Journal of Universal College of Medical Sciences <p>An official medical journal of the Universal College of Medical and Dental Sciences, Ranigaon, Bhairahawa, Nepal</p> en-US <p>Authors have to give the following undertakings along with their article:</p> <ol> <li class="show">I/we declare that this article is original and has not been submitted to another journal for publication.</li> <li class="show">I/we declare that I/we surrender all the rights to the editor of the journal and if published will be the property of the journal and we will not publish it anywhere else, in full or part, without the permission of the Chief Editor.</li> <li class="show">Institutional ethical and research committee clearance certificate from the institution where work/research was done, is required to be submitted.</li> <li class="show">Articles in the Journal are Open Access articles published under the Creative Commons CC BY-NC License (<a href=""></a>)</li> <li>This license permits use, distribution and reproduction in any medium, provided the original work is properly cited, and it is not used for commercial purposes.</li> </ol> (Prof. (Dr.) Hemant Kumar Halwai) (Sioux Cumming) Fri, 25 Jun 2021 16:03:35 +0000 OJS 60 Multiple Odontogenic Keratocysts in a Non-syndromic Young Patient: An Unusual Case Report <p>Odontogenic keratocyst (OKC) is a benign intraosseous lesion with invasive and aggressive behavior. It comprises approximately 2-21.8% of all jaw cysts. Odontogenic keratocysts (OKCs) are believed to arise from remnants of the dental lamina most common site in the molar ramus area. OKCs have a specific histopathologic appearance and are found to be locally aggressive and have a high recurrence rate, thus requires close long-term follow-up. OKCs are one component of the Gorlin-Goltz syndrome and all patients with multiple OKCs should be evaluated for this syndrome. In this paper, we present a case of a 13-year old non-syndromic female patient with multiple OKCs located at symphysis and bilateral mandibular angle region who was treated surgically with no obvious post-operative complications during follow-up period.</p> Ravish Mishra, Laxmi Kandel, Deepak Yadav, Shashank Tripathi, Bijay Karki, Nitesh Chaurasia, Sunil Kumar Singh Copyright (c) 2021 Journal of Universal College of Medical Sciences Tue, 22 Jun 2021 00:00:00 +0000 Post Dural Puncture Headache After Elective Caesarean Section Using 27 G Quincke and Whitacre Spinal Needles: A Comparative Study <p><strong>INTRODUCTION</strong></p> <p>Post-dural puncture headache (PDPH), a serious complication of spinal anesthesia (SA) may persevere for long time and can be unbearable to the patients. The incidence of PDPH unswervingly relies on the size of the spinal needles used and this gradually decreases with the use of thinner spinal needles.</p> <p>&nbsp;</p> <p><strong>MATERIAL AND METHODS</strong></p> <p>A prospective randomized single blinded study was conducted during the period between 1 to 29 January 2019, at Universal College of Medical Sciences, Nepal. A total of 120 patients (between 20-35 years of age) were divided into two groups: Group I: 60 patients given SA with 27-G Quincke needle and Group II: 60 patients given SA with 27-G Whitacre. Randomization was done by coin tossing method and double-blinded except for the anesthetist performing the spinal block. Patients were interviewed on days 1 to 5 and were questioned with regard to headache based on its severity, location, character, duration, associated symptoms (nausea, vomiting, auditory and ocular symptoms). The severity of the headache was analyzed by Crocker scale.</p> <p>&nbsp;</p> <p><strong>RESULTS</strong></p> <p>The results showed that 33% more headache in group A, but the t-value was 0.727 and <em>p</em>-value was 0.2345 which was statistically insignificant.</p> <p>&nbsp;</p> <p><strong>CONCLUSION</strong></p> <p>Hence, using 27-G Quincke spinal needles does appear to be advantageous to the patients whereas, Whitacre spinal needles are shown to be clearly associated with fewer cases of PDPH.</p> Pawan Puspa Baral, Laxmi Pathak, Rejin Kumar Udaya, Anita Lawoju, Sita Pokhrel, Pramod Kumar Gupta Copyright (c) 2021 Journal of Universal College of Medical Sciences Tue, 22 Jun 2021 00:00:00 +0000 Preoperative Determination of Tibia Length Using Contralateral Tibial Tubercle-Medial Malleolar Distance (TMD) in Western Part of Nepal <p><strong>INTRODUCTION</strong></p> <p>Intramedullary (IM) nailing is most commonly preferred for adult tibial shaft fracture. The objective of this study was to find the accuracy of predicting the tibial nail length pre-operatively from contra-lateral tibial tubeorsity to medial malleolar distance (TMD) length.