scholarly journals Patients’ Preference to Bedside Teaching Encounters in Four Major Wards in a Tertiary Care Centre

2019 ◽  
Vol 57 (220) ◽  
Author(s):  
Calvin Ghimire ◽  
Sajan Acharya ◽  
Abhiskar Thapa ◽  
Asha Shrestha ◽  
Deep Basnet ◽  
...  
Keyword(s):  
Medical Students ◽  
Confidence Interval ◽  
Binary Data ◽  
Care Center ◽  
Tertiary Care ◽  
Point Estimate ◽  
International Studies ◽  
Bedside Teaching ◽  
Care Centre ◽  
Tertiary Care Centre

Introduction: Patient interaction is a vital aspect of medical education. Bedside teaching encounters involve clinicians, medical students, and patients, and comprise a formative and focused activity. Patients' willingness to cooperate and contribute to the education and training of medical students provide better teaching opportunities. The study aims to find the patients’ preference to bedside teaching encounters in four major wards in a tertiary care center in Nepal. Methods: This descriptive cross-sectional study was performed in four major wards in a tertary care centre from June 3, 2015 to July 3, 2015 after receiving ethical approval. Convenient sampling was done. Data was collected in Microsoft Excel and analyzed in Statistical Package for Social Sciences 13.0. Point estimate at 95% Confidence Interval was calculated along with frequency and proportion for binary data. Subgroup analysis was done on the basis of demographic variables. Results: Seventy-eight (77.2%) patients preferred bedside teaching encounters among 101 participants (77.12-77.28 at 95% Confidence Interval). Among which, females, age ranging from 16 to 32 years, education below secondary school and with hospital stay<4 days were most common. Conclusions: The results showed that most of the patients preferred bedside teaching encounters which was congruent with the other national and international studies.

scholarly journals Prevalence of Self Induced Abortion by Self-Administration of Abortive Pills among Abortion-related Admissions in a Tertiary Care Centre

2020 ◽  
Vol 58 (232) ◽  
Author(s):  
Bibechan Thapa ◽  
Nisha Sharma ◽  
Yam Prasad Dwa
Keyword(s):  
Confidence Interval ◽  
Binary Data ◽  
Care Center ◽  
Tertiary Care ◽  
Medical Abortion ◽  
Induced Abortion ◽  
Point Estimate ◽  
Self Administration ◽  
Tertiary Care Centre ◽  
Cross Sectional

Introduction: Each year, unsafe medical abortion costs the lives of thousands worldwide. Despite the legalization of abortion in Nepal in 2002, many still seek services from unauthorized sources. This has led to grave consequences including death. Our objective is to find out the prevalence of self-induced abortion by self-administration of abortive pills and related complications. Methods: It is a descriptive cross-sectional study carried out among abortion-related admissions in a tertiary care center from June 15 2018 to March 15, 2020. Ethical approval was taken from the institutional review committee (076/077/51). Data was collected using pre-designed proforma and analyzed in Statistical Package for the Social Sciences version 26. Point estimate at 95% Confidence Interval (CI) was calculated along with frequency and proportion for binary data. Results: Out of 223 cases enrolled, 37 (16.6%) (9.6-23.6 at 95% Confidence Interval) were self-induced abortion cases by self-administration of abortion pills. The mean gestational age at the time of intake of pills was 7+6±3+1 week of gestation. The majority were diagnosed with incomplete abortion 14 (37.8%) followed by septic abortion 8 (21.6%). A surgical evacuation was performed in 25 (67.6%). Anemia was observed in 19 (51.3%) with severe anemia in 4 (10.8%). Blood transfusion was carried out in 14 (37.8%). Post abortive contraception was accepted by only 16 (42.3%). Conclusions: Medical abortion is safe if done under supervision but self-induced abortion by self-administration of abortion pills has a high complication rate. Therefore, further studies exploring a different dimension of the serious issue is the need of time.

scholarly journals Patient Satisfaction with Nursing Care in Five Major Departments in a Tertiary Care Centre

2019 ◽  
Vol 57 (219) ◽  
Author(s):  
Sajan Acharya ◽  
Calvin Ghimire ◽  
Akriti Shrestha ◽  
Ashok Kumar Yadav ◽  
Seema Bhandari
Keyword(s):  
Patient Satisfaction ◽  
Nursing Care ◽  
Binary Data ◽  
Care Center ◽  
Tertiary Care ◽  
Point Estimate ◽  
Care Hospital ◽  
Care Centre ◽  
Tertiary Care Centre ◽  
Cross Sectional

