Kathmandu University Medical Journal最新文献

{"title":"Musculoskeletal Ultrasonography of Baker's Cyst in Primary Osteoarthritis of Knee: An Observational study.","authors":"S Shakya, S P Amatya, J Singh, B Shrestha, B P Sharma, R Gelal","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>Background Knee pain and limitation of joint movement are common compliant in pain clinic due to knee osteoarthritis and often associated with Baker's cyst. These are usually asymptomatic during the initial phase and might be missed during clinical examination and later may present in complicated form. Musculoskeletal ultrasonography might be helpful in detecting asymptomatic Baker's cyst during the early course of the disease. Objective To observe the incidence of Baker's cyst in patient with primary osteoarthritis of knee with the help of routine musculoskeletal ultrasonography of knee during clinical evaluation of patient. Method A total of 114 patients with unilateral or bilateral knee pain diagnosed as primary osteoarthritis of knee were included in this study. Musculoskeletal ultrasonography was performed on all patients to look for the presence of Baker's cyst. The incidence of Baker's cyst was the primary outcome of this study. Depending upon the presence/ absence of Baker's cyst, two groups were formed, and variables were compared between these groups to find the factors associated with Baker's cyst. Statistical analysis was done using student t-test, ANOVA test and Chi-square test. Result The incidence of Baker's cyst in this study was 21.1% of the patients and 89.28% were asymptomatic. Baker's cysts were strongly associated with joint effusion and synovial hypertrophy. Conclusion Baker's cyst was a common finding in the patient with knee osteoarthritis. Musculoskeletal ultrasound would be a valuable tool to detect such asymptomatic cysts early.</p>","PeriodicalId":35493,"journal":{"name":"Kathmandu University Medical Journal","volume":"22 88","pages":"398-403"},"PeriodicalIF":0.0,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144209718","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":"Menstrual Hygiene Management among Nepalese Adolescent Schoolgirls: Results from a cross-sectional study.","authors":"A Shrestha, S Shrestha, S Koirala, P Subedi, D Tiwari, B M Karmacharya","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>Background Adolescent schoolgirls in Nepal lack adequate support to manage menstruation. Little studies have been conducted to date to learn how menstruation affects daily lives of adolescents and how they were managing it. Menstruation also comes costly in rural Nepal and the majority of them do not have capacity to afford menstrual products due to high price. Objective The main objective of this study is to assess about menstrual challenges among adolescent girls of rural Nepal. Method We deployed descriptive, cross-sectional study to analyze adolescent girls' experience of menstruation from purposively selected schools in Kavre and Sindhupalanchowk districts of rural Nepal. The data was collected from May to July 2024 among adolescent girls using semi-structured questionnaire of grade 8 and 9. The adolescents were questioned regarding their own experiences with menstruation. The interview included household related information, water, sanitation and hygiene practices, self-menstruation practices and management, challenges they had been facing, and sociocultural taboos about menstruation. Result All schools included in this study were government schools. 38% of an adolescents reported of starting their menstruation at an age of 12 years. 39% of the respondents reported of having an ability to challenge the existing social taboos relating to menstruation. Above 60% uses sanitary pads as a menstrual product and for the disposal of these products, 50% respondents reported of throwing them in the dustbin followed by burying (21%) and burning (16%). And 10% of the respondents reported of throwing the used menstrual products into Indrawati river. Majority of respondents reported of not being able to visit temples and performing any religious visits during menstruation and the main reasons behind was family prohibition and fear of divine retribution. Conclusion Access to management materials of menstruation is problematic in the surveyed schools especially in the rural areas where almost half of the girls do not have access to sanitary pads and they resort to the use of cloth. Lack of affordability for purchasing sanitary napkins were the most crucial predictors of menstrual hygiene management. The Government of Nepal should take an initiative to provide schoolgirls with sanitary pads in order to improve menstrual hygiene management in all across schools within Nepal, particularly in rural areas.