Journal of Universal College of Medical Sciences 2022-08-10T09:31:26+00:00 Prof. (Dr.) Hemant Kumar Halwai Open Journal Systems <p>An official medical journal of the Universal College of Medical and Dental Sciences, Ranigaon, Bhairahawa, Nepal</p> Human Monkeypox: An Emerging and Neglected Viral Zoonosis of Public Health Concern 2022-08-01T12:53:42+00:00 Rajeshwar Reddy Kasarla <p>The world has witnessed several emerging and re-emerging infectious diseases. The recent COVID-19 pandemic is one of the biggest incidents that happened in human history.&nbsp; The war against COVID-19 is not over yet, and the sudden and unexpected outbreak of monkey pox has begun to invoke panic worldwide. Monkeypox is a rare viral zoonotic disease that occurs primarily in tropical rainforest areas of central and West Africa.</p> 2022-08-09T00:00:00+00:00 Copyright (c) 2022 Journal of Universal College of Medical Sciences Doxycycline Induced Toxic Epidermal Necrolysis with a Single Dose: A Case Report 2022-08-04T12:45:45+00:00 Navin Patil Anjan Palikhey Chandra Mohan Sah Shanti Gurung Laxmi Shrestha Jharana Shrestha Laxmi Pathak <p>Toxic epidermal necrolysis (TEN) is a rare, life-threatening, severe epidermal necrolytic exanthematous vesicobullous usually drug-induced, mucocutaneous disease characterized by a widespread sloughing of the skin and mucosal surfaces. The most common drugs attributable to cause TEN are antibiotics, anti-inflammatory drugs, chemotherapeutic agents, antivirals, and anticonvulsants. The evolution is accompanied by local as well as general complications which can range from superinfections to multiple organ failure. It is of utmost importance that the treating physician promptly recognizes these conditions, withdraws the offending drug and follows the specific treatment protocol and guidelines (SCORTEN) which together would constitute for a better management and prognosis, with higher rates of survival, and a low prevalence of sequlae. We hereby report the first ever case in Nepal of Doxycycline induced Toxic epidermal necrolysis with a single dose at a tertiary care center.</p> 2022-08-09T00:00:00+00:00 Copyright (c) 2022 Journal of Universal College of Medical Sciences Thyrotoxicosis Induced Hypokalemic Periodic Paralysis in Organophosphorous Poisoning: A Case Report 2022-08-04T13:07:36+00:00 Manoj Karki Bidhata Rayamajhi Prabesh Raghubanshi Sanjog Kandel Goody Jha Narayan Gautam Rano Mal Piryani Monica Nepal <p>Organophosphate poisoning is a common emergency illness that requires medical attention because it causes a cholinergic state. As a result, atropine infusion is a sensible therapy option for patients. In our clinical setting, however, the unusual complication of thyrotoxicosis-induced hypokalemic periodic paralysis was reported.</p> 2022-08-09T00:00:00+00:00 Copyright (c) 2022 Journal of Universal College of Medical Sciences A Study of Functional Outcome of Retrograde Intramedullary Interlocking Nailing in Treatment of Supracondylar Femoral Fracture 2022-08-01T13:05:41+00:00 Prakriti Raj Kandel Bipan Shrestha Kishor Man Shrestha Pritam Chaudhary <p><strong>INTRODUCTION<br /></strong>Fractures of the distal femur are usually sustained from high velocity trauma in adults and trivial fall in elderly. These fractures are usually associated with severe degree of comminution and intra-articular involvement. Therefore, anatomical reduction of fracture fragments, restoration of limb length, and early mobilization are key factors for optimal outcomes of involved limb. This longitudinal study was intended to evaluate the functional outcome of distal femoral fracture in adults managed surgically by Retrograde Nail.</p> <p><strong>MATERIAL AND METHODS<br /></strong>This prospective and observational hospital based study was carried out in Orthopedics Department, Universal College of medical Sciences-Teaching Hospital (UCMS-TH) from July 2020 to June 2021. All patients with traumatic distal femoral fractures (AO/OTA type A) who fulfilled the inclusion criteria were enrolled in the study and were treated surgically by Retrograde Nail. Fracture was classified according to AO/OTA classification and functional outcome was assessed according to Neer’s scoring system. Post-operatively patients were regularly followed at 6 weeks, 3 months and 6 months.</p> <p><strong>RESULTS<br /></strong>In this study of 30 cases, male to female ratio was 3:2 with mean age of 39.47 years. Road Traffic Accident (RTA) was most common mode of injury. The functional outcome evaluated according to Neer’s scoring system was found good result in 43.3%, excellent in 36.7%, fair in 16.7% and poor in 3.3%. The mean Neer’s score was 78.9.