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Successful Outcome of Transfixation Technique with Linen in Dorsal Wrist Ganglion: A Descriptive Cross-sectional Study
(Nepal Medical Association, 2021) Thapa, Pralhad; Lakhey, Rajesh Bahadur
Abstract: Introduction: Ganglion is a commonly encountered soft tissue tumor. Most commonly patients seek treatment for cosmetic issues. There are a variety of treatment options available but very few are effective and cosmetically acceptable. Common treatment techniques have either high recurrence rates or have complications. Treatment by transfixation with linen suture under local anaesthesia on an outpatient basis is an upcoming treatment. The objective of the study is to find out the prevalence of successful outcome of transfixation techniques in treatment of dorsal wrist ganglion. Methods: This study is a descriptive cross-sectional study undertaken at a tertiary care center from November 2018 to May 2020. Ethical approval was taken from the same institution. Convenient sampling method was used. Patients presenting with dorsal wrist ganglion and consenting for the transfixation underwent the procedure. All the patients were operated under local anesthesia. Statistical analysis was done using Statistical Package for Social Sciences version 24.0. Point estimate was done at 95% Confidence Interval and frequency and percentage were calculated. Results: Out of 30 cases, 29 (96.66%) have got successful outcomes with transfixation techniques. Among 30 patients, recurrences were seen in 2 (6.66%) cases. Patient satisfaction was high in 27 (90 %) cases. No complication was encountered. Conclusions: Transfixation technique had good results in terms of low recurrence rate, percentage resolution in size and high patient satisfaction.
Mean Knowledge Score of Self-Medication among First and Second Year Medical and Dental Students in a Medical College: A Descriptive Cross-sectional Study
(Nepal Medical Association, 2021) Kafle, Sajala; Jha, Nisha; Pathyil, Ravi Shankar
Abstract: Introduction: Self-medication is common among medical students. Medical and dental students can also educate the population about the use of medicines. The aim of the study was to find the mean knowledge score of self-medication among first and second year medical and dental students at a medical college in Nepal. Methods: A descriptive cross-sectional study was carried out in a medical college from 1st to 28th February 2021 using a structured online questionnaire after obtaining approval from the Institutional Review Committee (approval number 077/78/32). Convenience sampling method was undertaken. The responses were analyzed using Statistical Package for Social Sciences version 26. Results: Out of 173 students the mean±SD knowledge score was 79.47±6.76. The mean knowledge score of the participants of age group 17-18, 19-20 and 21-22 years were 83.8, 79 and 79.1 respectively. The mean knowledge scores of the male and female participants were 80.2 and 78.6 respectively. Similarly, the knowledge scores of respondents from undergraduate medical and dental backgrounds were 80.1 and 77.7 respectively. Conclusions: Knowledge of self-medication was high among the students. However, educational sessions to further improve and strengthen knowledge can be carried out to improve the knowledge.
Benign Histopathologic Findings of Endometrium among Perimenopausal Women presenting with Abnormal Uterine Bleeding: A Descriptive Cross-sectional Study
(Nepal Medical Association, 2021) Dhakhwa, Ramesh; Bhattarai, Rashmi; Shah, Jayanti; Shakya, Archana; Pradhan, Sailesh
Abstract: Introduction: Abnormal uterine bleeding is the most common presenting complaint in the perimenopausal age group. Endometrial biopsy obtained by dilatation and curettage is the preferred modality of investigation to determine the causative pathology of abnormal uterine bleeding. The objective of this study was to find out the prevalence of the benign histopathological findings in perimenopausal women presenting with abnormal uterine bleeding. Methods: This descriptive cross-sectional study was conducted among patients between 1st June 2020 to 30th September 2021. Ethical approval was taken from the Institutional Review Committee of Kathmandu Medical College (reference number: 305202002). Using the convenience sampling method, 96 cases of endometrial biopsies were studied under light microscopy. Data was analyzed using the Statistical Package for the Social Sciences version23.0. Point estimate at 95% Confidence Interval was calculated along with frequency and proportion for binary data. Results: Among the 96 specimens, the prevalence of benign findings was 93 (96.9%) (93-100 at 95% Confidence Interval). Among them, the commonest benign histopathologic spectrum was hormonal imbalance pattern in 40 (41.7%) followed by normal menstrual pattern 35 (36.5%). Five (5.2%) cases showed chronic endometritis. Six (6.2%) cases of endometrial hyperplasia without atypia were identified. Three (3.1%) cases showed endometrial atrophy. Four (4.1%) cases showed endometrial polyp. Conclusions: The prevalence of benign histopathological findings among endometrial biopsies in the study was similar to other studies.
