bluuebunny/crossref_metadata_2025_split huggingface dataset:
Tubercular Osteomyelitis of Tibia: A Case Report
Authors: Shrestha Amin Kumar , Shrestha Suman Raja , Thakur Gopesh Kumar , Dumre Arjun Prasad 
Published: December 2019

Tubercular osteomyelitis of long bone is extremely rare and very few cases have been reported in literature. We are presenting a case of 43 years gentlemen presented with pain and swelling over lower half of leg for 5 months. There was associated pus discharging sinus and often low-grade fever but no history of weight loss or pulmonary symptoms. X-ray chest was normal. X-rays of involved leg was suggestive of osteomyelitis. Curettage and Biopsy was done, report was suggestive of tuberculous osteomyelitis. As tuberculosis is still common in developing countries like Nepal, for any osteolytic lesion in bone, tubercular osteomyelitis should always be considered in differential diagnosis.
Keywords: extrapulmonary tuberculosis; osteolytic lesion in bone; tubercular osteomyelitis.
Lightning Maculopathy: A Case Report
Authors: Shrestha Ruchi , Shah Ritesh Kumar , Joshi Purushottam 
Published: December 2019

Lightning induced maculopathy is a very rare condition and there are barely any published reports on lightning induced maculopathy in our country. Here we present a case of twenty three years female who presented with lightning induced burns on the neck, chest and abdomen. She had unconsciousness for 3 days after lightening injury for which she was treated in intensive care unit. She presented with complain of diminution of vision in both eyes after 2 weeks. Optical Coherence tomography revealed cystic changes in fovea in right eye and a macular hole in left eye. Lightning injury is a life threatening condition. Lightning maculopathy should always be ruled out which can be best detected on optical coherence tomography.
Keywords: foveal cyst; lightning injury; maculopathy; optical coherence tomography.
Pattern of Menisci and Cruciate Ligaments Injury of Knee Joint in MRI and Arthroscopy
Authors: Joshi Santosh , Pandit Swayam Prakash , Sherchan Binod 
Published: December 2019

Introduction: The traumatic or internal derangement of the knee requires certain investigations for the establishment of diagnosis. With advances in technology and because of high resolution and accuracy a MRI scan is now a standard for evaluating the knee injuries before a subsequent arthroscopy. When used properly after a thorough clinical examination, an MRI can prove to be an efficient and non-invasive diagnostic tool in the management of knee injuries. On the other hand, arthroscopy is considered as the gold standard method for the diagnosis of such injuries.
Methods: The prospective hospital based study was conducted on fifty one symptomatic patients with knee injuries over a period of one year. All the patients underwent MRI of the knee joint on Philips Achieva 1.5 Tesla MRI Machine in Bir Hospital, NAMS and they were evaluated and cross checked by faculty members. After proper evaluation, diagnostic arthroscopy was done, if needed therapeutic intervention was also performed. The sensitivity, the specificity, the positive predictive value and the negative predictive value of MRI for MM, LM, ACL and PCL were calculated.
Results: A total of 51 patients were included with a mean age of 30.92 years. Left knee was predominantly involved in 56.1% of the cases with 43.9% involvement of right knee. Overall, MRI showed a total of 32 medial menisci tears and 8 lateral menisci tears. There were 5 false negative cases for MMT. MRI revealed tears of ACL in 44 patients and no patient with PCL tear. Arthroscopy revealed ACL tears in 44 cases and confirmed no patient with PCL tear.
Conclusions: MRI is a noninvasive, useful and reliable diagnostic tool for evaluating knee injury and it can be used as a first line of investigation in patients with knee injury.
Comparative Study of Ultrasonography and Computed Tomography in the Evaluation of Blunt Abdominal Trauma at CMS-TH
Authors: Thapa Subash , Thapa Madan 
Published: December 2019

