Zimmermanli6839

In December 2019, the world was disrupted by the news of a new strain of virus known as Novel Corona virus, taking lives of many in China. Wuhan, the capital of Central China's Hubei province is said to be the place where the outbreak started. The city went on a lockdown as the disease spread rapidly. After the lockdown, most countries like India and Bangladesh airlifted their citizens who were studying in Wuhan. Similarly, Nepal also has many youth studying medicine in Wuhan. Pleas for help from the students reached the government. This was a first encounter of such experience for Nepal government. With the help of Health Emergency Organizing committee, Epidemiology and Disease Control Division, Nepal Army Hospital, Nepal Police Hospital, Waste Management team, Nepal Ambulance service, Tribhuwan Airport and Royal Airlines the government of Nepal planned, organized and successfully brought back all the 175 students on 15 the February, 2019 from Wuhan, China. The aim of the present article is to share the experience, the challenges faced and recommendations for future similar cases. Keywords evacuation; Nepal; Novel Corona virus; Wuhan.Quadruplet pregnancy is a pregnancy state where four fetuses grow simultaneously inside a mother's womb. Four fetuses developing in a womb is a challenge not only to the mother but to the obstetrician who has to calculate every risk associated with such pregnancy. High order pregnancy is considered a high risk pregnancy due to increase in maternal, fetal and neonatal morbidity and mortality. So a multidisciplinary approach with early involvement of neonatologists and anesthesiologists for the assessment of such case is essential for a successful obstetric outcome. Here we present a case report of 27 years G3P1L1A1 at 33 weeks 2 days of gestation with quadruplet pregnancy with previous lower segment Cesarian section with history of ovulation induction, delivered successfully via cesarean section with successful outcome of all 1 female and 3 male babies. Keywords case report; cesarean section; fertility agent; multiple pregnancy; pregnancy; quadruplets.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.Adult-onset Still's Disease is a rare auto inflammatory disorder of unknown etiology characterized mainly by high spiking fever, arthritis, evanescent rash and lymphadenopathy. It is a form of systemic onset juvenile rheumatoid arthritis that is encountered in adults, typically between 15-25 years and 36-45years. We here describe a 28 years lady with fever, arthritis of multiple large joints, lymphadenopathy and rash, with negative Rheumatoid factor and evidence of past infection with Ebstein-Barr virus and Parvovirus B19. History, examination findings and investigations showed several features consistent with adult-onset Still's disease along with high ferritin level. After exclusion of probable other diagnosis and use of Yamaguchi criteria, she was diagnosed with adult-onset Still's disease. All the major and minor criteria of Yamaguchi for diagnosis were met. Her disease responded well with steroid, she achieved remission and is currently under maintenance therapy. Keywords Adult-onset stills disease; arthritis; ferritin; fever.Hydatidiform mole is an abnormal pregnancy common in Asian populations compared to western countries; however, a partial hydatidiform mole is relatively uncommon and very challenging to diagnose on ultrasound. We reported a 24 years old female visited our clinic whose first antenatal visit was regular with normal viable fetus on ultrasonographic scan. However, an uneventful scan at 12 weeks period of gestation revealed a large irregular gestational sac with the disproportionately small embryo corresponding to 6+6 weeks with no cardiac activity. Additionally, there was markedly thickened placenta measuring 30mm in thickness without cystic spaces within the placenta. Further, her beta-human chorionic gonadotrophin level was very high and suction evacuation sample showed hydropic chorionic villi lined by trophoblastic cells with cistern formation and scalloped border. In conclusion, partial hydatidiform mole is an uncommon molar pregnancy rarely diagnose on ultrasonography. Late first-trimester scan and excessively high beta-human chorionic gonadotrophin levels confirm the diagnosis. Keywords Hydatidiform mole; molar pregnancy; partial hydatidiform mole.INTRODUCTION Hepatitis B is one of the most common contagious diseases in Nepal and is a signifi- cant public health issue. It is transmitted through contact with contaminated blood or other bodily fluids on broken skin or mucous membranes. Junior doctors and dentists are at particular risk of hepatitis B exposure. This study aims to find the level of knowledge of transmission and prevention of hepatitis B among the dental students. METHODS This was a descriptive cross-sectional study conducted among dental students and interns at Kantipur Dental College Teaching Hospital and Research Center, Kathamndu from January 2019 to February 2019 after ethical approval was provided by the Institutional Review Committee. The study included dental students and graduate intern doctors. Convenience sampling was done. Point estimate at 95% Confidence Interval was done along with frequency and proportion