JNMA; Journal Of The Nepal Medical Association[JOURNAL]
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200 papers
Foreign Body Migration from Subglottis to Bronchus in a Tracheostomised Child: A Case Report.
Aryal A, Maharjan L, Yadav D
JNMA J Nepal Med Assoc · 2025 Aug · PMID 41783680 · Full text
Foreign body (FB) aspiration is a critical paediatric emergency, often requiring timely diagnosis and intervention to prevent complications. We report the case of a three-year-old female presenting with persistent cough...
Foreign body (FB) aspiration is a critical paediatric emergency, often requiring timely diagnosis and intervention to prevent complications. We report the case of a three-year-old female presenting with persistent cough and breathing difficulty, initially managed as croup. Imaging revealed a subglottic FB, necessitating tracheostomy for airway stabilization. During the first rigid bronchoscopy attempt, the FB migrated into the left main bronchus, likely due to manipulation and the use of an uncuffed tracheostomy tube. A second bronchoscopy successfully removed the FB, a 2.5*2 cm bone chip, using telescope-mounted forceps. This case highlights the rare phenomenon of FB migration during intervention and emphasizes the importance of tracheostomy in maintaining airway. Awareness of migration risks and tailored interventions are critical for successful outcomes.
Validation of the Nepalese Version of the Quality of Recovery-15 Questionnaire in Patients Undergoing Elective Surgery.
Thapa C, Gauchan S, Acharya S … +1 more , Sharma MR
JNMA J Nepal Med Assoc · 2025 Aug · PMID 41783679 · Full text
INTRODUCTION: The 15-item Quality of Recovery scale is a widely used tool for assessing postoperative recovery. It has been translated and validated in various languages and cultural settings. However, a validated Nepale...
INTRODUCTION: The 15-item Quality of Recovery scale is a widely used tool for assessing postoperative recovery. It has been translated and validated in various languages and cultural settings. However, a validated Nepalese version is currently unavailable. METHODS: A cross-sectional study was conducted among 216 patients undergoing elective surgery under general anesthesia, following ethical approval (Ref. No. 21-081/082). The 15 items of the Quality of Recovery scale were translated into Nepalese and modified as needed, resulting in the final version: Quality of Recovery scale-N. Patients were interviewed preoperatively (the day before surgery) and on the first postoperative day using the QoR-N. Reliability, validity, responsiveness, and feasibility of the QoR-N were then evaluated. RESULTS: The Quality of Recovery scale-N showed acceptable reliability, with a Cronbach's alpha of 0.890, mean inter-item correlation of 0.413, split-half reliability of 0.94, and standard error of measurement of 2.79. Responsiveness was supported by a Cohen's effect size of 1.4 and standardized response mean of 1.39. QoR-N scores did not correlate with age or surgery duration, and showed no significant difference between ASA physical status I and II, or across minor, intermediate, and major surgeries. However, scores were significantly higher in males than females, and in patients with good overall recovery (per visual analogue scale) compared to those with poor recovery. The recruitment rate was 100%, and completion rate was 94.33%. CONCLUSIONS: The Quality of Recovery scale-N demonstrated acceptable validity, reliability, responsiveness, and clinical feasibility, and is suitable for use in Nepalese patients undergoing elective surgery.
Evaluation of Preference of Pain Scale in Children using Novel Animated Emoji Scale in Nepal: An Observational Study.
Agrawal A, Upadhyay M
JNMA J Nepal Med Assoc · 2025 Aug · PMID 41783678 · Full text
INTRODUCTION: Pain is a common concern for pediatrics patients, maybe challenging because the child cannot properly explain the extent of pain they are experiencing. Several pain assessment tools have been developed and...
