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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

Availability, accessibility and affordability of diabetes health care facilities in Latur, India

(Nepal Medical College Pvt. Ltd., 2023) Bansode, Balasaheb; Biradar, Rajeshwari A; Prasad, Jang Bahadur

Abstract: Despite the enormous burden, diabetes care in the community is still substandard. According to studies conducted in the Latur District, there is a significant gap between recommended and actual diabetes care, which results in poor health outcomes. A cross-sectional survey was undertaken in the Latur District of Maharashtra. A sample of 505 self-reported persons with diabetes from 413 households were interviewed from May to October 2017. The study used total samples of self-reported diabetes for the bivariate and multivariate analyses. Only 19% of respondents reported that they accessed government hospital facilities for treatments of diabetes. Elderly, belonging to SC/ST, working as a farmer/labour, and poor categories accessed government facilities for diabetes treatment. Most of the people could not access healthcare facilities because more than a third of respondents live more than 31km from hospital facilities because of poor transportation, lack of connectivity, and highly unaffordable healthcare expenses and time access to healthcare facilities. The adjusted odds ratios show that after controlling for important background factors find the link between unaffordability, distance, and poor transportation to healthcare institutions. The government and private sector must urgently decentralize healthcare facilities, and the government must enhance the health system by making health check-ups available at sub-centres, PHCs, rural hospitals, and special diabetic departments in the district and sub-district hospitals. Furthermore, the private sector and non-governmental organizations (NGOs) have to take steps to raise diabetes awareness and provide healthcare services at the grassroots level.

Article

Neuroleptic malignant syndrome: a potential mimic of acute encephalitis syndrome

(Nepal Medical College Pvt. Ltd., 2023) Yadav, Radhay Shyam; Upreti, Anup Raj; Khatri, Prabin; Bharati, Bishal; Khadka, Pingala; Manandhar, Ashryata; Joshi, Sammi; Chaudhary, Khusboo

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.

Article

New-onset severe diabetic ketoacidosis in a 13-months old Nepali toddler: a case report

(Nepal Medical College Pvt. Ltd., 2023) Basnet, Bijay; Bhattarai, Chaitanya Darshan; Bhatt, Rohit; Chimoriya, Romila; Adhikari, Kushal; Yadav, Birendra Kumar

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.

Article

Topography and indexing of the nutrient foramina of the adult long bones

(Nepal Medical College Pvt. Ltd., 2023) Thakur, Umeshwar Prasad; Yadav, Pranav Kumar; Sah, Brijendra Kumar; Prasad, Ram Jiban; Shah, Tirtha Narayan

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.

Article

Effect of routine dental procedures on the pulse rate and peripheral oxygen saturation in pediatric patients

(Nepal Medical College Pvt. Ltd., 2023) Khanal, Sanskriti; Shah, Priyanka; Khapung, Anju

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.

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