</p> <p><strong>MATERIAL AND METHODS</strong></p> <p>After ethical clearance (UCMS/IRC/239/19) from the Institutional Review Board (IRB) of Universal College of Medical Sciences, all patients with recent fracture of tibia, who fulfilled the inclusion criteria were enrolled in the study and the informed written consent was obtained. The study was conducted on 45 patients of aged more than 15 years who attended Universal College of Medical Sciences Teaching Hospital (UCMS-TH) over a period of one year (Nov 2019 to Oct 2020). The TMD length of contra-lateral leg were measured preoperatively using a measuring tape and the ideal length of IM nail were measured intra-operatively using IM tibial nail under fluoroscopic guidance.</p> <p><strong>RESULTS</strong></p> <p>Analysis showed that majority of patients were males (77.78%) out of total 45 patients. The mean length of TMD length of contra-lateral leg and the ideal length of IM nail were 33.067 ±1.60 and 33.11 ±1.68 respectively. The mean difference between these two measurements was 0.04 (95% CI, -0.64 to 0.72). The significant correlation was found between these two measurements i.e r=0.88 by Pearson’s correlation (95% CI, 0.79 to 0.93), (<em>p</em>&lt;0.001). Most of the TMD length were equal (37.78%) to ideal length of IM nail.</p> <p><strong>CONCLUSION</strong></p> <p>We recommended TMD length measurement of contralateral leg as an excellent anthropometric parameter for preoperative planning.</p> <p><strong>&nbsp;</strong></p> Kishor Man Shrestha, Prakriti Raj Kandel, Bipan Shrestha, Shreshal Shrestha Copyright (c) 2021 Journal of Universal College of Medical Sciences Tue, 22 Jun 2021 00:00:00 +0000 Clinical Profile and Colonoscopic Findings in Patients Presented with Lower Gastrointestinal Bleeding in UCMS <p><strong>INTRODUCTION</strong></p> <p>The lower gastrointestinal bleeding (LGIB) is an alarming symptom and common disease with annual admission of 0.15% with mortality rate of 5-10%. LGIB is caused by neoplastic and non-neoplastic lesions. For accurate diagnosis of various colorectal lesions, colonoscopy is gold standard, convenient and cost effective procedure. It is the investigation of choice in LGIB and helps in early diagnosis of colorectal carcinoma. This study was aimed to scrutinize the clinical and colonoscopic findings in patients with LGIB in UCMS.</p> <p>&nbsp;</p> <p><strong>MATERIAL AND METHODS</strong></p> <p>This was a hospital based prospective observational study conducted after taking permission from institutional review committee in January 2017 at UCMS-TH from 15<sup>th</sup> January 2017 to 15<sup>th</sup> January 2018. All patients presenting with LGIB who fulfilled inclusion and exclusion criteria and gave written consent were included.</p> <p>&nbsp;</p> <p><strong>RESULTS</strong></p> <p>Total 88 patients were included in the study. The mean age of our patients was 48 ±17 years with age range from 17-81 years. Majority were in the age group 50-60 years (25%) (n=22). Colonoscopy detected abnormality in 73.8% cases. The common non-neoplastic were haemorrhoids and non-specific colitis (14.5% each) followed by 12.5% of neoplastic cases. The higher frequency of colorectal lesions was observed in males comprising 72.7% (n=64) patients. The most commonly diagnosed etiologies of LGIB were haemorrhoid and nonspecific colitis respectively.</p> <p>&nbsp;</p> <p><strong>CONCLUSION</strong></p> <p>Colonoscopy detected abnormality in 75% of cases. The common causes of LGIB were haemorrhoids and non-specific colitis followed by neoplastic lesion. A careful history, physical and colonoscopic examination with or without biopsy makes significant impact for early diagnosis and treatment.</p> <p>&nbsp;</p> Aakash Shahi, Suresh Shrestha, Shatdal Chaudhary, Pushpa Raj Dhakal, Anita Shah Copyright (c) 2021 Journal of Universal College of Medical Sciences Tue, 22 Jun 2021 00:00:00 +0000 Surgical Management of Tibial Plateau Fractures with Locking Compression Plate <p>&nbsp;</p> <p><strong>INTRODUCTION</strong></p> <p>Tibial plateau fracture is a common fracture that accounts for 1-2% of all fracture. Various treatment options including proximal tibial plating with locking compression plates are available for the treatment of tibial plateau fracture. This study was done to determine the clinical profile and functional outcome of tibial plateau fracture following locking compression plating.