Birat Journal of Health Sciences https://www.nepjol.info/index.php/bjhs <p>Official journal of Birat Medical College and Teaching Hospital.</p> <p>Author submissions should be made on the journal's own website <a title="BJHS" href="http://bjhsnepal.org/" target="_blank" rel="noopener">http://bjhsnepal.org/</a></p> en-US biratjournal2016@gmail.com (Professor Dr. Hem Sagar Rimal) sioux.cumming@ubiquitypress.com (Sioux Cumming) Fri, 24 Jun 2022 07:31:04 +0000 OJS 3.3.0.6 http://blogs.law.harvard.edu/tech/rss 60 Status of Patient-Doctor Communication in a Nepali Hospital https://www.nepjol.info/index.php/bjhs/article/view/45786 <p><strong>Introduction:</strong> The dialog of thoughts and information verbally or nonverbally between doctors and patients is patient-doctor communication. This study explores the persuasive quality of patient-doctor communication in a Nepali hospital. With the help of the data collected, the study evaluates mainly ethical appeals, logical appeals and emotional appeals.</p> <p><strong>Objective</strong>: The objective of this research is to evaluate the persuasive elements specifically ethos, logos and pathos of patient-doctor communication in a Nepali hospital.</p> <p><strong>Methodology</strong>: This is a hospital based descriptive study. This research has used Aristotle’s rhetoric: Ethos, logos and pathos. Because of the lack of big data in this area, secondary data is scanty, so an empirical tool (survey) is adopted for generating data. First a survey is done on 50 doctors working in the hospital, and 300 outpatients suffering from chronic diseases. The data is collected and entered on an Excel file. Later it is analyzed and interpreted thematically with the help of pie charts and tables.</p> <p><strong>Results</strong>: Ethical appeals, logical appeals and emotional appeals are found good in patient-doctor communication in this hospital under study.&nbsp;</p> <p><strong>Conclusion</strong>: In terms of ethos, logos and pathos separately, patient-doctor communication in Nepali hospital appears to be good. However, there is a lack of combination of all these three elements in most of the respondents.</p> Eak Prasad Duwadi, Siza Adhikari, Sujan Nepal Copyright (c) 2022 Eak Prasad Duwadi, Siza Adhikari, Sujan Nepal https://creativecommons.org/licenses/by-nc/4.0 https://www.nepjol.info/index.php/bjhs/article/view/45786 Fri, 24 Jun 2022 00:00:00 +0000 Clinical profile of renal diseases in children in tertiary care centre https://www.nepjol.info/index.php/bjhs/article/view/45787 <p><strong>Introduction:</strong> Renal diseases in children and young adult can be difficult to diagnose early as it may present only with few symptoms, tends to have different course than adult and respond variously to different treatment. The pattern of renal disease in children is different from developing countries as compared to developed countries.</p> <p><strong>Objective:</strong> &nbsp;To know the current profile and aetiology of renal disease in children</p> <p><strong>Methodology:</strong> This is a hospital based prospective observational study carried from March, 2014 to February 2015 at BPKIHS. Patients with renal disease, both inpatient and outpatient from birth to 14 years of age were enrolled in the study. The diagnosis of renal disease was be made on clinical and laboratory criteria.</p> <p><strong>Results:</strong> Total of 120 patients were enrolled in our study which contributed to 3.74%&nbsp; of total admission. The commonest feature of presentation was edema (75%) , followed by fever (65%), hypertension (60%), decreased urine output (45%) and hematuria (25%) . Most common diagnosis was acute glomerulonephritis (40%) followed by Nephrotic syndrome (25%) and UTI (25%). Renal biopsy was done for 10% of cases and most of them were steroid dependant nephrotic syndrome. 5% of our cases expired because of MODS, sepsis and AKI.</p> <p><strong>Conclusion:</strong> Renal disease contributes to a large part of hospital pediatric admission as well as mortality and morbidity to the children. There is scanty data and need for detailed study on specific renal disease is of great need to plan optimal renal care for these children.</p> Jyoti Agrawal, Shipra Chaudhary, Manju Shrestha Copyright (c) 2022 Jyoti Agrawal, Shipra Chaudhary, Manju Shrestha https://creativecommons.org/licenses/by-nc/4.0 https://www.nepjol.info/index.php/bjhs/article/view/45787 Fri, 24 Jun 2022 00:00:00 +0000 Evaluation of Hepatic, Renal and Cerebral Function Test in Preeclampsia-Eclampsia Syndrome and its Correlation to Maternal and Fetal Outcome https://www.nepjol.info/index.php/bjhs/article/view/45790 <p><strong>Introduction</strong>: Hypertensive disorders complicates 5-10% of pregnancies all over the world and its incidence in India was found to be 10.08% as per data of National Eclampsia Registry (NEP).</p> <p><strong>Objectives: </strong>The objectives of this study were to determine the incidence of abnormal liver, renal and cerebral function test among patients with preeclampsia and eclampsia and their correlation to maternal and fetal outcome.