Kathmandu University Medical Journal最新文献

{"title":"The Characteristic of Pain and Disability among Patients with Neck Pain in Nepal: A Study in a Tertiary Hospital.","authors":"R Shijagurumayum Acharya, J Shrestha","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>Background Neck pain is a major public health problem and found to be associated with people who have low income, low educational levels, and occupational activities that involve strenuous, manual labor work. Agriculture is the main occupation for the majority of the Nepalese population and they are potentially exposed to these risk factors. Hence, it is important to explore the characteristics of neck pain among the Nepalese population. Objective To explore characteristics of socio-demographic, pain and disability among the Nepalese population with neck pain. Method A cross-sectional study was conducted using convenience sampling in Dhulikhel Hospital from February 2019 to April 2019. Patients with neck pain, aged > 18 years were included in the study. Information on age, sex, marital status, occupation, educational status, income, and working hours were collected from the patients. Nepali versions of the Neck Disability Index and Numerical Pain Rating Scale were used to assess disability and pain intensity respectively. Result Among 120 participants, 88 patients were included in the study. The mean age of the patients was 41.38 (SD 15.26) and the majority (72%) were females. The majority were uneducated (35.2%) and unemployed (64. 8%). The mean score of pain in the past 24 hours was 6.48 (SD 1.28). The majority had a mild disability (55.7%) followed by moderate disability (43.2%). Conclusion Neck pain is common among women, the middle-aged population, and patients with a poor level of education and income. The patients reported moderate neck pain with mild to moderate disability. The results of our study highlighted the importance of implementing screening measures to enable the timely identification and treatment of neck pain, especially among high-risk individuals. This would prevent or minimize the development of disability associated with neck pain.</p>","PeriodicalId":35493,"journal":{"name":"Kathmandu University Medical Journal","volume":"22 87","pages":"320-324"},"PeriodicalIF":0.0,"publicationDate":"2024-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144200192","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":"Correlation between Computed Tomography and Ultrasonography Findings in Patients with Fatty Liver.","authors":"P Kayastha, S Paudel, P Chapagain, S S Shingh, B Adhikari, S Joshi, S Katwal","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>Background Fatty liver disease, linked to obesity, alcohol consumption, and insulin resistance, is characterized by pathological fat deposition exceeding 5%. Its rising global prevalence, particularly in Southeast Asia, highlights the need for effective diagnostic modalities. Objective To find the correlation between computed tomography and ultrasonography findings in patients with fatty liver. Method A prospective cross-sectional study was conducted on 211 patients from December 2016 to October 2017. Patients referred for computed tomography chest and abdomen were included, excluding those with diffuse or focal liver disease other than fatty liver. Computed tomography attenuation values were measured using noncontrast sequences, with participants showing mean hepatic attenuation less than +48 Hounsfield units subjected to further ultrasound and shear wave elastography examinations. Data were analyzed using Microsoft Excel and SPSS, with associations examined through Pearson correlation, ANOVA and Shapiro-Wilk test. Result The study included 100 males and 111 females, aged 21 to 65 years. The mean computed tomography attenuation was +40.31 Hounsfield units. A moderately strong negative correlation was found between Computed Tomography attenuation and ultrasound grades of fatty liver (Spearman's coefficient = -0.775, p = 0.005). No significant correlation was observed between computed tomography attenuation and shear wave elastography values, nor between patient age and hepatic attenuation. Conclusion This study demonstrates a significant correlation between computed tomography attenuation and ultrasound grades of fatty liver, highlighting their complementary roles in diagnosing fatty liver disease. However, no significant correlation was found between computed tomography attenuation and shear wave elastography values.