scholarly journals Comparative study of cast immobilization of wrist in functional position versus conventional palmar flexion in Colles’ fracture

2020 ◽  
Vol 10 (3) ◽  
pp. 47-52
Author(s):  
Shriraj Shrestha ◽  
Parash Bhandari ◽  
Saurav Dahal ◽  
Basanta Maharjan ◽  
Suraj Bajracharya
Keyword(s):  
Functional Outcome ◽  
Scoring System ◽  
College Teaching ◽  
The Elderly ◽  
Fracture Site ◽  
Cast Immobilization ◽  
Medical College ◽  
Colles Fracture ◽  
Grip Power ◽  
Palmar Flexion

Background: Colles’ fracture is a common injury in the elderly population. Although it can be easily reduced, it is difficult to maintain the reduction in the conventional position of the wrist in palmar flexion with a poor functional outcome. Thus our study aimed to compare the radiological and functional outcome of such fractures with the wrist in two different posi­tions of dorsiflexion and palmar flexion. Methods: A prospective, observational study was conducted from April 2019 to March 2020 in the Orthopedics and Emergency department of KIST Medical College Teaching Hospital, Lalitpur, Ne­pal. Sixty-two patients, 31 in each group, all above 45 years with Colles’ fracture underwent close reduction and below elbow cast immobilization under hematoma block. Maintaining palmar flex­ion and ulnar deviation at the fracture site, the wrist was immobilized in dorsiflexion and palmar flexion attitude alternatively. During the respective follow-ups, the Demerit Scoring System of Saito was evaluated. Data collection and entry was done using the statistical package for social science version 16 and analyzed by using descriptive and inferential statistics. Results: All fractures were united. At the end of twelve weeks, Saito Scoring System of good to ex­cellent was markedly better in dorsiflexed group 29(93.5%) patients as compared to palmar flexed group 22(71.0%) patients, similarly grip power was also superior in dorsiflexed group 19(61.3%) patients than in palmar flexed group 11(35.5%) patients. Conclusions: Cast immobilization of Colles’ fracture with the wrist in dorsiflexion prevents re-dis­placement of the fragments resulting in significantly better radiological and functional outcomes.

scholarly journals Near miss maternal morbidity and maternal mortality at Kathmandu Medical College Teaching Hospital

1970 ◽  
Vol 8 (2) ◽  
pp. 222-226 ◽  
Author(s):  
NS Shrestha ◽  
R Saha ◽  
C Karki
Keyword(s):  
Maternal Mortality ◽  
Teaching Hospital ◽  
Maternal Death ◽  
Scoring System ◽  
College Teaching ◽  
Near Miss ◽  
Hypertensive Disorder ◽  
Maternal Deaths ◽  
Medical College ◽  
Obstetric Morbidity

Background: Maternal mortality traditionally has been the indicator of maternal health all over the world. More recently review of the cases with near miss obstetric events has been found to be useful to investigate maternal mortality. Cases of near- miss are those in which women present with potentially fatal complication during pregnancy, delivery or the puerperium, and survives merely by chance or by good hospital care. Objectives: The objective of this study is to determine the prevalence and nature of near miss obstetric cases and maternal deaths at Kathmandu Medical College Teaching Hospital. Material and methods: This was a descriptive study done for the period of 24 months (1 January 2008 to 31 December 2009). Cases of severe obstetric morbidity were identified during daily morning meetings. All the cases were followed during their hospital stay till their discharge or death. Five factor scoring system was used to identify the near miss cases from all the severe obstetric morbidity. For each case of maternal death, data were collected from records of maternal death audit. Results: During the study period, 1562 women delivered at the institution and 36 women were identified as near-miss obstetrical cases. The prevalence of near miss case in this study was 2.3%. Five maternal deaths occurred during this period, resulting in a ratio of maternal death of 324 maternal deaths per 100,000 live births. Of the five maternal deaths three were due to pregnancy complicated with hepatitis E infection, one each due to Eclampsia and amniotic fluid embolism. Fifteen cases of near miss were due to haemorrhage (41.66%) and hypertensive disorder of the pregnancy was the cause in 10 (27.77%). Dystocia was the cause in 1(2.77%) case and infections in 7(19.4%) cases. Rare causes like anaesthetic complications were the cause in one case and dilated cardiomyopathy was the cause in two cases. Conclusion: The major causes of near-miss cases were similar to the causes of maternal mortality of Nepal. Need for the development of an effective audit system for maternal care which includes both near-miss obstetric morbidity and mortality is felt. Key words: Near-miss obstetric morbidity; Maternal mortality; Five factor scoring system DOI: 10.3126/kumj.v8i2.3563 Kathmandu University Medical Journal (2010), Vol. 8, No. 2, Issue 30, 222-226