</p> <p><strong>Methodology</strong><strong>: </strong>The study was a prospective cohort study comparing the maternal and fetal outcomes of preeclampsia and eclampsia patients with abnormal parameters (cases; n=50) and pre-eclampsia and eclampsia patients with normal parameters (controls; n=50).&nbsp; Both case and control were examined clinically apart from biophysical and biochemical investigation.</p> <p><strong>Results</strong><strong>:&nbsp; </strong>Deranged LFT was present in approximately 56% -70% of cases. Serum albumin was decreased in 80% of cases. Prothrombin time (PT) was raised in 48% of cases. Abnormal GFR, urea, creatinine and uric acid level were present in 44%, 10%, 10% and 64% of cases. Among all the pregnancy outcomes in preeclampsia and eclampsia cases with abnormal LFT, preterm labour, PPH, IUFD, meconium stained liquor and neonatal death had significant “p” value &lt;.05. There were 16% preterm labours, 60% IUGR, 36% ARF, 18% Neonatal death, in cases with abnormal RFT. It was found from the study that CVA, Cerebral hemorrhage, fetal distress, and still birth were present in 16%, 24%, 36% and 8% of cases with abnormal cerebral function.</p> <p><strong>Conclusion: </strong>Deranged liver function test was associated with increased incidence of postpartum hemorrhage (P value=0.0001) and postpartum eclampsia (P value &lt;0.0001).</p> Sangita Patra, Suchibrata Das, Sujata Dalai, Pallab Kumar Mistri Copyright (c) 2022 Sangita Patra, Suchibrata Das, Sujata Dalai, Pallab Kumar Mistri https://creativecommons.org/licenses/by-nc/4.0 https://www.nepjol.info/index.php/bjhs/article/view/45790 Fri, 24 Jun 2022 00:00:00 +0000 A study of Heart Rate Variability (HRV) in healthy offsprings with parental history of type 2 diabetes mellitus https://www.nepjol.info/index.php/bjhs/article/view/45791 <p><strong>Introduction:</strong> Type 2 diabetes mellitus (T2DM) is a heterogeneous polygenic metabolic disease condition that is caused by insulin resistance leading to hyperglycemia. Since, T2DM is genetically inherited and autonomic dysfunction is its major complications, healthy offsprings of diabetic parents are highly vulnerable to manifest dysautonomia leading to insulin resistance.</p> <p><strong>Objectives:</strong> We aimed to assess cardiac autonomic function using heart rate variability (HRV) parameters in healthy offsprings having parental history of T2DM.</p> <p><strong>Methodology:</strong> A comparative cross-sectional study was carried out in the laboratory of department of Physiology enrolling 30 healthy offsprings of non-diabetic parents (Group 1) and 30 healthy offsprings of diabetic parents (Group 2). Anthropometric, biochemical and cardiovascular variables were assessed using standard procedures. Time domain and frequency domain parameters of HRV spectrum were assessed using photoplethysmography principle.</p> <p><strong>Results: </strong>HRV findings revealed that markers of sympathetic regulation were significantly higher and those of parasympathetic function were significantly reduced in subject group having parental history of T2DM. LF/HF ratio was significantly increased suggesting sympatho-vagal imbalance in offspring of diabetic parents even in their euglycemic state.</p> <p><strong>Conclusion:</strong>&nbsp; Alteration of cardiovascular autonomic function is found in healthy offspring of diabetic parents, characterized by reduced vagal activity and pronounced sympathetic regulation. Assessment of cardiac autonomic function would help in timely detection of such dysautonomia and reducing the life-threatening effects on offspring having parental history of T2DM.</p> Suman Pokhrel, Kopila Agrawal, Santosh Dev, Binnam Shakya, Sharad Hari Gajuryal Copyright (c) 2022 Suman Pokhrel, Kopila Agrawal, Santosh Dev, Binnam Shakya, Sharad Hari Gajuryal https://creativecommons.org/licenses/by-nc/4.0 https://www.nepjol.info/index.php/bjhs/article/view/45791 Fri, 24 Jun 2022 00:00:00 +0000 Effect on mode of Child birth and its outcomes before and during the COVID-19 pandemic at Ilam district hospital: A comparative descriptive cross-sectional study https://www.nepjol.info/index.php/bjhs/article/view/45792 <p><strong>Introduction:</strong> Nepal started full lockdown from 24 March to 14 June 2020, followed by partial lockdowns multiple times as a precaution for the prevention of COVID-19 infection. Managing health care services was a major issue during the COVID-19 pandemic for both the patients and health care professionals including services targeting pregnant women in developing countries like Nepal.</p> <p><strong>Objectives:</strong> To study the impact of the COVID-19 pandemic on childbirth services attended at a district government hospital and to observe the impact on mode of delivery and maternal-child health.