Introduction: Patient satisfaction is an important component of quality nursing care and is often determined by the nursing care in any health institution. The aim of the study is to find the presence of satisfaction among in-ward patients of five major wards at a tertiary care hospital regarding the quality of care provided by nursing staff. Methods: A descriptive cross-sectional study was conducted among 105 patients of Patan Hospital from 3rd July to 3rd August, 2015 after obtaining ethical clearance from Institutional Review Committee. Sample size was calculated and stratified random sampling was done. Data was collected in Microsoft Excel and analyzed in Sta 13.0. Point estimate at 95% Confidence Interval was calculated and frequency and percentage was calculated for binary data. Subgroup analysis was done on the basis of demographic variables. Results: Among 105 patients, 99 (94.3%) [94.93-95.07 at 95%CI] were satisfied with the nursing care provided at a tertiary care center in Nepal. Among them, 60 (60.6%) were females and 39 (39.4%) were males. Age of the patients ranged from 1 year to 85 years. The length of the stay in the hospital ranged from 2 to 17 days (mean = 5.6 days). Conclusions: Most of the patients were satisfied with the nursing care provided in a tertiary care centre. Routine nursing care surveys and immediate feedbacks would keep the authorities updated and deliver good health care.

scholarly journals Prevalance of Elevated D-dimer Levels in Confirmed COVID-19 Cases in Intensive Care Unit of a Tertiary Care Centre of Western Nepal

2021 ◽  
Vol 59 (235) ◽  
Author(s):  
Prabin Khatri ◽  
Krishna Kumar Agrawal ◽  
Dipesh Sharma ◽  
Pradip Chhetri ◽  
Aryan Neupane ◽  
...  
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Binary Data ◽  
Clinical Decision Making ◽  
Tertiary Care ◽  
Point Estimate ◽  
Care Hospital ◽  
Care Centre ◽  
Tertiary Care Centre ◽  
D Dimer

Introduction: D-dimer is currently the best available marker for COVID-19 associated hemostatic abnormalities. This study aims to find out the prevelance of elevated D-dimer levels in confirmed COVID-19 cases in intensive care unit of a tertiary care hospital of western Nepal. Methods: This descriptive cross-sectional study was conducted among 95 patients admitted to COVID Intensive Care Unit of a teriary care centre from August 2020 to January 2021 after taking ethical clearence from Institutional Review Committee in order to determine the D-dimer levels in confirmed COVID-19 cases. D-dimer value was measured at the admission and the highest D-dimer value was recorded during the course of hospital stay with the risk of mortality in confirmed COVID-19 cases. The normal range of D-dimer was taken as <0.35 mg/dl as per our hospital laboratory standards. Convenience sampling method was used. Data entry and descriptive analysis were done in Statistical Package for the Social Sciences version 25.0, point estimate at 95% Confidence Interval was calculated along with frequency and proportion for binary data. Results: Out of total 95 cases of COVID-19 included in this study, 25 (89.3%) patients with age ≥65 years and 42 (62.69%) patients aged <65 years had elevated D-dimer on admission. Data showed that 29 (67.4%) patients having elevated D-dimer at admission had mortality. Conclusions: Elevated D-dimer levels was frequently seen in patients admitted in Intensive Care Unit with COVID-19. Our study suggested that measurement of D-dimer may guide in clinical decision making.

scholarly journals Prevalence of Colistin-resistant Gram-negative Isolates Carrying the mcr-1 Gene among Patients Visiting a Tertiary Care Center

2020 ◽  
Vol 58 (232) ◽  
Author(s):  
Ashmita Paudel ◽  
Surya Prasad Devkota ◽  
Anima Shrestha ◽  
Anil Kumar Shah
Keyword(s):  
Confidence Interval ◽  
Binary Data ◽  
Care Center ◽  
Tertiary Care ◽  
Point Estimate ◽  
Drug Resistant ◽  
Tertiary Care Center ◽  
Colistin Resistance ◽  
Cross Sectional ◽  
Gram Negative

Introduction: Gram-negative isolates harboring mobilized colistin resistance (mcr-1) gene are a great threat to human health. They have been reported worldwide among various bacterial isolates. This work aimed to study the prevalence of colistin resistance among Gram-negative bacteria and the incidence of mcr-1 gene among these isolates. Methods: A descriptive cross-sectional study was done at a tertiary care center from June 2016 to February 2017. An ethical approval was taken from review board of the Nepal Health Research Council (Reg. no: 274/2016). Convenience sampling was used. The data was collected and analyzed using Microsoft Excel 2010 and Statistical Package for Social Sciences (SPSS) Version 16 . Point estimate at 95% Confidence Interval was calculated along with frequency and proportion for binary data. Results: Among 485 gram-negative isolates, only 13 (2.68%) (1.26-6.62 at 95% Confidence Interval) isolates were colistin-resistant and mcr-1 was present in two isolates. Predominant colistin-resistant isolates were E. coli 6 (4.1%), Enterobacter spp 2 (2.81%), and Acinetobacter spp 2 (2.81%). A high level of colistin-resistance was noted in 4 (30.7%) isolates as indicated by the very high value of colistin MIC (>256 µg/ml). ICU was the major site of isolation of colistin-resistant and mcr-1 positive pathogens. The majority of colistin-resistant isolates were highly drug-resistant and were sensitive only to polymyxin B. Antibiotics like imipenem, amikacin, gentamicin, aztreonam, ciprofloxacin, and piperacillin-tazobactam were effective for few of these isolates. Conclusions: Though the prevalence of mcr-1 gene was low among colistin-resistant gram-negative isolates, the resistant pattern was quite alarming as these isolates were highly drug-resistant.

