Journal of Universal College of Medical Sciences 2023-05-11T07:28:48+00:00 Prof. (Dr.) Hemant Kumar Halwai Open Journal Systems <p>An official medical journal of the Universal College of Medical and Dental Sciences, Ranigaon, Bhairahawa, Nepal</p> Training Workshop on Assessment for Faculty Members of Bilawal Medical College, Jamshoro: Feedback of Participants at New World Kirkpatrick' Model Level-2 2023-05-05T06:48:36+00:00 Rano Mal Piryani Nudrat Zeba Suneel Piryani Abdul Ghani Soomro <p><strong>INTRODUCTION</strong></p> <p>Faculty training in understanding basics of assessment is among key tasks of medical school and faculty members. So, Bilawal Medical College Jamshoro, organized 1-day Training Workshop on Assessment in Medical Education. As feedback is necessary for bringing improvement in conducting such workshops in future, so, feedback from faculty participants was taken and evaluated at New-World Kirkpatrick' Model Level-2.</p> <p><strong>MATERIAL AND METHODS</strong></p> <p>This cross-sectional study was conducted utilizing self-administered questionnaire having 4-parts: 1) Demographics; 2) Retro-pre-questionnaire on knowledge and understanding about basics of assessment at Likert-scale 1-4 (1=not-understand; 4=completely-understand); 3) Retro-pre-questionnaire on participants’ confidence on Likert-scale 1-4 (1=Not-confident, 4=Extremely-confident); and 4) Open-ended questions on strengths and areas for improvement. Data was analyzed for frequency and central tendency and mean of items of before and after participation compared using paired t-test. Open-ended questions’ data was examined manually.</p> <p><strong>RESULTS</strong></p> <p>Significant improvement (p&lt;0.001) in knowledge and understanding on items related to basics of assessment, such as difference between evaluation, assessment and research; fundamentals- why to assess, why assessment needed, what to assess, when to assess, how to assess; Miller’s Pyramid; curricular alignment; tools for assessment; blueprinting for assessment; developing blueprint; purpose of assessment; formative and summative assessment; utility, reliability and validity of tools; why multiple tools used for assessment; and criteria for effective assessment. The confidence of participants significantly enhanced (p&lt;0.001) in developing blueprint and choosing tools for assessment.</p> <p><strong>CONCLUSION</strong></p> <p>Gain in participants knowledge and understanding related to basics of assessment was significant and participants confidence was significantly enhanced in developing blueprint and choosing tools.</p> 2023-05-11T00:00:00+00:00 Copyright (c) 2023 Journal of Universal College of Medical Sciences Otogenic Brain Abscess in a Child of Third World Country - A Single Stage Transcranial Transmastoid Approach: A Case Report 2023-05-05T07:15:42+00:00 Apar Adhikari Tekendra Khanal Rajesh Kumar Yadav Bibek Ghimire Meenakshi Basnet Sanjeev Kumar Thakur Prakash Kafle <p>Brain abscess, though not rare, is an uncommon complication of otitis media. We report a case of 12 years old male for chronic ear discharge, throbbing headache and post aural swelling for three weeks. A detailed history and physical examination of the child was performed and a Magnetic Resonance Imaging (MRI) scan was done. A diagnosis of an intracranial abscess, secondary to the chronic otitis media was made. An emergency craniotomy with drainage of brain abscess was planned and performed by the Neurosurgeon. Otolaryngolgoist performed mastoidectomy, in the same setting. After the surgery, post-operative manage- ment was done and the patient was discharged, uneventfully. The complete management in a single sitting of primary cause and resulting complication with no added expenses is the necessity of a poor country citizen.</p> 2023-05-11T00:00:00+00:00 Copyright (c) 2023 Journal of Universal College of Medical Sciences Clinico-Etiological Profile and Outcome of Neonatal Seizures - A Hospital-Based Cross-Sectional Study in Western Nepal 2023-04-27T04:20:51+00:00 Nagendra Chaudhary Astha Paudel Dinesh Chaudhary Binod Kumar Gupta <p><strong>INTRODUCTION</strong></p> <p>Neonatal seizure, a common problem encountered in neonatal intensive care unit (NICU) setting, is an important determinant of outcome of neurological disorders in newborn period. The aim of the study was to study the clinical and etiological profile of neonatal seizures along with their outcomes.</p> <p><strong>MATERIAL AND METHODS</strong></p> <p>A prospective observational study was conducted in the NICU of Department of Pediatrics at Universal College of Medical Sciences, Bhairahawa, Nepal from November 2019 to March 2021. Babies with neonatal seizures were enrolled in the study after obtaining written consent from parents.