Persistent Positivity of Reverse Transcriptase-Polymerase Chain Reaction Test among Patients with COVID-19 in Rural Teaching Hospital: A Descriptive Cross-sectional Study
(Nepal Medical Association, 2021) Maharjan, Narayani; Thapa, Niresh; Magar, Bibek Pun; Maharjan, Muna; Tu, Jiancheng
Abstract: Introduction: The persistence positivity detected for severe acute respiratory syndrome coronavirus 2 ribonucleic acid by real-time reverse transcriptase-polymerase chain reaction test in asymptomatic coronavirus disease 2019 positive patients has attracted a lot of attention. There is limited data on the duration of viral shedding. We aimed to determine the proportion of coronavirus disease patients with persistent positivity of real-time reverse transcriptase-polymerase chain reaction test in a teaching hospital of Nepal. Methods: A descriptive cross-sectional study was conducted using medical records from May to September 2020 in a teaching hospital of Nepal. The study was approved by the Institutional Review Committee of Karnali Academy of Health Sciences (Reference no 077/078/03). Convenient sampling method was used. Data was analysed by Statistical Package for the Social Sciences. Point estimate at 90% Confidence Interval was calculated along with frequency and proportion for binary data. Results: Of the total 95 cases, 9 (9.5%) cases (4.6-14.4 at 90% Confidence Interval), were repeat positive after achieving the first negative. The mean day required of achieving the last negative for the repeat positive group was 62.11±3.95, range (60-70 days). The mean time duration for the virus shedding was found to be 20.43±12.19 days (range 7-60 days) after the first positive test result. Conclusions: This study concludes that there might be a persistent positivity of the polymerase chain reaction test among patients with COVID-19. The majority of the patients were test positive for 8-14 days, and some were positive till 60-70 days.
Hyponatremia among Postoperative Children Administered with Hypotonic Fluids in a Tertiary Care Hospital: A Descriptive Cross-sectional Study Authors
(Nepal Medical Association, 2021) Shrestha, Ashish Lal; Jehangir, Susan; Thomas, Reju Joseph
Abstract: Introduction: Hypotonic solutions in postoperative children may cause hyponatremia. Considering humidity and temperatures in India, this study was conducted to find out the prevalence of hyponatremia among postoperative children who were administered with hypotonic solutions in a tertiary care hospital. Methods: A descriptive cross-sectional study was conducted at a tertiary care hospital. Ethical approval was taken from the institutional review board of Christian Medical College, Vellore, India (Reference number: 9177). Children aged less than 15 years undergoing elective surgery, requiring fasting for more than 12 hours post-operatively with normal preoperative electrolytes and renal functions were included. Hypotonic fluids were administered following existent protocol. Electrolytes were repeated immediate postoperatively and at 12-24 hours. Data was entered into and analyzed using the Statistical Package for the Social Sciences version 18.0. Point estimate at 90% Confidence Interval was calculated along with frequency and proportion for binary data. Results: Among 109 participants, hyponatremia in the postoperative period was seen in 53 (48.6%) (40.7-56.5 at 90% Confidence Interval) children. Hyponatremia was found in the immediate postoperative period in 10 (9.2%) children. All received Ringer Lactate as maintenance intra-operatively and none were severe enough to need correction. In the 12–24-hour sample, 43 (39.41%) had hyponatremia and none in severe category. Conclusions: Asymptomatic hyponatremia was noted in normal children planned for elective surgery. Among children managed with the existing institutional perioperative (hypotonic) fluid management protocol, subclinical postoperative hyponatremia within 12-24 hours of surgery was noted in a significant proportion, which was more in the hot and warm months in tropics. There are grounds for switching to isotonic fluids for perioperative management.
