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Perception of Online Lectures among Students of a Medical College in Kathmandu: A Descriptive Cross-sectional Study
(Nepal Medical Association, 2021) Bhattarai, Bhagabat; Gupta, Sujaya; Dahal, Sirjana; Thapa, Aarzu; Bhandari, Pooja
Abstract: Introduction: The COVID-19 global pandemic has affected all aspects of human life, with education no exception. Online lectures have been practiced in different academic institutions around the world. The objective was to know the perception towards online lectures by the undergraduate students of a medical college. Methods: This descriptive cross-sectional study was conducted among the undergraduate students of dentistry, medicine, and nursing at Kathmandu Medical College via self-administered online questionnaire. Data were collected from November to December 2020 after ethical clearance from institutional review committee (Ref. no. 0311202002). Students who had not attended even one hour of online learning per week were excluded. Responses were collected using Google Forms which were analysed in Microsoft Excel. Results: Out of 318 valid questionnaires, 143 (44.97%) students agreed that online lectures were effective but 138 (43.4%) disagreed that online lectures were more useful than traditional lectures. One hundred and forty five (45.60%) found online classes difficult to concentrate and 175 (55.03%) agreed that they preferred a combination of traditional teaching and online tutorials. Only two (0.63%) students strongly agreed on excellent internet during classes and 104 (32.70%) agreed it caused economic burden. Mean age of participants was 20.75Â±1.538 years; 202 (63.52%) were females; online learning per week was 18.75Â±9.157 hours; and duration of online learning was 20.28Â±9.997 weeks. Conclusions: Most of the students had a positive attitude towards e-learning when compared to similar studies. Further multicentric studies with larger sample size would better demonstrate whether online education partly or fully can be effective adjunct to traditional face to face interaction.
Anxiety during COVID -19 among School Going Adolescents of Six Private Schools in Kathmandu Valley: A Descriptive Cross-sectional Study Authors
(Nepal Medical Association, 2021) Bhatta, Anwesh; Kafley, Rishi Kesh; Yadav, Rishi Kesh; Phuyal, Rajan; Chikanbanjar, Vijaya Kumar
Abstract: Introduction: Psychological health problems are common in adolescent and young adults. The psychological well-being is greatly influenced by stressful environment and the coping mechanism of an individual. The 2019 Coronavirus disease has caused unprecedented morbidity and mortality worldwide owing to its high infectivity and mortality. In addition to these physical manifestations, psychological impact has also been substantial. This study is a descriptive cross-sectional study done to find out the prevalence of anxiety disorder and its severity during the COVID-19 pandemic in school going adolescents of Kathmandu valley. Methods: A descriptive cross-sectional study was carried out among adolescents from August 15 to September 30, 2020. Two private schools from each district in the Kathmandu valley i.e. Kathmandu, Lalitpur and Bhaktapur were included in the study using convenient sampling. Ethical clearance was obtained from Institutional Review Committee (reference no: 1208202007). All data were inserted on Microsoft Excel 2016 and analysed using Statistical Package for the Social Sciences version 20. Point estimate at 95% Confidence Interval was calculated along with frequency and proportion for binary data. Results: Among 358 students, 165 (46.1%) at 95% Confidence Interval (40.8-51.2) were found to have anxiety. Out of these patients, 115 (69.7%) had mild, 39 (23.6%) had moderate and 11 (6.7%) had severe anxiety. The mean age was 16.17Â±1.57 years. Conclusions: This study shows that a remarkably higher number of children had symptoms of anxiety disorder. Majority of the children with anxiety had mild form. The study further highlights the need of emotional support to adolescent children during the current ongoing pandemic.
