https://nepjol.info/index.php/mjen/issue/feed Medical Journal of Eastern Nepal 2022-06-17T07:54:14+00:00 Dr. A.K. Sinha (Ph.D) editormjen@gmail.com Open Journal Systems <p>The Medical Journal of Eastern Nepal is a peer-reviewed scientific journal published by B &amp; C Medical College Teaching Hospital and Research Center, Birtamode, Jhapa, Nepal. This is a new journal intended to uphold the education discussion in the field of Medical Science and its allied subjects.</p> https://nepjol.info/index.php/mjen/article/view/45853 MR Imaging Evaluation of Perianal fistulae 2022-06-16T13:37:27+00:00 Umesh Kumar Sharma druksharma@hotmail.com Suraj Thapaliya druksharma@hotmail.com Abishek Pokhrel druksharma@hotmail.com Manmohan Bir Shrestha druksharma@hotmail.com Bashu Dev Baskota druksharma@hotmail.com Dinesh Kumar Thapa druksharma@hotmail.com Ujwal Rai druksharma@hotmail.com <p><strong>Background:</strong> Perianal fistula is a troublesome condition both for patient and surgeon with significant morbidity and challenging treatment. MRI is considered as the technique of choice for preoperative evaluation of perianal fistulae, as it provides accurate anatomical information for appropriate surgical treatment, decreasing the incidence of recurrence and allowing side effects such as fecal incontinence to be avoided. The study aimed to describe the role of magnetic resonance imaging (MRI) in the diagnosis and classification of perianal fistulae.</p> <p><strong>Methods</strong>: This retrospective study looked at 52 patients referred to the radiology department with a clinical diagnosis of perianal fistula. MRI grading of anal fistula done according to St. James’s University Hospital classification.</p> <p><strong>Results:</strong> The MRI showed 46 internal openings in 44 patients; two patients had more than one. The internal opening was mostly at the 6 o’clock position in 59.9% patients, followed by 7 o’clock and 5 o’clock position in 11.3% of patients. According to the St. James’s University Hospital classification, 21 (47.7%) patients had grade 1, 11 (25%) patients had grade 2, 2 (4.5%) had grade 3, 7 (15.9%) had grade 4, and 4 (9%) had grade 5 fistulae. Twenty-five patients had associated abscesses. The most common location of the abscess was in the perianal region (8 patients).</p> <p><strong>Conclusions:</strong> MR imaging examinations is a highly accurate imaging method for preoperative evaluation perianal fistula. It provides precise information of the fistulous track, along with its relationship to pelvic structures and plays crucial role for surgical planning.</p> 2022-06-17T00:00:00+00:00 Copyright (c) 2022 B & C Medical College and Teaching Hospital and Research Centre https://nepjol.info/index.php/mjen/article/view/45854 Status of Vitamin D Deficiency among the Patients in a Tertiary Care Hospital 2022-06-16T13:50:37+00:00 Amar Kumar Sinha sinhaamar96@gmail.com Tirtha Narayan Shah sinhaamar96@gmail.com Ujwal Rai sinhaamar96@gmail.com <p><strong>Background:</strong> It has been observed that one billion people in the world have vitamin D deficiency as a public health problem. This study aims to find out the status of vitamin D in the gender of male, females, and different age groups &lt;15 to &gt;62 years of age.</p> <p><strong>Methods:</strong> This was a retrospective study carried out at B&amp;C Medical College Teaching Hospital and Research Centre, Jhapa from 1st January to December 31st, 2021. Vitamin D3 levels were tested with Chemiluminescence Immuno Assay (CLIA) technique. The status of vitamin D was defined as deficient if vitamin D3 level was less than 20ng/ml. We focused to find out the pattern of increased or decreased serum vitamin D level as its deficiency and surplus have an adverse effect on our health. Ethical approval was obtained from the Institutional Review Committee of B&amp;C Medical College Teaching hospital and research Centre (Ref-0012022).</p> <p><strong>Results:</strong> A total of 7,402 healthy individuals (&lt;15-&gt;62 years of age) females 4914 (66.4%) and males 2288 (33.6%). Vitamin D deficiency was observed high in females than males. It was also observed that in the age group 15-30 years vitamin D deficiency was 52.8% which was highest among the age group and sufficiency only 18.4% were in this group.