Ureteric Injuries after Hysterectomy in a Tertiary Care Center of Nepal: A Descriptive Cross-sectional Study

Introduction: Pelvic surgery is the most common cause of iatrogenic ureteral injury. The incidence of ureteric injuries varies between skilled and inexperienced surgeons. The study aims to determine the prevalence of ureteric injuries sustained during hysterectomy in a tertiary care center of Nepal. Methods: A descriptive cross-sectional study involving the women attending the gynecological outpatient department of a tertiary care center of Nepal, for various benign and malignant conditions and later on underwent hysterectomy from June 2019 to June 2020 was done after obtaining ethical clearence from the Institutional Review Committee (Reference No. 245). Convenient sampling method was used. The data were entered in Excel and analyzed using Statistical Package for Social Sciences version 17. Point estimate at 95% Confidence Interval was calculated along with frequency and proportion for binary data. Results: Altogether, 1 (0.63%) (0.55-0.71 at 95% Confidence Interval) out of 159 patients sustained the ureteric injury during hysterectomy in a tertiary care center of Nepal. The injury was seen during the exploratory laparotomy for adnexal mass. The injury was recognized intraoperatively and was repaired with double J stenting. A total of 159 patients were enrolled in the study that had undergone hysterectomy over one year for various benign and malignant conditions. Out of which 21 (13.2%) had undergone surgeries for malignant conditions and 138 (86.79%) for benign conditions. Conclusions: Iatrogenic ureteric is still a major cause of harm and concern in hysterectomy. Patients with ureteric injury should be evaluated and intervened at the earliest.

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Perinatal Mortality among All Deliveries in a Tertiary Care Center: A Descriptive Cross-sectional Study

Journal of Nepal Medical Association ◽

10.31729/jnma.6691 ◽

2021 ◽

Vol 59 (243) ◽

pp. 1075-1080

Author(s):

Saraswoti Kumari Gautam Bhattarai ◽

Roshana Ghimire ◽

Sapana Duwadi ◽

Rabin Khadka ◽

Kanchan Gautam

Keyword(s):

Confidence Interval ◽

Perinatal Mortality ◽

Congenital Anomalies ◽

Binary Data ◽

Care Center ◽

Tertiary Care ◽

Cross Sectional Study ◽

Tertiary Care Center ◽

Sectional Study ◽

Cross Sectional

Introduction: Perinatal mortality comprises the number of stillbirths and death of newborns within seven days of life which is the main contributor to infant and maternal mortality. The aim of this study was to find out the prevalence of perinatal mortality among all the deliveries in a tertiary care center of a remote part of Nepal. Methods: This was a descriptive cross-sectional study conducted in a tertiary care center located in Jumla among 3798 deliveries (childbirth) from August 2014 to April 2020. Ethical approval was taken from the institutional review committee (2076/2077/05) of the same institution. A convenience sampling technique was used and the data were collected from the medical record section and then entered and analyzed in Statistical Package for Social Sciences version 16. Point estimate at 95% Confidence Interval was calculated along with frequencies and percentages for binary data. Results: The prevalence of perinatal mortality was 187 (4.92%) (4.23-4.60% at 95% Confidence Interval) among 3798 deliveries. Regarding the primary causes; the highest proportion was intrapartum hypoxia 62 (33.3%), spontaneous preterm labor 40 (21.5%), and congenital anomalies 38 (20.4%). Similarly, about the final cause; the highest proportion was birth asphyxia 64 (34.2%), intrauterine fetal death 51 (27.3%), congenital anomalies 35 (18.7%), and complication of prematurity 32 (17.1%). Conclusions: The perinatal mortality was quite high in this study with respect to similar studies done in other countries. The finding of this study showed that quality antenatal care with rural ultrasound service is essential to reduce the causes of perinatal mortality.

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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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Non-neoplastic Lesions of Gallbladder Among Cholecystectomy Specimens of a Tertiary Care Center: A Descriptive Cross-sectional Study

Journal of Nepal Medical Association ◽

10.31729/jnma.5861 ◽

2021 ◽

Vol 59 (242) ◽

pp. 834-838

Author(s):

Dilasma Ghartimagar ◽

Manish Kiran Shrestha ◽

Adarsh Jhunjhunwala ◽

Arnab Ghosh ◽

Sushma Thapa ◽

...

