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Clinico-etiological Profile of Melasma among Female Health Workers in a Tertiary Care Center of Central Nepal - A Cross Sectional Study
(Kathmandu University, 2017) Karn, D; Subedi, A; KC, S
ABSTRACT Background Melasma is an acquired symmetrical dyschromia with profound psychosocial impacts. It is a common pigmentary disorder with less clear etiology and limited management options. There are limited data regarding melasma in our scenario. Objective To evaluate the clinico-etiological profile of melasma, among the female health workers (FHW) in a tertiary health center. Method This is a single center, cross-sectional, descriptive study involving female health workers with or without melasma. A total of 198 female health workers were evaluated at Dhulikhel hospital Kathmandu university hospital for clinic-etiological profile of melasma in January 2017. Video-dermatoscopy was used for the clinical diagnosis of melasma. A structured, self-administered questionnaire was used for assessment. Risk factor assessment of etiological agents as sun exposure, hormonal medication, photo aggravating drugs, stressors as night duty were evaluated. Result The point prevalence of melasma among female health workers 20.7% (n=41). The mean age of respondents was 26.2 ± 3.23 years with duration of disease process 3.6 ± 2.5 years. Centro-facial pattern was the commonest clinical type (53.7%) and video-dermatoscopy revealed mixed pattern as the commonest (56.1%) pigment deposition pattern. Among 132 female health workers doing night duty on regular basis, 23 had melasma while 66 female health workers not doing night duty, 18 had melasma (p = 0.10). Whereas while comparing hours of night duty per week among respondents with melasma (n=23) and without melasma (n=18) were 23.72±10.08 hours and 17.8±4.77 hours respectively (p=0.02). Conclusion The present study reveals higher prevalence of melasma among female health workers having more stressors as night duty. KEY WORDS Female, health worker, melasma
Perceived Health Promoting Education Needs of Middle-aged Population in Dhulikhel Municipality of Nepal
(Kathmandu University, 2017) Karki, S; Koirala, P
ABSTRACT Background Health promoting education need assessment is of utter importance while conducting health promoting education programs. However little efforts have been put on this by the policy level authorities and there are no studies to assess the perceived health promoting education needs of the middle aged population of Nepal till date. Objective The objective of this study was to assess the perceived health promoting education needs of middle-aged population in Dhulikhel municipality. Method A descriptive cross-sectional study was conducted among 300 respondents using two staged cluster and systematic technique. Face to face interview technique was used for data collection. T-test was used for comparison of dependent variables with independent variables. Result The study revealed that the mean education need score was 66.66±16.09 (in a score of minimum 25 and maximum 125). Cancer prevention was perceived as the topic of highest education need and retirement planning as the topic of least education need. There was statistically significant difference in the mean perceived education need score between male and female (p=0.048), respondents with exposure and non-exposure to health related programs on mass-media (p=0.020) and mental component summary score <50 and mental component summary scores >=50 (p=0.048). Conclusion This study suggested that the community people have perceived moderate level of health promoting education need. Since cancer prevention was the highest rated topic followed by chronic illness prevention and dementia, it is recommended to focus on these topics while organizing any health promoting education programs in the community. KEY WORDS Health promotion, health promoting education, perceived needs
Assessment of The Relationship of Incisive Papilla to Maxillary Central Incisor and Canine-Papilla-Canine Line among the Dentate population of Central Nepal
(Kathmandu University, 2017) Sapkota, B; Srii, R; Srivastava, S; Marla, V; Koju, S
ABSTRACT Background Incisive papilla has been used as a fixed anatomical landmark to guide in teeth arrangement. Objective To assess the relationship of distance from central incisor to incisive papilla with various types of arch forms, shapes of incisive papilla and types of canine-papilla- canine relation. Method Two hundred maxillary stone casts were prepared. Eighteen casts were excluded as they had voids and the final study was carried out in 182 participants. The arch form was assessed according to Testut L. and shape of incisive papilla was recorded according to Filho IE et al. A digital Vernier caliper was used to measure the distance from posterior point of incisive papilla to the mesio-incisal edge from the labial side of maxillary central incisor. The inter-canine line was drawn and its position with incisive papilla was assessed. The analysis was done using SPSS version 20.0. One way ANOVA was done. Result Result showed that parabolic type of arch was the most common i.e. 76.4%. Mean distance of central incisor to incisive papilla was 11.093±1.894 mm. No significant difference was observed in the distance of Central incisor to Incisive Papilla among different arch forms (p=0.854) and various shapes of incisive papilla (p=0.091). The mean distance of central incisor to incisive papilla was significantly greater when canine-papilla-canine line passed from the middle than from posterior part of incisive papilla. Conclusion These results suggest that incisive papilla is a reliable biometric guide which would help to reduce the clinical time of both the dentist and the patients in placement of the anterior teeth. KEY WORDS Central incisors, canine-papilla-canine line (CPC), incisive papilla (IP)
