Birat Journal of Health Sciences最新文献

{"title":"Outcomes of Arterio-venous Fistula Reconstruction in Chronic Kidney Disease Patients Presenting in Tertiary Care Hospital in Eastern Nepal","authors":"D. Thakur, A. Yadav, C. Agrawal","doi":"10.3126/bjhs.v7i2.49306","DOIUrl":"https://doi.org/10.3126/bjhs.v7i2.49306","url":null,"abstract":"Introduction: Renal Replacement Therapy is the treatment modality for the chronic kidney disease (CKD) which ranges from hemodialysis, peritoneal dialysis to the renal transplantation, the latter being the best form of treatment. But, renal transplantation is available at limited centers only so hemodialysis is the most commonly used treatment modality of chronic kidney disease which requires a vascular access. But there are limited vascular surgeons in the region so most of the  arterio-venous (AV) fistulas are reconstructed by Urologist/Surgeons exposed to vascular surgery during their residency/training period.\u0000Objectives: To know the factors influencing the site selection, to assess the success rate and to document the complications of AV fistula reconstruction.\u0000Methodology: This is a hospital based prospective observational study conducted in the Birat Medical College – Teaching Hospital, Morang, Nepal from June 2021 to May 2022. We included the CKD patients requiring vascular access for hemodialysis with Color Doppler available for vascular mapping. Patients with brachial sites previously used and without Color Doppler were excluded from the study. AVF was reconstructed under local anesthesia and outcomes were recorded.\u0000Results: Thirty one patients of CKD underwent AVF reconstruction over the study period. Male and female ratio was 1.33 (57% and 43%). The mean age was 42.14 ± 11.34 years (Range 26-65 years). The mean diameter of radial artery (RA) and cephalic vein (CV) at wrist were 1.92 ± 0.56mm and 1.91 ± 0.20 mm respectively. Similarly, the mean diameter of brachial artery (BA) and CV at elbow were 3.66 ± 0.87mm and 3.57 ± 0.55 mm respectively. The fistula reconstructed were Lt RC (radio-cephalic) – 50% (14),  Lt BC (brachio-cephalic) -35.71% (10) and Lt BB ( brachio-basalic) - 14.29% (4) respectively. Complications occurred in 4 cases (14.28%).\u0000Conclusion: Selection of type of AVF creation is influenced by the vessel diameter as well as previous fistula surgery status and AVF access for hemodialysis has adequate patency with acceptable complications.","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":"43622405","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":"Awareness of cross-infection and its control measures among patients attending a tertiary dental hospital in Nepal","authors":"Sushant Pandey, U. Shrestha, Regina Dahait","doi":"10.3126/bjhs.v7i2.49303","DOIUrl":"https://doi.org/10.3126/bjhs.v7i2.49303","url":null,"abstract":"Introduction: Dental procedures frequently lead to exposure to blood and saliva which can carry a variety of pathogens. Aerosols produced during dental treatment procedures can further facilitate the transmission of these infectious agents. It is equally important for the patients to be aware of cross-infection and measures taken to prevent it in a dental setting. \u0000Objectives: The main objective of this study was to assess the awareness of cross-infection and its control measures among patients attending College of Dental Surgery, B.P. Koirala Institute of Health Sciences (BPKIHS). \u0000Methodology: A cross-sectional study was carried out among 362 patients who attended College of Dental Surgery, BPKIHS. Data was collected by administering a questionnaire that consisted of 4 questions intended to collect sociodemographic information and 10 close-ended questions designed to assess awareness of cross-infection and its control measures. The data was entered and analyzed using SPSS® software for Windows®. \u0000Results: The majority of the participants were aware that there was a chance for an infection to be transmitted from a dentist to a patient (82%), from a patient to a dentist (80.4%), and in between patients attending the same dental clinic (70%). Most of the participants considered wearing gloves (94.4%) and facemask (86%) by the dentist to be important. Only 40.3% of participants were aware of better methods of sterilization other than boiling in water. Awareness was higher among participants with higher education (p<0.05). \u0000Conclusion: The majority of the participants were aware that there was a chance for an infection to be transmitted from a dentist to a patient. However, the dental healthcare professionals should educate people about the possible risks of cross-infection and the importance of infection-control practices in dental clinics. Modern mass media and social media can be used to spread awareness to a large segment of the population.","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":"44011547","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":"End of Life Care : Challenges in Nepal","authors":"Sulav Sapkota, M. Priyadarshini","doi":"10.3126/bjhs.v7i2.49292","DOIUrl":"https://doi.org/10.3126/bjhs.v7i2.49292","url":null,"abstract":"<jats:p>N/A</jats:p>","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":"49478858","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 