Kathmandu University Medical Journal最新文献

{"title":"Violence Exposed Nepalese Pregnant Women have an Accepting Attitude to Domestic Violence and Suffer from Emotional Distress.","authors":"K D Pun, J H Bjørngaard, B Schei, E Darj","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>Background Violence against women and girls is frequent, a third of all women is estimated to experience violence in their lifetime and mostly by an intimate partner. Women in Southeast Asia are most affected, and previous studies in Nepal found that one in five women had experiences of domestic violence, including being afraid of someone in the family. Objective To investigate women's attitudes to domestic violence and their emotional distress, in a specific group of pregnant women. Method Validated questions from the WHO multi-country study on women's health and experiences of domestic violence, and questions from the Hopkins Symptom Checklist (HSCL-5), measuring depression and anxiety, were used. Women could answer anonymously by hearing questions in a headset and touching a tablet screen, for 'yes' or 'no'. Result In total 1011 pregnant women participated in the research and 240 women admitted being exposed to domestic violence (23.7%). These women had a more accepting attitude to violence compared to non-violence exposed women. They agreed more that the husband had good reasons to hit his wife, if she does not complete the household work to his satisfaction, she disobeys or refuses to have sex with him. Violence exposed women also reported more emotional distress and subsequently reduced wellbeing. They admitted worrying too much, feelings of hopelessness, feeling blue, fearful, or nervous. Conclusion The present study found that the pregnant Nepali women having an accepting attitude to violence suffer from emotional distress.</p>","PeriodicalId":35493,"journal":{"name":"Kathmandu University Medical Journal","volume":"21 82","pages":"118-124"},"PeriodicalIF":0.0,"publicationDate":"2023-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140852316","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":"Analgesic Efficacy of Fascia Iliaca Compartment Block for Positioning During Spinal Anesthesia in Patients with Femur Fractures.","authors":"A Jha, S Khatiwada, K Pokharel, A Ghimire, S N Singh, J N Prasad","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>Background Positioning patients with femur fractures for spinal anesthesia is associated with excruciating pain. Fascia iliaca compartment block has the potential to block all nerves supplying the femur and therefore may provide effective analgesia during positioning these patients for spinal anesthesia. Objective To assess the analgesic efficacy of Fascia iliaca compartment block, during positioning patients with femur fracture for spinal anesthesia. We also assessed the duration of analgesia and the requirement for rescue analgesics in the postoperative period. Method Seventy adult patients with fracture femurs were randomly divided into two equal groups (A and B). Patients in both groups received fentanyl one mcg/kg intravenously, 20 minutes before positioning them for spinal anesthesia. Patients of group B additionally, received ultrasound-guided Fascia iliaca compartment block with 40 ml of 0.25% Ropivacaine, immediately after intravenous fentanyl. Numerical rating score (0-10) was used for the assessment of pain at five, 10, and 20 minutes after the block and immediately after positioning patients for spinal anesthesia. Result Immediately after positioning patients for spinal anesthesia, the numerical rating score of pain was 5.06±1.5 in group A and 2.49±1.2 in group B (p<0.001). The duration of analgesia was 799.7±62.1 minutes in group B and 314.65±118.9 minutes in group A (p<0.001). One (2.8%) patient of group B and 18(51.4%) patients of group A required rescue analgesics within four to twelve hours in the postoperative period (p=0.001). In group A, seven patients were satisfied with the analgesia technique while in group B, 17 were satisfied and eight patients were strongly satisfied (p<0.001). Conclusion Ultrasound-guided Fascia iliaca compartment block is effective in reducing pain during positioning patients with femur fractures for spinal anesthesia. Patients receiving this block had a prolonged duration of analgesia, required lesser analgesics, and were more satisfied in the postoperative period as compared to patients not receiving the block.</p>","PeriodicalId":35493,"journal":{"name":"Kathmandu University Medical Journal","volume":"21 82","pages":"133-137"},"PeriodicalIF":0.0,"publicationDate":"2023-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140869398","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":"Online Teaching during Pre and Para Clinical Phase in Response to COVID-19 Pandemic and its Impact on Clinical Training-Perception of Indian Medical Students.","authors":"V Satya Prasad, S Manjunatha","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>Background COVID-19 pandemic has thrown a lot of challenges at medical education system and has necessitated a swift change from conventional classroom/laboratoryoriented/bed-side teaching to technology based online teaching. Academicians have worked hard to overcome robust challenges to facilitate students' continued learning. Objective In the wake of this drastic shift in teaching