Medical Journal of Shree Birendra Hospital <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> en-US <p>This license enables reusers to distribute, remix, adapt, and build upon the material in any medium or format for noncommercial purposes only, and only so long as attribution is given to the creator.</p> (Dr Bikash Shrestha) (Sioux Cumming) Fri, 07 Jun 2024 07:45:46 +0000 OJS 60 Awareness and Perception of Sexual Harassment among Female Adolescent Students <p><strong>Introduction</strong>: Sexual harassment is the unwanted sexually determined behavior such as physical contact, making sexual comments, and sexual pressure whether by verbal or non-verbal actions. Sexual harassment among school adolescent girls is high, they choose to be silent after victimization without reporting due to a lack of awareness. The perception reflecting the apathy our society feels toward sexual harassment is indicated throughout our culture. The objective of the study was to find out the awareness and perception of sexual harassment among female adolescent students.</p> <p><strong>Method</strong>: A descriptive cross-sectional study was used. Total enumerative sampling technique was used with the total sample size of 139 female adolescent students. Data was collected by using semi-structured, self-administered questionnaires. Descriptive and inferential statistics were used to analyze and interpret the findings using SPSS version 16.</p> <p><strong>Result: </strong>The findings of the study revealed that more than one-fourth (28.1%) of the respondents had a high level of awareness, nearly two-thirds (61.9%) had an average level of awareness and 10 % had a low level of awareness. Cent percent of the respondents had negative perceptions regarding sexual harassment. There was significant association found between levels of awareness on sexual harassment with the respondents’ parents level of education (<em>p </em>&lt;0.05).</p> <p><strong>Conclusion: </strong>The present study concluded that students had average level of awareness and negative perceptions on sexual harassment. Therefore, the awareness program regarding sexual harassment should be conducted with the maximum involvement of female adolescent students.</p> Alina Shrestha, Shanti Bajracharya Copyright (c) 2023 Medical Journal of Shree Birendra Hospital Sun, 31 Dec 2023 00:00:00 +0000 Comparative Analysis of Preoperative Ultrasonography Reports with Intraoperative Findings in Cholelithiasis <p><strong>Introduction:</strong> Cholecystectomy is a popular surgical intervention for cholelithiasis. Preoperative abdominal ultrasonography is helpful for diagnosis and prediction of possible surgical complications. This research was planned to correlate the preoperative abdominal ultrasonography findings with intraoperative findings and complications.</p> <p><strong>Methods:</strong> A hospital based retrospective study was conducted among 300 patients visiting Surgery Department and Department of Radiology of Shree Birendra Hospital, Kathmandu, Nepal. Descriptive statistics was used to present the comparative analysis of preoperative ultrasonography reports with intraoperative surgical findings in cholecystectomy.</p> <p><strong>Results:</strong> Total 300 participants were who were diagnosed by ultrasonography and underwent cholecystectomy were included in the study. Complications were reported among 110 subjects with adhesions in 20%, mucoceles in 7.3%, empyema in 8%, and impacted stone in 1.3.%. Out of 75 patients in which preoperative USG reports showed increased GB wall thickness, 17 (22.6%) had adhesions, 10 had mucoceles (1.3%), eight had empyema (10.6%), one had impacted stone (1.3%) and three had hemorrhage (4%).</p> <p><strong>Conclusion:</strong> The most reliable preoperative abdominal ultrasonography indicators of a challenging cholecystectomy are gall bladder wall thickness, impacted gall stones, adhesion and hemorrhage.