Medical Journal of Shree Birendra Hospital最新文献

{"title":"Residual Lung Parenchymal CT Changes in COVID-19 Patients and its Association with Common Predictors","authors":"R. Shahi, Bibek Karki, L. Budhathoki, Shavana RL Rana, S. Panta, Bikalp Thapa, Ranju Shrestha Shrestha, P. Karki","doi":"10.3126/mjsbh.v21i1.41539","DOIUrl":"https://doi.org/10.3126/mjsbh.v21i1.41539","url":null,"abstract":"Introduction: Chest computed tomography (CT) is used for the screening and diagnosis of COVID-19 pneumonia. The aim of the study is to study the prevalence of residual lung parenchymal CT changes in COVID-19 patients and its association with common predictors.\u0000Methods: Longitudinal study conducted at Shree Birendra Hospital in which diagnosed COVID-19 patients with initial CT scan showing COVID-19 related changes were retrospectively enrolled after ethics approval. The study period was from 15 February 2020 to 15 November 2021. Chest CT changes were evaluated and CT scan severity score (CT SS) assigned. Data was entered in Microsoft Excel and analysed in SPSS (Statistical Package for Social Sciences) version 16. \u0000Results: Males were more common (72.6%) among the 62 enrolled participants with the mean age 53.63 ± 15.05 years. Median interval between two scans was 137 days. Residual lung parenchymal CT changes were seen in 43 (69.4%) participants. Hypertension (25, 40.3%) and GGO (55, 88.7%) were the most common comorbidity and CT features respectively. The mean initial and final CT SS was 10.84 ± 5.87 and 3.55 ± 4.58 respectively (Total score 25, p = 0.001). Age was significantly associated with severity of CT score (p = 0.04).\u0000Conclusions: A large percentage of COVID-19 patients have chest CT changes after three months of initial chest CT scan. CT SS reduced significantly in the second scan. Similar studies with long term serial CT follow up of patients is recommended to be carried out in future.","PeriodicalId":33963,"journal":{"name":"Medical Journal of Shree Birendra Hospital","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-07-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"45176056","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, Attitude and Practice (KAP) on Oral Health among students of Nepalese Army Institute of Health Sciences","authors":"M. Gurung, Sudha Sen Malla, Bipul Rajbhandari, B. Bajracharya","doi":"10.3126/mjsbh.v21i1.39856","DOIUrl":"https://doi.org/10.3126/mjsbh.v21i1.39856","url":null,"abstract":"Background: Oral health plays an important role in the overall health of the individual. Both medical and nursing students are expected to possess good oral health awareness and work together for public health promotion especially in developing countries like Nepal. The aim of the study is to assess and compare Knowledge, Attitude and Practice (KAP) on Oral Health among students of Nepalese Army Institute of Health Sciences (NAIHS)\u0000Methods: This is a cross sectional questionnaire based study conducted at Nepalese Army Institute of Health Sciences, from 2020.10.15 to 2021.04.15.  A total of fourteen standard structured close ended questionnaire was sent to all the medical and nursing students in g- mail to assess and compare KAP on Oral Health.\u0000Result: Among 200 MBBS students, 157, 184, 200 had knowledge about sugar, bacteria and not brushing respectively which causes dental caries and 163 had knowledge about benefits of fluoride on dental health. On the other hand out of 200 nursing students 147, 178, 200 had knowledge about sugar, bacteria and not brushing respectively which causes dental caries and 152 had knowledge about benefits of fluoride on dental health. On an average 88% of MBBS students had good knowledge about dental caries whereas 84.62% of nursing students had good knowledge about dental caries. More of nursing students had attitude of visiting dentist in a year than medical students whereas more of medical students had never visited a dentist. Among 200 MBBS students 143 (71.5%) were found brushing twice daily, 121 (60.5%) brushes after every meal (i.e. morning and night), 35 (17.5%) followed proper vertical tooth brushing technique and as for the duration of brushing 104 (52%) brushed for 2 min. On the other hand, among 200 nursing students 152 (76%) were found brushing twice daily, 132 (66%) brushes after every meal, 43 (21.5%) followed proper vertical tooth brushing technique and as for the duration of brushing 116 (58%) brushed for 2 min.