Birat Journal of Health Sciences最新文献

{"title":"Supraorbital and Auriculotemporal Nerve Entrapment: A Lesser-Known Cause of headache mimicking Migraine-like Symptoms","authors":"A. Rayamajhi, P. Bhattarai","doi":"10.3126/bjhs.v8i2.59863","DOIUrl":"https://doi.org/10.3126/bjhs.v8i2.59863","url":null,"abstract":"Extracranial headaches, although not rare, can be a significant contributor to chronic headaches, affecting approximately 4% of individuals. Among the potential causes of these headaches, entrapment neuropathy in the facial area is a prominent factor, with supraoptic nerve entrapment being a leading cause. The resulting pain typically manifests in the frontal forehead regions that are innervated by this nerve. Ultrasound-guided supraoptic nerve interventions serve a dual purpose, acting as both a diagnostic tool and a therapeutic measure, offering valuable benefits in managing this condition.","PeriodicalId":31640,"journal":{"name":"Birat Journal of Health Sciences","volume":"25 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-11-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139229759","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":"Bridging Disparities: The Crucial Role of ICU Registries in Advancing Critical Care Research in LMICs","authors":"D. Aryal","doi":"10.3126/bjhs.v8i2.59843","DOIUrl":"https://doi.org/10.3126/bjhs.v8i2.59843","url":null,"abstract":"<jats:p>NA</jats:p>","PeriodicalId":31640,"journal":{"name":"Birat Journal of Health Sciences","volume":"11 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-11-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139229623","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":"Assessment of geneXpert test for diagnosis of pediatric pulmonary tuberculosis","authors":"Km Roma, Suvesh Kumar Shrestha, Nirajan Bhandari, Gaurav Jung Shah, Shivam Khetan","doi":"10.3126/bjhs.v8i2.59853","DOIUrl":"https://doi.org/10.3126/bjhs.v8i2.59853","url":null,"abstract":"Introduction: Pediatric tuberculosis is an infectious disease and is a leading cause of death in Nepal. The incidence of pediatric TB is a key tool of ongoing transmission of tuberculosis within the community and vital indicator of disease control. Its diagnosis is very much challenging and delay in diagnosis leads to mortality. Objectives: This study was conducted to assess the utility of the gene Xpert test for diagnosis of pediatric pulmonary tuberculosis. Methodology: A hospital based prospective study done at Pediatric department of a teaching hospital, Nepalgunj, Banke conducted over a period of 1 year from 1 January 2021 to 31 December 2021 with presumptive diagnosis of pediatric pulmonary tuberculosis. Chi-square test was used to determine the association between categorical variables and a receiver operating curve (ROC) analysis was performed to compare the performance of gene Xpert test with other lab parameters like sputum/gastric lavage sample microscopy for acid fast bacilli, erythrocytic sedimentation rate, Tuberculin test (TT) and chest X-ray.   Results: We enrolled a total of 294 patients in our study. Out of 294 samples 5.1% samples came out to be positive for gene Xpert for MTB. The sputum/gastric lavage samples for AFB showed both sensitivity and specificity of 100%. The tuberculin test showed a sensitivity of 80% and specificity of 37.3%. Chest X-ray showed a sensitivity of 66.7% and specificity of 43.7%. The area under the curve for acid fast bacilli in microscopy, tuberculin test and ESR was found to be 100% (95% CI: 100%-100%), 58.6% (95% CI: 44.9%-72.4%), and 52.6% (95% CI: 37%-68.3%) respectively.    Conclusion: This study highlights the utility of gene Xpert as a good diagnostic tool for rapid diagnosis of pulmonary tuberculosis in pediatric population.","PeriodicalId":31640,"journal":{"name":"Birat Journal of Health Sciences","volume":"20 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-11-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139228048","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":"Clinical Characteristics and Mortality Predictors of Acute Respiratory Distress Syndrome Patients in ICU- an Observational Study","authors":"L. Rajbanshi, Batsalya Arjyal","doi":"10.3126/bjhs.v8i2.59859","DOIUrl":"https://doi.org/10.3126/bjhs.v8i2.59859","url":null,"abstract":"Introduction: Adult respiratory distress syndrome (ARDS) is an inflammatory lung condition characterized by a sudden onset of severe oxygen deficiency, bilateral chest infiltrates, and high morbidity and mortality rates. The causes and prognostic factors for ARDS may vary in tropical