bluuebunny/crossref_metadata_2025_split huggingface dataset:
MAYOEPITHELIAL CARCINOMA OF MAXILLARY SINUS: A CASE REPORT
Authors: Liaquat Ahmad , Riaz Nabeela , Shah Arun Kumar 
Published: May 2022

Mayoepithelial carcinoma of the salivary gland is extremely rare malignancy. It may arise either in recurrent or pre existing pleomorphic adenoma or de novo in salivary glands. We herein present the case report of 35 years old male patient who presented to us with myoepithelial carcinoma of minor salivary gland of right maxillary sinus. Right total maxillectomy with functional neck dissection was done with orbital floor reconstruction with titanium mesh.
KNOWLEDGE REGARDING PREVENTIVE MEASURES OF PRESSURE ULCER AMONG NURSES
Authors: Neupane Gita , Chanda Sah  
Published: May 2022

Background: Pressure ulcer is a preventable medical complication. Nurses are primarily respon­sible in pressure ulcer prevention. This study was designed to find out knowledge regarding pre­ventive measures of pressure ulcer among nurses.
Methods: Descriptive study was conducted among 100 nurses, selected by using non-probability convenience sampling technique. Pretested Self-administered semi-structured questionnaire was used and collected data were analyzed by using descriptive and inferential statistics with Statistical Package for Social Sciences software version 20.0.
Results: The findings of the study revealed that nearly half (48%) of the respondents had low knowledge regarding pressure ulcer. Regarding age, majority (52%) of the respondents were of age group 18-27 years. Regarding qualification, 48% of the respondents were PCL nursing and 47% had working experience of 1-5 years. Similarly, 17% of respondents were working in Gynecology ward and 85% had exposed to managed patients with pressure ulcer. Among them, 76% of the respondents had knowledge regarding meaning and 96% had knowledge regarding signs of pres­sure ulcer. Ninety two percent of the respondents had knowledge that position of patients should be changed every 2 hourly, 38% had knowledge that patient’s head should be elevated at or below 300 and 73% had knowledge that normal saline is the best solution to cleanse pressure ulcer. There was statistically significant association of respondents’ level of knowledge regarding ulcer with working department (p=0.001).
Conclusions: The study concluded that nearly half of the nurses have low knowledge regarding pressure ulcer. It is recommended to hospital management to conduct in-service education for nurses.
STUDY OF DENTAL DISEASE PATTERN AND DRUG UTILIZATION EVALUATION AMONG PATIENTS VISITING DENTAL OUTPATIENT DEPARTMENT OF TERTIARY CARE CENTER
Authors: Ruchi Shrestha  , Sony Shakya Shrestha  , Sushmit Koju  , Manoj Humagain  
Published: May 2022

Background: Oral health has been an integral component of general health, with a serious impact on the quality of life and the overall well-being. Limited availability and accessibility of oral health services are risk factors for poor oral health and diseases. This study aimed to observe common dental disease pattern and to evaluate drug utilization pattern among patients visiting Dental Outpatient Department of Dhulikhel Hospital- Kathmandu University Hospital.
Methods: A descriptive, cross-sectional study was conducted from October 2018 to January 2019 in Dental Outpatient Department of Dhulikhel Hospital-Kathmandu University Hospital. Two hundred forty prescriptions were collected and analyzed. Descriptive statistical analysis was carried out to find out common dental disease pattern and to evaluate drug utilization pattern.
Results: Total 240 prescriptions were analyzed. Pulpitis 54 (22.5%) was the most common diagnosis, followed by periapical abscess 34 (14.16%). Out of 411 drugs prescribed, 166 (40.38%) were analgesics, 116 (28.22%) were antibiotics and 93 (22.62) were topical agents. Combination of paracetamol with ibuprofen was most commonly prescribed analgesics 133 (80.12%) and combination of amoxicillin with clavulanic acid was most commonly prescribed antibiotics 51 (43.97%). Out of all drugs prescribed, fixed dose combination was given in 194 (47.20%). Only 260 (63.26%) drugs were given by generic name and 133 (32.36%) drugs were from National List of Essential Medicines-Nepal.
Conclusions: Awareness among dental doctors for prescribing drugs by generic name and from essential drug lists should be encouraged.

