JNMA; journal of the Nepal Medical Association最新文献_第5页

Clinical and Radiological Outcome of Anterior Only Stabilization for AO Type B and C Subaxial Cervical Spine Injury: An Observational Study. 单纯前路稳定治疗AO型B型和C型下轴颈椎损伤的临床和影像学结果：一项观察性研究

JNMA; journal of the Nepal Medical Association Pub Date : 2025-01-01 Epub Date: 2025-01-31 DOI: 10.31729/jnma.8857

Ram Sharma Subedi, Bhadra Hamal, Kabita Devi Baral, Badri Rijal, Mahesh Karmacharya, Prem Kumar Sah, Gaurav Raj Dhakal

{"title":"Clinical and Radiological Outcome of Anterior Only Stabilization for AO Type B and C Subaxial Cervical Spine Injury: An Observational Study.","authors":"Ram Sharma Subedi, Bhadra Hamal, Kabita Devi Baral, Badri Rijal, Mahesh Karmacharya, Prem Kumar Sah, Gaurav Raj Dhakal","doi":"10.31729/jnma.8857","DOIUrl":"10.31729/jnma.8857","url":null,"abstract":"Introduction: AO type B and C subaxial cervical spine injuries are highly unstable and require surgical fixation for the stabilization. This study aims to determine their outcome after anterior stabilization clinically and radiologically.Methods: This was an observational longitudinal study conducted at tertiary level trauma center, from March 2021 to April 2022 after ethical approval from Institutional Review Board (Reference Number: 665/2077/78). Based on inclusion criteria total sampling was done. Cervical spine injuries AO type B and C operated with anterior cervical stabilization were included. Descriptive statistics were used to analyze data.Results: Among 21 total cases, 14 (66.67%) were male and 7 (33.33%) were female with the median age of 40 (IQR 32-51) years. Eleven (52.38%) patients sustained AO type B injury and 10 (47.61%) patients sustained AO type C injury. The commonest mode of injury was fall from height 14 (66.66%) followed by RTA 6 (28.57%) and physical assault 1 (4.76%). Postoperatively there was 33% improvement in incomplete neurology by one grade on ASIA neurology. Pain was evaluated using Visual Analogue Score and disability was evaluated using Neck disability Index scoring with the median value of 2 (IQR 0.4-3) and 10 (IQR 3-13) respectively. Radiographic failure was present in 2(9.52%) patients. Forteen (66.66%) patients showed Grade 1 fusion, six (28.57%) showed Grade 2 fusion, and one (4.76%) showed Grade 3 fusion.Conclusions: Most of the patients experienced mild pain and disability, stable fusion and low rate of radiographic failure with no new neurological deterioration. Almost half of the injuries occurred at the level of C5-C6.","PeriodicalId":520657,"journal":{"name":"JNMA; journal of the Nepal Medical Association","volume":"63 281","pages":"23-27"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11930032/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144629381","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

Tracking Progress of National Health Summit Declarations - Health Policy Analysis: A Qualitative Study. 跟踪国家卫生首脑会议宣言的进展-卫生政策分析：一项定性研究。

JNMA; journal of the Nepal Medical Association Pub Date : 2025-01-01 Epub Date: 2025-01-31 DOI: 10.31729/jnma.8871

Ashis Shrestha, Lisasha Poudel, Dipesh Tikhatri, Sushant Regmi, Jay Bhushan Jha, Shreya Baniya, Mandish Prasad Phuyal, Akanshya Prasai, Sunil Kunwar, Amit Chand, Prakriti Karki, Nurusha Tamrakar, Ritu Sapkota, Raman Yadav

