Journal Issue: Vol. 63 No. 284 (2025): JNMA
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Volume
63
Number
Issue Date
Journal Title
Journal ISSN
JNMA Print ISSN: 0028-2715; Online ISSN: 1815-672X
Journal Volume
Volume 63
(63)
Articles
Prevalence of Surgical Glove Perforation in Orthopedic Surgery at Tribhuvan University Teaching Hospital: An Observational Study
(Nepal Medical Association, 2025) Bhandari, Prawesh Singh; Adhikari, Shirish; Deo, Nitish Bikram; Uprety, Suresh; Bastola, Priska
Abstract
Introduction: Gloves provide a physical barrier preventing cross-infection between the operating team members and the patient. However, there is always a chance of the gloves perforating and breaching this barrier. This study attempts to understand the prevalence of perforation of surgical gloves in orthopedic surgery at Tribhuvan University Teaching Hospital.
Methods: This was an observational cross-sectional study carried out over three months. Gloves from the chief and first assistant surgeons were checked for visible perforation and occult perforation by water leak test. The type of surgery, hand dominance, duration of surgery, time during surgery when perforation occurred, and area of glove perforation were noted. Operative perforation rate, Overall glove perforation, and Operative perforation based on type of surgery, and duration of surgery were calculated. The categorical variables obtained were summarized with frequency and percentage.
Results: A total of 166 cases were included in the study. The operative perforation rate was 79 (47.59%; 95% CI: 39.80-55.47%) and the overall glove perforation was 117 (8.81%). Trauma surgery was the most common surgery performed during this study 111 (66.86%) and 56 (50.45%) of trauma surgery cases had glove perforation. Glove perforation was noticed by 25 (43.85%) of chief surgeon during surgery, out of which 11 (44%) of it was between 0.5 to 1 hour. Similarly, 20 (50%) of assistant surgeon noticed glove perforation during surgery, out of which 9 (45%) of it was between 1 to 1.5 hour after starting the surgery.
Conclusions: Perforations of the surgical gloves was comparable to other published literature. Trauma surgery was the most common
Assessment of Number of Cusps and Occlusal Groove Pattern in the Primary Mandibular Molars: An Observational Study
(Nepal Medical Association, 2025) Pradhan, Megha; Singh, Preeti; Ranjan, Anu; Joshi, Ujjwal; Prasamsa Chhetri
Abstract
Introduction: Primary mandibular molars have diverse morphological variations. This trait of human dentition is very important for restoring the anatomy of the tooth as well as for the anthropological study to characterize the ethnicity. Anatomical landmarks like the cusp, groove and ridges vary even among same species.The study was aimed to assess the number of cusps and occlusal grooves in primary mandibular molars of children.
Methods: An observational cross-section study was conducted among pediatric patients in the Outpatient Dental Department of a tertiary care center from October 2023 to March 2024. Fully erupted primary mandibular molars in children aged 3-6 years were included . Intraoral examination of the patient were performed using Gregory WK criteria . A convenience sampling method was used. The point estimate was calculated at a 95% Confidence Interval.
Results: Among 303 patients, the study showed 118 (38.94%) left and 106 (34.98%) right primary mandibular first molar had four cusps and a 'Y' groove pattern. Among the 303 subjects, male 58 (34.12%) were having a 4Y pattern followed by 46 (27.06%) 4X pattern, while in 48 (36.09%) 4Y pattern followed by 45 (33.83%) 4X pattern was seen.
Conclusions: The result in present study showed Y groove pattern in occlusal surface of primary mandibular molars with four cusps that can be related with conservative pattern of deciduous molar in context of Nepali population.
Utilization of Antimicrobial Agents in Intensive Care Units of Tertiary Care Hospital: An Observational Study
(Nepal Medical Association, 2025) Aryal, Sushant; Joshi, Mili; Gupta, Mayuri; Uprety, Bipashwi Nath; Shrestha, Ram Krishna; Shah, Pranita; Rajbhandari, Piyush
Abstract
Introduction: The rising incidence of antibiotic resistance is a global threat. Monitoring antibiotic use is one of the strategies to address this issue. Intensive Care Units (ICUs) have high prevalence of antibiotic use and multidrug-resistant organisms. This study aims to study the status of antibiotic usage within the ICU in a tertiary care center.
Methods: An observational cross-section study was conducted from July 15, 2021 to December 20, 2021 in the adult ICU and record section of a tertiary care hospital of Nepal after approval from Institutional Review Committee. Data were collected from medical records of patients admitted to the ICU from January 1, 2018 to December 31, 2020 and who received antibiotics. Data were presented in terms of days of therapy per 1000 patient days (DOT/1000PD).
Results: Total antibiotic consumption increased from 324.2 DOT/1000 PD in 2018 to 564.25 DOT/1000 PD in 2020. Consumption of Watch group antibiotic nearly doubled from 248.21 to 473.23 DOT/1000 PD, while Access antibiotics increased from 49.09 to 73.5 DOT/1000 PD. In contrast, Reserve group antibiotic usage declined from 26.91 to 17.49 DOT/1000 PD. In 2018, highest consumed antibiotics were piperacillin/tazobactam 57.89 (17.89%), azithromycin 53.98 (16.70%), ceftriaxone 49.58 (15.34%) and vancomycin 43.87 (13.57%) DOT/1000 PD. By 2020, their usage increased to 129.87 (23.02%),69.38 (12.30%), 94.29 (16.71%), and 87.77 (15.55%) DOT/1000 PD respectively.
Conclusions: Total antibiotic consumption increased over the years. There was a substantial rise in the use of Watch group antibiotics, particularly piperacillin/tazobactam, ceftriaxone, azithromycin and vancomycin. Meanwhile, the use of Reserve group antibiotics declined during the same period.
Clinico Socio-Demographic Profile of Children with Autism Spectrum Disorder from a Mental Health Clinic in Nepal: An Observational Study
(Nepal Medical Association, 2025) Karki, Utkarsh; Jha, Amit; Parajuli, Samjhana; Sharma, Anil; Gurung, Bhupendra; Bhattarai, Dipesh
Abstract
Introduction: Autism Spectrum Disorder (ASD) is a neurodevelopmental disorder with symptoms manifesting in early childhood. There is limited information regarding the clinical scenario of ASD within Nepal. The study aims to determine the clinical and socio-demographic profile and evaluate the association between clinical and socio-demographic parameters in children with ASD.
Methods: This was an observational cross-section study which examined the records of children diagnosed with ASD at a Mental Health Clinic in Nepal. Approval for the study was granted by NHRC. The analysis focused on data extracted from clinic records of ASD patients spanning from 16 September 2022 to 15 March 2024 encompassing one and a half years. Data were entered and analyzed using SPSS Statistics for Windows, version 16.0 (SPSS Inc., Chicago, Ill., USA).
Results:A total of 138 children were diagnosed with ASD, with a mean age of diagnosis at 42.94 ±17.49 months.Among the participants, there were 110 (79.69%) male, 105 (76.01%) first born with a male to female ratio of 3.9:1 and 114 (82.59% ) were going to regular school. Parents' 39 (28.29%) and relatives' 25 (18.01%) concerns were the primary reasons for seeking a diagnosis followed by referrals from pediatricians 19 (13.79%). The mean Childhood Autism Rating Scale (CARS) score of 34.33±3.99 was indicative of mild to moderate symptoms of ASD. The mean Vineland Social Maturity Scale (VSMS) score of 69.02±13.25 was indicative of mild impairment in socio-adaptive functioning.
Conclusions: The study shows higher rate of ASD among males and first-born children. Early age at diagnosis is encouraging and is associated with better outcomes.