Medical Journal of Shree Birendra Hospital <p>Official Journal of NAIHS (Nepalese Army Institute of Health Sciences). Full text articles available.</p> <p>MJSBH is now accepting online submission of manuscripts.We recommend that you review the <a href="/index.php/MJSBH/about">About the Journal</a> page for the journal's section policies, as well as the <a href="/index.php/MJSBH/about/submissions#authorGuidelines">Author Guidelines</a>. Authors need to <a href="/index.php/MJSBH/user/register">register</a> with the journal prior to submitting, or if already registered can simply <a href="/index.php/index/login">log in</a> and begin the 5 step process.</p> NAIHS (Nepalese Army Institute of Health Sciences) en-US Medical Journal of Shree Birendra Hospital 2091-0185 A rare Occurrence of Anonychia in a Neonate : A case Report <p>Congenital anonychia in isolated form is a rare anomaly in which there is an absence of nails of fingers and toes since birth. However, other ectodermal and mesodermal defects in the body are absent. Here, we report a case of 30-hour old female with e rare congenital disorder anonychia in fingernails of her left hand and all toenails. All other systemic examinations were normal. The baby was born of a consanguineous marriage, and the father also had absent nails in multiple fingers.</p> Deepak Mishra Pankaj Ray Chandra Bhal Jha Rakesh Mishra Copyright (c) 2023 Medical Journal of Shree Birendra Hospital 2023-10-23 2023-10-23 22 1 47 49 10.3126/mjsbh.v22i1.44357 Orthodontic Management of Malocclusion with Anterior and Posterior Crossbite: A case Report <p>Crossbite affects the growth and development of teeth and jaws, temporomandibular joint, and masticatory system. This malocclusion should be corrected when first diagnosed. This case report presents the case of skeletal class II malocclusion with unilateral posterior crossbite as well as anterior crossbite, which were managed with activation of transpalatal arch (TPA) and fixed orthodontic appliance. This case is unique as the management of posterior crossbite with TPA is scarce in the literature. The patient was satisfied as both the anterior and posterior crossbite, and competency of the lip were achieved at the end of treatment.</p> Nabin Kumar Chaudhary Suvin Chaudhary Copyright (c) 2023 Medical Journal of Shree Birendra Hospital 2023-10-23 2023-10-23 22 1 50 54 10.3126/mjsbh.v22i1.49168 Sole Epidural Anaesthesia for Caesarean Section in a Patient with Multiple Sclerosis: A case Report and Literature Review <p>Neuraxial blocks in patients with multiple sclerosis has been controversial, because the effect of local anaesthetic drugs on the course of the disease is unclear. We report an obstetric patient with multiple sclerosis whose Caesarian section was performed successfully under sole epidural anesthesia and postoperative pain control was managed using epidural morphine. There were no exacerbations of neurologic symptoms and no relapse of disease at one month follow-up. We suggest that the choice of anaesthetic technique for patients with multiple sclerosis should be determined after evaluation of the course of the disease and informed consent. </p> Biplov neupane Dilip Baral Bashudev Parajuli Copyright (c) 2023 Medical Journal of Shree Birendra Hospital 2023-10-23 2023-10-23 22 1 55 57 10.3126/mjsbh.v22i1.54660 Assessment of Patient Satisfaction Towards Ophthalmology Services in a Tertiary Care Hospital: A Cross-sectional Study <p><strong>Introduction:</strong> The quality of medical care directly affects patient satisfaction. The delicate nature of eye care and its potential impact on patients’ well-being necessitates the assessment of patient satisfaction towards ophthalmology services. This study was conducted to evaluate the patient satisfaction towards ophthalmology services.</p> <p><strong>Methods:</strong> A hospital based cross-sectional study was conducted among 384 patients visiting Ophthalmology Department of Shree Birendra Hospital. Descriptive statistics was used to present the demographic details of the participants. Normality of the data was checked by Shapiro-Wilk test.</p> <p><strong>Results:</strong> The response rate of participants was 98.46%. Out of 384 respondents, 214 patients were satisfied with the healthcare they received. The satisfaction level was 55.7% (95% CI: 51.0-60.4).