https://www.nepjol.info/index.php/MJSBH/issue/feed Medical Journal of Shree Birendra Hospital 2021-09-06T10:10:43+00:00 Dr Bikash Shrestha kalmaan@yahoo.com Open Journal Systems <p>Official Journal of NAIHS (Nepalese Army Institute of Health Sciences). Full text articles available.</p> <p>MJSBH is now accepting online submission of manuscripts.We recommend that you review the <a href="/index.php/MJSBH/about">About the Journal</a> page for the journal's section policies, as well as the <a href="/index.php/MJSBH/about/submissions#authorGuidelines">Author Guidelines</a>. Authors need to <a href="/index.php/MJSBH/user/register">register</a> with the journal prior to submitting, or if already registered can simply <a href="/index.php/index/login">log in</a> and begin the 5 step process.</p> https://www.nepjol.info/index.php/MJSBH/article/view/36632 Eosinophilic Ureteritis Causing Ureterohydronephrosis: A Case Report 2021-07-18T08:18:18+00:00 Uspal Bahadur Bajracharya dr.uspal@gmail.com Anil Kumar Sah anil.frens@gmail.com Hari Baral hari.baral@gmail.com Ghanasham Sigdel gssigdel@gmail.com Guna Kumar Shrestha drgk_shrestha@yahoo.com Rojan Adhikari anil.frens@gmail.com <p class="p1"><span class="s1">Eosinophilic ureteritis is a rare cause of ureteric stricture causing hydroureteronephrosis. The exact aetiology of this condition is still unknown. This condition has been described in relation to atopy, hypereosinophilic syndrome and prior ureteral interventions. The histopathology is the conclusive diagnostic modality. The surgical resection of the ureteric stricture part with end-to-end anastomosis is usually successful. Herein, we report a case of a 19-year-old woman, who presented with right flank pain. With imaging and diagnostic ureteroscopy, the case was diagnosed as eosinophilic ureteritis. The case was successfully managed with resection of the stenosing part and end-to-end anastomosis. No cases of the disease have been reported until now in Nepal. </span></p> 2021-09-06T00:00:00+00:00 Copyright (c) 2021 Medical Journal of Shree Birendra Hospital https://www.nepjol.info/index.php/MJSBH/article/view/32856 Osteochondroma of the Distal Tibia Leading to Deformity and Stress Fracture of the Fibula - A Case Report 2021-07-18T08:31:52+00:00 Chander Mohan Singh thapamagarmohit@gmail.com Mohit Thapa Magar thapamagarmohit@gmail.com Ajay Deep Sud thapamagarmohit@gmail.com <p class="p1"><span class="s1">Osteochondromas seldom arise from the interosseous border of the distal tibia and may progress to involve the distal fibula. We present the case of a 14-year-old teenager with a stress fracture of the distal fibula, secondary to an osteochondroma arising from the distal tibia. Early excision of this deforming distal tibial osteochondroma was necessary in order to avoid a progressive deformity which would affect the biomechanics of the ankle joint resulting in gait disturbances.</span></p> 2021-09-06T00:00:00+00:00 Copyright (c) 2021 Medical Journal of Shree Birendra Hospital https://www.nepjol.info/index.php/MJSBH/article/view/33226 Tubercular Mastitis in an Elderly Female: A Rare Entity 2021-07-18T08:36:27+00:00 Manvendu Jha jhamanvendu@rediffmail.com Hakam Singh jhamanvendu@rediffmail.com Amulyajeet Kaur jhamanvendu@rediffmail.com <div class="page" title="Page 87"> <div class="section"> <div class="layoutArea"> <div class="column"> <p>Introduction: Tuberculosis of the breast is a rare entity, especially in elderly females. Moreover, the disease is overlooked and misdiagnosed as malignancy or pyogenic abscess. Here we report a case of an elderly female who presented with a lump in her left breast which resembled malignancy. Fine needle aspiration cytology followed by histopathological examination confirmed the diagnosis of breast tuberculosis. Patient underwent excision of the lump followed by six months of anti tubercular therapy to which she responded well.