{"title":"Tracking Progress of National Health Summit Declarations - Health Policy Analysis: A Qualitative Study.","authors":"Ashis Shrestha, Lisasha Poudel, Dipesh Tikhatri, Sushant Regmi, Jay Bhushan Jha, Shreya Baniya, Mandish Prasad Phuyal, Akanshya Prasai, Sunil Kunwar, Amit Chand, Prakriti Karki, Nurusha Tamrakar, Ritu Sapkota, Raman Yadav","doi":"10.31729/jnma.8871","DOIUrl":"10.31729/jnma.8871","url":null,"abstract":"Introduction: The National Health Summit is a policy discussion platform that advocates the policy statement stated by National Health Policy 2019 which results in a set of declarations to address issues in the health system. This study's objective is to monitor the extent of declaration's implementation, its facilitators-barriers, and to formulate recommendation for future National Health Summit declarations and implementation strategies.Methods: This is a qualitative study conducted by Nepal Medical Association. in November-December 2024. Ethical approval from Nepal Health Research Council, Ethical Review Board (Reference number: 1069). The study was designed using the Realistic Evaluation Framework to look into the \"context\" which are the external factors impacting implementation of the declarations, the \"mechanism\" which are key elements facilitating or hindering policy changes, and the \"outcome\" which were the tangible results of NHS declarations.Results: Review and analysis of the participant responses identified policy influene and advocacy as contexts. The mechanisms identified were political and bureaucratic challenges, collaboration, finaicial hurdles, commitment, accountability, leadership, evidence based practices. The outcome discussed were health system strengthening, health workforce, governance, innovation, advocacy and digaital transformations.Conclusions: Implementation of declaration is challenging, with fragmentation as major health issues, however, continuous advocacy has had a synergistic effect in implementation and prioritization of the policy.","PeriodicalId":520657,"journal":{"name":"JNMA; journal of the Nepal Medical Association","volume":"63 281","pages":"3-11"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11930041/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144629366","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

A Rare Case of Bronchopulmonary Infection by Lophomonas Blattarum : A Case Report. 罕见的Blattarum单胞菌支气管肺感染1例。

JNMA; journal of the Nepal Medical Association Pub Date : 2025-01-01 Epub Date: 2025-01-31 DOI: 10.31729/jnma.8866

Arun Kumar Mahato, Sonu Shah, Rupak K C, Sudarshan Kandel, Neetika Paudel, Saharoj Siddiqui, Niranjan K C

引用次数: 0

LIMP Score and Anterior Cruciate Ligament Injury in Patient Undergoing Arthoscopy for Acute Knee Injury: An Observational Study. 急性膝关节损伤行关节镜检查患者的跛行评分和前交叉韧带损伤：一项观察性研究。

JNMA; journal of the Nepal Medical Association Pub Date : 2025-01-01 Epub Date: 2025-01-31 DOI: 10.31729/jnma.8858

Mahesh Karmacharya, Binod Sherchan, Bikash Kc, Ram Sharma Subedi, Badri Rijal, Saphalata Devi Koju

{"title":"LIMP Score and Anterior Cruciate Ligament Injury in Patient Undergoing Arthoscopy for Acute Knee Injury: An Observational Study.","authors":"Mahesh Karmacharya, Binod Sherchan, Bikash Kc, Ram Sharma Subedi, Badri Rijal, Saphalata Devi Koju","doi":"10.31729/jnma.8858","DOIUrl":"10.31729/jnma.8858","url":null,"abstract":"Introduction: Globally, anterior cruciate ligament injury is common but difficult clinical diagnosis in acute setting because of pain during examination and difficult availability of investigations and diagnostic arthroscopy. Legs giving way, Inability to continue the task, Massive effusion and pop sound heard at the time of injury or LIMP score is a history based scoring which can be aid to diagnose anterior cruciate ligament injury. This study is designed to find out the proportion of patient with LIMP score of >2 having anterior cruciate ligament injury.Methods: An observational cross-section study was done among the patients visiting emergencies and out patient department of respective hospitals after approval from Institutional review Committee (Reference number: 23/2078/79). The LIMP score was assessed during the presentation and patients were followed up at arthoscopy for the final diagnosis.Results: There were 126 patients enrolled in the study among which 68 (54%) had LIMP score of >2. Out of the total, 74 (59%) had anterior cruciate ligament inury among which 67 (90.5%) had LIMP score >2. Among the patient who did not have anterior cruciate ligament injury, 51 (98%) had LIMP score <2.Conclusions: The proportion of patients having anterior cruciate ligament injury were higher in the category with LIMP score >2.","PeriodicalId":520657,"journal":{"name":"JNMA; journal of the Nepal Medical Association","volume":"63 281","pages":"28-32"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11930030/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144629386","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

Postoperative Complications among Major Abdominal Surgeries using Clavien-Dindo Classification in Tertiary Hospital: An Observational Study. 三级医院应用Clavien-Dindo分级对腹部大手术术后并发症的观察研究

JNMA; journal of the Nepal Medical Association Pub Date : 2025-01-01 Epub Date: 2025-01-31 DOI: 10.31729/jnma.8854

