Clinico-radiological Profile of Stroke in Western Nepal

Introduction: Stroke is a major public health burden worldwide and is responsible for a large proportion of disability. It ranks third in the causation of morbidity and mortality. This study was carried out to establish the pattern of various types of cerebrovascular accident (CVA) in western Nepal, to correlate the clinical data and radiological findings in cases of stroke, and to identify the common risk factors associated with stroke. Methods: A total of 200 patients presented at the department of Radiodiagnosis from emergency or ward within six months of study period from 18th of September 2015 to 17th of March 2016 with clinical diagnosis of stroke. Brain CT scan was done within 14 days of onset. Results: There were 200 patients with stroke (124 males and 76 females), aged 19 to 92 years in which infarction was more common than hemorrhage (57% Vs 41.5%) clinically. Hypertension was the commonest risk factor noted in 59% cases followed by Diabetes Mellitus in 39%. Middle cerebral artery (MCA) territory infarction was the most common site of infarction. Clinical and CT localization of hemorrhage and infarct was correct in 153 cases (75%) which was statistically significant. Conclusion: Infarction is more common than hemorrhage as the type of stroke. Hypertension is the commonest risk factor followed by diabetes mellitus. &nbsp

Prevalence of Helicobacter Pylori among Patients undergoing Gastrodudenoscopy in a Hospital in Western Nepal

Introduction: Helicobacter pylori (H. pylori) related chronic gastritis is a major health problem worldwide, specially in the developing countries. The prevalence of H. pylori infection has been reported to vary between and even within countries. There are limited data on this infection in Western Nepal. Our objective was to study the prevalence of H. pylori infection and its association with presenting complains and upper gastrointestinal diseases. Methods: Medical records of patients undergoing gastrodudenoscopy and biopsy for various upper gastrointestinal symptoms from 1st of January 2015 to 30th of June 2017 were reviewed for presence of H. pylori infection, demographics, indications for gastrodudenoscopy, and histopathology findings. T-test, Chi-square test, and Fisher exact test were applied. Results: Two hundred fifty six patients (135 male and 121 female) with a mean age of 47 (SD = 16.5) underwent gastroscopic biopsy and had an overall H. pylori prevalence of 24.6%. H. pylori infection was most commonly noted between 41 to 60 years of age. Gender did not seem to be significantly associated (p = 0.82) but gastrointestinal bleed was significantly associated with H. pylori infection (p = 0.006). The most common histopathological diagnosis was gastritis followed by gastrodudenitis; however, none of the diagnosis were found to be significantly associated with H. pylori infection. Conclusion: The overall prevalence of H. pylori infection was 24.6% and was most common between 40 to 60 years of age. Heart burn was the most common symptom and gastrointestinal bleed was the only significantly associated symptom with H. pylori infection

Pattern of Acute Poisoning Attending a Tertiary Care Hospital of Western Nepal

Introduction: Poisoning with various substances is a major public health problem and a reason for significant morbidity and mortality throughout the globe. It is one of the most common presentation in an emergency department. This study was conducted to determine the sociodemographic, poisoning types, and mode of poisoning in cases attending a tertiary hospital of Western Nepal. Methods: A retrospective observational study of two years was conducted from July 2014 to June 2016. Demography details, name of poisonous substance, and reasons for poisoning were reviewed and analyzed using descriptive statistics. Results: A total of 65 cases of poisoning were recorded. The occurrence was more common in female (n=44, 67.7%) than in male (n=21, 32.3%) with a F:M ratio of 2.1:1.  Poisoning  was most  common in the age group of 11-20 years (32.3%). Most of the cases were students (37%) followed by farmers (26%). The most commonly abused poisoning substance were organophosphorous compounds, zinc-phosphate,  and  kerosene in adults, adolescents, and children respectively. Oral route was the most common (99%) route of administration. Suicidal attempt, as a mode of poisoning, accounted for 70.8% of total poisoning cases. Conclusion: Female and young people are at greater risk of acute poisoning. Insecticide was the most common agent and self administer poisoning was the most common mode of poisoning. The occurrence of poisoning and its morbidity and mortality can be reduced by developing and implementation of effective prevention strategies like restricting easy poison sales, establishing drug and poison information centers,  and community awareness programs

Influenza B virus: Need for heightened surveillance and epidemiologic case studies

