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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.

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Article

Completeness of computed tomography (ct) requisition forms in a tertiary care center of nepal: a mixed-method study

(Nepal Medical College Pvt. Ltd., 2025) Shah, Laliteshwar; Pokharel, Asmit; Gaire, Sandesh; Sharma, Krishna; Bhattachan, Maya

Abstract: Properly completed Computed Tomography (CT) requisition forms are essential for accurate imaging, timely diagnosis, and patient safety. Incomplete documentation may lead to delays, errors, and potential harm. This audit evaluated the completeness of CT requisition forms at Nepal Medical College Teaching Hospital. A cross-sectional audit of 267 CT requisition forms was performed. Data on patient demographics, clinical information, and administrative details were collected and analyzed against established standards. Descriptive statistics were used to quantify completeness. Patient name and age were recorded in 99.3% and 98.9% of forms, respectively, while 97.4% documented patient sex. Hospital numbers were missing in 50.2%, provisional diagnosis in 59.6%, and the referring department in 77.9%. Doctor signatures were absent in 29.2%, and allergy history was omitted in 92.5%. Only 7.5% of the forms were fully complete. The audit revealed considerable gaps in the completion of CT requisition forms. Targeted interventions, staff training, and periodic re-audits are recommended to enhance documentation quality and patient safety.

Article

Morphometric analysis of the anterior cruciate ligament – a cadaveric study

(Nepal Medical College Pvt. Ltd., 2025) Chalise, Usha; Kharbuja, Rabita; Dhungel, Shaligram

Abstract: The knee joint is the bicondylar variety of synovial joint of the human body formed by the articulation of lower end of femur with the tibia and patella. The anterior cruciate ligament (ACL) is an intra-articular, extra synovial ligament which is most frequently damaged ligament and also requires reconstructive surgery. As there are variation among the age, gender and different populations, the morphometric understanding of ACL is essential. This study aimed to assess the morphometric analysis of ACL in a cadaver. A descriptive observational study was carried out in the Department of Human Anatomy, Nepal Medical College and Teaching Hospital from August 2024 to July 2025 in 26 cadavers including both right and left knees. The formalin preserved cadaveric knees were dissected, exposing the knee joint following the standard procedures. The length and breadth of the ACL were measured by Digital Vernier Caliper. The mean and standard deviation was calculated applying SPSS version 16. All the 52 knees were measured and the mean length of ACL was 38.5 ± 0.49 mm and mean breadth of ACL was 10.00 ± 0.19 mm. The mean length of right and left side ACL was 38.60 ± 0.47 mm. and 38.40 ± 0.52 mm respectively. Similarly, the mean breadth of right and left side of ACL was 9.70 ± 0.16 mm and 10.31 ± 0.22 mm respectively. The present study concluded that the variation in both length and breadth of right and left ACL exists. A thorough understanding of ACL is mandatory during surgical intervention and reconstructive procedure of anterior cruciate ligament.

Article

Clinical outcome of laparoscopic pyeloplasty in a Tertiary hospital

(Nepal Medical College Pvt. Ltd., 2025) Koju, Rajan; Sharma, Vijay; Shah, Arun

Abstract: Laparoscopic pyeloplasty is preferred surgery to treat patients with Pelvi-ureteric junction obstruction(PUJO). The main objective of the study was to assess outcome of laparoscopic pyeloplasty in our university hospital. This was retrospective descriptive observational study which included 36 patients diagnosed with PUJO by CT IVU (intravenous urography) and diuretic DTPA (Diethylenetriamine Pentaacetic acid) renogram presented to Dhulikhel hospital from 1st January 2023 to 30th January 2025. Patient were reviewed in terms of demographic characteristics, clinical presentation and radiological findings. Statistical correlation with the presence of crossing vessels was analyzed using student’s t-test and Fisher’s exact test. Mean age was 30.03±10.66 years, 17(47.22%) female and 19(52.78%) male patient. Most of the patient were asymptomatic 38.89% followed by pain 33.33%. crossing vessel compression was noted in 10 patient(27.78%). Mean operative duration was 174.17±18.80 minutes. Mean hospital stay was 2.67±0.48 days. A statistically significant correlation was noted between the presence of crossing vessels and gender, as well as kidney stones. Recurrence noted in 1 patient (2.78%) managed with redo laparoscopic pyeloplasty. Laparoscopic pyeloplasty is safe, effective option for treatment of PUJO with comparable success rate, less post operative pain, short hospital stay however operative duration is prolonged.

Article

Antimicrobial resistance profile and molecular screening of blakpc gene among clinical isolates of pseudomonas aeruginosa from a Tertiary care hospital, Nepal

(Nepal Medical College Pvt. Ltd., 2025) Adhikari, Ram Prasad; Khanal, Laxmi Kant; Sapkota, Jyotshna; Pandey, Ritu; Sah, Anil Kumar; Khadka, Shusila; Rai, Shiba Kumar

Abstract: Pseudomonas aeruginosa is a major opportunistic pathogen with increasing antimicrobial resistance, creating significant treatment challenges in hospital settings. This study aimed to determine the antimicrobial resistance profile of P. aeruginosa and screen for the blaKPC gene among meropenem-resistant isolates. A descriptive cross-sectional study was conducted from December 2021 to May 2022, yielding 75 non-duplicate isolates identified through standard microbiological methods; antimicrobial susceptibility testing was performed using the Kirby- Bauer technique, and 17 meropenem-resistant isolates underwent PCR for blaKPC detection. Sputum (33.33%) and pus (29.33%) were the most common specimen sources, and multidrug resistance was observed in 54.7% of isolates, particularly among inpatients and ICU cases. High-rate resistance to ceftazidime and piperacillin was noted, while carbapenem resistance remained moderate (21-23%). None of the meropenem-resistant isolates carried the blaKPC gene, indicating alternative carbapenem resistance mechanisms. These findings highlight a substantial burden of MDR P. aeruginosa and underscore the need for ongoing surveillance and strengthened infection control practices.

Article

Prevalence of appendicular perforation among patients undergoing emergency appendectomy at a Tertiary care hospital

(Nepal Medical College Pvt. Ltd., 2025) Shrestha, Sudip; Bhattarai, Shardul; Singh, Bhanu Pratap; Shrestha, Sudip

Abstract: Appendicitis is a common cause of abdominal pain, and misdiagnosis or delayed diagnosis of acute appendicitis leads to perforation, postoperative complications, and an increased length of hospital stay. A retrospective study was performed at the Department of Surgery, Nepal Medical College Teaching Hospital, Gokarneshwor Municipality-8, Kathmandu, from Jan 2020 to Dec 2022, involving 235 patients who fulfilled the inclusion criteria. In our 3-year study, 235 patients (139 males and 96 females) underwent emergency appendectomy. Pain was present in all patients, with a mean duration of 24.89 ± 6.835 hours and a WBC ranging from 9,600 to 18,400 cells/mm3. The average luminal diameter was 9.362 ± 1.3 mm. A total of 22 patients (9.4%) had a perforated appendix. Perforation was more common among males. Similarly, perforated patients presented with pain for 24.5 ± 7.7 hours and a WBC of 15,454 ± 1818.044 cells/mm3. Imaging revealed the luminal diameter of 10.7 ± 1.069 mm. The prevalence of perforation among patients with appendicitis was relatively low with higher male-to-female ratio and a substantial portion of patients occurring in the 18-23 years age group.

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