Non-Communicable Diseases among Women of Reproductive Age Visiting the Department of Obstetrics and Gynecology of a Tertiary Care Hospital.

Introduction: Non-communicable diseases are a significant cause of mortality worldwide, posing a substantial risk to women's health, as stated by the World Health Organization. In Nepal, a survey revealed that 10.5% of the population suffers from hypertension. The primary objective of this study was to determine the prevalence of non-communicable diseases among women of reproductive age visiting the Department of Obstetrics and Gynecology of a tertiary care hospital. Methods: A descriptive cross-sectional study was conducted at the Department of Obstetrics and Gynecology among women of reproductive age presented from 6 November 2023 to 6 January 2024. The data was retrieved from the medical record during 1 November 2023 to 1 December 2023. Ethical approval was taken from the Institutional Review Committee. Convenience sampling method was used. The point estimate was calculated at a 95% Confidence Interval. Results: The prevalence of non-communicable diseases was 608 (39.02%) (36.60-41.45, Confidence Interval). The mean age was 29.26±3.46 years. The most common non-communicable disease reported was hypertension 204 (33.55%) followed by chronic respiratory diseases 200 (32.89%) and diabetes mellitus 154 (25.34%). Conclusions: The prevalence of non-communicable diseases among women of reproductive age group was higher as compared to other studies done in similar setting. The study underscores the urgency for stakeholders to implement health education, early detection, and preventive strategies, emphasizing the necessity of targeted interventions and broader public health initiatives to address non-communicable diseases. Keywords: chronic disease; non-communicable disease; prevalence; risk factors.

Diabetes Mellitus among Patients with Acute Ischemic Stroke Admitted to the Department of Medicine in a Tertiary Care Center.

Introduction: Diabetes mellitus is a major public health concern and a continuously growing chronic disease worldwide. Diabetes mellitus is one of the modifiable, independent, and major risk factors of ischemic stroke. This study aimed to find the prevalence of diabetes mellitus among patients with acute ischemic stroke admitted to the Department of Medicine in a tertiary care centre. Methods: This descriptive cross-sectional study was conducted among patients with acute ischemic stroke admitted to the Department of Medicine from 19 July 2023 to 19 November 2023 after obtaining ethical approval from the Institutional Review Committee. Detailed clinical history, random blood sugar and glycated haemoglobin were used to define diabetes mellitus. A convenience sampling method was used. The point estimate was calculated at a 95% Confidence Interval. Results: Among 80 patients, diabetes mellitus was seen in 25 (31.25%) (21.09-41.41, 95% Confidence Interval). Among them, 19 (76%) had previously diagnosed and 6 (24%) had newly diagnosed diabetes mellitus. The poor glycemic control was seen in 11 (44%). Conclusions: The prevalence of diabetes mellitus among patients with acute ischemic stroke was found to be higher than in studies done in similar settings. Keywords: diabetes mellitus; glycated hemoglobin; ischemic stroke.

Tuberous Sclerosis Complex in a 17-month-old: A Case Report.

Tuberous sclerosis complex is a rare autosomal dominant genetic disorder that affects multiple organ systems, primarily affecting the central nervous system. It develops with a pathogenic mutation in tumour suppressor genes i.e. Tuberous Sclerosis Complex 1 or Tuberous Sclerosis Complex 2 which codes for protein hamartin and tuberin leading to unopposed hyperactivation of the mammalian target of the rapamycin signalling pathway. It presents with a triad of facial angiofibroma, intellectual disability, and epilepsy. We present a case of a 17-month female toddler with abnormal body movement with loss of consciousness and later developing into generalised jerky movements. On magnetic resonance imaging, a diagnosis of tuberous sclerosis was made. The patient underwent symptomatic management with anti-epileptic. As seizures in these cases are subtle, they remain undiagnosed for a long time leading to delays in management and developing refractory seizures. Keywords: angiofibroma; case reports; seizures; tuberous sclerosis; tumor suppressor gene.

Finding and Maintaining Motivation in Medical School.

Medicine is a line of work in which expectations run high, having a competitive spirit is considered a virtue and relentless hard work is deemed a reward in itself. Yet, in a strenuous environment such as this, communication about the struggles medical students face is found to be almost non-existent. This leads to medical students feeling burnt out, lost and inadequate, bringing about a drop in performance quality and/or quantity, which breeds further insecurity. This acts as a vicious cycle that is further perpetuated by the lack of effective communication, which becomes a bedrock for the deficit in support from peer groups, educators and authorities. There are different theories of motivation and these form the basis for exploring the different ways in which it can be increased. These methods, which contribute to enhancing productivity and curtailing stress, are detailed in the article. Keywords: cognition; medical students; motivation; self-concept.

Acute Kidney Injury among Patients Visiting the Nephrology Unit in a Tertiary Care Centre: A Descriptive Cross-sectional Study.

Introduction: Acute kidney injury is an abrupt decline in renal function often associated with a decrease in urine output. It is the leading cause of in-hospital mortality worldwide with prolonged hospital stays, the requirement of mechanical ventilation and short-term dialysis. The aim of the study was to find out the prevalence of acute kidney injury among patients visiting the Nephrology unit in a tertiary care centre. Methods: This descriptive cross-sectional study was done among patients presented to the Nephrology Unit of the Department of Internal Medicine in a tertiary centre from 9 February 2022 to 21 October 2022. Ethical approval was taken from Institutional Review Committee (Reference number: UCMS/IRC/047/22). Data was collected from hospital records and the outcome was recorded in terms of in-hospital mortality and the requirement for renal replacement therapy. Convenience sampling was done. Point estimate and 95% Confidence Interval were calculated. Results: Among 1848 patients, 113 (6.12%) (5.03-7.21, 95% Confidence Interval) had acute kidney injury. About 38 (32.75%) required inotropes whereas 10 (8.85%) required mechanical ventilation. In-hospital all-cause mortality was seen in 14 (12.39%) of the study population and 20 (17.70%) of the study population required renal replacement therapy. The most common cause of acute kidney injury was infection pneumonia followed by acute gastrointestinal infections were the most common infective aetiology. Conclusions: The prevalence of acute kidney injury was found to be lower than the studies done in similar settings. It is common in patients admitted with infection. It is responsible for in-hospital mortality. Keywords: acute kidney injury; mortality; renal replacement therapy.