Journal Issue:
Volume: 13, No 4, Issue 52 (OCT-DEC) 2015

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Volume

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Issue Date

2015

Journal Title

Journal ISSN

1812-2027

Journal Volume

Journal Volume
Volume: 13

Articles

Publication
Is the Science in Right Direction? Pitfalls of Evidence Based Medicine in Nepal
(Kathmandu University, 2015) Sathian, B
NA
Publication
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
Publication
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
Publication
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
Publication
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

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