</p> <p><strong>Conclusions:</strong> This study shows vitamin D deficiency was higher in females than males. If the deficiency can be deducted early, prompt management can be carried out and thus complications can be prevented. &nbsp;</p> 2022-06-17T00:00:00+00:00 Copyright (c) 2022 B & C Medical College and Teaching Hospital and Research Centre https://nepjol.info/index.php/mjen/article/view/45855 Histopathologic Analysis of CT-Guided Core Needle Biopsy in Radiologically Detected Suspicious Mediastinal and Lung Mass: Two Years’ Study in Tertiary Hospital 2022-06-16T14:06:53+00:00 Ujwal Rai ujwal1235@gmail.com Umesh Kumar Sharma ujwal1235@gmail.com Birendra Kumar Yadav ujwal1235@gmail.com <p><strong>Background:</strong> Pulmonary nodule ranges from infective to neoplastic lesion and thus at times remain diagnostic challenge for the management of patient. Therefore, proper diagnosis is very essential for appropriate treatment. Biopsy and FNAC plays important role in diagnosing these cases. After 2004 with establishment of therapeutic implication of distinguishing histologic subtypes of lung carcinoma with immunohistochemistry, lung biopsy has become inevitable even for molecular analysis as well. We studied our institution’s experience with percutaneous CT guided biopsy of lung nodules to determine the impact of this procedure in diagnosis of disease.</p> <p><strong>Methods:</strong> This is hospital based descriptive study, of two years’ duration (March 2019 to April 2021), carried out at Department of Pathology, B&amp;C Medical College Teaching Hospital and Research Centre Pvt. Ltd., Birtamode, Jhapa. Total 97 cases of CT guided biopsy were performed. Histopathologic analysis was performed and data were analyzed.</p> <p><strong>Results:</strong> The most common malignancy diagnosed was Non-small cell carcinoma (NSCC), lung comprising 43.7% which required further immunohistochemistry testing for subcategorization. All infective cases were of Tuberculosis constituting 9.37% of all the cases. Benign cases were of mature cystic teratoma, thymoma and fibroma.</p> <p><strong>Conclusions:</strong> Nowadays biopsy of lung in suspicious lesion is mandatory to establish diagnosis for appropriate management, moreover in malignancy cases for which most of the cases require immunohistochemistry and molecular analysis.</p> 2022-06-17T00:00:00+00:00 Copyright (c) 2022 B & C Medical College and Teaching Hospital and Research Centre https://nepjol.info/index.php/mjen/article/view/45856 Spectrum of Chest Computed Tomography (CT) Findings of COVID-19 Pneumonia Patients in B & C Hospital, Birtamode, Jhapa, Nepal 2022-06-16T14:15:32+00:00 Manmohan Bir Shrestha macbirshrestha@gmail.com Umesh Kumar Sharma macbirshrestha@gmail.com Suraj Thapaliya macbirshrestha@gmail.com Abishek Pokhrel macbirshrestha@gmail.com Shreya Shrestha macbirshrestha@gmail.com Prajwal Nepal macbirshrestha@gmail.com Ujwal Rai macbirshrestha@gmail.com <p><strong>Background:</strong> Coronavirus disease outbreak, first reported in Wuhan, China in December, 2019 is a WHO declared pandemic. Chest tomography (CT) findings can supplement in the diagnosis of COVID-19 pneumonia.</p> <p><strong>Methods:</strong> This was a retrospective descriptive study in 40 patients with reverse transcriptase polymerase chain reaction (RT-PCR) positive patients with respiratory symptoms who underwent Computed tomography (CT) chest. This retrospective study was conducted at B &amp; C Medical College Teaching Hospital, Birtamode, Jhapa, Nepal.</p> <p><strong>Results</strong><strong>:</strong> Total 40 patients, more than 3 lobes of lung involved in all 40 patients (100 %). Only ground-glass opacities seen in 11 patients, only consolidative opacities seen in 5 patients, both ground-glass and consolidation seen in 23 patients, and 1 patient had neither of them. Subpleural linear density was present in 16 patients (40%). Pleural effusion was present in 8 patients and crazy paving pattern in 9 patients. Total lung severity score range from 3 to 19 with a mean score of 9.8.</p> <p><strong>Conclusions:</strong> Characteristic chest Computed tomography (CT) findings were observed in Corona virus disease 2019 infection, which are helpful to the radiologists, clinical physicians and other public health officials in the early detection and diagnosis of this global health emergency. &nbsp;</p> 2022-06-17T00:00:00+00:00 Copyright (c) 2022 B & C Medical College and Teaching Hospital and Research Centre https://nepjol.info/index.php/mjen/article/view/45859 Assessing the Level of Knowledge and Practice regarding Blood transfusion and Its Complications among Staff Nurses working at B & C Teaching Hospital and Purbanchal Cancer Hospital, Birtamode, Jhapa, Nepal 2022-06-16T14:29:06+00:00 Sushmita Dahal dahalsushmita2045@gmail.com Smita Khanal dahalsushmita2045@gmail.com <p><strong>Background</strong><strong>:</strong> Blood transfusion is a liquid transplant. Nurses are having more responsibility in many aspects of the transfusion process such as taking and labeling blood samples, collection of blood from the blood bank, short term storage in ward