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Comparison of Phenylephrine, Mephentermine and Ephedrine for Maintenance of Blood Pressure During Subarachnoid Block in Cesarean Section and their Effects on Fetal Outcome
Background: Globally, the incidence of hypotension has been very high during cesarean section under spinal anesthesia. Hence, to manage hypotension and maintain adequate blood pressure, vasopressors such as Phenylephrine, Mephentermine, and Ephedrine are commonly used. Materials and Methods: A Prospective Randomized Double-blind study was conducted among 102 singleton pregnant women undergoing cesarean section at Nobel Medical College Teaching Hospital Ltd. Following hypotension, group P received Phenylephrine 100 mcg IV, Group E received Ephedrine 6 mg IV and group M received Mephentermine 6 mg IV. Vital parameters like blood pressure (systolic, diastolic and mean), heart rate, and oxygen saturation were recorded preoperatively as well as intraoperatively. Results: After administering vasopressors, Group P showed a significantly greater increase in blood pressure than Groups E and M at the 4-, 6-, 8-, and 10-minute intervals. However, Group P also demonstrated a significant decrease in heart rate at 4, 6, 16, 18, 20, and 30 minutes compared with Groups E and M. Drug bolus requirements and maternal side effects were similar among groups. Neonatal outcomes were comparable, with Apgar scores >7 in all cases. Conclusion: From our study, it can be concluded that all three vasopressors Phenylephrine, Ephedrine, and Mephentermine were able to restore hypotension during cesarean section, although Phenylephrine achieved faster blood pressure control, though it was associated with a reduction in heart rate. Therefore, phenylephrine is most suitable when rapid blood pressure control is required, provided that heart rate is closely monitored.
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Relationship Between Dermatoglyphic Pattern and Dental Caries Among Pre-School Children of Kathmandu, Nepal
Background: Development of dermal ridges and primary palate occurs at same time of intrauterine life. Also, epithelium of both enamel and finger buds have ectodermal origin due to which dermatoglyphics is considered as a genetic marker of dental caries. Therefore, this study was conducted to determine relationship between dermatoglyphic pattern and dental caries status among preschool children in Kathmandu, Nepal. Materials and Methods: An analytical cross-sectional study was conducted among 236 schoolchildren of 2-6 years (Group 1, dmft=0, Group 2, dmft≥1). Dermatoglyphic pattern was assessed from all 10 fingers of two hands using inkpad and fingerprint cards and dmft index was recorded. Data collected were analyzed in statistical package for social sciences version 24. Mean, standard deviation, frequency and percentage were calculated for descriptive analysis. Chi-square test and Mann Whitney-U test were done to determine the relationship between dermatoglyphic pattern and caries experience. Results: Arch pattern in left thumb was significantly associated with caries free children (p=0.023). Caries-free group had significantly higher counts of arches (p=0.007), while whorl patterns were prevalent in children with dmft≥1 (p=0.017) in right hand. Significantly more loops in caries-free group (p=0.030) were found in left hand. Overall observations showed significantly higher number of whorl patterns in children with dmft≥1 (p=0.017). Conclusion: The findings of this study showed a potential relationship between dermatoglyphic patterns and dental caries experience in preschool children. Children with caries experience had a significantly higher number of whorl patterns whereas arch and loop patterns were more prevalent in caries-free children.
Intercanine and Intermolar Widths in Class I, II And III Malocclusions
Background: Transverse malocclusions are quite common in almost all population. Abnormal intermolar and intercanine width results in transverse malocclusions. Materials and Methods: Study models of 83 orthodontic patients attending orthodontic department of Nobel Medical College Teaching Hospital from 2021 Jan to 2024 Sep were segregated according to Angle’s classification of malocclusion. The intercanine and intermolar widths were assessed on the dental casts. The data were subsequently analyzed using SPSS version 20. A one-way ANOVA analysis was conducted to compare the intercanine and intermolar widths across the five malocclusion groups. Results: The mean intercanine width of maxilla among all types of malocclusions is 24.837 mm whereas it is 18.172 mm in mandible. Similarly, the mean intermolar width of maxilla is 33.973mm and 29.771mm in mandible among all types of malocclusions. There was no any statistically significant difference in intermolar and intercanine width of both maxilla and mandible among different 5 types of malocclusion groups. Conclusion: Class I malocclusion had maximum maxillary and mandibular intermolar width whereas Class III maloclussion had minimum maxillary and mandibular intermolar width. However, no significant difference was present in the intercanine and intermolar width among the different malocclusion groups.
