bluuebunny/crossref_metadata_2025_split huggingface dataset:
Systemic Inflammatory Response Syndrome following Gastrointestinal Surgery
Authors: Koirala Udaya , Thapa Prabin Bikram , Joshi Mukunda Raj , Singh Deepak Raj , Sharma Sunil Kumar 
Published: September 2018

Introduction: Systemic inflammatory response syndrome symptoms immediately after surgery have lately been regarded as potential warnings of impending post-operative complications and multiple organ failure. This study was conducted to find out the clinical significance of systemic inflammatory response syndrome in postoperative patients and to investigate the relationship between the duration of post-operative systemic inflammatory response syndrome and the post-operative morbidity and mortality.Methods: Total 30 patients who received different gastrointestinal surgery and fulfilled the diagnostic criteria for systemic inflammatory response syndrome between 2006 and 2008 at Kathmandu Medical College Teaching Hospital were included. Patients were analyzed for preoperative physiologic status, surgical stress parameters, and postoperative status of systemic inflammatory response syndrome, complications, and end-organ dysfunction.Results: Duration of systemic inflammatory response syndrome or positive criteria's number of systemic inflammatory response syndrome after surgery significantly correlated with surgical stress parameters (blood loss/body weight and operation time). Septic complications and prolongation of systemic inflammatory response syndrome were associated with multiple organ dysfunction syndrome and increased mortality.Conclusions: Systemic inflammatory response syndrome is a useful criterion for the recognition of postoperative complications and end-organ dysfunctions. Early recovery from systemic inflammatory response syndrome may arrest the progression of organ dysfunction, thus reducing the mortality.Keywords: gastrointestinal surgery; multiple organ dysfunction syndrome; systemic inflammatory response syndrome. [PubMed]
Unresolving Pneumonia with Pleural effusion: Pulmonary Paragonimiasis
Authors: Gaire Deepshikha , Sharma Santosh , Poudel Kumar , Pant Pankaj 
Published: September 2018

Paragonimiasis is a zoonosis caused by many species of Paragonimus commonly P. westermani. Human get infected by eating raw, salted, pickled, smoked, partially cooked crustaceans (crayfish or crabs). Clinical manifestations ranges from non-specific symptoms like pain abdomen, diarrhea, urticarial rashes, fever to pleuropulmonary symptoms like cough, hemoptysis, chest pain and dyspnea. 48 yrs, female presented at TUTH emergency with fever on and off for 9 months, cough and shortness of breath for 3 months, lethargy, malaise and urticaria with history of raw crab intake one month prior to the onset of symptoms. Blood and pleural fluid analysis revealed raised total counts with eosinophilia and x-ray showed bilateral infiltration of lower lobes with pleural effusion. Diagnosis was confirmed by microscopic examination of sputum for Paragonimus. She responded well to Praziquantel. Pulmonary paragonimiasis must be considered in the differential diagnosis of unresolving pneumonia and unexplained hypereosinophilia. [PubMed]
Ocular Morbidity among Children of Government Schools of Kathmandu Valley: A Follow-up Study
Authors: Shrestha Rajesh Kishor , Shrestha Gauri Shankar 
Published: September 2018

Introduction: Ocular and vision defects are common among school going children. Vision disorders, especially refractive error are the m disability of children and the leading cause of handicapping conditions in childhood. The present study was conducted to find out ocular morbidity among students of government schools of Kathmandu valley.Methods: In the descriptive and cross-sectional study, 2412 students, comprising of 1114 (46.2%) males and 1298 (53.8%) females were enrolled in to the study from the five government schools of Kathmandu valley from 2012 to 2013. Detailed eye examination included distance visual acuity testing, anterior and posterior segment examinations, retinoscopy and refraction, cover test, near point of convergence, amplitude of accommodation and color vision test. The Chi-square test was performed to analyze the association between ocular morbidity and age and sex. P-value was considered significant at 0.05 for 95% confidence interval.Results: Majority of children was age group between 11 and 13 years (n=783, 32.5%). A male to female ratio was 0.85. Presenting and best spectacle corrected visual acuity of 6/6 was present in 2257 (93.6%) and 2380 (98.7%) respectively. Total ocular morbidity was observed in 515 (21.4%) subjects. The most common types of ocular morbidity were refractive error in 241 (10%), conjunctivitis in 104 (4.3%) and convergence insufficiency in 82 (3.4%).Conclusions: Refractive error, conjunctivitis and convergence insufficiency represent the most common ocular morbidities among students of government schools.Keywords: conjunctivitis; government school; ocular morbidity; refractive error; students. [PubMed]
Gestational Weight Gain and its Relation with Birth Weight of the Newborn
Authors: Thapa Meena , Paneru Rupa 
Published: September 2018