</p> <p><strong>&nbsp;</strong></p> <p><strong>MATERIAL AND METHODS</strong></p> <p>This prospective and observational study was carried out&nbsp;in Orthopedics Department of Universal College of Medical Sciences-Teaching Hospital (UCMS-TH) from December 2018 to July 2020. After Ethical clearance (UCMS/IRC/224/18) from Institutional Review Board (IRB) of UCMS-TH and informed written consent, all patients with tibial plateau fracture (Schatzker II-VI) who fulfilled the inclusion criteria were enrolled in the study and treated with locking compression plate. Post-operatively patients were regularly followed at 6 weeks, 3 months and 6 months for clinical, radiological and functional assessment. Descriptive statistics like frequency, percentage, mean and standard deviation were used to analyze the data.</p> <p><strong>&nbsp;</strong></p> <p><strong>RESULTS</strong></p> <p>In our study of 30 cases, the mean age was 37.77 ±15.65 years. Most of the cases were Schatzker type VI (13 patients) and type II (9 patients). The average duration for fractures union was 23.4 ±2.1 weeks. Superficial wound infection was the common complication seen in five cases. At six months, the mean knee society score (KSS) was 78 ±7.22 and majority of patients (19 patients) had good results.</p> <p>&nbsp;</p> <p><strong>CONCLUSION</strong></p> <p>Locking compression plate has an excellent functional and radiological outcome. It is an effective implant that can be adopted for the treatment of tibial plateau fractures in adults.</p> <p><strong>&nbsp;</strong></p> Bipan Shrestha, Prakriti Raj Kandel, Kishor Man Shrestha, Shreshal Shrestha, Rakesh Yadav Copyright (c) 2021 Journal of Universal College of Medical Sciences Tue, 22 Jun 2021 00:00:00 +0000 Gender Differences in Clinical and Epidemiological Profile of Adult Patients with Vitiligo <p><strong>INTRODUCTION </strong></p> <p>Vitiligo is an acquired disorder of skin characterized by white macules. Though there are many studies describing clinical and epidemiological features of vitiligo; there are few studies which have attempted to see the differences between male and female. Understanding the gender differences in clinico-epidemiological features will help to find the direction for further research in understanding pathogenesis. The objective was to find the gender wise differences in clinico-epidemiological pattern of vitiligo.</p> <p>&nbsp;</p> <p><strong>MATERIAL AND METHODS</strong></p> <p>This was cross sectional study done at Dermatology and Venereology out-patient clinic of Universal College of Medical Sciences Teaching hospital, Bhairhawa, Nepal from January 1, 2015 to December 31, 2016. Consecutive sampling technique was used and the cases of 18 years and above were taken. Chi-square test, multi-variate logistic regression, two sample t-tests were used to analyze the data.</p> <p>&nbsp;</p> <p><strong>RESULTS</strong></p> <p>The total number of case was 190. Female to male ratio was 1.38:1. Vitiligo vulgaris was seen more in female and mucosal vitiligo more in male and the difference was statistically significant. &nbsp;&nbsp;However, there was no statistically significant difference among gender in family history, duration of disease, mucosal and hair involvement, history of recurrence and various age groups.</p> <p><strong>&nbsp;</strong></p> <p><strong>CONCLUSION</strong></p> <p>Vitiligo vulgaris is seen more in female and mucosal vitiligo is seen more in male. This study has strengthened the evidence regarding the difference noted in clinic-epidemiological aspect of vitiligo. There should be more studies, so that more patterns in gender differences could be understood, and this will help in understanding the pathogenesis of vitiligo.</p> <p><strong>&nbsp;</strong></p> Yogesh Poudyal, Chandra Bhal Jha, Niraj Parajuli Copyright (c) 2021 Journal of Universal College of Medical Sciences Tue, 22 Jun 2021 00:00:00 +0000 Incidence and Risk Factors Associated with Blood Culture Proven Neonatal Sepsis <p><strong>INTRODUCTION</strong></p> <p>Neonatal sepsis (sepsis neonatorum) is a clinical syndrome resulting from the pathophysiologic effects of local or systemic infection. This is a major cause of morbidity and mortality around the world affecting newborns up to one month of age with clinical symptoms and positive blood cultures.&nbsp; This study aimed at examining the risk factors of neonatal sepsis at pediatric tertiary care hospital.</p> <p>&nbsp;</p> <p><strong>MATERIAL AND METHODS</strong></p> <p>This was a hospital based cross-sectional case control study conducted among 350 neonates admitted within April to September 2015 at the Kanti Children’s Hospital, Kathmandu Nepal. Cases were neonates who had sepsis and controls were neonates who did not have sepsis with their index mothers.&nbsp; CRP screening tests and blood culture was performed. Data were entered using the SPSS (Version 22).