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Triple vessel diseasetreated funcitional endoscopic sinus surgery
(Institute of Medicine, 2018) Gautam, N; Pradhan, B; Thapa, N; Hira; Sharma, A
Abstract Triple vessel disease, a coronary artery diseasecaused by narrowing of plagues which is cholesterol deposit on the vessel wall resulting abnormal and gradual ticking-off the lining of the heart arteries condition known as atherosclerosis. The narrowing usually develops slowly over many years. Thishigh-risk case was operated by the team in TUTH ENT Operation theater. We report a 75-year-old man with triple vessel diseasewith diagnosisof right allergic fungal rhinosinusitis with left deviated nasal septumsuccessfully undergone right Functional Endoscopic Sinus Surgery and recovered. It had emergent condition. Keyword: FESS :Functional Endoscopic sinus surgery
Supernumerary Maxillary Lateral Incisor with Dens Evaginatus in Maxillary Second Premolar: A case report
(Institute of Medicine, 2018) Dahal, S; Agrawal, NK
NA.
De-worming during pregnancy in Nepal: an effect on neonatal mortality
(Institute of Medicine, 2018) Shedain, PR; Dixit, Devkota M; Paudel, R; Wagle, RR; Karki, S; Shrestha, R; Sharma, Y
Abstract Background: The Ministry of Health and Population, Nepal has been administering the de-worming medication (with tablet albendazole) to pregnant women aiming at reducing maternal anemia and neonatal death since 2001. The neonatal mortality has remained stagnant for the past decade. The effect of de-worming during pregnancy on neonatal mortality is not known yet. Methods: This study is based on the database of Nepal Demographic and Health Surveys (NDHS) 2006 and 2011. This study includes the recent singleton live births within five years preceding the survey as the de-worming medication during the pregnancy was collected only in the recent live births (the last live birth) in the five years preceding the surveys. The newborn death of the pregnant women administered with de-worming medication was compared with those pregnant women who were not administered with de-worming medication during the pregnancy. An association has been established with the logistic regression model adjusting several potential confounding factors. Results: In the pooled data, the recent singleton live births were 8,147. A total of 813 and 2,274 mothers were found to have taken de-worming medication during pregnancy in the NDHS 2006 and 2011, respectively. The use of de-worming during pregnancy increased from 20% to 56% between the surveys, but the newborn deaths in de-worming group rose from 1.2% to 1.4%. The adjusted OR of the neonatal death with the de-worming was {aOR 1.129 (95% CI 0.696-1.829), P = 0.623}. Conclusion: The de-worming during pregnancy in Nepal was not found significantly associated with reduction on neonatal deaths, which suggests timely review of the program. Keywords: De-worming, neonatal mortality, pregnancy, Nepal
Five Years Audit On Vaginal Hysterectomy for Utero Vaginal Prolapse
(Institute of Medicine, 2018) Shrestha, R; Singh, A; Pradhan, B; Shrestha, SD; Thapa, A
Abstract Introduction: Hysterectomy is one of the most common surgeries performed in gynecology. It can be performed by vaginal and abdominal route. Only 10.0% of hysterectomies aredone by vaginal route. Vaginal hysterectomy is associated with less febrile morbidity, less bleeding necessitating transfusion, shorter hospitalization and faster convalescence than abdominal hysterectomy.This is a study onoutcomes of vaginal hysterectomy for uterovaginal prolapse at Patan Hospital over five years. Methods: This was a retrospective descriptive study on vaginal hysterectomies for uterovaginal prolapsed done in the Department of Obstetrics and Gynecology of Patan Academy of Health Sciences over a period of 5 years (January 2010 to December 2014). After ethical clearance from Institutional review committee details of 50 vaginal hysterectomy performed during this period was obtained from medical record section of the hospital.Datawere recorded in Microsoft excel 2010, frequency distribution and mean of relevant data was then calculated. Results: This study included 50 cases of vaginal hysterectomy, the mean age of patient was 57.4 ±9.3 (range 40-74) years. All except one case was multiparous. 80% had home delivery and 20 % had hospital delivery. The mean duration of prolapse was9.41 ±2.68yrs (range 0.5 -44 yrs). 26 (52 %) cases had third degree uterovaginal Prolapse. Therewas no intraoperative complications but postoperative complication was seen in 9 cases. In all cases, histopathology findings were suggestive of chroniccervicitis. Conclusions: Vaginal hysterectomy for utero vaginal prolapse isa safesurgery with less postoperative morbidity. Keywords: Uterovaginal prolapse (UVP), VaginalHysterectomy (VH)