</p> <p><strong>Methodology:</strong> This descriptive cross-sectional study aimed to find out the impact on delivery services during the pandemic compared to pre-pandemic duration that includes one year period from 22<sup>nd </sup>October 2019 to 22<sup>nd </sup>March 2020 (before pandemic) and from 23<sup>rd </sup>March 2020 to 23<sup>rd </sup>September 2020 (pandemic duration) at Ilam District Hospital. All the information used in this research was taken from Health Management Information System (HMIS) logbook. The permission to use the recorded data was obtained from the hospital. Anonymity and confidentiality of data were maintained and no personal information was used in this research to protect the identity of the patients. The data was collected from the HMIS records of the hospital and was then processed in Microsoft excel.</p> <p><strong>Results:</strong> The result shows despite the lockdown and pandemic the percentage of patients coming to receive delivery services within the hospital increased about 9% which is an exceptionally good result. Emergency CS was found to be decreased by 3%. During the pandemic Hospital stay was significantly reduced for patient’s safety due to COVID-19. However, no adverse impact was observed on the health outcomes of the mother and baby due to a short stay at the hospital.</p> <p><strong>Conclusion:</strong> Despite lockdown and pandemic, the number of parents receiving hospital delivery services increased at Ilam hospital. This was possible due to proper management and pre-plan services according to the government’s COVID-19 protocol to cope with the pandemic and demand of the health services as other nearby hospitals closed their door during the pandemic. In the future, a short stay at the hospital can be continued to cope with a high demand of the services in the maternity department as we found the health of both mother and baby has not been impacted due to short stay in the hospital during the pandemic.</p> Prabhu Sah, Shradha Shrestha, Anju Deo, Shivam Karn Copyright (c) 2022 Prabhu Sah, Shradha Shrestha, Anju Deo, Shivam Karn https://creativecommons.org/licenses/by-nc/4.0 https://www.nepjol.info/index.php/bjhs/article/view/45792 Fri, 24 Jun 2022 00:00:00 +0000 Pattern of ocular morbidities among preschool children of Biratnagar Metropolis of Nepal https://www.nepjol.info/index.php/bjhs/article/view/45793 <p><strong>Introduction: </strong>Children use their vision to enhance motor skills, develop parent–child bonds, build picture perception, and gain balance. Children may enter school with vision problems. Sub-optimal vision can lead to poor academic performance, a lack of interest in school, and even dropping out.</p> <p><strong>Objective: </strong>To evaluate the pattern of various ocular morbidities among preschool children of Biratnagar metropolis.</p> <p><strong>Methodology: </strong>A cross sectional study was conducted from October 2020 -Jan 2021 among 393 study participants at 5 different preschools of Biratnagar using total enumeration sampling. Vision was assessed with Snellen's visual acuity charts and Kay Picture chart. Anterior and posterior segment examination was done using a hand-held portable slit lamp and a direct ophthalmoscope respectively. Binocularity was assessed with a cover test at a distance and near targets and the Hirschberg corneal reflex. The refractive status of the eyes was assessed by performing static retinoscopy. All the data was analyzed according to sex, age, causes of visual impairment and types of ocular morbidity.</p> <p><strong>Results</strong>: Among the total 393preschool children screened, 169 children were boys and 224 were girls. The prevalence of ocular morbidity was found to be 20.1 %. Refractive error was the most common cause of visual impairment which was seen in 14.7% of children. The overall prevalence of myopia, hyperopia, and astigmatism was 7.9%, 4.8%, and 2.1% respectively. The other types of ocular morbidities were strabismus in 1.3%, congenital cataract in 1%, conjunctivitis in 1%, chalazion in 1.3%, vernal keratoconjunctivitis in 1% and congenital ptosis in 0.6%.</p> <p><strong>Conclusion:</strong> The relatively high prevalence of refractive error and occurrence of other ocular morbidities in our studied population suggests that there is a need for a large-scale community-based preschool screening program in Nepal so that affected preschool children can be identified early and appropriate treatment can be promptly started.</p> Neha Priyadarshani Chaudhary, Badri Prasad Badhu, Surya Bahadur Parajuli, Barun Dev Copyright (c) 2022 Neha Priyadarshani Chaudhary, Badri Prasad Badhu, Surya Bahadur Parajuli, Barun Dev https://creativecommons.org/licenses/by-nc/4.0 https://www.nepjol.info/index.php/bjhs/article/view/45793 Fri, 24 Jun 2022 00:00:00 +0000 Normative value of adductor squeeze test in Nepali male professional football players: A cross-sectional study https://www.nepjol.info/index.php/bjhs/article/view/45799 <p><strong>Introduction:</strong> Groin pain is a common problem. Adductor squeeze test are used to diagnosed, monitor and prophylactically determine the risk of developing groin pain.