INTRODUCTION: Pain is a common concern for pediatrics patients, maybe challenging because the child cannot properly explain the extent of pain they are experiencing. Several pain assessment tools have been developed and introduced in dentistry that facilitate self-report of pain in children. Three such pain rating scales Animated Emoji Scale, Visual Analogue Scale and Wong-Baker Faces Pain Rating Scale were used in this study to evaluate the pain perception among pediatric patients. This study was aimed to evaluate the preference of pain scale among these three scales in pediatrics patients. METHODS: This hospital based cross sectional study was carried out from January till June in 182 children aged between 3-14 years divided into three groups on the basis of age: Group A (3-6 years, Group B 7-10 years, and Group C 11-14 years). Ethical clearance was taken (Reference number: UCMS/IRC/02/25). Pain score was recorded among these children using Animated Emoji Scale (AES), Visual Analogue Scale (VAS) and Wong-Baker Faces Pain Rating Scale (WBFPS). The data were entered into Excel and analyzed using IBM SPSS Statistics for Windows, version 26 (IBM Corp., Armonk, N.Y., USA). RESULTS: Spearman's rank correlation coefficient evaluated a positive correlation among the three pain rating scales. Chi-square test showed statistically significant association between age group and preferred pain scale (p<0.001). CONCLUSIONS: AES was most preferred in younger age groups from age 3-10 years whereas elder children 11-14 years relied more on VAS as a self-reporting tool.
Mucinous Ovarian Cancer in a Young Woman: A Case Report.
Kunwar R, Shakya B, Vaidya KM … +2 more , Dahal B, Shrivastav S
JNMA J Nepal Med Assoc · 2025 Aug · PMID 41783677 · Full text
Mucinous ovarian cancer is a rare subtype of epithelial ovarian carcinoma, comprising <5% of all cases. Twenty three years old lady with increasing abdominal fullness and discomfort. Contrast enhanced computed tomography...
Mucinous ovarian cancer is a rare subtype of epithelial ovarian carcinoma, comprising <5% of all cases. Twenty three years old lady with increasing abdominal fullness and discomfort. Contrast enhanced computed tomography revealed a multiloculated ovoid cystic mass (17.5*21.6*9.1)cm in right adnexa. She underwent staging laparotomy with right salphingo-oophorectomy, peritoneal fluid cytology, bilateral pelvic lymph node dissection, infracolic omentectomy and appendectomy. Histopathology confirmed stage IA, grade 1, (well differentiated) mucinous adenocarcinoma of the ovary. After counseling, patient opted for completion surgery and underwent total abdominal hysterectomy with left salphingo-oophorectomy, repeat peritoneal fluid cytology and supracolic omentectomy. Due to malignant cell in the peritoneal fluid, she received adjuvant chemotherapy. She remains disease-free one year postoperatively. Fertility sparing surgery is oncologically permissible for stage IA MOC but contraindicated in 1C3 disease. In Nepal, scaling diagnostic capacity, centralizing services, and integrating culturally sensitive councelling are critical to balance fertility preservation with survival.
Conundrum of Cholesterol Management and Health Implications of Low Cholesterol Levels: A Narrative Review.
Bashyal S, Karki M, Shah D
JNMA J Nepal Med Assoc · 2025 Aug · PMID 41783676 · Full text
Lowering cholesterol for the health benefit of dyslipidemia is a well-known fact, but emerging evidence highlights risks associated with excessive lowering. The use of lipid-lowering agents to reduce cardiovascular risk...
Lowering cholesterol for the health benefit of dyslipidemia is a well-known fact, but emerging evidence highlights risks associated with excessive lowering. The use of lipid-lowering agents to reduce cardiovascular risk is well-established; however, excessive cholesterol reduction has raised concerns about the potential health implications of excessively low cholesterol levels. This review explores the "cholesterol paradox," highlighting the dual nature of cholesterol as both a contributor to cardiovascular risk and an essential component for cellular integrity, hormone synthesis, brain function, and vitamin D production. A systematic search of PubMed, Google Scholar, JAMA, and Cochrane Library for eligible studies was conducted from 1980 until December 1, 2024. Evidence suggests that excessively low cholesterol levels may impair cell membrane integrity, neurotransmission, and immune function. This review underscores the need for balanced clinical approach to cholesterol management rather than solely aiming for aggressive reduction, ensuring both cardiovascular protection and broader systemic health.
Clinical Profile and Management of Pleural Effusion at Tertiary Hospital of Nepal: An Observational Study.
Singh AK, Karmacharya RM, Vaidya S … +6 more , Singh S, Shrestha I, Bhandari P, Bhatta G, Basnet S, Neupane S
JNMA J Nepal Med Assoc · 2025 Aug · PMID 41783675 · Full text
INTRODUCTION: Pleural effusion is the accumulation of excessive fluid in the pleural cavity. Despite the high incidence of pleural effusion in Nepal, there is limited data regarding the clinical profile and its managemen...