Prevalence and Risk Factors of Diabetic Peripheral Neuropathy in T2DM Patient Presenting to Community Hospital in Nepal
(Kathmandu University, 2017) Shrestha, HK; Katwal, PC
ABSTRACT Background Diabetic peripheral neuropathy (DPN) is a well-known microvascular complication of type 2 diabetes mellitus (T2DM) attributed to chronic hyperglycemia, and is defined as the presence of peripheral nerve dysfunction in patients with diabetes after exclusion of other causes. Objective To determine the prevalence and risk factors of Diabetic Peripheral Neuropathy among type 2 diabetes mellitus patients. Method A cross sectional study was carried out in a University Teaching Hospital. Type 2 diabetes mellitus patients with diabetes duration of more than 6 months were recruited. Michigan Neuropathy Screening Instrument Scoring was used to diagnose Diabetic Peripheral Neuropathy. Result Among a total of 160 patients who were enrolled, 61 (38.1%) had diabetic peripheral neuropathy and 26 (16%) had diabetic peripheral neuropathy within 1 year of being diagnosed with diabetes. Mean Diabetes duration was 5.56 years and mean age was 57.32 years, with 90 (56%) of the participants being female. The mean HbA1c was 8.33%. Among them 25% of the participants were alcoholics and 30% were smoker. No statistically significant risk factors are evident on multivariate analysis. Conclusion Diabetic peripheral neuropathy was found to be highly prevalent in patients with type 2 diabetes including the patients with relatively shorter diabetes duration. This finding warrants the need of improving the preventive measures and quality of care related to foot complication among patients with type 2 diabetes. KEY WORDS Diabetic peripheral neuropathy, michigan neuropathy screening instrument, prevalence, type 2 diabetes mellitus
Takayasu's Arteritis: A Case Report
(Nepal Medical Association, 2022) Khadka, Arzoo; Singh, Sumi; Timilsina, Sarika
Abstract Takayasu's arteritis is a chronic vasculitis of medium and large vessels. The most involved vessel is the aorta and its major branches. The disease is primarily seen in young women. The described incidence of the disease ranges from 0.3 to 3.3 million per year. The vessels are characterized by mononuclear infiltration and granulomatous inflammation of vascular media, which leads to arterial wall thickening with stenosis, occlusion, and aneurysmal dilation. Here we present a case of Takayasu's arteritis in a 26-year-old woman who presented with syncope and dizziness with thickened walls of the arch of the aorta and its branches in Magnetic Resonance Imaging angiogram finding. Women of Japanese descent are not the only ones who can develop Takayasu's arteritis; it can affect anyone. Therefore, early diagnosis and treatment are warranted. When the disease is dormant, the outcome seems favourable.
Mean Micronuclei Score in Fine-Needle Aspiration Cytology of Patients with Malignant Breast Lump in the Department of Pathology in a Tertiary Care Centre: A Descriptive Cross-sectional Study
(Nepal Medical Association, 2022) Dahal, Mona; Upadhyaya, Paricha; Adhikari, Purbesh; Regmi, Niraj
Abstract Introduction: Micronucleus is used as a biomarker of chromosomal instability, which is one of the hallmarks of neoplastic transformation. As micronuclei score increases with malignancy, it can be an effective and inexpensive adjunct to breast fine needle aspiration cytology, in diagnosing breast lumps, especially detecting grey lesions between benign and malignant tumours. The aim of this study is to find out the mean micronuclei score in fine-needle aspiration cytology of patients with malignant breast lumps in the Department of Pathology in a tertiary care centre. Methods: A descriptive cross-sectional study was conducted among patients with malignant breast lumps in the Department of Pathology in a tertiary care centre between 1 May 2020 to 31 May 2021 after receiving ethical approval from the Institutional Review Committee (Reference number: IRC/2139/021). The fine-needle aspiration cytology of breast lumps was diagnosed as per National Health services breast screening program guidelines. The mean micronuclei score was calculated. Convenience sampling was done and data were collected from the hospital records in the Department. Point estimate and 95% Confidence Interval were calculated. Results: Among 20 malignant breast aspirates, the mean micronuclei score was found to be 8.30±3.75 (3-19, 95% Confidence Interval). Conclusions: The mean micronuclei score in fine-needle aspiration cytology of malignant breast lumps was found to be similar when compared to similar studies conducted in similar settings.
