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 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 Perinatal Mortality among All Deliveries in a Tertiary Care Center: A Descriptive Cross-sectional Study

2021 ◽  
Vol 59 (243) ◽  
pp. 1075-1080
Author(s):  
Saraswoti Kumari Gautam Bhattarai ◽  
Roshana Ghimire ◽  
Sapana Duwadi ◽  
Rabin Khadka ◽  
Kanchan Gautam
Keyword(s):  
Confidence Interval ◽  
Perinatal Mortality ◽  
Congenital Anomalies ◽  
Binary Data ◽  
Care Center ◽  
Tertiary Care ◽  
Cross Sectional Study ◽  
Tertiary Care Center ◽  
Sectional Study ◽  
Cross Sectional

Introduction: Perinatal mortality comprises the number of stillbirths and death of newborns within seven days of life which is the main contributor to infant and maternal mortality. The aim of this study was to find out the prevalence of perinatal mortality among all the deliveries in a tertiary care center of a remote part of Nepal. Methods: This was a descriptive cross-sectional study conducted in a tertiary care center located in Jumla among 3798 deliveries (childbirth) from August 2014 to April 2020. Ethical approval was taken from the institutional review committee (2076/2077/05) of the same institution. A convenience sampling technique was used and the data were collected from the medical record section and then entered and analyzed in Statistical Package for Social Sciences version 16. Point estimate at 95% Confidence Interval was calculated along with frequencies and percentages for binary data. Results: The prevalence of perinatal mortality was 187 (4.92%) (4.23-4.60% at 95% Confidence Interval) among 3798 deliveries. Regarding the primary causes; the highest proportion was intrapartum hypoxia 62 (33.3%), spontaneous preterm labor 40 (21.5%), and congenital anomalies 38 (20.4%). Similarly, about the final cause; the highest proportion was birth asphyxia 64 (34.2%), intrauterine fetal death 51 (27.3%), congenital anomalies 35 (18.7%), and complication of prematurity 32 (17.1%). Conclusions: The perinatal mortality was quite high in this study with respect to similar studies done in other countries. The finding of this study showed that quality antenatal care with rural ultrasound service is essential to reduce the causes of perinatal mortality.

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 Knowledge on Diet among the Hypertensive Patients in a Tertiary Care Center Nepal: A Descriptive Cross-sectional Study

2020 ◽  
Vol 58 (222) ◽  
Author(s):  
Nabina Maharjan ◽  
Narayani Maharjan ◽  
Rui Li
Keyword(s):  
Binary Data ◽  
Care Center ◽  
Tertiary Care ◽  
Cross Sectional Study ◽  
Point Estimate ◽  
Sectional Study ◽  
Cross Sectional ◽  
Hypertensive Patients ◽  
Diet And Exercise ◽  
Health Research Council

Introduction: Hypertension is one of the leading causes of death and disability in both developed and developing countries. The prevalence of hypertension is increasing rapidly worldwide. The aim of the study was to determine the knowledge of diet and exercise among hypertensive patients. Methods: This descriptive cross-sectional study was conducted using a structured questionnaire among 169 hypertensive patients at Kathmandu diabetes and thyroid center from May 2017 to July 2017 after taking ethical clearance from Nepal Health Research Council, Nepal. A convenience sampling method was used. Data was collected and entry was done in Statistical Package for the Social Sciences version 16.0 point estimate at 95% confidence interval was calculated along with frequency and proportion for binary data. Results: Out of total 169 participants enrolled in this study, only 79 (46.7%) had good knowledge and 90 (53.3%) had poor knowledge regarding diet and exercise. The mean age of participants was 54.68±13.91 years. Conclusions: This study revealed that the knowledge about diet and exercise among hypertensive patients is poor and this study suggests the need for a proper educational intervention to improve awareness and to control hypertension effectively.

scholarly journals Tuberculosis among Patients Admitted to the Department of Medicine of a Tertiary Care Center in Nepal: A Descriptive Cross-sectional Study