INTRODUCTION: Pleural effusion is the accumulation of excessive fluid in the pleural cavity. Despite the high incidence of pleural effusion in Nepal, there is limited data regarding the clinical profile and its management. The study aims to find out the clinical profile and management of pleural effusion in a tertiary care hospital. METHODS: This is a descriptive cross-sectional study done over 24 months in patients with pleural effusion admitted to a tertiary care hospital in Nepal. Ethical clearance was taken from the Institutional Review Committee (No: 134/20). Census sampling was done. All patients who were diagnosed to have pleural effusion were included in the study. The clinical findings, radiological imaging reports, management record and relevant data of each case were retrieved from the medical records. Data were analysed using Statistical Package for the Social Sciences 25. RESULTS: Among 273 cases ofpleural effusion, 186 (68.1%) were male. The mean age of the patients was 48.83±22.87 and 97 (35.53%) were above 60 years. The pleural effusion on right side was 137 (50.93%). Among all cases, 241 (88.3%) were managed conservatively; 72 (29.88%) with antitubercular therapy and 169 (70.12%) without antitubercular therapy, while surgical management was required in 32 (11.7%) cases. CONCLUSIONS: The most common cause of pleural effusion was tubercular in origin; majority of cases can be managed conservatively, and only particular cases require surgical interventions like chest tube placement or thoracotomy.
Patient Safety Framework in Healthcare Regulatory System of Nepal: A Call for Action.
Deo SK, Shakya S, Gupta S
JNMA J Nepal Med Assoc · 2025 Aug · PMID 41783674 · Full text
Patient safety in Nepal's healthcare system remains a critical challenge due to fragmented regulatory frameworks, resource constraints, and inadequate monitoring mechanisms. Despite multiple regulatory bodies overseeing...
Patient safety in Nepal's healthcare system remains a critical challenge due to fragmented regulatory frameworks, resource constraints, and inadequate monitoring mechanisms. Despite multiple regulatory bodies overseeing healthcare services, their lack of coordination limits effectiveness. Learning from international models, Nepal can enhance patient safety by establishing a unified governance system, strengthened monitoring mechanisms, and increased budget allocations. A dedicated patient safety framework, including stakeholder collaboration, capacity-building, and a national reporting system, is crucial. Increasing healthcare funding to at least 5% of Gross Domestic Product (GDP) would demonstrate Nepal's commitment towards improving patient safety and achieving global healthcare standards.
Functional Outcome of Transforaminal Lumbar Interbody Fusion Surgery in Spondylolisthesis: An Observational Study.
Dahal SC, Pokharel S, Waiba SBL … +4 more , Kaucha D, Chaudhary RK, Barakoti RK, Shrestha BK
JNMA J Nepal Med Assoc · 2025 Aug · PMID 41783673 · Full text
INTRODUCTION: Transforaminal lumbar interbody fusion is indicated for stabilizing and fusing spondylolisthesis. There is no uniformity in functional outcomes reported across different studies. We aimed to find the functi...
INTRODUCTION: Transforaminal lumbar interbody fusion is indicated for stabilizing and fusing spondylolisthesis. There is no uniformity in functional outcomes reported across different studies. We aimed to find the functional outcomes of transforaminal lumbar interbody fusion in our cases. METHODS: This retrospective observational study included post-operative spondylolisthesis cases. Visual Analogue Scale and the validated Nepali Oswestry Disability Index (version 2.1a) were used to grade pain and functional outcomes. Data were entered in MS Excel 2016 and analysed using JASP version 0.19.3. Point estimates at 95% Confidence Interval were calculated, along with frequencies and percentages for binary data, and mean with standard deviation or median with interquartile range for continuous data. RESULTS: Among the total 68 patients, the median post-operative duration of follow-up was 27 months (IQR 39), ranging from 6 to 80 months. Sixty-three (92.65%) cases belonged to lower grade (grade I and II) spondylolisthesis. Predominant radiculopathy accounted for 56 (82.35%) cases. A total 61 (89.71%) cases underwent single-level transforaminal lumbar interbody fusion, whereas remaining 7 (10.29%) had two-level transforaminal lumbar interbody fusion surgery. The VAS score mean was 2.09+1.05 (95% CI: 1.83 - 2.34), where 63 (92.65%) had mild pain and 5 (7.35%) cases had moderate symptoms at the final follow-up. The mean Oswestry Disability Index score was 9.57+3.81(95% CI: 8.65 - 10.49). CONCLUSIONS: Patients reported lower pain scores and better functional outcomes post-operative in transforaminal lumbar interbody fusion surgery.
