Janaki Medical College Journal of Medical Science

Healthcare providers in South Asia must pay attention to DEPRESCRIBING

Rano Mal Piryani — 2023-12-15

Zika Virus Infection: An Emerging global Public Health Concern

Rajeshwar Reddy Kasarla — 2023-12-15

Zika virus disease is caused by a virus transmitted primarily by day biting Aedes mosquitoes. Symptoms are generally mild and include fever, rash, conjunctivitis, muscle and joint pain, malaise or headache, and last for two to seven days. Most people with Zika virus infection do not develop symptoms. Zika virus infection during pregnancy can cause infants to be born with microcephaly and other congenital malformations, known as congenital Zika syndrome, and other complications of pregnancy including preterm birth and miscarriage. In adults and children an increased risk of neurologic complications is associated with Zika virus infection, including Guillain-Barré syndrome, neuropathy and myelitis. Therefore, WHO declared Zika virus infection a public health emergency of global concern. And also, the knowledge and scientific information on Zika virus infection is relatively limited. Hence this comprehensive review on Zika virus infection is undertaken to provide an overview of its transmission, pathogenesis, clinical symptoms, diagnosis, treatment and preventive aspects and to highlight its importance, and impact on public health and further research.

Evaluation of In-vivo Anti-Depressant, Anti-Anxiety and Anti-Convulsant Activity of Ficus Lacor Bark

Roshan Kumar Mehta — 2023-12-15

Background and Objectives: Ficus lacor is a large deciduous, rapidly growing closely foliaceous tree about 20 m in height with a fine shaped crown. It is widely distributed in tropical and subtropical regions of the world. This plant is mentioned in different ayurvedic texts with different therapeutic values and literatures. Ficus lacor is used for its anti-inflammatory, anti-arthritic, antioxidant and anti-diabetic activities from time era. The present study was conducted to evaluate Antidepressant, Anxiolytic and Anticonvulsant activity of Ficus lacor bark using various animal models.

Materials and Methods: Wistar rats of either sex weighing 150-250 gram were used in this study. Extract was studied for acute toxicity study. Ethanolic extract of low dose (250 mg/kg) and high dose (500 mg/kg) were performed for anti-depressant, anxiolytic and anti-convulsant activity. Antidepressant and anxiolytic activity were performed by Rota-rod and elevated plus maze. Anti-convulsant activity was studied in isoniazid induced convulsion in Wistar rat.

Results: Extract treated 500 mg/kg showed more effective and significant (P<0.05) anti-depressant activity. Extract treated group with 500 mg/kg and 250 mg/kg showed significant anxiolytic activity in both No. of open arm entries and time spent in open arm but have no significant anti- convulsant activity.

Conclusion: The study concludes that the ethanolic extract possesses anti-depressant and anxiolytic activity of Ficus lacor bark but have no significant anti-convulsant activity in isoniazid induced convulsion. Our study will aware the community people for the preservation of this medicinal plant and will reduce the wastage of drug by proper utilization of the crude drug.

Demography, Clinical Features and Outcome of Bacterial Keratitis Presenting in Tertiary Eye Care in Nepal

Leena Bajracharya — 2023-12-15

Background and Objectives: Bacterial keratitis is an important cause of ocular morbidity in developing country like Nepal and this warrants a detail study of it including its outcome.

Material and Methods: Data of demography, clinical features and risk factors of bacterial keratitis were segregated from our previous cross-sectional study of microbial keratitis and retrospective data of treatment and outcome were taken from electronic medical record.

Results: Among 123 cases of bacterial keratitis, 111 had bacteria isolated in the culture whereas 12 had bacteria seen only in Gram stain. Average age of patients was 52.6 years; 65(52.8%) were female; 68.3% of total subjects were farmers. Patients had visited the tertiary hospital at an average of 12.9 days since onset of symptoms. Of culture isolates, 55 were Streptococcus pneumonia followed by Staphylococcus aureus (n=25) and Streptococcus viridians (n=14). Regarding clinical characteristics, 78(63.4%) cases had hypopyon; 24.3% (n=30) had infiltrate size of >¼ of corneal surface; 16(13.0%) were either perforated or impending to perforate at presentation. Trauma was the main risk factor in 35% (n=43), followed by topical steroid (19.5%, n=24) and dacryocystitis (16.2%, n=20). Patients were treated with combination of fortified cefazoline and amikacin or monotherapy with moxifloxacin or ofloxacin. Overall, 90(73.2%) responded to medical treatment, 19(15.4%) underwent therapeutic penetrating keratoplasty and 3(2.4%) needed evisceration. Smaller sized ulcers had better healing rates (81%) with statistical significance.

