Medical Journal of Shree Birendra Hospital最新文献

{"title":"Chest Ultrasonography in Diagnosing Etiology of Acute Respiratory Failure","authors":"C. Pant, A. Pal, M. Yadav, Bishow Kumar Shrestha, S. Rana","doi":"10.3126/mjsbh.v19i1.26670","DOIUrl":"https://doi.org/10.3126/mjsbh.v19i1.26670","url":null,"abstract":"Introduction: Lung ultrasonography (LUS) is a useful diagnostic tool in critical care setting. Lung ultrasound at bed side is relatively easy to perform, cost effective and reproducible. Analysis of various sign and profile, alone or in combination is as accurate as gold standard test like Computed Tomography scan of the chest in detection of etiology of acute respiratory failure. The aim of our study was to perform bed side lung ultrasound in patent with ARF and to find out the diagnostic accuracy of lung ultrasound when compared with diagnosis made by the clinician. Methods: This descriptive observational study was conducted at tertiary care teaching centre in Nepal between February 2019 and July 2019. Consecutive samples of acute respiratory failure patient were included. Lung ultrasound was performed at bed side by fellows of pulmonary critical care medicine. Specific 10 signs of blue protocol were assessed in six different sites of both the chest. Findings of LUS was recorded and analysed to formulate a diagnosis, and finally compared with the final diagnosis. Results: Forty eight patients of acute respiratory failure with median age of 66 years (17 to 89 years) were included with 66.7% being females. 97.9 % of the patient presented with acute shortness of breath of less than one week duration. A total of 13 different diagnosis was made at the end of the treatment for all the patient. LUS accurately diagnosed them in 43 cases, with an overall accuracy of 89.6 %. Chronic obstructive pulmonary disease, pulmonary edema, pneumonia, pleural effusion, pneumothorax were accurately diagnosed with LUS however in acute respiratory distress syndrome and interstitial lung disease, lung ultrasound had poor diagnostic accuracy. Conclusions: Lung ultrasound is useful tool in diagnosing etiology of acute respiratory failure. Diagnosis made by lung ultrasound was 89.6% correct when compared with final diagnosis made by clinician.","PeriodicalId":33963,"journal":{"name":"Medical Journal of Shree Birendra Hospital","volume":"19 1","pages":"20-25"},"PeriodicalIF":0.0,"publicationDate":"2020-01-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.3126/mjsbh.v19i1.26670","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"48043010","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 Descriptive Study of Anaesthesia in Mobile Surgical Camps in Nepal","authors":"B. Amatya, Bhubhan Raj Kunwar, Sunita Panta, S. Khadka, Mallika Rayamajhi, P. Thapa","doi":"10.3126/mjsbh.v19i1.24894","DOIUrl":"https://doi.org/10.3126/mjsbh.v19i1.24894","url":null,"abstract":"Introduction: Mobile medical and surgical camps are one of the means of providing medical and surgical facilities to people living in rural areas of developing country like Nepal. Methods: An observational cross-sectional descriptive retrospective study was done collecting data from surgical camps done by Nepali Army in six years from February 2013 to February 2019 AD. Total number of surgical cases requiring anaesthesia along with type of anaesthesia, American Society of Anaesthesiologist physical status classification and anaesthesia related complications were collected. Results: In a six year period, total 12 mobile surgical camps were conducted by Nepali Army. Out of which, two were done in collaboration with Ministry of Health, Government of Nepal. Total 703 surgical cases were conducted. Out of which, 583 were general surgical cases and 120 were gynaecological cases. 262 cases were done in local anaesthesia, 242 cases were done in spinal anaesthesia, 108 cases were done in total intravenous anaesthesia and 91 cases were done in general anaesthesia. Hypotension, nausea, vomiting, shivering, failed spinal and difficult airway were the complications noticed during intra-operative and postoperative period. Conclusions: Surgical outreach camps are beneficial in providing surgical care to unaffordable people living in rural and remote areas where health care facilities are limited and inaccessible. Safety of patient is the key concern in such camps. Proper organised plan is required selecting target group of populations with target surgeries per day for successful conduction of safe surgeries in such camps.","PeriodicalId":33963,"journal":{"name":"Medical Journal of Shree Birendra Hospital","volume":"19 1","pages":"2-9"},"PeriodicalIF":0.0,"publicationDate":"2020-01-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.3126/mjsbh.v19i1.24894","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44121201","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":"Cadaveric Temporal Bone Dissection Workshop in a Tertiary ENT- HNS Centre: Is Our Teaching Satisfactory?","authors":"P. Rayamajhi, Susmita Shrestha, R. Pradhananga, H. Bhattarai","doi":"10.3126/mjsbh.v19i1.26489","DOIUrl":"https://doi.org/10.3126/mjsbh.v19i1.26489","url":null,"abstract":"Introduction: Teaching learning skills are developed through various skill lab procedures. In the Department of ENT and HNS, Temporal Bone Dissection (TBD) is one of the methods of teaching. The TBD workshop conducted in the Department caters to most of the postgraduate students in the country. This study was conducted in the Department of ENT and HNS to evaluate the participants’ satisfaction on TBD course conducted in the Department. Methods: The TBD participants who had undergone TBD course in the Department of ENT and HNS were asked to fill up the questionnaire regarding the satisfaction of the TBD course and suggestions for the improvement of the course. The participants provided the response of the questionnaire in the email or in hand filling of the forms. Results: Total of 42 students responded to the questionnaire regarding the TBD course. 