Medical Negligence and Duty of Care in Nepal: A Legal and Ethical Analysis.
Shrestha K, Joshi J, Yadav D
JNMA J Nepal Med Assoc · 2025 Aug · PMID 41783672 · Full text
Medical negligence, a critical intersection of ethical obligations and legal standards, is an evolving concern in Nepal's medico-legal landscape. This article explores the concept of duty of care, which is fundamental to...
Medical negligence, a critical intersection of ethical obligations and legal standards, is an evolving concern in Nepal's medico-legal landscape. This article explores the concept of duty of care, which is fundamental to medical negligence, and emphasizes the need for a robust legal framework to ensure justice for both the patients and the healthcare professionals. The key elements of negligence: duty, dereliction, direct causation, and damage are examined alongside international precedents like Donoghue v. Stevenson, Bolam v. Friern Hospital, Bo-litho v. City and Hackney and Montgomery v. Lanarkshire, which shape standards of care and informed consent. In Nepal, cases such as the Infant Amputation Case, Dr. D.B. Shah v. Srijana KC and the Sterilization Malpractice Case highlight the growing recognition of patient rights and institutional accountability. This article advocates for a dedicated Medical Negli-gence Act to strengthen legal protections, emphasizing expert testimony, informed consent, and institutional responsibility to foster a balanced, ethical, and just healthcare system.
Quality of Sleep among the Post Operative Patients at a Tertiary Care Hospital: An Observational Study.
Mahotra N, Shrestha L, Chaudhary S … +2 more , Thakurai T, Bhandari T
JNMA J Nepal Med Assoc · 2025 Aug · PMID 41783671 · Full text
INTRODUCTION: A good sleep is important for recovery after stress like surgeries in patients. This study aims to study the quality of sleep postoperatively in our population to know the distribution of poor sleepers. MET...
INTRODUCTION: A good sleep is important for recovery after stress like surgeries in patients. This study aims to study the quality of sleep postoperatively in our population to know the distribution of poor sleepers. METHODS: A descriptive cross-sectional study was carried out from February, 2025 to April, 2025 after receiving ethical approval 081/082] in tertiary care hospital. The patients who were 18 years and above residing in the hospital after any surgery were included in the study. The general information of the patients was recorded followed by the responses in Pittsburgh Sleep Quality Index Questionnaire. Data was entered in Microsoft Excel 2016 and analysis was done using IBM SPSS Statistics version 16.0 and the descriptive statistics was used in the variables considered. RESULTS: Out of 141 postoperative cases, only 133 participants were included for the analysis of Pittsburgh Sleep Quality Index questionnaire responses. The prevalence of poor sleepers was 92 (69.17%, 95% CI: 60.58%-76.89%). Severe difficulty was observed in the daytime dysfunction (27; 20.30%), sleep quality (17; 12.78%), and sleep latency (17; 12.78%) components of the Pittsburgh Sleep Quality Index. Among the poor sleepers, 67 (50.37%) were female, 40 (30.07%) were in the 40-59 years age group, and 86 (64.66%) were married. Of the total poor sleepers, 64 (48.12%) were within one week of the postoperative period. CONCLUSIONS: Poor sleep quality was prevalent after surgery, especially in the first week. It was more noticeable among females, middle-aged adults, and married individuals.
An Uncommon Presentation Severe Hypercalcemia Linked to Cystic Parathyroid Adenoma Despite Negative Sestamibi Scan: A Case Report.
Acharya S, Daniel S, Acharya S … +2 more , Gupta R, Kannappan D
JNMA J Nepal Med Assoc · 2025 Aug · PMID 41783670 · Full text
Cystic parathyroid adenomas are uncommon occurrences, constituting approximately 1-2%, of primary hyperparathyroidism cases. They frequently pose diagnostic difficulties due to their limited detection in sestamibi scans....