</p> <p>Key words: breast; mastitis; tuberculosis</p> </div> </div> </div> </div> 2021-09-06T00:00:00+00:00 Copyright (c) 2021 Medical Journal of Shree Birendra Hospital https://www.nepjol.info/index.php/MJSBH/article/view/30726 A 27 - Gauge Microincision Vitrectomy Surgery for Posterior Segment Diseases in a Tertiary Centre, Nepal 2021-07-17T12:43:47+00:00 Chunu Shrestha chunu20@hotmail.com Sabina Shrestha sabina_drs@hotmail.com Aparajita Manoranjan aparajita.manoranjan@gmail.com Reeta Rajbhandari fren.reeta@gmail.com <p class="p1"><span class="s1"><strong>Introduction: </strong>Transconjunctival micro incision vitrectomy surgery (MIVS) with 23 or 25 gauge instrumentation is more advantageous than traditional 20 gauge surgery. We intended to evaluate the visual outcome, complications and indication of various vitreoretinal diseases using 27 Gauge vitrectomy systems. </span></p> <p class="p1"><span class="s1"><strong>Methods:</strong> This study was a prospective, interventional, non-comparative study conducted in Nepal Eye Hospital from June 2017 to July 2018. Fifty-two patients with various vitreoretinal diseases were recruited. The main outcome measures included corrected distance visual acuity (CDVA) preoperative and postoperative, intraocular pressure (IOP) preoperative and postoperative, indication for vitreoretinal surgery, intraoperative complications, and postoperative complications.</span></p> <p class="p1"><span class="s1"><strong>Results: </strong>Fifty two eyes of 52 patients (26 men and 26 women; mean age, 59 years) underwent 27-gauge pars planavitrectomy. Surgical indications included epiretinal membrane (n&nbsp;= 11), full-thickness macular hole (n&nbsp;= 11), rhegmatogenous retinal detachment [n = 14 (12 vitrectomy only and two vitrectomy with scleral buckle)], vitreous haemorrhage (n&nbsp;= 3), vitreous opacities (n&nbsp;= 3), silicon oil removal (n&nbsp;= 3), proliferative diabetic retinopathy [n = 6 (5 vitreous haemorrhage and one tractional retinal detachment)], posterior IOL dislocation (n = 1). Postoperative complications included transient ocular hypertension in eight eyes (15.39%), transient hypotony in five eyes (9.62%) and vitreous haemorrhage in five eyes (9.62%). No cases of postoperative endophthalmitis, sclerotomy - related tears, or choroidal detachments were encountered in the follow-up period. Mean corrected distance visual acuity improved from 20 / 796 (logarithm of the minimum angle of resolution, 1.60 ± 0.64) preoperatively to 20 / 49 (logarithm of the minimum angle of resolution, 0.42 ± 0.26) postoperatively (p = 0.000,) at final follow up.</span></p> <p class="p1"><span class="s1"><strong>Conclusions: </strong>27-gauge micro-incision vitrectomy surgery was found to be a safe and effective suture-less surgery with favourable outcomes, in terms of vision. </span></p> 2021-09-06T00:00:00+00:00 Copyright (c) 2021 Medical Journal of Shree Birendra Hospital https://www.nepjol.info/index.php/MJSBH/article/view/31755 A Retrospective Case-Control Study of Lipid Profiles in Carcinoma Breast in Comparison with Normal Controls 2021-07-17T12:59:37+00:00 Gurushantappa Yalagachin praveenashhally@gmail.com Praveena S praveenas82@gmail.com <p class="p1"><span class="s1"><strong>Introduction: </strong>Breast cancer is the second most common cancer in the world. One of the reasons for its increasing prevalence, especially in younger women has been attributed to lifestyle changes. All these factors also have a strong association with lipid metabolism. More evidence is coming forward to emphasise the protective effect of lifestyle modification to lower lipid levels and thus decreasing the risk of breast cancer.</span></p> <p class="p1"><span class="s1"><strong>Methods:</strong> It is a retrospective, case control study. The patients with carcinoma breast and normal controls were taken as subjects. The data for this study includes clinical profile and lipid profile measured in early morning fasting sample of the subjects. The patients of carcinoma breast, normal control aged &gt; 18 years were included, while patients with diabetes, thyroid disorders, on treatment for hyper-lipidaemia, dieting or anorexic, pregnant patients were excluded.