</p>","PeriodicalId":35493,"journal":{"name":"Kathmandu University Medical Journal","volume":"22 88","pages":"433-440"},"PeriodicalIF":0.0,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144209717","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":"Intrinsic Capacity of Older People in Panchkhal Municipality of Nepal: A cross-sectional study.","authors":"L Shrestha, R Neupane, L Paudel, N Manandhar","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>Background With the global trend of rising ageing population, health care to the elderly needs special focus as absence of disease merely does not mean that older people are healthy and have full functional ability. So, WHO introduced intrinsic capacity to define healthy ageing. Objective To find the prevalence of decline in intrinsic capacity in older people of Panchkhal Municipality. Method A community based cross-sectional observational study was conducted in 5 simple randomly selected wards of Panchkhal Municipality of Nepal. Total sample sizes of 848 data were collected using proportionate convenience sampling. Data collection techniques were interview with observation using predesigned proforma containing WHO (Integrated Care for Older People-ICOPE) tool. Result The prevalence of decline in intrinsic capacity of older people in Panchkhal Municipality was 86.9%. The decline in individual domains was visual acuity 58.0 % followed by cognition 48.9%, locomotion 48.8%, hearing ability 38.6%, vitality 38.0% and psychology 28.5%. The mean age was 71.18 ±8.769 years (60-100). The majority of older people were male 55.8%, Hindu 91.7%, had joint family 77.7% and illiterate 60.3%. There was significant moderate positive correlation of age with decline in locomotion (r=0.469, p=0.029), hearing ability (r=0.312, p=0.032), cognitive ability(r=0.209, p=0.034) and low negative correlation of age with vitality (r=-0.161, p=0.035), psychology (r=-0.130, p=0.034),visual acuity (r=-0.126, p=0.034). Conclusion There was a high prevalence of decline in intrinsic capacity of the older people from Panchkhal Municipality. Special and focused care is required for older people from the government along with implementation of WHO-Integrated Care for Older People-ICOPEtool in every healthcare setting to promote healthy ageing.</p>","PeriodicalId":35493,"journal":{"name":"Kathmandu University Medical Journal","volume":"22 88","pages":"447-452"},"PeriodicalIF":0.0,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144209715","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":"Pain-related Beliefs, Coping Strategies and Pain Catastrophization in Older People with Chronic Musculoskeletal Pain.","authors":"I Bimali, K Awal, R S Acharya","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>Background Chronic musculoskeletal pain is a major health concern among older people. The experience of chronic musculoskeletal pain is influenced by psychosocial factors such as beliefs, coping strategies, and pain catastrophizing. It is believed that culture can influence pain related factors and psychosocial factors vary across different cultures. Objective To identify the common pain-related beliefs, coping strategies and pain catastrophizing in older people with chronic musculoskeletal pain. Method A descriptive cross-sectional study was conducted in Dhulikhel among 150 older people. Semi-structured questionnaire gathered information on pain beliefs and coping strategies, while, pain catastrophizing scale was used to identify catastrophization. A convenient sampling was used and data were analyzed using SPSS, version 26. Result The median age of the participants was 69 years (IQR 10). The median pain score on facial pain rating scale was 6 (IQR 2). Participants believed that musculoskeletal pain was associated with aging (81%), past workload (64%) and karma (49%). They predominantly believed in doctors (78%) and physiotherapists (43%) for treatment. Nearly half also believed in spiritual healers. Commonly utilized coping strategies were self-statements like \"I can handle anything\" (89%) and it is not so bad, it's normal\" (81%), massage (88%), God (87%) and exercise (84%). The level of pain catastrophization was not statistically significant among the participants. Conclusion The findings of the study highlighted the significance of beliefs and coping strategies in influencing pain experiences, suggesting a strong need of implementation of biopsychosocial approach in assessment and management of pain among older people.</p>","PeriodicalId":35493,"journal":{"name":"Kathmandu University Medical Journal","volume":"22 88","pages":"453-458"},"PeriodicalIF":0.0,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144209720","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":"Socio Demographic Profiling of Victims of Sexual Offense in Kavrepalanchowk District: a cross-sectional study at a tertiary care center, Nepal.","authors":"A S Khan, S Pokharel, S Paudel, P Poudel, A Karki","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>Background Sexual offence is an umbrella term referring to a classification of sexual acts and experiences that are imposed, pressured, coerced onto a person. The latest information from women children and senior citizen survey center of Nepal stated that about 2321 rape cases were recorded in the year 2020 to 2021. Objective This study is aimed at socio-demographic profiling of victims of sexual assault, identify the most vulnerable age group and the area with highest incidence for future sexual assault prevention. Method The descriptive cross-sectional study at Dhulikhel Hospital (December 2018 to June 2023) analyzed 136 sexual offense cases via convenience sampling. Data