Journal Issue: Volume: 18, No 3, Issue 71, JULY-SEPT, 2020
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Volume
Number
Issue Date
2020
Journal Title
Journal ISSN
1812-2027
Journal Volume
Articles
Global Burden of Disease, Air Pollution and COVID-19
(Kathmandu University, 2020) Dhimal, M; Shrestha, R
NA
Clinico-pathological Profile of Kidney Biopsy Patients in a Tertiary Hospital of Central Nepal
(Kathmandu University, 2020) Ghimire, M; Vaidya, S; Upadhyay, HP
ABSTRACT
Background
Kidney biopsy is an important diagnostic tool in Nephrology. As of now, we don’t have
a central kidney biopsy registry in our country and there are many studies showing
heterogeneous patterns of pathologies observed in the country. We thought of
looking on the clinico-pathological profile of kidney biopsy patients prevailing in our
centre.
Objective
This study was carried out with an objective to know the clinico-pathological profile
of kidney biopsy patients prevailing in our centre.
Method
This was a hospital based, prospective, observational study carried out in a tertiary
teaching hospital of Chitwan over a period of 3 years from May 2016 to April 2019.
All the consecutive kidney biopsy patients were included in the study. The indication
of kidney biopsies were the standard indication based on clinical presentation and
investigations. The patient`s demographic profile, indication of kidney biopsy and
histological patterns were studied and analysed using appropriate statistical tools.
Result
A total of 210 kidney biopsies were analysed over a period of three years, that makes
around 5-6 biopsies per month. The mean age of the patient was 35.7 ± 14.9 years.
Male were 106 (50.5) and females were 104 (49.5) with male to female ratio of
1.01. The average number of glomeruli was 23.4 ± 11.0. The commonest indication
of kidney biopsy and histological pattern were nephrotic syndrome 56 (26.7) and
IgA nephropathy 51 (24.2) respectively. Among nephrotic syndrome group, the
commonest histological pattern was minimal change disease 21 (37.5). Non-diabetic
kidney diseases in diabetes were seen in eight (53.4) diabetic patients making it a
significant problem in diabetes and the commonest histological pattern in them were
minimal change disease and idiopathic cresentic glomerulonephritis two (13.3) each.
Conclusion
The commonest indication and histological pattern of the kidney biopsy were
nephrotic syndrome 56 (26.7), and IgA Nephropathy 51 (24.2) respectively. Non-
diabetic kidney diseases in diabetes were seen in eight (53.4) of the diabetic patient
making it a significant problem in diabetes and the commonest histological pattern
in them were minimal change disease and idiopathic cresentic glomerulonephritis
two (13.3) each.
KEY WORDS
IgA nephropathy, Kidney biopsy, Nephrotic syndrome
Intraoperative Infusion of Magnesium Sulphate does not Reduce Laryngospasm and Agitation during Emergence from Anaesthesia in Children
(Kathmandu University, 2020) Khatiwada, S; Pokharel, K; Subedi, A
ABSTRACT
Background
Laryngospasm and agitation during emergence from general anaesthesia are frequent
in children. Magnesium sulphate may have the potential of reducing both of these
adverse events. In addition, magnesium has analgesic and anaesthetic properties.
Objective
To find out the effectiveness of magnesium sulphate in reducing the occurrence of
emergence laryngospasm and agitation and other adverse events if any in children.
Method
Randomized, placebo controlled study was conducted at a tertiary care hospital
in 132 children, aged 3-12 years undergoing general anaesthesia for hernia and
hydrocele surgery. Children with American Society of Anaesthesiologist Physical
Status > II were excluded. After insertion of laryngeal mask airway, 20 ml of either
magnesium sulphate 15 mg/kg (Group M) or normal saline (Group N) was infused at
the rate of 1 ml/min. The severity of laryngospasm and agitation was assessed. We
also noted other adverse events, if occurred.
