Janaki Medical College Journal of Medical Science

Permanent URI for this collection

https://imsear.searo.who.int/handle/123456789/149790

Executive Editor: Assoc. Prof. Kshitiz Upadhyay-Dhungel

ISSN: 2091-2358 (Online) 2091-2242 (Print)

Frequency: 2 issues a year

Language: English

Official journal of the Janaki Medical College.

Online Peer-reviewed journal

Web site: https://www.nepjol.info/index.php/JMCJMS/index/

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Now showing 1 - 20 of 184

Clinical and procedural skills – A step by step approach
(Janaki Medical College, 2025-04) Shankar, Pathiyil Ravi
Genetics of Male Infertility
(Janaki Medical College, 2025-04) Thakur, Nilam; Saxena, Ajit; Garg, Amar Prakash
Infertility is defined as the inability to conceive after at least one year of regular, unprotected sex. This affects 15–20% of couples and estimated to affect 72.4 million people globally. According to WHO, 9% of couples worldwide struggle with fertility issues and the male factor accounts for 50% of couple sub-fertility with only responsibility in 30% of cases and a co-contributing female factor in 20% of factors. Male infertility is widely known to be partially caused by genetic disorders. Genetic abnormalities can affect spermatogenesis, hormone regulation, and reproductive tract development, leading to various forms of male infertility. This review paper provides an in-depth analysis of the genetic factors contributing to male infertility, including chromosomal abnormalities, single-gene mutations, and Y chromosome microdeletions.
Histopathological findings of Endoscopic Gastric Biopsies of Patients attending a Tertiary Care Hospital
(Janaki Medical College, 2025-04) Maharjan, Rajendra
Background & Objectives: Chronic gastritis, is an inflammatory condition of the gastric mucosa, which can affect various parts of the stomach, causing degrees of mucosal damage. The purpose of this study was to find out the prevalence of histopathological findings of gastric mucosal biopsies among patients at a tertiary care hospital. Materials and Methods: A descriptive cross-sectional study was done among outpatients from January 9, 2017, to June 8, 2018, along with ethical approval from the Institutional Review Committee (Reference number: 12252016). Biopsy samples were collected from the antral mucosa, corpus, and angularis incisura mucosa of patients who underwent upper gastrointestinal endoscopies. Socio-demographic details and histopathological findings were noted. Convenience sampling was utilized, and the point estimate and 95% Confidence Interval were calculated. Results: Among 385 hospital-visiting patients, 80 (20.78%) had histopathological abnormalities (19.14-22.42, 95% Confidence Interval) with mean age of 69.90±15.32 years. Among patient with histopathological findings, eighty patients (100%) had dyspepsia, and 29 (36.30%) had ulcers findings on endoscopy, with higher prevalence in males and those aged 61-70 years. Provisional endoscopic diagnosis showed malignancies in 32 (40.00%) patients, but histopathological diagnosis revealed chronic gastritis in 40 (50.00%) patients. Conclusion: In patients who had undergone histopathological assessment, dyspepsia was frequently diagnosed by endoscopy, but chronic gastritis on histopathological assessment, most commonly in men and older adults.
Thyroid Dysfunction in Patients with Type 2 Diabetes Mellitus attending Medical Outpatient/Inpatient Departments at a Tertiary Care Hospital
(Janaki Medical College, 2025-04) Ghimire, Nirmal; Devkota, Krishna Chandra; Koirala, Dinesh; Gyawali, Susmita
Background & Objectives: Diabetes mellitus and thyroid dysfunction are the two most common endocrine disorders in clinical practice. The unrecognized thyroid dysfunction may adversely affect the metabolic control and add more risk to an already predisposing scenario for cardiovascular diseases. The objective was to find out the spectrum of thyroid dysfunction in patients of type 2 diabetes mellitus. Materials and Methods: Seventy patients (40 female and 30 male) of age more than 30 years with type 2 diabetes mellitus were evaluated for one year visiting Nepal Medical College and Teaching Hospital. All the patients were evaluated for thyroid dysfunction by testing thyroid function test. The correlation of prevalence of thyroid disorder with gender distribution, age distribution, HbA1c, duration of diabetes was evaluated. The observations and interpretations were recorded and results obtained were statistically analyzed. Results: There was a high prevalence (27.1%) of thyroid disorders in patients of type 2 diabetes mellitus. Among all, the most common was subclinical hypothyroidism (20.0%) which was further found to be more in females (30.0%) and elderly patients (37.0%). Duration of diabetes had positive association with the incidence of thyroid disorders (P value 0.003). Conclusion: Findings of this study suggests that thyroid disorders were commonly associated with diabetes mellitus among which subclinical hypothyroidism being the commonest. Moreover, thyroid disorders were more common in females and elderly population.
