Universal College Of Medical Sciences Research Articles

FREQUENCY OF SECOND MESIOBUCCAL CANAL IN PERMANENT MAXILLARY SECOND MOLARS AT A TERTIARY CARE CENTRE OF NEPAL

Background: The success of endodontic treatment relies on the precise identification of root canals followed by cleaning, shaping, and obturating the canals. Mesiobuccal root of maxillary second molar teeth present wide variations with regard to the number and type of root canals. The complexity of the root canal varies widely in different ethnic groups. The study aimed to determine the prevalence of second mesiobuccal canal (MB2 canal) in maxillary second molar. Methods: A descriptive cross-sectional study was conducted at Department of Conservative Dentistry and Endodontics, Universal College of Medical Sciences, Bhairahawa. A total of 100 permanent maxillary second molar undergoing endodontic treatments were studied. After access cavity preparation ultrasonic tips and magnification loupes were used to open the subpulpal groove in a direction from first mesiobuccal (MB1) canal towards the palatal canal to locate the second mesiobuccal (MB2) canal. Radiovisiography (RVG) was taken to confirm the presence of MB2 canals. Results: MB2 canals were detected in 52 teeth out of 100 teeth that were studied. It was found that the younger adult (18-35 years) tends to have a higher proportion of MB2 canals (65.6%) as compared to the middle-aged elderly (36-55years) in whom it could be identified only 33.4% of the time. Conclusions: Based on this study, it can be concluded that the prevalence of MB2 canal in mesiobuccal root of the permanent maxillary second molar is high.

Prevalence of Diabetes, Hypertension and Obesity among Doctors and Nurses in Universal College of Medical Sciences, Bhairahawa, Nepal

INTRODUCTION Hypertension (HTN) and diabetes mellitus (DM) both are rapidly emerging as public health problems in developing countries. Hypertension is the leading cause of cardiovascular disease and is also a major cause of disability, causing an estimated 13% of all deaths in the world. Diabetes mellitus, hypertension and obesity are very strongly associated with cardiovascular diseases all over the world. MATERIAL AND METHODS A cross sectional study was done among the doctors and nurse working in UCMS teaching hospital from Sep, 2020 to  Feb, 2021. A total of 138 doctors and nurses were selected using a simple random sampling technique. Descriptive statistical analysis was used for the calculation of central tendency and dispersion measures. Chi- Square test was applied for categorical predictors and P value of less than 0.05 was considered as statistically significant. RESULTS Doctors formed 47 % while nurses formed 53% of the study population. Prevalence of hypertension was found to be 18% among doctors and 7% among nurses. Prevalence of diabetes mellitus was found to be 6% among doctors and 8% among nurses. Prevalence of obesity was found to be 47% among doctors and 48% among nurses. The overall prevalence of hypertension, diabetes mellitus and obesity was the order of 25%, 14% and 95% respectively. CONCLUSION These findings provide important information on prevalence of hypertension, diabetes mellitus and obesity along with its associ- ated risk factors among doctors and nurses working in UCMS teaching hospital. Preventive health measures like low fat diet, physical activity, cessation of smoking, control of alcohol and various strategies are needed for the prevention of these cardio-vascular disease among doctors and nurses working at UCMS teaching hospital.

Diabetes Mellitus & Thyroid Dysfunction in Vitiligo of Terai Regions of Nepal

INTRODUCTION Vitiligo is common acquired disease. Clinically it present with depigmented, macules and patches. Vitiligo has been shown association with many autoimmune diseases like Diabetes mellitus, Thyroid disorders, Graves disease, pernicious anemia, etc. This study was undertaken to assess the prevalence and association of diabetes mellitus and thyroid dysfunction in vitiligo patient. MATERIAL AND METHODS This study was a case control study carried out in Dermatology Department, Universal College of Medical Sciences – Teaching Hospital (UCMS-TH) from Dec 2022 to Nov 2023. 70 cases of Vitiligo and 70 control with same sex, ages and gender matched were enrolled. All patients in both the group, we performed thyroid function test and fasting blood sugar. RESULTS Out of 70 cases, 6 (8.6%) people has impaired FBS and 6 (8.6%) people have high T3 & T4 and 10 (14.3%) people have high TSH whereas 3 (4.3%) people have low T3 & T4 and 4 (5.7%) people have low TSH. Association with different age group in both case and control group with fasting blood sugar and thyroid function test was seen which was statistically not significant. CONCLUSION There were impaired fasting blood sugar and abnormal thyroid dysfunction in many cases. Therefore vitiligo patient needs to undergo thyroid function test and blood sugar level to prevent the complication.

