Kathmandu University Medical Journal最新文献

{"title":"Better Social-emotional Behavior in Young Nepali Children is Associated with Household Wealth, Child Age, and Family Participation in a Community Development Intervention.","authors":"L C Miller, S Neupane, M Shrestha, N Joshi, M Lohani, A Thorne-Lyman","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>Background Mental health and behavior problems are under-recognized in low- and middleincome countries, especially in young children. Early identification of these problems could encourage governments to address the shortages of child mental health professionals and promote early intervention programs to help children achieve their full developmental potential. Objective Describe the social-emotional development of young rural Nepali children; explore risk factors for poor development. Method The study was embedded in a longitudinal intervention trial comparing control households with those who received training in family nutrition+livestock management (Partial Package) or family nutrition+livestock management+community mobilization (Full Package). At midline, enumerators completed a 145-item household questionnaire, child anthropometry, and Administered the Ages and Stages Questionnaire-Social-Emotional (ASQ-SE) to all enrolled children age 33-47 months (n=310). Bivariate and regression analyses examined the relationship of child and household risk factors to administered the Ages and Stages QuestionnaireSocial-Emotional scores. Result Administered the Ages and Stages Questionnaire-Social-Emotional scores were below age cutoffs in 24% of children, suggesting worse social-emotional development. In bivariate analyses and the adjusted linear regression model, older child age, greater household wealth, and Full Package Intervention status were all associated with better social-emotional development scores. Partial Package Intervention status was associated with worse scores. Conclusion The Administered the Ages and Stages Questionnaire-Social-Emotional is a potential tool to assess child social-emotional development in the context of household and community level interventions. Further work is necessary to validate the administered the Ages and Stages Questionnaire-Social-Emotional and similar tools in Nepal, and to better understand the prevalence of challenges to optimal socialemotional development in young children in order to use this information to design and monitor needed interventions.</p>","PeriodicalId":35493,"journal":{"name":"Kathmandu University Medical Journal","volume":"21 82","pages":"197-206"},"PeriodicalIF":0.0,"publicationDate":"2023-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140866035","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":"Clinical Profile and Knowledge, Attitude and Practice of Patients Presenting with Headache.","authors":"M R Ghimire, M Thapa, A M Shrestha, S Bhattrai, S Ghimire, N Sharma, B Soti, A Dutta, S Shrestha, M Pokhare, R Poudel, L J Thapa","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>Background Headache disorders are among the most prevalent and disabling conditions worldwide. People, however, do not seek early advice in developing countries. Objective To study clinical profile of patients with headache and their existing knowledge, attitude, and practice regarding primary headaches. Method Descriptive cross-sectional study conducted among 196 patients. Patients were selected using purposive sampling technique fulfilling inclusion criteria. Patients were interviewed based on semi-structural headache questionnaire and data was collected from 4th October to 21st December 2021. Descriptive statistics was used for analysis and interpretation. Result Among 196 participants, 74% were females, 29.6% of patients were between (31 to 40) years of age. The majority were Hindu and belongs to province 3; 36.7% were homemakers, and 32.2% were literate. Migraine headache was the most common type with 14.3% reporting aura. Most reported headache within 1 to 5 years. The commonest triggers were sunlight 64.8%, crowd 54.7%, stress 39.8%, fasting state 31.7%, cold 26.3%. Almost 39% believed that headache could be a chronic neurologic disorder. Majority had knowledge of the causes, triggers, and the relieving factors. Fifty-five percent seek help of a doctor for first time, and the rest seek help of a pharmacist or self-medication. Only 19% tried to manage the headache triggers; 66.8% felt that lifestyle modification is the best treatment for headache comparing drugs. Conclusion Migraine headache was the commonest headache occurring at middle age group with sunlight being the most common trigger factor. Lifestyle modification was perceived to be the best for headache management.