Nepal Mediciti Medical Journal最新文献_第3页

Pattern and Outcome of Organophosphorus Poisoning Cases in Bheri Hospital, Nepal 尼泊尔Bheri医院有机磷中毒病例的模式和结果

Nepal Mediciti Medical Journal Pub Date : 2021-12-08 DOI: 10.3126/nmmj.v2i2.41280

R. Mandal, Nirmal Shakya, Sanket Kumar Risal

{"title":"Pattern and Outcome of Organophosphorus Poisoning Cases in Bheri Hospital, Nepal","authors":"R. Mandal, Nirmal Shakya, Sanket Kumar Risal","doi":"10.3126/nmmj.v2i2.41280","DOIUrl":"https://doi.org/10.3126/nmmj.v2i2.41280","url":null,"abstract":"BACKGROUND: Organophosphorus (OP) are frequently used as pesticides and the most common agents of poisoning in developing countries including Nepal. There is paucity of data about characteristics of organophosphorus poisoning in our localities. Therefore, we aimed to evaluate its clinical pattern and factors affecting outcome. \u0000METHODS: It was a cross-sectional study conducted in Bheri Hospital Nepalgunj between 15th July 2019 to 14th July 2020. The hospital records of patients of acute organophosphorus poisonings were collected. Data regarding age, gender, predisposing factors, duration of hospitalization and outcome of the patients were recorded. Data was analyzed using SPSS 20. \u0000RESULTS: A total of 53 patients out of which 22(41.5%) were male and 31(58.49%) were female with F:M ratio of 1.40: 1. The maximum number of the patients 25(47.16%) were in the age group of 20 to 40 years. Incidence of poisoning was more common in married patients 36(67.92%) The suicidal motive for poisoning was found in 49 cases (92.45%). The most commonly used organophosphorus poison was Dichlorvos 32(60.34%) followed by methyl parathion 14(26.41%). Domestic quarrel was the most common predisposing factor 32(60.37%). 45(84.90%) of the patients were discharged after successful treatment while there was mortality of 3 patients (5.66%). \u0000CONCLUSIONS: Organophosphorus poisoning is a common mode of suicidal attempts leading to morbidity and mortality every year. Strict policies against the free availability and sale of insecticides is required to control organophosphorus poisoning. Mental health education programme should be conducted for the prevention of suicide and poisoning.","PeriodicalId":131440,"journal":{"name":"Nepal Mediciti Medical Journal","volume":"15 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2021-12-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"121281734","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}

引用次数: 2

Ultrasound fetal biometry in third trimester in urban Nepalese population 尼泊尔城市人口妊娠晚期超声胎儿生物测定

Nepal Mediciti Medical Journal Pub Date : 2021-12-08 DOI: 10.3126/nmmj.v2i2.41274

B. Kayastha, Shahjan Raj Giri, Bibek Gurung, O. Panta

{"title":"Ultrasound fetal biometry in third trimester in urban Nepalese population","authors":"B. Kayastha, Shahjan Raj Giri, Bibek Gurung, O. Panta","doi":"10.3126/nmmj.v2i2.41274","DOIUrl":"https://doi.org/10.3126/nmmj.v2i2.41274","url":null,"abstract":"INTRODUCTION: Fetal biometry is an important component of fetal growth surveillance and can detect small for gestation age fetuses. However, we use growth curves from studies done in other high-income countries and do not have a standard of our own. This study aims to study the deviation of biometry and expected fetal weight from these curves in pregnancy with normal birth weight term deliveries. \u0000METHODS: The study was a retrospective hospital record-based study including term delivery from 2018 May to 2020 January. All lowrisk patients visiting ultrasound OPD in our hospital in 3rd trimester were retrieved and included in the study. Patient with low AFI, major fetal anomaly, abnormal fetal heart rate, preterm delivery, birth weight less than 2500 gm (low birth weight), intrauterine fetal demise, preeclampsia or other complications were excluded from the study. Fetal biometry and expected fetal weight were evaluated. Data was entered in predesigned performa and analysis was performed with IBM SPSS 20.0. \u0000RESULTS: A total of 590 ultrasound examinations done in 372 patients were included in the study. Mean age of the patients was 30.78+/-3.98 years, median age was 30 years (IQ range-5). Approximately 316(53.6%) patients were under 30 years of age, 198(33.6%) patients were between 30-35 and 76(12.9%) patients were above 35 years. Median gestational age at birth was 39 weeks and median birth weight was 3120 grams. Median and percentile for various biometry was calculated. EFW was below 50th percentile in 424(71.9%) according to WHO chart. The median percentile for EFW was 30.6 (IQ-33.6). \u0000CONCLUSION: Expected fetal weight in Nepalese population is smaller than that predicted by WHO chart. Development of country specific fetal growth curve is recommended for accurate fetal growth surveillance. ","PeriodicalId":131440,"journal":{"name":"Nepal Mediciti Medical Journal","volume":"25 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2021-12-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"125319821","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}

