Journal Issue: Volume: 61, No. 263 (2023)
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Volume
Number
Issue Date
2023
Journal Title
Journal ISSN
JNMA Print ISSN: 0028-2715; Online ISSN: 1815-672X
Journal Volume
Articles
Leave Against Medical Advice among Neonates Admitted to Neonatal Intensive Care Unit in a Tertiary Care Centre: A Descriptive Cross-sectional Study
(Nepal Medical Association, 2023) Yograj Sharma, Om Krishna Pathak, Asmita Sharma, Suvekhsya Khanal, Niruta Baral, Sagar Shrestha, Pradeep Adhikari
Abstract
Introduction: Leave against medical advice is a condition in which a patient leaves the hospital against the treating physician's recommendation and is a sensitive issue occurring frequently in neonatal intensive care units across the developing world. Investigating the causes of newborn deaths is essential as there is high neonatal mortality rate in context of Nepal and a huge gap between that rate and desired outcomes. Self-discharge of sick neonates from hospitals further increases the chance of death. Hence, this study aimed to find out the prevalence of leave against medical advice among neonates admitted to the neonatal intensive care unit in a tertiary care centre.
Methods: This descriptive cross-sectional study was conducted among patients admitted to the Neonatal Intensive Care Unit from 14 April 2021 to 13 April 2023 after obtaining ethical approval from the Institutional Review Committee (Reference number: 077/78-021). The patient’s demographic and clinical characteristics and reasons for self-discharge were recorded. Convenience sampling was done. Point estimate and 95% Confidence Interval were calculated.
Results: Among 1352 neonates, the prevalence of leave against medical advice was 119 (8.80%) (7.29-10.31, 95% Confidence Interval).
Conclusions: The prevalence of leave against medical advice from the neonatal intensive care unit was lower than in other studies done in similar settings.
Scrub Typhus among Febrile Patients Admitted to the Department of Medicine in a Tertiary Care Centre: A Descriptive Cross-sectional Study
(Nepal Medical Association, 2023) Shrestha, Sanjeeb; Pradhan, Shanti; Shrestha, Niranjan; Karn, Mitesh
Abstract
Introduction: Scrub typhus is an acute febrile illness caused by obligate intracellular bacteria of the family Rickettsia after an incubation period of 6-21 days. The disease may lead to several complications such as acute hepatitis, sepsis, myocarditis, respiratory distress and disseminated vasculitis if not treated properly. The aim of the study was to find out the prevalence of scrub typhus among febrile patients admitted to the Department of Medicine in a tertiary care centre.
Methods: This descriptive cross-sectional study was conducted among febrile patients admitted to the Department of Medicine in a tertiary care centre from 12 November 2020 to 11 May 2023 after obtaining ethical approval from the Institutional Review Committee (Reference number: 26/076-077). All patients with acute febrile illness from 17 years to 70 years were included. Patients with an acute febrile illness diagnosed with other infections such as dengue, leptospirosis, typhoid, brucellosis, malaria, and COVID-19 were excluded. Convenience sampling was done. Point estimate and 95% Confidence Interval were calculated.
Results: Among 640 patients presenting with acute febrile illness, 38 (5.94%) (4.11-7.77, 95% Confidence Interval) patients were diagnosed to have scrub typhus. Among 38 patients, 2 (5.26%) patients suffered from acute hepatitis, and 1 (2.63%) each suffered from sepsis, myocarditis, disseminated vasculitis and respiratory distress.
Conclusions: The prevalence of scrub typhus among patients admitted to the Department of Medicine was found to be slightly higher than in other studies done in similar settings.
Hepatic Encephalopathy among Patients with Chronic Liver Disease Admitted to the Department of Internal Medicine in a Tertiary Care Centre: A Descriptive Cross-sectional Study
(Nepal Medical Association, 2023) Karki, Ujjwal; Upreti, Nischal; Gyawali, Bindu; Shrestha, Sandesh Kumar; Basnet, Chandra Kiran; Sharma, Devashish; Dangol, Neha
Abstract
Introduction: Hepatic encephalopathy is a condition that impairs the neurological and psychiatric function of a patient as a result of advanced liver disease or portosystemic shunt. Early detection and treatment of hepatic encephalopathy can lessen its severity, length of stay in the hospital and potential fatality. The aim of this study was to find out the prevalence of hepatic encephalopathy among patients with chronic liver disease admitted to the Department of Internal Medicine in a tertiary care centre.
Methods: A descriptive cross-sectional study was done among patients with chronic liver disease admitted to the Department of Internal Medicine in a tertiary care centre. Data from 1 October 2021 to 15 May 2023 were collected between 20 May 2023 and 30 May 2023 from the hospital records. Ethical approval was obtained from the Institutional Review Committee (Reference number: 808/2023). The diagnosis was made based on the history, clinical examinations, and gradings were done as per West Haven criteria. Convenience sampling was done. Point estimate and 95% Confidence Interval were calculated.
Results: Among 389 patients with chronic liver disease, hepatic encephalopathy was seen in 40 (10.28%) (7.26-13.30, 95% Confidence Interval). The mean age of patients was 55.27±13.52 years.
Conclusions: The prevalence of hepatic encephalopathy among patients with chronic liver disease was lower than the studies conducted in similar settings.