</p>","PeriodicalId":35493,"journal":{"name":"Kathmandu University Medical Journal","volume":"21 82","pages":"190-196"},"PeriodicalIF":0.0,"publicationDate":"2023-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140872612","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":"The Comparative Accuracy of BISAP and PANC3 Scoring System for the Disease Severity and Outcome in Acute Pancreatitis in Tertiary Care Hospital from North India.","authors":"S Gupta, H S Dhillon, N Gupta","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>Background Acute pancreatitis has local and systemic manifestations, so it's important to assess the severity by various scoring system. Among them bed side index for severity of acute pancreatitis and pancreatitis three score have been considered to be more predictive and easier. Objective To determine the comparative prognostic value of bed side index for severity of acute pancreatitis and pancreatitis 3 score and its correlation with the outcome. Method A prospective observational study was conducted on 50 cases of acute pancreatitis. The patients were assessed clinically, radiologically and biochemically and were categorised into mild, moderate and severe category as per Atlanta Classification. Bed side index for severity of acute pancreatitis and pancreatitis 3 score was calculated at the time of admission and followed till the time of discharge or they had mortality. Result Receiver operating characteristic curve, showed bed side Index for severity of acute pancreatitis score had sensitivity (66.67%), specificity (84.09%), diagnostic accuracy (84%) while pancreatitis 3 score had sensitivity (50%), specificity (81.82%), diagnostic accuracy (80%) for the severity of acute pancreatitis. Bed side index for severity of acute pancreatitis had sensitivity (100%), specificity (66.67%) and Pancreatitis 3 score had sensitivity (66.67%), specificity (80.85%) for predicting the mortality in acute pancreatitis. Conclusion Bed side index for severity of acute pancreatitis and pancreatitis 3 score are both simple, bedside tool for assessing the severity and mortality but bed side index for severity of acute pancreatitis score had better sensitivity, specificity for assessing the severity and mortality as compared to pancreatitis three score.</p>","PeriodicalId":35493,"journal":{"name":"Kathmandu University Medical Journal","volume":"21 82","pages":"138-143"},"PeriodicalIF":0.0,"publicationDate":"2023-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140853772","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":"Retroperitoneal Cyst of Mullerian Type.","authors":"D Basnet, R Makaju, N Gautam, B Shretsha","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>Retroperitoneal mullerian cysts are rare, benign neoplastic cyst of urogenital subtype. They are usually asymptomatic and may present with symptoms if they grow considerably in size with pressure over the adjacent organ or follow infection, hemorrhage or rupture. Histologically, these cyst are lined with benign ciliated columnar epithelium. We present the case of a 30-year-old female with history of abdominal distension and epigastric pain. The mass excised was in retroperitoneal space and microscopic examination revealed benign cyst of mullerian origin.</p>","PeriodicalId":35493,"journal":{"name":"Kathmandu University Medical Journal","volume":"21 82","pages":"238-240"},"PeriodicalIF":0.0,"publicationDate":"2023-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140872351","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":"Clinical Profile and Outcome of Children Admitted with Multisystem Inflammatory Syndrome (MIS-C) in a Tertiary Hospital.","authors":"S K Singh, V K Sah, A Pyakurel","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>Background Most children infected with SARS-CoV-2 infection, are asymptomatic or develops mild to moderate symptoms. Few weeks later, few children develops delayed hyper inflammatory syndrome known as Multisystem inflammatory syndrome in children (MIS-C). Objective To describe various demographic features of children with Multisystem inflammatory syndrome in children. To analyze common clinical presentation, clinical and laboratory markers of severity and outcome of children with Multisystem inflammatory syndrome. Method This study was prospective observational study conducted on children with Multisystem inflammatory syndrome in children. This was conducted in Department of Pediatrics of Nobel Medical College during 12 months period from July 2021 to June 2022. Basic demographic features, common clinical presentation in children with Multisystem inflammatory syndrome in children and its severity and outcome were analyzed. Independent sample t-test and chi square test was used for comparison of means and categorical variables. Logistic regression was done to assess the relationship between clinical variables and outcome. Result A total of 36 children were included in our study. Maximum number of cases were male (61.11%) and age group > 10 years (58.33%). Fever, gastrointestinal symptoms, shock and renal dysfunction were common clinical features. Children requiring mechanical ventilation had higher C-reactive protein (CRP), lower platelets, higher d-Dimer and lower ejection fraction. Vasoactive Inotropic score (VIS > 10) was associated with higher chances of mechanical ventilation and prolonged pediatric intensive care unit (PICU) stay. Mortality rate in our study was 5.55% and three children developed coronary aneurysm.