scholarly journals Prevalence of Psychological Effect of COVID-19 on Medical Professionals in a Tertiary Care Center

2020 ◽  
Vol 58 (228) ◽  
Author(s):  
Surendra Lal Shrestha
Keyword(s):  
Confidence Interval ◽  
Binary Data ◽  
Medical Profession ◽  
Care Center ◽  
Tertiary Care ◽  
Point Estimate ◽  
Tertiary Care Center ◽  
Medical Doctors ◽  
Cross Sectional ◽  
Doctors And Nurses

Introduction: COVID-19 is a pandemic disease first detected in Wuhan, China on last December 2019. Many doctors and nurses, were infected and lost their life by COVID-19 around the world. Therefore COVID-19 brought unbearable psychological pressure on doctors, and nurses. The objective of this study is to find the prevalence of anxiety among medical doctors and nurses. Methods: This is a descriptive cross-sectional study of 101 doctors and nurses carried out in a tertiary care center. Convenience sampling was done with the study period from April to May 2020. Ethical approval was taken from the institutional review board of NAMS (IRB reference no. 1076). The collected data stored and analyzed with statistical software (SPSS version 26.0). Point estimate at 95% Confidence Interval was calculated along with frequency and proportion for binary data. Results: Out of 101 participants prevalence of anxiety was found to be 74 (73.3%) (64.68-81.33 at 95% Confidence Interval). Among them, 9 (8.9%) of participants experienced sever types of generalized anxiety disorder, 23 (22.8%) moderate, and 42 (41.6%) mild type. Similarly, 18 (17.8%) and 10 (9.9%) of participants felt very difficult and extreme difficulty at the workplace and home respectively. Conclusions: The mental health of medical doctors and nurses is significantly affected during the COVID-19 pandemic. Hospital administration should conduct psychological preparedness training to the medical profession before posting on duty to provide quality health services to the patients.

scholarly journals Advance Age Pregnancy in a Tertiary Care Centre: A Descriptive Cross-sectional Study

2021 ◽  
Vol 59 (236) ◽  
Author(s):  
Vibha Mahato ◽  
Pravin Shrestha ◽  
Smita Shrestha
Keyword(s):  
Binary Data ◽  
Perinatal Death ◽  
Tertiary Care ◽  
Cross Sectional Study ◽  
Point Estimate ◽  
Hypertensive Disorder ◽  
Care Centre ◽  
Sectional Study ◽  
Tertiary Care Centre ◽  
Cross Sectional

Introduction: Women who conceive at advance age are at risk of pregnancy complications and adverse foetal outcome. This study aims to find out the prevalence of pregnancy at advance age in a teaching hospital. Methods: A descriptive cross-sectional study was conducted between October 2019 to August 2020 at department of obstetrics and gynaecology of a tertiary care centre of Nepal, after obtaining ethical clearance from Institutional Review Committee (dated 03/09/2019 with ref no. 266) and informed consent from patient. Convenience sampling was done. All the patient who were ≥35 years and >28 weeks of gestation without any chronic illness were selected. Data and descriptive analysis were done using Statistical Package for the Social Sciences version 16. Point estimate at 95% Confidence Interval was calculated along with frequency and percentage for binary data. Results: Women aged 35 years and above constituted 104 (5.73%) of the total deliveries of study period. Most were multigravida 72 (69.23%) and 23 (22.12%) had preterm delivery. Rate of caesarean section were higher in advance maternal age 69 (66.35%). Maternal complications such as Hypertensive disorder of pregnancy 9 (8.65%), and mal-presentation 15 (14.42%) were higher among them. Perinatal outcome in form of low birth weight 9 (8.65%) and perinatal death 5 (4.80%) were increased in those women. Conclusions: From this study, it can be concluded that prevalence of advanced age at pregnancy was lower than study done in developed country but it was similar to study in India and is increasing in Nepal.

scholarly journals Cervical Intraepithelial Lesions in Women with Persistent Inflammatory Smear on Pap Smear: A Descriptive Cross-sectional Study