Result
Laryngospasm occurred in 7(10.6%) patients of group M and in 10(15.1%) patients
of group N(p=0.40). While 14(10.6%) patients developed laryngospasm immediately
after removal of LMA, only 3(2.2%) patients developed it in the post anaesthetic
care unit. Two (3.0%) patients of group M and four patients (6.0%) of group N were
agitated (p=0.40). Three (4.5%) patients of group M and 14(21.2%) patients of group
N coughed during emergence (p=0.004).
Conclusion
Intraoperative infusion of 15 mg/kg magnesium sulphate, does not reduce the
occurrence of emergence laryngospasm and agitation in children. However, it
significantly reduce emergence cough.
KEY WORDS
Agitation, Cough, Emergence laryngospasm, Pediatric anaesthesia
Factors Influencing Male Participation in Maternal Health Care among Married Couples in Nepal: A Population-based Cross-sectional Study
(Kathmandu University, 2020) Sharma, S; Aryal, UR; Shrestha, A
ABSTRACT
Background
The male involvement in maternal health care is essential to reduce obstetric
complications. However, there is little known about factors contributing to male
participation in maternal health in Nepal.
Objective
To assess predisposing, enabling and reinforcing factors contributing male
participation in maternal health care in Nepal.
Method
A population based cross-sectional study was conducted among 374 married couples.
Ethical approval was obtained from Institutional Review Board of Kathmandu Medical
College Teaching Hospital. The data was collected, using modified Safe Motherhood
and Partnership Family Approach Model. Multivariable logistic regression was applied
to account associated paternal factors. Concentration curve and concentration index
were computed to measure equity gap between lowest and highest quintiles.
Result
While four out of ten husbands reported high level of their involvement in maternal
health care practices, wives reported relatively less involvement of their husbands.
Logistic regression showed that husband having low family income, knows about
immunization, contact with family planning providers were more likely to participate.
In contrary, according to wives, husbands’ who have ever been to health facility,
discuss family planning with others, contact with family planning providers and who
knows about exclusive breast feeding were less likely to participate. The study also
showed that socio-economic factors play a significant role.
Conclusion
Male involvement in maternal health care practices is low. Predisposing, enabling
and reinforcing factors play a significant role; however, some contradictions among
husbands’ and wives’ perspectives provide strong evidence on significance of
communication within partners on maternal health care issues.
KEY WORDS
Disparity, Male participation, Reproductive health, Sexual health, Women’s health
A Community Based Cross Sectional Study to Estimate the Prevalence and Associated Factors of Hypertension in Rural Nepal
(Kathmandu Unversity, 2020) Chataut, J; Jonchhe, S; Tamrakar, D
ABSTRACT
Background
Hypertension is a major global public health problem because of its high prevalence as
it significantly increases the risk of heart attack, stroke, kidney failure and blindness.
Epidemiological shift in prevalence of non-communicable diseases have been
observed in Nepal and it is also evident that hypertension and related complications
are major contributors to death and disability in Nepal.
Objective
To estimate the prevalence and explore the associated factors of hypertension in
study population.
Method
A community based cross-sectional study was conducted in rural population of
Nepal with multistage sampling design. A total of 422 participants aged 18 to 65
years of age participated in the study. The information was obtained using pretested
questionnaire which included demographic information of individuals and other risk
factors like alcohol and tobacco use, physical activity. Anthropometric measurements
and blood pressure was recorded and hypertension was defined as per JNC VII
criteria.
Result
The overall prevalence of hypertension was 27.7% (male: 32.7%, female: 19.8%).
Mean systolic and diastolic BP were 123.79 ± 12.46 mmHg and 81.56 ± 8.32 mmHg,
respectively. Age (eldest age group, AOR=4.92: CI: 1.24-19.46), participants with
lower level of education (higher education, AOR=0.173: CI: 0.05-0.53), ethnicity
(Janajatis, AOR=2.85: CI: 1.44-5.65) and smoking (current smokers, AOR=10.30: CI:
4.39-24.16) are found to be significantly associated with hypertension.
Conclusion
This study showed the prevalence of hypertension is high in study population.
Increasing age, low level of education, ethnicity and smoking were independent risk
factors for hypertension.
KEY WORDS
Hypertension, Prevalence, Risk factor