Journal Issue: Volume: 56, No. 211, May-Jun, 2018
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Volume
Number
Issue Date
2018
Journal Title
Journal ISSN
JNMA Print ISSN: 0028-2715; Online ISSN: 1815-672X
Journal Volume
Articles
Perceptions of Medical Students About Bedside Teaching in a Medical School
(Nepal Medical Association, 2018) Dhakal, Ajaya kumar; Shrestha, Devendra; Bajracharya, Suraj; Pradhan, Amita; Karki, Balman Singh; Dhakal, Sanjaya
Abstract
Introduction: Bedside teaching is an important and established learning tool in medical education. However there is a decline in bedside teachings over the years throughout the world including Nepal, due to advancement in medical technology, clinical skills labs and simulation techniques. This study aimed to find out the perception of Nepalese medical students towards different domains of bedside teaching.
Methods: This was a descriptive cross-sectional study. A questionnaire consisting of Likert scale, open ended and closed ended questions was developed on different aspect of bedside teaching and the filled questionnaires were included for analysis.
Results: Three hundred and six questionnaires were included. Almost all of medical students responded that bedside teaching is a useful learning modality in clinical teaching 304 (99.3%) and provides active learning in real context 291 (95%). The majority of medical students 233 (76%) were satisfied with the steps of history taking, examination followed by management discussion employed at bedside teaching. The students 223 (73%) were satisfied, how to elicit signs following demonstration of clinical exam by teachers at bedside. However majority 196 (64%) felt lack of individual opportunity at bedside. According to students, focussing more on practically oriented clinical skills with proper supervision would improve learning while hindering factors were large number of students and patient’s uncooperativeness. Good communication was considered the best method of alleviating patient discomfort at bedside teaching in this study.
Conclusions: The study concluded that medical students have positive response and learning attitudes towards different aspects of bedside teaching.
Keywords: Bedside teaching, Medical education, Medical students
Lifetime Experience of Violence in Early Adulthood Female
(Nepal Medical Association, 2018) Silwal, Kalpana; Dhakal, Prativa; Raut, Krishna Bahadur; Chaudhary, Rajendra Kumar
Abstract
Introduction: Despite political commitment and a supportive legal and policy framework, violence against women remains a significant problem in Nepal. Nepal Demographic and Health Survey reported more than one in five women experience violence in lifetime. Three fourth of women who had experienced physical or sexual violence had not sought any help.
Methods: Descriptive cross-sectional study was carried out in an Institute in Lalitpur. Accessibility sampling was used to find out the experience of violence from their childhood to this date. The data were collected by self-administered questionnaire was distributed to the female students. Data were analyzed using SPSS. Frequency, mean, percentage and standard deviation were calculated.
Results: More than three fourth 71 (79.8%) of the female students were victim of violence and among them most 67 (75.3%) were at age of 11 to 19 years. Majority 63 (70.8%) were victimized from strangers followed by friends 11 (12.4%). Teasing 55 (61.8%) and unwanted touching 35 (39.3%) were the most common type of violence. Most 51 (57.3%) were the victim while traveling by public vehicle and walking on road 47 (52.8%). More than half (57.7%) were suffered <5 times. One third 34 (38.2%) told strict punishment to the offenders followed by awareness program 32 (36%) for the prevention of violence.
Conclusions: Majority of the female students were victim of violence and offenders were young adult. Awareness program, strict rules and punishment to offenders should be implemented to prevent the violence among girls.
Innovative Method of Using Endoscope in Postoperative Canal Wall Down Mastoid Cavity
(Nepal Medical Association, 2018) Bista, Meera; Mahato, Nain Bahadur; Regmi, Deepak
Abstract
Introduction: Poor access to the difficult areas in the middle ear and mastoid cavity is considered as the major reason for failure in mastoid surgery. Wide field visibility, visualization of nooks and corners by an endoscope could contribute to better clinical control of the disease in these patients that cannot be accessed by the operating microscope.
