Journal of Lumbini Medical College最新文献_第10页

Correlation between C - Reactive Protein and Blood Culture in Neonatal Sepsis at a Tertiary Care Centre in Western Nepal 尼泊尔西部某三级护理中心新生儿败血症C反应蛋白与血培养的相关性

Journal of Lumbini Medical College Pub Date : 2019-11-17 DOI: 10.22502/JLMC.V7I2.286

A. Lamichhane, A. Mishra

{"title":"Correlation between C - Reactive Protein and Blood Culture in Neonatal Sepsis at a Tertiary Care Centre in Western Nepal","authors":"A. Lamichhane, A. Mishra","doi":"10.22502/JLMC.V7I2.286","DOIUrl":"https://doi.org/10.22502/JLMC.V7I2.286","url":null,"abstract":"Introduction: Neonatal sepsis is a serious problem that needs to be addressed for a better outcome of the neonates. This study was conducted to determine the sensitivity, specificity, positive predictive value (PPV) and negative predictive value (NPV) of C-Reactive Protein (CRP) in neonates with sepsis in comparison with blood culture. Methods: This cross-sectional study was carried out in clinically suspected neonates with sepsis in a tertiary hospital. Association between C-reactive protein and blood culture positivity in neonatal sepsis was studied. Results: Out of 245 patients admitted with clinical suspicion of sepsis, 104 (42.45%, 95% CI: 36.18-48.90%) were blood culture-proven sepsis. CRP was reactive in 92 cases (88.5%, 95% CI: 80.71 % - 93.89%) of blood culture-proven sepsis. Gram-negative organisms were predominant, 58 (57.55%) seen from the isolates of blood culture while gram-positive organisms were found to be 46 (43.23%). Early-onset sepsis was seen in 194 (79.18%) cases, while late-onset sepsis accounted for 51(20.82%). The sensitivity and specificity of CRP in the diagnosis of neonatal sepsis was 88.5% and 46.1% respectively with the positive predictive value of 54.8% and negative predictive value of 84.1% and diagnostic accuracy of 64.1%. Conclusion: Neonatal sepsis is still an important cause of hospital admission in the neonatal intensive care unit of our hospital. This study highlights the high sensitivity and negative predictive value but lower specificity and positive predictive value of CRP in relation to blood culture. The present study depicts a significant correlation between culture positivity and CRP.","PeriodicalId":16109,"journal":{"name":"Journal of Lumbini Medical College","volume":"7 1","pages":"88-92"},"PeriodicalIF":0.0,"publicationDate":"2019-11-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"47503761","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: 5

the Cardio-respiratory Fitness in Medical Students by Queen’s College Step Test: A Cross-sectional Study 皇后学院步进测试对医学生心肺健康的横断面研究

Journal of Lumbini Medical College Pub Date : 2019-06-28 DOI: 10.22502/JLMC.V7I1.268

Bibek Koju, Shaligram Chaudhary, Anupama Shrestha, Lok Raj Joshi

{"title":"the Cardio-respiratory Fitness in Medical Students by Queen’s College Step Test: A Cross-sectional Study","authors":"Bibek Koju, Shaligram Chaudhary, Anupama Shrestha, Lok Raj Joshi","doi":"10.22502/JLMC.V7I1.268","DOIUrl":"https://doi.org/10.22502/JLMC.V7I1.268","url":null,"abstract":"Introduction: Cardio-respiratory fitness indicates the ability of circulatory system to supply oxygen toworking muscles during continuous physical activity. Maximum oxygen uptake (VO2max) is a single bestmeasure of cardio-respiratory fitness and is considered gold standard to quantify aerobic capacity. Methods:Eighty students of age group 18-25 years were taken by simple random sampling. VO2max was estimatedindirectly by following the protocol of Queen’s College Step Test (QCST) method. Results: Mean value ofVO2max for male (51.61±6.26 ml/Kg/min) and female (36.02±3.71 ml/Kg/min) was compared, which wasfound significantly higher in males than in females (p<0.001). There was negative correlation of gender(r = -0.838), body mass index (BMI) (r = -0.339), obesity category (r = -0.275), obese vs non-obese (r =-0.264) and basal pulse rate (r = -0.456) with VO2max and positive correlation of height (r = 0.592) and hoursof study(r = 0.309) with VO2max. Conclusion: This study showed that increased BMI is associated withdecreased level of VO2max in young adults. One can improve VO2max by maintaining BMI within normallimits.","PeriodicalId":16109,"journal":{"name":"Journal of Lumbini Medical College","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2019-06-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43414001","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: 4

