Nepal Medical College journal : NMCJ最新文献

{"title":"Determinants of immediate adverse pregnancy outcomes: A hospital based study","authors":"Jaya Koirala, Sudha A. Raddi, A. Dalal","doi":"10.3126/nmcj.v24i3.48599","DOIUrl":"https://doi.org/10.3126/nmcj.v24i3.48599","url":null,"abstract":"Adverse pregnancy outcomes are a major public health problem which can lead to serious short and long- term health effect to the mother and the newborn. Hence, the objective of this study is to find out the determinants of immediate adverse pregnancy outcomes in tertiary care hospital in South India. The study comprised of antenatal mothers admitted for delivery in selected tertiary care hospital in Belgaum, Karnataka, India from 10th November, 2021 to 20th January 2022. All registered deliveries in the study period have been included, comprises of 101. Bivariate logistic regression was used to determine the factors associated with outcome variables. A significance level of 5% was used to decide the significance of statistical tests. The mean age in years (± SD) of the mother was 24.6 (± 3.9). The average cost invested for a family health check-up in a year was Rupees 18,099. The average birth weight of the newborn was 2.7 kg, while the minimum weight of the newborn was 1.4 kg, and the maximum weight was 3.8 kg. The average week of gestation for the first-time with respect to antenatal care visit of pregnant women was 9.6 weeks. The average weight of the women was 47.6 kg during first antenatal care visit and 61.5 kg during last antenatal care visit. Adverse outcomes reported were post-partum hemorrhage was 7.9%, low birth weight 26.7%, preterm delivery 28.7%, anemia 53.5%, neonatal physiological and jaundice 15.8%. However, use of mode of transportation during antenatal care visit was found to be significant factor for preterm delivery. Every fourth baby was low birth weight, and every fourth women have preterm delivery and every second woman was anemic. Socioeconomic, demographic and chronic illness was associated with immediate adverse pregnancy outcomes.","PeriodicalId":87122,"journal":{"name":"Nepal Medical College journal : NMCJ","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-09-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41797700","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":"Evaluation of Retinal Nerve Fibre Layer and Macular Thickness in Amblyopia","authors":"S. Subedi, Jyoti Baba Shrestha, Anand Kumar Sharma, J. Sapkota","doi":"10.37080/nmj.128","DOIUrl":"https://doi.org/10.37080/nmj.128","url":null,"abstract":"Introduction: Amblyopia is reduced visual acuity in one or both eyes due to abnormal visual development in early part of life. Purpose of this study was to evaluate and compare the retinal nerve fibre layer (RNFL) and central macular thickness (CMT) between amblyopic and fellow (normal) eyes using spectral-domain optical coherence tomography (SD-OCT). \u0000Methods: This was a hospital based, cross-sectional comparative study conducted in the department of Ophthalmology, B.P. Koirala Lions Centre for Ophthalmic Studies (BPKLCOS), Institute of Medicine (IOM), Tribhuvan University Teaching Hospital (TUTH). All consecutive cases of age ≥5 years and ≤15 years diagnosed with unilateral amblyopia from January 2013 to June 2014 were included in this study. RNFL and macular thicknesses were measured using SD-OCT and compared between fellow eyes. \u0000Results: A total of 32 cases with unilateral amblyopia, 19 with hypermetropic anisometropic, 4 with myopic anisometropic and 9 with strabismic amblyopia were enrolled in the study. The mean age of presentation was 9.75±2.77 years. The mean CMT in amblyopic eyes (241±45.27 μm) was significantly greater than the normal fellow eyes (233.22±44.24 μm), p= 0.042. The difference remained significant in hypermetropic anisometropic group but not in myopic anisometropic and strabismic group. The mean RNFL thickness was similar in amblyopic (104.16±13.64 μm) and fellow eyes (104.03±13.06 μm). \u0000Conclusions: The CMT was significantly greater in the amblyopic eyes than the normal fellow eyes. There was no significant difference in the RNFL thickness between the amblyopic and normal eyes.","PeriodicalId":87122,"journal":{"name":"Nepal Medical College journal : NMCJ","volume":"23 