</span></p> <p class="p1"><span class="s1"><strong>Results: </strong>There was no statistically significant differences in age (p = 0.920) and BMI (p = 0.137) between study and normal control group. Total Cholesterol (TC) and Triglycerides (TG) levels were significantly elevated (p = 0.009 and 0.000 respectively) in carcinoma breast group compared to normal controls, however no significant differences (p &gt; 0.05) observed in the levels of HDL-C, LDL-C. </span></p> <p class="p1"><span class="s1"><strong>Conclusions: </strong>There is a significant alteration in lipid metabolism in carcinoma breast patients in comparison to normal controls.<span class="Apple-converted-space">&nbsp; &nbsp;</span></span></p> 2021-09-06T00:00:00+00:00 Copyright (c) 2021 Medical Journal of Shree Birendra Hospital https://www.nepjol.info/index.php/MJSBH/article/view/30309 Awareness and Practice of Junk Foods among Adolescents in Secondary Level Students 2021-07-17T13:18:16+00:00 Radha Paudel radha2739@gmail.com Sarita Shrestha radha2739@gmail.com <p class="p1"><span class="s1"><strong>Introduction: </strong>Junk food consumption among adolescents has become a serious issue that may lead to harmful effects on health. Dietary patterns of people are shifting from homemade foods to junk foods. Therefore, this study was undertaken to assess the awareness and practice of junk foods among adolescents.</span></p> <p class="p1"><span class="s1"><strong>Methods:</strong> A descriptive cross-sectional study was conducted among adolescents of secondary level students. A simple random sampling technique was used to select the sample and the sample size was 237. Data collection was done from April 15, 2019 to May 14, 2019. A set of semi-structured self-administered questionnaire was used for data collection. Descriptive and inferential statistics were used to analyse and interpret the findings.</span></p> <p class="p1"><span class="s1"><strong>Results: </strong>The findings showed that more than three-fifth (67.9%) of adolescents had a moderate level of awareness about junk foods. Half (49.4%) of them consumed junk foods highly. All (100%) adolescents have consumed junk foods regularly whereas two-fifth (42.2%) replaced meals once a week with junk foods. Four-fifth (82.3%) of adolescents did not bring tiffin from home. There was no significant association between the awareness and practice of junk foods&nbsp;(p &lt; 0.05).</span></p> <p class="p1"><span class="s1"><strong>Conclusions: </strong>This study concludes that most of the adolescents possessed a moderate level of awareness of junk foods. Majority of them did not bring tiffin from their home. Around half of them consumed junk foods in their daily life. Majority of them were aware of junk foods, although they still consumed junk foods.</span></p> 2021-09-06T00:00:00+00:00 Copyright (c) 2021 Medical Journal of Shree Birendra Hospital https://www.nepjol.info/index.php/MJSBH/article/view/33399 Bacteriological Profile and Antimicrobial Resistance Pattern in Surgical Site Infection in a Tertiary Care Hospital, Central Nepal 2021-07-18T04:15:49+00:00 Beena Jha drbeenajha@gmail.com Saroj Gautam gautamsaroj@gmail.com Jyotshna Sharma 21jyotszee@gmail.com Manisha Sharma manishasharma84@yahoo.com <p class="p1"><span class="s1"><strong>Introduction: </strong>Surgical site wound infections (SSI) are the third most commonly reported nosocomial infection and they account for approximately a quarter of all nosocomial infections. Apart from bacterial contamination of wound, various patient and environment related factors play a role in development and outcome of SSI. The present study is undertaken to study the frequency of SSI and the antimicrobial resistance pattern of the causative organisms isolated. </span></p> <p class="p1"><span class="s1"><strong>Methods: </strong>This cross-sectional prospective study was carried out over a period of one year. A total of 245 pus samples from suspected