Feasibility of Non-Fasting Before Coronary Angiography and Angioplasty: A Safety and Outcomes Study
Background: Traditionally, preprocedural fasting before coronary angiography and angioplasty is recommended to reduce the risk of aspiration during sedation. However, prolonged fasting causes patient inconvenience, hypoglycemia, and procedural delays. Recent evidence suggests that fasting may not always be necessary. Materials and Methods: This was a prospective, observational study conducted at Kathmandu Medical College and Teaching Hospital. Patients were selected using simple random sampling and allocated into fasting and non-fasting groups. 400 adult patients scheduled for elective coronary angiography or PCI were randomly assigned to a fasting group (nil per os ≥6 hours, n = 200) or a non-fasting group (light meal ≥4 hours prior, clear liquids allowed up to 2 hours prior, n = 200). The primary outcome was aspiration-related complications (cough, desaturation, or radiographic changes). Secondary outcomes included procedural delay, hypoglycemia, nausea, and patient satisfaction (Likert scale). Logistic regression adjusted for age, sex, diabetes, hypertension, and procedure type. Results: Aspiration-related events were rare and occurred equally in both groups (0.5% each; OR 1.0, 95% CI 0.06–16.1; p = 1.0). Non-fasting patients had significantly fewer procedural delays (1.5% vs. 7.5%; OR 0.19, 95% CI 0.05–0.64; p = 0.002) and hypoglycemia events (0.5% vs. 5.0%; OR 0.09, 95% CI 0.01–0.73; p = 0.005). Patient satisfaction was higher in the non-fasting group (4.7 ± 0.5 vs. 3.5 ± 0.8; mean difference 1.2, 95% CI 0.9–1.5; p < 0.001). Conclusion: The study found no significant difference in the primary outcome of aspiration-related complications between the fasting and non-fasting groups.
Estimation of Stature from Percutaneous Length of Radius and Ulna in Nepalese Medical Students
Background: Stature estimation is an integral part of forensic identification along with race, sex and age. The relevance is greater when decomposed, mutilated and burnt bodies are brought for autopsy. Previous studies have shown isolated body parts and bones reasonably accurate in estimating stature. Present study aims at estimating stature from percutaneous lengths of radius and ulna in Nepalese medical students. Material and Methods: A cross sectional study was conducted from April 2024 to September 2025 in Nobel Medical College Teaching Hospital, Nepal; including 412 Nepalese medical students (182 males and 230 females). After taking informed consent; Stature was measured with standard stadiometer, while Percutaneous Radial Length (PCRL) and Percutaneous Ulnar Length (PCUL) were measured by flexible measuring tape using standard techniques. Data was analyzed using Statistical Package for Social Sciences (SPSS Ver. 20) software. Pearson’s correlation coefficient was used to find correlation of stature with PCRL and PCUL, and its significance tested by t-test (p < 0.005). Linear regression equations were derived to estimate stature from PCRL and PCUL. Results: Stature showed significant positive linear correlation with PCRL and PCUL in both sexes. The derived linear regression equation for stature estimation for males was 116.478 + 2.108*PCRL and 107.056 + 2.326*PCUL, for females was 104.006 + 2.356*PCRL and 107.228 + 2.087*PCUL and for entire cases was 88.145 + 3.132*PCRL and 86.793 + 2.994*PCUL. Conclusion: Stature shows significant positive correlation with PCRL and PCUL in Nepalese medical students. Hence stature estimation can be done from PCRL and PCUL in Nepalese context.
