Journal of Karnali Academy of Health Sciences最新文献

{"title":"Comparative Study of Ropivacaine Alone Versus Combination of Ropivacaine with Either Dexmedetomidine or Dexamethasone for Ultrasound Guided Supraclavicular Brachial Plexus Block","authors":"K. Pyakurel, Kanak Khanal, Sonia Dahal","doi":"10.61814/jkahs.v6i3.782","DOIUrl":"https://doi.org/10.61814/jkahs.v6i3.782","url":null,"abstract":"Background: Ropivacaine is a common choice for supraclavicular brachial plexus block. Dexmedetomidine and Dexamethasone are frequently added to local anesthetics for improved effects. With limited comparative evidence, this study aimed to assess Dexmedetomidine and Dexamethasone as adjuvants to Ropivacaine in ultrasound-guided supraclavicular brachial plexus block.Methods: This prospective double-blind study enrolled patients aged 18-60, scheduled for elective upper limb surgery below mid-humeral level. They were randomly assigned into three groups: Ropivacaine alone, Ropivacaine with Dexmedetomidine (1 mcg/kg), or Ropivacaine with Dexamethasone (8 mg). The study aimed to compare sensory and motor blockade onset and duration, postoperative analgesia duration, and adverse event occurrence among the groups.Results: Ninety-eight patients participated in the study. All three groups showed similar characteristics in terms of age, weight, gender, ASA grade, and surgery duration. The onset and duration of sensory and motor block were comparable between the Dexamethasone and Dexmedetomidine groups. A significant difference was observed when comparing the Ropivacaine only group to either of the other two groups or when comparing all three groups. Similarly, postoperative analgesia duration was comparable between the Dexamethasone and Dexmedetomidine groups while it differed significantly when comparing all three groups or when comparing the Ropivacaine only group to either of the other groups. Ropivacaine with Dexmedetomidine group experienced notable occurrence of bradycardia.Conclusion: Dexamethasone and Dexmedetomidine as adjuvants to 0.5% Ropivacaine for ultrasound-guided supraclavicular brachial plexus blockade have comparable effects on sensory and motor blockade onset and duration, along with postoperative analgesia duration. Dexmedetomidine, however, is linked to more bradycardia compared to Dexamethasone.","PeriodicalId":111957,"journal":{"name":"Journal of Karnali Academy of Health Sciences","volume":"13 5","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-01-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139380348","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Performance Obstacles and Workload of Nurses Working in Critical Care Unit at Teaching Hospital","authors":"S. Poudyal, Kalpana Sharma, Soni Kc","doi":"10.61814/jkahs.v6i2.813","DOIUrl":"https://doi.org/10.61814/jkahs.v6i2.813","url":null,"abstract":"Background: Performance obstacles are the elements of immediate workplace that restrict nurses' capacity to perform their duties. Performance obstacles are significant predictor of nurses' workload, which lowers their satisfaction and, in turn, affects their quality of work life. This study aimed to assess the performance obstacles and workload of nurses working in critical care unit. Methods: The descriptive cross-sectional study was carried out among all the 103 nurses working in critical units of selected hospital. Non-probability total enumerative sampling technique was used. Data were collected using self-administered questionnaire from 5th March 2023 to 5th April 2023. Data were analyzed in SPSS version 15 using descriptive statistics for the description of variables, and Spearmann correlation coefficient was calculated to measure the relationship between variables. Results: Study revealed that, among the four domains of obstacles, nurses experienced higher performance obstacles in task domain (50.0%), followed by work environment (37.5%), whereas lowest in organization domain (28.5%). The median overall performance obstacle score reported by nurses was 36%. There was positive correlation between performance obstacles related to tasks with workload domains of mental demand (r=0.257, p=0.009), physical demand (r=0.258, p=0.009), temporal demand (r=0.212, p=0.031) and efforts (r=0.250, p=0.011). Likewise, performance obstacles related to organization was positively correlated with mental demand (r=0.236, p=0.017), physical demand (r=0.246, p=0.012), temporal demand (r=0.361, p<0.001) and efforts (r=0.309=, p=0.001). Further, positive correlation was found between performance obstacles related to tools with temporal demand (r=0.300, p=0.002) and efforts (r=0.201, p=0.042). Conclusions: Nurses experience performance obstacles in the critical care units. Performance obstacles are positively correlated with the workload of the nurses. Therefore, efforts are needed to reduce performance obstacles of the nurses in the critical care unit.","PeriodicalId":111957,"journal":{"name":"Journal