</p> <p><strong>Conclusions:</strong> The patient satisfaction towards ophthalmology services was found satisfactory. However, there are various aspects which need to be improved for enhancing quality service for the better healthcare facility.</p> Ram Shrestha Sagar Rajkarnikar Kamala Thapa Roshija Khanal Rijal Neyaz Kausar Sitaram Khadka Copyright (c) 2023 2023-10-23 2023-10-23 22 1 1 6 10.3126/mjsbh.v22i1.59434 Attitude Towards Euthanasia Among Health Care Professionals of a Tertiary Care Hospital in Nepal: A Descriptive Cross-sectional Study <p><strong>Introduction:</strong> The deliberate termination of a life to end suffering is known as euthanasia. There have been discussions on legalizing euthanasia in Nepal among physicians and legislators, but nothing has come out of it yet. It is critical to consider the opinions of medical experts while making decisions on euthanasia. Therefore, the purpose of this study is to find the attitude towards euthanasia among health care professionals in Nepal.</p> <p><strong>Methods:</strong> A descriptive cross-sectional study was conducted among consultants, medical officers, post-graduate residents, and interns of a tertiary care hospital from November 2021 to May 2022 after getting approval from Institutional Review Committee. The responses were collected from convenience sampling was used and the findings were presented in descriptive manner using mean and percentages.</p> <p><strong>Results:</strong> Among 107 participants, 71% of them showed positive attitude towards euthanasia and only 22.4% reported that they will perform euthanasia on themselves if it is needed and approved at any point of time.</p> <p><strong>Conclusions:</strong> The majority of the healthcare professionals at a tertiary care hospital in Nepal revealed the wide range of opinions on euthanasia. This highlighted the need of ethical discussion and consideration to mold policies and practices in accordance with patient-centered care, cultural sensitivity, and the ethical obligations of healthcare professionals.</p> Anjan Khadka Sabin Banmala Bibek Timilsina Suhail Sapkota Saurab Karki Copyright (c) 2023 2023-10-23 2023-10-23 22 1 7 11 10.3126/mjsbh.v22i1.59435 Awareness and Practice Regarding Weaning Among Mothers of Under two Years Children at Tertiary level Hospital <p><strong>Introduction:</strong> Weaning describes how a baby moves or shifts from having breast milk to consuming semi-solid or solid foods with a gradual reduction in breast milk and baby formula intake. The study aims to assess the level of awareness, practice, and association between awareness and practice regarding weaning among mothers of under two years of children.</p> <p><strong>Methods:</strong> This descriptive cross-sectional study was conducted in Shree Birendra Hospital, Chhauni, Kathmandu. Mothers having under two years children visiting the Paediatric OPD of Shree Birendra Hospital, Chhauni, were included. Descriptive analysis of data was performed.</p> <p><strong>Results:</strong> The total number of samples was 96, and the response rate was 100%. Majority (55.2%) of the respondents were between 26 to 30 years of age, and two third (66.7%) had two children. The majority (65.6%) of the respondents have an average level of awareness regarding weaning. Most (55.2%) of respondents had good practice on weaning. However, there was a nonsignificant association between awareness and practice regarding weaning among mothers under two years of children with selected demographic variables.</p> <p><strong>Conclusions:</strong> The mothers of under two years child had an average level of awareness and practice regarding weaning, with a notable association between their awareness levels and actual weaning practices.</p> Sumitra Mulepati Sumana Lama Sushila Bhandari Copyright (c) 2023 Medical Journal of Shree Birendra Hospital 2023-10-23 2023-10-23 22 1 12 15 10.3126/mjsbh.v22i1.58519 Clinical Outcomes in Patients with Cervical Spondylotic Myelopathy Treated with French door Laminoplasty <p><strong>Introduction:</strong> Cervical spondylotic myelopathy (CSM) is a condition that results from cervical stenosis. The clinical manifestation of CSM are paresthesia of extremities, loss of motor functions, difficulty in walking and in severe cases bowel and bladder dysfunction. Mostly CSM is treated with surgical methods. In case of single level involvement, anterior surgery is commonly done and preferred posterior surgery for multilevel involvement. Among all posterior techniques, laminoplasty is one of the most popular ones. The study aims to assess the clinical outcomes of French door Laminoplasty in CSM.