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-09-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"83274938","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":"Effect of Persistent Hyperglycemia and Lipid Profile and its role in Glycation and Oxidative stress in Chronic Type 2 Diabetes Mellitus subjects","authors":"D. Kafle","doi":"10.37080/nmj.125","DOIUrl":"https://doi.org/10.37080/nmj.125","url":null,"abstract":"Introduction: Diabetes mellitus is a disease of carbohydrate metabolism disorder which results in increase in blood glucose level. Hyperglycemia may increase oxidative stress through a variety of ways impairs an antioxidant defenses mechanism. Reactive oxygen species are increased as a result of the oxidative stress caused by hyperglycemia, which activates a number of redox-sensitive cell signaling molecules producing cytotoxic materials. \u0000Methods: 250 randomly visited the OPD at the Chitwan Medical College Department of Medicine were chosen for this cross-sectional study. 10ml of blood sample was drawn from anticubital vein following overnight fasting and was centrifuged at room temperature for 10 minutes at 3000 rpm. The serum was stored at 4oC for biochemical investigations. Fasting blood sugar, lipid profile and HbA1c etc. were analyzed via chemiluminescence Analyzer (CLIA) in the Hospital Laboratory of Chitwan Medical College. With SPSS version 22, statistical analysis was carried out. \u0000Results: IIt was found from the study that type 2 diabetic subjects have significant increase of fasting blood sugar and malondialdehyde (MDA) but glutathione peroxidase was found to be decreased in type 2 diabetic subjects as compared to healthy controls. Glutathione reductase was found non-significant at (P>0.05) in both the subjects. It was found from the study that association of HbA1c with Total cholesterol, Triglyceride, LDL-C was found to be positively correlated and was significant at P<0.05. \u0000Conclusions: When predicting glycemic control in T2DM patients, lipid profiles (LDL-C) and glycation status can be helpful tools.","PeriodicalId":87122,"journal":{"name":"Nepal Medical College journal : NMCJ","volume":"13 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-09-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"79699872","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":"Assessment of dental myths and misconceptions among the people of Chitwan, Nepal","authors":"Ayam Chhatkuli, Shristi Kafle, Saroj Balami, R. Chaulagain","doi":"10.37080/nmj.127","DOIUrl":"https://doi.org/10.37080/nmj.127","url":null,"abstract":"Introduction: Even though, dentistry has developed a lot in present days, dental myths and misconceptions still exist which is also in a way creating hinderance in accepting the advanced curative, preventive treatments. The present study was aimed to assess the prevalent dental myths and misconceptions among the people of Chitwan, Nepal. \u0000Methods: This was a descriptive cross-sectional study conducted among 250 residents of Chitwan, Nepal, from 15th July 2021 to 15th August 2021. A convenience sampling method was employed to collect the data from the residents of Chitwan. A self-administered questionnaire was used. The data was entered into Microsoft Excel Version 2019 and later transferred into Statistical Package of Social Science (SPSS) version 16 and analysed using descriptive statistics (mean, standard deviation, frequency and percentage). \u0000Results: There were in total 250 residents of Chitwan who participated in the study. The mean age of participants was 52.51±10.23 years. Among the 250 participants 153 (61.2%) were females and 97 (38.8 were females). About 108 (43.2%) participants believed that dental pain can be reduced by visiting shaman, hermits and monks. While 146 (58.4%) agreed that extraction of upper teeth affects eye vision, 152 (60.8%) were positive towards association of wisdom tooth with human intelligence. About 66.8% believed that charcoal whitens the tooth. \u0000Conclusions: The present study concluded that dental myths are prevalent among the residents of Chitwan. These myths should be addressed by creating awareness programs from the community level.","PeriodicalId":87122,"journal":{"name":"Nepal Medical College journal : NMCJ","volume":"28 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-09-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"82569976","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":"Patterns