Introduction: This study was conducted to compare the role of USG and CT as noninvasive imaging techniques for assessing the patient with blunt abdominal trauma.
Methods: A prospective longitudinal study was performed at the College of Medical Sciences Teaching Hospital, Bharatpur, Chitwan in the department of Radiodiagnosis, from January 2011 through July 2013. Where 150 patients following abdominal injuries were recorded, including patient age group, sex and mode of injury. Patient underwent USG and CT evaluation. The role of USG and CT was compared in the diagnosis of blunt abdominal trauma.
Results: In our study, 80% of patient with blunt abdominal injury were male with the M:F ratio of 4:1. Road traffic accident was the most common cause of blunt abdominal trauma (72%). There were 95 (92.22%) patients positive for free fluid by USG and CT where 15 had no organ injury. CT revealed organ injuries in 88 (85.43%) patients whereas USG detected 72 (69.90%) organ injuries. Spleen 42 (47.72%) was the most common organ to be injured followed by liver29 (32.95%), kidney 7 (7.9%) and pancreas 3 (3.4%). 16 (18.18%) patients out of 88 positive for organ injuries were not associated with free fluid. Overall sensitivity, specificity, positive predictive value, negative predictive value and accuracy of USG for organ injury were 81.81%, 100%, 100%, 79.48% and 89.3% respectively.
Conclusions: USG and CT are useful noninvasive tools in detecting free intraperitoneal fluid and organ injuries in patients with blunt abdominal trauma. CT is superior to detect organ injuries in patients with blunt abdominal trauma.
Knowledge and Practice Regarding Nursing Care in Terminally Ill Patients among Nurses
Authors: Khanal Basu , Pradhan Srijana , Lamichhane Suraj 
Published: December 2019

Introduction: Advanced illness occurs when one or more conditions become serious enough that general health and functioning declines and treatment begins to loose their impact. This is a process that continues to the end of life. It can also be called as “End of life care”, “serious illness” or “advanced illness”. Advanced illness includes different diseases: The Pulmonary advanced illness- Chronic Obstructive Pulmonary Disease; Cardiovascular advanced illness- Stroke, Congestive Cardiac Failure; Immunological advanced illness- HIV/AIDS; Endocrine advanced illness- Diabetes Mellitus (Type 1 and 2) and Cancer.To assess the level of knowledge and practice regarding nursing care in advanced ill patients.
Methods: A descriptive cross sectional study was undertaken in Om Hospital and Research Centre, Chabahil, Kathmandu. A total number of 100 nurses were taken as sample for study via non probability purposive sampling. Data collection was done through self structured questionnaire and observational checklist. Data processing was through using Statistical Package for Social Science version 16.
Results: The findings of the study revealed that 22 respondents have adequate knowledge, 57 respondents have average knowledge and 21 respondents have inadequate knowledge.
Conclusions: This study concludes that the periodic in-service education, seminar, conferences, continue education, workshop and trainings regarding Nursing care in Advanced ill patients would enhance the knowledge and practice of nurses.
Distrubution of Extended Spectrum β-Lactamase and AMPC-β Lactamase Among Bacteria Isolated From Urine Samples
Authors: Shrestha Bishal , Acharya Jyoti , Chhetri Jyoti , Gurung Krishna , Khaling Rai Mamita 
Published: December 2019

This study was designed to determine the distribution of bacterial strains isolated from patients with urinary tract infections (UTI) at Sukrararj Tropical and Infectious Disease Hospital (STIDH) with special reference to ESBL, ABL and the co-existence of the phenotype (ESBL and ABL in the population of different uropathogens. Urine samples from 500 patients suspected of UTI were analyzed by conventional semi-quantitative culture technique. The antimicrobial susceptibility to various drugs was studied by the Modified Kirby-Bauer disk diffusion method, by following the ClSI guidelines. Confirmation of the extended spectrum β-lactamase (ESBL) and AmpC β-lactamase production was done by the phenotypic confirmatory disc diffusion test (PCDDT) and the AmpC disk test (ADT). Overall, the prevalence of ESBL and ABL and the co-existence of the phenotype (ESBL and ABL) in urinary isolates were found to be 39.22%, 15.69% and 5.88%. The implementation of appropriate infection control measures and the formulation of an antibiotic policy must be done, to prevent the spread of these strains.
Key words: MDR, ESBLs. AmpC β-lactamase
Psychological Effects of Social Media among Pre-University Adolescences in Bangalore, India
Authors: Ojha Jenny , Jayapalan Sharmila 
Published: December 2019