Cystic parathyroid adenomas are uncommon occurrences, constituting approximately 1-2%, of primary hyperparathyroidism cases. They frequently pose diagnostic difficulties due to their limited detection in sestamibi scans. These cases of primary hyperparathyroidism commonly manifest with hypercalcemic crisis despite negative scan results. We present a rare scenario involving an elderly male who arrived at the emergency department with a swollen left neck, primarily due to a thyroid cyst causing breathing difficulties. Incidentally, hypercalcemia was also discovered during examination. Thorough investigations ensued, leading to the decision to perform a right hemithyroidectomy to address the large thyroid cyst and a parathyroidectomy. Histopathological analysis confirmed the presence of a cystic parathyroid adenoma, with subsequent normalization of calcium levels. Following the procedures, the patient experienced hypocalcemia and required calcium supplementation. This case stands out due to the high levels of parathyroid hormone, which typically raises suspicion for parathyroid carcinoma, making it a unique diagnostic challenge.
Alveolar Bone Loss at Maxillary and Mandibular Permanent First Molars in Periodontitis Patients: A Descriptive Cross-sectional Study.
Shah HK, Shah R, Gupta S … +4 more , Singh HM, Hussain A, Ahmad S, Singh A
JNMA J Nepal Med Assoc · 2025 Aug · PMID 41783669 · Full text
INTRODUCTION: Periodontitis is an inflammatory condition of periodontium that results in alveolar bone loss. Panoramic radiograph is one of the methods used to evaluate alveolar bone loss. However, in Nepal data quantify...
INTRODUCTION: Periodontitis is an inflammatory condition of periodontium that results in alveolar bone loss. Panoramic radiograph is one of the methods used to evaluate alveolar bone loss. However, in Nepal data quantifying the extent and site-specific pattern of alveolar bone loss using panoramic radiograph are still lacking. The objective of this study was to determine the amount of alveolar bone loss at the mesial and distal sites of maxillary and mandibular permanent first molars. METHODS: This descriptive cross-sectional study was conducted in the Department of Periodontology and Oral Implantology at National Medical College from 15 July 2023 to 15 March 2024 among 190 periodontitis patients using convenience sampling method after institutional ethical clearance. Alveolar bone loss at mesial and distal sites was measured in millimeters from cementoenamel junction to alveolar crest on a digital orthopantomogram. Data was entered in Microsoft Excel Sheet and descriptive analysis was done. The findings are presented as frequencies, percentages, means, and standard deviations. The point estimate was calculated at a 95% confidence. RESULTS: In patients with periodontitis, the alveolar bone losses at mesial and distal sites of the maxillary first molars were 4.27±1.07 (95% CI: 4.11-4.41) mm and 4.45±1.12 (95% CI: 4.29-4.62) mm. For mandibular first molars the corresponding values were 3.69±0.92 (95% CI: 3.55-3.82) mm and 3.87±1.03 (95% CI: 3.72-4.01) mm. The mean alveolar bone loss was found to be higher among smokers, older age groups, and those who brushed their teeth only once a day. CONCLUSION: The alveolar bone loss was greater in the maxillary first molar than mandibular first molar.
Clinico-epidemiological Profile of Colorectal Cancer in Oncology Department of Tertiary Centre Hospital in Nepal: An Observational Study.
Mahaseth RK, Upadhyaya R, Panjiyar PC … +2 more , Jha N, Jha UK
JNMA J Nepal Med Assoc · 2025 Aug · PMID 41783668 · Full text
INTRODUCTION: Colorectal cancer is a major global health concern with variable incidence and presentation across regions. The study was aimed to describe the clinic-epidemiological profile of colorectal cancer in a terti...