Alkalined and Plain Local Anesthetic on Onset, Duration and Quality of Bracheal Plexus Block by Supraclavicular Approach.","authors":"R. Yadav, A. Thapa, Rakesh Sah","doi":"10.3126/bjhs.v7i2.49307","DOIUrl":"https://doi.org/10.3126/bjhs.v7i2.49307","url":null,"abstract":"Introduction: Pain is an unpleasant sensory and emotional experience associated with actual or potential tissue damage, or described in term of such damage. The relief from pain is the essence of anesthesia. Peripheral nerve blocks provide longer and more localized pain relief than neuraxial techniques while also avoiding the side effects of systemic medication. This study was aimed to find the effectiveness of Study solution (addition of Sodium bicarbonate to 0.375% Bupivacaine) on onset time, duration and quality of Brachial Plexus Block.\u0000Material and methods: This study was conducted among 60 different patients undergoing surgical procedure of the upper limb. They were categorized into two different groups. The first group (Group 1), 30 patients received Brachial Plexus block with 30 ml of study solution (0.375% Bupivacaine with 2 ml of Sodium bicarbonate7.4%). The second group (Group 2) received 30 ml of 0.375 % plain bupivacaine only and the differences in onset, duration and quality of blockade were studied.\u0000Result: The similarity of age between the two groups can be seen. In Group 1 the mean onset time of sensory blockade was 9.43 minutes and motor blockade was 10.43 minutes when compared to Group 2 having sensory onset of minutes 23.93 and motor onset of 26.33 minutes. Similarly, In Group I the mean duration of sensory blockade was 477.67 minutes and motor blockade were 467.67 minutes when compared to Group 2 having sensory duration of 215.67 and motor duration of 205.67 minutes. The quality of sensory blockade was also better in group1 (P-Value:0.006).\u0000Conclusion: Addition of Sodium bicarbonate to bupivacaine had significant clinical advantage over plain bupivacaine on onset time, duration and quality of sensory and motor blockade in brachial plexus block.","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":"46357655","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":"Prevalence of surgical site infection among bile spillage and non-spillage patients undergoing laparoscopic cholecystectomy: A cross-sectional study","authors":"Sameer Bhattarai, Dinesh Nalbo, Sanjib Koirala, Ramkumar Singh","doi":"10.3126/bjhs.v7i2.49305","DOIUrl":"https://doi.org/10.3126/bjhs.v7i2.49305","url":null,"abstract":"Introduction: Laparoscopic cholecystectomy, a common procedure is not without complications, and bile spillage can cause surgical site infection (SSI). There is no local evidence in our hospital setting. \u0000Objective: The objective of this study was to find the prevalence of surgical site infection among bile spillage and non-spillage patients following laparoscopic cholecystectomy at BMCTH \u0000Methodology: A hospital-based cross-sectional study was conducted from 25 February 2021 to 25 August 2021 at the surgery department of BMCTH. We enrolled 120 patients through the total enumeration technique who underwent laparoscopic cholecystectomy. We enrolled all the eligible study participants who were more than 18 years excluding patients having age >75 years, acute calculous cholecystitis, evidence of cholangitis and/or obstructive jaundice, previous biliary tract surgery, or previous Endoscopic retrograde cholangiopancreatography, evidence of uncontrolled diabetes mellitus and patients taking immunosuppressive drugs and immunosuppressed conditions like HIV/AIDS. The surgical site infection was assessed on the 7th postoperative day. \u0000Results: Among 120 patients undergoing laparoscopic cholecystectomy, the majority were female 92(76.7%) and 40-50 years age group 65(54.2%). Bile spillage was found in 27(22.5%) and non-spillage in 93(77.5%).  The prevalence of surgical site infection (SSI) was found to be 7.5% which was more in the bile spillage group 25.9% than the non-spillage group 2.2%. The odds of having SSI among the spillage group was 15.9 times more than the non-spillage group and was statistically significant (p <0.05).  The pus culture of SSI found the predominant organism as Staphylococcus aureus 6(66.7%) followed by Escherichia coli 3(33.3%). The common indications of laparoscopic cholecystectomy were symptomatic cholelithiasis 95(79.1%) followed by chronic calculus cholecystitis 15(12.5%), gall bladder polyp 8(6.7%) and gall stone pancreatitis 2(1.7%). \u0000Conclusion: More than two and almost one out of ten had bile spillage and surgical site infection (SSI) respectively.  