Conclusions: Awareness among dental doctors for prescribing drugs by generic name and from essential drug lists should be encouraged. Use of fixed dose combination should be minimized.
POSTNATAL CARE SERVICES UTILIZATION IN BHARATPUR SUB METROPOLITAN CITY, CHITWAN, NEPAL
Authors: Shrestha Niki , Tiwari Binita , Piryani Suneel , Khanal Gayatri 
Published: May 2022

Background: Postnatal period is a critical phase in the lives of mothers and newborn infants. 2.9 million neonatal deaths occur in the first week of life on an annual basis globally. In Nepal, the level of postnatal care coverage remains low despite the efforts and research on factors influencing the Post-natal care (PNC) services utilization is limited. Hence this study was conducted to explore the predictors of PNC utilization among mothers who had under one-year child.
Methods:A community-based cross-sectional study was conducted in Bharatpur Sub Metropolitan city, Chitwan among mothers having a child of less than one year age. Data was collected through face-to-face interview using interview-schedule. Descriptive (frequency and percentage), Bivariate (Chi-squre) and Multivariate (logistic regression) analyses were performed.
Results:This study showed that the proportion of recommended PNC services utilization is low in comparison with those utilizing ANC services in Nepal. The percentage of women attending all the three recommended PNC visits was only 17.5%. The utilization of PNC services was associated with mother’s educational status, parity, place of PNC services received and awareness about PNC services. The mode of delivery, danger signs seen in postnatal mothers, and danger signs seen in newborn were statistically significantly associated with PNC services utilization.
Conclusion:The findings of this study suggest context specific evidence which might be taken into consideration while planning to develop new policies to increase PNC utilization.
EARLY MANAGEMENT OF MALARIA IN THE CONTEXT OF ELIMINATION: OBSERVATIONS FROM CHITWAN MEDICAL COLLEGE, NEPAL
Authors: Lamsal Daya Ram , Mirdamadi Shirin 
Published: May 2022

Background: Nepal is entering a malaria elimination phase with the target for no indigenous cases set for 2025. The elimination phase is known to be a challenge due to knowledge and skills reduction as cases become rarer.
Methods: We audited all malaria parasitology tests in Chitwan Medical College from January 2017 to December 2018. Slide positive rate, case treatment and timings were identified from case note review.
Results: Over the 2 years, 1455 malaria tests were performed, 12 were positive, making the positive test rate at 0.83%. Eleven of these 12 case files were found. They were reviewed to find the case details. All cases were >16 years old. Four cases had P. falciparum, six cases had P. vivax,and in one case, the species was not identified. Four of the 12 cases fulfilled criteria for severe malaria. All P. falciparum cases had travelled outside Nepal in the past year. Median time from symptom onset to treatment was 170 hours. Median time from attendance to anti-malarial treatment was 9 hours. Three cases did not receive guideline antibiotics according to Nepal National Protocol.
Conclusions: In conclusion, immediate testing with malaria RDT in all febrile patients presenting to CMC for early diagnosis and prompt treatment is recommended. In addition, we urge to inform colleagues on the features of severe malaria and the national treatment protocol including use of Primaquine for progressing to elimination target.
KNOWLEDGE ON MENSTRUATION AND MENSTRUAL HYGIENE PRACTICES AMONG ADOLESCENTS GIRLS OF SELECTED SCHOOLS, CHITWAN
Authors: Sharma Mamata , Sharma Kalpana , Pandey Bista Archana , Subedi Subash , Lamichhane Sandesh 
Published: May 2022

