Birat Journal of Health Sciences最新文献

{"title":"Problem Based Learning: An emerging method of teaching learning in medical education","authors":"Parth Guragain","doi":"10.3126/bjhs.v8i1.57279","DOIUrl":"https://doi.org/10.3126/bjhs.v8i1.57279","url":null,"abstract":"No abstract available.","PeriodicalId":31640,"journal":{"name":"Birat Journal of Health Sciences","volume":"63 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-08-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135818100","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":"Quality of life in individuals with spinal cord injury treated in tertiary care centers in Nepal","authors":"B. Parajuli, Khagendra Acharya, Jemina Shrestha, Raju Dhakal","doi":"10.3126/bjhs.v8i1.57286","DOIUrl":"https://doi.org/10.3126/bjhs.v8i1.57286","url":null,"abstract":"Introduction: Traumatic spinal cord injury (SCI) constitutes a significant challenge to the quality of life (QoL). People with SCI perceive the overall QoL at a lower level in comparison to normal individuals. \u0000Objective: This study aims to access the QoL among individuals with SCI and identify factors affecting the QoL. \u0000Methodology: This prospective cross-sectional study was done in Dhulikhel Hospital, Kathmandu University Hospital (DH, KUH), and Spinal Injury Rehabilitation Center (SIRC), Sanga, Nepal. All the individuals above 18 years with SCI of at least 3 months from trauma seeking treatment in DH, KUH, or SIRC from June 2019 to May 2021 were included. We utilized the WHO quality of life questionnaires (WHOQOL–BREF) for assessing the QoL. \u0000Result: The mean age was 32.95 ± 11.7 years with the majority being males (74.5%). The majority had ASIA Impairment Scale grade A. The social health domain had the highest mean raw and transformed score (13.87 ± 3.13 and 61.7 ± 19.59 respectively). The transformed total QoL score was 50.76±29.76. Only 22 individuals (15.6%) had a transformed total score of > 60 signifying good/ satisfactory QoL. \u0000Conclusion: There is a high rate of poor/ unsatisfactory QoL in individuals with SCI in Nepal. Female gender, married status, loss of relative during trauma, ASIA injury severity (AIS) A or B during admission, and no improvement in AIS grade after treatment are significant predictors of poor/ unsatisfactory QoL. Physical health, compared to psychological, social, and environmental health, correlates highest with the transformed total score.","PeriodicalId":31640,"journal":{"name":"Birat Journal of Health Sciences","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-08-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44882059","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 Profile and Outcome of Children with Empyema Thoracis in Tertiary Hospital","authors":"V. Sah, S. Singh, S. Yadav, A. Giri, Praveen Kumar","doi":"10.3126/bjhs.v8i1.57291","DOIUrl":"https://doi.org/10.3126/bjhs.v8i1.57291","url":null,"abstract":"Introduction:  Empyema thoracis (ET) is an accumulation of pus in the pleural space. It is a common condition in childhood having significant morbidity and mortality. The clinical manifestations of empyema are high grade fever with chills and rigors, cough, breathlessness, chest pain. The present study analyses the epidemiological aspects of the disease, etiological agents, clinical features and associated lesions in diagnosis of empyema and the outcome of early Video-assisted thoracoscopic surgery (VATS) on morbidity of disease in children. \u0000Objectives: To study various demographic characteristic and to evaluate various management strategies and outcome in children with empyema thoracis. \u0000Methodology: This is a prospective hospital based observational study, conducted at Nobel Medical College Teaching Hospital Biratnagar, from December 2021 to November 2022. All children in the age group of 1month to 16 years diagnosed pyogenic empyema by lights criteria during the study are included in the study. Children below 1 month of age and pleural effusion not meeting the criteria for exudative pleural effusion by Light's criteria are excluded from the study. \u0000Results: Majority of the study population are in the age group of >5 years. Males are more common than females. Most common clinical feature was fever followed by cough, chest pain and shortness of breath. Culture is positive in 68% out of which 32% is staphylococcus aureus, 20% is mycobacterium tuberculosis ,16% is streptococcus pneumonia. Duration of illness is <1week in 48% of the children, 1-2weeks in 40% and >3weeks in 12% of the children. In 80% of the children there is unilateral involvement in the x- ray chest. In the children who are uncomplicated all of them had intercoastal chest tube drain (ICD) usage,76.4% had urokinase therapy and 5.8% had undergone thoracotomy and none of them had need for surgery. In the children with complication 87.5% had ICD usage and urokinase therapy,25% of them had undergone thoracotomy and 12.5% had need for surgery. \u0000Conclusion: Empyema thoracis is more commonly seen in the males of the group>5 years with duration of illness <1 week maned mostly by ICD usage, where there was mostly unilateral involvement in x ray chest.","PeriodicalId":31640,"journal":{"name":"Birat