Poisoning is an important cause of morbidity as well as mortality in India, more than 50,000 people die of poisoning every year. Dhatura poisoning is relatively rare in occurrence which is mostly accidental. However, its use as a roadside poison with criminal intension for the purpose of robbery and kidnapping is frequently reported in media. The victims are usually travelers by train or long distance buses. Suicidal poisoning still occurs but rarely. Analysis of Dhatura poisoning cases encountered in Pruvara Rural Hospital, Loni, over a period of 12 years has been done.
Background: Antimicrobial resistance is evolving as a major global public health problem. This study was aimed to assess the knowledge, attitude and practice on antibiotic use and its resistance among medical students in a tertiary care hospital. Methods: Questionnaire was administered to the students of an undergraduate medical college hospital to assess their knowledge, attitude and practice about rational use of antibiotics. Data was analyzed using SPSS version 20. Results: Two hundred fifty three undergraduate students completely filled the electronic questionnaire. About 76.3% of the students believed that improper use of antibiotics/self-prescription can cause and promote antibiotic resistance. One third (33.2%) of students thought that use of antibiotics will speed up recovery from flu and cold and skipping one or two doses does not contribute to the development of antibiotic resistance. Majority (93.3%) of the students had never attended a Continuing medical education about rational use of antibiotics in the past. The knowledge, attitude and practice domain scores were not significantly different between the students among various academic years. Conclusions: Our study showed that the majority of the students had good knowledge and attitude about antibiotics and its resistance. Their practice was satisfactory towards rational use of antibiotics. Medical students need to be sensitized regarding antimicrobial resistance through various Continuing medical education and workshops highlighting its burden and impact. Proper guidelines and strict policy on sales of antibiotics without prescription should be implemented and monitored regularly.
Background: Obesity is one of the major public health problems worldwide. The trend has been increasing in lower socioeconomic country like Nepal. Obesity and overweight are prevalent in all age groups and responsible for various health issues. Children and adolescent group are more vulnerable in developing countries like ours. So, this study is aimed to estimate the prevalence of overweight and obesity among secondary school students of Bharatpur-10.
Methods: It was a cross-sectional study done on class 9 and10 (Two private and two government secondary schools) of Bharatpur-10 Municipality, Chitwan. A predesigned questionnaire was distributed among the students. Weight was recorded by standardized weighing machine and height by metallic measuring tape. Body mass index was calculated by appropriate formula.
Results: There were 266 students (55.6% male and 44.6% female) in this study with the mean age of 14.91 years and majority (74.8%) were in age group 13-15 years. 9.77% students were overweight and 3% obese; overweight was prevalent in 8% male and 18% female students, and 6% public and 20% private school students. Students who take snacks during watching television were significantly overweight as compared to those who do not (13.33% vs 6.11%). There was no significant association between overweight and ethnicity/religion, type of family, number of siblings, family history of diabetes, socioeconomic status, food consumption frequency, hours of watching TV or not involving in physical activities in school.
Conclusions: This study found a relatively high prevalence of overweight among female students of 13-15 years age group from private school. Also eating snacks during watching television is associated with a higher BMI.
Introduction: Ectopic pregnancy is a life threatening emergency in first trimester of pregnancy. Hemodynamic stability of the patient remains one of the crucial factors that determine the treatment modalities. The main objective of this study was to study the correlation between the vital signs and amount of hemoperitoneum in ruptured ectopic pregnancy so that early and active interventions can be done. Methods: We conducted a cross sectional study of all the pregnant women with ruptured ectopic pregnancy with hemoperitoneum who presented to the emergency department of College of Medical Sciences Teaching Hospital from time period of 1st May 2017-31st May 2020.The different vital signs present at the time of initial emergency department and preoperative period prior surgery were reviewed and used for correlation with amount of hemoperitoneum by using Pearson correlation analysis. Results: A total of 61 patients were studied. Pearson correlation between different vital signs and amount of hemoperitoneum were: heart rate(r=0.48, p<0.001), systolic blood pressure(r= -0.41,p=0.001), diastolic blood pressure (r= -0.34,p=0.06), mean arterial pressure (r= -0.37,p=0.03), respiration rate (r= 0.33, p=0.08) temperature (r=0.09,p=0.94), and shock index (r=0.55,p<0.001). Only 19 of 36 patients with hemoperitoneum ≥750 ml had HR≥100 beats/min and 8 patients had SBP≤90mmHg. Conclusions: None of the vital signs showed strong association with the amount of hemoperitoneum. If decision for surgical interventions were made based on hemodynamic instability, most of the patients would have been over-diagnosed and treated differently. Proper and timely diagnosis with immediate management should be done.
