Journal of Chitwan Medical College

Journal Information
ISSN / EISSN : 2091-2412 / 2091-2889
Current Publisher: Nepal Journals Online (JOL) (10.3126)
Total articles ≅ 419

Latest articles in this journal

Mamata Sharma Neupane, Siddeshwar Angadi, Alisha Joshi, Harish Chandra Neupane
Journal of Chitwan Medical College, Volume 10, pp 8-11; doi:10.3126/jcmc.v10i3.32001

Background: Healthcare workers like nurses’ are the primary group who come in contact with patients, an important source of exposure to infected cases in healthcare settings. Co­rona Virus Disease 2019 (COVID-19) pandemic has brought all the health care professionals including nurses to work as a frontline member which may bring threat to mental wellbeing. The nurse’s psychological impact including stress and anxiety remains unknown. Hence, this study aimed to assess the stress and anxiety regarding COVID-19 among nurses working at Chitwan medical college and teaching hospital. Methods: A Descriptive cross-sectional survey was carried out among nurses working in Chitwan Medical College and teaching hospital. A total of 181 Nurses were selected through non probability consecutive sampling from various wards of Chitwan Medical College and Teaching Hospital. Data was collected using structured questionnaire. Data analysis was performed in SPSS version 20 for window using descriptive statistics. Results: The findings of the study revealed that out of 181 nurses 54.7% nurses reported moder­ate and 37.6% reported high level of stress and 10.5% of nurses reported mild to moderate level of anxiety. Conclusions: Considerable proportion of nurses working in different wards of hospital appear to experience some degrees of stress and anxiety during COVID-19 pandemic. Hence, it is essential that health organization takes measures to improve nurses’ mental health by intervening stress management programme to ensure positive attitude and maintain mental well-being.
Shriraj Shrestha, Parash Bhandari, Saurav Dahal, Basanta Maharjan, Suraj Bajracharya
Journal of Chitwan Medical College, Volume 10, pp 47-52; doi:10.3126/jcmc.v10i3.32040

Background: Colles’ fracture is a common injury in the elderly population. Although it can be easily reduced, it is difficult to maintain the reduction in the conventional position of the wrist in palmar flexion with a poor functional outcome. Thus our study aimed to compare the radiological and functional outcome of such fractures with the wrist in two different posi­tions of dorsiflexion and palmar flexion. Methods: A prospective, observational study was conducted from April 2019 to March 2020 in the Orthopedics and Emergency department of KIST Medical College Teaching Hospital, Lalitpur, Ne­pal. Sixty-two patients, 31 in each group, all above 45 years with Colles’ fracture underwent close reduction and below elbow cast immobilization under hematoma block. Maintaining palmar flex­ion and ulnar deviation at the fracture site, the wrist was immobilized in dorsiflexion and palmar flexion attitude alternatively. During the respective follow-ups, the Demerit Scoring System of Saito was evaluated. Data collection and entry was done using the statistical package for social science version 16 and analyzed by using descriptive and inferential statistics. Results: All fractures were united. At the end of twelve weeks, Saito Scoring System of good to ex­cellent was markedly better in dorsiflexed group 29(93.5%) patients as compared to palmar flexed group 22(71.0%) patients, similarly grip power was also superior in dorsiflexed group 19(61.3%) patients than in palmar flexed group 11(35.5%) patients. Conclusions: Cast immobilization of Colles’ fracture with the wrist in dorsiflexion prevents re-dis­placement of the fragments resulting in significantly better radiological and functional outcomes.
Shashi Keshwar, Deependra Prasad Sarraf, Ashish Shrestha, Basant Kumar Karn
Journal of Chitwan Medical College, Volume 10, pp 20-24; doi:10.3126/jcmc.v10i3.32015

Background: Early recognition of oral cancer is essential for higher cure rate and better prog­nosis. Nurses can play a significant role in the early diagnosis of cancers. The study aimed to assess the awareness of oral cancer among nursing students. Methods: A cross-sectional survey was conducted among Bachelor of Nursing Students at College of Nursing, B.P. Koirala Institute of Health Sciences. A semi-structured questionnaire was used to collect the sociodemographic data and awareness of cancer. Descriptive statistics were calculated using Statistical Package for Social Sciences version 22.0. Results: Out of 116, 89 (76.7%) students were of age 21-25 years. One hundred and twelve stu­dents (96.6%) were aware that various form of tobacco increases risk of oral cancer; however, only 55 (47.4%) students knew alcohol drinking as a risk factor. Only 29 (25.0%) students were aware of loose-fitting denture as a risk factor for oral cancer. Ninety-six (82.8%) students knew white or red patch as possible signs of oral cancer; however, only six (5.2%) students were aware of the most common site of oral cancer. Only 16 (13.8%) students considered that they are adequately trained to screen oral cancer. One hundred and fifteen (99.1%) students demanded more education on oral cancer. Conclusions: This study revealed that nursing students’ awareness of risk factors and the impor­tance of screening of oral cancer is suboptimal. It highlights a need for basic education on oral can­cer to make them more aware and further competent toward oral cancer screening and referral.
Tilak Raj Limbu, Sovit Jung Baral, Amit Jha, Donjon Lamichane
Journal of Chitwan Medical College, Volume 10, pp 88-90; doi:10.3126/jcmc.v10i3.32057