</p> <p><strong>CONCLUSION<br /></strong>Distal femoral fractures (AO/OTA type A) when treated with retrograde nailing has good to excellent functional outcome in majority of cases with minimal manageable complication.</p> 2022-08-09T00:00:00+00:00 Copyright (c) 2022 Journal of Universal College of Medical Sciences Clinical Profile and Outcome in Patients with Organophosphorous Poisoning 2022-08-02T05:33:12+00:00 Niraj Kumar Jaiswal Pushpa Raj Dhakal Manish Dahal Aakash Shahi Manoj Karki Shatdal Chaudhary <p><strong>INTRODUCTION<br /></strong>Organophosphorous poisoning is a prevalent emergency care problem found in Nepal. Nepal being agricultural country and pesticide being easily available, organophorous poisoning is most common cause of poison related morbidity and mortality in Nepal. Main objective of the study is to evaluate the clinical profile and outcome of patients on the basis of demographic profile, type of compound, presenting symptoms and outcome.</p> <p><strong>MATERIAL AND METHODS<br /></strong>Our study included 80 patients with organophosphorous ingestion, admitted in ICU and wards of Universal College of Medical Sciences Teaching Hospital (UCMS-TH), Bhairahawa, Rupendehi, Nepal from1th July, 2019 AD to 30th July 2020 AD. Ethical clearance was obtained along with consent from patient. Data was collected from patient’s visitor.</p> <p><strong>RESULTS<br /></strong>Females (63%) were more common than males (37%). Age group 21-30 was most likely to ingest OP compound for suicidal attempts.Chlorpyriphos (80%) was most common compound ingested.41% cases consumed alcohol, 10% cases were smokers, 11% cases had diabetes and 22% cases had hypertension. Vomiting (90% cases) was most common symptom. 54% cases had hospital stay of less than 5 days and 43% cases had hospital stay of 5-10 days.Based on POP scoring 24 cases of moderate severity 1 case died where as 3 cases out of 8 severe cases died.74% had uneventful recovery,11% developed intermediate symptoms,10% needed ventillatory support and 5% died due to poisoning. </p> <p><strong>CONCLUSION<br /></strong>Organophosphorous poisoning was the most common acute poisoning in young female population.Strict policies against the free availability and sale of insecticides is required to control organophosphorus poisoning.</p> 2022-08-09T00:00:00+00:00 Copyright (c) 2022 Journal of Universal College of Medical Sciences Plasma CRP Level and its Association with Outcome in Patients with Severe COVID-19 Pneumonia 2022-08-02T05:50:52+00:00 Pushpa Raj Dhakal Niraj Kumar Jaiswal Manish Dahal Manoj Karki <p><strong>INTRODUCTION<br /></strong>Corona virus disease 2019 (COVID-19) has become a global public health issue with unpredictable progression to ARDS. Therapy timing of anti-inflammatory agents and immune-suppressing medication is of utmost importance. Previous studies have consistently found elevated levels of C-Reactive Protein with disease severity. In this study, we aimed to investigate the relationship between C-Reactive Protein and severe SARS-COV-2 pneumonia.</p> <p><strong>MATERIAL AND METHODS<br /></strong>Our study included 55 patients with COVID-19, admitted in COVID Unit of Universal College of Medical Sciences Teaching Hospital (UCMS-TH), Bhairahawa, Rupendehi, Nepal from 16<sup>th</sup> June 2021 to 15<sup>th</sup> September 2021. We included COVID-19 cases confirmed by a RT-PCR test with severe pneumonia based on W.H.O criteria and those undergoing C-Reactive Protein levels.</p> <p><strong>RESULTS<br /></strong>Males (56%) were more compared to females (44%). Age group 41-60 years were likely to develop severe COVID-19 pneumonia. Cough (44%), dyspnea (42%) and fever (40%) were most common symptom. Hypertension (34%) and diabetis (24%) were common comorbidities present. Patients with severe COVID-19 pneumonia had average CRP value of 59.6 mg/l.</p> <p><strong>CONCLUSION<br /></strong>Elevated CRP level was associated with COVID-19 severity.</p> 2022-08-09T00:00:00+00:00 Copyright (c) 2022 Journal of Universal College of Medical Sciences The Outcome of Trauma Patients in the Mixed Semi-closed Intensive Care Unit 2022-08-03T12:36:34+00:00 Niraj Kumar Keyal Rajesh Yadav Alok Kumar Singh Amit Singh Mohammed Islam Mansuri <p><strong>INTRODUCTION<br /></strong>Nepal due to its geographical condition, inadequate resuscitation on time, and lack of full-time intensivist in a trauma team is a cause of trauma-related morbidity and mortality.