Nepal Journal of Health Sciences 2023-07-20T08:34:42+00:00 Dr. Roshan Kumar Chaudhary Open Journal Systems <p> Nepal Journal of Health Sciences (NJHS) is an Official Peer-Reviewed Scientific Publication of Madan Bhandari Academy of Health Sciences, Hetauda, Nepal. It publishes papers on research in the field of biomedical sciences, covering all disciplines of medicine, dental, medical education, public health, and health care administration, as well as ethical and social concerns related to health. Clinical studies are given priority over laboratory and animal studies by the journal. Original research articles, case studies, systematic reviews, and meta-analyses will be pub­lished in the journal, which would be peer-reviewed. The editorial board invites submissions for editorials, guest editorials, viewpoints, and letters to the editor.</p> Enhancing Gingival Esthetics by Depigmentation 2023-07-20T08:16:33+00:00 Rejina Shrestha Shaili Pradhan <p>The color of the gingiva has an important role in determining the esthetics of an individual. There are many etiological factors responsible for gingival pigmentation. Depigmentation of the gingiva can be done by various procedures which include scalpel surgery, cryosurgery, bur abrasion, laser surgery and electrosurgery. Among these procedures, laser depigmentation is the most comfortable method.</p> 2022-12-31T00:00:00+00:00 Copyright (c) 2022 Forced Orthodontic Eruption of Impacted Maxillary Canine: A Case Report 2023-07-20T08:25:42+00:00 Nabin Kumar Chaudhary Jamal Giri Rajesh Gyawali Prabhat Ranjan Pokharel <p>Maxillary canines affect the smile and facial esthetics providing upper lip and alar base support. This article presents the case report of skeletal class I malocclusion with Angle’s class III (Right) subdivision and impacted left maxillary canine of poor prognosis for traction which was managed successfully with a combined surgical and orthodontic approach. The diagnosis of the impaction was done through the Orthopantogram, intra-oral periapical, and occlusal radiographs and was localized buccally through clinical examination and Clark’s technique. The impacted canine was brought into the arch which improved the smile and self-esteem of the patient.</p> 2022-12-31T00:00:00+00:00 Copyright (c) 2022 Mad Honey Intoxication: A Rare Case Report 2023-07-20T08:34:42+00:00 Raunak Khakural Shailesh Shrestha Kundan Raj Pandey Sanyukta Gurung <p>Honey containing grayanotoxin is called mad honey which is found in Turkey, Japan, Brazil, Europe, North America and Nepal. Patients present with clinical manifestations like bradycardia, hypotension and syncope. In this case report we present a 27 years male who presented with bradycardia and first-degree heart block after consumption of only 10 grams of mad honey.</p> 2022-12-31T00:00:00+00:00 Copyright (c) 2022 Pattern of Self-medication in Primary Dysmenorrhea among Nursing Students at a Nursing College in Eastern Nepal 2023-07-19T14:33:29+00:00 Deependra Prasad Sarraf Basant Kumar Karn Smita Singh <p style="text-align: justify;"><strong>Introduction:</strong> Primary dysmenorrhea (PD) leads to college absenteeism, interference with daily living activities and higher intake of medications without consulting a physician and/or without a valid prescription.</p> <p style="text-align: justify;"><strong>Objectives:</strong> To estimate the prevalence of PD, to know the pattern of self-medication in dysmenorrhea and to know the impact of dysmenorrhea on academic performance among undergraduate nursing students.</p> <p style="text-align: justify;"><strong>Methods:</strong> A cross-sectional study was conducted among undergraduate nursing students at a nursing college in Eastern Nepal using a semi-structured questionnaire consisting of demographic characteristics, the impact of dysmenorrhea on academic performance and self-medication practices. A visual analogue scale was used to assess the severity of dysmenorrhea. Descriptive statistics were used to present the findings.