Janaki Medical College Journal of Medical Science

The Magical Wonders of Nitric Oxide: The Molecule of the Millennium

2022-04-25T09:31:29+00:00

NO is a gas and has a very short half-life (3-5s), as it is highly reactive. No and its products are inactivated through oxidation into nitrite (NO₂^-) and nitrate (NO₃^-) Which is excreted in the urine. NO is regarded as magical molecule which has profound role in regulation of various function in various organs of human body and in health and disease. Here in this review article authors has discussed about its chemistry and metabolism, its discovery, its basic functions, role in pathophysiology of various diseases and its therapeutic implications.

Yoga Sastra Sangamam-2022 in Kanyakumari and Tribute to ‘Mahamanav Pita’: An experience of respect of Nepali Guru in India

2022-04-25T10:10:09+00:00

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Artificial intelligence in healthcare in Nepal

2022-04-25T05:10:07+00:00

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Immediate Psychological Impact among ENT-HNS doctors during the second wave of COVID-19 havoc in Nepal

2022-04-25T06:45:43+00:00

Background and Objectives: The priority after the outbreak of COVID-19 pandemic has been treating cases and counting the number of fatalities. But mental health impact has been neglected, even though evidence show that frontline health care workers are at risk of mental health issues in such situations. This study aimed to determine the status of anxiety among ENT-HNS doctors and the associated factors in Nepal during the second wave of COVID-19 havoc in Nepal.

Material and Methods: This is a web-based cross-sectional study carried out from 1st May to 31st May 2021. The study participants: ENT-HNS consultants and residents, were approached for the study through different social media, and data was collected through an app-based self-administered questionnaire. The anxiety level was measured using the GAD-7 scale, and the chi-square test was applied to study the factors associated with anxiety.

Results: Among sixty-two participating ENT-HNS doctors, 33.9% already had contracted COVID-19, and 77.4% had mild to severe anxiety. Just below half (45.2%) of the participants worked in COVID-dedicated hospitals and treated patients every working day. None of the respondents could comply with social distance at their workplace, and 75.8% believed they lacked sufficient personal protection equipment (PPE). The potential aerosol-generating procedures like epistaxis management, tracheostomy, and flexible endoscopy were regarded as the highest risk of viral transmission by 35.5%, 30.6%, and 21.0% of respondents, respectively. The young doctors, female doctors, and residents were more likely to be anxious than their counterparts. The ENT-HNS doctors who had lost a family member, close relatives, or colleague were seven times more likely to have anxiety.

Conclusion: The ENT-HNS doctors are neither immune to the COVID-19 infection nor the anxiety. They must have access to required PPE as well as psychosocial support to prevent anxiety. Early identification and timely intervention at the institutional level are vital to maintaining a well-staffed workforce during a pandemic like COVID-19.

Knowledge, attitude and practice of mothers in breast feeding: A hospital based study

2022-04-25T07:09:21+00:00

Background and Objectives: Breastfeeding (BF) is a socially constructed and controlled practice. Although breastfeeding is a common practice in Nepal, proper breastfeeding is on the decline due to several factors. The impact of knowledge and attitude about breastfeeding practice, i.e., duration of breastfeeding, proper techniques, proper time of weaning is poorly understood. So, this study is designed to assess the knowledge, attitude and practice of mothers in breastfeeding.

Material and Methods: This is an observational descriptive cross sectional study carried out among 220 mothers of under 2 years old children attending the pediatric out-patient department (OPD) at Janaki Medical College teaching hospital (JMCTH), Janakpur, Nepal. Mothers were interviewed using pre-designed questionnaire constructed after proper literature review.

