Journal of Lumbini Medical College <p>Journal of Lumbini Medical College (JLMC) is a biannually, peer reviewed, open access, Scientific Medical Journal published in English by Lumbini Medical College in Palpa, Nepal. The journal is also available on its own website at <a title="JLMC" href="" target="_blank" rel="noopener"></a></p> en-US The <strong>Journal of Lumbini Medical College</strong> (JLMC) publishes open access articles under the terms of the <a href="" target="_blank">Creative Commons Attribution</a>(CC BY) License which permits use, distribution and reproduction in any medium, provided the original work is properly cited.<p>JLMC requires an exclusive licence allowing to publish the article in print and online.</p><p>The corresponding author should read and agree to the following statement before submission of the manuscript for publication,</p><p><strong>License agreement</strong><br />In submitting an article to Journal of Lumbini Medical College (JLMC) I certify that:</p><ol start="1"><li>I am authorized by my co-authors to enter into these arrangements.</li><li>I warrant, on behalf of myself and my co-authors, that:</li><ul><li>the article is original, has not been formally published in any other peer-reviewed journal, is not under consideration by any other journal and does not infringe any existing copyright or any other third party rights;</li><li>I am/we are the sole author(s) of the article and have full authority to enter into this agreement and in granting rights to JLMC are not in breach of any other obligation;</li><li>the article contains nothing that is unlawful, libellous, or which would, if published, constitute a breach of contract or of confidence or of commitment given to secrecy;</li><li>I/we have taken due care to ensure the integrity of the article. To my/our - and currently accepted scientific - knowledge all statements contained in it purporting to be facts are true and any formula or instruction contained in the article will not, if followed accurately, cause any injury, illness or damage to the user.</li></ul><li>I, and all co-authors, agree that the article, if editorially accepted for publication, shall be licensed under the <a href="" target="_blank">Creative Commons Attribution License 4.0</a>. If the law requires that the article be published in the public domain, I/we will notify JLMC at the time of submission, and in such cases the article shall be released under the <a href="" target="_blank">Creative Commons 1.0 Public Domain Dedication waiver</a>. For the avoidance of doubt it is stated that sections 1 and 2 of this license agreement shall apply and prevail regardless of whether the article is published under <a href="" target="_blank">Creative Commons Attribution License 4.0</a> or the <a href="" target="_blank">Creative Commons 1.0 Public Domain Dedication waiver.</a></li><li>I, and all co-authors, agree that, if the article is editorially accepted for publication in JLMC<em>,</em> data included in the article shall be made available under the <a href="" target="_blank">Creative Commons 1.0 Public Domain Dedication waiver</a>, unless otherwise stated. For the avoidance of doubt it is stated that sections 1, 2, and 3 of this license agreement shall apply and prevail.</li></ol><p>Please visit <a href="">Creative Commons</a> web page for details of the terms.</p> (Dr. Anup Acharya) (Sioux Cumming) Wed, 27 Jun 2018 10:51:57 +0000 OJS 60 Hypovitaminosis D in Healthy Health Care Professionals: A Real Deficiency or Necessity of New Reference Value for Specific Population? <p><strong>Introduction</strong>:</p><p>Vitamin D, a steroid vitamin, has attracted noticeable interest of clinicians and researchers for decades because of its diverse array of biological functions. Various studies have shown that the level of vitamin D is low in significant proportion of healthy individuals. However, indoor workers especially health care professionals are not focused, particularly in Nepal. We aimed to measure level of vitamin D in apparently healthy health care professionals.</p><p><strong>Methods</strong>:</p><p>A descriptive cross-sectional study was carried out in apparently healthy health care professionals working at Kathmandu University Hospital in Dhulikhel, Nepal. Structured questionnaire including socio­demographics, dietary habits, and anthropometric measurements was filled in by the participants. Total serum 25-hydroxy vitamin D was measured by Chemiluminescence Immunoassay (CLIA) technique. Results were analyzed with <em>t-test</em>, <em>Chi-square</em> test, and <em>Pearson correlation</em> test.