</p>","PeriodicalId":35493,"journal":{"name":"Kathmandu University Medical Journal","volume":"22 87","pages":"260-264"},"PeriodicalIF":0.0,"publicationDate":"2024-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144200169","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":"Development of a Model One Stop Approach to Post-COVID-19 and other Rehabilitation Conditions.","authors":"P Adhikari, D Tamrakar, C Thakur, R Shakya, N Vaidya, R Acharya, J Shrestha, I Byanju Shrestha","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>Background Post-COVID-19 cases can cause severe disabling symptoms and functional disabilities. WHO recognizes the severity of the condition and publishes a standardised Case Report Form to inform clinical management and public health response. Objective To determine the post-COVID-19 case load. A multidisciplinary team including a diverse team were composed and priority intervention areas were identified through a transdisciplinary approach eventually developing a Model One Stop Approach to post-COVID-19 and other Rehabilitation Conditions. Method The COVID-19 cases recorded at Dhulikhel Hospital were monitored through phone calls to post-COVID-19 complications. Patients were then invited for additional clinical assessments. A diverse team conducted these assessments to identify the needs for expanding a post-COVID-19 clinic and devised rehabilitation services based on predefined criteria. Result A total of 550 respondents were included in the study. The proportion of males (51.7%) was slightly higher than females (48.3%) with the majority of them being Brahmin/Chettri. The primary comorbidities identified were diabetes (10.55%) and hypertension (11.4%). Of the participants, about 50.73% experienced persistent symptoms. About 17.8% reported lasting muscle-related problems, 12.1% had persistent joint pain, and 33% faced temporary cardiac issues. Less than 10% experienced enduring health problems related to vision, hearing, and sleep patterns. Conclusion After COVID-19, patients experienced cardiac and muscle-related issues, increasing morbidity, financial burdens, and pressure on healthcare systems. With the need of sustainable rehabilitation training package, Dhulikhel Hospital serves as a model for a One-Stop Approach to post-COVID-19 and other rehabilitation conditions.</p>","PeriodicalId":35493,"journal":{"name":"Kathmandu University Medical Journal","volume":"22 87","pages":"271-276"},"PeriodicalIF":0.0,"publicationDate":"2024-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144200171","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":"Efficacy of Four Herbal Extracts on Actinobacillus Actinomycetemcomitans and Prophyromonas Gingivalis: an in vitro microbiological study.","authors":"D Kafle, M Humagain, S Luintel, A Karki, J Lamichhane","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>Background Periodontitis is probably one of the most common diseases occurring worldwide caused by interaction of anaerobic and aerobic microorganism found in dental plaque. Medicinal plant extracts, rooted in traditions like Ayurveda, provide a promising avenue for antimicrobial study against periodontal pathogens. Objective To assess the antimicrobial properties of extracts from indigenous medicinal plants against Actinobacillus actinomycetemcomitans (ATCC: 29522) and Prophyromonas gingivalis (ATCC: 33277), two potent periodontal pathogens. Method Four medicinal plants grown in different altitudes of Nepal were selected Tejpatta (Cinnamomum tamala), Vajradanti (Barleria prionitis), Danti (Baliospermum montanum), and Ghotape (Centella asiatica), henceforth denoted as GP1, GP2, GP3 and GP4 respectively), and their extracts were prepared using standard biochemical protocol. Phytochemical composition was analyzed through Fourier Transform Infrared Spectroscopy (FTIR) and Liquid Chromatography-Mass Spectrometry (LCMS). Antimicrobial activity against A. actinomycetemcomitans and P. gingivalis was assessed through MIC, MBC, and zone of inhibition assays. Result All of the four extracts were found to have antimicrobial activities against A. actinomycetemcomitans and P. gingivitis. The dry extract of Tejpatta was the most effective for zone of inhibition with minimal concentration of 187.5 µg/ml for MIC and 750 µg/ml for MBC. Additionally, Vajradanti and Danti were also effective against P gingivalis with the highest zone of inhibition (25 mm) followed by the dry extract of Tejpatta (22 mm) at a concentration of 100 mg/ml. Conclusion Phytochemical analysis revealed diverse chemical compounds in the plant extracts, indicating a potential therapeutic value. Among the four herbal plants, GP1 (Cinnamomum tamala) was found as the most potent against A. actinomycetemcomitans. GP2 (Barleria prionitis), GP3 (Baliospermum montanum) and GP1 (Cinnamomum tamala) displayed significant inhibition zones against both the periodontal pathogens A. actinomycetemcomitans and P gingivalis.