https://nepjol.info/index.php/JGMCN/issue/feed Journal of Gandaki Medical College-Nepal 2022-07-25T11:15:48+00:00 Dr. Nuwadatta Subedi drndsubedi@gmail.com Open Journal Systems <p>An official publication of the Gandaki Medical College Teaching Hospital &amp; Research Centre Pvt. Ltd.</p> https://nepjol.info/index.php/JGMCN/article/view/41388 Prevalence of hypertension and its associated factors among adults living in Pokhara metropolitan city 2021-12-12T10:01:11+00:00 Bishnu Gurung bisnuonline@gmail.com Nirupa Thapa thapa_nirup05@yahoo.com Usha Kiran Paudel ushakiransubedi@gmail.com <p><strong>Introduction:</strong> Hypertension is one of the silent killer diseases affecting multiple organs. Hypertension prevalence is increasing in developing countries. So, the present study was conducted to find out the prevalence and associated factors of hypertension among adults living in Pokhara metropolitan city.</p> <p><strong>Methods:</strong> This was a community-based cross-sectional study conducted in Pokhara metropolitan city. Study participants were aged 18 to 70 years, residing permanently in the study sites. Wards, households, and respondents were selected randomly. Data was entered in Epi Data and analysed using SPSS 16 version. Descriptive statistics and inferential statistics at 5% level of significance were used.</p> <p><strong>Results:</strong> Of the 293 participants, 60.8% were females, mean (standard deviation) of age was 41.7(14.6) years, 29.3% had no formal education, 35.1% were brahmins, and 41.2% were homemakers. Prevalence of hypertension was 35.5%. Age, gender, education, marital status, smoking, alcohol consumption, salt adding habit, presence of diabetes status, use of cholesterol drugs and body mass index were significantly associated with hypertension. In multivariate analysis, age, gender, alcohol consumption, salt adding habit and body mass index were identified as significant factors for hypertension.</p> <p><strong>Conclusions:</strong> The study concluded that the prevalence of hypertension in Pokhara metropolitan city was alarming. There were greater number of pre-hypertension cases which are in turn at great risk of developing hypertension if not intervene timely. Therefore, community awareness program on hypertension and its preventive measures is must in preventing the dreadful complications.</p> 2022-07-25T00:00:00+00:00 Copyright (c) 2022 Bishnu Gurung, Nirupa Thapa, Usha Kiran Subedi https://nepjol.info/index.php/JGMCN/article/view/43938 Prevalence of cervical rib in patients visiting department of Radiodiagnosis at a tertiary care hospital: A descriptive cross-sectional study 2022-04-24T08:17:13+00:00 Ruku Pandit ruukuu_252@yahoo.com Aarati Adhikari luckyaarati@gmail.com Nitasha Sharma sharmanitasha@gmail.com Hari Prasad Upadhyay hpchalise@gmail.com <p><strong>Introduction:</strong> The cervical ribs are the supernumerary ribs that are often associated with neuro-vascular symptoms in thoracic outlet syndromes. The objective of the study is to find the prevalence of cervical ribs among the patients visiting the Radiodiagnosis department of a tertiary care hospital.</p> <p><strong>Methods:</strong> This is a cross-sectional study comprising 1533 chest and cervical spine radiographs of patients visiting the Radiodiagnosis department of a tertiary care hospital from March to June 2021. Ethical approval was taken from the Institutional Review Committee at the College of Medical Sciences and Teaching Hospital (Reference Number: COMSTH-IRC/2021-63). The presence or absence of a cervical rib was noted in the digital x-rays. The collected data were statistically analyzed using Statistical Package for Social Science version 20.</p> <p><strong>Results:</strong> The prevalence of cervical ribs was 1.5%, with males and females accounting for 0.85% and 0.65% respectively. Amongst the cases with cervical ribs, the unilateral (73.91%) cervical rib was significantly more than bilateral (26.01%) occurring more frequently on the left side. The cervical rib was found to be more predominant in males than in females without significant difference. Sexual dimorphism was not found to be significantly associated with laterality and sidedness of cervical ribs.</p> <p><strong>Conclusions:</strong> The cervical ribs were commonly encountered in our study. As the presence of the cervical rib is one of the leading causes of thoracic outlet syndromes, clinicians should not overlook the existence of cervical ribs while ruling out the etiology of thoracic outlet syndromes.