Journal of the Institute of Medicine最新文献_第3页

Head Injuries at the Emergency Department of a University Hospital 大学医院急诊科的头部损伤

Journal of the Institute of Medicine Pub Date : 2020-12-31 DOI: 10.3126/JIOM.V42I3.37581

Thérèse Henriksson, J. Kjellberg, Y. Shakya, G. Kurlberg

引用次数: 0

Correlation of Body Mass Index with Handgrip Strength and Endurance of Dominant Hand in Medical Students 医学生体质指数与优势手握力和耐力的相关性研究

Journal of the Institute of Medicine Pub Date : 2020-12-31 DOI: 10.3126/JIOM.V42I3.37583

L. Shrestha, Sanyukta Gurung, N. Bhat, N. Mahotra, M. Bajimaya, S. Kandel, N. Malla, Aman Shakya, Vibina Aryal, B. Gyawali, Nirmala Rayamajhi, S. Pradhan

引用次数: 2

Research and Publication from Developing Countries 发展中国家的研究和出版物

Journal of the Institute of Medicine Pub Date : 2020-12-31 DOI: 10.3126/JIOM.V42I3.37478

M. Sharma

引用次数: 0

Relation of Neck Circumference to Central Obesity and Overweight in Patients with Type 2 Diabetes Mellitus Presenting to a Tertiary Center 到三级中心就诊的2型糖尿病患者颈围与中枢性肥胖和超重的关系

Journal of the Institute of Medicine Pub Date : 2020-12-31 DOI: 10.3126/JIOM.V42I3.37598

Ishwor Sharma, Sanjay Gupta, Kiran Niraula

{"title":"Relation of Neck Circumference to Central Obesity and Overweight in Patients with Type 2 Diabetes Mellitus Presenting to a Tertiary Center","authors":"Ishwor Sharma, Sanjay Gupta, Kiran Niraula","doi":"10.3126/JIOM.V42I3.37598","DOIUrl":"https://doi.org/10.3126/JIOM.V42I3.37598","url":null,"abstract":"Introduction Overweight and obesity with their surrogate anthropometric markers like body mass index (BMI), waist circumference (WC) and waist hip ratio (WHR) have been shown to be strongly associated with Type 2 diabetes mellitus. Neck circumference (NC) though less used can be an equally effective alternative to diagnose overweight and obesity in patients with Type 2 diabetes mellitus in a resource limited setting. Methods Patients who had Type 2 Diabetes Mellitus for 5 years or more and above 35 years underwent simple random sampling. Weight, height, WC and NC were measured. BMI was calculated and patients were graded into overweight and obesity based on the Asian cutoffs for BMI and abdominal obesity. Results Among 100 patients enrolled in this study, 45% were men and the mean age was 53.05. Mean neck circumference was 36.55 ± 1.28 cm and 35.27 ± 1.78 cm for male and female respectively. NC was positively correlated with WC and BMI in both men and women (p ˂ 0.001). In the ROC curves, NC presented the largest area under the curve (AUC) for overweight in males (p ˂ 0.001), while NC presented a large AUC for central obesity in both genders. Furthermore, the cut off value of neck circumference for overweight was 35.6 cm in males vs 35.2 cm in females and for central obesity was 36.75 cm in males vs 34.75 cm in females. Conclusion Neck circumference was positively associated with overweight and central obesity in patients with type 2 diabetes mellitus.","PeriodicalId":85033,"journal":{"name":"Journal of the Institute of Medicine","volume":"42 1","pages":"92-96"},"PeriodicalIF":0.0,"publicationDate":"2020-12-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"48303168","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}

引用次数: 0

Prevalence of Stunting among 6-59 Months Children and its Association with Water, Sanitation and Hygiene Practice in Urban Slums of Kathmandu, Nepal 尼泊尔加德满都城市贫民窟6-59个月儿童发育迟缓的患病率及其与水、环境卫生和个人卫生实践的关系

Journal of the Institute of Medicine Pub Date : 2020-12-31 DOI: 10.3126/JIOM.V42I3.37590

