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 175

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.
Pulmonary Surfactant in Health and Disease: An Overview
(Janaki Medical College, 2024-09) Prakash, Satyam; Yadav, Hem Shankar; Yadav, Om Prakash
Surfactant is a complex mixture of phospholipids, mainly dipalmitoylphosphatidylcholine (DPCC) and surfactant proteins (SP); SP-A, SP-B, SP-C, and SP-D. DPCC plays a crucial role in lowering the surface tension, while SPs provide immunity against invading pathogens. SPs also enhance the activity of phospholipids, aiding in the adsorption and spread of surfactants all over the alveolar surface. Surfactant production starts as early as 24 weeks of gestation in humans and peaks at about 36-38 weeks. The generation and secretion of lung surfactants are tightly regulated processes. Surfactant is synthesized by type II alveolar cells and stored in lamellar bodies. Following stimulation, these lamellar bodies combine with the cell membrane and release their content into the alveolar spaces. Respiratory distress syndrome (RDS) is a fatal disease that primarily occurs in premature infants, and is mainly caused by the absence or dysfunction of pulmonary surfactant. The alveoli collapse due to surfactant insufficiency impairs the gas exchange in RDS causing respiratory failure. One of the treatment options for RDS in preterm infants is surfactant replacement therapy (SRT), where exogenous surfactant preparations are given to replete the levels of surfactant in the lungs. Prophylactic corticosteroids given at about 24 to 34 weeks of gestation to the pregnant mother may prevent surfactant deficiency in babies as it hastens surfactant production. In this review, we have explored the role of surfactants in the normal functioning of the lungs and different disease conditions.
The revised declaration of Helsinki: Time for ethical review committees to revise their guidelines
(Janaki Medical College, 2024-09) Piryani, Rano Mal; Piryani, Suneel
Qualitative analysis of IgM antibody in tuberculosis
(Janaki Medical College, 2024-09) Mandal, Ram Narayan; Mishra, Ajay Kumar; Mandal, Elena Leonidovna; Mandal, Margarita Ramovna; Sah, Vijay Kumar; Jha, Rajiv
Background & Objectives: Nearly one third of the global population is infected with mycobacterium tuberculosis and at risk of developing the disease. More than eight million people develop active tuberculosis every year and about two million dies. Thus, this study was evaluated to study of the sensitivity and specificity of IgM antibody by ICT (Immuno-chromatographic test) method in diagnosing tuberculosis. Materials and Methods: This study comprised of 100 subjects, of which 25 were sputum positive tuberculosis, 25 were sputum negative tuberculosis diagnosed on the basis of clinical and radiological backgrounds, and 50 subjects were taken as control of which 25 were chest infections other than tuberculosis and the rest of 25 were clinically normal subjects. Results: The sensitivity and specificity of IgM antibody was found to be 32% and 94% in the AFB positive group, where as in the AFB negative group it came out to be 24% and 94%, overall, on combining both the group the sensitivity and specificity of IgM antibody came out to be 28% and 94%. Conclusion: Serum IgM antibody test has a low sensibility in diagnosing tuberculosis, but it can be helpful in excluding tuberculosis in individuals suspected to have tuberculosis.
The influence of the arts and the humanities on ‘personal skills’ among medical students and doctors: a scoping review
(Janaki Medical College, 2024-09) Shankar, Pathiyil Ravi
Medical humanities programs are offered at several medical schools. Workshops and sessions on the arts are also offered. The author examined studies from the literature to evaluate the evidence for the influence of the medical humanities on ambiguity and uncertainty, communication skills, empathy, observation skills, resilience and self-care either alone or in combination. Original research studies published between January 2000 to June 2024 in English language among premedical, medical students (preclinical and clinical), interns and residents were examined. PubMed and the Google Scholar databases were searched using the key words ‘Empathy’, ‘Tolerance of ambiguity’, ‘Wellbeing’, ‘Uncertainty’, ‘Observation skills’, ‘Resilience and self-care’, ‘Communication skills’, ‘Medical humanities’ and ‘Health humanities’. The abstract of the retrieved articles was carefully read through to examine if they explored the impact of the humanities module on one or more of the characteristics mentioned either quantitatively and/or qualitatively. If the abstract was deemed suitable to the study, the full text of the article was obtained and carefully read through. Duplicates were removed manually. A total of 52 articles were included. Twenty-seven studies (51.9%) focused on empathy either alone or with other characteristics and 25 studies described interventions among basic science medical students. More studies were quantitative, and 30 studies (57.7%) were from the United States. Most measured the studied parameters before and after the intervention using a validated checklist. The evidence for influence is strong for empathy and visual observation skills. There is also moderate evidence for resilience and well-being. The arts and the humanities can create ‘better’ doctors. More studies from developing countries are required.