Prevalence of Vitamin D Deficiency among Patients of Acute Coronary Syndrome in a Tertiary Care Center of Eastern Nepal
(Nepal Medical Association, 2021) Nepal, Richa; Karki, Prahlad; Uraw, Surendra; Lamsal, Madhab
Abstract: Introduction: Vitamin D deficiency is an emerging risk factor for cardiovascular diseases. Very few studies have been done to find out vitamin D deficiency status among cardiovascular patients in Nepalese setup. This research aims to find out the prevalence of vitamin D deficiency among patients of acute coronary syndrome admitted in a tertiary care center of eastern Nepal. Methods: This was a descriptive cross-sectional study conducted among patients of acute coronary syndrome admitted in a tertiary care hospital from 1st February 2018 to 31st July 2018. Ethical clearence was taken from Institutional Review Committee of B.P. Koirala Institute of Health Sciences (Reference number: 259/074/075-IRC). Convenience sampling method was used. Data was entered in Microsoft Excel and analyzed using Statistical Package for the Social Sciences version 25. Point estimate at 95% Confidence Interval was calculated along with frequency and proportion for binary data. Results: A total of 33 (64.7%) at 95% Confidence Interval (51.58-77.82) patients of acute coronary syndrome had vitamin D deficiency in our study with 19 (37.3%) having mild deficiency and 14 (27.4%) having moderate deficiency. None of the patients had severe vitamin D deficiency in our study. The mean vitamin D levels were lower in diabetics (23.57Â±9.28ng/ml) as compared to non-diabetics (31.91Â±12.50ng/ml), in hypertensive patients (24.36Â±7.67ng/ml) as compared to non-hypertensive patients (30.97Â±13.72ng/ml), and in patients with dyslipidemia (22.86Â±6.44ng/ml) as compared to those without dyslipidemia (37.68Â±13.15ng/ml). Conclusions: Prevalence of vitamin D deficiency among patients of acute coronary syndrome in our study was comparable to various other homologous international studies.
Rational Use of Oxygen in COVID-19 Pandemic – Are We Doing Enough? Authors
(Nepal Medical Association, 2021) Shrestha, Gentle Sunder; Lamsal, Ritesh
Abstract: During the episodes of large case surge of COVID-19, the health care system of many nations have struggled, more so in nations with resource limitations. Recently, Nepal and the neighboring nation India are being hit hard by the pandemic. Management of patients with moderate and severe COVID-19 remains largely supportive, with oxygen therapy being the cornerstone of the management. Procurement, maintenance of oxygen supply system, coupled with avoiding misuse and wastage of oxygen is of paramount importance to better utilize the scarce resources amidst the peaks of a pandemic. Nepal needs to adopt policies to make best use of its oxygen stores and supplies with a collective effort from all stakeholders to save additional lives.
Experience Sharing: Final Year MBBS Journey
(Nepal Medical Association, 2021) Maharjan, Sujata; Pandey, Ashmita
Abstract: Studying medicine is tough. The saying: It is hard to enter medical school but easier later is a myth. All the semesters and years have their trials and tribulations but the final year is known among students to be a terror. Here we share our experience of the final year hoping it could give insight to the medical students about what to expect in the ultimate year and prepare themselves mentally as well as academically beforehand.
Kawasaki Disease- Management Strategies Given Symptoms Overlap to COVID-19: A Review
(Nepal Medical Association, 2021) Wang, Linna; Zhang, Sheng; Ma, Ji; Ni, Jing; Wang, Juyan; Li, Xiaohong; Mu, Zhilong; Han, Wei; He, Gaitao; Ma, Lei; Shah, Jenifei; Shah, Jay; Jiao, Jay
Abstract: Kawasaki disease is an acute, self-limiting vasculitis in children. Early treatment is necessary to prevent cardiovascular complications. The acute phase of Kawasaki disease may present with hemodynamic instability. An association between viral respiratory infections and Kawasaki disease has been reported. Studies have shown that Kawasaki and Kawasaki-like disease may be associated with and have symptoms overlapping COVID-19. Children with COVID-19 may present as Kawasaki-like disease with pediatric inflammatory multisystem syndrome, or macrophage activation syndrome. Clinicians need to be aware of the early diagnosis and management of Kawasaki disease to prevent the development of coronary artery aneurysms. The symptoms overlap of multisystem inflammatory disease seen in COVID-19 adds to the difficulties in timely diagnosis and treatment. Children with Kawasaki disease require regular follow-up plans for coronary artery aneurysms. This adds to the difficulties during the changed environment of COVID-19 for control and prevention. Missed diagnosis and early treatment of Kawasaki disease with immunoglobulin and aspirin results in the development of coronary artery aneurysm in up to 25% of cases, with grave consequences. Here, we briefly review the management of typical and atypical Kawasaki disease which has symptoms overlapping with the multisystem inflammatory disease as seen in COVID-19.