Sarswoti Singh, Nil P Dhital, R. Paudel, D. K. Sah, Arjun Hamal, J. Shrestha

{"title":"Prevalence of Stunting among 6-59 Months Children and its Association with Water, Sanitation and Hygiene Practice in Urban Slums of Kathmandu, Nepal","authors":"Sarswoti Singh, Nil P Dhital, R. Paudel, D. K. Sah, Arjun Hamal, J. Shrestha","doi":"10.3126/JIOM.V42I3.37590","DOIUrl":"https://doi.org/10.3126/JIOM.V42I3.37590","url":null,"abstract":"Introduction Childhood malnutrition is a critical public health concern in Nepal. Slums are supposed to have poor water, sanitation and hygiene practices. This study has aimed to examine association between water, sanitation and hygiene (WASH) variables and stunting among 6 to 59 months children of slums of Kathmandu metropolitan city. Methods Descriptive cross-sectional study design was employed where 335 households were included in the study. Data were collected using standard questionnaire and observation checklist. Weight and height of children were taken using seca digital weighing scale and wooden height board of UNICEF respectively. Anthropometric analysis was done using WHO Anthro version 3.2.2 software and other statistical analysis was conducted using SPSSversion 22 software. Results The prevalence of stunting was 23%. Four out of five household (80%) in slum used to drink water from unimproved source. Absence of handwashing station (AOR=2.109, 95% CI:1.05-3.27) and absence of water storage covering (AOR=2.46, 95% CI: 1.16–5.23) were found to be significantly contributing to stunting status. Conclusion This study highlights the importance of good WASH practices, and the potential of WASH interventions, to contribute for the improved childhood stunting living in urban slums in Nepal. Also, the findings recommend the need of strategies on purification of water, improvement of toilets, behaviour change and awareness related activities to improve the stunting among children.","PeriodicalId":85033,"journal":{"name":"Journal of the Institute of Medicine","volume":"42 1","pages":"76-81"},"PeriodicalIF":0.0,"publicationDate":"2020-12-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44491478","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}

引用次数: 0

Management of Postpancreatectomy Hemorrhage Following Pancreaticoduodenectomy at a Tertiary Care Center in Nepal 尼泊尔三级保健中心胰十二指肠切除术后出血的处理

Journal of the Institute of Medicine Pub Date : 2020-12-31 DOI: 10.3126/JIOM.V42I3.37574

Nirajan Subedi, B. Kandel, B. Ghimire, P. Kansakar, R. Bhandari, P. Lakhey

{"title":"Management of Postpancreatectomy Hemorrhage Following Pancreaticoduodenectomy at a Tertiary Care Center in Nepal","authors":"Nirajan Subedi, B. Kandel, B. Ghimire, P. Kansakar, R. Bhandari, P. Lakhey","doi":"10.3126/JIOM.V42I3.37574","DOIUrl":"https://doi.org/10.3126/JIOM.V42I3.37574","url":null,"abstract":"Introduction Postpancreatectomy hemorrhage (PPH) is an important complication which significantly increases morbidity and mortality following pancreaticoduodenectomy (PD). This study aims to find the incidence, classification, management, and mortality associated with PPH following PD. This study also describes the changes in management and outcomes between the period of 2004-2014 and 2015-2019 in our institute as in the later time period there was use of CT angiography and interventional radiology (IR) to identify and control the bleeding site. Methods This is a retrospective study in which medical records of patients having PPH following PD between 20042019 were analyzed. The grading and classification were done according to the International Study Group of Pancreatic Surgery (ISGPS). Management and outcomes were analyzed using standard descriptive statistics. Results A total of 43 patients developed PPH out of 336 PDs. Out of 43 patients, 4 (9.3%) had Grade A, 16 (37.2%) had Grade B and 23 (53.5%) had Grade C PPH. Fifteen (35%) patients were managed conservatively, seven (16.2%) with IR procedure and 21 (48.8%) were reexplored. There were 16 (37.2%) mortalities, out of different factorsintraoperative blood loss >500 ml showed the predictability for mortality (p= 0.01). On comparing two time periods it was seen that the PPH rate was almost similar but the mortality decreased from 58.8% to 23.07%. Conclusion PPH following PD is associated with high mortality. Increased use of IR procedure and CT angiography can decrease the relaparotomy rates and eventually decrease mortality.","PeriodicalId":85033,"journal":{"name":"Journal of the Institute of Medicine","volume":"42 1","pages":"26-31"},"PeriodicalIF":0.0,"publicationDate":"2020-12-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42568410","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}

