bluuebunny/crossref_metadata_2025 huggingface dataset:
Prevalence of Postpartum Depression in A Tertiary Health Care
Authors: Pradhananga Priza , Mali Prajita , Poudel Lisasha , Gurung Minani
Published: November 2020

Introduction: Postpartum Depression is an important public health problem in developing country like Nepal. Although prevalence of postpartum depression is high in our setting, it is most neglected area of mental health. These have negative consequences not only to mother but also to infant. Data related to postpartum depression in Nepal are limited, research in this particular field will contribute in knowing the gravity of the situation and helps to formulate the factor association to upcoming researchers. This research is done in order to find out the prevalence of postpartum depression.

Methods: A descriptive cross-sectional study was carried out in Paropakar Maternity and Women’s Hospital, among total 348 postnatal mothers who were selected through convenient sampling technique. Validated Nepalese version of Edinburg Postnatal Depression Scale was used to screen depressive symptoms. Data was collected after receiving ethical approval letter. Data entry was done using SPSS version 20.

Results: Out of total mothers, the prevalence of Postpartum Depression (PPD) was seen among 51 mothers (14.7%).

Conclusions: Postpartum Depression being a common yet neglected area of maternal health in Nepal, should be detected in early stage. As, the study showed that about one sixth of mothers had postpartum depression, more focus should be given to maternal mental health.
Prevalence of Atrial Fibrillation in Obstructive Sleep Apnea Patients in a Tertiary Care Center
Authors: Dhakal Subodh Sagar , Neupane Asmita , Bhattarai Mahesh , Karki Dambar Bahadur
Published: November 2020

Introduction: Atrial fibrillation is the most common sustained arrhythmias.Recently there has been evidence of higher prevalence of atrial fibrillation in obstructive sleep apnea patients compared to the general population. The aim of this study was to find the prevalence of atrial fibrillation in patients of obstructive sleep apnea in a tertiary care center.

Methods: This descriptive cross-sectional study was done in Om Hospital and Research Centre from January 2016 to 2018 March after ethical clearance. Convenience sampling was done. Data was collected and entry was done in microsoft excel, point estimate at 95% Confidence Interval was calculated along with frequency and proportion for binary data.

Results: The prevalence of atrial fibrillation in patients with obstructive sleep apnea is 7 (10.44%) at 95% Confidence Interval (6.70-14.17%). Apnoea–Hypopnoea Index of more than 30was present in 3 (42.8%) patients of atrial fibrillation. Atrial fibrillation was seen highest, 3 (42.8%) in patients with BMI more than 30 and lowest, 1 (14.28%) patients with BMI less than 23.5. Prevalence of atrial fibrillation was seen 5 (71.4%) in male patients and 2 (28.57%) in female patients. Sixty seven (75.28%) patients had obstructive sleep apnea in which male patients was predominant 48 (71.64%).

Conclusions: Prevalence ofatrial fibrillation in patients of obstructive sleep apnea was found to higher than the similar studies done. It is important to obtain detail cardiac history in any patients with obstructive sleep apnea and look for arrhythmias speciallyatrial fibrillation.
Sleep Quality among Medical Students of a Tertiary Care Hospital: A Descriptive Cross-sectional Study
Authors: Sundas Nabin , Ghimire Saransh , Bhusal Suzit , Pandey Rakshya , Rana Krishna , Dixit Hemang
Published: November 2020

Introduction: Medical students are under constant stress due to demanding academic load, fearof exam failure and hectic schedules. These factors can lead to poor sleep quality among medicalstudents. Sleep quality of medical students not only determine their academic performance but isalso important in determining long term effect on cognitive, psychosocial, behavioural as well asphysical health of individuals. Although there are not enough recent studies to assess sleep qualityof students, it is necessary to evaluate the condition of sleep among students. This study aims to findout the prevalence of poor sleep quality among medical students.

Methods: This descriptive cross-sectional was conducted among undergraduate medical studentsof Kathmandu Medical College from October to November 2019 after taking ethical clearance fromInstitutional Review Committee of a tertiary care hospital before collecting data from participants.Subjects were recruited by simple random sampling from students of first, second, third and finalyears and were asked to fill the self-reported questionnaires, using Pittsburgh Sleep Quality Index.Descriptive statistical analysis was done using Statistical Software for Social Sciences version 24.

Results: Out of 217 selected medical students, 96 (44.23%) of students have poor sleep quality withprevalence among male and female students as 41 (39.8%) and 55 (48.2%) respectively. The meanduration of sleep among students was 6.7±1.6 hours.

Conclusions: Significant numbers of medical students have poor sleep quality which may affecttheir academic performance and may have long term impact on their health. Efforts must be directedtowards educating about the sleep hygiene as well as proper time management skills.
Early experience of Retrograde Intrarenal Surgery for Renal stone: A Descriptive Cross-sectional Study
Authors: Joshi Robin
Published: November 2020

Introduction: Retrograde intrarenal surgery with improving skill and knowledge may be consideredone of the first-line treatment options for removal of renal stones. The study is done to find theoutcome of retrograde intrarenal surgery in patients with renal stone.

Methods: This descriptive cross sectional study was carried out on patients undergoingretrograde intrarenal surgery for renal stone at a tertiary care hospital December 2019 to March2020. Ethical approval was taken from the institutional review committee (Ref. no.200120202).The Convenient sampling method was applied. Data was collected and analyzed in StatisticalPackage for the Social Sciences version 20.0. Point estimate at 95% confidence interval wascalculated along with frequency and proportion for binary data.