引用次数: 0

Multiple meningiomas in different neuroaxial locations: report of a rare case 不同神经轴位多发性脑膜瘤:罕见病例报告

Nepal Mediciti Medical Journal Pub Date : 2021-12-08 DOI: 10.3126/nmmj.v2i2.41284

G. Sharma, S. Aryal, R. Shrestha, A. Deo, R. Pathak

引用次数: 0

A Study of the ST Changes in the aVR Lead on 12-Lead ECG to Identify Infarct - Related Artery (IRA) in Patients With Acute Inferior Wall Myocardial Infarction 急性下壁心肌梗死患者12导联aVR导联ST段变化识别梗死相关动脉(IRA)的研究

Nepal Mediciti Medical Journal Pub Date : 2021-12-08 DOI: 10.3126/nmmj.v2i2.41273

A. Mahaseth, B. Nepal, B. Karki, J. Ghimire, N. Pandey, P. Shah, P. Karki

{"title":"A Study of the ST Changes in the aVR Lead on 12-Lead ECG to Identify Infarct - Related Artery (IRA) in Patients With Acute Inferior Wall Myocardial Infarction","authors":"A. Mahaseth, B. Nepal, B. Karki, J. Ghimire, N. Pandey, P. Shah, P. Karki","doi":"10.3126/nmmj.v2i2.41273","DOIUrl":"https://doi.org/10.3126/nmmj.v2i2.41273","url":null,"abstract":"BACKGROUND: Lead avR is a valuable but mostly ignored lead in clinical electrocardiography. Recently, ST-segment depression in lead aVR during an inferior wall myocardial infarction has been suggested as a predictor of LCX artery involvement. \u0000METHODS: This study was a single centre cross sectional observational study done in BPKIHS, Dharan from February 2018 to January 2020. Patients presenting to the OPD or emergency room of BPKIHS diagnosed as acute inferior wall myocardial infarction based on clinical symptoms, ECG and/or Cardiac tropinin I levels, and planned for coronary angiography, meeting the inclusion and exclusion criterias were included. \u0000RESULTS: Among 134 cases, male:female ratio was 1.3:1. Overall, 38 patients (28.4%) were found to have aVR depression and 96 patients (71.6%) were without aVR depression. The culprit artery was found to be the right coronary artery in 95 patients (70.9%), the LCx in 39 patients (29.1%). The sensitivity and specificity of ST-segment depression in lead aVR for LCx as the culprit artery were 92.3% and 97.9% respectively. Positive predictive and Negative predictive value for LCx as the culprit arteries were 94.74% and 96.87%. The sensitivity, specificity, positive predictive value and negative predictive value for RCA as the culprit artery were 97.89%, 92.3%, 96.89% and 94.73% respectively. \u0000CONCLUSION: Significant ST depression in aVR is associated with a higher specificity and good sensitivity for LCX lesions, the ST changes in this lead should be carefully examined in all patients who are suspected of having inferior wall myocardial infarction.","PeriodicalId":131440,"journal":{"name":"Nepal Mediciti Medical Journal","volume":"78 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2021-12-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"117034042","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}

引用次数: 0

Trans abdominal Ultrasonography in Acute Pancreatitis: a cross sectional study 急性胰腺炎经腹部超声检查:横断面研究

Nepal Mediciti Medical Journal Pub Date : 2021-12-08 DOI: 10.3126/nmmj.v2i2.41278

