Journal Issue: No. 02 (2024): Issue 63 Apr-Jun
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Volume
Number
Issue Date
2024
Journal Title
Journal ISSN
1999-6217
Journal Volume
Articles
Clinical Profile of Thoracoscopic Bullectomy in Treatment of Pneumothorax
(Nepal Health Research Council, 2024) Gautam, Pratima; Sapkota, Ranjan; Shrestha, Suraj; Mainali, Prakash
Background: In pneumothorax patients requiring surgery for various indications, thoracotomy was the traditional approach until the advent of video-assisted thoracoscopic surgery. In the last decade, role of thoracoscopy in the surgical management of pneumothorax has been consolidated and established. In this study, we aim to report our experience of thoracoscopy in the surgical management of pneumothorax.
Methods: A descriptive review of prospectively maintained data on all the patients undergoing thoracoscopic bullectomy for pneumothorax was done.
Result: Over the period of 9 years, a total of 120 patients underwent thoracoscopic bullectomy. Among them, 95 entered final analysis. Most common age group was 21-40 years, with male predominance (80%); most common diagnosis was primary pneumothorax (67%), first episode (74%), and on the right (65%) side; commonest symptom was shortness of breath (84%) of a median duration of 7 days. A chest tube was placed in 96% of patients before the operation. Commonest radiological finding was multiple bullae (45%) in the apical region (71%). Majority of patients underwent surgery via 3 ports, and a single bulla in the apical region was the most common intraoperative finding. Among the postoperative complications which occurred in 17%, an air leak was present in 9%. The median intensive care stay was 23 hours, the median chest tube duration was 3 days, and the median hospital stay was 9 days.
Conclusions: Thoracoscopy can be used as a safe, feasible, and effective procedure in patients presenting with pneumothorax with minimal postoperative complications.
Keywords: Bullectomy; pneumothorax; video-assisted thoracoscopic surgery.
Clinical Profile of Peripheral Artery Disease of Patients Attending Shahid Gangalal National Heart Center, Janakpurdham, Nepal
(Nepal Health Research Council, 2024) Singh, Amit Kumar; Pradhan, Pranil Man; Shah, Rajesh Kumar; Mahaseth, Aditya
Background: Peripheral artery disease is an important vascular disease. There is an increased incidence of acute limb ischemia in cases of peripheral artery disease. Objective of this study was to assess the prevalence of peripheral artery disease among high-risk patients attending out patient department in Shahid Gangalal National Heart Center, Janakpurdham.
Methods: A total of 386 high risk patients for Peripheral Artery Disease were included in the study. Informed consent was taken from patients undergoing the study. Patients underwent ankle brachial index calculation to make a diagnosis of peripheral artery disease. Patients having ankle brachial index of <= 0.9 was considered to have peripheral artery disease. Patients diagnosed with peripheral artery disease further underwent doppler study.
Results: The study showed the prevalence of peripheral artery disease to be 17.4% among high-risk patients attending Shahid Gangalal National Heart Centre, Janakpurdham. The prevalence of peripheral artery disease was more in females as compared to male which was statistically significant. Most of the high-risk patients were patients with hypertension at Shahid Gangalal National Heart Centre.
Conclusions: Peripheral artery disease prevalence is significant among high-risk patients attending Shahid Gangalal National Heart Centre, Janakpurdham. High risk patients should undergo evaluation of peripheral artery disease for early detection and treatment.
Keywords: Ankle brachial index; chronic kidney disease; coronary artery disease; hypertension; peripheral artery disease.
Assessment of Antenatal Care Services Utilization and Its Associated Factors
(Nepal Health Research Council, 2024) Paudel, Nabaraj; Paneru, Damaru Prasad; Pahari, Sandip; Poudel, Arati; Sharma, Yam Prasad
Background: Every pregnant woman supposed to have Antenatal care visits at least four times during 4th, 6th, 8th and 9th month of gestation. This contributes to the reduction in maternal mortality. The main objective of the study was to assess the utilization of antenatal care services and its associated factors in Pokhara Metropolitan.
Methods: A community based cross-sectional analytical study was conducted in Pokhara Metropolitan between 16th May 2019 to 30th June 2019 among 325 mothers using probability proportional to size sampling and face to face interview. Ethical approval was obtained from Nepal Health Research Council. Data analysis was done using SPSS version 22 and Chi-square test and binary logistic regression analysis was performed.