Clinico-demographic feature of anemic pregnant women attending for antenatal checkup at a tertiary care hospital
(Janaki Medical College, 2025-04) Subedi, Dharma Datta; Mishra, Nishanta
Background & Objectives: Anemia during pregnancy is a common and significant public health issue, leading to maternal and fetal complications, particularly in low- and middle-income countries. Understanding the clinico-demographic characteristics of anemic pregnant women can provide insights for targeted interventions and improve maternal health outcomes. The study was aimed to assess the clinico-demographic features of anemic pregnant women attending antenatal checkups at a tertiary care hospital in Madhesh Province, Nepal. Materials and Methods: A hospital based an analytical observational study with a prospective a cross-sectional study was conducted among pregnant women attending the antenatal clinic of a tertiary care hospital in Madhesh Province from July 2023 to June 2024. A total of 87 anemic pregnant women were included in the study. Data were collected through structured interviews, medical records, and laboratory results. Clinico-demographic variables such as age, education level, occupation, socioeconomic status, gestational age, parity, history of anemia, nutritional status, and laboratory results for hemoglobin levels were analyzed. The data were analyzed using SPSS version 20. Chi-square test was performed to find out the factors associated with anemia at 95% confidence interval. Results: Among 87 anemic pregnant women, 52 (59.77%) were mildly anemic, whereas 31 (35.6%) were moderately anemic and 4(4.59%) were severely anemic. Regarding, analysis of clinical symptoms 26 (29.88%) complained of dizziness and 11(12.64%) had palpitation. Clinical sign showed 37 (42.5%) had pallor. Analysis of anemic women in relation to age group was statistically significant and P value 0.02. Among illiterate women 25 (71.4%) had moderate to severe anemia, whereas among literate women had 10 (19.2%) moderates to severe anemia. Birth spacing helps to decrease severity of anemia. Among total 22 multi gravida females with moderate to severe anemia < 2 years of birth spacing were 20 (80.0%) and birth spacing > 2 years were 2 (11.8%). Conclusion: Clinico-demographic factors such as age, education, parity, and nutritional status were strongly associated with anemia in pregnancy. There is a need for enhanced public health strategies to address the causes of anemia, including better antenatal care, nutritional supplementation, and health education, to reduce the adverse outcomes for both mothers and infants.
Pretreatment with a Small Dose of Ketamine to Prevent Withdrawal Movement caused by the Rocuronium Injection during Induction
(Janaki Medical College, 2025-04) Gautam, Shailendra Nath; Yadav, Rajiv; Khanal, Anupa; Bhandari, Sabin
Background & Objectives: Rocuronium causes pain on injection during the induction of anesthesia. This study was carried out to evaluate the efficacy of a small dose of ketamine in managing injection pain and withdrawal movement during induction. Materials and Methods: This observational study was carried out from August 2022 to November 2022 at Nepal Medical College and Teaching Hospital. The inclusion criteria for the study were ASA I and II. 67 patients (aged 16-65 years) scheduled for elective surgery were included in the study after following the inclusion and exclusion criteria. Then the intravenous ketamine was given without venous occlusion, 30 seconds after followed by rocuronium 0.6 mg/kg intravenous. Then the patient's response to rocuronium injection was recorded on a five-point scale, as well as a change in the vital parameters was collected. Results: The incidence of pain was significantly less in 49 patients (73.13%), and remaining 18 (26.86%) patients out of 67 patients still had pain after intravenous Ketamine 0.5mg/kg, the incidence was more in the younger patients’ groups than older patients’ groups. The cause of this incidence was still to find out. The pain score was significantly less in patients receiving ketamine. Conclusion: We concluded that pretreatment with ketamine 0.5 mg/kg without venous occlusions is effective in decreasing the incidence of pain caused by rocuronium injection
Prevalence of Acute Poisoning Cases in Tertiary Care Hospital: A Descriptive Cross-sectional Study
(Janaki Medical College, 2025-04) Alok, Dhungel; Asim, Pandey; Sohil, Neupane; Samriddhi, Parajuli; Roshan, Bhatta; Sambhav, Ojha
