Medical Journal of Shree Birendra Hospital最新文献

{"title":"Visual Function at High Altitude in Nepal","authors":"S. Shrestha, A. Gurung, A. Manoranjan, Kamakshi Kanojia","doi":"10.3126/mjsbh.v21i2.45000","DOIUrl":"https://doi.org/10.3126/mjsbh.v21i2.45000","url":null,"abstract":"Introduction: Assessment of visual function is important for diagnosing ocular diseases. In the present study we are assessing different components of visual functions like visual acuity, color vision, contrast sensitivity and stereoacuity at high altitude in Nepal.\u0000Methods: A cross- sectional quantitative study was conducted in Bargaun village at an altitude of 3330 meters of Humla district of Western Nepal. Detailed eye examination was carried out for the participants consenting for the study who were from Bargaun and Limatang villages of Humla. Visual acuity, color vision, contrast sensitivity, stereoacuity and oxygen saturation were measured. Convenience sampling was done. Data were entered in excel, converted to a comma separated values format and supplied for regression analysis in Python 3. T-tests were done and a linear regression model was fitted to the data to determine the relationship between independent and dependent variables and obtain coefficients for the relationship.\u0000Results: One hundred and sixty four participants completed the study. Among them, 60.37% were 50 years of age and below. Oxygen saturation was 91 - 100% in 64.63%, 81 - 90% in 33.53% and 70-80% in 1.83% participants. Maximum number of participants had visual acuity of 0.48-1 (6/18-6/6). Contrast sensitivity was 10% in 4.88%, 5% in 23.17%, 2.5% in 40.24% and 1.25% in 31.71%. Stereoacuity was < 30 seconds of arc in 78.5%, 30-60 seconds of arc in 12.80% and 9% of participants had decreased stereoacuity. Color vision was decreased in 4.88%. Increase in age was associated with decrease in oxygen saturation, poorer visual acuity, decrease in color vision and poorer contrast sensitivity (p value = 0.00). Increase in oxygen saturation was associated with better visual acuity, better contrast sensitivity and better stereoacuity which was statistically significant (p value = 0.00).\u0000Conclusions: Oxygen saturation was reduced in 35%, visual acuity was decreased in 2.44%, contrast sensitivity was reduced in 28.05%, stereoacuity was reduced in 9% and color vision was abnormal in 4.88% of the participants residing at high altitude of Nepal.","PeriodicalId":33963,"journal":{"name":"Medical Journal of Shree Birendra Hospital","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-12-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42703941","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 Case of Hydropyometra Secondary to Vaginal Atresia: A Case Report","authors":"D. Mishra, S. Sipai, N. Jha, Pankaj Ray","doi":"10.3126/mjsbh.v21i2.44354","DOIUrl":"https://doi.org/10.3126/mjsbh.v21i2.44354","url":null,"abstract":"Hydrometrocolpos refers to the accumulation of secretions within the endometrial and endovaginal canal. The causes of retention of cervico-vaginal secretions are varied. Herein, we report a case of a seven-day-old female child presented to us for follow up as antenatal ultrasound done at nine months which had showed round cystic lesion with internal echoes in fetal lower abdomen. With the help of clinical examination and diagnostic imaging, the case was diagnosed as hydropyometra secondary to vaginal atresia and managed successfully by surgical intervention.","PeriodicalId":33963,"journal":{"name":"Medical Journal of Shree Birendra Hospital","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-12-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42786437","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":"Endovascular Management of a Rare Case of a True Facial Artery Aneurysm: A Case Report","authors":"M. Jha, Girija Nandan Tripathy, Anand Vembu","doi":"10.3126/mjsbh.v21i2.40676","DOIUrl":"https://doi.org/10.3126/mjsbh.v21i2.40676","url":null,"abstract":"True aneurysms of the facial artery are rare and their management protocol is not defined. There are only eight cases reported in the literature. Here we report a case of true aneurysm of the facial artery in a 78 years old female. She presented with swelling left side of the neck who underwent further imaging including CT angiography which revealed an aneurysm of left facial artery. She was successfully treated with coiling.","PeriodicalId":33963,"journal":{"name":"Medical Journal of Shree Birendra Hospital","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-12-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43624963","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":"Spectrum of Neurological cases in OPD of Tertiary Paediatric care Center of Nepal","authors":"S. Adhikari, Bina Prajapati Manandhar, A. Jha, Tek Bahadur Bista, Srijana Bhattarai, Muskan Bichha","doi":"10.3126/mjsbh.v21i2.44534","DOIUrl":"https://doi.org/10.3126/mjsbh.v21i2.44534","url":null,"abstract":"Introduction: Advancement of different mortality of investigation and super specialization of medical science has been able to develop different diagnosis and treatment possible. Neurology is one of the super specialties. Cases are increasing day by day. We aimed to change the data of paeditric neuro OPD.