JNMA; journal of the Nepal Medical Association最新文献

Heat, Health and the Himalayas: Tackling Health System Impacts of Global Climate Change. 热、健康和喜马拉雅山：应对全球气候变化对卫生系统的影响。

JNMA; journal of the Nepal Medical Association Pub Date : 2026-01-01 Epub Date: 2026-01-31 DOI: 10.31729/jnma.v64i293.9285

Aishana Joshi

引用次数: 0

Management of Pressure Sore at Tertiary Care Center in Western Nepal: An Observational Study. 尼泊尔西部三级护理中心压疮管理：一项观察性研究。

JNMA; journal of the Nepal Medical Association Pub Date : 2026-01-01 Epub Date: 2026-01-31 DOI: 10.31729/jnma.v64i293.9303

Piyush Giri

{"title":"Management of Pressure Sore at Tertiary Care Center in Western Nepal: An Observational Study.","authors":"Piyush Giri","doi":"10.31729/jnma.v64i293.9303","DOIUrl":"10.31729/jnma.v64i293.9303","url":null,"abstract":"Introduction: Pressure sore are localized skin and soft tissue damage typically occurring over bony prominences due to impaired blood supply from sustained pressure. This study aims to review the clinical profile of patients with pressure sore and the type of management of pressure sore in regional referral center of western Nepal.Methods: This retrospective, observational study was conducted at the Department of Burns, Plastic and Reconstructive Surgery, Charak Memorial Hospital, Pokhara, from January 2023 to December 2024. Ethical approval was obtained from National Health Research Council on 16 February 2025 (Reference no:1839). The study included all patients regardless of age and gender who were treated for pressure sores during the study period, with complete medical records. Patient demographics, sore characteristics, predisposing factors, and treatment modalities were analyzed.Results: There were 21 patients with 42 pressure sore wounds, included with mean age 45.14±25.54 years (range: 16-92 years). Of all patients 16 (79.19%) were male and 16 patients (76.19%) were patients from outside Pokhara Valley. Spinal cord injury was present in 12 (57.14%) patients. The sacral and trochanteric regions were affected with 14 (33.33%) wounds each. There were 26 (61.90%) wounds classified as National Pressure Ulcer Advisory Panel Stage IV. Surgical management was performed in 14 (66.67%) patients with Local flap was used to reconstruct 12 (50%) of the wounds.Conclusions: Pressure sore in this population predominantly affected middle-aged males with spinal cord injuries, presenting with advanced-stage wounds. Local pattern flap was the most common method of soft tissue coverage.","PeriodicalId":520657,"journal":{"name":"JNMA; journal of the Nepal Medical Association","volume":"64 293","pages":"38-42"},"PeriodicalIF":0.0,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12925830/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147358512","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Culture Negative Infective Endocarditis Presenting as Renal Infarction in a Low-risk Young Woman: A Case Report. 培养阴性的感染性心内膜炎表现为低危年轻女性肾梗死1例报告。

JNMA; journal of the Nepal Medical Association Pub Date : 2026-01-01 Epub Date: 2026-01-31 DOI: 10.31729/jnma.v64i293.9300

