Birat Journal of Health Sciences最新文献

{"title":"Effect of Oral Clonidine Premedication on Hemodynamic Stress Response to Laryngoscopy and Tracheal Intubation","authors":"J. Prasad, Satendra Narayan Singh, S. Sah, K. Guddy, D. Sarraf","doi":"10.3126/bjhs.v7i3.52764","DOIUrl":"https://doi.org/10.3126/bjhs.v7i3.52764","url":null,"abstract":"Introduction: Different techniques have been tried to blunt undesirable hemodynamic effects like tachycardia, hypertension and dysarrhythmias during and after laryngoscopy and tracheal intubation. \u0000Objective: To find out the effect of oral clonidine premedication on hemodynamic stress response to laryngoscopy and tracheal intubation. \u0000Methodology: It was a prospective, randomized, double-blind comparative study conducted in patients undergoing laparoscopic cholecystectomy. Either oral clonidine 300 mcg (n=30) or placebo (n=30) was given one hour before the surgery. Depth of anesthesia was monitored and maintained at 40-60 level using bispectral index (BIS) monitor. Heart rate (HR), systolic blood pressure (SBP), diastolic blood pressure (DBP), mean arterial blood pressure (MABP) and oxygen saturation (SpO2) at baseline, one hour after premedication, on operation theatre (OT) table, just before and after one, two and five minutes after laryngoscopy and intubation were compared in Clonidine and placebo group using Paired t test and Chi-square test. SPSS was used for statistical analysis at P-value<0.05 \u0000Results: Hemodynamic variables like HR, SBP, DBP and MBP were significantly lower in the clonidine group compared to placebo just before and after the first five minutes of laryngoscopy and tracheal intubation (P<0.05). Propofol requirement for induction of anesthesia was less in the clonidine group (95±31.8 mg vs 75.3±28.5 mg, p=0.014) compared to the placebo group. Adverse effects like hypotension and bradycardia were comparable in the groups. Time taken for extubation, time to follow verbal commands and time to orientation after surgery were similar in the both groups (P>0.05). \u0000Conclusion: Oral clonidine premedication was effective in blunting undesirable hemodynamic stress response to laryngoscopy and tracheal intubation compared to the placebo.","PeriodicalId":31640,"journal":{"name":"Birat Journal of Health Sciences","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-12-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"47188866","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":"Large Radicular cyst disfiguring the midline face; a case report","authors":"Brihaspati Sigdel, Kuseshwar Sah, B. Neupane","doi":"10.3126/bjhs.v7i2.49309","DOIUrl":"https://doi.org/10.3126/bjhs.v7i2.49309","url":null,"abstract":"A radicular cyst is an inflammatory odontogenic cyst of the jaw commonly found at the apices of the tooth of the anterior maxilla. It develops as a sequel of untreated dental caries with pulp necrosis and periapical infection. Different treatment includes surgical endodontic treatment, extraction of the involving tooth, marsupialization, and enucleation with primary closure followed by rehabilitation. We presented a case of a huge midline radicular cyst of a 52 years lady who presented with increasing size of swelling at the midline of the upper lip region which makes patients ugly for 25 years. It leads to the mass effect at the philtrum of the upper labium at midlines leads to elevation and ugly looking face making her socially embarrassing. Endoscope-assisted complete excision was performed via midline mini visor incision and with no evidence of recurrence found at three-month follow-up.","PeriodicalId":31640,"journal":{"name":"Birat Journal of Health Sciences","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-11-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"48930449","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":"Nutrition Status of Cancer Patients Attending Oncology Unit at Birat Medical College","authors":"M. Priyadarshini, G. Karki, Sulav Sapkota","doi":"10.3126/bjhs.v7i2.49299","DOIUrl":"https://doi.org/10.3126/bjhs.v7i2.49299","url":null,"abstract":"Introduction: Malnutrition is a major problem in cancer patients which results in high morbidity and mortality. There are lack of comprehensive centers providing nutritional support to cancer patients in eastern region of Nepal.\u0000Objective: The objective of this study was to analyze the malnutrition status of cancer patients at Birat Medical College. It aimed to calculate the prevalence of malnutrition in cancer patients.\u0000Methodology: This descriptive cross sectional observational study of six months duration was conductedfrom 15th January 2021 to 15th July 2021 in the department of Oncology at Birat Medical College Teaching Hospital.All the histologically proven cancer patients during the study period were taken as study population whose body mass index were calculated. The relevant data were maintained inexcel sheet and analysis was done with the help of statistical software SPSS version22.\u0000Results:  A total of 70 cases attended oncology unit during the study duration at Birat Medical College. The mean age of the cases were60 years (range 21-85) with the proportion of female patients almost equal(53%) to that of males. There was total 28 (40%) malnutrition cases out of which 22% were overweight,17% were underweight and only 1% obese. During the study period total 50% of the malnutrition cases were alive and 50% cases expired due to disease progression.