Keyword(s):

Confidence Interval ◽

Care Center ◽

Tertiary Care ◽

Cross Sectional Study ◽

Common Finding ◽

Tertiary Care Center ◽

Sectional Study ◽

Cross Sectional ◽

Female Ratio ◽

Neoplastic Lesions

Introduction: Gallbladder diseases are prevalent worldwide and present with a diverse histopathological spectrum. Mucosal irritation and chronic inflammation is considered as an important etiological factor for the mechanical or functional dysfunction of emptying of the gallbladder. This study aims to find the prevalence of non-neoplastic lesions of gallbladder among cholecystectomy specimens of a tertiary care center. Methods: A descriptive cross-sectional study was conducted in the Department of Pathology, of a tertiary care center from January 2005 to December 2020. Ethical approval was taken from the Institutional Review Committee. All the patients who had undergone cholecystectomy procedures which showed non-neoplastic lesions were enrolled in the study. Convenient sampling was done. Statistical Package for Social Sciences version 21 and Microsoft Excel were used for data analysis. Point estimate at 95% Confidence Interval was calculated along with frequency and proportion forbinary data. Results: Out of 4914 cholecystectomy specimens, 4852 (98.73%) (95% Confidence Interval= 98.42- 99.04) were non-neoplastic lesions. There were 1252 (25.8%) males and 3600 (74.2%) females with a male to female ratio of 1:2.87. Age ranged from 2 to 89 years with a mean age of 45±14.48 years. Gallbladder lesions were observed maximum in age group 41-50 years with 1200 (24.7%) cases. Among the non-neoplastic lesions, cholecystitis without any specific finding was the most common finding with 3028 (62.4%) cases followed by cholelithiasis with 1478 (30.5%) cases. Conclusions: The prevalence of non-neoplastic lesions of gallbladder is similar to other studies done in similar setings. Female predominance was noted in non-neoplastic lesions.

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Non-neoplastic Lesions among Lateral Neck Mass Specimens in a Tertiary Care Center: A Descriptive Cross-sectional Study

Journal of Nepal Medical Association ◽

10.31729/jnma.6430 ◽

2021 ◽

Vol 59 (239) ◽

Author(s):

Rachana Dhakal ◽

Ramesh Makaju ◽

Monika Pokharel ◽

Dipika Basnet ◽

Mukta Singh Bhandari

Keyword(s):

Confidence Interval ◽

Care Center ◽

Tertiary Care ◽

Cross Sectional Study ◽

Neck Mass ◽

Tertiary Care Center ◽

Lateral Neck ◽

Sectional Study ◽

Cross Sectional ◽

Neoplastic Lesions

Introduction: Lateral neck masses present clinically as neoplastic or non-neoplastic lesions of lymph nodes, salivary glands, and thyroid. Non-neoplastic lesions, if evaluated timely, may not transform into malignancy thus reducing clinical burden. A cytomorphological study using fine needle aspiration is a reliable method for the diagnosis of such masses. The aim of this study was to find out the prevalence of non-neoplastic lesions of lateral neck mass specimens received in the Department of Pathology in a tertiary care center. Methods: This descriptive cross-sectional study was carried out in the Department of Pathology among lateral neck mass specimens of a tertiary care center from January 2019 to December 2020 after obtaining ethical approval from the Institutional Review Committee (Reference no: 155/19). A convenience sampling method was used and data analysis was done in Microsoft Excel 2019. Point estimate at 95% Confidence Interval was calculated along with frequency and proportion for binary data. Results: Out of 300 lateral neck mass specimens, non-neoplastic lesions were found in 246 (82%) (77.7-86.3 at 95% Confidence Interval). The involvement of lymph nodes in 117 (47.6%) was the most common finding followed by thyroid 112 (45.5%). Among non-neoplastic lesions, the cytomorphological features of benign nodular goiter 93 (37.8%) was the most common lesion followed by reactive lymphoid hyperplasia 73 (29.7%). Conclusions: The study showed that the prevalence of non-neoplastic lesions was similar to that of other national and international studies.

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Endodontic Indications among Patients Visiting a Tertiary Care Center: A Descriptive Cross-sectional Study

Journal of Nepal Medical Association ◽

10.31729/jnma.5424 ◽

2021 ◽

Vol 59 (240) ◽

Author(s):

Deepa Kunwar ◽

Archana Manandhar ◽

Gita Gurung ◽

Jwolan Khadka ◽

Manisha Nepal

Keyword(s):