\u0000Conclusion: Based on the present study the total knowledge on dental caries was found to be significantly higher in MBBS students than nursing students however nursing students had more positive attitudes towards oral health. Oral health practice of nursing students in terms of frequency of brushing, times, method and duration of brushing was also found to be comparatively better than MBBS students. With proper knowledge of oral health behavior, medical and nursing students can play an important role in the oral health education of individuals and groups and act as role models for patients, friends, families and the community at large.","PeriodicalId":33963,"journal":{"name":"Medical Journal of Shree Birendra Hospital","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-07-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44554492","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":"COVID-19 Preparedness and Response Hands-on Training to Healthcare Workers at Shree Birendra Hospital, Nepal","authors":"G. Chalise, Moon Thapa, L. Paudel, R. Paudel, Laxmi Gurung","doi":"10.3126/mjsbh.v21i1.39714","DOIUrl":"https://doi.org/10.3126/mjsbh.v21i1.39714","url":null,"abstract":"Introduction: COVID-19 pandemic in many countries of the world, including Nepal, is requiring a level of response which is beyond the capacity of the nation. It needs collaborative action to increase the capacity to respond to outbreaks. With the aim of providing and assessing the effectiveness of hands-on training, healthcare professionals from Nepalese Army Institute of Health Sciences (NAIHS) and Shree Birendra Hospital (SBH) started COVID-19 Preparedness and Response Hands-on training to frontline workers from April to December 2020.\u0000Methods: The training was initiated with the formation of core group of trainers, who conducted training of trainers (TOT) for 31 healthcare workers. The trainers who received TOT further trained 2549 healthcare workers from different health institutions. The training included topics like COVID-19 introduction and case definition; hand hygiene, respiratory hygiene and physical distancing; donning and doffing; disinfection and waste management; sample collection; patient transfer; dead body management and stress coping. Pre-test and post-test was done on 821 training participants to assess the effectiveness of training by using semi-structured self-administered questionnaire. From among 821 trainees involved in pre and post-test, 266 participants were randomly selected for data analysis from the training register. Data were analyzed by using Microsoft Excel and described by using descriptive and inferential statistics.\u0000Results: In our study, a score of ≥80% was acquired by 25.2% participants in pre-test and 76.3% participants in post-test. There was a significant increase in participants’ scores in post-test as compared to pre-test scores (p-value <0.001).\u0000Conclusions: On-site hands-on training is effective in acquisition of knowledge on key areas of COVID-19 preparedness and response.","PeriodicalId":33963,"journal":{"name":"Medical Journal of Shree Birendra Hospital","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-07-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42048211","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":"Empanelment: A Novel Healthcare Initiative - Viewpoint","authors":"Sarita Kc","doi":"10.3126/mjsbh.v21i1.36988","DOIUrl":"https://doi.org/10.3126/mjsbh.v21i1.36988","url":null,"abstract":"Military hospital management in Nepal faces challenges to meet the rising demands for quality care while enhancing efficiency and effectiveness as well as maintaining a workforce capable of meeting both peacetime and wartime needs. Empanelment of a tertiary civil hospital at a military regional command hospital is presented as an innovative strategic arrangement for leveraging productivity. Patient data for the first six months is analysed and key empanelment implementation issues are presented to enhance performance of healthcare providers.","PeriodicalId":33963,"journal":{"name":"Medical Journal of Shree Birendra Hospital","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-07-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42717654","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":"Successful Laparoscopic Retrieval of an Accidental Intra - Abdominal Sewing Needle – A Case Report","authors":"Sunil Basukala, N. Thapa, Sushil Rana Magar, Bikash Bahadur Rayamajhi, Alok Raj Gautam, Ravi Bhandari","doi":"10.3126/mjsbh.v21i1.40349","DOIUrl":"https://doi.org/10.3126/mjsbh.v21i1.40349","url":null,"abstract":"Accidental ingestion of sewing needle is a common presentation in daily emergency medical practice but its insertion through the abdominal wall is quite rare. We present a case of 26 years old serving soldier who had an accidental intraabdominal insertion of sewing needle which was managed laparoscopically. Initially patient was asymptomatic, however he complained of lower abdominal pain later. This was followed by successful laparoscopic retrieval of sewing needle located in right iliac fossa with no documented complications during six months of follow-up of the patient.","PeriodicalId":33963,"journal":{"name":"Medical Journal of Shree Birendra Hospital","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-07-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"45222463","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Comparison Between Harmonic scalpel and Cold dissection in Tonsillectomy at Shree Birendra Hospital: A Retrospective Study","authors":"R. Karki, R. Mahaseth, V. Dutta, S. Bhattarai","doi":"10.3126/mjsbh.v21i1.40287","DOIUrl":"https://doi.org/10.3126/mjsbh.v21i1.40287","url":null,"abstract":"Introduction: Tonsillectomy is the most common surgery performed by otorhinolaryngologist worldwide. It is a surgical procedure of removing tonsil with commonest indications for recurrent tonsillitis and tonsillar hypertrophy. The two most important complications of this surgery are bleeding (intraoperative, postoperative) and postoperative pain. Various surgical techniques have been developed to minimize this complication. Harmonic scalpel is an ultrasonically activated surgical device which can coagulate and cut vessels and tissues at a very low temperature. This study was conducted to compare the operative time, intraoperative blood loss and early post-operative pain between Harmonic scalpel and cold dissection tonsillectomy.