</p> <p><strong>Objectives:</strong> The aim of study was to establish normative adductor squeeze test values in Nepali male professional football players.</p> <p><strong>Methodology: </strong>One hundred and sixty-one healthy players from top football clubs attended the study. Hip adductor muscle strength was assessed using sphygmomanometer at 0⁰, 45⁰ and 90⁰ hip flexion.</p> <p><strong>Results:</strong> The mean value of adductor squeeze test score at 0⁰ of hip flexion position was 152.03 ± 33.18, for 45⁰ of hip flexion position was 152.38 ± 27.52 and for 90⁰ of hip flexion position was 120.57 ± 21.88. 45⁰of hip flexion has the highest value of the adductor squeeze test.</p> <p><strong>Conclusion:</strong> This study established reference ranges for adductor squeeze tests for normative pre-season data in Nepali male A-division professional football players.</p> Umesh Adhikari, Yubaraz Prasad Sharma Humagain, Rajan Shrestha Copyright (c) 2022 Umesh Adhikari, Yubaraz Prasad Sharma Humagain, Rajan Shrestha https://creativecommons.org/licenses/by-nc/4.0 https://www.nepjol.info/index.php/bjhs/article/view/45799 Fri, 24 Jun 2022 00:00:00 +0000 A descriptive cross-sectional study on knowledge of Hand washing among health professionals in a medical college https://www.nepjol.info/index.php/bjhs/article/view/45800 <p><strong>Introduction: </strong>Nosocomial infection is common due to poor practice of hand hygiene. There is a variation in the level of knowledge of handwashing among different health professionals.</p> <p><strong>Objectives:</strong> The aim of the study was to assess the basic knowledge of handwashing among health professionals.</p> <p><strong>Methodology:</strong> This cross-sectional study was done in 370 healthcare professionals like doctors, nurses, health assistants of a National medical college. The questionnaire used was adapted from the World Health Organization about hand hygiene knowledge for health professionals. There were 18 questions assessing the basic knowledge and practice of handwashing. The level of hand hygiene knowledge was calculated by dividing the responses into four groups based on score more than 90% as excellent, 75-90% considered as good, 50-74% moderate, and less than 50% considered as low.. All data was transferred to the excel sheet and transferred to a statistical package for the social sciences-17. The result was presented using frequency tables, graphs, and charts.</p> <p><strong>Result:</strong> Out of 370 participants, 318(85.9%) were females, and 52(14.1%) males. The mean age was 24.59±4.48 years. Of all the respondents, 24% had low, 30% moderate, 26% good, and 21% had excellent knowledge of hand hygiene. In terms of practice, only 34% had a moderate level of practice of hand hygiene.</p> <p><strong>Conclusion: </strong>Regular training and re-training through simulations of hand hygiene will lead to an improvement in the knowledge and practice of handwashing.</p> Niraj Kumar Keyal, Alok Kumar Singh, Pankaj Chaudhary, MD Safroz Ansari, Sudesh Khanal Copyright (c) 2022 Niraj Kumar Keyal, Alok Kumar Singh, Pankaj Chaudhary, MD Safroz Ansari, Sudesh Khanal https://creativecommons.org/licenses/by-nc/4.0 https://www.nepjol.info/index.php/bjhs/article/view/45800 Fri, 24 Jun 2022 00:00:00 +0000 Outcomes of Autologous Blood Injection for Treatment of Tennis Elbow https://www.nepjol.info/index.php/bjhs/article/view/45820 <p><strong>Introduction: </strong>Lateral tendinosis of the elbow, sometimes called tennis elbow, refers to the degenerative process in the common source of the extended group of forearm muscles. In orthopedic clinics, it is the most prevalent cause of elbow discomfort and pain. The condition caused by repeated muscular motions is a typical cause of elbow discomfort.</p> <p><strong>Objectives: </strong>To assess the clinical and functional outcomes of autologous blood injection for the treatment of tennis elbow.</p> <p><strong>Methodology: </strong>This is a hospital based cross-sectional study, conducted in Birat Medical College teaching hospital.&nbsp; Here, the patients diagnosed with a Tennis elbow in orthopedic OPD during the study duration of September 2020 to August 2021 were included in the study. Total 93 samples were studied. Two ml of the patient's blood has withdrawn from the right antecubital vein and has been injected around the affected common extensor tendon origin. Data was analyzed using SPSS version 23.</p> <p><strong>Results: </strong>Total Ninety Three (59% females, 41% male) patients were treated with the diagnosed concerned disease. The mean age of the patients was 45.39 ± 10.109 years. At the end of the trial, 90% of the patients were satisfied fully with the treatment. The overall performance of the regression model is significant in all scenarios.</p> <p><strong>Conclusion: </strong>Given the satisfactory results, the blood injection in question can be deemed a suitable medication alternative to the conventional therapy.