Journal Issue: Volume: 58 No. 228, August (2020)
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Volume
Number
Issue Date
2020
Journal Title
Journal ISSN
JNMA Print ISSN: 0028-2715; Online ISSN: 1815-672X
Journal Volume
Articles
Telemedicine and Virtual Health Care during Coronavirus Disease Pandemic
(Nepal Medical Association, 2020) Shrestha, Badri Man
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Prevalence of Psychological Effect of COVID-19 on Medical Professionals in a Tertiary Care Center
(Institute of Medicine, 2020) Shrestha, Surendra Lal
Abstract
Introduction: COVID-19 is a pandemic disease first detected in Wuhan, China on last December 2019. Many doctors and nurses, were infected and lost their life by COVID-19 around the world. Therefore COVID-19 brought unbearable psychological pressure on doctors, and nurses. The objective of this study is to find the prevalence of anxiety among medical doctors and nurses.
Methods: This is a descriptive cross-sectional study of 101 doctors and nurses carried out in a tertiary care center. Convenience sampling was done with the study period from April to May 2020. Ethical approval was taken from the institutional review board of NAMS (IRB reference no. 1076). The collected data stored and analyzed with statistical software (SPSS version 26.0). Point estimate at 95% Confidence Interval was calculated along with frequency and proportion for binary data.
Results: Out of 101 participants prevalence of anxiety was found to be 74 (73.3%) (64.68-81.33 at 95% Confidence Interval). Among them, 9 (8.9%) of participants experienced sever types of generalized anxiety disorder, 23 (22.8%) moderate, and 42 (41.6%) mild type. Similarly, 18 (17.8%) and 10 (9.9%) of participants felt very difficult and extreme difficulty at the workplace and home respectively.
Conclusions: The mental health of medical doctors and nurses is significantly affected during the COVID-19 pandemic. Hospital administration should conduct psychological preparedness training to the medical profession before posting on duty to provide quality health services to the patients.
Keywords: COVID-19; doctor; generalized anxiety disorder; nurses.
Prevalence of Acute Kidney Injury in Patients with Liver Cirrhosis
(Nepal Medical Association, 2020) Thapa, Pukar; KC, Sudhamshu; Hamal, Achyut Bikram; Sharma, Dilip; Khadka, Sandip; Karki, Niyanta; Jaishi, Bikash; Tiwari, Pratap Sagar; Vaidya, Anshu; Karki, Binod
Abstract
Introduction: Acute kidney injury is a common and life-threatening event in patients with liver cirrhosis occurring in approximately 20-50% of hospitalized patients of liver cirrhosis. Pre-renal acute kidney injury, the hepatorenal syndrome type of acute kidney injury and acute tubular necrosis represent the common causes. The aim of this study was to study the profile of acute kidney injury in patients with liver cirrhosis.
Methods: Consecutive patients of liver cirrhosis admitted in Liver unit of Bir Hospital were studied to see the presence of acute kidney injury in this hospital based descriptive cross-sectional study. Clinical and laboratory parameters along with various clinical outcome were compared between different groups categorized by the severity of liver disease and renal dysfunction.
Results: Out of 302 liver cirrhosis patients, 56 (18.5%) had acute kidney injury among which 23 (46%) were found to have pre-renal acute kidney injury, 15 (30%) with hepatorenal syndrome– acute kidney injury and 12 (24%) with intrinsic renal disease. Patients with higher stages of acute kidney injury had longer duration of hospital stay and hepatorenal syndrome-acute kidney injury was seen in patients with higher grade of ascites and with hyponatremia.
Conclusions: Acute kidney injury is a common occurrence in patients with advanced liver cirrhosis with pre-renal acute kidney injury being the commonest cause. Median hospital stay is directly affected by the severity of acute kidney injury and hepatorenal syndrome–acute kidney injury was seen in patients with higher grade of ascites and hyponatremia. Early identification of patients at high risk for acute kidney injury may help to reduce mortality and contain costs.
Keywords: Acute kidney injury; Hepatorenal syndrome; Liver cirrhosis.
Distress Screening among Patients with Hematological Malignancies: A Descriptive Cross-sectional Study
(Nepal Medical Association, 2020) Paudel, Bishal; Paudel, Bishnu Dutta; Mishra, Rupesh; Karki, Onika; Shahi, Rukmini; Poudyal, Bishesh Sharma
Abstract
Introduction: Distress is a major concern during diagnosis and treatment of hematological malignancies. The Distress Thermometer is a commonly used screening tool to detect distress. The objectives of this study was to know the prevalence and identify distress score among patients with hematological malignancies in Nepal.
Methods: A descriptive cross sectional study was carried out at the Hematology Unit of Civil Service Hospital after obtaining an ethical approval from the Institutional Review Committee (reference number 931/076/077). A convenient sampling technique was used for this study. Statistical Package for the Social Sciences version 20.0 was used. All patients within one week of diagnosis and before the start of definitive treatment of hematological malignancies were included in the study. National Comprehensive Cancer Network Psychosocial Distress Screening Tool was used to measure the seriousness of distress.
Results: A total of 100 patients were enrolled in the study, among them 56 (56%) were male and 44 (44%) were female. The mean distress score in our study was found to be 5.68±1.75. Mean distress score among male and female patients were 5.84±1.65 and 5.48±1.86 respectively. Thirty three percentage (n=33) of patient had mild distress whereas, sixty six percentage (n=67) of patients experienced moderate to severe distress.
Conclusions: There was a significant level of distress among the patients with hematological malignancies in Nepal. Therefore, distress screening should be done to all the patients when initial diagnosis is made.
Keywords: distress; distress thermometer; hematological malignancy.
Prevalence of Helicobacter Pylori in Endoscopic Gastric Biopsies of Chronic Gastritis Patients at A Tertiary Care Centre
(Nepal Medical Association, 2020) Tiwari, Archana; Rai, Ramji; Dahal, Prahar; Regmi, Sudeep
Abstract
Introduction: Presence and severity of Helicobacter pylori (H. pylori) colonization is an important factor to decide the treatment of chronic gastritis. This study aimed to find the prevalence of H. pylori colonization in chronic gastritis patients.
Methods: This descriptive,cross-sectional study was carried out at the tertiary care center in the the western region of Nepal among the dyspeptic patients undergoing endoscopic gastric biopsy from October 2018 to March 2020 after approval from the Institutional review committee. Convenience sampling was done to reach the sample size. Two hundred fifty cases were included in the study. Data were recorded in proforma and Data analysis was done in the statistical package for social sciences (SPSS 16.0). The severity of H. pylori colonization and gastritis was graded using the Updated Sydney System.
Results: All cases showed chronic gastritis on histopathology. H. pylori were seen in 150 (60%) of cases. Mild, moderate, and severe H. pylori infection was seen in 59, 78, and 13 cases respectively. Out of 59 mild H. pylori cases, 35 (59.32%) had mild chronic inflammation; out of 78 moderate H. pylori cases 51 (65.38%) had moderate chronic inflammation and among 13 severe H. pylori cases, 10 (76.92%) had severe chronic inflammation.
Conclusions: Prevalence of H. pylori colonization is high in chronic gastritis and there is a parallel increase in the severity of gastritis with an increase in the severity of H. pylori load.
Keywords: endoscopy; gastritis; H.pylori.