\u0000Methods: This was a retrospective study conducted in ENT and Head and Neck Surgery department of Shree Birendra Hospital, Chhauni, Kathmandu from July 2018 to July 2019. Each patient was assessed by ENT Head and Neck Surgeon. Clinically diagnosed recurrent tonsillitis and tonsillar hypertrophy were included in the study. Those with age < 14 years, acute infection, obstructive sleep apnoea syndrome, adenoid hypertrophy, nasal pathology, cleft, history of bleeding disorders, inability to give informed consent, individual who would have difficulty communicating their pain levels, any chronic illness was excluded.\u0000Results: Out of 50 patients, 33(66%) were males and 17(34%) were females. The operative blood loss in harmonic scalpel was lesser (21.89 ± 8.89 ml) than in cold dissection group (49.74 ± 19.69 ml) which was statistically significant (p value = 0.000). The operating time in harmonic scalpel group was longer (8.48 ± 4.58 minutes) than in cold dissection group (8.14 ± 2.01 minutes). Pain on the early postoperative period (3 hours post-surgery, 1st and 2nd postoperative day) was lesser in harmonic scalpel group 68% (34/50) than in cold dissection group 32% (16/50).\u0000Conclusion: Harmonic scalpel is easy to use instrument which reduces intra-operative blood loss and post-operative pain as compared with cold dissection method.","PeriodicalId":33963,"journal":{"name":"Medical Journal of Shree Birendra Hospital","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-07-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44227113","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 Lipid Profile in Patients with Diabetes Mellitus Presenting at Tertiary Referral Center in Nepal","authors":"Indu K.C., R. Deo, K. Roka, Punita Singh, Z. Alam","doi":"10.3126/mjsbh.v21i1.41605","DOIUrl":"https://doi.org/10.3126/mjsbh.v21i1.41605","url":null,"abstract":"Introduction: Diabetes mellitus is a metabolic disorder associated with dyslipidemia especially in type 2 diabetes mellitus. Lipid abnormalities are associated with increased risk of cardiovascular diseases.  The aim of the study was to find out the incidence of dyslipidemia in patients with diabetes mellitus presenting at tertiary referral center of Kathmandu, Nepal. \u0000Methods: This was a retrospective study conducted in Medicine and Endocrine OPD of Shree Birendra Hospital, Chhauni, Kathmandu, Nepal after approval from the Institution Review committee. Cases within the period from December 2019 to January 2021 were studied. Data were analyzed using SPSS 21.0.\u0000Results: Out of 150 patients with diabetes mellitus, 32.6% had total cholesterol > 200 mg / dl, 60% had elevated LDL, 26.67% patient had elevated TG and 36% patients had low HDL level.  Poor glycemic control (HbA1c > 7%) was observed in 86 (57.33%) subjects. Among patients with HbA1c > 9, 3.33% patients had cholesterol > 200, 4.67% patients had TG > 250, 5.33% patients had LDL > 100 and 6.67% patients had HDL < 40. \u0000Conclusions: Diabetes mellitus is associated with high incidence of dyslipidemia. The most common pattern observed was elevated level of low-density lipoprotein, cholesterol and triglyceride and low level of HDL. Routine monitoring of lipid profile should be part of patient care. ","PeriodicalId":33963,"journal":{"name":"Medical Journal of Shree Birendra Hospital","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-07-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46473547","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":"Self-reported Adverse Effects in Health Care Professionals Following First and Second Dose Vaccination Against SARS-CoV 2 (Covishield)","authors":"Heleena Rayamajhi, Sammodavardhana Kaudinnyayana, A. Khadka, Sudha Sen Malla","doi":"10.3126/mjsbh.v21i1.40663","DOIUrl":"https://doi.org/10.3126/mjsbh.v21i1.40663","url":null,"abstract":"Introduction: The ChAdOx 1 n Cov-19 vaccine, called Covishield, was rolled out in Nepal targeting health care professionals. The study was conducted to assess the pattern of self-reported adverse events following immunization and to compare AEFI on the basis of previous COVID status.\u0000Methods: A cross sectional study of four months duration was conducted in Shree Birendra Hospital, a tertiary care hospital, in Kathmandu, Nepal.  AEFI associated with first and second dose of Covishield were assessed for a period of seven days from the day of vaccination in health care professionals and comparison was done based on COVID status.