Depression and its Associated Risk Factors among Residents of a Geriatric Home in Western Nepal 尼泊尔西部一家老人院居民的抑郁及其相关危险因素

Journal of Lumbini Medical College Pub Date : 2019-06-26 DOI: 10.22502/JLMC.V7I1.285

B. Pokharel, Bhaskkar Sharma

引用次数: 2

Central Retinal Artery Occlusion Associated with Atrial Septal Defect: A Case Report 视网膜中央动脉闭塞伴心房间隔缺损1例

Journal of Lumbini Medical College Pub Date : 2019-06-25 DOI: 10.22502/JLMC.V7I1.281

Sharad Gupta, Manoj Aryal, Yogita Rajbhandari, Ajay Adhikari, V. Kamble, B. Aryal

{"title":"Central Retinal Artery Occlusion Associated with Atrial Septal Defect: A Case Report","authors":"Sharad Gupta, Manoj Aryal, Yogita Rajbhandari, Ajay Adhikari, V. Kamble, B. Aryal","doi":"10.22502/JLMC.V7I1.281","DOIUrl":"https://doi.org/10.22502/JLMC.V7I1.281","url":null,"abstract":"Introduction: Central retinal artery occlusion (CRAO) is characterized by sudden obstruction of the arterial blood flow in the retinal circulation with consequent ischemic damage to the retina resulting in vision loss. An interesting case of unilateral CRAO associated with atrial septal defect (ASD) in a young female is reported here. Case: A young female presented to emergency department with history of sudden and painless loss of vision in her right eye for one day. Her visual acuity at the time of presentation was perception of light in right eye and 6/6 in left eye. On examination, anterior segments of both the eyes were normal. However, relative afferent pupillary defect was positive in her right eye. On fundus examination, right eye showed pale retina and cherry red spot whereas left eye was unremarkable. Findings were suggestive of right eye CRAO. Ocular massage was done and oral carbonic anhydrase inhibitor was given. Patient was referred to a cardiologist for further evaluation and establishment of the etiology. All tests were within reference limit except a large ASD (secundum type with left to right shunt) with a diameter of 28 mm was revealed on transthoracic echocardiogram. Conclusion: The association between ASD and CRAO is rare. Intracardiac shunts through defect may predispose the disease. Detailed cardiac evaluation is mandatory to rule out possible causes to prevent ocular or systemic embolic events and associated morbidity.","PeriodicalId":16109,"journal":{"name":"Journal of Lumbini Medical College","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2019-06-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"48716838","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: 1

Drug Utilization Pattern by Using WHO Core Prescribing Indicators in Orthopedics and Obstetrics / Gynecology Departments of a Tertiary Care Hospital 某三级医院骨科和妇产科使用WHO核心处方指标的药物利用模式

Journal of Lumbini Medical College Pub Date : 2019-06-21 DOI: 10.22502/JLMC.V7I1.280