Introduction: Gestational weight gain is an important predictor of the health of the newborn. It is affected by body mass index of the women. This study was conducted to find out gestational weight gain according to Institute of Medicine 2009 recommendation and relationship of newborn birth weight to body mass index and gestational weight gain of the women.
Methods: It was cross sectional, hospital based study. The women, who attended at term pregnancy for delivery and having recorded first trimester body weight, were included in the study. Their body mass index was calculated and they were stratified into 4 groups according to body mass index. The gestational weight gain was calculated by subtracting first trimester body weight from body weight at the time of admission for delivery. All the women were followed till delivery. The newborn birth weight was taken immediately after delivery.
Results: A total of 227 women were enrolled in the study. More than half of the women had normal body mass index. There were 36% overweight and obese women. Mean gestational weight gain was 10.21 kg, and mean weight of the newborn was 3.05 kg. There were equal number of women who had adequate weight gain and less weight gain according to the recommendation. Excess weight gain was seen in 15% of women. Women of higher body mass index and women who had gain more weight during pregnancy had larger newborns.
Conclusions: Body mass index and gestational weight gain of the women were important predictors of birth weight of the newborn.
Clinicohematological Study of Pancytopenia in a Tertiary Care Hospital of Western Region of Nepal
Authors: Ghartimagar Dilasma , Ghosh Arnab , Thapa Sushma , Sapkota Deepa , Jhunjhunwala Adarsh Kumar , Narasimhan Raghavan , Talwar O P 
Published: September 2018

Introduction: Pancytopenia is a relatively common hematological entity and is a manifestation of many illnesses which can be life threatening at times. The severity of pancytopenia and the underlying pathology determine the management and prognosis. This study was conducted to evaluate hematological and bone marrow findings in patients presenting with pancytopenia.
Methods: It was a prospective study carried out in Department of Pathology, Manipal College of Medical Sciences, Pokhara, Nepal, during the period of January 2011 to December 2016. Clinical and hematological parameters including bone marrow aspiration and biopsy were evaluated in all patients who presented with pancytopenia.
Results: Among 138 cases studied, patient’s age ranged from 2 to 82 years with a mean age of 43.95 years, and there was male predominance. Most of the patients presented with generalized weakness, pallor, dypnoea and fever. Hypoplastic marrow was seen in 38(27.5%) cases, followed by megaloblastic anemia 26 (18.8%) cases and acute leukemia 19(13.76%) cases. Other findings included one each case of hemophagocyosis, leishmaniasis, plasmodium vivex malaria and metastatic carcinoma.
Conclusions: This study highlights that pancytopenia is a common hematological problem and the study of detailed primary hematological investigations along with bone marrow study in patients with pancytopenia will help to identify the cause for further planning and management.
Keywords: hypoplastic marrow; leukemia; megaloblastic anemia; pancytopenia.
Prevalence of Alcohol Consumption and Knowledge About Alcohol at Bhimtar, Sindhupalchowk
Authors: Manandhar Naresh , Shrestha Marina Vaidya , Joshi Sunil Kumar 
Published: September 2018