cases of surgical site infections were processed for gram staining, culture, biochemical identification tests and antimicrobial susceptibility testing using standard microbiological protocol. Data was analysed using software word version SPSS 19. </span></p> <p class="p1"><span class="s1"><strong>Results: </strong>The overall frequency of SSI was 13.87%. Most common isolates were staphylococcus aureus and <em>Escherichia coli</em>. All four staph aureus strains were resistant to penicillin and cefixime but were 100% sensitive to vancomycin and cloxacillin. Two out of four stains were methicillin resistant <em>Staph. aureus</em> (MRSA). Another concern in recent time is the isolation of acinetobacter from surgical wounds. </span></p> <p class="p1"><span class="s1"><strong>Conclusions:</strong> Preoperative antibiotics, reduced hospital stay and proper control of co-morbidities decrease the incidence of post-operative infections. Marked resistance of isolates to commonly used antibiotics signifies the need for judicious and rational use of these drugs to prevent the emergence of antibiotic resistant strains.</span></p> 2021-09-06T00:00:00+00:00 Copyright (c) 2021 Medical Journal of Shree Birendra Hospital https://www.nepjol.info/index.php/MJSBH/article/view/36502 Clinical significance of Catheter-Associated Urinary Tract Infection (CAUTI) in Intensive Care Units: Three Year Experience at a Single Centre 2021-07-18T04:28:47+00:00 Sunil Basukala anyurysm@gmail.com Punit Yadav anyurysm@gmail.com Arinidam Chatterjee anyurysm@gmail.com Rakesh kumar Ranyal anyurysm@gmail.com Manish Baidya mnsbdy@gmail.com <p class="p1"><span class="s1"><strong>Introduction: </strong>Catheter Acquired Urinary Tract Infection (CAUTI) is one of the most common Health Care Acquired Infections (HCAI); most of these infections are attributable to use of an indwelling urethral catheter. The aim of this study was to investigate patients with catheter-associated urinary tract infection over three years at a single hospital’s Intensive Care Unit (ICU) and to identify meaningful risk factors and causative organisms.&nbsp;</span></p> <p class="p1"><span class="s1"><strong>Methods: </strong>A retrograde analysis was performed on patients with indwelling catheters in ICU of Armed Forces Medical College, Pune, India. CAUTI was defined as isolated bacterial growth of 100,000 colony-forming units or more either 48 hours after transfer to the ICU if a urinary catheter was placed before the transfer or 48 hours after insertion if the catheter was inserted in the ICU. Only the patients whose culture results were negative before ICU admission were included.</span></p> <p class="p1"><span class="s1"><strong>Result: </strong>Among 350 samples collected in medical and surgical ICU, 38 patients (10.85%) had CAUTI. Using multivariate logistic regression analysis, the study showed that those with diabetes were 4.51 (p</span><span class="s2"><</span><span class="s1">0.001) times likely to have occurrences of CAUTI than those without and also showed an increased incidence of CAUTI &gt; 1.19 fold (p</span><span class="s2"><</span><span class="s1">0.01) among patient with longer duration of an indwelling catheter.</span></p> <p class="p1"><span class="s1"><strong>Conclusions: </strong>CAUTI is a preventable HCAI and thus the risk factors and causative organisms contributing to its development in the management of ICU patients must be considered to prevent the occurrence of UTIs in this setting.</span></p> 2021-09-06T00:00:00+00:00 Copyright (c) 2021 Medical Journal of Shree Birendra Hospital https://www.nepjol.info/index.php/MJSBH/article/view/30777 Factors Affecting Choice Of Health Care Facilities Among The Adults of an Urban Community 2021-07-18T04:41:36+00:00 Raksha Shrestha rakshashrestha804@gmail.com Sarita Adhikari rakshashrestha804@gmail.com <p class="p1"><span class="s1"><strong>Introduction: </strong>Health service delivery systems that are safe, accessible, high quality, people-centred, and integrated are critical for moving towards universal health coverage. World Health Organisation is supporting to improve the efficiency and effectiveness of health service delivery systems to all the population not only the patients. This study aims to identify the factors affecting the choice of health care facilities among the adults of an urban community and its association with the selected socio-demographic variables.