were collected from medical records, following ethical approval. Incomplete or unrelated cases were excluded, and hospital/national protocols were adhered to. Data analysis was conducted using Microsoft Excel with descriptive statistics. Result Out of 136 victims, most were aged between birth and 20 years (71.32%), while only 1.47% were aged 60-80 years. The youngest victim was 15 months old, and the oldest was 65 years. Females comprised 98.52% and males 1.48% where all the males were victims of sodomy. The type of offence most prevalent was rape (70.58%) followed by indecent assault (19.11%), with some cases of incest (7.35%). The municipality with the most number of cases was Panauti (16.16%), followed by Panchkhal (13.23%) and Bhumlu with 10.29%. The majority of the cases took place in the year 2077 BS rounding up to 39 cases in Kavrepalanchowk district. However, noting the numbers in the year 2080 BS, there seems to be a rapid rise of cases as there have already been 19 cases in four months. Conclusion The most vulnerable group for sexual offenses was the population below the age 20 and most of the cases occurred in Panauti municipality which emphasizes the need of sexual and moral education in that place and age group. The areas in Kavrepalanchowk district with increasing cases of sexual offenses should incorporate standardized protocols in implementing education as well as strict regulations of the community guidelines.</p>","PeriodicalId":35493,"journal":{"name":"Kathmandu University Medical Journal","volume":"22 88","pages":"459-463"},"PeriodicalIF":0.0,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144209726","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":"Outcome of Transurethral Vaporisation of Prostate in Small Volume Prostate: A prospective observational study.","authors":"R Dahal, B Adhikari, U Mishra, A K Shah, R B Basnet, A Shrestha, P M Shrestha","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>Background Benign Enlargement of Prostate is common in aging men. Transurethral vaporisation of prostate is one modality of minimal invasive management of benign enlargement of prostate. This study assesses the efficacy and safety of transurethral vaporisation of prostate in small volume prostate. Objective To assess the efficacy and safety of bipolar plasma vaporisation of small volume prostate (Prostate Volume less than 40 grams). Method A total of 40 patients with prostate volume less than 40 grams and indications for operative management of benign enlargement of prostate were included. Patients with prior prostate surgery, urethral stricture surgery, presence of vesical calculus, urethral stricture and neurogenic bladder were excluded. Preoperative prostate size was assessed by transrectal ultrasonography. Comparison of preoperative and postoperative hemoglobin, sodium, international prostate symptom score and maximum flow rate was done. Perioperative complications were documented. Result The mean age of patients was 66.88 ± 9.09 years and the mean size of prostate was 32.52 ± 4.66 grams. Significant improvement in IPSS (preoperative 22, postoperative 9) and Qmax (preoperative 8.4 ml/min, postoperative 18.5 ml/min) was noted. There was significant drop in hemoglobin (p < 0.001) but no patients required blood transfusion. There was significant drop in sodium (p < 0.001) but no patients developed transurethral resection syndrome. Most complications were Clavien grade I. Two patients required recatheterization and all were catheter free on follow up. Two patients developed urethral stricture. Conclusion Bipolar transurethral vaporisation of Prostate is effective and safe treatment option for prostate volume less than 40 grams.</p>","PeriodicalId":35493,"journal":{"name":"Kathmandu University Medical Journal","volume":"22 88","pages":"373-378"},"PeriodicalIF":0.0,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144209719","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 Comprehensive Review on Curriculum in Reference to Bachelor of Dental Surgery Kathmandu University.","authors":"A H Rijal, R Rajbanshi, M Humagain","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>This review article provides a detailed analysis of educational curricula, focusing on their design, content, and teaching methods. It explores how a well-structured curriculum can support effective learning by balancing theoretical knowledge with practical skills. The article discusses key elements that make a curriculum successful, such as clear objectives, up-to-date content, and interactive teaching methods. It also identifies common gaps, like the need for regular updates and better alignment with current professional standards. By reviewing various curricula and comparing them to global best practices, the article suggests ways to enhance educational quality and ensure students are well-prepared for their careers.