&nbsp; Bivariate and multivariate logistic regression was used to determine the risk of neonatal sepsis.</p> <p>&nbsp;</p> <p><strong>RESULTS</strong></p> <p>A total of 59 (17%) neonates who had sepsis (cases) with their index mothers’ and 291 (83%) neonates who had no sepsis (controls) with their index mothers were enrolled. Maternal factors that predicted the occurrence of sepsis among neonates were parity (<em>p</em>&lt;0.027), mode of delivery (<em>p</em>&lt;0.001) and PROM (<em>p</em>&lt;0.001). Neonatal risk factors which predicted the occurrence of sepsis were duration of stay in the facility (<em>p</em>&lt;0.001) and neonatal age on admission (<em>p</em>&lt;0.001).</p> <p><em>&nbsp;</em></p> <p><strong>CONCLUSION</strong></p> <p>The study found both maternal and neonatal factors to have a strong association with the risk of developing neonatal sepsis. Encouraging maternal antenatal care utilization would help identify the risk factors during prenatal and postnatal care and appropriate interventions implemented to reduce the likelihood of the neonate developing sepsis.</p> <p><strong>&nbsp;</strong></p> Nikita Singh Yadav, Pranav Kumar Yadav, Rajeshwar Reddy Kasarla, Pramila Parajuli Copyright (c) 2021 Journal of Universal College of Medical Sciences Tue, 22 Jun 2021 00:00:00 +0000 Anatomical Variations in the Origin of Superior Thyroid Artery and its Relation with External Laryngeal Nerve and their Clinical Importance-A Cadaveric Study <p><strong>INTRODUCTION</strong></p> <p>The major arterial supply of thyroid gland is from superior and inferior thyroid arteries. The superior thyroid artery (STA) usually arises from the external carotid artery. The external laryngeal nerve runs in close proximity to the origin of the superior thyroid artery later leaves the artery by turning medially above or below the upper pole of the thyroid gland.</p> <p>&nbsp;</p> <p><strong>MATERIAL AND METHODS</strong></p> <p>A descriptive study was undertaken on 20 embalmed cadavers. The anterior triangle of neck was dissected bilaterally. The site of origin of STA level of origin in relation to the upper border of lamina of thyroid cartilage and relation of the STA with external laryngeal nerve were observed and noted.</p> <p><strong>&nbsp;</strong></p> <p><strong>RESULTS</strong></p> <p>The STA arises from the external carotid artery in 27.5%, common carotid artery in 62.5%, common carotid bifurcation in 5% and arises by a common trunk with lingual artery at common carotid bifurcation in 5%. The distance from the upper pole to the point where external laryngeal nerve turns medially is more than 10 mm in 50%, less than 10 mm in 25% and 10 mm in 25%.</p> <p><strong>&nbsp;</strong></p> <p><strong>CONCLUSION</strong></p> <p>The variations in the pattern of origin of the superior thyroid artery and its relation to external laryngeal nerve is a very common phenomenon. The head and neck surgeons must be aware of all possible variations to avoid postoperative complications and legal issues.</p> <p><strong>&nbsp;</strong></p> Manjappa T, Ruku Pandit Copyright (c) 2021 Journal of Universal College of Medical Sciences Tue, 22 Jun 2021 00:00:00 +0000 Asymptomatic Bacteriuria among Pregnant Women Attending a Tertiary Care Hospital in Western Nepal: A Cross-sectional Prospective Study <p><strong>INTRODUCTION</strong></p> <p>Urinary tract of female undergoes tremendous changes during pregnancy which increases their risk of acquiring infection. Asymptomatic bacteriuria is a common entity among pregnant women which refers to significant bacteriuria (&gt;10<sup>5 </sup>bacteria per ml of urine) without any typical symptoms of urinary tract infection. Asymptomatic bacteriuria can lead to various maternal and fetal complications if not detected and treated on time.</p> <p><strong>MATERIAL AND METHODS</strong></p> <p>Total 280 urine samples were collected in sterile universal containers from pregnant women not showing typical symptoms of urinary tract infection at the time of sample collection. Urine samples were inoculated in both MacConkey agar and Blood agar by semi quantitative culture method. Culture plates were reported after 24 hours of incubation at 37<sup>0</sup>C. Bacteria isolated were subjected to antibacterial susceptibility testing by modified Kirby-Bauer disc diffusion method.</p> <p><strong>RESULTS</strong></p> <p>Out of 280 urine cultures, 213 samples were sterile. Significant bacteriuria was seen in 25 cases (8.9%) followed by insignificant bacteriuria (20, 7.14%) and contamination (17, 6.10%). Highest number of cultures positive were in age group 21-30 years (19, 9.1%,). Out of 25 cases of significant bacteriuria, 60% were primigravida and 40% were multigravida. The most common organism isolated was <em>Escherichia coli</em> (10, 60%) followed by <em>Klebsiella pneumoniae</em> (5, 40%).