Manoj Kumar Jha, Kunda Bikram Shah, Anup Thapa, Sunil Basukala, Sumit Kumar Sah

{"title":"Postoperative Complications among Major Abdominal Surgeries using Clavien-Dindo Classification in Tertiary Hospital: An Observational Study.","authors":"Manoj Kumar Jha, Kunda Bikram Shah, Anup Thapa, Sunil Basukala, Sumit Kumar Sah","doi":"10.31729/jnma.8854","DOIUrl":"10.31729/jnma.8854","url":null,"abstract":"Introduction: The Clavien-Dindo Classification is an easy way to grade any deviation from the postoperative course that is not a normal part of the procedure and does not indicate a failure to achieve the desired cure, regardless of the physician's age or level of competence. We aimed to conduct a this study to determine the prevalence of post-operative complications after major abdominal surgery and to grade them using the Clavien-Dindo Classification.Methods: This was an observational cross-section study conducted after approval from the Institutional Review Committee (Reference Number: 656). A retrospective data of patients admitted to surgical wards for major surgery from January to June 2022 was included in the study. The postoperative complications were divided as per Clavien-Dindo classification from grade I to grade V. Descriptive statistics was used to analyse data.Results: Out of 78 patients, 45 (57.69%; 95% CI: 52.69%-62.69%) patients had complication after major abdominal surgery. Among them, 17 (37.78%) patients belonged to age group more than 60 years and 24 (53.33%) patients were female. Amongst the morbidities, diabetes mellitus was seen in 7 (15.56%) patients, hypertension in 6 (13.33%), chronic obstructive pulmonary disease in 5 (11.11%) cases and anaemia in 3 (6.67%) cases. There were 19 (42.22%) patient with Clavien-Dindo Classification Grade II and surgical site infection was observed in 26 (57.78%) cases.Conclusions: The prevalence of post-operative complication after major abdominal surgery in our study was found to be comparatively higher as compared to similar studies done in similar settings.","PeriodicalId":520657,"journal":{"name":"JNMA; journal of the Nepal Medical Association","volume":"63 281","pages":"12-17"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11930031/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144629388","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

Surgical Removal of a Long-standing Impacted Tooth in Upper Alveolus Following Blast Injury: A Case Report. 爆炸伤后上牙槽长期阻生牙的手术切除一例报告。

JNMA; journal of the Nepal Medical Association Pub Date : 2025-01-01 Epub Date: 2025-01-31 DOI: 10.31729/jnma.8864

Arun Adhikari, Shila Acharya, Sadhana Sharma, Luna Mathema, Bijay Khatri

引用次数: 0

Ultrasonography Findings of Testicular Tuberculosis in Nepalese Patients: A Case Series. 尼泊尔患者睾丸结核的超声检查结果：一个病例系列。

JNMA; journal of the Nepal Medical Association Pub Date : 2024-12-01 Epub Date: 2024-12-31 DOI: 10.31729/jnma.8835

Madan Thapa, Sushmit Kafle, Pratik Lamichhane, Suresh Thapa

引用次数: 0

Neck of Femur Fracture among Senior Citizen Managed with Hemiarthroplasty in a Tertiary Care Center in Nepal: An Observational Study. 尼泊尔三级护理中心半关节置换术治疗老年人股骨颈骨折：一项观察性研究。

JNMA; journal of the Nepal Medical Association Pub Date : 2024-12-01 Epub Date: 2024-12-31 DOI: 10.31729/jnma.8844

Bijay Poudel, Bhaskar Raj Karki, Rohit Shrestha, Ashkal Basi, Sushant Kumar Khadka, Aashutosh Chaudhary, Amartya Dahal, Shreejana Pandey, Darshan Gopal Dhoju

{"title":"Neck of Femur Fracture among Senior Citizen Managed with Hemiarthroplasty in a Tertiary Care Center in Nepal: An Observational Study.","authors":"Bijay Poudel, Bhaskar Raj Karki, Rohit Shrestha, Ashkal Basi, Sushant Kumar Khadka, Aashutosh Chaudhary, Amartya Dahal, Shreejana Pandey, Darshan Gopal Dhoju","doi":"10.31729/jnma.8844","DOIUrl":"10.31729/jnma.8844","url":null,"abstract":"Introduction: Hemiarthroplasty is recognized as a prominent therapeutic option for neck of femur fracture without preexisting acetabular pathology; however, there are controversies in the scientific literature regarding this. The study aims to analyze epidemiology of patients sustaining NoF fracture and the functional outcomes following hemiarthroplasty.Methods: This is a observational cross-section study in a single tertiary care center of Nepal. Senior citizens, 60 years or above patients, with neck of femur fracture who underwent hemiarthroplasty from January 2017 to December 2022 were included in the study. Patient related data were retrieved from the medical record department of the hospital. A semi-structured proforma was designed which included patient demographic information, operative details and follow up evaluation using Modified Harris Hip Score. Ethical approval was obtained from the Institutional Review Committee (Reference number: 34/24).Results: The overall mean Modified Harris Hip score for patients who received hemiarthroplasty for neck of femur fracture from January 2017 to December 2022 was 76.36, with 4 (9.30%) achieving excellent results, 19 (41.19%) good, 14 (32.56%) fair, and 6 (13.95%) poor outcomes.Conclusions: Hemiarthroplasty emerges as a valuable treatment for femoral neck fractures in senior citizens, aged 60 and above, providing good functional results.","PeriodicalId":520657,"journal":{"name":"JNMA; journal of the Nepal Medical Association","volume":"62 280","pages":"832-836"},"PeriodicalIF":0.0,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11930057/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144629354","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