</p> <p><strong>RESULTS</strong></p> <p>Out of 870 admitted neonates, 9.7% (n=85) developed clinical seizures where 62.4% were males. Most cases (87.1%) had seizures within 48-hour of life with subtle seizures (92.9%) being the commonest. About 43.5% cases had single episode of seizure followed by multiple episodes. Perinatal asphyxia (92.9%) either alone and/or associated with hypocalcemia (80%) followed by sepsis (40%) and hyponatremia (18.8%) were common etiologies for neonatal seizures. Most of the seizures (76.5%) were aborted with use of single anti-epileptic drug. About 86% (n=73) survived and rest expired.</p> <p><strong>CONCLUSION</strong></p> <p>Subtle seizures were common and perinatal asphyxia was the predominant etiology for neonatal seizures. Thus, strengthening the healthcare facility during delivery of the newborn, proper newborn care and nutrition must be emphasized to decrease the incidence of seizures in developing nations like Nepal.</p> 2023-05-11T00:00:00+00:00 Copyright (c) 2023 Journal of Universal College of Medical Sciences Cardiac Disorders in Patients with Ischemic Stroke 2023-04-27T05:09:46+00:00 Bikram Prasad Gajurel Anju Gurung Rajeev Ojha Reema Rajbhandari Ragesh Karn <p><strong>INTRODUCTION</strong></p> <p>Worldwide cardioembolic strokes account for one third of non-lacunar strokes and almost half of all risk factors of ischemic stroke in Nepal. This study was done to describe the types of cardiac disorders and their associations with younger and older patients with ischemic stroke.</p> <p><strong>MATERIAL AND METHODS</strong></p> <p>In this prospective observational study, data were collected by convenience sampling and analyzed by the Statistical Package for the Social Sciences version 26. Cardiac disorders were divided into rhythm disturbances and structural disorders. Patients were divided into younger (≤ 50 years) and older (&gt; 50 years) patients based on standard definition. The associations were analyzed by using Chi-square test. Other data were expressed as frequencies and percentages.</p> <p><strong>RESULTS</strong></p> <p>Of 145 patients were included, cardiac disorders were present in 88.3%. Cardiac structural disorders were present in 86.2% out of which the commonest were left ventricular hypertrophy (26.2%), left ventricular diastolic dysfunction (23.4%) and mitral stenosis (13.8%). Cardiac rhythm abnormalities were present in 42.1% and atrial fibrillation (17.2%), atrial ectopics (14.5%) and ventricular ectopics (4.8%) were the commonest. When considered in total, there was no statistically significant differences in the distribution of these disorders between young and old patients. However, mitral stenosis was strongly associated with young patients (p=0.001). Atrial fibrillation and older patients were also significantly associated (p=0.04).</p> <p><strong>CONCLUSION</strong></p> <p>Though common, cardiac disorders in total were not significantly associated with young and older patients with ischemic stroke; however, mitral stenosis was significantly associated with young patients and atrial fibrillation with older patients.</p> 2023-05-11T00:00:00+00:00 Copyright (c) 2023 Journal of Universal College of Medical Sciences Clinical Presentation of Varicose Vein - A Hospital-based Cross-sectional Study 2023-04-27T06:23:02+00:00 Santosh Shah Raj Kumar KC Rajesh Poudel Santosh Mishra Sagun Thapa Sabir Miya Pratik Adhikari <p><strong>INTRODUCTION</strong></p> <p>Varicose veins are one of the major problems with patients presenting with symptoms of heaviness, tingling sensation, swelling, aching, restless legs, cramps and itching. Other clinical conditions with which patients presents are pigmentation of lower limbs, healed or active venous ulcers, lipodermatosclerosis. We studied various clinical presentations of varicose veins.</p> <p><strong>MATERIAL AND METHODS</strong></p> <p>A cross-sectional observational study was done in all patients presented to UCMS Teaching Hospital from 2021 to 2022.The primary objective was to assess various clinical signs and symptoms of patients with varicose veins.</p> <p><strong>RESULTS</strong></p> <p>Out of 260 patients, 172 were males and 88 were females. The mean age was 43.87±14.31 years. Patients with occupation involving long standing had more incidence of varicose veins with heaviness and aching as the most common clinical presenta- tion.</p> <p><strong>CONCLUSION</strong></p> <p>Security guard, cook, housewife, teacher, farmer occupational people seem to be affected. Heaviness and aching are more common symptoms, least common clinical presentation were bleeding, thrombosis, and ulceration.