</p> <p style="text-align: justify;"><strong>Results:</strong> A total of 125 students participated in the study out of which 64 (51.20%) were 21-24 years old. Eighty-four (67.20%) students had PD that had affected academic performance negatively in 81 (96.43%) students. Fifty six (66.67%) students had a lack of concentration during study hours due to dysmenorrhea. A total of 42 (50.00%) students practiced self-medication for relieving the pain during dysmenorrhea. Mefenamic acid (90.48%) was the most commonly used analgesic. Only 29 (69.05%) students were able to mention the correct dose of the analgesic drug they take and 38 (90.48%) students were not able to mention the correct frequency of the drug intake they were taking during dysmenorrhea.</p> <p style="text-align: justify;"><strong>Conclusions:</strong> Dysmenorrhea was highly prevalent among nursing students and had affected their academic performance negatively. The self-medication practices were not appropriate in a significant proportion of the students.</p> 2022-12-31T00:00:00+00:00 Copyright (c) 2022 Status of Serum Vitamin B12 in Type 2 Diabetes Mellitus Patients under Metformin Therapy 2023-07-19T15:28:19+00:00 Sanjay Kumar Sah Suprita Gupta Amit Chandra Jha Surendra Marasini Tapeshwar Yadav Brijesh Shrestha <p style="text-align: justify;"><strong>Introduction:</strong> Type 2 diabetes mellitus, a prevalent global health problem, is a major cause of morbidity and mortality. Metformin, the most widely used hypoglycemic agent can lead to a deficiency of vitamin B12. Very less information is available regarding the relationship between metformin therapy and vitamin B12 deficiency in the Nepalese population.</p> <p style="text-align: justify;"><strong>Objectives:</strong> The study aims to evaluate the level of vitamin B12 in cases of diabetes mellitus under metformin therapy and to access the relationship of serum vitamin B12 level with the duration of metformin therapy.</p> <p style="text-align: justify;"><strong>Methods:</strong> A hospital-based cross-sectional study with 300 diagnosed diabetes mellitus cases under metformin therapy were enrolled in the study after the consent was taken. The prior ethical clearance was taken and the duration of the study was from December 2021 to June 2022.</p> <p style="text-align: justify;"><strong>Results:</strong> The study showed 78% (n=234) of the total diabetic cases under metformin therapy had lower vitamin B12. In 50-60 years, age group, 91% of them were vitamin B12 deficient. Vitamin B12 deficient cases were more with the increase in duration and dose of metformin therapy. All the diabetics who were under medication for 16-20 years had lower vitamin levels. About 94% (n=200) of the diabetics taking more than 1000 mg/day were vitamin B12 deficient whereas only 39% (n=34) of diabetics taking less than 1000mg/day were found to be deficient.</p> <p style="text-align: justify;"><strong>Conclusions:</strong> Vitamin B12 is deficient in diabetics under long-term and higher doses of metformin therapy. Diabetic patients who are undergoing metformin treatment should monitor their vitamin B12 status as they are more prone to vitamin B12 deficiency.</p> 2022-12-31T00:00:00+00:00 Copyright (c) 2022 Relationship of Scores of Empathy with Human Body Dissection and Gender among Undergraduate Medical Students of BPKIHS 2023-07-19T15:57:28+00:00 Sandip Shah Sarun Koirala Laxman Khanal Presha Baral <p style="text-align: justify;"><strong>Introduction:</strong> Medical empathy is defined as the predominantly cognitive attribute that involves the ability to understand patients’ experiences, concerns, and perspectives, and communicate this understanding with the intention of helping.</p> <p style="text-align: justify;"><strong>Objectives:</strong> The main aim of present study was to determine the relationship of human body dissection and gender with level of empathy among the first and third year undergraduate medical students of B.P. Koirala Institute of Health Sciences.</p> <p style="text-align: justify;"><strong>Methods:</strong> A cross-sectional study conducted on first and third years medical students between the periods of August 2020 to March 2021. “The Jefferson Scale of Physician Empathy-Student version” was used for assessment of empathy. Sample size of the study was 176 and the results were analyzed in Statistical Package for the Social Sciences, version 11.5. Student’s t-test, ANOVA and bivariate correlation models were employed for statistical analysis. The p &lt;0.05 was considered as the significant level.The respondent rate of questionnaire was 88%.