Poor Correlation Between Functional Results and Radiographic Findings in Colles’ Fracture

1993 ◽  
Vol 18 (5) ◽  
pp. 588-591 ◽  
Author(s):  
T. TSUKAZAKI ◽  
K. TAKAGI ◽  
K. IWASAKI
Keyword(s):  
Functional Outcome ◽  
Functional Results ◽  
Poor Correlation ◽  
Ulnar Styloid ◽  
Cast Immobilization ◽  
Poor Functional Outcome ◽  
Radiographic Findings ◽  
Non Union ◽  
Dorsal Angulation ◽  
Colles Fracture

We reviewed 83 consecutive patients with unilateral Colles’ fracture in order to identify factors that predict poor functional outcome. All fractures were treated by closed reduction and cast immobilization, and followed-up for at least 2 years. Our results showed that only final dorsal angulation was correlated to loss of flexion. In contrast to other reports, we could not find any relationship between radial shortening and loss of grip strength or loss of range of motion. In addition, the severity of initial displacement, involvement of radio-carpal or distal radio-ulnar joints, and the presence of ulnar styloid fractures or their non-union did not affect the functional outcome.

A Review on Outcomes of Distal Radius Fracture Treated With Different Modes of Treatment and Rehabilitation

2020 ◽  
Author(s):  
Asad Aziz
Keyword(s):  
Functional Outcome ◽  
Operative Treatment ◽  
Wrist Joint ◽  
Fracture Site ◽  
Original Research ◽  
Dorsal Plate ◽  
Range Of Movement ◽  
Cast Immobilization ◽  
Choice Of Treatment ◽  
Open Fixation

Fractures around wrist joint are common complication happening after fall on an outstretched hand. It is more common in female, and mostly in age above 55 years. Different methods of treatment has been established such as surgical and conservative management, each mode of treatment has its own complication such as, pain, stiffness, swelling, deformity, infection. Non operative treatment include splinting or casting with or without reduction, operative treatment includes percutaneous k-wiring, external fixator for complex fracture or fracture with open wound, open fixation with volar or dorsal plate. Still there is controversy that what method is better in getting the good functional outcome, minimizing the duration of cast immobilization, early fixation, and early start of rehabilitation. All of them play part in better functional outcome. In the past manipulation and fixation without opening the fracture site has been the choice of treatment, comparatively in recent advances fixation with plate through anterior approach is a preferred option because it has less complication rate, plays better role in early range of movement. The information was retrieved from reliable search engines e.g. PubMed, Medline, Google scholar and others, through original research papers and reviews from2003 to 2019. Purpose of this study is to know which method of management has better outcome and its role in early rehabilitation.

scholarly journals Efficacy of Possum in Surgical Audit of Patient Undergoing Emergency Surgery at Nepalgunj Medical College

2018 ◽  
Vol 14 (2) ◽  
pp. 2-7
Author(s):  
S V Bharti ◽  
S M Mishra ◽  
R R Ranjitkar ◽  
A O Chhetri
Keyword(s):  
Risk Factors ◽  
Emergency Surgery ◽  
Severity Score ◽  
Scoring System ◽  
College Teaching ◽  
Treatment Modalities ◽  
Mortality And Morbidity ◽  
Medical College ◽  
Operative Severity Score ◽  
Significant Difference