Computed Tomography Evaluation of Mucosal Thickening of Maxillary Sinus in Relation to Sinus Outflow Obstruction
Background: Maxillary sinus mucosal thickening is a common radiologic finding, often incidentally detected on computed tomography scans. Its relationship with sinus outflow obstruction remains clinically significant but underexplored. Materials and Methods: This prospective cross-sectional study was conducted at Birat Medical College Teaching Hospital over one year. A total of 106 patients undergoing CT scans of the paranasal sinuses were included based on the presence of mucosal thickening. Patients with facial trauma, suspected malignancy, or intubation were excluded. CT scans were analyzed for mucosal thickening patterns, grades, and presence of outflow obstruction. Statistical analysis was done using SPSS. Results: Out of 106 patients, 51.9% were female and 48.1% male. Headache (60.4%) was the most common presenting symptom. Circumferential thickening was the predominant pattern (42.5%), followed by polypoidal (27.4%), focal (18.9%), and complete opacification (11.3%). Outflow obstruction was present in 60.4% of cases. A statistically significant association was found between both the grade and pattern of mucosal thickening and sinus outflow obstruction (p < 0.001). Notably, higher grades (>15 mm) and complete/circumferential patterns had a stronger correlation with obstruction. Conclusion: Our study demonstrates a significant association between the grade and pattern of maxillary sinus mucosal thickening and sinus outflow obstruction on CT imaging. Higher grades of thickening, particularly those exceeding 15 mm, and complete or circumferential patterns, were more frequently associated with obstruction.
Endoscopic Retrograde Cholangiopancreatography: Therapeutic/Diagnostic Modality and Outcome Analysis
Background: Endoscopic Retrograde Cholangiopancreatography is an essential therapeutic modality for pancreaticobiliary diseases, but its outcomes and complication rates vary across clinical settings. This study assesses indications, success rates, and complications of Endoscopic Retrograde Cholangiopancreatography (ERCP) in a tertiary care center in Nepal. Materials and Methods: A prospective cross-sectional study was conducted at the Department of Gastroenterology, Nobel medical college teaching hospital, from November 2024 to October 2025. All adults undergoing ERCP for therapeutic indications were included. Demographics, indications, procedural details, and complications were recorded. Statistical analysis was performed using SPSS version 26, with chi-square tests applied to assess associations. Results: A total of 151 patients underwent ERCP, with a mean age of 55 ± 16.5 years; females accounted for 63.6%. Choledocholithiasis was the most common indication (76.8%). Selective biliary cannulation was successful in 97.4%, and overall procedural success was 90.7%. Endoscopic sphincterotomy was performed in 88.1% of patients, while 11.9% required precut. Immediate complications occurred in 19.2%, most commonly post-ERCP pancreatitis (5.3%) and bleeding (5.3%). Papilla type showed a statistically significant association with complications (p = 0.006). Conclusion: Most patients underwent ERCP for benign diseases like common bile duct (CBD) stone and benign biliary stricture. Despite extensive research and refinement of this technique ERCP-related complications remain a major issue. The identification of risk factors for ERCP-related complications and implementation of measures that decreases the risk of complications and its prompt identification and treatment are key to ensuring good clinical outcomes.
Association between Adiposity Indices and Blood Pressure among Young Adults: A Cross Sectional Study
Background: The prevalence of obesity is rising rapidly in many low and middle income countries and is strongly linked to an increased risk of cardiovascular disease (CVD) and related health complications. Thus, this study aimed to see the association between adiposity indices and blood pressure using different markers of obesity among young adults. Materials and Methods: A cross sectional study was carried out in the Kathmandu University School of Medical Sciences, from June to August 2025. A total of 426 participants, aged 18 – 30 years were enrolled through convenience sampling. The height in meter, weight in Kg, hip circumference and waist circumference in centimeter were recorded for each participant than body adiposity index, body mass index, waist hip ratio and waist height ratio were calculated. Blood pressure was recorded by digital sphygmomanometer. Gender comparison was made and independent sample t-test, ANOVA and Pearson’s correlation analysis was used. Results: Out of total 426 participants, 174 were males and 252 were females. 24.71% males and 12.30% females were overweight/obese. Body adiposity index, hip circumference, waist circumference, waist to height ratio and waist to hip ratio were higher in males compared to females. Considering BMI, systolic and diastolic blood pressure tends to increase in overweight/obese participants but insignificant. Mean BAI was 22.00±6.14, whilst 29.17% had a body fat percentage in the overweight/obese category. Considering BAI, overweight/obese female had higher systolic and diastolic blood pressure. Conclusion: Our findings concludes that overweight/obese females are more prone to develop hypertension in future.
