Journal Issue: Volume: 57 No. 217 (2019) May-June
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2019
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JNMA Print ISSN: 0028-2715; Online ISSN: 1815-672X
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Articles
Prevalence of Retrocaecal Appendix among Patients with Appendicitis in A Tertiary Care Hospital of Nepal
(Nepal Medical Association, 2019) Khatun, Sanzida; Thakur, Dipendra; Shah, Diwakar Kumar
Abstract
Introduction: Appendicitis is one of the most common causes of acute abdomen. The clinical presentation of appendicitis and its susceptibility to acute inflammation may be affected by the length and position of vermiform appendix. Length and position of appendix are variable. The aim of the study was to find the prevalence of retrocaecal appendix among patients undergoing appendectomy for appendicitis.
Methods: A descriptive cross-sectional study was performed in 264 patients undergoing appendectomy in Department of Surgery, Nobel Medical College, Biratnagar, Nepal 1st May, 2018 to 15th May, 2019. Ethical approval was taken. Simple random sampling was done. The position of appendix was noted before appendectomy. Subgroup analysis was done on the basis of gender and length of appendix recorded in centimeters with a measuring scale immediately after removal of appendix. Data was collected in excel and was analyzed in SPSS version 16.
Results: Prevalence of retrocaecal appendix among patients with appendicitis was 95 (35.98%). Similarly, other positions noted were pelvic in 67 (25.37%), post-ileal in 61 (23.10%), pre-ileal in 11 (4.16%) and subcaecal in 30 (11.36%) individuals. The length of appendix ranged from 1.7 cm to 14.7 cm. The mean length was 8.67±2.44 cm.
Conclusions: The most common position of appendix in patients with appendicitis is retrocaecal position followed by pelvic position in both males and females.
Keywords: Appendicitis; Appendix; Position of appendix; Vermiform appendix.
Prevalence of Agenesis of Mandibular Third Molars in A Tertiary Healthcare Centre of Nepal
(Nepal Medical Association, 2019) Regmee, Pragya; Rimal, Jyotsna; Maharjan, Ichha Kumar; Niraula, Surya Raj
Abstract
Introduction: Racial variation, genetic inheritance and various other factors can affect the jaw size and ultimately the tooth size and number. Studies for agenesis of mandibular third molars have been carried out in various populations but the data relating to these are not evident from most of the parts of Nepal. Hence, the objective of the present study is to determine the prevalence of agenesis of mandibular third molars among the population of patients visiting the Department of Oral Medicine and Radiology of B. P. Koirala Institute of Health Sciences.
Methods: This descriptive cross-sectional study was conducted at Department of Oral Medicine And Radiology, College of Dental Surgery, B. P. Koirala Institute of Health Sciences from September 2015 to September 2016 after taking ethical approval from Institutional Review Committee. Two hundred and eighty four patients (568 sites of third molar bilaterally), visiting the Department of Oral Medicine and Radiology were studied with Panoramic Radiograph to assess for agenesis of mandibular third molars bilaterally. Data was entered in Microsoft Excel sheet and transferred to Statistical Package for the Social Sciences version 11.5.
Results: Out of 284 participants, 568 sites of mandibular third molars were evaluated and agenesis was seen among 163 (28.7%) participants at the confidence interval of 95% (28.643 to 28.757). Total numbers of patient with single missing mandibular third molar were 35 (6.2%). Twenty one had agenesis only on the right side and 14 had agenesis only on the left. The total number of patients with agenesis of both the mandibular third molars was 64 (22.5%).
Conclusions: Agenesis was highly prevalent in this study group. The likelihood of third molar being absent on one side, when there was concurrent missing third molar on the other side of mandible was also high.
Keywords: Anodontia; Mandible; Molar; Nepal; Panoramic radiography.
Prevalence of Community-Acquired Pyoderma in Dermatological Outpatient Department of A Tertiary Care Hospital
(Nepal Medical Association, 2019) Ghimire, Rupak Bishwokarma; Pokhrel, Khilasha; Shrestha, Sanjubabu
Abstract
Introduction: Pyoderma is defined as any purulent skin disease and represents infections in epidermis and dermis or hair follicles. This study aims to find out the prevalence of communityacquired pyoderma in dermatological outpatient department of a tertiary care hospital.
Methods: A descriptive cross-sectional study was carried out among patients who presented at dermatology outpatient department of Kathmandu Medical College Teaching Hospital between December 2018 and March 2019 after ethical clearance from institutional review committee. Convenience sampling method was done. Data was collected and analysis was done using SPSS software, point estimate at 95% CI was calculated along with frequency and proportion for binary data.
