Kathmandu University Medical Journal最新文献

{"title":"Acute Kidney Injury in Neonates with Perinatal Asphyxia in a Tertiary Care Hospital of Nepal: a cross-sectional study.","authors":"S Gautam, P Gautam, A Chaudhary, A Dahal, A Manandhar, P Giri, A Dulal, S Pokhrel","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>Background Renal involvement is the most common form of systemic complication in neonates with perinatal asphyxia. Acute Kidney Injury (AKI) can be oliguric or non oliguric. There is no consensus on the definition of acute kidney injury in neonates, which makes early diagnosis and management difficult. Acute kidney injury leads to significant morbidity and mortality in neonates. Objective Current study aims to explore the prevalence of Acute Kidney Injury in Neonates with perinatal asphyxia and its relation to the severity of Hypoxic Ischemic Encephalopathy (HIE). Method A single-center, retrospective, cross-sectional study was carried out to analyze the cases of perinatal asphyxia in the Neonatal Intensive Care Unit (NICU) and Neonatal Ward (NNW) for a period of three years (September 2020 to August 2023) in a tertiary care center. The study analyzed 195 neonates with perinatal asphyxia and Hypoxic Ischemic Encephalopathy (HIE). Data analysis was done using Statistical Package for Social Sciences (SPSS) version 25. Descriptive statistics(mean ± SD for continuous variables; percentages for categorical variables) and chi-square test (to compare categorical associations) were applied. The prevalence of acute kidney injury and its relation to grades of HIE were determined using a chi-square test. Result The prevalence of acute kidney injury among cases of perinatal asphyxia was 17.4%. The prevalence of acute kidney injury increased with an increase in the grading of hypoxic ischemic encephalopathy. Acute kidney injury was predominant among males with a male-to-female ratio being 3.2:1. Oliguric acute kidney injury was more common than non-oliguric acute kidney injury. 8.8% of cases had mortality, with the majority of cases being hypoxic ischemic encephalopathy grade II. The Chisquare test found a statistically significant association between hypoxic ischemic encephalopathy grades and acute kidney injury (p value=0.0113, i.e., p < 0.05) Conclusion Acute kidney injury remains one of the common complications of Perinatal Asphyxia (PA). There was a significant association between acute kidney injury cases and grades of Hypoxic Ischemic Encephalopathy (HIE), with HIE II being the most common type. Screening for acute kidney injury in case of hypoxic ischemic encephalopathy should be prioritized.</p>","PeriodicalId":35493,"journal":{"name":"Kathmandu University Medical Journal","volume":"22 88","pages":"63-66"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144217110","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Prevalence Survey of Antimicrobial Use among Admitted Patients in Tertiary Care hospital: An observational study.","authors":"S Aryal, M Joshi, B N Uprety, R K Shrestha, M Gupta, P Shah, P Rajbhandari, R Amatya, P Shrestha, A R Ojha","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>Background Monitoring the antimicrobial use is one of the key strategies to address the growing global threat of antimicrobial resistance. Objective To find out antimicrobial usage at tertiary care hospital of Lalitpur, Nepal. Result An observational cross-sectional study was carried out at the Patan Academy of Health Sciences, Lalitpur, Nepal on September 25 and 26, 2023. World Health Organization point prevalence survey methodology was used with minor modification to meet hospital's context. The data on antimicrobial usage were collected from the medical records of patients admitted at or before 08:00 am on the day of the study in the acute care ward. Result The study involved 324 inpatients, with females comprising 176 (54.3%) and males 148(45.7%). The mean age was 37.89 years ± 24.87. Antibiotics usage was 78.1%. A total of 471 drug was prescribed of which 312 (66.2%) was used for therapeutic purpose and 159 (33.8%) for prophylaxis. Of 312 antibiotics, 283 (90.7%) were utilized empirically. Majority of prescribed medications belonged to watch group 16 (48.5%). Ceftriaxone was the most frequently prescribed antibiotic 142 (30.1%) and was the preferred choice for surgical prophylaxis 68 (94.4%). A total of 24 (72.7%) drugs were prescribed from the National List of Essential Medicines and 432 (91.7%) prescriptions were written using generic names. Conclusion The use of antibiotic was high, with good adherence to essential medicines and generic prescribing. Strengthening antimicrobial stewardship and evidence-based practices can further optimize prescribing, enhance patient safety and help combat antimicrobial resistance effectively.