Journal of Lumbini Medical College (JLMC)
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COVID-19: Intranasal and Oral Routes of Vaccination
Get PDFThe mainstay protocol exercised by global health leaders to control the spread of severe acute respiratory syndrome corona virus (SARS-CoV-2) has been screening, the identification of cases, isolation thereof, contact tracing and nation-wide lockdowns. The development of vaccinations against the SARS-CoV-2 virus has marked a new dawn for the war against corona virus disease (COVID-19)
Anatomical Variants of Portal Vein Branching in CECT Scan of Abdomen: A Descriptive Study
Get PDFIntroduction: Various anatomical variants are encountered in portal venous system which are quite important while undergoing hepatobiliary surgeries and percutaneous radiological interventions. Contrast enhanced computed tomography (CECT) of the abdomen is considered a better imaging modality to identify these variations. Methods: A descriptive prospective study was conducted in 1000 individuals undergoing CECT of abdomen. Triple phase CECT scan of the abdomen was done and the portal vein anatomy was reconstructed and analyzed. Results: Normal branching pattern of the portal vein was seen in 786 (78.6%) patients. Variations were seen in rest of the 214 (21.40%) patients. The most common variant was trifurcation of the portal vein seen in 113 (11.3%) patients. Right posterior portal vein as the first branch of main portal portal vein was found in 72 (7.2%) patients. Right anterior portal vein arising from left portal vein was seen in 29 (2.9%). Sixty nine of the 567 males had trifurcation accounting for 12.1% incidence of this variation amongst males. Trifurcation was seen in 44 of the 433 females resulting in an incidence of 10.1%. Forty-four (7.7%) males and 28 (6.4%) females had right posterior portal vein as the first branch of main portal vein. Right anterior portal vein was noted to arise from the left portal vein in 20 (3.5%) males and nine (2.07%) females. Conclusion: The most common variation in portal venous system was trifurcation of portal vein followed by right posterior as first branch and right anterior branch arising from left portal vein respectively
Readiness for Self-directed Learning among Nursing Students of Lumbini Medical College and Teaching Hospital: A Cross-sectional Study
Get PDFIntroduction: Self-directed learning is an independent learning approach and especially appropriate for adult learners where control over the learning is exerted by the learners than by teachers. Methods: A descriptive cross-sectional study was conducted among 147 nursing students. All the students of 2nd and 3rd years Proficiency Certificate Level (PCL) and 2nd, 3rd, and 4th-year bachelor in science (B.Sc) nursing were selected purposefully. The level of readiness was assessed through internationally validated “Self-Directed Learning Readiness Scale (SDLR)â€. Data were analyzed using descriptive and inferential statistics. The p-value was set at <0.05. Results: The mean age of participants was 20.10±1.73 years and 55.1% of participants were from PCL nursing and 51.7% were from Brahmin/Chhetri ethnicity. Nearly three quarter (72.3%) were hosteller. A majority (83.7%) of participants had a high level of readiness for self-directed learning with an overall mean score of 158.78±14.27. The mean score (60.42±6.99) of the self-control subscale was higher than the mean score of self-management (49.82±5.01) and desire for learning (48.53±5.47). The year of study (p<0.001), level of study (p<0.001), age (p<0.001), and grade obtained in previous level education (p<0.001) were statistically significant with the readiness level for self-directed learning. Conclusion: Nursing students had a higher level of readiness for self-directed learning, so the teachers need to adopt those learning strategies that help and encourage nursing students for independent learning which enhances students’ learning with better retention, good decision making, and confidence
Knowledge, Practices and Anxiety related to Corona Virus Disease-19 (COVID -19) among Nursing Students in Nepal