Background & Objectives: Poisoning with intention of self-harm is a leading cause for mortality in developing country like Nepal. Higher number of Organophosphate poisoning cases are being reported due to easy accessibility and low cost. Depression and Alcohol use disorder are the most common risk factor associated with intentional suicide. This study aims to quantify the prevalence of acute poisoning in tertiary care setting, identify the most affected age and sex groups, and assess key risk factors for intentional self?harm. Materials and Methods: This was the cross-sectional study done in tertiary care hospital in Nepal. The study was conducted between 1st September 2022 to 30th March 2023 in patient with poisoning presenting at Emergency Department or the ICU. Convenience sampling was done. Total sample size for the study was 68. Preformed questionnaire was given for data collection and analysis was done in SPSS version 24. Results: The prevalence of organophosphate poisoning was found to be 44.10%. Amongst all cases of poisoning, highest number of poisoning patients were prevalent in patients aged 20-30 (26.5%). Alcohol use disorder was common in male patients with poisoning whereas depressive disorder was common in female patients. Conclusion: Organophosphate self?poisoning predominates in young Nepali adults, particularly women, underscoring urgent needs for stricter pesticide control and targeted mental?health support.
Daily Fruit-Vegetable Consumption, Morbidity Pattern and Healthcare Seeking Behaviour in General Adults Living on the Outskirts of a Sub-Metropolitan City
(Janaki Medical College, 2025-04) Singh, Jitendra Kumar; Shrestha, Kshitiz; Poudel, Alina; Mishra, Raman; Paudel, Rajan; Acharya, Dilaram
Background & Objectives: Fruits and vegetables are essential for a healthy diet, yet global consumption remains below recommended levels, particularly in developing countries like Nepal, increasing the risk of non-communicable diseases. This study examines fruit and vegetable intake, morbidity patterns, and healthcare-seeking behavior among adults in the outskirts of Janakpur Sub-Metropolitan. Materials and Methods: A community-based cross-sectional study was conducted between September 2024 and December 2024 with a sample of 466 general adult population aged 18 years and above. Data were collected through face-to-face interviews with structured questionnaire selected through multistage random sampling. Binary logistic regression was employed to identify predictors of fruit and vegetable consumption. Results: Out of 466 participants, only 15.23% of participants consumed fruit on a daily basis. Majority (68.3%) sought care from qualified doctors followed by qualified paramedical (23.8%) and few (7.9%) sought care from non-health professionals. Further, people who sought health care from qualified doctor had a significantly higher likelihood of consuming leafy vegetable 2-3 times per week. Similarly, Participants with anaemia were significantly less likely to consume leafy vegetable frequently. Conclusion: This study highlights the low consumption of fruits and vegetables, with a higher likelihood of consuming leafy vegetables among those who seeks care from qualified medical doctors. However, frequent consumption of leafy greens has been observed to be greatly constrained among anaemic. Public health education should focus on the importance of fruit and vegetable intake and its impact on overall health.
Patient Satisfaction and Quality of Life after Bariatric Surgery among Iraqi Patients
(Janaki Medical College, 2025-04) Taqi Mohammed Jwad Taher, Ali Abdul Jabbar Mahdi.
Background & Objectives: Obesity is a global epidemic associated with significant health and economic burdens. Bariatric surgery has emerged as a highly effective intervention for severe obesity, offering substantial and sustained weight loss, resolution of comorbidities, and improved quality of life (QoL). Materials and Methods: This cross-sectional descriptive study evaluated patient satisfaction and QoL outcomes among 150 patients who underwent bariatric surgery in Al-Zahraa Teaching Hospital and private clinics in Wasit Province, Iraq. Participants completed a structured questionnaire assessing satisfaction with surgical outcomes, QoL metrics, and postoperative challenges. Results: The findings revealed a mean BMI reduction of 15.7 kg. Gastric sleeve surgery was the most common procedure (60%). High satisfaction levels were reported, with 46.7% rating postoperative care as excellent, and 80% recommending surgery to others. QoL metrics demonstrated marked improvements, particularly in physical health (73.3% reporting better outcomes), social life (80% reporting positive changes), and emotional well-being (66.7% experiencing improvements). A strong positive correlation (r = 0.65, p < 0.01) was observed between patient satisfaction and QoL. Despite these positive results, 33.3% of patients reported difficulty adjusting to dietary changes, and 26.7% experienced side effects. Conclusion: This study underscores the transformative impact of bariatric surgery on holistic patient well-being. However, the findings also highlight the importance of individualized care and ongoing follow-up to optimize outcomes and address challenges. Further research exploring long-term outcomes and strategies to enhance patient-centric care is recommended.
