Journal Issue: Volume 26, No. 2 (2024)
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Volume
Number
Issue Date
2024
Journal Title
Journal ISSN
Online ISSN: 2676-1424; Print ISSN: 2676-1319
Journal Volume
Articles
Knowledge of tooth discoloration and tooth bleaching amongst adult patients visiting a dental hospital in Kathmandu, Nepal
(Nepal Medical College Pvt. Ltd., 2024) Joshi, Rojin; Gautam, Suman; Joshi, Barsha
Abstract:
A beautiful smile increases the self-confidence and well being of an individual. Tooth discoloration is one of the cause for a patient to stop smiling, be less interactive with other people and the person might feel neglected from the society. Many people don’t know about the various causes of tooth discoloration and the treatment options. Bleaching is a very conservative method to whiten the teeth. Until now limited studies have been done to assess the knowledge of tooth discoloration and vital tooth bleaching in context to Nepal. Hence, the objective of this study was to assess the knowledge of tooth discoloration and tooth bleaching amongst adult patients. This cross sectional study was done on 326 patients of 18 years and above. Personal interviews using a structured and validated questionnaire were conducted to collect the following information: demographic data, the participant’s level of satisfaction of their tooth color, the participant’s level of knowledge on tooth discoloration and tooth bleaching. Data were analyzed using Chi square test and descriptive statistics were calculated. It was found that majority of the study participants (63.8%) were satisfied with the color of their teeth and most of them (58.9%) had not heard about tooth bleaching. It was seen that there was no association of different aspects of bleaching as well as etiology of tooth discoloration with gender, age group, level of education and marital status.
The association between s.t.o.n.e. nephrolithometry score and hemoglobin drop in patients undergoing percutaneous nephrolithotomy
(Nepal Medical College Pvt. Ltd., 2024) Khadka, Mohan; Bhomi, Krishna Kaji; Shrestha, Amit; Thapa, Bineet
Abstract:
Nephrolithiasis is a very common condition with significant burden to patients. Percutaneous nephrolithotomy (PCNL) is safe procedure considered as gold standard for large renal stones. The most common complication of PCNL is bleeding which can require blood transfusion to angioembolization and may even need nephrectomy. The purpose of this study is to assess if STONE Nephrolithometry Score can predict hemoglobin drop in PCNL procedure. A total of 104 patients who underwent PCNL during one year period from October of 2022 to September of 2023 were taken using consecutive sampling method. All patients with renal stones underwent routine blood tests including complete blood counts, renal function and electrolytes. CT scans were then done and STONE nephrolithometry Score was evaluated. PCNL was performed and hemoglobin investigation was sent at 24 hours postoperatively. The two data were compared with the STONE nephrolithometry Score and other factors. More than three-fourths (78.8%) of the patients had comorbidities with hypertension being the commonest (76.9%). There was a significant association of drop of hemoglobin more than 1 g/dl with age <30 years (p <0.034), higher preoperative hemoglobin (p <0.046), larger stone size (p <0.001), shorter tract length (p=0.017) and STONE Score greater than 10 (p<0.001). On correlation study only STONE score (p = 0.015) and larger stone size (p = 0.002) were associated with hemoglobin drops of more than 1 g/dl. STONE Nephrolithometry score is a good predictor of bleeding complications during PCNL and higher score is associated with more drop in hemoglobin levels.
Perception of objective structured clinical examination among undergraduates medical students
(Nepal Medical College Pvt. Ltd., 2024) Pandey, Srijana; Gartoulla, Kshitij
Abstract:
Objective structured clinical examination (OSCE) is a valuable assessment tool that enhances in-depth learning and preparation of students for clinical practice. The tasks to be assessed should be of different types and of varying difficulties. The tasks in OSCE depend on the level of students training. The aim of the study was to assess the perception of OSCE among under-graduates’ medical students. A mixed methods study (cross sectional exploratory and content analysis) was conducted with the simple random sampling, purposive sampling and content analysis technique among 86 undergraduates’ medical students at tertiary hospital. SPSS 16 was used for data entry. Frequency, percentage, Mean, Standard deviation, Mann-Whitney U-test and One Way Anova was used for data analysis. Most of the participants perceived that OSCE identified knowledge gaps (84.8%) and was educative (79.0%). There was no significant difference of perception of OSCE related to gender. There was no significant variation in participant’s perceptions of OSCE in relation to academic year regarding OSCE domain characteristics (p =0.333). However, regarding perception of OSCE domain structure in relation to their academic year, there was a significant difference as p =0.013. The overall perception of OSCE among medical students was positive. This study has identified a need for training, practice prior to an OSCE exam and allocation of adequate timefor each spot during the exam.