Status of glycemic control and lipid profile in type 2 diabetes mellitus: A descriptive cross-sectional study

Introduction: Dyslipidemia in diabetes mellitus is commonly seen in the form of high total cholesterol (TC), high lowdensity lipoprotein (LDL), high triglyceride (TG) and low high-density lipoprotein (HDL) levels. This study was done to study the association of glycemic control with lipid profile in Type 2 Diabetes Mellitus (T2DM) patients. Methods:This was a cross sectional, observational study conducted from December 2018 to June 2020 at Universal College of Medical Sciences and Teaching Hospital, Bhairahawa. It involved 125 patients of type 2 diabetes mellitus (68 males and 57 females), who visited in outpatient department of Internal Medicine. Laboratory tests [(Fasting Blood Sugar(FBS), Post Prandial Blood Sugar (PPBS), Glycosylated Hemoglobin (HbA1c), Renal Function Test (RFT) and Fasting Lipid Profile] were noted. The data was analyzed with SPSS Version 25. Descriptive statistics like frequency, percentage,mean and standard deviation (SD) were calculated. Independent t-test was used to measure the association between glycated hemoglobin with blood glucose level and glycated hemoglobin with lipid profile. Results: The study patients were categorized into two groups on the basis of HbA1C level [(good glycemic control ≤7 (n=33) and poor glycemic control >7 (n=92)]. In good glycemic control the mean TC was 143.30, LDL 71.88, HDL 43.70, VLDL 29.55, TG 134.39 mg/dl while in poor glycemic control the mean TC was 182.47, LDL 114.85, HDL 32.03. VLDL 36.61, TG 179.33 mg/dl with p-value <0.05. Conclusions: There was significant positive association of HbA1c with TC, LDL, VLDL, TG and significant negative association with HDL.

A Descriptive Cross-Sectional Study of Urinary Tract Abnormalities Utilizing Multi-Detector Computed Tomography Urography

INTRODUCTION Multidetector Computed Tomography Urography (MDCTU) is presently considered the preferred imaging modality for the urinary tract. Advanced MDCTU enables a comprehensive assessment of the kidneys, ureters, urinary bladder. MDCTU is commonly employed to investigate various conditions such as renal calculi, renal cysts, congenital kidney and ureter abnormali- ties, and specific renal inflammatory conditions. The objective of this study was to evaluate the diagnosis of various urinary tract abnormalities using MDCTU. MATERIAL AND METHODS This descriptive cross-sectional study was conducted from June to August 2023, at the Department of Radiodiagnosis & Medical Imaging, Universal College of Medical Sciences and Teaching Hospital, Bhairahawa, Nepal, examined a total of fifty-nine patients. The examination protocol comprised triphasic techniques, which included unenhanced, nephrographic, and excretory phases, utilizing a MDCT scanner. The descriptive data were analyzed using SPSS version 20 and presented in the form of a number and percentage. RESULTS A total 59 patients, 32 were male and 27 were female. Mean age of patients were 44.17±15.66 years, with the majority (28.81%) falling within the age range of 20-30 years. Abdominal pain was the most common symptom (79.66%), followed by hematuria (18.64%). Urolithiasis was the most frequent diagnosis (47.46%), followed by ureterohydronephrosis (22.03%) and hydrone- phrosis (18.64%). Inflammatory change/infection affected 13.56% of patients, while congenital abnormalities were the least prevalent (3.39%). CONCLUSION MDCT urography is considered the optimal modality for detecting a broad range of urinary tract abnormalities, due to its utilization of a combination of unenhanced, nephrographic-phase, and excretory-phase imaging techniques.