Results: Out of the 28 patients, the retrograde intrarenal surgery was successful in 27 (96.4%)cases. There were 16 (57.15%) females and 12 (42.86%) male patients with the mean age of37.86±11.47 years. Most of the stones were in renal pelvis 18 (64.28%) followed by lowercalyx 8 (28.57%). The mean diameter of the stone was 11.47 ±3.33mm whereas most ofthe stones were on the right side 16 (57.15%). The mean hardness was 1155.21±265.34Hounsfield units. Perioperative complications like failed access sheath placement in 2 (7.14%)cases, hematuria in 6 (21.43%) cases, fever in 6 (21.43%) cases, and septicemia in 4 (14.28%)cases.

Conclusions: We found that the success rate of retrograde intrarenal surgery for the renal stonewas acceptable and similar to other published studies . Retrograde intrarenal surgery is feasiblefor the treatment of kidney stones with acceptable complications and success rates.
Critical Incidents during Anesthesia and Early Post-Anesthetic Period: A Descriptive Cross-sectional Study
Authors: Gautam Binod , Shrestha Babu Raja
Published: November 2020

Introduction: Critical incidents related to peri-operative anesthesia carry a risk of unwanted patientoutcomes. Studying those helps detect problems, which is crucial in minimizing their recurrence. Weaimed to identify the frequency of peri-anesthetic critical incidents.

Methods: This is a hospital-based descriptive cross-sectional study of voluntarily reported incidents,which occurred during anesthesia or following 24 hours among patients subjected to non-cardiacsurgery within the calendar year 2019. Patient characteristics, anesthesia, and surgery types, category,context, and outcome of incidents were recorded in an indigenously designed form. Incidents wereassigned to attributable (patient, anesthesia or surgery) factor, and were analyzed for the system,equipment or human error contribution.

Results: Altogether 464 reports were studied, which consisted of 524 incidents. Cardiovascularcategory comprised of 345 (65.8%) incidents. Incidents occurred in 433 (93%) otherwise healthypatients and during 258 (55.6%) spinal anesthetics. Obstetric surgery was involved in 179 (38.6%)incidents. Elective surgery and anesthesia maintenance phase included the context in 293 (63%)and 378 (72%) incidents respectively. Majority incidents 364 (69.5%) were anesthesia-attributable,with system and human error contribution in 196 (53.8%) and 152 (41.7%) cases respectively. Allrecovered fully except for 25 cases of mortality, which were mostly associated with patient factors,surgical urgency, and general anesthesia.

Conclusions: Critical incidents occur even in low-risk patients during anesthesia delivery. Patientfactors and emergency surgery contribute to the most serious incidents.
Diagnosis of Achondroplasia at Birth: A Case Report
Authors: Bhusal Suzit , Gautam Uttara , Phuyal Rajan , Choudhary Robin , Manandhar Sunil Raja , Niroula Aliska
Published: November 2020

Autosomal dominant mutations in fibroblast growth factor receptor 3 cause achondroplasia, the most common form of dwarfism in humans. Achondroplasia is a genetic disorder causing rhizomelic shortening of limbs. Head is often large with prominent forehead causing vaginal delivery difficult. A twenty-one years old multipara mother gave birth to a baby with achondroplasia via spontaneous vaginal delivery with episiotomy without any complication. Achondroplasia, in this case, was diagnosed on the basis of antenatal ultrasonography finding, clinical features and radiological finding of the baby. He was admitted in the special baby care unit for observation and discharged on the next day as no complications were noted.
Oral Cancer Awareness among Undergraduate Dental Students and Dental Surgeons: A Descriptive Cross-sectional Study
Authors: Poudel Pratibha , Srii Ritesh , Marla Vinay
Published: November 2020

Introduction: The incidence of oral cancer is rising due to overindulgence in tobacco chewing and smoking. Its detection in early stage makes it more amenable to treatment and helps to reduce associated morbidity. However, most cases are diagnosed at later stage due to lack of awareness about oral cancer and associated risk factors. This study aims to observe the oral cancer awareness among undergraduate dental students and dental surgeons of three dental institutions of Nepal.

Methods: This descriptive cross-sectional study was conducted in three dental institutions of Nepal from January 2019 to May 2019. Convenience sampling method was used. The data was collected from 508 participants through questionnaire adopted from Carter and Ogden. Point estimate at 95 % Confidence Interval was calculated along with frequency and proportion for binary data. Statistical analysis was done using Statistical Package for the Social Sciences.

Results: Our study showed that 120 (23.6%) of the participants were well informed about the clinical appearance of oral cancer at 95% confidence interval (19.91-27.29). Most of the participants i.e. 457 (89.96%) and 395 (77.75%) were aware that smoking and chewing tobacco were most commonly recognized risk factors. Only 200 (39.37%) participants were aware that non-healing ulcer is considered as the changes associated with oral cancer. Three hundred and forty-four (67.7%) said they have no knowledge about the prevention and detection of oral cancer.