2021 ◽  
Vol 59 (238) ◽  
Author(s):  
Suman Thapa ◽  
Anupam Bista ◽  
Prashant Subedi ◽  
Aaradhana Adhikari ◽  
Sunil Pokharel
Keyword(s):  
Pulmonary Tuberculosis ◽  
Binary Data ◽  
Care Center ◽  
Extrapulmonary Tuberculosis ◽  
Tertiary Care ◽  
Cross Sectional Study ◽  
Point Estimate ◽  
Care Hospital ◽  
Sectional Study ◽  
Cross Sectional

Introduction: Tuberculosis has high burden in developing countries like Nepal. This study aims to determine the prevalence of tuberculosis among patients admitted in the department of medicine of a tertiary hospital. Methods: A descriptive cross-sectional study of all the patients admitted to the tertiary care hospital from 1st January 2017 to 31st December 2019 was done. Ethical approval was obtained from Institutional Review Committee (Ref: drs2006181387). Convenience sampling method was used. A descriptive analysis of demographic, clinical and laboratory profile of patients was made using Microsoft Excel version 2016. Point estimate at 95% Confidence Interval was calculated along with frequency and proportion for binary data. Results: Among 6829 patients admitted to the department of medicine, 209 (3.06%) (2.65-3.47 at 95% CI) patients were diagnosed with tuberculosis. Among them, 147 (70.33%) were males and the mean age was 49.77 years. Pulmonary and extra-pulmonary tuberculosis were present in 153 (73.20%) and 56 (26.79%) patients, respectively. Bacteriological confirmation was limited to 107 (70%) of pulmonary tuberculosis and 3 (5%) of extrapulmonary tuberculosis. Fever was the commonest presentation in 166 (79.42%) followed by cough in 164 (78.46%), anorexia in 108 (51.67%), weight loss 104 (49.76%), and others. Conclusions: The study showed that the prevalence of tuberculosis among admitted patients was higher than national prevalence.

scholarly journals Non-neoplastic Lesions of Gallbladder Among Cholecystectomy Specimens of a Tertiary Care Center: A Descriptive Cross-sectional Study

2021 ◽  
Vol 59 (242) ◽  
pp. 834-838
Author(s):  
Dilasma Ghartimagar ◽  
Manish Kiran Shrestha ◽  
Adarsh Jhunjhunwala ◽  
Arnab Ghosh ◽  
Sushma Thapa ◽  
...  
Keyword(s):  
Confidence Interval ◽  
Care Center ◽  
Tertiary Care ◽  
Cross Sectional Study ◽  
Common Finding ◽  
Tertiary Care Center ◽  
Sectional Study ◽  
Cross Sectional ◽  
Female Ratio ◽  
Neoplastic Lesions

Introduction: Gallbladder diseases are prevalent worldwide and present with a diverse histopathological spectrum. Mucosal irritation and chronic inflammation is considered as an important etiological factor for the mechanical or functional dysfunction of emptying of the gallbladder. This study aims to find the prevalence of non-neoplastic lesions of gallbladder among cholecystectomy specimens of a tertiary care center. Methods: A descriptive cross-sectional study was conducted in the Department of Pathology, of a tertiary care center from January 2005 to December 2020. Ethical approval was taken from the Institutional Review Committee. All the patients who had undergone cholecystectomy procedures which showed non-neoplastic lesions were enrolled in the study. Convenient sampling was done. Statistical Package for Social Sciences version 21 and Microsoft Excel were used for data analysis. Point estimate at 95% Confidence Interval was calculated along with frequency and proportion forbinary data. Results: Out of 4914 cholecystectomy specimens, 4852 (98.73%) (95% Confidence Interval= 98.42- 99.04) were non-neoplastic lesions. There were 1252 (25.8%) males and 3600 (74.2%) females with a male to female ratio of 1:2.87. Age ranged from 2 to 89 years with a mean age of 45±14.48 years. Gallbladder lesions were observed maximum in age group 41-50 years with 1200 (24.7%) cases. Among the non-neoplastic lesions, cholecystitis without any specific finding was the most common finding with 3028 (62.4%) cases followed by cholelithiasis with 1478 (30.5%) cases. Conclusions: The prevalence of non-neoplastic lesions of gallbladder is similar to other studies done in similar setings. Female predominance was noted in non-neoplastic lesions.