</p> <p>&nbsp;</p> 2023-05-11T00:00:00+00:00 Copyright (c) 2023 Journal of Universal College of Medical Sciences Traumatic Perforation – Etiology, Outcome and Factors Affecting the Outcome 2023-04-27T06:34:26+00:00 Roshan Acharya Bishow Tulachan Anup Acharya Anuj Devkota <p><strong>INTRODUCTION</strong></p> <p>Traumatic tympanic membrane perforation is the most common type of trauma – induced otologic dysfunction. The study is aimed to evaluate factors affecting healing of truamatic tympanic membrane perforation after 12 weeks.</p> <p><strong>MATERIAL AND METHODS</strong></p> <p>A prospective observational study conducted at UCMS, Bhairahawa, Nepal. Sixty patients with traumatic tympanic membrane perforation were evaluated on the basis of causes of trauma, symptoms, otoscopic examination, size of perforation and other factors affecting the outcome of perforation.&nbsp; Healing status of tympanic membrane was assessed 12-week post injury.</p> <p><strong>RESULTS</strong></p> <p>The age of the patients ranged from 4-79 years with mean age (years) of 27.84 ± 13.16. Otalgia was seen in 36 (60%) followed by hearing loss 21 (35%) and least common was vertigo 2 (3%). Most common etiology for injury was ‘Slap’(30%) followed by fall injury and physical assault excluding slap with each comprising 16%. Number of patients with small, medium and large perforations were 27 (45%), 21 (35%) and 12 (20%) respectively.</p> <p>&nbsp;</p> <p>After 12 weeks, 46 (77%) cases had healed perforation with best healing seen in younger patients having age group 11-40 years (26.28±13.5) and least in age group &gt;60 years (52±25.11 ) with <em>p </em>value of 0.01. 97% cases of smaller perforation had healed tympanic membrane whereas in larger perforation healing was observed in only 42 % cases.</p> <p><strong>CONCLUSION</strong></p> <p>Age, size of perforation, types of traumas have significant effect on outcomes of spontaneous healing. With cautious care and</p> <p>strong aural precautions, the prognosis of tympanic membrane perforation spontaneous healing is favourable.</p> <p>&nbsp;</p> 2023-05-11T00:00:00+00:00 Copyright (c) 2023 Journal of Universal College of Medical Sciences The Prognostic Consequence of Red Cell Distribution Width in Acute Pancreatitis 2023-04-27T06:43:42+00:00 Aditya Prakash Binay Kumar Shah Ang Dali Sherpa Rahul Singh <p><strong>INTRODUCTION</strong></p> <p>Acute pancreatitis is commonly a self-limiting disease but, about 25% of patients consequently develop a severe pancreatitis which leads to increase mortality. The available Scoring system is use to predicate severity of the Acute Pancreatitis, which is used for early diagnosis and management. Aim of this study is to assess the association of red blood cell distribution width (RDW) with severity and mortality in patients of acute pancreatitis.</p> <p><strong>MATERIAL AND METHODS</strong></p> <p>This retrospective study was carried out in Department of Surgery of National Medical College and Teaching Hospital. A total of 50 patients with diagnosis as acute pancreatitis over period of March 2020 to February 2022 was included. History and detailed clinical examination was performed as per the working proforma. Blood investigation was done. Data analysis was done using SPSS (Statistical Package for social sciences), version 25.</p> <p><strong>RESULTS</strong></p> <p>Mean age was 39.03 years. 68% cases were female. Acute Biliary was the most common cause. Mean RDW was 12.461, 14.50 and 15.309 in mild, moderate and severe Pancreatitis respectively with a p value of &lt;0.001 showing significant association of RDW and severity of Pancreatitis. Mean RDW in alive was 13.046 and 16.625 in death with a p value of &lt;0.001 showing signifi- cant association between RDW and outcome of acute Pancreatitis.</p> <p><strong>CONCLUSION</strong></p> <p>RDW is a predictor of severity in patients with severe acute pancreatitis.</p> 2023-05-11T00:00:00+00:00 Copyright (c) 2023 Journal of Universal College of Medical Sciences Clinical, Socio-Demographic and Biochemical Variables in Patients With Covid-19: A Cross Sectional Study 2023-04-27T11:34:50+00:00 Manoj Karki Narayan Gautam Bidhata Rayamajhi Niraj Kumar Jaiswal Manish Dahal Shatdal Chaudhary Pushpa Raj Dhakal <p><strong>INTRODUCTION</strong></p> <p>Covid-19 is a debilitating disorder which affects the lungs with multiple organs involvement. The biochemical variables play important role in the management of the Covid-19 patients who are with different clinical profile, socio-demographic, and co-morbid conditions like diabetes and hypertension.