Management of Locally Advanced Esophageal Cancer
(Nepal Medical Association, 2021) Thakur, Binay; Devkota, Mukti; Chaudhary, Manish
Abstract: Esophageal cancer is diagnosed usually at a locally advanced stage. Surgery alone has less optimal results and a multimodality approach has been established as the standard of care for cII-III stages of esophageal cancer. This review focuses on the recent evidences of management of esophageal cancer with various variations in approaches in Eastern and Western countries. The major difference is the selection of induction treatment. Till the results of some ongoing trials become available, most of the evidences support neoadjuvant chemoradiation followed by surgery for squamous cell carcinoma and perioperative chemotherapy and surgery for adenocarcinoma.
Culture and Sensitivity Pattern of Sepsis in Ventilated Newborns
(Nepal Paediatric Society (JNPS), 2016) Sur, Somen; Dr Pallavi,; Mondal, Sanjib; Gupta, Atul Kumar
Abstract: Introduction: Neonatal sepsis is a major cause of mortality and morbidity in modern neonatal intensive care units (NICU). Increasing trend of antibiotic resistance makes this problem more difficult to tackle, at present. Haemodynamically compromised neonates, particularly those requiring ventilator support, often suffer from multidrug resistant sepsis. The objectives of this study were to determine micro-organisms causing sepsis in those neonates requiring ventilator support and the sensitivity patterns of those micro-organisms. Material and Method: During 18 months of study period, 48 neonates, who had fulfilled the chosen inclusion criteria were included in this study. They were investigated with blood culture, urine culture, CSF culture, and endotracheal tube tip culture (taken within 48 hours of starting ventilation), as per relevance. Those who were found positive to any micro-organism, were also explored. They were studied further for antimicrobial sensitivity pattern. Data obtained from this study were analysed using SPSS-20.0. Results: 15(31.3%) neonates were found to be culture positive. Klebsiella sp. was most common (33.3%) organism isolated, followed by Pseudomonas aeruginosa (20%). Most common antibiotic found to be sensitive was Meropenem (86.67%), followed by Colistin and Tigecycline (80% each). Conclusion: Nowadays, all NICUs throughout the world face a common problem of multidrug resistant sepsis. There is always a doubt regarding choice of second line antibiotics, when one considers for upgradation. As per this study, authors considered Meropenem as second line antibiotic of choice, as other sensitive antibiotics like Colistin, Tigecycline wield more adverse effects on neonates.
Culture and Sensitivity Pattern of Urinary Tract Infection in Hospitalized Children in Patan Hospital
(Nepal Paediatric Society (JNPS), 2016) Amatya, Puja; Joshi, Suchita; Shrestha, Shrijana
Abstract: Introduction: Urinary tract infection is one of the most common infections in children. Antibiotics are usually given empirically before urine culture reports are available. The primary aim of this study was to see the causative organisms and culture and sensitivity pattern of urinary tract infection in hospitalized children. Material and Methods: All children aged 0-15 years with culture positive urinary tract infections who were admitted to children’s ward from 14th April 2013 to 14th April 2014 were included. The causative organisms for urinary tract infection along with its antibiotic sensitivity pattern were retrospectively reviewed and analyzed. Results: 48 cases of culture positive urinary tract infection were enrolled in this study in a period of 12 months. The most common causative organism was Escherichia coli (67%), followed by Klebsiella pneumoniae (21%), Non-hemolytics streptococcus (4%), Enterobacter (2%), Acinetobacter (2%), Proteus (2%) and Coagulase negative staphylococcus (2%). Most cases of the culture positive urinary tract infection occurred between 2 months to 1 year of age. Out of 48 cases, 90% were sensitive to Amikacin and 85% were resistant to Ofloxacin. Conclusion: Escherichia coli is the most common organism causing urinary tract infection in children. As resistant to first line antibiotic is increasing, antibiotic stewardship programme should be strengthened.
