Hypocalcemia in Elderly Population in a Tertiary Care Hospital: A Descriptive Cross-sectional Study

Introduction: As the medical facilities are improving, the life expectancy is increasing which has led to rapid rise in elderly population. The epidemiology of many diseases in elderly has been modified, including calcium imbalance. This study aims to know the prevalence of hypocalcemia in elderly population visiting a tertiary care center of Kathmandu. Methods: A descriptive cross-sectional study was conducted in a tertiary care center of Kathmandu from March to July 2020 after obtaining ethical clearance (Ref: 2003202007). Total 402 participants at or above 60 years of age groups visiting outpatient departments were included in the study by convenience sampling method excluding those under vitamin D and calcium supplements. Serum total calcium level was measured using standard routine method and corrected with albumin. The serum calcium value less than 8 mg/dl was considered as hypocalcemia in accordance with the reference range of our laboratory. Data analysis for calculation of frequency and proportion was done in Statistical Package of Social Sciences. Results: The prevalence of hypocalcaemia in elderly was found to be 97 (24.1%). Out of 286 participants of age group 60-74 years, hypocalcemia was seen in 75 (26.2%) and among 116 participants of age group >74 years, 22 (19%) were hypocalcemic. Among 181 male participants, 44 (24.3%) had hypocalcemia and out of 221 female participants, 53 (24%) had hypocalcemia. Conclusions: The finding of present study suggests that hypocalcemia is common among elderly which can be life threatening. Therefore, regular monitoring of serum calcium is recommended for this age group.

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Prevalence of Hypomagnesemia among Elderly Patients attending a Tertiary Care Center: A Descriptive Cross-sectional Study

Journal of Nepal Medical Association ◽

10.31729/jnma.5764 ◽

2021 ◽

Vol 59 (233) ◽

Author(s):

Surakchhya Gautam ◽

Anju Khapunj

Keyword(s):

Confidence Interval ◽

Elderly Population ◽

Magnesium Deficiency ◽

Care Center ◽

Tertiary Care ◽

The Elderly ◽

Cross Sectional Study ◽

Tertiary Care Center ◽

Sectional Study ◽

Cross Sectional

Introduction: Magnesium deficiency is common in the elderly and critically ill population and hasbeen associated with a prolonged ICU stay. The knowledge of hypomagnesemia is essential as itcould have prognostic and therapeutic implications in the elderly population. This study aimed toestimate the prevalence of hypomagnesemic in the elderly population visiting a tertiary care center. Methods: This descriptive cross-sectional study was conducted in a tertiary care hospital fromMarch 21, 2020 to September 21, 2020. After obtaining ethical clearance from the institutional reviewcommittee (Ref. 2003202008), convenience sampling was done. Data were collected and entered inMicrosoft Excel version 2007. Point estimate at 95% Confidence Interval was calculated along withfrequency and proportion for binary data. Results: Out of 384 participants, 174 (45%) participants were found to have deranged magnesiumlevels, in which 111 (29%) (31.3-26.7 at 95% Confidence Interval) were found to be hypomagnesemia.Among them, 62 (29.4%) males and 49 (28.5%) females were hypomagnesemia. The average level ofserum magnesium was 2.02±0.76 mg/dl ranging from 0.03 to 4.71. The mean age of participants was70.31±8.13 years, among which the participants between the age group of 71-80 years presented witha maximum percentage of hypomagnesemia. Conclusions: The present study has shown that an apparently-healthy elderly population mayhave a magnesium deficiency that may need to be identified and treated for optimizing clinicalcare. Further multicentric studies with a greater sample size should be done in this field, which willbenefit the elderly population.