Clinical and etiological profile of optic disc edema cases in neuro-ophthalmology clinic of B.P Koirala lions centre of ophthalmic studies, IOM
(Institute of Medicine, 2018) Sah, RK
Abstract Introduction: Optic disc edema can be a manifestation of various neurological disorders. Identification of those causes is possible in most cases using tests like visual acuity, color vision, visual field and suitable radiological imaging. Study in Nepalese population with regard to optic disc edema is scarce. Hence this study aims to act as a guideline for evaluation of such cases and help in further studies in this regard. Methods: A descriptive, cross-sectional study was conducted in all cases of optic disc edema presenting to neuro-ophthalmology clinic of B.P. Koirala Lions Centre for Ophthalmic Studies from January 2011 to June 2012. A detailed history was obtained and proper ocular and nervous examination was done by ophthalmologist and neuro-physician. Assessment of visual acuity, color vision, contrast sensitivity and visual field along with radiological tests were done in all possible cases. Results: Out of all the cases evaluated, 38 cases where causes of optic disc edema could be established were included in the study. The commonly affected age group was 31 to 40 years (26.3%) and most of them were males. The commonest cause observed was optic neuritis (36.8%). Others were papilledema, idiopathic intracranial hypertension, toxic optic neuropathy, non-arteritic anterior ischemic optic neuropathy (NA-AION), compressive and traumatic optic neuropathy. Conclusion: Optic neuritis and papilledema should be considered as common differential diagnosis in patients with optic disc edema. NA-AION is a relatively uncommon disease among Nepalese population. Keywords: optic disc edema, optic neuritis, papilledema, and NA-AION
Academic stress and self-esteem among Nursing Students
(Institute of Medicine, 2018) Jirel, S; Sharma, BD; Dawadi, N
Abstract Introduction: Academic stress in nursing students is a common mental distress with respect to some anticipated frustration that is associated with academic failure which may be due to examination pressure, assignment load as well as challenges of clinical practices. And self-esteem reflects a person’s overall subjective emotional evaluation of his or her own worth and is an important predictor of stress coping. Continuous high level of stress may influence learning process and self-esteem as well. The main objective of this study is to assess the academic stress and self-esteem among nursing students. Methods: A descriptive, cross sectional research design was adopted. Probability simple random sampling technique was used to select the sample which was 118 medical nursing students studying in the Yeti Health Science Academy, Kantimargh, Maharajgunj. Data was collected by using structured questionnaire including Student Academic Stress and Rosenberg self-esteem scale. Data analysis was done by descriptive statistic and inferential statistic with the help of (SPSS) version 20. (9). Results: Regarding the level of academic stress, about half of the respondents ( 50.8 %) had moderate academic stress followed by 31.4 % slight stress, 12.7 % high stress and 1.7 % extreme stress. And while assessing level of self-esteem, a majority of the respondents (83.9 %) had high self-esteem and 16.1 % had normal self-esteem. Conclusion: Based on findings academic stress in nursing students is about half of the Respondents. Therefore, intervention to reduce the academic stress should be carried out by identifying the causes of stress, stress reducing measures, counseling program and by developing a variety of skills to cope with negative aspects of stress so as to produce professionals who are confident, efficient and having clear vision about their future. Keywords: Academic Stress, self - esteem, Student Academic Stress Scale and Rosenberg self-esteem scale.