</p>","PeriodicalId":35493,"journal":{"name":"Kathmandu University Medical Journal","volume":"22 88","pages":"3-8"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144217137","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":"Radiological Assessment of Femoroacetabular Impingement Morphology Using Computed Tomography in Asymptomatic Young Population.","authors":"S Koirala, M K Gupta, P Baral, K Adhikari","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>Background Femoroacetabular impingement is regarded as precursor of osteoarthritis. Various studies have discussed the prevalence of femoroacetabular morphology but only few studies have been done on asymptomatic population using cross-sectional imaging. Objective To determine the prevalence of femoroacetabular impingement morphology in young asymptomatic population on computed tomography. Method This cross-sectional study was done in 200 individuals who underwent computed tomography for abdominal pathologies without any symptoms of hip pain, hip pathology or osteoarthritis. Multiplanar images were reformatted and assessed for the presence of parameters associated with femoroacetabular impingement; alpha angle greater than 55°, femoral head-neck offset less than 8 mm, angle of acetabular version less than 15°, lateral center edge angle greater than 40°. Result At least one of the femoroacetabular impingement morphology was detected in 162 hips. The prevalence of abnormal hip joint was higher in male patients than in female patients (47.3% vs 31.8%). Prevalence of cam morphology was 14.5%, pincher was 17.5% and mixed morphology was 8.5%. Prevalence of cam and mixed morphology were common in male hips however there was no statistically significant difference in prevalence of pincher morphology between male and female hips. Conclusion Femoroacetabular morphology was noted with high frequency in asymptomatic young population on computed tomography. Diagnosis of femoroacetabular impingement syndrome should be based on combination of clinical and radiological findings.</p>","PeriodicalId":35493,"journal":{"name":"Kathmandu University Medical Journal","volume":"22 88","pages":"15-19"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144217138","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 Occurrence of an Optical Phenomenon: \"The Butterfly Effect\" in Cross Section of Extracted Mandibular First Premolars.","authors":"N Acharya, R Srii, R Hasan, D Kafle, S Dahal, T Saito","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>Background The butterfly effect is an optical phenomenon with endodontic and a restorative significance that can be seen in cross-sections of some of the tooth roots. Objective To investigate occurrence of butterfly effect in roots of extracted human mandibular first premolars and to determine differences in tubule density in mesio-distal and bucco-lingual direction of sections of root having buttery effect. Method It was an prospective experimental study comprised of twenty single rooted extracted mandibular first premolars. Each tooth was divided into three sections: coronal, middle and apical third. Then, nine sections of each sample were taken, three from each section i.e., coronal, middle and apical third, hence making sample size of total 180. All the selected samples were ground into 1 mm thickness and examined under 20X magnification microscope. Five samples presenting with the butterfly effect were selected and prepared for Scanning Electron Microscope to evaluate the difference in density of dentinal tubules among mesio-distal and buccolingual direction. Mann Whitney U test was applied to find out the significance of butterfly effect among different sections. The data was entered in Microsoft excel sheet and transferred to Statistical Package for Social Sciences (SPSS) version 20 for statistical analysis. Ethical approval was obtained from Kathmandu University School of Medical Sciences institutional review committee (IRC No.:127/16). Result Butterfly effect was seen in 19.4% of sample. Apical sections had more occurrence rate (30%) followed by middle (23.3%), and coronal sections (5%). Female predilection (30%) for occurrence was seen. Under SEM, the samples with butterfly effect presented with higher median density (2349.32 number/mm2 ) of dentinal tubules in bucco-lingual section as compared to mesio-distal section (1208.23 number/mm2 ). Conclusion Butterfly effect was present in 19% of the samples. Butterfly effect is more seen on aplical section of tooth. Female have more chance of having butterfly effect than male.