Journal of Karnali Academy of Health Sciences最新文献

{"title":"Hematological Markers in Accessing Clinical Characteristics and Disease Severity in Hospitalized Patients with COVID-19: A Single-Centric Cross-Sectional Study","authors":"Sundar Pandey, Abhinash Pokharel","doi":"10.61814/jkahs.v6i2.741","DOIUrl":"https://doi.org/10.61814/jkahs.v6i2.741","url":null,"abstract":"Background: Coronavirus disease is a respiratory illness caused by coronavirus infection. Considering its capability of involving multiple systems showing diverse clinical patterns with complications and death, its needful to recognize reliable predictors of disease severity so that we can allocate the available healthcare facilities and arrange a prompt clinical intervention. This study aims to identify common easily available hematological markers and correlate the clinical severity and outcome. Methods: This observational cross-sectional study was done on 110 COVID-19 RT-PCR-positive patients admitted to the Intensive care unit of Devdaha Medical College. Clinical and laboratory values of hematological parameters like Hemoglobin, leucocyte count, platelets, Neutrophil to lymphocyte ratio, platelets to lymphocyte ratio, and, serum ferritin were recorded from hospital records and case files and analysis was done in relation to disease severity and outcome. Results: Total 110 patients (56 females) were included in this study. The mean age at presentation was 56.5±15.6 years. Fifty-four patients had a chronic disease, the most common were hypertension and diabetes; and complications were high in them (70.38%). The most common complaints were shortness of breath, cough, and fever. Anemia was present in 61.8% of patients, and lymphopenia in 70%. Increased levels of neutrophil to lymphocyte ratio was seen in 93.6% while that of platelets to lymphocyte ratio in 63.64%, and of ferritin in 42.7% of patients. Sixty percent of patients improved with treatment while 11.6% expired during the course of hospital stay. Most of the patients with complications and mortality had deranged hematological markers. Conclusions: Ferritin levels were statistically significant for assessing mortality outcomes. Other common hematological biomarkers like lymphocyte count, platelet to lymphocyte ratio, and neutrophil to lymphocyte ratio could be used for risk stratification and prediction of disease course, identifying vulnerable patients at an early phase of illness, and managing patients as per need.","PeriodicalId":111957,"journal":{"name":"Journal of Karnali Academy of Health Sciences","volume":"33 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-08-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139347166","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":"An Attempted Homicidal Cut Throat Injury: A Case Study","authors":"M. K. Sah, M. Thakur","doi":"10.3126/jkahs.v3i2.30728","DOIUrl":"https://doi.org/10.3126/jkahs.v3i2.30728","url":null,"abstract":"Homicidal cut throat is an injury over the front of neck by sharp instruments with an intent of murder. The neck contains vital structures (nerves, blood vessels, airway and pharyngeal conduit) in a compact fashion that may be difficult to access for physical examination or surgical exploration in a limited time. That is why these cases create panic and pose great challenges in the management. Here is a case of an attempted homicidal cut throat injury that highlights some of the challenges encountered in the management along with discussion on the evolving knowledge of the optimal management practice.","PeriodicalId":111957,"journal":{"name":"Journal of Karnali Academy of Health Sciences","volume":"8 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2020-08-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"123646074","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":"Evaluating Quality of Life of Parents Having a Child with Disability","authors":"R. K. Ban, Iswari Luitel, K. Regmi","doi":"10.3126/jkahs.v3i1.28455","DOIUrl":"https://doi.org/10.3126/jkahs.v3i1.28455","url":null,"abstract":"Introduction: Disability is the condition of difficulty in carrying out daily activities normally and in taking part in social life due to problems in parts of the body and the physical system. Children with disabilities are one of the most marginalized and excluded groups in society. Facing daily discrimination in the form of negative attitudes, Estimates suggest that there are at least 93 million children with disabilities in the world, but numbers could be much higher. \u0000Method: A descriptive-analytical research design was used to identify the quality of life of parents/caretakers having a child with disability/ies in Illam district. Systematic random sampling was used and collected data from 244 participants. World Health Organization Quality of Life-Brief (WHOQOL-BREF) Questionnaire was adopted Association between the socio-demographic variables and four domains of WHOQOL was determined using one way ANOVA. In the end, multiple linear regression analysis was performed to find the predictors of domains of WHOQOL and to control the confounding effect. \u0000Results: The quality of parents having a child