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Association of Haemophilia with Down Syndrome
(Nepal Paediatric Society (JNPS), 2016) Narang, Gursharan Singh; Singh, Tarsem; Sharma, Anubha; Malik, Supriya; Kaur, Amandeep
Abstract: Hemophilia B is a hereditary bleeding disorder caused by a lack of blood clotting factor IX. Without enough factor IX, the blood cannot clot properly to control bleeding. Hemophilia B presenting in association with Down’s syndrome is quite rare. We report a case of a one month old child who presented to us with continuous unexplained bleeding.
A Case of Hodgkin Lymphoma Presenting as Nephrotic Syndrome
(Nepal Paediatric Society (JNPS), 2016) Dakhane, Yogesh Rambhau; Singh, Rajesh Kumar; Thapar, Rajeev Kumar
Abstract: Nephrotic changes as part of the paraneoplastic syndrome are rare in lymphoid malignancies. One percent of cases of Hodgkin's Lymphoma cases may present with nephritic syndrome. We are reporting a case which initially presented as nephritic syndrome and later was diagnosed to have of Hodgkin's Lymphoma and managed accordingly.
Nonsyndromic Split Hand/ Foot Malformation: Ectrodactyly
(Nepal Paediatric Society (JNPS), 2016) Ray, Sanghamitra; Jain, Prakash Chand
Abstract: The Case A three year old girl came to our OPD with deformity of left hand called ectrodactyly. She had no other deformities, dysmorphic features and was developmentally appropriate. The X-ray of the hand showed normal radius, ulna and metacarpals but absence of phalanges of the middle three fingers of left hand. She was examined in detail for any ectodermal anomaly, clefting of lip or palate. USG abdomen, kidney and urinary tract was done to rule out any urinary tract malformation. She was finally referred to higher centre for reconstructive surgery for ectrodactyly.
Sex ratio at Birth in a Tertiary Care Hospital in Western Nepal are the Trends Changing?
(Nepal Paediatric Society (JNPS), 2016) Aryal, Shreyashi; Kalakheti, Balkrishna
Abstract: Introduction: Sex ratio at birth remains unchanged in absence of human intervention. A tendency of skewing towards males is seen in Asian population attributable to various reasons, foremost being abortions. The decreasing number of female population is a form of gender discrimination and has serious implications for both sexes in the future. The purpose of this study was to analyze the trends of sex ratio at birth among deliveries at Lumbini Medical College Teaching Hospital, Palpa, Nepal over the past eight years. Materials and Methods: A retrospective audit of deliveries from 1st January 2008 to 31st December 2015 was carried out. Sex ratio at birth was calculated and its relationship with maternal age, birth order and number of previous abortions was analyzed. Results: The total number of live-births during the study period was 9394 consisting of 5008 male and 4350 female with an overall sex ratio at birth of 112.6. Every year, there was an increasing trend in total number of live births and sex ratio at birth. The number of male births increased with increase in parity but there was no statistical difference seen between maternal age, parity and number of abortions for male and female births. Conclusion: The sex ratio at birth in hospital deliveries is unbalanced with inclination towards male, more so in women with high parity. Additional research exploring the reason for increase in male births is needed, so that potential programs which can reverse this trend can be implemented.
Prevalence of Under-Nutrition Measured by Composite Index of Anthropometric Failure (CIAF) Among the Bhumij Children of Northern Odisha, India
(Nepal Paediatric Society (JNPS), 2016) Goswami, Monali
Abstract: Introduction: Under-nutrition continues to be a serious health problem among the children in India. In view of the paucity of recent attempts to classify under-nourished children satisfactorily the Composite Index of Anthropometric Failure (CIAF) has been implemented to measure the seriousness and severity of overall under-nutrition in a population. However, there exists scanty information of the prevalence of under-nutrition among the tribal children of Odisha and India. Therefore the objective of the present study is to evaluate the overall prevalence of under-nutrition among the Bhumij children of Northern Odisha, India. Materials and Methods: A total of 136 Bhumij children aged 1 to 6 years (69 boys and 67 girls) were measured. Children were considered as underweight, stunting and wasting if their weight-for-age, height-for-age and weight-for-height Z-scores below -2.0 SD of the National Center for Health Statistics (NCHS) reference data. Severe under-nutrition was assessed as Z-score below -3.0 SD. Results: The overall age and sex combined prevalence of stunting, underweight and wasting recorded was 32.4%, 42.6% and 25% respectively, and these rates were considered as high (30-39%), very high (≥30%) and also very high (≥15%), respectively. CIAF showed a higher prevalence of undernutrition (54.4%) i.e., children suffering from anthropometric failure, in comparison to other three conventional indicators (stunting, underweight and wasting). Conclusions: Therefore various nutritional intervention programs can be formulated to improve the nutritional status of the children. It was established herein that CIAF is a better indicator of nutritional status than traditional measures of stunting, underweight and wasting because it differentiates overall and total anthropometric failure.