88% of the students graded it as good, 11% replied as satisfactory and 1% of them graded it as needs improvement. Maximum number of students commented on the inadequate time for dissection. Few participants replied the need of live demonstration in the course. 9.5% of the participants who had come for the course more than once commented on the great help done by the course in performing live otology surgery. Conclusions: Maximum participants were satisfied about the TBD workshop which helped them to know the intricate temporal bone anatomy.","PeriodicalId":33963,"journal":{"name":"Medical Journal of Shree Birendra Hospital","volume":"19 1","pages":"10-15"},"PeriodicalIF":0.0,"publicationDate":"2020-01-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.3126/mjsbh.v19i1.26489","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42793811","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":"Helping Babies Breathe (HBB) Program for Reduction of Neonatal Mortality: A Hospital Based Cost Effective Intervention in Nepal","authors":"K. Thapa, R. Clark, Michael K. Visick, Y. Basaula, Rakesh Hamal, N. Kc","doi":"10.3126/mjsbh.v19i1.25961","DOIUrl":"https://doi.org/10.3126/mjsbh.v19i1.25961","url":null,"abstract":"INTRODUCTION\u2029 Helping Babies Breathe (HBB)1 is an evidencebased curriculum being used worldwide to teach neonatal resuscitation skills. The intervention is particularly famous for saving the lives of neonates in low resource countries.2 Nepal has high neonatal and maternal mortality rate in Asia.3 HBB is a key interventions to reduce neonatal mortality through the management of birth asphyxia. It focuses on action within the “golden minute,” referring to appropriate resuscitation in the first 60 seconds of life.","PeriodicalId":33963,"journal":{"name":"Medical Journal of Shree Birendra Hospital","volume":"19 1","pages":"48-50"},"PeriodicalIF":0.0,"publicationDate":"2020-01-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.3126/mjsbh.v19i1.25961","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42293195","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":"Rejected","authors":"S. Rana","doi":"10.5194/bg-2018-126-rc1","DOIUrl":"https://doi.org/10.5194/bg-2018-126-rc1","url":null,"abstract":"Rejection is faced by all of us; it is upon us to take it in one’s stride. If we consider rejection as a step in scientific writing, handling a rejection becomes easy and bearable. The very fact that most of the well known scientific authors have faced rejection somewhere down their academic career would perhaps help most of the academicians to take rejections logically. It is no wonder to many academicians that even Albert Einstein had been rejected for the post of Lecturer in numerous universities and worked as a clerk in a Patent office.1 \u0000The letter of rejection might state various reasons, common ones being lack of originality, incomprehensibility, poor scientific reasoning or unsuitable to that journal’s readership. No matter what the reason may have been, a set format of polite rejection mail from the most journals is quite familiar to most of us. This is a very important guiding principle for improvement of the quality of the article. This should be taken as a stepping-stone in the process of acceptance for publication. \u0000The rejection rate of journals can vary tremendously. Generally, the higher the academic value of the journal, the higher the rejection rate. Most of us are discouraged by the higher rejection of the highly reputed journals. Many reputed journals have a rejection rate of 80 to 85%.2 However, the best part of highly reputed journals is that along with their polite mail of rejection, they also send the expert opinion of the reviewers why the particular article would have been rejected. In this regards, it is sometimes more logical to consider such reputed journals for ones submission. If the rejection mail arrives in less than a month, then it is probable that it was not sent to a reviewer and was rejected by the editors, in view of basic formatting not being in consonant with the journal or the substance matter not fitting in with the scope of the journal. \u0000It is upon the author to decide whether to reform the article or send it to a new journal after the rejection. Generally, the pool of reviewers for many reputed journals have many names common. So, if the author does not modify the article and submit it to another journal, very likely, the reviewer’s comments also remain the same. Usually if the reviewer has sent some comments, amending the article according to the critical comments and resubmitting is wise and more scientific rather than hunting exasperatedly for optional