https://www.nepjol.info/index.php/JPAHS/issue/feed Journal of Patan Academy of Health Sciences 2020-01-10T16:06:36+00:00 Dr Jay N Shah editor.jpahs@pahs.edu.np Open Journal Systems <p>Published by the Patan Academy of Health Sciences, Kathmandu, Nepal</p> https://www.nepjol.info/index.php/JPAHS/article/view/27205 History and development of medical ethics- the international norms 2020-01-10T16:06:09+00:00 Jay N. Shah editor.jpahs@pahs.edu.np <p>&nbsp;Medical ethics encompasses a broad field, including ethics in day to day medical practice, in research and publication. The historical development in the context of international norms of medical ethics is presented here, with brief mention of ‘research and publication ethics’, the latter two being a broad topic in itself.</p> 2019-12-31T00:00:00+00:00 ##submission.copyrightStatement## https://www.nepjol.info/index.php/JPAHS/article/view/27206 Outcome of tibial diaphyseal fracture fixation with Surgical Implant Generation Network (SIGN) nail 2020-01-10T16:06:10+00:00 Balakrishnan M. Acharya balakrishnanmacharya@pahs.edu.np Rojan Tamrakar balakrishnanmacharya@pahs.edu.np Pramod Devkota balakrishnanmacharya@pahs.edu.np Abhishek K. Thakur balakrishnanmacharya@pahs.edu.np Suman K. Shrestha balakrishnanmacharya@pahs.edu.np <p class="Default"><strong><span style="font-size: 10.0pt;">Introductions</span></strong><span style="font-size: 10.0pt;">: Fractures of diaphyseal region of the tibial bone are amongst the most commonly seen extremity injuries in the developing countries. The surgical implant generation network (SIGN) intramedullary (IM) nail was designed for the treatment of long bone fractures in the developing nations. </span></p> <p class="Default"><strong><span style="font-size: 10.0pt;">Methods: </span></strong><span style="font-size: 10.0pt;">From March 2008 to December 2018, a total of 104 patients with 104 tibial diaphyseal fractures were treated with SIGN IM nail. The follow-up visits were arranged at 6, 12, 24 weeks and one-year post operatively. During follow-up visits, the signs of fracture union clinically as well as radiologically and the presence of complications any were recorded and analyzed. </span></p> <p class="Default"><strong><span style="font-size: 10.0pt;">Results: </span></strong><span style="font-size: 10.0pt;">The mean age of the patients was 32.81 (16 – 65) years, male 74 (71.2%) and female 30 (28.8%). Majority of the patients 70 (67.3%) had fractures after road traffic accidents. The mean time of surgery was 13.58 (1 – 463) days. Six (5.8%) patients had delayed union and no non-union was detected. We had 10 cases (9.6%) of mal-alignment but were on acceptable range. </span></p> <p class="Default"><strong><span style="font-size: 10.0pt;">Conclusions: </span></strong><span style="font-size: 10.0pt;">In the developing country like Nepal, the SIGN nail is an effective surgical implant for the management of the tibial diaphyseal fractures with good result of fracture union and low rates of nonunion, mal-alignment and manageable complications.</span></p> 2019-12-31T00:00:00+00:00 ##submission.copyrightStatement## https://www.nepjol.info/index.php/JPAHS/article/view/27207 Laparoscopic surgery for intestinal obstruction in children due to water absorbing gel beads 2020-01-10T16:06:11+00:00 Zhou Liang hougj66608@163.com Hou Guangjun hougj66608@163.com Geng Xianjie hougj66608@163.com Zhang Xianwei hougj66608@163.com Jay N. Shah hougj66608@163.com <p>&nbsp;<strong>Introductions</strong>: Super absorbent polymer gel bead (SAPGB) is increasingly available as toys for children. When ingested it swells by absorbs water and leads to acute intestinal obstruction. Diagnosis and surgery is challenging as its radiolucent, fragile and slippery. We present outcome of our innovative technique of stabilization and removal SAPGBs by laparoscopy minimal invasive surgery (lap-MIS).</p> <p><strong>Methods: </strong>This retrospective analyse of outcome of lap-MIS in intestinal obstruction caused by ingestion of foreign body, the SAPGBs, in children who were managed at Children's Hospital Affiliated to Zhengzhou University, China. The outcome variables included removal of SAPGBs, length of hospital stay and postoperative occurrence of anastomotic leak, wound infection, wound dehiscence, re-surgery, or mortality.