Pattern of Growth Retardation and Sexual Maturation in Children having Beta Thalassaemia
(Nepal Paediatric Society (JNPS), 2016) Chhabra, Gurpreet Singh; Sodhi, Manmeet Kaur
Abstract: Introduction: Thalassaemia is a group of genetic disorders of blood, characterized by decreased synthesis of one of two types of poly peptide chain (α or ß) that form a normal adult human haemoglobin molecule (Hb A- α2 ß2). This results in decreased filling of red cell with haemoglobin and anaemia. Retardation of growth and delayed sexual maturation can occur as a complication of thalassaemia. The objectives of this study were to study the pattern of growth failure and sexual maturity rate (SMR) in children with β-thalassaemia major, and to compare it with controls. Material and Methods: In this case-control study conducted simultaneously at two centres at Bebe Nanki Mother And Child Care Centre, Amritsar and Sri Guru Ram Das Charitable hospital, Amritsar, the growth parameters (height,weight and sexual maturation ) and serum ferritin levels of a total of 114 patients aged 8-16 years (64 males and 50 females) with β-thalassaemia major were compared with those of 100 healthy controls of the same age and gender. Results: Underweight was observed in 89(78.1%) of patient group and 9(9%) of control group. Short stature was observed in 64(56.1%) patients and 7(7%) of the control group. The mean age of menarche for female thalassaemia patients was 12.11±2.1 years and for control females was 11.42±1.11years, The SMR were delayed in 108(95%) of patients and in 6 (6%) of controls. The level of serum ferritin was found to be significantly associated with delayed SMR in thalassaemia patients. Conclusion: Growth failure and delayed SMR significantly occur in thalassaemia patients, when compared to the controls. Adequate chelation therapy can help in controlling serum ferritin levels and thereby facilitating normal physical growth and sexual development in chronically transfused thalassaemia patients.
Surgical Outcome of Traumatic Cataract Following Corneal Perforation in Children in a Tertiary Eye Care Centre in Nepal
(Nepal Paediatric Society (JNPS), 2016) Shrestha, Ujjowala Devi; Adhikari, Srijana
Abstract: Introduction: Traumatic paediatric cataract is challenging and its management is difficult. It is associated with other distortion of ocular anatomy and subsequent post- operative complication poses more problems. It is mostly unilateral. The purpose of this study is to assess the outcome of traumatic cataract following corneal perforation in Nepalese children in a tertiary eye hospital in Nepal. Material and Methods: It was a retrospective review of medical records of children who developed cataract following perforating corneal injuries. The study included 69 cases diagnosed as unilateral traumatic cataract over a period of 70 months (January 2010 till October 2015) at Tilganga Institute of Ophthalmology (TIO). Traumatic cataracts caused by other than the perforating corneal injuries were excluded from the study. Results: Children between 6 to 10 years of age had highest percentage of ocular trauma. Boys were more commonly affected than girls. Forty two percentages of children had visual outcome of better than or equal to 6/18.Poor visual outcome was mainly due to anterior segment pathology- corneal scar (14.49%).Posterior segment pathology like macular scar, vitreous haemorrhage and retinal detachment contributed to 7.34% of the cause. Conclusion: Outcome of the traumatic cataract surgery varied. Visual outcome of post traumatic cataract after corneal perforation was dependent on multiple factors like co- existence of the anterior and posterior segment trauma, per –operative and post-operative challenges. Prompt and good management of traumatic cataract can result in good visual outcome.