regions. Objective: This study aimed to investigate the causes, clinical characteristics, and outcomes of ARDS patients admitted in ICU. Methodology: We conducted a prospective observational study involving 92 ARDS patients admitted to the medical and surgical intensive care units of a tertiary care hospital in eastern Nepal from 2021 to 2023. We included patients aged 15 years and above who met all the Berlin criteria for ARDS. Patients with burns, end-stage renal disease, hepatic disease, head injuries, congestive cardiac failure, and postoperative patients were excluded. We assessed demographic parameters, initial clinical presentations, causative agents, ventilation parameters, organ failure during the ICU stay, and factors influencing patient mortality. Results: Our cohort had a mean age of 45.71 ± 20.02 years, with a predominance of male patients. The majority of patients presented with fever and shortness of breath. Approximately 26.1% had mild ARDS, while 25% had severe ARDS. The initial Sequential Organ Failure Assessment (SOFA) score was 10.11 ± 6.07, with most patients having a lung injury score of less than 2.5. Higher lung injury scores and low PaO2/FiO2 ratios were associated with increased mortality (P<0.05). The overall mortality rate in our study was 33.6%. Conclusion: Pneumonia emerged as the most common cause of ARDS in our region. Low PaO2/FiO2 ratios and higher lung injury scores significantly influenced ARDS mortality.","PeriodicalId":31640,"journal":{"name":"Birat Journal of Health Sciences","volume":"14 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-11-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139230606","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":"Correlation of Body Mass Index with Blood Pressure in School Going Children Aged 6 To 14 Years in Ramdhuni Municipality of Eastern Nepal","authors":"Nabal Kishor Ray, H. Rimal, Rajnish Mishra, Shivani Singh, Shailendra Kumar Yadav","doi":"10.3126/bjhs.v8i2.59860","DOIUrl":"https://doi.org/10.3126/bjhs.v8i2.59860","url":null,"abstract":"Introduction: Children of school age groups in developing countries are facing the problem of overweight and obesity. Childhood obesity continues as obesity in adulthood. The chance of high blood pressure (BP) in overweight and obese children is more than healthy weight children. However, in Nepal, data on the relationship between hypertension and obesity, and disease burden in children at the national level are limited. To overcome these diseases and to develop effective prevention strategies, knowing the prevalence of the disease is a priority. Thus, this study aims to determine the prevalence and the relationship between overweight/obesity with BP in school going children aged 6-14 years, living in Ramdhuni municipality of eastern Nepal. Objective:  To find prevalence and the association of BMI with blood pressure in school going children aged 6 to 14 years in Ramdhuni municipality of eastern Nepal. Methodology: This was a school based cross-sectional prospective study conducted at various schools in Ramdhuni municipality from February -March 2022.  A total of 490 apparently healthy students of age group 6-14 years of both boys and girls were enrolled. Measurement of height and weight was done by standard procedure. The data was entered into Microsoft offices excel and analyzed using a statistical package for social sciences (SPSS 20.0). Results: In this present study, data of 490 students aged between 6 and 14 years were evaluated. Of them, 77.8% (n=381) were normal weight, 10.6% (n=52) were overweight and 5.9% (n=29) were obese. The prevalence of hypertension and prehypertension was 0.8% (n=4) and 0.6% (n=3), respectively. The body mass index was statistically significant as an explanatory variable of hypertension for both genders. Conclusion: This study concludes that overweight and obese children are at a significantly higher risk for hypertension than are normal weight children. Blood pressure measurement should be routine and frequent in children, especially overweight and obese children.","PeriodicalId":31640,"journal":{"name":"Birat Journal of Health Sciences","volume":"321 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-11-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139230989","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":"Indications and Findings of Coronary Angiography: A Descriptive Cross-Sectional Study","authors":"Madhab Bista, Prashant Shah, Ram Kumar Mehta","doi":"10.3126/bjhs.v8i2.59854","DOIUrl":"https://doi.org/10.3126/bjhs.v8i2.59854","url":null,"abstract":"Introduction: Coronary artery disease is an important subset of cardiovascular disease that requires timely, accurate, and cost-effective diagnosis. Among several modalities practiced to evaluate this disease; coronary angiography is the gold standard. Objective: The objective of this study was to identify indications and findings of coronary angiography among patients admitted at Birat Medical College Teaching Hospital. Methodology: A descriptive cross-sectional study conducted at Department of Cardiology, Birat Medical College Teaching Hospital from 1 September 2021 to 30 June 2022 after taking ethical approval from Institutional Review Committee (Ref No: IRC-PA-167/2078-79). A total of 202 patients were included through consecutive sampling. Data was collected on baseline characteristics, indications and findings of coronary angiography. Frequency, percentage, mean and standard deviation was calculated. Result: Maximum percentage of patients were in the age group 60-69 years (20.8% males and 16.3% females) with mean± S.D(60.1± 11.1). The most common indication for coronary angiography was angina (34.1%) and treadmill test positive (24.3%). Nearly 62% had abnormal findings. Single vessel disease was present in 25.2%, double vessel disease in 5.9% and triple vessel disease in 20.6%. Other findings were cardiac bridging (2.9%), non-critical coronary artery disease (1.9%) and in-stent restenosis (0.5%). Conclusion: The most common indication of coronary angiography was chronic stable angina and the majority had vessel diseases.","PeriodicalId":31640,"journal":{"name":"Birat Journal of Health Sciences","volume":"33 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-11-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139230087","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":"A Rare Case of Gastric Ectopic Pancreatic Tissue - An Incidental finding","authors":"Rajat Kumar Shah, Mrinalini Singh, Dipesh Mandal Dhanuk","doi":"10.3126/bjhs.v8i2.59861","DOIUrl":"https://doi.org/10.3126/bjhs.v8i2.59861","url":null,"abstract":"Ectopic pancreas is an infrequent lesion presenting as a nodule or a submucosal mass in the gastrointestinal tract. Depending upon its anatomical location, it can cause clinical symptoms like abdominal pain, intussusceptions, or obstruction, or it can remain clinically silent. Though radiologic diagnostic tools are available, the preoperative diagnosis is tough and is seldom made. We report a case of a 61-year-old male with the chief complaint of pain in the abdomen for 15 days. Advanced diagnostic tools like Contrast enhanced CT scan can characterise the submucosal mass in the stomach and able to confirm the nature of the lesion, whether it was non-neoplastic, benign, or malignant. Therefore, surgical excision was done. The final confirmatory diagnosis of ectopic pancreas in the stomach was made on histopathologic examination.","PeriodicalId":31640,"journal":{"name":"Birat Journal of Health Sciences","volume":"11 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-11-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139229506","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 between clinical and ultrasonographic parameters in predicting difficult airway: An observational prospective study","authors":"Deepak Poudel, K. Pyakurel, B. Sah, A. Pokhrel, Kanak Khanal, L. Rajbanshi","doi":"10.3126/bjhs.v8i2.59856","DOIUrl":"https://doi.org/10.3126/bjhs.v8i2.59856","url":null,"abstract":"Introduction : Various clinical tests are applied at the bedside to predict difficult airway during the pre-anaesthetic examination. Ultrasonography can be used to evaluate the airway and predict difficulty in laryngoscopy and endotracheal intubation. Objective : To compare the various clinical and ultrasonographic parameters in predicting difficult airway. Methodology: This prospective observational study was carried out at Birat Medical College and Teaching Hospital. The clinical parameters obtained were Modified Mallampati Grade (MMP), Upper Lip Bite Test (ULBT) and Thyromental Distance (TMD) and the ultrasonographic (USG) parameters used were Tongue Volume (TV), Hyomental Distance Ratio (HMDR) and distance of soft tissue from skin to hyoid bone (DSHB).These results were correlated with Cormack-Lehane (CL) grade during laryngoscopy of 200 patients. The sensitivity, specificity, Receiver Operating Characteristic (ROC) curve along with Area under the curve (AUC) was calculated for each parameter. Result: Incidence of difficult airway was 15.5%. The sensitivity and specificity of ultrasonographic tongue volume (TV) was higher