Knowledge, Attitude and Practice of Reproductive Aged Women regarding Emergency Contraceptives in Tertiary Hospital
(Institute of Medicine, 2018) Rana, M; Ranjitkar, UD
Abstract Background: In Nepal maternal mortality rate is very high more than one in five women die from pregnancy or pregnancy related causes. Emergency contraception is a method used to avoid pregnancy after unprotected sexual intercourse unlike the regular methods of contraception that are taken before sexual contact. Oral contraceptive pills and intrauterine contraceptive devices are mainly used as emergency contraceptives. The aim of this study was to assess knowledge, attitude and practice of emergency contraceptive among women Methods: A descriptive cross sectional research design was carried out .Non probability purposive sampling was used to select sample which was 174 reproductive aged women attending family planning clinic of TUTH. Data was collected by interview using semi structured interview questionnaire. Data analysis was done by descriptive and inferential statistics using SPSS version 17.0. Results: Based on findingsmajority 67.24% of respondent had knowledge to prevent unintended pregnancy, regarding practice only 13% used emergency contraceptive (EC) correctly within 72 hours of unsafe intercourse. 90.80% of respondents used family planning (FP) methods to reduce unwanted pregnancy. 47.13% responded correctly as EC is not a method of abortion and among all respondents 43.68% did abortion for unwanted pregnancy. Maximum82.76% respondents had positive attitude towards EC. Conclusion: The study findings showed majority of respondents had knowledge to prevent unintended and unwanted pregnancy; but only few percentage practice EC correctly within 72 hours of unsafe intercourse. Similarly majority of respondents had positive attitude towards EC, hence IEC programme should be planned to provide information regarding prevention of unintended pregnancy among reproductive aged women. Key words: Reproductive aged women, emergency contraceptive, knowledge, attitude and Practice
Pattern of toxicology cases in Emergency, Tribhuvan University Teaching Hospital
(Institute of Medicine, 2018) Raut, S; Shakya, YL; Maharjan, RK; Shrestha, TM; Neupane, RP
Abstract Background: Acute poisoning is one of the major contributors of heath problem causing morbidity and mortality in the emergency of the hospital. The study focused on the demographic and epidemiological aspects of all the poisoning cases that came to Emergency of TUTH. Methods: The study was a cross-sectional retrospective data collection of all poisoning cases recorded in hospital from April 2016 to March 2018. Hospital records of all poisoning cases were used to extract demographic and other data such as poisonous agents used, circumstance of poisoning, route and outcome of poisoning. The data analysis was done in Microsoft Excel. Results: The total number of cases was 641 out of which 40 cases were excluded from the study. Of 601 cases, males were 42.09% and females were 57.90%. The most common age group for both male and female was 16-26 years group and male to female ratio was 1:1.3. The most common circumstance of poisoning was deliberate self-harm which was 91.68% followed by accidental which was 4.6%. The common route of administration was ingestion at 99.91%. The mortality in the Emergency was 5.15% and total of 75.04% cases were admitted in observation after primary management in ER and discharged from the observation after improvement and psychiatric evaluation. The most common toxicology agent was pesticide at 52.57%followed by pharmaceuticals at 25.45%. Conclusions: Pesticides are the major cause of poisoning and accounts for majority of cases of toxicology followed by pharmaceuticals. The study also concludes that the young age group is more vulnerable to poisoning, hence strong regulatory measures are required for control of easy accessibility of these substances. Keywords: Toxicology, Poisoning, TUTH