</p>","PeriodicalId":35493,"journal":{"name":"Kathmandu University Medical Journal","volume":"21 82","pages":"175-179"},"PeriodicalIF":0.0,"publicationDate":"2023-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140860781","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":"Effect of Weekly Text Messaging Reminders on Medication Adherence in Hypertension and Type 2 Diabetes Mellitus at a Tertiary Care Center in Eastern Nepal.","authors":"D P Sarraf, G P Rauniar, P P Gupta, R Maskey, V Kattel","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>Background The short-message service (SMS) reminder techniques are found to be important in increasing medication adherence in non-communicable diseases. Objective To assess the effect of SMS on medication adherence in hypertension and/or type 2 diabetes mellitus. Method An observational study was conducted in the outpatient department using a semistructured questionnaire. Patients having hypertension and/or type 2 diabetes mellitus and taking at least one medication and having low to medium adherence were enrolled and short-message service was sent to them twice a week for up to two months reminding them to take medications as prescribed. At the end of two months, medication adherence was assessed using SPSS at P-value less than 0.05. Result Out of 105 patients, 64 (60.95%) were females. The mean age (±SD) was 51.15 ± 11.01 years. After two months of the short-message service reminders, majority of the patients were graded as having high adherence (73.33%) followed by medium adherence (20.0%) and low adherence (6.67%). The mean medication adherence scores on day one and after two months were 5.50 ± 1.14 and 7.50 ± 0.93 respectively (P-value=0.000). A high medication adherence was seen in individuals aged above 45 years (75.7%), males (78.0%) and those using a basic mobile phone (76.7%) after two months of follow-up; however it was statistically not significant (P-value > 0.05). Conclusion The SMS reminders had significantly improved the medication adherence in patients with hypertension and/or type 2 diabetes mellitus. However, none of the baseline variables were significantly associated with improvement in the adherence.</p>","PeriodicalId":35493,"journal":{"name":"Kathmandu University Medical Journal","volume":"21 82","pages":"185-189"},"PeriodicalIF":0.0,"publicationDate":"2023-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140855510","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":"Discrepancies between Glycated Hemoglobin and Fasting Plasma Glucose in New-onset Diabetes Mellitus.","authors":"R Tamrakar, D Tamrakar, P Katwal","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>Background Fasting plasma glucose (FPG) and glycated hemoglobin (HbA1c) are commonly used for diagnosing diabetes mellitus in Nepal. Though HbA1c criteria are convenient for diagnosis there is a discrepancy between the fasting plasma glucose and HbA1c for diagnosis. Objective To assess the comparability between fasting plasma glucose and glycated hemoglobin levels in the new-onset diabetes mellitus. Method This is a hospital-based descriptive cross-sectional study including 128 newly diagnosed diabetes mellitus conducted at Dhulikhel Hospital, Kathmandu University Hospital. New onset diabetes patients above 18 years of age who met inclusion criteria were included. The clinical characteristics and biochemical parameters were analyzed. Statistical analysis was done using student's t-test and correlation coefficient. Result There were 128 newly diagnosed diabetes mellitus patients included in the study among which 57.0% were males with a mean age of 49.48±11.40 years. The mean fasting plasma glucose, postprandial sugar (PPBS), and glycated hemoglobin were 205.54±88.93 mg/dL, 331.08±146.61 mg/dL, and 9.59±2.70% respectively. Diabetes was diagnosed using fasting plasma glucose, and glycated hemoglobin criteria in 84.4% and 90.6% of patients. In new-onset diabetic patients, 76.56% of patients had both elevated levels of fasting plasma glucose and glycated hemoglobin. Of the diabetic patients who had fasting plasma glucose ≥126 mg/dL, 90.7% of patients had HbA1c ≥ 6.5% whereas 1.6% of new-onset diabetes had < 126 mg/dL and glycated hemoglobin < 6.5%. There was a strong correlation between fasting plasma glucose and glycated hemoglobin (r=0.723; p<0.01). Conclusion Both fasting plasma glucose and glycated hemoglobin tests have to be used together for diagnosing diabetes mellitus.</p>","PeriodicalId":35493,"journal":{"name":"Kathmandu University Medical Journal","volume":"21 82","pages":"144-148"},"PeriodicalIF":0.0,"publicationDate":"2023-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140866036","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":"Intraurethral Instillation of Ketamine and Lidocaine versus Lidocaine for Male Rigid Cystoscopy: A Prospective Randomized Controlled Trial.","authors":"U Pradhan, P R Chalise, B R Luitel, S Kriti, S Devkota","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>Background Male rigid cystoscopy is one of the most common outpatient procedures in urology because of it lower cost, better optical area and better orientation compared with flexible devices. However, performing rigid cystoscopy is not only painful but equally apprehensive in awake male patients. Objective The study was conducted to evaluate the efficacy of lidocaine gel and ketamine solution together compared with lidocaine gel alone during male rigid cystoscopy. Method A total of 76 male patients who visited the hospital for rigid cystoscopy were randomized into two groups before undergoing cystoscopy. The experimental group received 15 ml lidocaine with 2 ml (100 mg) Ketamine solution while the control group received 15 ml lidocaine gel with 2 ml Normal saline. Patient's heart rate and mean arterial pressure were recorded in five minutes interval till twenty minutes after completion of the procedure. The level of pain perception of all the patients was measured with Visual analogue scale (VAS) score, at the beginning, during and after cystoscopy. Independent sample t-test was used to compare outcome measures and p value of < 0.05 was considered statistically significant. Result Out of the total 70 patients analyzed at the end of study with 35 patients in each group, the VAS score in each stage were lower in lidocaine plus ketamine group compared to lidocaine gel alone. The difference was significant at the commencement and middle of the procedure (p < 0.05). Conclusion Intraurethral instillation of ketamine and lidocaine is more effective in reducing mean pain score during cystoscopy as compared to lidocaine alone.