methodology, the present study aimed to investigate and understand the perceptions of medical students about online teaching and its impact on clinical training. Method Fifty students of 1st Year MBBS professional course of 2019 admission batch voluntarily and anonymously filled-in a questionnaire on online teaching and its effects on learning compared with regular classroom teaching in 2020 within 3 months of introduction of first ever online teaching methodology. Same students were followed up with same questionnaire during their final year of MBBS course in April 2023. Additionally, they were given a questionnaire to assess the impact of this shift on their learning. Result In Indian scenario most of the students opined regular classroom teaching as the better method over online teaching reasoning that concentration and learning are better in classroom teaching. Additionally, internet connectivity and accessibility issues further affected the reach and effect of online teaching. This perception did not change from 1st year to their final year. Also, the students believethat shift in teaching methodology has hampered negatively on their learning, understanding and developing clinical skills. Conclusion Overall Indian medical students preferred regular classroom teaching over online teaching.</p>","PeriodicalId":35493,"journal":{"name":"Kathmandu University Medical Journal","volume":"21 82","pages":"221-226"},"PeriodicalIF":0.0,"publicationDate":"2023-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140866058","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 Qualitative Evaluation and Cross-Cultural Adaptation of the Short Form of the Sense of Coherence Scale (SOC-13) in Nepali.","authors":"D R Thapa, M Subedi, A Ekström-Bergström, K Areskoug Josefsson, A Krettek","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>Background Sense of Coherence (SOC) relates to an individual's overall life orientation, and stronger SOC is associated with better health, quality of life, and coping strategies. When our research group used the SOC-13 questionnaire for the first time in Nepal, we identified difficulties in response patterns. The findings necessitated further evaluation of the Nepali version of the SOC-13 questionnaire. Objective To qualitatively evaluate the SOC-13 questionnaire in Nepali for cross-cultural adaptation. Method Nineteen nurses were interviewed. We used the methodological approach of \"think aloud\" to obtain a deeper understanding of the interferences of the scales. Transcribed materials were analyzed using a deductive approach through qualitative content analysis. The original translated version of the SOC-13 questionnaire in Nepali was modified by replacing words that were easier to understand. Result Participants found the questionnaire content general and non-specific but easy to complete. The nurses experienced that the meanings and sentences in some of the items and response alternatives were difficult to understand. However, the overall comprehensiveness of most items and response alternatives was perceived as good. Nurses' interpretation of the SOC-items in the translated version of the SOC-13 questionnaire in Nepali matched the original English version. Items that were experienced as difficult in the Nepali language were modified to increase their comprehensiveness. Modified items and response alternatives had the same content as before, but some words and meanings were substituted with easier language. Conclusion The current revised version of SOC-13 in Nepali is valid and useful to explore individuals' overall life orientation and their abilities to deal and cope with various life events in the Nepalese context.</p>","PeriodicalId":35493,"journal":{"name":"Kathmandu University Medical Journal","volume":"21 82","pages":"112-117"},"PeriodicalIF":0.0,"publicationDate":"2023-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140866685","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":"Comparison of Surgical Outcome of Bipolar Scissors with Conventional Cold Dissection Tonsillectomy.","authors":"B L Shrestha, L Khadka, A K Kc, A Dhakal, K S Shrestha, M Pokharel","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>Background The tonsillectomy is the most common Ear, Nose, and Throat (ENT) surgical procedure. Different methods have been used to improve the outcome of the surgery. One such method is tonsillectomy performed with bipolar scissors. In our scenario, the comparison of bipolar scissors tonsillectomy with conventional cold dissection has not been done. Objective To compare the surgical outcomes of bipolar scissors tonsillectomy and conventional cold dissection tonsillectomy. Method A prospective randomized study was conducted in 40 patients who underwent tonsillectomy on one side using bipolar scissors and on the other side using conventional cold dissection. Intraoperative blood loss, operation time, postoperative pain, and postoperative hemorrhage were all analyzed in both surgical techniques. Result The median operative time was 10 minutes for bipolar scissors compared with 12 minutes for conventional cold dissection, with a p-value of 0.390 which was not statistically significant. The median blood loss was 48 mL on the bipolar scissors side and 60 mL on the conventional cold dissection side, with a p-value of 0.232 which was also not statistically significant. The overall postoperative hemorrhage rate was 12.5%. Of these, 4 (10%) occurred on the bipolar scissors side (left side mainly) and 1 (2.5%) on the conventional cold dissection side (also left side), with a p-value of 0.002 which was statistically significant. There was no statistically significant difference in the pain scores between the two methods in both rest and swallowing (p > 0.05). Conclusion The bipolar scissors did not show any benefit over conventional cold dissection in terms of surgical time, intraoperative blood loss, or postoperative pain. However, postoperative hemorrhage was more common with bipolar scissors. Therefore, conventional cold dissection remains a safe technique for tonsillectomy in adult patients.