Journal Issue: Volume: 2 No. 2 (2026): AUG
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2026
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eISSN: 3102-0194 pISSN: 3102-0186
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The Pulse of Progress: Bridging Gaps in National HealthcareResearch in Nepal
(Nepal APF Hospital, 2026) Chaulagain, Rajib
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Analgesic Efficacy of Intraincisional and Intraperitoneal Bupivacaineversus Ropivacaine in Laparoscopic Cholecystectomy in a TertiaryCare Hospital: A Prospective Observational Study
(Nepal APF Hospital, 2026) Yadav, Vimal Kumar; Dhittal, Saroj Prasad; Deo, Kishor Kumar
Abstract:
Introduction: Laparoscopic Cholecystectomy is established as the standard treatment in cases of symptomatic cholelithiasis and chronic cholecystitis. Adequate postoperative pain management has favorable outcomes for the patients. Port site and intraperitoneal instillation of local anesthetics have shown good results. The aim of this study was to compare the analgesic effects of bupivacaine and ropivacaine in postoperative pain relief following laparoscopic cholecystectomy.
Methods: An observational study was conducted among 60 patients who underwent elective Laparoscopic Cholecystectomy in a tertiary care hospital from August 2020 to January 2021, following ethical approval from the Institutional Review Board (IRB Ref No. 449/2077/78). The patients received intraincisional (10 ml) and intraperitoneal (10 ml) infiltration of 25% bupivacaine or 25% ropivacaine. The pain was evaluated via a 100 mm Visual Analogue Scale. Statistical analysis was performed using independent sample t-test, Mann-Whitney U test, and Chi-square test and analyzed using the Statistical Package for the Social Sciences version 23. Point estimate at 95% Confidence Interval was calculated along with frequency and percentages for binary data and mean and standard deviation for continuous data.
Results: The mean duration of surgery was 90.58±10.67 minutes. Out of total patients, the ropivacaine group had significantly lower Visual Analogue Scale at 1 hour and 6 hours compared to the bupivacaine group (p= 0.028 and p= 0.007, respectively). The ropivacaine group had a significantly longer mean time to first rescue analgesia (203±40.52 minutes) than bupivacaine group (141.50±43.80 minutes) (p= 0.001). The total amount of pethidine consumption after 24 hours was significantly less in ropivacaine group (30 mg) than bupivacaine group (70 mg; p <0.001).
Conclusions: Ropivacaine provided superior analgesia with lower pain scores, prolonged analgesic duration, and reduced opioid requirements following cholecystectomy compared to bupivacaine, while both agents were realtively safe.
Clinical Profile and Outcome of Guillain Barré Syndrome in a TertiaryCare Hospital: A Retrospective study
(Nepal APF Hospital, 2026) Lamichhane, Jayaram; Gajurel, Bikram Prasad; Karn, Ragesh; Rajbhandari, Reema; Gautam, Niraj; Ghimire, Pukar; Panthee, Pradeep; Bhandari, Pragya; Khanal, Kapil
Abstract:
Background: Guillain-Barré syndrome (GBS) is an acute autoimmune polyradiculopathy characterized by a highly variable long-term prognosis. There isn't much data from resource limited settings like Nepal. The objective of this study was to assess the clinical characteristics and disability outcomes one year later in GBS patients at a tertiary care center.
Methods: This retrospective study encompassed adult patients diagnosed with Guillain-Barré Syndrome (according to Brighton criteria) at Tribhuvan University Teaching Hospital from May 2023 to May 2024. We gathered information about the patients' clinical, electrophysiological, and treatment history. The Hughes GBS Disability Scale (GBS-DS) was employed to evaluate the severity of disability. One-year outcomes were classified as favorable (GBS-DS 0–2) or unfavorable (GBS-DS 3–6). Statistical analysis was employed to ascertain prognostic factors.
Results: The study included 62 patients, with a mean age of 40.18 ± 17.52 years, of whom 74.2% were male. The most common types were typical GBS (88.7%) and acute inflammatory demyelinating polyneuropathy (AIDP, 37.5%). Almost half of the patients (49%) only got treatment for their symptoms. 31.4% got intravenous immunoglobulin (IVIG), and 19.6% got plasma exchange. A year later, 51 patients were checked on again. 92.2% of them had a good outcome, and 7.8% of them had a bad outcome.