</p> <p><strong>Methods:</strong> We retrospectively analysed the patients hospital record and radiographs who were operated with French door laminoplasty for cervical spondylotic myelopathy. We analysed pre and post operative mJOA score, axial neck pain and cervical lordosis. The data were analysed with SPSS version 20.</p> <p><strong>Results:</strong> A total of 30 patients were evaluated. Majority of patients were males (27). All the patients pre and postop cervical lordosis measured and there is maintained cervical lordosis postoperatively. The mJOA score improved from 9.83 ± 1.82 to 14.27 ± 1.28 postoperatively at one year. Mean axial pain improved from 4.1 ± 1.19 to 1.7 ± 0.651 postoperatively.</p> <p><strong>Conclusions:</strong> There is improved clinical outcome of cervical spondylotic myelopathy patients after French door laminoplasty surgery.</p> Bishnu Babu Thapa Rajesh Pratap Shah Dipendra Maharjan Copyright (c) 2023 Medical Journal of Shree Birendra Hospital 2023-10-23 2023-10-23 22 1 16 19 10.3126/mjsbh.v22i1.51078 Effect of Educational Intervention on Knowledge and Attitude Toward Consanguineous Marriage among Secondary Level Students <p><strong>Introduction:</strong> Consanguineous marriage (CM) is an allowed and preferred practice among some ethnic groups in Nepal. Such a union puts couples at higher risk of having offspring with genetic disorders, including autosomal recessive diseases and congenital malformations. The objective of this study was to assess the effect of educational intervention on knowledge and attitude towards CM among secondary-level Mongolian students.</p> <p><strong>Methods:</strong> A quasi-experimental pretest-posttest non-equivalent group study was conducted among students in grades 9 - 12 of two schools in Dhading, with one school as the experimental group (N = 69) and another as the control group (N = 45). Educational intervention on CM was provided to the experimental group through an interactive lecture method. Pretest and posttest data were collected in both groups by using a validated and pretested selfadministered questionnaire. Data were analyzed using descriptive statistics.</p> <p><strong>Results:</strong> In the experimental group, most (87.0%) participants had an inadequate level of knowledge in the pretest, whereas in the posttest, most (85.5%) had adequate knowledge. In the control group, both during pretest and posttest, most (i.e. 82.2% and 78.6%, respectively) had inadequate level of knowledge. In the experimental and control groups during the pretest most of the participants (87.0% and 88.9%, respectively) had a negative attitude. In contrast, in the posttest, the negative attitude decreased to 46.4% in the experimental group, and in the control group the attitude level decreased only slightly to 84.4%. Unpaired t-test computed on pretest knowledge of the experimental group and control group showed no significant difference (t = 0.968, p &gt; 0.05), whereas the posttest knowledge between the two groups revealed a statistically significant difference (t = 23.643, p &lt; 0.05).</p> <p><strong>Conclusions:</strong> The educational intervention package effectively increases knowledge and changes attitudes towards consanguineous marriage among secondary-level students.</p> Alina Ghale Sarala Shrestha Copyright (c) 2023 Medical Journal of Shree Birendra Hospital 2023-10-23 2023-10-23 22 1 20 25 10.3126/mjsbh.v22i1.50219 Knowledge and Utilization of Sexual and Reproductive Health Services Among Secondary Level Students of Bhaktapur, Nepal <p><strong>Introduction:</strong> According to WHO and ICPD, sexual and reproductive health is defined as “a state of physical, emotional, mental and social well-being in relation to sexuality and reproductive system”. The study aims to assess the knowledge and utilization of sexual and reproductive health services among secondary level students.</p> <p><strong>Methods:</strong> Descriptive cross-sectional study was done among 118 adolescent students from selected school by using non probability purposive sampling technique. Self-administered semi-structured questionnaire was used for data collection. Analysis was done in SPSS version 16 using descriptive and inferential statistics.