Endoscopic Findings in Patients Presenting with Dyspepsia
Background: Dyspepsia is one of the most frequently encountered complaints in Medicine department, representing a significant proportion of outpatient visits. The objective of our study was to evaluate the endoscopic findings in patients presenting with dyspepsia. Materials and Methods: This descriptive, cross sectional study was conducted in the Department of Internal Medicine, Nobel Medical College Teaching Hospital from May, 2024 to April, 2025 after obtaining ethical clearance from the Institutional Review Committee. The sample size was calculated to be 320. Age, gender and clinical symptoms were assessed. Upper gastrointestinal endoscopy was performed in all patients, and a rapid urease test was done to detect Helicobacter pylori infection. Results: The mean age of the study population was 34±5.65 years. Out of 320 patients, 170 were males and 150 were females, with a slight male predominance (male to female ratio 1.13:1). The most common upper GI endoscopy finding was gastritis (40%) followed by duodenitis (20%), duodenal ulcer (10%) and gastric ulcer (5%). Normal UGI endoscopy findings was observed in 25% of the study population. Epigastric pain (44.37%) was the most common symptom followed by epigastric burning (25%), post prandial fullness (19.06%) and early satiety (11.56%). Rapid Urease Test (RUT) for Helicobacter pylori infection was positive in 66.87% of the study population. Conclusion: Gastritis was the most common upper gastrointestinal endoscopic finding in our study followed by duodenitis. Normal endoscopic finding was observed in one fourth of the study population.
Perception of Human Cadaver Dissection by MBBS Students of a Medical College in Nepal
Background: Cadaveric dissection has traditionally played a central role in anatomical teaching pedagogy due to being immersive in nature and providing hands-on experience to students. Recent advancements have sparked debates about the replacement of dissection-based learning by the modern technology assisted learning tools in contemporary anatomy curricula. This study aims to systematically explore the perspectives of second- and third-year MBBS students in a Nepali medical college towards the usage of cadaveric dissection as a learning tool in anatomy education. Materials and Methods: A descriptive cross-sectional study was conducted to explore the perception of MBBS students regarding the dissection. The study included 115 MBBS students currently in their second or third year who have a minimum of one year of experience in cadaveric dissection and have been actively involved in dissection-based learning activities within the last two academic years. A structured, questionnaire comprising 26 Likert-scale items was used to assess the students' perception, attitude, and response to cadaveric dissection. The responses were coded, entered and analysed. Chi-square tests were applied to assess the association between variables. Results: Out of 115 participants, 73.0% strongly agreed that their first visit to the dissection room was exciting, 86.1% agreed or strongly agreed that dissection deepened their understanding of anatomical concepts, 96% of the students agreed that dissection enhanced their respect for the human body, 93.9% said it made learning more interesting, 92.1% acknowledged that dissection helped them recall what they learned, 88.2% felt it provided them with lasting knowledge and 92.2% acknowledged three-dimensional understanding of body structures gained through dissection. Among the total participants, 94.8% believed they would be disadvantaged if they missed out on dissection. Conclusion: The findings of this study suggests that cadaveric dissection is perceived by MBBS students as essential and irreplaceable component of anatomy education and should be integrated as learning tool for anatomy curriculum.