Sandip Pandey, Anu Timalsina, Sagar Pokhrel, Vivek Chhetri, Nawaraj Ranabhat

{"title":"Culture Negative Infective Endocarditis Presenting as Renal Infarction in a Low-risk Young Woman: A Case Report.","authors":"Sandip Pandey, Anu Timalsina, Sagar Pokhrel, Vivek Chhetri, Nawaraj Ranabhat","doi":"10.31729/jnma.v64i293.9300","DOIUrl":"10.31729/jnma.v64i293.9300","url":null,"abstract":"Culture-negative infective endocarditis is difficult to diagnose because it often presents with vague symptoms, delaying recognition and worsening outcomes. Renal infarction is rare but may be the first clue. A previously healthy 32-year-old woman had intermittent fever for six weeks and sudden right-sided flank pain for two days. Examination revealed a holosystolic murmur and right costovertebral angle tenderness. Investigations showed raised inflammatory markers and a positive rheumatoid factor, while repeated blood cultures were negative. Echocardiography showed severe mitral regurgitation without visible vegetations, and computed tomography angiography confirmed right renal infarction. Using modified Duke criteria, the diagnosis was made and empiric intravenous vancomycin and ceftriaxone were started. Despite intensive care and aggressive therapy, she deteriorated and died from refractory heart failure due to severe valvular dysfunction. This case shows the disease can be insidious even in low-risk patients, stressing early suspicion, multidisciplinary care, and timely surgical evaluation when appropriate.","PeriodicalId":520657,"journal":{"name":"JNMA; journal of the Nepal Medical Association","volume":"64 293","pages":"43-46"},"PeriodicalIF":0.0,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12925840/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147358594","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Prevalence of Over-the-counter use of Antibiotics among Patients visiting Outpatient Department of a Primary Health Centre: An Observational Study. 某初级卫生中心门诊病人非处方使用抗生素的流行情况：一项观察性研究。

JNMA; journal of the Nepal Medical Association Pub Date : 2026-01-01 Epub Date: 2026-01-31 DOI: 10.31729/jnma.v64i293.9280

Shova Sapkota, Kiran Shrestha, Parikshit Prasai, Mausam Thapa Magar, Ojaswee Karki

{"title":"Prevalence of Over-the-counter use of Antibiotics among Patients visiting Outpatient Department of a Primary Health Centre: An Observational Study.","authors":"Shova Sapkota, Kiran Shrestha, Parikshit Prasai, Mausam Thapa Magar, Ojaswee Karki","doi":"10.31729/jnma.v64i293.9280","DOIUrl":"10.31729/jnma.v64i293.9280","url":null,"abstract":"Introduction: Antimicrobials are the most commonly used medicine. Over-the-counter use of antibiotics is more prevalent in developing countries, contributing to inappropriate use and increasing antimicrobial resistance. Studies regarding over the counter use of antibiotics are lacking in Nepal. The objective of this study was to determine prevalence of over the counter use of antibiotics among patients visiting primary health centre.Methods: A descriptive cross-sectional study was conducted among 377 participants from October 2024 to February 2025 at Outpatient department of Melamchi Primary Health Centre after obtaining ethical approval from the Ethical Review Board of Nepal Health Research Centre (Reference no: 820). Written informed consent was obtained and prevalence of over-the-counter use of antibiotics was examined using a structured proforma. Data was entered into Microsoft Excel, and descriptive statistics were calculated.Results: Among 377 participants, 86 (22.81%) were using over-the-counter antibiotics, of which 45 (52.32%) were male and 41 (47.67%) were female. 40 (46.51%) of those participants using over-the-counter antibiotics were older than 15 years, whereas 3 (3.48%) were less than 1 year of age. The most common presenting symptoms in these patients were related to the respiratory system 39 (45.34%). The most commonly used antibiotic was Amoxicillin plus clavulanic acid; 32 (37.20%).Conclusions: The study reported a lower prevalence of over-the-counter use of antibiotics among patients presenting to primary health centers compared to the 'WHO South-East Asia Region'.","PeriodicalId":520657,"journal":{"name":"JNMA; journal of the Nepal Medical Association","volume":"64 293","pages":"34-37"},"PeriodicalIF":0.0,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12925833/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147358660","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Allergy to Ringer's Lactate - Uncommon Cause of Anaphylaxis during Intraoperative Period: A Case Report. 术中致乳酸林格氏酸过敏的罕见原因：1例报告。

JNMA; journal of the Nepal Medical Association Pub Date : 2026-01-01 Epub Date: 2026-01-31 DOI: 10.31729/jnma.v64i293.9287

Shova Dangol, Surendra Man Shrestha, Prabhat Rawal, Nitendra Raj Bajracharya, Kundu Shrestha, Saurav Shrestha, Pushkar B K, Rabi Paudel