\u0000Methods: Those cases that visited the Neuro department of only one governmental tertiary paediatric care center of Nepal and have been registered in outpatient register were analyzed. Mean, frequency etc. were calculated using Microsoft excel.\u0000Results: Out of diagnosed 2517 patients, 64.48% (N = 1623) were males, 35.51% (N = 894) were females. The mean age of the children was 57.64. Global developmental delay comprised 24.19% (N = 609), epilepsy comprised 21.81% (N = 549), motor delay comprised 5.68% (N = 143), intellectual delay comprised 1.98% (N = 50), speech delay comprised 3.33% (N = 84), febrile seizure comprised 3.41% (N = 86, 3.41%), seizure disorder comprised 16.84% (N = 424), headache / migraine comprised 3.33% (N = 84), Duchene muscular dystrophy and spinal muscular atrophy comprised 1.5% (N = 38), cerebral palsy comprised 2.41% (N = 61), acute encephalitis syndrome comprised 1.23% (N = 31) and others were 1.03% (N = 26) diagnosis made in the Neuro OPD.\u0000Conclusions: Our study showed that there were more male children in Neuro OPD than females and the commonest morbidities included global development delay, hypoxic ischemic encephalopathy, seizure disorder in children visiting the Neuro OPD in tertiary paediatric care center of Nepal.","PeriodicalId":33963,"journal":{"name":"Medical Journal of Shree Birendra Hospital","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-12-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44059332","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":"Perceived Experience of Old Adult Patients with Services provided in the Tertiary Level Hospitals in Kathmandu: A Cross-Sectional study","authors":"P. Khatri, Muna Sharma, Shreejana Singh","doi":"10.3126/mjsbh.v21i2.49066","DOIUrl":"https://doi.org/10.3126/mjsbh.v21i2.49066","url":null,"abstract":"Introduction: Most old adults are vulnerable to multiple non-communicable diseases and need extensive care, treatment and support for a good quality of life. The main objective of this study was to identify the old adult patient’s perceived experience with the care provided in the tertiary level hospitals under the Institute of Medicine, Tribhuvan University, Kathmandu, Nepal.\u0000Methods: The cross-sectional study was conducted among 404 old adult patients admitted with non-communicable diseases in two tertiary levels University Hospitals in Kathmandu, Nepal. An interview schedule was conducted with hospitalized old adult patients to collect data using a consecutive sampling technique.\u0000Results: Most participants [208 (51.5%)] were from the age group of 60 to 69 years with a mean age (± SD) of 71.1 (± 9.7) years. One-fourth [103 (25.5%)] of them were financially independent. Two hundred thirty-three (57.7%) were admitted with a single diagnosis. Two hundred forty (59.4%) participants bore their hospital expenses with out-of-pocket payment, and 40.6% were covered by a third party payment. The majority of them (86.1%) had the experience of finding approachable health personnel in the hospital whereas 82.7% felt that the cost of treatment was higher than expected. 80.4% perceived that access to the hospital service (e.g. getting the outpatient tickets) was user-friendly. However, only 10.9% experienced follow-up visits user friendly.\u0000Conclusions: The hospitals where this research was done have a relatively high standard of care for old adult patients. Old adult-friendly health policy, physical environments of the hospital, and advocacy for them should further be considered in the tertiary level hospitals for the benefit of old adult patients.","PeriodicalId":33963,"journal":{"name":"Medical Journal of Shree Birendra Hospital","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-12-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"45567604","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 Retrospective study to Analyze the Outcomes of Paediatric Pyeloplasty in Poorly Functioning Kidneys","authors":"Nayan Timbadiya, P. S, Prasanna Matippa","doi":"10.3126/mjsbh.v21i2.46686","DOIUrl":"https://doi.org/10.3126/mjsbh.v21i2.46686","url":null,"abstract":"Introduction: Pyeloplasty has success rate of up to 98%. We believe that paediatric pyeloplasty even in poorly functioning kidney, will result in maximum salvage of renal function. The aim of our study was to evaluate the outcome of pyeloplasty in poorly functioning kidneys with PUJO in the paediatric population.