</p> <p style="text-align: justify;"><strong>Results:</strong> The mean empathy score was found to be 88.13.The empathy score increased with increase of age (p&lt;0.001) and year of course (p=0.066).The empathy score of Nepalese student was found to be lower as compare to Non–Nepalese student (p=0.016). The bivariate correlation analysis between empathy score and age was found to have positive correlation with statistical significant level (rs=0.270; p&lt;0.001).</p> <p style="text-align: justify;"><strong>Conclusions:</strong> These results suggest that the empathy score of Nepalese students’ increases with age and year of medical education.</p> 2022-12-31T00:00:00+00:00 Copyright (c) 2022 Antioxidant, Antibacterial and Analgesic Activities of Buddleja asiatica Extract 2023-07-19T16:12:13+00:00 Subash Karki Biswash Sapkota <p><strong>Introduction:</strong> <em>Buddleja asiatica</em> is an upright, evergreen shrub of the Loganiaceae family that can reach up to 1 to 8 meters tall and found between 300-2000 meters height in Nepal.</p> <p><strong>Objectives:</strong> The objectives of this study are to assess the antibacterial, antioxidant, and analgesic properties of <em>Buddleja asiatica</em> aerial component.</p> <p><strong>Methods:</strong> A typical chemical test was outlined to conduct the phytochemical analysis. The 2,2-diphenyl-1-picrylhydrazyl (DPPH) free radicals scavenging experiment was used to quantitatively quantify the antioxidant activity of the methanolic extract. By using the well diffusion method, the antibacterial activity was assessed against <em>Escherichia coli</em> and <em>Staphylococcus aureus</em>. Swiss albino mice were utilized to test the analgesic efficacy of the extracts using the acetic acid-induced writhing method and the tail flick method.</p> <p><strong>Results:</strong> The phytochemical screening identified the presence of reducing sugars, tannin, phenol, alkaloid, glycoside, and flavonoids. With a zone of inhibition of 19 mm, antibacterial efficacy against <em>Staphylococcus aureus</em> was demonstrated. The extract demonstrated scavenging potential in the DPPH free radical scavenging experiment, with an IC50 value of 123.68 μg/mL. At 600, 800, and 1000 mg/kg, the acetic acid-induced writhing method showed a significant (P &lt; 0.05) analgesic effect. The tail flick approach, which evaluates the pain reaction time, also produced similar results.</p> <p><strong>Conclusion:</strong> Different secondary metabolites contained in<em> Buddleja asiatica</em> were found in the methanolic extract, and these secondary metabolites were determined to be physiologically active in terms of good antioxidant, analgesic, and antibacterial activities.</p> 2022-12-31T00:00:00+00:00 Copyright (c) 2022 Invitro Activity of Tigecycline against Multidrug-Resistant Enterobacteriaceae from Blood Stream Infection at a Tertiary Care Hospital of Nepal 2023-07-19T16:28:01+00:00 Ajay Yadav Basudha Khanal Amit Kumar Patel Alina Karna <p><strong>Introduction:</strong> Any bacterial isolates showing resistant to three or more than three different types of antimicrobial groups are termed as multidrug resistant. Such superbugs have shown significant challenge not only to microbiologist but also to clinicians. Multidrug resistant like extended-spectrum and metallo-beta lactamase are being encountered as the causative agents of blood stream infection. Accurate diagnosis of blood stream infection, timely isolation and identification of the causative agents and determination of their antimicrobial susceptibility are crucial, as effective management depends on the selection and timely administration of the most appropriate antimicrobial agent.</p> <p><strong>Objectives:</strong> This study is aimed to find out the efficacy of tigecycline against multidrug resistance enterobacteriaceae.<br />Methods: A descriptive cross-sectional study was conducted in the Department of Microbiology, BP Koirala Institute of Health Sciences, from 1st September 2014 to 31st August 2015. Confirmation for ESBL was done as recommended by Clinical and Laboratory Standard Institute (CLSI) and MBL production was detected by double disk synergy test. Antibiotic sensitivity test against tigecycline was done by Kirby-Bauer disk diffusion method.