</p> Mukunda Singh Shrestha, Sujit Pant, Bikash Bahadur Rayamajhi, Milan Khadka, Ramesh Khadka, Sudesh Lamsal Copyright (c) 2023 Medical Journal of Shree Birendra Hospital Sun, 31 Dec 2023 00:00:00 +0000 Early versus Delayed Feeding in Uncomplicated Primary Caesarean Section - A Comparative Study at Shree Birendra Hospital <p><strong>Introduction:</strong> Conventionally, oral feeding is delayed after Caesarean section fearing delayed bowel motility. This study is designed to compare early oral feeding within six hours versus our conventional delayed 24 hours of oral feeding for women at term undergoing primary Caeserean section.</p> <p><strong>Methods:</strong> A prospective, comparative study was conducted over a six months period at Shree Birendra Hospital, Kathmandu, Nepal. All pregnant ladies undergoing uncomplicated Caeserean section at 37 to 42 weeks of gestation were randomly placed in two groups: (A) Early feeding group (Oral fluids within six hours) (54) and (B) Delayed feeding group (Oral fluids after 24 hours) (56). The patients were noted for symptoms of nausea, vomiting, abdominal distension, return of bowel sound, passing of flatus, duration of stay in hospital and total IV fluid requirements. </p> <p><strong>Results:</strong> The passage of flatus was significantly earlier in Group A compared to Group B (12.54 hours vs 15.38 hours - p &lt; 0.05). Appearance of bowel sounds was also earlier in Group A (8.85 hours vs 12.63 hours – p &lt; 0.05). The mean IV fluid requirement was comparatively less in Group A (4.15 litres vs 5.71 litres – p &lt; 0.05). The average hospital stay was also significantly less in Group A (2.89 days vs 4.16 days - p &lt; 0.05). </p> <p><strong>Conclusion:</strong> Early feeding in patients undergoing uncomplicated primary Caesarean section is safe, generally well tolerated with early return to bowel functions, less intravenous fluid requirements and reduced duration of hospital stay.</p> Rosy Vaidya Malla, Shailaja Khadka, Bibhushan Neupane, Sumit Bidari, Sumana Thapa Copyright (c) 2024 Medical Journal of Shree Birendra Hospital Sun, 31 Dec 2023 00:00:00 +0000 Intraoperative Awareness Among Patients Following General Anaesthesia - A Descriptive, Cross - sectional study. <p><strong>Introduction:</strong> Operative awareness with recall refers to recalling of the intra operative events in the post-operative period by the patients which may have significant psychological and legal implications. Bispectral index (BIS) analysis is a processed EEG that can be used to monitor the depth of anaesthesia, titrate the dose of anaesthetic agents and hence prevent intraoperative awareness. </p> <p><strong>Methods:</strong> It is a prospective, cross-sectional, observational study, where total of 103 cases operated under general anaesthesia were included. BIS score was monitored intraoperatively at various points of time during the surgery and Modified Brice questionnaires was used in post-operative to illicit intraoperative awareness. </p> <p><strong>Results:</strong> The maximum and minimum BIS score was 97.46 ± 0.84 before induction and 50.20 ± 7.43, 30 minutes after intubation. None of the patients remembered anything between going to sleep and waking up indicating there was no incidence of awareness. However, 55.4% remembered “seeing the operating room before going to sleep”, 71.8% remembered “hearing voices’’ first thing after waking up and 59.3% were worried about pain in the post-operative period. </p> <p><strong>Conclusion:</strong> There were no incidence of intraoperative awareness among the patients during surgery under general anaesthesia.</p> Bhuban Raj Kunwar, Aashish Shah Copyright (c) 2023 Medical Journal of Shree Birendra Hospital Sun, 31 Dec 2023 00:00:00 +0000 Phenylephrine for Blood Pressure Control under Sub-arachnoid Block in Elective Caesarean Section: Prophylactic vs Therapeutic Approach <p><strong>Introduction:</strong> Hypotension after spinal anaesthesia is common during Caesarean section with incidence of 50 - 80%. There are various methods to prevent maternal side effects like hypotension, nausea and vomiting and fetal outcome by preloading or co-loading with crystalloids, left tilt and vasopressors like phenylephrine. In this study we hypothesized that prophylactic phenylephrine offers better hemodynamic control than therapeutic doses in elective Caesarean section after subarachnoid block. </p> <p><strong>Methods:</strong> A comparative, prospective, randomized double blind study was conducted in 104 patients scheduled for elective Caesarean section. 