Journal Issue: Volume: 57 No. 219 (2019) Sep-Oct
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Volume
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Issue Date
2019
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Journal ISSN
JNMA Print ISSN: 0028-2715; Online ISSN: 1815-672X
Journal Volume
Articles
Prevalence of Perinatal Asphyxia in Neonates at a Tertiary Care Hospital: A Descriptive Cross-sectional Study
(Nepal Medical Association, 2019) Manandhar, Sunil Raja; Basnet, Rydam
Abstract
Introduction: Perinatal asphyxia is one of the major causes of perinatal and early neonatal mortality in developing countries. The main objective of this study was to observe the prevalence of perinatal asphyxia in babies born at Kathmandu Medical College Teaching Hospital.
Methods: This was a descriptive cross-sectional study conducted at Kathmandu Medical College Teaching Hospital over six month period (January to June 2019). All preterm, term and post term babies delivered at Kathmandu Medical College Teaching Hospital were included. Ethical clearance was received from Institutional Review Committee of Kathmandu Medical College (Ref.:2812201808). Convenient sampling method was applied. Data analysis was done in Statistical Package for Social Sciences (SPSS 18), point estimate at 95% Confidence Interval was calculated along with frequency and proportion for binary data.
Results: A total of 1284 babies delivered over six months period were enrolled in this study and 47 (3.66 %) babies were asphyxiated, at 95% Confidence Interval (2.64%-4.68%). The mean birth weight of asphyxiated babies was 2759.75±65 grams and gestational age was 37.57±2 weeks. Among asphyxiated babies, 15 (32%) babies were normal, 15 (32%) babies were in Hypoxic Ischemic Encephalopathy stage I, 14 (30%) were in stage II and 3 (6%) were in stage III. Twenty Three (49%) asphyxiated babies had antenatal risk factors and all 47 babies had intrapartum risk factors leading to asphyxia.
Conclusions: Prevalence of perinatal asphyxia was lower compared to that of other similar tertiary care hospitals. Perinatal asphyxia remains a major cause of neonatal morbidity and mortality.
Keywords: apgar score; hypoxic ischemic encephalopathy; perinatal asphyxia.
Study of Fingerprint Patterns in Population of a Community
(Nepal Medical Association, 2019) Shrestha, Iju; Malla, Banshi Krishna
Abstract
Introduction: Fingerprints, serve as one of the crucial tools for identification of the individual for various purposes. Sex, being one of those tools, researchers have suggested the use of fingerprints for gender identification. The objective of the study was to observe the distribution of various fingerprints patterns in the population of a community, together with the most prevalent pattern.
Methods: This descriptive cross-sectional study was conducted in the population of Duwakot VDC, Bhaktapur from May 2019 to July 2019. Ethical clearance was obtained from the Institutional Review Committee with reference no. 2812201804. One hundred and ninety-six individuals of 18 to 60 years of age were enrolled. Fingerprints of all ten fingers were taken and studied to see the distribution pattern and analyzed for gender differences. Simple random sampling was done and the sample size was calculated with a prevalence of 50%. The data obtained were computed and analyzed using Excel to find the results.
Results: The study showed the highest frequency of loops 1033 (52.71%) followed by whorls 537 (27.38%), arches 300 (15.28%) and composite pattern 90 (4.61%). The radial loops were observed more in the males 397 (5.54%) of total males whereas ulnar loops were observed more in the females 636 (96.38%) of total females. Among whorls, the concentric whorls were seen more in males 245 (52.03%) whereas the spiral whorls were seen more in the females 292 (53.27%).
Conclusions: For standard authenticity of the sexual dimorphism, fingerprint patterns, can also be considered for gender identification purposes.
Keywords: fingerprint pattern; gender identity; sexual dimorphism.
Prevalence of Iron Deficiency Anemia in Biochemically Defined Moderate to Severely Anemic patients in a Tertiary Care Centre
(Nepal Medical Association, 2019) Shah, Niharika; Pokharel, Sairil; Mishra, Deebya Raj; Adhikari, Purbesh
Abstract
Introduction: Anemia due to iron deficiency and chronic diseases is common occurrence in developing country like Nepal, the latter seen in patients with various inflammatory, autoimmune, and malignant disorders . The Intensive method of marrow iron examination, which this study has employed, provides clinically useful iron status classification in cases of functional iron deficiency. The aim of the study is to find out the prevalence of iron deficiency anemia in biochemically defined moderate to severe anemic patients in tertiary care center.
Methods: A descriptive cross-sectional study was done in 43 patients who underwent bone marrow aspiration for evaluation of any cause and had moderate to severe anemia at the same time over a period of one year from Nov 2015 to 2016. Ethical clearance was obtained from Institutional Review Committee. The bone marrow iron stores were assessed by“intensive method†apart from the routinely used Gale’s method. Data was collected and entry were done in Statistical Package for Social Sciences version 24. Point estimate at 95% Confidence Interval was calculated along with frequency and proportion for binary data.