2021 ◽  
Vol 59 (241) ◽  
pp. 848-852
Author(s):  
Junu Shrestha ◽  
Dilasma Gharti Magar ◽  
Chandani Pandey
Keyword(s):  
Confidence Interval ◽  
Binary Data ◽  
Pap Smear ◽  
Tertiary Care ◽  
Point Estimate ◽  
Low Grade ◽  
Tertiary Care Centre ◽  
Cross Sectional ◽  
Cervical Intraepithelial Lesions ◽  
Intraepithelial Lesions

Introduction: Persistent inflammatory smear is a benign finding on pap test but is associated with premalignant lesion of the cervix. Further evaluation is therefore necessary. This study was done to determine the prevalence of cervical intraepithelial lesions in women with persistent inflammatory smear. Methods: This is descriptive observational study conducted in Department of Obstetrics and Gynaecology of tertiary care centre of Nepal from 15th May 2020 to 14th May 2021 after obtaining ethical clearance from Institutional Review Board (Reference no MEMG/IRC/338/GA). Women with two consecutive pap smear reports showing inflammatory findings were enrolled. Colposcopy was performed and Modified Reid’s colposcopic index was used to grade the lesions. Colposcopic guided biopsy was taken and tissue sent for histopathology for abnormal colposcopic lesions. Data analysis was done using Statistical Package for Social Sciences version 21 and frequency and percentages were used to present data. Point estimate at 95% Confidence Interval was calculated along with frequency and proportion for binary data. Results: Among 115 women, 57 (49.5%) at 95% Confidence Interval (40.37-58.63) had Cervical Intraepithelial lesions. Among them 48 (41.7%) had low grade intraepithelial lesions and 9 (7.8%) had high grade lesions on colposcopy. Conclusions: The prevalence of cervical intraepithelial lesions in women with persistent inflammatory smear on pap was higher in our study compared to other studies.

scholarly journals Detection and Enumeration of the Commonest Stool Parasites Seen in a Tertiary Care Center in South India

2013 ◽  
Vol 2013 ◽  
pp. 1-6
Author(s):  
Vani Chandrashekar
Keyword(s):  
Entamoeba Histolytica ◽  
South India ◽  
Care Center ◽  
Tertiary Care ◽  
Age Group ◽  
Tertiary Care Center ◽  
Care Centre ◽  
Tertiary Care Centre ◽  
Stool Samples

The aim of this study was to identify common stool parasites in patients attending a tertiary care centre in South India. We evaluated 2355 stool samples and parasites were detected in 7.9% of samples. 41.1% of our patients were in the 45–58-year age group. Protozoal infections were the commonest seen in 7.8% of samples. Entamoeba histolytica was the commonest protozoa (4.6%) followed by Entamoeba coli (1.2%) and Giardia (0.8%). Entamoeba histolytica and Entamoeba coli were together seen in 0.63%, and they were the commonest organisms seen in samples with multiple-organism infection. Both were equally detected in diarrheal samples.

scholarly journals Changing trends in idiopathic retinal vasculitis in a tertiary eye care centre of Nepal over a ten-year period

2012 ◽  
Vol 4 (2) ◽  
pp. 256-262 ◽  
Author(s):  
R Sitaula Kharel ◽  
S Aryal ◽  
S N Joshi ◽  
J K Shrestha
Keyword(s):  
Care Center ◽  
Tertiary Care ◽  
Retinal Vasculitis ◽  
Visual Outcome ◽  
Common Finding ◽  
Ocular Involvement ◽  
Care Centre ◽  
Eye Care ◽  
Tertiary Care Centre ◽  
Female Ratio

Objectives: To study the demographic profile, clinical presentations, management and visual outcome of retinal vasculitis in a tertiary eye care center of Nepal Materials and methods: A retrospective, record based study of retinal vasculitis cases in the retina clinic of a tertiary care centre in Nepal from January 2009 to January 2011 was carried out. Results of the study were compared to those from the study conducted in a similar set- up between 1998 and 2000. Results: Sixty-nine eyes of 51affected patients were evaluated in the study. The male/female ratio was 2.64:1 vs 19:1 a decade ago (p=0.0027). The mean age of the patients was 33.53 ± 12.29 years in the present study. Bilateral ocular involvement was present in 18 cases (35.3%) vs 56.14% in the past decade (p=0044).The common symptoms were dimness of vision (29.4%), floaters (25.5 %) and flashes of light (3.92%). Seventy-one eyes (69.6%) had the best corrected visual acuity of 6/18 or better. Four eyes (3.92 %) had no light perception. Vascular sheathing was the most common finding (32.35%), followed by vitritis (30.39%). Corticosteroids were primarily used to manage retinal vasculitis (39.21%). No association of retinal vasculitis with tuberculosis was found.Conclusion: The demographic pattern and clinical presentation of idiopathic retinal vasculitis has changed over a decade period in Nepal.DOI: http://dx.doi.org/10.3126/nepjoph.v4i2.6541 Nepal J Ophthalmol 2012; 4 (2): 256-262  

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