</p>","PeriodicalId":35493,"journal":{"name":"Kathmandu University Medical Journal","volume":"21 82","pages":"215-220"},"PeriodicalIF":0.0,"publicationDate":"2023-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140871448","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":"Artificial Intelligence in Medical Practice: The Promise and the Challenges.","authors":"B L Shrestha","doi":"","DOIUrl":"","url":null,"abstract":"","PeriodicalId":35493,"journal":{"name":"Kathmandu University Medical Journal","volume":"21 82","pages":"110-111"},"PeriodicalIF":0.0,"publicationDate":"2023-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140855509","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":"Impact of Adolescent's Obesity in Cardiac Function: An Association of Cardiac Structural and Metabolic Risk Factors with Physical Fitness.","authors":"L R Yadav, L K Yadav, N B Mahotra, D Sharma","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>Background Elderly obese results metabolic, cardiac structural and functional derangements. However, such alterations including physical fitness in early age obesity are still controversial. Objective To evaluate physical fitness, cardiac structural, functional and metabolic remodeling and their association with obesity markers in adolescents. Method This cross-sectional comparative study included 90 adolescents with median age -14(2) years were grouped into Normal weight (NW) and Overweight/Obese (OW/OB) based on the BMI percentile for age and sex. International Diabetes Federation criteria for adolescents selected for lipid profiles, fasting sugar, systolic (SBP) and diastolic blood pressure (DBP). Echocardiographic standard 2-dimensional measurements for cardiac structures, percent ejection fraction (EF%) were performed with standard procedure. Physical fitness index (PFI) was graded using the modified Harvard step test. The data compared with Mann Whitney U test and Spearman's Rank correlation test used to find association among study variables. Result Compared to normal weight adolescents, overweight/obese individuals exhibited significantly higher cardiac function parameters, including heart rate, systolic and diastolic blood pressure. Within the realm of cardio-metabolic parameters, it was observed that individuals exhibited diminished levels of high-density lipoproteins and elevated levels of low-density lipoproteins. Notably, these individuals manifested cardiac structural remodeling characterized by augmented left atrial wall and aortal base thickness, and increased left ventricular end-diastolic diameter, concomitant with a markedly decreased percentage of left ventricular ejection fraction. Cardiac structural and functional parameters revealed adverse correlation with obesity markers. Conclusion The onset of obesity in early age has been ascertained to exert profound ramifications, encompassing not solely metabolic and biochemical parameters, but also extending to the structural integrity of the cardiovascular system. These outcomes synergistically contribute to a notable attenuation in overall physical fitness.</p>","PeriodicalId":35493,"journal":{"name":"Kathmandu University Medical Journal","volume":"21 82","pages":"156-162"},"PeriodicalIF":0.0,"publicationDate":"2023-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140871449","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":"Carotid Plaque Burden in Patient who Underwent Coronary Angiogram at Dhulikhel Hospital.","authors":"S Humagain, S R Pathak, R P Koju","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>Background Coronary artery disease (CAD) is a leading cause of death worldwide and is primarily caused by atherosclerosis. Carotid plaque and coronary artery disease share a common pathogenesis and risk factor. Carotid arteries are accessible through noninvasive imaging method. By characterizing the carotid arteries, it becomes possible to estimate the total burden of atherosclerosis, including that of coronary artery disease. According European Society of Cardiology (ESC) ultrasound of the carotid arteries should be considered, and be performed to detect plaque in patients with suspected chronic coronary syndrome. Objective To establish a relationship between coronary artery disease and carotid plaque. Method It is a cross sectional analytical study. Patients who underwent coronary angiogram at Dhulikhel Hospital from 1st April 2022 till 31st March 2023 were assessed for carotid plaque using carotid ultrasound. Chi square test was done to find the relationship between presence of carotid plaque and coronary artery stenosis of more than 50%. Positive