Background: Menstrual hygiene is very important aspect for adolescent girls and proper men­strual hygiene has not been sufficiently addressed in developing countries including Nepal. This study aimed to assess the knowledge on menstruation and menstrual hygiene practices among adolescent girls.
Methods: Descriptive cross-sectional study was conducted among adolescent girls studying in selected schools of Chitwan district. A total 193 girls who had menstrual flow experience for at least three consecutive menstrual cycles were selected as sample using the consecutive sampling technique. Data were analyzed in Statistical Package for Social Sciences (SPSS) version 16.0 using descriptive and inferential statistics.
Results: Most of the girls knew about menstruation as physiological process, normal age of men­struation, and causes of menstruation as hormonal change. Overall, 66.8% of girls had adequate level of knowledge on menstruation. Regarding practice, 94.8% cleaned their genitalia properly, 93.8% used the sanitary pads, and 97.4% wrapped and disposed the pads in dustbin after use. Over­all, 72.5% of girls had good level of menstrual hygiene practices. Adolescent girl’s age and grade, and occupation status of their father were significantly associated (p < 0.05) with menstrual hygiene practice. Further, significant positive relationship found between knowledge on menstruation and menstrual hygiene practice.
Conclusions: One third of adolescent girls have inadequate knowledge on menstruation and one fourth have poor menstrual hygiene practice. Therefore, an awareness and advocacy programs on menstruation and menstrual hygiene practices are needed for the adolescent girls to safeguard themselves against reproductive tract infections.
SPECTRUM OF ABO AND RH BLOOD GROUP IN NEPALI MEDICAL STUDENTS
Authors: Joshi Bishal , Kar Sanjit Kumar , Shrestha Laxmi , Yadav Shankar 
Published: May 2022

Background: ABO and Rh systems are most important types of blood group systems that should be taken into consideration during blood transfusion. Many studies have been done across the globe to determine the distribution of these blood groups among different strata of population. But there are very few studies done in Nepali population. Therefore, in this study we aimed to find out the distribution of blood groups among Nepali medical students and to compare it with the other studies done in Nepal and other countries of the World.
Methods: This was a retrospective study, containing the data of ABO and Rh blood groups of medi­cal students recorded over a period of 21 years in Department of Physiology of Universal College of Medical Sciences, Bhairahawa, Nepal. The blood group was determined by open slide test method by using commercially available standard monoclonal antibody.
Results: A total of 2031 Nepali medical students were included in the study. Among them 1147 were male and 884 were female. In the present study we found that the most common blood group was O (739, 36.4%) followed by B (624, 30.7%) and A (522, 25.7%) and least common blood group was AB (146, 7.2%). Among all participants 96.8% of the people were Rh positive and 3.2% were Rh negative.
Conclusions: This study done in Nepali medical students can provide a new insight for the further study of distribution of blood groups in Nepali population. A study with high sample size, repre­senting every zones of Nepal is the demand of future.
MAGNITUDE OF REFRACTIVE ERRORS IN CHILDREN IN TERTIARY CARE HOSPITAL OF WESTERN NEPAL
Authors: Godar Srijana Thapa 
Published: May 2022

Background: Refractive error is one of the most common causes of the visual impairment and second leading cause of treatable blindness. The objective of the study was to determine the mag­nitude of refractive errors in children.
Methods: This was a hospital based cross-sectional study conducted on 254 children attending Ophthalmology OPD of Manipal Teaching Hospital, Pokhara. The children whose visual acuity was worse than 6/6 but improved with pinhole were included in this study. Vision test, retinoscopy and subjective refraction was done in all subjects and cycloplegic refraction was done when needed. Statistical analysis was carried out using Epi-info version 7.
Results: The commonest type of refractive error was astigmatism (46.06%) followed by myopia (42.31%). Majority of children had low grade of refractive errors (46.85%). Among the children, “with the rule astigmatism” was maximum (27.56%). Majority of children were in the age between 11 to 15 years (77.95%). The refractive error was seen more in female (63.78%). Among the chil­dren of refractive errors, 29.13% had family history, 33.46% had given the history of wearing spec­tacles and 10.24% children had amblyopia. There was statistically significant association between refractive errors and age groups, history of wearing spectacles, amblyopia and grading of refractive errors. However, there was no statistically significant association of refractive error with gender, residence and family history.
Conclusions: Astigmatism was the common type of refractive error followed by myopia. This study emphasizes the importance of detection of refractive error in children.
FACTORS AFFECTING JOB SATISFACTION AMONG NURSES WORKING IN TEACHING HOSPITAL, CHITWAN, NEPAL
Authors: Poudel Sashi , Sharma Kalpana 
Published: May 2022

