Turnover intention and job satisfaction among nurses in a tertiary level hospital

Introduction: Turnover intention, the likelihood of leaving a job, is a global challenge in nursing, affecting healthcare stability. Job satisfaction, a positive attitude toward job stability and professional growth, plays a crucial role in retaining nurses and ensuring quality care.This study aims to identify turnover intention and job satisfaction level among nurses. Method: A mixed-method descriptive cross-sectional study design with a simple random sampling technique, select 422 nurses from a tertiary-level hospital in Lalitpur, Nepal. Data were collected from 408 nurses using the Job Satisfaction Survey (JSS) and Turnover Intention Scale (TIS-6) from January to March 2024. Data were analyzed using SPSS 16 for quantitative data, descriptive statistics for socio-demographics, job satisfaction, and turnover intention levels. A chi-square test examined the association between turnover intention and job satisfaction. Thematic analysis was done for open-ended questions. Result: More than half, 243(59.6%), reported ambivalence, 123(30.10%) were satisfied, and 42(10.30%) were dissatisfied with their jobs. Additionally, 205(50.20%) reported turnover intention, while 203(49.8%) did not. There was a significant association between turnover intention and job satisfaction among nurses in the tertiary-level hospital (p<0.001). Conclusion: Most of the respondents revealed ambivalence regarding job satisfaction, and half expressed turnover intention. The significant association highlights the need for targeted interventions to enhance job satisfaction such as improving workplace conditions, fostering supportive management, and implementing retention strategies to reduce turnover intention

Perception of interns on laboratory medicine curriculum in the clinical practice

Introduction: Around 70-80% diagnoses are based upon laboratory medicine. Traditionally, laboratory medicine subjects like Biochemistry, Pathology and Microbiology were limited to the first two years of Bachelor of Medicine & Bachelor of Surgery (MBBS) basic sciences curriculum. With recent advances, laboratory medicine is being included in the clinical years as well. Patan Academy of Health Sciences (PAHS) has included laboratory medicine curriculum in clinical years. This study aimed to know the perception of interns on laboratory medicine curriculum in the clinical practice. Method: This was a descriptive cross-sectional study conducted among interns (fifth batch) of MBBS, PAHS. Ethical clearance was taken from the Institutional Review Committee, PAHS (Ref. drs2007091393). Research questionnaires were constructed and validated by faculties of laboratory medicine. A total of 43 out of 65 Interns had responded the questionnaires emailed. Responses were noted on four-point Likert scale as strongly agree, agree, disagree and strongly disagree. Result: A total of 26(60.47%) interns had strongly agreed; 14(32.56%) had agreed that they perceived the importance of filling laboratory requisition form with all the required information. A total of 37(86.03%) interns agreed that they were aware about possible errors that can occur in laboratory testing procedures. A total of 36(83.72%) interns had agreed that they felt free to communicate with lab personnel when lab report did not correlate with clinical features. Conclusion: Interns perceived that the lab medicine curriculum learning was beneficial to them for understanding of the laboratory process and its importance in patient diagnosis and management

Self-stigma and self-esteem among patients with alcohol use disorder in selected hospitals

Introduction: Self stigma occurs when people internalize the public attitudes and suffer numerous negative consequences as a result. The severe negative consequences of self-stigma are low self-esteem, increase inseverity of symptoms, low treatment adherence and decrease quality of life. This study aimed to find the prevalence of self-stigma and its effect on self-esteem of patients with alcohol use disorder (AUD). Method: A cross-sectional study (n=132) was conducted among patients with AUD attending psychiatric outpatient department (OPD) of Patan Hospital and Mental Hospital, Lagankhel. Non probability purposive sampling technique was used for the study. The data was collected by face-to-face interview technique using structured interview schedule. Descriptive and inferential statistics (Pearson chi-square and Pearson correlation) were used for data analysis. Result: Among AUD patients, 129(97.80%) had self-stigma. Among them 29(22%) experienced mild, 60(45.50%) moderate, and 40(30.30%) severe self-stigma. Among the five components of self-stigma, alienation had highest mean score followed by discrimination experience and lowest in stigma resistance. Regarding self-esteem, 117(88.60%) had low, 7(5.30%) had moderate and only 8(6.10%) had high self-esteem. There was a significant negative correlation (r=-.458) between self-stigma and self-esteem. Conclusion: Based on the findings of the study, it is concluded that almost all of the respondents with AUD experienced self-stigma. More than three-fourth of respondents had low self-esteem. Self-stigma was negatively correlated with self-esteem

Clinical and radiological outcome of anterior inferior plating of middle third fracture of clavicle

Introduction: Various techniques have been documented for managing fractures of the middle third of the clavicle. This prospective study aimed to assess the outcomes of anterior-inferior plating using a 3.5-mm reconstruction locking plate for middle-third clavicle fractures. Method: Sixty-eight patients presenting with middle-third clavicle fractures underwent treatment via anterior-inferior plating. Surgical indications included complete displacement, severe comminution, and significant shortening of the clavicle (greater than two cm). Result: The mean duration for fracture union was 14 weeks . At the most recent follow-up, all patients had resumed their pre-injury activity levels. No cases required plate removal due to implant-related complications till final follow-up. Conclusion: Anterior-inferior plating is an effective treatment modality for middle-third clavicle fractures, offering stable fixation with minimal complications. This technique mitigates the risk to vital structures beneath the clavicle and is associated with a low incidence of implant prominence issues