among all parameters in predicting difficult airway. The specificity of HMDR and DSHB were better compared to clinical parameters. Conclusion: The use of ultrasound in pre-anaesthetic examination can be a viable tool along with clinical parameters for prediction of difficult airway.","PeriodicalId":31640,"journal":{"name":"Birat Journal of Health Sciences","volume":"35 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-11-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139231691","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":"Drug-Induced Gingival Enlargement- A Practical Insight Into its Etiopathogenesis and Management","authors":"S. Lamichhane, M. Humagain, Prakriti Rupakhety, A. Rijal, Bhojraj Adhikari","doi":"10.3126/bjhs.v8i2.59862","DOIUrl":"https://doi.org/10.3126/bjhs.v8i2.59862","url":null,"abstract":"Drug-induced gingival enlargements are a familiar finding in a dental setup. They are seen especially in the patient on anti-convulsant, immunosuppressive, and calcium channel blockers therapy. Amlodipine used primarily as a monotherapy or in combination therapy in the management of a trailing disease like hypertension is associated with gingival enlargement constantly. This case report unveils the management of amlodipine-induced gingival enlargement and accentuates the important considerations regarding etiopathogenesis and practical ways of managing the case on a daily basis.","PeriodicalId":31640,"journal":{"name":"Birat Journal of Health Sciences","volume":"6 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-11-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139234589","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":"Comparative Study of Clinical Outcome of Low Pressure Versus Standard Pressure Pneumoperitoneum in Laparoscopic Cholecystectomy at Birat Medical College Teaching Hospital (BMCTH)","authors":"Shivraj Sharma, Bhupendra Charan Shrestha, Dhurba Narayan Shah, Ismita Sharma","doi":"10.3126/bjhs.v8i2.59855","DOIUrl":"https://doi.org/10.3126/bjhs.v8i2.59855","url":null,"abstract":"Introduction: Laparoscopic cholecystectomy at standard pressure pneumoperitoneum ( 12-15 mmHg of Co2) is standard of practice among surgeons. The increase in intraabdominal pressure by insufflation of carbon dioxide during laparoscopy brings certain changes in function of cardiopulmonary systems and also leads to postoperative pain due to stretching of the diaphragm. Objective: To minimise this impact on human physiology there is increasing effort of performing laparoscopic cholecystectomy at low pressure pneumoperitoneum (8mm Hg) however its safety has not been established. This study aims to compare outcomes of laparoscopic cholecystectomy at low pressure pneumoperitoneum versus standard pressure pneumoperitoneum in people undergoing laparoscopic cholecystectomy in terms of intraoperative time, postoperative pain including shoulder tip pain and length of hospital stay.Methodology: This descriptive randomised prospective study was conducted from Feb 2023 to Aug 2023 in the department of general surgery, BMCTH in patients diagnosed with symptomatic gallstone disease meeting inclusion criteria and willing for laparoscopic cholecystectomy. All patients were prospectively randomized into two groups randomly by the lottery method. A convenient sampling method was used. Group A odd number patients underwent surgery under low pressure (LPPLC group), Group B patients at standard pressure pneumoperitoneum (SPPLC). Results:A total of 145 patients (114 female and 31 male) with mean age 44.99 years of presentation. 73 patients underwent surgery under LPPLC group and 72 under SPPLC group. Mean pain recorded as per VAS score at 6, 12, 24 and 36 hours postoperatively showed no significant difference in pain among two groups with p value 0.972,0.121,0.212,0.072 respectively. Shoulder tip pain and additional need of analgesia was significantly less in LPPLC group, p value 0.002 and 0.015 respectively. No significant difference was observed in terms of operating time p value 0.151.Conversion between two groups p value 0.494 suggested no significant difference between two group. Conclusion:LPPLC is feasible, safe and can be considered over SPPLC. LPPLC is non inferior to SPPLC in terms of postoperative pain including shoulder tip pain and additional need of analgesia.","PeriodicalId":31640,"journal":{"name":"Birat Journal of Health Sciences","volume":"25 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-11-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139230500","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}