Sonographic measurement of the size of fetal cisterna magna in low risk population of pregnant women at 16-38 weeks of gestation
(Institute of Medicine, 2018) Yadav, B; Ghimire, RK; Joshi, BR
Abstract Introduction: The purpose of this study was to determine the normal size values of fetal cistern magna(CM) and to evaluate its changes in normal fetuses in low risk population of pregnant women in the second and third trimesters of pregnancy using transabdominal ultrasonography. Methods: This was a prospective cross-sectional study involving 290 women with uncomplicated singleton gestation between 16-38 weeks. CM was visualized in 264 cases. Gestational age was calculated by measuring fetal biparietal diameter (BPD). CM was measured from the posterior aspect of the cerebellar vermis to the inner edge of occipital bone. Nomogram of the sizes of CM was prepared. Results: CM was visualized in 91% of the fetuses. The ages of the patients ranged from 17-30 years (mean 24.29, SD 2.78). The maximum numbers of case were at 23 and 27 weeks of gestation and the minimum number of cases were at 37 weeks of gestation. The mean size of the CM was 6.32mm, (SD1.09; range 3- 9 mm). Conclusion: The size of fetal CM showed continuous increment and showed significant positive correlation with the gestational age( r2 value of 0.48; p<0.001). The findings were consistent with the previous studies done by various authors. The percentile fitted values and nomograms will be valuable for the serial measurement of the CM for complicated pregnancies. Keywords: cisterma magna, ultrasonography, vermis
Sero prevalence of Scrub Typhus among Suspected Cases in Selected Area of Nepal
(Institute of Medicine, 2018) Gautam, R; Parajuli, K; Sherchand, JB
Abstract Introduction: Scrub typhus is an mite-borne acute, febrile, infectious illness that is caused by Orientia tsutsugamushi The causative organism, Orientia tsutsugamushi, is transmitted to the human beings by the bite of larval stage (chiggers) of the trombiculid mites, Leptotrombidium delience. This disease is most common in rural areas of low income countries. It is difficult to differentiate clinically from other tropical infections such as malaria, dengue, enteric fever and leptospirosis. Hence the study aim was to determine the seroprevalence of scrub typhus among the acute febrile illness patients attending in different hospitals of Chitwan district. Methods: The study was based on patients with suspected scrub typhus cases in Chitwan district from March 2017 to August 2017. Blood samples were collected from the suspected patients of scrub typhus, having acute febrile illness. IgM antibody to Orientia tsusugamushi was detected by using Scrub Typhus Detect™ Kit, In Bios International, USA. Results: A total of 451 samples, 112 (24.80%) were positive for IgM Antibodies. Multivariate analysis demonstrated that the following factors were significantly associated with the scrub typhus. 1. Females (odd ratio [OR] =2.088, P=<0.004, confidence interval [CI] =1.268-3.438) 2. House near grassland (odd ratio [OR] =10.380, P=<0.001, confidence interval [CI] =3.615-29.802), 3. Piling weeds in house (odd ratio [OR] =0.498, P=0.011, confidence interval [CI] =0.290-0.855), 4. Presence of mouse inside the house (odd ratio [OR] =2.157, P=0.003, confidence interval [CI] =1.290-3.608), 5. Working in the field (odd ratio [OR] =10.295, P=0.002, confidence interval [CI] =2.309-45.905). All cases enrolled have presented fever (100%) followed by headache (56.2%), nausea (55.4%), shortness of breath (40.2%), abdominal pain (14.3%), jaundice (8.9%), hypertension (8.9%), COPD (8.0%), tachypnoea (4.5%), diabetes (4.5%), eschar (2.7%) and seizure (1.8%). Conclusion: In the study the proportion of Scrub typhus infection was 25% among acute febrile cases. Our finding also explored the burden of scrub typhus in relation to demographic trend, risk factors, clinical characteristics and findings of different laboratory parameters. Early diagnosis, appropriate treatment along with health education and vector control measures are best way to prevent and management of scrub typhus. Key words: Scrub typhus, ELISA, Orientia tsutsugamushi, Nepal