Conclusions: Our study exhibited the apparent lack of awareness in some aspects of oral cancer and highlights the need of enhancing the undergraduate dental syllabus.
Full-time Studies and Volunteering
Authors: Niroula Aliska , Acharya Shreedhar Prasad
Published: November 2020

Our volunteering began being a part of the editorial support team in the Journal of Nepal Medical Association. This has really built up our confidence to work as a team. During our days in Journal Office, a sudden knock of another opportunity stroke our door. The Administrative Officer of Nepal Medical Association asked us about volunteering in the Election of Nepal Medical Association which held from 17th to 21st Magh, 2076 and we accepted it. We also helped NMA during the pre-election procedure that needs to be done before going for the election. We think that was the work where we got the trust of NMA officers.
Selected Risk Factors and Pattern of Semen Abnormality in Male Partners of Infertile Couples in Eastern Nepal: A Descriptive Cross-sectional Study
Authors: Pokhrel Sita , Ghimire Ashima , Chhetry Manisha , Lamichane Sabina , Shreewastav Rupesh Kumar
Published: November 2020

Introduction: Semen analysis is an initial basic step in evaluating and diagnosing male infertility. Multiple risks factors in combination or alone are responsible for abnormal semen parameters. The present study aimed to study certain risk factors and semen parameters of infertile male.

Methods: It was a descriptive cross-sectional study. We consecutively enrolled 186 male partners of infertile couple who underwent certain risk factors evaluation and semen analysis according to WHO guideline.

Results: Multiple risk factors were present like Gulf country migration, smoking, chemical exposure and heat exposure in infertile male partners. Forty six percent of our patients were gulf workers. Eleven percent patients had azoospermia, 27% had abnormal sperm morphology and 23% had <25% motile spermatozoa.

Conclusions: Surprisingly 46% of our patients were Gulf country workers and abnormal semen analysis is very important factor for infertility. Large prospective studies need to be carried out involving Gulf migrant workers only.
Prevalence of Domestic Violence among Infertile Women attending Subfertility Clinic of a Tertiary Hospital
Authors: Silwal Ajita , Thapa Bandana
Published: November 2020

Introduction: Millions of couples suffered from Infertility worldwide. Infertility can cause intenseemotional pain in women resulting in stress, anxiety and depression. Domestic violence in infertilewomen can further results in poor health status and lowers the quality of life. The objective of thisstudy is to find out the prevalence of domestic violence among infertile women attending subfertilityclinic of tertiary hospital.

Methods: This descriptive cross-sectional study was conducted among infertile women in a tertiaryhospital from July to August 2018 after taking ethical approval. Convenient sampling was used. Faceto face interview was conducted using a structured interview schedule. Data analysis was done inthe Statistical Package for Social Sciences. Descriptive statistics (frequency, percentage) were used toanalyze the data. Point estimate at 95% CI was calculated along with frequency and proportion forbinary data.

Results: Domestic violence was found among 62 (55.35%) women at 95% Confidence Interval (46.15-64.55). The emotional violence accounted for 57 (50.89%), physical violence for 19 (16.96%) and sexualviolence for 18 (16.07%). The prevalence of domestic violence was more 22 (61.11%) in women withsecondary infertility than in women with primary infertility 40 (52.63%). The main perpetrators ofdomestic violence were family members 28 (45.16%).

Conclusions: The study concluded that women experiencing infertility are exposed to various formsof domestic violence, emotional one being most common. Routine screening for domestic violencein infertility clinics is necessary to give affected women an opportunity to access appropriate healthcare and support services.
Management of Neglected Post-traumatic Bilateral Facet Dislocation of Sub-axial Cervical Spine: A Case Series
Authors: Marasini Rudra Prasad
Published: November 2020

Neglected bilateral facet dislocation of the lower cervical spine is a rare condition and found mostlyin developing countries like Nepal. Delayed presentation makes treatment more challengingconcerning decompression, reduction, neurological recovery, and overall outcome. We managedthree cases of bilateral facet dislocations of the fifth-sixth-seventh cervical vertebra level presentedafter three months of injury. All of those were treated surgically by combined anterior-posterioranterior approaches with the same principle. One patient had a complete neurological recovery, thesecond one recovered partially with few long-term complications and the third one did not improveat all.
Patient Satisfaction in Out-patient Services at a Tertiary Care Center: A Descriptive Cross-sectional Study
Authors: Poudel Lisasha , Baskota Swechhya , Mali Prajita , Pradhananga Priza , Malla Nabina , Rajbhandari Bibek , Nepal Susmita
Published: November 2020

Introduction: Patient satisfaction is an important and commonly used valid indicator for themeasurement of service quality. Patient responses to healthcare services are one of the bestways to obtain information about patient views regarding the quality of healthcare. The mainaim of the study was to find out the patient’s satisfaction level in the tertiary care center.

Methods: A descriptive cross-sectional study was conducted among 94 outpatients at a tertiary carecenter. Data were collected after obtaining ethical clearance from the institutional review committee.Patients were selected conveniently who visited any four of the major department. We collecteddemographic data and the patient satisfaction towards outpatient clinic experience was studied. Weused the Patient Satisfaction Questionnaire–18 to assess patient satisfaction. Data were entered andanalyzed in Statistical Package for the Social Sciences version 23. The mean score and the standarddeviation were calculated.

Results: Overall satisfaction was 74.78% with a mean value of 3.7394±0.40128. The highest satisfactionscore was found in regards to the interpersonal manner of health personnel (4.2872±0.61561) followedby communication (3.9628±0.40982) and the lowest was seen in accessibility and convenience(3.2394±0.81478).