</p> 2022-07-25T00:00:00+00:00 Copyright (c) 2022 Ruku Pandit, Aarati Adhikari, Nitasha Sharma, Hari Prasad Upadhyay https://nepjol.info/index.php/JGMCN/article/view/42526 Perception and experience of online classes among undergraduate and postgraduate medical students during COVID-19 2022-01-20T15:11:53+00:00 Suman Sharma drsumanms@hotmail.com Brihaspati Sigdel brihassig1@gmail.com <p><strong>Introduction: </strong>The purpose of this study was to analyze the perception and experiences of online classes among undergraduate and post-graduate medical students during COVID-19.</p> <p><strong>Methods:</strong> This prospective cross-sectional study was conducted in the Medical College of Nepal. A self-administered semi-structured questionnaire was developed through extensive review of related literature. It was sent among 304 students. Student who did not want to take part in a survey, didn’t respond to all questions were excluded from the study. The data was received via email and completeness was checked. Out of 304 student, 265 students met the criteria for study. Two parts of the questionnaire included: demographic data related to medical students and online classes; and five perception-related questions which are measured by Likert scale. Perception of student were divided into positive, neutral and negative.</p> <p><strong>Results: </strong>About 265 students out of 304 students completed the form which is 87.1% response rate. The mean age of the students was 24.5±2.5 years. Majorities of students (87.5%) used wifi and almost two third students (66%) wanted two classes per day. Nearly half (49.4%) students felt happy with initiation with online classes and 50.1% said voice was clear during classes. Overall, positive perception was found on was 72.15% of students toward online classes.</p> <p><strong>Conclusions: </strong>Majorities of students used wifi. Nearly 50% of the student feel happy with initiation of online classes. More than two third students had a positive perception toward online classes. Online learning became the alternative option to continue academics during COVID-19.</p> 2022-07-25T00:00:00+00:00 Copyright (c) 2022 Suman Sharma, Brihaspati Sigdel https://nepjol.info/index.php/JGMCN/article/view/42900 Comparison of ultrasonography and computed tomography in detecting urolithiasis in a teaching hospital of Kaski district 2022-02-04T08:51:50+00:00 Nawaraj Paudel nawarajpaudel5@gmail.com Pujan Sharma Pujansharma1@hotmail.com Bhoj Raj Sharma bhojrajsharma2@gmail.com Keshav Sharma sharmakeshab911@gmail.com Santwana Parajuli parajulisantwana11@gmail.com Krishna Timilsina pokharalikrishna2045@gmail.com <p><strong>Introduction: </strong>Urolithiasis is an increasing health problem worldwide including developing countries like Nepal. Ultrasonography and computed tomography of kidney, ureter and urinary bladder imaging modalities are used in detection of urolithiasis. This study was done to compare ultrasonography and computed tomography of kidney, ureter and urinary bladder findings for detection of urolithiasis.</p> <p><strong>Methods:</strong> A cross-sectional study was conducted in Department of Radiology, Gandaki Medical College, Pokhara, Nepal from July to October, 2021 after obtaining ethical clearance from Institutional Review Committee of Gandaki Medical College. Total 92 patients who had urolithiasis in computed tomography and had ultrasound report available within one week were selected for the study. Demographic data of patients, location and side of calculi were recorded. The findings of ultrasonography and computed tomography were then compared. Similarly, sensitivity and specificity of ultrasonography were calculated.</p> <p><strong>Results:</strong> Urolithiasis was more common in middle age groups i.e. 20 to 40 years (n= 57, 62.0%) and in males (n=56, 60.9%). Kidney was the commonest location detected by both ultrasonography (n=45, 48.9%) and computed tomography (n=44, 47.8%) with predominance in right side. Some of the calculi that were undetected by ultrasonography were easily confirmed by computed tomography in various locations. This was found to be statistically significant (p&lt;0.05). The sensitivity and specificity of ultrasonography in compared to computed tomography was 83.7% and 100% respectively.