Tag: pubmed

J Nepal Health Res Counc. 2022 Mar 13;19(4):824-829. doi: 10.33314/jnhrc.v19i04.3963.

ABSTRACT

BACKGROUND: Elevated intraocular pressure in thyroid associated orbitopathy may lead to development of secondary glaucoma in them. This study evaluated IOP in primary gaze correlation with clinical activity score in them.

METHODS: A cross-sectional study was conducted from November 2020 to October 2021.Information on age, gender, thyroid function test, intraocular pressure, cup-disc ratio and clinical activity score were recorded. Purposive sampling was done. Statistical analysis was done using Statistical Package for Social Sciences version 21.

RESULTS: Total of 74 thyroid dysfunction patients was included in the study. There were14.86% patients with raised intraocular pressure. The mean intraocular pressure in hyperthyroidism was 15.4 ± 1.92 mm Hg and 15.48 ± 2.11mm Hg on right and left eyes respectively and in hypothyroidism, it was 15.08 ± 2.7mmHg and 15.12 ± 3.02 mmHg on right and left eyes respectively. The mean clinical activity score was 1.06 ± 1.23 mmHg. The mean intraocular pressure in eyes in active stage (n=9) was 16.3 ± 3.4 mm Hg, which was not significantly different from the mean intraocular pressure of 15 ± 2.4 mm Hg in inactive eyes (64), p= 0.1. Clinical activity score showed a significant correlation (p=0.03) with intraocular pressure in right eyes whereas it showed no significant correlation with intraocular pressure in left eyes (p=0.37).

CONCLUSIONS: In this study elevated intraocular pressure occurred in about 1 in 7 thyroid associated orbitopathy. It also had positive correlation with clinically activity score in right eyes. Regular intraocular pressure measurement should be done in thyroid associated orbitopathy to prevent intraocular morbidity.

PMID:35615845 | DOI:10.33314/jnhrc.v19i04.3963

J Nepal Health Res Counc. 2022 Mar 13;19(4):830-837. doi: 10.33314/jnhrc.v19i04.3990.

ABSTRACT

INTRODUCTION: Executing their daily duties, police officers are expected to perform complex, physically demanding activities, often at maximal levels of exertion. Given these criteria, training must be rigorous enough to ensure that when trainees graduate, they are competent in their response to crisis and flexible enough to sustain this for the span of their career. The present study aimed to determine the impact of scale diet and physical training (SDPT) on body composition and aerobic performance among Nepal police officer trainees.

METHOD: We conducted a cross-sectional analytic study among 570 Nepal Police recruits from Nepal Police Academy of Butwal and Kathmandu. Null hypothesis was created followed by an alternative hypothesis. Alpha (1 – ?) for the above-mentioned study design were set. Parametric statistical analysis was done with criteria set for acceptance or rejection of the null hypothesis. We collected the data from the field as per Nepal police basic exercise and diet protocol to determine the effect of physical training and scale diet on body composition and aerobic performance. We enrolled all the recruits from March to May, 2019 who met the eligibility criteria in the study. We used Microsoft Excel 2013 for data entry and R program (version: 4.0.3) for statistical analysis. Results:There was a significant rise in aerobic performance (4.51 ± 3.39 ml/kg/min) and remarkable reduction in body fat (-4.49 ± 2.33 %) and Body Mass Index (-0.433 ± 1.00 kg/m2) after SDPT among participants with normal BMI at the time of recruitment. Body fat was significantly reduced (-4.36 ± 2.3%) and aerobic performance was significantly increased (6.93±4.70 ml/kg/min) among overweight participants at the time of recruitment.

CONCLUSIONS: The methodology adopted in the physical training of Nepal Police was effective in reducing body mass index and fat, improving the physical capacity. . Key words: Scale Diet; Physical Training, Body Fat; Aerobic Performance; VO2max, Body Mass Index.

PMID:35615846 | DOI:10.33314/jnhrc.v19i04.3990

J Nepal Health Res Counc. 2022 Mar 13;19(4):820-823. doi: 10.33314/jnhrc.v19i04.3961.

ABSTRACT

BACKGROUND: To ameliorate the intra and post-op morbidities associated with newer techniques for tonsillectomy like coblation has been introduced in the recent past. This study was aimed to compare the cold steel dissection with the coblation technique with regards to its effectiveness and safety.