Conclusions: The mean score and percentage of patient satisfaction were high in the hospital.However, the accessibility and availability of medical personnel were only a matter of concern.
Symptomatic Imperforate Hymen in Early Infancy: A Case Report
Authors: Dahal Geha Raj , Phuyal Subash , Agrawal Pooja
Published: November 2020

Imperforate hymen, though a congenital anomaly, usually presents late in puberty as lowerabdominal pain, primary amenorrhea, and cyclical pain. Blood collects in vagina and uterus,proximal to imperforate hymen leading to their distention. Its presentation at infancy is a rare entity.We report such a rare case of symptomatic imperforate hymen in infancy, who presented with acuteretention of urine, chills and rigor. Abdominal examination revealed an intra-abdominal mass in thelower abdomen and pelvis with the absence of vaginal opening on perineal examination. Contrast enhanced computed tomography abdomen showed large abdominopelvic cystic lesion posterior tothe urinary bladder and anterior to the rectum consistent with a highly distended vagina. She wasmanaged by the incision of the imperforate hymen and drainage of the pus. A high index of suspicionis necessary whenever a female infant presents with abdomino-pelvic mass with symptoms of feveror urinary retention.
Nepalese Medical Students in the COVID-19 Pandemic: Ways Forward
Authors: Guragai Mandeeep
Published: November 2020

The coronavirus disease 2019 has not hit Nepal as hard as it has the rest of the world (as of 4th April2020). Countries are reporting a saturation in healthcare facilities and facing a rise in demand forhuman resources for health. It is difficult to predict the extent of the disease transmission in Nepal inthe absence of epidemiologic and statistical analysis in our context. But based on calculations madeby epidemiologists in other countries, there seems to be a significant possibility of an outbreak in ourcommunities too. Medical students can be a valuable human resource in a variety of ways to aid inthe country’s response to a possible outbreak. However, their involvement in the pandemic comeswith its own challenges. Thorough planning and preparation must be done before allowing medicalstudents to take part in the battle against the pandemic.
COVID 19 and Nepal: Identification of Critical Public Health Measures
Authors: Neupane Harish Chandra , Shrestha Niki , Adhikari Shital , Gauli Basanta
Published: November 2020

The COVID-19 pandemic is unfolding at an unprecedented pace. The unprecedented threat providesan opportunity to emerge with robust health systems. Nepal has implemented several containmentmeasures such as Rapid Response Team formulation; testing; isolation; quarantine; contact tracing;surveillance, establishment of COVID-19 Crisis Management Centre and designation of dedicatedhospitals to gear up for the pandemic. The national public health emergency managementmechanisms need further strengthening with the proactive engagement of relevant ministries; weneed a strong, real-time national surveillance system and capacity building of a critical mass of healthcare workers; there is a need to further assess infection prevention and control capacity; expandthe network of virus diagnostic laboratories in the private sector with adequate surge capacity;implement participatory community engagement interventions and plan for a phased lockdownexit strategy enabling sustainable suppression of transmission at low-level and enabling in resumingsome parts of economic and social life.
Left Chronic Otitis Media with Squamous Cell Carcinoma of the Middle Ear and Postauricular Mastoid Fistula: A Case Report
Authors: Acharya Shreedhar Prasad , Pathak Chetana , Giri Sandarva , Bista Meera , Mandal Deependra
Published: November 2020

Though squamous cell carcinoma is the commonest tumor, it rarely presents in the middle ear andfollows a history of chronic ear discharge. Postauricular mastoid fistula is also a rare complicationof chronic otitis media. These two pathological changes occurring simultaneously are even rarer.We report a rare case of a 37 years old male with a history of left-sided chronic ear discharge andconductive hearing loss. Squamous cell carcinoma along with postauricular mastoid fistula wasdiagnosed based on high-resolution computed tomography scan and histopathology. Left modifiedradical mastoidectomy with tympanic membrane grafting was done under general anesthesia.Often middle ear tumor is associated with long-standing ear discharge and this case is a very goodexample. The co-occurrence of the middle ear tumor with mastoid fistula is extremely rare as boththe entities are rare in itself.
Micro-Erythrocyte Sedimentation Rate in Neonatal Sepsis of a Tertiary Hospital: A Descriptive Cross-sectional Study
Authors: Manandhar Sunil Raja , Basnet Rydam
Published: November 2020

Introduction: Neonatal sepsis is the most important cause of morbidity and mortality among lowbirth weight and preterm babies in developing countries. The main objective of this study is to findthe level of micro-Erythrocyte sedimentation rate in neonatal sepsis.

Methods: This is a descriptive cross-sectional study conducted at the neonatal unit over six monthsperiod (November 2019 to April 2020). All preterm, term and post-term babies with neonatal sepsisdelivered at Kathmandu Medical College Teaching Hospital were enrolled. Ethical clearance wasreceived from the Institutional Review Committee of Kathmandu Medical College (Ref: 181020191).Convenient sampling method was applied and statistical analysis was done with Statistical packagefor social sciences 19 version.

Results: Out of 75 babies, confirm sepsis is 13 (17.3%), probable sepsis is 40 (53.4%) and suspectedsepsis is 22 (29.2%). Micro-Erythrocyte sedimentation level is elevated (≥15mm in 1st hr) in 25 (33.3%)babies with a mean micro-Erythrocyte sedimentation level 9.32±5.4 (2-18) mm in 1st hr. The elevatedmicro- Erythrocyte sedimentation level was seen in relation to sepsis types and C-reactive protein.