</p> <p><strong>Conclusions:</strong> Ultrasonography has poor sensitivity and high specificity for detecting urolithiasis. Thus, computed tomography can be considered as better imaging modality as compared to ultrasonography for diagnosis of urolithiaisis. </p> 2022-07-25T00:00:00+00:00 Copyright (c) 2022 Nawaraj Paudel, Pujan Sharma, Bhoj Raj Sharma, Keshav Sharma, Santwana Parajuli, Krishna Timilsina https://nepjol.info/index.php/JGMCN/article/view/44897 Monopolar versus bipolar cautery in tonsillectomy: A comparative study 2022-05-09T06:25:43+00:00 Neeraj K.C. kcneer@gmail.com Rajendra Nepali kcneer@gmail.com Tulika Dubey kcneer@gmail.com <p><strong>Introduction: </strong>Tonsillectomy is the most commonly performed surgeries in otolaryngology. Despite the evolution in surgical and anaesthetic techniques, pain and bleeding are still the most important surgical complications. This study was done to compare the pain and bleeding following tonsillectomy using monopolar and bipolar cautery techniques in our population.</p> <p><strong>Methods: </strong>It was a prospective, longitudinal study done over a period of one year at Gandaki Medical College, Pokhara, Nepal. Total 45 patients who underwent tonsillectomy by either monopolar or bipolar cautery were included in the study and assessed for postoperative pain and haemorhage. The data was entered in Microsoft Excel and further analysis done by statistical package for the social sciences 16.0. The association of variables was be tested by Chi square test and p-value of less than 0.05 was considered significant. Confidence interval was be kept at 95%.</p> <p><strong>Results: </strong>Out of the 45 patients who underwent tonsillectomy, 35.5% were males and 64.5% were females. The age of patients varied from 16 to 60 years. Mean age of the patients was 27.5 years. Fourty percent of the total patients underwent tonsillectomy by monopolar cautery whereas 60% patients were operated by bipolar cautery. No statistically significant difference was found between the two groups regarding age, sex ratio, postoperative pain and bleeding.</p> <p><strong>Conclusions: </strong>Both monopolar and bipolar cautery are equally effective methods of tonsillectomy in terms of postoperative pain and haemorrhage. </p> 2022-07-25T00:00:00+00:00 Copyright (c) 2022 Neeraj K.C., Rajendra Nepali, Tulika Dubey https://nepjol.info/index.php/JGMCN/article/view/42141 Common allergens in patients of allergic rhinitis in Gandaki province of Nepal 2022-01-06T08:05:02+00:00 Rajendra Nepali drrajendra28@yahoo.com Brihaspati Sigdel drrajendra28@gmail.com Tulika Dubey drrajendra28@gmail.com Neeraj KC drrajendra28@gmail.com Banita Gurung drrajendra28@gmail.com Pravin Baniya drrajendra28@gmail.com <p><strong>Introduction: </strong>Atopic disorder is very common globally and in Nepal which has affected quality of life resulting into loss of working and school days. Change in lifestyle is one of the important recommendations for fighting back with allergy, which suggests for avoidance of allergens developing allergic rhinitis. The objectives of the study were to find out common allergic conditions in Pokhara, Nepal and to identify the allergens, which induced IgE mediated disorder.</p> <p><strong>Methods: </strong>A retrospective study was done among the patients with different allergic disorders who were referred from different specialist clinic attending Pokhara ENT Center at Pokhara from January 2011 to December 2017. The study sample included 1810 patients to find the distribution of various allergic disorders among them. Further, a sample of 430 patients of allergic rhinitis who had undergone skin prick test according to international guidelines were included in order to find out the common allergens among them. Set of allergens included in this study were mites, pollen, fungus, insects, dusts, epithelia-danders, feather &amp; fabric, non-juicy foods, and juicy foods. These nine allergen types further included several allergens. Data were analyzed using descriptive statistics using Stata 15.1. The study was done from after taking ethical clearance from the institutional ethical committee of Gandaki medical college.