Stress, anxiety, and depression among adolescent students of public schools in Kathmandu
(Institute of Medicine, 2018) Sharma, P; Choulagai, BP
Abstract Background: Adolescence is a period characterized by changes in emotion, perception, cognition, and judgment which may adversely affect their mental health. This study aimed to find out the prevalence and associated factors of stress, anxiety, and depression among adolescent students of Kathmandu, Nepal. Methods: We used a descriptive cross-sectional study. The study included 411 adolescent students aged 14 to 19 years from six randomly selected public schools of Kathmandu Metropolitan City. Depression, Anxiety and Stress Scale 21(DASS-21) was administered to the students to identify the prevalence of depression, anxiety, and stress. Logistic regression analysis was performed to find out the associated factors of stress, anxiety, and depression. Results: The prevalence of stress, anxiety, and depression was 27.5%, 56.9% and 41.6% respectively. Factors associated with stress were being female, high academic pressure, and abuse. The factor associated with anxiety was high academic pressure and factors associated with depression were being female, high academic pressure and witnessed/exposed to domestic violence. Conclusion: Depression, anxiety, and stress are common among school adolescents. Academic pressure was a major factor of depression, anxiety, and stress. Adolescent girls were more prone to develop stress, and depression compared to adolescent boys. Keywords: Adolescent; anxiety; DASS-21; depression; stress; Nepal
Role of Ultrasonography in Early Diagnosis of Acute Osteomyelitis
(Institute of Medicine, 2018) Sigdel, Bhim; Uprety, Suresh; Bhandari, Prawesh Singh; Paudel, Sharma
Abstract Background: Osteomyelitis is the inflammation involving bone and bone marrow caused by a pathogenic organism. Acute osteomyelitis is one of the commonest bone infection in childhood and is a significant cause of morbidity. Timely diagnosis and intervention is critical for outcome. Imaging studies play an important role in diagnosis of osteomyelitis. Various modalities, including conventional radiography, bone scintigraphy, ultrasonography, computed tomography (CT) and magnetic resonance (MR) imaging have all been used. The purpose of this study is to evaluate the diagnostic value of ultrasonography in early diagnosis of acute osteomyelitis Methods: A prospective non-randomised analytical study in 30 children with sign and symptoms suggesting acute osteomyelitis presenting in Emergency Room(ER) and Out-patient department(OPD) of Tribhuvan University Teaching Hospital (TUTH) was carried out. Plain radiograph was done to each patient followed by Ultrasonography. Results: Twenty four patients (80%) were finally diagnosed to have osteomyelitis. Distal femur was most commonly involved site (33.33%). Sensitivity of USG was found to be 91.6% and specificity to be 83.3%. Conclusion: Ultrasonography was found to be highly sensitive and highly specific in early diagnosis of acute osteomyelitis in children with clinical suspicion of the disease and negative plain radiographs. Keywords: Acute hematogenous osteomyelitis, Cortical erosion, Deep soft tissue swelling, periosteal elevation, pericortical fluid, Ultrasonography.
