bluuebunny/crossref_metadata_2025_split huggingface dataset:
Audio Visual aids in Medical teaching: Are they being over Subscribed?
Authors: Mishra S.M. 
Published: May 2019

In the ancient past the teaching was quintessentially verbal. The Students had to be “Shrutidhar”(remembering by listening to the teachers). Our ancient Scriptures are a witness to this.
Since then, much water has flown under the bridge. We now live in a time where an effective communication has not only to be verbal but visual as well. The controlled trials have unequivocally shown that verbal presentations beefed-up with visual supplements make such presentations more informative, interesting and intensify cognitive learning.
For this, the cutting-edge technology and tools like PowerPoint presentations and OHPS have opened new vistas and dimensions in teaching methods. The poor black-board and chalk have been given a cold valediction.
However, wisdom always demands a re-assessment of the usefulness of the newly invented tools. Are these visual aids making the teaching more immersive and interactive? Are these aids being used in proper perspectives?
The answer will be a flat “no” if a student is asked to answer honestly. A large majority of the teachers are using this aid for their convenience not to increase the students cognitive engagement in the class. Transparencies of OHPS howsoever transparent they might be yet, they create a barrier between the students and teacher. The PowerPoint Presentations are more often too numerous and contain too much information that student can digest. A monotonous recital of these makes the students totally disinterested in the lecture. They feel that teacher is reciting from the lines taken down from the books.
I think there is still a place for black-board and the newer invaluable teaching aids should be very subtlety used and used in proper perspective.
Prof. S.M. MishraMS (Surgery), MS (Ortho), FRCSEditor In Chief
Pattern of Provoking Factors and Psychiatric Co- morbidity in Migraine Headache: A Study from Tertiary Care Hospital
Authors: Khan Tanveer Ahmed 
Published: May 2019

Introduction: Headaches are the most prevalent neurological disorders and among the most frequent symptoms seen in general practice among which migraine only accounts up to 30%. Certain factors are found to play role in the triggering of migraine headache. Avoidance of such factors is part of migraine management. Psychiatric co morbidities are common in migraine. Recognizing these co morbidities could therefore result in improved patient management.
Methods: This study was done at Nepalgunj medical college hospital, Nepalgunj. Duration of study was six months i.e. from 1st July 2017 to 31st December 2017. All the new cases fulfilling diagnostic criteria of migraine headache visiting to psychiatric outpatient department were included in this study. The diagnosis of migraine was made based on criteria mentioned by the international classification of headache disorders (ICHD-II).
Result: A total of 50 patients were enrolled in this study. The mean age of participants was 28.60 ± 10.388 years. There was significant predominance of female participants. Family history of migraine was found in 20 (40%) of participants. The mean age of onset was 22.76± 7.899 years. The commonest type of migraine was migraine without aura in 2/3rd number of cases. Psychiatric co-morbidity was found in 26 (52%) subjects among which the most common co-morbidity was anxiety disorder in 16 (32%) followed by depression in 8 (16%). Presence of provoking factors was found in 38 (76%) subjects. Light, smoke, smell, noise and lack of adequate sleep were the common provoking factors.
Conclusion: Migraine predominantly affects females with common age of onset in second and third decade. Psychiatric co-morbidities are common in migraine patients. Anxiety disorder and depression are the commonest co-morbidities. The common provoking factors are light, smoke, smell, noise and lack of adequate sleep found in migraine. Avoidance of provoking factors and early detection and management of psychiatric co morbidities can result in better outcome.
Prevalence of Hypertension in Hemorrhagic Stroke at NGMCTH, Kohalpur
Authors: Shrestha Anil , Shrestha Richa 
Published: May 2019

