Journal of Universal College of Medical Sciences 2020-01-10T05:25:13+00:00 Prof. (Dr.) Maruti S. Sawadkar MD Open Journal Systems <p>An official medical journal of the Universal College of Medical and Dental Sciences, Ranigaon, Bhairahawa, Nepal</p> We cannot afford to ignore the Ancient Pandemic Zoonotic Scourge of Mankind: Plague 2020-01-09T15:54:18+00:00 Rajeshwar Reddy Kasarla <p>Not Available.</p> 2019-12-31T00:00:00+00:00 ##submission.copyrightStatement## Prevalence of Depression in Patients with Chronic Backache 2020-01-09T15:54:19+00:00 Sandip Subedi Alok Pandey Shirish Aryal <p><strong>INTRODUCTION:-</strong>Backache is a common problem with about 70% of people in developed countries experience low back pain at some time in their lives. A number of studies done previously shows that there is high prevalence of depression in patients with chronic backache. This study was carried out to find out the prevalence of depression in patients with chronic backache in Nepalese subjects.</p> <p><strong>MATERIAL AND METHODS:-</strong>This was a cross-sectional descriptive study conducted in Universal College of Medical Sciences, Bhairahawa, Nepal. Patients presenting to Orthopaedics OPD with history of backache lasting for more than 12 weeks were referred for psychiatric evaluation. One Hundred cases were included in the study based on inclusion / exclusion criteria in six months period (from 1st &nbsp;Jan 2019 to 30th&nbsp; June 2019). Detailed evaluation was done by a psychiatrist to find out the presence of depression. Diagnosis of depression was made based on ICD-10 DCR. Data was analysed using SPSS.</p> <p><strong>RESULTS: </strong>Out of total 100 subjects, more than half (56%) were females. Majority of the subjects (61% ) were below 45 years of age. The average age of the subjects was 45 years minimum age being 16 and maximum 77. About 59% were also suffering from depressive disorder.</p> <p><strong>CONCLUSION: </strong>This study concludes that significant number of patients with chronic backache attending OPD of tertiary care hospital suffers from depression. It is therefore essential to screen for depression in these patients.</p> 2019-12-31T00:00:00+00:00 ##submission.copyrightStatement## Awareness among Adult Females about Thyroid Disorder attending Neuro and Allied Clinic, Bhairahawa, Rupandehi, Nepal 2020-01-09T15:54:21+00:00 Mahesh Raj Ghimire Sulochana Ghimire Thapa Lekhjung Thapa Binita Soti <p><strong>INTRODUCTION:&nbsp;</strong>Thyroid disorder is common endocrine disorder second to diabetes. With the advancement of laboratory facilities in urban and rural areas, detection rate of thyroid disorder is escalating. Both hyperthyroidism and hypothyroidism can lead to dreaded complication like hypertensive heart disease, coronary arterial disease, arthralgia, severe myalgia, infertility, arrhythmia and many more, so our study helps us to know the awareness amongst a group of population from mid Western part of Nepal.</p> <p><strong>MATERIAL AND METHODS:&nbsp;</strong>This is cross sectional descriptive study, conducted in mid Western region of Nepal, among 105 subjects attending Neuro and Allied Clinic, Bhairahawa, Nepal from 15 August, 2019 to 20 August. 2019.</p> <p><strong>RESULTS:&nbsp;</strong>Majority 42 (40%) of participants are of age group 36-40 years and are housewives. All are literate and 91 (87%) are married. Most of them 93 (88%) know that it is common in female and one third of them has had their family history positive for this disorder. More than half 37 (53%) of the respondents had inadequate awareness on thyroid disorders whereas 33 (47%) had adequate awareness with mean score 19.9 and 12.4 standard deviation. The maximum score of awareness related question was 42 and minimum 3 obtained by the respondents out of 53. Finally, there is an association between age, education level, occupation status of respondents, respondent's family members or herself having thyroid disease with awareness level (P ? 0.005), but no association between marital status and awareness level.</p> <p><strong>CONCLUSION:&nbsp;</strong>This study reveals majority of people are aware of thyroid disorder but still awareness is inadequate. So, it is mandatory to perform public awareness by NGOs, INGOs and Government sector about thyroid disorder for early diagnosis and to prevent from its complications.