Hematological Parameters in Adult Type 2 Diabetes Mellitus Patients Visiting a Tertiary Care Center of Western Nepal

INTRODUCTION Various mechanisms suggest changes in hematological profiles of Type 2 Diabetes Mellitus (T2DM) patients. Similarly, alterations in hematological profiles have been linked with pathogenic mechanisms in Diabetes. We aim to determine hematological profiles of adult MATERIAL AND METHODS This hospital-based cross-sectional study was conducted from March 2020 to December 2020 at the department of Pathology and Biochemistry of Universal College of Medical Sciences. After ethical clearance (UCMS/IRC/016/20), 90 adult patients diagnosed with T2DM were considered. Both verbal and written consent was taken. Type 1 diabetics, patients with history of hemoglobinopathies, recent blood transfusion, chronic illnesses and acute infections, and whose peripheral smear showed dimorphic pictures were excluded. The glycemic and hematological parameters were estimated. The data were analyzed using SPSS (version 20). Categorical data were expressed in frequency and percentage. Numerical data were expressed as median (interquartile range). Mann-Whitney U test was used to compare the hematological parameters between patients with good and poor glycemic control. RESULTS Among the total 90 participants, 34.4% had anemia. Mean Corpuscular Hemoglobin Concentration (MCHC) correlated positively with both Random Blood Sugar (RBS) and HbA1C. RBC count and Packed Cell Volume (PCV) were significantly higher in patients with good glycemic control, whereas MCHC was significantly lower in that group. CONCLUSION High prevalence of anemia was noted in T2DM patients. RBC and PCV levels were significantly lower in patients with poor glycemic control and MCHC levels were significantly lower in patients with good glycemic control.

A Critical Study of Attitudes of MBBS and BDS Students Towards Their Future Profession

INTRODUCTION The attitudes of the students play a very vital role in choosing a particular career. The amount of study in MBBS and BDS is significantly higher than many other professions. Hence the present study was designed to assess and explore the attitudes of MBBS and BDS students towards their future medical profession. MATERIAL AND METHODS A descriptive, cross-sectional study was conducted by administering online Google Form questionnaire to all MBBS and BDS students (1st year to 4th year) Universal College of Medical Sciences, and College of Dental Surgery, Bhairahawa, Nepal, during the period of 1 October, 2020 to 30 December, 2020, using non-probability purposive sampling. The sample size of the present study is 283 (198 MBBS and 85 BDS). The questionnaire was consisting of 32 statements, both positive as well as negative (Likert scale), on 5 options via strongly disagree, disagree, neutral, agree and strongly agree, was mailed to all students. The students were asked to read each statement carefully and click on their opinion/response. RESULTS The overall mean and standard deviation for MBBS students’ attitude towards their medical profession was 3.73 and 0.87 respec- tively. Similarly, the overall mean and standard deviation for attitude of BDS students’ towards their future profession was 1.60 and 0.37 respectively. CONCLUSION Both MBBS and BDS students were having a positive and right attitude towards their future medical profession.

Overweight Among Medical Students in Universal College of Medical Sciences: A Descriptive Cross Sectional Study