Background: Peritonsillar abscess is one of deep neck space having significant morbidity and mor­tality. The treatment is still controversial regarding best method to perform. The aim of the study was to study the effect of needle aspiration in the treatment of peritonsillar abscess among the patients of Chitwan Medical College. Methods: A retrospective study was designed which included all aged patients and were admitted in tertiary centre for peritonsillar abscess treatment between January 2015 to December 2019. All patient was treated with needle aspiration method under local spray anaesthesia and intravenous antibiotics. Number of aspirations, hospital stay, recurrence and complications were assessed as main outcomes. Descriptive analysis was performed by using SPSS version 16.0. Results: Over 5-year duration, 57 patients were admitted for PTA and included for analysis. About 45(78.9%) of patients were under 40 years. Male dominance of 41(71.6 %) was found. All cases were unilateral and no significant laterality found. All patients had prior medications outside be­fore hospital visit. Length of hospital stay was 3.11+/-.939 days. Single or repeat aspiration of pus showed significant improvement of symptoms. One patient had recurrence and another one case had developed complication. Conclusions: Our study showed needle aspiration is effective modality for peritonsillar abscess treatment due to early clinical improvement, low recurrence and decrease hospital stay.
Sameer Timilsina, Poojan Bhusal, Ram Lochan Yadav, Niraj Khatri Sapkota, Nazrul Islam
Journal of Chitwan Medical College, Volume 10, pp 43-46; doi:10.3126/jcmc.v10i3.32039

Background: Several teaching-learning methods are widely used in medical schools all over the world. Optimizing and promoting active student learning has been the fundamental goal of these strategies. Team-Based Learning (TBL) is a structured form of small-group learn­ing which is a relatively new pedagogy in medical education. We aimed to introduce TBL in place of traditional lectures to teach physiology general concepts and evaluate its perception among undergraduate medical students at Chitwan Medical College. Methods: This was a cross-sectional descriptive study conducted among all 100 (95/100 respon­dents) year I undergraduate medical students. We requested the students to complete a Team- Based Learning- Students Assessment Instrument (TBL-SAI) to study the preference towards TBL after completing 12 weeks of TBL. Results: The study included 67 males and 28 females. Students reported agreement in TBL-SAI statements complementing and enjoying this newly introduced method. The overall mean TBL-SAI score was 111.55±11.05 (Range 78-128) which was above the defined threshold of 102 indicating favor to TBL over traditional lecture system. Sex, entry-type, and, past educational institutes were not associated with a preference of TBL. TBL-SAI is a reliable tool to use among undergraduate medical students in Nepal. Conclusions: The study demonstrates TBL could be an effective way of teaching physiology general concepts to undergraduate medical students.
Dil Islam Mansur, Raj Kumar Karki, Pragya Shrestha, Dilip Kumar Mehta, Sunima Maskey, Shreya Dahal
Journal of Chitwan Medical College, Volume 10, pp 39-42; doi:10.3126/jcmc.v10i3.32036

Background: The human foot shows variations in its dimensions and shape in different age group of both male and female. It can be used as gender predictor of an individual in forensic science investigations which may have a great value for identification of unknown deceased body. This study was aimed to measure the various dimensions of foot and derive a tool to predict gender of an individual. Methods: This study was the cross-sectional type which consisted of 556 individuals (268 males and 288 females). Foot dimensions (foot length and foot breadth) were measured in centimeter and the foot index was derived for both sexes separately. The data was analyzed using descriptive statistics with SPSS vesion 20.0. Results: It was concluded that there were gender differences in foot length and breadth. The foot length and foot breadth were found to be higher among males than females. The bilateral differences of foot dimensions were not recorded in both male and female. There were gender differences in foot index. Conclusions: The male is found having longer and broader foot than female foot. The foot index is not used as an appropriate tool to determine gender.
Ashish Kumar Bhattarai, Prabin Kumar Karki
Journal of Chitwan Medical College, Volume 10, pp 25-28; doi:10.3126/jcmc.v10i3.32017

