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

The prescribing cascade- spotting and aborting it 处方级联-发现和流产

Journal of Kathmandu Medical College Pub Date : 2020-10-20 DOI: 10.3126/jkmc.v8i4.32380

S. M. Dixit

引用次数: 0

Role of cervical length assessment at mid-trimester scan for predicting preterm births: An experience from Tertiary Hospital 孕期中期宫颈长度评估在预测早产中的作用:来自三级医院的经验

Journal of Kathmandu Medical College Pub Date : 2020-10-20 DOI: 10.3126/jkmc.v8i4.32383

S. Tamrakar, R. Shrestha

{"title":"Role of cervical length assessment at mid-trimester scan for predicting preterm births: An experience from Tertiary Hospital","authors":"S. Tamrakar, R. Shrestha","doi":"10.3126/jkmc.v8i4.32383","DOIUrl":"https://doi.org/10.3126/jkmc.v8i4.32383","url":null,"abstract":"Background: Ultrasound has revolutionized the pattern of care and management. Mid trimester ultrasound (transabdominal) is a valuable method for pregnant clients to predict preterm births. Objectives: To assess cervical length at 20 to 24 weeks obstetric scan for predicting risk of preterm delivery and to determine the sensitivity and specificity of assessing cervical length as a predictor of preterm delivery. Methodology: This is a prospective study conducted at a Tertiary Hospital. Pregnant clients with singleton pregnancy at 20 to 24 weeks were enrolled for transabdominal ultrasound for assessing cervical length as a predictor of preterm delivery. Results: Of 1027 pregnant clients screened, the mean age was 22.92±3.45. Mean gestational age during scan was 21+5 weeks of gestation. About 2.43% of clients were found to have short cervix < 2.5 cm with mean cervical length 3.8 cm. The risk of preterm delivery was almost two fold when cervical length was < 2.5 cm. The sensitivity, specificity, positive predictive value and negative predictive value to predict preterm delivery were 32%, 85.9%, 5.44% and 98.04% respectively. Conclusion: Assessment of the cervical length at mid-trimester can be useful tool for predicting risk of preterm delivery.","PeriodicalId":254049,"journal":{"name":"Journal of Kathmandu Medical College","volume":"80 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2020-10-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"127593927","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

Cat fit and bull fight: Assessment of aggression in medical students as a prelude to conduct violence in future 试猫与斗牛:医学生未来暴力行为前奏的攻击性评估

Journal of Kathmandu Medical College Pub Date : 2020-10-20 DOI: 10.3126/jkmc.v8i4.32381

J. Acharya, G. Lama, J. Acharya, N. Manandhar, A. Pant

{"title":"Cat fit and bull fight: Assessment of aggression in medical students as a prelude to conduct violence in future","authors":"J. Acharya, G. Lama, J. Acharya, N. Manandhar, A. Pant","doi":"10.3126/jkmc.v8i4.32381","DOIUrl":"https://doi.org/10.3126/jkmc.v8i4.32381","url":null,"abstract":"Background: The intensity of aggression present in any person determines his/her threat to conduct violent and impulsive act against members of the society or else family, friends or foes, which necessitates a crucial analytical instrument for identification of such behaviour in smaller groups of societies. Objectives: To assess a group of medical students from Kathmandu, Nepal for potential risk they bear to conduct violence in future medical practice. Methodology: A self-administered pre-validated Bush and Perry Aggression Questionnaire was used in this descriptive cross-sectional study to analyse emotional and cognitive component among 235 medical students of Nepal between February and May 2019. A Likert-type bipolar scale was used for response format ranging from one (extremely uncharacteristic) to five (extremely characteristic). Questionnaire explored four factors: physical aggression, verbal aggression, anger and hostility. Mean scores of aggression were computed and compared with gender and level of education by conducting independent t-test with level of significance at 0.05. Results: The mean scores were 20.73± 6.33, 13.97± 3.87, 18.79± 5.20 and 20.17±6.68, for physical aggression, verbal aggression, anger and hostility respectively. Males had higher score of physical aggression statistically significant at p<0.05. The mean Bush and Aggression Perry Questionnaire score was calculated to be 71.66± 15.71, but insignificant (p>0.05) when compared between sexes, and level of education (second semester and seventh semester students). Conclusion: Male medical students were more prone to hostility and physical aggression than female students who were more liable (statistically insignificant) to verbal aggression and anger.","PeriodicalId":254049,"journal":{"name":"Journal of Kathmandu Medical College","volume":"138 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2020-10-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"121970463","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

Effect of ondansetron on spinal induced hypotension in caesarean deliveries 昂丹司琼对剖宫产脊柱性低血压的影响