M. Gyawali, A. Shrestha, P. Sharma, B. Shrestha, S. Bhattarai

{"title":"Trans abdominal Ultrasonography in Acute Pancreatitis: a cross sectional study","authors":"M. Gyawali, A. Shrestha, P. Sharma, B. Shrestha, S. Bhattarai","doi":"10.3126/nmmj.v2i2.41278","DOIUrl":"https://doi.org/10.3126/nmmj.v2i2.41278","url":null,"abstract":"BACKGROUND: Acute pancreatitis (AP) is a common cause of acute pain abdomen. Contrast-enhanced Computed Tomography (CECT) of the abdomen is the imaging method of choice in acute pancreatitis. Ultrasonography can be used as the first, easily available imaging modality for the assessment of the pancreas. This study aims to study the transabdominal USG findings in patients with acute pancreatitis. It will also compare USG findings with CT findings in acute pancreatitis. \u0000METHODS: A hospital-based cross-sectional, prospective study comprising of consecutive 55 patients with acute pancreatitis was conducted over a study period of 15 months. Trans abdominal USG findings and CECT abdominal findings in acute pancreatitis were studied and compared. Data analysis was done using SPSS version 20 and a p-value of ≤0.05 was considered significant. \u0000RESULTS: Pancreas was visualized by USG in only 69%. Ultrasonography had some pancreatic and/or extrapancreatic findings in patients with acute pancreatitis in 84.2% of patients in whom the pancreas was visualized, whereas, it was 98.2% by CECT abdomen. USG was unable to demonstrate findings in 75% of patients with mild acute pancreatitis. \u0000CONCLUSION: Transabdominal ultrasonography detection of pancreatitis was inferior to the CECT. It had a limited role in detecting mild acute pancreatic cases. Nonetheless, detection of etiological factor such as gallstones, and assessment of extra pancreatic fluid collection like ascites and pleural effusion were better visualised with ultrasound. USG is readily available, cheap, noninvasive, and can be utilized as an initial diagnostic tool for acute pancreatitis and ruling out other causes of acute abdomen.","PeriodicalId":131440,"journal":{"name":"Nepal Mediciti Medical Journal","volume":"12 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2021-12-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"124025104","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}

引用次数: 0

Quick-Wee method Versus Standard method for urine collection in infants 1-12 month old 速尿法与标准法在1-12月龄婴儿尿液收集中的比较

Nepal Mediciti Medical Journal Pub Date : 2021-12-08 DOI: 10.3126/nmmj.v2i2.41276

K. Malla, S. Singh, Brajesh Raj Chaudhary, Nabal Kishore Ray, Shivani Singh

{"title":"Quick-Wee method Versus Standard method for urine collection in infants 1-12 month old","authors":"K. Malla, S. Singh, Brajesh Raj Chaudhary, Nabal Kishore Ray, Shivani Singh","doi":"10.3126/nmmj.v2i2.41276","DOIUrl":"https://doi.org/10.3126/nmmj.v2i2.41276","url":null,"abstract":"BACKGROUND: Urinary Tract infections [UTI] often presents with fever and nonspecific findings in infants less than one year. So urine sample collection is mandatory for diagnosis or exclusion. Collecting Urine sample is very challenging in infants and choosing the method of collection must balance the reliability, speed and contamination. Clinical guidelines have different recommendations so there is a need for reliable collection method. Therefore this study was conducted to determine if a simple stimulation method (Quick–wee Method) increases the rate of clean catch voiding of urine within five minutes. \u0000METHODS: A prospective age and sex matched case control study in 1-12 months children conducted from June 2017 – June 2018 in Pediatric ward of Manipal college of medical sciences, Pokhara, after Ethical clearance from Institutional review Board [IRB]. The study population was randomized to either clean catch midstream urine with stimulation [Quick–Wee method] or without stimulation [Standard method]. The primary outcome was voiding of urine within 5 minute. Secondary outcome were waiting time for voiding, successful collection, parental satisfaction, and contamination. The analysis was done using SPSS version 20 and a ‘p’value <0.05 was considered statistically significant. \u0000RESULTS: Waiting time for voiding in Quick wee group was less and statistically significant compared to standard group. There was 10% increment in voiding within 5 minutes in Quick wee group . It had higher successful urine collection rate (91.4%), slightly higher contamination rate (14.28%) but better parental satisfaction. \u0000CONCLUSIONS: Quick wee method is easy, reliable, successful method of urine collection in infants with better parental satisfaction and slightly higher contamination rate.","PeriodicalId":131440,"journal":{"name":"Nepal Mediciti Medical Journal","volume":"20 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2021-12-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"129286647","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}