</p> <p><strong>Results: </strong>There were 15 children, male 9 (60%), average age 2 years, and duration of ingestion of SAPGBSs 1.5 days (range 2-4 days), parents gave history of accidental ingestion in 6 (40%). All children had uneventful postoperative recovery after lap-MIS removal of foreign body with no wound infection, anastomotic leak, re-surgery or mortality. Average hospital stay was 4 days (range 3 to 5 days).</p> <p><strong>Conclusions: </strong>We had successful outcome lap-MIS with our innovative technique to stabilize and extract foreign bodies, the super water absorbent gel beads, ingested by children.</p> 2019-12-31T00:00:00+00:00 ##submission.copyrightStatement## https://www.nepjol.info/index.php/JPAHS/article/view/27225 Age specific clinicopathological profile of ovarian mass 2020-01-10T16:06:13+00:00 Laxmi R.C. Karki nishchalbogati@pahs.edu.np Nishchal Bogati nishchalbogati@pahs.edu.np <p><strong>Introductions</strong>: Ovarian cancer is seventh leading cause of cancer death among women. Ovarian mass has age specific occurrence and may may help in screening and management plans. This study was conducted to determine the age-wise clinical profile of the ovarian mass.</p> <p><strong>Methods: </strong>This review done to analyse the histologically diagnosed ovarian masses in cases operated during three years at Patan Hospital, Patan Academy of Health Sciences, Nepal. Clinical profile of the patients and age-wise distribution of histological types of ovarian mass were analyzed descriptively using Microsoft Excel.</p> <p><strong>Results: </strong>Peak incidence of ovarian tumor was in age group of 20-29 years with 93 (36%) cases out of 258 ovarian masses. All eight malignant tumors were in age group of ≥40 years. Neoplastic masses were 188 (72.9%), 95 (50.5%) germ cell tumor. In 70 (27.1%) non-neoplastic lesion, corpus luteal cyst were 24 (34.3%).</p> <p><strong>Conclusions: </strong>Peak incidence of ovarian tumor was seen in age group of 20-29 years. Germ cell tumors accounted for half of the neoplastic lesions. All malignant ovarian tumors were in found in age group ≥40 years.</p> 2019-12-31T00:00:00+00:00 ##submission.copyrightStatement## https://www.nepjol.info/index.php/JPAHS/article/view/27226 Perioperative outcomes after open radical cystectomy for muscle invasive bladder cancer 2020-01-10T16:06:14+00:00 Samir Shrestha samir_shrestha99@yahoo.com Pukar Maskey samir_shrestha99@yahoo.com Anjit Phuyal samir_shrestha99@yahoo.com Jay N. Shah samir_shrestha99@yahoo.com <p><strong>Introductions</strong>: Radical cystectomy with bilateral pelvic lymphadenectomy is a primary intervention for muscle invasive or refractory, high grade Ta, T1, Tis bladder cancer. Owing to its major undertaking, patient succumbs to infection and various morbidities. This study was to assess the perioperative outcomes and complications of radical cystectomy.</p> <p><strong>Methods: </strong>This retrospective study analyzed the perioperative outcome (early mortality within 30 days, length of stay, requirement of blood transfusion) of radical cystectomy in patients with bladder cancer during four years at Patan Hospital, Patan Academy of Health Sciences, Lalitpur, Nepal. Ethical approval was obtained. Study variables included patient’s demographics, presenting symptoms, tumor types and configuration, need for blood transfusion, length of surgery, pathological stages, types of urinary diversions, hospital stay, early (&lt;30 days) and late (31-90 days) morbidity and mortality.</p> <p><strong>Results: </strong>Total 32 patients underwent radical cystectomy. Data analysed on 18 patients, mean age was 66.7 years and painless hematuria 17 (94.4%). All were transitional cell carcinoma, high grade lesion in 17 (94.4%). Overall 6 (33.3%) patients developed early postoperative complications, paralytic ileus and prolong lymph drainage in 5 (27.8%), wound dehiscence in 4 (22.2%) and ureteric catheter dislodgement in two. There were 2 (11.1% of 18) mortalities (the mortality audit showed total 5 (15.6%) out of 32 radical cystectomy during the study period.