of Karnali Academy of Health Sciences","volume":"5 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139344693","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Domestic Violence against Women during COVID-19 Pandemic in Nepal","authors":"Madhu Koirala Dhital, Raju Laudari, Vickie Owens, Nabin Regmi, S. R. Dhital","doi":"10.61814/jkahs.v6i2.552","DOIUrl":"https://doi.org/10.61814/jkahs.v6i2.552","url":null,"abstract":"Domestic violence perpetrated is a public health problem commonly for women in developing nation like Nepal.Major causes of domestic violence are unemployment, alcohol drink, lack of education, loneliness, crowded livingspaces, lack of privacy. These factors may be aggravated by pandemic such as COVID-19. Women experiencefrom domestic violence due to dominant patriarchal culture combined with a lack of self-awareness and educationamongst adult males. Domestic violence is mostly instigated by intimate partners and maybe intensified due to theunusual stress of pandemic stress and spending increased time with wives and families. Domestic violence usuallymanifested in the form of adverse physical, mental and social health. The COVID-19 pandemic may have increasedthat adverse health of women in Nepal. Preventive strategies of domestic violence could be self-awareness,counselling, create a job, stop living alone at home, sharing with all family members and strong governmentalrules. This paper argues the effects of COVID-19 pandemic on domestic violence and possible preventive strategiesof domestic violence.","PeriodicalId":111957,"journal":{"name":"Journal of Karnali Academy of Health Sciences","volume":"272 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-08-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139347415","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Parental adherence to prevent unintentional home injuries among children in a community of Bhaktapur, Nepal","authors":"Bima Thapa Chhetri, Nabina Rai","doi":"10.61814/jkahs.v6i2.709","DOIUrl":"https://doi.org/10.61814/jkahs.v6i2.709","url":null,"abstract":"Background: Unintentional injuries are the serious worldwide public health problem directing to mortality, morbidity, disability, economic stress to health care system and household level. Curious nature of children to learn new skills around the home premises can be harmful sometime. Household injuries are often fatal but are prevantable. The study was conducted to analyse the level of parental adherence to prevent unintentional injuriesamong under five children and its association between independent variables.Methods: An analytical cross sectional research design was conducted in Madhyapur Thimi Municipality, Bode8, Bhaktapur, Nepal among 220 parents. Data was collected in August 2021 by using non-probability purposive sampling technique. A semi-structured questionnaire was self developed, it was pretested and was used for data collection.Results: The study suggests that majority (65.9%) of the respondents had more level of adherence and 34.1% had less level of adherence regarding unintentional injury prevention. Level of parental adherence was significantly associated with religion (p=0.048), number of siblings (p=0.045), number of floors (p=0.047) and number of rooms in the house (p=0.046).Conclusion: The study concludes that parents were able to maintain more level of adherence regarding injury prevention among children. Parental experience on injuries helps to prevent its occurrence in the future.","PeriodicalId":111957,"journal":{"name":"Journal of Karnali Academy of Health Sciences","volume":"45 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-08-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139347616","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Incorporating Physical Activity Lifestyle Management of Cardiovascular Disease","authors":"N. Bhat, N. Mahotra, Sanyukta Gurung, Bidhi Dhital","doi":"10.61814/jkahs.v6i2.777","DOIUrl":"https://doi.org/10.61814/jkahs.v6i2.777","url":null,"abstract":"The prevalence of cardiovascular diseases has almost doubled in Nepal from 1990 to 2019, causing the majority of deaths in the country. Despite numerous theories and experiments, satisfactory health outcomes have not been achieved. A holistic approach to lifestyle management is necessary to address the burden of cardiovascular disease. The Center for Disease Control recommends physical activity for lifestyle modification, which can help reduce the risk of cardiovascular disease morbidity and mortality. Using the Metabolic Equivalent, physical activity can be quantified and prescribed based on frequency, intensity, time, type, and progression. Physicians can motivate patients, incorporate physical activity in intervention strategies, and guide patients to empirical workout plans led by qualified exercise experts. In addition to individual interventions by physicians, the government should develop and enforce policies aimed at increasing