Conclusions: The bedside micro-Erythrocyte sedimentation level aids in the diagnosis of neonatalsepsis.
Anti-leucine-rich Glioma-inactivated-1 Encephalitis with Faciobrachial Dystonic Seizures and Behavioral Problems: A Case Report
Authors: Adhikari Ayush , Subedi Ram Chandra , Acharya Subi , Paudel Raju
Published: November 2020

Anti-Leucine-rich glioma-inactivated-1 encephalitis is a subtype of autoimmune encephalitischaracterized by cognitive impairment, faciobrachial dystonic seizures, and behavioural changes.There is no reported case from Nepal. We report a case of a 54-year old male who presented withabnormal body movement, behavioural changes, rapid eye movement sleep behavioural changes,and cognitive decline. Investigations revealed magnetic resonance imaging findings of fluidattenuated inversion recovery intensity signal in bilateral temporal lobes with anti-leucine-richglioma-inactivated-1 antibody in serum leading to diagnosis of anti-leucine-rich glioma-inactivated-1encephalitis. He was treated with steroids and intravenous immunoglobulin. Timely diagnosis isvital to prevent complications and improve outcomes.
Dental Practice during COVID-19 in Nepal: A Descriptive Cross-sectional Study
Authors: Humagain Manoj , Humagain Rashmi , Rokaya Dinesh
Published: November 2020

Introduction: Currently, coronavirus disease (COVID-19) has become pandemic and spread globally. In Nepal, the number of COVID-19 is increasing day-by-day. This research was done to find out the impact of COVID-19 on dentists, patients, and dental practice in Nepal.

Methods: This study is a cross-sectional study conducted using an online survey from May 10 to17, 2020. A questionnaire was designed and uploaded in Freeonlinesurveys.com. Following ethical approval, the questionnaire was distributed among 500 dentists, and 406 dentists participated in the study. The survey link was dispersed to the Nepali dentists through social media and e-mail, and the results of the responses were received online. The questionnaire consisted of a total of 34 closed-ended questions containing three parts; demographic details, knowledge of dentists on COVID-19, and the impact of COVID-19 on dentists, patients, and dental treatments.

Results: It showed that majority of the participants were females 243 (60%) of the age group 25-29 years with the clinic as the workplace. Patients receive dental treatments only from 40 (10%) of the dentist. A high number of dentists: 284 (70%) were severely affected by the financial burden and were not receiving a salary during this lockdown. About 349(86%) of the dentist think they should do regular dental treatments, but only 101 (25%) think the dentist should do only dental emergency treatments for COVID-19 infected cases.

Conclusions: Dentists, patients, and dental practice are severely affected by the COVID-19.The majority of the dentists have faced financial burdens. The dental treatments should be done with high standards of care and infection control following proper recommendations.
Perception of Dental Students of COMS-TH regarding Future of Dentistry in Nepal amid COVID-19 Pandemic
Authors: Garg Deepanshu , Kapoor Deepika
Published: November 2020

Introduction: There is a global crisis which has been led by COVID-19. The patients undergoingdental procedures and dental professionals are at higher risk of contracting this disease owing toaerosols generated and a lot of face to face contact during the procedures. The aim of this study was to know the perceptions of dental students of COMS-TH regarding future of dentistry in Nepal amidCOVID-19 pandemic.

Methods: The present cross-sectional descriptive study was conducted at COMS-TH, Bharatpur by sending an online e-survey questionnaire to 146 dental students out of which 99 responded. The e-survey questionnaire consisted of three parts which consisted of questions about demographics, knowledge about COVID-19 and their perceptions about future of dentistry.

Results: The results of the study depicted that most of the students thought dentistry is good and noble profession and will recommend it to young medical aspirants. Most of them wanted to pursue post graduation courses in future giving preference to Oral and Maxillofacial Surgery.

Conclusions: The study concluded that most of the dental students were satisfied with dentistry as their profession and wanted National Dental Association to fix the minimum charges of each dental procedure. Also there is a need to start more post graduation courses in existing institutions providing dental education as most of the students want to pursue it in future.
Acute on Chronic Bilateral Subdural Hematoma in a Woman with a Remote History of Previous Subdural Hematoma Managed by Trephination: A Case Report
Authors: Karn Mitesh , Yonghang Sapana
Published: November 2020

Bilateral chronic subdural hematoma are not that common. It may be recurrent and rarely superimposed by acute bleed leading to rapid progression and poor clinical outcomes. We report the case of a seventy six years old lady with a history of traumatic subdural hematoma evacuated by trephination twenty years back, presenting at our hospital with a history of persistent headache and acute onset of several episodes of vomiting. A non-contrast head CT revealed bilateral chronic subdural hematoma with acute on chronic bleed on one side. Trephination was done initially unilaterally, but the symptoms persisted and bilateral trephination was performed. The patient developed bilateral pneumocephalus and chest infection post-surgery. Bilateral, recurrent subdural hematoma with acute superimposition of bleed is a rare entity that presents with signs of increased intracranial pressure as opposed to unilateral SDH. A single burr hole trephination can be an effective intervention in these cases.
Mechanical Thrombectomy for Basilar Artery Occlusion Stroke: A Case Report
Authors: Phuyal Subash , Dawadi Kapil , Paudel Raju , Lamsal Ritesh , Agrawal Pooja
Published: November 2020