</p> <p><strong>Conclusions: </strong>Perioperative complications occurred in 1/3rd following radical cystectomy for muscle invasive bladder, more complications in those with preoperative associated co-morbidities.</p> 2019-12-31T00:00:00+00:00 ##submission.copyrightStatement## https://www.nepjol.info/index.php/JPAHS/article/view/27227 Clinicopathological profile of colorectal cancer managed at a university teaching hospital, Nepal 2020-01-10T16:06:16+00:00 Sanjaya Paudyal sanpau3003@gmail.com Shiva Raj KC sanpau3003@gmail.com Shantabir Maharjan sanpau3003@gmail.com Surendra Shah sanpau3003@gmail.com Niraj Giri sanpau3003@gmail.com Samyukta KC sanpau3003@gmail.com Bidhan Sigdel sanpau3003@gmail.com <p class="Default"><strong><span style="font-size: 10.0pt;">Introductions</span></strong><span style="font-size: 10.0pt;">: Colorectal carcinoma is the third most common cancer worldwide. The incidence is increasing in developing countries including Nepal. The aim of this study is to find out the clinicopathological pattern of colorectal carcinoma locally. </span></p> <p class="Default"><strong><span style="font-size: 10.0pt;">Methods</span></strong><span style="font-size: 10.0pt;">: Data were recorded retrospectively by reviewing the charts of the patients who were diagnosed and treated for in patients having colorectal cancer managed during three years period of 2016-9 at Patan Hospital, the university teaching hospital of Patan Academy of health sciences, Nepal. Clinicopathological profile, age, gender, surgery, histopathological findings were descriptively analised. </span></p> <p class="Default"><strong><span style="font-size: 10.0pt;">Results: </span></strong><span style="font-size: 10.0pt;">There were 36 colorectal cancer patients, male 20 (56%) and females 16 (44%), mean age 56.9 years (range 24 to 89). Curative surgery was possible in 17 (47.2%) and adenocarcinoma of moderate differentiation was found in 25 (70%) of the resected specimen. </span></p> <p class="Default"><strong><span style="font-size: 10.0pt;">Conclusions: </span></strong><span style="font-size: 10.0pt;">Colorectal carcinoma was found in old age, slightly more in male than female, adenocarcinoma being most common histology type.</span></p> 2019-12-31T00:00:00+00:00 ##submission.copyrightStatement## https://www.nepjol.info/index.php/JPAHS/article/view/27228 Clinico-histopathological analysis of orbito-ocular lesions: a hospital-based study 2020-01-10T16:06:17+00:00 Santosh Upadhyaya Kafle drsantoshkafle@gmail.com Mrinalini Singh drsantoshkafle@gmail.com Prerna Arjyal Kafle drsantoshkafle@gmail.com Bal Kumar KC drsantoshkafle@gmail.com Sanjeev Kumar Yadav drsantoshkafle@gmail.com Anadi Khatri KC drsantoshkafle@gmail.com <p><strong>Introductions</strong>: Preoperative diagnosis of orbital and ocular lesions is necessary for optimum treatment. The study aims to analyze the histomorphological spectrum of orbito-ocular lesions and to evaluate the need of ancillary techniques for confirmation of diagnosis.</p> <p><strong>Methods: </strong>A cross sectional hospital based study of orbito-ocular surgical biopsy samples obtained in the Department of Pathology, at Birat Medical College Teaching Hospital, Nepal during one-year period was analysed for clinical and histopathological findings. Demographic data, site and tissue type, benign or malignant, recommendations for special stains and immunohistochemistry panel study were analysed.</p> <p><strong>Results: </strong>Out of 185 total samples, male to female ratio of 1.1:1, age ranged from ten month to 82 years, 11-20 year age group had 39 (21.1%) orbito-ocular lesions and cornea-conjunctiva was involved in 104 (56.2%). Clinical diagnosis correlated well with histopathological diagnosis, p&lt;0.001. The non-neoplastic, benign and malignant lesions were 36.7%, 33.5% and 29.7% respectively. Squamous cell carcinoma was seen in 28 (50.9%) of malignant lesions followed by sebaceous carcinoma 7 (12.7%). The special stains and immunohistochemistry panel was recommended in 38 (20.5% and 21 (11.3%) cases respectively.</p> <p><strong>Conclusions: </strong>Findings suggest the clinical and histopathological diagnosis correlated well in diagnosis of a wide spectrum of orbito-ocular lesions.