Journal Issue: Volume: 23, No 1, Issue 89 (JANAURY - MARCH) 2025
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Volume
Number
Issue Date
2025
Journal Title
Journal ISSN
1812-2027
Journal Volume
Articles
Physician Burnout: Time for Systemic Change, Not Just Resilience Training
(Kathmandu University, 2025) Shrestha, A
NA
Radiological Assessment of Femoroacetabular Impingement Morphology Using Computed Tomography in Asymptomatic Young Population
(Kathmandu University, 2025) Koirala, S; Gupta, MK; Baral, P; Adhikari, K
ABSTRACT
Background
Femoroacetabular impingement is regarded as precursor of osteoarthritis. Various
studies have discussed the prevalence of femoroacetabular morphology but only few
studies have been done on asymptomatic population using cross-sectional imaging.
Objective
To determine the prevalence of femoroacetabular impingement morphology in
young asymptomatic population on computed tomography.
Method
This cross-sectional study was done in 200 individuals who underwent computed
tomography for abdominal pathologies without any symptoms of hip pain, hip
pathology or osteoarthritis. Multiplanar images were reformatted and assessed for
the presence of parameters associated with femoroacetabular impingement; alpha
angle greater than 55°, femoral head-neck offset less than 8 mm, angle of acetabular
version less than 15°, lateral center edge angle greater than 40°.
Result
At least one of the femoroacetabular impingement morphology was detected in 162
hips. The prevalence of abnormal hip joint was higher in male patients than in female
patients (47.3% vs 31.8%). Prevalence of cam morphology was 14.5%, pincher was
17.5% and mixed morphology was 8.5%. Prevalence of cam and mixed morphology
were common in male hips however there was no statistically significant difference
in prevalence of pincher morphology between male and female hips.
Conclusion
Femoroacetabular morphology was noted with high frequency in asymptomatic
young population on computed tomography. Diagnosis of femoroacetabular
impingement syndrome should be based on combination of clinical and radiological
findings.
KEY WORDS
Alpha-angle, Cam, Femoroacetabular impingement, Pincher
Efficacy of Budesonide Nasal Irrigation in Comparison to Normal Saline Irrigation in Post-Operative Management of Functional Endoscopic Sinus Surgery
(Kathmandu University, 2025) Shrestha, BL; Sijapati, D; Dhakal, A
ABSTRACT
Background
Nasal irrigation with normal saline and topical steroid spray forms the mainstay of
treatment in post endoscopic sinus surgery patients. However nasal sprays may not
deliver optimum dosage of drug to the paranasal sinus mucosa. Budesonide nasal
irrigation solves this problem by delivering drugs in a high-volume high-pressure
system.
Objective
The main objectiveof this study will provide insight into the efficacy of budesonide
nasal irrigation following functional endoscopic sinus surgery (FESS) surgery and will
help to establish new protocols in future.
Method
Forty-four patients were included and divided into 2 groups of 22 each. One arm
received normal saline nasal irrigation and the other arm received budesonide nasal
irrigation (1 mg in 500 ml) twice daily. Patients were followed up at 1st post-operative
week and 10th post-operative week and on each visit Sino-Nasal Outcome Test (SNOT)
22 and Lund Kennedy Endoscopic scores (LKES) were assessed.
Result
The mean scores in the first visit was SNOT 22 : 15.73 + 8.897 vs 12.73 + 16.110 (p <
0.05) and LKES : 2.82 + 1.097 vs 1.77 + 1.52 (p > 0.05) in the saline and budesonide
groups respectively. The mean scores in the second visit was SNOT 22 : 7.09+3.87
vs 3.73 + 8.70 (p < 0.05) and LKES : 1.64 + 0.790 vs 0.18 + 0.501 (p < 0.05) in the
saline and budesonide groups respectively. Thus the budesonide arm had statistically
significantly better scores when compared to the normal saline group.
Conclusion
Budesonide nasal irrigation with a positive pressure high volume device was found
to have better efficacy when compared to normal saline irrigation. Budesonide
nasal irrigation may be used in the post-operative management of endoscopic sinus
surgery patients.