&nbsp;</span></p> <p class="p1"><span class="s1"><strong>Methods: </strong>A descriptive cross-sectional study was conducted among the community residence with 120 respondents using non-probability purposive sampling technique. Data was collected using semi-structured interview schedule that was analysed by using descriptive statistical methods such as frequency, percentage, mean, standard deviation and inferential statistics such as chi-square test.</span></p> <p class="p1"><span class="s1"><strong>Result: </strong>The findings of the study revealed that majority (60.8%) of the respondents used private health care facilities and there was significant association of the choice of health care facility with the health care services related factors whereas no significant association was found with the selected socio-demographic variables.</span></p> <p class="p1"><span class="s1"><strong>Conclusions: </strong>Based on the study findings, it concluded that various health care services related factors like availability, affordability, acceptability and accessibility factors tends to affect the choice of health care facility</span></p> 2021-09-06T00:00:00+00:00 Copyright (c) 2021 Medical Journal of Shree Birendra Hospital https://www.nepjol.info/index.php/MJSBH/article/view/33048 Impact of COVID-19 on Orthopaedic Surgery: Comparison Between Before and During COVID-19 Pandemic 2021-07-18T05:04:14+00:00 Ravi Bhandari contactravi@hotmail.com Mohit Thapa Magar thapamagar@gmail.com Sushil Shrestha drsushil7636@gmail.com Ritesh Sinha dr.ritesh.sinha@gmail.com Nirab Kayastha nirabk@hotmail.com Bishnu Babu Thapa drbishnuthapa@gmail.com <p class="p1"><span class="s1"><strong>Introduction: </strong>Orthopaedic surgical activity has been significantly affected by COVID-19 pandemic. The decision to perform operative interventions is based on balancing risk to benefit to the patient and health care workers. Though different guidelines have been published, there is a lack of reliable data on orthopaedic surgical activities. Our study aimed to evaluate the impact of the COVID-19 pandemic on Orthopaedic surgeries comparing with the previous year.<span class="Apple-converted-space">&nbsp; &nbsp;</span></span></p> <p class="p1"><span class="s1"><strong>Methods: </strong>This was an epidemiological retrospective comparative study conducted at </span><span class="s2">Shree Birendra Hospital, Nepal </span><span class="s1">after taking ethical approval from the Institutional Review Committee of NAIHS</span><span class="s2">. Data of the first four month of orthopaedic surgeries after National lockdown (from </span><span class="s1">March 24 to July 23, 2020)</span><span class="s2"> and</span><span class="s1"> the</span><span class="s2"> same four month period of the previous year (The year 2019) were retrieved. </span><span class="s1">The demographic profiles and operations categories (trauma, elective and infections) were compared between two periods using SPSS 21.</span></p> <p class="p1"><span class="s1"><strong>Result: </strong>Out of total of 651 patients enrolled, 169 patients operated during the pandemic compared with 482 patients before the pandemic. There was a </span><span class="s2">65% reduction in total surgical procedures, 94% reduction in elective cases and trauma cases were reduced by 29% </span><span class="s1">(P &lt; 0.05). Implant removal (107, 42.8%) constituted the highest elective cases in the year 2019.