Journal Issue: Volume: 61, No. 261 (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
Peripartum Hysterectomy among Patients Admitted to the Department of Obstetrics and Gynaecology in a Tertiary Care Centre: A Descriptive Cross-sectional Study
(Nepal Medical Association, 2023) Lama, Sushma; Todi, Sushila; Shrestha, Reena; Acharya, Swikrity
Abstract
Introduction: Emergency peripartum hysterectomy is a life-saving procedure performed as an emergency procedure to control torrential bleeding and it is associated with significant maternal morbidity and mortality. There are only a few studies regarding this topic so this study guides us to monitor the trend and start appropriate policies to reduce unnecessary caesarean deliveries. The aim of this study was to find out the prevalence of peripartum hysterectomy among patients admitted to the Department of Obstetrics and Gynaecology in a tertiary care centre.
Methods: A descriptive cross-sectional study was conducted in the Department of Obstetrics and Gynaecology of the tertiary care centre. Data from 1 January 2015 to 31 December 2022 were collected between 25 January 2023 and 28 February 2023 from the hospital records. Ethical approval was obtained from the Institutional Review Committee of the same institute (Reference number: 2301241700). Convenience sampling was done. Point estimate and 95% Confidence Interval were calculated.
Results: Among 54,045 deliveries, peripartum hysterectomy was seen in 40 (0.074%) (0.05-0.10, 95% Confidence Interval). The major indication of emergency peripartum hysterectomy was abnormal placentation (placenta accreta spectrum) which was 25 (62.50%) followed by uterine atony in 13 (32.50%) of patients and uterine rupture in 2 (5%).
Conclusions: The prevalence of peripartum hysterectomy was lower than in other studies done in similar settings. The indication for Emergency peripartum hysterectomy has changed in recent years from uterine atonicity to the morbidly adherent placenta which is due to a rise in the caesarean section rate.
Blunt Abdominal Trauma among Patients Admitted to the Department of Surgery at a Tertiary Care Centre: A Descriptive Cross-sectional Study
(Nepal Medical Association, 2023) Ghimire, Roshan; Acharya, Bidur Prasad; Pudasaini, Prashanta; Limbu, Yugal; Maharjan, Dhiresh Kumar; Thapa, Prabin Bikram
Abstract
Introduction: Blunt abdominal trauma bears significant morbidity and mortality worldwide and needs careful evaluation and management for a better outcome, where the resources are limited and the impact of the financial burden is very important. Previously, many cases used to be managed with operative procedures, and now the trend has been shifting to non-operative management. This study aimed to determine the prevalence of blunt abdominal trauma among patients admitted to the Department of Surgery of a tertiary care centre.
Methods: This was descriptive cross-sectional study done between 1 February 2022 to 31 January 2023 after taking ethical approval from the Institutional Review Committee (Reference number: 2312202103). The decision of non-operative versus operative treatment was decided with dynamic clinical evaluation and severity of intraabdominal injuries. Demographic data, the mechanism of injury, and both conservative and operative management were studied. All the patients who were more than 18 years of age, and admitted to the Department of Surgery were included in the study. Convenience sampling method was used. Point estimate and 95% Confidence Interval were calculated.
Results: Among a total of 1450 patients, the prevalence of blunt abdominal trauma was 140 (9.65%) (8.13-11.17, 95% Confidence Interval). A total of 61 (43.57%) were young within the age group of 18-30 with a male-female ratio of 4:1. Road traffic accidents 79 (56.43%) were the most common mechanism followed by falls from heights 51 (36.43%).
Conclusions: The prevalence of blunt abdominal trauma among patients admitted to the Department of Surgery was found to be higher than in other studies done in similar settings.
Diabetic Ketoacidosis among Diabetic Patients Admitted in the Department of Medicine of a Tertiary Care Centre: A Descriptive Cross-sectional Study
(Nepal Medical Association, 2023) Karki, Lochan; Khadka, Milan; Oli, Milan Purna; Joti, Santosh; Tamrakar, Rama; Adhikari, Siddhant; Khatri, Suman; K C, Poonam
Abstract
Introduction: Diabetic ketoacidosis is one of the most severe acute complications of diabetes mellitus characterised by hyperglycemia, hyperketonemia, and metabolic acidosis. Prompt diagnosis and treatment of diabetic ketoacidosis can decrease severity, hospital stay, and possible mortality. This study aimed to find out the prevalence of diabetic ketoacidosis among diabetic patients admitted to the department of medicine of a tertiary care centre.