</p> <p><strong>MATERIAL AND METHODS<br /></strong>It was a prospective, descriptive observational cross-sectional study in a level three intensive care unit of National Medical College for six month. All patients &gt;18 years with a history of road traffic accidents, falls, drowning, physical assaults, and self-inflicted violence admitted to the mixed intensive care unit of a tertiary care hospital were included in this study.</p> <p><strong>RESULTS<br /></strong>One hundred and ninety-one patients were included in this study. 152(79.5%) were males and 39(20.4%) were females. A road traffic accident was the most common mode of injury in 166(86.9%) patients. 178(93.1%) patients survived and went home, 10(5.3%) expired, 2(1%) left the hospital against medical advice (LAMA) and 1(0.5%) gave do not resuscitate orders (DNR). The mean days on the mechanical ventilator was 3.39±2.57 days. Mortality in an intubated patient was 8.6%. Mean LOS in the ICU was 4.28±4.12 days. SOFA and APACHE II scores were a good predictor of outcome, with the SOFA score being the most effective Injury severity score predicted mortality with a sensitivity of 88.9%, a specificity of 22%, with an AUROC curve of 0.543±0.092 with cut off score of 5.5.</p> <p><strong>CONCLUSION<br /></strong>Raising public awareness, and strictly following the traffic rules can help in reducing the incidence of trauma. Trauma team consisting of full-time intensivists should be established to decrease the mortality in the intensive care unit.</p> 2022-08-09T00:00:00+00:00 Copyright (c) 2022 Journal of Universal College of Medical Sciences Myringoplasty graft uptake: Short and long term outcome 2022-08-03T13:26:41+00:00 Roshan Acharya Bishow Tulachan Anup Acharya <p><strong>INTRODUCTION<br /></strong>Myringoplasty is surgical procedure to restore tympanic membrane perforation. The objective of the study is to compare overall success rate of myringoplasty after 6 weeks and 6 months post-operatively.</p> <p><strong>MATERIAL AND METHODS<br /></strong>This is a retrospective, comparative study carried out in the Department of ENT (Ear, Nose and Throat) and Head and Neck Surgery (ENT-HNS), Universal College of Medical Sciences-Teaching Hospital (UCMS-TH), Bhairahawa, Rupandehi, Nepal. All the data was collected from the operative notes and operative record book of our hospital which were done from October 2018 to September 2020 over a period of 24 months by single surgeon. A total of 77 patients with age range of 12-70 years including all gender with chronic otitis media (COM) mucosal type, inactive who underwent myringoplasty were studied. Graft uptake results were assessed after 6 weeks and 6 months following surgery.</p> <p><strong>RESULTS<br /></strong>The age of the patients ranged from 12-70 years. The mean ± standard deviation (S.D) of age was 27.84 ± 13.16 years. There were 47 (61%) female patients and 30 (39%) male patients involved in the study. Graft uptake success rates were 84.4% (65) and 83.1% (64) after 6 weeks and 6 months respectively.</p> <p><strong>CONCLUSION<br /></strong>No statistical significance was noted in graft success and failure rates between 6 weeks and 6 months (p = 0.320).</p> <p><strong> </strong></p> 2022-08-09T00:00:00+00:00 Copyright (c) 2022 Journal of Universal College of Medical Sciences Clinicoepidemiological Pattern and Outcome of Poisoning in Children in a Tertiary Care Hospital of Western Nepal 2022-08-03T13:35:10+00:00 Nagendra Chaudhary Binod Kumar Gupta Astha Poudel Pradip Chhetri <p><strong>INTRODUCTION<br /></strong>Poisoning in children is one of the leading public health problem in low and middle income countries and a common cause of morbidity and mortality.</p> <p><strong>MATERIAL AND METHODS<br /></strong>This prospective observational study was conducted for one year from 1<sup>st</sup> June, 2019 to 31<sup>st</sup> May 2020 to study the clinicoepidemiological pattern and outcome of children with poisoning in a tertiary care hospital of western Nepal.</p> <p><strong>RESULTS<br /></strong>Total 38 children with poisoning were admitted and enrolled during the study period. The frequency of poisoning in children aged 0-5 years, 6-10 years and 11-16 years were 47.4%, 18.4% and 34.2% respectively. Poisoning was predominant in females (n=21, 55.3%). Majority poisoning cases (55.3%) were noticed in between May to August. More than three-fourth of the poisoning cases were noticed in the afternoons and evenings. Pesticides (organophosphorus, fungicide, herbicide, aluminium phosphide, and household rodenticides/insecticides) constituted 55.7% of total poisoning cases. Household rodenticides/ insecticides, volatile hydrocarbons and organophosphorus poisonings were noticed in 23.7%, 15.8% and 13.2% respectively.