INTRODUCTION: Colorectal cancer is a major global health concern with variable incidence and presentation across regions. The study was aimed to describe the clinic-epidemiological profile of colorectal cancer in a tertiary care hospital in Nepal. METHODS: This observational cross-section study was conducted at a tertiary care hospital in Nepal from April 2021 to March 2024. Ethical clearance was obtained (Reference number: IRC/NMCTH/024/21). A total sampling method was used to include 69 patients with histologically confirmed colorectal cancer. Data were collected from patient records and analyzed using Statistical Package for the Social Sciences version 16.0. Point estimate at 95% Confidence Interval was calculated along with frequency and percentages for binary data, and mean and standard deviation for continuous data. RESULTS: Out of 69 patients, 39 (56.52%) were male and 30 (43.48%) female. The most affected age group was 35-50 years, accounting for 26 (37.68%) patients. Rectum including recto-sigmoid colon was the most common tumor location in 38 (55.07%) cases. The most common presenting symptom was bowel habit change, seen in 46 (66.67%) patients. Lower anterior resection was performed in 26 (37.68%) cases. Histologically, moderately differentiated adenocarcinoma was the predominant type, found in 53 (76.81%) patients. CONCLUSIONS: Colorectal cancer in this study predominantly affected middle-aged males, with the rectum being the common site and moderately differentiated adenocarcinoma the main histological type.
Femoral Notch Anatomy and Tibial Slope in Anterior Cruciate Ligament Injuries: An Observational Study.
Mishra JB, Thapa SS, Kafle KR … +2 more , Suwal S, Lamichhane AP
JNMA J Nepal Med Assoc · 2025 Aug · PMID 41783667 · Full text
INTRODUCTION: The anterior cruciate ligament is a primary knee stabilizer frequently injured during sports activities, with risk factors including intrinsic anatomical variations. These anatomical factors vary by race, s...
INTRODUCTION: The anterior cruciate ligament is a primary knee stabilizer frequently injured during sports activities, with risk factors including intrinsic anatomical variations. These anatomical factors vary by race, sex, and body structure. The study aimed to identify anatomical risk factors for anterior cruciate ligament injury in the Nepalese population using magnetic resonance imaging. METHODS: This observational comparative study was conducted from December 2021 to July 2023 after obtaining ethical clearance (Reference number: 286(6-11) E2 078/079). Magnetic resonance imaging scans of 122 knees (61 anterior cruciate ligament injured and 61 intact) were analyzed. Intercondylar femoral notch width, notch width index, notch angle, medial and lateral posterior tibial slopes were measured. Notch shapes (A, U, W) were classified. Independent t-test and chi-square test were used for comparing continuous and categorical variables, respectively. The Statistical Package for the Social Sciences (version 26) was used for analysis. RESULTS: The anterior cruciate ligament injured group showed significantly smaller mean notch widths (coronal: 1.90±0.28cm, axial: 1.98±0.30cm), lower notch width indices (coronal: 0.27±0.03, axial: 0.28±0.04), and more acute notch angles (coronal: 49.89±6.12°, axial: 48.70±6.67°) compared to controls (all p<0.05). Both medial (11.23±5.21° vs 8.76±4.76°) and lateral (11.24±5.33° vs 8.76±4.94°) posterior tibial slopes were significantly steeper in injured knees (p<0.01). Type A notches were more common in injured knees. CONCLUSIONS: Smaller femoral notches, lower notch indices, more acute notch angles, and steeper posterior tibial slopes were associated with anterior cruciate ligament injuries.
Exploring the Need for Psychiatry Sub-Specialization in Nepal: A Cross-sectional Survey Among Psychiatrists.
Dhungel O, Poudel R, Singh YM … +3 more , Khadka B, Shah A, Adhikari SP
JNMA J Nepal Med Assoc · 2025 Aug · PMID 41783666 · Full text
INTRODUCTION: The complexities in the identification and management of mental disorders have demanded sub-specialization. In Nepal, the number of psychiatrists still does not meet the minimum requirement of the psychiatr...
INTRODUCTION: The complexities in the identification and management of mental disorders have demanded sub-specialization. In Nepal, the number of psychiatrists still does not meet the minimum requirement of the psychiatrist-population ratio. There is a dilemma regarding the need for further subspecialization in psychiatry. This study aimed to assess the perceived need for psychiatry sub-specialization courses among Nepalese psychiatrists. METHODS: This cross-sectional descriptive study was conducted via an online survey (using Google Forms) among Nepalese psychiatrists and psychiatry residents. Convenience and snowball sampling was used. Data was analysed using Statistical Package for Social Sciences (SPSS), presented in frequency and percentage. RESULTS: Among 165 respondents, 99 (60%) were male, 105 (63.60%) were between 30-40 years of age, 125 (75.80%) were psychiatrists, and 138 (83.60%) expressed a need for further sub-specialization, although only 102 (60%) were interested. The primary reason for not pursuing sub-specialization was the need for general psychiatrists. Fellowship in addiction psychiatry was the most frequently selected sub-specialty. CONCLUSIONS: Most of the participants stated that there is a need for pyschiatry sub-specialization in Nepal.