Get PDF Introduction: COVID-19 is a pandemic that emerged and rapidly spread throughout the world in no time. Nursing students are the foundation of nursing profession and they have enormous role to control the spread of the disease in society. The present study was conducted to assess knowledge, practice and anxiety related to COVID-19 among nursing students of Nepal and to find out the correlation between anxiety and knowledge and practice. Methods: A descriptive cross-sectional survey was conducted among 214 Proficiency Certificate Level and Bachelor of Sciences in Nursing students of Nursing Programme, Manipal College of Medical Sciences. Data were collected from 25th May to 2nd June 2020 through self-developed structured questionnaire to measure knowledge and practice whereas, a validated “Self -rating Anxiety scale (SAS)†was used to measure anxiety level via Google form. Data were analyzed using descriptive and inferential (spearman rho correlation) statistics. Results: Majority (73.80%) were from age group 16-20 years of age with mean age of 19.33±1.96 years. Majorities (83.60%) were Hindus. More than half (57.50%) of the respondents had adequate knowledge regarding corona virus infection, 58.90% had good practice and only 6.10% had mild to moderate anxiety level. There was no significant correlation of anxiety with knowledge (p=0.857) and practice (p=0.375). Conclusion: The study showed that more than half of the nursing students had inadequate knowledge, poor practices regarding corona virus infection and very few had mild to moderate anxiety level. Anxiety was not related to knowledge and practice regarding corona virus infection
A Study on Electroencephalography Findings of Patients Visiting the Psychiatric Clinic: An Experience at A Tertiary Care Center in Western Nepal
Get PDFIntroduction: The electroencephalography (EEG) is the recording of brain’s spontaneous electrical activity over a period of time (20-40 minutes) recorded from multiple electrodes placed on the scalp. It is used in seizure disorder, organicity, and psychiatric conditions. There is a paucity of literature with regard to the application of EEG in various conditions in our setting. Methods: This was a cross-sectional study, where data of the patients who visited the EEG section of psychiatric clinic from September 15, 2019 to July 14, 2020 were collected retrospectively. The demographic details, EEG details, and the clinical details were recorded and analyzed. Results: A total of 110 patients underwent EEG during the study period. Of them, 61 (55.45%) had normal EEG. Among the patients with normal EEG, 60 (98.36%) had clinical history suggestive of seizure disorder. Of the rest 49 (44.55%) patients with abnormal EEG, 48 (97.96%) had history of seizure. Majority patients referred for EEG fell in the prime of their life (1-30yrs). Almost all (98.2%) patients with the history of seizure were taking anti-epileptic drugs. Conclusion: EEG is a common investigation done in psychiatric clinic. Nearly half of the patients with seizure disorders will have an abnormal EEG
Assessment of Prescription Errors in the Internal Medicine Department of a Tertiary Care Hospital in Nepal: A Cross-Sectional Study
Get PDFIntroduction: Prescription errors are common problems in hospitals that lead to increase in morbidity, mortality and cost of treatments. They also reduce faiths towards healthcare providers. They are avoidable and their adverse outcome can be reduced if they are assessed and recognized earlier. This study was conducted to assess prescription errors occurred in tertiary care hospital Methods: A cross sectional study was conducted in Internal Medicine department of Lumbini Medical College for five months duration. Patients who prescribed at least one drug in prescription form were included. Results: Out of total patients, 39.5% had medication error. Among medication errors, 37.6% patients had error of omission. Among error of omission, dose of the drug was not mentioned in 26.1% patients. Category B (21.6%) of severity of medication error was the most common. Patients with one diagnosis less likely had medication errors comparing to the patients with more than one diagnosis (p = 0.0002). The tendency of making medication errors was higher among patients with polypharmacy (p < 0.001) and patients who prescribed Fixed-Dose Drug Combination (p < 0.001). Similarly, the tendency of making errors of omission was also higher among patients with more than one diagnosis (p = 0.0002), patients with polypharmacy (p < 0.001) and patients who prescribed Fixed-Dose Drug Combinations (p < 0.001). Conclusion: One-third of patients had medication errors. Among them, errors of omission were the most common. The collaborative program between doctors, clinical pharmacologists and hospital administration to minimize the occurrence of errors will be effective.  