journals. It is always advisable to rethink and spend some time reforming your article according to the journal’s guidelines and the reviewer checklists. And many of the times, it would be much prudent to take the reviewer’s comments seriously and it would surprise the author how his/her article can turn out so beautiful after modifications. If you are not ready to accept the reviewer’s comments, it is better to give reason validating your writing but continuous letter of rejection demands serious rethinking of the whole approach.","PeriodicalId":33963,"journal":{"name":"Medical Journal of Shree Birendra Hospital","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2020-01-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"48810135","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":"Medical Students’ Perception on Joining Military Medical Services: A Mixed Method Study","authors":"B. Shrestha, R. Shrestha","doi":"10.3126/mjsbh.v19i1.22044","DOIUrl":"https://doi.org/10.3126/mjsbh.v19i1.22044","url":null,"abstract":"Introduction: Currently, in Nepal there are 19 Medical Colleges, most of them under Tribhuwan University and Kathmandu University. Nepalese Army Institute of Health Sciences (NAIHS) is Not-for-profit organization run by Nepal Army Welfare Fund, affiliated to Tribhuwan University. Excluding the medical graduates from abroad there are around 1500 doctors graduating from Nepal every year. After graduation they have the options joining as a Medical Officer in hospitals around Nepal or go abroad. Joining the Military Medical services seems appealing. However the options are broadening with the jobs in the private and other sectors becoming more lucrative. This study attempts to explore the perception of medical students on joining the Military Medical services. \u0000Methods: The study was conducted during November 2016 to December 2017 among first and second year MBBS students of NAIHS. Comprehensive information about becoming a Military doctor in Nepal Army Medical Corps was provided. Student perceptions about joining Military Medical Services were studied using the semi-structured questionnaire. Informed written consent was taken from the students for the study. \u0000Results: From the total (204) respondents, 64.7% (132) chose to join the Military medical services. Among the responses, serving the nation, job security and opportunity for career development were the most chosen. Reponses like; preferring private practice, less pay/salary, and deployment consideration were the reasons for not choosing to join the Military Medical Services. \u0000Conclusion: Job as a Military Doctor seems attractive to majority of the Medical students. Male and Female medical students are equally interested towards becoming a military doctor in Nepal Army.","PeriodicalId":33963,"journal":{"name":"Medical Journal of Shree Birendra Hospital","volume":"19 1","pages":"39-44"},"PeriodicalIF":0.0,"publicationDate":"2020-01-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.3126/mjsbh.v19i1.22044","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"47422867","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":"Methemoglobinemia in a Newborn","authors":"Shristi Shakya, N. Shrestha, K. Subedi","doi":"10.3126/mjsbh.v19i1.26567","DOIUrl":"https://doi.org/10.3126/mjsbh.v19i1.26567","url":null,"abstract":"Methaemoglobinaemia in a newborn is a rare cause of cyanosis. We report a case of a new born presented with cyanosis and with normal cardio-pulmonary system. He was diagnosed as methaemoglobinaemia due to persistent cyanosis despite administration of oxygen and arterial blood gas collection appeared chocolate brown in colour. As methaemoglobin report was in mild range (11.7%), he was treated symptomatically.","PeriodicalId":33963,"journal":{"name":"Medical Journal of Shree Birendra Hospital","volume":"19 1","pages":"45-47"},"PeriodicalIF":0.0,"publicationDate":"2020-01-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.3126/mjsbh.v19i1.26567","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"47027153","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":"Causality Assessment of Adverse Drug Reaction Using Naranjo Probability Scale: A Retrospective Study","authors":"S. R. Bajracharya, R. Ghimire, P. Gyanwali, A. Khadka","doi":"10.3126/mjsbh.v19i1.21573","DOIUrl":"https://doi.org/10.3126/mjsbh.v19i1.21573","url":null,"abstract":"\u0000 \u0000 \u0000 \u0000Introduction: Globally, Adverse Drug Reaction (ADR) has been listed as the sixth leading causes of death. Recognition of ADR and establishment of relationship of drug with the symptom is the first step to the management of the problem. In this study, Naranjo algorithm has been used which is one of the most accepted tools for the assessment of causality of ADR with the suspected drug. \u0000Methods: A retrospective descriptive study was done which included 35 reported cases of ADRs in Drug Information Unit (DIU) in tertiary care teaching institute of Nepal from Dec 2015 to Oct 2016. Based on the information in the reported ADRs forms, categorisation was done using Naranjo’s ADR Probability scale. The data was analysed using SPSS version 16.0 and descriptive statistics was used. \u0000Results: It was seen that ADRs were more common in male (n=20) as compared to female (n=15). Amongst male, ADRs were more common in age group 