</p> <p><strong>CONCLUSION</strong></p> <p>Screening of all pregnant women for asymptomatic bacteriuria is essential during their antenatal checkup. <em>Escherichia coli</em> is the commonest organism that cause asymptomatic bacteriuria. Appropriate antibiotic therapy is absolutely necessary for positive cases on the basis of antimicrobial susceptibility result to prevent unwanted obstetric complications.</p> Shristi Raut, Sulochana Khatiwada, Narayan GC Copyright (c) 2021 Journal of Universal College of Medical Sciences Tue, 22 Jun 2021 00:00:00 +0000 Prevalence and Pattern of Rheumatic Heart Disease among Reproductive Age Group Female <p><strong>INTRODUCTION</strong></p> <p>Rheumatic heart disease (RHD) remains a major public health problem in developing countries. In low income countries RHD accounts for approximately 90% of all cardiovascular disease among pregnant women. This study aims to evaluate the prevalence and pattern of RHD among reproductive age group women presenting to a tertiary care teaching hospital in Central Nepal.</p> <p><strong>MATERIAL AND METHODS</strong></p> <p>Prospective observational study was carried out in College of Medical Sciences Teaching Hospital, Bharatpur, Nepal from January 2019 to December 2019 by doing transthoracic echocardiography (TTE) of reproductive age group females (n=800) from 15 years to 45 years of age. The data were collected in pre-structured proforma.</p> <p><strong>RESULTS</strong></p> <p>Out of 800 patients, RHD was present in 46 (5.75%) patients. The incidence of RHD was found to be highest in the age group of 30-35 years 13 (28.3%) and the mean age of presentation was 29.24 years. Mitral valve was the most common valve involvement and mitral regurgitation 37 (80.4%) was the most common valvular dysfunction present in patients with RHD.</p> <p><strong>CONCLUSION</strong></p> <p>The prevalence of RHD among reproductive age group female is high and mitral valve is the most commonly affected valve.</p> Manoj Shrestha, Prakash Aryal Copyright (c) 2021 Journal of Universal College of Medical Sciences Tue, 22 Jun 2021 00:00:00 +0000 Serum Vitamin D and B12 Levels in Alcoholic Male Patients: A Cross-sectional Study <p><strong>INTRODUCTION</strong></p> <p>Alcohol dependence is a global problem and is rapidly increasing in developing countries. We aimed to analyze the serum levels of vitamin B12 and vitamin D in chronic alcoholic patients and their association with parameters of liver function.</p> <p><strong>MATERIAL AND METHODS</strong></p> <p>A cross-sectional study was carried out in Universal College of Medical Sciences, Bhairahawa, Nepal from March 2020 to September 2020 on patients visiting the Psychiatric Out Patient Department (OPD) for the treatment of alcohol dependence. The patients were categorized as excessive and moderate drinkers. Serum vitamin B12, vitamin D, and hepatic function parameters were measured.</p> <p><strong>RESULTS</strong></p> <p>The median serum vitamin B12 and vitamin D levels were 467.8 pg/ml and 24.9 ng/ml respectively. Excessive drinkers had significantly higher B12&nbsp;&nbsp; levels than moderate drinkers. Vitamin B12&nbsp;&nbsp; levels correlated positively with liver function parameters, as well as alcohol amount and duration of consumption. Vitamin D levels were insufficient in 57 (71.25%) of the overall participants.</p> <p><strong>CONCLUSION</strong></p> <p>Serum levels of vitamin B12 are not affected in patients with alcohol dependence. Alcohol consumption, however, reduces serum concentrations of vitamin D. Vitamin B12 &nbsp;concentration is positively associated with liver enzymes and other parameters of liver function.</p> <p>&nbsp;</p> Archana Jayan, Buddhi Raj Pokhrel, Narayan Gautam, Amit Chandra Jha, Binaya Tamang, Jharana Shrestha, Sanjeev Ranjan, Raju Kumar Dubey Copyright (c) 2021 Journal of Universal College of Medical Sciences Tue, 22 Jun 2021 00:00:00 +0000 Hematological Findings in COVID-19 Patients at Birat Medical College Teaching Hospital <p><strong>INTRODUCTION</strong></p> <p>The outbreak of 2019 novel corona virus has also affected the Nepalese population<strong>. </strong>Real Time-Polymerase Chain Reaction (RT-PCR) is the diagnostic laboratory test for confirming the diagnosis. The complete blood count (CBC) is the laboratory test routinely done in patients suffering from any type of infection. This test provides the information to physicians regarding the inflammatory process. The objective of this study was to evaluate and find out whether hematologic parameters are affected in a person suffering from Covid<strong>-</strong>19 infections.