areas, checking, administering, documenting transfusion process and monitoring of the patient, it is vital that they are through and methodical in all task related to transfusion to ensure patients safety and must be aware of the steps necessary at each stage to safe guard the patient. Nurses are responsible not only for the actual administration of the blood product and monitoring of the patient during its administration but they also need to efficiently identify and manage any potential transfusion reactions. It is important to remember that transfusion reactions can occur during the actual blood transfusion as well as for days and weeks following the administration of the blood product. Although blood transfusion reactions are rare, it is important that any nurse who administers a blood product be aware of potential reactions and knows how to manage these reactions safely and effectively.</p> <p><strong>Methods:</strong> This is a descriptive study to assess the knowledge and practice regarding blood transfusion and its complications.</p> <p><strong>Results:</strong> Forty-four percent (44%) of the nurses had obtained Proficiency Certificate Level (PCL) Nursing and Health Assistant (HA) degree qualification. Forty percent (40%) of the nurses had one year of experience. Forty percent of the nurses worked in general ward at the hospital. Almost 80% of the nurses (79%) of the nurses stated that they attended Continuing Nursing Education regarding blood transfusion. 59% of total respondents have adequate knowledge.</p> <p><strong>Conclusions:</strong> Continuous Nursing Education for the improvement of nurses’ knowledge and skills as well as routine monitoring should be carried out to ensure safe practice in blood transfusion.</p> 2022-06-17T00:00:00+00:00 Copyright (c) 2022 B & C Medical College and Teaching Hospital and Research Centre https://nepjol.info/index.php/mjen/article/view/45860 Discover the association between music and pain 2022-06-16T14:36:02+00:00 Pratiksha Khadka onlinenanu@gmail.com Anshu Bhattarai onlinenanu@gmail.com Ojashwi Nepal onlinenanu@gmail.com <p><strong>Background</strong><strong>:</strong> Blood transfusion is a liquid transplant. Nurses are having more responsibility in many aspects of the transfusion process such as taking and labeling blood samples, collection of blood from the blood bank, short term storage in ward areas, checking, administering, documenting transfusion process and monitoring of the patient, it is vital that they are through and methodical in all task related to transfusion to ensure patients safety and must be aware of the steps necessary at each stage to safe guard the patient. Nurses are responsible not only for the actual administration of the blood product and monitoring of the patient during its administration but they also need to efficiently identify and manage any potential transfusion reactions. It is important to remember that transfusion reactions can occur during the actual blood transfusion as well as for days and weeks following the administration of the blood product. Although blood transfusion reactions are rare, it is important that any nurse who administers a blood product be aware of potential reactions and knows how to manage these reactions safely and effectively.</p> <p><strong>Methods:</strong> This is a descriptive study to assess the knowledge and practice regarding blood transfusion and its complications.</p> <p><strong>Results:</strong> Forty-four percent (44%) of the nurses had obtained Proficiency Certificate Level (PCL) Nursing and Health Assistant (HA) degree qualification. Forty percent (40%) of the nurses had one year of experience. Forty percent of the nurses worked in general ward at the hospital. Almost 80% of the nurses (79%) of the nurses stated that they attended Continuing Nursing Education regarding blood transfusion. 59% of total respondents have adequate knowledge.</p> <p><strong>Conclusions:</strong> Continuous Nursing Education for the improvement of nurses’ knowledge and skills as well as routine monitoring should be carried out to ensure safe practice in blood transfusion. &nbsp;</p> 2022-06-17T00:00:00+00:00 Copyright (c) 2022 B & C Medical College and Teaching Hospital and Research Centre https://nepjol.info/index.php/mjen/article/view/45851 Message from Editor-in-Chief, Vol.1(1) 2022-06-16T12:58:55+00:00 Umesh Kumar Sharma druksharma@hotmail.com <p>No abstract available.</p> 2022-06-17T00:00:00+00:00 Copyright (c) 2022 B & C Medical College and Teaching Hospital and Research Centre https://nepjol.info/index.php/mjen/article/view/45852 Executive Editor: Inaugural Message 2022-06-16T13:27:06+00:00 A.K. Sinha sinhaamar96@gmail.com <p>No abstract available.