Correlation between Insulin Like Growth Factor -1 and Anthropometric Measurements of Premature Infants
(Nepal Paediatric Society (JNPS), 2016) Abdelwahab, Amina; Khashana, Abdelmoneim; Ahmed, Nesma; Younis, Soha
Abstract: Introduction: It is agreed that insulin like growth factor 1 (IGF- 1) influence growth. IGF-1) is a significant endocrine mediator of growth and encourages cellular propagation, survival, and differentiation. The aim of this study was to correlate insulin like growth factor 1 and anthropometric measurements in the neonatal age of the premature infants. Material and Methods: This study was performed at a level III intensive care unit at Suez Canal university hospital, Ismailia, Egypt. It is a cross sectional analytical study in the period from the March 2014 to September 2014. All cases are premature and were imperiled to history taking, clinical examination includes weight, length, head circumference and measurement of serum (IGF-1). Results: There were a total of 40 neonates. Gestational age extended from 31 to 36 weeks with a mean of 34.32±1.68 weeks; weight ranged from 1.15 to 3.20 kg with a mean of 2.14±0.59 kg and length ranged from 37 to 49 cm with a mean of 43.85±3.25 cm. Regarding neonatal gender, 21 neonates out of 40 neonates (52.5%) were males and 19 neonates (47.5%) were females. Mother’s age ranged from 19 to 35 years with a mean of 27.47±4.46 years. IGF- 1α concentration, it ranged from 13.55 ng/ml to 163.34 ng/ml with a mean of 99.64±32.43 ng/ml and there was statistically significant decrease in neonates with restricted growth when compared to non-restricted growth group (77.67±30.92 ng/ml vs 121.62±13.64 ng/ml respectively). Conclusion: There was significant correlation between IGF-1α and weight and head circumference of preterm neonates.
Changes in the Disease Spectrum of Hospitalized Children in a County Hospital of China
(Nepal Paediatric Society (JNPS), 2016) Liu, Yonglin; Liu, Juan; Shamsi, Bilal Haider; Hao, Xiao Xia
Abstract: Introduction: Considering the present situation of disease spectrum changes, it is very important to understand the changes of disease in primary settings, to find out the feature of disease area, to direct the decision making so as to allocate the medical resources accordingly. The objectives of this study were to understand the changing trends in disease spectrum and mortality rate of children hospitalised in the department of paediatrics in Shenmu hospital, and to provide scientific basis for the future medical care and prevention of childhood diseases. Material and Methods: A retrospective statistical analysis was done using the data regarding hospitalization of children in Shenmu County. The study lasted fifteen years, from January 1998 to December, 2012. Results: A total of 23,448 children were hospitalized below the age of 14. Majority of the patients were younger than three years old constituting 78.8% (which included age 1 month~1 year 57.2%). The average number of days of hospitalization was 6~8 days, with a median time of six days. The leading cause of hospitalization was respiratory disease. Other major illnesses causing hospitalization included: infectious diseases, digestive tract diseases, neonatal diseases and nervous system diseases. A total of 144 children died during this period. The top three causes of death were: asphyxia, premature birth and neonatal respiratory distress syndrome. Conclusion: The changing trends in paediatric disease hospitalisations and mortality rate over the 15 years are significant for clinicians so as to prevent and minimise such diseases by appropriate preventive and therapeutic options to contain them.