</p> <p><strong>Results:</strong> 98.96% of multidrug resistant enterobacteriaceae were sensitive against tigecycline. None of the isolates were resistant against tigecycline and only 1.04% of the isolates showed intermediate susceptibility. A total of 64 (33.4%) isolates were found to be multidrug resistant.</p> <p><strong>Conclusion:</strong> Tigecycline is found to have excellent invitro activity against MDR enterobacteriaceae from blood stream infection.</p> 2022-12-31T00:00:00+00:00 Copyright (c) 2022 Mental Health Status of Secondary Level School Students of Gorkha District 2023-07-20T01:33:33+00:00 Ashwin Karakheti Namra Kumar Mahato Roshan Kumar Chaudhary Biswash Sapkota Sansar Babu Tiwari Pratiksha Khadka Arati Karakheti <p><strong>Introduction:</strong> Mental health problem among the adolescent is one of the major global challenges. Adolescence is a transition phase ranging from 10 to 19 years. Most of these problems are manifested at this stage of life. Adolescents are more vulnerable to mental health problems as they face biological, physical, social and cultural transition simultaneously.</p> <p><strong>Objective:</strong> The study objective of this study is to assess mental health status among secondary level school adolescents.</p> <p><strong>Methods:</strong> This study is a cross-sectional study conducted among 317 secondary level school students of Gorkha, Nepal. Structured self-administered questionnaire and General Health Questionnaire-28 (GHQ-28) were used. Data was entered in Epidata and analyzed in SPSS 11.5</p> <p><strong>Results:</strong> In this study, 24.9% of the respondents were found to have mental health problems. The mean age of respondent was 16.47 ± 1.32 years. In the study female respondents and adolescents from community school were more likely to develop mental health problems.</p> <p><strong>Conclusions:</strong> Mental Health problem among secondary level school going adolescents was in alarming situation. Thus, to improve this problem among adolescents a comprehensive effort needs to be initiated.</p> 2022-12-31T00:00:00+00:00 Copyright (c) 2022 Obesity and Disease Severity among COVID 19 Cases: A Hospital Based Study 2023-07-20T01:51:31+00:00 Aashma Dahal Nabina Karki <p><strong>Introduction:</strong> According to World Health Organization report obesity has tripled between 1975 and 2016. The COVID-19 pandemic has occurred at a time when the prevalence of individuals with overweight/obesity is increasing at an unprecedented rate throughout all the continents.</p> <p><strong>Objectives:</strong> This research aims to explore increased BMI (obesity) as a potential cause for COVID-19 disease severity in hospitalized patients by looking at the association between these two variables.</p> <p><strong>Methods:</strong> It is a cross sectional analytical study which aims to assess the association between obesity and COVID-19 case severity in hospitalized patients of Hetauda Hospital.</p> <p><strong>Results:</strong> 30.4 percent of the COVID-19 hospitalized cases had normal weight, 44.6 percent of them were obese, 17.4 percent were overweight whereas 7.6 percent of the admitted patients were underweight. Only 1 was mild case (1.1%), 52 participants (56.52%) were moderately severe cases and 39 (42.39%) cases of the 92 research participants were critically severe. Fisher Exact tests were performed to find the association between BMI and disease severity as categorical variables which showed that there was no significant association between the two variables (Fisher exact value=0.665).</p> <p><strong>Conclusions:</strong> This study concludes that there is no association in between obesity and COVID-19 disease severity. However, this relationship should be further explored by research studies with more sample size.</p> 2022-12-31T00:00:00+00:00 Copyright (c) 2022 Antibacterial Sensitivity Profile of Bacteria Isolated from Solid Dump Waste of Hetauda Hospital, Nepal 2023-07-20T02:02:53+00:00 Satish Kumar Deo Sailendra Chaudhary Ajay Yadav <p><strong>Introduction:</strong> Lack of knowledge and awareness about hospital waste has been a concern amid inadequate hospital waste management facilities and ineffective policies.