Nepal Medical College journal : NMCJ最新文献

{"title":"Comparison of accuracy of panoramic radiograph and lateral cephalogram in determining linear mandibular measurements among orthodontic patients in tertiary dental care center of Kathmandu","authors":"Anshu Piya, Bikash Veer Shrestha, Anju Khapung, Prakash Bhattarai","doi":"10.3126/nmcj.v25i3.58723","DOIUrl":"https://doi.org/10.3126/nmcj.v25i3.58723","url":null,"abstract":"Mandibular dimensions are one of the key parameters for planning the treatment by an Orthodontist. Lateral cephalograms are usually used to evaluate the skeletal relationship. However, due to the superimposition of both the sides, lateral cephalogram may not be reliable in measuring the right and left sides of the cranial landmarks. Panoramic radiography delivers a wide-ranging view of maxillofacial structures with comparatively lesser radiation exposure than other tools and superimposition of structures is less compared to lateral cephalogram image. OPG and lateral cephalograms of all the patients of age group 16-35 years attending Department of Orthodontics in Nepal Medical College from September 2022 to February 2023, having Angle’s Class I Molar relationship with minimum crowding was taken. Linear measurements (ramus height, total mandibular length and mandibular body length) were measured on OPG and Lateral cephalogram. The data was processed in SPSS version 17 for further analysis. There was no statistically significant difference in mean linear measurements between right and left sides on OPG (p-value 0.77, 0.49 and 0.59 respectively). But there was a statistically significant difference in mean linear measurements between both sides on OPG and lateral cephalograms (p-value <0.001). OPG can be used reliably to measure the mandibular length and ramus height of right and left side but comparison of mandibular length and ramus height between lateral cephalogram and OPG may not be reliable.","PeriodicalId":87122,"journal":{"name":"Nepal Medical College journal : NMCJ","volume":"97 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-10-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135739538","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":"Prescription audit and drug interactions of anti-diabetic drugs at Outpatient Department at a tertiary care teaching hospital in Eastern Nepal","authors":"Prabina Shrestha, Anil Kumar Sah, Kadir Alam, Deependra Prasad Sarraf, Shyam Kumar Mallik","doi":"10.3126/nmcj.v25i3.58724","DOIUrl":"https://doi.org/10.3126/nmcj.v25i3.58724","url":null,"abstract":"Type 2 diabetes mellitus (T2DM) is the third major non-communicable disease in Nepal. Drug utilization studies help in reducing the patient’s expenditure, adverse drug reactions and drug-drug interactions. It would help in understanding of consumption of drugs including newer ones. Objective was to analyze the prescribing pattern and drug interactions of anti-diabetic drugs. A prospective cross-sectional study was conducted among patients having T2DM at Birat Medical College and Teaching Hospital (BMCTH), Biratnagar, Nepal from May 2019- August 2019. WHO core drug use indicators were used to analyze the obtained data. Descriptive statistics like mean, standard deviation, frequency and percentage were calculated using Microsoft Excel 2013. Out of 200 patients, 104 (52.0%) were females and 49.5% were from the age group of 41-60 years. Average number of drugs per patient was 5.74. Biguanides (40.7%) were the most common prescribed oral antidiabetic drugs followed by Sulfonylureas (23.3%). The percentage of drugs prescribed by generic name and from WHO essential drug list was 0.6% and 15.4% respectively. A total of 95 (47.5%) patients has potential drug-drug interaction (DDI) and it was most common in the age group of 41-60 years (43.2%). Among 95 DDI, Metformin+Amlodipine ranked in 1st position (16 encounters). Polypharmacy was prevalent in the present study. Metformin was the most commonly prescribed anti-diabetic drug. The percentage of drugs from the WHO essential medicine list and prescribed by generic names was low. Prevalence of potential DDI was high.","PeriodicalId":87122,"journal":{"name":"Nepal Medical College journal : NMCJ","volume":"1 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-10-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135696053","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":"Knowledge of prostate cancer and its screening among males attending Urology OPD in a tertiary care hospital in Kathmandu","authors":"Neeraj Subedi, Mohan Khadka, Suman Adhikari","doi":"10.3126/nmcj.v25i3.58722","DOIUrl":"https://doi.org/10.3126/nmcj.v25i3.58722","url":null,"abstract":"Prostate cancer is a global burden on public health and it has been ranked as the second most common cancer in males worldwide. The incidence of prostate cancer generally increases with age and men with family history of prostate cancer have an increased risk of getting prostate cancer. The incidence varies across the world, where developed countries have a higher incidence as compared to developing countries. It is well known that early detection of certain grades of prostate cancer leads to a higher remission rate. Starting the screening for prostate cancer at the age of 40 for specific population provides the only way to reduce mortality from prostate cancer. A cross sectional hospital study was conducted using Consecutive sampling of eligible patients in the Urology Outpatient Department (OPD) of