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Overweight among Medical Students in a Tertiary Care Center: A Descriptive Cross-sectional Study

Journal of Nepal Medical Association ◽

10.31729/jnma.6607 ◽

2021 ◽

Vol 59 (240) ◽

Author(s):

Chandra Kala Rai ◽

Sarbada Makaju

Keyword(s):

Medical Students ◽

Confidence Interval ◽

Care Center ◽

Tertiary Care ◽

Cross Sectional Study ◽

Overweight And Obesity ◽

Care Hospital ◽

Tertiary Care Center ◽

Sectional Study ◽

Cross Sectional

Introduction: Today’s generation is facing an increased prevalence of overweight and obesity. It may be genetic or habitual due to overeating of junk foods and sedentary lifestyle. It directly affects an individual personality and health. The main aim of this study is to find out the prevalence of overweight among medical students in a tertiary care center. Methods: This is a descriptive cross-sectional study done in 385 students in a tertiary care hospital from 25th January 2020 to 28th February 2021. The sample was collected by simple random sampling method after the approval from the Institutional Review Committee of Kathmandu Medical College and Teaching Hospital. Height in meter and weight in kilogram of students were measured to calculate body mass index. Data were analyzed by using Statistical Package of Social Science software version 16. Point estimate at 95% confidence interval was calculated along with frequency and proportion for binary data. Results: Among 385 students, 75 (19.48%) (95% Confidence Interval= 15.53%-23.44%) were overweight. Fifty-seven (14.85%) males and 18 (4.69%) females were overweight respectively. In total, there were 197 (51.01%) males and 188 (48.99%) females. Conclusions: The current study shows the prevalence of overweight among medical students is slightly higher than in studies done in similar settings.

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Orthopedic Implant Removal in the Department of Orthopedics of a Tertiary Care Centre of Nepal: A Descriptive Cross-sectional Study

Journal of Nepal Medical Association ◽

10.31729/jnma.6171 ◽

2021 ◽

Vol 59 (234) ◽

Author(s):

Ravi Bhandari ◽

Pravakar Dawadi ◽

Mohit Thapa Magar ◽

Ritesh Sinha ◽

Nirab Kayastha ◽

...

Keyword(s):

Surgical Procedures ◽

Care Center ◽

Tertiary Care ◽

Cross Sectional Study ◽

Implant Removal ◽

Orthopedic Implant ◽

Age Group ◽

Tertiary Care Center ◽

Sectional Study ◽

Cross Sectional

Introduction: Implant removal surgery is one of the common surgical procedures done in orthopedics. Studies report that a major portion of orthopedic surgeries carried out in different institutions comprises implant removal procedures. This can be challenging in limited manpower and infrastructure availability scenarios, like in developing countries like Nepal. This study aims to study the prevalence of orthopedic implant removal procedures carried out among overall surgical procedures in the orthopedic department of a tertiary care center in Nepal. Methods: A descriptive cross-sectional study was performed on the medical records of the department of orthopedics of a tertiary care center after approval from the institutional review committee. The data included records from the starting of 2018 to the end of 2019. Data related to the number of implant removal procedures, types of implants, indications, fracture sites, anesthesia use, gender and age distribution were studied. Statistical Package for Social Sciences version 20 was used to study descriptive data. Results: Out of 2557 orthopedic operations carried out in the study duration, 458 (17.91%) of implant removal procedures were done in the department. The most common age group was the young adult age group, 255 (55.68%). Medium-sized implants were the commonly removed ones, 337 (73.58%). Elective procedures were the most common indication, 369 (80.57%). Conclusions: Implant removal procedures cover a major fraction of overall orthopedic operations carried out by the department, most of which are elective procedures. In limited-resource settings, this can be challenging, and a proper evaluation with counseling could be done before implant removal surgery.