An Experience of Pediatric Upper and Lower Gastrointestinal Endoscopy in a Tertiary Center
(Kathmandu University, 2017) Upadhyay, S; Sharma, A
ABSTRACT Background Although upper gastrointestinal endoscopy and colonoscopy is considered to be a gold standard in the diagnosis of many pediatric gastrointestinal disorders, there is limited data about its utility from our country. This important diagnostic tool is underutilized. Objective The objective of this study is to report the common indications, endoscopic findings and complications of pediatric upper gastrointestinal endoscopy and colonoscopy in a tertiary center to increase awareness amongst pediatricians. Methods This descriptive cross-sectional study was conducted in children undergoing upper gastrointestinal endoscopy and colonoscopy for various indications in a tertiary center from November 2014 to October 2016 (24 months). Results We performed 192 endoscopies during this period. Upper gastrointestinal endoscopy 158 and Colonoscopy 34. Mean age of patients was 10.2 years (range 6 months to 16 years) and 140(72.9%) patients were under 10 years of age. Common indications of UGI endoscopy were recurrent abdominal pain (67%), acute abdominal pain (12.6%), recurrent vomiting (8.0%), upper GI bleed (4.4%), failure to thrive (3.1%) and caustic ingestion (2.5%). An abnormality was detected in 128(81%) patients. Antral gastritis (55%) was the most common diagnosis. Thirty two percent of children with RAP had chronic moderate to severe gastritis and were positive for H. pylori in Giemsa stain on histopathological examination. Common indications of colonoscopy were Lower GI bleed and chronic diarrhea. Out of 22 patients who underwent colonoscopy for lower GI bleed, 18(82%) patients had rectal polyp and underwent snare polypectomy. Out of 12 patients who were evaluated for chronic diarrhea, 7(20%) were diagnosed to have cow’s milk protein allergy and 5(15%) patients had inflammatory bowel disease. An abnormality was detected in 30(88%) patients. All children received sedation/ analgesia and tolerated the procedure well. Conclusion Upper gastrointestinal endoscopy and colonoscopy are safe procedure in children. The awareness about its diagnostic and therapeutic role should be raised amongst pediatricians in developing countries. There is also a need to develop training programs of pediatric gastroenterology and pediatric endoscopic suites in developing countries so that children may benefit from this state of the art diagnostic modality. KEY WORDS Colonoscopy, pediatric, upper gastrointestinal endoscopy
Postoperative Analgesic Effect of Morphine Added to Bupivacaine for Transversus Abdominis Plane (TAP) Block in Appendectomy
(Kathmandu University, 2017) Ghimire, A; Bhattarai, B; Prasad, JN; Subedi, A; Thapa, P; Limbu, PM; Adhikari, S
ABSTRACT Background Transversus abdominis plane (TAP) block with local anaesthetics produces effective pain relief following lower abdominal surgeries. Although opioids have been found to have effects through peripheral receptors also, reports on their effect when used as additive to local anaesthetics for TAP block are lacking. Objective To assess the analgesic effect of peripherally administered morphine with bupivacaine for ipsilateral TAP block in patients undergoing emergency appendectomy under general