scholarly journals Study on clinical profile of dengue in a tertiary care hospital of Nepal

2018 ◽  
Vol 8 (1) ◽  
pp. 54-58
Author(s):  
Kenopama Gyawali ◽  
Reisha Rijal ◽  
Shanti Regmi ◽  
Sabina Sedhai ◽  
Shital Adhikari
Keyword(s):  
Care Center ◽  
Tertiary Care ◽  
Laboratory Data ◽  
College Teaching ◽  
Warning Signs ◽  
Care Hospital ◽  
Medical College ◽  
Ns1 Antigen ◽  
Dengue With Warning Signs ◽  
Base Data

Background: This study was conducted to elucidate the clinical features, laboratory parameters and management outcome of dengue patients admitted in a tertiary care center of Nepal. Methods: This was a retrospective descriptive study in dengue patients aged 12 years or more who were admitted in Tropical Wards and Intensive Care Unit of Chitwan Medical College Teaching Hospital (CMCTH), Chitwan, Nepal from November 2016 to December 2017. Diagnosis of dengue was confirmed by positive NS1 antigen or ELISA IgM or both. The required data were retrieved from patient’s medical records and laboratory data base. Data analysis was performed by using IBM-SPSS 20. Results: Of 60 patients, majority (65%) were male. Forty-one (68.33%) patients were diagnosed by positive NS1 and 18 (30%) were ELISA IgM positive. In the year 2017, highest numbers of cases (20, 33.33%) were in the month of November, followed by 14 cases (23.33%) in October. Similarly, in the year 2016, dengue cases peaked in the month of November. All patients had fever as a presenting complaint. Other common presenting features were myalgia 42 (70%) and headache 32 (53%). Thrombocytopenia was observed in 52 (86.66%) patients followed by leucopenia in 41 (68.33%) cases. Elevation of AST and ALT were found in 45 (75%) and 38 (63.33%) patients respectively. Only 2 patients (3.3%) had dengue with warning signs. Four (6.8%) patients needed platelet transfusion. No mortality was observed. Conclusions: Majority of dengue patients had thrombocytopenia, leucopenia, and elevated AST and ALT. Only two patients had dengue with warning signs. Hospital mortality was not documented.

scholarly journals A Study of Surgical Cases During Earthquake Disaster in A Medical College

2019 ◽  
Vol 57 (215) ◽  
Author(s):  
Kanchan K.C ◽  
Raj Kumar Thapa ◽  
Sanubhai Khadka ◽  
Damodar Paudel
Keyword(s):  
Surgical Procedures ◽  
Care Center ◽  
Tertiary Care ◽  
College Teaching ◽  
Treatment Modalities ◽  
Care Hospital ◽  
Female Ratio ◽  
Earthquake Disaster ◽  
Medical College ◽  
Richter Scale

Introduction: An earthquake is an intense shaking of earth’s surface which is caused by movements in earth’s outermost layer. The earthquake of 25th April 2015, with a magnitude of 7.8 richter scale with its major aftershock on 12th May 2015 of 7.3 richter scale claimed around 8,962 lives across several districts of Nepal with 22,302 injuries. In this study we tried to figure out various surgical cases and the surgical procedures performed in a tertiary care hospital during an earthquake disaster.Methods: This study was a descriptive cross-sectional study of hospital data on all admitted surgical cases during an earthquake disaster. A total of 238 earthquake victims brought to emergency department of Kathmandu Medical College Teaching Hospital , a tertiary care center, from 26th April 2015 to 7th Jun 2015, for the period of 42 days were included. Those brought dead and discharged after primary treatments were excluded. Data obtained were entered and analysed in Microsoft Excel 2010.Results: Among 238 patients enrolled, 122 (51%) were male and 116 (49%) female with male to female ratio of 1.05:1. Age group (31-60 years) with an average age of 45 years were encountered most frequently 110 (46%) with the maximum number of patient burden from Sindhupalchowk district 80 (33.6%). Orthopedic surgery 185 (76%) appeared to be the most frequent followed by neurosurgery, plastic surgery, general surgery and dental surgery.Conclusions: In natural disaster like earthquakes, traumatic injuries are very common and thereby various surgical procedures especially ortho-plastic are the domain of treatment modalities. Disaster preparedness and combined surgical team effort needs to be focused to reduce both mortality and morbidity. Keywords: disaster; earthquake; Nepal; surgery.

scholarly journals Prevalence of Pulmonary Tuberculosis among the suspected patients visiting tertiary care hospital in Birgunj, Nepal