Journal of Health Sciences","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-08-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"47005135","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":"Admission Pattern and Outcome in Paediatric Intensive Care Unit of Tertiary Level Teaching Hospital in Eastern Nepal","authors":"M. Chaudhary, H. Rimal, R. Subedi, T. Kafle","doi":"10.3126/bjhs.v8i1.57285","DOIUrl":"https://doi.org/10.3126/bjhs.v8i1.57285","url":null,"abstract":"Introduction: Paediatric Intensive Care Unit (PICU) is a relatively new concept with rapidly growing paediatric subspecialty in resource limited-countries. Introduced in Nepal in the 1980s, the first PICU was established in 1986 in Kanti Children’s Hospital, Kathmandu with 4 beds. Later in BPKIHS in Eastern Nepal. Currently only a few dedicated PICU running in Nepal. Our PICU was started in 2021 with 8 beds in the private sector for the management of critically ill children. \u0000Objectives:  To study the admission pattern and outcome of the children at our paediatric intensive care unit. \u0000Methodology: This was a Cross Sectional Descriptive study conducted at PICU of Birat Medical College Teaching hospital in Eastern Nepal. From August 2021 to July 2022, records of all possible admissions in PICU were reviewed. Demographic profile, diagnosis, outcome and duration of stay were analysed. \u0000Results: Out of 260 analysed data, there were 156 (60%) males and 104 (40%) females. Age wise distribution was 101 (38.85%), 82 (31.5%), 38 (14.6%) and 39 (15%) for 1 months-1 year, 1-5 year, 5-10 year and 10-15 year respectively. Disease wise distribution was 129 (49%) respiratory, 49 (18.8%) neurological and 26 (10%) gastrointestinal, mostly infective causes like Pneumonia (78, 30%), Bronchiolitis (34, 13.1%), febrile convulsion (29, 11.2%) meningitis/encephalitis (19, 7.3%), Sepsis (12, 4.6%), dengue (6, 2.3%) other infections (19,6.3 %). In outcome, discharged (231,88.85%), DOPR (5,1.92%), LAMA (4,1.54%), Death (16,6.2%) and Referral (4,1.54%). Mortality was high (11, 38.6%) in under five years. Sepsis (4, 33.3%), Meningitis / encephalitis (3, 15.8%) and pneumonia (4, 5.1%) were the common causes. Mean duration of PICU stay was 2.73 days (median=2). Overall mortality rate was 6.2% (16). Sepsis, LOS and need of mechanical Ventilation were significant predictors of mortality. \u0000Conclusion: Respiratory illnesses including infections were common causes of admission with low mortality (6.2%). Sepsis, Meningoencephalitis and pneumonia were common causes of death in our PICU. Sepsis, LOS and need of mechanical Ventilation were significant predictors of mortality.","PeriodicalId":31640,"journal":{"name":"Birat Journal of Health Sciences","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-08-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42270168","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 Comparative Study of Intramuscular Ketamine and a Combination of Intramuscular Dexmedetomidine and Ketamine as Premedication in Paediatric Anesthesia","authors":"Riya Singh, Barkha Pradhan","doi":"10.3126/bjhs.v8i1.57289","DOIUrl":"https://doi.org/10.3126/bjhs.v8i1.57289","url":null,"abstract":"Introduction: Preoperative anxiety is an issue of concern in paediatric anaesthesia practice. Forceful transfer of children into the operating room can cause long-term psychological trauma. This clinical study compares intramuscular ketamine and a combination of intramuscular dexmedetomidine and ketamine as anaesthetic premedicants in terms of +anxiolysis, sedation and ease of IV cannulation. \u0000Objectives: To compare the level of preoperative anxiety, sedation and ease of cannulation following premedication between intramuscular ketamine and a combination of intramuscular dexmedetomidine and ketamine. \u0000Methods:  Total of 60 patients belonging to American Society of Anaesthesiologists physical status I-II, in the age group of two to ten years, scheduled for elective surgery under general anaesthesia were included in the study; Group A patients received ketamine 3mg/kg body weight while Group B patients received ketamine 2mg/kg body weight and dexmedetomidine 1mcg/kg body weight intramuscular. The outcome variables were sedation score (Richmond Agitation Sedation Scale), IV cannula acceptance (IV cannula Acceptance Score), and parental separation (Separation Score). \u0000Results: The groups were comparable in patient characteristics and hemodynamic parameters between the groups. Median (IQR) sedation score at 10 min were -1 (-2—0) and 0(-1—1) (p< 0.001); mean parental separation scores were 3.76± 0.43 and 3.36±0.55 (p< 0.001); IV cannula acceptance score were 3.73±0.44 and 4.53±7.27 (p= 0.001) in Group A and Group B respectively. \u0000Conclusion:  Combination of dexmedetomidine and ketamine is superior to ketamine alone in terms of sedation at 15 min and ease of IV cannulation but comparable in terms of anxiolysis.","PeriodicalId":31640,"journal":{"name":"Birat Journal of Health Sciences","volume":"1 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-08-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41378490","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":"Amniotic Band Sequence: A Rare Case Seen In Birat Medical College","authors":"Sudha Neupane, S. Shrestha, Mukunda Kumar Jha, Nirajan Shakya, Pratik Neupane","doi":"10.3126/bjhs.v8i1.57294","DOIUrl":"https://doi.org/10.3126/bjhs.v8i1.57294","url":null,"abstract":"<jats:p>N/A</jats:p>","PeriodicalId":31640,"journal":{"name":"Birat Journal of Health Sciences","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-08-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"45683292","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":"Stress and Coping Mechanism among Nurses Working at Nobel Medical College Teaching Hospital Nepal during Covid 19 Pandemic","authors":"Sita Chapagain","doi":"10.3126/bjhs.v8i1.57287","DOIUrl":"https://doi.org/10.3126/bjhs.v8i1.57287","url":null,"abstract":"Introduction: Novel Corona Virus (SARS-CoV-2) is a highly contagious respiratory disease caused by a severe acute respiratory syndrome Coronavirus 2 (SARS-CoV-2). Nurses at the frontline of caring for COVID-19 patients are sure to face frequent experiences of mental health challenges. Hence they need special supportive coping strategies to control and reduce their stress. \u0000Objective: The aim of this study was to identify level of stress and coping mechanisms used to deal with stress among nurses at Nobel Medical College and Teaching Hospital, Biratnagar, Nepal. \u0000Methodology: A cross-sectional study was conducted from August 2021 to February 2022. A total of 300 nurses were selected by using a non-probability consecutive sampling technique. Ethical clearance was taken from the Institutional Review Committee of Nobel Medical College and IRC Registration Number 505/2021. Data was collected by using self-administered questionnaire. The collected data were entered in MS Excel and statistical analysis were processed by the SPSS Version 23. Chi-square test was used to show the association between variables. \u0000Results: The findings of the study revealed that out of 300 nurses 91.7% nurses reported moderate and 5.3% reported high level of stress and 92% of nurses used moderate level of coping strategies and only 3.3% of nurses used high level of coping strategies to reduce perceived stress. There was statistically significant association of stress in nurses with marital status, duty schedule and monthly income. Likewise, there was a significant association between living condition of the nurses and coping strategies. \u0000Conclusion: The research finding showed all working nurses having some level of stress during the COVID-19 Pandemic. Moreover, about 96% nurses having moderate or high level of stress and in contrast they were also following moderate level of coping strategies. However, they need high level of coping strategies to overcome the persisting stress level.","PeriodicalId":31640,"journal":{"name":"Birat Journal of Health Sciences","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-08-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"48942928","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":"Periodontal Practice and Referral of Patients by General Dental Practitioners in Province No.1 Nepal","authors":"P. Acharya, U. Gautam","doi":"10.3126/bjhs.v8i1.57293","DOIUrl":"https://doi.org/10.3126/bjhs.v8i1.57293","url":null,"abstract":"Introduction: General dental practitioners and periodontists working in a close alliance is considered to bestow effective outcome in the context of diagnosis and management of periodontal diseases. Recently, general practitioners are inclined to render the majority of non-surgical procedures by themselves and avoid surgical part. This obscures functional as well as esthetic demand contributing to periodontally challenged conditions. In advanced stages, no matter how efficiently a skilled periodontist handles the case, redemption is not possible. \u0000Objectives: To assess the periodontal practice and referral of patients by general dental practitioners to periodontists. \u0000Methodology: An online survey using Google Forms was conducted among the general dental practitioners working in private clinics in province no.1, Nepal from November 2021 to January 2022. A total of 64 general dental practitioners were surveyed using a self-administered questionnaire. Descriptive statistics were calculated. \u0000Results: The response rate for the present study was 51.2% out of which only 17.2% referred patients to periodontists for non-surgical periodontal therapy and scaling was the most performed procedure by all the practitioners themselves. However, 92.2% referred patients to periodontists for surgical procedures and a majority of the referrals were for mucogingival surgeries. Majority of them expressed satisfaction regarding the number of continuing dental education programs being conducted despite minimum participation. \u0000Conclusion:  Majority of the general dental practitioners seemed to perform non-surgical periodontal therapy by themselves while considering referral for surgical interventions. Also, minimum participation despite remarkable satisfaction in the conduction of continuing education programmes calls for a need to explore the inadequacy.","PeriodicalId":31640,"journal":{"name":"Birat Journal of Health Sciences","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-08-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49425201","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 Spot Urinary Protein Creatinine Ratio and 24 hour Urinary Protein Excretion in Children presenting with Nephrotic Syndrome in Tertiary Care Hospital of Eastern Nepal","authors":"A. Giri, Sunilkumar. Yadav, V. Shah, N. Niraula, Anand Rauniyar","doi":"10.3126/bjhs.v8i1.57290","DOIUrl":"https://doi.org/10.3126/bjhs.v8i1.57290","url":null,"abstract":"Introduction: Nephrotic syndrome is an important chronic disorder in children and it’s one of the important diagnostic criteria is presence of heavy proteinuria (> 40 mg/m2/hour).