Recurrence of Avellino Corneal Dystrophy Following Penetrating Keratoplasty: A Case Report
(Nepal Medical Association, 2021) Rana, Rachana Singh; Bajracharya, Leena; Gurung, Reeta
Abstract: Granular – lattice (Avellino) corneal dystrophy is inherited in an autosomal dominant fashion which affects stroma of the cornea with recurrent erosions and decreased vision due to clouding of cornea in later stage. We reported a case of 53-year old woman presented with pain and blurring of vision of left eye for 10 days with history of right eye deep anterior lamellar dystrophy and Left eye penetrating keratoplasty 5years back for Avellino dystrophy. On examination right eye graft was clear and left eye showed circular edges of irregular epithelium with patchy stains and epithelial defect suggestive of recurrence of dystrophy. A patient with recurrent corneal erosions and opacity in cornea has to be examined carefully so as not to overlook Avellino corneal dystrophy. Being a rare disorder this case has been reported to draw the attention of ophthalmologists about its recurrence following keratoplasty.
Burst Fracture of C5 with Traumatic Anterior Spondyloptosis of C6 and Posterior Spondylolisthesis of C4 Vertebra: A Case Report
(Nepal Medical Association, 2021) Rokaya, Poojan Kumar; Khadka, Nilam Kumar; Giri, Praveen Kumar; Khapung, Robin; Mahaseth, Nirajan
Abstract: Burst fracture of C5 with traumatic anterior spondyloptosis of C6 and posterior spondylolisthesis of C4 vertebra is an exceedingly rare high energy injury. Treatment includes decompression, reduction, stabilization, and fusion via anterior or posterior or combined anterior-posterior approach with or without prior traction. We report this rare subaxial cervical spine injury associated with quadriplegia managed with combined anterior and posterior instrumented fusion. A multidisciplinary approach with preoperative assessment and planning is crucial in managing cervical spine injury. Immediate postoperative critical care support, rehabilitation, and dedicated nursing care are required for a favorable outcome in traumatic quadriplegia.
Morbilliform rashes in a patient with COVID-19 infection: A case report
(Nepalese Respiratory Society, 2021) Ghimire, Kiran; Adhikari, Nabin
Abstract: As the current COVID-19 pandemic is evolving, skin lesions are being reported more, the most common skin manifestation being morbilliform rashes. We describe a patient of severe COVID-19 infection, 48-year-old who initially presented with fever, cough and constitutional symptoms who developed morbilliform macular rashes during his illness. The rash appeared on 6th day of illness in the trunk, arms with sparing of palms and soles, associated with itching. He later developed features of the cytokine-storm syndrome. The exact mechanism for the rashes is yet to be elaborated, however, it is postulated that it is either due to immune-mediated vasodilation or micro thrombosis secondary to low-grade-coagulopathy associated with COVID-19. Recognition of rashes as a feature of this disease is particularly significant to clinicians as it aids in early diagnosis, particularly in resource-poor countries. There is no evident association, however, between the severity and the rashes in COVID-19 infection.
Misoprostol Induced Expulsion of Fetus Following Diagnosis of Anencephaly on Ultrasound: A Case Report
(Nepal Medical Association, 2021) Shrestha, Hari Kishor; Koirala, Suphatra; Shrestha, Ingima
Abstract: Anencephaly is a condition in which there is an absence of skull and brain tissues. Absence of cranial vault mainly results because of defective neurulation. Absence of cerebral tissues may cause diminished heart size, due to decreased heart load causing various cardiac abnormalities. Here, we report a case of a primigravida lady at 17 weeks of gestation with misoprostol induced expulsion of fetus after ultrasonography revealed absence of brain tissue and calvarium above the orbits suggesting anencephaly. A 300g fetus was delivered which confirmed the ultrasound findings. The patient was discharged with advice for intake of folic acid beginning from 3 months before conception in future pregnancies. Neural tube defects can manifest within approximately 28 days of gestation which highlights the importance of oral folic acid intake before pregnancy.
