Lumbini Medical College Research Articles

Health risk behaviors among medical and nursing students of Lumbini Medical College, Nepal: A cross-sectional study.

Healthcare students are expected to lead healthy lives yet they may engage in health risk behaviors (HRBs) like physical inactivity, poor diet, and substance use. These behaviors can have negative consequences for both the individual's health and well-being, as well as their ability to perform their future roles as healthcare providers. This study aimed to assess the prevalence of HRBs and associated factors among medical and nursing students at Lumbini Medical College, Nepal. A cross-sectional study was conducted among 412 undergraduate healthcare students using a self-administered questionnaire. HRBs across various domains were assessed. Validated scales screened for anxiety and depression. Regression analyses determined associations between mental health and HRBs. Low physical activity was prevalent, with only 10.7% exercising ≥5 times/week. Inadequate fruit/vegetable intake (1-2 servings/day) was reported by 79.9% students. Short sleep duration (5-6 h) on weeknights (51.2%) was common. More than three quarter (76.5%) of students met the screening cutoff score for HRBs. The study highlighted that students with addiction, depression and anxiety are more likely to exhibit HRBs (p < 0.01). Multiple HRBs were highly prevalent among the students. A considerable proportion demonstrated a clustering of risky lifestyle factors, which were linked to poor mental health. Interventions should address academic burden, promote positive health behaviors, and target mental well-being in this vulnerable group.

Evaluation of Errors on Death Certificates.

Death certificates provide vital data for disease surveillance and health policy. However, errors are common globally, undermining data reliability. This study analyzed prevalence and types of errors in death certificates at a tertiary hospital in Nepal. A cross-sectional study reviewed all death certificates issued at Lumbini Medical College, Nepal from April 2020 to April 2022. Certificates were assessed for errors including improper sequencing, absent time intervals, abbreviations, illegible writing, and inaccurate immediate, antecedent, and underlying causes of death as per international guidelines. Errors were classified as major or minor. Of 139 certificates, none were error-free. The most common error was incorrectly or incompletely filling the immediate cause of death (77.7%). Other errors included absent time of death (17.3%), abbreviations (57.6%), illegible writing (22.3%), and omitting the hospital stamp/medical council registration number (8.6%). Based on international criteria, 76.3% had minor errors, 23% had both major and minor errors. This study found a high rate of errors in death certification at a tertiary hospital in Nepal, undermining data accuracy. Regular training and monitoring with feedback are recommended to improve certification practices. Accurate cause-of-death data is vital for healthcare policy and decision-making in Nepal.

Study on Assessment of the Diameter of Thoracic Aorta by Computed Tomography of Chest

INTRODUCTION: Computed tomography (CT) is frequently used for the evaluation of different aortic diseases which is a good method of measuring the aortic diameter. Thus, knowledge of normal aortic diameters is very important in the assessment of aortic disease.&#x0D; METHODS: This was a prospective cross sectional study done on 105 patients who presented in department of Radiodiagnosis in Lumbini Medical College, Palpa, Nepal from February 5th 2022 to February 4th 2023. Plain helical scan was performed using Siemens Somatom 16 slice CT scanner. CT images were obtained in supine position with full inspiration. Diameters of the aorta was measured at the level of aortic valve sinus, ascending aorta, proximal to innominate artery, transverse aortic arch, distal transverse aortic arch, aortic isthmus and descending aorta at the level of diaphragm perpendicular to the axis of the aorta.&#x0D; RESULTS: Diameter of thoracic aorta was found to be maximum at ascending aorta with mean of 2.85 cm, followed by aortic valve sinus 2.80 cm, 2.68 cm at proximal to innominate artery, 2.57 cm at proximal transverse arch, 2.41 cm at distal transverse arch, 2.24 cm at isthmus and 2.03 cm at descending aorta at the level of diaphragm. There was smooth tapering of aortic diameter from ascending aorta onwards. There was a significant correlation of mean ascending aorta diameter with the age of the patients(r = 0.475, p&lt; 0.05).&#x0D; CONCLUSION: Diameter of thoracic aorta was found to be maximum at the level of the ascending aorta and minimum at the level of diaphragm. The diameter of thoracic aorta had significant correlation with the age of patients.