</p> <p><strong>MATERIAL AND METHODS</strong></p> <p>This cross sectional study was conducted in the Covid-19 hospitalized cases at UCMS, Bhairahawa. Total of 150 patients were enrolled in the study period from May 2021 and October 2021 whose clinical profile, sociodemographic and biochemical variables were assessed.</p> <p><strong>RESULTS</strong></p> <p>The gender wise distribution shows the male dominancy with M:F ratio 1:0.85. The maximum age group vulnerable to Covid-19 in our study was found to be 41-60 years with median age of 47 years. There were constellations of symptom with shortness of breath 70% becoming first followed by cough 67.3% and fever 54%. The frequency of diabetes and hypertension was 19.3% and 24% showing co-morbidity associated changes in biochemical parameters. The male to female differences in biochemical changes have been associated with Covid-19 patients, however age wise distribution do not show any difference in biochemical parameters.</p> <p><strong>CONCLUSION</strong></p> <p>COVID 19 patients have a high prevalence of diabetes and hypertension, which is a common morbidity. A few biochemical indices (D-dimer, LDH, CRP, and ALT) change significantly between males and females. All biochemical parameters, on the other hand, are unaffected by age.</p> <p>&nbsp;</p> 2023-05-11T00:00:00+00:00 Copyright (c) 2023 Journal of Universal College of Medical Sciences Evaluation and Comparison of the Accuracy and Efficacy of Alvarado and Appendicitis Inflammatory Response Scoring in Acute Appendicitis 2023-05-04T04:33:52+00:00 Santosh Mishra Archan Ghimire Rajesh Poudel Sagun Thapa Sanjay Shrestha Pradip Chhetri <p><strong>INTRODUCTION</strong></p> <p>Acute appendicitis (AA) is one of the most common causes of acute abdominal pain. Early surgery for acute appendicitis may lead to inadequate evaluation of differential diagnoses of acute abdominal pain and increases the chances of negative appendectomy, whereas delaying it leads to potential complications. Appendicitis inflammatory response (AIR) score, has been created to overcome shortcomings of the Alvarado score. In this, a mathematical model focused on detecting perforated appendicitis has been used. Unlike previously reported scores, this included C-reactive protein (CRP), which had been previously reported to have high accuracy in discriminating between simple and advanced acute appendicitis.</p> <p><strong>MATERIAL AND METHODS</strong></p> <p>Observational Cross sectional study was done in all patients admitted to UCMS hospital diagnosed to have acute appendicitis from October 2019 to March 2021. The primary objective was to determine if use of Appendicitis Inflammatory Response Score is better suited for planning management of patients with acute appendicitis. Comparison between groups was done with one-way Analysis of Variance (ANOVA). Receiver Operating Curve (ROC) was used to identify whether Appendicitis inflam- matory response (AIR) score or Alvarado score was good predictor of acute appendicitis. Sensitivity, Specificity and Area under Curve (AUC) was used as indicators to predict the acute appendicitis.</p> <p><strong>RESULTS</strong></p> <p>In our study, the sensitivity of Appendicitis inflammatory response (AIR) score is high (85.4%) as compared to 82.3% of Alvarado score.</p> <p><strong>CONCLUSION</strong></p> <p>We concluded that Appendicitis inflammatory response (AIR) score is more reliable scoring system for the diagnosis of acute appendicitis and its use can be justified over the pre-existing Alvarado scoring.</p> <p>&nbsp;</p> 2023-05-11T00:00:00+00:00 Copyright (c) 2023 Journal of Universal College of Medical Sciences Association between Glycated Hemoglobin and Lipid Profile in Type 2 Diabetes Mellitus Patients Attending Tertiary Care Hospital: A Cross Sectional Study 2023-05-04T06:33:39+00:00 Mahesh Raj Ghimire Sundar Pandey Deepak Aryal Pooja Shah Monica Thapa Yogesh Pandey Aliza Aryal Pooja Belbase Rahul Budhathoki <p><strong>INTRODUCTION</strong></p> <p>Glycated haemoglobin levels are routinely measured in type 2 diabetes mellitus to monitor their glycaemic control. Lipid disorder in diabetes is common issues either independently or in association with type 2 Diabetes mellitus. We aim to establish the association between Glycated haemoglobin and lipid profile in type 2 diabetes mellitus patients attending our centre.</p> <p><strong>MATERIAL AND METHODS</strong></p> <p>This is hospital based cross-sectional study conducted on 161 patients conducted in out-patient department of internal medicine and from 10/02/2079 to 20/04/079 at Devdaha Medical College and Research Institute (DMCRI). Patients were enrolled after taking informed consent fulfilling inclusion and exclusion criterias. Data were entered on Microsoft Excel 2010 and analyzed using SPSS v25.