52 patients each were assigned into either prophylactic (P) or therapeutic (T) group. Baseline data, hemodynamics, nausea and vomiting and APGAR score were collected. Hemodynamics were analyzed using 2-tailed student’s t-test for intergroup and paired t-test for intragroup comparison. Nominal categorical data such as gender was also analyzed with Chi-square test.</p> <p><strong>Results:</strong> Systolic, diastolic and mean arterial pressure were significantly lower in therapeutic group as compared to prophylactic group. The overall incidence of hypotension was 53% in group T and 21% in group P. Similarly, nausea and vomiting were significantly higher in group T (46%) compared to group P (11%) at 15, 20 and 30 mins. </p> <p><strong>Conclusion:</strong> Prophylactic dose of phenylephrine significantly prevents hypotension and nausea and vomiting in patients undergoing elective Caesarean section.</p> Anand Thakur, Amit Sharma Bhattarai, Binita Acharya Copyright (c) 2023 Medical Journal of Shree Birendra Hospital Sun, 31 Dec 2023 00:00:00 +0000 Postoperative Complications in Post-Tonsillectomy Patients Without Post-Operative Antibiotics <p><strong>Introduction:</strong> Empirical use of antibiotics has tremendous effects in the health sector in terms of medical expenses and antibiotic resistance. Current guidelines do not recommend antibiotic use post tonsillectomy however, some surgeons prefer antibiotic use in the post-operative period. This study aims to evaluate post-operative findings such as haemorrhage and fever in patients without the use of post-operative antibiotics. </p> <p><strong>Methods:</strong> This was a descriptional retrospective study conducted with chart review of medical records of the patients operated and not receiving post tonsillectomy antibiotics at the Department of ENT, Head and Neck Surgery, Shree Birendra Hospital, Chhauni, Kathmandu, Nepal. The post-tonsillectomy findings such as hemorrhage and fever were recorded and analyzed. </p> <p><strong>Results:</strong> There were a total of 146 patients (87 males and 59 females) aged four to 72 years with a mean age of 26.76 ± 12.07 years during the study period. Haemorrhage was seen in eight (5.4%) patients. Two had primary haemorrhage and six had secondary haemorrhage. There was fever among seven patients (4.79%) out of which three had developed fever on 1st postoperative day (POD), two on second, one on fifth and one on eighth post operative day. </p> <p><strong>Conclusion:</strong> Post-tonsillectomy morbidity such as haemorrhage and fever were minimal in patients without post operative antibiotics.</p> Suman Raj Dongol, Rajeev Kumar Mahaseth, Ranishma Bista, Sarita KC Copyright (c) 2023 Medical Journal of Shree Birendra Hospital Sun, 31 Dec 2023 00:00:00 +0000 Profile of Patients Visiting a Surgical Eye Camp in Pokhara, Nepal - A Descriptive Cross Sectional Study <p><strong>Introduction:</strong> Nepal is a lower-middle-income country with low health literacy and challenging healthcare access. Various health camps are conducted throughout the country to address these needs. This study was conducted to understand the demographic and clinical profile of patients visiting a surgical eye camp in Pokhara, Nepal. </p> <p><strong>Methods:</strong> A cross-sectional study was conducted among 945 patients visiting the eye camp at Military Hospital, Pokhara, Nepal. Descriptive statistics were used to present the demographic details and clinical profile of the patients. </p> <p><strong>Results:</strong> The demographic profile of the participants showcased a diverse sample regarding age group, gender, and ethnic group. Among the total 945 patients, 306 (32.38%) had prior ophthalmological conditions, with presbyopia (25.49%) and refractive errors (15.03%) being the most common. During the camp, prevalent diagnoses included presbyopia (27.39%), refractive errors (22.23%), and cataract (16.10%). Only 45.75% of previously diagnosed patients were on regular follow-ups. </p> <p><strong>Conclusion:</strong> Different types of eye disorders are prevalent among general population. Presbyopia and refractive errors are the commonest eye disorders in the study population.