Histopathological evaluation of placenta in low-birth-weight babies at a tertiary care center of Nepal
(Janaki Medical College, 2024-09) Shrestha, Binaya; Makaju, Ramesh; Shakya, Sunila; Basnet, Dipika; Dhakal, Binod; Gautam, Nikita
Background & Objectives: Pregnancy-related death and morbidity rates are significantly impacted by the prenatal care provided to expectant mothers. Low birth weight (LBW) is the single most important factor among the several causes of perinatal mortality; consequently, placentas from all LBW babies (LBWB) should be routinely investigated to determine the likely reason. The purpose of this study was to evaluate the pathological alterations in the placenta associated with LBWB. Materials and Methods: This is a cross-sectional observational study performed at Dhulikhel Hospital, Kathmandu University School of Medical Sciences, Kavre, Nepal. In this study, 100 placentae were included. 44 placentae from full-term delivered babies and 56 from pre-term delivered babies, all of them weighing less than 2500 gms. A gross and microscopic examination of the placentae was done. Results: 100 placentas from low-birth-weight babies were studied. Most of the mothers were in the age group of 26-30 years with primi contributing to 59%. Gross findings like infarction and calcification were noted in 8% and 29 % of the cases. Microscopic findings like Intervillous hemorrhage (44%), Syncytial knots (69%), Stromal fibrosis (24%), Basement membrane thickening (26%), Cytotrophoblastic hyperplasia (28%), Increased villous vascularity (12%), Fibrinoid necrosis (17%), Calcification (38%), Villitis (12%) and Chorangiosis (15%) were noted. Conclusion: Histopathological study together with clinical examination of placenta is simple and cost-effective technique in identifying the features present in LBWB placentae.
Effect of moderate intensity exercise on cardiovascular autonomic function in obese female adults of Western Nepal
(Janaki Medical College, 2024-09) Yadav, Om Prakash; Pant, Bhawana Neupane; Neupane, Ashish
Background & Objectives: Obesity is a known risk factor for metabolic disorders such as high blood pressure, body fat abnormality, and glucose intolerance. In addition, obesity has been associated with dysregulation of autonomic function in humans, which may influence the morbidity and mortality of cardiovascular (CV) diseases. Being physically active has been proven to be a protective measure against CV diseases. Thus, this study aimed to determine the effect of moderate-intensity aerobic exercise on CV modulation among obese females in the mid-western region of Nepal. Materials and Methods: We screened 28 healthy subjects to study the correlation between exercise and CV reactivity (Autonomic Nervous System (ANS) modulated) in obese subjects. Anthropometric and autonomic function parameters were measured before and after the intervention of four months of aerobic exercise and analysed. Results: The result showed a strong correlation of exercise with Resting Heart Rate (RHR) (p= 0.02), baseline systolic blood pressure (SBP) (p= 0.01), and diastolic blood pressure (DBP) (p =0.03 ). It also showed a significant correlation between exercise and CV reactivity change in SBP (p = 0.01) during the cold pressor test (CPT). However, some variables like change in DBP during CPT did not have a significant correlation (p= 0.94 ) with exercise. Conclusion: As obesity-related morbidity and mortality are burgeoning in our society, it is imperative to focus on exercise training to prevent and reverse CV neuropathy. Relevant aerobic exercise intervention can serve as an excellent countermeasure for the prevention of CV disease (CVD) by CV autonomic modulation.