引用次数: 0

Normative Measurement of Orbital Structures in Computed Tomography 计算机断层扫描中轨道结构的规范测量

Journal of the Institute of Medicine Pub Date : 2020-12-31 DOI: 10.3126/JIOM.V42I3.37580

D. Rokka, S. Poudel, P. Kayastha, S. Suwal, Sudil Poudyal, Saroj Chhetry, S. Shrestha, R. Karn

{"title":"Normative Measurement of Orbital Structures in Computed Tomography","authors":"D. Rokka, S. Poudel, P. Kayastha, S. Suwal, Sudil Poudyal, Saroj Chhetry, S. Shrestha, R. Karn","doi":"10.3126/JIOM.V42I3.37580","DOIUrl":"https://doi.org/10.3126/JIOM.V42I3.37580","url":null,"abstract":"Introduction Normal orbital dimensions are important for diagnosing orbital pathologies. Computed tomography (CT) of the orbit is an important modality offering high accuracy for precise measurements of orbit. The study was disbursed to ascertain criteria for the normative values of the various orbital dimensions using computed tomography in patients visiting Tribhuvan University Teaching Hospital, Kathmandu. Methods Orbital volume, ocular diameter, length of the interzygomatic line (IZL), the distance of the posterior extent of the globe from the interzygomatic line, globe position, diameters of extraocular muscles (medial, lateral, superior group, and inferior rectus) and lens density were measured in each eye of 172 patients undergoing CT examination of paranasal sinuses. The correlations with age and sex were also analyzed. Results Mean values (mean±SD) of orbital volume, ocular diameter, IZL, globe position and lens density were 24.54±2.57 cm3, 2.44±0.22 cm, 94.3±6.2 mm, 12.3±2.4 mm and 141.43±16.62 HU respectively. Mean diameters of extraocular muscles were 3.67± 0.52 mm, 3.36± 0.50 mm, 3.74±0.42 mm and 3.87±0.38 mm for medial rectus, lateral rectus, inferior rectus and the superior group respectively. There was no significant age and gender difference in most of the measurements. There was significant positive correlation of age with lens density, orbital volume and ocular diameter (p<0.05). Conclusion Normative data of different orbital measurements were obtained. The present result may help radiologists and ophthalmologists to accurately assess various orbital parameters, particularly in Nepalese populations.","PeriodicalId":85033,"journal":{"name":"Journal of the Institute of Medicine","volume":"42 1","pages":"42-46"},"PeriodicalIF":0.0,"publicationDate":"2020-12-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44155651","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}

引用次数: 1

Short Term Outcome of Acute ST Elevation Myocardial Infarction in a Tertiary Care Cardiac Center 三级医疗中心急性ST段抬高型心肌梗死的短期疗效

Journal of the Institute of Medicine Pub Date : 2020-12-31 DOI: 10.3126/JIOM.V42I3.37570

