Journal Issue: Volume: 29, No. 3, December 2007
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Volume
Number
Issue Date
2007
Journal Title
Journal ISSN
ISSN (Print) : 1993-2979 | ISSN (Online) : 1993-2987
Journal Volume
Articles
Organic psychiatric disorders in the older persons
(Institute of Medicine, 2007) Chandrasekaran, PK
Abstract
Background: A primary, retrospective study was done to determine the frequency and describe the patterns of presentation of delirium, dementia and mood disorder in the elderly.
Methods: The sample was collected over 3 months and consisted of 10 patients above 60 years of age with features fitting those conditions, conventionally labeled at the time as Organic Brain Syndromes (OBS).
Results: We found that OBS in hospitalized older people was common (29.41%) and the detection of these syndromes was poor, taking almost 5 days for a psychiatric referral to be made. Clinical presentations heterogeneously varied and the majority of cases were in a delirium (60%) due to various causes. Only low dosages of treatment were required to treat the symptoms, except in those
who had a premorbid psychiatric disorder. Finally, symptom resolution was achieved (30%) only where the medical conditions causing the OBS were reversible, as is expected.
Conclusion: This cost-effective study found that OBS in hospitalized older people was common, frequently diagnosed late and had a varied presentation.
Keywords: Delirium, Dementia, Depression, Pseudodementia, Post-stroke dementia
Prevalence of chronic suppurative otitis media in school children of Kathmandu district
(Institute of Medicine, 2007) Adhikari, P; Sinha, BK; Pokharel, NR; Kharel, B; Aryal, R; Ma, J
Abstract
Background: Chronic suppurative otitis media is a major health problem throughout the world in developing countries including Nepal. This study was carried out to find the prevalence of chronic suppurative otitis media (CSOM) among school going children of Kathmandu district.
Methods: This is a prospective cross sectional study among 1070 school children aged between 5 - 12 years. Students were randomly selected from four different schools of Kathmandu district. All these students were interviewed and examined otoscopically from November 2006 to January 2007. Data were analyzed statistically.
Results: Results showed that 5.4% of the children had CSOM. Unilateral disease was seen in 79.3% and 96.5% had a tubotympanic disease. Around 24.1% had active disease, 65.4% used unhygienicand risky materials to clean their ears. There were 10.3% students having CSOM who did not receive any treatment. More than half were treated by paramedics.
Conclusion:The prevalence of CSOM among school children in Kathmandu district is lower as compared to rural areas of Nepal. This might be due to the improvement of health care facilities or due to increase in the use of antimicrobials in Kathmandu. Awareness for school children as well as parents through health education is in need to reduce the prevalence of CSOM.
Keywords: Chronic suppurative otitis media (CSOM), tubotympanic disease, health education
Do behavioral patterns of university students of Nepal make them vulnerable to HIV/AIDS?
(Institute of Medicine, 2007) Joshi, DR; Khattri, DB; Rosyara, KP; Malla, B
Abstract
Introduction: Nepal is confronted with the increasing incidence of HIV among young adults. The University students at their age are at increased risk of the disease, determined by their behaviors Thus, Assessment of knowledge, attitude, and beliefs of them are essential prior to implementation of prevention and control strategies.
Methods: This cross sectional study was carried out in 2006 among university students at Tribhuvan University, Kirtipur, Nepal. A total of 100 students participated from different departments. The questionnaire design included background characteristics, condom use, knowledge and opinion towards HIV/ AIDS, Sexual risk behavior and sexual relation, symptoms on STI and HIV/ AIDS, stigma and discrimination regarding HIV/AIDS.
Results: The median age of male respondents was 26 years and that of female was 23 years. Among married respondents (16.7%), female respondents were married at younger age (F=23yrs, M=24yrs). The majority of them were unemployed (78.1%). The major sources of information regarding HIV/ AIDS were television (95.8%) and radio (91.7%). Only 13.5% of respondents (F=12%, M=15.2%) knew about voluntary counseling and testing services (VCT). The age of first sexual intercourse was 22 years; same for both men and women. Among them, 65.4 % admitted using condoms during first intercourse. Family planning centre was the major condom supply source (78.1%). Use of condoms was the most common perceived method of protection against HIV/AIDS for both male (93.5%) and female (78%). Seventy- nine percentage of respondents maintained that HIV is transmitted by sharing of food, and mother to child, and HIV+ individuals looked healthy.
Conclusions: This study provides empirical evidence of stirring knowledge about HIV and sexual behavior among adults; however; needs further examination through a longitudinal study.
Keywords: Sexual behaviour, human immunodeficiency virus
Patients’ perspective on informed consent in ear surgery
(Institute of Medicine, 2007) Adhikari, P; Guragain, RPS
Abstract
Background: Informed consent is required before any surgical procedure. This study was done to assess patient’s expectations before to signing consent forms for ear surgery.
Methods: This study was done in Department of ENT and Head and Neck Surgery, T U Teaching Hospital from August to December 2006. All patients attending to OPD for appointment of surgery were randomly selected and were explained verbally about the possible complications of surgery, by the first author. There were 100 patients and they were interviewed with a standard questionnaire just one day before surgery. Answers were written by the first author on a standard questionnaire form. All those 100 patients who were informed previously about the possible complications were included in the study. Informed consent was obtained from all patients for the study. Data analysis was done statistically using frequency and percentage.
Results: Ninety five percentages of patients were satisfied with the information given by doctors before ear surgery. There were very few patients (7.0%) who looked for further information. Only 27.0% patients could tell complication of ear surgery. Among them, 5.0% patients could list more than one complication. The common complications listed by our patients before ear surgery werebleeding (10.0%), infection (9.0%). Around 96.0% want to be informed all known complications even if the incidence was less than one percent.
Conclusion: The information given by the doctors might not meet the expectation of the patients of twenty first century as they have a high expectation. However, the doctors should give a sufficient time to explain about the surgical procedure and they should not miss a common and important complication of surgery.
Keywords: Informed consent, Patients expectation, Ear surgery