Journal of Gandaki Medical College-Nepal 2023-07-03T09:58:48+00:00 Dr. Nuwadatta Subedi Open Journal Systems <p>An official publication of the Gandaki Medical College Teaching Hospital &amp; Research Centre Pvt. Ltd. </p> Prevalence and factors influencing physical activity among secondary school adolescents: A cross-sectional study 2023-03-21T01:49:51+00:00 Samata Nepal Anu Marhatta Sajja Shrestha Deelip Kumar Karki <p><strong>Introduction:</strong> Physical inactivity is a major health concern among adolescents and is an independent, modifiable risk factor for several non-communicable diseases. Despite the World Health Organization recommended physical activity levels, many adolescents do not meet these guidelines. This study was conducted among secondary school students in Palpa district of Nepal to assess their physical activity levels and associated factors.</p> <p><strong>Methods:</strong> A modified version of the Physical Activity Questionnaire Adolescents was used to collect data from 506 grade eight and nine students from six schools in Palpa district.</p> <p><strong>Results:</strong> The results revealed that only 25.31% of students engaged in physical activity quite often or always, and only 23.10% met the daily WHO recommendation of at least 60 minutes of physical activity per day. Additionally, females were less likely to achieve the recommended physical activity level compared with males.</p> <p><strong>Conclusions:</strong> The low levels of physical activity among secondary school students in Palpa district of Nepal highlight the need for interventions to promote physical activity. This study identified several factors associated with low physical activity levels, including limited break time at school, lack of parks or playgrounds near homes, and gender differences.<br /><br /></p> 2023-07-03T00:00:00+00:00 Copyright (c) 2023 Samata Nepal, Anu Marhatta, Sajja Shrestha, Deelip Kumar Karki A comparative study of students’ performance in flipped classroom and structured interactive session teaching learning method in Conservative Dentistry and Endodontics 2023-01-24T16:06:53+00:00 Sushmita Shrestha Mannu Vikram Navin Agrawal Ashok Ayer Ashish Shrestha <p><strong>Introduction:</strong> Flipped classroom is an element of blended learning, integrating both face-to-face learning in the class through group discussion and distance learning outside the class by watching video lessons and online collaboration. The objective of the study was to introduce and assess the effectiveness of flipped classroom in teaching and learning of Conservative Dentistry and Endodontics and to understand the perspective of students about the same.</p> <p><strong>Methods:</strong> Third year undergraduate dental students were randomly divided into two groups: structured interactive session group and flipped classroom group. Structured interactive session group had their class taken in the traditional manner while the flipped classroom group was given power point presentation and videos beforehand so that students came to class being prepared. The in class time was utilized for group discussions and peer exercises. Same set of questions including multiple choice questions (MCQs) and problem based questions (PBQs) validated by the faculties involved in the research was used for assessment. A questionnaire was then provided to students regarding their perception of flipped classroom method.</p> <p><strong>Results:</strong> Among the 41 students, 19 students were in structured interactive session group and 22 were in flipped classroom group. The mean MCQ and PBQ score in structured interactive session group was 69.47 and 59.39 respectively whereas it was 73.17 and 66.55 respectively in flipped classroom group.</p> <p><strong>Conclusions:</strong> The performance of flipped classroom group was better in both MCQs and PBQs. Students preferred flipped classroom method and were ready to accept it as their teaching learning modality.</p> 2023-07-03T00:00:00+00:00 Copyright (c) 2023 Sushmita Shrestha, Mannu Vikram, Navin Agrawal, Ashok Ayer, Ashish Shrestha Incidence and reasons for conversion of laparoscopic cholecystectomy to open cholecystectomy 2023-02-22T13:38:37+00:00 Arjun Acharya Narendra Vikram Gurung Suresh Raj Poudel <p><strong>Introduction:</strong> Cholelithiasis is one of the most common problems affecting the gastrointestinal tract. The objective of the study was to find the incidence of cases converted to open cholecystectomy from laparoscopic cholecystectomy and find the association with other intra-operative and preoperative findings.</p> <p><strong>Methods:</strong> This is a prospective observational study. One hundred elective laparoscopic cholecystectomy cases in the institution of the study were the study sample. Pre-operative and intra-operative findings were noted. Conversion in surgery from laparoscopic cholecystectomy to open cholecystectomy was also recorded and the association was tested through Fisher’s exact test.