</p> <p><strong>Results: </strong>Among various types of allergic diseases, allergic rhinitis accounted for one fourth (23.8%) of the cases. The patients with allergic rhinitis who underwent skin prick test against various allergens were evaluated. Skin prick test positive test result were seen for non-juicy foods (96%), pollens (95%) and then juicy foods (93%). On the contrary, least percentage (13.72%) of people were found positive against feather &amp; fabrics. Radish (7.7%) and snake gourd (6.99%) were only two juicy vegetables against which people were found positive in skin prick test. Among non-juicy foods, tobacco was the commonest allergens which was reported positive in skin prick test of 16% people. Pollen of Zea mays, Azadirachta indica, Mangifera indica and Prosopis juliflora were top allergens diagnosed positive among 12.65%, 10.95%, 7.79%, and 7.54% of people respectively. The mite Dermatophagoides pteronyssinus yielded highest prevalence (69.36%) of positive test.</p> <p><strong>Conclusions: </strong>Based upon the findings of our study, allergic rhinitis is one of the most common allergic diseases in Gandaki province, Nepal. Patients of allergic rhinitis should be tested for certain allergens which are locally present and they need to modify lifestyle and avoid allergens which can induce IgE-mediated disorder. Further research is needed to establish causation. </p> 2022-07-25T00:00:00+00:00 Copyright (c) 2022 Rajendra Nepali, Brihaspati Sigdel, Tulika Dubey, Neeraj KC, Banita Gurung, Pravin Baniya https://nepjol.info/index.php/JGMCN/article/view/43225 Study of nasal packing versus quilting following septoplasty surgery 2022-02-18T15:47:50+00:00 Kusheswar Sah sahkusheswar@gmail.com Brihaspati Sigdel brihassig1@gmail.com Rajendra Nepali drrajendra28@gmail.com <p><strong>Introduction: </strong>Nasal packing is a commonly performed procedure after septoplasty. Quilting is alternative procedure which reduces the complications of nasal packing. This study aims to compare the post-operative outcome of quilting and nasal packing following septoplasty.</p> <p><strong>Methods: </strong>This is a prospective comparative study carried on 80 patients divided into two equal groups who had undergone quilting and nasal packing randomly after septoplasty surgery for symptomatic deviated nasal septum. Post-operative nasal outcome score, pain, haemorrhage, anxiety, infection was compared between two groups at 1st, 3rd, 7th and 30th post-operative days.</p> <p><strong>Results: </strong>There was significant improvement in nasal obstruction post-operatively in quilting group (p&lt;0.05). Polyvinyl acetate sponge nasal packing group patients experienced significantly higher intensity of pain on 1st and 3rd post-operative days (p&lt;0.05). Post-operative bleeding was also relatively higher in nasal packing group compared to quilting group at 3rd post-operative day. Patients had significantly higher levels of anxiety in the nasal packing group throughout a week post-operatively compared to the quilting group. Similarly, no statistically significant difference was noted in terms of adhesion between group A and group B on 7th and 30th post-operative day.</p> <p><strong>Conclusions: </strong>Quilting technique following septoplasty showed higher improvement of post-operative nasal obstruction compared to Polyvinyl acetate sponge packing. It also decreased post-operative pain, bleeding, anxiety and adhesion. Quilting suturing following septoplasty can be recommended as an effective and comfortable alternative to nasal packing. </p> 2022-07-25T00:00:00+00:00 Copyright (c) 2022 Kusheswar Sah, Brihaspati Sigdel, Rajendra Nepali https://nepjol.info/index.php/JGMCN/article/view/44270 Evaluation and surgical outcome of inverted nipple at Kathmandu Medical College Teaching Hospital 2022-04-03T05:47:49+00:00 Amir Bajracharya amirbajracharya@hotmail.com <p><strong>Introduction: </strong>Inverted nipples are related to multifactorial aspects, relating with aesthetic, biological, and psychological to the patient. The treatment depends on the patient’s symptoms and aesthetic complaints caused by the inverted nipple. The objective of this study was to evaluate the grading of inverted nipple and the surgical outcome by using Sakai method for its correction.</p> <p><strong>Methods: </strong>It is a hospital based descriptive study conducted to assess age, sex, site, shape, grading. The history of peri-areolar abscess, recurrence and treatment outcome by Sakai method for its correction.