KEY WORDS
Budesonide, Endoscopic surgical procedure, LKES, Nasal irrigation, SNOT 22
A Spatial Model of Socioeconomic and Demographic Determinants of Dengue Hemorrhagic Fever in Nepal
(Kathmandu University, 2025) Mahato, RK; Htike, KM; Yadav, A; Baral, S; Yadav, RK; Kafle, A; Sharma, V
ABSTRACT
Background
Dengue hemorrhagic fever (DHF) has re-emerged across the global South, particularly
in tropical and subtropical urban areas, driven by environmental changes alongside
local demographic and socioeconomic factors.
Objective
To investigate the spatial patterns and socioeconomic determinants of dengue fever
in Nepal from 2020 to 2023.
Method
Using Geographic Information Systems (GIS), Gi* cluster analysis, and Local Moran’s
I statistics, the study examined the relationship between socio-economic variables
and dengue incidence across districts. Key factors analyzed included population
density, urbanization, and night-time light (NTL) intensity.
Result
Bivariate Local Indicators of Spatial Association (LISA) analysis showed fluctuating
correlations between dengue hemorrhagic fever incidence and factors such as
population density, urbanization, and night-time light intensity. Moran’s I value for
population density were -0.083 in 2020, -0.082 in 2021, 0.526 in 2022, and -0.020
in 2023. Similarly, for urbanization, Moran’s I values shifted from -0.103 in 2020
to -0.090 in 2021, 0.458 in 2022, and 0.007 in 2023. Night-time light intensity also
demonstrated changing correlations, with Moran’s I values of -0.091 in 2020, -0.102
in 2021, 0.415 in 2022, and -0.068 in 2023. A notable shift from negative to positive
correlations occurred between 2020 and 2022. In 2022, high-incidence dengue
hemorrhagic fever clusters emerged in densely populated areas, while distinct spatial
patterns were observed in 2020 and 2021.
Conclusion
Dengue hemorrhagic fever risk spatial models are useful tools for detecting high-risk
locations and driving proactive public health initiatives. The study emphasized the
importance of dynamic, targeted public health interventions based on spatial and
socio-economic factors to effectively manage evolving dengue outbreak patterns.
KEY WORDS
Dengue, Gi* statistics, Local indicators of spatial association, Socio-economic status,
Spatial analysis
Prevalence Survey of Antimicrobial Use among Admitted Patients in Tertiary Care hospital: An observational study
(Kathmandu University, 2025) Aryal, S; Joshi, M; Uprety, BN; Shrestha, RK; Gupta, M; Shah, P; Rajbhandari, P; Amatya, R; Shrestha, P; Ojha, AR
ABSTRACT
Background
Monitoring the antimicrobial use is one of the key strategies to address the growing
global threat of antimicrobial resistance.
Objective
To find out antimicrobial usage at tertiary care hospital of Lalitpur, Nepal.
Result
An observational cross-sectional study was carried out at the Patan Academy of Health
Sciences, Lalitpur, Nepal on September 25 and 26, 2023. World Health Organization
point prevalence survey methodology was used with minor modification to meet
hospital’s context. The data on antimicrobial usage were collected from the medical
records of patients admitted at or before 08:00 am on the day of the study in the
acute care ward.
Result
The study involved 324 inpatients, with females comprising 176 (54.3%) and males
148(45.7%). The mean age was 37.89 years ± 24.87. Antibiotics usage was 78.1%.
A total of 471 drug was prescribed of which 312 (66.2%) was used for therapeutic
purpose and 159 (33.8%) for prophylaxis. Of 312 antibiotics, 283 (90.7%) were
utilized empirically. Majority of prescribed medications belonged to watch group 16
(48.5%). Ceftriaxone was the most frequently prescribed antibiotic 142 (30.1%) and
was the preferred choice for surgical prophylaxis 68 (94.4%). A total of 24 (72.7%)
drugs were prescribed from the National List of Essential Medicines and 432 (91.7%)
prescriptions were written using generic names.
Conclusion
The use of antibiotic was high, with good adherence to essential medicines and
generic prescribing. Strengthening antimicrobial stewardship and evidence-based
practices can further optimize prescribing, enhance patient safety and help combat
antimicrobial resistance effectively.
KEY WORDS
Antibiotic, Nepal, Point prevalence survey, Tertiary care hospital