</p> <p><strong>MATERIAL AND METHODS</strong></p> <p>This is a prospective study done from 3rd December 2020 to 3rd February 2021 for a period of two months. All the confirmed patients of corona (COVID-19) with RT-PCR, between days-1 to day-15 of PCR positivity, whose hematological profile was sent to the pathology laboratory department, were studied. The hematologic parameters studied include total white blood cells count (TLC), differential white blood cell count (DLC), hemoglobin and platelet counts.</p> <p><strong>RESULTS</strong></p> <p>Out of one hundred (100) RT-PCR positive patients eighty (80%) were male and twenty (20%) were female. Age group of patients ranged from 27 years to 94 years. Ninety-four (94%) patients reveal leukocytosis and Ninety-six (96%) patients showed increased in differential neutrophil count. Fifty-two (52%) patients reveal anemia and platelets count was normal in seventy-eight (78%) cases.</p> <p><strong>CONCLUSION</strong></p> <p>Covid-19 infection causes changes in the hematological parameters. Study of these parameters provides significant clinical information.</p> Mrinalini Singh, Santosh Upadhyay Kafle, Surya B Parajuli, Neeta Kafle, Amrita Sinha, Randhir Kumar Singh Copyright (c) 2021 Journal of Universal College of Medical Sciences Tue, 22 Jun 2021 00:00:00 +0000 Exclusive Breastfeeding Practice and Maternal Employment among Mothers of Infants: A Comparative Cross-Sectional Study <p><strong>INTRODUCTION</strong></p> <p>Exclusive breastfeeding (EBF) practices during first six months of life are the most cost-effective intervention for reducing infant and child morbidity and mortality. However, adherence to EBF practices in developing countries remains unsatisfactory, where maternal employment has been identified as one of the influencing factor. The study aims to identify and compare EBF practices and its factors influencing among employed and unemployed mothers.</p> <p><strong>MATERIALAND METHODS</strong></p> <p>An institutional based comparative cross-sectional study was conducted among 362 mothers of infants visiting the immunization clinic of Universal College of Medical Sciences, Bhairahawa, Nepal, from December 2020 to March 2021 following ethical clearance (UCMS/IRC/114/20) and verbal consent from participants. Descriptive statistics was used to compare EBF practices and multivariate logistic regression to identify independent predictors of EBF.</p> <p><strong>RESULTS</strong></p> <p>Total 362 (181 employed and 181 unemployed) mothers were interviewed<strong>. </strong>Prevalence of EBF was 13.8% and 81.2% among employed and unemployed mothers respectively. Further EBF practice had significant association with working status of mothers (AOR= 15.44, 95% CI 6.76-35.25) and monthly family income (AOR=3.31, 95% CI 1.24-8.84). Among employed, EBF practice had significant association with carry infant to work place (AOR= 12.36, 95% CI 4.35-49.87) whereas type of delivery (AOR= 3.88, 95% CI 1.69-8.90) was significantly associated among unemployed mothers.</p> <p><strong>CONCLUSION</strong></p> <p>EBF practices among employed mothers were less than that of unemployed mothers. Provisions to provide additional supports, either by revising the period of maternity leave or adopting different alternatives to prolong the period of EBF may be beneficial for employed mothers and their children.</p> Rubina Shrestha, Pradip Chhetri, Jyoti Priyanka, Chet Kant Bhusal Copyright (c) 2021 Journal of Universal College of Medical Sciences Tue, 22 Jun 2021 00:00:00 +0000 Estimation of Serum Vitamin D2, Growth Hormone, Alkaline Phosphatase and Calcium Phosphate Product in Patients with End Stage Renal Disease <p><strong>INTRODUCTION</strong></p> <p>The chronic kidney disease (CKD) patient's calcium phosphate product, alkaline phosphatase (ALP), vitamin-D2 &nbsp;and human growth hormone (hGH) are altered under haemodialysis. This study aimed to evaluate these biochemical variables in conjunction with haemoglobin and blood pressure to find out their association in End Stage Renal Disease (ESRD) patients.</p> <p><strong>MATERIAL AND METHODS</strong></p> <p>This cross-sectional study comprised of 104 patients with ESRD undergoing haemodialysis. The estimated glomerular filtration rate (eGFR) was calculated by Cockcroft-Gault (CG) equation and calcium, phosphorus, ALP were measured by fully automated analyzer whereas vitamin-D2&nbsp; and hGH were measured by sandwich and competitive enzyme linked immune sorbent assay (ELISA) techniques.