</p>","PeriodicalId":35493,"journal":{"name":"Kathmandu University Medical Journal","volume":"22 87","pages":"283-289"},"PeriodicalIF":0.0,"publicationDate":"2024-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144200172","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":"Role of Media Reporting on Suicide.","authors":"D Kunwar","doi":"","DOIUrl":"","url":null,"abstract":"","PeriodicalId":35493,"journal":{"name":"Kathmandu University Medical Journal","volume":"22 87","pages":"252-253"},"PeriodicalIF":0.0,"publicationDate":"2024-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144200188","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":"Soil Bacteria that Kill Mosquito Larvae.","authors":"G Gc, M R Banjara, I Gautam, P Ghimire, K R Rijal","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>Background To control the deadliest mosquitoes, Bacillus thuringiensis var israelensis and Bacillus sphaericus are the tools to prevent the development of adult mosquitoes by killing the larvae in different water sources. Various countries formulated Bacillus thuringiensis and Bacillus sphaericus larvicide in different forms isolated from various sources to control mosquitoes. These bacteria are nontoxic for humans and other living organisms. In Nepal, unawareness and unavailability of these isolates made us inaccessible to these tools to control mosquito vectors. To address the increasing trend of mosquito-borne diseases in Nepal these bacteria should be included as a vector control tool. Objective To isolate and test the novel bacteria Bacillus thuringiensis and Bacillus sphaericus from the soil sample of Nepal as a biological mosquito control tool. Method Soil samples collected from seven provinces of Nepal were processed by two different techniques to isolate these two bacteria. The isolates were characterized by different staining techniques, and by larvicidal bioassay against Aedes aegypti larvae. Result From 282 soil samples analyzed by the acetate selection method 846 Bacillus thuringiensis isolates were obtained producing different types of crystal protein. Among 846 isolates only one isolate showed 100% mortality against Aedes aegypti larvae. On analysis of 32 soil samples by heat shock selection method, 11 Bacillus sphaericus and 11 Bacillus thuringiensis were obtained. Only one Bacillus sphaericus showed 25% mortality against Aedes aegypti larvae. Conclusion Two different Bacillus strains obtained from the soil sample of Nepal showed 100% and mild toxicity against Aedes aegypti larvae.</p>","PeriodicalId":35493,"journal":{"name":"Kathmandu University Medical Journal","volume":"22 87","pages":"296-301"},"PeriodicalIF":0.0,"publicationDate":"2024-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144200191","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":"Unwinding Teaching Strategies in Medical Pedagogy-A compelling requisite for execution to avoid stumbling blocks.","authors":"O Nepal","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>Medical education is the pillar of the health profession, and proper scientific research is lacking to determine concrete results in Nepal. Basic medical science teachers equipped with knowledge and skillsin teaching and learning methodologies are crucial players in the medical curriculum in the foundational years of young medical and allied health students. The importance of the instructional model for teaching medical students is shadowed in the health profession. Teaching strategies in the basic and clinical years of undergraduates have seen a sea of changes with the advancement of technology and is a huge challenge for Nepali Medical Schools to keep up with the world in this regard. Administrators of the University and medical schools must invest in medical education on time to avoid potentially disastrous consequences ahead. There has never been a better opportunity for rigorous practice of scientifically supported methods in medical education with rapid advancements in technology in teaching and research in recent years.</p>","PeriodicalId":35493,"journal":{"name":"Kathmandu University Medical Journal","volume":"22 87","pages":"337-339"},"PeriodicalIF":0.0,"publicationDate":"2024-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144200210","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":"Satisfaction from Utilization of National Health Insurance Program in Nepal: Service User's Perspective.","authors":"S Ghimire, R Agrawal Sagtani, S Paudel","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>Background Health insurance is recognized as a valuable resource for improving healthcare access for financially disadvantaged individuals, resulting in better health outcomes and increased productivity. The satisfaction and experiences of health insurance users are crucial for enhancing services and policies. Objective To assess the satisfaction of users within the national health insurance program. Method A household survey in Bhaktapur district of Nepal, conducted between September and November 2019, assessed satisfaction with health insurance services under the national program. Interviews were conducted with 173 individuals who had utilized the insurance scheme, using a structured questionnaire. Collected data were analyzed with STATA 13 software, and logistic regression analysis determined associations between satisfaction and independent variables. The study adhered to the STROBE Checklist guidelines for standardized reporting of results. Result The most satisfied domain was the registration and renewal process, while the least satisfied domain was the information about insurance services. In the adjusted analysis, literacy was the only variable significantly associated with satisfaction, with literate individuals (AOR 2.5, 95% CI 1.12-5.66) being more likely to be satisfied with the health insurance program compared to illiterate individuals. Conclusion The study found generally high satisfaction levels among individuals utilizing health insurance services. However, dissatisfaction was particularly linked to the information provided by health facilities about these services. Literacy was identified as a significant factor influencing satisfaction with the health insurance program. This highlights the need for an awareness program to educate the insured community about the diverse benefit packages available.