Conclusion: The majority of GBS patients exhibited significant recovery one year later. Future larger prospective studies are necessary to elucidate the prognostic factors for GBS in resource-constrained regions.
Assessing Knowledge of Cervical Cancer Screening and HumanPapilloma Virus Prevention in Security Personnel and Their Families:A Cross-Sectional Study Authors
(Nepal APF Hospital, 2026) Karmacharya, Saujanya; Khatri, Nisha; Maharjan, Rajendra; Adhikari, Laxmi; Khaural, Binita; Dulal, Ramila; Shrestha, Amrita; Yadav, Rina Kumari
Abstract:
Introduction: Cervical cancer is a leading cause of cancer-related morbidity and mortality among women in Nepal, despite being largely preventable through early screening and Human Papillomavirus vaccination. Limited evidence exists regarding knowledge of cervical cancer prevention among Armed Police Force personnel and their families. This study aimed to assess awareness and knowledge of cervical cancer, its risk factors, screening methods, and vaccination among this population.
Methods: This was a hospital-based descriptive cross-sectional study conducted over a four-month period after obtaining approval from the Institutional Review Committee (Reference number: NAPFH-026/2024). A structured, validated questionnaire was used to collect data on socio-demographic characteristics and knowledge of cervical cancer, screening methods, and vaccination. A convenience sampling included 410 participants. Data were analyzed using Statistical Package for the Social Sciences version 26.
Results: Among 410 participants, 315 (76.83%) had heard of cervical cancer, with media 104 (25.36%) being the most common source of information. Knowledge of cervical cancer risk factors and symptoms was variable, with multiple sexual partners 157 (38.29%) and post-menopausal bleeding 154 (37.56%) being the most frequently identified. More than half of the respondents, 225 (54.87%), believed cervical cancer is preventable, and 222 (54.15%) identified regular screening as a key preventive method. Although 251 (61.22%) had heard of the HPV vaccine, only 95 (23.17%) correctly identified the optimal timing for vaccination, and substantial misconceptions persisted regarding HPV infection, vaccine availability, and the necessity of screening after vaccination.
Conclusions: While general awareness of cervical cancer was moderate, substantial knowledge gaps exist regarding HPV-related prevention and screening practices. Targeted education and counselling initiatives are essential to improve cervical cancer prevention and early detection among security personnel and their families.
Study of Co-morbidities in Schizophrenia in Patients Admitted to aTertiary Care Centre: An Observational Study
(Nepal APF Hospital, 2026) Amatya, Anugya; Pradhan, Sudarshan Narsingh
Abstract:
Introduction: Patients with schizophrenia vary substantially relative to their symptoms, response to treatment, disease impact on function and biological correlates. Approximately 50% of patients with schizophrenia have at least one comorbid psychiatric or medical condition. This study was conducted to assess various psychiatric and medical comorbidities complicating the clinical picture of schizophrenia.
Methods: A hospital-based descriptive cross-sectional study was conducted at the Department of Psychiatry of a medical college in Nepal from November 2018 to December 2019. All the admitted patients in Psychiatry Ward, 18 years and above with diagnosis of Schizophrenia were included. Patients admitted in intensive units and outpatient patient visits were excluded. Ethical approval was taken from Institutional Review Committee. A data collection tool which contained of semi-structured questionnaire was developed for data collection of clinical and demographic profile. The Positive and Negative Syndrome Scale, Beck Anxiety Inventory Nepali version, Beck Depression Inventory II Nepali version and CAGE Questionnaire for assessing syndrome of Schizophrenia, depression, anxiety and use of alcohol. The collected data was entered in the Microsoft Excel and Descriptive statistics were used to summarize and present the data.
Results: Out of 60 patients, 55 (91.68%) and 37 (61.68%) had psychiatric and medical comorbidities respectively. Co-morbid psychiatric conditions such as substance use, anxiety and depression were found in 37 (61.68%), 35 (58.33%) and 30 (50%) of them. Sexual dysfunction and menstrual dysfunction were common co-morbidities followed by dyslipidaemia and electrolyte imbalance.
Conclusions: This study found the substantial burden of comorbid conditions in the patients with schizophrenia.