Journal Issue: Vol. 62 No. 272 (2024) APRIL
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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
Peptic Ulcer Disease among Patients Undergoing Upper Gastrointestinal Endoscopy in a Tertiary Care Centre: A Descriptive Cross-sectional Study
(Nepal Medical Association, 2024) Sapkota, Shova; Oli, Saurav Sen; Karki, Mamata; Rokaha, Prerana Singh; Aryal, Ananta
Abstract
Introduction: Peptic ulcer is a common disease of gastrointestinal tract usually present with epigastric pain and discomfort. Upper gastrointestinal endoscopy is its gold standard investigation. There has been limited study on the prevalence of peptic ulcer disease among patients undergoing upper GI endoscopy especially in Nepal. Our study aimed to find the prevalence of peptic ulcer disease among patients undergoing upper GI endoscopy at our centre.
Methods: A descriptive cross-sectional study was conducted among patients undergoing upper gastrointestinal endoscopy at a tertiary care centre from October 1, 2022 to March 31, 2023. Data was retrieved from hospital records using a preformed proforma and sample size of 219 was calculated and data of 273 cases was collected using the convenience method of sampling.
Results: Among 273 patients, peptic ulcer disease was found in 29 (10.62%) of patients among which 28 (10.25%) had antral ulcer and only 1 (0.36%) had duodenal ulcer.
Conclusions: The prevalence of peptic ulcer disease is lower in our study centre compared to other studies and further studies can be conducted on the associated risk factors and socio-demographic distribution of peptic ulcer disease.
Post-discharge Outcomes of COVID-19 Patients in a Tertiary Care Hospital: A Descriptive Cross-sectional Study
(Nepal Medical Association, 2024) Phuyal, Naveen; Bhandari, Ganesh; Budhathoki, Lee; Kumar, Kshitiz; Shrestha, Lochana; Singh, Poonam
Abstract
Introduction: Understanding the post-discharge outcomes of COVID-19 patients is essential for informed healthcare planning and support services. This study aimed to assess the physical health status of COVID-19 patients three months after discharge from a tertiary care hospital in Kathmandu, Nepal.
Methods: A descriptive follow-up study design was used, involving 200 COVID-19 discharged patients. Data were collected from healthcare facilities and participants through structured questionnaires and telephonic interviews. The study duration was between November 2020 to April 2021.
Results: Persistence of COVID-19-related symptoms was reported by 49 (24.50%) of participants reported at follow-up, while 41 (20.50%) indicated previous symptoms from discharge.
Conclusions: After discharge, most of patient returned to normal activities within three months.Persistence of symptoms and test positive rate was less in those patients.
Etiological Profile of First Episode Seizures in Paediatric Patients at a Tertiary Care Centre: A Descriptive Cross-sectional Study
(Nepal Medical Association, 2024) Shah, Madhu; Poudel, Saurav; Parajuli, Bivusha; KC, Niranjan; KC, Rumi
Abstract
Introduction: Seizures are the most common neurological emergency and one of the most common reasons for paediatrics hospital admissions. This study aimed to identify the etiology, clinical profile, and immediate outcome of children with the first episode of seizure in Eastern Nepal.
Methods: This was a prospective descriptive study carried out in the Tertiary Care Centre from September 2022 to August 2023. Ethical clearance was taken from the Institutional Review Committee (Ref no:654/2022). Convenience sampling was done to include 170 children presenting with the first episode of seizure at age 6 months to 15 years. Variables collected were demographics, clinical presentations, family history, trauma history, laboratory tests, neuroimaging, EEG, final diagnosis, and immediate outcome.
Results: A total of 170 patients were admitted with the first episode of seizure with 123 (72.36%) males and 47 (27.64%) females. The mean age of the patients was 5.13±2.95 years with 104 (61.18%) patients under 5 years of age. The most common seizure was generalized tonic-clonic type in 132 (77.64%) patients. The most common associated symptom was fever in 150 (88.23%) children. Neuroimaging was abnormal in 52 (30.59%) patients, with neurocysticercosis seen in 27 (15.88%). The most common etiology was febrile seizure in 92 (54.17%) patients, neurocysticercosis in 27 (15.88%), and meningitis in 12 (7.05%).