Methods: This descriptive cross-sectional study was conducted at a tertiary care centre. Data from 1 March 2022 to 1 December 2022 were collected between 1 January 2023 and 1 February 2023 from the hospital records. The ethical approval was taken from the Institutional Review Committee of the same institute (Reference number: 466/2079/80). All the diabetic patients admitted to the Department of Medicine during our study duration were enrolled for the study. Diabetic patients who left against medical advice and those with incomplete data were excluded from the study. Data were collected from the medical record section. Convenience sampling method was done. Point estimate and 95% Confidence Interval were calculated.
Results: Among 200 diabetic patients, the prevalence of diabetic ketoacidosis was 7 (3.5%) (3.47-3.53, 95% Confidence Interval) among which 1 (14.29%) patients had type I diabetes mellitus and 6 (85.71%) had type II diabetes mellitus patients and the mean HbA1C level was 9.77%.
Conclusions: The prevalence of diabetic ketoacidosis among diabetes mellitus patients admitted to the department of medicine of a tertiary care centre was found to be higher than in other studies done in similar settings.
Hypothyroidism among Patients Visiting the Department of Biochemistry in Central Laboratory of a Tertiary Care Center: A Descriptive Cross-Sectional Study
(Nepal Medical Association, 2023) Pokhrel, Buddhi Raj; Chandra Jha, Amit; Ghimire, Rachita; Shrestha, Jharana; Tamang, Binaya; Gautam, Narayan; Yadav, Tapeshwar; Gharti, Sakar Babu
Abstract
Introduction: The global burden of thyroid disorders, especially hypothyroidism, is high and increasing. Prevalence studies of such disorders are limited in Nepal. The aim of this study was to find out the prevalence of hypothyroidism among patients visiting the Department of Biochemistry in the central laboratory of a tertiary care centre.
Methods: A descriptive cross-sectional study was conducted among patients visiting the Department of Biochemistry in the central laboratory from 1 August 2020 to 31 July 2021 after taking ethical approval from the Institutional Review Committee (Reference number: UCMS/IRC/054/20). Patients of all age groups and gender were considered. Hypothyroid patients were identified based on the thyroid function parameters. They were further categorized as sub-clinical and overt hypothyroid. A convenience sampling method was used. Point estimate and 95% Confidence Interval were calculated.
Results: Among 3,010 patients, the prevalence of hypothyroidism was seen in 770 (25.58%) (24.02-27.14, 95% Confidence Interval). Out of total hypothyroid patients, 555 (72.08%) were females. Overt hypothyroidism 519 (67.40%) was the most prevalent hypothyroid disorder, followed by subclinical hypothyroidism 251 (32.60%).
Conclusions: The prevalence of hypothyroidism among patients visiting the Department of Biochemistry in the central laboratory of a tertiary care centre was higher than in other studies done in similar settings.
Postdural Puncture Headache after Spinal Anaesthesia in Parturients Undergoing Cesarean Section in the Department of Anesthesia in a Tertiary Care Center: A Descriptive Cross-sectional Study
(Nepal Medical Association, 2023) Lakhe, Gajal; Shrestha, Pravin; Duwadi, Vijaya
Abstract
Introduction: The post-dural puncture headache is one of the common complications of spinal anaesthesia. It is one of the most frequent claims for malpractice involving obstetrics anaesthesia. Though self-limiting it is troublesome to the patient. The aim of this study was to find out the prevalence of post-dural puncture headache after spinal anaesthesia in parturients undergoing cesarean section in the Department of Anesthesia in a tertiary care centre.
Methods: A descriptive cross-sectional study was done among parturients who underwent cesarean section under spinal anaesthesia from 27 June 2022 to 19 January 2023 after receiving ethical approval from the Institutional Review Committee (Reference number: MEMG/480/IRC). The pregnant patients aged 18-45 years of the American Society of Anesthesiologists Physical Status II/IIE who underwent elective or emergency cesarean section under spinal anaesthesia were included. A convenience sampling method was used. Point estimate and 95% Confidence Interval were calculated.
Results: Among 385 parturients, the prevalence of post-dural puncture headache was 27 (7.01%) (4.53-9.67, 95% Confidence Interval). A total of 12 (44.44%) cases experienced post-dural puncture headache in the first 24 hours followed by 9 (33.33%) and 6 (22.22%) cases in 48 and 72 hours respectively. Moderate pain was complained of by 3 (11.11%) and 2 (7.41%) cases at 48 and 72 hours post-cesarean section respectively.
Conclusions: The prevalence of post-dural puncture headache after spinal anaesthesia in parturients undergoing cesarean section was similar to studies done in similar settings.