Journal Issue: Vol. 62 No. 275 (2024) JULY
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Volume
Number
Issue Date
2024
Journal Title
Journal ISSN
JNMA Print ISSN: 0028-2715; Online ISSN: 1815-672X
Journal Volume
Articles
Pre-hospital care, pre-hospital delay, and in-hospital delay in patients with traumatic brain injury in getting neurosurgical care in a tertiary care center: A Cross-Sectional study.
(Nepal Medical Association, 2024) Regmi, Milan; Bhatta, Om Prakash; Sharma, Mohan Raj
Abstract
Introduction: Timely institution of pre-hospital therapies aimed at damage control and the appropriately timed decision of transfer to higher centers for definitive neurosurgical management are crucial in determining the outcome of patients following traumatic brain injury. This study aimed to evaluate the factors determining pre-hospital care and delay in patients with traumatic brain
injury.
Methods: This was a descriptive cross-sectional study conducted in a tertiary care center after obtaining ethical approval from the Institutional Review Board (approval number 392 (6-11) E2). All patients with traumatic brain injury who presented to the emergency department from 1 July, 2018 to 15 June, 2019 were enrolled. Data related to patient demographics, the primary cause of the incident, grading of traumatic brain injury on admission, pre-hospital care, and variables that cause pre-hospital delay were collected.
Results: In this study of 144 patients with traumatic brain injury, we found that 70 (48.61%) experienced transfer delays exceeding one hour. There were 71 (49.31%) patients aged 15-44 years, and 100 (69.44%) were males , with falls being the primary cause of 119 (82.64%). Most patients had mild traumatic brain injury 80 (55.56%). Out of 144, 20 (13.89%) received prehospital care, and 28
(19.44%) underwent a computed tomography scan of the head before arrival.
Conclusions: Our study highlights the challenges in pre-hospital care and delays in reaching for neurosurgical care in patients with traumatic brain injury. Falls, road accidents, and physical assaults were the leading causes.
Knowledge and Perception of Community Based Integrated Management of Neonatal and Childhood Illnesses among Medical Students at a Medical College: A Descriptive Cross-sectional Study
(Nepal Medical Association, 2024) Bhandari, Swasti; Ghimire, Pranish; Lama, Tenzin Lhamo; Nepal, Samata; Joshi, Lok
Abstract
Introduction: Community-Based Integrated Management of Neonatal and Childhood Illnesses (CBIMNCI) is the integrated approach for the management of children’s common health concerns in outpatient primary health care settings and interventions at the family and community level. This study aimed to assess the knowledge and perception regarding CB-IMNCI in medical students studying in the clinical phase of a medical college.
Methods: A descriptive cross-sectional study was conducted from February to June 2023 among 218 clinical-year medical students after obtaining ethical clearance from the Institutional Review Committee (Reference number: IRC-LMC-04/M-022). A self-administered questionnaire with CB-IMNCI-related multiple-choice questions was used for data collection and the responses to knowledge-related questions were evaluated using a predefined answer key. The results were expressed in terms of the number and percentage of the participants who answered each questions correctly.
Results: Of the 218 students, 111 (50.92%) were male and 107 (49.08%) were female. Among the participants, 164 (75.23%) (70-80% at 95% Confidence Interval) demonstrated basic knowledge of CB-IMNCI, successfully answering 50% or more of the questions. Among the males, 81 (72.97%), and among the females, 83 (77.57%) had basic knowledge of CBIMNCI. In terms of semester-wise distribution, 33(53.22%) in the 5th semester, 43 (82.69%) in the 7th semester, 41 (80.39%) in the 9th semester and 47 (88.67%) were able to answer 50% or more of the questions correctly.
Conclusions: This study showed that one fourth of the students lack the basic knowledge about CB-IMNCI. It suggests the need for further work to enhance effectiveness of pre-service CB-IMNCI training.
Perceived Prevalence, Awareness and Attitude towards Counterfeit Medicines among Community Pharmacists of Kathmandu Valley: A Descriptive Cross-sectional Study
(Nepal Medical Association, 2024) Kafle, Sajala; Jha, Nisha; Bhandary, Shital; Shankar, Pathiyil Ravi
Abstract
Introduction: Counterfeit medicines are a significant problem globally. In a developing country like Nepal, community pharmacists play an important role in dispensing medicines. The study was done to assess community pharmacists’ perceived prevalence, awareness and attitude towards counterfeit medicines in Kathmandu valley.
Methods: A cross-sectional study design was used. Data was collected conveniently from Kathmandu, Bhaktapur, and Lalitpur districts in March 2022 after obtaining ethical clearance from Nepal Health Research Council (reference no. 2200) and taking written informed consent from Community Pharmacists.