</p>","PeriodicalId":35493,"journal":{"name":"Kathmandu University Medical Journal","volume":"22 88","pages":"40-43"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144217142","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":"Community-based Screening of Cervical Cancer in an Urban Setting in Nepal: A Cross-sectional Study.","authors":"A Shrestha, L Poudel, B Khanal, K Poudel, S Shakya, P Timsina, P Shakya, S Shrestha, B Paneru","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>Background In Nepal, cervical cancer is among the most prevalent cancers among females, yet only about 8% of women have undergone screening, highlighting significant barriers to access in low-resource settings. Objective To assess and report the outcomes of a community-based cervical cancer screening with visual inspection of acetic acid and an active follow-up program in Budhanilkantha municipality, Kathmandu Valley. Method We conducted a cross-sectional study in Budhanilkantha Municipality among 1360 women aged 30 to 60 who attended community-based cervical cancer screening camps. Trained research assistants collected socio-demographic and reproductive health data through interviews, abstracted medical records about Visual Inspection with Acetic Acid outcomes, and made follow-up calls to those who screened positive. We conducted descriptive analysis and logistic regression to assess associations between screen positivity and women's characteristics. Result A total of 1,360 women visited the camp, with 98.3% undergoing visual inspection with acetic acid, and 7.25% screening positive. Among those referred, 78% followed up at the recommended hospital; diagnostic tests indicated that 12.3% had lowgrade lesions and 1.36% had high-grade pre-cancerous lesions. The adjusted model revealed no statistically significant associations between Visual Inspection with Acetic Acid positivity and variables such as age, ethnicity, education, and reproductive history. Conclusion This study demonstrates that the community-based Visual Inspection with Acetic Acid (VIA) cervical cancer screening method was highly acceptance and had high treatment follow-up among women in urban Nepal.</p>","PeriodicalId":35493,"journal":{"name":"Kathmandu University Medical Journal","volume":"22 88","pages":"413-418"},"PeriodicalIF":0.0,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144209709","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":"Diagnosis of Pancreatic Adenocarcinoma in a Case of 25-year-old Female from Nepal.","authors":"K Bhattarai, A Bhandari, A Acharya, S Uprety","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>Pancreatic adenocarcinoma is one of the lethal form of malignant change involving the pancreas. The median age of diagnosis is 71 years and is uncommon below 40 years. Here we intend to report an uncommon case of a 25-year-old woman who presented to our institution with complaints of fever, severe abdominal pain. The laboratory workup showed bicytopenia with USG abdomen revealing a bulky pancreas. The Contrast Enhanced Computed Tomography and Magnetic Resonance Cholangiopancreatography suggested malignancy followed by Fine Needle Aspiration Cytology (FNAC) which confirmed the diagnosis of adenocarcinoma. Pancreatic adenocarcinoma is the 14th most common cancer and 7th most common cause of cancer death. Computed tomography is most useful modality of investigation used to diagnose and stage the cancer. This is supported by FNAC and CA19-9 tumor marker. The management includes surgical resection and chemotherapy. Although pancreatic adenocarcinoma is uncommon among the young population, it requires early management protocols.</p>","PeriodicalId":35493,"journal":{"name":"Kathmandu University Medical Journal","volume":"22 88","pages":"491-494"},"PeriodicalIF":0.0,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144209711","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Prevalence and Severity of Gingival Enlargement among Antihypertensive Drug Users: A cross-sectional study.","authors":"S Kafle, E Shrestha, B M Dhital","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>Background Drug-induced gingival enlargement is a well-known consequence of the administration of some antihypertensive drugs, including angiotensin-converting enzyme inhibitors, beta-blockers, and calcium channel blockers. Objective To determine the prevalence and severity of antihypertensive drug-induced gingival enlargement and to assess the probable risk factors associated with gingival enlargement. Method A hospital-based cross-sectional study was conducted in patients attending the Outpatient Department of Periodontology and Oral Implantology, Chitwan Medical College and Teaching Hospital, Bharatpur, Chitwan, Nepal, from July 2023 to May 2024. A total of 246 patients of both genders taking antihypertensive medications for a variable period and meeting all inclusion criteria were selected for the presence of gingival enlargement and classified by severity. Descriptive analysis was performed in the Statistical