</p><p><strong>Results</strong>:</p><p>Data from 64 female and 47 male were analyzed, mean 25-hydroxy vitamin D level was 8.81 ng/dl (<em>SD</em> = 4). Almost all (98.2%, <em>n</em> = 109) participants had vitamin D lower than normal where 72.7% (<em>n</em> = 92) were deficient, 24.5% (<em>n</em> = 17) were insufficient, and only 2.7% (<em>n</em> = 2) were having adequate level. Non-specific body pain was the only factor among all we studied that was significantly associated with vitamin D levels (<em>p</em> = 0.002).</p><p><strong>Conclusion</strong>:</p><p>Hypovitaminosis of 25-hydroxy vitamin D was found to be very common (98.2%) in apparently healthy health care subjects of Dhulikhel Hospital. This may necessitate further research to redefine the biological reference value for our population.</p><p> </p><p>DOI: <a href=""></a></p> Rajendra Dev Bhatta, Nikita Pradhan, Rojeena Gurung, Prabodh Risal ##submission.copyrightStatement## Wed, 27 Jun 2018 10:50:53 +0000 Knowledge and Perception of Public Towards Medico Legal Autopsy in Nepal <p><strong>Introduction:</strong></p><p>Autopsy is an important tool to determine the cause of death. This study was conducted with the objectives to assess the knowledge and perception of Nepalese people towards medico legal autopsy.</p><p><strong>Methods:</strong></p><p>It was a questionnaire based cross sectional study performed among the general public of Nepal. A standard pretested questionnaire was used to collect the responses on knowledge and perception of the people about medico legal autopsy. Independent samples <em>t-test</em> was used to compare the mean score of knowledge among the various groups. <em>P</em> value of &lt; 0.05 was considered significant.</p><p><strong>Results:</strong></p><p>Mean age of the respondents was 29.06 years (<em>SD</em> = 10.50) and 72.31% were male (<em>n</em> = 188, <em>N</em> = 260). Mean score of knowledge was 6.65 (<em>SD</em> = 1.76) out of a total ten. The score was significantly higher (<em>p</em> = 0.02) among the respondents whose relatives had undergone an autopsy than those whose were not. It was comparable among the educated and uneducated groups.  A total of 75.77% respondents (<em>n</em> = 197, <em>N</em> = 260) would not reject the autopsy of their relatives.</p><p><strong>Conclusion:</strong></p><p>People lack knowledge mostly in basic elements of medico legal autopsy. Most of the people showed positive perception towards autopsy and those who were negative, feared of disfigurement of the bodies after an autopsy.</p><p> </p><p>DOI: <a href=""></a></p> Nuwadatta Subedi, Ishwari Sharma Paudel, Dipendra Kandel, Akash Chudal ##submission.copyrightStatement## Wed, 27 Jun 2018 10:51:02 +0000 Evaluation of Clinical Characteristics and Outcomes of Obstetric Patients Admitted to Intensive Care Unit: A case control study <p><strong>Introduction</strong>: The need for critical care support and admission to intensive care unit (ICU) in obstetric population is infrequent. The proportion ranges from 0.1 to 8.5%. Yet, obstetric admissions to ICU and mortality continue to have a significant impact on overall maternal health care. The study of epidemiology and predictors of obstetric admissions to ICU will prove a useful proxy for better understanding maternal near miss events and mortality.</p><p><strong>Methods</strong>: This was a case control study reviewing all the obstetric cases admitted to ICU over a study period of five years. The individual files were recovered from the record section and data pertaining to referral status, demographics, clinical profile and ICU information were retrieved. The ICU data comprised of the length of ICU stay, indications for admission, interventions required, and outcomes. The data were then compared to historical controls.</p><p><strong>Results</strong>: A total of 80 patients were admitted to ICU accounting for 0.84% of total deliveries and 4.6% of total ICU admissions. Mean age was 24.84 years, mean gestational age was 32.33 weeks, and mean blood loss was 707.27 ml. Hypertensive disorder of pregnancy followed by obstetric hemorrhage were the most common indications. Lower gestational age, increased blood loss, emergency cesarean sections, and surgical interventions were noteworthy risk factors for ICU admissions. There was a mortality rate of 5%.</p><p><strong>Conclusion</strong>: Hypertensive disorders account for the most number of admissions to ICU followed by obstetric hemorrhage. Lower gestational age, increased blood loss and emergency cesarean section are notable risk factors for ICU admission.