</p>","PeriodicalId":35493,"journal":{"name":"Kathmandu University Medical Journal","volume":"21 84","pages":"367-371"},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142112918","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, Perception and Confidence in Performance on Infection Prevention and Control Measures among the Nursing Students.","authors":"S Shrestha, Y Cho, C Bhuju, K Cha, M Chung, K D Pun","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>Background Healthcare-associated infections increase the patients' hospital stay, morbidity and mortality. It is important that professionals including students acquire knowledge on infection and acquire skills regarding preventive measures. Objective The objectives of this study were to assess the knowledge, perception and confidence on infection prevention and control measures and to find the correlation between variables among nursing students. Method A cross-sectional descriptive study was conducted among 163 nursing students where a purposive sampling method was used to collect data using the selfstructured questionnaire via emails. The questionnaire contained four parts; part I: demographic characteristics, part II: knowledge (40 items), part III: perception (42 items) and part IV: confidence in performance (42 items) on infection prevention and control. Data was analyzed using descriptive and inferential statistics where analysis of variance using Scheffe's post hoc test and Pearson's correlation test were used. Result Overall knowledge of the participants was fair (71%). They had good knowledge in general principles (85%) but notable poor knowledge in waste management (2%). There was a statistically significant difference in the knowledge among different levels of the students. A static correlation was found between the knowledge and confidence in performance whereas, perception was highly correlated with the confidence in performance of the participants. Conclusion Based on the findings of this study, it can be concluded that the students had fair level of knowledge regarding infection control measures. This study recommends the revision of nursing curriculum and mandating a standardized infection control curriculum across all schools of nursing in the country to improve the knowledge and practice.</p>","PeriodicalId":35493,"journal":{"name":"Kathmandu University Medical Journal","volume":"21 84","pages":"383-388"},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142112920","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":"Morphometric Study on Wormian Bone of Dry Adult Skull of Nepalese Population.","authors":"A Shrestha, G A Khan","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>Background Accessory (supernumerary bone) is small irregular worm like bone. These bones are also known as wormian bone. Accessory bone develops when additional ossification centers appear and form extra bones. Many bones develop from several ossification centers of ossification and these separate parts normally fuse. Sometimes one of these centers fails to fuse with main bone. Circumscribed areas of bone are seen along the sutures of the cranium where flat bones about, particularly related to parietal bone. Objective To investigate presence and to determine morphologic and morphometric characteristics of wormian (sutural) bones. Method The study was conducted on 25 dry human skulls with unknown gender, ethnicity and race in Department of Anatomy, School of Basic Sciences, Kailashnagar, Bharatpur-5, Chitwan Nepal. The study was conducted on 25 dry human skulls with unknown gender, ethnicity and race in Department of Anatomy, School of Basic Sciences, Kailashnagar, Bharatpur-5, Chitwan Nepal. The deformed skull and skull of pediatrics age group are excluded. The location, shape, number and side of Wormian bone are determined. The SPSS 20 program and descriptive statistical method analysis were used for data analysis. Result Total 25 adult dry skulls were observed in the study. Both sides of skull were observed. Out of 25 skulls Wormian bones are not found in left sided three lambdoidal suture (four percent). Conclusion The knowledge of Wormian bones plays a major role for the neurosurgeons, neuroanatomists, radiologists, forensic experts and anthropologist. Presence of few bones are normal. But multiple Wormian bones need attention as it may have underlying skeletal or central nervous system pathology. In radiographs they mimic fracture lines. Wormian bone at pterion may produce complications in neurosurgical procedures like burr holes.</p>","PeriodicalId":35493,"journal":{"name":"Kathmandu University Medical Journal","volume":"21 84","pages":"372-375"},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142112922","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}