</p> <p><strong>Results: </strong>A total of 20 patients were included with 26 cases of inverted nipple in which six cases of bilateral, nine cases of left sided and five cases of right sided. The mean age was 30±8.399 years ranging from 18 to 52 years. Most of them were females 19(95%). We found grade II inverted nipple on 16(80%) of patients and grade III inverted nipple on 4(20%). Most of them were round shape 16(50%), rest were rectangular 4(20%), slanting 3(15%), omega 2(10%) and one with cup shape nipple. Patients were followed up for three months for observation.</p> <p><strong>Conclusions: </strong>The common type of inverted nipple was Grade II followed by Grade III and the defects were successfully corrected using Sakai method. </p> <p> </p> 2022-07-25T00:00:00+00:00 Copyright (c) 2022 Amir Bajracharya https://nepjol.info/index.php/JGMCN/article/view/44791 Clinico-epidemiological study on animal bite presenting to a tertiary care hospital in western part of Nepal 2022-05-20T05:41:41+00:00 Saroj Pokhrel drsaroj62@gmail.com Roshan Yadav drsaroj62@gmail.com Karuna Sharma drsaroj62@gmail.com Abhishek Shrestha drsaroj62@gmail.com Rekha Poudel drsaroj62@gmail.com Chandra Bahadur Pun drsaroj62@gmail.com <p><strong>Introduction: </strong>Animal bite is a common public health problem and dog bites are most common among them in Nepal. Rabies infection is of most significant concern following animal-bites’ injuries. This study aimed to assess the epidemiological variation in terms of demographic variables, type of animal, circumstances of bite, type and site of wound and outcome of the animal bite.</p> <p><strong>Methods</strong>: It was a descriptive cross-sectional study conducted at emergency department of Gandaki Medical College Teaching Hospital and Research Centre among animal-bite cases from October 1, 2020 to September 30, 2021 using a pre-designed questionnaire.</p> <p><strong>Results: </strong>Out of total 217 cases of animal-bite included in the study, 65 (29.95%) were of 21 to 30 years and 129 (59.46%) were males, 120 (55.23%) cases hailed from rural area and 63 (29.03%) were farmers. Most cases 168 (77.42%) were bitten by dog among which 93 (55.35%) were owned dogs and only 22 dogs were vaccinated. A total of 127 (58.53%) were unprovoked and lower limb 130 (59.91%) was the commonest site. World Health Organization (WHO) Category II wound were the most commonly encountered 122 (56.22%). Majority 99 (45.62%) came to hospital within 25 to 48 hours of bite and after cleaning the wound site 115 (52.99%). Only 81 (37.78%) animals were observed for 10 days after the bite out of which 5 (6.09%) developed signs of rabies.</p> <p><strong>Conclusions: </strong>Animal bite was common in males and source was owned dogs. Majority of the owned dogs were not vaccinated and most of the cases visited hospital without following first-aid measures. </p> 2022-07-25T00:00:00+00:00 Copyright (c) 2022 Saroj Pokhrel, Roshan Yadav, Karuna Sharma, Abhishek Shrestha, Rekha Poudel, Chandra Bahadur Pun https://nepjol.info/index.php/JGMCN/article/view/42219 Magnitude and pattern of combination traumatic dental injuries: An institution based retrospective study in Nepal 2022-01-10T04:16:25+00:00 Sanjeeb Chaudhary sanjeebchaudhary@yahoo.com <p><strong>Introduction: </strong>Traumatic dental injuries can occur as combination injuries, where both fracture and luxation injuries occur concomitantly in the same tooth. The aim of this study was to evaluate prevalence of concomitant fracture and luxation injury (combination dental injuries) in permanent teeth.</p> <p><strong>Methods</strong>: A total of 455 traumatized anterior teeth from 175 patients (131 males and 44 females; age ranged from 14 to 70 years), coming for treatment of traumatic dental injuries over a five-year period from January 2016 to December 2020 were included in the study. Patient’s age and sex, type of injury, type and number of injured teeth were recorded from the clinical and radiographic examination records. Descriptive statistical methods were used for data analysis.