</p> Mithilesh Kumar Gupta, Ajay Chaudhary, Ajay Mahato Copyright (c) 2022 Mithilesh Kumar Gupta, Ajay Chaudhary, Ajay Mahato https://creativecommons.org/licenses/by-nc/4.0 https://www.nepjol.info/index.php/bjhs/article/view/45820 Fri, 24 Jun 2022 00:00:00 +0000 COVID-19 Infection in Pregnancy: A Descriptive Cross-sectional Study https://www.nepjol.info/index.php/bjhs/article/view/45821 <p><strong>Introduction: </strong>There is diverse evidence regarding the maternal and fetal effect of coronavirus disease 2019 (COVID-19) in pregnancy.</p> <p><strong>Objectives: </strong>The objective of this study was to assess the effect of COVID-19 in mother and fetus during pregnancy.</p> <p><strong>Methodology: </strong>A descriptive cross-sectional study was conducted during the second wave of COVID-19 in the Department of Obstetrics and Gynaecology at Birat Medical College Teaching Hospital from April 3 to July 3, 2021. All pregnant women admitted in the antenatal ward were sent real-time reverse transcription polymerase chain reaction (RT-PCR) for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection. The patients with RT-PCR confirmed SARS-CoV-2 infection were enrolled in the study and followed up until discharged.</p> <p><strong>Results: </strong>The COVID-19 positivity rate was 18.0%.The mean age was 24.38 years. Majority of the patients were asymptomatic (79.7%) Among symptomatic patients, 73.3% had fever and respiratory symptoms and 95.9% of women didn't give any history of contact with COVID-19 patients. After confirmed SARS-CoV-2 infection, all pregnant women were immediately shifted to COVID ward, another COVID hospital or advised home isolation. Only one patient had pre-existing hypertension. Among the pregnancy complications, preterm labour was seen in 12.2% followed by premature rupture of membranes in 6.8 %, fetal distress in 5.4%, and still birth in 2.7% of the pregnant women with SARS-CoV-2 infection. The minimum days of hospital stay was one and maximum days of hospital stay were 29 days. Average days of hospital stays was 2.24 days. Only 5.4% of patients who had severe disease required an intensive care unit (ICU) and one patient needed a mechanical ventilator. There was one maternal mortality due to Acute Respiratory Distress Syndrome (ARDS).</p> <p><strong>Conclusion: </strong>Symptom, clinical course and severity of COVID-19 in pregnancy is comparable with non-pregnant women with COVID-19 but associated with increases the risk of Preterm labour, Premature rupture of membranes, foetal distress and stillbirth.</p> Raj Deb Mahato, Yogesh Prasad Yadav, Tarun Pradhan Copyright (c) 2022 Raj Deb Mahato, Yogesh Prasad Yadav, Tarun Pradhan https://creativecommons.org/licenses/by-nc/4.0 https://www.nepjol.info/index.php/bjhs/article/view/45821 Fri, 24 Jun 2022 00:00:00 +0000 Comparison of Aboul-Azm and Fouda’s approach of mixed dentition analysis with Moyers technique https://www.nepjol.info/index.php/bjhs/article/view/45822 <p><strong>Introduction: </strong>The prediction of mesiodistal widths of unerupted canines and premolars are an important aspect of analysis of the developing permanent dentition. Various radiographic as well as non radiographic methods have been tested and researched to predict the width of these teeth. The Moyers mixed dentition analysis is a universally accepted technique. Whereas Aboul-Azm and Fouda’s approach of mixed dentition analysis is a concept that derives the measurement from equation based on the buccolingual width of the permanent first molars. It does not require any table for the prediction.</p> <p><strong>Objective: </strong>The present study compares the Aboul-Azm and Fouda’s approach of mixed dentition analysis with Moyers technique.</p> <p><strong>Methodology: </strong>Estimations of the widths of the unerupted permanent canines, first and second premolars were performed for maxillary and mandibular arches using Aboul-Azm and Fouda’s and Moyers prediction methods. The predicted values were then compared with the measurements of the actual teeth on 224 study models of males and females. The study was conducted from October to December 2021.</p> <p><strong>Results: </strong>The study was conducted on 112 male and female samples each. For males, statistically significant underestimation were found for Aboul-Azm and Fouda’s method in both arches whereas Moyers method showed better accuracy in males. In females Moyers method showed a significant overestimation. In the total sample the Moyers method showed accuracy for maxillary arch whereas Aboul-Azm and Fouda’s method was more accurate for the mandibular arch.</p> <p><strong>Conclusion: </strong>Moyers method showed a good accuracy in the maxillary arch while in the mandibular arch Aboul-Azm and Fouda’s method was more accurate.