Drug-drug Interactions between Hypoglycemic and Non-hypoglycemic Medication in Diabetic Patients with Comorbidities in a Tertiary Care Center: A Descriptive Cross-sectional Study
(Nepal Medical Association, 2021) Tuladhar, Lujaw Ratna; Shrestha, Shirish Lal; Bimali, Sneha; Bhusal, Srijana; Khadka, Pingala
Abstract: Introduction: Drug-drug interaction is one of the causes of adverse drug reactions. Generally, drug-drug interaction is common in multidrug therapy. Diabetic patients, particularly due to associated comorbidities tend to have various drug-drug interactions due to the effect of multiple drugs. The objective of this study was to find out the prevalence of drug-drug interactions in diabetic patients. Methods: It was a descriptive cross-sectional study that was conducted among previously diagnosed diabetic patients visiting the outpatient department of medicine at a tertiary care hospital between March 2021 and August 2021. Ethical approval was taken from the institutional review committee (Ref no: 030-076/077). Data was collected from diabetic patients presenting to the outpatient department of medicine using a preformed self-constructed questionnaire. Convenient sampling was done. Statistical Package for Social Sciences version 21 and Microsoft Excel were used for data analysis. Point estimate at 95% confidence interval was calculated along with frequency and proportion for binary data. Results: The prevalence of drug-drug interaction between hypoglycemic and non-hypoglycemic medication was 56 (44.1%) (35.5-52.7 at 95% Confidence Interval) of the patients out of which at least one drug-drug interaction was seen in 48 (37.8%) of the patients. Conclusions: Our study showed the prevalence of drug-drug interactions in diabetic patients to be higher than other studies done in similar settings. Based on the severity, we observed two types of drug-drug interactions; close monitoring drug-drug interactions and minor drug-drug interactions.
Knowledge of Oral Cancer among Online Respondent General Dentists: A Cross-sectional Survey Authors
(Nepal Medical Association, 2021) Ojha, Bidhata; Bajracharya, Dipshikha; Baral, Radha
Abstract: Introduction: Oral cancer is a worldwide medical issue with expanding paces of occurrence and rising mortality rates. Oral cancer is the sixth most common cancer in Nepal with a prevalence of 4.6%. Examination of the oral cavity includes evaluating all teeth, supporting tissue, and surrounding oral tissue and recording the condition of these structures. The present study was conducted to find out the knowledge of oral cancer among general dental practitioners responding to a general survey. Methods: A cross-sectional survey was conducted among general dental practitioners from March 2020 to July 2020 in 234 sample sizes. Convenience sampling technique was used. Data collection was done after taking ethical approval from the Institutional Review committee (Ref no. 10/020). Data collection was done using a self-administered questionnaire through Google forms. Data analysis was done using Statistical Package of the Social Sciences version 20 software. Results: Our study showed that most of the participants i.e. 131 (56.2%) have moderately adequate knowledge about oral cancer. One-hundred and eighty four (78.6%) and 178 (76.1%) identified smokeless tobacco and smoking tobacco as high-risk factors for oral cancer. Two-hundred (85.5%) participants recognised buccal/labial mucosa as a common site for oral cancer. And, 138 (59.2%) have knowledge about early detection of oral cancer. Conclusions: Our study highlights that general dentists have moderate knowledge regarding oral cancer and. Study also states that more practical knowledge and training should be included in undergraduate programs.