63 Background: Patients with localized pancreatic adenocarcinoma (PDAC) generally benefit from multi-modality therapy, which may be best coordinated through a pancreas multi-disciplinary clinic (PMDC). Whether treatment practice patterns vary based on whether a patient was seen through PMDC versus individual specialty-specific clinics is unclear. Methods: Using institutional Pancreatic Cancer Registry, we identified patients who came to Johns Hopkins Hospital through either PMDC or one of the individual surgical, medical, or radiation oncology clinics for localized PDAC between 2018-2020 and eventually underwent resection. During this time, it was standard practice for borderline resectable (BRPC) patients to undergo at least 4 months of neoadjuvant chemotherapy, with or without radiation, before transitioning to exploration, while locally advanced (LAPC) patients were treated with 4-6 months of chemotherapy, followed by radiation, followed by potential exploration. The primary outcome was completion of neoadjuvant therapy as per the above stage-specific institutional standards. Multivariable analyses were performed to find association between PMDC visit and completion of neoadjuvant therapy, controlling for age, sex, race, stage, baseline performance status and type of chemotherapy. Results: A total of 240 patients met inclusion criteria. Of these, 157 (65.4%) had PMDC visits. Distribution of stage across the cohort included 81 (34.3%), 91 (38.5%), and 64 (27.1%) patients with resectable PDAC, BRPC and LAPC, respectively. Patients in the PMDC group received radiation therapy more commonly (59.7% vs 34.9%, p = 0.004), as compared to patients seen through individual specialty-specific clinics. Mean duration of chemotherapy was higher for patients seen through PMDC (4.4 (SD: 1.7) vs 3.9 (SD: 2.0) months) compared with individual clinics. Completion of neoadjuvant therapy per institutional stage-specific standards was seen in 46% (n = 24) of the patients visiting individual specialty-specific clinics compared to 71% (n = 85) of patients who were seen through PMDC (p = 0.002). The adjusted odds ratio of completion of neoadjuvant therapy per institutional standards for patients seen through PMDC visit was 3.35 times the odds for patients seen through individual clinics (95% CIs 1.46-7.07; p = 0.004). Of note, a higher proportion of patients who were seen through PMDC enrolled in a clinical trial (n = 26, 16.6%) compared with patients seen through individual clinics (n = 6; 7.2%) (p = 0.043). Conclusions: Provision of care through a multi-disciplinary clinic was associated with significantly higher odds of completing neoadjuvant therapy per institutional standards as compared to care through individual specialty-specific clinics. In addition, care through a PMDC may also be associated with increased trial enrollment.
Road Traffic Accidents have emerged as the leading cause of mortality and morbidity globally. The burden of road traffic accidents has escalated gradually in Nepal and is a common cause of injury and trauma. The study aims to identify the prevalence of road traffic accidents in the emergency department.This descriptive cross-sectional study was conducted among hospital records of cases admitted to the emergency department of tertiary care hospital between March to August, 2020. Ethical approval was taken from the ethical review board of College of Medical Sciences (reference number: 2020-035). Information was collected through pro-forma and hospital records. Convenience sampling was done. The data were entered in the Statistical Package for the Social Sciences version 24 and analysed using descriptive statistics. Point estimate at 95% Confidence Interval was calculated along with frequency and proportion for binary data.Among 4050 cases presenting to the emergency department, 228 (5.6%) (4.9-6.3 at 95% Confidence Interval) cases of road traffic accidents were seen. The most common injuries involved were soft tissue injury 90 (39.47%) and head injury 77 (33.77%). Most patients admitted to the hospital were male 178 (78.07%) aged 21 to 30 years 79 (41.38%). The vehicles mostly involved in the accidents were motorized two-wheelers 120 (50.6%) and pedestrians 51 (22.4%).The prevalence of road traffic accidents was similar to the findings from similar studies. Strengthening the capacities of the pre-hospital care and emergency department is necessary along with preventive intervention in public to reduce such health burden.
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