Prevalence and Associated Factors of Hypertension: A Community-Based Cross-Sectional Study in a Rural Municipality of Eastern Nepal
Background: Hypertension is a major modifiable risk factor for premature mortality. The 2022 Nepal Demographic and Health Survey report a prevalence of about 20%, yet fewer than 5% of cases are adequately controlled, indicating major gaps in detection and management despite initiatives such as the Hypertension Care Cascade. Evidence from the limited studies in Nepal applying the ACC/AHA 2017 guidelines suggests that lower blood pressure cut-offs improve early identification of individuals at increased cardiovascular risk. Materials and Methods: A rural community-based cross-sectional study was conducted among 357 adults using multistage random sampling. Data were collected using a pre-tested questionnaire. Blood pressure was measured using standard procedures and classified according to the ACC/AHA 2017 guidelines. Results: The prevalence of hypertension was 52.1% (n=186). Among hypertensive participants, 61.3% were aware of their condition, 47.8% were receiving antihypertensive treatment, and 33.9% had controlled blood pressure. Age was significantly associated with hypertension (p=0.048), with a higher prevalence of stage 2 hypertension among those aged >60 years. Educational status showed a significant association (p=0.002), with higher prevalence among individuals with no formal education. Physical inactivity and smoking history (pack-years) were also significantly associated (p=0.040). Hypertension was more common among participants from joint or extended families (p=0.016), those reporting financial inadequacy (p<0.001), and certain occupational groups (p<0.001). Conclusion: This study demonstrates a high prevalence of hypertension as compared to other studies in these settings with low levels of treatment and control. Lack of formal education was significantly associated with high blood pressure category. Socioeconomic, Occupational, lifestyle and behavioural factors were also associated with causation of hypertension.
Knowledge, Attitude and Practice Regarding Menstrual Hygiene among Women of Reproductive Age in Duhabi, Sunsari
Background: Menstrual hygiene remains a public health concern in Nepal, particularly in rural areas where cultural restrictions, limited awareness, and inadequate access to menstrual products influence women’s practices. Existing studies predominantly focus on adolescents, leaving gaps in understanding menstrual hygiene among the wider reproductive-age population. This study assessed the knowledge, attitudes, and practices regarding menstrual hygiene among women of reproductive age in Duhabi, Sunsari. Materials and Methods: A descriptive cross-sectional study was conducted from April to August 2024 among 102 women aged 15–49 years in Ward No. 11 of Duhabi Municipality. Participants were selected through convenience sampling. Data were collected using a structured, interviewer-based questionnaire covering socio-demographic characteristics and menstrual hygiene related knowledge, attitudes, and practices. Ethical approval and written informed consent were obtained. Descriptive statistics were analyzed using SPSS version 29. Results: A total of 102 women of reproductive age (15 to 49 yrs) were analyzed. Knowledge assessment showed that 58.8% of participants recognized disposable sanitary pads as the best absorbent, while 41.2% believed in cloth. Most women (89.2%) believed that poor menstrual hygiene could lead to health issues, identifying problems like infections (4.9%) and diseases related to the uterus (35.3%). Cultural restrictions were prevalent, with 79.4% avoiding religious activities during menstruation. Daily bathing (93.1%) and genital cleaning (100%) were widely practiced. The majority (62.7%) had frequent changing habits of absorbents, while the infrequency of changing habits, reported by 37.3% of respondents, indicates a significant knowledge gap. Conclusion: The findings show a combination of appropriate and suboptimal menstrual hygiene practices among women in Duhabi. Despite basic awareness of hygiene, significant gaps persist in absorbent choice, frequency of changing, and culturally influenced restrictions. These patterns reflect how economic limitations and cultural beliefs shape menstrual hygiene behaviors in this rural community.
Prevalence and Risk Factors of Low Birth Weight in Tertiary Level Hospital in Eastern Nepal
Background: The birth weight of the newborn determines of its survival, growth and development. World health organization defined low birth weight as weight at birth less than 2500 grams. Low birth weight baby die 20 times more than normal weight baby. There are 16% of the live birth are low birth weight worldwide. The prevalence of low-birth-weight newborn in Nepal was 12%. Materials and Methods: A cross-section study was under taken in the Nobel Medical College Teaching Hospital Biratnagar. All newborn babies delivered in the department of obstetrics and gynecology at Nobel Medical College Teaching Hospital during study period was under taken as sample size. The collected DATA were entered in software Microsoft Excel and transferred to SPSS version 27 and analysis was done. Results: The prevalence of low birth weight was 23.3% in our study. The low birth weight was significant associated with gestational age and parity of mother. The gestational age less than 37 weeks had more low birth weight 133(58.9%). Similarly, primi parous mother had high low birth weight146(61.3%) than multi parous mother. Conclusion: In our study we found that the low-birth-weight baby was more common in the mother with gestational age less than 37 weeks, primi parous and Janjati ethnicity.
