Journal Issue: Volume: 57 No. 216 (2019) Mar-Apr
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Volume
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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 Cesarean Section and Its Indications in A Tertiary Care Hospital
(Nepal Medical Association, 2019) Maskey, Smrity; Bajracharya, Manisha; Bhandari, Sunita
Abstract
Introduction: Cesarean section is a surgical procedure performed to deliver fetus through abdominal route. Increasing rate of cesarean section worldwide is an alarming concern for public health and obstetricians due to increase in financial burden and risk to health of the mother in comparison to vaginal delivery. The aim of the study was to find the prevalence of cesarean section and its most common indication in a tertiary care hospital.
Methods: This descriptive cross-sectional study was done in a tertiary care hospital, from July 2016 to June 2018 after taking ethical clearance from institutional review board. Convenience sampling was done to reach the sample size. Data was collected and entry was done in microsoft excel, point estimate at 95% CI was calculated along with frequency and proportion for binary data and analysis was done.
Results: Out of total deliveries conducted, 862 (36.8%) were CS deliveries, 1477 (63.1%) were vaginal deliveries, and 12 (0.51%) were instrumental deliveries. Prevalence of CS is 862 (36.8%) at 95% CI (34.82%-38.78%). Mean age±S.D of delivering mother was found to be 26.1±0.25 years. Primi cesarean section was more than repeat cesarean section. Most common indication of cesarean section was fetal distress 243 (28%) followed by previous cesarean section 165 (18%), non-progress of labour 106 (12%), oligohydramnios 59 (7%), malpresentation 59 (7%), cephalo pelvic disorders 52 (6.5%), and hypertensive disorder in pregnancy 33 (4%).
Conclusions: Prevalence of cesarean section in a tertiary care hospital is high compared to WHO data. The most common indication of cesarean section are fetal distress and previous cesarean section.
Keywords: Cesarean section; Fetal distress; Prevalence.
Knowledge, Attitude and Practice on Antibiotics Use and its Resistance Among Medical Students in A Tertiary Care Hospital
(Nepal Medical Association, 2019) Shrestha, Ruchi
Abstract
Introduction: Antimicrobial resistance is an urgent and serious global health problem, demanding considerable attention from health care professionals worldwide. The unavoidable consequence of the widespread use of these agents has been the reason for emergence of antibiotic resistant pathogens, leading to increase in need for new drugs. This study aims to assess knowledge, attitude and practice towards antibiotics use and its resistance in undergraduate medical students.
Methods: A descriptive, cross sectional study was conducted among 228 undergraduate medical students studying in Universal College of Medical Sciences in February, 2018. Data was collected through self administered questionnaire and was entered in Statistical Package for Social Sciences 2016. Descriptive statistical analysis was carried out to find out knowledge, attitude and practice on antibiotics use and its resistance on medical students.
Results: The mean knowledge, attitude and practice score towards antibiotics use among students was 7.44±1.26, 3.35±1.12 and 5.06±1.45 respectively. Out of total students, only 39 (17.1%) had good knowledge and practice whereas 114 (50%) had good attitude towards antibiotics use. Approximately all 224 (98.2%) students were aware that antibiotics are useful for bacterial infection. Fifty two (22.8%) students said that antibiotics are safe drugs, therefore can be used commonly.
Conclusions: Although half of the students had good attitude, majority had moderate knowledge and practice towards antibiotics use. Adequate educational training should be provided to future doctors regarding proper prescribing, dispensing and usage of antibiotics.
Keywords: antibiotics; attitude; knowledge; medical students.
Prevalence of Respiratory Manifestations in Chronic Kidney Diseases; A Descriptive Cross-sectional Study in A Tertiary Care Hospital of Nepal
(Nepal Medical Association, 2019) Pant, Pankaj; Baniya, Santosh; Jha, Ashish
Abstract
Introduction: Chronic kidney diseases affect patients with multiple respiratory complications by varied etiopathogenesis adversely affecting the outcome in them. The aim of the study is to find out the respiratory manifestations among patients with chronic kidney disease.
