Showing papers in "Journal of Lumbini Medical College in 2015"
TL;DR: Ezema and dermatophytes are the most common dermatological diseases in patients visiting Dermatology OPD, significantly more common in male whereas acne was significantly common in female.
Abstract: Introduction : The pattern of skin disease differs in different countries, and within various region of a country depending on socio-economic, racial and environmental factors. Many researchers have reported various patterns of skin disease in different countries. This type of study has not been done in this part of country. So, we decided to study, assess and compare the different pattern of dermatological disease in patients visiting our centre. Methods : This was retrospective study done from the hospital record of Lumbini Medical College Teaching Hospital (LMCTH). The study was carried out from September 2014 to December 2014 while the data were accessed from the records of respondents from September 2013 to August 2014. The diagnosis was categorized into 10 groups. The diagnosis which did not fit any category was kept in “Others”. The 10 categories include acne, bacterial infection, dermatophytes, eczema, leprosy, pigmentory diseases, psoriasis, scabies, urticaria and viral infection. Data was collected based on gender and categorized according to the diagnosis. Microsoft Excel was used for data entry while all the analysis both descriptive and inferential statistics was done using SPSS version 21. Results : There were a total of 7967 patients visiting Dermatology OPD. Out of the total patient, there were 52.10% female and 47.89% male and this difference was statistically significant. In both gender eczema was the most common skin disease. Eczema was significantly more common in male whereas acne was significantly common in female. Most of the patients were from age group of 15-30 yrs with eczema being commonest in this age group. Conclusion : Eczema and dermatophytes are the most common dermatological diseases. Eczema is significantly more common in male. Acne is significantly more common in female. DOI: https://doi.org/10.22502/jlmc.v3i1.63
5 citations
TL;DR: Ketamine gargle significantly reduced the occurrence and severity of postoperative sore throat after endotracheal intubation.
Abstract: Introduction : Postoperative sore throat (POST) is a common complication of general anesthesia with endotracheal intubation that affects the patient satisfaction after surgery. The aim of the study was to compare the effectiveness of ketamine gargle with placebo in preventing POST after endotracheal intubation. Methods : Sixty eight patients scheduled for elective surgery under general anesthesia were enrolled in this study. Patients were randomly allocated into two groups, 33 in study group and 35 in control group. Study group patients were asked to gargle with ketamine (50 mg in 1 ml mixed with 29 ml of drinking water) 10 minutes before induction for 30 seconds. Controls were made to do so with 30 ml of drinking water. POST was graded at one, two, four, and 24 hrs after operation on a four-point scale (0-3). The outcome measures were compared between two groups in terms of occurrence of POST and severity of POST at one, two, four, and 24 hr to determine the efficacy of ketamine. Results : Occurrence of POST was significantly less in study group at four hours. Severity of POST was significantly low in study group at one, two and four hours as compared to that in controls. It was comparable at 24 hours. Conclusion : Ketamine gargle significantly reduced the occurrence and severity of POST. DOI: https://doi.org/10.22502/jlmc.v3i1.61
3 citations
TL;DR: Being asymptomatic, diabetics fail to recognize ABU, however, ABU is preponderant in DM and is linked mainly with duration of DM and poor glycogenic control, Hence screening for ABU is imperative in diabetic adults if above mentioned risk factors are present.
Abstract: Introduction: Urinary Tract Infection (UTI) is a well- known complication of Diabetes Mellitus (DM). Its spectrum ranges from Asymptomatic Bacteriuria (ABU) to acute pyelonephritis. Many studies have delineated an increased prevalence of ABU in DM whereas to the same degree other studies have come to naught showing insignificant association. Hence, this study was drafted to evaluate the presence of ABU among diabetics and assess various risk factors. Methods: Total of 116 diabetic adults without symptoms of UTI attending medical out-patient department, Manipal Teaching Hospital were enrolled by detailed clinical history, examination and laboratorial examination as per standard set of questionnaire from February 2013 to May 2014. Data were analyzed by SPSS (17.0). Results: The rate of ABU in diabetic adults was 10.3% and was significantly associated with duration of DM, fasting blood glucose level and poor glycogenic control. Escherichia coli were the most frequently isolated pathogen which was sensitive to Nitrofurantoin and Impanel. Conclusion: Being asymptomatic, diabetics fail to recognize ABU, however, ABU is preponderant in DM and is linked mainly with duration of DM and poor glycogenic control. Hence screening for ABU is imperative in diabetic adults if above mentioned risk factors are present. DOI: https://doi.org/10.22502/jlmc.v3i2.66 J. Lumbini. Med. Coll. Vol 3, No 2, July-Dec 2015
3 citations
TL;DR: This study revealed that non-vegetarian decreased from 95.2% to 74.6% after diagnosis of hypertension and lifestyle modification criteria like amount of salt intake, smoking, and alcohol consumption were significantly reduced whereas physical exercise and stress reduction activity were significant increased.