Efficacy of Aceclofenac and Naproxen in Patients with Low Back Pain at Birat Medical College and Teaching Hospital
Background: Low back pain is a common global problem with a high incidence in Nepal and is a cause of disability. Non-Steroidal Anti-Inflammatory Drugs are the first-line option for managing both acute and chronic low back pain. This study aims to compare the efficacy and safety of Aceclofenac and Naproxen for acute low back pain due to the limited comparative data locally. Materials and Methods: This prospective, observational study at Birat Medical College enrolled 88 acute low back pain patients; categorized in two groups by simple random sampling, receive either Aceclofenac 100 mg twice daily or Naproxen 500 mg twice daily. Efficacy was assessed by measuring pain intensity with a Visual Analog Scale at baseline and one week after treatment, and monitoring adverse effects via a self-report checklist. Statistical significance was set at p < 0.05. Results: Baseline mean Visual Analog Scale pain scores were similar for both groups. By Day 7, mean Visual Analog Scale for Aceclofenac (3.0±0.96) was significantly lower in contrast to Naproxen (5.0±1.00), a difference was significant (p < 0.001) in paired t-test. Aceclofenac also had a superior safety profile with absence of side-effects, while Naproxen showed mild gastrointestinal problems in three patients. Our study also indicated significant associations for acute low back pain with variables such as age, gender, occupational status, and heavy physical work. Conclusion: Aceclofenac demonstrated superior pain relief and a better safety profile than Naproxen for acute low back pain. It is thus a preferable therapeutic option for use in similar clinical settings.
Immediate Effects of Functional Strength Training on Dynamic Balance in Individuals with Unilateral Knee Osteoarthritis
Background: Knee osteoarthritis causes discomfort, diminished proprioception, and impaired dynamic balance, which can limit daily activities. Exercise continues to be an important part of OA care; however, the immediate effects of a single session of functional strength training on balance and pain are unknown. The purpose of this study was to assess the immediate effects of one session of functional strength exercise on dynamic balance and pain in people with unilateral knee osteoarthritis. Materials and Methods: The quasi-experimental one-group pre-post study design was used. The study included 39 adults who had been diagnosed with unilateral knee OA using Altman clinical criteria. Each participant did one functional strength training session lasting 30-40 minutes. The Star Excursion Balance Test (SEBT) was used to assess dynamic balance before and after the intervention in all eight directions. The Visual Analogue Scale (VAS) was used to quantify pain intensity. Baseline demographic data, as well as the Knee Injury and Osteoarthritis Outcome Score (KOOS), were collected. SEBT reach distances were adjusted for leg length. Paired t-tests were used to examine pre-post comparisons, with a significance level of p < 0.05. Results: Following the exercise session, all subjects showed statistically significant improvements in SEBT reach distances across all eight directions in both the injured and unaffected limbs. The afflicted limb improved more significantly, indicating improved neuromuscular activation and postural control. Pain levels indicated by VAS were significantly lower after intervention. KOOS scores indicated intermediate functional capacity, with higher scores in activities of daily living and lower scores in sports and quality of life domains. Conclusion: A single session of functional strength training resulted in immediate and significant improvements in dynamic balance and pain reduction in those with unilateral knee osteoarthritis. These data support the clinical use of functional strength training as an effective immediate intervention in knee osteoarthritis rehabilitation.
Histopathological Changes in Placenta in Pre-Eclampsia/Eclampsia: A Case-Control Study in A Tertiary Care Center
Background: Hypertensive disorders of pregnancy, particularly pre-eclampsia and eclampsia, remain major causes of maternal and perinatal morbidity and mortality. The placenta plays a pivotal role in their pathogenesis, with histopathological lesions correlating with adverse outcomes. This study was therefore conducted to compare various placental gross and histopathological changes in hypertensive disorders of pregnancy as compared to normotensive pregnancy. Materials and Methods: A case-control study was conducted on 28 placentas from pre-eclamptic/eclamptic pregnancies and 28 from normotensive controls at Nobel Medical College (Sep 2024–Feb 2025). Birth weight in both groups was compared. Various gross and histological features like placental weight, umbilical cord length, insertion of placenta, infarction, calcification, chorioamnionitis, villitis, placental dysmaturity, chorionic vessel thrombosis, and subchorioinic fibrin deposition were assessed and compared. Data were analyzed using appropriate statistical tests. Results: Placental weight and neonatal birth weight were significantly lower in hypertensive pregnancies (p=0.0001 and p=0.018, respectively). Histopathological lesions—such as calcification, infarction, subchorionic fibrin deposition, chorionic vessel thrombosis, and chorioamnionitis—were significantly more frequent in hypertensive cases (p<0.05 for each). Conclusion: Significant gross and microscopic placental changes are associated with hypertensive disorders of pregnancy. Routine placental histopathology can aid in understanding disease mechanisms.
