Journal Issue: Volume: 58 No. 227, July (2020)
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Volume
Number
Issue Date
2020
Journal Title
Journal ISSN
JNMA Print ISSN: 0028-2715; Online ISSN: 1815-672X
Journal Volume
Articles
Prevalence of Cervical Cancer among Cervical Biopsies in a Tertiary Care Center
(Nepal Medical Association, 2020) Parajuli, Ganesh; Dawadi, Pravakar; Khadka, Sabina
Abstract
Introduction: Cervical cancer is one of the most common cancer among the female population in
Nepal. The incidence and mortality rate due to cervical cancer is higher in developing countries
like Nepal due to a lack of proper screening and early diagnosis. This study aims to find out the
prevalence of cervical cancer among cervical biopsies in a tertiary care center.
Methods: A descriptive cross-sectional study was conducted among the hospital records of cervical
biopsies from the department of pathology of Shree Birendra Hospital from 1st May 2018 to 30th
April 2019. Ethical approval was taken from the Institutional Review Committee in February 2020.
This study was conducted among 146 cervical biopsies by using convenience sampling method.
Point estimate at 95% Confidence Interval was calculated along with frequency and proportion for
binary data. Data were analyzed using excel 2016 software.
Results: The prevalence of cervical cancer among 146 cases included in our study is found to be
6 (4.11%) at 95% Confidence Interval (0.90-7.32). Among those cases of cervical cancer, 4 (66.67%)
were squamous cell carcinoma, 1 (16.67%) was adenocarcinoma, and 1 (16.67%) was of other type.
Maximum cases of cervical cancer were prevalent among higher age groups.
Conclusions: Cervical cancer-related morbidity and mortality are different in different parts of
the world. It’s burden is primarily seen in developing countries where there is a lack of effective
screening programs.
Keywords: cervical cancer, mortality, prevalence, screening
Abnormal Fetal Echocardiography in Diabetic Pregnant Women at a Tertiary Care Hospital: A Descriptive Cross-sectional Study
(Nepal Medical Association, 2020) Sharma, Jyotshna; Tiwari, Sanjeeb
Abstract
Introduction: The sedentary lifestyle of women and change in their food habits has a significant
role in developing diabetes in pregnancies. This leads to an increased chance of fetal cardiac
abnormality born by a mother with gestational diabetes and pre-existing diabetes. The objective
of the study is to find out the prevalence of abnormal fetal echocardiography in gestational and
pre-existing diabetic pregnant women at a tertiary care hospital.
Methods: A descriptive cross-sectional study was conducted among 104 diabetic pregnant
women in a tertiary care hospital from April 15, 2017, to April 14, 2018. Ethical approval
was obtained from the institutional review committee. The convenient sampling method was
used. The patients who were diagnosed as gestational diabetes and diabetic before pregnancy
were included in the study. Fetal echocardiography was mainly done at a gestational age of
22-32 weeks depending upon the time of diagnosis of gestational diabetes and for pre-diabetic
women, fetal echocardiography was done at 24-26 weeks of gestation. Statistical analysis was
done using the Statistical Package of the Social Sciences version 20.
Results: Among 104 patients, 16 (15.38%) patients had abnormal fetal echocardiography.
Eighty-three (79.81%) were gestational diabetics, 21 (20.19%) were pre-existing diabetic
women. Among 83 gestational diabetes, 7 (8.4%) had abnormal echo finding and among 21
pre-existing diabetics, 9 (42.8%) had abnormal echo finding.
Conclusions: There was an increased chance of fetal cardiac malformation in gestational diabetic
and pre-existing diabetics diabetic especially in an uncontrolled glycemic state. And, if they
were diagnosed prenatally, clinical outcomes for both mother and fetus would have been better.
Keywords: diabetes mellitus, echocardiography, gestational diabetes
Clinicodemographic Profile of Kidney Diseases in a Tertiary Hospital of Central Nepal, Chitwan: A Descriptive Cross-sectional Study
(Nepal Medical Association, 2020) Ghimire, Madhav; Vaidya, Shreeju; Upadhyay, Hari Prasad
Abstract
Introduction: Spectrum of kidney diseases differs significantly in developing and developed
countries. However, there is no central registry regarding the nature of such diseases in Nepal
and our center either. The study aims to know the clinicodemographic spectrum of kidney disease
patients admitted to our hospital.