</p> <p>Three-fourth of the cases were symptomatic during the presentation where vomiting (76.3%), abdominal pain (34.2%) and constricted pupils (18.4%) were three major clinical symptoms and signs due to poisoning. About 84.2% cases survived. Complications were observed in about 15.8% cases where shock and respiratory failure was seen in 10.5% each followed by pneumonia (7.9%) and hepatitis (5.3%).</p> <p><strong>CONCLUSION<br /></strong>Poisoning was common in children less than 5 years of age and majority of them were accidental in nature. Household rodenticides/insecticides, volatile hydrocarbons and organophosphorus poisonings were common types of poisoning.</p> 2022-08-09T00:00:00+00:00 Copyright (c) 2022 Journal of Universal College of Medical Sciences Reliability of ‘Ottawa Ankle Rules’ in Acute Ankle and Midfoot Injuries 2022-08-03T13:43:10+00:00 Abhishek Kumar Thakur Prakriti Raj Kandel <p><strong>INTRODUCTION<br /></strong>The Ottawa ankle rules (OARs) are clinical decision guidelines used to identify whether patients with ankle injuries need to undergo radiography. The OARs have been proven that their application reduces unnecessary radiography.</p> <p><strong>MATERIAL &amp; METHODS<br /></strong>This prospective study was conducted at Sumeru City Hospital, Lalitpur in the Department of Emergency and Outpatient Department of Orthopaedics. Thirty-six patients were included in the study. Twenty-five patients were in ankle group and 11 patients were in midfoot group. All patients were sent for X-rays after evaluating them according to OARs.</p> <p><strong>RESULTS <br /></strong>Among 36 cases, 8 clinically significant fractures were found. Sensitivity of OARs for detecting fractures was 100 % for both ankle and midfoot group. Specificity of OARs for detecting fractures were 47.36 % for ankle group and 66.67 % for midfoot group. Negative predictive value of OARs was 100 %.<strong> </strong></p> <p><strong>CONCLUSION<br /></strong>OARs are very accurate and highly sensitive tools for detecting fractures in acute ankle and midfoot injuries. Implementation of these rules would lead to significant reduction in the number of radiographs and thereby reduce the cost of the treatment, radiation exposure and waiting time of patients at hospital.</p> 2022-08-09T00:00:00+00:00 Copyright (c) 2022 Journal of Universal College of Medical Sciences Relation of Cholelithiasis and Body Mass Index among Different Age Groups 2022-08-03T13:50:32+00:00 Umesh Kumar Yadav Pashupati Bhatta Akash Raya Vibina Aryal <p><strong>INTRODUCTION<br /></strong>Cholelithiasis is a common presentation in the department of surgery. One of the potential risk factors of cholelithiasis is obesity, which is a common problem faced by most adult population. The aim of this study is to see the association of cholelithiasis with body mass index among different age groups.</p> <p><strong>MATERIAL AND METHODS<br /></strong>This cross-sectional study was done in the Department of General Surgery of National Medical College, Birgunj. Ethical clearance (Ref. F-NMC/565/078-079) was obtained from the institutional review committee. Total of 75 subjects were included in the study. Subjects presenting with cholelithiasis in the out-patient department of Surgery were included in the study. Height and weight of the subjects were recorded along with age and other parameters. Body mass index (BMI) was calculated using the Quetelet’s formula, weight in kg/ height in m<sup>2</sup>. The body mass index was than categorized according to World Health Organization.</p> <p><strong>RESULTS<br /></strong>The mean age of the total participants was 43.85±11.82 years. The mean BMI was 25.81±9.95 kg/m<sup>2</sup>. Among the age group 20 – 35 years 30% were overweight and 15% were obese where as in age group 36 – 50 years 44.4 % were overweight and 11.2 % were obese. Similarly in participants above 50 years 32.1% were overweight and only 3.6% were obese.</p> <p><strong>CONCLUSION<br /></strong>Cholelithiasis is one of the common surgical problems. Number of patients with gallstones increases with increasing age. In this study, more number patients are seen with normal BMI. However, higher number of patients are found having overweight or obesity in the age group of 36-50 years.