Aim: To study the prevalence of hypertension in hemorrhagic stroke in patients admitted in medical units of Nepalgunj Medical College Teaching Hospital (NGMCTH), Kohalpur.
Background : Hemorrhagic stroke has remained a serious disease despite recent advances in medical treatment. It is one of the most common emergencies encountered in clinical practice and predominantly effects elderly population leading to chronic disability and dependency. This study was designed to identify hypertension as a major cause of Intracerbral hemorrhage (ICH).
Material and methods: This is a cross sectional descriptive study conducted in the department of medicine of NGMCTH, Kohalpur between June 2017 and November 2017. A total of 51 patients were included in the study. History and clinical examinations were recorded. Plain CT scan head, ECG and chest x-ray PA view were done and the data were recorded and analysed.
Result: The age of patients ranged from 48 to 89 years with the mean age of 66.72 years. Among 51 patients, high BP at presentation along with ECG showing LVH was seen in 38 patients (74.5%) and chest x-ray PA view showing cardiomegaly was seen in 31 patients (60.8%). Most commonly involved ethinic group was Tharu (45.1%).
Conclusion: Hypertension is a major cause of ICH. So, early detection and regular treatment of hypertension with appropriate antihypertensive drugs and life style modification would prevent ICH.
Profile of Colonoscopy Findings: A single Centre Experience
Authors: Kidwai Roman , Sharma Anup 
Published: May 2019

Background: About 30% of patients presenting to surgical outpatient department has lower gastrointestinal (LGI) symptoms. Colonoscopy is a low risk and at the same time investigation of choice in these patients which allows visualization of the entire colon and the terminal portion of ileum. This study was done to evaluate the role of colonoscopy.
Methods: This was an observational, hospital based study from February 2014 to March 2018, carried out at Nepalgunj Medical College and Teaching Hospital.
Results: 245 patients underwent colonoscopy, among them 62.85% were male and 37.14% were female with the M:F ratio being 1.6:1. The youngest patient undergoing colonoscopy was 21 and the eldest was 78 with the mean age being 53.6±12. The common indications were per rectal bleeding (49.38%), alteration in bowel habit (40.49%), and constipation (13.46%). In 85.71% patients entire large bowel could be visualized. In 21.22% no abnormality was detected. Haemorrhoids (27.34%) were the most common findings and then nonspecific inflammatory bowel diseases (17.55%), colorectal polyps (15.51%) and colorectal cancers (14.28%). Biopsy was done in 39.51% patients and the most common finding was nonspecific inflammatory bowel disease, 36.08% had adenocarcinomas and rest had ulcerative colitis, juvenile and hamartomatous polyps.
Conclusion: Colonoscopy is a safe and effective investigation in diagnosing as well as managing the patients with LGI symptoms.
Comparison of Vestibular Function Between Right and Left Handed Normal Population
Authors: Bhandari Sharma , Shrestha Sagun , Saxena R.K. 
Published: May 2019

Objective To identify the side of vestibular dominance in right handed & left handed people.
Method A total of 50 normal subjects, aged between 15 - 45 years were included as Left handers (n = 25) and Right handers (n = 25). Handedness was confirmed by the Annett Hand Preference Questionnaire. Bithermal caloric testing was done which was recorded by Electronystagmography (ENG). Maximum Slow Phase Velocity (MSPV) was taken as the parameter of choice. Directional Preponderance (DP) and Canal Paresis (CP) were calculated in each group.
Results Out of the 25 Left handed subjects, 8 had DP towards Left whereas 7 had DP towards the Right and the remaining 10 showed no DP to any side (normal) (p<0.001). Out of the 25 Right handed subjects, 4 had DP towards Right and none had DP towards the Left, remaining 21 showed no DP to any side (normal) (p<0.001). For CP, out of 25 Left handed subjects, 2 showed CP towards the Left and 1 towards the Right, the remaining 22 showed no CP (normal) at all. Similarly out of the 25 Right handed subjects, 2 showed CP towards the Left and 1 towards the Right, the remaining 22 showed no CP (normal) at all. Out of 25 Right handers, it was found that Right handers showed Right vestibular preference whereas vestibular preference was almost equally distributed to Left and Right side in Left handers.
Conclusion On considering DP, it was found that Right handers showed Right vestibular preference whereas vestibular preference was almost equally distributed toLeft and Right side in Left handers (p<0.001).
Prevalence of Depression and Use of Antidepressant in Basic Medical Sciences Students of Nepalgunj Medical College, Chisapani, Nepal
Authors: Dhami Dabal B. , Singh Ankita , Shah Gaurav Jung 
Published: May 2019