</p> <p><strong>Results:</strong> 81.4% participants had adequate knowledge related to SRH services and 25.4% had utilized SRH services. Utilization was found to be associated with gender (p = 0.000), fathers’ education (p = 0.028), mothers’ occupation (p = 0.001), interaction with family (p = 0.040), availability of services within 30 minutes of walking distance (p = 0.000), sexually active in past 12 months (p = .000).</p> <p><strong>Conclusions:</strong> Majority of the respondents had adequate knowledge. Utilization among students was found to be low.</p> Sabika Munikar Iswari Luitel Rashi KC Copyright (c) 2023 Medical Journal of Shree Birendra Hospital 2023-10-23 2023-10-23 22 1 26 32 10.3126/mjsbh.v22i1.53704 Knowledge on the Environmental Factors Affecting Health of Traffic Police in Kathmandu Valley <p><strong>Introduction:</strong> Traffic police are the officers who play a vital role in maintaining laws and regulations on the road 24 hours a day. They are exposed to dust, fumes, noise, UV rays, germs and other factors which may have serious potential to cause health problems, which is preventable but may be unaware of it. Hence, this study aims to assess the knowledge of the environmental factors affecting health among traffic police.</p> <p><strong>Methods:</strong> A cross-sectional study was conducted among the traffic police of Kathmandu Metropolitan city from December 2021 to May 2022. The selfadministrated questionnaire was provided in different traffic police stations with permission of Metropolitan Traffic Police, Kathmandu. The questionnaire was structured with each separated section of environmental factors. Epidata was used for data entry and analyzed through IBM SPSS. Chi square test was used to measure the significant association of dependent and independent variables.</p> <p><strong>Results:</strong> A survey of 352 respondents found that the majority had fair knowledge on environmental factors such as air pollution, microbes, food and water borne diseases and 78.7% had fair knowledge about noise pollution. Dust from vehicular movement was reported as the main source of air pollution, while eye problems 46.6%and allergies 50.2% were the main health and skin problems respectively.</p> <p><strong>Conclusions:</strong> It is worrying that only a few traffic police officers have a good understanding of the environmental factors that can harm health. This poses significant public health issues. To address this problem, the study recommends raising awareness among authorities and providing education to traffic police officers and can facilitate change at the grassroots level.</p> Matrika Singh Ratika Shrestha Ajay Kumar Yadav Nishchal Devkota Kanchan Pariyar Sharad Hari Gajurel Copyright (c) 2023 Medical Journal of Shree Birendra Hospital 2023-10-23 2023-10-23 22 1 33 38 10.3126/mjsbh.v22i1.53671 Role of HbA1c as a Marker of Dyslipidemia in Patients with Type 2 Diabetes Mellitus Visiting Tertiary Health Care Center <p><strong>Introduction:</strong> Diabetic patients with accompanied (but often unnoticed) dyslipidemia are soft targets of cardiovascular deaths. Glycated hemoglobin (HbA1c) is a routinely used marker for long-term glycemic control. This investigation is an attempt to evaluate the diagnostic value of HbA1c in predicting diabetic dyslipidemia.</p> <p><strong>Methods:</strong> This was a cross-sectional study where the sera were analyzed for HbA1c, fasting blood glucose (FBG), total cholesterol, triglycerides, highdensity lipoprotein cholesterol (HDL) and low-density lipoprotein cholesterol. SPSS version 23.0 was used to analyze the data.</p> <p><strong>Results:</strong> The levels of HbA1c did not differ significantly between males and females whereas male patients had significantly higher fasting blood glucose than females. There was a highly significant correlation between HbA1c and FBG. Both HbA1c and fasting blood glucose exhibited direct correlations with cholesterol, TG and LDL and inverse correlation with HDL; the magnitude of significance for all these lipid parameters being greater with HbA1c than fasting blood glucose.</p> <p><strong>Conclusions:</strong> HbA1c can provide valuable information about the circulating lipids beside its primary role in monitoring long term glycemic control.</p> Prachi Rayamajhi Salina Pradhananga Arabinda Mohan Bhattarai Copyright (c) 2023 Medical Journal of Shree Birendra Hospital 2023-10-23 2023-10-23 22 1 39 46 10.3126/mjsbh.v22i1.54197