physical activity. This review provides an outline ways of integrating physical activity into lifestyle medicine to mitigate the burden of cardiovascular disease.","PeriodicalId":111957,"journal":{"name":"Journal of Karnali Academy of Health Sciences","volume":"19 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-08-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139347680","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Parental Experience of the Children with Gastrointestinal Stoma in Kanti Children Hospital, a Tertiary Level Children Hospital in Nepal","authors":"Smriti Manandhar, Sarala Shrestha, Sangita Shrestha, Mankeshari Maharjan","doi":"10.61814/jkahs.v6i2.704","DOIUrl":"https://doi.org/10.61814/jkahs.v6i2.704","url":null,"abstract":"Background: The gastrointestinal stomas are seen as the obligatory condition for the treatment of children with gastrointestinal malfunction where their parents have to face various challenges. The lived experience of parents having children with gastrointestinal stomas was explored in this study. Methods: Qualitative phenomenological research design was used. Data were gathered by interviewing total 11 mothers with children having stoma for at least 2 weeks and admitted in a hospital. Thematic analysis was done with obtained data. Results: Six major emergent themes from the study were the parent’s journey with child’s health, challenges faced, resilience in caring the child, change in family life, support system and socio-cultural perception and influence. Conclusion: Parents of the children with the stoma face a range of problems and challenges. So, to sustain a better and conducive life of the parent and their children with stoma, parental resilience must be enhanced by developing an integrated support in the journey of the parenthood.","PeriodicalId":111957,"journal":{"name":"Journal of Karnali Academy of Health Sciences","volume":"90 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-08-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139347507","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Formulation and Evaluation of Fast Disintegrating Tablets of Ondansetron Using Natural Superdisintegrants","authors":"Asha Maharjan, Keerthy Hs, Kulkarni Gururaj S., Sheeba Fr, S. Khadka","doi":"10.61814/jkahs.v6i2.717","DOIUrl":"https://doi.org/10.61814/jkahs.v6i2.717","url":null,"abstract":"Background: Fast disintegrating tablet (FDT) of ondansetron has better patient compliance as it is easy to swallow for the treatment of nausea and vomiting. Moreover, fast absorption, rapid onset, reduced loss of drugs, and enhanced bioavailability are making oral dispersible systems a better drug delivery system. This research was conducted with the objective to formulate and evaluate the oral FDT of ondansetron HCl using natural polymers. Methods: The tablets were formulated employing the direct compression technique using different ratios of natural super disintegrants such as spray-dried banana powder, ispaghula husk powder, and combination of both polymers. The developed powders were subjected to the pre-compression parameters and the powders were punched using a single-head rotatory compression machine. The formulated 200            mg tablets were subjected to post-compression evaluation. Results: The Fourier-transform infrared spectroscopy studies showed no chemical interaction between pure drugs, natural super disintegrants, and other excipients. Formulation F6 containing ispaghula husk powder in a 1:4 ratio demonstrated 98.60±0.003% of drug release within 10 minutes indicating the best formulation. Conclusion: FDT of ondansetron was considered the best formulation in the drug delivery system which followed the Higuchi model with the Fickian release.","PeriodicalId":111957,"journal":{"name":"Journal of Karnali Academy of Health Sciences","volume":"103 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-08-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139347730","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Seasonal Patterns of Peak Expiratory Flow Rate in Young Healthy Individuals","authors":"N. Mahotra, Sonam Chaudhary, S. Pradhan","doi":"10.61814/jkahs.v6i2.845","DOIUrl":"https://doi.org/10.61814/jkahs.v6i2.845","url":null,"abstract":"Background: The seasonal changes are associated with changes in pulmonary functions including Peak Expiratory Flow Rate (PEFR). These changes are different among different population and location. This study thus aimed to evaluate the seasonal variations in PEFR among healthy young individuals in Kathmandu. Methods: A comaparative study was carried out among 60 undergraduate medical students of Maharajgunj Medical Campus in the department of Clinical Physiology. The students were selected by convenient sampling technique and after obtaining the informed consent, the PEFR was recorded with the help of Wright’s peak flow meter with proper training. The PEFR was recorded two times i.e. morning