Women’s Satisfaction with Hospital Based Intrapartum Care in a Medical College of Western Nepal

INTRODUCTION Birth satisfaction is a multi-dimensional concept comprising structure, process and outcome of care that influence postnatal adjustment. Mother’s satisfaction during the birthing process is an important indicator in evaluating quality of maternity services. The aim of the study is to find out the women’s satisfaction with hospital based intrapartum care in a medical college of western Nepal. MATERIAL AND METHODS Cross-sectional analytical study was conducted to find women’s satisfaction with hospital based intrapartum care in a medical college of western Nepal among 332 postpartum inpatient women delivered in Lumbini Medical College and Teaching Hospital, Pravas, Palpa, who were selected by using purposive sampling technique. A pretested interview schedule was used for data collection. Descriptive statistics and inferential statistics were used for data analysis. RESULTS The study findings revealed that about half of the respondents (50.9%) were satisfied with hospital based intrapartum care. The level of satisfaction was significantly associated with gravida (p=0.008), type of labor onset (p=0.007) and episiotomy status (p&lt;0.001). CONCLUSION The study findings conclude that women attending teaching hospital for delivery tend to be somewhat satisfied with hospital based intra-partum care. Adequate counseling, reassurance and supportive care of women during intrapartum period might increase their satisfaction with intrapartum care.

Study of Electrocardiographic Changes and Spirometry Findings in Chronic Obstructive Lung Disease

Introduction: Chronic Obstructive Pulmonary Disease is one of the top three causes of death worldwide and patients have to do pulmonary function test by spirometry to diagnose and to evaluate the severity. Electrocardiogram abnormalities have been found uniformly increasing with the severity by Global Initiative for Obstructive Lung Disease stages.&#x0D; Aims: To know the role of Electrocardiogram in the evaluation of severity of Chronic Obstructive Lung Disease.&#x0D; Methods: This was conducted in the department of Internal Medicine of Lumbini Medical College Teaching hospital from December 2021 to June 2022. The Chronic Obstructive Pulmonary Lung Disease was established with history, examination and spirometry along with Electrocardiogram.&#x0D; Results: Among 72 patients included 40 (55.56%) were in mild to moderate stage and 32 (44.44%) were in severe stage. The mean Force Expiratory Volume in one Second/Force Vital Capacity of severe stage was 38.59± 6.9 and 66.32±7.37 in mild to moderate stages. The electrocardiographic abnormalities like right atrial enlargement (P –pulmonale), right ventricular hypertrophy, complete right bundle branch block, low voltage in limbs, right axis deviation, sinus tachycardia and supraventricular tachycardia were seen in severe stage with statistical significance (p&lt;0.05). Whereas left axis deviation and premature atrial contraction were found in mild to moderate disease and was statistically not significant.Increased percentage of normal electrocardiogram was found in mild or moderate than severe stage with statistical significance. So it is inversely related with the severity of disease.&#x0D; Conclusion: The relationship between Electrocardiogram findings and degree of airway obstruction was found to be highly significant. So, Electrocardiogram can be used as a surrogate investigation to evaluate the severity of Chronic Obstructive Pulmonary Disease.

Suicidal Ideation Among Medical and Nursing Students.

Suicidal ideation is a major predictor of suicide attempts. The present study was conducted to compare the prevalence of suicidal ideation and its risk factors among medical and nursing students in Nepal. An online survey was carried out among a cohort of medical and nursing students of Lumbini Medical College using questions derived from General Health Questionnaire-28 and Patient Health Questionnaire-9. 153 medical and 148 nursing students participated in the study. Lifetime suicidal ideation was present in 20.6%(n=62) medical and 13.95%(n=42) nursing students. Suicidal ideation in the last one year was present in 48 medical and 36 nursing students. There were higher odds of suicidal ideation in medical students who had parental neglect, psychiatric disorder, physical and sexual abuse, substance abuse, and academic performance dissatisfaction (p<0.05), whereas the odds were higher in nursing students with psychiatric disorder, parental demands, alcohol consumption, and academic performance dissatisfaction but was not statistically significant. Thematic analysis of the responses for open-ended question for reasons for previous suicide plans or attempts among four medical and eight nursing students revealed relationship issues, history of adverse childhood experiences, academics-related circumstances, and other individual problems as suicide antecedents. Periodic motivational speeches and counselling sessions during all the semesters of professional schooling would help decrease suicidal ideation. Mental health awareness programs for medical and nursing students should be aimed at reducing mental illness-associated stigma and promoting timely professional help-seeking behavior.