scholarly journals Anatomical Positions of Superior Parathyroid Gland with regard to the Zuckerkandl Tubercle in Patients Undergoing Thyroidectomy in a Tertiary Care Centre: A Descriptive Cross-sectional Study

2021 ◽  
Vol 59 (234) ◽  
Author(s):  
Deepak Regmi ◽  
Rachana Baidhya ◽  
Ashik Rajak ◽  
Nain Bahadur Mahato ◽  
Sangita Shrestha ◽  
...  
Keyword(s):  
Thyroid Surgery ◽  
Binary Data ◽  
Care Center ◽  
Tertiary Care ◽  
Cross Sectional Study ◽  
Point Estimate ◽  
Care Hospital ◽  
Sectional Study ◽  
Cross Sectional ◽  
The Right

Introduction: Zuckerkandl tubercle is a prominent anatomical structure of the thyroid lobe. Identification and preservation of recurrent laryngeal nerve and parathyroid glands during thyroid surgery can be made easier through assessment of their relationship with the Zuckerkandl tubercle. This study aims to determine the anatomical relationship between Zuckerkandl tubercle and superior parathyroid in patients who underwent thyroidectomy in a tertiary care center. Methods: This descriptive cross-sectional study was conducted at a tertiary care hospital of Nepal following ethical clearance from the Institutional Review Committee (Reference no: 0106201804) among patients who underwent thyroid surgery between July 2018 to February 2020. Convenience sampling was used for collecting data and was entered in Statistical Package for the Social Sciences version 20. Point estimate at 95% confidence interval was calculated along with frequency andproportion for binary data. Results: Out of 59 cases, 27 (96.4%) of superior parathyroid on the left were at the 1-2 o’clock position, and 28 (90.3%) of superior parathyroid on the right were at 10-11 o’clock position. On the left side, the superior parathyroid was adhered to Zuckerkandl tubercle in 10 (35.7%), was within 5 mm in 16 (57.1%), and was >5 mm away from Zuckerkandl tubercle in 2 (7.14%). On the right side, the superior parathyroid was adhered to Zuckerkandl tubercle in 12 (38.7%), was within 5 mm in 13 (41.93%), and was >5 mm away from Zuckerkandl tubercle in 6 (19.3%). Conclusions: Zuckerkandl tubercle has a consistent relationship with the superior parathyroid and can be used as an important landmark for identifying superior parathyroid during thyroid surgery.

scholarly journals Prevalence of Hypomagnesemia among Elderly Patients attending a Tertiary Care Center: A Descriptive Cross-sectional Study

2021 ◽  
Vol 59 (233) ◽  
Author(s):  
Surakchhya Gautam ◽  
Anju Khapunj
Keyword(s):  
Confidence Interval ◽  
Elderly Population ◽  
Magnesium Deficiency ◽  
Care Center ◽  
Tertiary Care ◽  
The Elderly ◽  
Cross Sectional Study ◽  
Tertiary Care Center ◽  
Sectional Study ◽  
Cross Sectional

Introduction: Magnesium deficiency is common in the elderly and critically ill population and hasbeen associated with a prolonged ICU stay. The knowledge of hypomagnesemia is essential as itcould have prognostic and therapeutic implications in the elderly population. This study aimed toestimate the prevalence of hypomagnesemic in the elderly population visiting a tertiary care center. Methods: This descriptive cross-sectional study was conducted in a tertiary care hospital fromMarch 21, 2020 to September 21, 2020. After obtaining ethical clearance from the institutional reviewcommittee (Ref. 2003202008), convenience sampling was done. Data were collected and entered inMicrosoft Excel version 2007. Point estimate at 95% Confidence Interval was calculated along withfrequency and proportion for binary data. Results: Out of 384 participants, 174 (45%) participants were found to have deranged magnesiumlevels, in which 111 (29%) (31.3-26.7 at 95% Confidence Interval) were found to be hypomagnesemia.Among them, 62 (29.4%) males and 49 (28.5%) females were hypomagnesemia. The average level ofserum magnesium was 2.02±0.76 mg/dl ranging from 0.03 to 4.71. The mean age of participants was70.31±8.13 years, among which the participants between the age group of 71-80 years presented witha maximum percentage of hypomagnesemia. Conclusions: The present study has shown that an apparently-healthy elderly population mayhave a magnesium deficiency that may need to be identified and treated for optimizing clinicalcare. Further multicentric studies with a greater sample size should be done in this field, which willbenefit the elderly population.