2013 ◽  
Vol 1 (1) ◽  
pp. 48-52
Author(s):  
S Shrestha ◽  
B Shakya ◽  
P Shrestha
Keyword(s):  
Pulmonary Tuberculosis ◽  
Teaching Hospital ◽  
Tertiary Care ◽  
College Teaching ◽  
High Morbidity ◽  
Major Public Health Problem ◽  
Care Hospital ◽  
National Medical College ◽  
Medical College ◽  
National Medical

Background and Objectives: Mycobacterial disease continues to cause high morbidity and mortality and is a major public health problem in Nepal. Bacteriological examination of sputum is the cornerstone in the diagnosis of pulmonary tuberculosis in the developing world. This prospective study was carried out with an objective to evaluate the prevalence of pulmonary tuberculosis among the patients visiting National Medical College Teaching Hospital by Ziehl- Neelsen (Zn) staining microscopy. Material and Methods: The study was cross-sectional study. Three consecutive early morning sputum collected from 626 patients were subjected to Zn staining and observed under oil immersion. Results: Among 626 patients, 85 (13.57%) were found to be Acid fast positive by Zn staining microscopy. Of total suspected patients,16.0% of male and 8.7% of female were infected, common among 41-60 years group (17.2%) followed by 21-40 years (12.6%) and multibacillary cases was 71.8%. Conclusion: The prevalence of pulmonary tuberculosis among National medical college teaching hospital was found to be higher than the Nation pulmonary tuberculosis detection rate, most commonly infecting males. DOI: http://dx.doi.org/10.3126/jmcjms.v1i1.7886 Janaki Medical College Journal of Medical Sciences (2013) Vol. 1 (1):48-52

scholarly journals Maternal Attitude and Knowledge towards Modes of Delivery

2018 ◽  
Vol 16 (2) ◽  
pp. 209-214
Author(s):  
Anshumala Joshi ◽  
Meeta Thapa ◽  
Om Biju Panta
Keyword(s):  
Pregnant Women ◽  
Vaginal Delivery ◽  
Caesarean Delivery ◽  
Care Center ◽  
Tertiary Care ◽  
Mode Of Delivery ◽  
College Teaching ◽  
Cross Sectional ◽  
Medical College ◽  
Acceptable Method

Background: Whether a mother should be allowed to choose between the modes of delivery is a matter of concern among practicing obstetricians. This study aims to explore the knowledge of the Nepalese women attending a tertiary care center about the benefits and complications of vaginal and caesarean delivery and their attitude and preference for the method of delivery.Methods: The study was a hospital based cross sectional questionnaire survey conducted in Nepal Medical College teaching Hospital, Jorpati from 1stShrawan 2074 to 31st Ashoj 2074. All pregnant women who were 36 weeks or more in gestation attending the clinic during the study period were included in the study. A questionnaire was made of 10 questions for knowledge assessment regarding mode of delivery consisting of the indications, the possible complications and advantages of vaginal and caesarean delivery. Results: A total of 256 pregnant women participated in the study. The knowledge of the mode of delivery, their benefit and complications was medium to good in approximately 90% of the mothers attending the antenatal OPD. Overall attitude for vaginal delivery was positive in 93% of women and negative or neutral in 6.6%.Overall attitude for caesarean delivery was positive in 24% and negative or neutral in 75.8%.Conclusions: Women in our setup agree that vaginal delivery is a natural and acceptable method of delivery and would prefer to have a vaginal delivery. Keywords: Attitude; knowledge; modes of delivery; women.

Knowledge and Attitude Regarding Cervical Cancer Screening in Women attending Obstetrics and Gynaecological Opd at Birat Medical College Teaching Hospital

2020 ◽  
Vol 5 (2) ◽  
pp. 1055-1059
Author(s):  
Raj Deb Mahato ◽  
Amit Deo ◽  
Hanoon Pokharel
Keyword(s):  
Cervical Cancer ◽  
Cancer Screening ◽  
Cervical Cancer Screening ◽  
Tertiary Care ◽  
Negative Attitude ◽  
College Teaching ◽  
Care Hospital ◽  
Medical College ◽  
The Mean ◽  
Knowledge And Attitude