</p> <p><strong>Results: </strong>A total of 257 teeth (56.48%) had fracture injury only, while 150 teeth (32.96%) were found to have luxation injury only. The most common isolated fracture injury was enamel-dentin fracture (n=93; 22.85%) and the most common isolated luxation injury was subluxation (n=77; 18.91%). A low prevalence of combination injury was observed in 48 teeth (10.54%). Enamel-dentin fracture (52.08%) was the most common fracture injury type presenting with a concomitant luxation injury. Similarly, the most frequent luxation injury type presenting with a concomitant crown fracture injury was subluxation (56.25%). The most common combination injury was enamel-dentin fracture in combination with subluxation injury (n=15; 31.25%).</p> <p><strong>Conclusions: </strong>The magnitude of combination injury was low in this study and was frequently observed in males of young age groups. The most common combination injury was enamel-dentin fracture in combination with subluxation injury. </p> 2022-07-25T00:00:00+00:00 Copyright (c) 2022 Sanjeeb Chaudhary https://nepjol.info/index.php/JGMCN/article/view/43157 Association between body mass index and blood pressure among adults 2022-02-15T06:00:16+00:00 Bindu Thapa binduthapa019@gmail.com Deepti KC kcdeepti05@gmail.com Kalpana Shrestha kalpanastha2000@gmail.com Sunita Gurung gursenisunu@gmail.com <p><strong>Introduction: </strong>Increase in body mass index increases risk of developing high blood pressure. Controversies have been found regarding the association of body mass index with high blood pressure. So, this study was conducted to find association between body mass index and blood pressure.</p> <p><strong>Methods: </strong>A cross-sectional study was conducted among 245 adults of Pokhara, Lekhnath Metropolitan Ward No. 27 using convenient sampling method. The questionnaire was adopted from the step 2 (physical measurements) section of the WHO STEPS instrument.</p> <p><strong>Results: </strong>Among 245 subjects, almost half (48.5%) of the subjects had normal body mass index. One-fourth (25%) of the subjects were overweight. About 60 percent of the respondents had normal systolic blood pressure. There were no significant positive correlations of body mass index with both systolic BP, diastolic BP and age. However, significant positive correlation was found between age and systolic BP.</p> <p><strong>Conclusions: </strong>The study finding concluded that there are no significant positive correlations of body mass index with both systolic BP, diastolic BP and age. However, age and systolic BP has significant positive correlation. Therefore, with increase in age, regular monitoring of BP is required. </p> 2022-07-25T00:00:00+00:00 Copyright (c) 2022 Bindu Thapa, Deepti KC, Kalpana Shrestha, Sunita Gurung https://nepjol.info/index.php/JGMCN/article/view/43999 Efficacy of dexamethasone as an adjuvant to bupivacaine in supraclavicular brachial plexus block 2022-03-24T07:15:38+00:00 Sagun Ram Vaidya sagunrv@hotmail.com Sandeep Neupane dr.sandeepneupane@gmail.com Kundu Shrestha kundushrestha@gmail.com Tumaya Ghale tmghale@gmail.com <p><strong>Introduction: </strong>Supraclavicular brachial plexus block provides the optimal operating conditions for upper arm surgery. The study was conducted to assess the efficacy of dexamethasone as an adjuvant to bupivacaine in supraclavicular brachial plexus block.</p> <p><strong>Methods: </strong>An experimental study was performed in Gandaki Medical College and Teaching hospital, Pokhara. Forty patients undergoing surgery of the elbow, forearm, and hand under supraclavicular brachial plexus block, with 0.25% bupivacaine with normal saline (n = 20) in the Group I versus 0.25% bupivacaine with dexamethasone (n = 20) in Group II with an equal volume of 30 ml in each group. Randomization was done and the onset of sensory and motor blockade and duration of analgesia was compared in both groups. Statistical package for the social sciences version 24.0 software was used. Continuous variables like the onset of sensory and motor block and time to first rescue analgesia were assessed with the student’s t-test and the chi-square test was applied to assess categorical variables like visual analogue score score.</p> <p><strong>Results: </strong>The time to onset of sensory block in the bupivacaine only group was 504.10±70.24 seconds compared to bupivacaine with dexamethasone group (255.65±75.28) seconds. The time to onset of motor block in the bupivacaine-only group was 813.00±74.57 seconds compared to bupivacaine with dexamethasone group (524.25±80.38) seconds. Time to first rescue analgesia in bupivacaine only group was 542.5±126.33 minutes compared to bupivacaine with dexamethasone group (1245±325.66) minutes. The difference was statistically significant in all the findings (p&lt;0.0001).