NepMed is a Nepal MEDLINE(Medical Literature Analysis and Retrieval System Online) by Nepal Health Research Council(NHRC). It includes bibliographic information for articles from academic biomedical journals covering medicine, dentistry, nursing, pharmacy, dentistry veterinary medicine, and allied health sciences.
Recent Publications
Association between Serum Uric Acid Levels and Stroke Severity inAcute Ischemic Stroke: A Cross-Sectional Study
(Nepal APF Hospital, 2026) Sah, Dayanand Prasad; Shah, Santosh Prasad; Subedi, Bhusan Kumar; Khatri, Ganga Ram; Poudyal, Himani; Sah, Muneshwar; Bastola, Basanta Kumar; Gaire, Prabin
Abstract:
Background: Ischemic stroke (IS) represents a significant global health burden, with multiple established risk factors. Studies have suggested a potential link between serum uric acid (SUA) levels and stroke risk. Some studies propose that elevated SUA may contribute to the pathophysiology of stroke through mechanisms such as oxidative stress and inflammation. This study explore the association between SUA and the incidence of acute ischemic stroke, taking into account confounding variables such as age, sex, comorbidities, lifestyles pattern.
Methods: The hospital based cross sectional observational study conducted with sample size of 95 including patients of either sex above the age of 18 years with acute ischemic stroke within 7 days of presentation and confirmed by neuroimaging. The study excluded patients with hemorrhagic stroke, known malignancies, chemotherapy, recent surgery, trauma, or drugs affecting SUA level. SUA levels and National Institutes of Health Stroke Scale (NIHS score) were calculated to assess stroke severity.
Results: The study found a higher incidence of stroke among males (56%), with smoking being the most common risk factor (64%) followed by hypertension (54%). The study found that 86.32% of patients had serum uric acid levels below 6.8mg/dl, while 13.68% had levels above 6.8mg/dl. Patients with low uric acid levels were seen having a higher risk of stroke as the severity of stroke was highest among those with serum uric acid levels (4.0-5.0 mg/dl) however there found statistically not significant association between serum uric acid level and NIHSS (p=0.52).
Conclusion: The mean serum uric acid was 5.19 mg/dl (SD 1.48) and mean NIHSS was 11.24 (SD 3.9). There is no correlation between Serum uric acid and severity of ischemic stroke by NIHSS(p=0.52).
Functional Outcomes of Uncemented Total Hip Arthroplasty forOsteonecrosis of the Femoral Head due to Sickle Cell Disease inNepal: A Retrospective Study
(Nepal APF Hospital, 2026) Khadka, Tirthendra; Pande, Rajan; Thapa, Prakash Bahadur; Mishra, Rahul
Abstract:
Introduction: Sickle cell disease is particularly prevalent among the Tharu population of western Nepal. Osteonecrosis of the femoral head is a common and debilitating complication of sickle cell disease, resulting from recurrent vaso-occlusive episodes. The study aimed to determine the functional outcomes and complications following total hip arthroplasty in patients with sickle cell disease-associated osteonecrosis of the femoral head.
Methods: A retrospective study was conducted at a tertiary care hospital after ethical clearance (Reference No: 1137/26-01-2026) between January 2019 and June 2025. Medical records of 16 patients who underwent total hip arthroplasty for advanced osteonecrosis of femoral head secondary to sickle cell disease were reviewed. Demographic characteristics, sickle cell genotype, functional outcome and complications were recorded. Functional outcomes were assessed using the Harris Hip Score preoperatively and at 6-month follow-up and were compared using a paired t-test.
Results: Among 16 patients (17 hips), the mean Harris Hip Score improved from 46.29±11.92 preoperatively to 86.47±5.96 at 6-month follow-up. The mean age was 40.88±10.31 years. There were 9 (56.25%) females and 7 (43.75%) males. Fourteen patients had homozygous genotype and two had sickle-beta thalassemia. Bilateral hip involvement was observed in 6 (37.50%) patients. Postoperative outcomes were excellent in 6 (35.29%) hips, good in 8 (47.06%), and fair in 3 (17.65%) hips. One superficial wound infection and three acute vaso-occlusive or acute anemic episodes requiring intensive care and transfusion were recorded.
Conclusions: Total hip arthroplasty provides significant functional improvement and pain relief in patients with sickle cell disease-associated osteonecrosis of the femoral head, with acceptable complication rates when appropriate perioperative management is provided.
Study of Co-morbidities in Schizophrenia in Patients Admitted to aTertiary Care Centre: An Observational Study
(Nepal APF Hospital, 2026) Amatya, Anugya; Pradhan, Sudarshan Narsingh
Abstract:
Introduction: Patients with schizophrenia vary substantially relative to their symptoms, response to treatment, disease impact on function and biological correlates. Approximately 50% of patients with schizophrenia have at least one comorbid psychiatric or medical condition. This study was conducted to assess various psychiatric and medical comorbidities complicating the clinical picture of schizophrenia.