</span></p> <p class="p1"><span class="s1"><strong>Conclusions: </strong>The orthopaedic surgical procedures were decreased in frequency during COVID-19 because of a decrease in elective cases. The total trauma patients remained more equable during pandemic despite strict lock-down. Health care facilities should consider this during post pandemic recovery.</span></p> 2021-09-06T00:00:00+00:00 Copyright (c) 2021 Medical Journal of Shree Birendra Hospital https://www.nepjol.info/index.php/MJSBH/article/view/37426 Knowledge, Acceptability, Perception and Stigmas on Safe Abortion among the women of reproductive age group (15-49 years) in Bhaktapur District. 2021-07-18T05:30:33+00:00 Ankisha Shrestha ankeeca@gmail.com Ram Chandra Sinha ramchandrasinha@gmail.com Aalia Ahmad ankeeca@gmail.com <p class="p1"><span class="s1"><strong>Introduction: </strong>The termination of&nbsp;<a href="https://en.wikipedia.org/wiki/Pregnan">pregnancy</a>&nbsp;by the removal of a foetus or an embryo before surviving outside the uterus or before attaining its viability is called abortion. This study was conducted to study the knowledge, acceptability, perception and stigma of safe abortion among women of reproductive age group.&nbsp;</span></p> <p class="p1"><span class="s1"><strong>Methods: </strong>A cross-sectional analytical study was carried out in Bhaktapur District, Nepal from July 2019 to December 2019. Women of reproductive age group were included in the study. The semi-structured questionnaires were used as a data collection tool and Likert scales were used for perception and stigma which were self-designed. For Likert scale on perception and stigma, Cronbach’s α was calculated from the pre-tested samples which was found to be acceptable i.e., 0.649 and 0.856. Interview was taken as data collection technique. Data-entry was done in Epi-Data and analysed through SPSS 16.0. Chi square test was used to measure the association between dependent and independent variables.</span></p> <p class="p1"><span class="s1"><strong>Result: </strong>The association between “Knowledge and Perception” was found to be significant with p-value of 0.04, the association between “Knowledge and Stigma” was also noted to be significant with p-value of 0.00 and “Knowledge and Acceptability” was also found to be significant with p-value of 0.00 through the assessment of knowledge, acceptability, perception and stigma.</span></p> <p class="p1"><span class="s1"><strong>Conclusions: </strong>The study emphasises on educating and making aware every woman on safe abortion, its legalisation and its amended law to avoid the stigma and unsafe abortion practices.</span></p> 2021-09-06T00:00:00+00:00 Copyright (c) 2021 Medical Journal of Shree Birendra Hospital https://www.nepjol.info/index.php/MJSBH/article/view/36409 Knowledge and attitude related to antibiotic use among high school students 2021-07-18T05:42:00+00:00 Manoj Sharma drmanojpharma@gmail.com Sammodavardhana Kaundinnyayana sammodacharya@gmail.com Premlata Das premlata.das@naihs.edu.np <p class="p1"><span class="s1"><strong>Introduction: </strong>Antibiotic resistance has been described by World Health Organisation as a major global health problem that threats our ability to treat common infectious diseases and needs urgent action.<span class="Apple-converted-space">&nbsp; </span>Among many other factors, knowledge and behaviour of community members that lead to inappropriate use of antibiotic highly contributes to development and spread of antimicrobial resistance. Hence this study has been undertaken with the aim to assess the knowledge and attitude related to antibiotic use among high school students.&nbsp;</span></p> <p class="p1"><span class="s1"><strong>Methods: </strong>A cross-sectional questionnaire based survey was conducted at a Kathmandu based high-school. The data were collected via self-administered questionnaire after verbal consent for voluntary participation. There were nine questions related to knowledge and five questions related to attitude. Data were aggregated to compile frequency distribution tables and the percentages of responses were calculated.