\u0000Conclusion: Malnutrition is a major concern worldwide and even in cancer patients of Nepal. There is a need of comprehensive cancer center providing nutritional support to cancer patients in eastern region of Nepal.","PeriodicalId":31640,"journal":{"name":"Birat Journal of Health Sciences","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-11-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46753948","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":"Evan’s Index in adult Nepalese population: A Computerized Tomographic Study","authors":"P. Shrestha, D. Mansur, S. Karki, S. Maskey, Bishal Sah, R. Chaudhary","doi":"10.3126/bjhs.v7i2.49311","DOIUrl":"https://doi.org/10.3126/bjhs.v7i2.49311","url":null,"abstract":"Introduction: Evan's Index is a linear measurement of the ventricular size which is used as an indirect marker of ventricular volume. It is used widely as a screening tool to rule out ventricular enlargement. As the ventricular enlargement indicates the neuropathological state of the brain, Evan's Index serves as the quick and reliable method to assess ventricular size.\u0000Objectives: The study aims to generate a baseline value of Evan's Index among the Nepalese population and also investigates the effect of age and gender on EI.\u0000Methodology: A quantitative study was conducted in the Department of Anatomy, Kathmandu University School of Medical Sciences and data was collected from the Department of Radiodiagnosis, Dhulikhel Hospital, Kathmandu University Hospital. The study was done on 385 head CT Scans of the individuals of mean age of 45.44years.   The ratio of inter anterior horns distance of the lateral ventricles and maximal internal diameter of the skull at the same level was taken to calculate Evan’s Index.\u0000Results: The mean value of Evan’s index in the present study was 0.250.03. The study did not report gender-wise variation in Evan's Index (p>0.05). Evan’s index was minimum at the age group of 20-29 and maximum at the age group of 80-89. The value of Evan’s Index showed a significant increase with the age (p<0.05).\u0000Conclusions: The study provides the mean value of Evan’s Index among the Nepalese population. Even though Evan’s Index is not influenced by gender, the value increases with normal aging.","PeriodicalId":31640,"journal":{"name":"Birat Journal of Health Sciences","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-11-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"47384264","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":"Study of Gastro-Oesophageal Reflux Disease among Patients with Type 2 Diabetes Mellitus presenting to Medicine Department at a Tertiary Care Hospital: A Descriptive Cross-sectional Study","authors":"A. K. Mahato, Madhu Shah, Nischal Shrestha","doi":"10.3126/bjhs.v7i2.49300","DOIUrl":"https://doi.org/10.3126/bjhs.v7i2.49300","url":null,"abstract":"Introduction: Gastro-oesophageal reflux disease is a chronic condition in which stomach contents regurgitates up into oesophagus causing symptoms like acidic taste in mouth, heart burn, bad breath and chronic cough. There is high prevalence of GERD in patients with Type 2 diabetes mellitus in the western countries, but such related data in our country are just few. \u0000Objectives: To find out the prevalence of gastroesophageal reflux among patients with Type 2 Diabetes Mellitus attending Nobel Medical College Teaching Hospital. \u0000Methodology: This was a descriptive cross-sectional study carried out in Department of Medicine of a tertiary care hospital from July 2020 to June 2021. Ethical approval was taken from Institutional Review Committee of Nobel Medical College Teaching Hospital (Reference number: 464/2020). Convenience sampling was done and data was collected from 191 patients presenting to the department. Collected data was entered, analysed in Statistical Package for the Social Sciences version 21 and documented for study. Point estimate at 95% Confidence Interval and descriptive statistics were interpreted as frequency, percentage, or as mean and standard deviations. \u0000Results: Among 191 patients with type 2 diabetes, gastroesophageal reflux was seen in 78 (40.84%) (33.87-47.81 at 95% Confidence Interval) with more prevalent in male 42 (53.84%) than female 36 (46.15%). Mean duration of type 2 diabetes among reflux cases was 10.20± 5.40 years. \u0000Conclusions: Gastroesophageal reflux was common associated condition among Diabetic patients.","PeriodicalId":31640,"journal":{"name":"Birat Journal of Health Sciences","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-11-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"45794827","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":"Nepali Translation and Validation of Dental Satisfaction Questionnaire","authors":"A. Rai, S. Shrestha, Ashok Ayer, Navin Agrawal, M. Vikram","doi":"10.3126/bjhs.v7i2.49297","DOIUrl":"https://doi.org/10.3126/bjhs.v7i2.49297","url":null,"abstract":"Introduction: Patient satisfaction is regarded as an important outcome of