Non-Steroidal Anti-Inflammatory Drugs in Orthopedic Outpatient Cases in a Tertiary Care Teaching Hospital: A Descriptive Cross-sectional Study
(Nepal Medical Association, 2021) Bhattarai, Aashish; Khanal, Krishna Raj; Bharati, Jyoti Prabha
Abstract: Introduction: Non-steroidal anti-inflammatory drugs are major drugs in treatment of pain and inflammation of different orthopedic conditions. There are different classes of non-steroidal anti-Inflammatory Drugs based on their selectivity to cyclooxygenase enzyme which has significant differences in safety profile. This study aims to determine the prevalence of non-steroidal anti-inflammatory drugs prescription in the orthopaedic outpatient department of a tertiary care hospital. Methods: This was a descriptive cross-sectional study conducted among the patients in the orthopedic outpatient department of tertiary care hospital from December 2020 to March 2021. Ethical approval was taken from the Institutional Review Committee of the college (Ref: 0311202007). Convenient sampling was done. A structured proforma was used with consent. The data were analyzed with Social Statistical Package for the Social Sciences version 20. Point estimate at 95% Confidence Interval was done and frequency and percentage were calculated. Results: Out of 140 orthopaedic out patient department prescriptions screened, 118 (84.28%) (78.25-90.30 at 95% Confidence Interval) prescriptions included non-steroidal anti-inflammatory drugs. Aceclofenac 76 (64.4%) was the most prescribed non-steroidal anti-inflammatory drug. Conclusions: Aceclofenac was the most preferred agent for the treatment in the department of orthopedics. The most common proton pump inhibitor used alone with non-steroidal anti-inflammatory drugs was rabeprazole.
Inducible Clindamycin Resistant Staphylococcus aureus among Patients Attending Tertiary Care Centre: A Descriptive Cross-sectional Study
(Nepal Medical Association, 2021) Pradhan, Shanti; Regmi, Sanjib Mani; Shrestha, Nabina
Abstract: Introduction: Staphylococcus aureus, a superbug, resistant to multiple antibiotics led to growing interest in the usage of macrolide-lincosamide-streptogramin B antibiotics, which are now rapidly developing resistance. This study aims to find the prevalence of inducible clindamycin-resistant Staphylococcus aureus among obtained clinical samples from in-patient and out-patient departments of a tertiary care center. Methods: This is a descriptive cross-sectional study done in clinical samples from the in-patient and out-patient departments of a tertiary care center from September 2020-May 2021. Ethical clearance was taken from the Institutional Review Committee (Ref: 068/2077/2078). Staphylococcus aureus were isolated and antibiotic susceptibility tests were performed by disc diffusion method. Inducible clindamycin and methicillin resistance Staphylococcus aureus were detected using D-test and cefoxitin disc according to Clinical and Laboratory Standards Institute guidelines. Convenient sampling was done and the data was analyzed using Statistical Package for Social Sciences version 20. Point estimate at 95% confidence interval was calculated along with frequency and proportion for binary data. Results: Among a total of 141 Staphylococcus aureus isolated, the prevalence of inducible clindamycin resistant phenotype was 41 (29.1%) (21.6-36.59 at 95% Confidence Interval). Whereas, 30 (21.3%) were constitutive clindamycin resistant. The inducible 28 (47.5%) and 19 (32.2%) constitutive clindamycin resistance was higher among methicillin-resistant Staphylococcus aureus. Conclusions: The frequency of inducible clindamycin resistance among methicillin resistant Staphylococcus aureus was high, which alarms the use of macrolide-lincosamide-streptogramin B antibiotics in Staphylococcus aureus infections. Hence, D-test should be performed to detect inducible clindamycin resistance in routine testing to prevent treatment failure.