</span></p> <p class="p1"><span class="s1"><strong>Result: </strong>A total of 232 students participated in the study. In the questions related to knowledge, nearly 62% of the students agreed to the statement “Antibiotics are needed to cure most coughs and cold”. About 19% students were not sure whether antibiotics can kill the useful bacteria in our body. In the attitude part, 53.87% students responded that they stop taking antibiotics when they start to feel better and 59.91% students responded that they buy antibiotics on their own from a pharmacist when needed.</span></p> <p class="p1"><span class="s1"><strong>Conclusions: </strong>The deficiencies in basic understanding about the nature and use of antibiotics and casual attitude in their use among high school students is a matter of great concern as it poses many serious problems including promotion of antibiotic resistance</span></p> 2021-09-06T00:00:00+00:00 Copyright (c) 2021 Medical Journal of Shree Birendra Hospital https://www.nepjol.info/index.php/MJSBH/article/view/31670 Knowledge and Attitude towards Do-Not-Resuscitate Order among Nurses of a Tertiary Level Hospital 2021-07-18T07:43:19+00:00 Asmita Shrestha asmitashrestha72@gmail.com Sarala Shrestha sashre2007@yahoo.com <p class="p1"><span class="s1"><strong>Introduction: </strong>Knowledge regarding and attitude towards end-of-life care can shape the behaviour and actions of a health professional in provision of supportive care for the comfort of the patients as well as their family members. Very little is known about nurses’ knowledge and attitude regarding do-not-resuscitate (DNR) order. Therefore, the purpose of this study was to identify the knowledge of and attitude towards DNR order and relationship between knowledge and attitude towards DNR order among the nurses of a tertiary level hospital.&nbsp;</span></p> <p class="p1"><span class="s1"><strong>Methods: </strong>Descriptive correlation design was used.<span class="Apple-converted-space">&nbsp; </span>Convenient sampling method was used to select 70 nurses from a tertiary level hospital. Data were collected using pretested self administered structured questionnaire. Data were analysed using SPSS version 20 and analysed using descriptive and inferential statistics.</span></p> <p class="p1"><span class="s1"><strong>Result: </strong>Among 70 respondents, almost all (95.7%) of the respondents had good level of knowledge, 2.9% had fair and 1.4% had poor level of knowledge. Most (80.0%) of the respondents had positive attitude towards DNR order and 20.0% had negative attitude. There was a positive relationship between knowledge of and attitude towards DNR order (r = 0.068) but the relationship was statistically insignificant.</span></p> <p class="p1"><span class="s1"><strong>Conclusions: </strong>Based on the findings, the study concludes that nurses of tertiary level hospital have good knowledge and positive attitude towards DNR order. Likewise, knowledge regarding DNR order is related with the attitude towards DNR order and thus knowledge can be enhanced to improve the attitude towards DNR by regular in-service education.</span></p> 2021-09-06T00:00:00+00:00 Copyright (c) 2021 Medical Journal of Shree Birendra Hospital https://www.nepjol.info/index.php/MJSBH/article/view/35505 Occurrence of Hypocalcaemia in Admitted Neonates in NICU 2021-07-18T07:56:45+00:00 Nisha jyoti Shrestha nishajyoti@hotmail.com Moon Thapa nishajyoti@hotmail.com Kalpana Upadhaya Subedi nishajyoti@hotmail.com Subhana Thapa Karki nishajyoti@hotmail.com Saroja Adhikari nishajyoti@hotmail.com Anuradha Pandey nishajyoti@hotmail.com <p class="p1"><span class="s1"><strong>Introduction: </strong>Hypocalcaemia is common metabolic manifestation in neonates and associated with both maternal and foetal conditions. Hypocalcaemia is labeled if term neonate’s total serum calcium is &lt; 8 mg/dl and preterm has &lt; 7 mg/dl. Association of neonatal and maternal hypovitaminosis D is very common. .