</p> 2022-08-09T00:00:00+00:00 Copyright (c) 2022 Journal of Universal College of Medical Sciences Efficacy and Safety of Dipeptidyl Peptidase-4 Inhibitor Compared to Sulphonylurea in Type II Diabetes Patients Inadequately Controlled with Metformin Alone 2022-08-04T04:27:07+00:00 Anjan Palikhey Manoj Karki Jharana Shrestha Laxmi Shrestha Amit Kumar Shrivastava Chandrajeet Kumar Yadav Bidhata Rayamajhi <p><strong>INTRODUCTION<br /></strong>Diabetes is a metabolic disorder marked by high blood glucose levels, and treatment often requires multiple drugs to achieve adequate glycemic control. In individuals with type 2 diabetes mellitus who do not respond to Metformin, doctors may prescribe a Dipeptidyl Peptidase-4 inhibitor or a Sulphonylurea as potential add-on therapy. The study was conducted to compare the efficacy and safety of the Dipeptidyl Peptidase-4 inhibitor with Sulphonylurea.</p> <p><strong>MATERIAL AND METHODS<br /></strong>This was an interventional, comparative study involving 100 type 2 diabetic patients who visited the Medicine department at Universal college of Medical Sciences. All the eligible patients were randomly divided into two treatment groups (50 each): Group A (Sulphonylurea + Metformin) and Group B (Dipeptidyl Peptidase-4 inhibitor + Metformin). Treatment was provided for 18 weeks, and patients were investigated for blood glucose parameters like glycosylated hemoglobin, fasting blood glucose, postprandial glucose at baseline and after 18 weeks of follow-up, and questions regarding adverse reactions. The efficacy of the drugs between the two treatment groups was compared using an independent t-test.</p> <p><strong>RESULTS<br /></strong>Dipeptidyl Peptidase-4 inhibitor plus Metformin was found to be superior to Sulphonylurea plus Metformin in terms of HbA1c-lowering efficacy (p=0.030). A total of 26% of patients in the Sulphonylurea group reported unpleasant hypoglycemic events, compared to 6% in the Dipeptidyl Peptidase-4 inhibitor group (p=0.006). Patients treated with Sulphonylurea gained weight over 18 weeks, but those on Dipeptidyl Peptidase-4 inhibitor lost weight (p=0.043).</p> <p><strong>CONCLUSION<br /></strong>Compared to Sulphonylurea, adding a Dipeptidyl Peptidase-4 inhibitor to a Metformin therapy significantly improves glycaemic control in type 2 diabetic patients who are not well controlled with Metformin monotherapy, without producing hypoglycemia or weight gain.</p> 2022-08-09T00:00:00+00:00 Copyright (c) 2022 Journal of Universal College of Medical Sciences Assessment of Knowledge, Attitude, and Practices of Adjunctive Oral Hygiene Aids Brushing Among Medical and Dental Students in UCMS, Nepal 2022-08-04T05:37:38+00:00 Bikash Kumar Baniya Soni Bista Nitin Sangwan Pujan Acharya <p><strong>INTRODUCTI</strong><strong>ON<br /></strong>Periodontal disease is a bacterial infection that affects tissues that support the teeth and bacterialplaque is the primary cause of this disease. In the interdental spaces, periodontal disorders are more common as a result, removing plaque from these regions is critical. This can be managed by using various interdental cleaning aids such as dental floss, interdental brushes, and chemical agents such as mouth washes. Thus, the aim of our study is to assess the knowledge of other oral hygiene aids except brushing among medical and dental students in a Teaching hospital. This is a knowledge, attitude, and practices model of analyzing the knowledge of adjunctive oral hygiene aids performance and measures other than tooth brushing among medical and dental students.</p> <p><strong>MATERIAL AND METHODS<br /></strong>A Knowledge, Attitude and Practices (KAP) survey was designed for the present cross-sectional study which was conducted for a period of three months from July 2021 to September 2021 among a sample of 275 medical and dental undergraduates in a Teaching hospital. Pre-tested structured 22-item closed-ended questionnaire was given to each on survey tool and the link was passed to the participants. Statistical analysis was done using SPSS (version 21.0) software.</p> <p><strong>RESULTS<br /></strong>The response rate for the present survey was 98.9% (272 participants). It was seen that, 29.78% participants reported that poor oral hygiene is the main cause of bleeding and 59.19 % believed that poor oral hygiene is responsible for bad breath. A total of 65.81% reported that most widely recommended interdental aid to be used is dental floss. On gender wise comparison, significant positive response (<em>p&lt; 0.05) </em>was seen among females for items (2,6,11) as compared to males. On stream wise comparison, significant positive response <em>(p&lt; 0.05) </em>was seen among dentists for items (16,17,20) as compared to medical students.