Benign Skin Neoplasms among the Histopathological Specimens of Skin Neoplasm in a Teaching Hospital: A Descriptive Cross-sectional Study
(Nepal Medical Association, 2021) Thapa, Sushma; Ghosh, Arnab; Ghartimagar, Dilasma; Regmi, Sudeep
Abstract: Introduction: Skin tumors are relatively uncommon malignancies worldwide, but its incidence has been progressively increased over the last few decades. Skin tumor belongs to a diverse group of neoplasms arising from the epidermis, adnexal structures and dermis rendering the classification difficult. The study aims to find out the prevalence of benign skin neoplasm among the histopathological specimens of skin neoplasm of a teaching hospital. Methods: A descriptive cross-sectional study among the hospital records of histopathological samples of skin neoplasm in the Department of Pathology of a tertiary care center from January 2017 to December 2020. Ethical approval was taken from the Institutional Review Committee (Ref: MEMG/IRC/427/GA). Convenient sampling was done. Data were entered in Microsoft Excel and analyzed using Statistical Package for the Social Sciences version 21 software. Point estimate at 95% Confidence Interval was calculated with frequency and descriptive statistics. Results: Out of total skin neoplasm samples, 121 (57.34%) (50.67-64.01 at 95% Confidence Interval) benign skin neoplasms were present. Among them, the majority were keratinocytic tumor 81 (66.9%) followed by skin appendageal 23 (19.0%) and melanocytic tumors 17 (14.0%). Acrochordan 18 (14.9%) and pilomatricoma 12 (9.9%) were the predominant keratinocytic and appendageal neoplasms respectively. Most of the cases occurred in head and neck region 64 (52.9%). Conclusions: The study concluded that the prevalence of benign skin neoplasm was slightly lower compared to the other studies. Most of the benign skin neoplasms were keratinocytic tumors followed by appendageal and melanocytic tumors. Acrochordan was the commonest benign keratinocytic tumor.
Abnormal Ultrasonographic Findings among Referred Patients with Pain Abdomen in the Radiology Department of a Tertiary Care Center: A Descriptive Cross-sectional Study
(Nepal Medical Association, 2021) Mulmi, Smriti; Shrestha, Marina Vaidya; Pradhan, Sanjeev
Abstract: Introduction: Correct and prompt diagnosis is essential for the appropriate management of patients. Often, children and their caretakers cannot provide a reliable history to allow clinicians to determine the cause of the pain. This study's objective was to find out the prevalence of abnormal ultrasonographic findings among referred patients with pain abdomen in the radiology department of a tertiary care center of Nepal. Methods: A descriptive cross-sectional study was conducted among patients in the out-patient and emergency department with complaints of abdominal pain from 2021 April 5 to August 30 in a tertiary care hospital. Ethical clearance was taken from IRC (registration no: 423/2021). The convenience sampling method was used. Written informed consent was taken from each study participant. Collected data were entered and analyzed on Statistical Package for the Social Sciences version 20. Point estimate at 95% Confidence Interval was calculated along with frequency and percentage for binary data. Results: Among 250 patients with pain abdomen referred to the department of radiology, 169 (67.6%) (61.80-73.40 at 95% Confidence Interval) had abnormal ultrasonographic findings. Mean age of the patients was 39.4±17.9 years. Initial clinical diagnosis was in agreement with the abdominal ultrasound diagnosis in 57 (22.8%) patients. For the remaining 193 patients, the diagnosis obtained from abdominal ultrasound differed from the initial clinical diagnosis. Conclusions: Most of the cases of pain abdomen showed abnormalities in ultrasound. Clinical evaluation should be used together with ultrasound abdomen in order to arrive at a correct diagnosis.
