Journal Issue: Volume: 22, No 2, Issue 86 (APRIL - JUNE), 2024
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Volume
Number
Issue Date
2024
Journal Title
Journal ISSN
1812-2027
Journal Volume
Articles
Workplace Violence in Health Care: Deciphering an Emerging Crisis
(Kathmandu University, 2024) Nepal, O
NA
Assessment of Cardiopulmonary Fitness and Physical Activity in Health Science Students
(Kathmandu University, 2024) Pun, DB; Jha, JP; Magar, BP; Thapa, B
ABSTRACT
Background
Insufficient physical activity and poor cardiopulmonary fitness increases the risk of
chronic diseases and premature mortality. Sedentary lifestyle is observed among
young health science students.
Objective
To assess cardiopulmonary fitness and physical activity levels among health science
students at Jumla.
Method
A cross-sectional study was conducted on health science students at Karnali Academy,
Jumla. Cardiopulmonary fitness was assessed using the Queen’s College Step Test
to calculate VO2max. International Physical Activity Questionnaire was applied to
measure physical activity in terms of Metabolic Equivalent of Task (MET) value. Data
analysis utilized GNU-PSPP software with descriptive and inferential statistics.
Result
Total 107 students participated (56 females), aged 18-37 years. Their median VO2max
was 40.05 ml/kg/min, significantly higher in males [51.69 (IQR 45.81 – 57.57)] than
females [36.37 (IQR 34.90 – 38.58)] (p<0.001). Median weekly physical activity was
1030 MET-minutes/week, with males reporting higher levels [1436 (962 - 2670)]
than females [678 (414 – 1103)] (p<0.001). VO2max had a positive correlation with
total MET value per week (r = 0.504, p<0.001), and negative correlation with body
adiposity (p<0.02). Multiple linear regression revealed physical activity level, sex, and
BMI as significant predictors of VO2max (p<0.01).
Conclusion
Health science students at Karnali Academy have average levels of cardiopulmonary
fitness and physical activity, lower in females. Targeted interventions can improve
their fitness, benefiting the wider population in future. Further research should
explore barriers to physical activity and factors influencing healthy lifestyle adoption
among health science students in this region.
KEY WORDS
Exercise, Health occupations, Physical fitness, Students
Clinical and Functional Outcome of Schatzker Type V and VI Tibial Plateau Fracture Treated by Open Reduction and Internal Fixation
(Kathmandu University, 2024) Ranabhat, A; Yang, C; Zhanpeng, G
ABSTRACT
Background
One of the most challenging intra-articular fractures to treat is tibial plateau fracture
type V and VI because of its controversial treatment protocol. Surgical intervention
is the most compatible modality to achieve stable internal fixation and early joint
movements. Although the soft tissue is compromised and chance of infection is high
due to long exposure time, but the outcome is good after surgery.
Objective
To evaluate the clinical and functional outcome treated with open reduction and
internal fixation (ORIF) and factors effecting the outcome of the patients.
Method
We treated 52 cases of Schatzker type V and VI tibial plateau fracture from April 2018
to May 2020. All of them were managed surgically and the outcomes were evaluated
with regular follow ups using oxford knee scoring (OKS) criteria.
Result
Forty-three cases (82.7%) had excellent Oxford Knee Scoring (OKS). Wound infections
were seen in 5 cases resulting poor outcome (Mean 24.0 compared to 44.7, p =
0.007). Female patients had better outcome in comparison to male patients (Mean
45.0 compared to 41.5, p = 0.041). Older patients had poor outcomes with negative
correlation of 0.371, p = 0.007.
Conclusion
Open Reduction and Internal fixation in Schatzker type V and VI tibial plateau
fractures is an excellent treatment option to achieve good clinical and functional
outcome within short period of time interval with very minimum chance of malunion
and other complications improving the patients’ quality of life. Age, gender and
infection are some of the factors that alters the outcome.