Background: Medical education is one of the toughest education systems where the stu­dents are under intense physical and mental pressure especially during the exam time. They have information of different drugs that can cope with their medical conditions and also aware of different cognitive enhancers. Self-medication results in wastage of resource, ad­verse effects, drug dependence and increase chances of resistance of pathogens. Hence, this study was undertaken to determine the knowledge, attitude and practice of irrational drug use among the medical students during the exam time. Methods: This was descriptive cross-sectional using semi-structured questionnaire in the one of the medical school located inside Kathmandu Valley. A total of 90 students participated in the study. The data was analyzed with SPSS version 20, by using descriptive statistics. Results: Among the total respondents,20 (17.7%) were practicing self-medication during the exam time. Of the participants who practiced the self-medication, most common drug used was NDAIDs. Most of the respondents 87(96.7%) were aware of the possible adverse consequences. About 75(83.3%) participants thought the self-medication practice during the exam time is acceptable while 15(16.7%) regarded this as unacceptable. Conclusions: Although low incidence of self-medication was found among students during exam time, the false prerogative of being medical students can lead to meager practice and awful con­sequences.
Naresh Manandhar, Isha Amatya, Arundhati Gautam, Gaurav Kumar, Himanshu Ahlawat, Nitesh Adhikari, Pawan Kumar Mahaseth
Journal of Chitwan Medical College, Volume 10, pp 53-56; doi:10.3126/jcmc.v10i3.32042

Background: Uncontrolled population growth has been a problematic issue all over the world. Knowing the women’s and their husband’s knowledge and attitude towards family planning may help to intervene so that the practice can be increased. This might ensure the right of women to have child as they wish and later reduce unwanted pregnancies and abor­tions. Hence the present study is concerned with knowledge and attitude of women towards family planning. Methods: A cross-sectional study was conducted during 10th-15thNovember 2019 among women of reproductive age of Khopasi, Kavrepalanchowk. Structured questionnaire consisting of knowl­edge, attitude and practice regarding family planning was administered to reproductive women age. Results: All respondents heard about the family planning methods. More than 90% of respondents knew about Norplant, Pills, Depo-Provera and condoms.60.8% respondents were currently using family planning methods. It has been observed that the respondents had positive attitude towards family planning. Conclusions: Knowledge about family planning methods was good among the reproductive age women whereas the practice and attitude seemed satisfactory. The knowledge about emergency contraceptive and abortion were poor among the reproductive age women. One of the promising findings of the study was, the majority of respondents showed a positive attitude towards contra­ceptive use. There is need to target these population for health education interventions in order to achieve the desirable practices.
Bandana Khanal, Basant Sharma, Renuka Tamrakar, Prekshya Singh
Journal of Chitwan Medical College, Volume 10, pp 91-94; doi:10.3126/jcmc.v10i3.32059

Background: There is no general consensus about the role of routine HPE of the obtained tissue at the time of uterine evacuation. However, it is understood clinically that it is of utmost importance to prove the presence of intrauterine gestation and to exclude gestational trophoblastic disease in the form of partial or complete mole. This study aimed to assess the role of histopathology in cases of first trimester miscarriages and to determine clinical relevance of histopathological examination following surgical evacuation. Methods: This was a retrospective study of collected data over 12 months (January 2018- De­cember 2018) in an agency for reproductive health setup with predefined inclusion criteria. We included 60 consecutive patients attended with history of first trimester bleeding. Patient’s record and the histopathological examination report of products of conception following uterine evacu­ation were observed. The data was analyzed descriptive statistics including percentage, stander deviation, mean, and range in Microsoft Excel software. Results: Missed abortion was the most common type and constituted 55% of the studied group. The histopathological reports confirmed the pregnancy in all patients and revealed partial mole in 6(10%) patients and complete mole in 2(3.33%) patients. Conclusions: Histopathological examination of products of conception detects under diagnosed molar pregnancies that necessitates special follow up and is a key step to do further management.
Babita Devi Dahal, Jayalaxmi Shakya
Journal of Chitwan Medical College, Volume 10, pp 57-60; doi:10.3126/jcmc.v10i3.32045

Background: Awareness towards the maternal condition has great potential to reduce occur­rence of life threatening maternal and child illness. Hence, this study aimed to find out the awareness and attitude regarding obstetric fistula among married women. Methods: A descriptive cross-sectional study was used to find out the awareness and attitude re­garding obstetric fistula among 206 married women. Data were collected by using semi structured interview schedule and Likert Scale. Analysis was done by using descriptive statistics. Results: The age range of the respondents was 15-79 years. Among literate 163, 34.4% attended general education, 75% were married at the age of 15-19 years, 50% had their first baby at the age of 15-19 years, 65.0 % had 1-3 babies, 66.0% had home delivery and postnatal visit was 9.5%. In this study 0.9% respondents were found with obstetric fistula and 60.2% had low level of aware­ness. Regarding the level of attitude, 50.0% had positive attitude. Conclusions: The finding concluded that there is low level of awareness and fifty percentages had negative attitude regarding obstetric fistula among married women so there is need of intervn­tional awareness program in community.
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