Conclusion: Patients with bacterial ulcers present late in tertiary eye center causing increased morbidity and even loss of eyes. Awareness, protective measures from trauma and proper treatment has to be undertaken for controlling its occurrence and for better prognosis of the ulcers.

Adjustment to Pubertal Changes among Adolescent Girls

Ajanta Maharjan Singh — 2023-12-15

Background and Objectives: Adolescence is the transitional stage of life from childhood to adulthood characterized by puberty. Dramatic physical, physiological, hormonal, and emotional changes occur, which are exciting as well as frightening at the same time. The objective of this study was to find out the adjustment of adolescent girls towards pubertal changes.

Materials and Methods: A descriptive cross-sectional study was conducted to find out the adjustment toward pubertal changes among adolescent girls studying in Grades 8, 9, and 10. A proportionate stratified random sampling technique was used to collect the samples, and a self-administered structured questionnaire was used. Descriptive statistics was used to analyze the data.

Results: All the respondents had experienced a rapid increase in height, weight, and development of breast bud, almost all (92.8%) had experienced pubic hair growth, the majority (85.6%) had experienced axillary hair growth, and three-fourths (76%) had experienced pimples on the face. Most (88.8%) of the respondents had received pre-information about pubertal changes. During menarche, more than two-thirds (68.0%) were restricted from worshipping, 20.8% were restricted from seeing or talking to male family members, 17.6% were restricted from cooking and doing household work, and 16.0% were kept in a separate room or neighbor’s house. Nearly three-fourths (74.4%) of the respondents used sanitary pads during their menarche. Similarly, more than three-fourths (77.6%) of the respondents experienced problems during menarche, and the majority (80.4%) had lower abdominal pain. Regarding emotional changes, nearly two-thirds (63.2%) had frequent mood swings, and nearly half (45.6%) shared their feelings with family members and friends.

Conclusion: Almost all the respondents have adjusted well to the pubertal changes, but restriction during menarche is still prevalent which needs to be addressed for respectful care during menstruation.

Evaluation of the Effectiveness of Structured Teaching Programme on Knowledge regarding First Aid Management of Epilepsy among Primary School Teachers

Shirjana Shrestha — 2023-12-15

Background and Objectives Children and youth represent one of the fastly growing populations affected by epilepsy, which is the most common childhood neurologic condition. The clinical spectrum of children and youth with epilepsy (CYE) varies as some forms of epilepsy can have dramatic effects on brain development in early childhood and lead to poor functioning later in life. The aim of the study was to evaluate the effectiveness of structured teaching programme on knowledge regarding first aid management of epilepsy among primary school teachers.

Materials and Methods: A pre-experimental one group pre-test and post-test design was used for the study. A quantitative pre experiment method was used for this study. The sample consists of 60 primary school teachers of selected schools, Bangalore. They were chosen by a non-probability purposive sampling technique. A structured knowledge questionnaire was used to collect the data from the subjects. The obtained data was analyzed by using descriptive and inferential statistics and interpretation in terms of objectives and hypothesis of the study. The level of significance was set at 0.05 levels.

Results: In the pre-test, majority of the respondents had inadequate knowledge with mean knowledge score of 43.2 % where as in post-test there was a significant gain in mean knowledge score of 85.3%. A significant association was found between demographic variables at 5% level of significance, the study shows there is the significant association of pre-test knowledge level with the demographic variables of respondents on Gender, marital status, Educational status, Know about first aid management of Epilepsy, teaching experience to an epileptic child, Experience in helping the epileptic child, ever observed student with epileptic attack in class room (P<0.05). Further, not significant association between the knowledge level found with age, religion, teaching experience, sources of information (p>0.05) at 5% of significant level.

Conclusion: The finding of the study shows that in the pre-test, majority of the primary school teachers had inadequate knowledge regarding first aid management of epilepsy where as in post-test majority of teachers had gained adequate knowledge after administration of structured teaching programme. The structured teaching programme was effective in enhancing the knowledge regarding first aid management of epilepsy among primary school teachers working in selected schools, Bangalore.

Quality of Work Life of Nurses in a Government Hospital, Nepal

Aakriti Rai — 2023-12-15

Background and Objectives: Work is an integral part of life where employees spend about one third of their entire life in workplace, thus working environment must be favorable. When the quality of work-life is stable, productivity is bound to increase. It seeks to benefit employees, their families, and the organization as well. The objective of the study is to identify the quality of work life of nurses working in Bharatpur hospital, Nepal.