50-75 years (n=8). ADRs were most commonly seen with antimicrobial agents (40%) followed by Non-Steroidal Anti-inflammatory Drugs (NSAIDs) (20%) and immunosuppressants (20%). Within the antimicrobial agents, anti-tubercular drugs (20%) contributed the most in ADRs and hepatotoxicity was the most common ADR seen. Majority of ADRs were categorised under possible (n=29) followed by probable (n=6). \u0000Conclusions: Naranjo algorithm could be a useful tool for causality assessment of ADR which can help physicians to guide the therapy. \u0000 \u0000 \u0000 \u0000","PeriodicalId":33963,"journal":{"name":"Medical Journal of Shree Birendra Hospital","volume":"1 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2020-01-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.3126/mjsbh.v19i1.21573","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46631951","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":"Infant and Young Child Feeding Practices Among Chepang Community, Chitwan","authors":"Iswari Luitel, R. K. Ban, S. Munikar","doi":"10.3126/mjsbh.v19i1.22813","DOIUrl":"https://doi.org/10.3126/mjsbh.v19i1.22813","url":null,"abstract":"Introduction: Infant and young child feeding practices play vital role for the growth and development. It is recommended to exclusively breastfed for first six months and thereafter receive complementary foods with continued breastfeeding. However Chepang, the indigenous community of Nepal depends primarily upon forest food. This study aims to determine the infant and young child feeding practices among Chepang children. Methods: A cross sectional study was conducted among the mothers of 77 children aged six to 59 months through purposive sampling. Data was collected through face to face interview taking informed written consent. The collected data were analysed for descriptive and bivariate analysis using SPSS version 21. Results: In this study, mean age of respondents was 25.92 (±7.04) years, 68.8% followed Christian religion, 51.9% were educated, only 45.5% of respondent’s spouse were educated and 51.9% belonged to nuclear family. Among the respondents, 65.7% had good breast feeding practice and 88.3% had good complementary feeding practice. Statistically significant relationship was found between breast feeding practice and educational status and also between complementary feeding practice and family type. Conclusions: This study found that respondents had good breast feeding practice and complementary feeding practice. Among the respondent, seven out of 10 had good breast feeding practice and nine out of 10 had good complementary feeding practice. Association between breast feeding practice and educational status puts light upon the need for educating and empowering women for improved infant and young child feeding practices.","PeriodicalId":33963,"journal":{"name":"Medical Journal of Shree Birendra Hospital","volume":"22 4","pages":"31-38"},"PeriodicalIF":0.0,"publicationDate":"2020-01-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.3126/mjsbh.v19i1.22813","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41293017","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":"Determinants and Aspirants of Nurse Migration from Nepal: A Cross Sectional Study from Kathmandu","authors":"S. Munikar, K. Thapa","doi":"10.3126/MJSBH.V18I2.22855","DOIUrl":"https://doi.org/10.3126/MJSBH.V18I2.22855","url":null,"abstract":"Introduction: Migration is the result of interplay of many factors, which guide the individual’s decision to emigrate. Health workers tend to go where the working conditions are best. This study aims to identify the determinants and aspirants of nurse migration from Nepal. \u0000Methods: A descriptive cross sectional study was conducted using interview technique. A semi structured questionnaire was administered to all nurses working at a private hospital who met the inclusion criteria. \u0000Results: Majority of the participants were 20- 30 years old (93.20%), Hindu (86.5%), Chhetri (35.1%), unmarried (66.2%), had completed intermediate level (58.1%). Among the total respondents, 93.20% intended to migrate to abroad and more than half of the respondent (62.20%) preferred Australia as destination. The general factor provoking migration was bad nature of politician (98.6%) followed by political instability (90.5%) and non-availability of job (90.5%). The major working condition and social factors provoking migration were occupational security in other country (85.10%) and peer influence (91.9%) respectively. The reasons for migration as mentioned by respondents were education (59.50%) followed by better job opportunities (40.50%), better living standard (21.60%) and family and/or peer pressure (8.10%). \u0000Conclusions: The present study concluded that majority wanted to migrate and Australia was famous choices for nurses. Bad nature of politician, occupational security in other country and peer influence were factors for migration.  The major purpose for migration was education.","PeriodicalId":33963,"journal":{"name":"Medical Journal of Shree Birendra Hospital","volume":"1 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2019-07-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.3126/MJSBH.V18I2.22855","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41585209","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}