</p> <p><strong>RESULTS</strong></p> <p>Among 161 Participants, male to female ratio was almost 1:1, with mean age of diabetes of male and female was 58.1 ± 11.2 standard deviation (SD) and 56.7 ± 10.4 SD, with 13.04% were alcohol consumer; 1.86% were smokers; 57.76% of them had high blood pressure; (29.19%) had known dyslipidaemia and 11.18% had hypothyroidism. While comparing controlled (HBA1c&lt;7%) with uncontrolled (HBA1c ≥7%) glycated hemoglobin and level of different components of lipid profile like total cholesterol, triglyceride, LDL- cholesterol and HDL-cholesterol, there is statistical correlation [χ²=4.67; df=1; p=0.031] between only high triglyceride level and uncontrolled type 2 diabetes.</p> <p><strong>CONCLUSION</strong></p> <p>High value of glycated hemoglobin not only measures uncontrolled type 2 diabetes but can also be considered for high lipid disorder biomarker. Early detection of high glycated hemoglobin could prevent complications related with diabetes independently or in combine with dyslipidemia.</p> 2023-05-11T00:00:00+00:00 Copyright (c) 2023 Journal of Universal College of Medical Sciences Utility of Mannheim’s Peritonitis Index in Predicting Outcome of Peritonitis in Patients with Hollow Viscous Perforation 2023-05-04T07:29:53+00:00 Akash Raya Aditya Prakash Yadav Sanjiv Kumar Shahi Binod Kr Rai <p><strong>INTRODUCTION</strong></p> <p>Peritonitis due to hollow viscous perforation is one of the common causes for emergency surgery requiring immediate surgical intervention. Scoring systems that provide objective descriptions of the patient’s conditions at specific points in the disease process aid our understanding of these problems. Hence this study is undertaken to study the effectiveness of Mannheim’s peritonitis index in predicting the outcome in peritonitis patient.</p> <p><strong>MATERIAL AND METHODS</strong></p> <p>This study was carried out in Department of Surgery of National Medical College and Teaching Hospital. A total of 44 patients with diagnosis of peritonitis due to hollow viscous perforation over period 2 years was included in this study. History and detailed clinical examination were performed as per the working proforma. Blood investigation was done. Data analysis was done using SPSS (Statistical Package for social sciences) version 25.</p> <p><strong>RESULTS</strong></p> <p>In this study 44 cases of peritonitis due to hollow viscous perforation were included. The mean age of patients was 38.16 ± 21.09 years. Abdominal pain and abdominal distension were most common presentation. MPI scoring system done in all patients depending on preoperative and intra-operative and patients were categorized into three categories, &lt;21, 21 to 29, and &gt;29 where 50% of patients had MPI less than 21, 25% of patient had MPI score 21-29 and 25% of patient had MPI score &gt;29.</p> <p><strong>CONCLUSION</strong></p> <p>MPI scoring system is required to predict the outcome in peritonitis patients and whether the line of management taken is appro- priate or needs to be changed.</p> 2023-05-11T00:00:00+00:00 Copyright (c) 2023 Journal of Universal College of Medical Sciences Evaluation of the Role of Potential Biochemical Markers to Assess The Severity of Hospitalized Patients With Covid 19: A Tertiary Hospital Care Study 2023-05-04T11:24:35+00:00 Sundar Pandey Shrijana Chapagain <p><strong>INTRODUCTION</strong></p> <p>Coronavirus disease has become a universal health problem and has resulted in millions of hospitalization and deaths. Coronavi- rus is a multi-system infection predominantly affecting the respiratory system, resulting in various hematological and biochemical alterations reflected in various investigations. Multitudes of research establishing the role of biomarkers in coronavirus infection are ongoing globally. This study aimed at studying the common biochemical markers like CRP, LDH, and D-dimer to access the severity of the disease and hospital outcome.</p> <p><strong>MATERIAL AND METHODS</strong></p> <p>This was a retrospective cross-sectional study performed at a tertiary care hospital in western Nepal among RT-PCR-positive ICU patients who were ≥ 18 years for a period of six months (May 1 to October 30, 2020). Demographic, clinical, and laborato- ry data were collected from hospital records and the results were analyzed.</p> <p><strong>RESULTS</strong></p> <p>Among 110 admitted patients, 56 were females and 54 were males. The mean age of presentation was 56.5 years. Shortness of breath, cough, and fever were the main presenting complaints. CRP was high in 95% of patients, LDH in 94.5%, and D-dimer in 81.67% of patients. Mechanical ventilation was required in 19.9%, complications were observed in 67.27% and in-hospital mortality was 11.6%. The most common cause of death was acute respiratory distress syndrome.