A significantly higher number of SSI among the spillage group should be a concern of surgeons. We need to be extra careful with the spillage group for surgical site infection.","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":"48094200","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":"Gestational Trophoblastic Neoplasia: A Clinico-Epidemiological Profile In A Tertiary Care Hospital","authors":"Indrani Das, Payel Mandal, S. Samanta, Pallab Kumar Mistri, Amit Kyal, P. Mukhopadhyay","doi":"10.3126/bjhs.v7i2.49295","DOIUrl":"https://doi.org/10.3126/bjhs.v7i2.49295","url":null,"abstract":"Introduction: Gestational trophoblastic neoplasia (GTN) is a group of interrelated lesions that results from abnormal proliferation of placental trophoblastic cells. Early diagnosis and treatment of GTN results in successful outcomes with fertility preservation.This study was intended to stratify GTN cases using WHO scoring system, to diagnose and manage cases as per protocol and to identify complications of treatment of GTN. \u0000Methodology: This was a single center prospective observational study conducted at Medical college Kolkata from June 2017 to December 2018. All the diagnosed cases of GTN fulfilling the inclusion criteria were incorporated in the study, data were collected from history, clinical examination and investigations. All the data were tabulated and analyzed by standard statistical methods \u0000Results:  In this study,  primiparous are more prone to have GTN and  molar pregnancy was the commonest antecedent event (71.4% of cases). 74.3% (26 out of 35) patients developed disease within four months of previous pregnancy. Anemia and vaginal bleeding were the presenting symptoms in >48.0% cases whereas hemoperitoneum,seizure, hemoptysis and respiratory distress were the rare presenting symptoms.In this study, the cases were diagnosed by histopathology or serial estimation of serum β-hcg. In our study, 91.4% patients  were successfully treated with methotrexate and only three cases received EMACO. \u0000Conclusion: To conclude this study established that cases of GTN can be successfully treated by early diagnosis and timely management.","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":"48238626","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":"Knowledge on Post Exposure Prophylaxis of HIV among Nurses of a Private Hospital","authors":"D. Khadgi, Pooja A Shah, A. Mahato, Karishma Khadgi","doi":"10.3126/bjhs.v7i2.49304","DOIUrl":"https://doi.org/10.3126/bjhs.v7i2.49304","url":null,"abstract":"Introduction: There are many effective prevention interventions available for those experiencing occupational exposure, and post exposure prophylaxis (PEP) is one of them. Different studies worldwide have shown low utilization of PEP for HIV due to lack of adequate knowledge. \u0000Objective: The purpose of this study was to assess the knowledge on PEP of HIV among nurses. \u0000Methodology: Descriptive cross-sectional research design was used and all the 130 nurses working in a private hospital of Biratnagar were the sample. Self-administered semi-structured questionnaire was used. Descriptive statistics as percentage, mean, median and standard deviation were used to analyse the data. \u0000Results: Almost all of the nurses knew the meaning of PEP and the majority were aware about components, indications and best time for initiating PEP after exposure. Less than half had knowledge about appropriate treatment regimen, antiretroviral drugs used for PEP, PEP drugs contraindicated during pregnancy, effectiveness of PEP and duration of protection by PEP. Findings also revealed that only one-third of the nurses (35.8%) had adequate knowledge on PEP of HIV. \u0000Conclusion: In least developed and developing countries like Nepal, healthcare workers including nurses have to work in resource-limited settings, putting themselves at higher risk of contracting different blood borne infections, including HIV, a disease without cure so far. Thus the findings reflect the need for the in-service awareness program and the integration of content in the pre-service curriculum on PEP of HIV for the nurses who are at risk for occupational exposure.","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":"47139677","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":"Role of Histopathology in diagnosis of Soft Tissue Tumors at Tertiary Care Center","authors":"N. Gautam, R. Makaju, R. Dhakal, D. Basnet, B. Lama","doi":"10.3126/bjhs.v7i2.49294","DOIUrl":"https://doi.org/10.3126/bjhs.v7i2.49294","url":null,"abstract":"Introduction: Soft tissue tumors (STTs) are a diverse group of neoplasms. It varies from the most common benign tumors to some self-limited lesions and rare malignant soft tissue tumors. Because of the overlap in their clinical and radiological characteristics, histopathology is crucial in determining their diagnosis. \u0000Objectives: To study the relative frequencies of types of soft tissue tumors (benign, intermediate and malignant) as well as their histological pattern in relation to age, gender and site of distribution. \u0000Methodology: This was a retrospective study conducted over a period of three years from January 2018 to December 2020 in the Department of Pathology, Dhulikhel Hospital, Kavre Nepal. This study included STTs of all the anatomical sites excluding STTs of the female reproductive system. The tumors were classified as benign, intermediate, or malignant using the WHO 2013 classification of soft tissue and bone tumors. The sarcomas were further graded into grades 1, 2, and 3 using the FNCLCC (French Federation Nationale des Centres de Lutte Contre le Cancer) grading system. Immunohistochemistry (IHC) and special staining procedures were also performed as and when required.  \u0000Result: A total of 198 STTs were studied, of which benign cases were 191 (96.45%), intermediate 03 (1.52%) and malignant 04 (2.03%) in number. The most common type of STTs was vascular tumors 77(38.89%) followed by adipocytic tumors 52(26.26%) and nerve sheath tumors 13(6.56%). STTs were most common in the third decade of life, with the head and neck region       being the commonest site.  All four malignant tumors were categorized using the FNCLCC grading system. There were three cases of Grade 2 sarcoma and one case of Grade 3 sarcoma. \u0000Conclusion: The most common benign tumors were vascular tumors followed by adipocytic tumors and nerve sheath tumors. STTs were most common in the third decade of life. Benign tumors were more common than malignant tumors.  In comparison to malignant tumors, benign tumors were found at a younger age group. STTs were found mainly in the head and neck region followed by upper and lower limbs. Despite the fact that molecular diagnostics is gaining popularity in the field of soft tissue tumors, histopathology still remains the gold standard.","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":"44431194","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":"Compound odontoma: A case report on 42 denticles hodgepodge in maxilla","authors":"S. Shrestha, A. Rai, B. Koirala, M. Dali, A. Shrestha","doi":"10.3126/bjhs.v7i2.49310","DOIUrl":"https://doi.org/10.3126/bjhs.v7i2.49310","url":null,"abstract":"Compound odontomas are the commonest benign odontogenic tumours of jaws affecting mostly children and adolescents. These developmental malformations display many tooth-like structures or denticles that consist of well-defined dental tissues with diverse morphologies. Majority of these lesions occur as intraosseous masses in the maxillary anterior region and are incidental radiographic findings. These are primarily associated with retention of primary teeth and delayed eruption of permanent teeth. The preferred treatment for these lesions is conservative surgical excision followed by a histopathological diagnosis. This case report presents a rare case of compound odontoma displaying numerous denticles (42 in number) in the maxillary anterior region of a 12-year-old male child and its surgical management.","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":"42132826","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":"Social norms of alcohol use among American Indian/Alaska Native college students.","authors":"Susanna V Lopez, Thad R Leffingwell, Ashley B Cole","doi":"10.1037/adb0000835","DOIUrl":"10.1037/adb0000835","url":null,"abstract":"<p><strong>Objective: </strong>Research on misperceived descriptive and injunctive drinking norms, or normative perceptions of frequency, quantity, and acceptability of drinking, has rarely been extended to American Indian/Alaska Native (AI/AN) college student populations. Ethnic identity, or strength of one's ties to their AI/AN culture, has been hypothesized as a protective factor against problematic alcohol use. As a step toward informing culturally appropriate and gender-specific norms-based interventions for AI/AN students, this study examined differences between perceived and actual descriptive and injunctive drinking norm reference groups (e.g., AI/AN males/females, \"typical\" males/females), and investigated ethnic identity as a moderator between perceived and actual drinking norms.</p><p><strong>Method: </strong>AI/AN college students (<i>N</i> = 356) completed an online survey assessing drinking patterns, descriptive norms, injunctive norms, and ethnic identity.</p><p><strong>Results: </strong>Compared to actual drinking levels, participants overestimated all gender-specific descriptive norm groups and all gender-specific injunctive norm groups except for AI/AN males. Participants estimated lower drinking levels for AI/AN-specific groups than non-AI/AN groups. Descriptive AI/AN male and best male friend norms significantly predicted drinking for men while only best female friend norms predicted drinking for women. Injunctive typical male norms significantly predicted drinking for men, and no injunctive norms predicted drinking for women. Finally, ethnic identity was unrelated to drinking and did not significantly moderate the relation between perceived and actual drinking.</p><p><strong>Conclusions: </strong>Current findings may inform norms-based alcohol use interventions, as AI/AN-specific reference groups may have a significant impact on drinking among men, but not women. Future culturally relevant alcohol use intervention research for AI/AN young adults is warranted. (PsycInfo Database Record (c) 2022 APA, all rights reserved).</p>","PeriodicalId":31640,"journal":{"name":"Birat Journal of Health Sciences","volume":"4 1","pages":"849-860"},"PeriodicalIF":3.4,"publicationDate":"2022-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"87292763","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}