Sjogren's Syndrome in the Mask of Hypokalemia: A Case Report. 低钾血症面罩下干燥综合征1例报告。

JNMA; journal of the Nepal Medical Association Pub Date : 2024-12-01 Epub Date: 2024-12-31 DOI: 10.31729/jnma.8836

Krishna Bahadur Sodari, Pragyan Basnet, Krishna Adhikari

{"title":"Sjogren's Syndrome in the Mask of Hypokalemia: A Case Report.","authors":"Krishna Bahadur Sodari, Pragyan Basnet, Krishna Adhikari","doi":"10.31729/jnma.8836","DOIUrl":"10.31729/jnma.8836","url":null,"abstract":"Sjogren's syndrome is an autoimmune disease characterized by lymphocytic infiltration of exocrine glands resulting in xerostomia and dry eyes affecting entire body. A 40-year-old woman presented with generalized weakness and shortness of breath. She had reduced muscle power (2/5) with reduced tone, and absent reflexes in four limbs. Further investigation revealed severe hypokalemia with metabolic acidosis. She was treated with intravenous potassium chloride and diagnosed with Sjogren's syndrome based on her serology profile. After treatment, her condition improved. Hypokalemia occurs due to increased renal excretions of potassium. Distal Renal Tubular Acidosis is a major cause of potassium loss in urine. Sjogren's Syndrome is an important cause of Distal Renal Tubular Acidosis, which can present as severe hypokalemia. Although it commonly presents with symptoms like dry eyes and dry mouth, it can rarely present as Distal Renal Tubular Acidosis and hypokalemia as the primary presentation. Sjogren's syndrome should be suspected in patients with hypokalemia with features of Distal Renal Tubular Acidosis.","PeriodicalId":520657,"journal":{"name":"JNMA; journal of the Nepal Medical Association","volume":"62 280","pages":"841-843"},"PeriodicalIF":0.0,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11930046/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144629359","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

World Health Organization Tool for Benchmarking Ethics Oversight of Health-Related Research with Human Participants. 世界卫生组织与人类参与者有关的健康相关研究的基准伦理监督工具。

JNMA; journal of the Nepal Medical Association Pub Date : 2024-12-01 Epub Date: 2024-12-31 DOI: 10.31729/jnma.8839

Namita Ghimire, Rojina Basnet, Richa Acharya, Santoshi Adhikari, Shashi Verma, Mohan Raj Sharma

{"title":"World Health Organization Tool for Benchmarking Ethics Oversight of Health-Related Research with Human Participants.","authors":"Namita Ghimire, Rojina Basnet, Richa Acharya, Santoshi Adhikari, Shashi Verma, Mohan Raj Sharma","doi":"10.31729/jnma.8839","DOIUrl":"10.31729/jnma.8839","url":null,"abstract":"Benchmarking ethics oversight is a process of aligning comparing and evaluating the strengths and room for improvement of ethical review and approval process across different institutions or the country. The World Health Organization tool for benchmarking ethics oversight is designed to help countries assess and improve their systems for ethically overseeing health-related research involving human participants. It identifies gaps in legal frameworks, committee structures, resources, accountability and transparency while promoting best practices and policy alignment. Nepal has made progress through the research regulations body like the Nepal Health Research Council , but challenges such as inconsistent implementation, oversight of the implementation and resource limitations remain. The tool offers an opportunity to strengthen Nepal's health research governance and regulation but it must be adapted to fit local contexts, emphasizing accountability, transparency, capacity-building, and improved communication.","PeriodicalId":520657,"journal":{"name":"JNMA; journal of the Nepal Medical Association","volume":"62 280","pages":"862-865"},"PeriodicalIF":0.0,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11930055/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144629363","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