.0% had double foramina. For the radii, 97.4% had single nutrient foramen and 2.6% had double foramina. A single nutrient foramen was observed in all the ulnae. In the lower limb bone, the femurs had 41.5% of single nutrient foramen, 56.6% had double foramina and only 1.9% had triple nutrient foramina. The tibiae showed 93.0% of the single nutrient foramen and only 7.0% had double foramen. In fibulae, only one nutrient foramen was seen. The mean foraminal index was 57.26 for the humerus, 34.82 for the radius, and 39.32 for the ulna. Similarly, the mean foraminal index of the femur was 44.73, the tibia was 32.32 and the ulna was 46.18. Understanding the location of foramina is crucial inmaintaining bone vasculature during surgical procedures, which can improve the success rates of bone grafting, fracture fixation, and replacement surgeries involving the shoulder, elbow, and knee joints.","PeriodicalId":87122,"journal":{"name":"Nepal Medical College journal : NMCJ","volume":"57 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-10-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135696340","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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