&nbsp;</span></p> <p class="p1"><span class="s1"><strong>Methods: </strong>One year retrospective study was conducted in a tertiary level private children hospital of Kathmandu, Nepal from 2018 June to 2019 July. Total 299 cases were selected and serum calcium were sent and analysed for its association with illness, associated maternal hypovitaminosis D and other relevant maternal tests.</span></p> <p class="p1"><span class="s1"><strong>Result: </strong>Among 686 NICU cases, calcium level was sent for 299</span> <span class="s1">cases. Among these, 254 were term and 45 were preterm babies and male to female ratio was 4:1. Mean calcium in term babies were 8.6 mg/dl and in preterm it was 8.1 mg/dl. Hypocalcaemia was found in 19% of cases with mean calcium level was 7.1 ± 0.84 mg/dl and severe hypocalcaemia accounted for 12%. There was no significant presence of hypocalcaemia in relation to gestation of newborn (p value 0.798). We found higher incidence of late onset hypocalcemia than early onset hypocalcemia but was not of statistical significance (p value 0.771). Associated disease were perinatal asphyxia, congenital heart diseases and prematurity. Among 27 late onset hypocalcaemia, 22% had hypovitaminosis D both in neonates and mother.</span></p> <p class="p1"><span class="s1"><strong>Conclusions: </strong>Neonatal hypocalcaemia is a common condition associated with sick newborns. In late hypocalcaemia both newborn and mother should be screened for associated lab tests like vitamin D, magnesium, PTH as there may be association between the two.</span></p> 2021-09-06T00:00:00+00:00 Copyright (c) 2021 Medical Journal of Shree Birendra Hospital https://www.nepjol.info/index.php/MJSBH/article/view/33507 Oral Cancer Awareness among Dental Patients 2021-07-18T08:09:12+00:00 Barsha Bajracharya dr.barsha.bajracharya@gmail.com Anita Dahal dr.anita.dahal@gmail.com Rajeeb Kumar Deo dr.barsha.bajracharya@gmail.com <p class="p1"><span class="s1"><strong>Introduction: </strong>The incidence of oral cancer in South Asian countries, including Nepal is increasing despite the fact that all of its risk factors are modifiable. This can be attributed to lack of awareness regarding oral cancer and its risk factors among general public. This study was conducted among subjects attending Dental OPD of a tertiary hospital to assess the knowledge and attitude regarding oral cancer and also practices of risk factors associated with it. </span></p> <p class="p1"><span class="s1"><strong>Methods: </strong>This is a questionnaire based cross-sectional study conducted from July 2020 to October 2020. Subjects attending Dental OPD of a tertiary hospital in Kathmandu were asked to fill a structured close-ended Questionnaire. Section one of the questionnaire focused on the demographic data of the subjects, second part elicited information pertaining to knowledge of oral cancer, third part focused on attitude and fourth part on practices of participants towards risk factors of oral cancer.</span></p> <p class="p1"><span class="s1"><strong>Result: </strong>Out of 300 subjects, 65% were males. Most were in the age group 41 - 50 years and 75.6% were literate. Majority mentioned smokeless tobacco as the risk factor, followed by smoking and alcohol. Regarding signs and symptoms, most of the participants mentioned non-healing ulcer, followed by lump and pain. Most of the participants responded tongue as the most common site of oral cancer. Majority answered that oral cancer can be prevented by not chewing tobacco. Among the total, 55.3% said oral cancer is non-contagious. Only 25% had undergone oral examination in the last one year. 31.7% had habit of tobacco and / or alcohol.</span></p> <p class="p1"><span class="s1"><strong>Conclusions: </strong>The awareness level and knowledge about risk factors and early signs of oral cancer in this cross-section of dental patients were satisfactory.</span></p> <p class="p1"><span class="s1"><strong>Key words:</strong> awareness; oral cancer; risk factors; tobacco</span></p> 2021-09-06T00:00:00+00:00 Copyright (c) 2021 Medical Journal of Shree Birendra Hospital