Posterior circulation strokes are potentially devastating events that carry a significant risk of morbidity and mortality. Acute basilar artery occlusion stroke is a rare posterior circulation stroke that needs emergent management. We report the case of a 67-year-old woman who developed an acute basilar artery occlusion. We achieved complete recanalization of the occluded basilar artery and its branches with endovascular mechanical thrombectomy. It is possible to achieve excellent results with mechanical thrombectomy in acute basilar artery occlusion if timely diagnosis and reperfusion can be done. We are not aware of any previous publication from Nepal describing this technique in acute basilar artery occlusion.
Functional Outcomes of Capitellum Fractures Treated by Open Reduction and Internal Fixation with Herbert Screw: A Descriptive Cross-sectional Study
Authors: K.C. Kapil Mani , Acharya Parimal , Marahatta Suman Babu , Sigdel Arun , K C Amuda , Dahal Sudip Chandra
Published: November 2020

Introduction: Based on the complex intra-articular nature of capitellum fractures, it has been sometimes difficult to formulate a universally accepted method of surgical treatment. The purpose of this study is to present the functional outcomes of capitellum fractures after fixation with Herbert screw including the safety and tips of the surgical approach.

Methods: This descriptive cross-sectional study was done from December 2014 to November 2019. Ethical approval was taken. The study included 22 capitellum fractures treated by open reduction and internal fixation with Herbert screws either lateral or anterolateral approach. Functional outcomes were assessed with Mayo elbow performance index scores at the latest follow-up visit. Convenient sampling was done. Data entry was done using the Statistical Package for the Social Sciences (version16.0).

Results: Out of 22 surgeries, the average time to unite the fracture was 11.13±1.20 weeks (range 9 to 15). The mean range of movement for flexion and extension was 138.41±8.22 degree while the mean supination and pronation range was 161.59±6.79 degree. The average time of follow-up in this series was 37.45±9.43 weeks (range 22 to 58 weeks). Similarly, the mean Mayo elbow performance index score at the latest follow-up was 90.22±8.65 (range 70 to 100).

Conclusions: Careful assessment and radiological evaluation, anatomical reduction, and stable fixation with Herbert screws maintaining the minimal damage to the articular cartilage can maximize the functional outcomes and minimize the incidence of complications.
Prevalence of Overweight Among Adult Women of A Metropolitan
Authors: Nepal Ashmita , Karki Urusha , Poudel Lisasha , Rajbhandari Bibek , Wagle Shreejana
Published: November 2020

Introduction: Globally, Overweight has reached epidemic proportions. It is an excessiveaccumulation of fat that may impair health. Overweight and obesity area major contributor tothe global burden of non-communicable disease. The prevalence of overweight is commonlyassessed by using Body Mass Index (BMI), where overweight is indicated by BMI greater orequal to 25. Overall, about 13% of the world’s adult population was obese in 2016, among themwomen were more affected than men. Overall,female population is higher than male in Nepaland concentrating on Kaski district female population are significantly more than that of maleas per population census of 2011. The objective of this study was to find out the prevalence ofoverweight among adult women.

Methods: This was a cross-sectional descriptive study, conducted among calculated samplesize of 185 adult women of Lekhnath Metropolitian of Kaski district, over six months’ period.Sampling technique was proportionate random sampling. Ethical approval was taken fromInstitutional Review Board (Ref no. 40/74/75). Anthropometric measurement was taken tocalculate BMI. Collected data was entered in Epi data, which was then exported to SPSS version20 for further analysis. Descriptive statistics was reported for demographic, socio-economic andvarious overweight related factors of the respondents as frequencies and percentage.

Results: Out of 185 adult women, 69 (37.3%) of them were overweight, 30 (16.2%) of them wereobese, and central obesity was seen among 97 (52.4%) women at 95% C.I.

Conclusions: The finding of this study shows prevalence of overweight and obesity was high.Regular Physical exercise and balanced diet should be followed to prevent overweight and noncommunicable diseases.
Prevalence of Intracranial Artery Stenosis in Patients with Acute Ischemic Stroke in a Tertiary Care Hospital of China
Authors: Jaiswal Sandip Kumar , Fuling Yan , Li Min
Published: November 2020

Introduction: Intracranial artery stenosis is the most common cause of acute ischemic stroke, especially among people in Asia. About its epidemiology, however little is understood. The goal of our research is to establish the prevalence of intracranial artery stenosis in patients with acute ischemic stroke in a tertiary care hospital.

Methods: A descriptive cross-sectional study was done in 1006 acute ischemic stroke patients at Affiliated Zhongda Hospital, School of Medicine, Southeast University China from May 2018 to May 2019. Ethical approval was taken from the Ethical review committee of the institution. A convenient sampling method was done. Intracranial artery stenosis was diagnosed when evidence of acute ischemic stroke was found in the territory of approximately 2 50% stenosis identified by Transcranial Doppler ultrasound and confirmed by magnetic resonance angiography or computed tomography. Statistical analysis was done using the Statistical Package for the Social Sciences version 20.

Results: The prevalence of intracranial artery stenosis was found in 331 (32.90%) patients at 95% Confidence interval (0.24-0.42%). Among 331 cases the anterior circulation artery stenosis was present on 201 (19.98%) patients, followed by posterior circulation artery stenosis on 80 (7.95%) patients, then anterior plus posterior circulation artery stenosis on 50 (4.97%) patients.