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Scrub Typhus among Febrile Children in a Tertiary Care Center of Central Nepal: A Descriptive Cross-sectional Study

Journal of Nepal Medical Association ◽

10.31729/jnma.6166 ◽

2021 ◽

Vol 59 (237) ◽

Author(s):

Isha Bhandari ◽

Kalpana Karmacharya Malla ◽

Pukar Ghimire ◽

Bibek Bhandari

Keyword(s):

Confidence Interval ◽

Scrub Typhus ◽

Care Center ◽

Tertiary Care ◽

Cross Sectional Study ◽

Care Hospital ◽

Tertiary Care Center ◽

Sectional Study ◽

Cross Sectional ◽

Central Nepal

Introduction: Scrub typhus is a mite borne infectious disease caused by Orientia tsutsugamushi, obligate intracellular bacteria, transmitted by chigger mites. Scrub typhus is an emerging febrile illness with clinical suspicion being the only key to diagnosis. This study was conducted to find out the prevalence of Scrub typhus among febrile children in a tertiary care center of central Nepal. Methods: A descriptive cross-sectional study was conducted from January 2018 to December 2019 in the pediatric inpatients of a tertiary care hospital after obtaining ethical clearance from Institutional Review Committee of Institute (Reference number 2020-105). Convenient sampling method was used. Data was analyzed using Statistical Packages for the Social Science version 16. Point estimate at 95% Confidence Interval was calculated along with frequency and proportion for binary data. Results: Out of 1024 febrile patients, prevalence of scrub typhus among febrile children was 55 (5.37%) (3.66-7.08 at 90% Confidence Interval). Of 55 patients, mean age was 9.2 years with 52 (94.6%) of cases diagnosed between July to November. Among 55 patients, other symptoms were vomiting 33 (60%), headache 22 (40%), abdominal pain 19 (34.5%), cough 15 (27.3%), nausea (25.5%), seizure 11 (20 %), and dyspnea 6 (10.9%). Major clinical signs was lymphadenopathy 29 (52.7%). Major complication noted was meningitis 11 (20%). Conclusions: The prevalence of scrub typhus is considerably high during July to November so it should be considered as a differential diagnosis of fever particularly in this period.

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Practice among Healthcare Workers Regarding the Use of Respiratory Protective Equipment during COVID-19 Pandemic in a Tertiary Care Center: A Descriptive Cross-sectional Study

Journal of Nepal Medical Association ◽

10.31729/jnma.5500 ◽

2021 ◽

Vol 59 (236) ◽

Author(s):

Sani Sipai ◽

Bishnu Rath Giri ◽

Sudhir Sapkota ◽

Ram Hari Chapagain ◽

Santosh Manandhar ◽

...

Keyword(s):

Confidence Interval ◽

Healthcare Workers ◽

Care Center ◽

Tertiary Care ◽

Cross Sectional Study ◽

Protective Equipment ◽

Care Hospital ◽

Tertiary Care Center ◽

Sectional Study ◽

Cross Sectional

Introduction: Healthcare workers are always at the risk of exposure to different diseases like respiratory illness including COVID-19. Using appropriate face mask or respiratory protective equipment correctly can prevent transmission of diseases from and to healthcare workers while caring for patients. The study aimed to find out the practice regarding use of face masks during the COVID-19 pandemic in a tertiary care center. Methods: A descriptive cross-sectional study was conducted at a tertiary care hospital during June-July 2020 after receiving ethical approval from the review committee regarding practice of use of face masks. Convenience sampling method was used and a sample size of 162 was taken. Descriptive statistical analysis was done. Point estimate at 95% Confidence Interval was calculated along with frequency and proportion for binary data. Results: Among 162 participants, 123 (75.9%) knew the correct way of using the masks (72.5-79.3 at 95% Confidence Interval). Conclusions: In this study regarding practice of use of face masks, most of the healthcare workers knew the correct way of using masks and practised hygiene before and after using masks.