</p>","PeriodicalId":35493,"journal":{"name":"Kathmandu University Medical Journal","volume":"22 87","pages":"302-307"},"PeriodicalIF":0.0,"publicationDate":"2024-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144200190","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":"Health Promotion of Ottawa Charter and Factors Associated with Quality of Life among Thai Monks.","authors":"S Janthapan, K Sornlorm, W Laohasiriwong, T Nutravong, S Muntaphan, R Nawawonganun, K Aunthakot","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>Background Health care is a significant health concern among monks, who are a special group that is different from the normal population in terms of access to the health care service system. Objective This study aimed to expose the prevalence of quality of life (QOL) and the association between health promotion and the quality of life of monks in the northeast of Thailand. Method This cross-sectional analytical research was conducted among monks in the northeast of Thailand. Of these, 420 samples were selected using the multi-stage random sampling method. The generalized linear mixed model was used to identify the association between health promotion, health literacy, and quality of life in the northeast of Thailand. Result The results found that 55.24% of the monks had health check-ups, and the prevalence of good quality of life was 49.05 (95% CI: 44.27-53.84). Good quality of life was associated with good implementation of the Ottawa Charter of Health Promotion (AOR = 5.35; 95% CI 3.42-8.36; p-value < 0.001) and adequate to excellent health literacy (AOR = 1.77; 95% CI 1.04-3.03; p-value = 0.034). Furthermore, low stress (AOR = 2.36; 95% CI = 1.07-5.20; p-value = 0.032) and low depressive symptoms (AOR = 2.32; 95% CI = 1.06-5.10; p-value = 0.036) have been associated with improved quality of life. Conclusion Almost half of the monks had a good quality of life. The major factors that determined the good quality of life were health promotion in the Ottawa Charter, health literacy, stress, and depression. Therefore, health policymakers could emphasize the principle of the Ottawa Charter, health literacy in monks, which will be attributed to other health promotions.</p>","PeriodicalId":35493,"journal":{"name":"Kathmandu University Medical Journal","volume":"22 87","pages":"314-319"},"PeriodicalIF":0.0,"publicationDate":"2024-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144200185","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":"Risk Factors for Severe Bronchiolitis in Children admitted at Birat Medical College Teaching Hospital.","authors":"S Yadav, R Yadav, R K Mahat, H Rimal","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>Background Bronchiolitis is the most common cause of hospitalization in infants under the age of 2 years. There are various risk factors associated with severe disease. Therefore, identifying risk factors of severe bronchiolitis and acting promptly is foremost to avoid its adverse outcome. Objective To find out the socio-demographic, clinical profile and risk factors associated with severe bronchiolitis. Method This was hospital based cross-sectional study of data of children between 3 months to 2 years admitted in the Department of Pediatrics with a clinical diagnosis of bronchiolitis from September 2023 to May 2024. Various factors were recorded to identify risk factors for severe bronchiolitis. Result Ninety children were included in the study with a majority of age group 3 to12 months (76%) and male to female ratio of 1.8. The most common symptoms were cough (85%), fever (76%), blocked nose (56%) and difficulty in breathing (35%). On applying bivariate analysis, age group, lack of exclusive breast feeding, having siblings and low maternal literacy were significant risk factors whereas on applying multivariate analysis, were found significant associations between having siblings (Adjusted Odd Ratio=5.555, 95% Confidence Interval=1.332-23.169, p value= 0.019) and low maternal literacy (Adjusted Odd Ratio =0.233, 95% Confidence Interval =0.063-0.859, p value= 0.002) for severe bronchiolitis. Conclusion In our study, cough and fever were the most common symptoms of bronchiolitis. Having siblings and low maternal literacy were the significant risk factors for severe bronchiolitis.</p>","PeriodicalId":35493,"journal":{"name":"Kathmandu University Medical Journal","volume":"22 87","pages":"308-313"},"PeriodicalIF":0.0,"publicationDate":"2024-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144200187","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}