Knowledge, Attitude and Socio-cultural Beliefs of Adolescent Girls towards Menstruation Authors
(Nepal Paediatric Society (JNPS), 2016) Kapoor, Anju; Khari, Smriti
Abstract: Introduction: Knowledge regarding physiology of menstruation and hygienic practices are poor in adolescent girls. Deep rooted social beliefs make their attitude more negative. Material and Methods: In a hospital based cross sectional study, one hundred adolescent girls who have attained menarche were interviewed with a pre-validated semi-structured questionnaire to assess their knowledge, experiences, effect of mother’s education on menstrual hygienic practices and factors affecting their positive and negative attitude. Results: Mean age of menarche was 13.28 (SD ± 1.42) years. Mothers were the first informant to 56% girls. Only 11% girls knew that menstruation is a normal biological phenomenon and 28% girls were mentally prepared before menarche. Readymade pads were being used by 46% girls. Most girls were forced to follow various restrictions during menstruation. Maternal education was significantly associated with use of readymade pads (p-value 0.031). Significant positive correlation was seen between premenarchal preparedness to pleasantness (r = 0.3215; p = 0.001) while negative correlation was found between preparedness to secrecy (r = -0.1549; p = 0.124), annoyance (r = -0.1421; p = 0.158) and worrying thoughts (r = - 0.2074; p = 0.038). Negative correlation was also seen between years of experience with menses to secrecy and worrying thought (r = -0.0162; p = 0.872 and r = -0.1033; p = 0.864 respectively). Conclusion: There is significant lack of knowledge, poor hygienic practices and negative attitude among adolescent girls that needs to be addressed by educating them and their mothers.
Incidence and Severity of Intra-Ventricular Hemorrhage (IVH) in Preterm Infants, Northeast of Iran
(Nepal Paediatric Society (JNPS), 2016) Fouladinejad, Mahnaz; Zak, Hadi Khorsand; Nematollahi, Nematollah; Alaee, Ehsan
Abstract: Introduction: The incidence rate of Intra-Ventricular Haemorrhage (IVH) varies from 20% to 25% among preterm infants with a very low birth weight. IVH could compose critical disabilities which are directly associated to its grade. The aim of this study was to evaluate the incidence and severity of IVH in preterm infants referred to the academic Hospital of Gorgan, Northeast of Iran. Materials and Methods: In this cross-sectional study, we examined all preterm infants who had been referred to the academic Hospital of Gorgan, Northeast of Iran between Augusts 2014 and February 2015. Seventy one preterm infants (≤34 weeks of gestation, ≤1500g birth weight) have been included. Cranial ultrasound was done within 3-5 days of birth for all subjects and subsequent ultrasounds were performed based on their birth weight by portable ultrasound device. Results: The overall incidence of IVH was 64.8% in the present study. There was a significant relationship between IVH incidence and the gestational age (p=0.010). Also the lower birth weight was associated to the higher rate of IVH complications reported in sequential ultrasounds (p<0.05). Conclusion: Gestational age and birth weight seem to have key roles in the occurrence and severity of IVH, respectively.
