Cholecystectomy among Patients Admitted to the Department of Surgery in a Tertiary Care Centre: A Descriptive Cross-sectional Study.

Introduction: Cholecystectomy refers to the surgical removal of the gallbladder. It is indicated in acute cholecystitis, and other complications of gallstones like cholecystitis, pancreatitis and bile duct obstruction, the presence of gallbladder trauma, and gallbladder cancer. The aim of this study was to find out the prevalence of cholecystectomy among patients admitted to the Department of Surgery in a tertiary care centre. Methods: A descriptive cross-sectional study was conducted among patients admitted to the Department of Surgery of a tertiary care centre. Data from 1 July 2021 to 1 July 2022 were collected between 10 February 2023 to 20 February 2023 from the hospital records. Ethical approval was taken from the Institutional Review Committee of the same institute (Reference number: 630/2079/80). Convenience sampling method was used. Documents and medical records of the cholecystectomy patients were assessed for personal data, medical history was extracted and analysed using Microsoft Excel 2016. Point estimate and 95% Confidence Interval were calculated. Results: Among 2452 patients admitted to the Department of Surgery, 894 (36.46%) (34.46-38.26, 95% Confidence Interval) underwent cholecystectomy. Conclusions: The prevalence of cholecystectomy in our study was found to be similar to other studies done in similar settings. Keywords: cholecystectomy; cholelithiasis; Nepal; prevalence.

Mean Cholinesterase Level among Organophosphorus Poisoning Patients Visiting the Emergency Department in a Tertiary Care Centre: A Descriptive Cross-sectional Study.

Introduction: Acute organophosphorus pesticide poisoning is widespread and the most common in many developing countries, including Nepal. Through the inhibition of acetylcholinesterase, organophosphorus poisoning is characterised by the clinical picture of acute cholinergic crisis. Many researchers have shown increased levels of liver enzymes and decreased levels of serum cholinesterase in organophosphorus poisoning, however, very little work has been done in Nepal that studies the correlation between serum cholinesterase and liver enzymes in organophosphorus poisoning. The aim of the study is to find out the mean cholinesterase level among organophosphorus poisoning patients visiting the Emergency Department in a tertiary care centre. Methods: This was a descriptive cross-sectional study done among 94 organophosphate poisoning cases visiting the emergency department of a tertiary care centre from August 2021 to August 2022 after obtaining approval from the Institutional Review Committee (Reference number: 04102021/06). Convenience sampling was done. Blood workups were done for cholinesterase and liver function tests. Point estimate and 90% Confidence Interval were calculated. Results: The mean cholinesterase level among organophosphorus poisoning patients was 1978.82±1878.22 (1660.17-2297.47, 90% Confidence Interval). Conclusions: The mean cholinesterase level among organophosphorus poisoning patients was similar when compared to other studies done in similar settings. Keywords: cholinesterases; liver function tests; organophosphorus poisoning.

Appendicitis among Patients Admitted to the Department of Surgery of a Tertiary Care Centre: A Descriptive Cross-sectional Study.

Introduction: The prevalence of appendicitis is widespread among both adult and pediatric populations. Despite being so common, its diagnosis remains difficult. Initially, acute appendicitis is managed conservatively. To reduce morbidity and mortality, surgery must be performed promptly. The main objective of the study is to find out the prevalence of appendicitis among patients admitted to the department of surgery of a tertiary care centre. Methods: A descriptive cross-sectional study was conducted among patients admitted to the Department of Surgery of a tertiary care centre from 1 July 2021 to 1 July 2022. Ethical approval was obtained from the Institutional Review Committee (Reference number: 202/2079/80). Convenience sampling was done. The patient admitted to the Department of Surgery during the study period was included. Point estimate and 95% Confidence Interval were calculated. Results: Out of 2452 patients, the prevalence of appendicitis was 321 (13.09%) (11.75-14.43, 95% Confidence Interval). The mean age of the patients with appendicitis was 31.57±14.14 years and among them, males were 176 (54.83%). Conclusions: The prevalence of appendicitis among patients admitted to the department of surgery of a tertiary care centre was lower compared to other studies conducted in similar settings. Keywords: appendectomy; appendicitis; prevalence; surgery.

Remarkable Recovery in a Patient with Lethal Dose Paraquat Poisoning: A Case Report.

Paraquat emerges as a formidable medical dilemma in Southeast Asia, its toxic effects attributed to the generation of free radicals and oxidative stress, with a specific predilection for diverse tissues, most notably the lungs. The scarcity of effective treatment modalities in resource-constrained settings magnifies the magnitude of the paraquat poisoning predicament. This report outlines the successful management of a 25-year-old man who ingested a lethal dose of paraquat. The patient presented solely with dysphagia devoid of accompanying symptoms, regardless of ingesting a fatal quantity of paraquat. The diagnosis was made based on history and a thorough clinical examination. Early, aggressive treatment with pulse therapy of steroids and antioxidants led to unexpected and quirky recovery. The case stresses the importance of prompt management and highlights the need for more research and public education to prevent future cases. Keywords: antioxidants; case reports; corrosive; paraquat; steroids.

Organophosphorus Poisoning among Patients Admitted to the Intensive Care Unit of the Department of Internal Medicine in a Tertiary Care Centre: A Descriptive Cross-sectional Study.