Confidence Interval ◽

Care Center ◽

Tertiary Care ◽

Cross Sectional Study ◽

Tertiary Care Center ◽

Sectional Study ◽

Cross Sectional ◽

Posterior Teeth ◽

Medical College ◽

Irreversible Pulpitis

Introduction: Endodontics is the study of prevention, diagnosis and treatment of diseases or injuries to the dental pulp. The ultimate goal of modern dental care is tooth preservation and root canal therapy/treatment is an available therapeutic strategy to retain teeth. The aim of the study is to find the prevalence of patients visiting a tertiary care center who had endodontic indications. Methods: A descriptive cross-sectional study was conducted over one year from April 15, 2020, to February 15, 2021 at a tertiary care hospital. The ethical approval was obtained from the Institutional Review Committee of Nobel Medical College (Reference number: 409/2020). Convenience sampling method was used. The patients admitted for alcohol use and related problems in the Psychiatry Department, Nobel Medical College Teaching Hospital, Biratnagar were included. Data entry was done using Microsoft Excel and statistical analysis was done by using Statistical Packages of Social Sciences Version 16.0. Point estimate at 95% Confidence Interval was calculated along with frequency and percentage. Results: Out of 1740 patients, 516 (29.66%) (95% Confidence Interval= 21.46% - 27.51%) had endodontic indications. Symptomatic irreversible pulpitis 306 (59.30%) was the most prevalent pulpal disease. Maxillary teeth 300 (58.13%) had more endodontic diseases. While in individual dental elements most affected by endodontic diseases was the mandibular molar teeth 149 (28.87%). Females 348 (67.44%) were predominant for demanding endodontic management than males 168 (32.5%). Conclusions: More female patients and of younger age group in this study population demanded endodontic treatment. Irreversible pulpitis was responsible for the majority of the cases treated and more affected were the posterior teeth

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Moderate Hydronephrosis among Acute Ureteral Calculus on Ultrasonographic Imaging in a Tertiary Care Center in Nepal: A Descriptive Cross-sectional Study

Journal of Nepal Medical Association ◽

10.31729/jnma.6879 ◽

2021 ◽

Vol 59 (244) ◽

pp. 1252-1255

Author(s):

Dipesh Paudel ◽

Deepak Adhikari ◽

Radha Devi Dhakal

Keyword(s):

Confidence Interval ◽

Care Center ◽

Tertiary Care ◽

Cross Sectional Study ◽

Ureteral Calculus ◽

Moderate Degree ◽

Tertiary Care Center ◽

Sectional Study ◽

Cross Sectional ◽

Female Ratio

Introduction: Ureteric calculi are lying at any point of ureter from the pelvic ureteric junction to the vesicoureteral junction. If left untreated, ureteropelvic junction obstruction can lead to hydronephrosis. With the improved availability of computed tomography and ultrasound scanning, hydronephrosis is being diagnosed more frequently. The main aim of this study is to find out the prevalence of moderate Hydronephrosis among ureteral calculus on ultrasonography imaging in a tertiary care center of Nepal. Methods: A descriptive cross-sectional study was conducted among 110 acute ureteral calculus cases at Radiodiagnosis and Imaging Department of Chitwan Medical College and Teaching Hospital, Bharatpur from 15th August 2020 to 15th May 2021. The ethical approval was taken from the Institutional Review Committee of same institution. Convenient sampling technique was used to select the participant. . The collected data was entered in excel 16 and analysed in Statistical Package for Social Sciences. Point estimate at 95% Confidence Interval was done and frequency and percentage were calculated Results: Out of the 110 cases of acute ureteral calculus, 31 (28.2%) (19.79-36.60 at 95% Confidence Interval) has moderate hydronephrosis in the ultrasonographic imaging. The mean age of participants was 31.61±8.51 years and male to female ratio was 1.97:1. Vesicoureteric junction was the most common site for ureteric calculus 39 (35.5%). Conclusions: The ultrasound is an easy method to be applied, and a fast one to help and diagnose obstructive hydronephrosis. The main causes of hydronephrosis are kidney stones, followed by ureteral stones, with a moderate degree of hydronephrosis.

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Cesarean Section in a Maternity Unit of a Tertiary Care Center of Nepal: A Descriptive Cross-sectional Study

Journal of Nepal Medical Association ◽

10.31729/jnma.5150 ◽

2021 ◽

Vol 59 (236) ◽

Author(s):

Dhan Bahadur Shrestha ◽

Ratna Khatri ◽

Prakash Raj Oli ◽

Rosy Malla ◽

Cimona Shrestha ◽

...

Keyword(s):

Confidence Interval ◽

Cesarean Section ◽

Care Center ◽

Tertiary Care ◽

Cross Sectional Study ◽

World Health ◽

Maternity Unit ◽

Tertiary Care Center ◽

Sectional Study ◽

Cross Sectional

Introduction: Cesarean section is a common obstetric procedure which is done to reduce complications in high risk pregnancies. The aim of study was to find out the prevalence of cesarean section in a maternity unit of a tertiary care center. Methods: A descriptive cross-sectional study was conducted among 497 pregnant women presenting in a maternity unit of a tertiary center of Kathmandu, Nepal over a period of six months from March to August 2017 after taking ethical approval from Institutional Review Committee (Ref. 24). In this study, the prevalence of cesarean section, perinatal outcome, maternal and neonatal complications if any were observed. Data and descriptive analysis were done using Statistical Package for the Social Sciences version 22. Point estimate at 95% Confidence Interval was calculated along with frequency and percentage for binary data. Results: The prevalence of cesarean section was 171 (34.4%) at 95% Confidence interval (30.2-38.7). Most common indication for cesarean section was fetal distress 53 (31%). The maternal complications developed in 11 (6.4%) among those who delivered via cesarean delivery; Surgical Site Infection being the most common maternal complication. The neonatal intensive care unit admission rate among the newborns via cesarean section delivery was 48 (27.43%) and neonatal sepsis 14 (8%) was most common adverse neonatal outcome. Conclusions: The cesarean rate at the study center is higher than standard target rate of World Health Organization. Neonatal and maternal adverse outcome in current study were comparable with existing literatures.