a tertiary care hospital in Kathmandu. A total of 378 patients attending Urology OPD were included in the study. A structured questionnaire which was sectioned into sociodemographic characteristics, knowledge of prostate cancer and its screening practices was administered to all the participants. Male more than 60 years of age attending Urology OPD were more (33.3%) followed by age group less than 40 years of age (28.6%). The majority of the patients visiting Urology UPD were from Province 3 (73.0%) and Province 1 (11.1%). Most of these patients were literate (34.9%) but the education level of college or higher were less (17.7%). When knowledge of prostate cancer among the participants were assessed, 55.6% participants replied that they have heard about the prostate cancer and among them, the majority of the participants (28.6%) had heard it from media like TV, radio and internet. The most common symptoms chosen by patients were hematuria (80.2%) and weight loss (72.0%). When asked about the prevention and cure of prostate cancer, 61.1% and 78.6% of them did not know about the prevention and its cure respectively. When knowledge on screening of prostate cancer was assessed, more than half of the participants were found to be aware of screening test and among them 94.4% chose blood test, Serum Prostate Specific Antigen (PSA) as the screening test. Majority of the patients (61.4%) had chosen the age for screening as <40 years and many more (91.3%) wanted to go for screening. Overall, 55.6% had heard about prostate cancer and 30.7% did not know any symptoms of prostate cancer. This study identifies some deficits in knowledge of prostate cancer and screening among participants which can be addressed to increase the knowledge related to prostate cancer. It is thus important that these participants and other men be educated more on these important domains of prostate cancer.","PeriodicalId":87122,"journal":{"name":"Nepal Medical College journal : NMCJ","volume":"45 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-10-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135738539","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":"Clinico-dermoscopic study of inflammatory dermatoses: a hospital based cross sectional study","authors":"Deeptara Pathak Thapa, Sushmita Pradhan, Harihar Adhikari, Sajana Bhandari, Prabhat Paudel","doi":"10.3126/nmcj.v25i3.58730","DOIUrl":"https://doi.org/10.3126/nmcj.v25i3.58730","url":null,"abstract":"Dermoscopy is a noninvasive, fast, and reliable diagnostic technique used to magnify and visualize structures on and beneath the skin surface which is difficult to observe by naked eyes, creating a link between macroscopic clinical dermatology and microscopic dermatopathology. The purpose of this study is to evaluate and compare the dermoscopic features of common inflammatory dermatological conditions of skin sharing similar clinical presentation according to the available literature data. All dermoscopic findings were studied using a handheld pocket dermoscopy (Dermlite DL1) with high magnification. Variables used for dermoscopic evaluation were divided into vascular and nonvascular features and specific clues. Descriptive analysis and Chi square test were used where appropriate and p < 0.05 was considered statistically significant. There were a total of 205 patients enrolled in the study. The most common clinical diagnosis was psoriasis seen in 42.0%, lichen planus in 13.0%, contact dermatitis in 12.0%, polymorphic light eruption 7.0%, seborrheic dermatitis 4.0%, discoid lupus erythematosus 5.0%, pityriasia Rosea 5.0%, urticaria 5.0% and others 7.0%. Dermoscopic vascular changes were seen as regular in 52.0% and irregular in 46.0%. The most common type of vessels observed were dotted in 70.0%, linear in 7.0%, and coiled in 2.0%. Non-vascular changes were seen in 61.0%. The commonest type of scales were whitish scales seen in 63.0%. Pigmentary changes were seen in 19.0%. The commonest type of vessels observed were dotted vessels (p value 0.000) in most inflammatory diseases. Features like wickham striae were characteristic of lichen planus (p value 0.000). The characteristic dermoscopic features of various inflammatory disorders with the help of a dermoscope is easy to perform in outpatient without any invasive method and also helpful in guiding management of the patients with follow-up.","PeriodicalId":87122,"journal":{"name":"Nepal Medical College journal : NMCJ","volume":"1 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-10-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135738545","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":"BMI and sociodemographic characteristic among patients with tuberculosis attending a DOTS clinic at a tertiary care hospital in Kathmandu, Nepal","authors":"Supri Raj Shrestha, Niraj Shrestha, Nishchal Dhakal","doi":"10.3126/nmcj.v25i3.58707","DOIUrl":"https://doi.org/10.3126/nmcj.v25i3.58707","url":null,"abstract":"Tuberculosis (TB), an infectious disease caused by Mycobacterium tuberculosis is a serious public health threat in low- and middle-income countries. In tuberculosis, the sociodemographic aspects play a significant role in increasing the susceptibility to infection. The current study aimed to study the BMI and sociodemographic characteristic among patients with tuberculosis attending a DOTS clinic at a tertiary care hospital of Kathmandu. An observational descriptive cross sectional study using census sampling technique