</p> <p><strong>CONCLUSION</strong></p> <p>Biomarkers like CRP, LDH, and D-dimer can be used for stratifying coronavirus disease patient’s severity and clinical outcome which may later be helpful in identifying risk patients and taking immediate actions in terms of treatment, care, and evaluation.</p> <p>&nbsp;</p> 2023-05-11T00:00:00+00:00 Copyright (c) 2023 Journal of Universal College of Medical Sciences Indications of Root Canal Treatment for Patients Visiting Tertiary Care Hospital: A Hospital Based Prospective Study 2023-05-04T11:36:12+00:00 Manisha Nepal Snigdha Shubham Rupam Tripathi Jwolan Khadka Kriti Shrestha <p><strong>INTRODUCTION</strong></p> <p>Root Canal Treatment (RCT) when an irreversibly damaged or necrotic pulp with or without clinical and/or radiological findings of apical periodontitis occur. Apart from these there are various other reasons in which RCT is performed. There is paucity of literature revealing diseases requiring RCT and what are the presenting symptoms for patients requiring it. Hence, this study is conducted to overview the factors for it.</p> <p><strong>MATERIAL AND METHODS</strong></p> <p>Among 594 patients, 510 were included in the study. The survey form included patient specific characteristics such as: age, gender, tooth number and pain; tooth specific characteristic included swelling, previous root canal treatment, complain tooth characteristic, diagnosis and tooth wear. These data were matched with the respective radiograph and history form sheet. Two observers participated in collection of data in the study. Inter-observer agreement was tested with Cronbach’s alpha which was 0.79. The data were collected in a spreadsheet and simple descriptive statistical analysis was performed using SPSS software version 22 to get the results in percentages and frequencies.</p> <p><strong>RESULTS</strong></p> <p>54.1% of female patients had undergone RCT and 75.7% of patients presented with pain. The most common treated tooth was first molar. The most common pulpal diagnosis was symptomatic irreversible pulpitis (36.08%, n=184) followed by pulp necrosis (30.20%, n=154) and previously treated (17.25%, n=88). The most common periapical diagnosis was symptomatic apical periodontitis (62.94%, n=321).</p> <p><strong>CONCLUSION</strong></p> <p>Subjective symptoms were the most common factor for seeking treatment. Hence, a greater number of awareness campaign are required to acknowledge asymptomatic cases too.</p> 2023-05-11T00:00:00+00:00 Copyright (c) 2023 Journal of Universal College of Medical Sciences Evaluation of anti-diabetic activity of Justicia adhatoda (Linn.) Leaves in diabetic wistar rats 2023-05-04T11:48:01+00:00 Roshan Kumar Mehta Rupkala Thapa Mukesh Kumar Chaudhary <p><strong>INTRODUCTION</strong></p> <p>Diabetes mellitus is defined as the increase in blood glucose level resulting from defects in insulin secretion, insulin action, or both. The present study was conducted to evaluate anti-diabetic activity of Justicia adhatoda (Linn.) leaves extract in diabetic Wistar rats. Justicia adhatoda, commonly known as vasaka is rich in phytochemicals like alkaloids, saponins, steroids, flavonoids and glycosides. It is used in asthma, jaundice, wound healing, typhus fever, cough, chronic bronchitis and inflamma- tory swellings treatment.</p> <p><strong>MATERIAL AND METHODS</strong></p> <p>The extract was obtained by maceration process with the use of methanol as solvent. 30 Wistar rats of 150-250 gm were used taken as study animal. Diabetes was induced by single intraperitoneal injection of Alloxan 150 mg/kg body weight. The methan- olic extract of low dose (50 mg/kg) and high dose (100 mg/kg) were given orally for anti-diabetic activity. The standard drug glimepiride 0.5 mg/kg body weight was used.</p> <p><strong>RESULTS</strong></p> <p>The extract treated 50mg/kg and 100mg/kg showed significant <em>p</em>&lt;0.01 reduction in blood glucose level while the standard 0.5 mg/kg showed less significant <em>p</em>&lt;0.05. The standard and extract showed less significant <em>p</em>&lt;0.05 body weight recovery in compar- ison to negative control group. The extract 50 mg/kg, 100 mg/kg and standard showed significant <em>p</em>&lt;0.01 improvement in food intake when compared to negative control group. The extract 100 mg/kg treatment showed significant <em>p</em>&lt;0.01, highly significant <em>p</em>&lt;0.001 improvement in water intake on 1st, 2nd and 3rd week respectively when compared to negative control group.