Prevalence of Workplace Violence among Nurses: A Descriptive Cross-sectional Study in Pravas, Palpa

Introduction: The World Health Organization defined Workplace violence as ‘Incidents where staff is abused, threatened or assaulted in circumstances related to their work, involving an explicit or implicit challenge to their safety, well-being or health. Nurses are the second highest group experiencing problems like verbal abuse, physical abuse and sexual harassment at the workplace. Workplace violence will not affect the victim’s life but also produce negative consequences for the organization itself by decreased productivity of the nurse, low employee morale between nurses and co-workers, increased job stress, absenteeism, and diminished public image and trust in the organization.&#x0D; Methods: A descriptive cross-sectional study was conducted to assess the prevalence and perpetrators of workplace violence among 109 nurses in Lumbini Medical College, Tansen, Palpa. Structured and pretested self-administered questionnaires were used for data collection using a proportionate simple random sampling technique.&#x0D; Results: More than three-fourths (78.9%) of participants said that they had ever been abused one way or the other. The prevalence of verbal violence (65%) was higher than the prevalence of emotional violence (50.5%) and physical violence (30.3%). Regarding the perpetrators, nearly three-fifths (61.5%) of respondents were abused by patients and more than half (51.4%) respondents were abused by the relatives of the patient. In almost all types of violence most of the victims; 23.94%, 30.9%, and 42.42% sought counseling in verbal, physical, and emotional violence respectively.&#x0D; Conclusions: Workplace violence is an alarming problem among nurses at the workplace in Lumbini Medical College, Palpa, Nepal. Verbal violence was more commonly encountered compared with physical, emotional and sexual violence.

Sphenopalatine Ganglion Block versus Conservative Management for Post Dural Puncture Headache in Cesarean Section

Introduction: Post-dural puncture headache is one of the frequently encountered and inevitable post-operative complications of the subarachnoid block. The primary treatment is always considered conservative management in such instances. However, an epidural blood patch remains an invasive gold standard treatment. Sphenopalatine ganglion block is propounded as minimally invasive with prompt and better outcomes. Objective: To assess the efficacy of Sphenopalatine ganglion block (SPGB) when compared to conservative management based on the onset of analgesia and its duration. Methods: This is a prospective study performed on 40 obstetrics patients who underwent Lower segment cesarean section in Lumbini Medical College and Teaching Hospital (LMCTH) who complained of Post dural puncture headache within 7 days. All the parturients are categorized into Group A, those who are treated with sphenopalatine ganglion block, and Group B, where post-dural puncture headache was treated with conservative management. Independent t-tests and Fischer’s test were used for statistical analysis. Results: The patients in group A showed positive outcomes where all of them were relieved of post-dural puncture headache within 10 mins after Sphenopalatine ganglion block (p&lt;0.001) and the mean pain score, based on a numerical pain rating scale was less or equal to 4 for the first 8 hours. Conclusions: Sphenopalatine ganglion block (SPGB) could be used as an effective first-line treatment modality in the management of post-dural puncture headache compared to conservative management.

Assessment of fear, anxiety, obsession and functional impairment due to COVID-19 amongst health-care workers and trainees: A cross-sectional study in Nepal.