Recent report of increased influenza B virus infection, particularly theclinical profiles and treatment challenges imposed like that of influenza A,underscores the importance of continuing influenza B virus surveillance.This is, especially in resource limited country, early detection of influenzavirus, its clinical presentation and complications would be vital in minimizingthe public heath burden imposed by this virus.Keywords: chronic obstructive pulmonary disease, influenza B, severe acutepulmonary infection

Clinico-radiological Profile of Stroke in Western Nepal

Introduction: Stroke is a major public health burden worldwide and is responsible for a large proportion of disability. It ranks third in the causation of morbidity and mortality. This study was carried out to establish the pattern of various types of cerebrovascular accident (CVA) in western Nepal, to correlate the clinical data and radiological findings in cases of stroke, and to identify the common risk factors associated with stroke. Methods: A total of 200 patients presented at the department of Radiodiagnosis from emergency or ward within six months of study period from 18th of September 2015 to 17th of March 2016 with clinical diagnosis of stroke. Brain CT scan was done within 14 days of onset. Results: There were 200 patients with stroke (124 males and 76 females), aged 19 to 92 years in which infarction was more common than hemorrhage (57% Vs 41.5%) clinically. Hypertension was the commonest risk factor noted in 59% cases followed by Diabetes Mellitus in 39%. Middle cerebral artery (MCA) territory infarction was the most common site of infarction. Clinical and CT localization of hemorrhage and infarct was correct in 153 cases (75%) which was statistically significant. Conclusion: Infarction is more common than hemorrhage as the type of stroke. Hypertension is the commonest risk factor followed by diabetes mellitus

Mortality pattern in Emergency Department of a Tertiary Care Center in Western Nepal

Background : There is abundance of evidence regarding various aspects of mortality in emergency department from different parts of world but there is limited number of studies on mortality in context of western Nepal. The objectives of this analysis were to review the demographical pattern of mortalities and define the cause and frequency of death in the Emergency Department (ED) of our institute within 24 hours of treatment process.Material and Methods : A retrospective study was carried out evaluating all patients who died during the treatment process in the Emergency Department of Lumbini Medical College in a three and half year of period from January 2014 to June 2017.Results : A total of 33,472 patients attended to ED with mortality rate of 36.4%, 33.6% and 28.2% on consecutive three years in which 110 deaths occurred. There were 66 (60%) male and 44 (40%) female. The highest mortality was seen after age of 60 years (range 2 month to 90 year). Non-communicable causes &amp; stroke deaths were found to be higher in number. Most of our patient n=52 (47.3%) death occurred within 6-12 hours of admission in ED.Conclusion : Mortality within 24 hours of presentation at ED remains high. Well organized emergency setup, transport, development of protocol as well as new guideline will definitely help in reducing hospital mortalities.Journal of Nobel Medical CollegeVolume 6, Number 2, Issue 11 (July-December, 2017) Page:48-52</jats:p

Attitude and Perception of Preclinical Undergraduate Medical Students about Problem Based Learning in Medical College of Nepal: A Descriptive Cross-sectional Study

Introduction: Problem-based learning is a student-centered learning method. Assessing students’ understanding, settled way of thinking and interpretation towards problem-based learning is essential. The objective of the study was to understand the attitude and perception of preclinicalM.B.B.S. students about problem-based learning. Methods: A descriptive cross-sectional study was conducted from July 5, 2023 to September 4, 2023 for the duration of two months after duly approval from Institutional Review Committee (Protocol No: IRC-LMC-04/Q-23). First and second year M.B.B.S. students who had good experience of attending problem-based learning sessions in integrated basic science subjects were included in the study. Fifteen close-ended questions related to attitude and perceptions were designed in Google Form. The responses were taken on five point Likert scale ranging from strongly disagree (1), disagree (2), neutral (3), agree (4), and strongly agree (5). Data were expressed as frequency and percentage. Results: Among 164 participants, 92 (56.09%) strongly agreed and 67 (40.87%) agreed that problem based learning enhances self-directed learning on the topic. Similarly, 103 (62.80%) strongly agreed and 59 (35.98%) agreed that problem based learning improves communication skills. Likewise, 78(47.57%) agreed and 53 (32.32%) strongly agreed that this learning method improves confidence in decision-making. Moreover, 89 (54.28%) agreed and 58 (35.36%) strongly agreed that tutors motivate students to learn themselves through problem based learning. Conclusions: Majority of the students have positive attitude and good perception towards problem based learning. This method helps in generating skills like communication skills, group discussion, constructive critical reasoning, decision–making