</p> <p><strong>CONCLUSION</strong></p> <p>The present study concludes that the extract possesses potent and significant anti-diabetic activity of Justicia adhatoda leaves.</p> 2023-05-11T00:00:00+00:00 Copyright (c) 2023 Journal of Universal College of Medical Sciences Confidence Level of Interns for Performing Root Canal Treatment: A Descriptive Cross-Sectional Study 2023-05-05T05:41:07+00:00 Rupam Tripathi Nisha Acharya Sirjana Dahal Jwolan Khadka Pujan Kranti Kayastha Manisha Nepal <p><strong>INTRODUCTION</strong></p> <p>Due to various anatomic complexities within root canals, endodontic treatment sometimes become a difficult dental procedure to perform even for the specialist. Many dental students consider endodontics to be complicated and stressful. However, dental students must be competent enough to manage specific clinical procedures. This study was conducted to assess the confidence level of dental interns in performing endodontic treatment.</p> <p><strong>MATERIAL AND METHODS</strong></p> <p>A descriptive cross-sectional study was conducted among dental interns of Nepal from December 2021 to January 2022. Ethical clearance was obtained from institutional review committee of UCMS (UCMS/IRC/105/20). Census method was used for selecting study participants. An online questionnaire was distributed that covered demographic details and the interns’ confidence level regarding endodontic treatment. Participants were asked to indicate their self confidence level by Likert scoring system ranging between 1-5. The data were analyzed in Statistical Package for Social Sciences (SPSS) version 20 software.</p> <p><strong>RESULTS</strong></p> <p>Majority of dental interns were confident in establishing successful communication with pa¬tients during diagnosis, root canal treatment and irrigation. Placement of rubber dam, root canal shaping and management of flare-ups were the procedures in which dental interns reported the lowest confidence (2.21±1.047, 2.65±.974, 3.31±.780). Lowest confidence was reported in the treatment of maxillary followed by mandibular molars (2.72±.821 and 3.14± .959). They also reported the lowest confidence in teeth with root resorptions, immature apices and re-treatment cases (2.39±.842, 2.49±.836 and 2.52±.981).</p> <p><strong>CONCLUSION</strong></p> <p>Dental interns reported confidence in carrying out basic endodontic skills but lower confidence in challenging and complicated procedures. Further training should be emphasized in management of such situations.</p> 2023-05-11T00:00:00+00:00 Copyright (c) 2023 Journal of Universal College of Medical Sciences Drug Utilization Pattern and Cost Analysis of Drugs used at Dermatology Out Patient Department in a Tertiary Care Hospital 2023-05-05T06:10:51+00:00 Anita Yadav Birendra Kumar Yadav Pradip Chhetri <p><strong>INTRODUCTION</strong></p> <p>The irrational prescription of drugs is highly prevalent among patients suffering from skin diseases. Since it has a serious impact on health and economy, there is an urgent need to study drug utilization pattern in hospital settings. Therefore, this study aims to investigate drug utilization pattern and its cost analysis in Dermatology Out Patient Department in a tertiary care teaching hospital.</p> <p><strong>MATERIAL AND METHODS</strong></p> <p>A four-month, prospective, cross-sectional descriptive study was conducted from 10th February 2022 to 10th June 2022 in newly diagnosed cases attending Out Patient Department of dermatology at Universal College of Medical Sciences, Bhairahawa, Nepal. Ethical approval was obtained from the Institutional Review Committee (UCMS/IRC/037/22). Purposive consecutive sampling technique was used. The data were collected from patient cards and details were filled in predesigned proforma. The collected data were analyzed in Statistical Package for Social Sciences version 20.</p> <p><strong>RESULTS</strong></p> <p>A total of 601 prescriptions were scrutinized. The common skin condition found was eczema (9.98%) while the common classes of drugs prescribed were antifungals (31.94%). The number of drugs per prescription varied from one to five with an average of 3.11. It was observed that 3.95% of prescription was by generic names. The maximum of drugs (36.06%) was prescribed in tablet form. The percentage of antibiotics prescribed and drugs prescribed from the WHO Essential Drugs List were 12.31% and 27.88% respectively. The average cost per prescription calculated was 739.39 Nepali Rupees.</p> <p><strong>CONCLUSION</strong></p> <p>A drug utilization study can help to rationalize prescriptions, reduce errors, and improve cost-effective treatment.