引用次数: 0

Clinical application of AIMS65 score to predict outcome in patients with acute upper gastrointestinal bleeding AIMS65评分预测急性上消化道出血预后的临床应用

Nepal Mediciti Medical Journal Pub Date : 2021-12-08 DOI: 10.3126/nmmj.v2i2.41281

K. Maharjan, R. Mandal, Sanjay Shrestha

{"title":"Clinical application of AIMS65 score to predict outcome in patients with acute upper gastrointestinal bleeding","authors":"K. Maharjan, R. Mandal, Sanjay Shrestha","doi":"10.3126/nmmj.v2i2.41281","DOIUrl":"https://doi.org/10.3126/nmmj.v2i2.41281","url":null,"abstract":"BACKGROUND: Acute upper gastrointestinal bleeding (AUGIB) is a potentially life-threatening condition that requires rapid assessment in the emergency department. The current available scores are complex and have not been widely used in clinical practice. AIMS65 score is a simple score that can be used to risk stratify patients with AUGIB. \u0000METHODS: This was a descriptive cross-sectional study done at a single tertiary centre, NAMS, Bir Hospital among the patients presenting with AUGIB from August 2018 to January 2019. AIMS65 scores were calculated in patients presenting with acute UGIB by allotting 1 point each for albumin level < 3g/dl, INR > 1.5, alteration in mental status, systolic blood pressure ≤90 mm Hg, and age ≥65 years. Risk stratification was done during the initial 12 hours of hospital admission. \u0000RESULTS: A total of 84 patients consisting of 68 males and 16 females were enrolled in our study, with age ranging from 27 to 80 years. ICU admission, endoscopic therapy and blood transfusion were required in 22,44 and 49 patients respectively. In-patient mortality, the need for blood transfusion, endoscopic therapy or ICU admission were higher in those with AIMS65 score ≥ 2 showing statistically significant positive association (p=0.000). \u0000CONCLUSION: AIMS65 score is a simple non-endoscopic risk score that can be applied in patients of acute upper gastrointestinal bleeding to risk stratify and to predict in-patient mortality, the need for blood transfusion, endoscopic therapy or ICU admission. ","PeriodicalId":131440,"journal":{"name":"Nepal Mediciti Medical Journal","volume":"20 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2021-12-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"126536051","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}

引用次数: 0

Sociodemographic factors associated with Covid-19 in Canada 加拿大与Covid-19相关的社会人口因素

Nepal Mediciti Medical Journal Pub Date : 2021-12-08 DOI: 10.3126/nmmj.v2i2.41275

S. Mathew, Shadi Zain

{"title":"Sociodemographic factors associated with Covid-19 in Canada","authors":"S. Mathew, Shadi Zain","doi":"10.3126/nmmj.v2i2.41275","DOIUrl":"https://doi.org/10.3126/nmmj.v2i2.41275","url":null,"abstract":"BACKGROUND: Coronavirus disease or Covid-19 has caused more than 30 million documented infections and 1 million deaths worldwide as of Oct 2020. It was shown that several sociodemographic factors play a significant role in shaping the Covid-19 outcome and associated death rates across the globe. Thus the present study aims to study the sociodemographic parameters associated with the Covid-19 cases in Canada. \u0000MATERIAL AND METHODS: In this retrospective study, the data was collected from the Official data repository present in Canada. The patients' data were evaluated and sociodemographic parameters were checked and recorded. After the data was recorded they are categorized based on the different states and statistical analysis was done. \u0000RESULT:The present study reported that in Canada total cases as reported in the repository are 1,253,519 cases. This result indicates that maximum of the patients suffering from Covid-19 belonged to the younger age category. Compared to the males, females were more to suffer from Covid-19. Most of the patients who required hospitalization were in the 80+ year age group (28.5%). Only 1.7% of patients in the age group below 19 years are required to be hospitalized. The regional data variation showed that in Alberta female patients were more in all the age groups compared with the male patients. Saskatchewan also reported a higher number of death cases in older people. In Manitoba, in the younger age category (0-29 years) less number of female patients suffered Covid-19. Interestingly, this number reversed as the age group increased. In Ontario, 72.1% of people reported being admitted to ICU and required a ventilator. In British Columbia, the gender distribution showed no such difference among all the Covid-19 positive cases. In Quebec among the covid-19 positive cases, 47.2% were male and 52.8% were females. \u0000CONCLUSION: Age is a significant predictor of Covid-19 mortality and patients from both genders aged more than 75 years and more need to provide more care and increased medical supervision to decrease the Covid-19 casualty.","PeriodicalId":131440,"journal":{"name":"Nepal Mediciti Medical Journal","volume":"10 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2021-12-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"127067743","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}