was conducted among 170 persons with tuberculosis coming for ATT drugs in Community Medicine OPD of Nepal Medical College Teaching Hospital. The information was obtained using self-constructed structured questionnaire from the study population. The information regarding socioeconomic characteristics, medical and family history, type and clinical presentation of tuberculosis and anthropometric measurement were taken. Out of 170 tuberculosis patient 93 had pulmonary tuberculosis, 71 had extrapulmonary tuberculosis and 6 had both. The different types of tuberculosis showed the association with occupation of respondents, family types, socioeconomic status, family size, BCG scar and social habits before tuberculosis. Weight loss and cough were most common clinical presentation among the participants whereas lymphnode and gastrointestinal tract were most common sites for extrapulmonary tuberculosis. According to BMI, 16.5% of the study population were underweight. Thus, the present study provides valuable information regarding association of sociodemographic factors with tuberculosis and nutritional status of persons with tuberculosis.","PeriodicalId":87122,"journal":{"name":"Nepal Medical College journal : NMCJ","volume":"112 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-10-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135738546","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":"Knowledge, Attitude, and Practice regarding Cervical Cancer Screening among Female Health Professionals of a Tertiary Care Hospital in Kathmandu District","authors":"R. Mahaseth, R. Pun, Prakiti Baral","doi":"10.3126/nmcj.v25i2.56079","DOIUrl":"https://doi.org/10.3126/nmcj.v25i2.56079","url":null,"abstract":"Cervical cancer is the cancer that forms in the tissue of cervix. It is usually slow growing cancer that may not have symptoms but can be found with regular Pap tests and proper screening. Hence it is absolutely necessary for the health workers especially female workers to have proper knowledge about cervical cancer and have a positive attitude to getting screening tests done as per the Cervical Cancer Screening guidelines so that early detection and diagnosis can be done leading to decrease in the incidence of the disease. We have conducted this study to see the knowledge, attitude and practice regarding cervical cancer screening among female health professionals of a tertiary care hospital in Kathmandu District. Overall score for adequate knowledge about cervical cancer among different health professionals was not significantly different (χ2 = 1.118, p-value = 0.572). However, there was a significant association between knowledge and those who underwent screening (χ2 = 8.481, p-value = 0.004). There was no association between Knowledge and attitude towards cervical cancer (χ2 = 3.144, p-value = 0.076). However, there was significant association between attitude and profession (χ2 = 4.568, p-value = 0.033).","PeriodicalId":87122,"journal":{"name":"Nepal Medical College journal : NMCJ","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-07-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41975670","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":"Serum Aminotransferases in Chronic Kidney Disease Patients: A Hospital based Comparative Study","authors":"A. Pokhrel, B. R. Pokhrel, Rachana Pandey, Pragya Malla, Bishesh Sah, Jharana Shrestha, M. Khanal","doi":"10.3126/nmcj.v25i2.56054","DOIUrl":"https://doi.org/10.3126/nmcj.v25i2.56054","url":null,"abstract":"Estimation of serum aminotransferase levels play important role in the diagnosis and monitoring of hepatic diseases. Studies suggest that in patients with chronic kidney disease, especially in those under hemodialysis, the reference ranges of the serum aminotransferases might not be reflective of hepatic function. Due to this, diagnosis and management of liver diseases in such patients becomes quite challenging. This study aims to estimate and compare serum aminotransferases levels of hemodialysis patients and healthy controls. Seventy-five patients undergoing hemodialysis in Nepal Medical College Teaching Hospital for at least three months were included in the study as cases and apparently healthy individuals with no active illness and regular medication use for the past three months and were recruited as controls. Predialysis blood samples were drawn and were analyzed for serum aminotransferases and other blood parameters. The median serum AST and ALT values for hemodialysis patients were 15 U/L and 21 U/L, while for the healthy controls, it was 30 U/L and 36 U/L and the differences were statistically significant (p < 0.001). Among the hemodialysis patients, serum AST was positively correlated with eGFR (ρ = 0.247, p = 0.033) and negatively correlated with serum creatinine levels (ρ = -0.307, p = 0.007). Hence, serum aminotransferases levels were found to be low in patients with impaired kidney function compared to those with normal kidney function.","PeriodicalId":87122,"journal":{"name":"Nepal Medical College journal : NMCJ","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-07-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43583848","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":"Prevalence of Dental Caries and Associated Factors among Patients Visiting a Dental Teaching Hospital of Kathmandu","authors":"Barsha Joshi, S. Gautam, Rojin Joshi, A. Khapung","doi":"10.3126/nmcj.v25i2.56049","DOIUrl":"https://doi.org/10.3126/nmcj.v25i2.56049","url":null,"abstract":"Dental