INTRODUCTION: Organophosphates are potent cholinesterase inhibitors that when ingested in excessive amounts can be fatal. Organophosphorus poisoning has become an important clinical problem with increased mortality in the country from accidental or intentional ingestion of, or exposure to the pesticide. This study aimed to find out the prevalence of organophosphorus poisoning among patients admitted to the Intensive Care Unit of the Department of Internal Medicine in a tertiary care centre. METHODS: A descriptive cross-sectional study was conducted among patients admitted to the Intensive Care Unit of the Department of Internal Medicine of a tertiary care centre after receiving ethical approval from the Institutional Review Committee (Reference number: 2003202205). The study was conducted between 1 February 2021 and 1 February 2022 using hospital records. Convenience sampling was done among the patients who met the eligibility criteria. The diagnosis of organophosphorus poisoning was made based on the patient's history, clinical examination and the measurement of serum acetylcholinesterase levels. Point estimate and 95% Confidence Interval were calculated. RESULTS: Among 1108 patients admitted, organophosphorus poisoning was seen in 50 (4.15%) (3.29-5.73, 95% Confidence Interval). CONCLUSIONS: Our study found that the prevalence of organophosphorus poisoning was lower when compared to similar studies done in similar settings.

Metronidazole Induced Cerebellar Toxicity: A Case Report.

Metronidazole is a widely used antibiotic against bacterial and protozoan infections. Even though the therapeutic use of the drug is high, it is associated with some severe side effects like neurotoxicity such as optic neuropathy, peripheral neuropathy, encephalopathy and cerebellar toxicity. We present a case of a 55-years male presented with dysarthria, who had positive cerebellar sign and magnetic resonance imaging findings suggestive of metronidazole induced cerebellar toxicity following metronidazole therapy for two months in a case of liver abscess. And, the symptoms resolved after cessation of metronidazole.

Quarantine: A Period of Self-discovery and Motivation as Medical Student.

The ongoing nationwide lockdown due to the global pandemic COVID-19 started from March 24, 2020, in Nepal. Lots of medical students are in dilemma about how to utilize this time to make it more productive. To live a good life, we must be able to balance our life in general so, we can use this time to discover ourselves. It is equally important to adjust to the global pandemic and help locally to combat the current situation. This difficult time demands resilience. This article focuses on some ideas to discover ourselves and develop resilience within us.

Diagnosis of Achondroplasia at Birth: A Case Report.

Autosomal dominant mutations in fibroblast growth factor receptor 3 cause achondroplasia, the most common form of dwarfism in humans. Achondroplasia is a genetic disorder causing rhizomelic shortening of limbs. Head is often large with prominent forehead causing vaginal delivery difficult. A twenty-one years old multipara mother gave birth to a baby with achondroplasia via spontaneous vaginal delivery with episiotomy without any complication. Achondroplasia, in this case, was diagnosed on the basis of antenatal ultrasonography finding, clinical features and radiological finding of the baby. He was admitted in the special baby care unit for observation and discharged on the next day as no complications were noted. Keywords: achondroplasia; dwarfism; ultrasonography.

Full-time Studies and Volunteering.

Our volunteering began being a part of the editorial support team in the Journal of Nepal Medical Association. This has really built up our confidence to work as a team. During our days in Journal Office, a sudden knock of another opportunity stroke our door. The Administrative Officer of Nepal Medical Association asked us about volunteering in the Election of Nepal Medical Association which held from 17th to 21st Magh, 2076 and we accepted it. We also helped NMA during the pre-election procedure that needs to be done before going for the election. We think that was the work where we got the trust of NMA officers.

Prevalence of Type II Diabetes Mellitus Among Adult Population in Medical Department of A Tertiary Care Centre.

INTRODUCTION: Diabetes mellitus is a chronic metabolic disease that is mainly associated with a number of lifestyle behaviors. There is a high discrepancy among urban and rural populations with the prevalence of diabetes in rural areas as 2.5% and a high prevalence of 14.6% in urban areas. Type 2 diabetes mellitus accounts for the majority of all diabetes cases with a number of chronic effects that include cardiovascular disease, kidney disease, blindness, and disability. This study is done to determine the prevalence of Type II Diabetes Mellitus among the adult population in the medical department of a tertiary care center. METHODS: A descriptive cross-sectional study was done in a medical department of a tertiary care center of Himal Hospital Private Limited from March to April 2020. Ethical approval was taken from the Ethical Review Board of NHRC (Reference Number 752). All the data of the last two years from the medical record section were included in the study. The convenience sampling technique was followed. Descriptive statistical analysis was done. RESULTS: The study showed the prevalence of Type II Diabetes Mellitus among the adult population to be 23.93 % (0.23) (C.I= 0.20-0.26). CONCLUSIONS: The prevalence of Type II Diabetes Mellitus was found to be higher than the previous study done in similar settings.

Effective Way of Studying and Learning in Medical School.

Medical knowledge is growing. We struggle a lot to retain most of the studied information, but we forget it. Most of us are unaware of how to study effectively and improve memory.Understanding the neurobiology of learning and knowing some of the productive study techniques backed up by the researches can help us to study as well as learn effectively. This article may help medical students to study productively and motivate them to search for effective ways of studying actively.