</p> 2019-12-31T00:00:00+00:00 ##submission.copyrightStatement## Patterns of Pediatric Ear, Nose and Throat Disorders in a Tertiary Care Hospital of Western Nepal: A Cross-Sectional Study 2020-01-10T05:21:56+00:00 Shiva Regmi Nagendra Chaudhary Sandeep Shrestha Santosh` Pathak Badri Kumar Gupta Ravi Swar Om Prakash Kurmi <p><strong>INTRODUCTION: </strong>In outpatient department (OPD) of hospital in low and middle income countries (LMICs), pediatric ear, nose and throat (ENT) disorders are common and huge variation in number is being reported in different seasons. This study aimed to study the prevalence and seasonal effect of ENT disorder in children.</p> <p><strong>MATERIAL AND METHODS: </strong>One year (Jan-Dec, 2015) retrospective data of children (0 months-17 years) visiting ENT outpatient (ENT-OPD) department at Universal College of Medical Sciences-Teaching Hospital, Nepal was analysed. Descriptive statistics were calculated to report the prevalence of ENT disorders for various sub-groups including season. In addition to quantifying the prevalence of ENT disorders in children, the seasonal influence of each disorder was analysed.</p> <p><strong>RESULTS: </strong>Out of 14,126 patients visiting the ENT-OPD, 3,423 (24.23%) were children. The mean age of children having ENT- disorders were 8.4±5.1, 10.6±4.6 and 10.7±4.7 years respectively with male-female ratio of 1.3:1.</p> <p>During all seasons 2,645 (77.3%) had ear problems, 328 (9.6%) nose disorders and 450 (13.14%) throat disorders. The percentage of children with ear disorders declined significantly with increase in age unlike those with nose and throat disorders (P &lt; 0.001). Seasonal trend analysis showed that children had significantly higher number of ear disorders during summer and autumn seasons (P &lt;0.001) whereas nose disorders were more common in spring and winter seasons (P&lt;0.001) with chronic otitis media and wax being the main types of ear disorders and deviated nasal septum (DNS) for nose disorders. Among the throat disorders, tonsillitis was most prevalent in all seasons followed by pharyngitis.</p> <p><strong>CONCLUSION:- </strong>The study suggests a clear seasonal trend in the prevalence of ENT disorders that can be used for advanced planning and management of the conditions in hospitals.</p> 2019-12-31T00:00:00+00:00 ##submission.copyrightStatement## Clinico-Pathological Correlation in the Classification of Leprosy 2020-01-09T15:54:24+00:00 Anuj Poudel Anita Shah Sulochana Khatiwada Ashok Samdurkar <p><strong>INTRODUCTION:- </strong>Leprosy is one of the major health problems in Nepal, caused by <em>Mycobacterium leprae</em>. Histopathological examination is considered as important tool for proper classification of the disease. This study was carried out to study the histopathological features of leprosy in skin biopsies and classify based on microscopy, bacterial index to correlate with clinical presentations.</p> <p><strong>MATERIAL AND METHODS:- </strong>A retrospective observational study was done at Department of Pathology of Universal College of Medical Sciences (UCMS) Bhairahawa for 2 years from 1st November 2015 to 31stOctober 2017 and total 68 cases were analysed. Cases in which histopathological diagnosis of leprosy was made or considered differential diagnosis were selected for study. Ridley and Jopling classification was used histologically to make diagnosis of leprosy. Copies of issued histopathology reports, that are preserved in the department routinely were used to obtain data pertaining to age, sex, clinical information and histopathological findings.</p> <p><strong>RESULTS:- </strong>This study included 68 patients diagnosed histologically as leprosy. Histopathological examination of the skin biopsies of 68 patients revealed that, the maximum histopathological cases 28 (41.17%) are BT followed by 15 cases (22.05%) of IL (15) and 9 (13.23%) of TT. Complete parity between clinical diagnosis and histopathology was observed in 55.88 % and disparity was seen in 44.12%.</p> <p><strong>CONCLUSION:- </strong>For proper classification of Leprosy, correlation of clinical and histopathological features along with bacterial index is more useful than considering any of the single parameter.