KEY WORDS
Open reduction and internal fixation, Outcome, Tibial plateau fracture
Prevalence of Renal and Urinary Tract Diseases among Pediatric Cases Admitted in a Tertiary Hospital in Developing Country
(Kathmandu University, 2024) Gautam, S; Gautam, P; Chaudhary, A; Dahal, A; Giri, P; Poudel, S
ABSTRACT
Background
Kidney disease includes diseases of the glomerulus, tubular disorders, and conditions
associated with hematuria or proteinuria. Urinalysis can be a reliable and easy tool
to screen.
Objective
In this study, we aim to study the prevalence of renal and urinary tract diseases
among the pediatric population in a tertiary hospital in Nepal.
Method
A single-center retrospective cross-sectional study was conducted from 2022 to
2023 in the pediatric department. Information was obtained regarding clinical-
epidemiological profile, associated condition, investigations, diagnosis, and duration
of hospital stay, management, and outcome.
Result
The prevalence of renal disease was 5.6%, with urinary tract infection being the most
common diagnosis. Maximum cases presented between one and five years with a
male-to-female ratio of 1.1:1 and 80.9% of the patients had new onset disease. The
mean duration of hospital stay was six days. The mortality rate in renal diseases was
3.2%.
Conclusion
Renal diseases make up a significant portion of pediatric admissions. Renal diseases
contribute to significant morbidity and mortality. A large number of cases of renal
diseases are due to infective etiology hence they are preventable and curable. Renal
disease in children presents with vague symptoms and signs. Routine screening of
renal diseases is needed for early diagnosis and reduction in morbidity and mortality.
KEY WORDS
Kidney diseases, Pediatrics, Urinary tract infection
Assessing Drug Utilization in the Emergency Medicine Department at a Tertiary Care Teaching Hospital Using WHO Drug Use Indicators
(Kathmandu University, 2024) Jha, N; Manandhar, T; Oli, E; KC, P; Jha, AK; Karki, PS; Hada Batajoo, K; Shankar, PR
ABSTRACT
Background
Patients might need urgent care in critical cases. Limited resources and limited
manpower are limitations seen in developing countries. Very few studies have been
conducted on drug utilization in the emergency department in Nepal.
Objective
To find out the drug utilization pattern and the cost of medicines in emergency
medicine department as per WHO drug use indicators.
Method
The study design was a hospital based retrospective cross-sectional study done at
the emergency department of KIST Medical College and Teaching Hospital, Lalitpur,
Nepal. The study population were patients visiting the emergency department. The
data was collected during the period from April to June 2023. Data was collected
for one month from each quarter for the year 2023 from the medical records of the
patients from the medical records section. A structured proforma was used for the
data collection process. Census sampling method was used.
Result
Maximum patients, 257 (25.1%) were from age group 21-30 years. Females were
slightly more than males, 537 (50.5%). The top three diagnosis among the admitted
patients were soft tissue injury, 148 (13.9%), dengue fever, 138 (12.9%) and viral
fever, 51 (4.7%). Maximum patients, 346 (32.5%) were given two therapeutic classes
of drugs, followed by only one therapeutic class of drug for 251 (23.6%) patients. The
common classes of drugs prescribed for the patients were analgesics, 639 (60.1%)
followed by intravenous fluids, 410 (38.5%) and antiulcer drugs, 377 (35.4%). The
total cost of drugs used was calculated as Rs. 305126.4 (2280.99 USD) and the average
cost per patient was Rs. 297.97 NPR; 2.23 USD. The WHO drug prescribing indicators
showed maximum percentage, (85.4%) of encounters with injection prescribed
followed by the percentage of drugs prescribed from the Nepalese National List of
Essential Medicines 81.71%.
Conclusion
On the basis of the findings from this study injection prescribing, and the number of
drugs prescribed per encounter showed considerable deviation from the standards
recommended by the WHO. Hence, it is important for the hospital to design and
implement a system to promote judicious prescribing and injection medication
administration.
KEY WORDS
Drug utilization, Emergency department, WHO core drug use indicators, Nepal