</p> <p><strong>Objectives:</strong> To isolate the bacteria from the waste sample collected from the different departments of the hospital and study the sensitivity profile of the isolated bacteria.</p> <p><strong>Method:</strong> Cross-sectional study was conducted for a period of 3 months examining the solid waste of Hetauda hospital of Bagmati Province. Untreated hospital solid waste samples were collected from Hetauda hospital from different departments like general wards, ICU/HDU, Emergency, OPD, Pharmacy, Laboratories. Battery of biochemical were performed according to the guideline of the Bergey’s Manual of Determinative Bacteriology. At the end, sensitivity pattern of the isolates was determined by measuring the zones of inhibition with a calibrated ruler, also interpreted according to Clinical and Laboratory standards institute(CLSI) criteria.</p> <p><strong>Result:</strong> A total of 540 bacteria were isolated. Among them higher number of bacteria were isolated from the emergency department and general wards. Both gram positive and negative bacteria isolated from different wards/department has shown a higher percentage of resistant to different antibiotics; Ciprofloxacin, Ceftazidine, Cefotaxime, Gentamycin, Penicilin, piperatazobactum, imipenem, linezolid and cephalexin.</p> <p><strong>Conclusion:</strong> Antibiotic resistant to different antibiotic isolated from the hospital has shown greater public health threats. The facilities/waste management in the hospital should be properly handled and regular monitoring should be performed.</p> 2022-12-31T00:00:00+00:00 Copyright (c) 2022 Estimating Stature among Medical Students in Lalitpur, Tertiary Care Hospital, using Index and Ring Finger Length 2023-07-20T07:01:15+00:00 Amshu Pradhan Birendra Mandal Abhishek Karn <p><strong>Introduction:</strong> Anthropometry refers to a group of systematic methods for quantitatively measuring the dimensions of the human body and skeleton. It is the fundamental tool for biological anthropology that is closely related to determining an individual’s height based on the available information.</p> <p><strong>Objective:</strong> Medical and dental students in Nepal will use finger lengths to derive a regression equation to calculate an individual’s height in a tertiary care hospital.</p> <p><strong>Methods:</strong> A cross-sectional study included 250 healthy Nepali students from KISTMCTH (145 females and 105 men). Using SPSS software version 17, the index (2DL) and ring (4DL) finger lengths were measured in order to create a regression formula.</p> <p><strong>Results:</strong> Males outperform females in terms of Pearson’s correlation, coefficient of determination, and regression equation. Linear regression analysis was used to estimate stature using the assessed factors that were statistically significant (p 0.05) for both genders.</p> <p><strong>Conclusions:</strong> Forensic professionals and anthropologists will find it useful to be able to estimate stature from the length of the finger when identifying a person from skeletal remains.</p> 2022-12-31T00:00:00+00:00 Copyright (c) 2022 Determination of Alcoholic Concentration in Four Different Home Brewed Alcoholic Beverages Using Gas Chromatography 2023-07-20T07:17:37+00:00 Sushma Kaphle Apurba Acharya Arbin Shakya Bijay Aryal <p><strong>Introduction:</strong> Alcohol, one of the most commonly consumed beverages across the world is manufactured both industrially as well as locally in Nepal. The proportions of locally brewed alcoholic beverages are higher due to geographical variation as well as presence of a population with varied cultural background. Even though the industrially manufactured alcoholic beverages are quantified, the home brewed beverages usually are produced and consumed without quantification. These alcoholic beverages consist of various components such as ethanol, methanol, iso-propanol, iso-butanol and others, each component having different pharmacological properties.</p> <p><strong>Objectives:</strong> To determine the alcoholic concentration (ethanol, methanol, iso-propanol and iso-butanol) of four different varieties of home brewed alcoholic beverages in Jumla district, Nepal.