Measurement of Renal Arteries Using Multi detector Computed Tomography: A Study in Tertiary Care Hospital in Nepal
(Institute of Medicine, 2018) Khanal, UP; Ansari, M; Humagain, M; Dhakal, S
Abstract Introduction: The purpose of this study was to determine the dimensions ofthe renal arteries (length and diameter), among the patients referred for Contrast Enhanced CT(CECT) of abdomen in department of Radiology and Imaging, Tribhuwan University, Teaching Hospital. Methods: This prospective study was performed in Department ofRadiology and Imaging TUTH with A total of 135 (73 male and 62 female) patients underwent CECT abdomen from June to September 2018. In this study the diameter of right and left renal arteries, the length of right and left renal arteries were determined. Results: The mean values of right renal artery diameter were found to be(0 .5706 ± 0.09861 cm) in males and (0.5061 ± 0.08384 cm) in females respectively. The mean values of left renal arteries diameter were found to be (0.5889 ± 0.10351 cm) in males and (0.5354 ± 0.10552 cm) in females respectively. The mean values of right renal artery length were found to be (4.568751 ± 0.83128cm) in males and (4.0318 ± 0.87575cm) in females respectively. The mean values of left renal arteries length were found to be (3.5990 ± 0.79567cm) in males and (3.2002 ± 0.59207cm) in females respectively. The diameter of renal artery diameter exhibited statistically significant differences in relation to age of the patients (p<0.05) with peak values in 55- 64 years age group where the mean right and left renal arteries diameters were found to be 5.801 mm and 6.012 mm respectively. Conclusion: This study concluded that the diameter of the renal arteries variessignificantly with the age of the patients. Keywords: Multi detector computed tomography, renal artery dimensions
The Prevalence of Overweight and Obesity in Medical and Nursing Students of Institute of Medicine, Kathmandu
(Institute of Medicine, 2018) Mahotra, NB; Shrestha, L; Pradhan, S; Bajimaya, M; Malla, N; Aryal, V; Bhat, N
Abstract Introduction:Obesity has become one of the important global public health issues. It is significantly associated with the prevalence of diabetes, hypertension and coronary artery disease. Body Mass Index (BMI) assesses overweight and obesity based on statistical criteria. Methods:A cross-sectionaldescriptive study was carried out in young male medical and female nursing students in the department of Clinical Physiology, Maharajgunj Medical Campus, Institute of Medicine, Kathmandu from January 2019 to March 2019. Subjects were selected by convenient sampling and BMI was calculated in 116 medical and nursing students. Results:Out of 60 male medical students, 7(11.7%) were underweight, 48 (80%) were normal weight and 5(8.3%) were overweight. Similarly, out of 56 female nursing students, 1(1.8%) was underweight, 46(82.1%) were normal weight, 7(12.5%) were overweight and 2(3.6%) were obese. Conclusion:The prevalence of overweight and obesity is increasing worldwide in all age groups. Young Nepalese people are also affected and are at risk of developing non-communicable diseases. Adaptation of healthy life styles and healthy diets could prevent overweight and obesity. Key words: Body Mass Index (BMI), Obesity, overweight
Indications of Cesarean Section in a rural referral Hospital
(Institute of Medicine, 2018) Aryal, B; Shrestha, U
Abstract Introduction: There is a huge difference in cesarean section rate between rural (3.5%) and urban (15%) areas of Nepal. The national CS rate is around 5% whereas global CS rate is 26%. The objective of this study is to find out the delivery profile and rate and indications of CS in a rural university hospital. Methods: This is a three -year’s retrospective cross-sectional study done from January 2016 to January 2019 (Magh 2072 to Poush 2075) at Karnali Academy of Health Sciences, Jumla. The data was retrieved from hospital birth profile records and analyzed using SPSS 20. Permission was taken from Institutional review committee (IRC) to conduct the study. Results: Total number of delivery during this period was 1841 out of which 172 were Cesarean delivery giving a CS rate of 9.3%. The most common indication of CS were fetal distress (33.7%), previous CS (9.3%), failed induction of labor (9.3%). Non progress of Labor (8.1%) and post term pregnancy (8.1%). Majority of the CS were done as an emergency procedure. Conclusion: The CS rate at KAHS teaching hospital was within WHO recommendation of between 5-15% and was very low in comparison to other centers situated in urban areas of the country. The indications of CS was also similar to the other national and international statistics. Key words: Cesarean section, Indications, Nepal, Maternal health, rural area, Global trends
Does stenting improve the surgical outcome of Endoscopic Dacryocystorhinostomy? A prospective randomized study