</p> 2023-05-11T00:00:00+00:00 Copyright (c) 2023 Journal of Universal College of Medical Sciences Assessment of Radiation Exposure Awareness among Medical and Dental Interns: A Questionnaire-Based Cross-Sectional Study 2023-05-05T06:21:23+00:00 Subhash Chandra Yadav Sandip Gautam Sanju Rawal <p><strong>INTRODUCTION</strong></p> <p>Radiology is an integral part of modern medicine, but there are known potential risks of ionizing radiation that can lead to serious health hazards. Many studies indicate that primary care physicians are unaware of the risks associated with the use of radiation which is a growing concern. The objective of this study was to assess the knowledge of radiation awareness among medical and dental interns at UCMS-TH.</p> <p><strong>MATERIAL AND METHODS</strong></p> <p>A cross-sectional study was conducted among medical and dental interns at UCMS-TH, Bhairahawa, Nepal. One hundred eighteen participants were included in the study based on inclusion/exclusion criteria over a four-month period (from July to October 2018). Participants were surveyed by using the MCQ questionnaire and data were analyzed using SPSS software version 20.</p> <p><strong>RESULTS</strong></p> <p>A total of 118 interns (78 medical and 40 dental interns) participated in this study. The mean score of knowledge of medical interns was 6.95±3.04, range 1 to 13 out of 14. In a questionnaire survey, 52.6% had good knowledge and 47.4% had poor knowledge about radiation. The mean score of knowledge of dental interns was 8.03±2.58, range 1 to 13 out of 14. In a question- naire survey, 75% had good knowledge and 25% had poor knowledge about radiation.</p> <p><strong>CONCLUSION</strong></p> <p>The general knowledge of radiation awareness was good among medical and dental interns, but the radiation awareness of dental interns was higher than that of medical interns. It was recommended that courses/seminars/training courses on radiation protection for medical students to be held and conducted.</p> 2023-05-11T00:00:00+00:00 Copyright (c) 2023 Journal of Universal College of Medical Sciences Staphylococcus nepalensis: A New Species from Nepal 2023-05-05T06:33:46+00:00 Kripa Ghimire Rajeshawr Reddy Kasarla <p>The Genus <em>Staphylococcus </em>belong to the family Staphylococcaceae which comprise of 53 valid species. These are the normal flora of mucocutaneous membranes of mammals and usually of felines. <em>Staphylococcus nepalensis </em>is one of the member of genus <em>Staphylococcus </em>which show close resemblance to <em>Staphylococcus cohnii, Staphylococcus gallinarum </em>and <em>Staphylococcus succinus</em>. Thus, phenotypic tests are not sufficient to characterize them sufficiently, molecular intervention is required for their correct identification. In recent times, the cases associated with <em>S. nepalensis </em>is surging and this may create problems as they are seen to be highly resistant towards some of the antibiotics like cefoxitin and penicillin. Their potential to transfer resistant genes to <em>Staphylococcus aureus </em>isolated from human clinical samples via plasmid and their ability to form biofilm are threatening as they may lead to increase in burden of antimicrobial resistance. There may be more cases of infection with <em>S.nepalensis</em> but may have remained hidden due to limited number of research. Thus, the knowledge and scientific information on <em>Staphylococcus nepalensis </em>is still unknown or relatively limited; hence this comprehensive review of <em>S.nepalensis </em>is undertaken to highlight its importance and research.</p> 2023-05-11T00:00:00+00:00 Copyright (c) 2023 Journal of Universal College of Medical Sciences World Happiness Report 2023-05-05T11:06:10+00:00 Shatdal Chaudhary <p>Happiness is the main goal which most people and policy makers seek to find. The idea of happiness is as old as human civilization. The concept of happiness has been the core of ancient Hindu and Greek cultures. Definition of happiness can vary from person to person. Usually, happiness is defined as an emotional state characterized by feelings of joy, satisfaction, contentment and fulfillment. Multiple approaches by various researchers lead to numerous measures of happiness such as the PANAS scale, subjective happiness scale, Oxford happiness inventory and Seligman's PERMA model. Happiness correlates negatively with morbidity, mortality, stress and anxiety in contrast to a positive correlation with motivation, healthy behaviours and longevity. One should enjoy what they are doing rather than falling into the trap of endless accumulation of wealth.</p> <p> </p> 2023-05-11T00:00:00+00:00 Copyright (c) 2023 Journal of Universal College of Medical Sciences