Journal Issue: Volume: 13, No 4, Issue 52 (OCT-DEC) 2015
Loading...
Volume
Number
Issue Date
2015
Journal Title
Journal ISSN
1812-2027
Journal Volume
Articles
Is the Science in Right Direction? Pitfalls of Evidence Based Medicine in Nepal
(Kathmandu University, 2015) Sathian, B
NA
Comparison of Hysterosalpingography and Combined Laparohysteroscopy for the Evaluation of Primary Infertility
(Kathmandu University, 2015) Nigam, A; Saxena, P; Mishra, A
ABSTRACT
Background
Hysterosalpingography (HSG) is a useful screening test for the evaluation of female
infertility. Laparoscopy has proven role in routine infertility work up but role of
hysteroscopy in an infertile patient with normal HSG for additional information is a
subject of debate. Hysteroscopy permits direct visualization of the cervical canal and
the uterine cavity and thereby helping in the evaluation of shape, and cavitary lesion.
Objective
To detect uterine abnormalities in infertile women by various approaches i.e. HSG and
hysteroscopy and evaluating the role of combining hysteroscopy with laparoscopy
for the evaluation of tubo-uterine factor for primary infertility.
Method
One twenty eight infertile women were evaluated and HSG was performed as a basic
test for evaluation of tubes and uterine cavity. Women were subjected to combined
laparoscopic and hysteroscopic examination on evidence of HSG abnormalities. In
absence of any HSG abnormality, women were subjected to ovulation induction
for three to six months and if they did not conceive during this period they were
undertaken for combined laparo-hysteroscopic evaluation.
Result
The positive predictive value of HSG for detecting the intrauterine abnormalities was
70% among 126 patients where the hysteroscopy could be performed successfully.
The diagnostic accuracy of HSG for intrauterine abnormalities revealed false negative
rate of 12.96%. The most frequent pathologies encountered by laparoscopy were
tubal and/or peritoneal and were found in 68% (87/128) of women. Total 64.06%
infertile women had some abnormality on laparoscopy. This detection rate has been
increased from 64.06% to 71.86% on including the concomitant hysteroscopy.
Conclusion
HSG is a good diagnostic modality to detect uterine as well as tubal abnormalities
in infertile patient. HSG and hysteroscopy are complementary to each other and
whenever the patient is undertaken for diagnostic laparoscopy for the infertility,
hysteroscopy should be combined to improve the detection rate of abnormalities
especially in communities where there is enormous risk of pelvic infection.
KEY WORDS
Hysterosalpingography, hysteroscopy, infertility, laparoscopy
Sonographic Assessment of the Normal Dimensions of Liver, Spleen, and Kidney in Healthy Children at Tertiary Care Hospital
(Kathmandu University, 2015) Thapa, NB; Shah, S; Pradhan, A; Rijal, K; Pradhan, A; Basnet, S
ABSTRACT
Background
Ultrasonography is one of the most common imaging modality to measure dimensions
of visceral organs in children. However, the normal limit of size of visceral organs
according to age and body habitus has not been specified in the standard textbooks.
This might result in under detection of organomegaly in pediatrics population.
Objective
The objective of this study was to determine the normal range of dimensions for the
liver, spleen, and kidney in healthy children.
Method
This is prospective cross-sectional, hospital-based study done at Tertiary-care teaching
hospital. Participants included 272 pediatric subjects (152 male and 120 female) with
normal physical or sonographic findings who were examined because of problems
unrelated to the measured organs. The subjects were one month to 15 year (180
months) old. All measured organs were sonographically normal. Relationships of the
dimensions of these organs with sex, age, body weight and height were investigated.
Limits of normal dimensions of these organs were defined.
Result
Normal length of liver, kidneys and spleen were obtained sonographically for 272
children (152 male [55.9%] and 120 female [44.1%]) in the age group from 1 months
to 15 (180 months) years. The mean age was 45.78 months (SD, 44.73). The measured
dimensions of all these organs showed highest correlation with height and age so the
descriptive analysis of the organ dimensions (mean, minimum, and maximum values,
SD and 5th and 95th percentiles) were expressed in 10 age groups along with height
range of the included children. The mean length of right kidney was shorter than the
left kidney length, and the difference was statistically significant (p = 0.001).