Introduction: According to WHO, depression would be the second-most prevalent condition worldwide by 2020. The prevalence of depression is increasing in medical colleges because of stressful, competitive environment, long hours of trainings and studying. It is important for medical educators or teacher to know the magnitude of depression in students and factors causing it. The present study was carried to assess the prevalence of depression, use of antidepressant and to find out their stressors among preclinical students of Nepalgunj Medical College, Chisapani, Nepal.
Aims and objective: To assess the prevalence of depression, use of antidepressant and to find out their most common stressor among preclinical students
Materials and methods: The descriptive cross sectional study was carried in preclinical students of Nepalgunj Medical College, Chisapani, Nepal, The data was collected with questionnaires which comprised of personal data (age, sex, year of study, religion and home country) and Zung Depression Inventory scale was used to rate the depression.
Results: Among 218 students, the prevalence of depression was 24.3%. Male students are highly depressed (16.5%) then female (7.8%). First year student are more depressed (26.5%) then second year (22.4%). The depression score of the preclinical medical student was 44.67± 5.68 (mean ±SD). Majority of the students (>50%) found on academic stress and 3.6% of the total students were on antidepressants
Conclusion: As the prevalence of depression is high in medical students there is need for the counselling services to the students in the medical college to control this morbidity.
Incidental Findings in CT scan in Pediatric Populations with Head Injury
Authors: Ghimire Prasanna , Paudel Nabin , Koirala Dwight 
Published: May 2019

Objective: To investigate the incidental findings in computed tomography scans performed for mild head injury in pediatric patients at Nepalgunj Medical College and Teaching Hospital, Kohalpur, Banke, Nepal.
Materials and methods: It is a cross sectional hospital based study performed on two hundred and eighteen patients of age < 18 years presenting with mild head injury with no known neurological problem, recent surgery, and time of scanning < 24 hrs of sustaining injury were included in the study between Dec 2016 and June 2017.
Results: Among the 218 patients, 134 were males and 84 females, age ranged from 3 months to 18 years. 196 out of 218 patients (89.9%) had incidental findings in CT scan images with greater than 2 incidental findings present in 54 patients. Sinus opacification was the most common incidental finding noted in 86 cases (43.9 %) followed by calcified granuloma in 27 cases (13.8 %). Incidental findings unrelated to trauma which required further investigation was present in 5 cases.
Conclusion: Incidental findings are being increasingly encountered in computed tomography scan performed for mild head injury in pediatric age group with sinus opacification as the most common finding. Recognition of these findings and communication with the treating physician is helpful in the overall management of such cases.
Attitudes of Undergraduate Medical Students towards the Persons with Mental Illness in a Medical College of Western Region of Nepal
Authors: Jalan Rekha 
Published: May 2019

Background: The universality of harmful beliefs and subsequent negative attitude towards the persons with mental illness among medical students are the main obstacles facing the mentally ill people that further prevents them from seeking help and care for their mental health problems. Mental health education plays a significant role in changing medical students' attitude towards persons with mental illness.
Aim: The aim of this study was to assess undergraduate medical students' attitude towards persons with mental illness and to compare their attitudes before and after mental health education.
Materials and methods: A longitudinal prospective study was carried on final year MBBS students (N=68) from June, 2017 to November, 2017. Pretest- posttest design was adopted using Attitude Scale for Mental Illness (ASMI) before and after theory classes and clinical posting for mental health education.
Results: Findings of present study revealed that these students were less stigmatized (6.44+1.93). Domain of restrictiveness improved (9.44+2.94 from 10.54+3.09) and benevolence increased significantly (t=2.440; P=0.017*) after mental health education and training. Overall attitude of the study population was found to have unhealthy attitude towards persons with mental illness since the mean scores on separatism, stereotyping, restrictiveness and pessimistic prediction subscales were elevated on ASMI.
Conclusion: In conclusion, mental health education was found to be effective in changing the attitude of restrictiveness i.e., decreasing an uncertain view on the rights of people with mental illness and increasing kindness and sympathetic view to some extent among undergraduate medical students towards the persons with mental illness.
Burden of Anemia: A profile of a tertiary care hospital
Authors: Joshi Rinku , Bajracharya S. , Gurung S. , Shrestha D.B. 
Published: May 2019