For feeling safe and developing trust adolescences need a stable and caring environment. Their basic emotional and physical needs must be consistently met. Adolescences those are not properly guided and are not aware of proper use of social media may become distressful and avoid social contact. Some adolescence may also show signs and symptoms of the psychological effect caused by social media. Psychological effects like sleep disorder, sexual problems, attention deficiency, hyperactivity disorder, addiction, eating disorder, anxiety and depression may vary among adolescents as per the exposure of media. This study focused to assess the exposure of social media and its psychological effects among pre-university adolescences in Bangalore, India. This was institutional based cross-sectional descriptive study design. We carried out this study in purposively selected colleges in Bangalore City. We involved 80 adolescences using non-probability convenience sampling technique. We adopted quantitative method and used structured self-administered questionnaire for collecting required information. We consulted supervisors and experts in the field of nursing and medicine to assure content validity of the tools. We performed descriptive as well as inferential statistical analysis using SPSS 20 version for drawing and interpreting the findings. We assessed adolescences knowledge on social media whereas more than half (55.0%) were average, nearly one third (33.8%) had high and 11.3% had low knowledge. Similarly regarding the attitude of adolescents more two-thirds (71.3%) had constructive attitude, nearly one-third (28.8%) had positive attitude. The overall mean scores and standards deviations (SD) of knowledge and attitude were 15.11 and 2.38 out of maximum possible score 48 and 48.47 and 4.20 out of maximum possible score 60 . The total scores of knowledge and attitude were statistically significant(r = 0.348, P<0.05). We further assessed association of knowledge and attitude with socio-demographic factors. All almost all factors were not found to be associated with knowledge and attitude. Psychological effects of social media among pre-university adolescences in Bangalore, India varied considering their knowledge and attitude. However knowledge and attitude were significantly associated each other. Social media had constructive as well as destructive effect among adolescences. Family and academic institutions should closely monitor the adolescents and focused them on to use social media for academic purpose rather than entertainment.
Keywords: Knowledge, attitude, psychological effects of social media, adolescences
Antibiotic Sensitivity Pattern and Plasmid Profile Of Urinary Tract Infection Isolates among Children Below 10 Years Of Age
Authors: Wagle Ram , Timilsina Rajendra , Thapa Rojesh , Adhikari Nabaraj , Thapa Shrestha Upendra , Jaiswal Suresh , Tiwari Bishnu Raj 
Published: December 2019

Urinary tract infection (UTI) is defined as colonization of pathogen anywhere along the urinary tract. UTI has been classified by site of infection as Upper urinary tract infection and lower urinary tract infection and by severity as Complicated and uncomplicated UTI. This community based cross sectional study was conducted to determine the Antibiotic sensitivity pattern and plasmid profile of most prevalent urinary tract infection isolates among children below 10 years of age, from December 2013 to February 2014. Among the total 800 sample collected from the community 390(48.8%) were female and 410(51.2%) were male. The prevalence rate was found to be 44(5.5%) of total cases and was statistically significant (p<0.05). Among significant growth, 15(1.9%) and 29(3.6%) were male and female respectively (p<0.05). Out of 44 total isolates frequency of Escherichia coli (E. coli) was 20 followed by Staphylococcus aureus(12), which accounted for 45.5% and 27.3% respectively. Remaining were Pseudomonas(11.4%), Klebsiella(11.4%), Proteus(2.3%)and Citrobacter sps.(2.3%). Tobramycin(100%) and Amikacin(97.73%) were found to be the most sensitive antibiotics followed by Chloramphenicol(93.18%), Imipenem(90.91%) and Ciprofloxacin(75%) respectively.Out of 20 E. coli isolates, no plasmid was seen in 7(35%) while 8(40%) showed single plasmid which was present in 8 isolates. Plasmid copy number of 2, 3 and 4 were displayed by 2(10%), 2(10%) and 1(5%) of the isolates respectively. A common (>21 kilobases) plasmid was the most common among isolates under study. This study revealed that E. coli was the most prevalent organism causing community acquired pediatric UTI. Antibiotics that are commonly used for the management of UTI and other cases are being more resistant i.e., Ampicillin. Plasmid analysis showed the presence of plasmids in resistant E. coli isolates that might harbor resistant genes. So that further analysis is required for the detection of responsible genes.
Key words: Antibiotic sensitivity pattern, Plasmid profile, Urinary tract infection
Post Traumatic Stress Disorder (PTSD) and It’s Associated Factors among Secondary Level Students in Chautara Municipality, Nepal
Authors: Gurung Trima , Paneru Damaru Prasad 
Published: December 2019