\u0000Methods: The children with PUJO with a GFR < 30 ml / min or < 30% differential function on DTPA, who underwent pyeloplasty in NU hospitals, Bengaluru over a period of 11 years 2 months, were included in our retrospective study. Anteroposterior diameters (APD) and parenchymal thickness (PT) were assessed at three months. After one year of surgery, they underwent DTPA. Outcomes analyzed were febrile UTI, the need for secondary procedures, structural and functional outcomes in operated kidneys till one year of follow-up.\u0000Results: A total of 30 patients with a mean age of four years ± 4 SD (standard deviation) with poor function on DTPA renogram (< 30%) were included in the study. 10 patients (33.33%) had a differential renal function (DRF) of 15% or less. Pre - operative mean PT was 4.7mm, mean APD was 38.5 mm, mean DRF was 19.3% and mean GFR was 17.7 ml / min. PT was increased to 6.4mm (± 2.4SD) and APD reduced to a 16.7 mm (± 10 SD) at the end of three months (p < 0.001). Increment in DRF percentage was 33.2 (± 9.4 SD) and GFR was 33.9 (± 12.5 SD) at the end of one year (p < 0.001). 13.3% of the patients had UTI, none of the study subjects required re-intervention within one year.\u0000Conclusions: The pyeloplasty for pediatric PUJO significantly improved the functional outcomes even in poorly functioning kidney, hence we recommend the pyeloplasty for selected pediatric cases of poorly functioning kidney with PUJO.","PeriodicalId":33963,"journal":{"name":"Medical Journal of Shree Birendra Hospital","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-12-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41546570","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":"Post COVID Health Problems faced by COVID-19 Infected Healthcare Professionals of a Tertiary Level Hospital","authors":"Babita Sapkota, Gita Dhakal Chalise, S. Shrestha","doi":"10.3126/mjsbh.v21i2.47361","DOIUrl":"https://doi.org/10.3126/mjsbh.v21i2.47361","url":null,"abstract":"Introduction: COVID-19 is an infectious disease which predominantly affects the lungs but it can also affect other organs such as gastro-intestinal system, brain, heart etc. The substantial proportion of infected people experience mild to moderate symptoms and recover with no after-effects. Some people with COVID- 19 can experience long term health problems, known as post-COVID health problems. These are inflammatory or host response towards virus that occurs after four weeks of initial infection and beyond. The aim of this study was to find out the post COVID health problems faced by COVID-19 infected healthcare professionals of a tertiary level hospital.\u0000Methods: This was a descriptive cross-sectional study carried out among healthcare professionals recovered from COVID-19 infection who were selected by using non -probability purposive sampling technique. A semi-structured self-administered questionnaire was used for data collection. The collected data were analyzed by using descriptive and inferential statistics.\u0000Results: Out of 108 healthcare professionals who participated in the study, 42.6% were experiencing various post-COVID health problems. These problems included fatigue (78.3%), persistent cough (54.3%), headache (37%), malaise (34.8%), body ache (32.6%) and others. No significant association of the experience of post- COVID health problems among respondents with their age, sex and COVID-19 vaccination status was revealed at 0.05 level of significance.\u0000Conclusions: A considerable proportion of health professionals are liable to experience various post-COVID health problems after being infected with COVID- 19. Their age, sex and COVID-19 vaccination status do not tend to influence on their post-COVID health problems.","PeriodicalId":33963,"journal":{"name":"Medical Journal of Shree Birendra Hospital","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-12-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"47574543","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":"Rare Occurrence of Prostate Cancer Metastasizing to the Orbit: A Case Report","authors":"P. S, V. K, Karunakar Reddy Chalimidi, K. T","doi":"10.3126/mjsbh.v21i2.42879","DOIUrl":"https://doi.org/10.3126/mjsbh.v21i2.42879","url":null,"abstract":"Prostate cancer is second most common cancer with frequent metastasis occurring to bone. We report a unique case of soft tissue and bony orbital metastasis from carcinoma prostate. The patient presented with orbital metastasis after defaulting to the advised treatment. He responded well to radiation therapy and the lesion regressed completely. Our patient was diagnosed to have an oligo-metastatic carcinoma of the