anaesthesia. Method Sixty patients undergoing appendectomy were randomized to undergo ipsilateral TAP with 20 ml of 0.5% bupivacaine plus 2 ml of NS (total 22 ml) and 2 ml of intravenous (IV) saline (Group TB) or with 20ml of 0.5% bupivacaine plus 2 mg (2 ml) of morphine (total 22 ml) and 2 ml of NS IV (Group TBM) or with 20 ml of 0.5% bupivacaine plus 2 ml of NS (total 22 ml) and 2 mg (2 ml) IV morphine (Group TB-IVM). Pain severity was measured using Visual Analogue Scale (VAS) preoperatively (Baseline) and at 30 min, 6h, 12 h and 24 h postoperatively. Inj. tramadol 50 mg IV was used as rescue analgesic when postoperative VAS was 4 or more. The duration of analgesia (time to first analgesic) and the postoperative 24 h tramadol requirement was recorded. Result The mean duration of analgesia in Group TBM was significantly longer (801.50 ± 74.92 min, p=0.002) than in Group TB (720.00 ± 42.17 min) and Group TB-IVM (712.70 ± 40.94 min). The mean postoperative 24 h tramadol requirement was also less in Group TBM (69.23 ± 25.31mg) than in Groups TB (100.00 ± 38.34 mg) and TB-IVM (95.00 ± 39.40 mg) but did not reach the level of statistical significance (p=0.057). Significantly less ondansetron was required in Group TBM (3.80 ± 2.04 mg) than in Group TB (6.80 ± 2.93 mg) and TB-IVM (6.00 ± 2.75 mg) (p=0.002). Conclusion Morphine added to bupivacaine effectively prolongs the analgesic duration of TAP block in appendectomy. KEY WORDS Morphine, postoperative analgesia, transversus abdominis plane block, USG guided
Complete Stone Clearance after Retrograde Intrarenal Surgery among Patients with Urolithiasis in a Tertiary Care Centre: A Descriptive Cross-sectional Study
(Nepal Medical Association, 2022) Thakur, Dipak Kumar; Agrawal, Chandra Sekhar
Abstract Introduction: Retrograde intra-renal surgery using flexible scopes and laser energy is a newer alternative in stone disease treatment armamentarium. It is claimed to be superior to other modalities for stone clearance, complications and hospital stay. The aim of this study was to find out the prevalence of complete stone clearance after retrograde intra-renal surgery among patients with urolithiasis in a tertiary care centre. Methods: This was a descriptive cross-sectional study conducted in the Department of Urology in a tertiary care centre from 15 June 2021 to 14 May 2022 including adult patients with stone size up to 15 mm. Ethical approval was obtained from the Institutional Review Committee (Reference number: IRC-PA-143/2077-78). Convenience sampling was done. The prevalence of complete stone clearance (no residual fragment >4 mm) was calculated. Point estimation and 95% confidence interval were calculated. Results: Among 42 patients, 36 (85.71%) patients (75.1-96.3, 95% Confidence Interval) achieved complete stone clearance. The mean age was 40.26±14.05 (16-74) years and the stone size was 1.27±0.19 (0.9 -1.5) cm. Similarly, the mean operating time was 51.55±9.34 (40-85) minutes and the hospital stay was 1.33±0.52 (1-3) days. Grade 3 ureteric injury occurred in one case. Residual fragments were seen in 6 cases (14.29%). Sepsis occurred in 4 cases (11.11%). Conclusions: The prevalence of complete stone clearance was similar among patients undergoing retrograde intra-renal surgery in our study when compared to other studies conducted in similar settings.