 Introduction: The Physiological and Operative Severity Score for the en Umeration of Mortality and morbidity (POSSUM) has been proposed as a method for standardizing patient data so that direct comparisons can be made in spite of differing patterns of referral and population.Aims and objectives: To evaluate the efficacy of a scoring system for predicting the incidence of postoperative complications and mortality in patient undergoing Emergency Surgeries based on the Physiological and Operative Severity Score for the Enumeration of Mortality and Morbidity (POSSUM).Material and Methods: This is a hospital based cross sectional study of all the cases that had undergone Emergency Surgery at Nepalgunj Medical College Teaching Hospital from the period of July 2014 to June 2015. The period of follow up was 30 days following the surgical procedure? A total of 100 emergency surgeries, as defined by the POSSUM scoring system criteria were studied. Predicted mortality and morbidity rates were calculated using the POSSUM equation by exponential analysis method. It was then compared with the actual outcomes. Observed: Expected Ratio (O:E) was calculated and difference detected by chi-square test. The risk factors as scored in the POSSUM criteria were noted.Results: Applying exponential analysis, an observed to expected ratio (O:E) for mortality of 0.44 was obtained, indicating significant 2 difference between the predicted and observed values (x =93.207, df 63, p=0.008). But, an observed to expected ratio (O:E) for 2 morbidity of 1.01 was obtained and there was no significant difference between the predicted and observed values (x =76.295, df 71, p=0.312). It was found to be comparable to other studies. In all the risk factors studied, a positive correlation was found between deaths and post-operative complications with higher POSSUM scores.Conclusion: POSSUM scoring system could accurately predict overall morbidity while it over predicted the overall mortality. POSSUM scoring system serves as a good predictor of post-operative outcome in major general surgical procedures and was applicable even in our setup and be used for comparing various treatment modalities and assessing the quality of care provided. JNGMC Vol. 14 No. 2 December 2016,   page: 2-7  

Study on Knowledge and Prevalence of Computer Vision Syndrome among Computer Operators in Nobel Medical College Teaching Hospital, Biratnagar, Nepal

2020 ◽  
Vol 9 (2) ◽  
pp. 45-49
Author(s):  
Pramod Sharma Gautam ◽  
Uday Chandra Prakash ◽  
Subreena Dangol
Keyword(s):  
Computer Vision ◽  
Teaching Hospital ◽  
Human Life ◽  
College Teaching ◽  
Extended Period ◽  
Visual Display ◽  
Work Place ◽  
Medical College ◽  
Computer Vision Syndrome ◽  
Department Of Ophthalmology

Background: The eye and vision related problems that results from continuous use of computers and other visual display terminals for extended period of time leads to computer vision syndrome. Due to rapid digitalization in human life, the risk of developing it has also increased in many folds. So, with an aim of determining the prevalence and level of awareness of computer vision syndrome among computer users along with their attitude and practices to prevent it, this study was conducted in the office employees who use computer for a considerable period of time. Materials and Methods: A hospital based observational descriptive study was conducted in the out-patient department of Ophthalmology in Nobel Medical College and Teaching Hospital, Biratnagar, where 105 employees working in different work stations of same institution were enrolled. A questionnaire and the clinical findings were used to collect data. Results: About 80% of the employees were using computer for about (8-11) hours per day. Prevalence of computer vision syndrome noted was (92.4%) with low level of knowledge (85.7%) about it. About 45% of them wore glasses for their refractive errors but attitude and practices in work place to prevent the bad effects of using visual display terminals were found to be lacking (53.3%). Burning sensation in the eye, headache, ocular irritation and itching and neck, shoulder or back pain were the common symptoms. Around (60-70)% of the eyes tested positive for dry eye. Conclusion: Lack of awareness of computer vision syndrome and lack of personal protective measures were associated with its high level of prevalence.  

scholarly journals Histopathological Analysis of Endometrial Biopsy in Gandaki Medical College Teaching Hospital, Pokhara, Nepal

2019 ◽  
Vol 12 (1) ◽  
pp. 25-30
Author(s):  
B Parajuli ◽  
G Pun ◽  
S Ranabhat ◽  
S Poudel
Keyword(s):  
Histopathological Examination ◽  
Hydatidiform Mole ◽  
College Teaching ◽  
Histopathological Diagnosis ◽  
Age Group ◽  
Medical College ◽  
Dilatation And Curettage ◽  
Partial Mole ◽  
Proliferative Endometrium ◽  
The Common