with a disability has a good quality of life in a social relationship mean 15.6±1.3.The physical domain is weakly correlated with the social domain. There is a moderate positive correlation between psychosocial and social domains. Cognitive disability means the score was highest on the social domain that is 14.91and lowest on the physical domain (13.87). \u0000Conclusion:  To improve the quality of life of parents, health care and welfare professionals should focus on particular people with higher age group, disadvantaged and marginalized groups illiterate, those who are unmarried, divorced or separated and those engaged in agriculture and carry out interventions aimed at improving their quality of life. \u0000Keywords: Parents /caretaker, Quality of life, Children with disability","PeriodicalId":111957,"journal":{"name":"Journal of Karnali Academy of Health Sciences","volume":"165 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2020-04-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"115778420","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":"Health Promoting Lifestyle among Nurses of a Tertiary Level Hospital","authors":"P. Baral, N. Tamrakar","doi":"10.3126/jkahs.v3i1.28456","DOIUrl":"https://doi.org/10.3126/jkahs.v3i1.28456","url":null,"abstract":"Background: Lifestyle-related diseases are increasing worldwide representing 63% of all deaths globally. Health-promoting behaviors among nurses may affect the quality of patient care and education. This study aims to identify the health-promoting lifestyle among nurses. \u0000Methods: Descriptive, cross-sectional study design was used among 111 nurses working in Manipal Teaching Hospital, Pokhara from November 2016 to March 2017. A simple random sampling technique (lottery method) was applied using a self-administered structured standard tool, Health Promoting Lifestyle Profile II. The analysis was done using an independent t-test. \u0000Results: The total Health-Promoting Lifestyle Profile II mean score was 137.66±19.18. The highest mean score was in spiritual growth (27.43±4.63) and lowest in physical activity (17.03±4.88). A good health-promoting lifestyle was among 60.4% of the nurses. The significant difference in the mean score of total Health-Promoting Lifestyle Profile II was found in marital status (p=0.031) and educational qualification (p=0.009). Likewise, the significant mean difference of interpersonal relations, nutrition and stress management was found with educational qualification (p < 0.05). The significant mean difference in nutrition was also found with marital status (p=0.02). There was a significant mean difference in physical activity and spiritual growth with work experience  (p<0.05). \u0000Conclusion: The spiritual aspect of health has been more focused by the nurses. Along with this, nurses need to put greater emphasis on physical activity and stress management for better health.   ","PeriodicalId":111957,"journal":{"name":"Journal of Karnali Academy of Health Sciences","volume":"98 1 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2020-04-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"130981638","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":"Anesthetic Management of Humerus Fracture with Multiple Trauma and Pneumothorax","authors":"N. Gyawali, P. Sharma","doi":"10.3126/jkahs.v2i2.25182","DOIUrl":"https://doi.org/10.3126/jkahs.v2i2.25182","url":null,"abstract":"Background: Trauma is a significant health problem and a leading cause of death in all age group. \u0000Methodology: In this study we describe anesthetic management of poly trauma with pneumthorax in a 55 years old male with humerus fracture. \u0000Result: Patient with multiple trauma with pneumothorax was safely anaesthesized with regional anesthesia. This procedure also prevented progression of pneumothorax to tension pneumothorax. \u0000Conclusion: Regional anesthesia is a safe alternative of general anesthesia in case of patient with pneumothorax for the upper limb surgery.","PeriodicalId":111957,"journal":{"name":"Journal of Karnali Academy of Health Sciences","volume":"295 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2019-08-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"114323820","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":"Nurses Knowledge on Management of Patient Receiving Spinal Anaesthesia in a Government Hospital","authors":"Elisha Rijal, S. Silwal, Sheela Thapa, S. Basnet, S. Bhagat","doi":"10.3126/jkahs.v2i2.25179","DOIUrl":"https://doi.org/10.3126/jkahs.v2i2.25179","url":null,"abstract":"Introduction: Spinal Anaesthesia (SA) is a form of regional anaesthesia involving injection of a local anaesthetic into the subarachnoid space. SA is directly related to nervous system, so its mismanagement may cause various complications hence, prevention and management of complication is a vital and complex aspect of critical nursing care. Therefore, the objective of this study was to assess the nurse’s knowledge on the management of patient receiving spinal anaesthesia. \u0000Methodology: A cross-sectional descriptive study was conducted among nurses of Koshi Zonal Hospital of Province no. 1, Biratnagar, Nepal