Introduction: Cervical cancer is the most common Gynaecological cancer in Nepal which is preventable if appropriate screening and prevention measures are employed. Considerable reduction in cervical cancer incidence and cervical cancer related deaths can be achieved by effective screening. However, lack of knowledge and awareness can result in underutilization of the preventive measures.  Objectives: The objective of this study was to assess the knowledge and attitude regarding cervical cancer screening in women visiting Obstetrics and Gynaecology OPD at tertiary care Hospital in Eastern Nepal.  Methodology: A cross-sectional questionnaire-based study was conducted in Obstetrics and Gynaecology outpatient department of Birat Medical College Teaching Hospital from 1 January 2019 to 31 December 2019. Women were enrolled in the study by convenient sampling methods. Structured questionnaire was used to collect the data. The collected data was entered in Microsoft excel and analyzed by using SPSS version 22.  Results: Among 374 participants, the mean age was 31.13 years. More than three fourth (89.6%) of participants were literate. Regarding occupation, 89.8% of participants were housewives, and 82.9 % of participants were married. As per the findings, only 43.27 % of participants i.e. less than the mean, had adequate knowledge of cervical cancer and its screening. 65.50 % of participants had a negative attitude towards cervical cancer screening. Literate participants had good knowledge and positive attitude regarding cervical cancer screening than illiterate participants (P value less than 0.05).  Conclusion Considerable proportions of participants had inadequate knowledge and negative attitude regarding cervical cancer screening in Gynaecological patients visiting tertiary care Hospital in Eastern Nepal.

scholarly journals Epidemiology of carbapenem-resistant Enterobacteriaceae in a Tertiary Care Center in the Kingdom of Bahrain

2019 ◽  
Vol 11 (02) ◽  
pp. 111-117 ◽  
Author(s):  
Nermin Kamal Saeed ◽  
Safaa Alkhawaja ◽  
Nashawa Fawzy Abd El Moez Azam ◽  
Khalil Alaradi ◽  
Mohammed Al-Biltagi
Keyword(s):  
Control Measure ◽  
Care Center ◽  
Tertiary Care ◽  
Laboratory Data ◽  
Control Measures ◽  
Clinical Samples ◽  
Common Source ◽  
Care Hospital ◽  
Carbapenem Resistant ◽  
Carbapenem Resistant Enterobacteriaceae

Abstract PURPOSE: The purpose of the study is to estimate the rate of infection with carbapenem-resistant Enterobacteriaceae (CRE) in the main governmental tertiary care hospital in Bahrain. MATERIALS AND METHODS: All clinical samples with positive growth of CRE over 6-year period (January 2012–December 2017) were collected from the microbiology laboratory data. RESULTS: The CRE incidence was high in the first half of study period (2012–2014) and then decreased between 2015 and 2017, after implementation of intensified CRE control measure bundle. About 49.4% of CRE-positive samples were isolated from the elderly age group (above 65 years old), most of them were admitted in the intensive care unit (ICU). The most common isolated organisms were Klebsiella pneumoniae (87.0%), followed by Escherichia coli (7.9%). Isolates from deep tracheal aspirate and midstream urine specimens were the most common source of CRE isolates (27.3%) and (26.3%), respectively. Bacteremia was documented in 21.2% of cases. CRE isolates in the study showed high rates of resistance to aminoglycosides (72.2% resistant to amikacin and 67.3% to gentamicin). Alternatively, most isolates retained their susceptibility to colistin and tigecycline with sensitivity of 83.9% and 85.7%, respectively. Combined resistance to both colistin and tigecycline was observed in 0.06% of total isolates. CONCLUSION: Elderly population and ICU admission were important risk factors for CRE acquisition. Most of CRE isolates were sensitive to both colistin and tigecycline, which make them the best combination for empiric frontline therapy for suspected serious CRE infection in our facility. Implementing CRE-bundled infection control measures significantly reduced the incidence of CRE infection in our hospital.

scholarly journals Clinical and Genetic Spectrum of Inborn Errors of Immunity in a Tertiary Care Center in Southern India

2021 ◽  
Author(s):  
Harsha Prasada Lashkari ◽  
Manisha Madkaikar ◽  
Aparna Dalvi ◽  
Maya Gupta ◽  
Jacinta Bustamante ◽  
...  
Keyword(s):  
Tertiary Care Hospital ◽  
Care Center ◽  
Tertiary Care ◽  
Clinical Manifestations ◽  
Warning Signs ◽  
Southern India ◽  
Care Hospital ◽  
Optimal Care ◽  
Inborn Errors ◽  
Inborn Errors Of Immunity