</p> 2019-12-31T00:00:00+00:00 ##submission.copyrightStatement## Role of Micro ESR in the Evaluation of Neonatal Sepsis 2020-01-09T15:54:25+00:00 Raju Kafle Jaydeep Yadav Binod Kumar Gupta Badri Kumar Gupta <p><strong>INTRODUCTION: </strong>In a developing country like Nepal, where proper medical care and obstetrical facilities are still scarce in the rural areas, neonatal sepsis is a major cause of neonatal morbidity and mortality. With limited resources, early diagnosis and treatment if crucial, may not be achieved. Objective of this study is to evaluate the role of micro ESR in the diagnosis of neonatal sepsis.</p> <p><strong>MATERIAL AND METHODS: </strong>A prospective analytical study was done where all neonates with suspected sepsis admitted in NICU were included in the study. Micro-ESR was measured with relevant septic screening investigations. The micro-ESR was compared with age specific cut off value and the results were compared with various clinical presentations, laboratory findings and outcome variables.</p> <p><strong>RESULTS: </strong>Out of 250 neonates, micro-ESR was elevated in 12% (29 neonates) of cases. Total proven sepsis is 6%, probable sepsis 60.8% and no sepsis in 33.2%. Correlation of elevated micro ESR was statistically significant with presence of clinical symptoms, clinical and systemic signs. It had significant clinical association with blood culture and CSF findings. The sensitivity, specificity and positive and negative predictive value of micro ESR compared to blood culture was 93.3%, 93.6%, 48.3% and 99.5%.</p> <p><strong>CONCLUSION:- </strong>Micro ESR is a simple, relatively cheap and sensitive study in prediction of neonatal sepsis. It can be useful test in settings with limited resources.</p> 2019-12-31T00:00:00+00:00 ##submission.copyrightStatement## Knowledge regarding Arterio-Venous Fistula among Hemodialysis Patients in a Hospital of Rupandehi 2020-01-09T15:54:26+00:00 Pragya Shrestha Sanjeeta Bhujel Santosh Shah <p><strong>INTRODUCTION: </strong>An arteriovenous fistula (AVF) is a connection between an artery and a vein as an access for rapid blood flow for hemodialysis. The vascular access complications are the major causes for high morbidity and mortality among patients.</p> <p><strong>MATERIAL AND METHODS: </strong>A descriptive cross-sectional study was conducted to find out the awareness regarding AVF among 70 hemodialysis patients of Universal College of Medical Sciences, Rupandehi. The purposive sampling method was used. The data was collected by semi-structured interview schedule. The total duration of the study was from August 12, 2018 to October 5, 2018. The data was analyzed by using descriptive and inferential statistics with SPSS software version 20.0.</p> <p><strong>RESULTS: </strong>The study revealed that 58.57% of the respondents had high awareness regarding AVF, 54.28% answered 4-6 weeks as a maturation time for AVF, 12.90% answered at least three times of daily checking thrill, 95.71% answered to avoid to carry heavy items and to check blood pressure on AVF site and 24.28% answered at least 3-5 times as times of doing daily rubber ball exercise.</p> <p><strong>CONCLUSION: </strong>Based on the study findings, it is concluded that the respondents have good knowledge on maturation time of AVF, avoiding sleep on AVF arm, wearing tight cloth and carrying heavy items. Respondents had low knowledge on checking thrill on AVF site as well as rubber ball exercise. Hence, it is needed to continue awareness program regarding AVF among hemodialysis patients.</p> 2019-12-31T00:00:00+00:00 ##submission.copyrightStatement## Status of Serum Zinc Level in Hypothyroid Patients with Normal Serum Albumin Level: A Case Control Study 2020-01-10T04:18:26+00:00 Dipesh Regmi Narayan Gautam Aakash Shahi Sharad Bohara Seema Subedi Archana Jayan <p><strong>INTRODUCTION: </strong>Decreased thyroid hormone synthesis and low levels of circulating thyroid hormones result in clinical hypothyroidism causing many metabolic processes to slow down. Zinc is essential for many biochemical processes and cell proliferation. Thyroid hormones influence Zinc metabolism by affecting absorption and excretion.</p> <p><strong>MATERIAL AND METHODS: </strong>This case-control study was conducted in subclinical hypothyroidism (n=30), overt hypothyroidism (n=30) and compared with age and sex matched euthyroid controls (n=30) attending UCMS-TH. Serum free T3 (fT3), free T4 (fT4) and Thyroid Stimulating Hormone (TSH) were estimated by ELISA. The serum Zinc and Albumin were estimated by colorimetric Nitro-PAPS and BCG dye binding method respectively.