of prescription and adverse drug reaction profile of Non- Steroidal Anti-Inflammatory Drugs at orthopedic out-patients department","authors":"G. Neupane, Maya Rai, P. Rokaya","doi":"10.3126/nmcj.v24i2.46045","DOIUrl":"https://doi.org/10.3126/nmcj.v24i2.46045","url":null,"abstract":"Non-steroidal Anti-inflammatory Drugs (NSAIDs) are the most prescribed drugs all over the world. These are used in the treatment of pain and inflammation. Systematic evaluation of prescription patterns and monitoring of adverse drug reactions is required to increase the therapeutic benefit and decrease the adverse effects of these drugs. An observational, cross-sectional study was conducted for 6 months from September 2021 to February 2022 in 300 patients prescribed least one NSAID to assess the prescription patterns and adverse drug reaction profile (ADR) of NSAIDs prescribed in the orthopedic outpatient department. Among enrolled patients 52% were female and 48% were male. The most common age group was 20-39. The average number of drugs per prescription was 2.89. A total of 868 drugs were prescribed, out of which 402 were NSAIDs (46.31%). Naproxen was the most prescribed agent (45.02%), followed by Diclofenac (17.17%). ADR was reported in 12% of patients. Most of the ADRs were due to Naproxen (72.18%) followed by Ibuprofen (16.66%). The gastrointestinal system was involved in maximum patients and the most common ADR was abdominal pain. Most of the drugs were prescribed by brand name 95.18%. Naproxen was the most prescribed NSAID and responsible for most ADRs. There was a higher prevalence of irrational prescribing, polypharmacy, and underreporting of ADR. A strategy must be developed and implemented for prescribing and rational use of NSAIDs and monitoring their harmful effects.","PeriodicalId":87122,"journal":{"name":"Nepal Medical College journal : NMCJ","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-06-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"48025130","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":"Correlation between disc damage likelihood scale and vertical cup disc ratio with Automated Humphrey Perimetry in glaucoma patients attending a tertiary care hospital, Kathmandu, Nepal","authors":"Pranisha Singh, A. P. Rijal","doi":"10.3126/nmcj.v24i2.46036","DOIUrl":"https://doi.org/10.3126/nmcj.v24i2.46036","url":null,"abstract":"Glaucoma is the second leading ocular disease of irreversible blindness. Glaucoma is a progressive disorder and requires serial evaluation in order to monitor disease progression and optimize therapy. The objective of this study was to determine the correlation between disc damage likelihood scale (DDLS) and vertical cup disc ratio (VCDR) with the results of Humphrey field analyzer (HFA) parameters. This study was a descriptive, cross-sectional and observational study. A total of 104 eyes of 52 patients diagnosed with primary open angle glaucoma or normal tension glaucoma were examined. DDLS staging, VCDR and HFA 24-2 visual fields were obtained from the patients. The correlation of DDLS and VCDR with Mean deviation (MD), Pattern standard deviation (PSD) and Glaucoma hemi field test (GHT) of HFA was calculated by Pearson correlation coefficient (r). DDLS showed a coefficient correlation value of r = -.628, r = .391 and r = .395 (p = <0.000) when correlated against HFA MD, PSD and GHT respectively. VCDR showed a coefficient correlation value of r = -.524, r = .317 and r = .221 when correlated against HFA MD, PSD and GHT respectively. DDLS has a better correlation compared to VCDR with all the parameters.","PeriodicalId":87122,"journal":{"name":"Nepal Medical College journal : NMCJ","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-06-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42652841","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 regarding obstetric danger signs among pregnant women","authors":"B. Ghimire, P. Pathak, Pratima Ghimire","doi":"10.3126/nmcj.v24i2.46029","DOIUrl":"https://doi.org/10.3126/nmcj.v24i2.46029","url":null,"abstract":"Knowledge of obstetric danger signs is crucial to reduce maternal morbidity and mortality by identifying the problems earlier and avoiding the delay in seeking obstetric care. According to World