Introduction: Alcohol causes several health problems, economic and social consequences across the
world. Nepal is a multicultural and multi-ethnic country with an ambivalent regarding alcohol use
according to social, religious and cultural values. Alcohol use is very common and easily available
everywhere in Nepal. Objective of study is to find the prevalence of alcohol consumption and
knowledge of alcohol among people at Bhimtar.
Methods: A cross sectional study was conducted on a total of 369 households, age above 20 years
of Bhimtar, Sindhupalchowk district on November 2016. 41 households were selected using cluster
sampling from all nine wards of Bhimtar village development committee.
Results: The prevalence of alcohol consumption was 232 (62.9%) in which 144 (77.4%) of males and
88 (48.1%) of females. There was 3.3 times more chance of consuming alcohol in male than female.
Majority 137 (37%) consumed Raksi followed by Jaand/Chhyang 115 (31.3% ) and mix 97 (26.4%).
On knowledge of alcohol consumption, 280 (75.9 %) and 288 (78.0%) of current drinker opined that
it would effects own health and on the family respectively. After drinking alcohol 118 (31.9%) felt it
relieved tiredness followed by felt better 103 (28%) and reduced stress 70 (18.9%). It affects heart and
damage liver said by 72 (19.4%) and 59 (16%) respectively. There were family conflict after drinking
alcohol replied by 132 (35.8%). They have good knowledge about the affect of alcohol on pregnant
women. Only 50 (13.5%) of respondent expressed that it can be given to pregnant women.
Conclusions: The prevalence of alcohol consumption was very high. There is markedly differed
in alcohol consumption by sex. It is affecting their health and family. Consumption of alcohol is
financial burden and makes conflict in the family, which will also make psychological affect on their
children. There is significant difference in knowledge of harm on alcohol consumption by education
status. It is essential to plan and develop a specific health education program among these at-risk
populations for prevention of alcohol consumption.
Keywords: current drinker; economic burden; ever drinker; family conflict; initiation.
Clinical Profile of Atrial Fibrillation in Tertiary Hospital in Central Nepal
Authors: Dhungel Sachin , Laudari Shankar 
Published: September 2018

Introduction: Atrial fibrillation is common cardiac arrhythmia in elderly causing morbidity and mortality.
Methods: A cross-sectional study was conducted in College of Medical Sciences Teaching Hospital from August 2013 to Jul 2016. All in-patients diagnosed with atrial fibrillation were included.
Results: Two hundred five patients were studied from August 2013 to July 2016. Mean age was 63.95 ±16.5 years. There were 105 (51.2%) male and 100(48.8%) female. There were 154(75.1%) nonvalvular and 51 (24.9%) valvular causes for atrial fibrillation. Common presentations were SOB (41%), palpitations (27.8%), stroke (16.1%), fatigability (1.5%), abdominal pain (1.9%), chest pain (2.9%), pneumonia (1%), limb pain (0.5%) and severe bleeding (2.4%). For valvular causes, common lesions were disease of mitral valve (90 %) in isolation or mixed with aortic valve (23.5%). Warfarin was used in 32(62.7%) with mean INR of 2.038 ± 0.6. Seventeen (53.1% ) had INR below 2. In nonvalvular cases, types were paroxysmal (55.2%), persistant(34.4%) and permanent(10.4%). Elderly age, hypertension(30.5%), ischemic heart disease(13.6%), dilated cardiomyopathy(14.9%) , degenerative multivalvular heart disease(14.9%) , atrial septal defect(3.9%), lung cancer(2.3%), mitral valve prolapsed (0.6%), hyperthyroidism(1.9%), alcoholism (0.6%) , and pericardial effusion(1.2%) were common risk factors. CHADS(2) calculated 2 or more were in 98(63.6%) patients. Warfarin was used in 39 patients(25.3%) and 103 patients(66.9%) received aspirin in CHADS(2) score 2 or more. Mean INR in nonvalvular AF was 1.5 ±0.4.
Conclusions: Atrial fibrillation is a common arrhythmia as a result of valvular or nonvalvular origin. Common presentations were shortness of breath, palpitations and stroke. Common risk factors were old age, hypertension and heart failure. Warfarin is underused in nonvalvular causes in our settings.
Keywords: atrial fibrillation; valvular; nonvalvular; warfarin underuse.
Outcome of Needle Fenestration, Subacromial Steroid and Diclofenac Phonophoresis in Acute Calcific Tendinitis of Shoulder
Authors: Sanjel Chhetri Rajendra , Khatri Kishor Prashad , Khanal Jagadish , KC Milan 
Published: September 2018

Introduction: Acute calcific tendinitis of shoulder is very painful and disturbing condition. There are many modalities with variable outcome to address the condition. We studied needling technique with multiple fenestration, subacromial steroid and diclofenac phonophoresis and evaluated the outcome in term of pain relief and improvement of shoulder function at a simple outpatient clinical set up without image or ultrasound guidance.
Methods: We studied 18 cases of acute calcific tendinitis presenting within one week from onset of symptoms and X-ray showing calcific deposit. All underwent needle fenestration at maximum tender site with lignocaine loaded syringe, subsequent injection of 40 mg subacromial methylprednisolone and diclofenac phonophoresis done by qualified physiotherapist for five days. Visual Analogue Scale was used to measure pain, Simple shoulder Test applied to evaluate shoulder function and size of calcific deposit was measured at maximum length.
Results: Pain subsided dramatically and there was substantial improvement of shoulder function within a week.
Conclusions: Needle fenestration and subacromial methylprednisolone along with diclofenac phonophoresis without image guidance gives excellent pain reduction and improves shoulder function which can be done at simple outpatient clinic.
Chorioangioma of Placenta
Authors: Das Rubby , Subedi Nilam , Gurung Gahana 
Published: September 2018

