scholarly journals Etiological Profile and Management of Epistaxis in Tertiary Care Hospital

2019 ◽  
Vol 12 (1) ◽  
pp. 13-16
Author(s):  
B Sigdel ◽  
R Nepali ◽  
Neeraj KC ◽  
T Dubey ◽  
B Neupane ◽  
...  
Keyword(s):  
Tertiary Care ◽  
College Teaching ◽  
Nasal Packing ◽  
Care Hospital ◽  
Artery Ligation ◽  
Female Ratio ◽  
Medical College ◽  
Male Preponderance ◽  
Nasal Trauma ◽  
Nasal Drop

Introduction: Epistaxis is a common otolaryngological emergency condition. It occurs due to local and systemic cause. Local cause lies within the nose bleeding either anterior or posterior. Commonest site of bleeding anterior epistaxis is kiesselbach’s plexus. In posterior epistaxis, it is difficult to locate bleeding site. Epistaxis is controlled by simply pinching of nose, decongested nasal drop and abgel packing. Some cases become more challenging required nasal packing and arterial ligation. Objectives: To study the epidemiological pattern and management of epistaxis. Methods: This was a retrospective study on pattern of epistaxis man­aged at Gandaki Medical College Teaching Hospital over a period from April 2015 to April 2016. Information regarding demographic profile, presentation and management of epistaxis was obtained from the Hospital records, ENT Outpatient clinic, Emergency Department, ENT ward and operation theatre. Results: A total of 78 cases were managed during study period. There was a significant male preponderance with male to female ratio 1.78:1. Patients’ age varied from eight to 80 years with mean age 40.7 years. The peak age of incidence was 21 - 30 years group. Idiopathic nasal bleeding 27 (34.6%) was commonest followed by nasal trauma 23 (29.5%) cases and hypertension 16 (20.5%) cases. Seventeen (21.8%) cases managed in day care basis with decongested nasal drop, chemi­cal cautery and abgel packing. Remaining cases required nasal packing and bipolar cautery and other specific form of treatment. Five (6.4%) cases required sphenopalatine artery ligation with no recurrence of bleeding. Conclusions: Epistaxis is common ENT emergency. Most common causes are idiopathic followed by nasal trauma and hypertension. Prompt management is instituted according to cases. Most of the cas­es are managed by non-surgical method.

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.

A Clinical Study on Etiological Factors and Management of Epistaxis at a Tertiary Level Hospital

2020 ◽  
Vol 26 (1) ◽  
pp. 45-54
Author(s):  
Rashedul Islam ◽  
Mohammad Asraful Islam ◽  
AHM Rashid E Mahbub ◽  
AHM Rashid E Mahbub ◽  
Anup Kumar Chowdhury ◽  
...  
Keyword(s):  
Tertiary Care ◽  
Medical College Hospital ◽  
Nasal Packing ◽  
Urban Habitat ◽  
Care Hospital ◽  
College Hospital ◽  
Female Ratio ◽  
Medical College ◽  
Rural Habitat ◽  
Nasal Bleeding

Background: Epistaxis is a common otolaryngological emergency worldwide affecting up to 60% of the population in their lifetime. This study was conducted to describe the etiological profile and treatment outcome of epistaxis at Dhaka Medical College Hospital, a tertiary care hospital in BANGLADESH. Objective: The study is carried out with an objective to evaluate on etiological profile and management of epistaxis. Methods: This cross sectional study was conducted among the emergency and admitted patient with epistaxis at Dhaka Medical College Hospital from 1st November 2013 to 30th April 2014. Results: During the period under study, a total 104 patients were studied. The etiology of the cause of epistaxis was grouped into traumatic and non- traumatic. Among them 46 (44.23%) patient were in traumatic epistaxis and 58 (55.77%) patient were in non traumatic epistaxis. Male were affected more frequently than female in this study. There were 74 (71.15%) male and 30 (28.85%) females with a male female ratio of 2.47:1 Majority of the patients in this study were in 2nd decade (21.15%) followed by 6th decade (19.23%) and 3rd decade (17.31%). Among the 104 patients with epistaxis 78 (75%) were urban habitat and 26 (25%) were rural habitat. Significantly more patients were from urban resident. Regarding etiology and sex distribution there were no significant differences between urban and rural habitat. The present study shows that the most common cause of epistaxis was trauma (44.23%) followed by idiopathic (25%) and hypertension (17.31%). Local pain (41.31%), nasal obstruction (13.04%), nasal deformity (17.39%) associated other injury (13.04%) was more frequent in traumatic patient. Significant raise of blood pressure (Systoloic BP >160 mm Hg and diastolic BP > 100 mm Hg) were found in 58 (55.77%) non-traumatic patient. Severity of the nasal bleeding was mild to severe degree in both the groups. Significantly anterior epistaxis is common among the traumatic epistaxis group (69.57%) and posterior epistaxis in non-traumatic epistaxis group (46.55%). About 27.59% patient the exact site was not detected as there was diffuse bleeding. In case of nasal bleeding, bleeding from septum 42 (40.38%), from lateral wall 32 (30.76%) and from floor of the nose 23 (22.15%). Control of bleeding by the direct method was possible in 11 (10.57%) patients. Anterior nasal packing was given in 86 (82.69%) patients and post nasal packing was given in 3 (2.89%) patients. Conclusion: A high incidence in young adults was reported with preponderance of males over females. Occurrence of different types of epistaxis was strongly related with the certain demographic factors like age, sex and habitat of the patient. This study supports the credibility of conservative management procedure in the treatment of epistaxis. Simple nasal packing is the commonly practice conservative method with high success. Hence, this approach should be the preferred option in the management of epistaxis especially in developing countries. Bangladesh J Otorhinolaryngol; April 2020; 26(1): 45-54