The safety and feasibility of segmental thoracic spinal anesthesia above umbilicus and breast surgery
(Nepal Medical College Pvt. Ltd., 2024) Gautam, Shailendra Nath; Yadav, Rajiv; Khanal, Anupa; Dangol, Sanam
Abstract:
This study was conducted on 30 patients aged 16 to 70 years with American Society of Anesthesiology (ASA) physical status I, II, and III. Though general anesthesia (GA) is a universally accepted technique for most abdominal surgeries but not free from drawbacks including poly medicine side effects, prolonged recovery time, and unnoticed inadequate pain control, as well as risk to elderly patients with cardiopulmonary conditions, and safety issue limits the usefulness of general anesthesia. Thus, the new technique adopted attracts the attention of anesthesiologists, as thoracic segmental spinal anesthesia (TSSA) for several common surgeries where local anesthetic agents injected intrathecally above the termination of the spinal cord show value in patients with high risk for general anesthesia who need deep analgesia. The types of surgery were periumbilical hernia 7 (23.33%) in both age groups followed by epigastric hernia 8 (26.66%), neoplastic diseases of breast 6 (20%), laparoscopy cholecystectomy 4 (13.33%), open cholecystectomy 5 (16.66%). The analysis of intraoperative and postoperative mean systolic and diastolic arterial pressures (MAP) of patients up to 24 hours was found insignificant (P>0.05). Regarding the intraoperative hemodynamic changes, hypotension occurred in 3 patients and resolved with a single bolus of ephedrine, no tachycardia occurred, while bradycardia in 3 patients (15%). No patients need to be converted to general anesthesia due to inadequate block. On analysis complications, peri-operative or post-operative period showed that shoulder pain was experienced by 2 patients (6.66%) in the younger age group whereas in the older age group, two patients (6.66%) have hypotension and bradycardia was seen in 3 patients (13.33%). No respiratory complications, such as postoperative pneumonia or atelectasis were noted during the hospital stay with TSSA as well and no nausea/vomiting was noted. This study provides only preliminary evidence to support the feasibility and efficacy of segmental thoracic spinal anesthesia to be used effectively for safe anesthetic technique during routine laparoscopic surgery in normal patients as well as co-morbidity patients with stable intraoperative and post-operative hemodynamic and also avoidance of complications of general anesthesia with these benefits, decrease in length of stay in hospital, reduction of postoperative pain, and increased patients satisfaction. Thus, in future the segmental spinal anesthesia may become a good alternative to general anesthesia in normal patients as well as comorbid patients.
Awareness regarding stroke among the adult population of Gokarneshwor municipality
(Nepal Medical College Pvt. Ltd., 2024) Sapkota, Abja; Devkota, Sabitra
Abstract:
A stroke is a medical emergency that occurs as a result of decreased blood supply or cessation of blood flow to the brain. Even though there are preventable risk factors still, it is one of the leading causes of disability worldwide. Awareness of the risk factors and early recognition of the symptoms can help the prevention and management of stroke. This study was conducted with an aim of assessing the awareness regarding stroke among adult population residing at Gokarneshwor Municipality. A descriptive cross-sectional study was conducted among 195 adult populations using a non-probability convenience sampling method. Data was collected by face-to-face interview technique with the self-constructed questionnaire. Data were entered and analyzed using the SPSS-16. Descriptive statistics like frequency, percentage, and inferential statistics such as the chi-square test were used and were considered significant at p< 0.05 (95% CI). The mean age of the respondents was 36.01±12.66 years. Of all, hypertension was prevalent in 32 respondents. Almost three fourth of the participants had heard about stroke. Top three stated risk factors were hypertension, alcohol consumption, and smoking. We concluded that providing informal education and conducting awareness programs on stroke would be helpful to promote awareness regarding this condition.