health care that contributes to better patient compliance and consequently offers improved clinical outcomes Dental school clinics must regulate both the clinical and academic classes in balance without hampering the needs of both the patient and students. \u0000Objectives: To develop a reliable and valid Nepali version of Dental Satisfaction Questionnaire (DSQ-N). \u0000Methodology: The English version of the dental satisfaction questionnaire (DSQ) was translated into Nepali following a standard translation process. Content validity followed by pre-testing were evaluated to obtain the final version of DSQ-N. Two hundred patients attending the Department of Conservative Dentistry and Endodontics completed the DSQ-N in the waiting room, at their convenience. Internal consistency of the questionnaire was determined by Cronbach's alpha and Principal component analysis was used to determine the construct of the scale. \u0000Result: Content Validity Index of the scale was 0.9 (S-CVI/ Avg) and alpha (Cronbach's) coefficient for the overall construct of DSQ was ≈0.83. Principal Component Analysis confirmed the internal structure of the scale and four components emerged from it. \u0000Conclusion:  The translated nepali version of DSQ is a reliable and valid tool to determine patients’ satisfaction of dental care services based on the excellent content validation result together with robust internal reliability.","PeriodicalId":31640,"journal":{"name":"Birat Journal of Health Sciences","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-11-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42907224","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":"Outcome of unstable intertrochanteric fractures managed with Proximal Femoral Nail Anti-rotation-II: A study in elderly Nepalese population.","authors":"S. Kunwar, P. Sitoula, R. Jha, B. Thapa, Ashish Rajthala","doi":"10.3126/bjhs.v7i2.49308","DOIUrl":"https://doi.org/10.3126/bjhs.v7i2.49308","url":null,"abstract":"Introduction: The ideal implant for treating unstable intertrochanteric fracture has been controversial. Studies have shown good results with various intra-medullary nails. Likewise, Proximal Femoral Anti-rotation-II (PFNA-II) has been designed for the Asian population. But the knowledge about the outcomes of PFNA II in our particular region has been lacking.\u0000Objectives :  To evaluate the radiological and functional outcome of unstable intertrochanteric fractures in elderly patients managed with PFNA-II.\u0000Methodology: This is a prospective clinical study conducted at Nobel Medical College between February 2019 and March 2021. Patients above 65 years of age with unilateral unstable intertrochanteric fracture were managed with PFNA-II. Radiological union and complications were recorded. Functional outcome was assessed on the basis of modified Harris Hip Score.\u0000Results: Twenty-nine patients were included in the final evaluation and had at least one year follow-up. Two patients (6.8%) had superficial infection. The average Tip Apex Distance (TAD) was 22.28 mm (range, 18- 28 mm). Mean modified Harris Hip Score at one year was 82.59 with good outcome in 23(79.3%) patients.\u0000Conclusion: This study showed that good clinical outcome can be obtained when radiological parameters are restored. Good intra-operative fracture reduction, and optimal positioning and length of helical blade are crucial. We believe that PFNA-II is an excellent implant to treat unstable intertrochanteric fractures in elderly patients.","PeriodicalId":31640,"journal":{"name":"Birat Journal of Health Sciences","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-11-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43824824","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":"Clinico-pathological Study of Solid Cancer patients receiving chemotherapy at Birat Medical College Teaching Hospital","authors":"Sulav Sapkota, M. Priyadarshini","doi":"10.3126/bjhs.v7i2.49298","DOIUrl":"https://doi.org/10.3126/bjhs.v7i2.49298","url":null,"abstract":"Introduction: Solid cancers are increasing in eastern region of Nepal. There are very few centers providing chemotherapy treatment to solid cancer patients in eastern region of Nepal.\u0000Objectives: The aim of this study is to stratify the types of solid cancers and study their socio-demographic and clinicopathological features of solid cancer.\u0000Methodology:  This descriptive cross sectional study was conducted from 1st September 2020 to 1st july 2021 at the department of Oncology . All the histologically proven patients of solid cancers, derived from solid organs like lung, stomach, liver, breast etc, receiving chemotherapy during the study period were taken as study population. All the relevant data were entered in the excel sheet and analyzed by the help of statistical software.\u0000Result: There were total seventy three cases who got admitted for chemotherapy during the study duration at the department of Oncology. The patients were between 30-85 years, with the mean age of 59 years and the proportion of females were almost double (64%) than male. 78% cancers were advanced staged in contrast to 22% early stage cancers. Cases were majorly with clinical remission (30%) out of which most common were breast and colorectal cancers. Total 58% of the cases were alive while 42% of the cases expired during the study period.