</p> 2019-12-31T00:00:00+00:00 ##submission.copyrightStatement## https://www.nepjol.info/index.php/JPAHS/article/view/27229 Efficacy of intravenous Tramadol in prevention of catheter-related bladder discomfort in upper urinary tract surgery 2020-01-10T16:06:19+00:00 Sujita Manandhar sujitasayami@gmail.com Kishor Manandhar sujitasayami@gmail.com <p class="Default"><strong><span style="font-size: 10.0pt;">Introductions</span></strong><span style="font-size: 10.0pt;">: Catheter-related bladder discomfort (CRBD) is common in patients with urinary catheterization. Centrally acting intravenous opioid like Tramadol inhibits detrusor activity and incidence of CRBD. Present study aims to analyze efficacy of intravenous (IV) Tramadol in prevention of CRBD in patients undergoing upper urinary tract surgery. </span></p> <p class="Default"><strong><span style="font-size: 10.0pt;">Methods: </span></strong><span style="font-size: 10.0pt;">Adult patients undergoing elective open upper urinary tract surgeries at Bir Hospital, National Academy of Medical Sciences (NAMS), Nepal, over a period of six months, requiring urinary catheterization were randomly divided into Control (C) and Tramadol (T) groups. After general anesthesia, patients in T-group received IV Tramadol 1.0 mg/kg and C-group received normal saline 30 minutes before extubation. In post-operative ward, CRBD was graded as mild, moderate or severe at 0, 1, 2 and 6 hours. Post-operative Ramsay sedation score and nausea vomiting were compared in two groups. </span></p> <p class="Default"><strong><span style="font-size: 10.0pt;">Results: </span></strong><span style="font-size: 10.0pt;">There were total 70 patients, 35 in each of groups-T and C. Incidence of CRBD in T-group was significantly low compared to the C-group at all points of evaluation (p&lt;0.05). Postoperative sedation score, analgesic requirement and nausea vomiting were not significantly different in two groups. </span></p> <p class="Default"><strong><span style="font-size: 10.0pt;">Conclusions: </span></strong><span style="font-size: 10.0pt;">Intravenous Tramadol administered before extubation in upper urinary tract surgery reduces the incidence of CRBD.</span></p> 2019-12-31T00:00:00+00:00 ##submission.copyrightStatement## https://www.nepjol.info/index.php/JPAHS/article/view/27230 Salmonella gastroenteritis outbreak in a family: a case report 2020-01-10T16:06:21+00:00 Sunil Adhikari suniladhikari@pahs.edu.np Suraj Rijal suniladhikari@pahs.edu.np Ashish Shrestha suniladhikari@pahs.edu.np <p>Five members of a family were brought to emergency with complaints of high grade fever, pain abdomen, diarrhoea and vomiting. The symptoms started after five hours of food, the vegetable curry by this family. Four of them were in hypovolemic shock and two had significant pus cells in stool examination. All of them were discharged by seven days. Stool culture of three of these patients showed salmonella.</p> 2019-12-31T00:00:00+00:00 ##submission.copyrightStatement## https://www.nepjol.info/index.php/JPAHS/article/view/27231 Mutiloculated thymic cyst: unusual presentation of mediastinal mass 2020-01-10T16:06:22+00:00 Uttam Laudari youttam@hotmail.com Shreya Bhandari youttam@hotmail.com Rupesh Ramtel youttam@hotmail.com Bibhuti Adhikari youttam@hotmail.com Mohan Dev Bhandari youttam@hotmail.com <p class="Default"><span style="font-size: 10.0pt;">Here we present a case of 47 year male found to have large multiloculated thymic cyst during work up done for recurrent pleural effusion. Mediastinal cyst constitutes 10-15% of all radiographically detected mediastinal masses. Thymic cyst account only 5% of mediastinal masses. Thymic cyst can cause difficulty in diagnosis due to its rare presentation, invasive nature and occasional associated with thymic neoplasm. They have been detected incidentally and associated with Sjögren’s syndrome, aplastic anemia myasthenia gravis and immunocompromised patients. Here we present a case of 47-year-old male initially work up done for recurrent pleural effusion turned out to be large multilocuated thymic cyst improved after excision which had no associated syndromes and immunocompromised state.