Outcome of routine histo-pathological examination of gallbladder specimen followed by Elective Laparoscopic Cholecystectomy, Ghorahi, Dang, Nepal
(Janaki Medical College, 2024-09) Panthi, Janardan; Acharya, Ravi; Adhikari, Jeevan; Pokhrel, Bishal
Background & Objectives: Gall bladder disease is the one of the commonest surgical diseases which is encountered in the surgical department. Gall bladder stone is the commonest pathological condition which affects the gallbladder. Gallbladder carcinoma is a rare but highly lethal malignancy. Gallbladder carcinoma is highly challenging for the health care professionals. This study evaluated the outcome of the routine histopathological examination of laparoscopic cholecystectomy specimens. Materials and Methods: This study was a retrospective observational study, conducted on 209 patients, who had undergone cholecystectomy for the symptomatic cholecystitis at Gorkha Public Hospital Pvt Ltd, General Surgery Department from September 2023 to September 2024. After obtaining ethical clearance from the Institutional Review Committee, the data was retrieved from the hospital records. Results: Of the 209 patients, 80.9% (n=169) were females. Amongst the various histopathological findings, chronic cholecystitis was the most prevalent (71.8%, n=150/209), which was followed by chronic cholecystitis with cholesterolosis (23.0%, n=48/209). All the pathological specimens represented benign conditions except for one which was a 50-years-old female diagnosed with adenocarcinoma. Conclusion: Chronic cholecystitis was the commonest gallbladder pathology with females having higher preponderance for development. Studies are required to elicit further information in this important surgical entity.
Prevalence of sensorineural hearing loss in patients with Diabetes Mellitus
(Janaki Medical College, 2024-09) Karmacharya, Sameer; Dhakal, Ashish; Sah, Santosh Kumar
Background & Objectives: Various kinds of auditory involvement are reported in diabetic subjects. One of them is that of gradual onset of bilateral sensorineural deafness, involving mainly higher frequencies in elderly patients. This study was aimed to access the prevalence of sensorineural hearing loss (SNHL) in a patient with Diabetes Mellitus and its relation to age, sex, duration of DM, and control of DM. Results: Diabetic patients had insidious onset, gradually progressive, bilaterally symmetrical SNHL. SNHL is prevalent in 72% of type 2 diabetes patients compared to 18% of controls. It is correlated with the increasing age and duration of diabetes. Poor control of diabetes showed an increased prevalence of SNHL compared to good control of diabetes. Conclusion: There was an increased prevalence of SNHL in type 2 diabetes patients and it is more evident in patients with long duration of diabetes and more pronounced in patients with poor diabetic control.
Acute-Onset Plica Polonica following shampoo application: a case report
(Janaki Medical College, 2024-09) Jha, Prasanna Kumar; Yadav, Hem Shankar; Shrestha, Nabina; Yadav, Hridhika; Pandit, Santosh
Background & Objectives: Plica Polonica or Polish plait is a rare condition characterized by tangling and matting of hair that can lead to secondary infections. It has been reported globally with various etiologies including psychiatric illness and pathophysiology involves longitudinal splitting of hair often leading to complications. This study aimed analyze an unusual case of acute-onset Plica Polonica following shampoo application, highlighting the importance of recognizing non-psychiatric triggers. Presentation of Case: A 25-year-old female presented with sudden hair matting within minutes of shampoo application, exhibiting characteristic "bird's nest" appearance without evidence of infection or infestation. The patient had no history of psychiatric illness or other comorbidities. Discussion: While Plica Polonica is commonly associated with psychiatric conditions and self-neglect, this case demonstrates an acute presentation triggered by shampoo use. The pathophysiology may involve alterations in hair shaft bonds leading to matting. Conclusion: This case highlights the importance of considering external triggers in Plica Polonica, beyond the traditional associations with psychiatric conditions and self-neglect. Early recognition and appropriate management are crucial for preventing complications.
