Journal Issue:
Volume: 57, No. 220 (2019) Nov-Dec

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2019

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JNMA Print ISSN: 0028-2715; Online ISSN: 1815-672X

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Publication
Women in Surgery: Changing Perspectives
(Nepal Medical Association, 2019) Shrestha, Badri Man
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Publication
Prevalence of Osteoporosis among Adults in a Tertiary Care Hospital: A Descriptive Cross-sectional Study
(Nepal Medical Association, 2019) Shrestha, Shriraj; Dahal, Saurav; Bhandari, Parash; Bajracharya, Suraj; Marasini, Anurag
Abstract Introduction: Osteoporosis is a common metabolic bone disease characterized by increased bone fragility, yet underdiagnosed and undertreated. With the increase in longevity of the populace, it is becoming an urgent and serious global epidemic. This being a preventable disease, has no clinical manifestations until there is a fracture. Early diagnosis and treatment are of dire necessity. Hence the aim of our study is to find the prevalence of osteoporosis among adults attending a tertiary care hospital-based on calcaneal quantitative ultrasound. Methods: This descriptive cross-sectional study was done in a tertiary care hospital, from 15th July 2019 to 15th October 2019 after receiving ethical approval from the Institutional Review Committee (Registration number: 2075 / 76 / 119). Convenient sampling was done. Data collection and entry was done in Microsoft excel, point estimate at 95% Confidence Interval was calculated along with frequency and proportion for binary data. Results: Out of 464 participants the overall prevalence of osteoporosis was 38 (8.2%) at a 95% confidence interval (5.7-10.7). Among the participants, 141 (30.4%) were male and 323 (69.6%) were female. The mean age of the participant was 41.02±14.96 years. Osteoporosis was more common in the older age group 11.66 (30.7%) in 60 years above Women were found to be more osteoporotic than men, 3.42 (9.0%) and 2.43 (6.4%) respectively. Bone mineral density and osteoporosis had a bimodal distribution, underweight 5.01 (13.2%) and obese group 5.32 (14.0%) were the two peaks. Conclusions: The prevalence of osteoporosis in our study is high and is consistent with other South Asian studies. Early detection of osteoporosis using calcaneal quantitative ultrasound can be a good screening tool. Keywords: body mass index; osteoporosis; prevalence
Publication
Prevalence of Staphylococcus aureus Isolated from Clinical Samples in a Tertiary Care Hospital: A Descriptive Cross-sectional Study
(Nepal Medical Association, 2019) Sapkota, Jyotshna; Sharma, Manisha; Jha, Beena; Bhatt, Chandra Prakash
Abstract Introduction: Staphylococcus aureus is one of the commonest cause of nosocomial infections. Resistant Staphylococcus aureus strain has become a matter of concern. This study was done to find out the prevalence of Staphylococcus aureus from different clinical samples. Methods: The descriptive cross-sectional study was carried out in the Clinical Microbiology laboratory from January 2019 to June 2019. Ethical approval was received from the Institutional Review Committee (Ref: 28122018010). Six hundred sixty-six sample size was calculated. Convenient sampling was done. Staphylococcus aureus was identified on the basis of its microscopy and morphological characteristics followed by catalase and coagulase test. Antibiotic sensitivity test of misolated pathogens was done using Muller Hinton Agar by Kirby-Bauer method. Statistical analysis was done by Excel 2018, point estimate at 95% confidence interval was calculated along with frequency and proportion for binary data. Results: Out of the 666 bacteria isolated from clinical specimens, 133 (19.96%) were Staphylococcus aureus at 95% confidence interval (129.91-136.01%). Seventy nine (78.95%) of which is isolated from pus and wound infections. Out of 133 Staphylococcus aureus, 70.64% were Methicillin-Resistant Staphylococcus aureus. Conclusions: This study provides valuable information regarding the high prevalence of Staphylococcus aureus from pus and wound infections. The alarming number of Methicillin-Resistant Staphylococcus aureus is worrisome finding. Antibiotics like Vancomycin and Linezolid which has not developed resistance should be cautiously used only in Methicillin-Resistant Staphylococcus aureus cases. Keywords: antibiotic resistance; MRSA; Staphylococcus aureus.