Abstract Objectives To study the incidence, clinical manifestations, and genetic spectrum of primary immunodeficiency diseases (PID)/inborn errors of immunity (IEI) in a tertiary care hospital in Southern India. Methods A retrospective analysis of all patients with a clinical suspicion of PID/IEI seen at a tertiary care hospital was performed. All patients had at least one or more warning signs of PID. Serum immunoglobulin levels and other targeted investigations were performed as warranted by the clinical presentation. All families with suspected PID were counseled and offered genetic testing. Results A total of 225 children were evaluated for PID during the study period of 6 y. Fifty-six of them did not meet the European Society of Immunodeficiencies (ESID) criteria (working definition of clinical diagnosis) and were excluded. An IEI was found in 30/49 (61.2%) patients. The most frequent reason for referral was recurrent/unusual or serious infections (28%), or cytopenia (16%). Group IV diseases of immune dysregulation was the most common category (19%), followed by group III predominant antibody deficiencies in 23/163 (14%), as per the International Union of Immunological Societies (IUIS) classification. Conclusions This study highlights the heterogeneity of the present cohort, the underuse of genetic tests, and efforts to provide optimal care for children with possible IEI in this center.

scholarly journals Practice of “Defensive Medicine” Among Doctors at a Tertiary Care Hospital

2019 ◽  
Vol 17 (2) ◽  
pp. 28-31
Author(s):  
Binus Bhandari ◽  
Dipendra Khadka ◽  
Prem Saxena ◽  
S.M. Mishra
Keyword(s):  
High Risk ◽  
Tertiary Care ◽  
College Teaching ◽  
Defensive Medicine ◽  
Medical Decision ◽  
Care Hospital ◽  
Care Providers ◽  
High Risk Patients ◽  
Medical College ◽  
Risk Patients

Introduction: Defensive medicine is the short term coined for a defensive medical decision making.It means advising diagnostic tests, prescribing more drugs than required or avoids treating and operating high risk patients. These may not be the best options for the patient but the practice among doctors is currently adopted to avoid litigation. A situation aggravated by the promulgation of tough consumer laws and other criminal laws applicable to health care providers. This study was conducted to assess the frequency of defensive medicine practice among doctors at the teaching medical college hospital of NGMC. Methods: A cross sectional study was conducted at Nepalgunj Medical College, Teaching Hospital, Kohalpur, a tertiary care center in between January to December 2018. A questionnaire was developed to assess the various aspects of defensive medicine practice. In this study, a total of 75 doctors participated. Results: Practice of defensive medicine was common in age between 30-40 years. Fear of caring high risk patients (76%)), ordering un-necessary tests (56%)) followed by avoiding high risk procedures (46%) were common forms of defensive medicine practices observed in sampled doctors. Senior faculties were found practicing more defensive medicine than juniors (69.4% versus 30.6%) and more in surgical field as compared to non-surgical 61% vs. 39%. Conclusion: Defensive medical practice in various ways is common among the doctors. This has produced a positive impact in the form of greater communications with the patients and awareness to have a good medical record keeping. However, the negative impacts on the doctors have been more in the form of prescribing more investigations, drugs, more referral and reluctance to accept high risk patients if there is choice.  

scholarly journals Prevalence and complications of Hypothyroidism during pregnancy in western Nepal

2014 ◽  
Vol 3 (1) ◽  
pp. 48-50 ◽  
Author(s):  
TL Upadhyaya ◽  
A KC ◽  
S Paudel
Keyword(s):  
Thyroid Function ◽  
Care Center ◽  
Tertiary Care ◽  
College Teaching ◽  
Thyroid Function Test ◽  
Overt Hypothyroidism ◽  
Medical College ◽  
Study Results ◽  
Function Test ◽  
Entire Pregnancy

Background: This study was designed to know the prevalence of hypothyroidism during pregnancy in western part of Nepal and its potential complications. Methods: One Hundred seven pregnant cases from Gandaki Medical college teaching hospital and Diabetes thyroid and Endocrinology care center, two of the tertiary care centers in Pokhara were enrolled in the study from the year 2011 January to 2012 December. Detailed history and physical examination was done. Thyroid Function test (FT3, FT4 andTSH) were performed after the confirmation of pregnancy. Patients were followed up during entire pregnancy. Seven patients dropped out from the study. Results: Out of 107 patients 56 patients had TSH below 6 mIU/L,31patients had TSH between 6mIU/L - 10 mIU/L and 13 patients had TSH more than 10 mIU/L. Seven patients dropped out from the study. There was1 miscarriage, 1 still birth from hypothyroid mother and 11 hypothyroid and subclinical hypothyroid mothers had preterm delivery. Conclusion: Prevalence of overt hypothyroidism is around 13% and subclinical hypothyroidism is around 31% in pregnant ladies in western Nepal. Also complications like stillbirth should be prevented by detecting and treating hypothyroidism early. So we recommend all patients with pregnancy to perform thyroid function test at the start of pregnancy. Nepal Journal of Medical Sciences | Volume 03 | Number 01 | January-June 2014 | Page 48-50 DOI: http://dx.doi.org/10.3126/njms.v3i1.10358

scholarly journals Pediatric Percutaneous Nephrolithotomy in a Peripheral Tertiary Care Center in Nepal