</p> <p><strong>Results:</strong> The rate of conversion from laparoscopic cholecystectomy to open cholecystectomy was 5%. which was significantly related to sex, time duration of the surgery, bleeding, and anatomical difficulties.</p> <p><strong>Conclusions:</strong> The conversion rate is only 5% which was significantly associated with sex, time duration of surgery, intraoperative bleeding, and anatomical difficulties.</p> 2023-07-03T00:00:00+00:00 Copyright (c) 2023 Arjun Acharya, Narendra Vikram Gurung, Suresh Raj Poudel Anosmia and dysgeusia associated with COVID-19 infection among patients visiting a tertiary hospital at Kaski, Nepal 2023-03-17T13:25:04+00:00 Swasti Sharma Aakash Mani Bhandari Ushant Acharya Ambalika Shakya Bonu Goudel Laxman Banstola <p><strong>Introduction:</strong> A number of studies have shown that anosmia and dysgeusia present as symptoms of COVID-19. These symptoms can appear with sudden onset following COVID-19 infection. The objective of the study was to observe epidemiological and clinical profile of COVID-19 patients who had experienced anosmia and dysgeusia.</p> <p><strong>Methods:</strong> A cross-sectional study was carried out in Ear, Nose and Throat outpatient department of Pokhara Academy of Health Sciences over a period of two months, from February 2022 to March 2022. Patients visiting the outpatient department were enquired<br />about the COVID-19 infection status in the past and symptoms related to taste and smell impairment were asked about.</p> <p><strong>Results:</strong> Out of total 198 patients, 141 (71%) had experienced impairment of taste and smell, either one or both, while the rest did not develop such features after testing positive for COVID-19 virus.</p> <p><strong>Conclusions:</strong> Anosmia and dysgeusia were common features in COVID-19 infection.</p> 2023-07-03T00:00:00+00:00 Copyright (c) 2023 Swasti Sharma, Aakash Mani Bhandari, Ushant Acharya, Ambalika Shakya, Bonu Goudel, Laxman Banstola Complementary feeding practices among mothers of 6-23 months of aged children at a tertiary level hospital in Nepal 2023-04-26T08:27:34+00:00 Pratima Ghimire Pratima Pathak Bijaya Ghimire Pramila Poudel Kunja Shrestha Rashmi Gachhadar Pooja Gauro <p><strong>Introduction:</strong> Complementary feeding is defined as the process starting when breast milk is no longer sufficient to meet the nutritional requirements of infants then other foods and liquids are needed, along with breast milk. This study was conducted to assess the complementary feeding practice among mothers of 6-23 months of aged children.</p> <p><strong>Methods:</strong> A cross-sectional study was conducted in Kathmandu among 240 mothers of 6-23 months of aged children attending the pediatric outpatient department and community medicine from June to September, 2022. A purposive sampling technique was used and data were collected using a structured questionnaire through a face-to-face interview. The obtained data were entered into Epi-data and converted into Statistical Package for the Social Sciences-20. Descriptive and inferential statistics were used for statistical analysis.</p> <p><strong>Results:</strong> The prevalence of Minimum Dietary Diversity (MDD),Minimum Meal Frequency (MMF), and Minimum Acceptable Diet (MAD) was 49.16% (0.42-0.55, 95% Confidence Interval), 44.58% (0.48-0.61, 95% Confidence Interval) and 27.91% (0.65-0.77, 95% Confidence Interval) respectively. Children of age 18-23 months were statistically significantly associated with MDD, MMF, and MAD respectively. Type of family, listening to radio as media, along with breastfeeding and bottle feeding since six months were statistically significantly associated with MMF and along with breastfeeding as well as bottle feeding since birth to six months were statistically significantly associated with MAD.</p> <p><strong>Conclusions:</strong> This study concluded that the children aged 18-23 months were more likely to have recommended standard complementary feeding practices than other younger-aged groups.</p> 2023-07-03T00:00:00+00:00 Copyright (c) 2023 Pratima Ghimire, Pratima Pathak, Bijaya Ghimire, Pramila Poudel, Kunja Shrestha, Rashmi Gachhadar, Pooja Gauro Awareness on breast cancer among females at Bharatpur metropolitan, Chitwan, Nepal 2023-06-21T06:36:18+00:00 Laxmi Neupane Hari Prasad Upadhyay Chandrakala Chhetri <p><strong>Introduction:</strong> Breast cancer is the most frequently diagnosed cancer in the world and second most common malignancy among Nepalese women with high prevalence. Countries with lower level of resources like Nepal, prevention of breast cancer is more important. The objective of the study was to find out the level of awareness on breast cancer among female at Bharatpur Metropolitan, Nepal.