Methods: This study was a descriptive cross sectional study done in the department of Nephrology,
College of Medical Sciences Teaching Hospital from May 2018 to April 219. Convenient sampling
was done and all the consecutive kidney disease patients irrespective of their age, sex, and renal
diagnosis were included in the study. Ethical approval was taken from the Institutional Review
Committee of the college (reference number. 2016/COMSTH/IRC/049). Clinicodemographic profile
of kidney diseases were studied using statistical package for the social sciences version 20 and were
represented as mean, standard deviation, number, percentage and ratio.
Results: Out of a total of 829 patients, the commonest clinical syndrome and the histological patterns
were end-stage renal disease 248 (29.9%) and IgA nephropathy 18 (20.7%) respectively. The mean
age was 51.4±18.6 years. The commonest reason for hospitalization was sepsis 372 (44.8%). Males
were 486 (58.6%) and females were 343 (41.4%).
Conclusions: The commonest clinical presentation and the reason for admissions were end-stage
renal disease and sepsis syndrome respectively.
Keywords: acute kidney injury, chronic kidney disease, end stage renal disease, sepsis
Early experience of Retrograde Intrarenal Surgery for Renal stone: A Descriptive Cross-sectional Study
(Nepal Medical Association, 2020) Joshi, Robin
Abstract
Introduction: Retrograde intrarenal surgery with improving skill and knowledge may be considered one of the first-line treatment options for removal of renal stones. The study is done to find the outcome of retrograde intrarenal surgery in patients with renal stone.
Methods: This descriptive cross sectional study was carried out on patients undergoing retrograde intrarenal surgery for renal stone at a tertiary care hospital December 2019 to March 2020. Ethical approval was taken from the institutional review committee (Ref. no.200120202). The Convenient sampling method was applied. Data was collected and analyzed in Statistical Package for the Social Sciences version 20.0. Point estimate at 95% confidence interval was calculated along with frequency and proportion for binary data.
Results: Out of the 28 patients, the retrograde intrarenal surgery was successful in 27 (96.4%) cases. There were 16 (57.15%) females and 12 (42.86%) male patients with the mean age of 37.86±11.47 years. Most of the stones were in renal pelvis 18 (64.28%) followed by lower calyx 8 (28.57%). The mean diameter of the stone was 11.47 ±3.33mm whereas most of the stones were on the right side 16 (57.15%). The mean hardness was 1155.21±265.34 Hounsfield units. Perioperative complications like failed access sheath placement in 2 (7.14%) cases, hematuria in 6 (21.43%) cases, fever in 6 (21.43%) cases, and septicemia in 4 (14.28%) cases.
Conclusions: We found that the success rate of retrograde intrarenal surgery for the renal stone was acceptable and similar to other published studies . Retrograde intrarenal surgery is feasible for the treatment of kidney stones with acceptable complications and success rates.
Keywords: nephrolithotomy, percutaneous, nephrolithiasis, renal, retrograde, surgery
Acute Poisoning among Patients Presenting to the Emergency Department of a Tertiary Care Center: A Descriptive Cross-sectional Study
(Nepal Medical Association, 2020) Thapa, Sameer; Dawadi, Bishwa Raj; Upreti, Anup Raj
Abstract
Introduction: Acute poisoning is a major global public health problem contributing to one of the
leading causes for a visit to an emergency department. This study aims to analyse the demographic
and psychosocial characteristics of patients with acute poisoning presented to the emergency
department.
Methods: This was a descriptive cross-sectional study conducted in a tertiary care hospital from
June to December 2019 after obtaining ethical approval from Institutional review board (reference
number. 041-075/0760). A convenient sampling method was applied. Epidemiological factors, types
of poison consumed, reason, motive, and place to take poison, time elapse in the presentation to the
hospital were studied. Statistical analysis was done using statistical package for the social sciences
version 20. Point estimate at 95% Confidence Interval was calculated along with frequency and
proportion for binary data.
Results: Out of 76 cases of acute poisoning, the organophosphorus poisoning was 18 (23.7%) followed
by unknown 12 (15.8). Of total, 28 (36.8%) had quarrel before taking poison and 41 (53.9 %) had
intention to commit suicide. Sixty-seven (88.2%) took a poison at home. The average elapsed time to
the visit of the emergency department was 110±80 minutes.
Keywords: acute, emergency, organophosphates, poisoning, suicide