Anatomical variations detected in the arterial arches of the palm: A case report
(Janaki Medical College, 2024-09) Khanal, Laxman; Yadav, Saroj Kumar
Background and objectives: The vascular anatomy of the hand, particularly the superficial palmar arch (SPA) and deep palmar arch (DPA), presents complex and variable patterns crucial for microsurgical interventions. Presentation of case: We encountered a unique case during routine cadaveric dissection, an incomplete SPA in a male cadaver. The left upper extremity revealed atypical branching of the ulnar artery (UA), where the superficial branch lacked the typical connection to the radial artery, deviating from conventional SPA anatomy. The medial branch of UA served as a common trunk, supplying the common palmar digital artery and the digiti minimi artery. Additionally, origin of first common palmar digital artery from palmar metacarpal artery (branch of radial artery) instead from ulnar artery itself further distinguished this case. Discussion: Incomplete SPA due to absence of connection between ulnar artery and superficial branch of radial artery is also reported by other studies with prevalence ranging from 3.6 % to 21.7%. Knowledge of this type of variation is significant for hand surgeries involving harvesting of the radial artery to prevent dangerous complications like ischemia and gangrene. Conclusion: Understanding anatomical variations in hand vasculature is pivotal for surgical procedures. This case highlights the importance of thorough anatomical knowledge in clinical practice and surgical planning.
Depression and anxiety during COVID-19 pandemic in remote community of Western Nepal
(Janaki Medical College, 2024-09) Jha, Jay Prakash; Upadhyay-Dhungel, Kshitiz
Background and objectives: Depression and anxiety are significant mental health concerns, particularly in low-resource settings. This study aimed to screen depression and anxiety using ultra-short questionnaires in a remote rural population of Nepal. Materials and Methods: A cross-sectional study was conducted among 218 participants of Guthichaur Rural Municipality, Nepal. Depression and anxiety were assessed using patient health questionnaire – 2 and generalised anxiety disorder questionnaire – 2 , respectively. Data were analysed using descriptive statistics, Chi-square tests, and Pearson correlation. Results: The mean age of participants was 40.39 ± 17.64 years, with 65.14% being male. Depression (PHQ-2 ?3) was identified in 9.63%, and anxiety (GAD-2 ?3) in 12.84% of participants, with 5.50% showing both conditions. No significant differences were found between genders or COVID-19 status. A mild positive correlation was observed between age and both scores. Conclusions: Depression and anxiety were prevalent in this rural community, highlighting the utility of ultra-short questionnaires for mental health screening in low-resource settings. Community-based mental health programs and early interventions are recommended to address these conditions effectively.
Dental students’ perception towards online MCQ tests
(Janaki Medical College, 2024-09) Kasarla, Rajeshwar Reddy; Ghimire, Kripa; Yadav, Nikita Singh
Background & Objectives: College of Dental Surgery, Universal College of Medical Sciences (UCMS), Bhairahawa, Nepal conducted online assessment MCQ tests during covid-19 lock down period. This study was taken up to measure/assess the BDS students’ perception towards online assessment MCQ tests conducted during the COVID-19 lockdown period. Materials and Methods: A descriptive, cross-sectional study was conducted by administering Google Forms questionnaire to BDS students of College of Dental Surgery, UCMS during the period the period of 2 October 2021 to 30 December 2021, using non-probability purposive sampling. General information proforma for socio-demography, and a questionnaire on the lines of Likert’s summated rating scale to assess the perception of BDS students towards online assessment was constructed. Simple frequency tables, cross tables, and mean tables have been used to analyze data. Characteristics of the sample were categorized using mean and standard deviation. Results: The overall mean and standard deviation for perception of online assessment tests were 3.31 and 0.77 respectively. The results indicate that BDS students were satisfied with online assessment tests. Conclusion: Online assessment tests were well received by BDS students. The online assessment tests enhance student learning by allowing immediate feedback. Online tests should be conducted in dental colleges on a regular basis.
Assessment of the prevalence and severity of Diabetic Retinopathy in Type 2 Diabetes mellitus in retina department of Lumbini Eye Institute and Research Center: A Cross-sectional study
(Janaki Medical College, 2024-09) Nau, Bishnu Prasad; Giri, Ramesh Chandra; Khadka, Dikshya; Yadav, Chandrajeet Kumar; Gurmaita, Raman Kumar
Background & Objectives: One of the most dangerous microvascular effects of diabetes mellitus is diabetic retinopathy, which harms the blood vessels that supply the light-sensitive tissue in the rear of the eye. The changing pattern of lifestyle and advancement of technology, type 2 diabetes mellitus has become more common. Thus, this study was aimed to determine the prevalence and severity of diabetic retinopathy in individuals with type 2 diabetes who visited the Lumbini Eye Institute and Research Center retina department. Results: It was found that 115 of the 725 participants in the study had type 2 diabetes. The average age of participants was found as 54.6 ±8.889 years. Among 115 type 2 diabetic patients, 15.86% of participants were observed having diabetic retinopathy. The 34.8% of participants had history of less than five, and 65.2% had history of more than five years, of type 2 diabetes. The prevalence of diabetic retinopathy was more common in men than in women. Out of the 230 eyes, 57.82% had diabetic maculopathy, 20.9% had proliferative diabetic retinopathy, 7.4% had Advanced Diabetic Eye Disease, and 8.7% had non-proliferative diabetic retinopathy. Conclusion: The present study found that people with type 2 diabetes had a higher prevalence and severity of diabetic retinopathy with a higher male-to-female ratio.