Hypothyroidism and its Physiological Consequences in Pulmonary Functions
(Janaki Medical College, 2024-09) Kharel, Sushil; Pant, Subash; Chalise, Sanat; Raut, Binod
Background & Objectives: Hypothyroidism is very common globally and there is exponential elevation in hypothyroidism in Nepal as well. There are very few studies done in past to assess effect of hypothyroidism on pulmonary function. This study was conducted to study pulmonary function test in hypothyroid patients and to evaluate and asses the pulmonary function with thyroid stimulating hormone levels in newly detected hypothyroid patients. Materials and Methods: A total of 51 (21 Male & 30 Female) hypothyroid patients were selected and equal number 51 (21 Male & 30 Female) of matched control groups were taken. Participants participated voluntarily after being given a detailed explanation of the purpose of the study. All newly detected hypothyroid patients visiting medicine OPD of KMCTH were included in the study. Smokers, former smokers, patients suffering from debilitating and pulmonary diseases were excluded from the study. Results: Pulmonary function tests were evaluated by computerized spirometer HELIOS 702. Data obtained was analyzed with the help of SPSS. Both FVC (Cases: 1.77 ± 0.35 & Controls: 2.85 ± 0.46) and FEV1 (Cases: 1.30 ± 0.35 & Controls: 2.38 ± 0.41) means were decreased in hypothyroid patients. Forced vital capacity (FVC) and forced expiratory volume in one sec (FEV1) showed strong negative correlation with Thyroid stimulating hormone levels (TSH). Conclusion: Hypothyroidism affects the pulmonary function to variable degree with higher levels of TSH. All hypothyroid patients must be assessed for abnormalities of pulmonary function to prevent from adverse outcomes.
Knowledge, attitude and practice regarding menstrual hygiene among secondary level students
(Janaki Medical College, 2024-09) Paudel, Mina; Ray, Richa; Rijal, Mala; Chaudhary, Tanuja
Background & Objectives: Menstrual hygiene is an integral aspect of health and wellbeing of adolescent girls. However, effective management to improve menstrual health remain scarce which is evidence by widespread lack of knowledge and unhealthy practice. The objective of this study was to find out knowledge, attitude and practice related to menstrual hygiene among secondary level students in Janakpur, Nepal. Materials and Methods: A cross-sectional descriptive study design was used in secondary level girls of Shree Laxminiya Janata Secondary School of Dhanusha district studying in grade 9,10,11, & 12. A self -administered structured questionnaire was used to collect data by using total enumerative method. All together 210 students are taking part and entire students fill the form. Descriptive (frequency, percentage, mean and standard deviation) and inferential statistics (chi-square test) was used. Results: The study revealed that 52.86%of the respondents had good level of knowledge regarding menstrual hygiene. It also showed that 53.33% had favorable attitude regarding menstrual hygiene. Similarly, 54.77% of the respondents had good practice regarding menstrual hygiene. Family income p=0.001), grade (p=0.03), age (p=0.007), mother education status (p= 0.003), family occupation (p=0.001), family income (p=0.012) was statistically significant with level of knowledge, and attitude regarding menstrual hygiene. There was statistically significant between level of practice regarding menstrual hygiene and grade (p=0.002) and family income (p=0.004). There was also statistically significant association between respondent knowledge and practice p=0.045 and also statistically significant association between respondent knowledge and attitude p=0.0002. Conclusion: Significant portion of students demonstrated a good understanding of menstrual hygiene, some still lack sufficient knowledge, although their practice is not poor. It is recommended that concerned authority to conduct awareness program regarding menstrual hygiene so that it helps to generate knowledge.
Nutritional Knowledge and Eating Habits among IT Undergraduates of Kathmandu Metropolitan City
(Janaki Medical College, 2023-04) Pokharel, S.; Dhungel, K. U.