from May to June 2017. Non-probability purposive sampling method was used where self-administered questionnaire was administered among 67 working nurses in the hospital. \u0000Results: The majority of the respondents (77.6%) belonged to 20-30 years of age group, nearly half (44.8%) of the respondents had completed PCL nursing. Only 67.2% explained the meaning of anaesthesia, and 58.2% had knowledge on physiological changes after SA. Regarding ambulation and cause of backache, 29.9% had knowledge whereas only 20.9% had knowledge about management of post spinal backache. Respondents facing problem to manage the complication after SA was 13.4%. This study also found that the overall knowledge regarding SA was adequate among 80.6% respondents. \u0000Conclusion: Nurses as the key personnel in management and prevention of complication, the obtained result was below the desired competence level among working nurses as it is the vital aspect of critical nursing care.","PeriodicalId":111957,"journal":{"name":"Journal of Karnali Academy of Health Sciences","volume":"11 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2019-08-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"122184304","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":"Comparison of High Resolution Computed Tomography with Intraoperative Findings in Patient with Chronic Suppurative Otitis Media, NAMS, Bir Hospital, Kathmandu, Nepal","authors":"Yagya Bahadur Rokaya, P. Shahi","doi":"10.3126/jkahs.v2i2.25181","DOIUrl":"https://doi.org/10.3126/jkahs.v2i2.25181","url":null,"abstract":" Introduction: Chronic suppurative otitis media (CSOM) is an important cause of middle ear disease and its complications challenge both otologist and radiologist. The major benefit of HRCT is an excellent visualization of the osseous structure by means of special algorithms. This study compares the HRCT with intraoperative findings in patients with CSOM. \u0000Methods: This is an observational descriptive study conducted at NAMS Bir Hospital. Total of 30 patients, referred for HRCT from the department of ENT were studied. Comparison of HRCT findings was done with intraoperative findings regarding the status of EAC, ossicular chain, bony plate, inner ear structure and facing nerve canal was done, considering intraoperative findings as the gold standard. \u0000Results: Out of 30 patients, 16 patients had CSOM with cholesteatoma and 14 patients had CSOM without cholesteatoma. HRCT presented sensitivity, specificity, positive predictive value, negative predictive value and accuracy of 87.5%, 85.7%, 87.5%, 85.7% and 86.7% respectively in diagnosing CSOM with cholesteatoma. HRCT presented sensitivity and specificity of 85.7% and 87.5% in identification of malleus erosion, sensitivity and specificity of 86.7% and 80%, in the identification of incus erosion. HRCT showed the specificity of 85% with relatively low sensitivity of 70% in identification of erosion of stapes. HRCT showed a sensitivity of 100% and specificity of 85.7%. HRCT presented sensitivity and specificity of 83.3% and 95.8% in diagnosing tegmen tympanum erosion. HRCT showed the highest sensitivity (100%) and specificity (100%) in diagnosing erosion of sigmoid sinus plate and mastoid cortex. HRCT showed relatively low sensitivity of 66.7% and 75% in diagnosing erosion of LSCC and facial canal respectively. HRCT detected soft tissue mass in the middle ear/mastoid in all 30 patients of CSOM. Hence, the sensitivity, specificity, positive predictive value and negative predictive value of HRCT for soft tissue mass in the middle ear and mastoid, all were 100%. \u0000Conclusion: The HRCT has a valuable role in preoperative evaluation of a case of CSOM. It has high sensitivity in diagnosing CSOM with cholesteatoma. However, HRCT has relatively low sensitivity for LSCC and facial nerve canal erosion.","PeriodicalId":111957,"journal":{"name":"Journal of Karnali Academy of Health Sciences","volume":"28 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2019-08-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"134478552","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":"Causes of Infertility amongst Couples Visited at Infertility Centre Kathmandu, Nepal","authors":"Pratima Neupane, D. Sharma, P. P. Panta, B. Aryal, Tarun Poudel, K. Amgain","doi":"10.3126/jkahs.v2i2.25180","DOIUrl":"https://doi.org/10.3126/jkahs.v2i2.25180","url":null,"abstract":" Introduction: Infertility is being a common global problem affecting one couple in six. Approximately 167 million ever married women aged 15-49 years in developing countries were infertile. The problem of infertility has not given attention considering the fact that it is not the life threatening, but, it has substantial community health problems such as depression, anxiety domestic violence and social isolation. The purpose of the study was to explore the causes of infertility among couples who visited the infertility centre. \u0000Methodology: Hospital based descriptive cross-sectional study had been carried out in infertility centre Kathmandu Nepal. One hundred and sixty five married couple with infertility problem availing the infertility treatment was selected