Children and adolescents are more prone to developing Post Traumatic Stress Disorders. Objective of this study was to assess the magnitude of Post Traumatic Stress Disorder and associated factors among secondary level students in Chautara Municipality, Nepal. A cross sectional study was conducted among 249 secondary level students. Data were collected using population proportionate sampling method along with UCLA PTSD RI with 31 questionnaires DSM V tool was used to assess the PTSD symptom. Questionnaire was design to obtain socio demographic factor and earthquake exposure. Factor associated with PTSD development was assessed through chi square and binary logistic regression. Mean age of respondents was 15.42±1.079 years. Majority of them were middle adolescents (74.3%) and 25.7 percent were early adolescents. More than half of respondents were female 54.6 percent. This study revealed that PTSD was found to be among 27(10.8%) respondents and dissociative subtype PTSD was among 14(5.6%) respondents. Age was significantly associated with development of PTSD. Earthquake exposures like financial constraints after earthquake food deficiency displacement due to earthquake was the major factors associated with PTSD development. Psychological tutorship for PTSD is found to be protective factors for PTSD development in adolescents. PTSD was quite high among the secondary level students after six month of earthquake in Chautara municipality, Sindupalchwok district and psychological tutorship and humanitarian program for traumatized students could prevent development of PTSD.
Key words: Post traumatic stress disorder; Associated factors; Earthquake; Secondary levels students
Prevalence of Tobacco Use and Its Associated Factors among School Going Adolescents in Birgunj Sub-Metropolitan, Nepal
Authors: Chaudhary Arbind Kumar , Bhandari Tulsi Ram 
Published: December 2019

Tobacco use means consumption of any form of tobacco products either smoked or smokeless. Common used tobacco products are cigarette, cigars, pipe tobacco and favored Sisha tobacco, Surti/khaini, Panmasala, and Gutkha. It is one of the major causes of preventable mortality and morbidity worldwide. Objective of the study was to assess the prevalence of tobacco use and its associated factors among higher secondary school going adolescents of Birgunj Sub-metropolitan, Nepal. A schools based cross-sectional descriptive study was carried out using self-administrative questionnaire and it was prepared based on Global Youth Tobacco Survey. It was developed and validated for assessing the tobacco use among adolescents. Amongst 16 higher secondary schools, three public and three private schools were selected randomly. Similarly required sample (307) were recruited as proportionately from each school considering number of students studying in each selected school from August to December 2016. Prevalence of ever use of tobacco was 15.6 %. Cigarette was the most (70.8%) commonly used as tobacco product. The average age of initiation of tobacco use was 13.96++2.62 year. More than half (52.1%) of the tobacco users purchased tobacco from shops. Peer pressure (45.8%) was one of the major influencing factors of ever use of tobacco. Age, gender, friends pressure and parent's education were found significantly associated with ever use of tobacco among students. Nearly one-fifth adolescents used some type of tobacco products in last six month. Tobacco used by parents, peers and others family members at home and public places, and easy access of tobacco products were the major influencing factors of tobacco use among students. School and community based awareness programs and tobacco control legislations should be implemented consistently to control and discourage the consumption of tobacco products.
Keywords: Adolescents, students, associated factors, tobacco use
Awareness and Utilization of Reproductive Rights Among the Women of Reproductive Age in Kapan VDC, Nepal
Authors: Kaphle Manju 
Published: December 2019