Prevalence of Obesity in Inguinal Hernia Repair Patients in a Tertiary Care Center
(Nepal Medical Association, 2021) Shrestha, Sundar; Upadhyay, Pramod Kumar
Abstract: Introduction: Inguinal hernia is a common surgical problem, with a lifetime risk of 27% in men and 3% in women. Its cumulative incidence is 17.2% and 12.3% in body mass index of <25 kg/m2 and 25â€“30 kg/m2 respectively. Obesity had been regarded as the risk factor for the development of an inguinal hernia. However, recent epidemiologic studies have suggested the decreased prevalence of inguinal hernia in increased weight and body mass index individuals. The aim of this study is to find out the prevalence of obesity in inguinal hernia repair patients in a tertiary care center. Methods: A descriptive cross-sectional observational study was performed in Bir Hospital from May 2018 to December 2019 after taking ethical approval from the institutional review board of NAMS. Convenient sampling was done with a sample size of 219. Statistical analysis was done using SPSS version 23 and Microsoft Excel software by descriptive statistics. Results: The mean body mass index was 22.10 Â±3.07 kg/m2. Body mass index category 18.5 â€“ 22.9 kg/m2 had 133 (61%) male and seven (3.2%) female patients, category â‰¥30 kg/m2 had four (1.8%) male. Most of inguinal hernia repair patients were farmers 158 (72.5%). Common risk factors noted were smoking 142 (65.1%), heavy work 112 (51.4%), chronic cough 65 (29.8%). Most of the complications occurred in the normal body mass index category and the prevalence of complications decreased as the body mass index increased. The recurrence was found in 3 (1.4%) inguinal hernia repairs. Conclusions: The majority of inguinal hernia repair patients were non-obese, and complications were less in obese patients
Anxiety among Pregnant Women about Corona Virus Infections during COVID-19 Pandemic at a Tertiary Care Center in Nepal: A Descriptive Cross-sectional Study
(Nepal Medical Association, 2021) Shrestha, Dipty; Saha, Rachana; Manandhar, Naresh; Adhikari, Asmita; Daha, lJyoti
Abstract: Introduction: COVID-19 is a beta coronavirus that is transmitted by physical interaction or close contact. This Coronavirus Pandemic has also created stress and anxiety among pregnant women all over the world. The disease was first identified in Wuhan city, China, in late December 2019 and was declared pandemic by the World Health Organization on 11th March 2020. Concern and stress in pregnancy are associated with pre-eclampsia, intrauterine growth restriction, preterm labour, depression etc. Pregnancy is an immune-compromised state and poses a high risk to this risk. This study aims to identify anxiety about the coronavirus infection among pregnant women visiting a tertiary care centre in Kathmandu, Nepal, during this COVIDâ€“19 pandemic. Methods: This is a descriptive cross-sectional study conducted at Kathmandu Medical College and Teaching Hospital from 15th July 2020 to 30th July 2020 after taking the ethical clearance from the Institutional Review Committee of Kathmandu Medical College (reference no. 207202002). Convenient sampling method was used. All the data were entered in Statistical Package for the Social Sciences data 20.0 and analyzed. Data was presented in frequencies, charts and percentage. Results: Among the total 273 cases, only 2 (0.73%) cases had a score between 25-30 corresponding to moderate to severe anxiety, 21 (7.69%) had a score between 18-24, which corresponds to mild to moderate anxiety and 250 (91.57%) had score 0-17 which corresponds mild status. Conclusions: Most of the participants in the study reported a mild status of anxiety. Very few participants reported moderate to severe anxiety.
Prevalence of Malnutrition among Elderly People Living in a Rural Area of Nepal
(Nepal Medical Association, 2021) Chataut, Jagdish; Jonche, Shristi; Ghimire, Manish; Tamrakar, Dipesh; Bhandari, Mukta Singh
Abstract: Introduction: Elderly population is more likely to suffer from malnutrition due to aging-associated factors that influence nutritional status like loss of appetite, swallowing difficulties, digestive problems, and chronic illness. There is insufficient information related to the nutritional status of the elderly in Nepal. Hence, this study aims to determine the prevalence of malnutrition among elderly people living in the rural area of the Kavrepalanchok district. Methods: A descriptive cross-sectional study was conducted among 320 elderly people aged â‰¥60 years in a rural area of Kavre district from August to October 2019. Ethical approval was taken from the Institutional Review Committee (IRC-KUSMS: 68/19). Convenient sampling was done. Data analysis was performed using the Statistical Program for Social Sciences version 23. Results: The prevalence of malnutrition and risk of malnutrition was 37 (11.6%) and 159 (49.7%), respectively. Of 320 elderly persons, 193 (60.3%) males and 127 (39.7%) females, with a mean age of 68.23Â±7.38 years, participated in this study. The mean BMI was 22.54Â±3.25 kg/m2 (MeanÂ±SD). The prevalence of malnutrition was higher among females 19 (15%) compared to males 18 (9.3%). Conclusions: The prevalence of malnutrition and risk of malnutrition is high in the study population. Interventions to improve the nutritional status of the elderly should focus primarily on older people, females, and those who have co-morbidities.