Conclusions: Intracranial artery stenosis is one of the most causes of acute ischemic stroke in China. The proportion of anterior circulation artery stenosis was higher than that in the posterior circulation.
Telemedicine and Virtual Health Care during Coronavirus Disease Pandemic
Authors: Shrestha Badri Man
Published: November 2020

N/A
Artificial Intelligence in Medical Science: Perspective from a Medical Student
Authors: Mainali Gaurab
Published: November 2020

N/A
Knowledge, Attitude and Practices among Mothers of Children 6 to 24 months of Age Regarding Complementary Feeding
Authors: Shrestha Sabina , Pokhrel Manoj , Mathema Smriti
Published: November 2020

Introduction: Complementary foods fill the gap between the total nutritional needs of the child and the amounts provided by breast milk. Inappropriate feeding practices are a major cause of the onset of malnutrition in young children. The objective of this study was to assess the knowledge, attitude, and practices of mothers of children between 6 to 24 months of age regarding complementary feeding.

Methods: This Knowledge, Attitude, and Practice Study was conducted among 250 mothers in Kathmandu Medical College and Teaching Hospital from June 2019 to November 2019 after obtaining ethical approval from the institutional review committee (Ref no. 150320199). Convenient sampling method was applied. The mothers of children between 6 to 24 months were interviewed using a structured questionnaire to ascertain the knowledge, attitude, and practices regarding complementary feeding. Statistical analysis was done using SPSS version 20.

Results: Two hundred and fifty mothers were interviewed. 151 (60.4%) mothers knew initiation of breastfeeding soon after birth and 179 (71.6%) were knowledgeable about exclusive breastfeeding for 6 months. 161 (64.4%) mothers knew the proper age of initiating complementary feeding but only 139 (55.6%) mothers practiced it. Early initiation of complementary feeding was done by 87 (34.8%) mothers while 24 (9.6%) mothers delayed it beyond 6 months.

Conclusions: There was a gap in knowledge and practice among mothers regarding adequate age of initiation of complementary feeding, complementary foods, preparation, and practices.
Safe Abortion among Underprivileged Group Married Women of Low Resource Country: A Descriptive Cross-sectional Study
Authors: Budathoki Sapana , Mali Prajita , Khadka Rakshya , Rajbhandari Bibek
Published: November 2020

Introduction: Unsafe Abortion is one of the leading causes of maternal death. The unhygienic and dangerous practice has been encountered in various geographical areas of Nepal. Despite its legalization, many women are still being not concerned and well informed regarding safe abortion and become victims of it. The main aim of this study was to assess the knowledge and practice regarding safe abortion among married women of reproductive (14 to 49) years of an underprivileged group of low resource country, Nepal.

 

Methods: A descriptive cross-sectional study design was done in Rajbanshi community of Jhapa District. Data collection was done after taking ethical approval. Study population was selected conveniently. Data was collected by using a semi-structured questionnaire via face to face interviews among 420 married women of reproductive (14-49) years. All the extracted data were entered and analyzed using Statistical Package for the Social Services version 20. Descriptive analysis was doneand presented using frequency and percentage.

Results: Out of 420 respondents, 388 respondents (92.4%) found to have poor knowledge, regarding safe abortion. Likewise, only 44 respondents (10.05%) had practiced abortion, of which only 2 respondents (0.05%) had an unsafe abortion and 42 respondents (10%) had practiced safe abortion.

Conclusions: Practices of unsafe abortion were prevalent. Respondents with poor knowledge werefound to have done abortion. In this context, it can be concluded that knowledge regarding safe abortion can be increased by educating and providing awareness to the people of society.
Patterns of Rheumatic Heart Disease and Treatment Practices at Tertiary Care Center in Nepal: A Descriptive Cross-sectional Study
Authors: Nepal Rajesh , Bista Madhab , Dhungana Sahadeb Prasad
Published: November 2020

Introduction: Rheumatic heart disease is a sequel of rheumatic fever which causes heart valve damage. This study was conducted to look at the pattern of valve lesions and treatment practices in patients with rheumatic heart disease.

Methods: A cross-sectional study conducted at the tertiary care center with a diagnosis of rheumatic heart disease from July 2018 to January 2020 by convenient sampling. Ethical clearance was obtained from the Institutional Review Committee (ref no. 55/2018). Data were analyzed by using Statistical package for social sciences version 20.

Results: Out of 600 patients, 428 (71.3%) were female. The mean age was 44.24±14.24 years. The isolated mitral valve was affected in 280 (46.6%). Dual involvement of mitral and aortic valve was present in 294 (49%). Only 14 (2.3%) had involvement of isolated aortic valve involvement. Overall, mitral stenosis was the most common abnormality 508 (84.6%) followed by mitral regurgitation 418 (69.6%), aortic regurgitation 320 (53.3%), and aortic stenosis 63 (10.5%). Assessment of the severity of lesions showed that 247 (41.2%) patients had severe mitral stenosis, 119 (19.8%) severe mitral regurgitation, 14 (2.3%) severe aortic stenosis, and 11 (1.8%) severe aortic regurgitation. Majority 493 (82.2%) were treated with medical therapies. Surgical procedures were performed in 51 (8.5%). The use of anticoagulation was in 212 (35.3%) of eligible patients.