Abstract: Introduction : Lifestyle modifications is an important aspect of hypertension therapy. However, studies on this non-pharmacological approach of hypertension management and its impact is very limited in a developing country like Nepal. The objective of the present study was to determine the life style of patients after diagnosis of hypertension. Methods : A descriptive cross sectional study design was conducted in Lumbini Medical College Teaching Hospital (LMCTH). A total of 63 patients attending Medical outpatient clinic of Lumbini Medical College who were diagnosed as hypertensive at least two months before the interview were included. Data were collected from 22nd February 2015 to 21st March 2015 by interview method using a questionnaire consisting of a combination of structured and semi-structured questions. Results : This study revealed that non-vegetarian decreased from 95.2% to 74.6% after diagnosis. Lifestyle modification criteria like amount of salt intake, smoking, and alcohol consumption were significantly reduced whereas physical exercise and stress reduction activity were significant increased. Conclusion : Majority of respondents has changed their lifestyle after diagnosis of hypertension. DOI: https://doi.org/10.22502/jlmc.v3i1.62
2 citations
TL;DR: The need of more education programs and education friendly socio-economic conditions which increases the acceptance of contraception thereby assisting family planning and population control is felt.
Abstract: Introduction : Acceptance of family planning is influenced by a variety of interrelated factors such as age at marriage, education, economic status, religion, number of living children etc. This study is an endeavor to assess the relation between education status of husband and wife and acceptance of contraception among postpartum women at Lumbini Medical College Teaching Hospital. Methods : A prospective, observational analytical study was conducted in Obstetrics and Gynecology department of Lumbini Medical College. The information on socio-demographic data, educational status of husband and wife and willingness to accept any form of contraception within the next three months was obtained by an interview, utilizing a questionnaire. Results : There were 615 postpartum ladies accompanied by their husbands who were included in the study. Mean age of wives was 25.11 years ( SD =5.36, range 17-45) and husbands was 27.89 years ( SD =5.55, range 20-47). Contraceptive acceptance was shown to increase significantly with literacy status. Illiterate husbands and wives refused to accept the contraception which was statistically significant. ( p <0.001) Conclusion : Contraceptive acceptance was significantly poor in illiterate wives and husbands whereas it was significantly higher in educated wives and husbands of all education levels. We feel the need of more education programs and education friendly socio-economic conditions which increases the acceptance of contraception thereby assisting family planning and population control. DOI: https://doi.org/10.22502/jlmc.v3i1.60
1 citations
TL;DR: Adolescent pregnancy is higher common in Palpa district of Nepal and Janajati adolescent girls are becoming pregnant early after marriage, and on reaching the tertiary center, obstetrical outcome is better with less maternal morbidity and no mortality and better neonatal survival.
Abstract: Introduction : Adolescent pregnancy is a common social phenomenon that results to both maternal and fetal related health consequences globally. Important factors affecting this high risk group of pregnancies are social, cultural, ethnic and racial disparities which may limit the care during pregnancy thereby affecting the perinatal outcome. The main objective of this study was to estimate the maternal and fetal outcome of adolescent pregnancies visiting Lumbini Medical college among ethnic variants of mid-western region. Methods : A retrospective observational study was conducted in Lumbini Medical College and Teaching Hospital for one year duration. Data was retrieved from the medical records of the admitted adolescent pregnant mothers with hospital delivery after 20 weeks’ gestation. Variables of interest were the selective demographic characteristics like place of residence and ethnicity of women, parity, and obstetrical &fetal outcomes. Results : The total numbers of admission for deliveries during the study period were 1905, out of which 462 (24.3%) were adolescent pregnancy. A total of 184 (39%) adolescent mothers were at the age of 19 and 334 (72.2%) of them were from Palpa district. The highest number of teenagers were from Janajati group i.e. 240 (52%). Among all, 38 (10%) had preterm delivery and 7 (1.5%) had intrauterine fetal death. While 407 (88.3%) adolescent pregnancies had vaginal deliveries, 54 (11.7%)of them had lower segment cesarean section (LSCS). Fifty-one (11.4%) neonates had low birth weight (below 2500 gm)and 11 (2.4%) had stillbirths. Among the low birth weight, 32 (51%) newborns were admitted to neonatal intensive care unit (NICU). Conclusions : Adolescent pregnancy is higher common in Palpa district of Nepal. Janajati adolescent girls are becoming pregnant early after marriage. Higher numbers of teenagers are 19 years of age and are primigravida. On reaching the tertiary center, obstetrical outcome is better with less maternal morbidity and no mortality and better neonatal survival. DOI: https://doi.org/10.22502/jlmc.v3i1.59
TL;DR: If trial of labor is allowed under careful patient selection and supervision, the rate of vaginal delivery after caesarean section can be increased safely and patients with previous CS are at high risk of RCS.