Results: The intensive grading system demonstrated normal marrow iron store in 13 (30.2%), depleted iron stores in 3 (7%), functional iron deficiency in 14 (32.6%), and combined deficiency in 13 (30.2%) patients. Mean log ferritin concentration was lower in patients with depleted iron stores (2.2μg/l) than in those with normal (2.7μg/l), and functional iron deficiency (2.4μg/l). The mean log ferritin in combined deficiency was lower than the mean log ferritin concentration in iron store deficiency (1.9μg/l).
Conclusions: The prevalence of functional iron deficiency anemia was greatest when the intensive method for assessment of bone marrow iron was used, thus differentiating four different iron status categories, including functional iron deficiency, from actual iron store deficiency, avoiding unnecessary iron supplementation in the former group.
Keywords: bone marrow iron; intensive method; serum ferritin.
Prevalence of Dyspnea among Patients Attending the Emergency Department of a Tertiary Care Hospital: A Descriptive Cross-sectional Study
(Nepal Medical Association, 2019) Shrestha, Anmol Purna; Shrestha, Roshana; Shrestha, Sanu Krishna; Pradhan, Alok; Basnet, Samjhana
Abstract
Introduction: Dyspnea is a common presenting complaint in the emergency department worldwide and a diagnostic challenge for emergency physicians. Our study aims to find the prevalence of dyspnea among patients attending emergency department in our hospital.
Methods: A descriptive cross-sectional study was conducted in the emergency department of Dhulikhel hospital from May 2019 to July 2019 after ethical approval from the institutional review committee. Total 1200 samples were collected by consecutive sampling method. All patients were triaged in the emergency department as a part of regular protocol. The participants were included in the study after obtaining an informed consent from the patient or caretaker (if the patient were not able to provide it). Point estimate at 95% confidence interval was calculated along with frequency and proportion for binary data. The statistical analysis was done using R version 3.5.3 (2019-03-11).
Results: The prevalence of dyspnea among patients attending emergency department of a tertiary care hospital was 107 (8.9%) (4.6%-13.2%) at 95% confidence interval. The patients triaged into red, orange and yellow categories were 14 (13.1%), 50 (46.7%) and 43 (40.2%) respectively. Median age was 64 years and 74 (69%) were ≥60 years. Sixty-seven (62.6%) were females and 40 (37.4%) were males. Forty-four (41.1%) arrived by ambulance. Most commonly associated symptoms were cough and fever 59 (51.1%) and 44 (41.1%) respectively.
Conclusions: The prevalence of dyspnea among patients attending emergency department of our hospital is higher compared to that of other studies. This warrants structured and prompt management of dyspnea for quality improvement.
Keywords: chronic obstructive pulmonary disease; dyspnea; emergency medicine; shortness of breath.
Burden of Alcoholic Liver Disease in a Tertiary Care Center: A Descriptive Cross-sectional Study
(Nepal Medical Association, 2019) Rizal, Shikha; Joshi, Bishal Raj; Singh, Arambam Giridhari
Abstract
Introduction: Alcoholic liver disease is a serious health problem related to an unhealthy lifestyle. The three most widely recognized forms of alcoholic liver disease are alcoholic fatty liver, acute alcoholic hepatitis, and alcoholic cirrhosis. The main aim of our study is to find out the prevalence of alcoholic liver disease in tertiary care center.
Methods: A descriptive cross-sectional study was conducted among inpatient cases admitted in the medicine department of tertiary care center from 1st June 2018 to 31st May 2019. Ethical approval was taken for the study. Convenience sampling method was used. All the biochemical parameters were expressed as mean±standard deviation for each group and point estimate at 95% Confidence Interval was calculated along with frequency and proportion for binary data.
Results: Prevalence of alcoholic liver disease is 50 (50%) at a 95% Confidence Interval (40.2%-59.8%) and non-alcoholic fatty liver disease is also the same. The mean age of alcoholic liver disease was 59±12 years where as the mean age for non-alcoholic fatty liver disease was 46±18 years. Out of fifty patients of alcoholic liver disease, majority 48 (96%) of the cases were males which suggests that the prevalence of alcoholic liver disease is very common in males. Similarly, for non-alcoholic fatty liver disease, prevalence was 34 (68%) showing higher prevalence than that of females.
Conclusions: Prevalence of alcoholic liver disease is low compared to previous studies done in the similar settings. Monitoring these biochemical parameters in alcoholic liver disease at early stage could guide in planning the protocol for the initial treatment.
Keywords: alanine transaminase; alcoholic liver disease; aspartate transaminase; de-ritis ratio; gamma glutamyltransferase.