\u0000Results: A total of 100 vaccine recipients were included in the study, out of which 83% showed AEFI. The most commonly reported AEFI after first dose were headache (56%), injection site tenderness (42%), myalgia (29%), fatigue (24%), dizziness (20%), pyrexia (19%), malaise (17%), nausea (10%), chills (8%), vomiting (2%) and arthralgia (1%) while among the AEFI after second dose were injection site tenderness (36%), headache (15%), myalgia (12%), fatigue (11%), nausea (9%), malaise (8%), pyrexia (8%), chills (5%), rashes (3%), drowsiness (3%), arthralgia (1%) and dizziness (1%). Previously infected participants were found to be prone to develop systemic adverse effects. The most of the adverse effects were subsided within four days and commonly used medication was paracetamol to relieve the symptoms.  \u0000Conclusions: AEFI following the first and second dose of vaccine were mild. Systemic adverse effects were more frequent in those with the history of COVID-19 infection.","PeriodicalId":33963,"journal":{"name":"Medical Journal of Shree Birendra Hospital","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-07-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41767470","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":"Contributing Factors of Elective Surgical Case Cancellation: A Cross- Sectional Descriptive Study","authors":"Sunil Basukala, N. Thapa, B. Pathak, Raveesh Mishra, A. Gautam, S. Karki, Bikram Basukala","doi":"10.3126/mjsbh.v21i1.41355","DOIUrl":"https://doi.org/10.3126/mjsbh.v21i1.41355","url":null,"abstract":"Introduction: Elective surgical case cancellation refers to a scheduled surgical procedure that not performed on a given day. Cancellation of elective surgical operation recognized as a major cause of emotional trauma to patients as well as their families.  It has been a long-standing problem for healthcare organizations across the world.\u0000Methods: This was a cross-sectional observational study conducted from September 01 to November 30, 2021 for a period of three months in a 750-bedded tertiary care hospital, Kathmandu. A cancelled procedure was defined as a patient’s name appearing on the list for surgical operations but the operation not being performed on the scheduled date. Patients scheduled for surgical procedures were recruited into this study by the principal investigator and research assistants on the day prior to their operation.\u0000Results: Of total 600 patients scheduled for elective procedures over a period of three months, the prevalence of cancellation of elective surgical procedures was found to be 15.33 % (n=92). Of the examined surgical specialties, the cancellation prevalence was highest in GI and HPB at 40.9% (n =47), closely followed by Urosurgery at 31(33.6%), general surgery17(18.47%), plastics, Paediatric surgery 5(5.4%) and burn and plastics surgery 2 (2.1%) having the least cancellationrate at 2(2.1%) which was statistically significant (p value<0.05).\u0000Conclusions:Inadequate preoperative preparation, prioritized emergency cases and equipment shortages are the common causes of elective surgical cancellations.","PeriodicalId":33963,"journal":{"name":"Medical Journal of Shree Birendra Hospital","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-07-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41700208","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":"Bullying Victimization and its Associated Factors among Adolescent Students","authors":"Manara Maharjan, S. Shrestha","doi":"10.3126/mjsbh.v21i1.39815","DOIUrl":"https://doi.org/10.3126/mjsbh.v21i1.39815","url":null,"abstract":"Introduction: Bullying is common type of school violence and is a major source of maladjustment with undue effect on health and academic performance among adolescents. This study aimed to identify the prevalence of bullying victimization among adolescent students and its association with socio-demographic, family and school characteristics.\u0000Methods: It was descriptive survey carried out among 568 adolescents studying in Grade 7 to 11 of 10 public and 10 private schools of Kathmandu municipality selected through multi-stage stratified cluster sampling technique. Nepali version of modified revised Olweus Bully Victim Questionnaire (OBVQ) was used for data collection through Google Survey Tool after taking informed consent.\u0000Results: Prevalence of bullying victimization was 20.4% among 568 respondents. In regards types of bullying, prevalence of verbal bullying was 75.8%, relational bullying was 57.7%, physical bullying was 23.2% and cyber bullying was 23.2%. Male respondents were more victimized (63.8%) than female (36.2%).The highest proportion (23.6%) of bullied respondents was from 15-19 years aged group.  About one-third (34.0%) of bullied students had family problem. Higher proportion of respondents who disliked school and who were afraid of being bullying, were bully victimized (40.9% and 33.3% respectively).\u0000Conclusion: Prevalence of bullying victimization tends to be an issue among adolescent students. Bullying victimization is likely to be high in 15-19 years aged group and in male adolescents. Prevalence of verbal bullying tends to be commonest types of bullying.","PeriodicalId":33963,"journal":{"name":"Medical Journal of Shree Birendra Hospital","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-07-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42737244","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}