(Institute of Medicine, 2018) Gurung, U; Rauniyar, N; Pradhan, B; Thapa, N
Abstract Introduction: The objective of this study was to compare the surgical outcome of endoscopic dacyrocystorhinostomy with or without stenting. It was a prospective, randomized study conductedfrom October 2011 to September 2013. Ganesh Man Singh Memorial Academy for ENT-Head and Neck Studies,Tribhuvan University Teaching Hospital, Maharajgunj Medical Campus, Institute of Medicine, Kathmandu, Nepal. Methods: Patients aged 15 years and above of all genders with primary acquired nasolacrimal duct obstruction (PANDO) were included in the study. Forty patients were randomly allocated into two groups, 20 each in Endoscopic Dacyrocystorhinostomy with stenting (EwS) and Endoscopic Dacyrocystorhinostomy without stenting (EoS). Post-operative assessment was done at 8 weeks. In the subjective assessment using with 5-point Likert Scale of degree of epiphora, a score of 1,2 or 3 was considered a success. Objective assessment with syringing and endoscopic evaluation of patency of rhinostome considered patent and partly patent lacrimal system on syringing and patent rhinostome as success. Results: Both the subjective and objectivesuccess rate was 95% in EwS and 90% in EoS.However, there was no significant statistical difference between the two groups (p value =1.00). Conclusion: The success rate of EwS was comparable to that of EoS with no added benefit in our study. In addition, EoS avoided the complications associated with stenting. So, we recommend EoS for PANDO. Keywords: Endoscopic Dacryocystorhinostomy, Primary acquired nasolacrimal duct obstruction, silicon stent
children with diarrhea in Nepal
(Institute of Medicine, 2018) Sherchand, Jeevan B.
NA.
Awake Throughout Craniotomy: Initial Experience and the Anaesthetic Challenges
(Institute of Medicine, 2019) Shakya, Bigen M; Acharya, Binita; Shrestha, Gentle S; Shrestha, Anil; Sedain, Gopal; Shrestha, Ninadini
ABSTRACT Awake throughout technique for craniotomy demands very careful titration of drugs for sedation. It does not utilize any airway devices. The success depends on experience of anesthesiologist, good team work and meticulous planning. This is the first case of awake throughout craniotomy in our institute. Keywords: Awake throughout, craniotomy, outcome
Lumbar Diastomatomyelia with Syringomyelia: A Case Report
(Institute of Medicine, 2019) Gyawali, Deepika; Lama, Dharana; Pradhananga, Amit B; Sharma, Mohan R.
ABSTRACT Diastomatomyelia with syringomyelia is a rare clinical condition where there is a duplication of spinal cord. We recently came across a child who had this anomaly. The case was successfully managed with an uneventful recovery. We describe this patient in detail in addition to reviewing the pertinent literature. Keywords: Diastomatomyelia, syringomyelia
Perception of Nursing Students toward Academic Learning Environment in a College of Kathmandu
(Institute of Medicine, 2019) Koirala, Manisa; Koirala, Surya; Neupane, Sharmila
ABSTRACT Introduction A supportive and systematic design of academic learning environment has been important for transfer of learning in clinical context, can lead to positive outcomes for graduates and best prepares for professional life. The objective of this study was to find out the perception of nursing students toward academic learning environment. Methods The descriptive, cross sectional study design was used among 172 proficiency certificate level (PCL) nursing students at Maharajgunj Nursing Campus, Kathmandu Nepal. The data were collected by using Dundee Ready Education Environment Measure (DREEM) Inventories with complete enumeration technique which was developed by Roff et al (1997). Data were analyzed using descriptive and inferential statistics. Results Overall mean score of academic learning environment was found 142.78 out of 200 for 50 items which was in the ranged for ‘positive’ learning environments. The total mean score for perception of learning was 34.4 out of 48; for perception of teacher 30.7 out of 44; for academic self-perception 25 out of 32; for perception of atmosphere 33.3 out of 48; for social self-perceptions 19.3 out of 28. Mean scores indicated that students’ rated all five dimensions of the educational environment in this institution as an average. The significant differences were found between overall mean score; mean score of teachers, academic self-perception & social self perception of students and different academic year. Conclusion The overall mean DREEM scores indicate a more positive academic learning environment. Although the overall learning environments score of this institution observe as an average, none of the items represents ‘excellent’ score or real positive academic learning environment. Keywords: Academic learning environment, nursing students, perceptions

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