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Urinary Incontinence among Pregnant Women in Third Trimester of Pregnancy in a Tertiary Care Center: A Descriptive Cross-sectional Study

Journal of Nepal Medical Association ◽

10.31729/jnma.6914 ◽

2021 ◽

Vol 59 (240) ◽

Author(s):

Atit Poudel ◽

Ganesh Dangal ◽

Madhu Shrestha

Keyword(s):

Urinary Incontinence ◽

Confidence Interval ◽

Pregnant Women ◽

Care Center ◽

Tertiary Care ◽

Cross Sectional Study ◽

Tertiary Care Center ◽

Sectional Study ◽

Third Trimester ◽

Cross Sectional

Introduction: Urinary incontinence is an involuntary passage of urine. The aim of the study was to find the prevalence of urinary incontinence among pregnant women in the third trimester of pregnancy at a tertiary care center. Methods: This descriptive cross-sectional study was conducted in a tertiary care center fromMarch 2021 to May 2021. Ethical approval was obtained from the Institutional Review Board(reference number: 854/2077/78). Convenience sampling method was used. A descriptive analysis of socio-demographic profile and urinary incontinence symptoms were recorded on International Consultation on Incontinence Questionnaire-Urinary Incontinence-Short Form questionnaire and analysis were done using Statistical Package for Social Sciences 27. Point estimate at 95% Confidence Interval was calculated along with frequency and proportion for binary data. Results: Among 277 pregnant women admitted in the antenatal ward, urinary incontinence was present in 26 (9.4%) (95% Confidence Interval= 5.96-12.84). Among them, stress urinary incontinence 16 (61%) was most common followed by mixed incontinence 6 (23%). Majority of them 18 (69.3%) had small leaks with almost all 25 (96.2%) having only a mild to moderate impact on the quality of life. Majority 197 (71.2%) had features of lower urinary tract syndrome. Conclusions: Our study showed similar prevalence of urinary incontinence compared to other international studies.

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Cesarean Sections under General Anesthesia at a Tertiary Care Center in Western Nepal: A Descriptive Cross-sectional Study

Journal of Nepal Medical Association ◽

10.31729/jnma.4724 ◽

2019 ◽

Vol 57 (220) ◽

Author(s):

Krishna Murari Adhikari ◽

Gajal Lakhe ◽

Anjali Subedi Adhikari

Keyword(s):

Confidence Interval ◽

General Anesthesia ◽

Care Center ◽

Tertiary Care ◽

Cross Sectional Study ◽

Caesarian Section ◽

Tertiary Care Center ◽

Sectional Study ◽

Cross Sectional ◽

Emergency Caesarean

Introduction: General anesthesia is feared to have adverse feto-maternal outcomes compared to neuraxial anesthesia. It is recommended to keep rate of caesarean sections under general anesthesia below 5% and 15% for elective and emergency caesarean sections respectively. This study was conducted to find out the prevalence of caesarean sections under general anesthesia at a tertiary care center in western Nepal.Methods: A descriptive cross-sectional study was conducted among caesarean sections conducted at Manipal Teaching Hospital, Pokhara, Nepal from January 2014 to December 2017. Ethical approval was taken from the Institutional Review Committee with reference number MEMG/IRC/GA/122. All the caesarean sections conducted during this study period were included in the study using whole sampling method. Point estimate at 95% Confidence Interval was calculated along with frequency and proportion for binary data. Data for each patient was subsequently entered into an Excel spreadsheet and analyzed using Statistical Package for Social Sciences version 20.Results: Among 3613 cases, caesarean sections under general anesthesia was observed in 175 (4.84%) in our center over a period of four years at 95% Confidence Interval (4.13-5.55%). The yearly variations ranges from 2.83% to 8.99%. The rate of general anesthesia was found slightly higher in elective 31 (5.82%) as compared to emergency caesarean section 144 (4.67%).Conclusions: The four year medical records of our institution showed fluctuating trend of caesarian sections under general anesthesia. The rate of general anesthesia for emergency caesarian section was within the recommended rate while it was slightly higher in elective caesarian section.

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