Journal Issue: Volume: 50, No. 187 (2012)
Loading...
Volume
Number
Issue Date
2012
Journal Title
Journal ISSN
JNMA Print ISSN: 0028-2715; Online ISSN: 1815-672X
Journal Volume
Articles
Psychological problems among nursing staff in a hospital
(Nepal Medical Association, 2012) Shakya, DR; Lama, S; Shyangwa, PM
Abstract
Introduction: A high prevalence of psychological/ mental disorders has frequently been reported among nursing staff. However, there is a scarcity of data about ‘psychological, mental and behavioural problems’ among Nepalese nurses. Current study aimed to measure the prevalence of psychiatric problems among nursing staff in a tertiary care hosital.
Methods: All nursing staffs working in the hospital during one year were the subjects of this study. With the informed written consent, the responses to semi-structured proforma and the questionnaire General Health Questionnaire 28 were collected. A semi-structured proforma was used to record socio-demographic, clinical profiles and other information. The GHQ 28 was used to screen major psychiatric disorders. The GHQ 28 gives ‘psychiatric caseness’ to the subjects with score of 4 or more.
Results: Overwhelming majority of nursing staff in BPKIHS is female certificate level staff nurses. Majority were from urban and semi urban settings. Some had job and institute related stressors. Most common among the reported health complaints were low back pain and headache. Few staff revealed psychiatric diagnosis. Among the enrolled 337 subjects, ‘psychiatric caseness’ was present in 34.72%. Some departments (e.g. dialysis, eye, medical, gynecology ward) had proportionately higher ‘psychiatric caseness’ rates than other (e.g. ENT, psychiatry ward, emergency OT, CSSD).
Conclusions: A great proportion of nursing staff suffer from mental and behavioral problems.
Keywords: Hospital; GHQ 28; Mental illness; Nursing staff; Psychology.
Clinical profile of patients with systemic lupus erythematosus
(Nepal Medical Association, 2012) Paudyal, BP; Gyawalee, M
Abstract
Introduction: Clinical features of Systemic lupus erythematosus vary between different parts of the World; however, this information on Nepalese Sytemic lupus erythematosus does not exist.
Methods: Patients with Systemic lupus erythematosus fulfilling the American College of Rheumatology criteria treated in Patan Hospital were studied by means of retrospective review of their case records. The results were compared with various regional and international studies.
Results: The female to male ratio was 36:1 with a mean age at diagnosis 28.67 years. Cutaneous manifestations were the most common 72 (96%) presentations followed by musculoskeletal involvement 70 (93%). Haematological and renal involvements each were present in 33 (44%) of patients. Pulmonary and neuropsychiatric involvements were present in 15 (20%) and 8 (11%) patients respectively. Antinuclear antibody and anti-double stranded deoxyribonucleic acid antibodies were positive in 70 (93%) and 66 (88%) of patients respectively. A quarter of patients had some form of co-morbid conditions. At the time of last follow up, 70 (93%), 66 (90%), and 6 (9%) of patients were taking antimalarials, steroids and immunosuppressive agents
respectively, mostly in combinations. Eighty seven percent of patients had their disease activity under control at the time of last follow up whereas four percent still had an active disease. In another four percent died during the course of therapy and the outcome was unknown in another four percent of patients who lost to follow up.
Conclusions: Clinical characteristics and antinuclear antibody pattern of Nepalese lupus patients is more or less similar to those with patients from other countries in the region and in the World.
Keywords: Clinical profile; Nepal; Systemic lupus erythematosus.
Acute intradialytic complications in end stage renal disease on maintenance hemodialysis
(Nepal Medical Association, 2012) Agrawal, RK; Khakurel, S; Hada, R; Shrestha, D; Baral, A
Abstract
Introduction: Hemodialysis is the preferred method of treatment for Nepalese patients with End Stage Renal Disease. Despite the technological advances and better understanding of physiology associated with hemodialysis, a number of complications are known to be associated with hemodialysis. This study was undertaken to study the frequency of acute intradialytic complications in patients undergoing hemodialysis.
Methods: A cross-sectional study was conducted at Nephrology unit of a tertiary care hospital from 15 June, 2007 to 15 December, 2007. A total of 28 patients were included in the study. Patients with acute renal failure and acute on chronic renal failure were excluded from the study.
Results: Total sessions of hemodialysis during the period were 1455. Hypotensive episode were 66 (4.5%) and was the commonest complication and followed by hypertensive episodes were 58 (3.8%). Other problems encountered were transfusion reactions were 23 episodes (1.5%), rigors not related to transfusions were 13 episodes (0.8%), nausea/vomiting were 20 episodes (1.4%), muscle cramps were 12 episodes (0.8%), hypoglycemia were 6 episodes 5(0.4%).
Conclusions: The frequency of intradialytic complications is low and many of them are not life threatening.
Keywords: Complications; End stage renal disease; Hemodialysis; Hypertension; Hypotension.
Professional satisfaction among B.Sc. nursing graduates of an institute
(Nepal Medical Association, 2012) Mehta, RS; Yadav, R
Abstract
Introduction: Professional Satisfaction is a measure of valuation judgment of whether the expectations are met from the profession or not. This study was conducted to find out the professional satisfaction among pass-out B.Sc. Nursing graduates from an institute from batches 1996 to 2004.
Methods: Descriptive cross-sectional study design was adopted using convenient and snowball sampling technique. Out of 104 graduates, 50 were included in the study. A pre-tested semistructured questionnaire was used by self administration method to collect the information.
Results: Highest satisfaction was with status 36 (75%) and lowest with working condition 27 (54%). The areas with decreasing value of satisfaction were growth and development 36 (72%), achievement and recognition 35 (70%), autonomy and challenging work 35 (69%). The majority of the respondents 27 (54%) stated that there is job security in the profession and the opportunity 26 (52%) to help others was the reason for their satisfaction but 28% said that there is no updating of knowledge and autonomy 15 (30%) in nursing profession.
Conclusions: There is no difference in professional satisfaction of the respondents living in Nepal and abroad. It is seen that though there are many problems and many areas of dissatisfaction in nursing profession the respondents were satisfied to some extent with it and the reason for brain drain among B.Sc. Nursing graduates were their personal interest.
Keywords: Graduate; Nursing; Professional; Satisfaction.
Clinicopathological evaluationof thyroglossal cyst
(Nepal Medical Association, 2012) Paudel, DR
Abstract
Introduction: Thyroglossal cyst is a common congenital anomaly of the thyroid gland. Though malignant transformation is rare one case was a papillary carcinoma in my series.
Methods: Retrospectively thyroglossal cyst who underwent surgery during the period of January 2004 to March 2009 were evaluated.
Results: Age incidence of the cysts in the present series varied between 4 and 41 years. 12 (63%) patients were male and 7 (37%) patients were female. The sites of the lesion were as:thyrohyoid in 13 (68%),suprasternal in 1 (5%) and suprahyoid in 5 (27%) cases. Twelve patients had painless swelling on the neck and 7 had discharging sinus.Pre-operative cytological evaluation showed non-malignancy in all cases.Postoperative histological result turned out to be papillary carcinoma in 1 female patient of 33 years old and the remaining 18 had non-malignancy. This patient with papillary carcinoma had her thyroid gland in its normal position.
Conclusions: Malignant transformation should be ruled out in all cases of thyroglossal cyst and fistula. Post-operatively specimen should be sent for histological examination.
Keywords: Papillary carcinoma;Thyroglossal cyst; Thyroid.