</p> <p><strong>Methods:</strong> An analytical cross- sectional study was conducted among 263 female of Bharatpur Metropolitan city, Nepal. Non probability purposive sampling technique was used for data collection. Data was entered and analyzed by using SPSS-20, p-value &lt;0.05 was considered as statistically significant.</p> <p><strong>Results:</strong> The mean±SD of age was found 34.40±11.42 years. Study showed that 61.2% (with 95% CI as 55.32-67.1%) had good awareness on risk factors, 60.5% (with 95% CI as 54.54-66.36) had good awareness on warning sign and symptoms and only 44.5% (with 95% CI as 38.48-50.49) had good awareness on screening and prevention. Overall level of awareness on breast cancer was found poor (50.2%). The mean+SD of overall awareness of the respondents on breast cancer was 15.51±2.84. Statistical significant association was found between overall level of awareness and respondents’ education (p=0.039), husband education (p=0.011) and occupation (p=0.046) of the respondents.</p> <p><strong>Conclusions:</strong> More than half of the respondents has poor level of awareness on breast cancer among women in Bharatpur, Chitwan, Nepal. Better health awareness among women in the community, breast cancer screening programmes and national policies to establish effective cancer literacy programs would cause a favorable and positive clinical picture in the country.</p> 2023-07-03T00:00:00+00:00 Copyright (c) 2023 Laxmi Neupane, Hari Prasad Upadhyay, Chandrakala Chhetri Tzanakis score as a diagnostic tool for an acute appendicitis: An institution-based retrospective study 2022-12-22T17:09:36+00:00 Devendra Shrestha Dilip Baral <p><strong>Introduction:</strong> Acute appendicitis is the most common pathology encountered among the patients with acute abdominal pain. Nowadays, different scoring systems are used to diagnose acute appendicitis. One of them is Tzanakis scoring, which is a combination of clinical examination, ultrasonography, and laboratory markers of inflammatory markers. Hence, this study was done to assess the diagnostic accuracy of Tzanakis scoring system in diagnosing acute appendicitis and compare its accuracy with histopathological examination.</p> <p><strong>Methods:</strong> A retrospective observational study of all cases of acute appendicitis was conducted from July 2018 to June 2019 at the Department of Surgery, Western Regional Hospital.Out of 403 patients who had undergone appendicectomy during the period of one year, the necessary documents of 83 patients could not be collected. Hence, 320 patients were included in our study. The ethical approval was taken from the Institutional Review Committee (Ref. No. 14. 2077/078). Total Tzanakis score of all patients who underwent appendicectomy during this period was calculated and compared with histopathology report. Sensitivity, specificity, positive predictive value, negative predictive value and diagnostic accuracy were calculated.</p> <p><strong>Results:</strong> The sensitivity,specificity of Tzanakis score of all 320 patients who underwent appendicectomy was 84% and 71% respectively. The diagnostic accuracy was 84% with positive predictive value 98% and negative predictive value 17%.</p> <p><strong>Conclusions:</strong> The Tzanakis scoring system is simple, effective and easy to be applicable for the diagnosis of acute appendicitis.</p> 2023-07-03T00:00:00+00:00 Copyright (c) 2023 Devendra Shrestha, Dilip Baral Localizing tip of conus medullaris in hospital visiting adults using MRI 2023-05-02T10:45:44+00:00 Madan Thapa Shyam Sundar Parajuly Manish Kiran Shrestha Roshan Pangeni Bhim Bahadur Thapa Santosh Baral <p><strong>Introduction:</strong> Generally, the spinal cord ends at the level between the first and second lumbar vertebrae. There are many studies published globally, yet no article has been published concerning this title in our settings. The objective of this study was to determine the tip level of conus medullaris by the Magnetic Resonance Imaging (MRI) in living humans in Nepalese population.</p> <p><strong>Methods:</strong> Images of the MRI done between August 2019 to June 2021 were accessed through the database of the radiology department for defining the level of conus medullaris. The termination level of conus medullaris was rescored in relation to the upper, mid, and lower third of the adjacent vertebrae and the intervertebral disc. Input data was processed in Microsoft Excel which was later analyzed by SPSS 20.0.</p> <p><strong>Results:</strong> Of the total, 202 study population, a higher number of spinal cords terminated at lower one-third of L1 vertebrae, accounting for 51 (females 26 and males 25) followed by L1-L2 intervertebral disc comprising only 35 (males 19; females 16). No significant differences in number existed between the two sexes having conus medullaris termination at both levels. Most of the cases who were in the age group of 40-49 years old, termination of CM was noted in L1 with the most common shape being the central type C, accounting for 38% (78/202).