of binary data. RESULTS Out of one hundred forty two students, 68 (48%) of participants had completed a full course of hepatitis B vaccine. Thirty seven (26%) had started but had less than three recommended shots and 37 (26%) had not received any vaccines for hepatitis B prevention. Only 14 (10%) of the study group had checked their hepatitis B titer prior to commencing medical education. CONCLUSIONS There is also a lack of understanding of transmission, prevention and post exposure prophylaxis for hepatitis B infection among them among new health care providers in Nepal. This puts both the practitioners and patients at risk of chronic hepatitis B infection, which is unnecessary given cheap and easy prevention strategies, can virtually eliminate the risk.INTRODUCTION The incidence of oral cancer is rising due to overindulgence in tobacco chewing and smoking. Its detection in early stage makes it more amenable to treatment and helps to reduce associated morbidity. However, most cases are diagnosed at later stage due to lack of awareness about oral cancer and associated risk factors. This study aims to observe the oral cancer awareness among undergraduate dental students and dental surgeons of three dental institutions of Nepal. METHODS This descriptive cross-sectional study was conducted in three dental institutions of Nepal from January 2019 to May 2019. Convenience sampling method was used. The data was collected from 508 participants through questionnaire adopted from Carter and Ogden. Point estimate at 95 % Confidence Interval was calculated along with frequency and proportion for binary data. Statistical analysis was done using Statistical Package for the Social Sciences. RESULTS Our study showed that 120 (23.6%) of the participants were well informed about the clinical appearance of oral cancer at 95% confidence interval (19.91-27.29). Most of the participants i.e. 457 (89.96%) and 395 (77.75%) were aware that smoking and chewing tobacco were most commonly recognized risk factors. Only 200 (39.37%) participants were aware that non-healing ulcer is considered as the changes associated with oral cancer. Three hundred and forty-four (67.7%) said they have no knowledge about the prevention and detection of oral cancer. CONCLUSIONS Our study exhibited the apparent lack of awareness in some aspects of oral cancer and highlights the need of enhancing the undergraduate dental syllabus.INTRODUCTION Hypertension is one of the leading causes of death and disability in both developed and developing countries. The prevalence of hypertension is increasing rapidly worldwide. The aim of the study was to determine the knowledge of diet and exercise among hypertensive patients. METHODS This descriptive cross-sectional study was conducted using a structured questionnaire among 169 hypertensive patients at Kathmandu diabetes and thyroid center from May 2017 to July 2017 after taking ethical clearance from Nepal Health Research Council, Nepal. A convenience sampling method was used. Data was collected and entry was done in Statistical Package for the Social Sciences version 16.0 point estimate at 95% confidence interval was calculated along with frequency and proportion for binary data. RESULTS Out of total 169 participants enrolled in this study, only 79 (46.7%) had good knowledge and 90 (53.3%) had poor knowledge regarding diet and exercise. The mean age of participants was 54.68±13.91 years. CONCLUSIONS This study revealed that the knowledge about diet and exercise among hypertensive patients is poor and this study suggests the need for a proper educational intervention to improve awareness and to control hypertension effectively.INTRODUCTION Detailed clinical history through a properly filled requisition form can help a radiologist in making a diagnosis. The objective of this study was to observe the missing clinical details of Computed Tomography requisition forms at radiology department in tertiary care hospital. METHODS This descriptive cross-sectional study was done in 196 Computed Tomography requisition forms in the department of radiology from September 2019 to October 2019. Ethical clearance from the Institutional Review Committee - Reference No. 120720194 was obtained. An informed consent from the participants was taken prior to the procedure. Convenient sampling was done. The data obtained were computed and analyzed using Statistical Package for Social Sciences to tabulate the results. The results were displayed in frequency and proportion of binary data. RESULTS All the request forms had name filled, however date was filled in 183 (93.4%), age was filled in 195 (99.5%), sex was filled in 193 (98.5%) and address was only in 30 (15.3%) of the forms. Clinical history and provisional diagnosis were written in 179 (91.3%) forms. Signature was found in more than half of forms 135 (68.9%) whereas the department referring the patient was filled in 92 (46.9%) of forms and the name of doctor referring the patient was not filled mostly. The handwriting was clear in 191 (97.4%) of cases and standard words were used. Use of non-standard abbreviation was found in only 2 (1%) forms. CONCLUSIONS Clinical details were filled in most of the requisition forms however other parameters were still incompletely and inadequately filled.