The emergence of the COVID-19 epidemic threw the world into turmoil. The medical community bore the brunt of the pandemic's toll. Long work hours, and a lack of personal protective equipment (PPE) and social support all had an influence on mental health. This cross-sectional study was conducted among Lumbini Medical College Teaching Hospital students and employees in Palpa, Nepal. Data entailing their demographic details, pre-existing comorbidities, or death in the family due to COVID-19 was collected using a self-administered survey.In addition, the level of fear, anxiety, obsession, and functional impairment due to COVID-19 was recorded using previously validated respective scales. In total, 403 health-care workers and trainees participated in our study. The mean age of the study participants was 23±4 years, and more than half of them (n=262, 65%) were females. A significant association was found between fear score with age (p-value=0.04), gender (p-value <0.01) and occupation (p-value<0.001). The participants suffering from chronic diseases (p-value=0.36), were not found to be significantly obsessed with COVID-19. Age (p-value=0.34), was not found to be significantly associated with higher anxiety levels. Nursing students suffered from a significantly greater functional impairment than other health-care professionals (mean rank score=269.15, p-value < 0.001). A moderately positive correlation was observed between fear, anxiety, obsession, and functional impairment scales. This study revealed various socio-demographic characteristics as risk factors for psychological stress in the people related to the health-care profession of Nepal during the COVID-19 pandemic. A viable answer to this quandary might be adequate psychosocial intervention by health-care authorities, increased social support, and the introduction of better mental health management measures for the front-line health-care workers.

Assessment of fear, anxiety, obsession and functional impairment of COVID-19 amongst health-care workers and trainees: A cross-sectional study in Nepal

Background: The emergence of the COVID-19 epidemic threw the world into turmoil. The medical community bore the brunt of the pandemic's toll. Long work hours, and a lack of personal protective equipment (PPE) and social support all had an influence on mental health. Methods: This cross-sectional study was conducted among Lumbini Medical College Teaching Hospital students and employees in Palpa, Nepal. Data entailing their demographic details, pre-existing comorbidities, or death in the family due to COVID-19 was collected using a self-administered survey. In addition, the level of fear, anxiety, obsession, and functional impairment due to COVID-19 was recorded using previously validated respective scales. Results: In total, 403 health-care workers and trainees participated in our study. The average age of the study participants was 23±4 years, and more than half of them (n=262, 65%) were females. A significant association was found between fear score with age (p-value=0.04), gender (p-value <0.01) and occupation (p-value<0.001). The participants suffering from chronic diseases (p-value=0.36), and those who had experienced a COVID-19 death in the family (p-value=0.18), were not found to be significantly obsessed with COVID-19. However, for those who had experienced a COVID-19 death in the family (p-value=0.51) and age (p-value=0.34), these factors were not found to be significantly associated with higher anxiety levels. Nursing students suffered from a significantly greater functional impairment than other medical professionals (mean score=269.15, p-value < 0.001). A moderately positive correlation was observed between fear, anxiety, obsession, and functional impairment scales. Conclusion: This study revealed various socio-demographic characteristics as risk factors for psychological stress in the people related to the health-care profession of Nepal during the COVID-19 pandemic. A viable answer to this quandary might be adequate psychosocial intervention by health-care authorities, increased social support, and the introduction of better mental health management measures for the front-line medical workers.

Assessment of fear, anxiety, obsession and functional impairment of COVID-19 amongst health-care workers and trainees: A cross-sectional study in Nepal.

The emergence of the COVID-19 epidemic threw the world into turmoil. The medical community bore the brunt of the pandemic's toll. Long work hours, and a lack of personal protective equipment (PPE) and social support all had an influence on mental health. This cross-sectional study was conducted among Lumbini Medical College Teaching Hospital students and employees in Palpa, Nepal. Data entailing their demographic details, pre-existing comorbidities, or death in the family due to COVID-19 was collected using a self-administered survey.In addition, the level of fear, anxiety, obsession, and functional impairment due to COVID-19 was recorded using previously validated respective scales. In total, 403 health-care workers and trainees participated in our study. The average age of the study participants was 23±4 years, and more than half of them (n=262, 65%) were females. A significant association was found between fear score with age (p-value=0.04), gender (p-value <0.01) and occupation (p-value<0.001). The participants suffering from chronic diseases (p-value=0.36), and those who had experienced a COVID-19 death in the family (p-value=0.18), were not found to be significantly obsessed with COVID-19. However, for those who had experienced a COVID-19 death in the family (p-value=0.51) and age (p-value=0.34), these factors were not found to be significantly associated with higher anxiety levels. Nursing students suffered from a significantly greater functional impairment than other medical professionals (mean score=269.15, p-value < 0.001). A moderately positive correlation was observed between fear, anxiety, obsession, and functional impairment scales. This study revealed various socio-demographic characteristics as risk factors for psychological stress in the people related to the health-care profession of Nepal during the COVID-19 pandemic. A viable answer to this quandary might be adequate psychosocial intervention by health-care authorities, increased social support, and the introduction of better mental health management measures for the front-line medical workers.