Package for the Social Sciences (SPSS, v.23.0.) using the chi-square test. Result A total of 210 (85.36%) subjects taking antihypertensive drugs appeared to have gingival enlargement. Among them, 86 (40.95%), 69 (32.86%) and 55 (26.19%) were taking calcium channel blockers, β-blockers and angiotensin-converting enzyme inhibitors, respectively. Regarding its severity, a marked severity was observed in patients taking calcium channel blockers followed by angiotensin converting enzyme inhibitors and beta-blockers accounting for 51 (56.0%), 19 (29.7%) and 13 (14.3%), respectively. Conclusion Patients taking antihypertensive medications are at high risk for gingival enlargement, and inflammation is considered an important cofactor for the expression of this effect.</p>","PeriodicalId":35493,"journal":{"name":"Kathmandu University Medical Journal","volume":"22 88","pages":"379-384"},"PeriodicalIF":0.0,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144209723","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":"Addressing Pediatric Hearing Impairment in Nepal: A Critical Public Health Concern.","authors":"B L Shrestha","doi":"","DOIUrl":"","url":null,"abstract":"","PeriodicalId":35493,"journal":{"name":"Kathmandu University Medical Journal","volume":"22 88","pages":"359-360"},"PeriodicalIF":0.0,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144209705","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":"Use of Artificial Intelligence in Medical Research: A SWOT Analysis.","authors":"J P Jha, K Amgain, L R Joshi","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>As artificial intelligence (AI) tools are shaping our work, this article discusses a nuanced SWOT analysis, focusing on the applications of artificial intelligence in the area of medical research. It aims to evaluate the applications of artificial intelligence tools in medical research, discussing their implications for researchers, journals and the scientific community, addressing the growing concerns of using artificial intelligence tools in research and publication, evaluating its potential risks while harnessing the transformative potential. The analysis is complemented by a qualitative review of online resources, articles, blogs, interviews and podcasts, elucidating the prevailing themes in artificial intelligence-related considerations. The strengths highlight artificial intelligence's capacity to accelerate research processes, particularly in diagnostics, drug production and data analysis. On the other hand, the weaknesses underscore concerns related to interpretability, biases, and ethical considerations, urging caution in artificial intelligence reliance. Opportunities arise in the form of explainable artificial intelligence, inclusive data practices, and enhanced model validation, while threats include issues of bias, privacy, overreliance and human exploitation. Such issues can be mitigated by collaboration from multiple experts and policymakers. The current state of artificial intelligence raises concerns about data quality, bias, transparency and ethical issues in its development and deployment. There is a need for collaborative efforts to establish ethical frameworks, regulations, and sustainability practices. A balanced approach, positioning AI as a collaborator that enhances human insights and creativity is recommended.</p>","PeriodicalId":35493,"journal":{"name":"Kathmandu University Medical Journal","volume":"22 88","pages":"464-470"},"PeriodicalIF":0.0,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144209728","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":"Assessment of Clinical Outcomes and Patient Response to Gingival Depigmentation Using Gingival Trimming Ceramic Bur and Conventional Scalpel Technique.","authors":"S Thapa, M Humagain, S Lamichhane, G Subedi, A H Rijal","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>In this era, role of esthetic in dentistry has been an evolving concern. One of the major concern is the hyperpigmented gingiva in patients with high smile line or excessive gingival display. This varies in different individuals and is assumed to be dependent on cutaneous pigmentation. Therefore, there are various methods of depigmentation. Hereby, is a case report of depigmentation done on upper anterior gingival region and comparing the output and patient response where half of the segment was done by using scalpel and the other half by ceramic bur with a follow up of three months. And this report concludes that ceramic bur has more advantages over scalpel technique.</p>","PeriodicalId":35493,"journal":{"name":"Kathmandu University Medical Journal","volume":"22 88","pages":"488-490"},"PeriodicalIF":0.0,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144209706","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}