</p> <p><strong>RESULTS</strong></p> <p>The mean age of patients was 53.12 ±16.37 years comprising 68% male. The hypovitaminosis D was 57.7% deficiency and 23.1% insufficiency states whereas hGH insufficiency was 22.1%. The calcium phosphate product was found to be increased in only 39.9% cases. The increased ALP level was observed in 64.4% cases. There was statistically significant association between hGH and Hb status (<em>p</em>=0.03). The significant difference in mean sodium and Ca×P of ESRD cases was observed with hypertension status (<em>p</em>=0.03 and <em>p</em>=0.01) respectively. Moreover, the significant difference in mean eGFR and hGH was observed with haemoglobin status (<em>p</em>=0.0001and <em>p</em>=0.01) respectively.</p> <p><strong>CONCLUSION</strong></p> <p>Increased level of ALP and hypovitaminosis-D was very common in ESRD patients undergoing dialysis with less prevalence of hGH insufficiency and calcium phosphate product increment. The anaemia and hypertension status can be pre-existing condition with ESRD which are cumbersome to control if not monitor in these patients.</p> Santosh Chaudhary, Narayan Gautam, Manoj Karki, Sunkeshari Deshar, Archana Jayan, Amit Chandra Jha, Binaya Tamang, Buddhi Raj Pokhrel, Jharana Shrestha, Raju Kumar Dubey Copyright (c) 2021 Journal of Universal College of Medical Sciences Tue, 22 Jun 2021 00:00:00 +0000 Knowledge Regarding Care of Low Birth Weight Neonates among Nurses of Morang, Nepal <p><strong>INTRODUCTION</strong></p> <p>Babies born preterm or at low birth weight are at increased risk of immediate life-threatening health problems as well as long-term complications and developmental delays. The occurrence of this condition causes substantial morbidity and mortality in children. The nurses are the key persons to provide care for the low birth weight neonates. The role of nurses to assess the low birth weight babies and to protect them from various complications.</p> <p><strong>MATERIAL AND METHODS</strong>&nbsp;</p> <p>A descriptive cross-sectional design was used to find out the level of knowledge regarding care of low birth weight neonates among 60 registered nurses of Nepal (staff nurses and bachelor nurses) by using enumerative technique in Koshi Hospital, Biratnagar, Nepal. Semi-structured, pre-tested interview schedule was used to collect data and analysed by using descriptive and inferential statistic with SPSS version 16.</p> <p><strong>RESULTS</strong></p> <p>The study findings revealed that 63.3% of the respondents had high level of knowledge regarding care of low birth weight neonates. There was no statistically significant association between respondents' professional qualification and respondents' level of knowledge regarding care of low birth weight neonates.</p> <p><strong>CONCLUSION</strong></p> <p>The study concluded that more than half of the respondents had high level of knowledge regarding care of low birth weight neonates. Nurse is an important primary care provider and therefore, her education and access to information on care of low birth weight new born will help her provide adequate care and prevent complications in low birth weight babies.</p> <p>&nbsp;</p> Anuja Kachapati, Kavita Lamichhane, Sangam Shrestha Copyright (c) 2021 Journal of Universal College of Medical Sciences Tue, 22 Jun 2021 00:00:00 +0000 Utilization of Maternal and Child Health Services among Women Admitted In Maternity Ward of A Hospital of Siddharthanagar Municipality <p><strong>INTRODUCTION</strong></p> <p>Maternal and child mortality is a global issue which could be prevented by the utilization of maternal and child health (MCH) services. The main objective of this study was to find out the utilization of MCH services among women admitted in maternity ward of a hospital.</p> <p><strong>MATERIAL AND METHODS</strong></p> <p>Cross-sectional descriptive study was conducted to find out the utilization of MCH services among 150 women admitted in maternity ward of a hospital. Non-probability purposive sampling technique was used to select the sample and semi- structured interview schedule was used to collect the data and collected data was analyzed with SPSS version 16.</p> <p><strong>RESULTS</strong></p> <p>The study showed that 100% of the women had utilized antenatal services, 98.67% delivered their baby in health centres and utilized postnatal services. During pregnancy, women got health education on danger signs (66.67%), avoidance of sexual intercourse (54%), and birth preparedness (44%). Cent percent of the children utilized at least one child health services, 80% were breastfed within hour of birth, and 93.24% of women were not aware of administration of vitamin K to their newborn. Ethnicity, religion, education, occupation, age at marriage, gravida, parity, history of abortion or child death and number of live children of women, education and occupation of spouses were significantly associated (<em>p</em>&lt;0.05) with utilization of maternal health services.