Journal of Kathmandu Medical College Pub Date : 2020-10-20 DOI: 10.3126/jkmc.v8i4.32384

P. Balla, A. Shrestha, Ninadini Shrestha, N. Bista, M. Marhatta

{"title":"Effect of ondansetron on spinal induced hypotension in caesarean deliveries","authors":"P. Balla, A. Shrestha, Ninadini Shrestha, N. Bista, M. Marhatta","doi":"10.3126/jkmc.v8i4.32384","DOIUrl":"https://doi.org/10.3126/jkmc.v8i4.32384","url":null,"abstract":"Background: Spinal anesthesia is the preferred technique of anesthesia employed for caesarean sections. However, it is very often complicated by hypotension. Different drugs and techniques have been used to prevent the hypotension induced by spinal anesthesia. In this study, the effect of ondansetron on the prevention of hypotension after spinal anesthesia was evaluated. Objectives: To determine the effect of prophylactic ondansetron on prevention of spinal induced hypotension in elective caesarean section. Methodology: Eighty-six parturients planned for elective caesarean deliveries were randomized into two groups of 43 each. Group O received Ondansetron 4 mg (4 ml) and Group S received Normal Saline (4 ml) intravenously 10 minutes prior to spinal anesthesia. Blood pressure, heart rate, phenylephrine requirements, occurrence of nausea and vomiting and APGAR scores of neonates were compared between the groups. Hemodynamic data was analyzed using Student’s t-test for intergroup comparison and ANOVA was used for intragroup comparison. Categorical data was analyzed using Pearson Chi-Square test. For all determinants, p-value <0.05 was considered significant. Results: Occurrence of hypotension in Group O (20.9 %) was significantly lower than in Group S (72.1%) (p < 0.05). The mean arterial pressure was significantly higher in Group O at 2, 6, 8, 12 and 14 minutes (p < 0.05). The use of phenylephrine (37.21 mcg vs. 146.51 mcg, p < 0.05) and occurrence of nausea (11.6%, vs. 41.9% p < 0.002) was significantly lower in ondansetron group. Conclusion: Ondansetron is effective in preventing spinal induced hypotension in elective caesarean sections.","PeriodicalId":254049,"journal":{"name":"Journal of Kathmandu Medical College","volume":"2 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2020-10-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"130863861","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

Acute appendicitis and acute mesenteric adenitis in children: Are they clinically distinguishable? 儿童急性阑尾炎和急性肠系膜腺炎:它们在临床上有区别吗?

Journal of Kathmandu Medical College Pub Date : 2020-10-20 DOI: 10.3126/jkmc.v8i4.32385

M. Pokhrel

{"title":"Acute appendicitis and acute mesenteric adenitis in children: Are they clinically distinguishable?","authors":"M. Pokhrel","doi":"10.3126/jkmc.v8i4.32385","DOIUrl":"https://doi.org/10.3126/jkmc.v8i4.32385","url":null,"abstract":"Background: Acute appendicitis and acute mesenteric adenitis have very similar clinical presentations but radically different treatment approaches in children. Objectives: This study aims to test the possibility of clinically distinguishing between acute appendicitis and acute mesenteric adenitis. Methodology: A cross-sectional study was designed to recruit all children (<16 years) presenting to Kathmandu Medical College Teaching Hospital with acute abdominal pain between July 2019 and November 2019. An initial diagnosis was made using clinical and laboratory data. Then all patients were subjected to ultrasound evaluation. The final diagnosis was based on the radiological or histopathological examination. The Paediatric Appendicitis score was calculated retrospectively, and a logistic regression model was used to assess the diagnostic accuracy of the clinical parameters. Results: A total of 107 patients were analysed. Among them, 31(28.97%) had acute appendicitis and 34 (31.77%) had acute mesenteric adenitis as the final diagnosis. The positive predictive value of clinical diagnosis was 0.91 for acute appendicitis and 0.73 for acute mesenteric adenitis, for Paediatric Appendicitis Score was 0.77 and for the predictive model to diagnose acute mesenteric adenitis was 0.89. Ultrasound had a positive predictive value of 0.97 to diagnose acute appendicitis and 0.94 to diagnose acute mesenteric adenitis. Conclusion: Although several clinical parameters show promise in differentiating AA from AMA, relying solely on clinical differentiation is not accurate enough to prevent diagnostic errors. It is still recommended to utilise abdominal ultrasound for the assessment of abdominal pain in children.","PeriodicalId":254049,"journal":{"name":"Journal of Kathmandu Medical College","volume":"8 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2020-10-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"129888703","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

Knowledge and attitude on infant oral health among graduating medical students in Nepal 尼泊尔医科毕业生对婴儿口腔健康的知识和态度