Results: All mothers have idea that they have to breast feed their babies, but they did not have adequate knowledge on the appropriate way of breastfeeding. Only, 12.27% knew that they have to initiate breast feeding within 1 hour of birth, 15% had idea on pre-lacteal feed, 5% had idea on importance of colostrum, 10% knew the meaning of exclusive breast feeding, and 0% of the mothers had idea on importance of night feeding. Only 7.27% have knowledge on method on maintaining aseptic precaution during breastfeeding. Only 20.90% were practicing exclusive breast feeding, 70% mothers were practicing night feeds, 15% mothers practiced feeding one side at a time and 15% mothers were practicing appropriate attachment and positioning during BF. None of the mothers got any advice regarding breast feeding during antenatal care (ANC) visits. Only 15% mothers got proper method of breastfeeding advice after birth. 30% practiced burping after breastfeeding. 30% underwent practice of proper food to increase breast milk secretion.

Conclusion: Undesirable cultural practices such as late initiation of breastfeeding after birth, giving pre-lacteal feeds, delay in introduction of weaning foods, not exercising exclusive breastfeeding practice are still prevalent. The maternal knowledge, attitude and practice (KAP) in breastfeeding is still inadequate with a big gap between actual and desired practices and there is urgent need of mother educational program in this society.

Antibiotic Prescribing Pattern in Paediatric Emergency Department at Tertiary Care Teaching Hospital in Nepal

2022-04-25T07:34:22+00:00

Background and Objectives: The indiscriminate use of antibiotics often results in an increased incidence of adverse drug reactions (ADR), suboptimal therapy, treatment failure, polypharmacy and most importantly, the emergence of antibiotic resistance. Thus, the objective of this study was to assess the paediatric emergency department, antibiotic prescribing pattern at a tertiary care teaching hospital, Universal College of Medical Sciences (UCMS), Bhairahawa, Rupandehi, Nepal.

Material and methods: A prospective, cross-sectional, observational study was carried out on 152 paediatric patients of ages between 2 months to 12 years at the paediatric emergency department of UCMS. The data were collected by reviewing the prescription paper, and the required information was recorded using a structured data collection sheet prepared for study. The prescribing pattern was assessed through the World Health Organization (WHO) prescription indicators using the WHO Children Formulary 1993 AD.

Results: This study revealed that out of 152 patients, average number of drugs prescribed was 5.13 and antibiotic per patient was 2.10±.540. Antibiotics were prescribed at least once for 93.4% of patients. Drugs prescribed from Essential drug list (EDL) was 46.46% and that encountered with injectable was 92.1%. There was a significant difference between the patients age group and the number of drugs prescribed (χ2 = 21.553, p = 0.010). The mean duration of antibiotic treatment was 6.95±3.145. Cephalosporin’s (36.6%) followed by aminoglycosides (28.8%) were most frequently prescribed antibiotics.

Conclusion: Multiple courses of antibiotics are most frequently prescribed, which could increase antibiotic resistance in future. Continuous audits, training and new treatment protocols should be developed for prescribing and using antibiotics in paediatric patients.

Knowledge, Awareness and Perception of Antibiotics Resistance among under graduates Paramedical students of Bangladesh

2022-04-25T07:51:23+00:00

Background and Objectives: Antibiotic resistance has become a global public health concern. Thus, the objectives of this study was to determine the overall knowledge of drugs and explore the level of awareness of antibiotic resistance among students studying at Jahangir-Nagar University, Bangladesh.

Material and Methods: The total period of sample collection was from June 2018 to October 2018 and the participants (was N=100). This descriptive cross-sectional study used a questionnaire that consisted of fifteen close ended questions and specific questions were on background (gender, age, education) characteristics. Descriptive statistics (frequency, distribution, mean and standard deviation was used to describe the data. The data collected from the 100 students nd analyzed by statistical tools (SPSS V.22) by drawing tables and graphs.

Results: Overall, 100 female students (age from 19 to 24 years) were interviewed and the response rate was 100%. Out of total respondents, around 86% of the sample stated that antibiotics are appropriate for bacterial infections and 34% of the students had agreed antibiotic can cure viral infections. 74% of the respondents hadn’t expected antibiotics when they had enough with cold, fever, cough and sore throat. Some had taken without prescription. Almost above 90% of the students stop taking those drugs when symptoms decrease and do not take full dose. About 91% respondent agreed to the need of more education about antibiotic resistance.