Rupture Uterus in a Tertiary Care Centre: A Descriptive Cross-sectional Study Authors
(Nepal Medical Association, 2021) Chudal, Deepa; Shrestha, Sebak; Shrestha, Ruby; Paudel, Vikash
Abstract: Introduction: Rupture uterus is an obstetric catastrophe with poor maternal and fetal outcome. The objective of the study is to determine the prevalence of rupture uterus in pregnancy. Methods: This was a descriptive cross sectional study conducted in a tertiary care centre from January 2016 to December 2016 after taking ethical approval (Approval No. F-NMC-510/76/77) from Institutional Review Committee. Convenience sampling method was used. Data were entered in the Microsoft Excel sheet and obtained data was analysed using Statistical Package for Social Sciences version 18 software for central tendency and frequencies. Results: Out of total 1559 deliveries, prevalence of rupture uterus was found to be 12 (0.0077%). Previous lower segment caesarean scar rupture was the most common risk factor noted in 7 (58.3%) cases. A total of seven patients (58.3%) required intensive care unit admission and blood transfusion. Other maternal complications were surgical site infection 2 (16.67%), sepsis 2 (16.67%), paralytic ileus 1 (8.3%), pelvic collection 1 (8.3%) and vesico vaginal fistula 1 (8.3%). Two maternal deaths (16.67%) and perinatal death was noted in 8 (66.66 % ) cases. Conclusions: Rupture uterus most commonly occurred in scarred uterus. Identification of high risk pregnancy, judicious caesarean section, proper labor monitoring, early diagnosis and prompt management are essential in reducing its occurrences.
Periodontal Disease in Patients Visiting a Tertiary Care Dental Hospital: A Descriptive Cross-sectional Study
(Nepal Medical Association, 2021) Dhami, Bhageshwar; Thapaliya, Kamal Babu; Shrestha, Dinesh Kumar; Bhandari, Bidhan; Gupta, Sujaya
Abstract: Introduction: Periodontitis is chronic disease leading to tooth loss. Oral hygiene practices combined with regular dental examinations keep oral cavity disease free and maintain periodontal health. The primary objective was to find out the prevalence of periodontal disease of patients measured by the Simplified Oral Hygiene Index and Community Periodontal Index. Methods: This descriptive cross-sectional study was conducted in department of Periodontics of a tertiary care dental hospital from April to June 2019 after obtaining ethical clearance and informed consent. Participants were recruited by convenience sampling and 183 sample size was calculated. Proforma included demographics, Simplified Oral Hygiene Index, Community Periodontal Index, body mass index, and smoking status. Data were entered in Statistical Package for Social Sciences version 23 and descriptive statistics were presented as frequency, percentage, mean, and standard deviation. Results: Prevalence of periodontal disease corresponding to loss of attachment 1, 2, 3, and 4 was found to in 104 (56.83%) participants. Simplified Oral Hygiene Index score was 1.67±0.89 with “fair” status in majority 114 (62.30%). Gingivitis (Community Periodontal Index 1, 2) was seen in 136 (74.32%). The mean age was 36.37±14.43 years of which 92 (50.27%) were female but smoking was more in males. Conclusions: This study suggests deteriorating periodontal health related to age, sex, oral hygiene, smoking, and BMI. As updated information on oral and periodontal health in Nepal is limited, this assessment would help the national policy makers on oral health intervention measures to prevent periodontitis and develop future programs to improve oral health.
Advance Age Pregnancy in a Tertiary Care Centre: A Descriptive Cross-sectional Study
(Nepal Medical Association, 2021) Mahato, Vibha; Shrestha, Pravin; Shrestha, Smita
Abstract: Introduction: Women who conceive at advance age are at risk of pregnancy complications and adverse foetal outcome. This study aims to find out the prevalence of pregnancy at advance age in a teaching hospital. Methods: A descriptive cross-sectional study was conducted between October 2019 to August 2020 at department of obstetrics and gynaecology of a tertiary care centre of Nepal, after obtaining ethical clearance from Institutional Review Committee (dated 03/09/2019 with ref no. 266) and informed consent from patient. Convenience sampling was done. All the patient who were ≥35 years and >28 weeks of gestation without any chronic illness were selected. Data and descriptive analysis were done using Statistical Package for the Social Sciences version 16. Point estimate at 95% Confidence Interval was calculated along with frequency and percentage for binary data. Results: Women aged 35 years and above constituted 104 (5.73%) of the total deliveries of study period. Most were multigravida 72 (69.23%) and 23 (22.12%) had preterm delivery. Rate of caesarean section were higher in advance maternal age 69 (66.35%). Maternal complications such as Hypertensive disorder of pregnancy 9 (8.65%), and mal-presentation 15 (14.42%) were higher among them. Perinatal outcome in form of low birth weight 9 (8.65%) and perinatal death 5 (4.80%) were increased in those women. Conclusions: From this study, it can be concluded that prevalence of advanced age at pregnancy was lower than study done in developed country but it was similar to study in India and is increasing in Nepal.