Results: Among the 343 pharmacists who participated, 250 (72.89%) were from Kathmandu, 57 (16.62%) were from Lalitpur, and 36 (10.50%) from Bhaktapur. Most 252 (73.47%) were aged between 20 to 30 years, 222 (64.72%) were male, 239 (69.68%) had done a Diploma in Pharmacy, 201 (58.60%) had working experience of more than 5 years and 342 (99.71%) had done their education in Nepal. Their median perceived prevalence of counterfeit drugs was 10.00% but only 2.30% had clear knowledge of such practice. 332 (96.79%) believed that actions should be taken against community pharmacists dispensing counterfeit drugs, 325 (94.75%) believed that pharmacists who dispense counterfeit medicines are unprofessional; 338 (98.54%) stated that there should be strong law against
counterfeit medicine sales.
Conclusions: Median perceived prevalence of counterfeit medicines was 10.00% but only 2.30% were aware of counterfeit medicine dispensing. Out of 343 pharmacists, 332 (96.79%) mentioned that action should be taken against those pharmacists knowingly dispensing counterfeit medicines and 338 (98.54%) stated that there should be strong law against counterfeit medicines.
Medication Adherence among Patients with Non-Communicable Diseases in a Tertiary Hospital: A Descriptive Cross-sectional Study
(Nepal Medical Association, 2024) Sharma, Bharati; Karki, Sabita; Bhetwal, Jyoti; Dahal, Akriti Shree
Abstract
Introduction: Non-communicable diseases (NCDs) are a leading cause of mortality, with a projected rise from 38 million in 2012 to 52 million by 2030. Among NCDs, hypertension, diabetes and Chronic Obstructive Pulmonary Disease are the major burdens in healthcare today, requiring long-term therapies and a significant effort in maintaining treatment adherence.
Methods: A descriptive cross-sectional study design was adopted to determine medication adherence among patients with non-communicable diseases using non-probability, consecutive sampling techniques after ethical approval from same institute (Reference number: 524). Medication adherence was assessed on 322 patients attending the outpatient department, using a structured
interview schedule, after getting Ethical approval from the Institution Review Committee. Morisky medication adherence scale (MMAS-4), Culig adherence Scale, and Beliefs about Medications (BMQ) tool were used to determine the adherence level, causes of non-adherence and belief in medication respectively. Data was coded and analysed using SPSS version 16. Descriptive statistics were used to summarise the data.
Results: The study population exhibited a mean age of 58 ± 12.80 years, with male participants 190 (59.01%). The present study revealed that 148 (45.96%) of the participants have a high adherence level to prescribed medication, and 246 (76.40%) strongly believed that without medication they would be very sick and life would be impossible.
Conclusions: The study found that less than half of participants fully adhered to prescribed medicine, with forgetfulness identified as a primary cause of non-compliance.
Cervical Cancer Screening Services in Nepal: A Descriptive Crosssectional Study
(Nepal Medical Association, 2024) Lal, Bibek Kumar; Bhatta, Ghanshyam Kumar; Adhikari, Ramesh; Karn, Abhishek; K.C, Ranju; Nyaupane, Sujata; Adhikari, Anuska; Shrestha, Binita; Shrestha, Merina; Bhattarai, Pankaj; Sah, Sujit; Shrestha, Bijaya
Abstract
Introduction: Cervical cancer, the most prevalent cancer among women, is also the primary cause of cancer-related deaths in reproductive age women in Nepal. The study aims to assess the situation of cervical cancer screening services in Nepal.
Methods: This cross-sectional study used quantitative methods to understand the situation of cervical cancer screening in 572 health facilities of Nepal. The research was conducted to assess screening facilities, the allocation of separate screening rooms, the availability of screening services on a routine basis throughout the week, screening facilities that are free of charge, human resources, and the availability of treatment. It was conducted in October to December 2022.
Results: The research was carried out among 572 healthcare facilities, out of which 134 (23.42%) had provision for cervical cancer screening services. Ethical approval was obtained from the Nepal Health Research Council (NHRC) under reference number 397/2022 P. Amongst those 134, 72 (53.73%) healthcare facilities had assigned separate rooms for screening intentions. One hundred and
two (76.12%) healthcare facilities provided regular screening services throughout the week, while 112 (83.58 %) had free-of-charge screening services. Concerning trained personnel, 121 (90.30%) health facilities had personnel trained in visual inspection with Acetic acid, 9 (6.72%) had personnel trained in use of colposcopy, and 5 (3.73%) had personnel trained in use of Loop Electrosurgical
Excision Procedure (LEEP). Lastly, 31 (23.13%) healthcare facilities offered treatment choices for cervical cancer.
Conclusions: Most of the health care facilities did not have provision of cervical screening. Amongst
those who had the provision, personnel trained in loop electrosurgical excision procedure colposcopy.