The awareness and utilization of reproductive right and health is not satisfactory in developing countries including Nepal. This study aimed to assess the awareness and utilization of reproductive rights among women of reproductive age having at least one child. Descriptive study was conducted among 101 married women of reproductive age having at least one child and residing in Kapan VDC, Ward No. 1, Kathmandu, during the year 2010 by using non-probability purposive sampling method and semistructured Nepali interview questionnaires through home visits. Of the total 101 respondents, most of them (26.5%) were of age group 35-39 years (mean age=33 years) from different ethnic groups and religions. Most were simply literate (38.6%). Of the total, 68.3% were aware of reproductive right with commonest response being family planning (30.4%). The percentages of aware respondents towards sex education, right marriage age, ideal pregnancy age, proper birth spacing and safe abortion were 59.4%, 83.2%, 98.0%, 99.0% and 66.3%, respectively. Furthermore, 38.6% got sex education (51.2% in proper age), 34.6% got married at the right age, 56.4% conceived at right age (29.7% on own will), 78.2% of them utilized any family planning methods of which 35.6% of respondents decided themselves for family planning and 77.2% maintained proper birth spacing. Moreover, 43.6% respondents did abortion due to no desire of child (36.4%) and 34.1% decided themselves for abortion. Furthermore, 65.3% respondents did ≥4 ANC visits, 52.5% delivered at health institution, 53.5% respondents did proper PNC visits with 70.3% respondents deciding themselves for PNC. The associations between awareness and utilization for Family Planning, ANC visit, PNC visit and abortion right were statistically significant (p<0.05) except for institutional delivery. Awareness and utilization of reproductive rights in the study population is higher with significant statistical associations. Similar studies in large scale are necessary for generalization of the results.
Key words: awareness, utilization, reproductive right, women, Nepal
HIV Status and High Risk Behavior of Men having Sex with Men
Authors: Bhatt Chandra Prakash , Sharma Medha 
Published: December 2019

Voluntary counseling and testing (VCT) of HIV is important intervention for the prevention of HIV infection. Aim of this study was to find out HIV status and high risk behavior of men having sex with men. This descriptive cross sectional study was conducted among men having sex with men (MSM) by administering structured questionnaires. The number of risk factors in a single individual ranged from one to seven out of eight. The mean risk factor was 3.38, with standard deviation 1.3. More than half (55.33%) of them perceived at low risk, 33% perceived themselves at high risk. Regarding HIV status of respondents, 8% were found to be positive. In the past 30 days the respondents had large number of sex partners; majorities of them 90% and 87.3% had 0-20 regular and casual sex partners but 9.8% of MSM had 21-40 regular sex partners and 2.9% had 81-100 casual sex partners respectively. Among the MSM 46.6% were commercial sex worker, 35% were sex drives and 18.4% were intravenous drug user. Majority of them (59.8%) always used condom but 21.56% used sometime only. Some respondents (3.9%) had sign of STIs and 5.8 % had accident of needle injured. There are higher chances for transmission of HIV and other STDS among MSM. The role of VCT centre should be strengthen to awareness raising, isolate HIV positive cases treat them with antiretroviral drugs and counseling them to behavior change.
Key words: HIV, MSM, Risk factor
Impact of Socio-Cultural Factors on Antenatal Practices
Authors: Ghimire Madhusudan , Gautam Gyanendra , , Ghimire Moushami , Sharma Tara Devi , Sharma Bimala 
Published: December 2019

The provision for special care during pregnancy through public health services is considered by World Health organization as a part of reproductive health right of women which, however, is not achieved till date due to socio-cultural factors resulting increased maternal morbidity and mortality. The objective of this study is to observe impact of socio-cultural factors on antenatal practices. The study was conducted in three Village Development Committees (Dakhaquady, Khaira, and Belbash) of Pyuthan district. During the period Cross-sectional study was followed. Two hundred forty six respondents were selected through simple random procedure. Interview schedules were used to collect information from respondents. Data were tabulated in Microsoft Excel spreadsheet and analyzed using SPSS 11.5. The mean age of first pregnancy among respondents was 18.75 years. Forty-two percent of them were illiterate and 76.90 percent respondents were involved in agricultural field work. Early marriage and pregnancy systems were most common in study population. Socio-cultural factors were strongly associated with ANC practices.
Key words: ANC practices, early marriage, early pregnancy, Pyuthan, socio-cultural factors, traditional beliefs.