Chorioangioma of placenta is the commonest benign tumour of the placenta. It consists of a benign angioma arising from chorionic tissue. We report a case of placental chorioangioma which was diagnosed in the post partum period in a patient with polyhydramnios who went into preterm labor and delivered a premature baby.
Keywords: chorioangioma; placenta; polyhydramnios.
Prevalence of Hepatitis D Among Patients with Hepatitis B Viral Infection Attending a Tertiary Care Centre of Nepal
Authors: Regmi Kiran , Shrestha Jeetndra Kaji , KC Sudhamshu , Jaishi Bikash , Karki Niyanta , Khadka Dipendra , Khadka Sandip 
Published: September 2018

Introduction: Worldwide there is variation in prevalence of Hepatitis D viral infection. Superinfection and co infection with hepatitis B viral infection is known to occur in 15-20 million people.
Methods: This was a descriptive cross-sectional hospital based study carried out in NAMS, Bir hospital, Kathmandu, Nepal from period of January 2017 to June 2017. Consecutive patients of chronic hepatitis B viral infection of HBsAg positive with more than two-time upper normal limit of ALT were enrolled and tested for HDV IgG.
Results: Forty patients were enrolled during study period. Mean age was 30.9±12.2 years. Males were 28 (70%) and females 12 (30%). Most of the patients were asymptomatic for HBV infection 32 (80%). HBeAg negative chronic hepatitis was most commonly present in 31 (77.5%). Family history of Hepatitis B viral infection was seen in 7 (17.5%) and sexual promiscuity in 5 (12.5%) as the mode of acquisition of hepatitis B viral infection. HBcIgM was positive in three patients with mean HBV DNA of 4.97x105±4.5x105 IU/ml in HBeAg positive group. HDV IgG was negative in all patients.
Conclusions: Coinfection and superinfection of hepatitis D virus were found to be uncommon at Bir hospital, Nepal.
Keywords: HbsAg; HDV DNA; HDV IgG; Hepatitis B; Hepatitis D.
Prehospital Events in ST- Elevation Myocardial Infarction Undergoing Primary Angioplasty
Authors: Dhungel Sachin , Malla Rabi , Ahikari Chandramani , Maskey Arun , Rajbhandari Rajib , Sharma Diwakar , KC Man Bhadhur , Rauniyar Binaya , Limbu Deepak , Gautam Milan , Adhikari Ajay , Chalise Hari 
Published: September 2018

Introduction: Pre-hospital delay includes time from onset of symptoms of myocardial infarction till arrival to emergency room of the hospital. This defines time from symptom onset to first medical contact and first medical contact to emergency room. This study aims to study the prehospital events and determining factors in patients undergoing primary angioplasty.
Methods: This was a cross sectional study in Shahid Gangalal National Heart Centre for three months. Timings of chest pain, first medical contact time, transfer time to hospital and overall pre-hospital time for PCI and risk factors were analysed.
Results: There were 79 cases with 66 (83.5%) males and 13 (16.5%) females with mean age 56±11.2 years. Risk factors were 60 (75.9%), smoking, 47 (59.5%) hypertension, 25 (31.6%) diabetes, 22 (27.8%) dyslipidaemia and 16 (20.3%) heart failure. Chest pain was maximum in 5 to 9 AM. The median prehospital delay was 300 minutes (5.0 hours) of which symptom to first medical contact was 165 minutes and first medical contact to hospital was 80 minutes. The longer median prehospital delay for hypertension, diabetes, female and age ≥50 years and the shorter for male, age less than 50 years, dyslipidemia and heart failure, though not statistically significant. Private transport was the preferred from symptom to first medical contact and ambulance for first medical contact to emergency room. Patients received in ER had aspirin 72 (91.1%), atorvastatin 54 (68.4%) and double anti-platelets 45 (57%).
Conclusions: Chest pain was common in morning and the prehospital delay can be minimized by improving time from symptom to first medical contact and first medical contact to Emergency room.
Keywords: cicardian pattern; prehospital delay; ST myocardial infarction.
Prevalence of Non-Communicable Diseases and its Associate Factors among Government Employees in Biratnagar, Nepal
Authors: Neupane Roshan , Bhandari Tulsi Ram 
Published: September 2018