Displaced Intra-Articular Calcaneal Fractures: Evaluation of Clinical and Radiological Outcome Following Open Reduction and Internal Fixation with Locking Branched Calcaneal Plate
(Kathmandu University, 2017) Shrestha, R; Shrestha, D; Kayastha, SR; Winker, H
ABSTRACT Background Calcaneal fractures are common, but are difficult to manage. Immediate concern is soft tissue problems, while long term concern is pain as a sequelae of subtalar arthritis. A consensus has not been reached in the management of calcaneal fractures. Objective This study aims to evaluate clinical and radiological outcomes of the patients managed with open reduction and internal fixation with Calcaneal Locking Plates for the displaced intra-articular calcaneal fractures presenting in Dhulikhel Hospital, Kathmandu University Hospital. Method This was a prospective study, conducted on displaced intra articular calcaneal fractures from January 2014 through December 2016. The patients underwent open reduction and internal fixation with Locking Branched Calcaneal Plates through the extensile lateral approach. Post-operatively, ankle was mobilized after two weeks. Weight bearing was started after 12 weeks. Patients were evaluated clinically with Maryland foot score and radiologically with measurements of Boehler’s and Gissane angle. Result Twenty-two cases of calcaneal fractures managed with open reduction and internal fixation with Locking Branched Calcaneal Plates were available for final evaluation. Seventeen of the enrolled patients were males in their third decade of life. On average, calcaneal fractures were operated on seven days after the injury. Sanders Type II were seen in 68.2% of the cases and Sanders Type III were in 31.8%. Mean follow-up duration was 21.5 months. The average Maryland foot score was 77.27. Seventeen cases (77.13%) had good, four cases (18.2%) had fair, and one case (5.5%) had poor outcome score. There was statistically significant improvement in Boehler’s and Gissane angle across all enrolled patients. Conclusion Displaced intra-articular calcaneal fractures treated operatively with open reduction and internal fixation with Locking Branched Calcaneal Plates through the extended lateral approach, with proper planning of operation and surgical techniques in soft tissue handling, results in good clinical as well as radiological outcomes. KEY WORDS Boehler’s angle, calcaneum, calcaneal locking plates, maryland foot score, ORIF
Disease Profile and Hospital Outcome of Newborn Admitted to Neonatal Intermediate Care Unit at Tertiary Care Center in Nepal
(Kathmandu University, 2017) Chapagain, RH; Basaula, YN; Kayatha, M; Adhikari, K; Shrestha, SM
ABSTRACT Background Neonatal mortality rate (NMR) is decreasing in Nepal but at a slower pace than infant and child mortality. In order to improve neonatal outcome, Care of sick children can be done better so as to aid in reducing neonatal mortality rate. Objective The objective was to identify pattern of diseases and outcome admitted to Neonatal Intermediate care Unit (NIMCU). Method A retrospective study was conducted at Neonatal Intermediate care Unit of Kanti Children’s hospital from Bhadra 2071 to Shravan 2073 (August 2014 to July 2016). Result Total 1286 neonates were admitted in Neonatal Intermediate care Unit with the highest admission in the months of Bhadra (August-September) 12.52% and the lowest in Push (December-January) 4.82%. Among the admitted cases, 1,028 (80.0%) were full term while 256 (20.0%) were preterm. Among the total admission, 43.6% were less than 7 days old which is the most vulnerable period during the newborn phase. Admission due to neonatal sepsis was 892 (69.36%). Among them, 628 (70.40%) were late onset neonatal sepsis while 264 (29.60%) were early onset. Neonatal jaundice accounted for 12.36% (159) of the cases while Hypoxic Ischemic Encephalopathy accounted for 4.80% (62) of cases. Congenital Heart Disease were 53 (4.12%) and neonatal pustulosis were 27 (2.20%). Meningitis accounted for 45 (3.49%) of cases and UTI 29 (2.22). Death during treatment were 18 (1.39%). 7% of cases deteriorated and referred to NICU while, 3.2 % of cases were referred to other centers and 5.1% of cases were either discharged on request or left against medical advice. Conclusion Neonatal sepsis including both early and late onset, Congenital Heart disease, birth asphyxia and neonatal Jaundice accounted for majority of admission in NICU. Three of four these etiologies are preventable up to some extent. KEY WORDS Morbidity, mortality neonate, sepsis, outcome
Nerve Root Sedimentation Sign among Lumbar Canal Stenosis Patients Visiting the Department of Orthopaedics in a Tertiary Care Centre: A Descriptive Cross-sectional Study
(Nepal Medical Association, 2022) Pant, Yugesh Raj; Paudel, Sushil; Lakhey, Rajesh Bahadur; Pokharel, Rohit Kumar
Abstract Introduction: Lumbar canal stenosis is a common cause of back pain and neurogenic claudication in the elderly population. Nerve root sedimentation sign-on Magnetic resonance imaging is a novel sign proposed for the diagnosis of lumbar canal stenosis. There is limited research so far. So, the aim of this study was to find out the prevalence of nerve root sedimentation signs in lumbar canal stenosis among patients visiting the Department of Orthopaedics in a tertiary care centre. Methods: This was a descriptive cross-sectional study conducted from 1 January 2020 to 31 July 2021 in the tertiary care centre, after receiving ethical approval from the Institutional ethical review board (Reference number: 299/(6-11)076/077). The anteroposterior diameter of the dural sac at the most stenotic level and nerve root sedimentation sign in magnetic resonance images were measured in patients with lumbar canal stenosis. Point estimate and 95% Confidence Interval were calculated. Results: Among 40 patients enrolled, 34 (85%) (84.01-85.99, 95% Confidence Interval) patients had positive nerve root sedimentation sign. Out of 34 (85%) cases with positive sedimentation signs, 32 (94.12%) had severe lumbar stenosis and the remaining 2 (5.88%) had moderate lumbar stenosis. Conclusions: The prevalence of nerve root sedimentation signs is similar to the similar studies done in similar settings. Nerve root sedimentation signs on magnetic resonance imaging can be used as an objective sign for the diagnosis of severe lumbar canal stenosis.