Thrombocytopenia and Community-acquired pneumonia: A comparative analysis at a teaching Hospital
(Janaki Medical College, 2024-09) Chaudhary, Sachin; Subedi, Dharma Datta; Purbe, Hari Narayan; Mandal, Ram Narayan
Background & Objectives Community Acquired Pneumonia (CAP) continues to be a significant cause of morbidity and mortality worldwide, especially in at-risk populations. There have been only some recent publications focusing on hematological parameters and how they correlate with clinical outcome, such as thrombocytopenia. This study aimed to investigate the association between thrombocytopenia and CAP severity, as well as the predictive value of other clinical markers such as leukocyte count, duration of hospital stays, and CURB-65 score. Materials and Methods: An analytical observational study with a prospective cross-sectional design was conducted on patients diagnosed with CAP at JMCTH from October 2023 to Sep 2024. Patient’s data were extracted from medical records. The correlation between the platelet count and CAP severity was analyzed. Results: A total of 102 cases were collected. Number of patients diagnosed with CAP was found to be 100%. Males 59 (57.8%) were more affected compared to females 43 (42.1%). Patient ages ranged from 16 to 75 years old. Mild thrombocytopenia was 9(8.8%), moderate thrombocytopenia 49(48%), severe thrombocytopenia 44(43%) was observed. Patients with >65 years had highest prevalence of thrombocytopenia 25(24.5%)). Similarly in terms of leukocytosis, it was found to be mild 43(42%), moderate 50(49%), severe 9(8.8%) respectively. Regarding severe thrombocytopenia 2(66.67%) participants were expired and in severe leukocytosis 2(66.67%) were expired which was statistically significant p value is <0.001. Also, CURB-65 score having >3, indicates the higher mortality rate which is statistically significant, p value < 0.001. Hospital stay was more than 14 days were 9(8.8%), where 2(66.67%) expired which was also statistically significant and p value < 0.001. Conclusion: The significance of thrombocytopenia and other clinical indicators as they relate to the prognosis of CAP, and paves the way for novel interventions and individualized therapies.
Radiation Perception and Knowledge among Patients at Referral and District Hospitals in Rwanda
(Janaki Medical College, 2024-09) Tuyishime, Louise; Usabyimbabazi, Yves; Kirezi, Eric; Afodun, Adam Moyosore; Mukangendo, Mecthilde; Adeoye, Azeez Omoniyi; Masud, Mustapha Akajewole
Background and objectives: The prevalence of cancer is on the rise, and radiation therapy is an essential part of treatment. However, patients frequently have a limited grasp of radiation therapy, which can result in anxieties and misconceptions. This study's main purpose was to investigate patients' radiation perceptions at both referral and district hospitals in Rwanda by examining patients’ knowledge, attitudes, and concerns related to medical radiation. Materials and Methods: The study employed a quantitative approach where data were collected through structured questionnaires and administered to a diverse sample of patients at referral and district hospitals in Rwanda. The quantitative data collected was analyzed using IBM SPSS software, version 27.0, which was released in 2015. The relationship between the variables was measured using a chi-square test from SPSS. Descriptive statistics were employed, utilizing percentages and frequencies. Results: Findings revealed significant misconceptions among patients, with many lacking awareness of radiation dangers despite undergoing radiological procedures. Factors such as education level influence knowledge levels with higher-educated individuals rating their understanding more positively. Conclusion: Significant exposure differences, knowledge and awareness gaps among selected respondents with varying educational levels regarding medical radiation dangers were found in this study conducted on radiation perceptions among patients in Rwandan hospitals.

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