Journal of Kathmandu Medical College Pub Date : 2020-10-20 DOI: 10.3126/jkmc.v8i4.32386

Shweta Dhital, M. Pradhan, S. Ghimire, D. Roy, S. Dahal

{"title":"Knowledge and attitude on infant oral health among graduating medical students in Nepal","authors":"Shweta Dhital, M. Pradhan, S. Ghimire, D. Roy, S. Dahal","doi":"10.3126/jkmc.v8i4.32386","DOIUrl":"https://doi.org/10.3126/jkmc.v8i4.32386","url":null,"abstract":"Background: Overall, children less than five years old are seen more by a physician than a dentist. Physician need more knowledge and skills to address children’s oral health due to the prevalence of dental diseases, the racial and socioeconomic disparities in disease burden, and the restricted access to dental care for many children. Thus, integrating oral health disease prevention and promotion strategies into these medical professionals’ practice becomes essential. \u0000Objectives: The objective of this study was to evaluate the knowledge and attitude of graduating medical students of Nepal towards infant oral health. \u0000Methods: A self-administered questionnaire included questions on knowledge and attitude regarding infant oral health was distributed to 180 final year MBBS students of Nepal. Data were collected and entered in Microsoft Excel sheet and analysis was done using Statistical Package for the Social Sciences (SPSS) software version 20. \u0000Results: The mean age of the participants was 23.36 ± 1.12 years. Only 23.9% of them knew that dental caries is infectious and transmissible from mother to baby and 38.9% were aware of the association of poor maternal gum health and preterm, low birth weight baby. Almost 73.9% knew that gum pads should be cleaned regularly and 46.1% knew that first dental visit of a child should be as soon as the first tooth erupts. \u0000Conclusion: This study shows that graduating medical students of Nepal were knowledgeable about some aspects of early childhood caries and infant oral health, but uncertain about other aspects like the association between poor maternal gum health and premature low birth weight babies.","PeriodicalId":254049,"journal":{"name":"Journal of Kathmandu Medical College","volume":"1 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2020-10-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"128485644","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

Study of the antero-posterior position of the mental foramen in the Nepalese population using digital Panoramic Radiograph 利用数字全景x线片研究尼泊尔人的精神孔的前后位置

Journal of Kathmandu Medical College Pub Date : 2020-10-20 DOI: 10.3126/jkmc.v8i4.32382

P. Khanal, Bikash Chaudhary, Rajesh Twayana

{"title":"Study of the antero-posterior position of the mental foramen in the Nepalese population using digital Panoramic Radiograph","authors":"P. Khanal, Bikash Chaudhary, Rajesh Twayana","doi":"10.3126/jkmc.v8i4.32382","DOIUrl":"https://doi.org/10.3126/jkmc.v8i4.32382","url":null,"abstract":"Background: Mental foramen is an important landmark to be considered when operating in the anterior mandible. It is mandatory to identify the location of the foramen to prevent injury to mental nerve and subsequent paresthesia. \u0000Objectives: The objective of this study was to identify the position of the mental foramen in relation to the mandibular premolars and first molar in patients visiting Kathmandu Medical College, Department of Oral Surgery, Duwakot using the Orthopantomogram. \u0000Methodology: A total of 200 digital panoramic radiographs of 92 males and 108 females in the age range of 20-50 years were collected. Consequently, 184 mental foraminain males and 216 mental foraminain females were evaluated. The outline of the mandible along with canine, first premolar, second premolar, and first molar was traced. The mental foramen opening was also traced and the position wasevaluated in relation to the first, second premolars and first molar. \u0000Results: Out of 400 foramina, 217 (54.2%) were located between the first and second premolar, i.e. position 3. The second most commonlocationof 152 (38%) foramina was in line with the second premolar, i.e. position 4. Position 2, i.e. in line with the first premolar was seen in 4% and position 5, i.e. between the second premolar and first molar was seen in 3.5%. The left side (29.2%) had a higher occurrence of position 3 as compared to the right side (25%). \u0000Conclusion: The location of mental foramen should be identified in all surgeries involving the anterior mandible as this will help us prevent injury to the mental nerve.In our population, position 3 was the most common location of the mental foramen.","PeriodicalId":254049,"journal":{"name":"Journal of Kathmandu Medical College","volume":"34 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2020-10-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"125648278","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

Laparoscopic pyeloplasty for pelvi-ureteric junction obstruction: Our single center experience 腹腔镜肾盂成形术治疗肾盂输尿管交界处梗阻:我们的单中心经验

Journal of Kathmandu Medical College Pub Date : 2020-10-20 DOI: 10.3126/jkmc.v8i4.32387

