scholarly journals Open Globe Injury in a Tertiary Care Hospital

2018 ◽  
Vol 16 (2) ◽  
pp. 62-65
Author(s):  
Bikram Bahadur Thapa ◽  
Dabal Bahadur Thapa ◽  
Har Karan Nath
Keyword(s):  
Visual Acuity ◽  
Primary Repair ◽  
Tertiary Care ◽  
College Teaching ◽  
Posterior Segment ◽  
Care Hospital ◽  
Open Globe Injury ◽  
Young Males ◽  
Medical College ◽  
Open Globe

Introduction: Open Globe Injury (OGI) is a type of mechanical eye injury in which there is a full thickness defect of the outer fibrous coat of eye ball. The Prognosis in the eyes with OGI has improved in these days. 2.4% of blindness in Nepal was due to ocular trauma in 1981. The aim of this study was to describe epidemiological profile, clinical profile and treatment outcome in eyes with open globe injury. Methodology: It is the prospective interventional non randomized hospital based study on the patients of open globe injury presented to the Nepalgunj Medical College, Nepalgunj from April 2017 to May 2018. Visual acuity, anterior and posterior segment evaluation, site and size of wound were recorded. All the eyes were underwent primary repair surgery. Postoperative visual acuity, anterior and posterior segment evaluation was carried out on all follow up. Second surgery was done if required. Results: 0.4% of ophthalmic and 0.016% of all hospital patients had open globe injury. Most of the victims were young males. The mean age of study population was 10.98±17.1 year. Playing (62.5%) was the most common time of injury and wooden stick (50%) was most common agent of injury. Zone I involvement (87.5%) and penetrating type (91.7%) was found in most of cases. 87.5% of eyes were blind, 4.2%were visually impaired and 8.3% had normal vision at the time of presentation. 79.2 % of eye were improved after treatment on visual function, 12.5% remained unchanged while 8.3% deteriorates and leads to pthysis bulbi. Conclusion: The incidence of open globe injury was 0.4% among ophthalmic patients and 0.016% among all patients of Nepalgunj Medical College Teaching Hospital, Nepalgunj. Early Primary repair, use of systemic antibiotics and postoperative care provides encouraging anatomical and functional outcome in these eyes with OGI.

scholarly journals Visual Outcome of Ocular Trauma Presenting in a Tertiary Care Hospital in Sahiwal

2020 ◽  
Vol 36 (2) ◽  
Author(s):  
Ahmad Zeeshan Jamil ◽  
Muhammad Luqman Ali Bahoo
Keyword(s):  
Visual Acuity ◽  
Ocular Trauma ◽  
Tertiary Care Hospital ◽  
Tertiary Care ◽  
Sampling Technique ◽  
Visual Outcome ◽  
P Value ◽  
Care Hospital ◽  
Open Globe ◽  
Patient Reported

Purpose: To find the visual outcome of ocular trauma presenting in a tertiary care hospital in Sahiwal. Study Design: Descriptive observational study. Place and Duration of Study: This study was conducted at District Headquarter Teaching Hospital affiliated with Sahiwal Medical College, Sahiwal from January 2016 to June 2019. Material and Methods:  Four hundred and thirty five patients were included in the study by convenient sampling technique. Patient’s age, gender, occupation, activity at the time of injury, nature of object causing trauma, duration of trauma, visual acuity at the time when patient reported to hospital, the time delay before coming to the hospital were recorded. Ocular injuries were classified according to Birmingham ocular trauma terminology. Detailed ocular examination was performed. Patients were managed and post-management visual acuity at three months was recorded. Results: Mean age of patients was 29.07 ± 12.53 years. There were 219 (50.3%) closed globe and 216 (49.7%) open globe injuries. In 59 (13.6%) cases, cause of injury was metal object. In 146 (33.6%) cases injury was classified as contusion. In 164 (37.7%) cases cornea was involved. Majority of the patients were male. Eighty-seven patients presented within 1 day after trauma. In 154 (35.4%) patients, visual acuity at the time of presentation was 6/12 or better while in 171 (39.3%) cases it was less than 6/60. Chi-square test was used to calculate the difference between pre and post-management visual acuity. This difference was statistically significant with p-value less than 0.05 Conclusion:  Ocular trauma cases, if properly and timely managed, have a statistically significant increase in visual acuity.

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

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 Bungee cord related ocular trauma: An avoidable cause of ocular morbidity

2021 ◽  
Vol 11 (2) ◽  
pp. 297-300
Author(s):  
Nazia Imam ◽  
Mobashir Sarfraz Ali ◽  
Bibhuti Prassan Sinha ◽  
Gyan Bhaskar ◽  
Rakhi Kusumesh
Keyword(s):  
Visual Acuity ◽  
Clinical Features ◽  
Medical Records ◽  
Tertiary Care ◽  
Final Visual Acuity ◽  
Ocular Injury ◽  
Age Group ◽  
Mechanism Of Injury ◽  
Open Globe Injury ◽  
Open Globe