Robson’s Group 2 Criteria among Total Caesarean Sections in a Tertiary Care Hospital: A Descriptive Cross-sectional Study
(Nepal Medical Association, 2021) Gautam, Pratigyan; Karki, Chanda; Adhikari, Asmita
Abstract: Introduction: Globally, there is a dramatic rise in cesarean section rate which has increased the maternal morbidity and adverse effects in a subsequent pregnancy. Robson’s classification will aid in the optimization of the cesarean section use, assessment of the strategies aimed to decrease the cesarean section rate and thus improve the clinical practices and quality of care in various health care facilities. The main aim of this study is to find out the prevalence of caesarean section for Robson’s group 2 among total caesarean sections done in a tertiary care hospital. Methods: A descriptive cross-sectional study was carried out at a tertiary care centre in Nepal from August 2020 to January 2021. Ethical approval was taken from the institutional review committee (reference number: 1607202003) and data were entered using Robson’s criteria. The convenient sampling technique was used. Data was analyzed using Microsoft Excel. Point estimate at 95% Confidence Interval was calculated along with frequency and percentage for binary data. Results: According to Robson’s group 10 classification, among 380 caesarean sections, 110 (28.94%) (24.38-33.50 at 95% Confidence Interval) cases were in Robson’s group number 2. Conclusions: This study showed that the prevalence of caesarean section which lies in Robson’s group 2 in our study is higher than the standard of World Health Organization. It showed that Robson’s group 2 was one of the significant contributors to the greater caesarean section rate. Improved case selection, standardization, and protocol for induction of labour as well as regular audit could also reduce caesarean section rates.
Fungal Infections among Teledermatology Consultations in Dermatology Department of a Tertiary Care Hospital: A Descriptive Cross-sectional Study
(Nepal Medical Association, 2021) Jha, Sagar Mani; Dangol, Anil Kumar Singh; Suwal, Bhabendra; Yadav, Jyotshna
Abstract: Introduction: Teledermatology provides virtual consultation to patients using telecommunication technology. Using this method dermatologists can diagnose a condition with the help of pictures of the lesions and short history. During the COVID-19 pandemic, practicing this method has become more relevant. Providing teleconsultations to patients with fungal skin infections can prevent inadvertent use of topical corticosteroids. The objective of this study was to find the prevalence of fungal infections among teledermatology consultations done in a tertiary care hospital. Methods: It was a descriptive cross-sectional study where the store and forward and real-time methods were used between February 2020 to July 2020. Ethical clearance was taken from the institutional review board (reference number: 245). Data of those patients who wanted consultations from this department were sent by medical officers deployed in military hospitals that are under the central army hospital located in Kathmandu. Convenient sampling was used. The collected data was entered and analyzed in the Statistical Package of Social Sciences version 20. Point estimate at 95% Confidence Interval was calculated along with frequency and percentage for binary data. Results: A total of 451 (33.45%) (30.93-35.97 at 95% Confidence Interval) were diagnosed with fungal infections out of 1348 patients who were enrolled for the study. About 361 (80%) of the patients suffering from fungal infections belonged to the Terai region and 90 (20%) belonged to mountainous areas. Conclusions: The prevalence of fungal infection among teledermatology consultation was lower than the findings from a similar international study.
Sputum Smear Non-conversion at the End of Intensive Phase of Tuberculosis Treatment at a Tertiary Center: A Descriptive Cross-sectional study
(Nepal Medical Association, 2021) Shah, Naveen Prakash; Regmi, Anil; Acharya, Aakash; K.C., Jwala; Khatiwada, Bidur; Hada, Meera
Abstract: Introduction: Sputum non-conversion is smear positive tuberculosis despite anti-tubercular therapy. Various factors may lead to sputum non-conversion including resistance to anti-tubercular drugs, age, gender, disease severity, non-compliance, drugs unavailability etc. Little is known and studied about the contribution of these individual factors. Our study sought to determine the prevalence of sputum smear non-conversion in patients at the end of intensive phase of tuberculosis treatment visiting a tertiary-level institution in Nepal. Methods: A descriptive cross-sectional study was conducted among recorded data of patients undergoing sputum Acid Fast Bacilli staining at the end of intensive phase at National Tuberculosis Control Center from April 2018 to April 2020. The study was approved by Nepal Health Research Council (Registration no: 76012020 P). The convenient sampling method was adopted. The data were analyzed using Microsoft Excel. Point estimate at 95% Confidence Interval was calculated along with frequency and proportion for binary data. Results: Our study found that out of 830 samples that were tested by Acid Fast Bacilli stain at the end of intensive phase, 40 (4.82%) (3.37-6.28 at 95% Confidence Interval) were sputum smear non-converters. The mean age of sputum non-converters was 41.25±15.543 years. Conclusions: The study shows that a significant proportion of patients remain acid-fast stain positive despite the treatment. However, the proportion is low compared to other similar studies around the globe. This study provides program managers with evidence to support the development of more tailored tuberculosis care and need to conduct more intensive studies about various factors that may lead to non-conversion.