Results: A total of 97.2 percent mothers had at least one time visit for ANC checkup while 88.6 percent mothers received four ANC visits as per protocol. A total of 94.6 percent mothers got counseling on early detection and management of complications, 95.9 percent consumed iron and folic acid and 94.3 percent consumed de-worming tablets. Mothers health literacy mobile phone ownership (AOR=11.26, 95% CI: 9.70-13.03), husband’s attitude towards ANC (AOR=6.71, 95%CI: 1.60-28.10), awareness on pregnancy complications (AOR=4.62, 95% CI: 2.53-21.73), and which is
decision making on household expenditure by self (AOR 8.57%, 95% CI: 3.64-9.48) history of abortion (AOR=5.22, 95%CI: 1.71-15.30) were the factors associated with ANC service utilization.
Conclusions: Majority of the pregnant women were found to be utilizing ANC services. Mobile phone ownership, health literacy, husband's attitude towards ANC, decision making on household expenses, awareness on pregnancy complications and history of abortion were the significant factors associated with ANC service utilization.
Keywords: Antenatal care; factors associated; Pokhara; utilization.
Prevalence of Internet Addiction among Secondary Level Students
(Nepal Health Research Council, 2024) Pathak, Susmita; Sharma, Bimala; Khatiwada, Sachin; Kandel, Bhawana; Karn, Abhishek
Background: The study aimed to assess the prevalence of internet addiction among Secondary level students in Waling Municipality, Syangja, Nepal.
Methods: A cross-sectional study was conducted among 280 students aged 15-19 from three schools in Waling Municipality in January 2022; stratified simple random sampling proportional to the size of the population was used. A self-administered structured questionnaire was used and an Internet Addiction scale was applied which includes 20 questions with a score of 1–5 for each question. Based on scoring subjects would be classified into normal users (0–30), mild (31–49), moderate (50–79), and severe (80–100) Internet Addiction groups. Descriptive statistics, bivariate analysis, and multivariate logistic regression analysis were computed at a 5% level of significance.
Results: of the total 30.7 had mild and 15.4 had moderate internet addiction. The likelihood of reporting internet addiction was significantly higher among those who used the internet for more than two hours (AOR, 2.91; 95% CI, 1.56-5.42), common mode to access the internet (AOR, 17.04; 95% CI, 2.09-138.61), friend's encouragements (AOR, 2.18; 95% CI, 1.17-4.05), living with family (AOR, 5.183; 95% CI, 1.55-17.30) and gender (AOR, 1.833; 95% CI, 1.04-3.22)
Conclusion: The current study documents almost half of the school adolescents had internet addiction. Carrying out public awareness campaigns and establishing ways to enhance the positive effect of the internet while minimizing the negative outcomes of the associated factors may be a profitable strategy to decrease its prevalence and effect.
Keywords: Internet addiction; secondary level students; Nepal.
Epidemiological and Spatial Distribution of COVID-19 Morbidity and Mortality in Nepal
(Nepal Health Research Council, 2024) Poudyal, Amod Kumar; Shakya, Karuna Laxmi; Sapkota, Vishnu Prasad; Paudel, Rajan; Myia, Salau Din; Pradhan, Pranil Man Singh; Upadhyaya, Dipak Prasad; Joshi, Naresh; Shrestha, Shital
Background: The Coronavirus (SARS-CoV-2) infection termed as COVID-19 was first detected in Wuhan, Hubei Province of China, in December 2019 and has been declared as a pandemic by the World Health Organization on January 30, 2020. The study aims to understand the time, place and person distribution of covid-19 morbidity, mortality of COVID-19 in Nepal.
Methods: The analysis produces the descriptive epidemiological features of COVID-19 pandemic in Nepal. The data was analysed to produce disaggregated case rate and case fatality rate across various time, place and personal characteristics aggregated at national and subnational level
Results: The study found that the observed case rate was significantly higher among males compared to females. Similarly, case rate was the highest among males of 31-40 years and females of 51- 60 years. Case fatality rate increased with age group. Above the age of 41-50 years, case fatality rate was higher among males compared to females. We observed that case fatality rate was disproportionately concentrated among the poor districts in terms of GDP
Conclusions: The observed case rate is significantly higher among males compared to females, however case fatality rate increased with age group. Case rate was found the highest in the Bagmati province followed by the Gandaki Province. However, case fatality rate was found the highest in hilly and mountain districts of Province 1, Gandaki and Karnali. Case fatality rate was disproportionately concentrated among the poor districts in terms of GDP.
Keywords: COVID19; morbidity; mortality; Nepal.