</span></p> 2019-12-31T00:00:00+00:00 ##submission.copyrightStatement## https://www.nepjol.info/index.php/JPAHS/article/view/27233 Working mother’s awareness and practice regarding feeding of expressed breast milk 2020-01-10T16:06:23+00:00 Monika Lama monilama2074@gmail.com <p class="Default"><strong><span style="font-size: 10.0pt;">Introductions</span></strong><span style="font-size: 10.0pt;">: Expressed breast milk (EBM) is a healthy feeding option as compared to formula milk for working mothers. Awareness and practice towards EBM may be helpful towards its promotion. </span></p> <p class="Default"><strong><span style="font-size: 10.0pt;">Methods</span></strong><span style="font-size: 10.0pt;">: A cross sectional study was conducted at Patan Hospital, Patan Academy of Health Sciences, Nepal. Working mothers with breastfeeding child of less than 2 year were interviewed for and practice regarding EBM. A self-constructed open and close ended questionnaire in Nepali was used for data collection to analyze the association of mother’s age, types of family structure and number of children with EBM. </span></p> <p class="Default"><strong><span style="font-size: 10.0pt;">Results</span></strong><span style="font-size: 10.0pt;">: Out of 178 working mothers, 121 (67.9%) had awareness about EBM and 22 had practiced it. Mother’s age, types of family structure and number of children were not statistically significant with level awareness. There was positive correlation between awareness and practice of EBM. </span></p> <p class="Default"><strong><span style="font-size: 10.0pt;">Conclusions</span></strong><span style="font-size: 10.0pt;">: This study demonstrated 2/3</span><span style="font-size: 6.5pt;">rd </span><span style="font-size: 10.0pt;">of working mothers had awareness of EBM and 1/10<sup>th </sup></span><span style="font-size: 10.0pt;">practiced EBM feeding, and there was positive correlation of awareness and practice.</span></p> 2019-12-31T00:00:00+00:00 ##submission.copyrightStatement## https://www.nepjol.info/index.php/JPAHS/article/view/27234 Stigma perceived by family members of psychiatric patients attending outpatient department of a teaching hospital 2020-01-10T16:06:26+00:00 Rama Kumari Lamichhane ramalamichhane77@gmail.com <p><strong>Introductions: </strong>Stigma and unfavorable view of people towards mental illness is prevailing in Nepal due to lack of awareness. Stigma among family members of people with mental illness has a serious impact on the outcome. This study aims to identify the level of perceived stigma by family members and association with selected demographical variables.</p> <p><strong>Methods: </strong>A cross-sectional research design was used to assess the stigma perceived by family members of patients visiting psychiatry outpatient department of Patan Hospital, Patan Academy of Health Sciences during 12 August to Sep 7, 2018. Questionnaire on socio-demographic variables and self-stigma of mental illness scale was used to interview the family members to assess the level of perceived stigma. Chi-square was used to examine the association between demographic variables and stigma, p &lt; 0.05 was considered significant.</p> <p><strong>Results: </strong>Out of 180 family interviewed 94 (52.2%) had perceived high level of stigma and 86 (47.8%) low level of stigma. There was significant association between age and perceived stigma (p value=0.030) at 95% of significance.</p> <p><strong>Conclusions: </strong>More than half of the family members of psychiatric patients had perceived high level of stigma and was associated with the age.</p> 2019-12-31T00:00:00+00:00 ##submission.copyrightStatement## https://www.nepjol.info/index.php/JPAHS/article/view/27235 Factors associated with safe intramuscular injection practice among nurses of a teaching hospital 2020-01-10T16:06:27+00:00 Rashmila Bajracharya rashmilalnc@gmail.com <p class="Default"><strong><span style="font-size: 10.0pt;">Introductions: </span></strong><span style="font-size: 10.0pt;">Injection medication is one of the major responsibilities of a nurse. The principles and techniques of intramuscular (IM) injections are associated with safe nursing practice. </span></p> <p class="Default"><strong><span style="font-size: 10.0pt;">Methods</span></strong><span style="font-size: 10.0pt;">: A self-administered questionnaire for