</p> <p><strong>RESULTS: </strong>The overall frequency of Zinc deficiency has been observed 12 (40%) in overt hypothyroidism, 9 (30%) in subclinical hypothyroidism and two (6.66%) in euthyroid controls. A significant association between serum Zinc with fT3, fT4 levels (p=0.0046) and with TSH level (p-value=0.030) was observed in all cases. The positive correlation of serum Zinc with fT3 level (r=0.217, p=0.04), fT4 level (r=0.267, p=0.011) while serum negative correlation with TSH level (r=-0.234, p=0.026) and Albumin (r=-0.039, p=0.713) were observed. The odds ratio shows 9.33 times Zinc deficiency likely to occur in overt hypothyroidism (CI: 1.86-46.68; p-value=0.0065) whereas 6.0 times in subclinical hypothyroidism (CI:1.17- 30.72; p-value=0.0315) than euthyroid controls.</p> <p><strong>CONCLUSION: </strong>The significant difference in Zinc deficiency was observed in overt hypothyroid patients. However, non-significant difference in sub-clinical hypothyroidism as compared to euthyroid controls was found in all groups having normal albumin level. This may conclude that with progression of hypothyroidism there is significant decrease in Zinc with normal albumin. Hence, there is association between thyroid profile and serum Zinc status.</p> 2019-12-31T00:00:00+00:00 ##submission.copyrightStatement## Analgesic Efficacy and Tolerability of Tramadol Versus Low Dose Tramadol-Paracetamol in Patients with Gastro Intestinal Surgery 2020-01-09T15:54:29+00:00 Monica Nepal Rama Paudel Rajesh Poudel Narayan Gautam <p><strong>INTRODUCTION: </strong>Analgesic regimens with an improved efficacy and tolerability balance have potential to improve acute pain management, and thus reduce the progression into chronic pain. Hence, an opportunity was gained to compare analgesic efficacy and tolerability of Tramadol (T) 1.5 mg/kg versus low dose Tramadol 1mg/kg-Paracetamol 1000mg (T-P) in patient with Gastro Intestinal (GI) surgery.</p> <p><strong>MATERIAL AND METHODS: </strong>The study was a hospital based prospective, observational study conducted in sixty post-operative GI surgery patient at Universal College of Medical Sciences-Teaching Hospital, Ranigaon, Bhairahawa, Nepal. One group received Tramadol 1.5mg/kg (n=30) while the other group received Tramadol 1mg/kg with Paracetamol 1000 mg (n=30). The primary efficacy outcome measures were pain intensity difference (PID) and sum of pain intensity difference (SPID) whereas secondary efficacy measures included number of patient who require rescue medication, haemodynamic parameter, their quality of sleep in the night and satisfaction with their medication. For tolerability, adverse effect was noted that occurred during study time intervals.</p> <p><strong>RESULTS: </strong>Mean pain intensity differences assessed on Numerical Rating Scores (NRS) were significantly better for Group T-P compared to Group T at all the points except 0.5, 1 and 6 hrs. The sum of pain intensity difference over 8, 16, 24, 48 hrs for Group T-P was significantly superior to Group T. Two patients in Tramadol group required rescue medication. Satisfaction to the pain medication was comparatively higher for Tramadol-Paracetamol group.</p> <p><strong>CONCLUSION :- </strong>Tramadol-Paracetamol had more pronounced analgesic effect with lower incidence of side effect than Tramadol alone. Thus, low dose Tramadol-Paracetamol is better option for management of post-operative pain in patient with GI surgery.</p> 2019-12-31T00:00:00+00:00 ##submission.copyrightStatement## Knowledge regarding Occupational Health Hazards among Nurses in a Hospital, Rupandehi, Nepal 2020-01-09T15:54:31+00:00 Moonu Shrestha Srijana Karki <p><strong>INTRODUCTION: </strong>Health organizations are characterized by multidimensional and complex environment that makes nurses prone to occupational hazards and injuries.</p> <p><strong>MATERIAL AND METHODS:&nbsp; </strong>A descriptive cross-sectional study was conducted to find out the knowledge regarding occupational health hazards among nurses. Sixty one respondents were selected as the study sample by using enumerative sampling method. Self- administered structured questionnaire was used to collect the data and collected data were analyzed by using descriptive and inferential statistics with SPSS software version 16.