Publication
Prevalence of Depression among Medical Students of a Tertiary Care Teaching Hospital
(Nepal Medical Association, 2019) Shrestha, Nikhil; Shrestha, Neharika; Khanal, Smriti; Dahal, Sujata; Lama, Roshan; Simkhada, Prashant; Pradhan, Sudarshan Narsingh
Abstract Introduction: Depression is one of the major problems encountered by medical students. This may cause a negative effect on cognitive functioning and learning of students resulting in poor health care and service delivery in future. The presence of this major problem is necessary to be evaluated. Enough recent data regarding its prevalence is not available in our country. Thus, the main aim of this study is to find the prevalence of depression among medical students of a tertiary care teaching hospital. Methods: This is a descriptive cross-sectional study which was conducted among undergraduate medical students of a tertiary teaching hospital over a four-month period (July to October 2019). Ethical clearance was received from the Institutional Review Committee of the same tertiary teaching hospital. Random sampling technique was used to collect data to meet the calculated sample size. Data analysis was done in the Statistical Package for Social Sciences. Point estimate at 95% Confidence Interval was calculated along with frequency and proportion for binary data. Results: The prevalence of depression among selected medical students of Kathmandu Medical College and Teaching Hospital is 59 (27.2%) at 95% Confidence Interval (21.28-33.12%). Thirty (14%) of the participants were mildly depressed, 21 (10%) moderately depressed while 8 (4%) were severely depressed according to Beck’s Depression Index II. Conclusions: Prevalence of depression among medical students is relatively significant as found in similar studies done in other centres. Thus appropriate programs and strategies should be implemented to avoid depression from causing a negative effect on cognitive functioning and learning of students. Favourable environment where students are able to talk about their mental health issues is a must. Keywords: depression; medical students; prevalence.
Publication
Prevalence of Kawasaki Disease in a Tertiary Care Hospital: A Descriptive Cross-sectional Study
(Nepal Medical Association, 2019) Rajak, Kripa; Twayana, Anu Radha; Shrestha, Rashmi; Amatya, Puja; Ghimire, Calvin
Abstract Introduction: Kawasaki disease is an acute vasculitis of unknown etiology. The epidemiological data available for Nepal remains insufficient. In Nepal, Kawasaki disease has only been reported in cases of brief reports, leaving the true disease burden unknown. Many cases go undiagnosed and untreated due to a lack of knowledge regarding this entity. The objective of this study was to find the prevalence of Kawasaki disease in a tertiary care hospital. Methods: This descriptive cross-sectional study was carried out in a tertiary care hospital of Nepal from 2013 to 2018 after taking ethical approval from the Institutional Review Committee. The sample size was calculated and the consecutive sampling method was done. Data collection and entry was done in Microsoft Excel, point estimate at 99% Confidence Interval was calculated along with frequency and proportion for binary data. Results: The overall prevalence of Kawasaki disease was found to be 0.1% among 11,416 patients under the age of 5 years admitted in pediatrics ward. There were 4 (33.33%) cases of complete Kawasaki and 8 (66.67%) cases of incomplete Kawasaki. There were 9 (75%) males and 3 (25%) females and the male to female ratio was 3:1. There was a male preponderance. The age at diagnosis ranged between 4 and 60 months. The median age at diagnosis was 10.5 months. The most common presentation was fever, conjunctivitis, rash, and oral changes. Conclusions: Prevalence of Kawasaki disease was found to be lesser compared to other studies done in other countries. Knowledge of Kawasaki disease among Nepalese pediatricians should be enhanced to guarantee the appropriate diagnosis and treatment of this disease. Keywords: Kawasaki disease; prevalence, vasculitis

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