scholarly journals Outcome of Endoscopic Retrograde Cholangio-Pancreatography at Nobel Medical College Teaching Hospital: A Single Centre Experience

2020 ◽  
Vol 9 (2) ◽  
pp. 8-11
Author(s):  
Rohit Prasad Yadav ◽  
Kamal Raj Subedi ◽  
Bibek Kumar Purbey ◽  
Manish Gautam ◽  
Amit Bhattarai ◽  
...  

Background: Endoscopic retrograde cholangiopancreatography is a technically demanding endoscopic procedure for both diagnostic and therapeutic purpose in treating various pancreaticobiliary diseases. This service is very limited in tertiary care center of our country Nepal mostly limited to Kathmandu valley and Dhulikhel hospital. Materials and Methods: This is a descriptive cross-sectional study patients who underwent ERCP with therapeutic intent in Nobel Medical College Teaching Hospital, Biratnagar from April 2019 to April 2020. Total 148 patients were included in this study for analysis. Results: The most common finding was choledocholithiasis in 132(89.2%) patients. Benign biliary stricture was found in 7 (4.7%). Biliary obstruction due to periampullary growth was found in 7 (4.7%) patients. Bile duct injury was found in 1(0.7%) and chronic pancreatitis in 1 (0.7%) patient. The therapeutic success of ERCP was for choledocholithiasis, Stone Clearance in 1st attempt 68.9%, in multiple attempts18.2%, failed stone extraction in 3 cases (2.0%) only biliary stenting was done in 15 (10.3%) patients of various biliary disease for therapeutic and palliative reason. Pancreatic stenting was done in1 (0.7%) patient. The most common complication was Acute Pancreatitis in 6(4.1%), Post-Sphincterotomy bleeding in 1 (0.7%), biliary septic shock in 1 (0.7%) and 1 death (0.7%). Conclusion: ERCP can be continued in Nobel Medical College Teaching Hospital as it has lots of benefits with minimal acceptable complications.

2021 ◽  
Vol 10 (2) ◽  
pp. 38-42
Author(s):  
Chandra Prakash Gaire

Background: Vitamin D deficiency is a serious health-problem worldwide and the estimation of its plasma concentration is crucial. The study aims to determine the circulating levels of vitamin D in patients visiting Birat Medical College Teaching Hospital, one of the tertiary care centers of Eastern Nepal. Materials and Methods: It was descriptive cross-sectional study conducted in the Department of Biochemistry at Birat Medical College Teaching Hospital, Nepal. From the hospital registry, clinical data of 250 patients including their age, gender and serum 25-hydroxy vitamin D was retrieved for the four months of May – August, 2021. The vitamin D status was classified as deficiency (<10 ng/mL), insufficiency (10–30ng/mL), sufficiency ≥ 30ng/mL) and toxicity (≥ 100 ng/mL). Results: Out of total subjects (n=250), none of them showed toxic serum concentrations of vitamin D, 38% had sufficient, 57% had insufficient and 5% had deficient levels of this vitamin. Among affected individuals, vitamin D insufficiency had predominated in 41% population who were 41-60 years old. Gender-wise comparison of vitamin D status in the insufficiency group showed around 33% males and 67% females having insufficient levels of this vitamin. Conclusion: With the vitmain D inssufficieny present in more than half of the study population, it becomes paramount to further scrutinize the associated factors apart from the age and gender. To this end, further studies are needed.  


Med Phoenix ◽  
2021 ◽  
Vol 6 (1) ◽  
pp. 14-18
Author(s):  
Smita Singh ◽  
Deependra Prasad Sarraf ◽  
Prabin Singh ◽  
Pragati Poudyel

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.


2018 ◽  
Vol 16 (2) ◽  
pp. 209-214
Author(s):  
Anshumala Joshi ◽  
Meeta Thapa ◽  
Om Biju Panta

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.


2019 ◽  
Vol 57 (219) ◽  
Author(s):  
Sunil Raja Manandhar ◽  
Rydam Basnet

  Introduction: Perinatal asphyxia is one of the major causes of perinatal and early neonatal mortality in developing countries. The main objective of this study was to observe the prevalence of perinatal asphyxia in babies born at Kathmandu Medical College Teaching Hospital. Methods: This was a descriptive cross-sectional study conducted at Kathmandu Medical College Teaching Hospital over six month period (January to June 2019). All preterm, term and post term babies delivered at Kathmandu Medical College Teaching Hospital were included. Ethical clearance was received from Institutional Review Committee of Kathmandu Medical College (Ref.:2812201808). Convenient sampling method was applied. Data analysis was done in Statistical Package for Social Sciences (SPSS 18), point estimate at 95% Confidence Interval was calculated along with frequency and proportion for binary data. Results: A total of 1284 babies delivered over six months period were enrolled in this study and 47 (3.66 %) babies were asphyxiated, at 95% Confidence Interval (2.64%-4.68%). The mean birth weight of asphyxiated babies was 2759.75±65 grams and gestational age was 37.57±2 weeks. Among asphyxiated babies, 15 (32%) babies were normal, 15 (32%) babies were in Hypoxic Ischemic Encephalopathy stage I, 14 (30%) were in stage II and 3 (6%) were in stage III. Twenty Three (49%) asphyxiated babies had antenatal risk factors and all 47 babies had intrapartum risk factors leading to asphyxia. Conclusions: Prevalence of perinatal asphyxia was lower compared to that of other similar tertiary care hospitals. Perinatal asphyxia remains a major cause of neonatal morbidity and mortality.


2018 ◽  
Vol 16 (2) ◽  
pp. 209-214
Author(s):  
Anshumala Joshi ◽  
Meeta Thapa ◽  
Om Biju Panta

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.