</p><p> </p><p>DOI: <a href=""></a></p> Deepak Shrestha, Shreyashi Aryal, Sebina Baniya ##submission.copyrightStatement## Wed, 27 Jun 2018 10:51:09 +0000 Bicondylar Angle and its Relation with Length and Neck Length of Human Femur <p><strong>Introduction</strong>: Femoral bicondylar angle has immense importance from anatomical and clinical (forensic and anthropometric) point of view and is the characteristic feature of bipedal gait in humans. It is the angle between axis of femoral shaft and a line perpendicular to its transcondylar axis. The study was carried out to assess bicondylar angle and its relationship with femur length and neck length.</p><p><strong>Methods</strong>: Bicondylar angle, length, and neck length of available dry human femurs of unknown sex and age were measured using osteometric board and vernier caliper. Bicondylar angle between two sides were compared. Similarly, relation between the angle and femoral length and length of femoral neck was studied.</p><p><strong>Result</strong>: Bicondylar angle on right side was 8.65° (<em>SD</em> = 2.03) and on left side was 9.35° (<em>SD</em> = 2.05) and the different was not statistically significant (<em>p</em> = 0.08). On both sides, no significant correlation was found between bicondylar angle with femoral length and length of femoral neck.</p><p><strong>Conclusion</strong>: Mean bicondylar angle of right femur was 8.65° and that of left was 9.35° and the difference was not statistically significant. There was no significant relation between the angle and other two parameters.</p><p> </p><p>DOI: <a href=""></a></p> Rabita Kharbuja, Rashmi Manjushree Adhikari, Anupama Shrestha ##submission.copyrightStatement## Wed, 27 Jun 2018 10:51:17 +0000 Knowledge and Practice of Self-medication among Undergraduate Medical Students <p><strong>Introduction</strong>: Self-medication is an important aspect of self-care. It is a common practice in society and medical students are no exception. The aim of this study was to explore the knowledge and practice of self-medication among students of a medical school in Western Nepal.</p><p><strong>Methods</strong>: A cross sectional study was conducted among basic science and clinical students after obtaining prior consent from those willing to participate. Respondents’ degree of agreement with a set of 25 statements was noted using Likert scale to assess their knowledge. The practice of self-medication was studied by asking about the use of selected groups of medicines during the past one-year period and noting the pattern of use.</p><p><strong>Results</strong>: Three hundred and thirty of the 356 students (92.6%) participated in the study. Mean knowledge score was 93.2 (<em>SD</em> = 8.1). Self-medication was practiced by 83.3% (<em>n</em> = 275) of respondents. Knowledge about self-medication differed among respondents according to gender (<em>p</em> = 0.03) and nationality (<em>p</em> = 0.04) but not other variables. Practice of self-medication was associated with father’s profession (<em>p</em> = 0.03) and nationality of the respondents (<em>p</em> = 0.04).</p><p><strong>Conclusions</strong>: Students’ knowledge about self-medication was good and they commonly practiced self-medication. Pain-killers were the most commonly used drug.</p><p> </p><p>DOI: <a href=""></a></p> Anishma Karmacharya, Bipashwi Nath Uprety, Ravi Shankar Pathiyil, Sudesh Gyawali ##submission.copyrightStatement## Wed, 27 Jun 2018 10:51:24 +0000 Estimation of Height from Foot Dimensions <p><strong>Introduction</strong>: Height determination by measuring various body parts is of value in medicolegal investigations as well as in anthropology. The current study was conducted to analyze interrelation between foot dimensions and stature, and to predict stature from foot dimensions.</p><p><strong>Methods</strong>: The study was done in medical students where stature, foot length, and foot breadth were quantified using standard instruments. We calculated correlations between variables with correlation test and predicted stature from foot length and foot breadth using linear regression.</p><p><strong>Results</strong>: The correlation between foot length and stature, and foot breadth and stature were statistically significant in both gender (<em>p</em> &lt; 0.05). Greater correlation coefficient between foot length and stature than that for foot breadth and stature indicated stronger correlation between foot length and stature. Separate formulae were drawn for calculation of stature from foot breadth and foot length by regression analysis.</p><p><strong>Conclusion</strong>: Both foot breadth and foot length were correlated with stature. Foot length was found to be a better predictor of stature.