Materials and Methods: A descriptive cross sectional study design was used. The total number of 84 nurses from Bharatpur Hospital were purposively selected. Non-probability convenience sampling techniques was used to select a nurse working in Bharatpur Government hospital, Bharatpur, Chitwan having maximum of 6 months job experience. Data were collected using standardized Brooks’ Quality of Nursing Work Life Survey tool. Data analyzed using the statistical package of social science (SPSS) version 20.0. Inferential statistic was used to measure the association between quality of life of nurse and selected variables.

Results: The study revealed that overall Quality of Work life were moderate (79.8%) of respondents. The findings on dimension wise Quality of Work Life of nurses were 83.3%, 67.3% and 65.5% of respondents had moderate level of quality in work design, home life/ work life and work world dimension respectively, while 57.1% of respondents had high level of quality of work life of nurses in work context dimension. The Quality of Work Life of nurses was associated with level of education (X² =11.027, p= 0.004).

Conclusion: The majority of nurse had moderate level quality of work life. The authorities in the health care system should develop strategies for improving the nurses work conditions and their quality of work life so that, nurses will be able to perform quality care for their patients.

Awareness and Pattern of Utilizing Family Planning Methods in Married Women visiting at Janaki Medical College Teaching Hospital

Sushma Deo — 2023-12-15

Background and Objectives: Family planning (FP) means a way of thinking, perceiving and utilizing which is accepted voluntarily upon the bases of attitude, knowledge, and important decisions by couples. This study was done to assess level of awareness and pattern of utilizing family planning methods among married women aged 20 to 45 years of reproductive age visiting at Janaki Medical College teaching Hospital, Ramdiaya.

Materials and Methods: A cross-sectional study was conducted from January 2023 to July 2023 at the department of obstetrics and gynecology of Janaki Medical College and Teaching Hospital, Ramdaiya, Dhanusha, Nepal. One hundred forty three (n=143) women of reproductive age, were interviewed by using a pre-tested semi structured questionnaire. After taking informed written consent, socio-demographic characteristics, knowledge, attitude and pattern of using family planning methods were recorded. The data was analyzed by using SPSS version 21.

Results: Majority (55.94%) of respondents were aware about the different contraceptive methods, and 46.85% of the respondents were using contraceptive methods at the time of our study. 16.08% were using oral contraceptives followed by condoms in 13.98%, tubectomy by 9.09%, vasectomy by 3.49%, traditional methods by 2.09 %, intrauterine device by 1.39% and injectable by 0.69%. The use of contraceptive methods increased with increasing age, number of living children and level of education.

Conclusion: Average number of women were aware about the contraceptive methods but the practice of contraception and utilization of family planning services were low. A gap was found between knowledge and implementation of contraceptive methods in the study population. This shows the need for more informative awareness campaigns for promoting contraceptive utilization.

Knowledge about Acute Respiratory Infection and Home Care Practice among Mothers of Under Five Years Children in Hima Rural Municipality, Jumla, Nepal

Bishal Pokhrel — 2023-12-15

Background and Objectives: Acute Respiratory Infection (ARI) is defined as acute infective inflammatory changes in any part of respiratory tract, from the nasal mucosa to the alveoli, with an alteration in the respiratory physiology. ARI is a leading causes of mortality and morbidity in under-five children worldwide. This study aimed to assess knowledge about acute respiratory infection and home care practice among mothers of under-five year’s children and to determine the factors associated with it among mothers of under five children in Hima Rural Municipality, Jumla.

Materials and Methods: The community based cross sectional study was conducted. Data was collected using systematic random sampling technique method and face to face interview was conducted using pretested semi-structured questionnaire. Data entry was used Epi-data 4.6 version and analyzed by using SPSS 20.0 version.

Results: About 94.9% of the participant’s mother had heard about the ARI and 24.9% participant’s mother had high level of knowledge about ARI. 70.8% participants keep the child in a room with window and door close the room warm. As prevention and control highest percentage of the participants mothers 61.1% preferred to give Tito leaf tea. 59.1% mother were breast feeding than frequently to their ARI babies.

Conclusion: The most of the women had knowledge about ARI. More than half of mothers preferred health facility for neighbor child as a choice of treatment. Most of the mothers kept their child in a room with window and door closed to keep the room warm. More than half reduce fever by cold sponge and wrap the child with tight and thick when child had ARI. Most of the ARI cases were treated at home and cured. Among total participants less than half followed health post after not cured at home.

Fundamental questions?

Pathiyil Ravi Shankar — 2023-12-15