</p> Ram Shrestha, Suchit Thapa Chhetri, Sagar Rajkarnikar, Ajay Rajbhandari, Oshan Shrestha, Sitaram Khadka Copyright (c) 2023 Medical Journal of Shree Birendra Hospital Sun, 31 Dec 2023 00:00:00 +0000 Risk of Fall among Elderly People Residing in an Urban Municipality of Eastern Nepal <p><strong>Introduction:</strong> Falls are a major public health issue and a leading cause of morbidity and mortality among older people. Majority of falls are preventable and injuries related to it can be reduced through early identification of risk factors and timely introduction of appropriate intervention. Therefore, the purpose of this study was to find out the risk of falls and its associated factors among elderly people.</p> <p><strong>Methods:</strong> A descriptive cross-sectional design was used. Using non-probability purposive sampling technique, a total of 103 elderly people aged 70 - 79 years were selected. Data were collected from the respondents by using pretested semi-structured interview schedule and “Time Up and Go” test at their homes. Data were analyzed by using descriptive and inferential statistics. </p> <p><strong>Results:</strong> Out of 103 respondents, 52.4% reported a history of falls within 12 months, 68% had history of chronic disease and 65% were taking medicine. Vision problem was reported by 74.8%. “Time Up and Go” test revealed that the majority (61.2%) were at high risk of fall. The risk was significantly associated with age (p = 0.001), educational status (p = 0.019) and history of fall within 12 months (p = 0.001).</p> <p><strong>Conclusion:</strong> Study concludes that elderly people aged 70 to 79 tend to be generally at high risk of fall. Age, educational status and history of fall within 12 months influence the risk of fall among elderly people.</p> Pramila Limbu, Gita Dhakal Chalise, Sarala Shrestha Copyright (c) 2023 Medical Journal of Shree Birendra Hospital Sun, 31 Dec 2023 00:00:00 +0000 Stress and Coping Strategies among Parents of Infants Admitted in Neonatal Intensive Care Unit at Tertiary Level Hospital <p><strong>Introduction:</strong> Having a newborn infant hospitalized in the NICU is an unexpected and stressful event for a family. Coping is defined by actions of self-regulation of emotions, cognitions, behaviors, and motivational orientation under stress. Present study is aimed at identifying the level of stress and coping strategies of parents of infants admitted in NICU. </p> <p><strong>Methods:</strong> A cross-sectional analytical study was conducted among 104 parent of infants admitted in NICU at Patan Hospital and Kanti Children’s Hospital, Nepal. Parental stress and coping strategy was assessed using PSS:NICU scale and modified coping checklist. Descriptive (frequency, percentage, mean) and inferential statistics (Pearson’s correlation and fisher exact test) was used to analyze the data. </p> <p><strong>Results:</strong> Among 104 parents, 97.12% had moderate, 1.92% had low and 0.96% had severe stress. Regarding coping strategies mostly used coping were, social coping (mean score 3.93) and emotional coping strategy (mean score 3.77). Social coping was positively correlated with overall stress level (r = 0.41). None of the parents and infants related variables were significantly associated with stress level. </p> <p><strong>Conclusion:</strong> Nearly all the parents had moderate level of stress and parental role was the major stressor. More than three fourth of the parents used social and emotional coping and followed by spiritual, diversional and least used was problem solving strategy. None of the parents and infants related variables was significantly associated with stress level. Social coping was positively correlated with overall stress level.</p> Bishnu Maya Banjade, Khagi Maya Pun, Sushila Khatri, Sunita Pokharel Copyright (c) 2023 Medical Journal of Shree Birendra Hospital Sun, 31 Dec 2023 00:00:00 +0000