Objective: To study the spectrum of histopathological diagnosis of endometrial lesions and their distribution according to age. Methods: All the endometrium samples obtained by the procedure of dilatation and curettage and hysterectomy sent for histopathological examination at Pathology Department of Gandaki Medical College Teaching Hospital, Pokhara, Nepal. The study duration was total 12 months ranging from July 2016 to June 2017. All the endometrial samples were processed, sectioned at 4 - 6 μm and stained with routine H & E stain. Patient’s data including age, sex, procedure of the biopsy taken and histopathological diagnosis were noted. A pathologist, using Olympus microscope, reported the slides. Cases were reviewed by a second pathologist whenever necessary. Results: A total of 128 cases were studied. The most common histopathological diagnosis was proliferative endometrium (28.9%) followed by disorder proliferative endometrium (15.65%). Most of the patients were in age group 36 - 45 years comprising 32.03%. Hydatidiform mole comprised of 7.03% and among Hydatidiform mole, partial mole was more common. Dilatation and curettage (82.8%) was the common procedure in compare to hysterectomy for the evaluation of endometrial lesions. Conclusions: In this study, we observed a variety of endometrial lesions. Most of them are benign; among benign, proliferative endometrium was the common histopathological diagnosis followed by disorder proliferative endometrium. Most common presenting age group was found to be at 36 - 45 years. In evaluation of hydatidiform mole, partial mole was more frequent in compare to complete mole. Conventional dilatation and curettage is the preferred method in developing countries with limited resource to screen endometrial lesion and therefore biopsy should be sent for histopathological examination. Thus histopathological examination of routinely stained hematoxylin and eosin is readily available and widely accepted standard technique for evaluation of the endometrial lesions.

scholarly journals Knowledge and attitude towards infection control among supporting staffs of Chitwan Medical College, Bharatpur, Chitwan

2017 ◽  
Vol 6 (1) ◽  
pp. 40-47
Author(s):  
M Lopchan ◽  
G Gurung ◽  
L Rajbanshi ◽  
C Osti ◽  
A Baniya
Keyword(s):  
Health Care ◽  
Developing Countries ◽  
Infection Control ◽  
Health Care Providers ◽  
Nosocomial Infections ◽  
Infection Prevention ◽  
College Teaching ◽  
Care Providers ◽  
Medical College ◽  
Regular Training

Nosocomial infections (NIs) are one of the most important health issues, particularly in developing countries, because these infections cause high mortality and morbidity, and economic and human resource loss as a consequence Nosocomial infections can be defined as those occurring within 48 hours of hospital admission, 3 days of discharge or 30 days of an operation. Many studies have examined risk factors of nosocomial infections. However, knowledge of frontline workers (attendants) in infection prevention have been reported rarely in developing countries. The aim of this study was to investigate the knowledge of attendants working in different wards and OPDs about infection prevention. S: Data were collected from 100 attendants in Chitwan Medical College Teaching Hospital. Regarding the knowledge on hand washing, gloving and personal accessories for Infection Prevention, majority of the respondents had good knowledge ranging from 94-100%. Though hospital has established Infection Prevention Committee and regular training on infection prevention is provided to all the staffs, the data indicated that only 68% respondents were benefitted by the infection prevention training and proper use of virex solution to disinfect the equipment’s was found unsatisfactory. Infection control is the responsibility of all Health Care Facility (HCF) personnel. The goal of the infection control policies are to identify and reduce risks of acquiring and transmitting infections among patients, staff, students, volunteers, contract service workers, and visitors Although significant effort has been made to reduce the Nosocomial infections, regular training as well as monitoring supervision will enhance the capacity of the health care providers and front line workers for cleaning services they are our valued respondents.DOI: http://dx.doi.org/10.3126/jcmc.v6i1.55069

Outcome of initial three years of Cranial Endoscopy at DG Khan Medical College & Teaching Hospital, Dera Ghazi Khan.