</p> <p><strong>Conclusions: </strong>The study concluded that the addition of dexamethasone to bupivacaine prolongs the duration of analgesia and provides faster onset of sensory and motor blocks. </p> 2022-07-25T00:00:00+00:00 Copyright (c) 2022 Sagun Ram Vaidya, Sandeep Neupane, Kundu Shrestha, Tumaya Ghale https://nepjol.info/index.php/JGMCN/article/view/43993 Validation of TIMI risk score for STEMI patients visiting a tertiary care hospital of western Nepal 2022-03-23T16:24:31+00:00 Ram Chandra Kafle drkafle30@gmail.com Dibya Sharma drkafle30@gmail.com Daya Ram Pokharel drkafle30@gmail.com <p><strong>Introduction: </strong>Cardiovascular disease is the leading cause of death globally, and ST elevation myocardial infarction remains main contributor to this mortality. Thrombolysis in myocardial infarction risk score which was derived from randomized clinical trials has been validated in non-selected western patient populations. The objective of this study was to find out the applicability of Thrombolysis in myocardial infarction risk score in our study population.</p> <p><strong>Methods: </strong>A prospective observational study was conducted in admitted patients of cardiology unit, Manipal teaching hospital from February 25, 2020 to December 31, 2021. All consecutive patients admitted with diagnosis of acute ST elevation myocardial infarction were selected. Patients admitted with diagnosis of ST segment elevation myocardial infarction and undergone either primary, rescue or elective coronary reperfusion therapy were included for analysis.</p> <p><strong>Results: </strong>Total of 339 cases with mean age of 60.62 ±12.64 were diagnosed to have acute ST elevation myocardial infarction and undergone coronary reperfusion therapy. Nearly two third cases were male and majority (61.35%) cases were below age of 65 years. Age of 65 years and above, Killip class III-IV [OR:20.54 (CI: 8.63–48.87), p&lt;0.001], low HDL [(OR:0.481 (CI: 0.23 – 0.97) p= 0.038], heart rate &gt;100 beats/ min [(OR: 5.79 (CI: 2.81 – 11.92), p&lt;0.001] and anterior wall involvement [(OR: 2.8 (CI: 1.39–6.41), p=0.004] were significantly associated with 30 days mortality.</p> <p><strong>Conclusions: </strong>Thrombolysis in myocardial infarction risk score is applicable in clinical practice for better risk stratified treatment in our setting. </p> 2022-07-25T00:00:00+00:00 Copyright (c) 2022 Ram Chandra Kafle, Dibya Sharma, Daya Ram Pokharel https://nepjol.info/index.php/JGMCN/article/view/43719 Perceived experience of respectful maternity care among mothers attending a selected teaching hospital of Kaski district 2022-03-08T15:10:55+00:00 Sharmila Poudel sharmilapoudel1234@gmail.com Deepti KC sharmilapoudel1234@gmail.com Shreejana Shrestha sharmilapoudel1234@gmail.com <p><strong>Introduction: </strong>Pregnancy and childbirth are momentous events in the lives of women and families and represent a time of intense vulnerability. Because parenthood is a uniquely female experience, questions of gender justice and violence are at the heart of maternity care. The study aimed to find out the perceived experience of respectful maternity care and its associated factors among postnatal mothers.</p> <p><strong>Methods: </strong>A descriptive cross-sectional research design was used. The study population consisted of mothers who had a normal vaginal delivery and were admitted to the Gandaki Medical College Teaching Hospital and Research Centre’s postnatal ward from July 1 to August 1, 2021. A purposive sampling technique was used. Standard Respectful Maternity Care scale was used to collect the data. Collected data were entered, coded and edited into Statistical package for the social sciences version 16.0 and analyzed using both descriptive and inferential statistical methods.</p> <p><strong>Results: </strong>Of total, 166 (83%) women did not receive respectful maternity care. Regarding the dimensions of RMC, more than half 106 (53%) of the mothers received abuse-free care. Only 40 (20%) of the mothers received friendly care. Parity with friendly care adjusted Odds ratio(AOR)=0.25, Confidence interval (CI) (0.10-0.64), education with abuse free care (AOR=3.66, CI 1.86-7.20), Parity with timely care (AOR=3.27, CI=1.45-7.38). Likewise, educational status of the respondent (AOR= 2.24,CI= 1.13-4.44), religion ( AOR=2.88, CI=1.19-6.95) and parity are the factors influencing discrimination free care( AOR= 0.36, CI=0.18-0.73).