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 Dengue Fever : Study of 100 Cases in a Tertiary Care Hospital in Dhaka City

2015 ◽  
Vol 24 (Number 1) ◽  
pp. 3-7
Author(s):  
A H M Karnal ◽  
K H Mollah ◽  
A Begum ◽  
K Khoda ◽  
S Tanzeem ◽  
...  
Keyword(s):  
Dengue Fever ◽  
Tertiary Care ◽  
Hemorrhagic Fever ◽  
Viral Disease ◽  
Care Hospital ◽  
College Hospital ◽  
Female Ratio ◽  
Medical College ◽  
Male To Female ◽  
Body Ache

Dengue is a rapidly spreading mosquito-borne viral disease worldwide. The endemicity in Bangladesh is also increasing gradually. The study was a prospective observational one, documented the presenting features and outcome of management. It was carried out in Department of Medicine in Holy Family Red Crescent Medical College Hospital, Dhaka from June 2013 to December 2013. Total 100 admitted cases of both sera positive and sera-negative were included in this study. Detailed history was taken, clinical examination and relevant investigations were done. Out of 100 patients 54 (54%) were male and 46 (46%) were female. So male to female ratio was 1.7:1. The age of the patients ranged from 12-75 years. Among them 20-40 years age group was highest 63%. Patients of higher socio-economic group were (69%) more affected. Out of 100 cases 54 had classical dengue fever (DF), 46 had dengue hemorrhagic fever (DHF). Antibody was positive in 81% cases. All patients presented with high fever, headache in 90%, retro-orbital pain in 45%, body ache in 56%, and backache in 48%. Leucopenia found in 60, platelet count <100x1091L was in 57, HCT- normal 17, <20% rise in 48%, ?20% rise in 28%. With proper management all patients were recovered.

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 Pattern of lipid levels of subjects seeking laboratory services in an established laboratory in the Dhaka city

2017 ◽  
Vol 16 (3) ◽  
pp. 375-379
Author(s):  
Syeda Fahmida Afrin ◽  
Abu Kholdun Al Mahmood ◽  
Kaniz Fatima Bari ◽  
Ferdousi Rahman ◽  
Zahid Hassan
Keyword(s):  
Total Cholesterol ◽  
Tertiary Care ◽  
Colorimetric Method ◽  
Reference Level ◽  
Care Hospital ◽  
Dhaka City ◽  
Lipid Levels ◽  
Female Ratio ◽  
Medical College ◽  
Laboratory Services

Background: Dyslipidemia is linked to the risk for coronary ischemic and cardiovascular disease. Considering the absence of national reference level for lipids in Bangladesh the present study was undertaken to look into the pattern of lipid levels among patients seeking laboratory services in a private medical college hospital.Materials and Methods: This cross sectional study was carried out in Ibn Sina Medical College Hospital in Dhaka city. Patients with antilipid and other medication which might affect the outcome were excluded. Consenting and eligible subjects seeking laboratory services were included in the study. Total 970 subjects finally entered in the study. Total cholesterol [TC], triglyceride and HDL-cholesterol [HDL-c] were measured by enzymatic colorimetric method. LDL-cholesterol [LDL-c] was derived using Friedewald equation. Data were expressed mean±SD, number (percent) as appropriate. Statistical analyses were carried out using SPSS version 17 tool. A p value <0.05 was taken as level of significance.Results: Male female ratio of the total subjects was 53.9:46.1. Of the total participants 27.1% were between 41-50 age group and 71% were between 31-60 years. Mean (SD) triglyceride, total cholesterol, HDL-c and LDL-c level for all participants was 182±134, 194±44, 38.4±11.5 and 119±37 respectively. Mean value of HDL-c for all subjects was 38.4mg/dl where as it’s cutoff value is 40 mg/dl and 50 mg/dl for male and female respectively suggesting relatively large number of subjects had HDL-c dyslipidemia of the study subjects. Percent subjects with isolated abnormal lipid component were 51%, 41%, 73.2% and 33.3% for triglyceride, total cholesterol, HDL-c and LDL-c respectively. Of the total subjects 22% had abnormal level of lipid for all four components.Conclusions: The data showed pattern of lipid levels of the subjects seeking laboratory services of a tertiary care hospital which might be taken a trend in the Bangladeshi population. Dyslipidemia appeared to be relatively high among the subjects studied of which HDL-c dyslipidemia was more prominent.Bangladesh Journal of Medical Science Vol.16(3) 2017 p.375-379