prostate. He was non-compliant with treatment and presented to us with proptosis, which was later diagnosed to be an orbital metastasis from prostate cancer. It responded well to the external beam chemotherapy. Orbital metastasis is a rare but known complication of carcinoma prostate. One must consider the diagnosis of orbital metastasis from carcinoma prostate in an elderly male presenting with proptosis.","PeriodicalId":33963,"journal":{"name":"Medical Journal of Shree Birendra Hospital","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-12-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44777574","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":"Infrared Spectroscopic Analysis of Chemical Composition of Urolithiasis Among Serving Nepalese Soldiers- An Institutional study","authors":"B. Bhandari, Sunil Basukala, N. Thapa, B. Thapa, Anjit Phuyal","doi":"10.3126/mjsbh.v21i2.42802","DOIUrl":"https://doi.org/10.3126/mjsbh.v21i2.42802","url":null,"abstract":"Introduction: Various pathologic and metabolic diseases might manifest as renal stones. Acquiring knowledge of the urinary stone constituents is important. Kidney stone analysis is recommended in the basic evaluation of stone disease. This study aims to identify the chemical composition of renal stones and briefly identify the predisposing factors.\u0000Methods: This was a retrospective analytical study conducted from May 01 2018 to May 30, 2020 for a period of two years in a 750-bedded tertiary care hospital, Shree Birendra Hospital (SBH), Kathmandu, Nepal. All patients who underwent Fourier transform infrared spectroscopy (FT-IR) analysis of the retrieved calculi were included in the study. The type of surgery performed was decided by the operating surgeon based on the treatment options available at the center and the recent evidences on management of the stone. The study was conducted after an approval from institutional Review Board (IRB) of NAIHS.\u0000Results: A total 400 patients underwent Infrared spectroscopic analysis (FT-IR) for the retrieved stone. Among them, majority of urolithiasis was seen among male population 277 (69.2%) with an age group between 31 – 45 years {204 (51%)}. Calcium - oxalate was detected in majority of cases 257 (64.25%) followed by struvite 90 (22.5%) and mixed stones 53 (13.2 %).\u0000Conclusions: Majority of the patients in our study had kidney stone followed by ureteric stone. The predominance of calcium oxalate stones was seen in kidney stones followed by Struvite and mixed stones.","PeriodicalId":33963,"journal":{"name":"Medical Journal of Shree Birendra Hospital","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-12-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"48244191","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 Regarding Childhood Anemia among Mothers of Under Five Children in a Maternal and Child Health Clinic of a Tertiary Hospital","authors":"Sunita Pokharel, Jamuna Adhikari","doi":"10.3126/mjsbh.v21i2.44412","DOIUrl":"https://doi.org/10.3126/mjsbh.v21i2.44412","url":null,"abstract":"Introduction: Anemia is the commonest nutritional problem in the world, mostly in developing countries. In Nepal, more than half of children aged six to 59 months are anemic. Anemia causes a lot of morbidity and mortality in children under five years. Thus, objective of this study is to find out the level of knowledge regarding childhood anemia among mothers of under five children.\u0000Methods: This is a cross sectional descriptive study among mothers having children under five years of age selected by using non-probability purposive sampling method. Structured questionnaire in Nepali version were used to interview with mothers in a Maternal and Child Health Clinic of Tribhuvan University Teaching Hospital, Kathmandu, Nepal. The study was conducted for 12 weeks. Results were analyzed by using descriptive (frequency, percentage, mean, standard deviation, median, interquartile range) and inferential statistics (Chi Square test) in SPSS version 20.\u0000Results: Total 206 mothers participated in the study. Nearly two third (62.1%) had high level of knowledge regarding childhood anemia among mothers of under-five children. There is statistical association between level of knowledge and occupation of mothers (p < 0.05).\u0000Conclusions: The level of knowledge is high in nearly two third of mothers of under five children regarding childhood anemia. Therefore, health education program should be launched by management committee to increase the knowledge of the mothers.","PeriodicalId":33963,"journal":{"name":"Medical Journal of Shree Birendra Hospital","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-12-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"47811285","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}