Introduction: Non-communicable diseases have along duration and slow progression. It is estimated that the attribution of NCDs in mortality has been rising gradually in Nepal. This study aimed to estimate the prevalence and factors associated with NCDs in Biratnagar, Nepal.
Methods: A cross-sectional study was conducted among government employees in Biratnagar, Nepal from August to December 2016. We used self-administrated modified WHO STEPS survey questionnaire and distributed to all government employees of Biratnagar Sub-Metropolitan. We used complete filled 323 questionnaires to analyze and draw the results.
Results: The prevalence of NCDs was found 72 (22.3%). Hence, 322 (99.6%)government employees had exposed at least one established risk factor of the NCDs. The prevalence of use of any type of tobacco products was 60 (18.5%) and consumption of alcoholic products was 187 (57.9%). More than two-thirds respondents answered that they consumed fruits once a week. Most government employees consumed vegetable regularly.The majority 193 (59.6%) respondents used motorcycle and electric rickshaw as means of transportation. Out of the total participants 60 (18.6%), 19 (5.9%), and 6 (1.9%) reported hypertension, diabetes, and cardiovascular diseases respectively.
Conclusions: Prevalence of Non-Communicable Diseases has been seen in Government Employees in Biratnagar, Nepal. Most of them had at least one associated factor related to NCD was found.
Clinical Outcome and Safety Profile of Patients Underwent Hair Transplantation Surgery by Follicular Unit Extraction
Authors: Bishwokarma Ghimire Rupak 
Published: September 2018

Introduction: Hair transplant surgery is a minimally invasive surgery, where hair follicle is transplanted from donor area of patient’s own body to the desired area.
Methods: Patient with hair transplant surgery from a clinic were followed up for one year. The patients were asked for their complications within 2 days, 7 days, one month, 2 to 6 months and one year for assessment of results, side effects. At the end of one-year, subjective evaluation was done with patient’s satisfaction to growth as- poor growth, satisfactory and good growth.
Results: Out of 152 patients, maximum patients 74 (48.6%) were in age group 21-30, followed by 61 (40.01%) in age group 31-40, mean age was 31.79, youngest being 21 years and oldest being 70 years of age. Among the complications, swelling of forehead was in more than two- thirds of the patients 106 (69.74%), followed by temporary hair fall noted in 65 (42.76%) of patients. Clients’ remarks noted at the end on one-year revealed 86.18% as excellent results, 11.84% as satisfactory and 1.97% as poor results.
Conclusions: Hair transplant sugary by FUE is a relatively safe surgery with optimum results and minimum complications, which can be useful to patients with androgenetic alopecia.
Teenage Pregnancies in Nepal – The Problem Status and Socio-Legal Concerns
Authors: Nepal Samata , Atreya Alok , Kanchan Tanuj 
Published: September 2018

Introduction: Teenage pregnancy is an issue that needs to be addressed for a better health of the women and the society. The present analysis is undertaken to find out the incidence of teenage mothers who have had hospital delivery and focuses upon the various reasons for teenage pregnancy with a brief discussion upon the associated medicolegal and social aspects.
Methods: A cross sectional study was carried out in a tertiary hospital in western region of Nepal. The delivery case register were reviewed for teenage pregnancies and the relevant data was captured in a data sheet and analysed.
Results: During the study period, a total of sixty-nine teenage pregnancies culminated into delivery/ childbirth. The mean age of teenage mother was 18.16±0.99 years. Majority of the teenage mothers had not completed their secondary education and were of low socioeconomic strata. Mode of delivery was caesarean section in thirty four cases, whereas vaginal delivery was conducted in thirty five cases. Live births accounted for 67 deliveries, a still birth case was of anencephalic foetus while the other one was a preterm which was spontaneously delivered at the 23rd weeks of gestation.
Conclusions: Education and awareness in the form of campaign, advertisements, road shows, television or radio programmes are suggested for a decline in the rate of teenage marriages and teenage pregnancies in Nepal in the days to come.