Naresh Karki, R. Joshi, B. K. Shrestha, Pravin Prasad

{"title":"Drug Utilization Pattern by Using WHO Core Prescribing Indicators in Orthopedics and Obstetrics / Gynecology Departments of a Tertiary Care Hospital","authors":"Naresh Karki, R. Joshi, B. K. Shrestha, Pravin Prasad","doi":"10.22502/JLMC.V7I1.280","DOIUrl":"https://doi.org/10.22502/JLMC.V7I1.280","url":null,"abstract":"Introduction: Drug utilization research is an important tool to facilitate rational use of drugs. In low income countries irrational use of drugs is a common problem like overuse of drugs and inappropriate use of antibiotics, leading to poor treatment outcome and increased burden of treatment. This study was conducted to provide understanding of drug utilization pattern by using WHO Core Prescribing Indicator. Methods: This study was conducted in Orthopedics and Obstetrics / Gynecology departments. Patients visiting these Out Patient Departments with at least one drug on prescription form were included in the study. Further, information related to WHO Core Prescribing Indicators were collected in pre-designed proforma. Results: Average number of drugs prescribed per prescription was 2.6. Means of number of drugs prescribed in Orthopedics and Obstetrics / Gynecology departments were 2.9 and 2.3 respectively (p < 0.001). Drugs prescribed in generic name and from essential drug list was 41.4% and 34.3% respectively. Prescription forms with generic name in Orthopedics department were significantly more compared to Obstetrics / Gynecology department (p = 0.00002). However, there was an increased tendency to prescribe drugs from essential drug list in Obstetrics / Gynecology department compared to Orthopedics department (p < 0.001). Conclusion: Drugs were prescribed by generic name and from essential drug list, but this was not sufficient to meet the ideal values of WHO Core Prescribing Indicator. Therefore, prioritization on prescribing drugs by generic name and from essential drug list by respective departments to achieve the standards of WHO needs to be encouraged.","PeriodicalId":16109,"journal":{"name":"Journal of Lumbini Medical College","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2019-06-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"48872813","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: 5

Gram stain and Giemsa stain as a rapid diagnostic tool for diagnosis of vaginal infections” in Western Nepal 革兰氏染色和吉姆萨染色作为诊断阴道感染的快速诊断工具”在尼泊尔西部

Journal of Lumbini Medical College Pub Date : 2019-05-22 DOI: 10.22502/jlmc.v5i1.105

K. Bajracharya, N. Kaur, S. S. Pant

{"title":"Gram stain and Giemsa stain as a rapid diagnostic tool for diagnosis of vaginal infections” in Western Nepal","authors":"K. Bajracharya, N. Kaur, S. S. Pant","doi":"10.22502/jlmc.v5i1.105","DOIUrl":"https://doi.org/10.22502/jlmc.v5i1.105","url":null,"abstract":"Abstract: \u0000Introduction: Infective vaginitis accounts for about 90% of all the cases of vaginal discharge in the women of reproductive age group. This includes triad of bacterial vaginosis, candidiasis and trichomoniasis. \u0000Method: The study was carried out in Lumbini Medical College and Teaching Hospital, Palpa, Nepal for a time period of 4 months. Total 125 high vaginal swabs from posterior fornix of vagina were collected from November 2014 to February 2015 in the department of Obstetrics and Gynecology, in the patients complaining of vaginal discharge. PH of the vaginal discharge was also determined by using litmus paper. Gram’s and Giemsa stain of vaginal swab smear were done to diagnose Bacterial vaginosis, Candidiasis and Trichomoniasis. Age, parity and pregnancy status of the patients were noted. \u0000Result: Out of 125 patient, bacterial vaginosis was found in 16% and candidiasis in 37%.Candidiasis and bacterial vaginosis were observed in child bearing sexually active women. Surprisingly bacterial vaginosis was not observed in pregnant women. Trichomoniasis infection was present in one case (0.8%) while severe invasive Candidiasis was observed in one woman. \u0000Conclusion: A definitive diagnosis can easily be made by Gram’s and Giemsa stain and microscopic examination of high vaginal swab. This may help in specific treatment and prevent associated morbidity and recurrence. \u0000Key words: Bacterial vaginosis, candidiasis, high vaginal swab, Gram’s stain, Giemsa stain.","PeriodicalId":16109,"journal":{"name":"Journal of Lumbini Medical College","volume":"7 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2019-05-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46713109","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