</p> Parajeeta Dikshit, Senchhema Limbu, Sunita Khanal, Manisha Malla, Lok Raj Dhakal Copyright (c) 2022 Parajeeta Dikshit, Senchhema Limbu, Sunita Khanal, Manisha Malla, Lok Raj Dhakal https://creativecommons.org/licenses/by-nc/4.0 https://www.nepjol.info/index.php/bjhs/article/view/45822 Fri, 24 Jun 2022 00:00:00 +0000 Awareness of Oral and Maxillofacial Surgery Specialty among Medical Students of a Tertiary Care Centre: A Descriptive Cross-sectional Study https://www.nepjol.info/index.php/bjhs/article/view/45823 <p><strong>Introduction: </strong>Oral and maxillofacial surgery is a relatively young surgical specialty with roots in dentistry and medicine. It has expanded with time from simple extraction of the tooth to the reconstruction of the facial deformity using microvascular free tissue transfer.</p> <p><strong>Objectives: </strong>To find out prevalence of awareness of oral and maxillofacial surgery specialty among medical students of Birat Medical College and Teaching Hospital, Nepal.</p> <p><strong>Methodology</strong>: A descriptive cross-sectional study was conducted from 1 September 2020 to 30 September 2020. A total of 100 medical students were chosen by convenience sampling method. A semi-structured questionnaire was developed in Google forms and sent to study participants through an internet link to assess the awareness of oral and maxillofacial surgery specialty. Data were analysed by Statistical Package for Social Sciences version 22.</p> <p><strong>Results: </strong>The data showed that 81 (81%) of medical students have heard of oral and maxillofacial surgery specialty. Most of the students expected oral and maxillofacial surgeon for treatment of fracture of the lower jaw [86(86%)], upper jaw [89(89%)] and cheekbone [91(91%)]. Many students expected oral and maxillofacial surgeons to treat tumours of jaws [78(78%], cysts of jaws [77(77%)], temporomandibular joint disorders [74(74%)]. Few students expected oral and maxillofacial surgeon for dental implants [16(16%)] and lip repositioning surgery [4(4%)].</p> <p><strong>Conclusion: </strong>The majority of medical students have heard of Oral and maxillofacial specialty; however, they are not fully aware of the expertise and potentiality of the specialty.</p> Gopal Gurung, Mona Pokharel Copyright (c) 2022 Gopal Gurung, Mona Pokharel https://creativecommons.org/licenses/by-nc/4.0 https://www.nepjol.info/index.php/bjhs/article/view/45823 Fri, 24 Jun 2022 00:00:00 +0000 Prevalence of Glucose-6-Phosphate Dehydrogenase Deficiency among hospitalized Children at tertiary care Hospital in Eastern Part of Nepal https://www.nepjol.info/index.php/bjhs/article/view/45824 <p><strong>Introduction:</strong> Glucose 6 phosphate dehydrogenase deficiency is the most significant enzyme defect. It is X linked inherited disorder that affects males and females are rarely affected by lyonization. Severe jaundice, anemia and hemolytic crisis following ingestion of fava beans and certain drugs are known to occur in children with G6PD deficiency.&nbsp; Therefore, routine neonatal and child screening programs to facilitate the identification and effective management of children with G6PD deficiency is paramount.</p> <p><strong>Objective:</strong>&nbsp; The main objective of this study is to find out the&nbsp; hospital prevalence of G6PD deficiency in hospitalized children at Birat Medical College teaching Hospital.</p> <p><strong>Methodology:</strong> This is a hospital based cross sectional study carried out in the Department of Paediatric, Birat Medical College Teaching Hospital&nbsp; from30th&nbsp; November 2020 to 30th May 2021. Three hundred children&nbsp; upto to ten years of age admitted in department of&nbsp; pediatrics were included in this study.&nbsp; This study was performed on hospitalized children who were screened for G6PD deficiency. The test was carried out using the Randox G6PD quantitative in vitro test to determine the prevalence of G6PD deficiency among the admitted children upto 10 years of age.Data was analysed using SPSS version 16.</p> <p><strong>Results:</strong>&nbsp; This study was performed on 300 children, in which male babies (n=192; 64%) outnumbered the female babies (n=108; 36%). The majority of children were in the age group of &lt; 1 years (n=131; 43.7%).The overall prevalence of G6PD deficiency was 9.3% of which 96.4% were moderately deficient while 3.6% was severely deficient.The highest proportion was noted in the age group of 1 to 5 years. The frequency of this disorder in males and females were 13.5% and 1.9% respectively which was statistically significant (p=0.001).</p> <p><strong>Conclusion:</strong>&nbsp; The present study confirms the high prevalence of G6PD deficiency in Eastern Region of Nepal. Therefore, we need to establish routine screening and educational programs in order to prevent grave complications in future.