Male genital injuries treated at a tertiary hospital in the western region of Nepal: A two-year snapshot.

Background: Male genital injuries are urological emergencies which if not promptly treated with correct therapeutic intervention may lead to loss of fertility due to infections and anatomical disruption of normalcy. This study highlights the clinical scenarios, etiology and outcome of male genital injury cases that were managed at a tertiary care center in Nepal. Such injuries are not frequently encountered as patients are hesitant to report such injuries. The present study is the first from Nepal which depicts a comprehensive report on male genital injuries. Methods: A retrospective analysis of discharge summaries of the cases of male genital injuries was reviewed during June 2020. All the treated cases during the two-year period from April 2018 to April 2020 at Lumbini Medical College, Nepal were included in the study. Results: There were eight cases of genital trauma admitted and treated during the study period. All the patients were males and age ranged from six to 71 years with a mean age of 33 ± 21.45 years. Fall injury and road traffic accidents (RTA) were observed to be the primary cause in the majority of cases. Conclusion: Superficial injuries to the penis and scrotum do not require surgical exploration and could be managed conservatively. However, deeper and complicated injuries, testicular preservation, the functionality of the part and cosmetic issues are taken into consideration which might require a multi-disciplinary approach. Apart from the medical issues pertaining to genital injuries, there are legal and psychological aspects of such events too which should not be ignored.

A study on referral of patients in Department of Psychiatry at Lumbini Medical College and Teaching Hospital

Introduction: In a developing country like Nepal, where there is inadequate awareness but more social stigma towards psychiatric illnesses among people, there is an important role of referral psychiatry. Referral psychiatry has been considered to be an interface between psychiatric and non-psychiatric medicines as practiced in general hospital settings. This study analyses the psychiatric problems among patient referred to psychiatry department from other outpatient departments and emergency department in a tertiary care centre. Methods: This was a descriptive hospital-based study conducted among patients who were referred to psychiatry department from different outpatient departments of Lumbini Medical College and Teaching Hospital from November 1, 2019 to April 30, 2020. Ethical issues were considered strictly. Data were entered into Statistical Package for the Social Sciences version 21.0 and descriptive analysis was done. Results: A total of 781 patients were referred out of which more than half (n=487, 62.35%) were females and the most common age group was 41 to 50 years (n=175, 22.4%). Majority of patients (n=284, 36.4%) were referred from medicine department. The most common psychiatric illness diagnosed were those included under International Classification of Diseases 10th Revision F40-48 (Anxiety, Dissociative, Stress-related, Somatoform and other Non-Psychotic Mental Disorders). Conclusions: Referral psychiatry plays an important role to diagnose the undiagnosed psychiatric illnesses earlier and better and manage accordingly so it should be prioritized and practiced in health centers.