and daytime hours in winter season (January-February) 2023 and also in same daily hours of summer season (May-June) 2023 in the same participants. The data were analyzed using SPSS-16 version and the paired T test was used to compare the mean changes in PEFR in winter and in summer seasons. Results: The PEFR in summer morning (499.50±89.50 L/min) was recorded higher than in winter morning (487.50±86.09 L/min) among total participants and also in male participants (567.33±69.34; 550.83±69.58) which was statistically significant with P value <0.05. Similarly, the PEFR in summer daytime (505.08±88.85 L/min) was comparatively more than in winter daytime (491.27±92.07 L/min) which was statistically significant among all participants with P value <0.05. The PEFR in the winter and summer seasons of male participants and in the summer of total participants showed the existence of diurnal variation which was statistically significant. Conclusions: There is seasonal variation as well as diurnal variations of PEFR. So, the clinicians should be aware that the PEFR recorded in winter season and in the morning time might be less than that recorded in the summer and at the daytime respectively.","PeriodicalId":111957,"journal":{"name":"Journal of Karnali Academy of Health Sciences","volume":"6 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-08-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139347853","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Morphometric Variations of Thyroid Gland: A Cadaveric Study","authors":"L. Bhattarai","doi":"10.61814/jkahs.v6i2.673","DOIUrl":"https://doi.org/10.61814/jkahs.v6i2.673","url":null,"abstract":"Background: The size of thyroid gland is subject to great variations. The thyroid gland consists of two lobes and a bridging isthmus. It is located anteriorly in the neck at the level of the C5–T1 vertebrae deep to the Infrahyoid muscles. The developmental anomalies of the thyroid gland are partial and total agenesis, various ectopic tissues, accessory thyroid, and absence of isthmus. This distorts the morphology of the gland and causes clinical and functional disorders. Methods: The thyroid gland was removed from 28 embalmed cadavers. Specimen of abnormal conditions like enlarged gland, partial and total agenesis of gland and absent isthmus was excluded from the study. Presence of pyramidal lobe and levator glandulae thyroidea was noted. The dimensions of each lobe was measured using Vernier caliper. Descriptive statistics was calculated as mean and standard deviation. Results: The average length (right lobe=4.96cm, left lobe= 4.48cm), width (right lobe=2.25cm, left lobe=1.86cm) and thickness (right lobe=1.53cm, left lobe=1.45cm) were measured. Pyramidal lobe was present in 32.14%. Levator glandulae thyroidea was found in only one case (3.57%). Conclusion: Variation in the dimensions of thyroid gland are reported. Knowledge of the wide ranging variations and measurements will help the surgeons and radiologists in correct interpretation, diagnosis and treatment of thyroid diseases.","PeriodicalId":111957,"journal":{"name":"Journal of Karnali Academy of Health Sciences","volume":"19 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-08-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139347714","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Patent Prolapsed Vitellointestinal Duct in Neonate: Sonographic and Magnetic Resonance Evaluation","authors":"Bharat Sharma, Shashi Sharma, Rohit Sharma","doi":"10.61814/jkahs.v6i2.518","DOIUrl":"https://doi.org/10.61814/jkahs.v6i2.518","url":null,"abstract":"Omphalomesenteric duct can result in various forms of anomalies due to the failure of its absorption. Various presentations can be in the form of patent vitelline duct, Meckel’s diverticulum, sinus tract, fibrous band, umbilical polyp prolapsing over the umbilicus or enteric fistula. It is important to diagnose these various anomalies in neonates with ultrasonography (USG) and magnetic resonance imaging (MRI) which are radiation free modalities. We present the case of a 20-day-old male baby who was having partial intestinal obstruction, umbilical discharge and slight herniated content from the umbilicus. The neonate underwent USG and MRI studies and was diagnosed with prolapsed vitellointestinal duct. In general, diagnosis of patent prolapsed vitellointestinal duct is difficult on clinical examination on the first look. USG and MRI help in the confirmation of the diagnosis as the anatomical details are well delineated by these modalities and in addition to being radiation hazards-free. This helps in early management as these types of pathologies can lead to many fatal complications.","PeriodicalId":111957,"journal":{"name":"Journal of Karnali Academy of Health Sciences","volume":"79 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-08-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139347175","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}