Introduction: Globally, anemia is the burning health problem with significant disability associated with it. Iron deficiency anemia (IDA) is the commonest cause of anemia more so in developing and underdeveloped part of world. Normocytic anemia is the common finding following microcytic hypochromic and macrocytic in peripheral blood film study. To understand more about the type of anemia among anemic patients in our setting this study was carried out.
Objectives: This study aims to see the prevalence and aetiology of anemia among Nepal army personnel and their families in a Kathmandu based tertiary level hospital.
Methods: This cross-sectional study was conducted over a six months period through June 30th to December 31st 2017 among 342 anemic patients presented to hematology clinic of Shree Birendra Hospital in Kathmandu with the help of data collection tool. Etiology of anemia was worked out. The study was conducted after approval from local IRC. Collected data were entered in SPSS version 22 and analyzed.
Result: Mean hemoglobin value was 8.45±1.61 gm/dL and the mean age of the patient was 52.04±18.32 years. Among the patients of anemia, generalized weakness was the commonest (159, 46.5%) presenting complaint followed by per vaginal bleeding and upper gastrointestinal bleeding. Moderately severe anemia was the commonest (159, 46.5%) laboratory finding. In peripheral blood film study, microcytic hypochromic picture was the commonest finding (169, 49.4%) favoring commonest cause of anemia as iron deficiency followed by anemia of chronic disease.70 % of the participants were female.
Conclusion: The study identified nonspecific complaints like generalized weakness as the predominant presenting complaints of anemia which is commonly neglected. Further, noninvasive tests like peripheral blood film are an important diagnostic tool which can guide us to the possible aetiology of anemia. This study showed iron deficiency anemia and anemia of chronic disease as important differential diagnosis of anemia in our context.
This was a small scale study conducted to access the prevalence of anemia among Nepal army personnel and their families. Hence a larger multicentric study is needed to make it more applicable.
Broken Femoral Intramedullary Locking Nails with Nonunion: A difficult combination!
Authors: DC Gopal Sagar , Gurung Sandeep 
Published: May 2019

Background: The diaphyseal fracture of femur is universally treated with intramedullary interlocking nails. Non-union with properly done interlocking nail is not very common. When broken nail and non-union coexist, it becomes a real challenge. We reviewed our isolated femoral shaft fractures treated with antegrade interlocking nails that presented with broken nails, bolts and non-union. We discuss our simple technique of retrieval of broken nail units, their management and results with revision nailing.
Materials and methods: We reviewed our cases of femoral intramedullary locking nails operated from 2012 November to 2017 November and observed that, out of 197 cases; Eight cases of broken nails were managed in our center Nepalgunj medical college Nepalgunj. Patients were operated in lateral position under combined spinal epidural anaesthesia. We removed the broken nail segment with our simple yet less destructive technique and revised with bigger nails.
Results: Out of 197 cases of fracture shaft femur treated with IM nail, 8 cases were found to have broken nails. Seven cases were associated with non-union of femur. In one case, the femur united in spite of broken nail. In all the cases broken nail were removed in a similar manner and was struggle free. Exchange nailing was done in seven cases and only one case was augmented with bone graft from ipsilateral iliac crest. Union was achieved in all seven cases.
Conclusion: IMIL nail is the well-established, minimally invasive osteosynthesis for long bones fracture. Nonunion and broken implant when coexist the management becomes difficult.
Seroprevalence of Human Immunodeficiency Virus, Hepatitis B Virus and Hepatitis C Virus in Nepalgunj Medical College, Nepal
Authors: Gurung Kishor , Poudel T.P. , Shah G.J. , Mishra D. 
Published: May 2019