Mental Health of Nepalese Migrant Workers: A Call for Action in South Korea.
Giri B, Gurung M, Adnani QES … +1 more , Chattu VK
JNMA J Nepal Med Assoc · 2025 Aug · PMID 41783665 · Full text
Mental health problems among migrants is a serious issue around the globe. Nepalese migrant workers in South Korea are facing serious mental health problem that affects not only the people involved but also the society a...
Mental health problems among migrants is a serious issue around the globe. Nepalese migrant workers in South Korea are facing serious mental health problem that affects not only the people involved but also the society at large. Moreover, the COVID-19 pandemic has worsened the already dire mental health situation of Nepali workers. Global health diplomacy can be a key factor in addressing mental health by engaging actors from various domains to evaluate mental health in global health priorities. This article reviews the current state of mental health and discusses the recent development in mental health among Nepalese migrant workers in South Korea.
Clinical Profile and Visual Rehabilitation with Mini-Scleral Device in Irregular Corneas at a Tertiary Eye Hospital : An Observational Study.
Adhikari PR, Aara T, Patel PK … +1 more , Karn RR
JNMA J Nepal Med Assoc · 2025 Aug · PMID 41783664 · Full text
INTRODUCTION: Keratoconus, Stevens-Johnson syndrome, corneal dystrophy, and corneal scar are the sight threatening conditions of the anterior eye. Optical management of these irregular corneas include use of spectacles a...
INTRODUCTION: Keratoconus, Stevens-Johnson syndrome, corneal dystrophy, and corneal scar are the sight threatening conditions of the anterior eye. Optical management of these irregular corneas include use of spectacles and contact lenses like corneal lenses (GP) as well as corneo-scleral/mini scleral and scleral lenses. Mini scleral device(MSD) delivers refractive corrections to most of the irregular corneas and provide maximum comfort with proper visual rehabilitation. It also halts the corneal transplant in many cases. The purpose of this study was to determine the clinical profile andvisual outcome ofmini scleral device in different irregular corneas. METHODS: The hospital based cross-sectional study was conducted between July 2022 to December 2023 in contact lens department of tertiary eye hospital of eastern Nepal. During study period total 208 eyes of 128 patients were included in the study. Eyes with different irregular cornea in which mini scleral device trial was performed were included in the study. RESULTS: The mean age (±SD) of the patients was 21.03 (6.70) with minimum 11 years and maximum 42 years. Majority of them were male 94 (73.44%) and below 30 years of age 113 (88.28%). Majority of eyes had keratoconus 180 (86.54%). After trial of MSD, majority of the eyes 201 (96.63%) achieved normal vision (0.0-0.50 log MAR) among them 84 (40.38%) eyes had achieved 0.0 log MAR visual acuity. CONCLUSIONS: Keratoconus was found the most common irregular cornea and majority of eyes achieved normal vision with MSD.
Antibiotic Susceptibility Profile of Carbapenem Resistant and in Urinary Isolates from a Tertiary Care Hospital: An Observational Study.
Verma G, Smriti S, Dash RK … +5 more , Das L, Pattnaik D, Singh N, Panda SS, Tripathy S
JNMA J Nepal Med Assoc · 2025 Aug · PMID 41783663 · Full text
INTRODUCTION: Urinary tract infections are common in both hospital and community settings and impose a significant financial burden. Among Enterobacterales, and are the leading uropathogens. The rise of carbapenem-resi...