</p> <p><strong>CONCLUSION</strong></p> <p>It is recommended that nurses and health personnel should provide health education focusing on birth preparedness, danger signs of mother and baby, and should inform about administration of vitamin K to mother.</p> <p>&nbsp;</p> Binita Khatri, Saraj Grurung, Anuja Kachapati Copyright (c) 2021 Journal of Universal College of Medical Sciences Tue, 22 Jun 2021 00:00:00 +0000 Writing A Research Paper: A Guide <p><strong>INTRODUCTION</strong></p> <p>A research paper is a part of academic writing where there is a gathering of information from different sources. It is multistep process. Selection of title is the most important part of research writing. The title which is interesting should be chosen for the research purpose. All the related information is gathered and the title for research is synthesized. After thorough understanding and developing the title, the preliminary outline is made which maintains the logical path for its exploration. After preliminary research, proper research work is started with collection of previous resources which is then organized and important points are noted. Then research paper is written by referring to outlines, notes, articles, journals and books. The research paper should be well structured containing core parts like introduction, material and methods, results and disscussion and important additional parts like title, abstract, references.</p> Laxmi Shrestha, Bishal Joshi, Anand Kumar Copyright (c) 2021 Journal of Universal College of Medical Sciences Tue, 22 Jun 2021 00:00:00 +0000 Curriculum Integration for Medical and Dental Students <p>Many medical and dental colleges have been following a traditional curriculum which is characterized by a discipline/subject wise model, with high degree of division of different subjects into pre-clinical, para-clinical, and clinical branches, without any correlation between the different subjects and topics. As a result, the knowledge gained by students becomes irretrievable and inadequate to apply in clinical situations. Lack of integrated approach to different subjects, during learning period, results in bringing out medical graduates lacking holistic approach toward the patients and the community while practicing medicine. Therefore, there is a need for a revision in medical education, not only in terms of the changes in our knowledge base, but also in terms of the regarding patients, medical practitioners and society in general. 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 problem solving skills. It views learning and teaching in a holistic way and reflects the real world, which is interactive, and helps students to apply their knowledge to their work and to their personal development. This article pertaining to the discipline of medical education makes an attempt to review and discuss the various types of curriculum and its integration for MBBS and BDS students.</p> Rajeshwar Reddy, Laxmi Pathak Copyright (c) 2021 Journal of Universal College of Medical Sciences Tue, 22 Jun 2021 00:00:00 +0000 Covid-19 Pandemic and Vaccine <p>COVID-19, caused by SARS-CoV-2, was first reported in Wuhan, in December 2019 and later spread globally. The World Health Organization (WHO) declared the outbreak a Public Health Emergency of International Concern (PHEIC) on 30 January and a pandemic on 11 March 2020.<sup>1</sup> &nbsp;In Nepal, the first case was registered on 3<sup>rd</sup> January 2020. Since then, there have been 591,494 confirmed cases of COVID-19 with 7,990 deaths.<sup>2</sup></p> <p>In the second wave of Covid-19, South Asia seems to have turned into the epicentre as most of the countries in the region, including India, Nepal, Bangladesh, and Pakistan have been badly infected by the coronavirus. Instead of being controlled, the situation is getting more flared up as each day passes. Of late, the situation in Nepal is gradually becoming alarming as two out of five people tested return positive. Subsequently, Nepal started to face shortage of oxygen, ventilators, and ICU facilities required for the treatment of severe cases. Medicines like Remdesivir and other medical equipment are sold at exorbitant prices.</p> Santosh Shah Copyright (c) 2021 Journal of Universal College of Medical Sciences Tue, 22 Jun 2021 00:00:00 +0000