METHODS: An observational comparative study was carried out in 90 patients undergoing tonsillectomy between July 2018 to December 2019. Forty-five patients in each group of cold steel dissection and coblation were compared between the operative time, intraoperative blood loss, post-operative pain, post-operative bleeding and return to work. Intraoperative blood loss was measured using a standard sized gauge piece whereas post-operative pain was measured using a visual analogue scale (0-10) at first and third day of surgery.

RESULTS: The age and sex were comparable between the groups. The mean operation time (31.40±4.52 min versus 17.02±3.11 min), intraoperative blood loss (27.20±7.16 ml vs 9.73±5.52 ml), post-operative pain in day 1 (8.02±1.27 vs 4.98±1.03), post-operative pain in day 3 (4.80±0.89 vs 2.76±0.74) and time needed to return to work in days (10. 31±1.29 vs 6.76±1.20) were statistically significant in coblation group (p<0.000). Primary and secondary post-operative haemorrhage rates were similar in both the groups. There was no return to theatre for hemostasis.

CONCLUSIONS: Coblation tonsillectomy significantly reduces operation time, intraoperative blood loss, post-operative pain (day1 and 3) and time required to return to work . This technique doesn’t differ from cold steel dissection tonsillectomy in terms of primary and secondary post-operative hemorrhage.

PMID:35615844 | DOI:10.33314/jnhrc.v19i04.3961

J Nepal Health Res Counc. 2022 Mar 13;19(4):772-777. doi: 10.33314/jnhrc.v19i04.3776.

ABSTRACT

BACKGROUND: The various pedagogical methods applied for teaching dental anatomy to dental students includes lectures, analysis of extracted natural teeth and carving of wax blocks to accurately replicate the morphology of teeth. The thorough knowledge of dental morphology is indispensable for a successful dental practice. This study was thus aimed to assess the perceived relevance of tooth carving using wax block among the dental practitioners.

METHODS: A cross-sectional study was designed with the objective of involving dental practitioners working in Kathmandu. Self-administered questionnaires were used for the data collection. The results were later analyzed for descriptive statistics using the Statistical Package for the Social Sciences (SPSS) 16 software.

RESULTS: About 232 (98.3%) participants practiced tooth carving using wax block to study dental anatomy. More than 96% of the participants agreed that tooth carving exercises have helped them better understand tooth morphology and more than 85% feel that their manual dexterity was developed by these exercises. A total of 223 (94.5%) were of the opinion that tooth carving should be continued in the BDS preclinical curriculum.

CONCLUSIONS: The dental wax carving is an effective pedagogical strategy to develop manual dexterity of dental students by recreating tooth morphological features using a wax block, thereby achieving the mandatory psychomotor skills.

PMID:35615836 | DOI:10.33314/jnhrc.v19i04.3776

J Nepal Health Res Counc. 2022 Mar 13;19(4):740-747. doi: 10.33314/jnhrc.v19i04.4017.

ABSTRACT

BACKGROUND: Mental disorders account for a large portion of burden of disease. In Nepal, the prevalence of mental disorders has been rising steadily, but national and province level prevalence is not available. This study aims to assess the prevalence of common mental disorders and suicidality in Nepal.

METHODS: We conducted nationwide descriptive cross-sectional community-based prevalence study of mental disorders and suicidality among adults (aged 18 years and above) and adolescents (aged 13 to 17 years) in Nepal. We included a total of 9200 adults and 5888 adolescents from seven provinces of Nepal by using a multistage Probability Proportionate to Size sampling technique. Mental disorders and suicidality were assessed using translated and adapted Nepalese version of Mini International Neuropsychiatric Interview (MINI) for disorders, English version 7.0.2 for Diagnostic and Statistical Manual of Mental disorders,5th Edition (DSM-5). Data were entered in CSPro v7.2. Weighted estimates for different mental disorders were calculated.

RESULTS: The overall weighted lifetime prevalence of any mental disorder among adults and adolescents was estimated at 10% and 5.2%, respectively. Suicidality was present among 7.2% of the adult and 4.1% of the adolescent participants. Among adult participants, the current prevalence of suicidal thoughts and lifetime suicidal attempts were found to be 6.5% and 1.1%, respectively.

CONCLUSIONS: This survey indicated that mental health problems are major public health concerns in Nepal that should not be overlooked. Hence, a multisectoral approach is needed to address the burden of mental health problems among adults and adolescents in Nepal.

PMID:35615831 | DOI:10.33314/jnhrc.v19i04.4017

J Nepal Health Res Counc. 2022 Mar 13;19(4):730-739. doi: 10.33314/jnhrc.v19i04.3900.