scholarly journals Prevalence of Laryngomalacia among Young Children Presenting with Stridor in a Tertiary Care Hospital

2020 ◽  
Vol 58 (230) ◽  
Author(s):  
Apar Pokharel
Keyword(s):  
Young Children ◽  
Confidence Interval ◽  
Binary Data ◽  
Tertiary Care Hospital ◽  
Tertiary Care ◽  
Cross Sectional Study ◽  
Point Estimate ◽  
Care Hospital ◽  
Cross Sectional ◽  
Female Ratio

Introduction: Laryngomalacia is one of the most common causes of stridor in young children. It can be a serious concern to both parents and caregivers. The main objective of this study is to find the prevalence of laryngomalacia among young children presenting with stridor in a tertiary care hospital in central Nepal. Methods: A descriptive cross-sectional study was carried out form 1st December 2017 to 1st May 2020 in children less than two years of age in a tertiary care hospital. Ethical approval was taken from the Institutional Review Committee of the hospital (reference number: 2020/23). Convenient sampling was done. Detailed demography, clinical examination, and video laryngoscopy findings were evaluated to find the prevalence of laryngomalacia among all children with stridor. Data were analyzed by using Statistical Package for the Social Sciences version 20. Point estimate at 95% confidence interval was calculated along with frequency and proportion for binary data. Results: Out of 430 participants who presented with stridor, the laryngomalacia was found in 234 (66%) (58.7-74.07) cases at a 95% confidence interval. The male: female ratio was 1.7:1. Most children, 192 (67.6%), presented with a milder form of laryngomalacia. The most common type was a mixed type of laryngomalacia in 159 (56%). Sleep-disordered breathing was seen in 113 (39.79%) of children diagnosed with laryngomalacia. Conclusions: Our study concluded that laryngomalacia was the most common cause of stridor in children less than two years of age. However, in most cases, the problem is not serious and a regular follow-up with weight monitoring is warranted.

scholarly journals Culture Positive Cases of Ophthalmia Neonatorum in a Tertiary Care Centre of Nepal: A Descriptive Cross-sectional Study

2021 ◽  
Vol 59 (236) ◽  
Author(s):  
Sabina Shrestha ◽  
Sunil Raja Manandhar ◽  
Om Krishna Malla
Keyword(s):  
Confidence Interval ◽  
Binary Data ◽  
Tertiary Care ◽  
Cross Sectional Study ◽  
Point Estimate ◽  
Coagulase Negative Staphylococcus ◽  
Sectional Study ◽  
Cross Sectional ◽  
Ophthalmia Neonatorum ◽  
Culture Positive

Introduction: Ophthalmia neonatorum although runs a benign course mostly, sometimes may progress to sight threatening complications. The study was conducted to find the prevalence of culture positive cases of opthalmia neonatorum. Methods: It was a descriptive cross-sectional study conducted at a tertiary care center from January to December 2019. Ethical clearance was obtained from institutional review committee of Kathmandu Medical College. Convenience sampling was done. All data were entered into excel and, then for analysis, exported to Statistal Package for Social Sciences version 21. Point estimate at 95% Confidence Interval was calculated along with frequency and proportion for binary data. Results: The prevalence of culture positive cases of opthalmia neonaturum is 10 (55.55%) (32.61-78.49 at 95% Confidence Interval). The causative organisms were coagulase negative Staphylococcus 4 (40%), Staphylococcus aureus 3 (30%), Klebsiella 2 (20%) and Pseudomonas 1 (10%). Culture sensitivity of the isolated organisms were different according to the patient even in case of the same organism. Vancomycin 7 ( 70%) was the most sensitive antibiotic followed by Ciprofloxacin 6 (60%), Amikacin 5 (50%) and Cloxacillin 5 (50%) while Azithromycin 1 (10%), Cefixime 1 (10%) and Cotrimoxazole 1 (10%) were the least sensitive. Conclusions: Staphylococcus species was the most common organism isolated from neonates with ophthalmia neonatorum and vancomycin was the most sensitive antibiotic.

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