Knowledge of Medical Students and Faculties of a Medical College Towards Human Body and Organ Donation: A Descriptive Cross-sectional Study
(Nepal Medical Association, 2021) Singh, Poonam; Phuyal, Naveen; Khadka, Sagar; Gurung, Minani
Abstract: Introduction: The study of clinical anatomy is inseparable from cadaveric dissection. However, scarcity of cadavers is observed all over the world. So, body donation is propounded and is a major source of cadavers worldwide. However, nowadays, there is a scarcity of cadavers for the body dissection in the medical course & also due to the rise in the number of medical institutions in Nepal. This research aimed to find out the knowledge of medical and nursing students at a medical college regarding human body and organ donation. Methods: A descriptive cross-sectional study was conducted among 400 medical and nursing students in a tertiary care hospital of Kathmandu valley. After obtaining ethical approval, a semistructured questionnaire was used to collect the data. Data were analyzed using Statistical Package for Social Sciences version 20.0. Results: Most of the respondents, 360 (90%) knew that organs could be donated from living donors as well as cadavers. A majority of the respondents 374 (93.5%) said that bodies could be donated for educational and learning purposes. The eyes were the most commonly donated organ. One hundred seventy five (43.5%) of the respondents were motivated to donate their bodies or organs. Self-motivation followed by motivation through media by celebrities, family members, and faculties were seen among the participants. Conclusions: We need a proper voluntary body donation act to facilitate medical teaching with the proper motivation of people for this generous gift to further the knowledge and expand the field of medical science.
Perception towards Online Teaching-learning in Medical Education among Medical Students during COVID-19 Outbreak in Nepal: A Descriptive Cross-sectional Study
(Nepal Medical Association, 2021) Singh, Rakesh; Subedi, Madhusudan; Pant, Smriti; Rai, Pragya; Gupta, Krishna Kumar; Pachya, Ambika Thapa; Singh, Kaushal Kumar; Khan, Abdul Sami; Adhikari, Kishor; Sharma, Shanta; Shah, Sanjeev; Singh, Babita
Abstract: Introduction: The outbreak of coronavirus disease in Nepal led medical colleges to suspend in person teaching-learning activities and ultimately online platform was introduced to deliver the contents of medical education. The objective of this study was to describe the perception of medical students towards online teaching-learning introduced during the COVID-19 outbreak in Nepal. Methods: An online survey using a descriptive cross-sectional study design was carried out among 515 undergraduate medical students currently enrolled in medical colleges in Nepal. Ethical approval was sought from Nepal Health Research Council to conduct this study, and digital informed consent was taken from study respondents. A semi-structured questionnaire in Google form was utilized to collect data. The link of the Google form was sent to the potential respondents through email and social media. Descriptive statistics, including frequency, percentage, mean, and standard deviation were used to analyze data in Stastical Package for the Social Sciences version 20. Results: The overall score of perception of online teaching-learning was 17.61Â±7.19, which indicated many problems in this method of teaching-learning. The mean score of perception of online teaching-learning was found to be different across sex, location of enrolled medical colleges, having a personal electronic device, having an internet connection at residence, having separate room/space for attending online classes, and self-rated computer skills. Moreover, only 28 (5.4%) of respondents had perceived online teaching-learning as a better method of delivering content of medical curricula. Conclusions: Surveyed medical students in Nepal were found to perceive many problems in online teaching-learning. Moreover, management and faculty members need to take the necessary measures for enhancing the online teaching-learning quality.