ABSTRACT

BACKGROUND: The AO Spine Patient Reported Outcome Spine Trauma has been validated in English and Dutch language, however, there is an absence of a translated and validated version in Nepali language. The purpose of this study was to translate the AO Spine Patient Reported Outcome Spine Trauma into Nepali and adapt cross-culturally as outlined by established guidelines, as well as test its psychometric properties among Nepali speaking spine trauma patients.

METHODS: Patients were recruited from two Nepali centers as a cross-sectional multicenter validation study. The English version of AO Spine Patient Reported Outcome Spine Trauma was translated and cross-culturally adapted into Nepali language following international guidelines. Next to AO Spine Patient Reported Outcome Spine Trauma also the EQ-5D-3L was filled out by the patients for concurrent validity. Descriptive statistics were used to analyze the patient characteristics. Assessment of measurement properties included content validity (floor and ceiling effects), internal consistency (Cronbach’s ? and item total-correlation coefficients) and test-retest reliability by the Bland-Altman plot and Intraclass Correlation Coefficients. Spearman correlation tests were performed within the items and in correlation to EQ-5D-3L.

RESULTS: Sixty two spine trauma patients completed the instrument with a mean time of 6.8 minutes. The translated version showed good content validity with no floor and ceiling effects. The internal consistency was excellent with a Cronbach’s ? of 0.95. The Spearman correlations within the AO Spine Patient Reported Outcome Spine Trauma items were 0.07 – 0.65 and the test-retest analysis showed excellent results with an Intraclass Correlation Coefficients value of 0.95 (CI 0.93 – 0.97). Inverse correlation was observed between Nepali AO Spine PROST with EQ-5D-3L components.

CONCLUSIONS: The Nepali version of AO Spine Patient Reported Outcome Spine Trauma demonstrated excellent validity and reliability results for measuring patient-reported outcomes of spine trauma patients.

PMID:35615830 | DOI:10.33314/jnhrc.v19i04.3900

J Nepal Health Res Counc. 2022 Mar 13;19(4):700-704. doi: 10.33314/jnhrc.v19i04.3665.

ABSTRACT

BACKGROUND: Many previous studies have shown that patients admitted to the hospital at weekends have a longer delay than those on weekdays. It has been proposed that the equality of specialist services throughout the week could mitigate the ‘weekend effect.’ This study aimed to determine whether or not a weekend effect is observed in Oral and Maxillofacial surgery patients at a medical college and teaching hospital.

METHODS: Our primary predictor variable was the day of admission. Our primary outcome of interest was the length of hospital stay from admission to operation. Descriptive analysis, correlation analysis, One way ANOVA, and post hoc comparison were performed for statistical analysis.

RESULTS: Out of 1185, 1005 (84.8%) were male and 180 (15.2%) female, with a mean age of 30.3 (SD=14.1) years. There was a significantly higher admission on weekends, Friday, and Saturday, and the weekend admissions were associated with a longer delay from admission to operation. The night shift was also associated with a longer delay from admission to operation. The diagnosis based procedure had the most significant effect on delay from admission to operation. The patient’s age and gender had no association with the primary outcome.

CONCLUSIONS: There is a delay in the definitive treatment of maxillofacial surgery patients admitted on weekends. These findings have implications for adequate staffing and resource allocation on the weekends based on admission volume.

PMID:35615825 | DOI:10.33314/jnhrc.v19i04.3665

J Nepal Health Res Counc. 2022 Mar 13;19(4):712-716. doi: 10.33314/jnhrc.v19i04.3797.

ABSTRACT

BACKGROUND: This study aimed to assess the distribution of fine-needle-aspiration-cytology or biopsy findings through cytopathological patterns of lymph nodes aspirations in different age groups of the population visiting a tertiary level hospital in Kathmandu.

METHODS: The retrospective study was conducted on the database of the 226 lymphadenopathy cases that underwent biopsy fine needle aspiration cytology from 1 January 2016 to 31 December 2019 at the Department of pathology of Helping Hand’s Community Hospital, Kathmandu. A descriptive analysis was performed yielding proportions and counts for the quantitative variables. Chi-squared test was used to compare the proportions. Point estimates and confidence intervals for measures of association were assessed with 95% confidence interval and p-value ?0.05 was considered statistically significant.