{"title":"Allergy to Ringer's Lactate - Uncommon Cause of Anaphylaxis during Intraoperative Period: A Case Report.","authors":"Shova Dangol, Surendra Man Shrestha, Prabhat Rawal, Nitendra Raj Bajracharya, Kundu Shrestha, Saurav Shrestha, Pushkar B K, Rabi Paudel","doi":"10.31729/jnma.v64i293.9287","DOIUrl":"10.31729/jnma.v64i293.9287","url":null,"abstract":"Perioperative anaphylaxis is a rare but potentially fatal event, with an incidence ranging from 1:300 to 1:20,000 surgeries and a mortality rate of 3-9%. Its intraoperative occurrence is diagnostically challenging due to patient sedation and overlapping drug effects. Crystalloids like Ringer's Lactate are rarely implicated. A 27-year-old American Society of Anesthesiologists grade I female undergoing mastoidectomy developed intraoperative hypotension, tachycardia, and generalized erythema after induction with standard anesthetics and Ringer's Lactate infusion. Anaphylaxis was suspected, and Ringer'Lactate was discontinued. The patient improved rapidly upon switching to normal saline. A subcutaneous challenge postoperatively confirmed Ringer's Lactate as the trigger. This case highlights an uncommon but serious hypersensitivity to Ringer's Lactate. Clinicians must maintain high suspicion for all agents, including crystalloids, during Perioperative anaphylaxis. Prompt recognition, discontinuation of the offending agent, and supportive treatment are crucial. Given the widespread use of Ringer's Lactate, awareness of this rare reaction is essential to prevent misdiagnosis and ensure patient safety.","PeriodicalId":520657,"journal":{"name":"JNMA; journal of the Nepal Medical Association","volume":"64 293","pages":"50-53"},"PeriodicalIF":0.0,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12925826/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147358505","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Obliterative Hepatocavopathy: The "Acrobatic Dolphin" Mimic as Endovascular Procedure Guide. 闭塞性肝空腔病：“杂技海豚”模拟血管内手术指南。

JNMA; journal of the Nepal Medical Association Pub Date : 2026-01-01 Epub Date: 2026-01-31 DOI: 10.31729/jnma.v64i293.9278

Ashwin Garg, Krantikumar Rathod

引用次数: 0

Socio-demographic Profile of Clinical Medico-legal Gender-based Violence Cases at Jumla Nepal: An Observational Study. 尼泊尔Jumla临床医学法律性别暴力案件的社会人口统计特征：一项观察性研究。

JNMA; journal of the Nepal Medical Association Pub Date : 2026-01-01 Epub Date: 2026-01-31 DOI: 10.31729/jnma.v64i293.9289

Apurba Acharya, Umesh Raj Aryal, Kushal Bhattarai, Jeetendra Bhandari, Sushma Kaphle, Ashna Parajuli, Arbin Shakya, Nilu Manandhar

{"title":"Socio-demographic Profile of Clinical Medico-legal Gender-based Violence Cases at Jumla Nepal: An Observational Study.","authors":"Apurba Acharya, Umesh Raj Aryal, Kushal Bhattarai, Jeetendra Bhandari, Sushma Kaphle, Ashna Parajuli, Arbin Shakya, Nilu Manandhar","doi":"10.31729/jnma.v64i293.9289","DOIUrl":"10.31729/jnma.v64i293.9289","url":null,"abstract":"Introduction: Gender-based violence is a burden throughout Nepal. This study aimed to assess the sociodemographic profile of Gender-based violence cases and shed light on factors associated with these incidents in the Jumla district of rural Nepal.Methods: A retrospective observational study involving all the Gender-based violence cases brought for clinical medico-legal examination at the Department of Forensic Medicine and Toxicology, Karnali Academy of Health Sciences, Jumla, Nepal, from January 01, 2022 - December 31, 2023. The study variables included various socio-demographic profiles of these cases. These variables were entered and analyzed using Microsoft Excel (version 16.16.27--201012) and SPSS 23.0.Results: Among the total clinical forensic medicine cases, Gender-based violence was present in 83 (41.92%). All the females were survivors, 53 (63.85%), and all the malex were perpetrators, 30 (36.14%). The median ages of the female and male were 20 years (Range: 11-73) and 19 years (Range: 13-52), respectively. Among these cases, 20 (24.10%) had physical assault, and 63 (75.90%) were related to sexual assault, with all male examinees presenting with sexual assault.Conclusions: Gender-based violence is common among females in Jumla and is primarily inflicted by males due to various sociocultural factors.","PeriodicalId":520657,"journal":{"name":"JNMA; journal of the Nepal Medical Association","volume":"64 293","pages":"29-33"},"PeriodicalIF":0.0,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12925834/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147358671","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Pyogenic Granuloma in the Floor of Mouth: A Case Report. 口腔底化脓性肉芽肿1例。