Ocular Morbidity among Earthquake Survivors in a Community Based Hospital in Nepal
(Kathmandu University, 2017) Shrestha, P; Sthapit, PR
ABSTRACT Background Nepal suffered a massive loss of lives and property following devastating earthquake on Saturday 25 April, 2015 and 12 May, 2015. Though Nepal is prone to natural disasters and ocular trauma being important cause of visual morbidity, the impact of ocular trauma in disaster setting has rarely been studied. Objective The aim of this study was to report the spectrum of ocular morbidities among the earthquake survivors who presented to a tertiary care Hospital which lies close to major earthquake hit districts of Nepal. Method This is a hospital based retrospective study where details of all the cases with ocular injury or ocular diseases during first three weeks of earthquake were extracted from the record books of Ophthalmology and Emergency department. Detail ophthalmic examination findings and treatment received by the patients were also noted from the records, tabulated and analyzed. Result There were total 3679 earthquake survivors, majority from Kavrepalanchowk district, visiting our Hospital during first three weeks of earthquake among which 92 patients had ocular problems. Among the 117 affected eyes, 75% had unilateral involvement. Males and females were equally affected. Children and adolescents of age group 11-20 years was the most commonly affected age group. Spectrum of ocular injuries ranged from lid lacerations, conjunctival inflammation to sixth nerve palsy and traumatic optic neuropathy. Conclusion Ocular morbidity either in the form of ocular injuries or diseases were common in polytrauma cases among the earthquake survivors. Though most of them had eyelid injuries and conjunctival inflammations, vision threatening conditions were also observed which needed expert opinion and meticulous treatment. KEY WORDS Earthquake, ocular trauma, ocular morbidity
Extra-pulmonary Tuberculosis among Tuberculosis Patients Visiting a Tertiary Care Centre: A Descriptive Cross-sectional Study
(Nepal Medical Association, 2022) Paudel, Damodar; Shrestha, Surendra Lal
Abstract Introduction: Tuberculosis outside of the lung is extrapulmonary tuberculosis. The diagnosis of extrapulmonary tuberculosis is not easy in a community setting even in district hospitals. Clinical symptoms and radiological diagnosis are effective for the diagnosis of pulmonary and extra-pulmonary cases. The aim of the study is to find out the prevalence of extra-pulmonary tuberculosis among tuberculosis patients visiting a tertiary care centre. Methods: This was a descriptive cross-sectional study conducted among the patient visiting a tertiary care centre from August 2019 to January 2020 after taking ethical approval from Institutional Review Committe (Reference number: 86) which observed different clinicoradiological and laboratory features in patients with extrapulmonary tuberculosis to address their respective accuracy and usability in measuring the burden of tuberculosis. The interview was taken for the symptoms, and then radiological and laboratory data were collected. Convenience sampling was used. Point estimate and 95% confidence interval were calculated. Results: Out of 60 patients with tuberculosis, 39 (65%) (62.83-67.17, 95% Confidence Interval) were diagnosed with extrapulmonary tuberculosis. Among them, 30 (76.9%) were with pleural effusions followed by lymphadenopathy in 9 (23.07%). Conclusions: The prevalence of extra-pulmonary tuberculosis was found to be higher as compared to the study done in similar settings.