</p> <p><strong>Conclusions: </strong>The majority of women did not receive dignified and respectful care throughout labor. </p> 2022-07-25T00:00:00+00:00 Copyright (c) 2022 Sharmila Poudel, Deepti KC, Shreejana Shrestha https://nepjol.info/index.php/JGMCN/article/view/45976 South Asian countries should be ready to combat monkeypox 2022-06-21T04:38:11+00:00 Rano Mal Piryani rano.piryani@gmail.com Suneel Piryani rano.piryani@gmail.com Nuwadatta Subedi drndsubedi@gmail.com <p>No abstract</p> 2022-07-25T00:00:00+00:00 Copyright (c) 2022 Rano Mal Piryani, Suneel Piryani; Nuwadatta Subedi https://nepjol.info/index.php/JGMCN/article/view/45313 Oral and systemic health: An inextricable linkage 2022-05-24T06:33:56+00:00 Rebicca Ranjit rebiranjit@gmail.com <p>No Abstract</p> 2022-07-25T00:00:00+00:00 Copyright (c) 2022 Rebicca Ranjit https://nepjol.info/index.php/JGMCN/article/view/41576 Recognition and management of palatogingival groove: Hidden trap in the tooth-A case report 2022-01-06T04:22:14+00:00 Soni Bista sonibista12345@gamil.com Rebicca Ranjit rebiranjit@gmail.com Suraksha Subedi surakshya691@gmail.com Deepa Kunwar drkunwardeepa@gmail.com <p>Palatogingival groove is a developmental anomaly, usually found on the palatal surface of maxillary incisor teeth. This hidden trap harbors plaque and bacteria around the tooth, ensuing periodontal destruction with or without pulpal pathologic changes. Several treatment modalities have been proposed for its management ranging from endodontic treatment, periodontal therapy or combined. Here, we present a case of a type II palatogingival groove causing endodontic- periodontal lesion successfully managed by endodontic treatment followed by periodontal surgery with an uneventful healing. Thus, this anomaly should be recognized early with timely intervention to avoid widespread involvement. </p> 2022-07-25T00:00:00+00:00 Copyright (c) 2022 Soni Bista, Rebiccca Ranjit, Suraksha Subedi, Deepa Kunwar https://nepjol.info/index.php/JGMCN/article/view/43208 Concha bullosa mucocele disguising as a nasal tumor in an epistaxis patient: A case report 2022-02-17T18:23:06+00:00 Brihaspati Sigdel brihassig1@gmail.com Amrit Pokhrel amritpokhrel12345@gmail.com Sujana Paudel fucheesuzee@gmail.com <p>Concha bullosa is the most common anatomical variant of middle turbinate in both children and adults. When the natural drainage of concha bullosa is obstructed, it leads to the formation of mucocele. It is confusing with nasal tumor when the entire nasal cavity gets occupied. Concha bullosa mucocele and profuse epistaxis is rarely found in the same patient. Both pathologies require appropriate management for the early recovery of the patient and prevent severe complications like concha bullosa mucopyocele from concha bullosa mucocele and hypovolemic shock from profuse epistaxis. We present a 74-year-old female who presented with profuse epistaxis from the left nasal cavity due to concha bullosa mucocele filling the right nasal cavity and pushing nasal septum towards left side which was confused with nasal tumor.</p> 2022-07-25T00:00:00+00:00 Copyright (c) 2022 Brihaspati Sigdel, Amrit Pokhrel, Sujana Paudel https://nepjol.info/index.php/JGMCN/article/view/43017 Co-infection with SARS CoV-2 and dengue virus with thrombocytopenia: A first case report from Nepal 2022-02-07T16:27:01+00:00 Sunil Maharjan sunilluiz@gmail.com Elina Maharjan eelinamhr@gmail.com Bidesh Bista bideshbista@hotmail.com <p>Co-infection of COVID-19 with dengue infection is quite challenging to differentiate due to it’s overlapping clinical and laboratory manifestations. We report a 22-year-old female with presented to Civil Service Hospital, emergency department with complaints of persistent fever with multiple episodes of vomiting, headache and myalgia. On examination, she was ill-looking, dehydrated with a low blood. Reverse transcriptase – polymerase chain reaction of nasopharyngeal swab detected SARS CoV-2, and dengue antibodies IgM detected. She was conservatively managed in COVID-high care unit with regular laboratory monitoring of platelet level and discharged after ninth day of admission.</p> 2022-07-25T00:00:00+00:00 Copyright (c) 2022 Sunil Maharjan, Elina Maharjan, Bidesh Bista