</p> Chandra Bhushan Jha, Hem Sagar Rimal, Ram Bhakta Subedi, Surya Bahadur Parajuli Copyright (c) 2022 Chandra Bhushan Jha, Hem Sagar Rimal, Ram Bhakta Subedi, Surya Bahadur Parajuli https://creativecommons.org/licenses/by-nc/4.0 https://www.nepjol.info/index.php/bjhs/article/view/45824 Fri, 24 Jun 2022 00:00:00 +0000 Anatomical variation of nose and paranasal sinuses among patients with chronic rhinosinusitis on computer tomography https://www.nepjol.info/index.php/bjhs/article/view/45825 <p><strong>Introduction: </strong>Chronic rhinosinusitis is one of the commonest diseases of sinonasal cavity seen in Ear nose throat clinic. Although chronic rhinosinusitis is a clinical diagnosis, CT scan imaging studies helps in accessing the disease and gives a clear anatomy of sinonasal cavity. Chronic rhinosinusitis is a group of disorders that is characterized by inflammation of the mucosa of the nose and paranasal sinuses of at least 12 consecutive weeks duration. There are number of factors that play role in the development of rhinosinusitis, including both host and environmental factors. CRS is a more persistent problem that requires a specific treatment approach.</p> <p><strong>Methodology: </strong>This is a prospective comparative study which was conducted in Department of otorhinolaryngology of Birat Medical College and Teaching Hospital from 1st August 2020-31st Dec 2020. This study was approved by Institutional Review Committee of Birat Medical College and Teaching Hospital. 124 patients were taken in the study. The primary objective of the study was to determine the anatomical variation of nose and paranasal sinuses among patients with chronic rhinosinusitis on computer tomography. Informed and written consent was taken from all the subjects participating in the study.</p> <p><strong>Result: </strong>A total of 124 patients was included in the study. Out of which 68 (54.76%) were men and 56 (45.24%) were female. The age of patients with CRS ranged from 15-75 years. Highest number of patients with CRS was in the range of 35- 44 years. Mucosal thickening was more common in maxillary sinus (91.12%) followed by ethmoidal (67.74%), spheniod (55.64%) and frontal (54.03%).</p> <p><strong>Conclusion: </strong>CT scan is the most common tool to know the anatomical variations of the nose and para nasal sinuses. Moreover it is highly recommended for the patients suffering from chronic rhinosinusitis. CT scan provides all the sinonasal variations and then it becomes easier for the treating physician for better surgical planning and overall management of chronic rhinosinusitis.</p> Rajeev Kumar Shah Copyright (c) 2022 Rajeev Kumar Shah https://creativecommons.org/licenses/by-nc/4.0 https://www.nepjol.info/index.php/bjhs/article/view/45825 Fri, 24 Jun 2022 00:00:00 +0000 Prevalence and Factors Associated with Anemia among Pregnant Women at Birat Medical College Teaching Hospital https://www.nepjol.info/index.php/bjhs/article/view/45826 <p><strong>Introduction: </strong>Anemia in pregnancy is associated with many adverse fetal and maternal outcomes. It is the commonest hematological disorder that occurs in pregnancy. Prevalence of anemia in pregnant women is very high worldwide, especially in developing countries. The objective of this study was to find the prevalence and the factors associated with anemia among pregnant women attending Birat Medical College Teaching Hospital.</p> <p><strong>Methodology: </strong>A Quantitative, cross-sectional study conducted for 6 months in the Department of Obstetrics and Gynaecology OPD at Birat Medical College Teaching Hospital. All consecutive pregnant women attending for antenatal checkup in the department of Obstetrics and Gynaecology OPD at Birat Medical College Teaching Hospital were included in the study. Participants with multiple pregnancy, history of recent blood transfusion, chronic kidney disease and other chronic medical diseases were excluded from the study. All participants were advised for Hemoglobin level checkup at first ANC visit as a routine antenatal investigation and questionnaire was asked about the associated risk factors of anemia on predesigned proforma. The collected data was entered in Microsoft Excel and analyzed by using SPSS version 22.</p> <p><strong>Results: &nbsp;</strong>The prevalence of anemia was high (58.9%)of which mild anemia (Hb level 9-10.9­ gm/dl) was found in 56.1% of participants, moderate anemia (Hb level 7-8.9­ gm/dl) found in 2.1% of participants and severe anemia (Hb level &lt;7 gm/dl ­) was found in 0.8 % of participants.&nbsp; Factors statistically associated with anemia in pregnancy were caste, literacy, vegetarian diet of pregnant women.</p> <p><strong>Conclusion: </strong>The prevalence of anemia was found to be very high in pregnancy. Anemia in pregnancy was found to be associated with literacy, socioeconomic status and dietary habits of pregnant women.</p> Amit Deo, Tarun Pradhan Copyright (c) 2022 Amit Deo, Tarun Pradhan https://creativecommons.org/licenses/by-nc/4.0 https://www.nepjol.info/index.php/bjhs/article/view/45826 Fri, 24 Jun 2022 00:00:00 +0000 Awareness of child oral health among parents and caregivers attending Pediatrics OPD at BPKIHS, Dharan https://www.nepjol.info/index.php/bjhs/article/view/45827 <p><strong>Introduction:</strong> Parents and caregivers are the key sources responsible for their children’s good health. They are the basic needs-provider and role models as well for their children to learn good oral habits early on. Thus, their awareness about the factors affecting child oral health is an essential component for the well-being of the child.