2021 ◽  
Author(s):  
Iqbal Ahmad ◽  
Ummer Farooq Raina ◽  
Muhammad Yousaf ◽  
Liaqat Jalal ◽  
Samia Saeed ◽  
...  
Keyword(s):  
Teaching Hospital ◽  
College Teaching ◽  
Medical College ◽  
Cranial Endoscopy

Anxiety and Depression among Patients with Chronic Obstructive Pulmonary Diseases in Pulmonology Unit of Nobel Medical College Teaching Hospital

2021 ◽  
Vol 6 (1) ◽  
pp. 1285-1290
Author(s):  
Nilam Kumari Jha ◽  
Komal Kant Jha
Keyword(s):  
Risk Factor ◽  
Teaching Hospital ◽  
College Teaching ◽  
Pulmonary Diseases ◽  
Anxiety And Depression ◽  
Chronic Obstructive ◽  
Early Assessment ◽  
Medical College ◽  
Copd Patients ◽  
Chronic Obstructive Pulmonary Diseases

Introduction: Anxiety and Depression is a common comorbidity in chronic obstructive pulmonary disease patients. Impaired lung function is a risk factor for depression In COPD patients, reduced recreational activities and social Isolation is a major risk factor resulting in anxiety and depression.  Objective: The objective of this study is to evaluate the prevalence of Anxiety and Depression among the COPD patients at Pulmonology unit of Nobel Medical College Teaching Hospital.  Methodology: A hospital based cross- sectional research design was used for the study. A total of 185 patients with previously diagnosed COPD. Data were collected by using a face to face interview technique in patients to evaluate anxiety and depression using Nepali version of Hospital Anxiety and Depression Scale questionnaire at Nobel Medical College Teaching Hospital, Biratnagar, Nepal from May to August 2020. Data analysis were done by descriptive and inferential statistics.  Results: A total of 185 patients participated in the study, 157 patients (84.9%) had anxiety, 107 patients (57.8%) had depression and 102 patients (55.1%) had both anxiety and depression. There was statistically significant association of anxiety and depression in COPD patients with age, religion, occupation, smoking status, duration of illness, history of previous hospitalization, number of hospitalization in previous year, type of family, domiciliary oxygen therapy.  Conclusion: The study concluded that anxiety and depression had been most prevalent in COPD patients. Therefore health personnel working in the Pulmonology unit should be aware the early assessment and treatment of anxiety and depression of chronic obstructive pulmonary diseases patients. 

Knowledge, Attitude and Practices of Pharmacovigilance among Doctors at a Tertiary Care Teaching Hospital Birgunj, Nepal

Med Phoenix ◽  
2021 ◽  
Vol 6 (1) ◽  
pp. 14-18
Author(s):  
Smita Singh ◽  
Deependra Prasad Sarraf ◽  
Prabin Singh ◽  
Pragati Poudyel
Keyword(s):  
Teaching Hospital ◽  
Health Care Professionals ◽  
Tertiary Care ◽  
College Teaching ◽  
Cross Sectional Study ◽  
Cross Sectional ◽  
Tertiary Care Teaching Hospital ◽  
Care Teaching ◽  
Medical College ◽  
National Medical

Introduction: Pharmacovigilance helps in the detection and prevention of adverse effects of drugs. For the effectiveness of this program, health care professionals should report adverse drug reactions (ADRs) considering it as their moral and professional obligation. The objective of the study was to assess the knowledge, attitude, and practices (KAP) of the doctors towards ADRs and pharmacovigilance in  National Medical College Teaching Hospital (NMCTH), a tertiary care teaching hospital situated in the Narayani zone. Materials and Methods: A cross-sectional study was carried out using a self-administered questionnaire consisting of four parts; first part included a demographic profile of participants, the second part consisted of ten questions for the assessment of the knowledge about pharmacovigilance, third part comprised of six questions on attitude and fourth part consisted of five questions on practice. The results were depicted in the form of percentages for each KAPs questionnaire.   Results: The response rate of participants was 85.16%. Pharmacovigilance was correctly defined by 52%. Department of drug administration was responsible for monitoring ADRs in Nepal was correctly given by 80%. Only 8% had reported ADRs, although 62% had encountered an ADR in their clinical practice. Conclusion: The doctors at NMCTH had a poor KAP towards pharmacovigilance and educational intervention is needed for the proper functioning of this program.

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