Attitude Towards Suicide among Caregivers of Patients Admitted with Suicide Attempt to a Tertiary Care Hospital: A Descriptive Cross-sectional Study
(Nepal Medical Association, 2021) Thapa, Prekshya; Lama, Sami; Pradhan, Nirmala; Thapa, Kriti; Kumar, Rajesh; Basnet, Madhur
Abstract: Introduction: Understanding the attitude of caregivers towards suicide attempters could be useful in suicide prevention. The objective of this study was to study attitude towards suicide among caregivers of patients with suicide attempt admitted to a tertiary care hospital in Nepal. Methods: A descriptive cross-sectional study was conducted with 52 caregivers of patients with suicide attempt who had been admitted to a tertiary care hospital of Nepal after obtaining ethical clearance from Institutional Review Committee (ref. IRC/0797/016). Data were collected through interviews using the Attitude towards Suicide Questionnaire and in-depth interviews conducted on five caregivers using the interview framework developed in the department for the purpose. Data and descriptive analysis were done using Statistical Package for the Social Sciences version 21. Point estimate at 95% Confidence Interval was calculated along with frequency and percentage for binary data. Content analysis was used for qualitative data. Results: Majority of the caregivers 34 (65.4%) had unfavorable attitude towards suicide. Caregivers reported that mental and chronic physical illness, financial difficulty, working environment, and social factors such as undue pressure and failure to perform the task, difficulty maintaining the relationship, abuse, and neglect could be some of the possible causes of suicide. Caring and understanding attitude of family members, health professionals, and society towards the suicidal individuals providing appropriate training and education to the public would help in reducing the stigma and burden of suicidal patients. Conclusions: The overall attitude of the caregivers was unfavorable. Interventions targeted towards improving attitude towards suicide could be helpful in suicide prevention.
Culture Positive Cases of Ophthalmia Neonatorum in a Tertiary Care Centre of Nepal: A Descriptive Cross-sectional Study
(Nepal Medical Association, 2021) Shrestha, Sabina; Manandhar, Sunil Raja; Malla, Om Krishna
Abstract: Introduction: Ophthalmia neonatorum although runs a benign course mostly, sometimes may progress to sight threatening complications. The study was conducted to find the prevalence of culture positive cases of opthalmia neonatorum. Methods: It was a descriptive cross-sectional study conducted at a tertiary care center from January to December 2019. Ethical clearance was obtained from institutional review committee of Kathmandu Medical College. Convenience sampling was done. All data were entered into excel and, then for analysis, exported to Statistal Package for Social Sciences version 21. Point estimate at 95% Confidence Interval was calculated along with frequency and proportion for binary data. Results: The prevalence of culture positive cases of opthalmia neonaturum is 10 (55.55%) (32.61-78.49 at 95% Confidence Interval). The causative organisms were coagulase negative Staphylococcus 4 (40%), Staphylococcus aureus 3 (30%), Klebsiella 2 (20%) and Pseudomonas 1 (10%). Culture sensitivity of the isolated organisms were different according to the patient even in case of the same organism. Vancomycin 7 ( 70%) was the most sensitive antibiotic followed by Ciprofloxacin 6 (60%), Amikacin 5 (50%) and Cloxacillin 5 (50%) while Azithromycin 1 (10%), Cefixime 1 (10%) and Cotrimoxazole 1 (10%) were the least sensitive. Conclusions: Staphylococcus species was the most common organism isolated from neonates with ophthalmia neonatorum and vancomycin was the most sensitive antibiotic.

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