Methods: A hospital-based descriptive cross-sectional study was conducted at the Department of Psychiatry of a medical college in Nepal from November 2018 to December 2019. All the admitted patients in Psychiatry Ward, 18 years and above with diagnosis of Schizophrenia were included. Patients admitted in intensive units and outpatient patient visits were excluded. Ethical approval was taken from Institutional Review Committee. A data collection tool which contained of semi-structured questionnaire was developed for data collection of clinical and demographic profile. The Positive and Negative Syndrome Scale, Beck Anxiety Inventory Nepali version, Beck Depression Inventory II Nepali version and CAGE Questionnaire for assessing syndrome of Schizophrenia, depression, anxiety and use of alcohol. The collected data was entered in the Microsoft Excel and Descriptive statistics were used to summarize and present the data.
Results: Out of 60 patients, 55 (91.68%) and 37 (61.68%) had psychiatric and medical comorbidities respectively. Co-morbid psychiatric conditions such as substance use, anxiety and depression were found in 37 (61.68%), 35 (58.33%) and 30 (50%) of them. Sexual dysfunction and menstrual dysfunction were common co-morbidities followed by dyslipidaemia and electrolyte imbalance.
Conclusions: This study found the substantial burden of comorbid conditions in the patients with schizophrenia.
Assessing Knowledge of Cervical Cancer Screening and HumanPapilloma Virus Prevention in Security Personnel and Their Families:A Cross-Sectional Study Authors
(Nepal APF Hospital, 2026) Karmacharya, Saujanya; Khatri, Nisha; Maharjan, Rajendra; Adhikari, Laxmi; Khaural, Binita; Dulal, Ramila; Shrestha, Amrita; Yadav, Rina Kumari
Abstract:
Introduction: Cervical cancer is a leading cause of cancer-related morbidity and mortality among women in Nepal, despite being largely preventable through early screening and Human Papillomavirus vaccination. Limited evidence exists regarding knowledge of cervical cancer prevention among Armed Police Force personnel and their families. This study aimed to assess awareness and knowledge of cervical cancer, its risk factors, screening methods, and vaccination among this population.
Methods: This was a hospital-based descriptive cross-sectional study conducted over a four-month period after obtaining approval from the Institutional Review Committee (Reference number: NAPFH-026/2024). A structured, validated questionnaire was used to collect data on socio-demographic characteristics and knowledge of cervical cancer, screening methods, and vaccination. A convenience sampling included 410 participants. Data were analyzed using Statistical Package for the Social Sciences version 26.
Results: Among 410 participants, 315 (76.83%) had heard of cervical cancer, with media 104 (25.36%) being the most common source of information. Knowledge of cervical cancer risk factors and symptoms was variable, with multiple sexual partners 157 (38.29%) and post-menopausal bleeding 154 (37.56%) being the most frequently identified. More than half of the respondents, 225 (54.87%), believed cervical cancer is preventable, and 222 (54.15%) identified regular screening as a key preventive method. Although 251 (61.22%) had heard of the HPV vaccine, only 95 (23.17%) correctly identified the optimal timing for vaccination, and substantial misconceptions persisted regarding HPV infection, vaccine availability, and the necessity of screening after vaccination.
Conclusions: While general awareness of cervical cancer was moderate, substantial knowledge gaps exist regarding HPV-related prevention and screening practices. Targeted education and counselling initiatives are essential to improve cervical cancer prevention and early detection among security personnel and their families.
Clinical Profile and Outcome of Guillain Barré Syndrome in a TertiaryCare Hospital: A Retrospective study
(Nepal APF Hospital, 2026) Lamichhane, Jayaram; Gajurel, Bikram Prasad; Karn, Ragesh; Rajbhandari, Reema; Gautam, Niraj; Ghimire, Pukar; Panthee, Pradeep; Bhandari, Pragya; Khanal, Kapil
Abstract:
Background: Guillain-Barré syndrome (GBS) is an acute autoimmune polyradiculopathy characterized by a highly variable long-term prognosis. There isn't much data from resource limited settings like Nepal. The objective of this study was to assess the clinical characteristics and disability outcomes one year later in GBS patients at a tertiary care center.
Methods: This retrospective study encompassed adult patients diagnosed with Guillain-Barré Syndrome (according to Brighton criteria) at Tribhuvan University Teaching Hospital from May 2023 to May 2024. We gathered information about the patients' clinical, electrophysiological, and treatment history. The Hughes GBS Disability Scale (GBS-DS) was employed to evaluate the severity of disability. One-year outcomes were classified as favorable (GBS-DS 0–2) or unfavorable (GBS-DS 3–6). Statistical analysis was employed to ascertain prognostic factors.
Results: The study included 62 patients, with a mean age of 40.18 ± 17.52 years, of whom 74.2% were male. The most common types were typical GBS (88.7%) and acute inflammatory demyelinating polyneuropathy (AIDP, 37.5%). Almost half of the patients (49%) only got treatment for their symptoms. 31.4% got intravenous immunoglobulin (IVIG), and 19.6% got plasma exchange. A year later, 51 patients were checked on again. 92.2% of them had a good outcome, and 7.8% of them had a bad outcome.
Conclusion: The majority of GBS patients exhibited significant recovery one year later. Future larger prospective studies are necessary to elucidate the prognostic factors for GBS in resource-constrained regions.