</p> <p><strong>CONCLUSION<br /></strong>The study concluded that dental and medical students must be encouraged to be good role models in practicing as well as promoting oral health for their patients, families, friends and ultimately the society.</p> 2022-08-09T00:00:00+00:00 Copyright (c) 2022 Journal of Universal College of Medical Sciences Prevalence of Maxillary Impacted Canine among Orthodontic Patients of Universal College of Medical Sciences, College of Dental Surgery, Bhairahawa, Nepal 2022-08-04T07:03:27+00:00 Sandeep Kumar Gupta Hemant Kumar Halwai Raju Shrestha <p><strong>INTRODUCTION<br /></strong>In general, canines play an essential role in establishing a functional occlusion as well as serving as the foundation of an esthetic smile. With the exception of the third molars, impaction of the maxillary permanent canines is the most common form of tooth impaction and prevalence of impacted permanent canine has been reported in 1-5% of population. In this study, we aimed to determine the prevalence of maxillary canine impaction among orthodontic patients of Universal College of Dental Surgery, Bhairahawa, Nepal.</p> <p><strong>METHODS <br /></strong>A retrospective study was conducted on orthodontic patients at UCMS,CODS during august 2017 to august 2019. The study included clinical examination of 384 patients who visited Department of orthodontics and Dentofacial Orthopedics seeking orthodontic treatment.</p> <p><strong>RESULTS <br /></strong>This study reveals, a total of 22 (5.73%) patients having maxillary canine impaction, where 13 (59.09%) were females and 9 (40.90%) were males. Likewise 6 (27.27% ) palatal and 16 (72.72%) buccal maxillary canine impaction was found.</p> <p><strong>CONCLUSION<br /></strong>Maxillary canines fulfill important esthetic and functional roles. Unfortunately, prevalence of impacted maxillary canine is approximately 5%, the second highest frequency behind that of third molar impaction. The prevalence of impacted maxillary canine is found to be (5.73%), where 13 (59.09%) were females and 9 (40.90%) were males. Likewise 6 (27.27% ) palatal and 16 (72.72%) buccal maxillary canine impaction was found.</p> 2022-08-09T00:00:00+00:00 Copyright (c) 2022 Journal of Universal College of Medical Sciences An Observational Study on Root Canal Morphology of Mandibular Incisors in a Dental College Hospital 2022-08-04T08:36:58+00:00 Sandhya Shrestha Anu Karmacharya Ankit Saha Meenu Shrestha <p><strong>INTRODUCTION<br /></strong>Additional canals are frequent findings in radicular morphology of the mandibular incisors. Finding additional canals and their obturation significantly improve the prognosis of endodontic treatment. Cone Beam Computed Tomography (CBCT) best visualize all canals and their configurations. The study assessed root canal anatomy of mandibular incisors on CBCT images of the patients.</p> <p><strong>MATERIAL AND METHODS<br /></strong>An observational cross-sectional study was carried during July-October 2021 on 42 CBCT images of the patients visiting Kantipur Dental College and Hospital. The samples were selected using convenience sampling presenting with bilateral mandibular central and lateral incisors. Root canals and their configurations were assessed on 168 teeth. The presence of unilateral or bilateral additional root canal was recorded and chi-square test was used to test its association with gender (<em>p</em> &lt; 0.05).</p> <p><strong>RESULT<br /></strong>The prevalence of additional canal was 27.4% in mandibular incisors. Bilateral symmetrical distribution of extra canal in mandibular central and lateral incisors were 36.3% and 41.6% respectively. There was a significant association between the presence of extra canal and gender in both central incisors (<em>p</em>-value 0.019) and lateral incisors (<em>p</em>-value 0.009). Type I canal configuration was most prevalent (72.6%) followed by Type III (22.6%). </p> <p><strong>CONCLUSION<br /></strong>The prevalence of double canals in mandibular incisors is 35% in male and 4% in female samples confirming the male predominance. Bilaterally symmetrical occurrence of double canal is evident up to 41%. CBCT evaluation helps in the visualization of missing root canals during endodontic therapy.