</p> <p><strong>RESULTS: </strong>The findings of the study revealed that 70.5% of respondents had knowledge on meaning of occupational health hazards. Forty six percent had knowledge regarding meaning of biological hazards, 86.9% and 65.6% had knowledge on high risk person and immediate management for blood and body fluids exposure respectively. The finding of the study showed that 52.5% had high knowledge and 47.5% had low knowledge regarding occupational health hazards. There was statistically significant association between in-service training and respondents' level of knowledge regarding occupational health hazard (p-value= 0.024).</p> <p><strong>CONCLUSION: </strong>Based on findings of the study, it is concluded that more than half of the respondents have high knowledge regarding occupational health hazards. Besides this, respondents have high knowledge on meaning of occupational health hazards, causative agents of biological hazards, diseases that can occur after exposure to infected body fluids, preventive measures and low knowledge on meaning of biological hazards, virus having chance of transmission and first person to report after exposure to blood and body fluids.</p> 2019-12-31T00:00:00+00:00 ##submission.copyrightStatement## Normal Kidney Size in Nepalese Female at KMCTH 2020-01-09T15:54:32+00:00 Muna Badu Shankar Bahadur Singh Rajbhandari Pashupati Regmi <p><strong>INTRODUCTION: </strong>Baseline knowledge of normal kidney size is essential when evaluating patients with possible renal disease. This study was done to assess normal kidney size in Nepalese female at Kathmandu Medical College Teaching Hospital.</p> <p>&nbsp;<strong>MATERIALAND METHODS:&nbsp; </strong>Prospective hospital based cross sectional study was conducted including 231 adult females without any known renal diseases from &nbsp;November &nbsp;2018 &nbsp;to February 2019. Renal length was measured as longest pole to pole distance. Renal width was measured as the maximum dimension in the cross section at the level of the renal hilum. Cortical thickness was measured between outer renal margin and renal sinus in transverse plane.</p> <p>&nbsp;<strong>RESULTS: </strong>The mean length of right and left kidneys were 96.53±8.29 mm and 100.47±9.15 mm respectively with a range of 76-120 mm and 78-120 mm respectively. The mean renal width was 46.80±6.87 mm for right kidneys and 48.61±6.64 mm for left kidneys. The mean cortical thickness were 17.03±3.58 mm for right kidneys and 17.43±3.73 mm for left kidneys. There was significant correlation between length of right and left kidney, however there was no significant correlation between kidney length with kidney width and kidney length with cortical thickness. There was no significant correlation of renal parameters with age, height, weight and body mass index.</p> <p>&nbsp;<strong>CONCLUSION: </strong>Normal kidney size of Nepalese females visiting Kathmandu Medical College was comparable to the previous studies. This will help as future reference to evaluate abnormal kidney sizes.</p> 2019-12-31T00:00:00+00:00 ##submission.copyrightStatement## The Effectiveness of Video Assisted Teaching Programme on Knowledge regarding Percutaneous Transluminal Coronary Angioplasty among Nursing Staff 2020-01-09T15:54:33+00:00 Neelam Shrestha Pragya Shrestha Roshan Dev Yadav <p><strong>INTRODUCTION:</strong> Percutaneous Transluminal coronary Angioplasty (PTCA) is an increasingly important revascularization strategy in coronary artery disease management and can be an emergent planned or rescue procedure. Nurses play a critical role in delivering care both in the independent and collaborative contexts of PTCA management. To improve the care given to patients, it is important to base practice on high level evidence. The study was carried out to assess the knowledge regarding percutaneous transluminal coronary angioplasty among nursing staffs and to evaluate the effectiveness of video assisted teaching programme.</p> <p><strong>MATERIAL AND METHODS:&nbsp; </strong>Quasi experimental one group pre-test post-test research was done. The target population for the study were nursing staffs working in Universal College of Medical Sciences (UCMS), Bhairahawa and those who were willing to participate were included in the study and non-willing staffs were excluded. The total duration of study was three months from 25/07/2018 to 22/10/2018.Convenient sampling technique was used for the study. Among 102 nursing staffs, 62 nursing staffs were participated in the study. The time taken to complete the demographic data and questionnaire was 20-30 minutes. On the same day after the pre-test video assisted teaching programme was administered to the subject to assess the knowledge regarding Percutaneous Transluminal coronary angioplasty. Post-test was conducted with the same questionnaire on the seventh day of pre-test. &nbsp;Data was collected using structured questionnaire. Statistical analysis was done using SPSS version 20.0.