Methods: The descriptive cross-sectional study was carried out Tribhuvan University Teaching Hospital from January 2019 to March 2019 after ethical approval. One hundred and two patients with established chronic kidney diseases being treated in a tertiary hospital for a month were included for the study. Clinical evaluation and relevant investigations; chest x ray, pleural fluid analysis, sputum analysis, echocardiography, biochemical investigations and hematological investigations were done to assess the respiratory manifestations of the patients.
Results: Pulmonary edema 41 (24.84%) was the most common manifestation followed by pleural effusion 18 (10.9%). Pleural effusions were predominantly bilateral and transudative type. Pneumonia 17 (10.3%) was predominantly lobar pneumonia. Sixteen (9.7%) of the patients were screened positive for obstructive sleep apnea syndrome. Pulmonary tuberculosis was present in 9 (5.45%) patients.
Conclusions: Varieties of respiratory complications can present in varied spectrum in patients with chronic kidney diseases and this carries adverse outcome to patient management as well as affects the quality of life of the patient and their family.
Keywords: Chronic kidney diseases; obstructive sleep apnea; pulmonary edema; pulmonary tuberculosis; respiratory manifestations.
Prevalence of Ventilator Associated Pneumonia in Neonates in A Tertiary Care Hospital in Western Nepal
(Nepal Medical Association, 2019) Lamichhane, Anita; Mishra, Aparna
Abstract
Introduction: Ventilator-associated pneumonia is a serious problem which needs to be addressed for a better outcome of the ventilated babies. The present study is undertaken to find out the prevalence of ventilator-associated pneumonia in neonates in a tertiary care hospital in western Nepal.
Methods: A descriptive cross-sectional study was carried out in a tertiary care hospital in the western region of Nepal from March 2016 to February 2019 after approval from the Institutional review committee. Sample size was calculated and convenience sampling was done to reach the sample size. Data were collected from hospital records and entered in Statistical Package for the Social Sciences, point estimate at 95% confidence interval was calculated along with frequency and proportion for binary data.
Results: Out of 95 patients ventilated in neonatal intensive care unit in the last 3 years, 23 (24.01%) developed ventilator-associated pneumonia. Prevalence of ventilator-associated pneumonia is 23 (24.01%) at 95% (14%-34%). Late onset ventilator associated pneumonia was seen in 15 (15.78%) while early onset ventilator associated pneumonia was seen in 8 (8.42%).
Conclusions: Prevalence of ventilator associated pneumonia in neonates in tertiary care hospital is high compared to other studies conducted in neonates.
Keywords: mechanical ventilation; neonatal intensive care unit; ventilator-associated pneumonia
Mean Nasal Index of Dental Students of A Dental College in Nepal
(Nepal Medical Association, 2019) Shrestha, Ritee; Manandhar, Bipana; Upadhyay, Hari Prasad; Madhikarmi, Nirjala Laxmi
Abstract
Introduction: Human nose is one of the important anthropometric parameters for identification of ethnicity and sex of an individual of an unknown identity. The nasal index holds a great value in anthropological studies, because it is one of the anthropometric indices acknowledged in nasal surgery as well as management. The study aims to find the mean nasal index and the nose type of dental students of Kantipur Dental College of Nepal.
Methods: This descriptive cross-sectional study was conducted among 140 dental students of age groups 17-25 years, in the Department of Anatomy, Kantipur Dental College Teaching Hospital and Research Center, Basundhara, Kathmandu. The studied population belongs to dental students of Kantipur Dental College and Research Centre. The nasal parameters including the nasal height, nasal width was measured using Digital Vernier Caliper and the nose was classified in three different types based on the value of nasal index.
Results: The mean nasal index of total population was 81.34±14.88 mm with confidence interval range of 78.85 and 83.83 mm. Mesorrhine type of nose was found to be most common among the total population. Mean nasal index in male is 84.49±12.46 mm and in female is 80.66±15.32 mm.
Conclusions: This study concludes that the mean values of nasal index of all the students falls under mesorrhine (medium) type of nose.
Keywords: Mesorrhine; Nasal height; Nasal index; Nose type; Nasal width.