Background: Job satisfaction is a major factor in nurse retention and the delivery of high quality care. Hence, aim of this study was to find out the factors affecting job satisfaction among nurses working in the teaching hospital, Chitwan.
Methods: A descriptive, cross-sectional research design was used and a total 135 nurses who were working for at least 3 months in the Chitwan Medical Teaching Hospital were taken as study sample. Simple random sampling technique was used to select the desired sample. Pre-tested structured self-administered questionniare with job satisfaction scale consisting eight domains was used to collect the data. Obtained data were entered into SPSS version 20.0 for window and analyzed using descriptive statistics and inferential statistics (chi-square test).
Results: The findings of the study revealed that more than half (57.85%) of the nurses were satisfied with their job. Nurses’ job satisfaction was higher on organization and administration policies (4.18±0.04) and least on salary and benefits (3.01±0.19) they were receiving from the institution. The significance influencing factors of job satisfaction were professional qualification (p=0.04), total work experience in nursing (p=0.004), working ward/unit (p=0.014), designation (p=0.007), number of patient assigned in general ward (p=<0.001) and leadership style in the ward (p=<0.001).
Conclusion: Considerable percentage of nurses is not satisfied with their job. Hence hospital management and professional associations need to address the identified factors to enhance the job satisfaction among nurses working in a teaching hospital.
USE OF ULTRASONOGRAPHY IN REDUCTION OF ISOLATED ZYGOMATIC ARCH FRACTURE
Authors: Dhungel Safal , Singh Ashutosh Kumar 
Published: May 2022

Background: Isolated zygomatic arch fractures, managed by closed methods, can be inadequate leading to facial asymmetry. Assessment of the reduction and ensuring correct alignment of frac­tured fragments in the operation table always avoids next surgery. This study aims to determine intraoperative, adequacy of reduction of by use of ultrasound in isolated zygomatic arch fracture.
Methods: During the closed reduction of isolated zygomatic arch linear probe of ultrasound was used to check the continuity of the echogenic line. The intraoperative ultrasound finding was com­pared with the gold standard CT scan.
Results: Ultrasound has 100% sensitivity and 80 % specificity. It also has high precision and accu­racy to determine the reduction of the fractured bone.
Conclusions: Ultrasound is a handy tool in the reduction of zygomatic arch fracture. It not only shows but also guides to adequate reduction.
ASSOCIATION OF HYPERTENSION AND ISCHAEMIC ECG CHANGES IN TYPE II DIABETES MELLITUS
Authors: Rai Chandra Kala , Poudel Nimesh 
Published: May 2022

Background: Type 2 diabetes mellitus (T2DM) is one of the most common metabolic disorders to the current generation. It usually leads to multi-systemic complications such as cardiovascular diseases, proteinuria, micro albuminuria, retinopathy, hypertension, ischaemic changes and chronic kidney disease. These complications increase the morbidity and mortality of patients. The prolonged hyperglycemia leads to vascular damage. It causes insufficient blood flow to the cardiac muscles which may cause myocardial or cardiac ischaemia. The aim of this study was to find out the prevalence of hypertension and ischaemic ECG changes in T2DM patients attending Kathmandu Medical College.
Methods: Total 360 type 2 diabetic patients were included. Blood pressure was measured and electrocardiogram (ECG) was recorded by 12 leads ECG. Statistical analysis was done using SPSS version 16. P<0.05 was considered to be statistically significant.
Results: The mean age of the patients was 66.88 ± 1.52 years, age ranging from 40 – 95 years. In this study 168 patients (46.66%) had systolic hypertension, 204 patients (56.67%) had diastolic hypertension and 126 (35%) had both systolic and diastolic hypertension. About 103 (28.61%) showed ECG changes in hypertensive patients. Only 4 (1.11%) non- hypertensive had ECG changes. This study showed statistically significant relation of hypertension and ischemic ECG changes in type 2 diabetes mellitus cases with p- value 0.03.
Conclusions: There is a high prevalence of hypertension among T2DM patients. In these patients, there is a statistically significant association between hypertension and ischaemic ECG changes.
ANESTHETIC MANAGEMENT OF AN ELDERLY PATIENT WITH DILATED CARDIOMYOPATHY AND HYPOTHYROIDISM FOR INTER-TROCHANTERIC FRACTURE
Authors: Subedi Deepika , Aryal Diptesh , Shrestha Anil 
Published: May 2022

