Journal Issue: Volume: 32, No. 3, December 2010
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Volume
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2010
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ISSN (Print) : 1993-2979 | ISSN (Online) : 1993-2987
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Articles
Incidence of dysmenorrhoea associated with high stress scores among the undergraduate Nepalese medical students
(Institute of Medicine, 2010) Pramanik, T; Shrestha, R; Sherpa, MT; Adhikari, P
Abstract
Introduction: Primary dysmenorrhoea is one of the major problems associated with menstruation among the young undergraduate medical students which affect the daily routine. Among various causes, mental stress is one of the major causes of primary dysmenorrhoea. This study aims to assess the relationship between the degree of stress and incidence of dysmenorrhoea amongst the young Nepalese medical students.
Methods: Young, unmarried, non-smoker female medical undergraduate students (age: 18-20years, n = 104) having no pelvic pathology participated in this study. A baseline questionnaire was used to note the medical history on menstruation, use of contraceptive pills, active or passive smoking exposure and alcohol use. The independent and individual perception of stress was evaluated by using a stress questionnaire.
Results: Result indicated that the stress score is significantly higher (31.30 vs. 18.81) in dysmenorrhoeic women (n=50) compared to eumenorrhoeic participants (n=54).
Conclusions: The present study indicated a positive relationship between psychological stress (supported by stress scores) and dysmenorrhoea. The path of solution of this painful problem might be paved out by de-stressing the person through relaxation exercise, yoga and pranayama (the breathing exercises.)
Keywords: Primary dysmenorrhoea, psychological stress, yoga
Reference values for Doppler indices of the umbilical and fetal middle cerebral arteries in uncomplicated third trimester pregnancy
(Institute of Medicine, 2010) Paudel, S; Lohani, B; Gurung, G; Ansari, MA; Kayastha, P
Abstract
Introduction: The purpose of this study was to categorize new reference ranges for measurements of commonly used umbilical artery and fetal middle cerebral artery Doppler indices (Pulsatility Index, Resistance Index, and Systolic: Diastolic ratio) in uncomplicated third trimester pregnancy.
Methods: This was a prospective cross sectional study involving 101 singleton uncomplicated pregnancies of 30 to 37 weeks of gestation. Umbilical artery indices were obtained from free floating loop and middle cerebral Doppler indices were obtained from the proximal third of the artery with flow towards the probe. Regression equations were used to categorize reference ranges and percentile fitted Normograms were obtained for all the parameters.
Results: Among 101 singleton pregnancies between 30 and 37 weeks of gestation, 65 (64.35%) were primigravida women and 36 (34.65%) were multigravida. Mean maternal age was 23.12years (range 16 to 35 years). Maximum number of pregnancies (18.81%) was at 34 weeks of gestation. The established percentiles of Doppler indices showed a continuous reduction of all the measured indices as pregnancy increases (p<0.0001).
Conclusions: Reference ranges were obtained for the middle cerebral artery and umbilical artery Doppler indices. These ranges are consistent with similar studies done by other authors.
Keywords: Doppler study, fetal Middle cerebral artery, pulsatility Index , resistance index, systolic , diastolic ratio, umbilical artery
Factors determining self-harm
(Institute of Medicine, 2010) Shakya, YL; Acharya, R; Gupta, MP; Banjara, MR; Prasad, PN
Abstract
Introduction: Self-harm forms a significant proportion of patient attending in emergency departments, typically 10-30 per 100000 people commit suicide annually. The objective of this study was to find out the factors responsible for self harm.
Methods: This is a cross-sectional study of 100 patients of self-harm coming to Emergency Department of Tribhuvan University Teaching Hospital from from 1st October 2007 to 31st March, 2008. Questionnaire about demographic information of patient along with details about cause of self-harm, and any other illnesses associated was filled. Information about duration of arrival in emergency department, place of self-harm was gathered. Patients were clinically examined and hematological and biochemical tests including liver function test and the type of poison used and its level in blood were examined.
Results: Total number of patients with self-harm was 100 (female - 71%; male- 29%). Among female,16-30 years age group to be the largest (76%). Mean duration of arrival in emergency department was3.08 hour. Metacid ingestion (29%) was found to be the most common cause for self-harm. There is no difference of self-harm for suicide and threat cause. Only 5% of patient with self-harm has psychiatry illness in the past.
Conclusions: Self harm forms a significant proportion of patient attending the Emergency department and the most common form of self-harm used was metacid ingestion. There is compelling evidence for the need to improve delivery of care for patients who inflict self-harm.
Keywords: Cause, emergency department, self harm
Taste disturbances following middle ear surgery
(Institute of Medicine, 2010) Gurung, U; Bhattarai, H; Shrivastav, RP
Abstract
Introduction: Iatrogenic chorda tympani nerve (CTN) injury during middle ear surgery is quite common. The objective of ours study is to observe frequency & types of CTN injury during middle ear surgery and assess types of post-operative taste disturbances and their functional recovery.
Methods: Patients who underwent middle ear surgery from 1st October 2005 to 1st January 2007 in Tribhuvan University Teaching Hospital were divided into 6 groups according to intraoperative CTN manipulation as; seen but not handled, handled but not stretched, stretched but intact, cut while stretching, cut while using burr and clean cut with scissors. Subjective assessment of taste disturbance was done after 2days & 2, 4 & 6 months post-operatively and categorized as altered taste sensation/metallic taste, tongue numbness and dry mouth.
Results: Amongst 260 patients, CTN was seen but not handled in 52/260 (20%), handled but not stretched in 54/260 (20.75%), stretched but intact in 66/260 (25.38%), cut while stretching in 17/260(6.5%), cut while using burr in 29/260 (11.15%) and clean cut with scissors in 42/260 (16.15%) patients. Eleven out of 260 patients (4.2%) symptomatic amongst which 6/11 (54.5%) had altered taste sensation,4/11 (36.3%) had tongue numbness and 1/11 (9%) had dry mouth. Complete recovery occurred in 9/11 (81.8%) patients by 6 months.
Conclusion: Though iatrogenic CTN injury was common during middle ear surgery, frequency of taste disturbance was comparatively less, commonest type of CTN injury being stretched but intact. The most common post-operative taste disturbance was altered taste sensation/metallic taste. Most patients recovered completely by 6 months. Functional recovery was earlier when CTN was preserved than when sectioned.
Keywords: CTN, middle ear surgery, taste disturbance