Multifocal Brown tumour associated with Parathyroid adenoma: A case report

Brown tumors are focal lytic bone lesions associated with primary or secondary hyperparathyroidism. In the present era, brown tumors causing multiple lytic bone lesions are rare due to the early detection of hyperparathyroidism through biochemical investigations and effective treatment. We report a case of a 30-year-old woman initially thought to have a bone tumour in her tibia, but further radiological and biochemical investigations revealed primary hyperparathyroidism with multiple brown tumors. This case underscores the importance of using imaging techniques to accurately diagnose and treat uncommon conditions like brown tumors in cases of primary hyperparathyroidis

Necessity of post-operative radiograph after percutaneous pinning of supracondylar humerus fracture

Introduction: Complications after closed reduction and percutaneous pinning (CRPP) include loss of reduction, pin site infection and iatrogenic nerve injury. There is little evidence to support an ideal post-operative follow-up protocol, leading to variation based on surgeon’s preference. This study aimed to determine the necessity of frequent radiographs after CRPP for supracondylar humerus fracture in children. Method: This was a prospective study involving 34 patients, who underwent CRPP for displaced supracondylar humerus fracture. Patients were divided into two groups: Group A were followed-up at 4 weeks, while Group B were followed-up at one, two and four weeks. All radiographs were evaluated for Baumann’s angle and anterior humeral line (AHL) relation with capitellum of humerus. There were 18 patients in group A and 16 patients in group B. Result: Fourteen patients in Group A and 13 patients in Group B had less than six degree change in Baumann angle. There was no change in anterior humeral line relation with capitellum in either group. Conclusion: This study found that loss of reduction after CRPP for supracondylar humerus fractures was similar in both groups. Therefore, post-operative radiographs after CRPP is not necessary.Keywords: children; radiograph; supracondylar distal humerus fractur

Soft tissue coverage of delayed presentation of meningomyocele by modified keystone flap

Neural tube defects are congenital abnormalities of neural development with a wide spectrum of clinical manifestations. Meningomyelocele a type of spina bifida , in which the spinal cord and meninges protrude through an opening. Early surgical interventions are required to reduce the mortality rate by preventing early cerebrospinal fluid leakage and related infections. Simple closures can repair small defects. Simple closure can be challenging in larger defects, leading to wound dehiscence and subsequent cerebrospinal fluid leakage. This case report discusses the successful use of modified keystone flap repair for large lumbosacral meningomyelocele defects. We report the 18th day of life, term female baby with lumbosacral meningomyelocele, who underwent neural placode reduction with repair of dura followed by modified keystone flap repair to achieve adequate neural closure and prevent subsequent infection. The flap preserved vascularity and decreased the need for complex grafts and revision surgery with no sign of flap necrosis, fistula, or cerebrospinal fluid leakage. This case highlights that modified keystone flap repair is a safe, simple, successful, and versatile technique that can be used to cover large meningomyelocele defects

Psychiatric morbidity among postnatal women in a tertiary care hospital

Introduction: Maternal psychiatric disorders during pregnancy and the postpartum period are associated with adverse outcomes both for the mother and offspring in the long term, which increases the risk of poor mother-infant bonding and delays in infant development. The study aimed to assess the psychiatric morbidities among postnatal women in a tertiary care hospital. Method: A cross-sectional study was conducted in Patan Hospital, Lalitpur, among 165 postnatal women using a purposive sampling technique from April 2020 to May 2021. Data was collected by the face-to-face interview technique using a structured interview schedule. Psychiatric morbidities were examined by using the Nepalese version of the Depression Anxiety Stress Scale 21 (N-DASS 21) and the Nepalese Version of the Edinburgh Postnatal Depression Scale (N-EPDS). Data were analyzed by using SPSS version 16. Descriptive statistics were used to analyze demographic variables. Chi-square and Fisher’s exact test were used to examine the association between independent variables and psychiatric morbidities. Result: The psychiatric morbidities were found among 56(34.51%) of postnatal women. Among them, postnatal depression 19(11.31%), anxiety 21(13.33%) and stress 16(9.67%) were prevalent. The gender of the baby was significantly (χ2 =6.382, p=0.012) associated with anxiety. No significant associations were found between other sociodemographic or obstetric variables and postnatal depression, anxiety, or stress. Conclusion: Anxiety is more prevalent than postnatal depression and stress among postnatal women. The baby’s gender is significantly associated with anxiety

Evaluating the effectiveness of basic life support (BLS) training for healthcare workers in a tertiary care centre in Nepal

Introduction: Basic Life Support (BLS) guidelines provide a structured sequence of interventions that can help revive individuals with life-threatening conditions. Healthcare workers’ knowledge and skills in performing BLS can mean the difference between life and death. This study aimed to evaluate healthcare professionals\u27 pre-existing knowledge and skills regarding BLS and the effectiveness of BLS training in improving the knowledge and skills of healthcare workers.  Method: This observational study was conducted at a tertiary-level hospital in Nepal. A group of 125 participants who were trained during the BLS training course were included in our study. Data were collected through structured pre-test and post-test questionnaires supplemented by direct observation during practical skills sessions. The knowledge and skills of the participants before and after training were compared to evaluate the effectiveness of BLS training in improving the knowledge and skills of healthcare workers. Result: The mean knowledge score of the participants was 62.88% before BLS training and 84.96% after training. The mean skills score was 59.02% before the training and 84.43% after the training. The improvement in knowledge and skills after the training was statistically significant. Conclusion: Participants receiving BLS training show a significant improvement in both their knowledge regarding BLS and their skills in administering BLS