Effectiveness of Health Education Techniques in Enhancing the Knowledge of Zika Virus Diseases among the Staff Nurses Working in Selected Hospitals of Biratnagar, Nepal
Background: Zika Virus Diseases has become a concern in the South-East Asia region. Aedes aegypti, the vector of the diseases, is already present in Nepal. Educating health workers is one of the most cost-effective measures to address emerging health problems. This study aimed analyses the effective technique to increase the knowledge among nurses about diseases. Materials and Methods: Pre and post study design was used. Total 5 hospitals among 19 hospitals of Biratnagar Metropolis were randomly selected in first stage. In second stage,25 nurses from each 5 hospitals were selected randomly making total sample size of 125. Different health education techniques were assigned to groups using a lottery method. The health education techniques included participatory lecture with PowerPoint presentation, video session, pamphlet distribution, and poster presentation Results: At the first post-test, the group subjected to video sessions and pamphlet showed highest mean knowledge scores (15.12, Std. deviation = 1.764 and 1.787, respectively). However, the participatory lecture group displayed the highest percentage increase in knowledge score (50.31%) in comparison to pretest. After the second post-test, the group exposed to poster presentations had the highest mean knowledge score (13.72, Std. deviation = 2.112). Nevertheless, the group undergoing participatory lectures with PowerPoint presentations still demonstrated the highest percentage increase in knowledge score (51.1%). Conclusion: Participatory lecture with power point presentation was the most effective measure to disseminate information about Zika Virus Diseases as the difference in knowledge score was significant.
Predictor of Outcome Among Patients with Infertility Undergoing In-Vitro fertilization /Intracytoplasmic Sperm Insemination
Background: Infertility is a prevalent global health concern arising from diverse etiologies, including hormonal imbalances, reproductive system disorders, lifestyle factors, genetic abnormalities, and age-related declines in reproductive capacity. In vitro fertilization (IVF) and intracytoplasmic sperm injection (ICSI) remain cornerstone therapeutic interventions for couples experiencing reproductive difficulties. Materials and Methods: A two years cross-sectional study was conducted to evaluate the underlying causes of infertility and to analyze treatment outcomes including success rates, pregnancy outcomes, and associated clinical factors among patients undergoing in vitro fertilization and intracytoplasmic sperm injection at the Nobel IVF Centre. Results: The study enrolled 126 patients, comprising 77 in the IVF group and 49 in the ICSI group. The mean (SD) age of participants was 33.45 ± 6.01 years, and the median (IQR) age was 34 (29–38) years. Patients were categorized according to the underlying cause of infertility, including tubal factor infertility, diminished ovarian reserve based on Anti-Müllerian Hormone (AMH) levels, polycystic ovary syndrome (PCOS), oligospermia, asthenospermia, unexplained infertility, and combined etiologies. Pregnancy-related outcomes, including implantation rates and neonatal results, were systematically documented. Conclusion: Higher pregnancy success rates were significantly associated with younger maternal age (<35 years). IVF demonstrated particularly favorable outcomes in cases of unexplained infertility and tubal factor infertility, whereas ICSI yielded superior results in male-factor infertility. Across all treatment groups, embryo quality remained a key determinant of implantation success.