</p> 2022-08-09T00:00:00+00:00 Copyright (c) 2022 Journal of Universal College of Medical Sciences Stroke Related Anxiety and Secondary Stroke Prevention Practices among Stroke Survivors 2022-08-04T09:00:55+00:00 Chanda Sah Sanjeev Shah Gita Neupane Pragya Shrestha Sulochana Ghimire <p><strong>INTRODUCTION<br /></strong>Stroke is a leading cause of death and permanent disability worldwide. A secondary stroke, also known as a recurrent stroke, is one which occurs 24 hours or more after a primary stroke. The objective of this study was to find out the stroke related anxiety, knowledge related to the risk factors of stroke and practices among stroke survivors to prevent secondary stroke. </p> <p><strong>MATERIAL AND METHODS<br /></strong>Descriptive cross-sectional study was conducted to find out stroke related anxiety and secondary stroke prevention practices among 76 purposively selected stroke survivors. Semi- structured interview schedule and Hospital Anxiety and Depression Scale (HADS) were used to collect data. Descriptive statistics (frequency and percentage) were used with SPSS version 20.0 for data analysis.</p> <p><strong>RESULTS<br /></strong>The findings of the study showed that out of 76 stroke survivors, 13.16% had borderline anxiety and 11.84 % were abnormal cases of anxiety. Knowledge on risk factors of secondary stroke as old age (94.74%), physical inactivity (55.26%), smoking (60.53%), excessive alcohol consumption (63.16%) and hypertension (92.11%). Poor practices were found regarding secondary stroke prevention such as monitoring blood pressure regularly (26.53%), regular exercise (40.79%), nearly half had not reduced alcohol intake (44.19%) and had not quit smoking (48.15%).</p> <p><strong>CONCLUSION<br /></strong>Findings of the study showed presence of stroke related anxiety among stroke survivors and poor secondary stroke prevention practices. These data will be helpful for concerned authority to focus on management of post stroke anxiety. It is recommended to concerned authority to conduct awareness program on secondary stroke prevention practices.</p> 2022-08-09T00:00:00+00:00 Copyright (c) 2022 Journal of Universal College of Medical Sciences Descriptive Cross-sectional Study on Mothers’ Knowledge Regarding Prevention of Neonatal Hypothermia 2022-08-04T09:43:03+00:00 Indu Shah Laxmi Paudyal Harikala Soti Nitu S Gautam <p><strong>INTRODUCTION<br /></strong>In today’s era neonatal hypothermia is ranked as high risk factor for newborn survival. Practicing kangaroo mother, mummifying newborn, delaying first bath etc are useful practices for maintaining warm chain and thermo-protection of newborns.</p> <p><strong>MATERIAL AND </strong><strong>METHODS<br /></strong>A cross-sectional descriptive study was used for the study. Setting of the study was post natal ward of Gandaki Medical College Teaching Hospital and Research Center with total sample of 70. Probability convenient sampling technique was used for the study. Data analysis was done through descriptive and inferential statistics.</p> <p><strong>RESULTS<br /></strong>Among the respondents 41.4% mothers were of age between 26-30yrs, majority 75.7% were Hindu, 42.9% had completed secondary level education, more than half 51.4% were residing in nuclear family, 45.7% were housewife, more than half 52.9% had income/month as 15001-20000, more than half 61.4% had normal delivery, and more than half 51.4% had two children. Almost half of the mothers 45.7% of mothers had inadequate level of knowledge, 32.9% had moderate knowledge and 21.4% had adequate knowledge, also there showed significant association between mothers level of knowledge on neonatal hypothermia with educational status, type of family and type of delivery at 5% level (ie., p&lt;0.05). <strong> </strong></p> <p><strong>CONCLUSION<br /></strong>Based on the findings it is concluded that almost half of the mothers have inadequate knowledge regarding neonatal hypothermia. Mothers knowledge might be helpful to prevent newborn from neonatal hypothermia, so training should be provided to mothers and family members during their antenatal period regarding thermal protection of the newborn. </p> 2022-08-09T00:00:00+00:00 Copyright (c) 2022 Journal of Universal College of Medical Sciences Computer Vision Syndrome Among Medical and Engineering Students, Rupandehi, Nepal 2022-08-04T12:06:07+00:00 Neelam Shrestha Roshan Dev Yadav Pragya Shrestha Astha Sharma Pokhrel <p><strong>INTRODUCTION<br /></strong>Computers and laptops have become an integral part of our daily life. We interact with computer screens for minutes to hours depending upon our need, for entertainment or official purposes. Using computers has become a 21<sup>st</sup> century necessity. The expansion of information technologies in recent decades has resulted in increased use of video display terminals (VDT) in the workplace. The American Optometric Association (AOA) defines Computer Vision Syndrome (CVS) as the complex of eye and vision problems related to near work, which are experienced during or related to computer use. CVS is characterised by visual symptoms resulting from interaction with a computer display or its environment. This study aimed to assess the prevalence of computer vision syndrome among medical and engineering students of Rupandehi, Nepal.