Background & Objectives: Undergraduate students can be almost of any age, but majority of the students are in their late teens and early twenties. It is the time of physical and emotional changes as the body matures and the mind becomes more curios and independent and there is an increased desire for knowledge. Thus, the aim of the study was to access the nutritional knowledge and eating Habits among Information technology (IT) undergraduates of Kathmandu Metropolitan City. Material and Methods: This was descriptive cross-sectional study based in Kathmandu Metropolitan City. A total of 422 samples were taken and the study population was IT undergraduates. Chi-square test was used to determine the statistical relationship between dependent and independent variables. Results: The respondent's average age was 20.19. One of the primary sources of nutritional knowledge was education. Nearly all of the respondents thought that fast food and junk food tasted good. The main drivers of junk food and fast food consumption were convenience and flavor. A statistical association existed between the amount spent each week on fast food and junk food and the amount of monthly pocket money. The vast majority of respondents had poor eating habits and insufficient nutritional knowledge. While the majority of students skipped their meals, three-fourths of respondents ate three meals a day, with breakfast being skipped the most frequently, followed by lunch, dinner, and snacks. Conclusion: The study concluded that the vast majority of respondents had poor eating habits and insufficient nutritional knowledge. The primary reason of meal skipping was irregular college hours. It requires constant and long-term effort in personal, parental and college policy in order to make healthy eating a lifestyle must begin from the earliest age possible.
Clinical diagnosis of stroke patients using SIRIRAJ stroke score and Computed Tomography
(Janaki Medical College, 2024-08) Mandal, Ram Narayan; Mishra, Ajay Kumar; Mandal, Elena Leonidovna; Mandal, Margarita Ramovna; Sah, Shambhu; Sah, Vijay Kumar; Jha, Rajiv
Background & Objectives: Stroke is a significant cause of disability and death globally, with ischemic and hemorrhagic types. Rapid diagnosis is critical, particularly in resource-limited settings where access to neuroimaging is restricted. Thus, this study aimed to diagnose stroke patients using the Siriraj Stroke Score (SSS) and computed tomography at Janaki Medical College Teaching Hospital. Materials and Methods: A total of 97 stroke patients presented within 72 hours of onset at Janaki Medical College Teaching Hospital, Nepal, were included in this study. Patients were clinically assessed using the SSS and subsequently underwent CT brain scanning to confirm the stroke subtype. The SSS was calculated based on consciousness level, headache, vomiting, atheroma markers, and diastolic blood pressure. The results from SSS were compared with the CT scan findings to determine the clinical diagnosis. Results: The study found that 56.7% of the patients had hemorrhagic strokes, with intraparenchymal hematoma being the most common subtype. The SSS showed a strong correlation with CT scan results, particularly for hemorrhagic strokes, where most patients with a score above 1 were accurately diagnosed. Conclusion: The Siriraj Stroke Score is a valuable tool for initial stroke assessment, especially in settings where advanced neuroimaging is not immediately available. The study supports using SSS in early stroke management, which could improve patient outcomes in resource-limited environments.
Optimizing Cardiovascular Performance Following Myocardial Infarction: The Significance of Nitroglycerin in Regulating Blood Flow
(Janaki Medical College, 2024-08) Sharma, Rohit Kumar; Akbar, Shabab; Kumar, Vivek; Jaiswal, Kshiteendra Mohan; Kumar, Vikas; Upadhyay, Ashutosh Kumar; Sadique, Mo; Chaturvedi, Purnima; Singh, Anurag; Shah, Sapna Ratan
Background & Objectives: Nitroglycerin, a potent vasodilator, is crucial in managing blood flow dynamics in patients recovering from Myocardial Infarction (MI). This research aims to comprehensively review the role of nitroglycerin in regulating blood flow and enhancing cardiovascular performance post-MI. Materials and Methods: Blood flow was modeled as a Herschek-Bulkley fluid. The study derives expressions for various blood flow characteristics, including pressure, viscosity, resistance to flow, and wall shear stress. Pharmacological mechanisms of nitroglycerin, its effects on vascular function, and its role in mitigating ischemic events are explored. Results: The findings indicated that blood flow increases with the height of stenosis. Nitroglycerin effectively dilates blood vessels, reducing peripheral vascular resistance and easing blood flow. Clinical applications, including administration routes, dosage regimens, and potential adverse effects, are discussed. Conclusion: Nitroglycerin plays a pivotal role in managing blood flow post-MI by dilating blood vessels and reducing peripheral vascular resistance. This mechanism contributes to improved cardiovascular outcomes and symptom relief in patients recovering from MI. Understanding its multifaceted role is crucial for optimizing treatment strategies and enhancing patient care.

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