Introduction: Human immune deficiency viruses (HIV), Hepatitis B viruses (HBV) and Hepatitis C viruses (HCV) are the three most common chronic viral pathogens known. The viruses have common routes of transmission (such as blood and blood products, sharing needles to inject drugs and sexual activities) and similar risk factors.
Aim and objective: The aim of study was to determine the seroprevalence of HIV, HBV and HCV in Kohalpur Teaching Hospital, Nepalgunj Medical College.
Materials and methods: This is a descriptive hospital based study. The study was conducted at Nepalgunj Medical College, KTH, Banke. In this study, 2865 were tested for HIV, 2849 were tested for HBV and 2950 were tested for HCV from 12-01-2017 to 06-07-2017.
Results: In case of HIV, 1781 (62.16%) were male and 1064 (37.84%) were female. The study revealed that in HIV reactive case was found to be 0.14% where 0.16% (3) were males and 0.09% (1) were females. In case of HBV, 1743 (61.18%) were males and 1106 (38.82%) were females. The prevalence of HBV reactive was found to be 1.65% where 1.2% (34) in male and 0.45% (13) in female. In case of HCV, 1200 (40.67%) were male and 1750 (59.33%) were female. The prevalence of HCV reactive was found to be 0.03% (1) which was only in female.
Conclusion: We found that the prevalence of HIV was more predominant in males 0.16% (3). The HBV was more prevalent followed by HIV and HCV and the prevalence of HBV in male was more 1.2% (34) as compared to females 0.45% (13).
Self-medication Practice Among Undergraduate Medical Students in Nepalgunj Medical College, Chisapani
Authors: Singh Ankita , Dhami Dhabal Bahadur , Singh Ritesh , Shah Gaurav Jung 
Published: May 2019

Introduction: Self-medication forms an essential part of the self-care. Since medical students are being exposed to the knowledge of diseases and drugs, would assume a special significance to assess the self-medication practice among them.
Methods: This was a cross-sectional study conducted from March to April 2018 in 200 preclinical medical students of Nepalgunj Medical College (NGMC), Chisapani. A structured questionnaire was used for data collection and the students who took self-medication within last two months were included.
Result: Out of 200 students, 123 (61.5%) were found practicing self-medication. Majority of students (47.97%) were taking Non-steroidal Anti-inflammatory Drugs (NSAIDs) for fever (18.70%), headache (17.89%) and abdominal pain (13.01%). 21.14% of students were consuming paracetamol for these health ailments. 44.72% of students reported that they were practicing self-medication because of the mild nature of illness.
Conclusion: Students are widely practicing self-medication, particularly NSAIDs group of drugs. In this situation, awareness about the pros and cons of self-medication should be must in the medical students.
Substance Abuse Among Medical Students – A Survey in a Medical College in Nepal
Authors: Roy Roshan Kumar , Roy Deepak Kumar , Goit Rajeh Kumar 
Published: May 2019

Introduction: Substance use among medical students could impact on the conduct, safety and efficiency of future doctors. Despite serious medico legal, ethical and political ramifications, there is paucity of published article on the subject, especially from Nepal.
Objective: We aimed to explore the patterns of substance abuse among a sample of Medical students from Nepalgunj Medical College.
Materials and Methods: A cross-sectional survey of medical students from Nepalgunj Medical College was done using a brief questionnaire schedule to identify current and lifetime use of tobacco, alcohol, cannabis and abuse of other drugs. An operational definition of substance abuse was made, 28 % of students fell within that criterion.
Results: Male substance abusers 81% exceeded female abusers 19%. Substances most commonly abused were alcohol 60%, minor tranquilizers 48%, and tobacco 35%, and only 11% abused cannabis. While most students were multidrug users, there was a low frequency of daily drug use. A general lifetime (occasional use) prevalence of substance use of 56% was found. Drugs consumed on a daily basis were alcohol 2% and tobacco 6%. The prevalence of drug use was highest among the fourth and final year students.
Conclusion: The majority of students were occasional abusers; there was no evidence of physical dependence. This study provides a snapshot of the problem of substance use among medical students of Nepal. Further research is needed to study nationwide patterns of substance use among medical students, and to identify important determinants and reinforce preventive measures. Strategies need to be developed for supporting students with a substance use problem.