</p> <p><strong>Methods:</strong> Probability random sampling method was used for sample collection and sampling. The samples were taken to Zest laboratory, Bhaktapur. The laboratory then analysed all four samples to determine the concentration of different alcohols using Gas Chromatography. Unknown concentrations of different alcohol in the sample were measured by injecting standard sample with known concentration.</p> <p><strong>Results:</strong> The concentration of alcoholic components in four different home brewed alcoholic beverage samples were<br />determined using gas chromatographywith ethanol concentrations being 14.209%v/v, 16.323%v/v, 11.473%v/v and 49.217%v/v. Contamination was not detected in any of the samples except for one sample which contaminated iso-butanol (0.063% v/v).</p> <p><strong>Conclusion:</strong> Various alcoholic components are present in home brewed alcoholic beverages at varied concentration levels and quantification of these beverages is highly essential in order to prevent health hazards associated with these components.</p> 2022-12-31T00:00:00+00:00 Copyright (c) 2022 Attitude of Medical Students towards Biochemistry and Its Integration through Problem-Based Learning 2023-07-20T07:29:11+00:00 Rachana Pandey Prabodh Risal <p><strong>Introduction:</strong> Biochemistry is an important but volatile subject for undergraduate medical students and is included in integrated organ-based system with problem-based learning method in the curriculum of Kathmandu University School of Medical Sciences.</p> <p><strong>Objective:</strong> This study was conducted to assess students’ attitudes toward Biochemistry and its integration into problem-based learning.</p> <p><strong>Methods:</strong> It was a descriptive cross-sectional study that lasted 5 months (October 2020-February 2021) after ethical approval from the Institutional Review Committee- KUSMS. Among 150 students participated in the study, 51 were girls and 99 were boys. After taking consent, a pretested self-assessment semi structured questionnaire with a five point Likert scale for each question was used. Out of the statements in the questionnaire, eight questions were positive statements. Mean for each statement was calculated along with average mean score for each positive and negative statements.</p> <p><strong>Results:</strong> The mean positive score was 3.06 for the attitude towards studying Biochemistry. The mean score towards the negative statements was 2.4. The mean score was 3.36 for positive statements towards attitude of students towards integration of Biochemistry in problem-based learning whereas the mean score of negative statements was 3.41.</p> <p><strong>Conclusions:</strong> Students had overall positive attitude towards studying Biochemistry and its integration into an organ system based curriculum using problem-based learning.</p> 2022-12-31T00:00:00+00:00 Copyright (c) 2022 Self-Esteem and Academic Performance among Undergraduate Medical Students in Nepal: A Cross-Sectional Study 2023-07-20T07:39:24+00:00 Harikala Ghimire Rachita Ghimire Nikita Yadav Priyanka Sharma Nabu Praveen Reiha Kiran Basnet Dilip Sharma Banjade Buddhi Raj Pokhrel <p><strong>Introduction:</strong> Self-esteem is related to self-worth which fuels motivation, productivity, and efficacy which is considered of high value in academic performance. However, no such studies have been published in Nepal.</p> <p><strong>Objective:</strong> We aimed to investigate the association between self-esteem and academic performance of medical undergraduates in Western Nepal.</p> <p><strong>Results:</strong> This analytical cross-sectional study was carried out among 226 undergraduate medical students. The majority of the participants had high self-esteem with a median self-esteem score of 29. The female participants had higher scores as well as academic performance than males. We found no association between self-esteem and academic performance.</p> <p><strong>Conclusions:</strong> We found no significant relationship between self-esteem and the academic performance of medical undergraduates.</p> 2022-12-31T00:00:00+00:00 Copyright (c) 2022