</p> 2022-06-17T00:00:00+00:00 Copyright (c) 2022 B & C Medical College and Teaching Hospital and Research Centre https://nepjol.info/index.php/mjen/article/view/45861 Standardized acute care doctors training on the emerging pandemic of coronavirus pneumonia 2022-06-16T14:46:40+00:00 Umesh Yadav umy492006@gmail.com Awan Kumar umy492006@gmail.com Amrita Kumari Yadav umy492006@gmail.com Ujwal Deo umy492006@gmail.com Bimal Yadav umy492006@gmail.com Sanjay Roy umy492006@gmail.com Jyoti Das umy492006@gmail.com Harishankar Yadav umy492006@gmail.com <p>The novel corona virus pneumonia epidemic poses a serious challenge to the medical and health systems of all nations in the world, especially discovering the severe shortage of intensive care medical professionals. Although our country’s intensive care medicine physicians have played a primary part in the combat against the epidemic, some problems have been debunked in the training of intensive care medicine personnel; equally there is inadequacy of standardized intensive care medicine training platform, and the lack of integrated training content and training format.</p> <p>Relatively single, insufficient preparations for responding to public health emergencies etc, Based on the actual experience of epidemic prevention and control and the treatment of critically ill patients, this article recommend that standardized training of resident physicians for critical care medicine should be carried out, the training content should be standardized, the combination of theory and clinical practice should be enhanced, the comprehensive quality of resident physicians should be improved, and the training methods should be expanded and strengthened. "Construction of a demand and capacity model for intensive care and hospital". These measures can make the critical care team become a professional team with a feel of social importance, which is of great acceptation for the long-term progress of critical care medicine, for the Nepalese medical system to easily respond to public health emergencies, and improve the comprehensive diagnosis and treatment capabilities of emergency and critical diseases. Excess deaths associated with COVID-19 are a direct result of the inadequate capacity of intensive care units and hospital beds.</p> 2022-06-17T00:00:00+00:00 Copyright (c) 2022 B & C Medical College and Teaching Hospital and Research Centre https://nepjol.info/index.php/mjen/article/view/45862 A rare case report of Urinary Bladder Paraganglioma 2022-06-16T14:57:40+00:00 Ujwal Rai ujwal1235@gmail.com Amit Kumar Shah ujwal1235@gmail.com Umesh Kumar Sharma ujwal1235@gmail.com <p>Paragangliomas are extra-adrenal tumors of the autonomic nervous system which is termed pheochromoctyoma in adrenal gland. These tumors are found within the skull base, neck, mediastinum and periaortic region. Paragangliomas of the urinary bladder are rare, and non-functioning bladder paraganglioma is even rarer and not easily recognized. Histopathological examination of the tumor is essential to establish the diagnosis of paraganglioma. This is a case report of 67year male patient presenting with hematuria and passage of blood clots per urethra in emergency department. Cystoscopic examination revealed an exophytic growth in upper posterior wall of his bladder with areas of hemorrhagic blood clots within the vicinity of growth. His blood pressure was found 120/75 mm of Hg with normal serum sodium and potassium levels. Bipolar transurethral resection of the bladder mass was performed. Intraoperative procedure was uneventful and no rise in blood pressure during resection was found. Histopathological examination with immunohistochemistry confirmed diagnosis paraganglioma, urinary bladder. Patient is doing well and is kept on follow up. &nbsp;&nbsp;</p> 2022-06-17T00:00:00+00:00 Copyright (c) 2022 B & C Medical College and Teaching Hospital and Research Centre https://nepjol.info/index.php/mjen/article/view/45864 The mechanical heart valve TTK Chitra is inexpensive and of proven effectiveness (widely used in India and then in Nepal) 2022-06-16T15:04:24+00:00 Vasanth Kumar umy492006@gmail.com Umesh Yadav umy492006@gmail.com Awan Kumar umy492006@gmail.com - Vijaylakhsmi umy492006@gmail.com <p>TTK Chitra heart valve prosthesis (chvp), a tilting disc mechanical heart valve of low cost and proven efficacy, has been in use for the last 15 years in India. Although various studies substantiating its long-term safety and efficacy are available but is less commonly used in Nepal. The TTK Chitra heart valve has been developed and widely used in India.</p> 2022-06-17T00:00:00+00:00 Copyright (c) 2022 B & C Medical College and Teaching Hospital and Research Centre