</p> <p><strong>Conclusions:</strong> The conus medullaris was terminated mostly at lower one third of L1 vertebral body in our settings with no gender difference.</p> 2023-07-03T00:00:00+00:00 Copyright (c) 2023 Madan Thapa, Shyam Sundar Parajuly, Manish Kiran Shrestha, Roshan Pangeni, Bhim Bahadur Thapa, Santosh Baral Visual outcome of standard treatment of sarcoid uveitis at a tertiary eye center in Nepal 2023-06-22T17:06:36+00:00 Kumudini Subedi Smita Shrestha Manish Poudel Anu Manandhar <p style="font-weight: 400;"><strong>Introduction:</strong> Sarcoidosis is a less-studied disease in Nepal, both as a systemic as well as ocular disease. We aimed to describe the visual outcome of standard therapy of sarcoid uveitis in Nepal.</p> <p style="font-weight: 400;"><strong>Methods:</strong> Observational study through Electronic Medical recording system of Tilganga Institute of Ophthalmology from December 2017 to March 2020. Patients diagnosed by IWOS criteria, treated with standard protocol and with minimum six-month follow up were included. The clinical parameters evaluated were type of uveitis, anatomical location and IWOS category. Treatment related factors evaluated were need for immunosuppressants, anti-glaucoma medication and cataract surgery. Visual outcome at six months was the major outcome evaluated, considering two lines of improvement or worsening as significant. Vision limiting complications assessed were cystoid macular edema, complicated cataract and secondary glaucoma. Visual outcome was stratified based on demography, anatomical involvement, uveitis subtype, IWOS category and need for immunomodulators.</p> <p style="font-weight: 400;"><strong>Results:</strong> Forty-six eyes of 25 patients were included. Based on IWOS criteria, presumed ocular sarcoidosis had best visual outcome with 93.33% improvement. Males had better post-treatment vision (90% vs.76.9%). 20-40 years age group had best improvement (96.5%) and anterior uveitis had best visual outcome (100%). A single immunomodulator could not be recommended based on this study. 18(39%) eyes had raised IOP, 4(8.6%) had secondary angle closure glaucoma, 4(8.6%) had hypotony, 1(2.1%) eye underwent cataract surgery and 1(2.1%) eye had cystoid macular edema.</p> <p style="font-weight: 400;"><strong>Conclusions:</strong> Sarcoid uveitis has good visual outcome. High degree of suspicion, early diagnosis and prompt treatment aids in diagnosis and limits vision-limiting complications.</p> 2023-07-03T00:00:00+00:00 Copyright (c) 2023 Kumudini Subedi, Smita Shrestha, Manish Poudel, Anu Manandhar Fruit and vegetable consumption among young school children in Pokhara, Kaski: A cross-sectional study 2023-04-02T08:29:00+00:00 Nirmala Shrestha Sanju Banstola Bimala Sharma <p><strong>Introduction:</strong> Low intake of fruit and vegetable (F&amp;V) increased the risk of non-communicable diseases, followed by disability and death. The fact that many diseases in adulthood have their origins in habits formed during childhood is undeniable. Therefore, the study assessed the prevalence of fruit and vegetable consumption among young schoolchildren aged 5 to 9 years.</p> <p><strong>Methods:</strong> A cross-sectional study was carried out among 352 children from March 8 to September 4, 2020. The multistage sampling method was used to select samples. A face-to-face interview was done with one of the parents at their home. Univariate and bivariate analyses were computed at a 5% level of significance. Ethical approval was obtained from the Nepal Health Research Council.</p> <p><strong>Results:</strong> Out of 352 children, none of the children met the WHO recommendation of F&amp;V of ≥5 servings per day. Around two percentage (2.30%) of children consumed neither fruits nor vegetables, while only 46(13%) had taken F&amp;V at least three servings per day. Children’s higher F&amp;V intake was found to be associated with family monthly income, parents’ higher education, the presence of a fruit and vegetable shop nearby, and giving money to children.</p> <p><strong>Conclusions:</strong> Intake of F&amp;V as compared to the recommendation was very low in the study area. This requires an immediate response including nutrition education for parents, teachers, and decision-makers and increasing easy access to F&amp;V.</p> 2023-07-03T00:00:00+00:00 Copyright (c) 2023 Nirmala Shrestha, Sanju Banstola, Bimala Sharma Misconduct in research: The troubling practice of salami slicing 2023-06-28T07:49:10+00:00 Krishna Subedi Nuwadatta Subedi <p>No Abstract available.</p> 2023-07-03T00:00:00+00:00 Copyright (c) 2023 Krishna Subedi, Nuwadatta Subedi