</p> <p><strong>Objectives:</strong> To assess awareness of child oral health among parents and caregivers attending Pediatrics OPD at BPKIHS, Dharan.</p> <p><strong>Methodology:</strong> A cross-sectional questionnaire-based study was conducted among conveniently selected 400 parents and caregivers of six months-to-14-year-old children attending Pediatrics OPD, BPKIHS, Dharan. A single interviewer administered pre-tested standardized questionnaires to the participants. The questionnaires consisted of five domains: socio-demographic profile of the participants; child’s oral hygiene practices; child’s feeding and dietary habits; awareness of child’s first dental visit and presence of family dental problems; and child’s dental service utilization. Data were entered in MS excel 2007 and statistically analyzed using SPSS version 11.5. Data analysis included descriptive statistics.</p> <p><strong>Results:</strong> Majority (90%) of the parents and caregivers were literate and 44.3% belonged to the lower-class socioeconomic status. 83.3% of the participants reported that their children took a sugary diet and 77.6% of them brushed once daily before breakfast. 91% of the respondents reported the age of the child’s first dental visit to be any age when there was a dental problem. The awareness of the presence of oral health problems in their child was seen in 29.5%, whereas 18% had made previous dental visits.</p> <p><strong>Conclusion:</strong> Despite the fact that most parents and caregivers reported factors affecting their children's oral health, there was evidence of lack of awareness and, as a result, low utilization of dental services for their children.</p> Sneha Shrestha, Bandana Koirala, Gauri Shankar Shah, Abhishek Kumar, Dharanidhar Baral Copyright (c) 2022 Sneha Shrestha, Bandana Koirala, Gauri Shankar Shah, Abhishek Kumar, Dharanidhar Baral https://creativecommons.org/licenses/by-nc/4.0 https://www.nepjol.info/index.php/bjhs/article/view/45827 Fri, 24 Jun 2022 00:00:00 +0000 Multinucleated Giant Cells in Ameloblastoma: An Uncommon Finding https://www.nepjol.info/index.php/bjhs/article/view/45829 <p>Ameloblastoma is a benign, slow growing and locally aggressive odontogenic tumor. Typical histopathological findings include islands, strands, sheets, cords of variable size with core of loosely arranged cells in reticular pattern and peripheral layer of palisading cuboidal to columnar cells. An uncommon event in this is presence of multinucleated giant cells. These cells are formed by the fusion of cells usually of monocyte or macrophage lineage and presence of these cells is indicative of the disease process. This case series affirms the presence of multinucleated giant cells in the different histopathological patterns of ameloblastoma. These cells may be related to the aggressive nature of the pathology. However, the origin and nature of the giant cells in the present case series could not be established. Further evaluation of more cases and investigations needs to be done to identify the nature and origin of these cells.</p> Sunny Bhattarai, Ashish Shrestha, Shashi Keshwar Copyright (c) 2022 Sunny Bhattarai, Ashish Shrestha, Shashi Keshwar https://creativecommons.org/licenses/by-nc/4.0 https://www.nepjol.info/index.php/bjhs/article/view/45829 Fri, 24 Jun 2022 00:00:00 +0000 Microsurgical Clipping of Giant Saccular Middle Cerebral Artery Aneurysm: A Case Report https://www.nepjol.info/index.php/bjhs/article/view/45830 <p>Giant saccular middle cerebral artery aneurysm is rare vascular lesion and few cases have been reported in the literature. Microsurgical clipping is applied to&nbsp;&nbsp; treat a giant middle cerebral artery aneurysm .A 26 year-male presented with complain severe headache, multiple episodes of vomiting and one episode of sudden loss conscious since few hours prior to admission at emergency department. Cerebral Angiography showed a giant saccular middle cerebral artery (MCA) aneurysm. A standard right pterional approach applied to expose MCA and microsurgical clipping was performed. No any serious neurological complication was noted after surgery except right facial palsy. Patient was discharged at the 12th day of surgery.Endovascular therapy as well as STA-MCA bypass surgery plus clipping are usually applied to manage the giant MCA aneurysm. However, alone microsurgical clipping is also effective and has better result.</p> Mohan Karki, Yam Bahadur Roka Copyright (c) 2022 Mohan Karki, Yam Bahadur Roka https://creativecommons.org/licenses/by-nc/4.0 https://www.nepjol.info/index.php/bjhs/article/view/45830 Fri, 24 Jun 2022 00:00:00 +0000 Artificial intelligence in futuristic medicine https://www.nepjol.info/index.php/bjhs/article/view/45784 <p>No abstract available.</p> Lalit Kumar Rajbanshi Copyright (c) 2022 Lalit Kumar Rajbanshi https://creativecommons.org/licenses/by-nc/4.0 https://www.nepjol.info/index.php/bjhs/article/view/45784 Fri, 24 Jun 2022 00:00:00 +0000