To study the mechanism and clinical features of ocular injury and its outcome associated with bungee cord related eye trauma. A retrospective review of medical records was performed at our tertiary care centre to identify patients presented with bungee cord related eye injury between March 2016 to February 2017. Data collected from medical records were age, sex, mechanism of injury, clinical features, therapeutic intervention, presenting visual acuity, final visual acuity and length of follow up. Total of thirteen patients with bungee cord related trauma were identified. Ten (77%) patients presented with closed globe injury and 3(23%) presented with open globe injury. All patients were male with mean age group of 30.15±7.38 years. Presenting visual acuity ranges from 6/12 to NPL. Only seven (54%) of patients were having final visual acuity of better than or equal to 6/18 in injured eye. Three patients (23.1%) with open globe injury had final visual acuity of counting fingers or worse. Main mechanism of injury being combination of blunt and high speed projectile injury due to slippage of metal or plastic hook while the cord is stretched. Trauma with bungee cord is usually affecting working age group male with injury resulting in loss of workable vision to loss of eye hence there is need of appropriate intervention like use of printed warning on package and modification of hook design to decrease the incidence of bungee cord related trauma.

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.

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 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 Impact of Antenatal Care on Maternal and Perinatal utcome: A Study at Nepal Medical College Teaching Hospital

2012 ◽  
Vol 6 (2) ◽  
pp. 37-43 ◽  
Author(s):  
H Tuladhar ◽  
N Dhakal
Keyword(s):  
Cesarean Section ◽  
Antenatal Care ◽  
Teaching Hospital ◽  
Tertiary Care ◽  
College Teaching ◽  
First Trimester ◽  
Elective Cesarean Section ◽  
Care Hospital ◽  
Medical College ◽  
Antenatal Visits

Aims: To identify the determinants of antenatal care (ANC) attendance and its impact on maternal / perinatal outcome. Methods: Prospective descriptive study of women delivered at Nepal Medical College Teaching Hospital (NMCTH), a 700 bedded tertiary care hospital situated at periphery of Kathmandu. Results: Among 322 women delivered during period of four months, majority (87%) reported of attending more than 4 antenatal visits, only 21 (6.5%) women had not attended ANC. The most preferred place of ANC was hospital (71.6%). Women with secondary education and above, business/service holders, 20-29 years age group, primigravida and Brahmin / Chhetri caste were more likely to attend ? 4 visits, while those living further than 6 km. from a health facility were less likely to attend. Financial problem (52.4%) followed by ignorance (28.6%) were the most commonly stated reasons for not attending ANC. Women attending more than 4 antenatal visits have more chance of full immunization with tetanus toxoid and iron supplementation. Most of the women started attending ANC from their second trimester (75.8%), only 21.9% had first ANC visit during first trimester. Overall Cesarean section rate was 17.4% and with increased rates in women who had attended ANC, because of the fact that all elective cesarean section were planned in these women only. Also, all inductions of labor (9.3%) were performed among them. Maternal complications like anemia and pregnancy induced hypertension occurred more commonly in women without ANC. The proportion of low birth weight and preterm babies was higher in women with inadequate or no ANC. Special care baby unit (SCBU) admission was also higher among them due to various reasons like neonatal sepsis, birth asphyxia, jaundice etc. While there were no neonatal deaths during the study period, 3 still births have occurred. Perinatal mortality rate was similar in no ANC and inadequate ANC groups; it was 16 times higher than that in the group with more than 4 visits. Maternal and perinatal outcomes were found to be better in women who attended regular ANC. Conclusions: Although attendance of ANC is quite encouraging, the proportion of women attending ANC from first trimester is low. The quality of antenatal care needs to be strengthened. The health system needs to ensure the availability of ANC in primary care level and to establish mobile clinics for those living far from the health facilities.NJOG 2011 Nov-Dec; 6 (2): 37-43 DOI: http://dx.doi.org/10.3126/njog.v6i2.6755

scholarly journals Profile of Ocular Trauma in a Tertiary Centre in Western Nepal

2018 ◽  
Vol 10 (2) ◽  
pp. 6-10
Author(s):  
S Tuladhar ◽  
S Dhakal ◽  
S Poudel ◽  
B Poudel
Keyword(s):  
Emergency Department ◽  
Visual Acuity ◽  
Ocular Trauma ◽  
Road Traffic ◽  
Public Awareness ◽  
Tertiary Care ◽  
College Teaching ◽  
Ocular Injury ◽  
Care Hospital ◽  
Tertiary Centre

Introduction: Ocular trauma is an important cause of blindness and ocular morbidity throughout the world. The present study was done to establish the common causes of ocular trauma in a Tertiary Care Hospital of Western Nepal.Methods: In this prospective study, all the patients with ocular trauma visiting eye Out Patient Department (OPD) and Emergency Department of Gandaki Medical College Teaching Hospital (GMCTH) from June 2015 to June 2016 were included. A complete history and detailed ophthalmological evaluation was done.Results: Over a period of one year, 226 patients attended to the OPD and Emergency Department of GMCTH. Mean age of patients was 30.41 ±15.7 years. Males were 70.8% and females 29.2%. About 82.5% patients had visual acuity better than 6/18 while 17.7% had visual acuity <3/60. Road traffic accident (RTA) was the most common cause followed by foreign bodies.Conclusions: Males are more prone to ocular trauma than females and majority of ocular trauma occurred at workplace. RTA is the commonest cause of ocular trauma. Very few patients used protective device. Public awareness and strict legislation for the use of personal protective devices can also help reduce the occurrence of ocular injury. J-GMC-N | Volume 11 | Issue 01 | January-June 2018, Page: 6-10

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