Knowledge, Attitude and Practice in Recurrent Shoulder Dislocation: an analysis of patients presenting at a tertiary referral centre.

Background Early diagnosis and treatment of recurrent shoulder dislocation are crucial to avoid complications associated with multiple dislocations. Little is known about knowledge, attitude, and practice of recurrent shoulder dislocation among patients. Objective To assess the knowledge, attitude, and practice among patients regarding recurrent shoulder dislocation. Method A retrospective study of prospectively collected data from December 2019 to November 2022 among patients seeking treatment for recurrent shoulder dislocation at a tertiary care centre was conducted. A 16-item questionnaire, including 5 items regarding patients' knowledge, 2 items regarding attitude, and 2 items regarding practice on recurrent shoulder dislocation, was devised and responses were recorded. Continuous data were reported as mean ± standard deviation and categorical data were reported as number (percentage). Comparative analysis was done using student t-test. Result A total of 220 patients completed the questionnaire. Out of 220, 159 (72.27%) were not informed about recurrence after first dislocation, 146 (66.36%) felt that they were not properly counselled regarding treatment, and 172 (78.18%) responded that they did not know that recurrent shoulder dislocation can be treated. Among 220 patients, 171 (77.73%) responded that their quality of life was affected by recurrent shoulder dislocation, and first dislocation was relocated by doctors in 116 (52.73%), self in 78 (35.45%), and relatives in 26 (11.82%). The number of dislocations was significantly higher among patients who did not visit the hospital after their first dislocation. Conclusion Majority of the patients have positive attitude, but poor knowledge and practice regarding recurrent shoulder dislocation. The findings would be useful for planning strategies to improve patients counselling regarding recurrent shoulder dislocation.

A scenario of cervical carcinoma in a cancer hospital.

INTRODUCTION: Cervical carcinoma is an important women's health problem throughout the world. There are very few published data on this disease in Nepal. We wanted to study the pattern of cervical carcinoma based on hospital data. METHODS: A 10 years retrospective study of scenario of cervical carcinoma was conducted. The data have been analyzed according to age, occurrence of other cancers, histological type, religion, risk factors and district wise. RESULTS: The number of cervical carcinoma showed a rising pattern over the 10 year period. The median age of the patients was 45 years and maximum frequency (33%) of cases were found in the age group 40 to 49 years. Squamous cell carcinoma comprised 40% of cases, Adenocarcinoma 4% and 1.1% cases were of mixed variety. 92% of cases were Hindu by religion. 43% of patients were smoker in our study, 5% had positive family history. Chitwan with 7.35% had the maximum number of cases followed by Rupandehi with 6.40% and Nawalparasi with 5.41%. CONCLUSIONS: The cancer pattern revealed by the present study provides valuable leads to cervical cancer epidemiology in Nepal. Routine cytological screening of the population for cervical cancer is highly necessary for its early detection and treatment.

Mass survey of leprosy in Lalitpur district, Nepal.

An intense mass survey of leprosy in Lalitpur District, Nepal, was carried for the period 1986 to 1990. This was the first such large scale survey in Nepal; 85% of the total population was examined. The 5-year case detection rate was 13 per 10,000; the 5-year child detection rate was 4 per 10,000. By the end of the survey the prevalence rate was 6.8 per 10,000; at the end of 1992 this had dropped to 2.2 per 10,000. In 1989, after a 3-year interval, a re-survey was done in three village development committees (VDCs) and 4 new cases were detected, bringing the 3-year case detection rate to 3.3 per 10,000; 36% of the old cases, 20% of the new adult cases, and 3% of the new child cases were classified as multibacillary. Overall, 62.7% of the patients had no disability, 18.8% had disability grade 1, and 12.7% had disability grade 2 while for 5.8% the data were incomplete. By the end of the survey 91% of the patients needing medical treatment were on multidrug therapy (MDT). At present this has increased to 100%. The regularity rate was 86%; at the end of 1992 this had increased to 96%. The cost for detecting one new patient was US$298. Because of the high cost, it is recommended that intense mass surveys not be performed when the estimated prevalence rate is less than 10 per 10,000 inhabitants. From the data collected conclusions were drawn and recommendations were formulated for developing new strategies for the National Leprosy Control Programme of the Government of Nepal.