Journal Issue: Volume: 41, No. 3 (2019) December
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Volume
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Issue Date
2019
Journal Title
Journal ISSN
ISSN (Print) : 1993-2979 | ISSN (Online) : 1993-2987
Journal Volume
Articles
Implementation of WHO Surgical Safety Checklist and its Outcome in South Asia
(Institute of Medicine, 2019) Kurlberg, Göran
NA.
Prevalence of Laryngopharyngeal Reflux in Patients with Gastroesophageal Reflux Disease Undergoing Upper Esophagogastroduodenoscopy
(Institute of Medicine, 2019) Chalise, Sangita R; Khadka, Subash; Mukhia, Rupesh; Thapa, Abishek; Gautam, Santosh; Sah, Mukesh; Ranjan, Rashmi
ABSTRACT
Introduction: Gastroesophageal reflux disease (GERD) has been defined as the retrograde flow of gastric contents into the esophagus. Laryngopharyngeal reflux (LPR) is one of the manifestations of GERD which can be diagnosed clinically by Reflux Symptom Index (RSI) and Reflux Finding Score (RFS). The aim of this study was to find the prevalence of laryngopharyngeal reflux in patients with GERD undergoing upper esophagogastroduodenoscopy.
Methods: This was a prospective cross sectional study and all the patients visiting author’s institute with GERD undergoing upper esophagogastroduodenoscopy were included. All the relevant data on history, examination, RSI scores, RFS scores and upper esophagogastroduodenoscopy findings were recorded in the standard proforma and data were analysed.
Results: A total of 205 patients with GERD and undergoing upper esophagogastroduodenoscopy were included whose mean age was 46.1 years. The female to male ratio was 1.3:1. The most common presenting symptoms in our study was hoarseness (97%) followed by coughing (90.7%). The mean RSI score was 11.6. The symptom prevalence of LPR was 23.4%. The prevalence in between age groups and gender was not significantly different. The mean RFS score was 9.5. The prevalence of LPR by RFS assessment was 64.4%, which is significantly more than the prevalence assessed by RSI (23.4%).
Conclusion: The prevalence of LPR in patients with GERD by RSI was less than the prevalence by RFS. So both the tools need to be used simultaneously to make the diagnosis and not recommendable to use independently.
Keywords: Gastroesophageal reflux disease, laryngopharyngeal reflux, reflux finding score, reflux symptom index
Screening of Kidney Disease in Asymptomatic Female College Students by Urine Dipstick Method
(Institute of Medicine, 2019) Chhetri, Santosh; Shah, Dibya S
ABSTRACT
Introduction: Urine examination by urine dipstick method is a useful tool to identify asymptomatic individual for kidney disease. A urine dipstick analysis was conducted on world kidney day to determine the urine abnormalities among asymptomatic female college students.
Methods: A cross-sectional study was carried out in a government female college in Kathmandu Nepal. Three hundred asymptomatic female students participated in this study. Fresh midstream urine samples were obtained and tested by urine dipstick method. Random Blood glucose was monitored with glucometer. Blood pressure was measured by manual sphynomanometer.
Results: The mean age of the female students was 22.62±2.686 years. Fifteen participants (5%) were found positive for proteinuria and only 1% of participants had glycosuria. The systolic blood pressure of >120 mm Hg was present in 14% of participants while 5% of participants had diastolic blood pressure of >90mm Hg. Participants who were found to have urinary proteinuria detected had both systolic and diastolic blood pressure increased. Only 8% of the participants had random blood sugar of >140 mg/dl.
Conclusion: Urinary abnormalities like proteinuria and glycosuria in asymptomatic female students has significant prevalence. Systemic prehypertension and hypertension has alarming rates among adolescents. Hence, screening for blood pressure and early detection of renal disorders will lead to effective interventions and possibly reduce the burden of renal diseases.
Keywords: Female adolescents, glycosuria, proteinuria, screening, urinalysis
Profile and Outcome of Patients Admitted to Pediatric Intensive Care Unit at a General Referral Hospital
(Institute of Medicine, 2019) Sharma, Arun K; Gurung, Binay
ABSTRACT
Introduction: Nepal has made substantial progress in child health primarily through preventive care. There is an increasing need for critical care services across the country which is highly resource-intensive. Periodic data of critical care admissions help plan the utilization of scarce resources in a low-income country like Nepal. This study aimed to analyze the epidemiologic patterns of critically ill pediatric patients admitted to the pediatric intensive care unit (PICU).
Methods: This descriptive study of all children admitted to PICU at Tribhuvan University Teaching Hospital for 18 months between October 2017 and April 2019 was conducted by a retrospective review of hospital records. Demographic data, etiologies of PICU admissions and outcomes of children admitted to the PICU were analyzed.
Results: PICU admitted 413 children during the study duration from all over the country. Children under the age of 2 years (36%) were admitted in the largest number and boys outnumbered girls (65.1%). Respiratory illnesses, neurosurgical and neurological problems, infectious disorders and airway foreign bodies were the most common etiologies for admission. The average length of ICU stay was around 4.4 days. Almost one-third of patients required circulatory and respiratory support. At the time of exit from PICU, 14.3% of patients died; 4.3% patients had opted for withdrawal of life support or decided to leave hospital against medical advice.
Conclusion: Patients with diverse etiologies were admitted to ICU from all over the country. A similar analysis from PICUs across the country can serve as the basis for development of newer intensive care facilities in the country, developing dedicated protocols for critical care and redistributing the ICUs’ available resources for optimal efficiency.
Keywords: Critical illness, intensive care unit, outcome, PICU, profile
Awareness Regarding Hypertension among Adults in a Community of Bhaktapur, Nepal
(Institute of Medicine, 2019) Pokhrel, Sanju; KC, Tulza
ABSTRACT
Introduction: Hypertension is a common global health problem with significant morbidity and mortality. Various preventive life style practices play significant role in controlling it. The objective of this study was to identify awareness regarding hypertension among the adult people in a community of Bhaktapur, Nepal.
Methods: A descriptive cross-sectional study was conducted among 138 adults aged 20-59 residing in Bhaktapur, selected through non probability purposive sampling technique. The data was collected by face to face interview method through semi structured questionnaire. Data was analyzed by using descriptive and inferential statistics.
Results: The study showed that 58.7% of adults had adequate awareness regarding hypertension. About 35.5% knew the range of value of high blood pressure and nearly half (47.8%) answered heart as the organ primarily related to hypertension. Stress was identified as a risk for hypertension by 96.4%, 92% specified headache as main symptom and only 31.9% knew about the asymptomatic nature of hypertension. Nearly 90% were aware that management of hypertension includes all: medicine, diet and exercise. Almost 99% of the respondents mentioned about restricting alcohol for BP control and 93.2% mentioned heart attack as the complication of hypertension.
Conclusion: The study concluded that only half of adults have adequate awareness regarding hypertension. It also showed that there is statistically significant association of awareness level with age, religion, educational status, occupation, economic status, family history and diagnosis of hypertension. Thus, it could be recommended that health personnel should provide education and information covering all aspects of hypertension to adults residing in community.
Keywords: Adult people, awareness, hypertension