on first come first serve basic sampling method from infertility treatment centre. \u0000Result: The infertility problem varied with the age. The problem was highest among the females of age group 26-30 years (51%), similarly in males it was predominant at the age of 31-35 years (45%). The most common causes of female infertility were ovarian cyst (37%) and heavy bleeding (18.7%), uterine fibroids (9%), Pelvic inflammation (9%), Thyroid disease (21.8%), whereas in males the infertility were mostly due to Oligospermia (17.5%), Azoospermia (5.5%), Hydrocele (7.8), Mumps orchids (6%). \u0000Conclusion: Infertility was due to various causes in the male or/and the female partner, however, the infertility among couples were mostly due to the problem in females. Infertility is a complex problem that should be considered carefully by the individual, community peoples, government and stakeholders in each country.","PeriodicalId":111957,"journal":{"name":"Journal of Karnali Academy of Health Sciences","volume":"103 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2019-08-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"122605298","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":"Status of Perinatal Mortality in Karnali Academy of Health Sciences, Jumla Nepal","authors":"Namrata Sindan, S. Shrestha, B. Acharya, Purnima Rai, N. Kayastha, Adheesh Bhandari, Namita Sindan","doi":"10.3126/jkahs.v2i2.25178","DOIUrl":"https://doi.org/10.3126/jkahs.v2i2.25178","url":null,"abstract":"Introduction:  Perinatal mortality rate is sensitive indicator of quality of obstetric and pediatric health services. It also helps us to evaluate efficiency of health care provided by a particular hospital. The aim of this study was to evaluate the cause of perinatal death in a tertiary care medical centre, which may help to reduce the incidence of perinatal death and improve the quality of care. \u0000Methods: The two-year retrospective study of perinatal deaths was done at Karnali Academy of Health Sciences (KAHS), Jumla from March 2017 to April 2019. Data was collected from monthly perinatal audit and annual mortality reviews. Registers in the maternity ward, sick Neonate Care Unit, and files of dead newborns kept in the record section of the hospital were studied and reviewed. \u0000Results: A total of 1354 deliveries were conducted in the 24 months period at KAHS with perinatal mortality rate of 36.08 per 1000 total birth and early neonatal death rate of 12.8 per 1000 live birth. The Perinatal mortality was higher in low birth weight and premature baby. The cause of stillbirth and early Neonatal death were identified. Most of the early neonatal death was due to Prematurity (41.17%) followed by Birth Asphyxia and Neonatal Sepsis. \u0000Conclusion: Prematurity and its related complication were the most common cause of early neonatal death followed by birth Asphyxia and Neonatal Sepsis. There is need to improve antenatal, early identification of high-risk pregnancy as well as Neonatal Intensive Care Unit (NICU) to further reduce deaths due to prematurity and birth asphyxia.","PeriodicalId":111957,"journal":{"name":"Journal of Karnali Academy of Health Sciences","volume":"25 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2019-08-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"124501369","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":"Can the Delhi Government’s ‘Mohalla’ clinic overcome its challenges and provide quality health services to the urban poor population?","authors":"Bhuwan Kc, P. Shankar, S. Shrestha","doi":"10.3126/jkahs.v2i2.25185","DOIUrl":"https://doi.org/10.3126/jkahs.v2i2.25185","url":null,"abstract":"  \u0000 The ‘Mohalla’ clinics were set up by the Delhi state (provincial) government in India in 2014 to provide basic health services to people of Delhi city and its vicinity, especially targeting the urban poor. The Mohalla clinics are staffed by a doctor, a nurse, a pharmacist and a laboratory technician and theyprovide basic health services including immunisation, family planning and counselling services. The Mohalla clinic program had a good start and its operation was cost-effective; however, it is still struggling to increase its coverage to entire Delhi state as it had planned. The program got caught up in the central government and state government bureaucratic tussle, especially on the issue of acquiring land for setting up such clinics and on the implementation front due to the lack of operational plan and collaboration with the government line agencies. Thus, despite political will and funding a potentially viable urban health programmay have got stuck in the operational procedural complexities and political-bureaucratic tussle. This commentary article tries to discuss the challenges faced by the Delhi government’s ‘Mohalla’ clinics and a possible way forward to scale it up as a model urban health program.","PeriodicalId":111957,"journal":{"name":"Journal of Karnali Academy of Health Sciences","volume":"45 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2019-08-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"132130317","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}