\u0000Conclusion: There is a need of comprehensive cancer center in eastern region of Nepal due to increase in the burden of solid cancers.","PeriodicalId":31640,"journal":{"name":"Birat Journal of Health Sciences","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-11-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42784225","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":"Functional outcome of column specific fixation in the management of complex tibial plateau fractures","authors":"B. Thapa, P. Sitoula, R. Jha, Santosh Thapa","doi":"10.3126/bjhs.v7i2.49293","DOIUrl":"https://doi.org/10.3126/bjhs.v7i2.49293","url":null,"abstract":"Introduction: Complex tibial plateau fractures usually have complicated intra-articular fracture pattern, often associated with severe soft tissue injury and high risk of wound complications. Single or dual column plating fixation principle based upon conventional x-ray for such fractures may not address multiplanar comminution that  often has posterior shearing or  coronal fractures. Computed tomography based evaluation of such fractures  and column specific  approach allow direct fracture visualization and anatomic reduction  that results in satisfactory outcome. \u0000Objectives: To assess the clinical and functional outcome and complications of complex tibial plateau fractures fixed with column specific fixation principle. \u0000Methodology: This prospective study was carried out from September 2019 to August 2021 in Orthopaedic department of Nobel Medical College, Biratnagar. Consecutive sampling was used among patient with complex tibial plateau fractures meeting the inclusion criteria. Among 30 patients, with  closed and Gustilo grade I or II Schatzker type V-VI fractures or AO type-C injuries to the proximal tibia were operated on column specific approach and followed up for clinico-radiological evaluation. \u0000Results: In this study, most of the patients belonged to 31-40 years of age group with mean age of 40.47 years. Majority of patients were male( 76.7%). Fracture was highly associated with road traffic accident which accounted for 83%. Fourteen patients underwent anteromedial and anterolateral plating(46.67%), 10 patients underwent anterolateral and posteromedial plating(33.33%) and remaining 6 patients underwent triple column plating(20%). The Rasmussen’s functional score at final follow up was  27.17±2.793(range 21-30). 86.7% patients had acceptable clinical outcome. The mean Rasmussen’s radiological score at final follow up was 8.97±1.217(range 6-10). Thus 93.4% patients had acceptable radiological outcome. \u0000Conclusion: Column specific approach addresses all the fracture fragments of complex tibial plateau fractures to achieve acceptable clinical and radiological outcome.","PeriodicalId":31640,"journal":{"name":"Birat Journal of Health Sciences","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-11-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"47811713","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":"Incidence of Color Blindness among Undergraduates Students of Medical College in Pokhara","authors":"Ripti Shrestha, Bijendra Prasad Yadav, Neebha Amatya, Raja Rana, R. Prajapati","doi":"10.3126/bjhs.v7i2.49296","DOIUrl":"https://doi.org/10.3126/bjhs.v7i2.49296","url":null,"abstract":"Introduction: There are many genetic disorders that are X-linked, one being the color blindness. Some individuals affected with the disorders may remain unaware till detected for a long time. There are very few reports about the incidence of the color blindness among the medical undergraduate students. \u0000Objectives: Ojective of our study was to assess the color blindness incidence, among the medical undergraduates at the Gandaki Medical College, Pokhara. \u0000Methodology: We piloted an observational cross-sectional study among the first and second year medical students (MBBS, BDS, Nursing, and paramedics) at Gandaki medical college. We finalized 300 students of both the genders based on the inclusion criteria. We performed in the natural day light, the color vision test using the Ishihara plates. We assessed incidence, the type of the color blindness and the gender distribution among the subjects. We compared the data thus obtained applying the “chi square statistical test” deliberating p<0.05 as significant.\u0000Results: We observed that all the colorblind subjects in the study were male who constituted 2% of the all the subjects. There was significant difference statistically among the types of the color blindness with majority having Deuteranomaly.\u0000Conclusions: We can conclude that incidence of the color blindness was exclusive among men in our study. Total color blindness was seen in majority of the male subjects. Screening the students will enable the unaware students of their disability and hence they can be guided to proper counseling. ","PeriodicalId":31640,"journal":{"name":"Birat Journal of Health Sciences","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-11-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"47280959","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}