Results: Out of 385 cases, 72 (18%) cases were of community-acquired pyoderma. Prevalence of community-acquired pyoderma is 72 (18%) at 95% CI(). Primary pyoderma was seen in 49 (12.72%) mainly folliculitis 17 (4.41%), furunculosis 16 (4.15%), impetigo 6 (1.55%), abscess 6 (1.55%) and bacterial paronychia 4 (1.03%). Staphylococcus aureus was the most common organism isolated in 42 (58.3%) cases and Staphylococcus epidermidis was isolated in 3 (4.17%) cases. Staphylococcus aureus was most sensitive to Vancomycin 42 (100%) followed by Gentamycin 40 (95.2%), Ciprofloxacin 40 (95.2%) and Ceftriaxone 40 (95.2%). Highest resistance was seen to Azithromycin in 13 (30.95%), followed by Cloxacilllin in 11 (26.19%). Males were affected predominantly in 49 (68.06%) as compared to females in 23 (31.94%).
Conclusions: Prevalence of community-acquired pyoderma is high among patients visiting dermatological outpatient departments of a tertiary care hospital compared to other studies. Antibiotic resistance of commonly used antibiotics are increasing and thus proper culture and sensitivity reports may be required to guide our treatment
Keywords: Drug resistance; Pyoderma; Skin infections; Staphylococcus.
Prevalence of Perinatal Deaths in A Tertiary Care Hospital of Nepal
(Nepal Medical Association, 2019) Dwa, Yam; Bhandari, Sunita
Abstract
Introduction: Perinatal mortality indicates quality of maternal and neonatal care and is high in Nepal. This study was conducted to find out the prevalence of perinatal deaths in a tertiary care center.
Methods: This descriptive cross-sectional study was conducted from July 2017 to June 2018 at KIST Medical College and Teaching Hospital. Details of each perinatal death were filled in predesigned proforma from hospital in-patient records within 24 hours of perinatal death. The total of 1088 cases were selected for the study and convenience sampling was done. Statistical analysis was done with Statistical Package for Social Sciences (SPSS 17.0).
Results: Out of 1088 births selected for the study, there were 16 cases of perinatal deaths. Hence, the prevalence of the perinatal deaths in KIST Medical College and Teaching Hospital is found to be 1.47%. In the same way, perinatal mortality rate, stillbirth rate and early neonatal mortality rate were calculated and found to be 14.61 per 1000 births, 8.21 per 1000 births and 6.44 per 1000 live births respectively. Preterm neonates constituted of 71.4% of early neonatal deaths.
Conclusions: Perinatal mortality rate was 50% lower than that of national survey, however comparable with study at another tertiary care center at Kathmandu. Stillbirth and prematurity contributed significantly to perinatal mortality. Provision of good antenatal surveillance, identification of high risk pregnancies and good neonatal care to preterm neonates would be required to reduce perinatal mortality.
Keywords: Live births; Perinatal mortality; Pregnancy.
Prevalence of Ruptured Intracranial Aneurysms in A Tertiary Care Hospital of Nepal
(Nepal Medical Association, 2019) Thulung, Suraj; Aryal, Binit; Baniya, Aashish; Ranabhat, Kajan; Shrestha, Bibhusan Kalu
Abstract
Introduction: Intracranial aneurysms affect 3-8 percent of the world’s population, with ruptured aneurysms being the most common cause of subarachnoid hemorrhage. The sensitivity of Computed Tomography Angiogram in diagnosing intracranial aneurysm is 97%. The aim of our study is to find out the prevalence of ruptured intracranial aneurysms among all the admitted cases encountered in our hospital.
Methods: A descriptive cross-sectional study was done at Upendra Devkota Memorial National Institute of Neurological and Allied Sciences from 2016 to 2018. Convenience sampling method was done. In order to detect the site and size of aneurysms16 slice Siemens Computed Tomography with Computed Tomography angiogram was used. Ethical approval was obtained from the Institutional Review Board at Upendra Devkota Memorial National Institute of Neurological and Allied Sciences. Based on demographic data and computed tomography angiography findings, various morphometric parameters along with demographic parameters were considered for the study.
Results: Among 10,856 cases, prevalence of ruptured intracranial aneurysms were found in 42 (0.386%) [Confidence Interval= 0.395 to 0.377]. Among 42 cases, Middle Cerebral Artery aneurysm was present on 16 (39.02%) followed by Anterior Communicating Artery on 14 (34.14%), then Posterior Communicating Artery on 5 (12.19%). The largest neck and dome size were seen in basilar tip aneurysm with size of 11mm and 8mm respectively. The most common type was Fischer grade 4.
Conclusions: The prevalence of ruptured intracranial aneursyms were found to be higher as compared to the other international studies.
Keywords: Computed tomography angiography; Intracranial aneurysm; Subarachnoid hemorrhage.