knowledge and observational checklist for procedure was used to assess the level of knowledge and practice of IM injection of nurses at Patan Hospital, Patan Academy of Health Sciences (PAHS), Nepal, during August 12 to September 07, 2018. Ethical approval was taken from Institutional Review Committee of PAHS. SPSS 16 was used for statistical analysis. </span></p> <p class="Default"><strong><span style="font-size: 10.0pt;">Results</span></strong><span style="font-size: 10.0pt;">: Out of total 78 nurses included, 5 (6.4%) had adequate knowledge, 59 (75.6%) moderate, 14 (17.9%) inadequate knowledge regarding IM injection. Similarly, out of 26 nurses observed for IM injection practices, 10 (38.5%) had good practice, 16 (61.5%) fair, and none had poor practice regarding IM injection. There was significant association of knowledge and practice of IM injection (p=0.03). </span></p> <p class="Default"><strong><span style="font-size: 10.0pt;">Conclusions</span></strong><span style="font-size: 10.0pt;">: The study shows three fourth nurses have moderately adequate level of knowledge of IM injection and more than half of them have fair practice.</span></p> 2019-12-31T00:00:00+00:00 ##submission.copyrightStatement## https://www.nepjol.info/index.php/JPAHS/article/view/27236 Incidence of neonatal hypothermia and its association with low birth weight, preterm delivery, APGAR score and nursing care 2020-01-10T16:06:29+00:00 Shanta Dangol Shrestha shanta.dangol@gmail.com <p><strong>Introductions: </strong>Neonatal hypothermia increases morbidity and mortality . This study aimed to assess the incidence of neonatal hypothermia and its association with low birth weight, preterm delivery, APGAR score and nursing care practices.</p> <p><strong>Methods: </strong>A cross-sectional analytical study was carried out to assess the neonatal hypothermia in neonates born via vaginal deliveries at Maternity ward of Patan hospital, Patan Academy of Health Sciences (PAHS), Nepal, during Aug–Sept 2018. The study was approved from institutional review committee of PAHS. Axillary temperature was measured 4 times, at ten minutes and at 1,2, 4 hours after delivery by using Micro Life digital thermometer. The SPSS was used to analyse data for association of hypothermia with low birth weight, preterm delivery, APGAR score and nursing care practices. Chi square and fisher exact tests were used and p&lt;0.05 was considered significant.</p> <p><strong>Results: </strong>Out of 153 neonates, neonatal hypothermia was seen in 61 (39.8%), 66 (43.1%), 52 (33.9%) and 41 (26.8%) at 10 minutes and 1, 2 and 4 hours after delivery. There was statistically significant association between APGAR score and hypothermia at 1 hour. There was significant association between nursing care practices after delivery and hypothermia at 4 hours.</p> <p><strong>Conclusions: </strong>In this study, the incidence of neonatal hypothermia was highoccurringin40% at 10 minutes and 25% at four hours after delivery. Low APGAR score was associated with hypothermia.</p> 2019-12-31T00:00:00+00:00 ##submission.copyrightStatement## https://www.nepjol.info/index.php/JPAHS/article/view/27237 Situational judgement test: Psychometric analysis of a pilot study for selecting post graduate medical student in residency program 2020-01-10T16:06:31+00:00 Ashis Shrestha ashisshrestha@pahs.edu.np Shital Bhandary ashisshrestha@pahs.edu.np Shrijana Shrestha ashisshrestha@pahs.edu.np <p class="Default"><strong><span style="font-size: 10.0pt;">Introductions: </span></strong><span style="font-size: 10.0pt;">Selection process of post graduate medical students requires combination of knowledge, cognitive abilities and skills. Situational judgement test (SJT) is one on the important tools to measure cognitive abilities and skills. This study aims to measure the internal consistency reliability of SJT tool and item quality for local validation of the non-academic attributes. It also aims to do sub-group analysis of SJT scores based on this tool to provide further evidence for validity. </span></p> <p class="Default"><strong><span style="font-size: 10.0pt;">Methods: </span></strong><span style="font-size: 10.0pt;">This cross-sectional study was conducted at Patan Academy of Health