Protective Effect of Aqueous Extract of Lagenaria Siceraria (Molina) Against Maximal Electroshock (MES) -Induced Convulsions in Albino Rats
(Kathmandu University, 2017) Tirumalasetti, J; Patel, MM; Shaikh, U; Pokala, N; Harini, K
ABSTRACT Background The Lagenaria siceraria (Molina) belongs to family Cucurbitaceae, commonly known as bottle guard or calabash in English. All the parts of plant like root, fruit, leaves and flower has been evaluated for its various activities like antioxidant, antihelmintic, cognitive enhancer, anticancer, antianxiety, antidepressant, antihyperlipidemic, fibrinolytic cardio protective and hepatoprotective. Even though it is claimed to have antiepileptic action, no documentation is available. Objective To assess the anticonvulsant activity of aqueous extract of Lagenaria siceraria by Maximal Electroshock seizure induced seizure models on Albino rats. Method Albino rats were taken and divided into five groups, each consisting of five rats. One group was used as control (normal saline 10 ml/kg), one as standard (phenytoin), and three groups for the test drug (aqueous extract of Lagenaria siceraria (AELS) in the doses of 200, 400 and 800 mg/kg) treatment. In MES model, Maximal electrical shock of 150 mA was passed for 0.2 seconds through corneal electrodes after 30 minutes of giving the drugs and normal saline. Different stages of convulsions were noted down along with time spent by the animal in each phase of convulsions. Data were statistically analyzed by One way ANOVA followed by multiple Dunnett’s test. Result The mean reduction in hind limb extension phase was 8.2±2.10 after 400 mg/kg of AELS which is highly significant (p<0.001) like phenytoin. AELS at 800 mg/kg exhibited a significant 17±2.64 (p<0.05) protection against tonic extensor phase. Conclusion Aqueous extract of Lagenaria siceraria has anticonvulsant activity. KEY WORDS Anticonvulsant, epilepsy, lagenaria siceraria, maximal electroshock
Mean Tip Apex Distance in Patients undergoing Dynamic Hip Screw Fixation for Pertrochanteric Fractures without using Traction Table: A Descriptive Cross-sectional Study
(Nepal Medical Association, 2022) Regmi, Subhash; Chaudhary, Rajesh Kumar; Pradhan, Ishor; Banskota, Bibek; Joshi, Amit
Abstract Introduction: Dynamic Hip Screw fixation has shown to be equally effective compared to cephalomedullary nailing. The effectiveness of dynamic hip screw fixation for pertrochanteric fractures without using traction table is not well investigated. This study aimed to find out the mean tip apex distance in patients undergoing dynamic hip screw fixation for pertrochanteric fractures without using traction table. Methods: A descriptive cross-sectional study was conducted among patients undergoing dynamic hip screw fixation for pertrochanteric fractures without using traction table between 1 September 2021 and 30 June 2022, after getting approval from institutional review committee (Reference number: IRC-2021-08-23-02). All patients undergoing dynamic hip screw fixation for pertrochanteric fractures without using traction table were included in the study. Patients with pre-existing ipsilateral or contralateral hip deformity, contra-lateral hip prosthesis, bilateral hip fractures, and history of prior ipsilateral hip surgeries were excluded. Point estimate and 95% confidence interval were calculated. Results: Among 45 patients, the mean tip apex distance was 20.45±6.13 mm (18.66-22.24 mm, 95% Confidence Interval). Among 45 patients, 24 (53.33%) were males and 21 (46.66%) were females. The average age of the participants was 67.75±21.33 years. Conclusions: The mean tip apex distance in patients undergoing dynamic hip Screw fixation for pertrochanteric fractures without using traction table was similar to that reported in other international studies.