R. Joshi

{"title":"Laparoscopic pyeloplasty for pelvi-ureteric junction obstruction: Our single center experience","authors":"R. Joshi","doi":"10.3126/jkmc.v8i4.32387","DOIUrl":"https://doi.org/10.3126/jkmc.v8i4.32387","url":null,"abstract":"Background: Open pyeloplasty is considered as the gold standard for the treatment of pelvi-ureteric junction obstruction. Laparoscopic pyeloplasty has added advantages with equivalent success rate and low complication rate. Objectives: The aim is to study our experiences in laparoscopic retroperitoneal and transperitoneal pyeloplasty. Methodology: Sixty-five patients with pelvi-ureteric junction obstruction were included in the study. The study was conducted between October 2016 and May 2019 at Kathmandu Medical College Teaching Hospital. Pelvi-ureteric junction obstruction was evaluated by ultrasound and intravenous or computed tomography urography. Clinical history, hospital stay, complications, success rate and functional outcome were analyzed. Statistical analysis was done using the Statistical Package for the Social Sciences,version 20.0 (SPSS Inc., Chicago, IL, USA). A p-value < 0.05 was taken as significant. Followup of the patients was carried out for six to twelve months clinically and radiologically. Results: Laparoscopic transperitoneal pyeloplasty was performed in 27 males and 8 females. Retroperitoneal pyeloplasty was performed in 30 cases (20 males and 10 females). The mean age was 20.26 ± 3.92 years for all cases. Operative time was longer in retroperitoneal group. There were four conversions in retroperitoneal group. Mean hospital stay was longer in retroperitoneal group with significant p-value<0.001. Success rate was almost similar in both groups with insignificant p-value of 0.46. Conclusion: Transperitoneal laparoscopic pyeloplasty group achieved better results than retroperitoneal pyeloplasty group in terms of hospital stay, complication and drain placement but with almost similar success rate.","PeriodicalId":254049,"journal":{"name":"Journal of Kathmandu Medical College","volume":"1 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2020-10-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"131146514","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

Total pancreatectomy and salvage completion pancreatectomy-early and late outcomes without Islet cell auto-transplantation 全胰切除术和补救性完全胰切除术-不进行胰岛细胞自体移植的早期和晚期结果

Journal of Kathmandu Medical College Pub Date : 2020-09-30 DOI: 10.3126/JKMC.V9I3.36421

D. Maharjan, P. Thapa

{"title":"Total pancreatectomy and salvage completion pancreatectomy-early and late outcomes without Islet cell auto-transplantation","authors":"D. Maharjan, P. Thapa","doi":"10.3126/JKMC.V9I3.36421","DOIUrl":"https://doi.org/10.3126/JKMC.V9I3.36421","url":null,"abstract":"Background: Total pancreatectomy was abandoned for decades because of high peri and post-operative morbidity and mortality. However, with better peri-operative outcome and post-operative management of exocrine and endocrine insufficiency, the hesitancy to perform total pancreatectomy has been disappearing. Objectives: This study aims to study exocrinal and endocrinal effects of total pancreatectomy without Islet cell autotransplantation and compare quality of life index among total pancreatectomy with Whipple patients. Methodology: This is a prospectively conducted matched-pairs study. Group A underwent total or completion pancreatectomy after non-salvageable complications of Whipple operation. A matched-pairs analysis of quality of life index of these patients by using SF-36 questionnaire were compared with Group B who underwent Whipple operation during the same period of time, according to age, gender and pre-operative diagnosis. Results: In four years (from February 2016 to February 2020), 160 patients underwent Whipple operation. The mean age of the patients was 59.9 +/-14.3 years. A total of nine patients underwent total pancreatectomy, among which two had peroperative decision of total pancreatectomy and seven had completion pancreatectomy. Median post-operative hospital stay was 11 days with two mortalities. Median follow-up of 12 months and quality of life index of total pancreatectomy patients were comparable to Whipple patients, although a few single quality of life items were reduced. Conclusion: Exocrinal pancreatic supplements and long acting insulin have augmented control of diabetes despite of not using Islet cell auto-transplantation. Quality of life index of total pancreatectomy patients were comparable to that of Whipple patients. Hence, this study signifies the importance of completion pancreatectomy following non-salvageable complications after Whipple operation in order to save life.","PeriodicalId":254049,"journal":{"name":"Journal of Kathmandu Medical College","volume":"4 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2020-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"127244383","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

Epidural blood patch in post-dural puncture headache in parturients: A case series 硬膜外补血治疗硬膜穿刺后头痛:一个病例系列

Journal of Kathmandu Medical College Pub Date : 2020-09-30 DOI: 10.3126/JKMC.V9I3.36416

B. R. Shrestha, S. Maharjan, U. Shrestha, S. Moktan

引用次数: 0