Use of Postpartum Family Planning among Women Undergoing Deliveries in a Tertiary Care Hospital: A Descriptive Cross-sectional Study Authors
(Nepal Medical Association, 2021) Pradhan, Noora; Dongol, Anjana; Bastakoti, Rashmi; Karmacharya, Shailendra Bir; Shrestha, Om Hari
Abstract: Introduction: The postpartum period is a high-risk time for unintended pregnancies. A short inter-pregnancy interval leads to a series of complications for both the mother and the fetus. Postpartum contraceptive knowledge helps women decide the time frame for future pregnancy and prepare. The study aimed to find out the prevalence of postpartum family planning among women undergoing deliveries in a tertiary care hospital. Methods: A descriptive cross-sectional study was conducted from hospital records of all postpartum women delivering in a tertiary care hospital from Jan 2017 to Jan 2019. Ethical approval was taken from the Institutional Review Committee (IRC) of Kathmandu University School of Medical Sciences/Dhulikhel Hospital (reference number: 62/19). Convenience sampling was done. Data was entered and analyzed using Statistical Package of the Social Sciences version 26. Point estimate at 95% Confidence Interval was calculated along with frequency and proportion for binary data. Results: Out of 4205 deliveries, 1211 (28.7%) (27.33-30.06 at 95% Confidence Interval) women utilized postpartum family planning. Depot-medroxyprogesterone acetate was adopted by a majority of the participants 802 (19.1%). Conclusions: The use of postpartum contraception in this study was similar to the findings from studies done in national data and studies.
Road Traffic Accidents Presenting to the Emergency Department of a Tertiary Care Center: A Descriptive Cross-sectional Study
(Nepal Medical Association, 2021) Jha, Rohan; Pathak, Priya; Koirala, Pallavi; Maharjan, Bishwash; Panthi, Srijana
Abstract: Introduction: Road Traffic Accidents have emerged as the leading cause of mortality and morbidity globally. The burden of road traffic accidents has escalated gradually in Nepal and is a common cause of injury and trauma. The study aims to identify the prevalence of road traffic accidents in the emergency department. Methods: This descriptive cross-sectional study was conducted among hospital records of cases admitted to the emergency department of tertiary care hospital between March to August, 2020. Ethical approval was taken from the ethical review board of College of Medical Sciences (reference number: 2020-035). Information was collected through pro-forma and hospital records. Convenience sampling was done. The data were entered in the Statistical Package for the Social Sciences version 24 and analysed using descriptive statistics. Point estimate at 95% Confidence Interval was calculated along with frequency and proportion for binary data. Results: Among 4050 cases presenting to the emergency department, 228 (5.6%) (4.9-6.3 at 95% Confidence Interval) cases of road traffic accidents were seen. The most common injuries involved were soft tissue injury 90 (39.47%) and head injury 77 (33.77%). Most patients admitted to the hospital were male 178 (78.07%) aged 21 to 30 years 79 (41.38%). The vehicles mostly involved in the accidents were motorized two-wheelers 120 (50.6%) and pedestrians 51 (22.4%). Conclusions: The prevalence of road traffic accidents was similar to the findings from similar studies. Strengthening the capacities of the pre-hospital care and emergency department is necessary along with preventive intervention in public to reduce such health burden.