caries is the most common oral health issue for the general population. Dental caries not only affects the quality of life but also brings economic burden to individual and society. The aim of this study was to determine the prevalence of dental caries and associated factors among patients. An analytical, cross-sectional study was conducted among the patients visiting Department of Oral Medicine of Nepal Medical College Dental Hospital of Kathmandu. The results showed that overall prevalence of dental caries was 81.6%. Dental caries among participants between 25-34 years was highest (33.1%) and more among females (84.9%). Majority of the participants used toothbrush 96.8%, while 78.3% used fluoridated toothpaste. Even though most study participants claimed to use toothbrush and fluoridated toothpaste, prevalence of dental caries was high.","PeriodicalId":87122,"journal":{"name":"Nepal Medical College journal : NMCJ","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-07-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46783614","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":"Availability, accessibility and affordability of diabetes health care facilities in Latur, India","authors":"B. Bansode, Rajeshwari A. Biradar, J. Prasad","doi":"10.3126/nmcj.v25i2.56042","DOIUrl":"https://doi.org/10.3126/nmcj.v25i2.56042","url":null,"abstract":"Despite the enormous burden, diabetes care in the community is still substandard. According to studies conducted in the Latur District, there is a significant gap between recommended and actual diabetes care, which results in poor health outcomes. A cross-sectional survey was undertaken in the Latur District of Maharashtra. A sample of 505 self-reported persons with diabetes from 413 households were interviewed from May to October 2017. The study used total samples of self-reported diabetes for the bivariate and multivariate analyses. Only 19% of respondents reported that they accessed government hospital facilities for treatments of diabetes. Elderly, belonging to SC/ST, working as a farmer/labour, and poor categories accessed government facilities for diabetes treatment. Most of the people could not access healthcare facilities because more than a third of respondents live more than 31km from hospital facilities because of poor transportation, lack of connectivity, and highly unaffordable healthcare expenses and time access to healthcare facilities. The adjusted odds ratios show that after controlling for important background factors find the link between unaffordability, distance, and poor transportation to healthcare institutions. The government and private sector must urgently decentralize healthcare facilities, and the government must enhance the health system by making health check-ups available at sub-centres, PHCs, rural hospitals, and special diabetic departments in the district and sub-district hospitals. Furthermore, the private sector and non-governmental organizations (NGOs) have to take steps to raise diabetes awareness and provide healthcare services at the grassroots level.","PeriodicalId":87122,"journal":{"name":"Nepal Medical College journal : NMCJ","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-07-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"45162776","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":"Prevalence and risk factors of low back pain among commercial motorbike riders in Kathmandu Valley","authors":"R. Gautam, Rejina Shrestha","doi":"10.3126/nmcj.v25i2.56048","DOIUrl":"https://doi.org/10.3126/nmcj.v25i2.56048","url":null,"abstract":"Low back pain is a major health problem because of its high pre valence and has a consequence for disability and burden in the use of health services. It has a great impact on an individual’s economic productivity and quality of life. Motorbike riders are the vulnerable population for musculoskeletal disorders including low back pain. The objective of the study was to find out the prevalence and risk factors for low back pain among motorbike riders in Kathmandu Valley. An analytical cross sectional study was conducted in 265 commercial motorbike riders in Kathmandu. To collect data, convenience sampling technique and face to face interview was employed by using structured interview questionnaire. Data was analyzed in IBM SPSS software. Descriptive statistics and regression analysis was calculated. The study findings demonstrated that 43.8% of the respondents had low back pain among them 31.1% experienced more than 3 episodes of pain in last year. Similarly, 38% of the respondents had low back pain in last seven days. Low back pain is associated with BMI (p = 0.004), duration of commercial motorbike rides (p = 0.000), mileage per day (p = 0.002) and total riding hour per day (p = 0.001). It is concluded that nearly half of the commercial motorbike riders had low back pain in last one year and a significant association was found between low back pain with BMI, duration of commercial motorbike riding duration, riding mileage and riding hour per day. As commercial motorbike riding is a trending business, there should be some government regulations on working hours and other safety measures for the riders.","PeriodicalId":87122,"journal":{"name":"Nepal Medical College journal : NMCJ","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-07-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"48109546","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}