Trend of Breastfeeding and its Impact on Morbidity in Children in a Tertiary Care Hospital in Kathmandu 加德满都一家三级护理医院的母乳喂养趋势及其对儿童发病率的影响

Journal of Lumbini Medical College Pub Date : 2019-04-26 DOI: 10.22502/JLMC.V7I1.262

Anwesh Bhatta, R. Basnet

{"title":"Trend of Breastfeeding and its Impact on Morbidity in Children in a Tertiary Care Hospital in Kathmandu","authors":"Anwesh Bhatta, R. Basnet","doi":"10.22502/JLMC.V7I1.262","DOIUrl":"https://doi.org/10.22502/JLMC.V7I1.262","url":null,"abstract":"Introduction: WHO advocates for exclusive breastfeeding in infants till six months of age. Exclusive breastfeeding has been estimated to reduce 70% of infection related mortality in children. This study aims to elaborate the current trend of breastfeeding and its impact on common infectious morbidities in children. \u0000Methods: This study was a prospective longitudinal study done at Kathmandu Medical College Teaching Hospital with a sample size of 103 infants. Detailed proforma including sociodemographic data, breastfeeding related data and morbidities were collected at one and half months of life. The patients were followed up at 6 months of age again and the same proforma was again filled up. Statistical analysis was done with SPSS 20.0 and various associations were elucidated. \u0000Results: A total of 103 infants were analyzed. Males were 58 in numbers with mean birth weight of the infants being 3048±537 grams. Breast feeding was initiated within an hour in around 37%. At one and half months of age, 63% reported of exclusive breastfeeding which decreased to 23% at 6 months of age. Breastfeeding for at least 45 days decreased the incidence of Acute Respiratory Infections(ARI), Acute Otitis Media(AOM) and diarrheal diseases although statistically significant difference was found with only ARIs. \u0000Conclusion: Prevalence of exclusive breastfeeding is low in the study. The study has also shown that breastfeeding significantly reduces incidence of common infectious morbidities in infants. ","PeriodicalId":16109,"journal":{"name":"Journal of Lumbini Medical College","volume":"1 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2019-04-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42456530","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: 1

Minimal Local Analgesic Dose of Intrathecal Bupivacaine and Ropivacaine in Patients Undergoing Cesarean Section: A Comparative Study 剖宫产患者鞘内布比卡因和罗哌卡因最小局部镇痛剂量的比较研究

Journal of Lumbini Medical College Pub Date : 2019-02-13 DOI: 10.22502/JLMC.V7I1.250