Undergraduate Medical Science Students' Positive Attitude towards Online Classes during COVID-19 Pandemic in a Medical College: A Descriptive Cross-sectional Study
(Nepal Medical Association, 2021) Chalise, Gita Dhakal; Bharati, Mamata; Bajracharya, Jayendra; KC, Ambu; Pradhan, Subhadra; Adhikari, Bibhav; Shrestha, Manoranjan
Abstract: Introduction: The outbreak of COVID-19 led to lockdown, which in turn led to the closure of schools and colleges. This situation created an opportunity to transform the conventional learning methods into an online or virtual method using various digital platforms. Nepalese Army Institute of Health Sciences started online classes as an alternative way to resume education during this pandemic. Therefore, this study aims to identify the prevalence of medical science students with a positive attitude towards online classes during the COVID-19 pandemic in a medical college of Kathmandu, Nepal. Methods: The study was conducted among 513 students using descriptive cross-sectional study design who were currently studying Bachelor of Medicine, Bachelor of Surgery, Proficiency Certificate Level Nursing, Bachelor of Science in Nursing, and Bachelor of Nursing Science under the Nepalese Army Institute of Health Sciences. Data was collected from June-July 2020 through an online self-administered questionnaire using Google forms. The results were presented through frequency, percentage, mean, and standard deviation. Results: In this study, 112 (87.5%) Bachelor of Science in Nursing, 189 (83.6%) Bachelor of Medicine, Bachelor of Surgery, and 63 (82.9%) Bachelor of Science in Nursing students had a positive attitude towards online classes, while 51 (61.5%) of Proficiency Certificate Level Nursing students had a negative attitude towards it. Conclusions: Most bachelor-level students had a positive attitude towards online classes. With a positive attitude, studentsâ€™ participation and adaptability in online classes will be high, resulting in better academic performance.
Clinico-pathological Spectrum of Oral Cavity Lesions at a Tertiary Care Center in Central Nepal: A Descriptive Cross-sectional Study
(Nepal Medical Association, 2021) Bastakoti, Shankar; Shrestha, Gambhir; Gautam, Dej Kumar; Dhungana, Ishan; Jha, Nandita; Pandey, Greta; Upreti, Suraj; Shrestha, Ashmita; Bhatta, Ranjan Raj
Abstract: Introduction: Head and neck cancer is the sixth most common cancer in the world. The disease burden is increasing at an alarming rate in developing Southeast Asian countries. This study aims to report the histopathological spectrum of oral cavity lesions at a tertiary cancer center in central Nepal. Methods: This study included all those cases of oral cavity lesions, of which diagnostic biopsy was done from January 2018 to December 2019. The data were retrieved from the Department of Pathology of BP Koirala Memorial Cancer Hospital. The study proposal was approved by the Institutional Review Committee at BPKMCH (Ref: 247/2020) on 28th June 2020. Convenience sampling was done. Data was analyzed using Statistical Package for the Social Sciences version 20 using descriptive statistics. Results: A total of 851 cases of oral cavity lesions were included in this study. The mean age of the study population was 55.9 years, with male to female ratio of 3:1. Malignant lesions composed of 472 (55.5%) cases followed by premalignant lesion of 104 (12%). More than 453 (95%) malignant cases were squamous cell carcinoma, of which 342 (75%) were a well-differentiated type. The buccal cavity is the most common site of malignant lesion 212 (45%), followed by tongue 96 (20%) and lower gingivobuccal region 86 (18%). Conclusions: Malignant lesions are the most common histopathological findings in the oral cavity lesion with squamous cell carcinoma type. Oral cancer is common cancer that can be prevented and cured if detected early.
Prevalence of Gastritis in a Tertiary Care Centre: A Descriptive Cross-sectional Study
(Nepal Medical Association, 2021) Dhunghana, Durga; Regmi, Yukta Narayan
Abstract: Introduction: Endoscopic examination is one of the commonest procedures done in day-to-day practice in evaluating gastrointestinal problems. Esophagogastroduodenoscopy provides an excellent view of mucosal surfaces of the esophagus, stomach, and proximal duodenum. Upper gastrointestinal endoscopy is utilized for various diagnostic and therapeutic reasons. This study aimed to study the prevalence of gastritis in a tertiary health care center in Pokhara. Methods: A descriptive cross-sectional study was conducted at Gandaki Medical College Teaching Hospital, Pokhara. After ethical approval from the institutional review board with Ref No: 070/2077/2078, endoscopic records of 889 patients undergoing upper gastrointestinal endoscopy from May 2018 to April 2019 were retrospectively reviewed. The convenience sampling method was used. Data entry and descriptive analysis were done in SPSS version 21.0. Descriptive statistics were performed. Results: A total of 889 patients undergoing upper gastrointestinal endoscopy during a period of 12 months period were studied. Among them, females were 472 (53.1%) and males were 417 (46.9%). The mean age of the study population was 45.6 years (SD, 16.86). The majority of the patients belonged to the age group 30 to 50 years. Gastritis was the most common finding in 452 (50.8%) cases. Conclusions: Gastritis was the most common finding in the patients undergoing upper gastrointestinal endoscopy. A significant proportion of people had normal endoscopy findings. Optimal selection of cases is needed to avoid overuse in younger and encourage use in older populations.