Conclusion: It is important to generate more awareness around this issue among all. It would be advisable to introduce a specific course and training on antibiotics in core curriculum of students.

Microbial burden of Coliform bacteria in commercially available Poultry-feeds

2022-04-25T08:06:54+00:00

Background and Objectives: Microbial burden is a great threat in production, transportation and distribution of poultry feed. E. coli and Salmonella is an important cause of food borne disease in humans throughout the world and is a significant cause of morbidity, mortality and economic loss. Therefore, the present study was designed to isolation of common coliform bacteria from the Poultry feed.

Material and Methods: This study was performed as per the standard protocol of microbial analysis of poultry feed to isolate and identify the common pathogen E. coli and Salmonella present in feed sample.

Results: Out of 70 samples examined, 62(88.57%) showed growth in which E.coli was 38(61%) and 24(39%) was Salmonella and 16(22.86%) samples showed fair growth and 8(11.42%) samples showed no growth.

Conclusion: Most of the poultry feed sample of this area was found to be highly contaminated with E. coli and Salmonella.

Evaluation of Knowledge, Attitude and Practice regarding Blood Donation among Bachelor Level Students in Kathmandu

2022-04-25T09:43:24+00:00

Background and Objectives: The practice of blood donation is largely dependent on one's level of education and attitude. Over 13 thousand blood facilities in 169 countries report collecting 106 million blood donations worldwide, totaling 118.5 million. However, there is still no equilibrium between blood demand and supply. Every year, in underdeveloped nations like Nepal, the need for safe blood is vital. Thus, this research was carried out to examine knowledge, practice, and attitude of blood donation among bachelor level Students.

Material and Methods: This study used a systematic approach to analyze knowledge, attitudes, and practices towards blood donation among undergraduate students. A descriptive cross-sectional analysis was conducted utilizing stratified random samples on 110 samples. The pretest self-administered questionnaire was employed, which included both structured and semi-structured questions (r=0.70). The respondents included first- and second-year Bachelor of Social Work and Business Studies students, as well as first-year Bachelor of Computer Administration students. The data was analyzed using descriptive and inferential statistics (i.e., chi-square and spearman's test) in SPSS 16 version.

Results: This study found that 4.5% of the respondents had good knowledge, 63.7% had average knowledge, and 31.2% had poor knowledge. Among the respondents 23.60% had practice of blood donation while 76.10 % have not performed blood donation. The study also revealed 21.10% have negative attitude and 78.20% have positive attitude. There is a positive relationship between knowledge and attitude as Spearman's coefficient value r = 0.150, and p= 0.117 (p>0.05)

Conclusion: The study concludes the highest number of female respondents and a Hindu majority. Despite having a positive attitude, they have not practiced blood donation indicating a need to increase reinforcement and motivation among youths to bring positive changes in blood donation.

Ulnar variance in normal Nepalese population

2022-04-25T09:59:44+00:00

Background and Objectives: There are many factors that influence the ulnar variance such as age, sex, genetic factors, gross elbow pathology, gripping of the hand, rotation of the forearm and positioning of the elbow. There are several pathologies of the wrist in which ulnar variance play a role. We lack study in Nepalese population regarding the influence of age and sex on ulnar variance. The primary objective of this study was to determine the mean ulnar variance in normal Nepalese population and to assess age and sex difference.

Material and Methods: This prospective study was conducted in Janaki Medical College and Teaching Hospital from July 2020 to March 2021. Total 120 patients were included in the study. Ulnar variance was measured by using the method of perpendiculars.

Results: The mean value of ulnar variance was 0.73±1.62 in our population. In our study, thirty two (26.7%) had neutral ulnar variance, twenty two (18.3%) had negative ulnar variance and sixty six (55%) had positive ulnar variance.

Conclusion: There was statistically significant difference in ulnar variance between male and female population (p<0.05). Females had higher ulnar variance than male population. There was more positive ulnar variance with higher age group (p<0.05).