2019 ◽  
Vol 57 (219) ◽  
Author(s):  
Anu Kushwaha ◽  
Anuj Raj Kadel

Introduction: Family medicine is a relatively overlooked specialty in Nepalese medical education. It is unclear how many interns are actually interested in Family medicine as a career and how many non-medical individuals are aware of its existence. The aim of this study is to assess information, expectation and perception among interns regarding family medicine and its choice as a career. Methods: This is a descriptive-cross sectional study carried out in Kathmandu Medical College Teaching Hospital from July 2018 to December 2018. Whole sampling was done. All interns of Kathmandu Medical College Teaching Hospital posted in different departments during the time period was the inclusion criteria. Chronic absentees was the exclusion criteria. Factor like age, sex, their residency of choice, and whether they consider family medicine as a potential career were considered. Data was entered in with Statistical Package for Social Services version 16 and necessary calculations were done. Results: Thirty three interns preferred internal medicine as their career of choice, 20 preferred surgery while only three preferred in family medicine. Eighty eight interns, including the three who had family medicine as their career of choice, said that they could consider family medicine as a potential career. Eighty eight out of the 100 interns in the study mentioned that their family had knowledge that a specialty called family medicine existed. Conclusions: Despite being the career of choice of only a few, majority considered family medicine as a potential career for them. And the knowledge about existence of family medicine was high among families of interns.


2016 ◽  
Vol 12 (2) ◽  
pp. 11-16
Author(s):  
Upendra Pandit

Background: Primary documentation of a patient is crucial for making effective healthcare decision and improvements in the quality of care. The objective of this study was to assess the quality of current documentation practice in tertiary care hospitals. Materials and methods: This was an assessment of medical documentation practice of one year from the period of January 2010 to December 2010 in Chitwan Medical College, Teaching Hospital. Total 184 patients' discharge files were enrolled and reviewed. Documentation was reviewed in its quality such as completeness, Coherent, consistency and Legibility.Results: In overall pooled analysis, High omission rate was observed in final diagnosis, results (cure, improved, referral and death), hospital stay, and final case summary. Although, satisfactory performance was observed in complete set of forms (72.2%); Patient consent for treatment &release authorization forms (78.2%) and treatment chart (60.8%), the overall pooled performance in ten components showed50% performance gap. Study demonstrated that documentation and its legibility, coherent and consistency in all departments needs substantial improvements in the institution.JNGMC Vol. 12 No. 2 December 2014, Page: 11-16


2013 ◽  
Vol 1 (1) ◽  
pp. 48-52
Author(s):  
S Shrestha ◽  
B Shakya ◽  
P Shrestha

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


2018 ◽  
Vol 7 (1) ◽  
pp. 45-49
Author(s):  
Manish Pradhan ◽  
Chandra Bhal Jha ◽  
Dipa Rai

Background: Acne is a very common distressing skin condition that affects multiple aspects of quality of life of an individual. It has been illustrated that acne have tremendous effect on an individual’s self-image and impacts his or her quality of life. The extent of burden of the disease experienced by the patients seems to be underestimated by the whole medical fraternity. The aim of the study is to determine the health related quality of life impairment in acne patients using CADI and to identify various variables that increase the patients’ susceptibility for quality of life impairment. Subjects and Methods: This is a hospital based, cross sectional study conducted in the Department of Dermatology, Nobel Medical College Teaching Hospital from Jan 2017 to December 2017.A total of 202 acne patients were evaluated with CADI. Clinical characteristics were recorded after history and clinical examination. Results: Out of total 202 patients enrolled, 56.4% of patient scored a CADI score of (5-9) indicating moderate quality of life impairment and 15.3% of patient scored a CADI score of 10 or more indicating severe quality of life impairment. The mean CADI score was 6.82 ± 2.75. There was positive correlation between the CADI score and impact on quality of life with grade of acne, which was statistically significant (p<0.001). Conclusion: Acne is a common skin disease with tremendous adverse effect on the patient’s health related quality of life. Patients are affected both physically and mentally with this condition. Journal of Nobel Medical College Volume 7, Number 1, Issue 12, January-June 2018, Page: 45-49 


2018 ◽  
Vol 8 (1) ◽  
pp. 1285-1288
Author(s):  
Sailesh Bahadur Pradhan ◽  
Binita Pradhan ◽  
Sailuja Maharjan ◽  
Prabin Bikram Thapa

Background: Gastrointestinal tract tumour is responsible for more cancers and death than any other cancers.  The tumour in GIT include the tumour of the Oral cavity, Esophagus, Stomach, Colon, Rectum, Liver, Gallbladder, Pancreas and Biliary tree.Materials and methods: A cross sectional study was carried out among all the gastrointestinal tract tumours specimens received for histopathological examination in between January 2016 to June 2017 in Department of Pathology, Kathmandu Medical College Teaching Hospital. All tumors diagnosed either benign or malignant were included in this study. Ethical clearance was obtained from the Institutional Review Committee in KMCTH.Results: Colorectum was found to be the most commonly involved site for malignant lesion comprising 40.2% among all malignant lesions followed by stomach comprising 28.6%. Malignancy was found to be more prevalent among male with M:F ratio of 1.6:1 in colorectal region and 1.4:1 in stomach cancers. Regarding benign lesions (polyps), rectum was found to be the commonest site (57.5%), followed by colon (20.0%) and stomach, the least common site.Malignant lesions were more common among the age group of 51-60 years (37.66%) with 70.13% above 50 years. Benign lesions were also found to be the most common above 50 years comprising 40.0 percent.Conclusion: Rectum & colon was found to be the most commonly involved site for both malignant and benign lesion. Malignancy is more prevalent among male and common above 50 years of age. However, malignant cases noted in the adult age group are a matter of great concern.


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