</p> <p><strong>MATERIAL AND METHODS <br /></strong>A cross‑sectional study was conducted among final year medical and engineering college students of Universal College of medical sciences and Lumbini Engineering college, Rupandehi, Nepal. Sixty-three students were included in the study based on inclusion/exclusion criteria in one-month period (from 1<sup>st</sup> September 2020- 30<sup>th</sup> September 2020. The participants were surveyed using a validated structured questionnaire and the data were analysed using SPSS software version 20.0.</p> <p><strong>RESULTS <br /></strong>Out of total 63 respondents (32 medical students and 31 engineering students), more than half (60.32%) were male. Majority of the respondents (73.01%) had ocular symptoms of CVS among medical and engineering students. Among medical and engineering students the most common symptoms were redness, which was present in 51 (80.95%) of the students, followed by foreign body sensation present in 48(76.19%) and itching in 45(71.43%) of the students.</p> <p><strong>CONCLUSION <br /></strong>This study concludes that more than half of the students complained of any one of the symptoms of CVS. Although CVS has not been found to cause any permanent damage to the eyes, yet it’s painful symptoms can affect the performance.</p> 2022-08-09T00:00:00+00:00 Copyright (c) 2022 Journal of Universal College of Medical Sciences An Emerging Zoonosis of Public Health Concern: A Comprehensive Review on Nipah Virus Infection 2022-08-04T12:22:16+00:00 Kripa Chimire Rajeshwar Reddy Kasarla Shristi Raut Adhikari Laxmi Pathak <p>Nipah virus (NiV) infection is an emerging zoonotic disease, which causes encephalitis and respiratory infections in humans with high mortality rate. Bats (<em>Pteropus</em>) are the natural hosts for for Nipah virus. The infection is transmitted from bats (<em>Pteropus</em>) to pigs and from pigs to humans or human-to-human. Clinical symptoms include fever, headache, dizziness, vomiting followed by drowsiness, disorientation, mental confusion, and neurological signs that indicate acute encephalitis. Due to lack of vaccines and effective antiviral drugs, and diagnostics, NiV infection poses a serious public health concern. The knowledge and scientific information on Nipah virus infection is still unknown or relatively limited to many clinicians, and received little attention; hence this comprehensive review of Nipah virus infection is undertaken to highlight its importance and further research.</p> 2022-08-09T00:00:00+00:00 Copyright (c) 2022 Journal of Universal College of Medical Sciences Methodologies and Models for Integration of Medical Curriculum for Effective Teaching and Learning: A Theoretical Review 2022-08-04T12:32:28+00:00 Rajeshwar Reddy Kasarla Aishwarya Verma Laxmi Pathak <p>There is a famous saying that, ‘Knowledge that is learnt in isolation is rapidly forgotten’. The dictionary meaning of integration is “to make entire”. Integration is defined as the organization of teaching matter to interrelate or unify the subjects which are frequently taught in separate academic courses or departments. Integrated curriculum seeks to break down the barriers between the subject areas i.e. basic and clinical sciences, in order to promote acquisition, retention, and progressive development of knowledge and skills, and facilitate applications of principles and concepts to understand problems and develop new solutions. To learn is to connect thoughts and ideas. If there is no connection, there is no learning. Integration views learning and teaching in a holistic way and reflects the real world, which is interactive. Disconnection breeds apathy while integration thrives on connections. An integrated curriculum helps raising students who will be able to apply their knowledge to their work and personal development. Integrating curriculum is a complex process. It can occur at different rates and some subjects are integrated more easily than others. This article reviews and discusses the comparison and commonalities of two most prominent methodologies/models of integration by Robin Fogarty and Ronald Harden.</p> 2022-08-09T00:00:00+00:00 Copyright (c) 2022 Journal of Universal College of Medical Sciences