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Surgical Emergencies among Gynecological Surgeries in a Tertiary Care Center: a Descriptive Cross-sectional Study

Journal of Nepal Medical Association ◽

10.31729/jnma.5888 ◽

2020 ◽

Vol 58 (232) ◽

Author(s):

Indira Acharya ◽

Sumana Thapa

Keyword(s):

Ectopic Pregnancy ◽

Care Center ◽

Tertiary Care ◽

Cross Sectional Study ◽

Age Group ◽

Tertiary Care Center ◽

Sectional Study ◽

Cross Sectional ◽

Gynecology And Obstetrics ◽

Surgical Emergencies

Introduction: The management of gynecological emergencies is essential for the preservation of the life of affected woman, her sexual functions and fertility particularly in disease conditions that threaten her life. The main objective of the study is to determine the proportion of the surgical emergencies among gynecological surgeries in a tertiary care center. Methods: This is a descriptive cross-sectional study conducted in the department of gynecology and obstetrics in Shree Birendra Hospital, Kathmandu, Nepal from April 2013 till March 2017. Ethical approval was taken from the Institutional Review Committee (IRC) in November 2019. This study was conducted among 515 gynecological surgeries by using convenience sampling methods. Point estimate at 95% Confidence Interval was calculated along with frequency and proportion for binary data. Data were analyzed using EXCEL software. Results: In our study, the proportion of surgical emergencies among total gynecological surgeries performed in the department of gynecology and obstetrics in Shree Birendra Hospital was 120 (23.30%). The highest number of surgical emergencies was observed in the age group of 20-29 years old, followed by less than 19 years of old age group. Ectopic pregnancy accounting for 85 (70.83%) is found to be the most common surgical emergencies in our study. Out of all surgical emergency cases, most of them underwent salpingectomy 65 (54.16%) followed by salpingectomy with tubal ligation 20 (16.16%). Conclusions: Surgical emergencies among gynecological surgeries are found to be in greater proportion in the department of gynecology and obstetrics in Shree Birendra Hospital. Ectopic pregnancy accounted for more than half of the diagnoses in this study.

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Recurrence of Varicose Vein after Endovenous Laser Therapy in a Tertiary Care Center: A Descriptive Cross-sectional Study

Journal of Nepal Medical Association ◽

10.31729/jnma.6163 ◽

2021 ◽

Vol 59 (235) ◽

Author(s):

Dinesh Chapagain ◽

Kiran Prasad Shrestha ◽

Deepak Thapa Magar ◽

Kumar Bahadur Shrestha ◽

Pramod Kumar Yadav

Keyword(s):

Laser Therapy ◽

Varicose Vein ◽

Care Center ◽

Tertiary Care ◽

Cross Sectional Study ◽

Care Hospital ◽

Tertiary Care Center ◽

Sectional Study ◽

Cross Sectional ◽

Endovenous Laser Therapy

Introduction: Varicosity is the common problem of various etiology having simple limb aching to worst complications like oedema, ulcer, and skin changes. Minimal invasive endovenous laser therapy is a noble procedure. The aim of the study is to find out the recurrence of the varicose vein after laser therapy in a tertiary care center. Methods: This descriptive cross-sectional study was done in 38 patients with varicosity of the lower limb in a tertiary care hospital, from January 2019 to June 2019 after taking ethical clearance from Institutional Review Committee. Convenience sampling was done. Data was collected and entry was done in Statistical Package for the Social Science software version 22, point estimate at 90% Confidence Interval was calculated along with frequency and proportion for binary data. Results: We recorded 38 patients with ablated limb out of which none of the ablated veins showed recanalization in six months follow up. Twenty two (58%) patients were male and 16 (42%) patients were female with a mean age of 40.26 years. Major bulk, 23 (60.5%) resumed activity in second postoperative day and only 1 (2.6%) patient waited for 5 days for normal activity with mean of 2.58 days postoperatively. Sixteen (42.1%) patients developed erythema or ecchymosis, 12 (31.6%) patients had induration along the long saphenous vein course, 7 (18.4%) patients had paresthesia, 2 (5.3%) patients had limb swelling and 1 (2.6%) patient had skin burn. Conclusions: Endovenous laser ablation has very low rate of recurrence of varicosity and has minorcomplications.

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