Conclusion
This study provides practical and comprehensive guide to the normal visceral organ
dimension in pediatric population. The normal range limit of the liver, spleen, and
kidney determined in this study could be used as a reference in daily practice in local
radiology clinics.
KEY WORDS
Children, kidneys, liver, spleen, ultrasonography
Knowledge, Attitude and Practice of Contraception among Postpartum Women Attending Kathmandu Medical College Teaching Hospital
(Kathmandu University, 2015) Bajracharya, A
ABSTRACT
Background
Failure to plan a pregnancy can adversely affect the health of the family as a
whole. High parity is related to increased maternal, perinatal and infant deaths
and is associated with nutritional problems of both mother and child. Hence,
good knowledge, attitude and practice of family planning among women are
important. This study is aimed to determine the knowledge, attitude and practice of
contraception among the postpartum women attending Kathmandu Medical College
Teaching Hospital.
Objective
To determine the knowledge, attitude and the practice of various contraceptive
methods among the postpartum women.
Method
A cross-sectional observational study was conducted in the department of Obstetrics
and Gynecology on 400 postpartum women (within 42 days of delivery) who
delivered and came for follow-up in this institution. All the postnatal women were
interviewed with pre-designed questionnaire and information on sociodemographic
variable, awareness and knowledge of various contraceptive methods, previous
and current use of family planning methods, source of information, utilization and
reasons for use/non-use of family planning methods were obtained. Data collected
were entered and analyzed using SPSS 20. The results were presented as percentages,
means, tables and charts.
Result
Majority of the participants 363 (90.8%) were aware of contraceptive usage. Amongst
60.5% of women who had previously used contraception, OCPs were the commonest
one. Maximum number of participants (60.35%) had used modern contraceptives
in the past. The most common source of information on contraception was media
(55.7%). The reason of using contraception was spacing between the subsequent
pregnancies, while the most common reason of discontinuation or not willing to use
family planning methods was husband being abroad, fear of side effects and not
knowing which contraceptives to use.
Conclusion
The contraceptive awareness and knowledge among the postpartum women was
high but their usage was low. Hence, efforts should be made to educate the public
about safety and convenience of modern methods of contraceptives. Health care
personnels should also counsel the clients for adopting the contraceptives according
to their need.
KEY WORDS
Contraception, knowledge, postpartum, practice
Self-Esteem and Academic Stress among Nursing Students
(Kathmandu University, 2015) Acharya Pandey, R; Chalise, HN
ABSTRACT
Background
Stress and self-esteem are common issues that everyone has to cope with at some
time in their lives and they could also affect other things going on in a persons’ life.
Academic stress is psychological condition often experienced by college students as,
to some extent, being multidimensional variables. Among others are self-esteem and
psychological well-being which are considered to have influences in explaining why
college students experience stress.
Objective
The objective of this study was to assess the self-esteem level and academic stress
among the nursing students.
Method
This is a cross-sectional study carried out in 2012. Total respondents were 190
nursing students selected randomly from Kathmandu University. Academic stress
was assed using 30-item Scale for Assessing Academic Stress (SAAS) and Self esteem
was assessed using 10 item Rosenberg’s Self-Esteem Scale. Information was collected
through the self-administered questionnaire. The collected data was analyzed using
SPSS version 16 software. Simple statistics measurement, percentage, means,
correlation was used for the data analysis.
Result
This study shows mean age of the respondent’s was 20.44±2.67 years. Majority
(88%) of students getting financial support of less than NRs 6000 per month and
64% have low perceived family support. This study found mean score of self esteem
and academic stress was 11.9 and 18.4 respectively. Further nearly 78% students
have low self esteem and 74% have high academic stress. Significant variable for high
academic stress and low self esteem were lower the age, lower the education and
low perceived family support. Lower financial support has also high academic stress.
Conclusion
Nursing students have low self esteem and high academic stress. Intervention to
lower the academic stress and increase the self esteem should be carried out so that
the learning of students will be efficient.
KEY WORDS
Academic stress, nursing students, self-esteem