Psychiatric Morbidity in Elderly Patients attending OPD of Lumbini Medical College and Teaching Hospital

INTRODUCTION: Geriatric psychiatry patients are increasing but enough work has not been done in this area of Nepal. We conducted this study to find out the prevalence of different psychiatric morbidities in elderly population and to find out if there are any age and gender specific differences. MATERIAL AND METHODS: Medical records of psychiatric patients above 65 years of age visiting outpatient department of Lumbini Medical College and Teaching Hospitalfrom April 1, 2018 to March 31, 2019 were reviewed. Risks of having different psychiatric disorders was estimated using odds ratio. RESULTS: A total of 300 cases were enrolled in the study. Mean age of the study group was 71.49(SD=6.99). There were more females. Depressive disorderwas the most common diagnosis followed by somatoform disorder, anxiety disorder, dementia and others. Depressive disorder was higher in females and in younger subgroup of the elderly patient.The risk of having dementia was higher in older group. CONCLUSION: Depressive disorder was the most common psychiatric disorderfollowed by somatoform disorder in elderly patients above 65 years of age. Male patients were more likely to suffer psychiatric disorder as compared to females in this age.

Readiness for Self-directed Learning among Nursing Students of Lumbini Medical College and Teaching Hospital: A Cross-sectional Study

Readiness for Self-directed Learning among Nursing Students of Lumbini Medical College and Teaching Hospital: A Cross-sectional Study

Clinico- etiological profile of acute poisoning and intoxication in children in western Nepal

Background: Pediatric poisoning is a common emergency. The present study was done to assess the incidence, clinico-etiological profile of acute poisoning and intoxication in children.Methods: This study was conducted in the Department of Pediatrics, Lumbini Medical College and Teaching Hospital, Nepal in which children aged less than 18 years, with history of consumption of poison accompanied or unaccompanied by container or poison or with doubtful history of consumption of poison but with definite signs and symptoms of acute poisoning we included. We also included children with history of bites by poisonous creatures like snakes, scorpions, bees and insects or with doubtful history of bites due to poisonous creatures but with definite acute onset of signs and symptoms locally or systemically.Results: In the present study, during the study duration, 68 children were included. The most common age group of included children was 1 to 5 years (59%). Accidental poisoning was reported in 93% of the cases, while the rest had suicidal poisonings. The most common type of poison used were different types of pesticides (46%). We observed that vomiting was the most common clinical presentation (79%). In our study sample, arrival of 46% of the children was delayed by 30 minutes to 2 hours. Majority of the patients arrived in the afternoon to the hospital (51%).Conclusions: The findings of the present study would enable emergency physicians to identify clinical features of common poisonings among children, which would enable manage the cases better.

Ormeloxifene in acute heavy menstrual bleeding in menopausal transition

Background: Ormeloxifene, a selective estrogen receptor modulator, is a safer, cost effective and convenient dosing medical therapy in heavy menstrual bleeding of acute abnormal uterine bleeding.&#x0D; Aims and Objective: The study aimed to find the effectiveness of Ormeloxifene as 1st line therapy for heavy menstrual bleeding in menopausal transition women to prevent unnecessary hysterectomies and improve quality of life.&#x0D; Materials and Methods: This descriptive study was conducted at Lumbini Medical College for a period of one year. Sixty-five cases of acute Abnormal Uterine Bleeding with heavy menstruation during menopausal transition period were provided with Ormeloxifene therapy of 60 milligrams dose two times per week after evaluating pre treatment hemoglobin percentage, Pictorial Blood Loss Assessment Chart (PBAC) score and endometrial thickness. The dose of the drug was reduced to 60 mg weekly after 3rd month if subjective improvement was documented and continued for further 3 months.&#x0D; Results: There was a statistically significant reduction in mean PBAC score, mean endometrial thickness and rise in hemoglobin level. Eighty percentages of women had marked subjective improvement of symptoms, 87.7% women had reduction of blood clots, 15. 8% women had relief from dysmenorrheal pain and 50.8% women had regularization of menstrual pattern after 6 months. Amenorrhea (25.3%) was the most common side effect reported in 6 months therapy.&#x0D; Conclusion: Ormeloxifene is an effective 1st line medical therapy in acute heavy menstrual bleeding in menopausal transition women.