The Cost of Menstrual Cycle in Young Nepali Women: A Cross-Sectional Study
Get PDFIntroduction: Every woman must have safe access to clean water and menstrual products. They have to spend more or less money to buy menstrual products or to alleviate menstrual symptoms. The cost of a menstrual cycle is often associated with period poverty. We found a research gap on this issue. The objective of this study was to find the cost of menstrual cycle and their perceptions on menstrual cost among young Nepali women. Methods: We conducted a cross sectional study from 15 August 2019 to 15 February 2020. The total enumeration sampling technique was used to enroll 157 female medical students. Ethical clearance was obtained from institutional review committee of Birat Medical College Teaching Hospital. Open data kit (ODK) collect software was used for data collection. The collected data was extracted in Microsoft Excel 2016 and analyzed by SPSS version 23. Results: Majority (33.8%) had menarche at 13 years and 47.8% had regular menstrual cycle. The total average cost of items used in last menstrual period was NPR 480.41 (NPR 40-1850) and lifetime cost was NPR 219066.96. Sanitary pads/ tampons/menstrual cups etc. should cost less money (85.4%) and tax currently put on it should be removed by government (91.1%) were the perceptions of the participants. Conclusion: Menstrual cycle added additional cost in women\u27s life. Participants perceived that cost is high and it should be tax free. Nepal\u27s constitution already passed sanitation as basic fundamental right. So, the cost of sanitary items needs to be minimized by removing the government tax
External Ophthalmomyiasis by Oestrus Ovis: Two Case Reports from Nepal
Get PDFIntroduction: Ophthalmomyiasis is an infestation of eye with larvae of dipteran flies most commonlyby Oestrus ovis (Sheep nasal botfly). External ophthalmomyiasis in humans is a rare condition seen inpeople residing in rural areas and also living close to livestock. Case Report: We report two cases ofexternal ophthalmomyiasis in 22 years old male and 38 years old female both having history of suddenonset of foreign body sensation and redness in left and right eyes respectively. Conclusion: This externalophthalmomyiasis presenting nonspecific symptoms similar to acute conjunctivitis is the first case reportedin Nepal to the best of our knowledge. This report may aware all ophthalmologists about larval conjunctivitispreventing misdiagnosis
Comparative Study on Effects of 2% Lidocaine Hydrochloride with Adrenaline (1:200000) on Blood Pressure Among Controlled Hypertensive and Non-hypertensive Patients During Dental Anesthesia
Get PDFIntroduction: Local anesthetic used for dental extraction is 2% lidocaine hydrochloride with adrenaline (1:200000). Lidocaine is cardiac depressant and adrenaline is cardiac stimulant; it decreases or increases blood pressure respectively. Methods: A total of 100 patients (50 controlled hypertensive and 50 non-hypertensive) were selected. The study was conducted over a period of 14 months from January 2020 to February 2021. Blood pressure was measured for patients who were planned for dental extraction by auscultatory method. Following that, 1.5-3 ml (depending upon the nerve block) 2% lidocaine with adrenaline (1:200000) was injected using a 3ml syringe (26 Gauge). Blood pressure was re-recorded after 10 minutes from the time of injection. Visual analog scale pain score was obtained during administration of local anesthesia. Paired t-test was applied to compare blood pressure change before and after administration of local anesthesia in controlled hypertensive and non-hypertensive patients. Results: There was a statistically significant increase in both systolic and diastolic blood pressure in non-hypertensive patients (p = 0.008, p = 0.017). This, however, was not the case with controlled hypertensive patients. There was statistically significant increase in systolic blood pressure (p < 0.001). Pain on injection (50% in non-hypertensive and 48% in controlled hypertensive patients) was the only adverse drug reaction that was reported in both groups. Conclusion: 2% lidocaine hydrochloride with adrenaline (1:200000) increased systolic but not diastolic blood pressure in controlled hypertensive patient
Morphological Variation of Circle of Willis in Nepali Population: A 3D Time-of-Flight Magnetic Resonance Angiography Based Study
Get PDFIntroduction: The Circle of Willis (COW) is an anatomic ring of vessels located at the base of the brain connecting the anterior and posterior circulation by uniting the internal carotid and vertebrobasilar systems to maintain adequate cerebral perfusion. The importance of detailed information of the COW morphology and integrity in any patient cannot be overemphasized, especially for neurophysicians, neurosurgeons, and interventional neuroradiologists who are considering intervention to the intracranial arteries. This study was conducted to study the variation of COW among the Nepalese population and compare the results with those of other nationalities. Methods: It was a prospective cross-sectional study performed using a 1.5 Tesla MRI machine. Complete anatomical assessment of the COW was done. The anterior and posterior components of COW were defined as per the standard literature and evaluated in detail. Results: A total of 118 patients were studied during the period out of which 75 (63.6%) were males and 43 (36.4%) were females. A morphologically normal COW configuration was found only in 55 (46.6%) cases whereas a variant configuration was present in 63 (53.4%) cases. The most common variation was noted in the posterior communicating artery (PCOM) which was present in 42 (67%) cases. The most common single variation in abnormal COW configuration was absent right PCOM. Conclusion: The morphologic variation of the COW is more common than the normal textbook configuration in the Nepalese population, PCOM being the most commonly involved vessel