</p>","PeriodicalId":35493,"journal":{"name":"Kathmandu University Medical Journal","volume":"22 88","pages":"478-485"},"PeriodicalIF":0.0,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144209703","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":"Audiological Outcome of Endoscopic Stapedotomy in Nepalese population.","authors":"S Subba Rai, B L Shrestha, A Pradhan","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>Background Otosclerosis is a complex disease of otic capsule that mainly affects the stapes footplate causing conductive hearing loss, sometimes mixed hearing loss. Microscope stapes surgery was used traditionally but endoscopic stapedectomy has ushered a new revelation. Objective To report the audiological outcome of solely endoscopic trans canal stapedotomy surgery for otosclerosis in Nepalese population. Method This retrospective case series study analysed pre and post operative pure tone average of air conduction (AC) and bone conduction (BC) threshold and air bone gap (ABG) at 0.5, 1, 2 and 4 kHz. Postoperative ABG ≤ 10 dBHL (decibels hearing level) and ABG ≤ 20 dBHL was used to consider surgical success and improvement respectively. Paired t-test was used to test the significance of the audiological outcome of the study group pre and post operatively. Result The study included 9 patients, 10 operated ears with male to female ratio of 1:2. Mean age was 37.60 ± 9.28 years and mean postoperative air bone gap was 19.00 (± 5.89) and gain in air bone gap 18.75 (± 8.70) which was found to be statistically significant (p < 0.000). Audiological outcome in each of the four frequencies, 500 Hz, 1000 Hz, 2000 Hz and 4000 Hz was also found to be statistically significant. Conclusion This limited series study concludes that because of its favourable audiological gain and closure of the air bone gap postoperatively and better intraoperative view, it can uplift other surgeons to choose this as preferred technique.</p>","PeriodicalId":35493,"journal":{"name":"Kathmandu University Medical Journal","volume":"22 88","pages":"393-397"},"PeriodicalIF":0.0,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144209708","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":"Gastric Neoplasm: A Clinicopathological Study in the Tertiary Care Center of Nepal.","authors":"D Basnet, R Makaju, R B Gurung, N Gautam, B Shrestha, P B Maharjan, P Kc","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>Background Gastric carcinoma is the commonest upper gastrointestinal malignancy contributing to global burden of cancer morbidity and mortality. Objective The objective is to study distribution of the gastric neoplasm according to age, sex, symptom, gross appearance, histological type and degree of differentiation. Method This was a retrospective study done from January 2022 to December 2023 in the Department of Pathology, Dhulikhel Hospital - Kathmandu University Hospital (DH - KUH). Relevant clinical data of the patients were obtained from the histopathological records of the patient from the pathology department and biopsies stained with Haematoxylin and Eosin were studied under the light microscope. Result A total of 40 cases of gastric neoplasm were studied out of which 36(90%) were malignant and 4(10%) were benign epithelial tumors and precursor lesions. Most frequent presentation was dyspepsia, abdominal pain, vomiting, dysphagia, anemia, anorexia and weight loss. Male to female ratio was 1.4:1. The age of the patient ranged from 33 to 89 years with mean age of 63.3 ± 13.4 years. Most common site of gastric neoplasm was pyloric antrum. Ulceroproliferative growth was most common gross morphology. Malignant neoplasm were more common. Intestinal type adenocarcinoma consisted of 28 (70%) cases followed by diffuse type 6 (15%) and mixed type 1 (2.5%). Diffuse adenocarcinoma was more common in females. Moderately differentiated adenocarcinoma was the most common differentiation. Conclusion The present study provided a fair insight into the clinciopathological features of gastric neooplasm in our institution.</p>","PeriodicalId":35493,"journal":{"name":"Kathmandu University Medical Journal","volume":"22 88","pages":"408-412"},"PeriodicalIF":0.0,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144209713","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":"Pregnancy Complicated by Ovarian Cysts.","authors":"S Shakya, A Shrestha, S Lama","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>The incidence of adnexal masses during pregnancy varies between 0.2% and 2%, with the majority of these tumors being benign and a 1% to 6% chance of malignancy. Due to widespread use of ultrasound during the first trimester, it is quite common to detect incidental ovarian cysts. Once a tumor is identified, the primary goal is to determine whether it is benign or malignant. The ultrasound feature helps to determine that with a minimal help with the tumor markers, as it is altered due to pregnancy. Then, the next step is to decide if surgical intervention is necessary. If surgery is required, it is important to determine the safest time to perform it and whether to opt for laparotomy or laparoscopy. We present two case reports of pregnancies with ovarian cysts, both diagnosed incidentally, with the timing of the operation chosen based on the cyst type, size, symptoms, and gestational age.</p>","PeriodicalId":35493,"journal":{"name":"Kathmandu University Medical Journal","volume":"22 88","pages":"499-502"},"PeriodicalIF":0.0,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144209722","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}