</p> <p><strong>RESULTS:</strong> The findings of the study revealed that only 1.6% of the nurses had adequate level of knowledge before video assisted teaching programme which increased to 64.5% in post-test.</p> <p><strong>CONCLUSION: </strong>The knowledge score of most of the nurses on PTCA was moderate before the administration of video assisted teaching programme whereas as most of the nurses had adequate knowledge score after the teaching. There was overall gain in knowledge score following the video assisted teaching programme</p> 2019-12-31T00:00:00+00:00 ##submission.copyrightStatement## The Analysis of Cell Phone Usage among Medical Students in UCMS, Bhairahawa, Nepal 2020-01-10T05:24:00+00:00 Nisha Maddheshiya Varun Rastogi Vanita Gautam Nishant K <p><strong>INTRODUCTION: </strong>The smartphones have become an integral part of human's life. It combines different sophisticated features that allow users to keep pictures, memories, personal information, correspondence, health and financial data in one place. The phones allow people to maintain continuous communication without interruption of their movements and distances. Smartphones and handheld devices (HHD) combine advanced computing capability, such as internet communication, information retrieval, video, e-commerce and other features, that makes the device one of the indispensable requirements for many people.</p> <p><strong>MATERIAL AND METHODS: </strong>The research work was carried out to understand and also find correlation between excess usage of cell phones and its impact on human health. The study incorporates structured questionnaire administered to 200 medical students of their knowledge with the data obtained and statistically analyzed during the course of the study.</p> <p><strong>RESULTS: </strong>Our findings indicated that students are influenced negatively by mobile phones because attention is focused on chatting, music, surfing, entertainment and movies neglecting their health that has an impact on their physical and psychological status, which directly relates to the duration of usage of phone.</p> <p><strong>CONCLUSION: </strong>Mobile phone is one of the technologies of present era. It has both positive and negative impact on society. However, addiction and huge reliance on cell phones carry risks on human development and health. The current study highlights potential risks that cell phones can cause to medical students and the negative impact it has on their health status.</p> 2019-12-31T00:00:00+00:00 ##submission.copyrightStatement## Experiences of Women with Infertility attending Gynae OPD of Tertiary Hospital of Rupandehi 2020-01-09T15:54:36+00:00 Saraj Gurung Sulochana Ghimire Anuja Kachapati <p><strong>INTRODUCTION:</strong> One of the most important and underappreciated reproductive health problems in developing countries is the high rate of infertility and childlessness. The inability to have a child is frequently considered a personal tragedy affecting the entire family and even the local community.</p> <p><strong>MATERIAL AND METHODS: </strong>The descriptive phenomenological research design was used to explore experiences of women with infertility. Fifteen women with infertility were selected by purposive sampling technique. Data was collected through in-depth interview method using unstructured questionnaire and thematic analysis was done.</p> <p><strong>RESULTS: </strong>Among 15, 46.66% of the participants had gynecological problems and 53.33% had medical problems such as hypothyroidism and hyperthyroidism. Thirty-three percentage of participants' spouse had problem of low sperm count and absence of sperm. Most of the participants and their spouses were under treatment. Sixty percentage of the participants had experienced psychosocial problems and 26.66% had experienced physical and sexual problems because of infertility.