predictive value and negative predictive value was calculated. Result Total number patient was 254 and the mean age was 61± 4.7 years. Out of which 85(33.5) had normal coronary artery, 143(56.3) had ≥ 50% stenosis and 120 (47.2) had ≥ 70% stenosis. Eight patients also had significant left main disease with ≥ 50 % stenosis. Carotid plaque was present in 121(47.6) patients. Out of 143 patients who had ≥ 50% stenosis in coronary angiogram, 104(72.7) patients also had carotid plaque which is statistically significant as p < 0.05. Positive predictive value (PPV) was 72.7% and negative predictive value was 84.7%. Conclusion This study establishes a relationship between coronary artery disease and carotid plaque, suggesting that the presence of carotid plaque may serve as an indicator of underlying coronary artery disease.</p>","PeriodicalId":35493,"journal":{"name":"Kathmandu University Medical Journal","volume":"21 82","pages":"170-174"},"PeriodicalIF":0.0,"publicationDate":"2023-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140870087","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":"Mental Health Status during COVID-19 Pandemic and its Relationship with Economic Hardship and Financial Threat among Rural Population in Sarawak, Malaysia.","authors":"N Amirah, R Rahman","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>Background During the COVID-19 pandemic, job and income loss, social isolation may aggravate mental health, particularly among the most vulnerable groups. Objective To assess the current mental health situation among the rural population in Samarahan district and determine the relationship between economic hardships, financial threats, and mental health status. Method This study was a cross-sectional study conducted among the 530 households in the Samarahan district. A multistage cluster sampling technique was used to select the participants in this study. Data were collected by face-to-face interview using a structured questionnaire. The mental health status was assessed by using a validated and translated DASS-21 scale. Data analysis was done by SPSS version 27.0. A p-value of ≤ .05 was considered statistically significant. Result Analysis showed that two-thirds of the respondents (66.6%) had no mental health problem. Meanwhile, 22.4% had anxiety, 1% had depression, and 0.19% had stress. Anxiety and depression accounted for 5.8% and stress and anxiety 1.3%. However, 2.64% had stress, anxiety, and depression. In bivariate analysis, age, monthly income, type of job, economic hardship, and expenditure difference appeared to be significant predictors of mental health problems (p < .05). Conclusion Depression, anxiety, and stress pose a significant threat to the rural population's health. Therefore, public health practitioners and policymakers need to address this to minimise the pandemic's impact on mental health and provide psychological support, particularly among the most affected group.</p>","PeriodicalId":35493,"journal":{"name":"Kathmandu University Medical Journal","volume":"21 82","pages":"149-155"},"PeriodicalIF":0.0,"publicationDate":"2023-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140865589","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":"Maternal Health Services Utilisation in Panchkhal Municipality, Kavrepalanchok, Nepal.","authors":"L Paudel, L Shrestha, L Budhathoki, S B Zoowa, G Bhandari, K K Shrestha","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>Background Maternal Health is a priority program of Nepal. The low utilization of maternal health services is one of the major contributing factors for high maternal morbidity and mortality in developing countries like Nepal. Objective To explore various maternal health services utilized by women and identify various factors affecting the utilization of maternal health services in Panchkhal Municipality. Method A descriptive cross-sectional study was conducted among 355 reproductive-age women who have given birth in the last 2 years in Panchkhal Municipality. The data collection period was from May to July 2020. A convenient sampling method was used to select the study population. The data analysis was done by using Statistical Package for Social Sciences (version 20.0). Variables were defined by the frequency in numbers and percentages. Result The findings from the study showed that the coverage of the antenatal care (ANC) visit was 77% and among them, 25.6% visited at least 4 antenatal care visits as recommended by the government of Nepal. Out of 355 respondents, 52.4% were delivered in the health institution, and only 20% visited postnatal care after the delivery. Among various factors, lack of treatment facilities and health facilities at a far distance were the most common factors for the underutilization of maternal health services. Conclusion The coverage of maternal health services is still low despite free maternal health services with an incentive scheme. A further detailed investigation is required to find the real scenario of the Panchkhal municipality to under-utilization of maternal health services.</p>","PeriodicalId":35493,"journal":{"name":"Kathmandu University Medical Journal","volume":"21 82","pages":"180-184"},"PeriodicalIF":0.0,"publicationDate":"2023-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140858171","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}