Conclusions: Mitral valve was affected commonly both in isolation and combination. The majority of patients who were eligible for cardiac interventions were treated medically with suboptimal use of anticoagulation and secondary prophylaxis.
Wódz doskonały w świetle łacińskich panegiryków późnoantycznych
Authors: Szopa Adrian
Published: November 2020

In this article I am describing how Roman panegyric’s writers of Late Antiquity (XII Panegyrici Latini, Claudius Claudianus, Sidonius Apollinaris, Flavius Merobaudes, Priscian, Ennodius, Corippus and others) presented an im­age of the perfect general with reference to their object of praise. On the ground of detailed analysis of those features I am going to indicate the most expected ones according to the social reception. Moreover, I will point out those means which were used by the authors to create the image of the ideal general. Next, I will pay attention to how the authors change their way in presenting the perfect general and how this development was connected with the general evolution of the genre. Lastly, I will answer a quite perverse question: if the perfect general could lead his soldiers to a victory in a real battle. In the background there will be a continu­ous question, if the panegyric – despite its limitation – can or can’t be treated as a valuable historical source.
Mnisi jako „żołnierze” Chrystusa w nauczaniu Jana Chryzostoma. Analiza 69. i 70. homilii z cyklu "Homilie na Ewangelię według św. Mateusza"
Authors: Szczur Piotr
Published: November 2020

This article considers the subject of spiritual warfare led by monks as the “sol­diers” of Christ. Author of the article analyzed two John Chrysostom’ homilies (69 and 70) from the series Homily on the Gospel according to St. Matthew. First, he emphasizes the important role of the monasticism in the life and thought of John Chrysostom already from the beginning of his literary activity. Then, on the basis of sources, he shows the monks as a “spiritual army” of Christ, who are stay­ing at the hermitage instead of at a military camp, and instead of arms have ascetic practices. This spiritual army of Christ refers more splendid victory than the crack troops of the Roman Empire army, because the battle with the demons is far more difficult than fighting with people. In the final part of the article pointed out the profile of pastoral teaching of John Chrysostom, who encouraged all Christians to take spiritual warfare as the monks.
Metamorfoza stosunku do mężczyzn. Apulejusz o mężczyznach odpowiedzialnych za patologiczne sytuacje w rodzinie
Authors: Jundziłł Juliusz
Published: November 2020

In Apuleius novel we have a seeming attack on bad character, bad behaviour of women for example main character is turn in to donkey by the witch. If we carefully analyse his literature that cover a topic of in family relationships, it can be notice thesis that, it is husband fault, by the rash and botched decision, lack of communication, starts conflicts that sometimes lead women to commit crimes. This confirm thesis that also Church Fathers preach about great responsibility of the husbands and fathers for shaping relation in his family.
Winiety metropolii pentarchii na mapach średniowiecznych i wczesnonowożytnych
Authors: Kochanek Piotr
Published: November 2020

The idea of the pentarchy directly expressed by Justinian I (527-565) – Novella 131 – is also perceptible in cartography. This paper examines the 41 medieval and early modern world maps in the context of the vignettes of the pentarchy. From the above analysis shows that almost every map from this period had a vignette of Jerusalem and 37 maps have a vignette of Rome. But only 28 maps have a vi­gnette of Alexandria, 24 maps have a vignette of Constantinople, and 20 maps have a vignette of Antiochia. In the case of Jerusalem, a huge majority of vignettes is a sacred buildings (most often it is the Tomb of Christ). Only in three cases is a Holy Cross. In contrast, Rome’s vignettes represent both religious buildings and fortifications. As for the drawings on the vignettes of Antiochia, Alexandria, and Constantinople, the vast majority of them are character of fortifications. These vignettes are, on the one hand, a close relationship with the history of these cit­ies, on the other hand, they are associated with the medieval and early modern politic ideology and theology. This paper is trying to capture and analyze these complicated, religious, political, and theological relationships, and explaining the meaning of these vignettes.
Teologia w posłudze pasterskiej Paulina z Noli
Authors: Pałucki Jerzy
Published: November 2020

The article presents – on the basis of analysies of the selected letters and of Carmen 20 by Paulinus of Nola – different ways to combine contemplatio and ac­tio in his life as a bishop and using theological argumentation in his pastoral care with a special emphasis on the Paulinus’ commitment as a bishop for the poor.
Rola modlitwy w życiu syryjskich mnichów według Teodoreta z Cyru
Authors: Skotnicka Katarzyna
Published: November 2020

Prayer was a basic goal of the lives of Christian monks. Historia religiosa by Theodoretus of Cyrus conveys a lot of valuable information on the subject of prayer of Syrian ascetics. The bishop of Cyrus used the notion of prayed to refer to any kind of requests and begging or thanksgiving and admiration. Theodoretus recorded particularly numerous examples of recoveries, which occurred by dint of intercessive prayer of ascetics. Monks prayed at different times of a day and in various postures (standing, lying or kneeling), they were also familiar with many kinds of prayer and addressed God with varied intentions. Historia religiosa in­forms us as well about gestures that accompanied prayers, such as bows, raising arms and eyes to the sky and places where it could be said. An important issue discussed by Theodoretus was the time of praying. In Historia religiosa we can find references to the ideal of incessant prayer and to morning and evening prayers typical for Christians. The aim of prayer was to help ascetics control their bodily needs, it drew the mind of an ascetic towards God, tearing them, at the same time, from worldly issues. Prayer was also a reflection of monk’s faith, since through it, they worshipped God, referred to him their requests and thanksgiving.