Jeevan Singh, Ashish Shrestha, Kalpana Kharbuja, A. Tandukar, A. Shrestha

{"title":"Minimal Local Analgesic Dose of Intrathecal Bupivacaine and Ropivacaine in Patients Undergoing Cesarean Section: A Comparative Study","authors":"Jeevan Singh, Ashish Shrestha, Kalpana Kharbuja, A. Tandukar, A. Shrestha","doi":"10.22502/JLMC.V7I1.250","DOIUrl":"https://doi.org/10.22502/JLMC.V7I1.250","url":null,"abstract":"Introduction: Spinal anesthesia is a reasonable option for cesarean section. Bupivacaine and ropivacaine have been used as intrathecal drugs alone or in combination with various opiods. Ropivacaine is considered a valid and safe alternative to bupivacaine for intrathecal anesthesia. This study aims to determine the median effective dose (ED50) of intrathecal bupivacaine and ropivacaine for cesarean section and defines this as the minimum local anesthetic dose (MLAD). Methods: Forty pregnant women undergoing elective cesarean section were allocated and randomized into two groups. The initial dose was 13mg for both ropivacaine and bupivacaine groups and was increased or decreased of 0.3mg, using the up-down sequential allocation technique. Efficacy was accepted if adequate sensory dermatomal anesthesia to pinprick to T6 was attained within 20 minutes after intrathecal injection and required no supplemental epidural injection for procedure until at least 50 minutes after the intrathecal injection of test drugs. The MLAD for both bupivacaine and ropivacaine was calculated with 95% confidence interval using the formula of Dixon and Massey. Comparison of different variables between the groups was done using t-test with significant p value at < 0.05. Results: The two groups were comparable in terms of demographic profile and clinical characteristics. The MLAD of ropivacaine and bupivacaine were 11.63 mg (95% CI, 11.5-12.92) and 10.459 mg (95% CI, 10.12-10.87) respectively. The potency ratio between spinal ropivacaine and bupivacaine was 0.89. Conclusion: Ropivacaine provided clinically surgical anaesthesia of shorter duration without compromising neonatal outcome and can be used as a safe alternative to bupivacaine.","PeriodicalId":16109,"journal":{"name":"Journal of Lumbini Medical College","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2019-02-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"48599044","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

Integration of Physical and Mental Health: A Reproductive Health Necessity 综合身心健康:生殖健康的必要性

Journal of Lumbini Medical College Pub Date : 2019-02-10 DOI: 10.22502/JLMC.V6I2.275

S. Aryal

引用次数: 0

A Comparative Analysis Between RIPASA and Alvarado Scoring Systems for the Diagnosis of Acute Appendicitis- A Nepalese Perspective RIASA和Alvarado评分系统诊断急性阑尾炎的比较分析——尼泊尔视角

Journal of Lumbini Medical College Pub Date : 2018-12-31 DOI: 10.22502/JLMC.V6I2.264

S. Baral, Neeraj Thapa, R. Chhetri, Rupesh Sharma

{"title":"A Comparative Analysis Between RIPASA and Alvarado Scoring Systems for the Diagnosis of Acute Appendicitis- A Nepalese Perspective","authors":"S. Baral, Neeraj Thapa, R. Chhetri, Rupesh Sharma","doi":"10.22502/JLMC.V6I2.264","DOIUrl":"https://doi.org/10.22502/JLMC.V6I2.264","url":null,"abstract":"Introduction: Various diagnostic criteria have been described for acute appendicitis. For decades the most commonly used one has been Alvarado score. RIPASA scoring system has also been developed for Asian population which has shown highest sensitivity and diagnostic accuracy. This study aimed to compare these two diagnostic criteria in Nepalese population attending a tertiary center. Methods: Patients with clinically suspected acute appendicitis were classified according to both Alvarado and RIPASA scoring systems before undergoing surgery. Histopathological examination was taken as the gold standard for diagnosis. Statistical analysis was done using McNemar's test as applicable. Results: Ninety nine (90 %) patients had histologically confirmed appendicitis. With the cut-off value greater than 7.5 for RIPASA score; sensitivity, specificity, positive predictive value, negative predictive value, diagnostic accuracy and negative appendectomy rates were 94.5%, 27.27 %, 92.16 %, 37.5 %, 88.18% and 7.84% respectively. With the cut-off value greater than 7 for Alvarado score, sensitivity, specificity, positive predictive value, negative predictive value, diagnostic accuracy and negative appendectomy rates were 71.72%, 72.73 %, 95.95 %, 22.22%, 71.82 %, and 4.05 % respectively. 94.5% of patients were correctly stratified by RIPASA under higher probability group while only 71.8 % were classified by Alvarado (p value= 0.0001). Conclusion: RIPASA scoring system showed high sensitivity and diagnostic accuracy in comparison to Alvarado scoring system. So, this method can be applied in Nepalese setting for the diagnosis of acute appendicitis.","PeriodicalId":16109,"journal":{"name":"Journal of Lumbini Medical College","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2018-12-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"47006518","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: 1