</p><p> </p><p>DOI: <a href=""></a></p> Sanjay Kumar Sah, Naresh Karki, Bashir Ahmed Jeelani ##submission.copyrightStatement## Wed, 27 Jun 2018 10:51:31 +0000 Pattern, Management, and Outcome of Poisoning in a Tertiary Care Hospital <p><strong>Introduction</strong>: Poisoning is a significant global public health problem. The appropriate management of poisoning at emergency needs accurate assessment and immediate treatment. The immense chance for better outcomes occurs with early diagnosis and treatment. This study was conducted to assess pattern, management, and outcome of poisoning in tertiary care hospital.</p><p><strong>Methods</strong>: An observational cross-sectional study was conducted in which records of patients with a diagnosis of poisoning over a period of four years were reviewed.</p><p><strong>Results</strong>: A total of 138 patients were included in the study. A majority (63%) of them were females. Most (67.4%) were managed by general or supportive measure only. Gastric lavage was done in 60% of total patients while 52.9% patients received activated charcoal. Pralidoxime and atropine was received by 51.1% of patients treated with specific antidote. All the antidotes were administered through intravenous route. Regarding outcome, 89.9% were completely recovered. Suicidal poisoning was significantly higher in married as compared to unmarried patients (<em>p</em> = 0.029). Similarly, there was a significant relationship between occupation of the patients and manner of poisoning (<em>p</em> = 0.003). Outcome of treatment had a significant association with the manner of poisoning (<em>p</em> &lt; 0.001). Further analysis revealed that the patients who expired in the hospital were more likely to ingest poison accidentally.</p><p><strong>Conclusion</strong>: Suicidal poisoning is common and females are more susceptible. Insecticide and rodenticide are the commonly ingested poisons. Treatment outcome of poisoning cases is generally favorable.</p><p> </p><p>DOI: <a href="">ttps://</a></p> Naresh Karki, Vijay Singh, Vinod Kumar Verma ##submission.copyrightStatement## Wed, 27 Jun 2018 10:51:37 +0000 Kluver-Bucy Syndrome in a Patient with Bipolar Affective Disorder: A Case Report <p><strong>Introduction</strong>: Kluver and Bucy described a behavioral syndrome in rhesus monkeys following bilateral temporal lobectomy which included psychic blindness, hyperorality, hypermetamorphosis, hypersexuality, and emotional unresponsiveness.</p><p><strong>Case report</strong>: A 44 years old right handed male of Indo-aryan origin, blacksmith by profession, had presented in manic phase of bipolar illness. He had hypersexuality, hypermetamorphosis, hyperorality, and altered dietary habits along with amnesia and fleeting misrecognition of even his close relatives. MRI of the patient showed mild cerebral atrophy with right temporal lobe atrophy. The patient was treated with lithium and olanzapine along with benzodiazepines. The symptoms resolved gradually with resolution of the manic phase. Patient had similar features in the previous manic episode as well that resolved with resolution of mania.</p><p><strong>Conclusion</strong>: The symptoms of Kluver-Bucy syndrome like increased libido, increased activity might be confused with that of mania. Other features of Kluver-Bucy syndrome and the overt hypersexuality could help identify it even during manic phase of bipolar illness.</p><p> </p><p>DOI: <a href=""></a></p> Madhur Bahnet, Luna Paudel, Bikram Prasad Gajurel, Nidesh Sapkota, Raj Kumar Rauniyar ##submission.copyrightStatement## Wed, 27 Jun 2018 10:51:44 +0000 Hereditary Spherocytosis: A Case Report <p><strong>Introduction</strong>: Hereditary spherocytosis is a red cell membrane disorder that causes hemolytic anemia. Due to defective cell membrane, red cells are spherical shaped and result in their early lysis. Osmotic fragility of spherocytic red cell is increased.</p><p><strong>Case report</strong>: A 22 year old female presented with chief complain of abdominal pain. Initially she was diagnosed as cholelithiasis. Under laboratory evaluation she was found to be anemic with reticulocytosis. In peripheral blood smear, spherocytes were moderately distributed. Antihuman globulin test was negative but osmotic fragility was high. Hence, she was confirmed as case of hereditary spherocytosis.</p><p><strong>Conclusion</strong>: Hereditary spherocytosis is a rare red cell disorder and its diagnosis can be made by osmotic fragility test.</p><p> </p><p>DOI: <a href=""></a></p> Surendra Koju, Ramesh Makaju ##submission.copyrightStatement## Wed, 27 Jun 2018 10:51:51 +0000 Top Ten Health Economics and Outcomes Research (HEOR) Trends: A booklet review <p>NONE.</p><p> </p><p>DOI:</p> Ravi Shankar Pathiyil, Anishma Karmacharya ##submission.copyrightStatement## Sat, 30 Jun 2018 00:00:00 +0000