scholarly journals Multimorbidity Patterns Among Hospitalized Geriatric Patients in Medicine Wards of a Tertiary Care Hospital in Dhaka City

2021 ◽  
Vol 7 (1) ◽  
pp. 56-59
Author(s):  
Sumiya Bent Kalam ◽  
Sadia Islam ◽  
Mohammad Abdullah Az Zubayer Khan ◽  
Tanjina Akhter
Keyword(s):  
Diabetes Mellitus ◽  
Elderly Patients ◽  
Tertiary Care Hospital ◽  
Tertiary Care ◽  
Medical College Hospital ◽  
Care Hospital ◽  
College Hospital ◽  
Cross Sectional ◽  
Female Ratio ◽  
Medical College

Background: Elderly people are posing a significant health burden in our country for their multi morbidity as economic growth has increased our life expectancy. Pattern of multi morbidity of this older people varies according to geography, ethnicity, culture and life style. Aim: The aim of this study was to identify the prevalence and pattern of multi morbidity of elderly patients admitted in a tertiary care hospital. Method: 50 random cases of elderly patients aged more than 60 years admitted in medicine and allied wards of Dhaka medical college hospital were observed at this cross-sectional study from January 2017 to June 2017(total 6 months period). Data were reviewed and analyzed using simple frequency and percentage. Protocol was reviewed by institutional ethical board (IRB) of Dhaka medical college hospital. Result: A total number of 50 elderly patients with age ranging from 60 to 95 years were observed with male and female ratio 1.3:1 having multi morbidity among 92.0% patients and female is more affected than male. Hypertension, ischemic heart disease, diabetes mellitus and stroke were found most common diseases as individual. Hypertension and diabetes mellitus was found as the most common multi morbidity pattern followed by hypertension and IHD, stroke & diabetes mellitus. Conclusion: This study sheds light on priority needs of elderly patients in terms of medical facility in tertiary care hospital of Bangladesh. Journal of National Institute of Neurosciences Bangladesh, January 2021, Vol. 7, No. 1, pp. 56-59

scholarly journals Current Spectrum of Intestinal Obstruction in a Teaching Hospital

2019 ◽  
Vol 32 (1) ◽  
pp. 62-69 ◽  
Author(s):  
Tamanna Tasnim ◽  
Md Mizanur Rahman ◽  
Ariful Alam ◽  
Rupsha Nura Laila ◽  
Abdul Matin ◽  
...  
Keyword(s):  
Intestinal Obstruction ◽  
Tertiary Care ◽  
Intestinal Tuberculosis ◽  
Large Bowel Obstruction ◽  
Care Hospital ◽  
College Hospital ◽  
Female Ratio ◽  
Medical College ◽  
Current Spectrum ◽  
Previous Laparotomy

Intestinal Obstruction is a common surgical emergency and constitutes a major cause of morbidity and financial expenditure in hospitals around the world. This study aimed to provide the current spectrum of intestinal obstruction in a tertiary care hospital with a special view to identify any change in the aetiologic pattern. This prospective observational study was carried out in all four surgical units of Rajshahi Medical College Hospital from September 2010 to August 2011. The study included 250 adult patients with clinical and radiological evidence of complete intestinal obstruction. Out of 250 consecutive patients ranging between (13-90) years with a male to female ratio of 2.1:1, the maximum cases were within (31-40) years and (51-60) years of age group. In this study 175 cases (70%) were presented with small bowel and 75 cases (30%) with large bowel obstruction. The main causes of obstructions were bands and adhesions (44%) followed by volvulus (18%), external hernias (16%), neoplasm (12%), intussusceptions (3.2%), intestinal tuberculosis (2.8%) and miscellaneous (4%). Approximately, 86% patient with adhesive obstructions had previous laparotomy while 42% needed surgical exploration for failed conservative management. The overall mortality was 8%; mainly owing to strangulating obstruction and old age. Varying degrees of wound infections were the common post-operative complications. There was a significant change in the aetiologic pattern of intestinal obstruction. Post operative adhesions were the commonest cause of obstruction and appendicectomy was the most common previous operation causing adhesion. TAJ 2019; 32(1): 62-69

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 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.

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