Methods: This was a descriptive cross-sectional study, done in Kathmandu Medical College from January to June 2017. Thirty two patients were included in the study. Data collection was done by convenient sampling. Statistical analysis was done by Chi square test and Fisher Exact test, P value of <0.005 was considered statistically significant.
Results: The study revealed that exposure benefit with an endoscope in canal wall down mastoid surgery was significantly better than with a microscope (P value of 0.034). The level of complete clearance and level of difficulty in cleaning with the help of a microscope compared to endoscope did not show a significant difference with P value of 0.288 and 0.652 obtained by Fisher extract test respectively. After microscopic removal of materials from the mastoid cavity, 22 (68.8%) which is more than half of cases had remaining materials in the cavity which was removed by endoscope completely.
Conclusions: Outcome will make the ENT surgeons aware of use of endoscopy in post mastoid follow up cases to give better results and make the surgeon much more successful in his/her endeavor to eradicate the disease.
Keywords: Canal wall down mastoidectomy, Cleaning of mastoid cavity, Oto-endoscopy, Recidivism
Cervical Cancer Awareness and Practice of Pap Smear Test Among Women with Gynecological Problems
(Nepal Medical Association, 2018) Thapa, Meena
Abstract
Introduction: Cervical cancer is the most common cancer in women in Nepal. Pap smear test is the most important screening test for cervical cancer, which helps in reducing mortality from it. This study is to assess the knowledge of cancer cervix and practice of Pap smear test and to analyze the impact of educational status on them.
Methods: This was a descriptive cross-sectional study, carried out among the married women who attended the Out Patient Department for gynecological problems at Kathmandu Medical College. Structured questionnaires were used to collect the data. The questionnaire consisted of three sections which included the demographic profile in first part , second part included assessment of the knowledge of cancer cervix, and third part included evaluation of the utilization of Pap smear test.
Results: A total of 205 married women were included in the study. Out of them, 74% were aware of cancer cervix. Only 39% of women were aware of Pap smear test. Pap smear test coverage was 16.6% in studied population. Main reason of not doing Pap smear test was lack of knowledge of the test. High educational status of the women had significant positive impact on knowledge of cancer cervix and practice of Pap smear test.
Conclusions: The knowledge of cancer cervix was good in our women, but knowledge and the practice of Pap smear test was poor. Good educational status of the women was found to influence the on knowledge of cancer cervix and uptake of Pap smear test.
Keywords: Awareness; Cervical cancer; Pap smear test.
Acoustic Analysis of Voice in School Teachers
(Nepal Medical Association, 2018) Mahato, Nain Bahadur; Bista, Meera; Regmi, Deepak; Sherpa, Pema
Abstract
Introduction: The term ‘voice' is the acoustic energy generated from the vocal tract that are characterized by their dependence on vocal fold vibratory pattern. Teachers as professional voice users are afflicted with dysphonia and are discouraged with their jobs and seek alternative employment. Loud speaking and voice straining may lead to vocal fatigue and vocal fold tissue damage.
Methods: Sixty teachers from various schools, volunteered to participate in this study. Acoustic analysis Doctor Speech Tiger Electronics, USA was used to assess the voice quality of the school teachers before and after teaching practice. The data were collected and analyzed using Doctor Speech Tiger Electronics, USA. Analysis was performed in terms of perturbation (jitter and shimmer), fundamental frequency, harmonic to noise ratio and maximum phonation time.
Results: We found statistically significant difference in all the four parameters except the Jitter value. The fundamental frequency and shimmer value has significantly increased (P<0.001) and (P=0.002) respectively after teaching practice. Unlikely, there was significant decrease in harmonic to noise ratio value (P<0.001) and maximum phonation time value (P<0.01) after teaching practice.
Conclusions: Vocal abuse, overuse, or misuse in teaching practice over a long period of time can result in inadequate phonatory pattern due to vocal fold tissue damage, which ultimately results in vocal nodules or polyps. So voice evaluation is particularly important for professional voice users and for the people who are concerned about their quality of voice.
Keywords: Acoustic analysis, Doctor speech, Fiberoptic laryngoscopy, GRBAS scale, Voice