Journal Issue: Vol. 63 No. 285 (2025): JNMA
Loading...
Volume
63
Number
Issue Date
Journal Title
Journal ISSN
JNMA Print ISSN: 0028-2715; Online ISSN: 1815-672X
Journal Volume
Volume 63
(63)
Articles
Scar among Bacillus Calmette-Guérin Vaccinated Children Presenting to an Immunisation Clinic at a Tertiary Hospital in Nepal: An Observational Study
(Nepal Medical Association, 2025) Dhakal, Ajaya Kumar; KC, Divya; Shrestha, Barsha; Shrestha, Devendra; Neupane, Nischal; Acharya, Sharda; Shrestha, Saurav
Abstract
Introduction: Bacillus Calmette-Guérin vaccination is associated with the development of scarring at the vaccination site in most children within 12 weeks of vaccination. However, due to various factors, some children do not develop scars. The aim of the study was to determine the prevalence of scar failure and the differences in clinical characteristics between scar-positive and scar-negative children.
Methods: This observational cross-section study was conducted between 12 September 2022 and 15 April 2024 on children attending a vaccination clinic at a tertiary care hospital for 12 or 15-month vaccination. A purposive sampling method was used, and 386 children were enrolled in the study. During medical history, information was collected on Bacillus Clamettte-Guérin vaccination, child and maternal clinical profiles, and hospitalisations for respiratory tract infections in children.
Results: Among 386 infants, prevalence of BCG scar was 341 (88.34%; 95% CI: 91.81%-91.37%). Vaccination was confirmed in 94.82% by history and card. The median scar size was 4mm (IQR: 2,5 mm) transversely and 3 mm (IQR: 2,5) vertically. Thirty-two (8.30%) infants required hospital admission for respiratory infections; none received anti-tubercular treatment.
Conclusions: The BCG scar formation was higher compare to the scar failure. The scar failure was comparable to other studies.
Profile of Neurosyphilis Patients Admitted to a Tertiary Care Centre of Nepal: An Observational Study
(Nepal Medical Association, 2025) Giri, Uma; Tangbetani, Laila Lama; karki, Anupama; Ghimire, Jagat Jeevan
Abstract
Introduction: Neurosyphilis is a rare complication of untreated syphilis with limited literature.We aimed to look for demographic characters and clinical presentation of patients admitted with the diagnosis of neurosyphilis.
Methods: This was an observational cross-sectional study that included analysis of records of neurosyphilis patients admitted to the National Academy of Health Sciences, Kathmandu, Nepal, from May 2015 to April 2024. All patients diagnosed with neurosyphilis were included, while those with incomplete data were excluded. The Centers for Disease Control and Prevention criteria were used to define and categorize neurosyphilis. Continuous variables were summarized as mean ± standard deviation for normally distributed data or as median and interquartile range for skewed data. Categorical variables were described using numbers and percentages.
Results: A total of 53 cases were included in the study, with 31 (58.49%) males. The median age was 46 years (interquartile range: 37–60 years). Decreased vision was ovserved in 30 (56.60%) patients, and redness of the eye in 11 (20.75%) and headache in 4 (7.55%). Eye signs were observed in 43 (81.13%) patients. Cerebrospinal fluid Venereal Disease Research Laboratory (VDRL) test was positive in 11
(20.75%) cases. Based on Centers for Disease Control and Prevention criteria, 11 (20.75%) patients had verified neurosyphilis, 34 (64.15%) had likely neurosyphilis, and 8 (15.09%) had possible neurosyphilis. Iintramuscular benzathine penicillin was administered in 26 (49.06%) patients.
Conclusions: There were more male patient with Neurosyphilis in our population. Decreased vision was the most common presentation. Likely neurosyphilis was most common diagnosis among studied population.
Accuracy of Magnetic Resonance Imaging in Diagnosis of Anterior Cruciate Ligament and Meniscus Tear: An Observational Study
(Nepal Medical Association, 2025) Thapa, Sushil; Panta, Sunil; Adhikari, Aarati; Upadhyay, Hari Prasad; Shrestha, Sarik Kumar
Abstract
Introduction: Magnetic resonance imaging is used for the diagnosis of anterior cruciate ligament and meniscus tears but its value in the diagnosis of these pathologies is limited. This study aims to evaluate the diagnostic value of magnetic resonance imaging in diagnosing anterior cruciate ligament and meniscus tears.