RESULTS: The 20-40 years were the most common age group undergoing biopsy fone needle aspiration cytology procedures. Males recorded majority of cases (68%, 153 of 226). The highest incidence of Reactive lymphadenitis was obtained (50%, 113 of 226) and it was the most common findings in the age group of <20 and 40-60 years. The Cervical lymph node (86%) was the most common anatomical location followed by axillary lymph nodes (8%). Squamous cell carcinoma and Adenocarcinoma accounted for more than half (53%, 20 of 38) of all the diagnosed malignancy. The incidence of Non-Hodgkin lymphoma and Hodgkin lymphoma were 8% (n = 3 of 38) and 5% (n = 2 of 38) respectively.

CONCLUSIONS: Lymph node enlargement is associated with a wide range of etiologies with Reactive lymphadenitis as the most common cause and cervical lymph node as the common site.

PMID:35615827 | DOI:10.33314/jnhrc.v19i04.3797

J Nepal Health Res Counc. 2022 Mar 13;19(4):688-692. doi: 10.33314/jnhrc.v19i04.3879.

ABSTRACT

BACKGROUND: Severe Acute Respiratory Syndrome Corona Virus 2019, a novel coronavirus first reported from China in 2019, is the causative agent of pandemic corona virus disease 2019. Antibody response and its dynamics may provide information about natural immunity conferred upon by corona virus disease 2019.

METHODS: A health-center-based follow up study of confirmed Severe Acute Respiratory Syndrome Corona Virus-2 infected patients was conducted from December 2020 to June 2021. Patients were followed up to period of 28 weeks during the study. An electrochemiluminescence immunoassay was used to test antibodies elicited by Severe Acute Respiratory Syndrome Corona Virus-2. Socio-demographic and clinical information was collected from each patient.

RESULTS: A total of 40 patients (18 males and 22 females) were enrolled in the study, with 90 % seropositivity of SARS-CoV-2 antibody. Antibody level was tracked up to 28 weeks following the infection, and persistence was observed till the end. Antibody level peaked on the 3rd to 4th month, after symptom onset. The male population was found to have higher antibody levels compared to females. Age-wise trend analysis showed lower antibody levels in the younger people (15-30 years) than those older (31-60 years).

CONCLUSIONS: We demonstrated that Severe Acute Respiratory Syndrome Corona Virus-2 specific antibodies in corona virus disease 2019 patients persist for at least 28 weeks, peaking at 13 to 20 weeks. Statistically, there was no correlation of antibody levels with the age and sex of individuals. Further study on a larger population is needed for determining long-term immunity.

PMID:35615823 | DOI:10.33314/jnhrc.v19i04.3879

J Nepal Health Res Counc. 2022 Mar 13;19(4):661-668. doi: 10.33314/jnhrc.v19i04.3524.

ABSTRACT

BACKGROUND: The accelerating rate of carbapenems resistance in Klebseilla pneumoniae isolates has put the treatment option worrisome. The effective strategy to ameliorate this alarming situation is possible through enhancing the combination therapy and appropriate laboratory diagnosis. Hence, the study was focused on identifying carbapenemase-producing K. pneumoniae and their antibiogram pattern.

METHODS: A total of 944 clinical samples from patients attending Sahid Gangalal National Heart Center were processed from September 2019 to March 2020 to identify the possible bacterial pathogens following the standard microbiological procedures. K. pneumonaie isolates were further subjected to antibiotic susceptibility testing by the modified Kirby Bauer disc diffusion technique. Phenotypic confirmation of carbapenemase production was done by the modified carbapenemase inactivation method. The minimum inhibitory concentration of colistin was determined by the broth microdilution method.

RESULTS: Of the total 944 samples, 15.47% (146) samples showed bacterial growth, among which 23.97% (35) were K. pneumoniae. Out of 35 K. pneumoniae isolates, 45.71% (16) were multidrug-resistant followed by 42.86% (15) extensively drug-resistant. Fourteen isolates of K. pneumoniae were carbapenemase producers among which 20% (7) were serine carbapenemase while 20% (7) showed metallo-?-lactamase production. All the carbapenemase-producing K. pneumoniae were susceptible to colistin with <0.125µg/ml. Carbapenemase activity showed statistically significant with multidrug resistance (p=<0.05).

CONCLUSIONS: An increasing resistance to the carbapenem drugs showed a great problem in the management of K. pneumoniae infections among immunocompromised patients especially cardiac patients however, colistin can be still an ultimate choice of drug for disease management.

PMID:35615819 | DOI:10.33314/jnhrc.v19i04.3524