H. Shrestha, R. Gajurel, C. Poudel, S. Thapa, A. Sayami

{"title":"Short Term Outcome of Acute ST Elevation Myocardial Infarction in a Tertiary Care Cardiac Center","authors":"H. Shrestha, R. Gajurel, C. Poudel, S. Thapa, A. Sayami","doi":"10.3126/JIOM.V42I3.37570","DOIUrl":"https://doi.org/10.3126/JIOM.V42I3.37570","url":null,"abstract":"Introduction Acute ST Elevation Myocardial infarction (STEMI) is a cardiovascular emergency and is associated with significant adverse short and long-term outcome. The objective of this study was to determine the shortterm outcome in terms of heart failure, myocardial reinfarction, stroke, hospital readmission and mortality in patients admitted with STEMI Methods It was a prospective observational study conducted at Manmohan Cardiothoracic Vascular and Transplant Center, Kathmandu from May 2014 to April 2015. All patients admitted with diagnosis of STEMI during study period were enrolled. Patients were treated on the basis of existing guidelines. Mode of management, adverse outcomes and mortality of patients during the study period were evaluated. The discharged patients were followed up for 30 days. Statistical analysis was performed with SPSS version 20. Ethical approval was taken from the Institutional Review Committee of Institute of Medicine. Results The median duration of presentation was 20 hours, and only 40% of the patients presented within 12 hours of symptom onset. Primary PCI was performed in 50 (33%), thrombolysis was performed in 29(19%) and conservative medical management was done in 72 (48%) patients. Overall outcome occurred in 52 (37.7%) patients. In hospital and 30 day mortality was 14 (9.2%) and 17 (11%) respectively. Heart failure was present in 28(18.5%), myocardial reinfarction 8 (5%), stroke 4 (2.6%), and hospital readmission was 18 (12%). Conservatively treated patients had significantly more adverse outcomes (p=0.02). More patients in conservatively managed group had hospital readmission. (p=0.04) Conclusion There were more overall adverse outcomes in conservatitley managed group which is mainly due to more hospital readmission.","PeriodicalId":85033,"journal":{"name":"Journal of the Institute of Medicine","volume":"42 1","pages":"12-17"},"PeriodicalIF":0.0,"publicationDate":"2020-12-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41351651","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}

引用次数: 1

Clinical Profile of Patients Presenting with Low Back Pain to Out Patient Department of a Tertiary Level Hospital 某三级医院门诊腰背痛患者的临床特点

Journal of the Institute of Medicine Pub Date : 2020-12-31 DOI: 10.3126/JIOM.V42I3.37596

P. Thapa, R. Lakhey, B. Shrestha

引用次数: 0

Assessment Of Third Ventricular Parameters in Computed Tomography of Head: A Pilot Study in Tertiary Level Hospital 头部计算机断层扫描评价第三脑室参数的初步研究

Journal of the Institute of Medicine Pub Date : 2020-12-31 DOI: 10.3126/JIOM.V42I3.37594

U. Khanal, K. Sah, R. Chand

{"title":"Assessment Of Third Ventricular Parameters in Computed Tomography of Head: A Pilot Study in Tertiary Level Hospital","authors":"U. Khanal, K. Sah, R. Chand","doi":"10.3126/JIOM.V42I3.37594","DOIUrl":"https://doi.org/10.3126/JIOM.V42I3.37594","url":null,"abstract":"Introduction Measurement of ventricles of the brain is important for evaluating changes due to growth, ageing, intrinsic and extrinsic pathologies. The aim of this study was to determine the various parameters of the third ventricle and to assess their association with gender and age using computed tomography (CT) scans of head. Methods This retrospective, quantitative, cross sectional study was performed in the Department of Radiology and Imaging, Tribhuvan University Teaching Hospital from July to October 2019 (4 months) on images of 100 patients (50 males and 50 females) whose age group were 18-87 years, who underwent non-contrast and contrast enhanced CT scan of head. Results The total mean of width of third ventricle was found to be 0.33±0.09 cm, 0.35±0.10 cm in male and 0.31±0.06 cm in female. Third ventricle width (TVW) showed statistically significant correlation with male and also with Age. Mean of third ventricle sylvian fissure distance index was 0.41±0.67 cm, 0.42±0.65 cm in male and 0.39±0.06 cm in female respectively. Mean of third ventricle ratio was 0.03±0.09 cm, 0.03±0.09 cm in male and 0.02±0.09 in female respectively. The value were slightly higher in male. Conclusion The third ventricle width in CT in this study was 0.33±0.09 cm. CT was very useful to determine the upper limits of normal value and its variation with age.","PeriodicalId":85033,"journal":{"name":"Journal of the Institute of Medicine","volume":"42 1","pages":"82-86"},"PeriodicalIF":0.0,"publicationDate":"2020-12-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"47158072","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}

引用次数: 0