Dilated cardiomyopathy is a primary myocardial disease characterized by left ventricular or biventricular dilation and impaired contractility. The anesthetic management of a patient with dilated cardiomyopathy undergoing a non-cardiac surgery is always challenging and may be associated with high mortality. Furthermore, perioperative morbidity becomes more frequent in the elderly with steep increases after the age of 75. We are reporting the successful anaesthetic management of a 93 years old patient with severe dilated cardiomyopathy planned for surgical repair of inter-trochanteric fracture under combined spinal anesthesia.
PSYCHOSOCIAL PROBLEMS AMONG SCHOOL GOING ADOLESCENTS IN GHORAHI SUB METROPOLITAN CITY OF DANG
Authors: Devkota Sapana , Adhikari Kishor , Ghimire Amrita , Koirala Subash , Chhetri Mamta 
Published: May 2022

Background: A psychosocial problem is a mental illness caused or influenced by life experiences, as well as maladjusted cognitive and behavioral processes. Psychosocial problems i.e. internalizing dis­orders, externalizing disorders and substance abuse are more prevalent among adolescents because of their rapid physical and physiological changes that occur in their body during this stage. The aim of the study was to identify the magnitude of psychosocial problems among school-going adolescents.
Methods: Present study was a descriptive cross-sectional study conducted in the ward no. 15 of Gho­rahi sub metropolitan city of Dang District, Nepal. A total of 325 adolescents were chosen from multi-staged random sampling. Pre-tested self-administered questionnaire was used to collect data. Part I and part II of questionnaire was self-constructed and Part III was adopted from standard tool of Youth Pediatric Symptoms Checklist. Descriptive (percentage, frequency, interquartile range and minimum and maximum values) and inferential analysis (chi-square test) was done through this IBM SPSS soft­ware version 20.
Results: The prevalence of psychosocial problems among school going adolescents was 26.8%. Socio-demographic characteristics such as age, ethnicity, occupational status of respondent’s father and mother were found to be significantly associated with psychosocial problems. The relation with teach­er and academic grade of respondent were found to be highly associated with psychosocial problems.
Conclusions: The study reported an alarming situation of psychosocial problems among adolescent students in Nepal where more than one quarter of participants found having psychosocial problems. The study may suggest the need of proper parenting and maintenance of an appropriate level of teacher-student relationship.
ASSOCIATION OF LIVER FUNCTION TEST PARAMETERS WITH HEMATOLOGICAL INDICES IN SEROPOSITIVE HEPATITIS B PATIENTS
Authors: Timalsina Santosh , Sandesh Nepal  , Shishir Mahato  
Published: May 2022

Background: Inflammation is increasingly being implicated for progression of Chronic Hepatitis B. Besides the usual liver function test (LFT) parameters, systemic inflammatory markers such as neutrophil-to-lymphocyte ratio (NLR) and platelet-to-lymphocyte ratio (PLR) have generated significant interest that could be useful in stratifying the severity and prognosis of liver disease. The aim of this study was to compare LFT parameters and hematological ratios (NLR and PLR) between seropositive hepatitis B patients and healthy controls and explore associations between them.
Methods: This cross-sectional study included 64 Hepatitis B surface antigen (HBsAg) positive patients and 62 apparently healthy seronegative individuals visiting Chitwan Medical College between March to October 2019. Laboratory data included standard LFT panel and hematological parameters including NLR and PLR. Data was analyzed using SPSS software, version 20. P<0.05 was considered to be statistically significant.
Results: The two groups (seropositive and seronegative group) did not differ by age and gender. LFT parameters except for total protein were higher in the seropositive group. Both median NLR and PLR were considerably lower in the seropositive group compared to the seronegative group (2.99 and 102.32 vs. 3.67 and 126.15 respectively). However, NLR showed a considerable overlap between the groups, indicating a high variability. No significant correlation was observed between these hematological indices with other LFT parameters.
Conclusions: NLR and PLR are easily obtainable, cost-effective parameters that are inversely related with Hepatitis B infection. They could supplement routine LFT parameters in characterization of the phase and severity of chronic Hepatitis B infection.