Psychiatric Morbidity among Children and Adolescents Attending Psychiatric Clinic of a Tertiary Hospital

Introduction: A variety of psychiatric manifestations can be seen in children and adolescents below the age of 19 years. This study aims to examine the socio-demographic, morbidity profiles, and clinical correlates of child and adolescent patients attending the psychiatry out-patient clinic of Lumbini Medical College and Teaching Hospital (LMCTH).&#x0D; Methods: It was an observational, cross-section study involving case record analysis of all children and adolescent patients attending the psychiatry out-patient clinic between December 1, 2018 to November 30, 2019 in LMCTH, Nepal. Socio-demographic and clinical data were entered into computer software and analysed. &#x0D; Results: One hundred and forty cases fulfilling inclusion criteria were included in the study. There were 96 (68.6%) females and 44 (31.4%) males. Majority of the patients were from 16-19 years age-group. Cases from urban areas predominated the picture. Most common psychiatric diagnosis was conversion disorder (29, 20.7%) followed by depressive disorder (25 or 17.9%) and anxiety disorder (14, 10%). Majority of females had conversion disorder (25 or 26%) followed by seizure disorder (23, 24%) and depressive disorder (15, 15.6%) whereas majority of males had equal count of depressive disorder and seizure disorder (10, 22.7%) followed by anxiety disorder (7, 15.9%).&#x0D; Conclusions: Psychiatric illness was most common in children and adolescents in the age group 16-19 years, followed by 11-15 years age-group. They were more common in female sex, and slightly higher in those from urban background. Common psychiatric diagnoses were conversion disorder followed by depressive disorder and anxiety disorder.

Prevalence of Refractive Error and Associated Risk Factors in School-Age Children in Nepal: A Cross-sectional Study

Introduction: The most common visual disorder in school age children is refractive error globally. The present study aimed to know the prevalence of refractive errors and explore the factors associated with the refractive error in school-age children in Palpa district of western part of Nepal. Methods: All the school children were selected between age groups 5 to 18 years from four schools of Palpa by multistage sampling method. After the preliminary examination on visual acuity, the children were referred to the Department of Ophthalmology, Lumbini Medical College, Palpa for confirmation of the refractive errors. Results: In school-age children the prevalence of refractive error was 9% of which myopia was the most common (4.05%). Females (about 12%) were more likely to have refractive errors than males (about 7%). The refractive error of males was 0.106 (right eye) and 0.564 (left eye) times more likely than females. The refractive errors were statistically found more common in Dalit students (14.6%) than Brahmin/Chhetri (about 12%) and Janajati (7.6%). The prevalence of refractive errors among students using smart phone/ laptop (about 12%) was higher than those not using (8.36%). Conclusion: Sex, ethnicity, and near-work activity like using the smart device were the covariates of developing refractive error on the eye. Myopia was more among those students who were using smartphones/laptops. Near activities stress on eyes of the children and might be one of the causes of developing myopia.

Assessment of Prescription Errors in the Internal Medicine Department of a Tertiary Care Hospital in Nepal: A Cross-Sectional Study

Introduction: Prescription errors are common problems in hospitals that lead to increase in morbidity, mortality and cost of treatments. They also reduce faiths towards healthcare providers. They are avoidable and their adverse outcome can be reduced if they are assessed and recognized earlier. This study was conducted to assess prescription errors occurred in tertiary care hospital Methods: A cross sectional study was conducted in Internal Medicine department of Lumbini Medical College for five months duration. Patients who prescribed at least one drug in prescription form were included. Results: Out of total patients, 39.5% had medication error. Among medication errors, 37.6% patients had error of omission. Among error of omission, dose of the drug was not mentioned in 26.1% patients. Category B (21.6%) of severity of medication error was the most common. Patients with one diagnosis less likely had medication errors comparing to the patients with more than one diagnosis (p = 0.0002). The tendency of making medication errors was higher among patients with polypharmacy (p < 0.001) and patients who prescribed Fixed-Dose Drug Combination (p < 0.001). Similarly, the tendency of making errors of omission was also higher among patients with more than one diagnosis (p = 0.0002), patients with polypharmacy (p < 0.001) and patients who prescribed Fixed-Dose Drug Combinations (p < 0.001). Conclusion: One-third of patients had medication errors. Among them, errors of omission were the most common. The collaborative program between doctors, clinical pharmacologists and hospital administration to minimize the occurrence of errors will be effective.