Conclusions: Febrile seizures, neurocysticercosis, infection, and trauma were the major causes of seizures in children. When simple febrile seizures were unlikely, lumbar puncture, neuroimaging, and laboratory tests were useful tools for diagnosing etiologies of seizures.
Pattern of Facial Laceration at Tertiary Care Centre in Eastern Nepal: A Descriptive Cross-sectional Study
(Nepal Medical Association, 2024) Gurung, Gopal; Pokharel, Mona
Abstract
Introduction: Facial lacerations are a source of concern as these can be life threatening at times due to extensive haemorrhage and also leave lifelong scars. The objective of this study was to find out the pattern of facial lacerations in the Nepalese population visiting a tertiary care centre in eastern Nepal.
Methods: A descriptive cross-sectional study was conducted among the maxillofacial trauma patients visiting the Emergency department and department of Dental Surgery at a tertiary care centre from 1 October 2022 to 30 September 2023. Ethical approval was taken from the Institutional Review Committee . All patients attending the Dental outpatient department and Emergency department for the management of facial laceration in the study period were included in the study.
Results: Out of 236 patients, there were 199 (84.32%) male and 37 (15.67%) female patients. The most common age group was of 21-30 years 88 (37.29%) and Road Traffic Accidents 183 (77.54%) was the main aetiology. Facial lacerations and maxillofacial fractures both were seen in 98 (41.53%) patients. There were a total of 358 facial laceration sites among 236 patients and chin region 76 (21.22%) was the most common followed by forehead region 54 (15.08%).
Conclusions: Facial lacerations were mostly seen in males, younger adults and road traffic accidents were the main aetiology for these injuries. Facial lacerations showed predominant T-shaped distribution with chin being the most common site.
Clinico-Demographic Profile of Children and Adolescents with Attention Deficit Hyperactivity Disorder Presenting to a Tertiary Care Centre: A Descriptive Cross-sectional Study
(Nepal Medical Association, 2024) Karki, Utkarsh; Sherchan, Supriya; Sharma, Anil; Jha, Amit
Abstract
Introduction: Attention deficit hyperactivity disorder (ADHD) is a common neurodevelopmental disorder in children. ADHD leads to significant impairment in overall functioning of the child. There is limited information concerning the clinical scenario of ADHD within Nepal. The study aims to determine the clinico-demographic profile and pattern of medication use in the treatment of ADHD.
Methods: This study retrospectively examines the records of children diagnosed with ADHD at the Child and Adolescent Psychiatry (CAP) Unit, Kanti Children’s Hospital (KCH), Nepal. Approval for the study was granted by KCH's Institutional Review Board. The analysis focused on data extracted from hospital records of ADHD patients spanning from 1 January 2021 to 30 June 2023 encompassing two and a half years.
Results: A total of 585 children were diagnosed with ADHD, with a mean age 7±3.04 years. The majority 501 (85.64%) were male, and 377 (64.44%) were from the school going age group (6 to 11 years). The prevalent psychiatric comorbidities included Autism Spectrum Disorder (ASD) at 102 (17.43%), Intellectual Disability (ID) at 93(15.89%), and Oppositional Defiant Disorder (ODD) at 36 (6.15%). The commonly used medication was Clonidine 165 (28.20%) followed by Atomoxetine 154 (26.32%) and Risperidone 65 (11.11%).
Conclusions: The study indicates that ADHD is highly prevalent in Nepal. Comorbidities like ASD and ID are frequently seen which further necessitates the need for structured assessments and multidisciplinary approaches to address ADHD. In our context with limited treatment options, the management of ADHD is extremely challenging.