2020 ◽  
Vol 42 (2) ◽  
pp. 80-84
Author(s):  
Dipesh K Gupta ◽  
Deepak Jaiswal
Keyword(s):  
Percutaneous Nephrolithotomy ◽  
Operative Time ◽  
Pediatric Population ◽  
Care Center ◽  
Tertiary Care ◽  
College Teaching ◽  
Physiological Factors ◽  
Medical College ◽  
Stone Free Rate ◽  
Free Rate

Introduction Pediatric nephrolithiasis though uncommon, poses clinical management dilemma due to anatomical and physiological factors. Percutaneous Nephrolithotomy (PCNL) is well established in adults and miniaturization of the instruments has helped to expand its indication for uses in pediatric population with equivalent results. The aim of our study is to evaluate the application of the procedure in our settings. MethodsThis was a retrospective study done at Nepalgunj Medical College teaching hospital from June 2017 to April 2020. Total of 75 patients with 76 renal units under 18 year of age were evaluated. PCNL was done in prone position in all patients using fluoroscopy for initial puncture and subsequently for clearance. The size of the tract varying from 15 Fr to 24 Fr was decided based on the degree of hydronephrosis. ResultsMean stone volume was 372 mm2. With mean operative time of 58 min, 96% of stone clearance rate was achieved. Mini PCNL was done in most of the cases. Single tract was used in 84% cases mostly with subcostal puncture. Major complications were pelvic perforation in 4% cases and two patients required restaging. ConclusionPCNL in pediatric population is safe with good stone free rate with minimal complications. Application of miniaturized instruments has further improved the outcome with comparable morbidity.

scholarly journals Community Acquired Pneumonia Due to Mycoplasma pneumoniae versus Non-Mycoplasma Pneumoniae: A Comparative Analysis from a Tertiary Care Hospital

2021 ◽  
pp. 21-28
Author(s):  
Chhavi Gandhi ◽  
Chiranjay Mukhopadhyay ◽  
Kiran Chawla ◽  
Rama Chaudhry
Keyword(s):  
Mycoplasma Pneumoniae ◽  
Prospective Observational Study ◽  
Care Center ◽  
Tertiary Care ◽  
Community Acquired Pneumonia ◽  
Care Hospital ◽  
Medical College ◽  
Microbiological Profile ◽  
Hospitalised Patients ◽  
Mycoplasma Pneumonia

Aims: The study aims to compare the clinical and microbiological profile in adult, hospitalised patients of community acquired pneumonia due to Mycoplasma pneumoniae (MP) vs other bacterial agents. Study Design: Prospective, observational study. Place and Duration of Study: Study was carried out in Department of Microbiology, Kasturba Medical College, Manipal in a span of eighteen months (August 2014 to February 2016). Methodology:   A Hospital based study in a tertiary care center was conducted. Adult hospitalised patients suspected of community acquired pneumonia (according to IDSA guidelines) were included in the study. Cases with immunosuppression and prior hospital admission were excluded. Respiratory samples were collected and cultured for all the studied cases. PCR was performed for the detection of Mycoplasma pneumoniae by targeting P1 gene. Results: The study cases (n=140) had mean age of 57 years and mean hospital stay of 7 days, comprising 67.6%  males and 32.4% females. Amongst all the cases of CAP that were included in the study, Mycoplasma pneumoniae was detected in 23(16.4%) cases with 12 (52.2%) cases due to MP alone and 11 cases (47.8%) had multiple bacterial etiology. Symptoms such as chest pain (91.7%), joint pains (45.8%), earache (41.7%) and sepsis (56.5%) were significantly higher (p<0.005) when Mycoplasma pneumonia was the detected pathogen. Moreover worsening of clinical condition and mortality was also observed higher in this group. Conclusion: Association of higher morbidity and mortality, as observed in current study, highlights the importance of early and timely diagnosis of Mycoplasma pneumoniae in hospitalized patients with community-acquired pneumonia.

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