</p> <p><strong>CONCLUSION:&nbsp; </strong>It is concluded that participants are suffered mainly from psychosocial problems beside that physical and sexual problems. Cent percent of the participants were under treatment and majority of participants said they will try for conception until fertility seized. One third of participants spouse had problem of sperm. It is recommended to concerned authority of hospital to provide couple counseling regarding infertility</p> 2019-12-31T00:00:00+00:00 ##submission.copyrightStatement## Comparative Study of Length and Diameter of Umbilical Cord in Normal Vs Gestational Hypertensive cases in a Tertiary Care Hospital in Eastern Nepal 2020-01-10T05:25:13+00:00 Subodh Kumar Yadav Renu Yadav Abhishek Karn Rakesh Kumar Adhikari <p><strong>INTRODUCTION :- </strong>The well being of the fetus and hence the baby is influenced by a number of factors among which the length and diameter of umbilical cord is one important aspect. Studies have found association between gestational hypertension and the structure of umbilical cord. The objective of this study was to determine the effects of gestational hypertension on the length and diameter of umbilical cord.</p> <p>&nbsp;<strong>MATERIAL AND METHODS :- </strong>A total of 70 umbilical cords with placenta were collected in Nobel Medical College and Teaching Hospital for comparison of umbilical cords length and diameter between normotensives and patients with gestational hypertension. Data were statistically analyzed.</p> <p>&nbsp;<strong>RESULTS :- </strong>The difference in umbilical cords' diameter was statistically significant between normotensives and patients with gestational hypertension whereas the length of the umbilical cord had no statistically significant difference.</p> <p>&nbsp;<strong>CONCLUSION :- </strong>We concluded that gestational hypertension affects the diameter of umbilical cord by decreasing it significantly which may affect normal fetal development.</p> 2019-12-31T00:00:00+00:00 ##submission.copyrightStatement## Critical Thinking in Nursing Education and Nursing practice 2020-01-09T15:54:39+00:00 Anuja Kachapati Sulochana Ghimire <p>Critical thinking is an essential component to competent nursing practice. Although critical thinking has been widely studied among student nurses.</p> <p>Nursing education consists of the theoretical and practical training provided to nurses with the purpose to prepare them for their duties as nursing care professionals.</p> <p>&nbsp;Nurse educators are under pressure to show critical thinking as a program outcome. Many different strategies have been suggested for developing critical thinking among nursing students. It is easy to believe these strategies increase critical thinking, but not all have actually been measured for reliability or validity. Based on an exhaustive literature search, the author attempted to identify teaching strategies that are being used to increase critical thinking and how effective those strategies have been.</p> 2019-12-31T00:00:00+00:00 ##submission.copyrightStatement## From Dismissal to Triumph in Scientific Publication 2020-01-09T15:54:40+00:00 Khushbu Adhikari Anand Kumar <p>For many aspiring researchers publishing their work in high-impact journals is a dream. An article is a publication that illustrates one or more outcomes of a well-designed and executed research. Scientific publishing is an essential aspect of medical progress where new advances in human knowledge are communicated to the outside world through it. Therefore, it is crucial that this knowledge is accurate, valid, reproducible, and of clinical use. One should follow the protocol provided by the journals for their dreams to become reality while writing research articles. In this paper, we discuss the points to focus in order to avoid rejection and increase the likelihood of getting published by providing what editors look for in a successful manuscript.</p> 2019-12-31T00:00:00+00:00 ##submission.copyrightStatement## Small Bowel Obstruction due to Foreign Body Ingestion in an Autistic Child 2020-01-09T15:54:41+00:00 Rajesh Poudel Samir Shrestha <p>&nbsp;The pica phenomenon is common in patients with behavioral and developmental disorders, particularly autism. Most ingested foreign bodies pass through the gastrointestinal system spontaneously and without complication. Small bowel obstruction is an uncommon complication of ingested foreign body. Herein, we present the case of an autistic child who was operated for peritonitis due to an unusual foreign body.</p> 2019-12-31T00:00:00+00:00 ##submission.copyrightStatement##