The Heart-health Associated Research, Dissemination and Intervention in the Community (HARDIC) Trial for Nepalese Mothers regarding Diet and Physical Activity: A Process Evaluation
(Kathmandu University, 2017) Vaidya, A; Oli, N; Eiben, G; Krettek, A
ABSTRACT Background Mothers with young children in the peri-urban Jhaukhel-Duwakot Health Demographic Surveillance site of Bhaktapur district have misconceptions and poor behavioural practice regarding diet and physical activity. We developed the Heart- health Associated Research, Dissemination and Intervention in the Community trial - a health promotion intervention for mothers. Objective The objective of this study was to evaluate the intervention’s feasibility, acceptability, potential for transferability and scaling up, and to determine its immediate outcome. Method Duwakot and Jhaukhel were randomly selected as the intervention and control communities, respectively. We trained 47 peer mothers from Duwakot, each of whom gave classes with 10 fellow mothers of their neighbourhood. The process evaluation was carried out on a continuous basis at different points of the intervention held from August to November 2016. Result In round one, the participation and completion rates were both > 90% for peer mothers; and 85% and 70%, respectively, for the fellow mothers. However, the participation rates fell in the round two of the intervention. On the whole, the mothers expressed satisfaction and acceptance of the course content and training modality. Immediate evaluation of the intervention showed improvement of knowledge, attitude and practice of diet and physical activity among both groups of mothers. Conclusion The successful implementation of the intervention targeting diet and physical activity clearly demonstrates the feasibility of health promotional activities in the Nepalese community for improvement of cardiovascular health. KEY WORDS Diet, health promotion, mothers, physical activity, process evaluation
Global Scenario of Allergies
(Kathmandu University, 2017) Wolfgang, Sieber; Henriette, Mueller
NA
Combination Therapy in Diabetes Mellitus Patients Attending Outpatient Department in a Tertiary Care Centre: A Descriptive Cross-sectional Study
(Nepal Medical Association, 2022) Karki, Naresh; Kandel, Kamal; Shah, Kyushu; Prasad, Pravin; Khanal, Jeevan
Abstract Introduction: Assessing anti-diabetic drug use patterns in hospitals is an important activity which helps to promote the rational use of drugs and may suggest measures to change prescribing habits for the better. This study aimed to find the use of combination therapy in diabetes mellitus patients attending the outpatient department of a tertiary care centre. Methods: A descriptive cross-sectional study was conducted among 201 diabetes mellitus patients in the internal medicine department from 2 March 2022 to 30 June 2022 for a duration of four months after approval from the Institutional Review Committee (Protocol No: IRC-LMC-01/R-022). Diabetic patients prescribed at least one anti-diabetic drug in prescription forms were included. Socio-demographic profiles, clinical characteristics and anti-diabetic drug use pattern-related data were collected. Convenience sampling was used. Point estimate and 95% Confidence Interval were calculated. Results: Among 201 patients, 134 (66.66%) (60.14-73.18, 95% Confidence Interval) patients were given combination therapy. The most common combination therapy was metformin 500 mg and sitagliptin 50 mg. A total of 324 anti-diabetic drugs were used. The average number of drugs prescribed per patient was 1.6±0.7. The number of anti-diabetic drugs prescribed by generic name and from the national essential drugs list was 74 (22.83%) and 188 (58.02%) respectively. Biguanides were used in 176 (87.56%) patients. Conclusions: These findings were similar to some other studies conducted in similar settings. In most patients, combination drug therapy was more prevalent. Among combination therapy, two drug combinations were more prevalent.
Self-medication in Primary Dysmenorrhea among Undergraduate Students in a Medical College: A Descriptive Cross-sectional Study
(Nepal Medical Association, 2022) Shrestha, Ruchi; Bhandari, Mukta Singh; Shrestha, Sony Shakya; Shrestha, Jyoti Tara Manandhar; Shrestha, Upama
Abstract Introduction: Primary dysmenorrhea is painful menstruation in women with normal pelvic anatomy, usually beginning during adolescence, primarily associated with a normal ovulatory cycle. There is an increased likelihood of self-medication among medical students. The aim of this study is to find out the prevalence of self-medication in primary dysmenorrhea among undergraduate students in a medical college. Methods: A descriptive cross-sectional study was conducted in a medical college among undergraduate female students with primary dysmenorrhea from 1 February 2022 to 31 May 2022. Ethical approval was obtained from the Institutional Review Committee of the same institute (Reference number: 254/2021). Convenience sampling was done. Data were collected through a self-administered questionnaire. Point estimate and 95% Confidence Interval were calculated. Results: Among 213 students with primary dysmenorrhea, self-medication was found to be in 78 (36.62%) (30.15-43.09, 95% Confidence Interval)). Among all the self-medications used, mefenamic acid was most common, used by 45 (57.69%) students, followed by paracetamol 11 (14.10%). Conclusions: The prevalence of self-medication practice in primary dysmenorrhea among undergraduate students was lower when compared to similar studies done in similar settings.

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