\u0000As 24-hour urinary protein estimation is cumbersome, inconvenient, time consuming and expensive, a more convenient and accurate method of urinary protein estimation is needed.\u000024-hour urinary protein estimation and urine protein/creatinine in a child with nephrotic syndrome correlates well but there are very few studies done in Nepal to prove this correlation. Hence, this study is undertaken with objective of evaluating usefulness of urine protein/creatinine (UP/UC) in random sample of urine as a rapid and reliable test for quantification of proteinuria and to know their correlation with 24hour urinary protein excretion.\u0000Objectives: \u0000Primary Objective: To evaluate accuracy of urine protein creatinine ratio (UP/UC) in early morning sample in comparison with 24 hours urinary protein excretion in children of nephrotic syndrome having normal Glomerular Filtration Rate.\u0000Secondary Objective:\u0000\u0000To evaluate usefulness of urine protein / creatinine ratio (UP/UC) in random sample of urine as rapid and reliable test for quantification of proteinuria.\u0000To evaluate biochemical and other laboratory abnormalities in children with nephrotic syndrome.\u0000To study varied clinical presentation of Pediatric nephrotic syndrome\u0000\u0000Methodology: This is a descriptive cross-sectional study conducted in pediatric unit, Nobel Medical College Teaching Hospital,  Biratnagar for 12 months. In this study, 50 patients of both sexes, ranging from one to fifteen years of age were studied. The modes of presentation, laboratory investigation reports which included urine routine microscopy, 24-hour urine protein estimation, urine protein / creatinine in random sample of urine were documented and data was analyzed by linear regression.\u0000Results: Linear regression revealed that as timed 24-hour urine protein in gm/24 hour increased, Random urine/protein creatinine ratio mg/mg also increased linearly with correlation coefficient of r = 0.56 which was highly significant (p < 0.001).\u0000Conclusion: This study concludes that UP/UC ratio in a spot urine reflects the amount of protein in 24-hour urine collection. UP/UC ratio > 2 in patients with normal renal function represents nephrotic range proteinuria.","PeriodicalId":31640,"journal":{"name":"Birat Journal of Health Sciences","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-08-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46651205","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":"Pattern and Outcome of Otolaryngological and Facial Injury in Road Traffic Accidents at a Tertiary Care Centre in Eastern Nepal","authors":"S. Thakur, Gyan Raj Aryal, R. Thakur, N. Ghimire","doi":"10.3126/bjhs.v8i1.57282","DOIUrl":"https://doi.org/10.3126/bjhs.v8i1.57282","url":null,"abstract":"Introduction: Otolaryngological trauma is prevalent in road traffic accidents (RTA), with or without multiple organ injuries. \u0000Objective: The aim was to report the number and pattern of otolaryngological injuries in cases of road traffic accidents (RTA) and their outcome. \u0000Methodology:  A prospective study over one year of cases of RTA was done. The pattern and outcome of the otolaryngological and facial injury was recorded. \u0000Result: Out of 90 cases, 69(76.66%) were male, 21 (23.33%) were female. The mean age was 32.33 ±13Yrs.The mean time of presentation to emergency was 16.24 ±19.61hrs. Motor vehicle accident was more common, 75 (83.33%). Multiple injury was found in 68(75.55%) cases. Among 89 cases with ear problem, common complaints were hearing loss, 20(22.47%), otalgia, 17(19.1%) and laceration of pinna 13(14.6%). Ear complications were seen in16 (17.97 %) cases . Among 55 cases of nose/face injury, common presentation were epistaxis, 20 (36.36%) and nasal bone fracture, 12 (21.81%).  Nasal complications were found in 8 (14.54%) cases. In 32 cases of neck/throat trauma, laceration was found in 11 (34.37%) cases. 4(12.5%) cases had undergone tracheostomy.  Complications (stenosis and hoarseness) were found in 6(18.75%) cases. Patients who required admission were 81(90%). \u0000Conclusion: Motor vehicle accidents were more common. It was commoner in male. Ear was most commonly affected by injury and complications.  The complication of nose and neck/throat was associated with prolonged admission.","PeriodicalId":31640,"journal":{"name":"Birat Journal of Health Sciences","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-08-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46771514","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}