JNMA; journal of the Nepal Medical Association Pub Date : 2026-01-01 Epub Date: 2026-01-31 DOI: 10.31729/jnma.v64i293.9288

Mahesh Khadka, Rinky Nyachhyon, Shally Raina, Nisha Maharjan, Pragya Poudel, Subhekhysa Gyawali

引用次数: 0

Perceived Stress Among Medical Doctors Working in Nepal: An Observational Study. 在尼泊尔工作的医生的感知压力：一项观察性研究。

JNMA; journal of the Nepal Medical Association Pub Date : 2026-01-01 Epub Date: 2026-01-31 DOI: 10.31729/jnma.v64i293.9291

Lochan Karki, Anil Bikram Karki, Bikrant Dhakal, Aashutosh Chaudhary, Ashlesha Chaudhary, Suzit Bhusal

{"title":"Perceived Stress Among Medical Doctors Working in Nepal: An Observational Study.","authors":"Lochan Karki, Anil Bikram Karki, Bikrant Dhakal, Aashutosh Chaudhary, Ashlesha Chaudhary, Suzit Bhusal","doi":"10.31729/jnma.v64i293.9291","DOIUrl":"10.31729/jnma.v64i293.9291","url":null,"abstract":"Introduction: Physician stress has been a growing critical concern worldwide, including the Nepali doctors. However, in the post-COVID-19 era, the evidence on current stress levels remains limited.Methods: We conducted a cross-sectional survey between January and March 2024 among Nepal Medical Council-registered doctors working across Nepal. A web-based questionnaire including the 10-item Perceived Stress Scale (PSS-10) was used for data collection. Spearman's coefficients were used to evaluate correlations, and t-tests and ANOVA were used to compare groups.Results: Among 302 medical doctors (median age 33 (IQR 28 to 41) years, 67.22% male), the mean PSS-10 score was 20.45±6.38. Overall, 43 (14.24%) had low stress, 205 (67.88%) had moderate stress, and 54 (17.88%) reported high stress. A higher PSS-10 score was associated with female gender, unmarried status, suicidal ideation/attempts, and family conflict. The PSS-10 scores of doctors in government hospitals were 21.80±6.43 and of those in teaching hospitals 18.71±6.49 (p=0.012). Compared to specialists (18.35±7.03), undergraduates and postgraduate physicians reported higher PSS-10 scores (21.61±6.15 and 20.62±6.05), and post hoc analyses confirmed significant differences (p<0.05). While social/family time was negatively correlated with PSS-10 scores (p<0.001), longer work hours were positively correlated with higher PSS-10 scores (p=0.008).Conclusions: Most participants reported moderate to high levels of stress, indicating a high prevalence of perceived stress among medical doctors in Nepal.","PeriodicalId":520657,"journal":{"name":"JNMA; journal of the Nepal Medical Association","volume":"64 293","pages":"13-19"},"PeriodicalIF":0.0,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12925837/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147358675","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

When Stroke Mimics Peripheral Nerve Injury: A Case Report of Isolated Wrist Drop. 当中风模拟周围神经损伤：一例孤立的手腕下垂。

JNMA; journal of the Nepal Medical Association Pub Date : 2026-01-01 Epub Date: 2026-01-31 DOI: 10.31729/jnma.v64i293.9281

Tai Anjuk Lama, Himal Karki, Kishor Khadka, Rabindara Raj Pandey, Bibek Rajbhandari

引用次数: 0