Orthopedic Implant Removal in the Department of Orthopedics of a Tertiary Care Centre of Nepal: A Descriptive Cross-sectional Study
(Nepal Medical Association, 2021) Bhandari, Ravi; Dawadi, Pravakar; Magar, Mohit Thapa; Sinha, Ritesh; Kayastha, Nirab; Shah, Rajesh Pratap; Thapa, Bishnu Babu; Magar, Sushil Rana
Abstract: Introduction: Implant removal surgery is one of the common surgical procedures done in orthopedics. Studies report that a major portion of orthopedic surgeries carried out in different institutions comprises implant removal procedures. This can be challenging in limited manpower and infrastructure availability scenarios, like in developing countries like Nepal. This study aims to study the prevalence of orthopedic implant removal procedures carried out among overall surgical procedures in the orthopedic department of a tertiary care center in Nepal. Methods: A descriptive cross-sectional study was performed on the medical records of the department of orthopedics of a tertiary care center after approval from the institutional review committee. The data included records from the starting of 2018 to the end of 2019. Data related to the number of implant removal procedures, types of implants, indications, fracture sites, anesthesia use, gender and age distribution were studied. Statistical Package for Social Sciences version 20 was used to study descriptive data. Results: Out of 2557 orthopedic operations carried out in the study duration, 458 (17.91%) of implant removal procedures were done in the department. The most common age group was the young adult age group, 255 (55.68%). Medium-sized implants were the commonly removed ones, 337 (73.58%). Elective procedures were the most common indication, 369 (80.57%). Conclusions: Implant removal procedures cover a major fraction of overall orthopedic operations carried out by the department, most of which are elective procedures. In limited-resource settings, this can be challenging, and a proper evaluation with counseling could be done before implant removal surgery.
Prevalence of Foreign Body Aspiration in Children in a Tertiary Care Hospital
(Nepal Medical Association, 2021) Dongol, Kripa; Neupane, Yogesh; Dutta, Heempali Das; Gyawali, Bigyan Raj; Kharel, Bijaya
Abstract: Introduction: Foreign body aspiration is a common problem in children with signifi cant mortality and morbidity. This study aims to determine the prevalence of foreign body aspiration in children in a tertiary care hospital of Nepal. Methods: A descriptive cross-sectional study was conducted at Tribhuvan University Teaching Hospital from April 2010 to March 2016 after obtaining ethical approval from Institutional Review Committee (Reference number- 08(6-11)E277/78). All children of age up to 15 years with suspected foreign body aspiration were included. The data was collected from the medical record section and entered in Microsoft Excel. The descriptive statistical analysis was performed. Results: A total of 26,294 patients were included in the study. The prevalence of foreign body aspiration in children was found to be 98 (0.37%). On rigid bronchoscopy, 82 patients (83.6%) were confirmed to have a foreign body in the airway. The peak incidence of foreign body aspiration was seen in patients of age group one to two years. The commonest foreign body in the airway was a peanut. Conclusions: The prevalence of foreign body aspiration in children was low, which is similar to other studies. Foreign body aspiration may lead to dreadful complications. Therefore, both the clinicians and the public need to be cautious about it.
Irritable Bowel Syndrome and Me: A Sworn Rivalry
(Nepal Medical Association, 2021) Shakya, Selika
Abstract: â€œThree more hoursâ€, I tell myself as I find my way to the exam hall. I see a bunch of my classmates cramming for the last minute, and here I am, in a corner, reminding myself that itâ€™s just three more hours till I get away from this horror. Irritable Bowel Syndrome is a gastrointestinal disorder in which there is dull achy lower abdominal pain associated with either diarrhea or constipation. Though it has high prevalence, it is still an underrated disease which can be easily missed in clinical settings.

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