Sciences (PAHS) in May 2017. Two sets of SJTs were developed after iterative discussion and modification to suit the local context. Set A had five options to a given situation, students had to rank these options from most appropriate to least appropriate. Set B had seven options to a given situations, students had to pick three best options. Medical officers and interns who were working at PAHS as medical officers participated in this study. </span></p> <p class="Default"><strong><span style="font-size: 10.0pt;">Results: </span></strong><span style="font-size: 10.0pt;">One hundred and sixteen medical officers participated in the study. Thirty-nine (33.6%) participants were interns who had graduated from PAHS and 77 (66.4%) were medical officers who had graduated from various institute inside and outside the Nepal. The overall Cronbach’s alpha for 35 questions was 0.65, that for set A (19 questions) was 0.56 and that for set B (16 questions) was 0.52. Adding SJT questions improved value of Cronbach’s alpha for SJT test as 40, 50, 60 and 70 questions gave Cronbach’s alpha of 0.68, 0.73, 0.76 and 0.79. Average percentage correct of set A was 76.3% and that of set B was 60.5%. SJT scores were statistically different for medical graduates from Nepal and different universities within Nepal. </span></p> <p class="Default"><strong><span style="font-size: 10.0pt;">Conclusions: </span></strong><span style="font-size: 10.0pt;">Locally developed situational judgement test is found to be reliable instrument for measuring non-academic construct of post-graduate medical entrance examination.</span></p> 2019-12-31T00:00:00+00:00 ##submission.copyrightStatement## https://www.nepjol.info/index.php/JPAHS/article/view/27238 Reflection on mandatory training workshop for intern doctors on "Research, Writing and Publication" at Patan Academy of Health Sciences, Nepal 2020-01-10T16:06:33+00:00 Sunil Kumar Daha sunildaha@pahs.edu.np <p>Not available.</p> 2019-12-31T00:00:00+00:00 ##submission.copyrightStatement## https://www.nepjol.info/index.php/JPAHS/article/view/27239 Neonatal and perinatal mortality trend among 23,000 babies delivered during three years at an urban university teaching hospital of Nepal 2020-01-10T16:06:34+00:00 Rateena Rajbhandari rateenarajbhandari@pahs.edu.np Puja Amatya rateenarajbhandari@pahs.edu.np Shova Shrestha rateenarajbhandari@pahs.edu.np <p class="Default"><strong><span style="font-size: 10.0pt;">Introductions</span></strong><span style="font-size: 10.0pt;">: Perinatal mortality rate (PMR) of Nepal is 31 deaths per 1000 pregnancies and neonatal mortality rate (NMR) is 21 deaths per 1000 live births according to Nepal Demographic and Health Survey (NDHS) 2016. This study aims to analyse the trend of PMR and NMR of babies delivered at Patan hospital, Nepal. </span></p> <p class="Default"><strong><span style="font-size: 10.0pt;">Methods: </span></strong><span style="font-size: 10.0pt;">This was a retrospective study done in the department of Pediatrics to analyse the trend of neonatal and perinatal outcome of babies delivered during three years from April 2016 to March 2019 at Patan Hospital, Patan Academy of Health Sciences, Nepal. Data was collected from hospital records and perinatal audit. The mode of delivery (vaginal, instrumental, caesarian), birth status (sex, premature, still, live, APGAR, birth weight) and final outcome (neonatal and perinatal mortalities) were analyzed descriptively using Microsoft Excel 2010. </span></p> <p class="Default"><strong><span style="font-size: 10.0pt;">Results: </span></strong><span style="font-size: 10.0pt;">The final outcome of total 22937 deliveries during three years were PMR 4.34, corrected PMR 10.85 per 1000 total births and NMR 3.62 per 1000 live births. There were 22913 (99%) live births, 3090 (13.3%) had low birth weight, 11898 (52%) spontaneous vaginal delivery, 10700 (47%) cesarean and 339 (1.5%) instrumental deliveries. </span></p> <p class="Default"><strong><span style="font-size: 10.0pt;">Conclusions: </span></strong><span style="font-size: 10.0pt;">The overall PMR was 4.34 per 1000 total births and NMR was 3.62 per 1000 live births at Patan Hospital.</span></p> 2019-12-31T00:00:00+00:00 ##submission.copyrightStatement##