Study of Normal Ranges of Radial and Ulnar Deviation among Female Medical Students
Background: Assessment of joint mobility is a fundamental component of the physical examination of the upper extremities. Accurate measurement of wrist movement helps clinicians evaluate joint laxity, functional capacity, and subtle variations in musculoskeletal structure. Radial and ulnar deviations, in particular, play an important role in activities requiring precision and dexterity, making their evaluation essential in clinical practice, rehabilitation, and research. Materials and Methods: This cross-sectional, descriptive study included 100 healthy female undergraduate Medical students of NMCTH, participants aged 18–24 years with normal wrist skeletal structure. Radial and ulnar deviations of both wrists were measured using a standard universal goniometer following established procedures. Results: The overall range of motion (ROM) across all four movements was comparable, averaging between 39° and 41°. Mean radial deviation was 38.76° ± 11.32° in the right hand and 41.18° ± 10.21° in the left hand. Mean ulnar deviation measured 39.84° ± 11.27° on the right and 40.46° ± 10.86° on the left. ROM values were consistently higher in the left wrist for both movements. Conclusion: This study demonstrates slightly greater wrist mobility on the left side compared to the right for both radial and ulnar deviations. No significant difference was observed between radial and ulnar deviation ranges themselves. Reduced mobility of the right wrist in predominantly right-handed individuals may reflect early functional strain or mild degenerative changes affecting the joint and surrounding ligaments.
Assessment of Drug Utilization Pattern of Chemotherapeutic Agents and its Cost Analysis in a Day Care Unit of a Tertiary Care Hospital: An Observational Study
Background: Cancer remains a leading cause of mortality worldwide, with increasing incidence and significant treatment costs, particularly in developing countries like Nepal. Main objective of this study is to evaluate the utilization pattern and cost assessment of chemotherapeutic agents among cancer patients at Birat Medical College Teaching Hospital, Nepal. Materials and Methods: A cross-sectional study was conducted from 26 May to 26 Oct 2024, enrolling 153 cancer patients receiving chemotherapy in a tertiary care hospital in Eastern Nepal. Data on demographics, cancer types, prescribed anticancer medications and associated costs were collected. It was analyzed using descriptive statistics and WHO prescribing indicators. Results: The majority number of patients were female 35 (22.87%) aged between 60-69 years. Breast 26 (16.99%) and lung cancer 25 (16.33%) were the most prevalent. Alkylating agents, antimetabolites and taxanes were the most frequently prescribed drugs. The average number of medications per prescription was 5.29, with chemotherapeutic agents constituting 1.82% and antibiotics 0.01%. Approximately 76.50% of drugs were prescribed by generic name, and 82.86% were from the National Essential Medicine list. The average daily cost of chemotherapy was NPR 927865 (62$). Conclusion: Breast and lung cancer were most common in the age groups 60–69 years. Chemotherapy predominantly involved alkylating agents, antimetabolites, and taxanes. Monoclonal antibodies were less frequently used but highly expensive. Prescribing practices largely followed rational drug-use indicators.
Post Traumatic Total Aniridia along with Superior Subconjunctival Dislocation of Posterior Chamber Intraocular Lens: A Rare Case Report
To report a case of post traumatic total aniridia along with superior subconjunctival dislocation of posterior chamber intraocular lens. A 55-year-old man who underwent small incision cataract surgery with posterior chamber intraocular lens 2 years back had traumatic total aniridia along with superior subconjunctival dislocation of intraocular lens to his right eye with cow’s horn. The patient was managed with surgical extraction of lens and iris from the subconjunctival space in conjunction with suturing in the incision site (wound dehiscence) was done. Patient was planned for secondary intraocular lens implantation. It is quite challenging to manage such a case. Despite proper surgical management visual outcomes are always guarded in such patients. Extrusion of intraocular lens (IOL) with total aniridia in pseudophakic eyes after trauma has rarely been reported in literature.
Metabolic Dysfunction Associated Steatotic Liver Disease, Not Just Fatty Liver Disease: A Systemic Shift in Naming and Understanding
The reclassification of fatty liver disease to Metabolic dysfunction-associated Steatotic Liver Disease (MASLD) marks a paradigm shift. Moving beyond stigmatizing, misleading terms, MASLD emphasizes metabolic dysfunction as the root cause. This systemic condition links to cardiovascular, renal, and diabetic risks, demanding comprehensive screening, research, and public health action worldwide.