INTRODUCTION: Urinary tract infections are common in both hospital and community settings and impose a significant financial burden. Among Enterobacterales, and are the leading uropathogens. The rise of carbapenem-resistant strains is concerning due to limited treatment options, with carbapenems often being the last line resort. This study intends to determine the microbiological profile of and uropathogens obtained from a tertiary care hospital. METHODS: A prospective study was conducted from October 2023 to June 2024 in a tertiary care hospital in Eastern India. Urine samples received for routine culture in the central laboratory were processed following standard microbiological protocols. Bacterial identification and antibiotic susceptibility testing were performed using the VITEK-2 compact system. A total of 958 isolates of and were obtained. Of these, 198 were identified as carbapenem-resistant as per the Clinical Laboratory Standard Institute 2023 guidelines. RESULTS: Of the, 7228 urine samples, 4336 (60%) yielded a positive culture. Among these, 1552 (36%) were gram-negative bacteria. Out of the gramnegative bacteria, 1209 (77.8%) were Enterobacterales. were 562 (46.4%) and was 396 (32.7%). Carbapenem resistant was 96 (17%) and Carbapenem resistant was 102 (26%). Both the Carbapenem resistant E. coli and K. pneumoniae showed susceptibility to fosfomycin and nitrofurantoin. CONCLUSIONS: Urinary tract infections caused by and are frequent, but Carbapenem resistant strains pose an emerging therapeutic challenge. This study highlights the prevalence and effective antibiotic options.
Epidemiology of Orthopaedic Trauma Cases at a Tertiary Level Hospital in Nepal: An Observational Study.
Kandel M, Shrestha SK, Paudel KP … +6 more , Bom R, Paudel A, Bhatta TR, Chaudhary P, Kandel P, Sharma S
JNMA J Nepal Med Assoc · 2025 Aug · PMID 41783662 · Full text
INTRODUCTION: Trauma is a leading cause of morbidity and mortality worldwide. While there has been significant progress in understanding trauma in high-income countries, data from Nepal is limited. This study's main obje...
INTRODUCTION: Trauma is a leading cause of morbidity and mortality worldwide. While there has been significant progress in understanding trauma in high-income countries, data from Nepal is limited. This study's main objective was to explore the demographic profile, injury patterns, and treatment of orthopaedic trauma patients presenting to a tertiary-level hospital in Nepal. METHODS: This was a retrospective study conducted at a tertiary-level hospital of Nepal. All complete records of trauma cases presenting to the hospital from January 2017 to December 2022 were included in the study. Data were collected from electronic and manual records, anonymized, and analyzed with Microsoft Excel 2021. RESULTS: A total of 27,893 complete records were included in the study. Of these, 19,679 (70.55%) patients were male. Patients aged 30-44 years accounted for 9,566 (34.29%) cases. The mechanisms of injury included falls in 12,585 (45.12%) cases and road traffic accidents in 8,524 (30.56%) cases. Fractures were identified in 17,593 (63.07%) patients, with 9,800 cases classified as lower extremity fractures. Additionally, 18,595 (66.67%) patients were referred from outside the district. CONCLUSIONS: Orthopaedic trauma was seen more commonly in males and the most common causes of injury are falls and RTA. Fractures were the most common pattern of orthopaedic injuries and lower extremity fractures were the most common.
Calcinosis Cutis Presenting as Multiple Discharging Sinuses in Skin: A Case Report.
Maharjan P, Aryal G, Rana R … +2 more , Pande K, Thakur N
JNMA J Nepal Med Assoc · 2025 Aug · PMID 41783661 · Full text
Calcinosis cutis is a rare but significant pathological condition that can present diagnostic and therapeutic challenges. It typically presents as firm nodules or plaques with extensive calcifications that lead to ulcera...
Calcinosis cutis is a rare but significant pathological condition that can present diagnostic and therapeutic challenges. It typically presents as firm nodules or plaques with extensive calcifications that lead to ulceration and sinus tract formation. We present a case of 44 years old female with calcinosis cutis presenting as multiple draining sinuses, a rare and severe manifestation of the disease. The patient developed chronic, non-healing ulcers with intermittent discharge of chalky material, significantly impacting quality of life. Diagnosis was confirmed through clinical examination, imaging, and histopathology. Management was challenging, requiring a combination of wound care, medical therapy, and surgical intervention. This case highlights the importance of early recognition and a multidisciplinary approach to prevent complications and improve outcomes in patients with severe calcinosis cutis.
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