Methods: This was an observational cross-section study conducted at a tertiary-level hospital in Nepal. The patients operated on for anterior cruciate ligament and/or meniscus tear were considered for the study. The accuracy of magnetic resonance imaging was calculated by comparing its findings with those in arthroscopy.
Results: The total number of cases were 134. The sensitivity and specificity were as follows: medial meniscus 88.81%, 95.10%; lateral meniscus 57.12%, 95.14%; anterior cruciate ligament 96.12%, 75%. The sensitivity and specificity of the injuries for 3 Tesla vs 1.5 Tesla Magnetic Resonance Imaging were as follows: medial meniscus 89.20%, 97.84% vs 87.52%, 87.52%; lateral meniscus 65.25%, 100% vs 30%, 90.91%; anterior cruciate ligament 96.12%, 75% vs 96.12, 75%.
Conclusions: The sensitivity of magnetic resonance imaging in diagnosing anterior cruciate ligament injury was higher while specificity was higher for lateral meniscus injury. The study also showed that 3 Tesla was better than 1.5 Tesla magnetic resonance imaging in diagnosing meniscus injury.
Anaesthetic Management of Foreign Body Bronchus: Profile of Cases Appearing at Tribhuvan University Teaching Hospital: An Observational Study
(Nepal Medical Association, 2025) Koirala, Megha; Parajuli, Bashu Dev; Joshi, Pankaj; Ghimire, Basanta; Bhattarai, Amit Sharma
Abstract
Introduction: Rigid bronchoscopy is the preferred method for extracting airway foreign bodies, as it allows grasping forceps to extract foreign bodies while maintaining ventilation through a side port. The main challenge to the Anesthesiologists is to maintain oxygenation and ventilation while sharing the common field with the surgeons. This study intends to evaluate our current practices, challenges, and intraoperative events to enhance patient safety during these procedures.
Methods:This is a prospective observational study that included patients with suspected or confirmed bronchial foreign bodies who underwent rigid bronchoscopy from February 2023 to February 2025. Data were collected by the anesthesiologists using the structured proforma, covering the anesthetic technique, complications, and details of foreign bodies. SPSS version 22 was used for analysis.
Results: A total of 41 rigid bronchoscopies were performed, including three repeat procedures. Intraoperative complications included desaturation in 29, vocal cord edema in 16, slipping of foreign body in 8, bradycardia and airway bleeding in 6 cases each. Postoperatively, 23 patients required mechanical ventilation, and one patient experienced cardiac arrest. During preoperative preparation, intravenous glycopyrrolate and steroids were used in 38 and 34 cases, respectively. For induction and maintenance, Intravenous anesthesia was the most common technique, with muscle relaxants used in 39 cases. Of the 41 bronchoscopies, 30 achieved successful foreign body removal, while five required thoracotomy referrals.
Conclusions: Anesthetic management of rigid bronchoscopy requires careful planning, vigilant monitoring and collaboration. Deasturation is the most frequent complication during removal of a foreign body bronchus.
Carrying Angle Variation in Relation to Gender Among Children: An Observational Study
(Nepal Medical Association, 2025) Makaju, Sarbada; Palikhe, Pratima; Chaudhary, Sonam; Rai, Chandra Kala
Abstract
Introduction: Carrying angle is the angle formed at the elbow joint during full extension and supination of arm and forearm which increases with increasing age till 14 years. This study measures the carrying angle variation with gender which can be beneficial for pediatricians in diagnosis, treatment planning of the related cases.
Methods: The study was conducted 70 patients of Kathmandu Medical College and Teaching Hospital at Sinamangal and Duwakot between 15 December 2023 to 30 December 2023 after getting the ethical clearance from the Institutional Review Committee (reference no. KMC-IRC 08122023/02) with convenience sampling method. The carrying angle was measured by manual goniometer by drawing the axes in the arm and forearm. The data obtained was analyzed in different age groups and body mass index between boys and girls. The data was analyzed with Statistical Package for the Social Sciences version 25.
Results: Out of 70 participants, 38(54.29%) were boys and 32(45.71%) were girls. The mean carrying angle among girls in right side was 10.53±2.52 degrees and 9.05±3.71 degrees for boys (p=0.06). Similarly, on left side it was 10.15±2.37 degrees for girls and 8.76±2.96 degrees for boys (p=0.036).
Conclusions: The Carrying angle on both sides was found to be increased among female children in comparison to male irrespective of different age and BMI groups.