Perinatal Mortality among All Deliveries in a Tertiary Care Center: A Descriptive Cross-sectional Study Authors
(Nepal Medical Association, 2021) Bhattarai, Saraswoti Kumari Gautam; Ghimire, Roshana; Duwadi, Sapana; Khadka, Rabin; Gautam, Kanchan
Abstract: Introduction: Perinatal mortality comprises the number of stillbirths and death of newborns within seven days of life which is the main contributor to infant and maternal mortality. The aim of this study was to find out the prevalence of perinatal mortality among all the deliveries in a tertiary care center of a remote part of Nepal. Methods: This was a descriptive cross-sectional study conducted in a tertiary care center located in Jumla among 3798 deliveries (childbirth) from August 2014 to April 2020. Ethical approval was taken from the institutional review committee (2076/2077/05) of the same institution. A convenience sampling technique was used and the data were collected from the medical record section and then entered and analyzed in Statistical Package for Social Sciences version 16. Point estimate at 95% Confidence Interval was calculated along with frequencies and percentages for binary data. Results: The prevalence of perinatal mortality was 187 (4.92%) (4.23-4.60% at 95% Confidence Interval) among 3798 deliveries. Regarding the primary causes; the highest proportion was intrapartum hypoxia 62 (33.3%), spontaneous preterm labor 40 (21.5%), and congenital anomalies 38 (20.4%). Similarly, about the final cause; the highest proportion was birth asphyxia 64 (34.2%), intrauterine fetal death 51 (27.3%), congenital anomalies 35 (18.7%), and complication of prematurity 32 (17.1%). Conclusions: The perinatal mortality was quite high in this study with respect to similar studies done in other countries. The finding of this study showed that quality antenatal care with rural ultrasound service is essential to reduce the causes of perinatal mortality.
Ways to Make Medical Students Competent Professionally: View of Medical Students Authors
(Nepal Medical Association, 2021) Khadka, Manoj; Kunwar, Bibash
Abstract: Medical students in Nepal learn passively by gaining encyclopedic knowledge, with little focus on the application of that knowledge to clinical scenarios and other soft skills like communication. This raises the question that whether medical students will be competent enough to serve their society in the future or not. The article highlights the domains where medical students should focus apart from medical knowledge to be competent enough to meet the health needs of society.
The Scope of Telemedicine in Nepal during COVID-19 Pandemic
(Nepal Medical Association, 2021) Koirala, Sanjib; Parajuli, Bibek Raj
Abstract: The government of Nepal proposed to provide health services for both COVID and non-COVID infected patients through telemedicine.After the outbreak of the COVID-19 in Nepal, the number of people taking online health services, including counselling, increased by 70% as compared to last year in the Kathmandu valley. People being depressed staying alone in isolation and quarantine can get an opportunity to talk and share their problems with doctors through the means of telemedicine. Telemedicine has saved the time, effort and money of people living in remote areas.
Multiple Neonatal Teeth in a Preterm Neonate: A Case Report Authors
(Nepal Medical Association, 2021) Gautam, Uttara; Phuyal, Rajan; Sapkota, Abhin; Chikanbanjar, Vijaya Kumar
Abstract: Prematurity and low birth weight are significantly associated with delayed dentition. Few cases of the eruption of a tooth immediately at or after birth in preterm neonates have been reported in the literature, although this is a rare presentation. The aetiology of this rare biological aberration is yet to be established but has been associated with hereditary predilection, nutritional factor, endocrine causes, infection, and some syndromes. Here, we present a case of a preterm male neonate at 28 weeks of gestation with very low birth weight and respiratory distress who presented with three neonatal teeth, two maxillary central incisors, and one mandibular central incisor and its subsequent management.

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