Health Organization (WHO) more than 70% of maternal deaths occur due to obstetric complications and most of these deaths occur in developing countries. Most of these are preventable if pregnant women can identify these life-threatening danger signs on time and seek appropriate emergency obstetric care. This study was conducted to assess the knowledge of obstetric danger signs among pregnant women. A descriptive cross-sectional study was carried out from 15th July to 30th August 2021, 194 pregnant women who visited the Gynaecology Outpatient Department in Nepal Medical College Teaching Hospital, were enrolled for the study. Data were collected through face to face interviews using a structured questionnaire. The study findings revealed that overall knowledge on obstetric danger signs was suboptimal (3.1%). The median knowledge score of respondents on antenatal danger signs was 30.0% (Q1-Q3=17.5-40), intra-natal danger signs was 0.0% (Q1-Q3=0-20) and postnatal danger signs were 25% (Q1-Q3=0- 25). Severe vaginal bleeding was the most frequently mentioned danger sign in each of the three gestational periods (antenatal: 78.9%, intra-natal; 29.9% and postnatal; 39.7%). In conclusion, service providers and health management teams should emphasize on information, education and communication for every pregnant woman focusing on obstetric danger signs to have better awareness and thereby reduce adverse maternal and neonatal outcomes.","PeriodicalId":87122,"journal":{"name":"Nepal Medical College journal : NMCJ","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-06-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43221463","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":"Cardiovascular reactivity to stress shows proneness to future blood pressure status in students of a teaching hospital in Nepal","authors":"Smriti Singh, R. Pandit, B. Katwal","doi":"10.3126/nmcj.v24i2.46018","DOIUrl":"https://doi.org/10.3126/nmcj.v24i2.46018","url":null,"abstract":"Stress is a condition that disrupts or threatens to disrupt homeostasis. Stress may be physical or mental. Physical stress includes exercise (isometric or isotonic), pain, temperature (too hot or cold) etc. The development of hypertension is usually preceded by a prehypertensive state that may be manifested by abnormal cardiovascular reactivity to different types of stress viz., mental stress, cold water immersion, isotonic exercise, isometric handgrip, and valsalva maneuver. In present study, we have used isometric handgrip (IHG) exercise, as a stressor, aiming to identify individuals at increased risk for developing hypertension at early life. Normotensive, non-smoker sedentary two hundred male subjects, one hundred each from normotensive and hypertensive families, of age group 18-25 years participated in the study as volunteers. The causal blood pressure and heart rate of the participants were recorded in the sitting position by using mercury sphygmomanometer and stethoscope. Then, the isometric handgrip (IHG) exercise demonstrated to each of them using handgrip dynamometer. Maximum voluntary contraction (MVC) was noted as maximum pressure (in Kg) sustained during three seconds of handgrip using a handgrip dynamometer. The participants were asked to sustain isometric handgrip at one third of MVC for one minute with the same instrument (handgrip dynamometer). Both blood pressure and heart rate were recorded immediately after 1 and 3 minutes following isometric handgrip (IHG) exercise. The data analyzed using t-test showed that diastolic blood pressure didn’t return and stabilized to pre-exercise level even after 3 minutes following exercise in volunteers who were mostly from hypertensive family. More number of volunteers with family history of hypertensive (24%) showed elevated diastolic blood pressure even after 3 minutes whereas a few of the volunteers (8%) with no family history of hypertension showed rise in DBP even after 3 minutes following isometric handgrip (IHG) exercise. This present study indicated that the individuals having family history of hypertension are prone to develop hypertension in their early life, therefore, must adopt the healthier life style like avoidance of alcohol, smoking, and practice yogic exercise.","PeriodicalId":87122,"journal":{"name":"Nepal Medical College journal : NMCJ","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-06-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"48402601","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":"Role of colour Doppler ultrasonography in the evaluation of deep vein thrombosis of peripheral limbs at a tertiary care centre in Kathmandu","authors":"A. S. Tuladhar, Pingala Khadka, Sammi Joshi, K. Koirala, S. Pradhan, A. Shrestha","doi":"10.3126/nmcj.v24i2.46046","DOIUrl":"https://doi.org/10.3126/nmcj.v24i2.46046","url":null,"abstract":"Deep venous thrombosis is the development of blood clots in the deep veins. The management of deep venous thrombosis has been irreversibly altered after the introduction of Doppler ultrasound. This study aims to find out the prevalence of deep vein thrombosis of lower limbs diagnosed with colour Doppler ultrasonography at a tertiary care centre. A descriptive cross-sectional study was conducted in the Department of Radiology at a tertiary care hospital from October, 2021 to March, 2022. The study was conducted among 100 patients with clinically suspected deep venous thrombosis. Data were entered and analyzed using Microsoft Excel. Point estimate at 95.0% confidence limits was calculated and results were expressed in frequency and proportion for binary data. Among 100 patients, deep venous thrombosis was diagnosed in 88 (88.0%) patients (95% CL: 81.63-94.37). The patients had a mean age of 48.4±1.6 years. Out of 88 patients, 46 (52.3%) were male and 42 (47.7%) were female. Seventy-three (82.9%) patients had acute DVT. Multiple contiguous veins were predominantly involved (75.0%) than isolated veins (25.0%). Coexisting pathological conditions were seen in 41 cases (46.6%). The prevalence of deep vein thrombosis of lower limbs diagnosed with colour Doppler ultrasonography was higher when compared to other similar reported literatures.","PeriodicalId":87122,"journal":{"name":"Nepal Medical College journal : NMCJ","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-06-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"48939207","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 malnutrition among under-five children residing in Kamal Gaupalika, Jhapa","authors":"B. Kayastha, Soniya Rai, Dibyashwori Lakhe, Rubi Pradhan, Sapana Sainju","doi":"10.3126/nmcj.v24i2.46025","DOIUrl":"https://doi.org/10.3126/nmcj.v24i2.46025","url":null,"abstract":"Malnutrition among under-five is a major global health problem in developing countries like Nepal. It directly or indirectly affects many aspects of the child’s health, adversely affecting growth and development. Also, malnutrition affects the child’s ability to learn and process information and growth. This study assesses the prevalence of malnutrition among under-five children in Kamal Gaupalika, Jhapa, Nepal. First, a descriptive cross-sectional method was conducted among 60 under-five children and their mothers. The interview included semi-structured and structured questionnaires regarding socio-demographic and contributing factors of malnutrition and anthropometric measurement (analog weighing machine, measuring tape, mid-upper arm circumference) used for data collection. Then, the collected data were analyzed using SPSS-16, employing descriptive statistics (i.e. percentage, frequency, mean and standard deviation) and inferential statistics (i.e. chi-square). This study shows that 41.67% were malnourished. Among them, stunting was 20.0%, wasting was 25.0%, and underweight was 31.7%. Anthropometric measurement showed 83.3% were well-nourished, 11.7% were at risk for acute malnutrition, and 5% were moderate acute malnutrition. Family income was found to be significantly associated with malnutrition (stunting p = 0.001, wasting p = 0.007 and underweight p = 0.000). In contrast, there was no association in age, gender, ethnicity, mother’s education, father’s education, and mother’s age at childbirth. Our results showed that malnutrition is prevalent in the selected study area. Therefore, community-based nutrition awareness and education programs are necessary to improve the nutritional status of children.","PeriodicalId":87122,"journal":{"name":"Nepal Medical College journal : NMCJ","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-06-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46072641","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}