Abstract: Introduction : Contrary to the WHO recommended caesarean section (CS) rate of 15%, there is an alarming trend of increasing caesarean section rates. An important reason for this is repeat caesarean section (RCS). Vaginal birth after caesarean (VBAC) is one of the methods of reducing CS rates in women with history of previous CS. This study was done with the aim to see the maternal and fetal outcome among parturient with history of single previous caesarean section and to determine the rate of VBAC at Lumbini Medical College, Nepal. Methods : This is a prospective study done for a period of ten months. Seventy parturient fulfilling inclusion criteria of term pregnancy with single live fetus and history of one Lower Segment Caesarean Section (LSCS) were enrolled in the study. Patients meeting the criteria for VBAC were given trial of labour and others were taken for elective repeat CS. This cohort was analyzed further, with respect to age, parity, period of gestation, mode of delivery, indication for CS, maternal and fetal complications and outcomes. Results : VBAC was successful in 27.14% of patients (n=19) while the rest 51 (72.85%) underwent RCS . Indications for RCS was mainly scar tenderness 7 (13.7%), fetal distress 6 (11.7%), non progress of labour 6 (11.7%), meconium stained liquor 6 (11.7%) and post-dated pregnancy 6 (11.7%). Maternal morbidity was comparable in women undergoing RCS or VBAC. There was one still birth and one early neonatal death in each group due to complications of meconium aspiration. Conclusion : Patients with previous CS are at high risk of RCS. If trial of labor is allowed under careful patient selection and supervision, the rate of vaginal delivery after caesarean section can be increased safely. As there is no added perinatal morbidity and mortality in cases of VBAC as compared to RCS, VBAC shows the right way forward to decrease the rate of caesarean section. DOI: https://doi.org/10.22502/jlmc.v3i1.64
TL;DR: This case presents a case of 86 yr old male who was operated for radius fracture after a fall injury under Bier’s Block or IVRA technique, and IVRA can be the choice of anesthesia for short procedures because of rapid onset of anesthesia, easy administration and cheaper cost.
Abstract: Introduction : Intravenous Regional Anesthesia (IVRA) has been first described in 1908 by the German surgeon August KG Bier. Although the technique was convenient to perform and effective in giving surgical anesthesia, the recent plexus block techniques have largely replaced the “Bier’s block” instantly because of time limitations and safety considerations of IVRA. Throughout the years, modifications in procedure and new pharmacologic adjuvants have shown to prevent toxic reactions to anesthetics and mitigate limitations of IVRA, still IVRA can be preferred as choice of anesthesia for short procedures. Case Report : We present a case of 86 yr old male who was operated for radius fracture after a fall injury under Bier’s Block or IVRA technique. Conclusion : IVRA can be the choice of anesthesia for short procedures because of rapid onset of anesthesia, easy administration and cheaper cost with special considerations on its side effects, complications which can be the outcome of technical errors. DOI: https://doi.org/10.22502/jlmc.v3i1.65
TL;DR: Endoscopic intervention of epistaxis seems to be safe, simple, fast, and effective for the management ofEpistaxis with low rates of morbidity and complications and can be preferred over the conservative nasal packing and considered as immediate second-line management.
Abstract: Introduction: Epistaxis is one of the commonest Ear Nose Throat (ENT) emergencies. Proper guidelines for its management are lacking; on the other hand, the management is mostly done by the junior health service providers which has invited non-standardized practice of epistaxis management. Thereby this study was much inclined towards assessment of the effectiveness of endoscopic management of epistaxis. Methods: This prospective study included patients above 16 years who were diagnosed with idiopathic epistaxis visiting Out Patient of ENT Department or in the Emergency Department of Lumbini Medical College from 1stof July 2014 to 30thof June 2015. ENT examination was done to find the cause and site of bleeding. Thereafter different epistaxis management interventions were done depending on the bleeding condition. The data were collected, entered and then analyzed using SPSS version 21. The descriptive statistics were applied. Results: Of the total 116 patients, 53 (45.69%) were male and 63 (54.31%) were female showing no gender preponderance with epistaxis in our study. Majority (49%) of the patients were managed with cauterization with silver nitrate or electrocautery in out-patient clinic. Second most common (18%) procedure was endoscopic sphenopalatine artery cauterization. Nasal packing was done only in three cases with zero posterior pack. Conclusion : Endoscopic intervention of epistaxis seems to be safe, simple, fast, and effective for the management of epistaxis with low rates of morbidity and complications. Thereby it can be preferred over the conservative nasal packing and considered as immediate second-line management. DOI: https://doi.org/10.22502/jlmc.v3i2.70 J. Lumbini. Med. Coll. Vol 3, No 2, July-Dec 2015