引用次数: 0

Availability and Use of Vaccines against COVID-19 in Pregnancy 妊娠期COVID-19疫苗的供应和使用

Nepal Mediciti Medical Journal Pub Date : 2021-12-08 DOI: 10.3126/nmmj.v2i2.41285

Saugat Koirala, S. Pant, B. Chaudhary

引用次数: 0

Laparoscopic cholecystectomy during COVID-19 pandemic- Retrospective analysis of tertiary care centre COVID-19大流行期间腹腔镜胆囊切除术-三级保健中心回顾性分析

Nepal Mediciti Medical Journal Pub Date : 2021-12-08 DOI: 10.3126/nmmj.v2i2.41282

U. Laudari, Rosi Pradhan, D. Shrestha, B. Timilsina, S. Sapkota, D. Karki, Suraj Lamichhane, A. Parajuli

{"title":"Laparoscopic cholecystectomy during COVID-19 pandemic- Retrospective analysis of tertiary care centre","authors":"U. Laudari, Rosi Pradhan, D. Shrestha, B. Timilsina, S. Sapkota, D. Karki, Suraj Lamichhane, A. Parajuli","doi":"10.3126/nmmj.v2i2.41282","DOIUrl":"https://doi.org/10.3126/nmmj.v2i2.41282","url":null,"abstract":"INTRODUCTION: Laparoscopic cholecystectomy is the most commonly performed general surgical procedure. During the COVID-19 pandemic, general recommendation worldwide is to postpone elective surgeries as far as possible to decrease the resource utilization and also aerosol-related transmission among hospital staff and patients. We conducted this study to see the burden of gallbladder disease, their management and outcomes of all patients who presented to our centre during first wave of COVID-19 pandemic. \u0000METHODS: We conducted a retrospective analysis of all patients who underwent laparoscopic cholecystectomy at the Hospital for Advanced Medicine and Surgery (HAMS) after the commencement of strict lockdown in the first wave of the COVID-19 pandemic. Ethical approval for the study was taken from Nepal Health Research Council. All the surgeries were performed as per HAMS interim policy for infection prevention and control during the COVID-19 pandemic. Data were extracted from the discharge sheet and outcomes in terms of duration of hospitalization, morbidity, mortality, and COVID -19 infection among patient and operating team staff after surgery were assessed. \u0000RESULTS: Out of 110 cases operated for gallbladder disease, 90 patients were included in the study with complete data. The most common presentations were dyspepsia (28) and biliary colic (22). Patients were managed with laparoscopic cholecystectomy (79), percutaneous cholecystostomy (4), laparoscopic subtotal cholecystectomy (5), open cholecystectomy (1). The median duration of hospitalization 22 hours. There was no COVID-19 transmission among staff and patients. \u0000CONCLUSIONS: Laparoscopic cholecystectomies are feasible during COVID-19 pandemic and safely performed following infection prevention guidelines. It can be still be performed in day case basis to decrease the bed occupancy and avoiding crowd in hospitals. ","PeriodicalId":131440,"journal":{"name":"Nepal Mediciti Medical Journal","volume":"6 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2021-12-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"129759713","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}

引用次数: 0