INTRODUCTION Overweight is a lifestyle disorder affecting both physical and psychological health of a person. The rate of overweight index is rising in people from all walks of life. The main aim of this study is to find out the prevalence of overweight among medical students in a tertiary care center creating self-awareness in them. MATERIAL AND METHODS This is a descriptive cross-sectional study done in 385 students in a tertiary care hospital from 15th August 2022 to 30th Novem- ber 2022.The sample was collected by simple random sampling method after the approval from the Institutional Review Committee of Universal College of Medical Sciences (reference number UCMS/IRC/100/22). Height in meter and weight in kilogram of students were measured to calculate body mass index and grouped according to Asian Criteria categories normal BMI is between 18.5 to 22.9 kg/m2, BMI 23 to 24.9 kg/m2 would be considered as overweight and BMI > 25 kg/m2 would be considered as obese. Data was analyzed by using Statistical Package of Social Science software version 16. RESULTS Among 385 students, 70 (18.1%) were found to be overweight with 95% Confidence Interval. Overweight males were 37 (9.6%) and females were 33 (8.5%) respectively out of the total number of male 173 (44.93%) and female 212 (55.07%). The mean age of the students and the mean BMI was found to be 21.01 ± 2.01 and 22.39 ± 3.54 respectively. CONCLUSION The current study shows the prevalence of overweight among medical students is slightly higher than in studies done in similar settings.

Maternal and Fetal Outcome in Cases of Preeclampsia and Eclampsia in Tertiary Care Center of Nepal

INTRODUCTION Hypertensive disorders of pregnancy includes Gestational Hypertension, Preeclampsia and Eclampsia, Chronic Hypertension and Preeclampsia superimposed in Chronic Hypertension. These condition complicates around 5 to 10 percent of pregnancies and have significant contributions on maternal and fetal adverse outcome. This study was done to find out the maternal and fetal outcome in cases of Pre-eclampsia and Eclampsia. MATERIAL AND METHODS It was a hospital based cross sectional observational study done in department of Obstetrics and Gynecology of Universal College of Medical Sciences from August 2021 to June 2022. Maternal and fetal outcome in Preeclampsia and eclampsia were studied in 116 cases. RESULTS Incidence of diseases was 5.94%, preeclampsia 33(28.4%), eclampsia 23(19.8%) and severe preeclampsia 60 (57.7%). Adverse maternal outcome were HELLP (Hemolysis, Elevated liver enzyme and Low platelets counts) syndrome 15 (12.93%), Abruption placenta 7(6.03%), need of blood transfusion 20 (17.24%), Pulmonary Oedema 3(2.58%), Post-Partum Hemorrhage 3(2.58%) and one case had maternal death. Total 121 babies were born, 42(36.20%) admitted in NICU, 10(8.26%) were intra uterine fetal death (IUFD), 3 (2.48%) were neonatal death (NND), 10(8.26%) refused treatment and leave against medical advice. Common fetal morbidities were intra uterine growth restriction (IUGR) 29 (23.76%), preterm Low birth weight 22(18.18%), anomalous baby 3(2.48%) and congenital pneumonia 1 (0.83%). CONCLUSION Proper Antenatal care and screening, timely referral and prompt management favoured the outcome in positive way.

Formulation and In-Vitro Evaluation of Fast Dissolving Oral Films of Promethazine

INTRODUCTION Fast disintegrating/dissolving medicine delivery devices are oral films that swiftly disintegrate or adhere in the mouth. It includes the ability to administer systemic medications without having any first-pass effects. A first-generation antihistamine from the phenothiazine family is promethazine HCl. It is effective in treating motion sickness but it has a poor oral bioavailability. The study aims is to formulate promethazine fast dissolving oral film using natural and synthetic polymers and compare the formulations. MATERIAL AND METHODS This experimental study was conducted in the Pharmaceutic laboratory of Department of Pharmacy at Universal College of Medical Sciences, Bhairahawa, Nepal from February 2022 to July 2022.  Fast dissolving oral films of promethazine were prepared by solvent casting method using polymers and plasticizers in varying concentrations. Weight variation, thickness variation, surface pH, folding endurance, swelling index, disintegration duration, dissolution study and medication content were among the several in vitro assessment criteria that were identified. RESULTS When examined for physical characteristics, thickness, weight uniformity, in vitro disintegration time, folding durability, drug content, and an in vitro drug release, films were determined to be adequate. The films of the F2 formulation demonstrated an increased rate of drug dissolution with a drug content of 99.17%, a disintegration time of 38 sec, and a drug release of more than 99% within 16 min. CONCLUSION Synthetic polymer (Hydroxypropyl methyl cellulose) showed better result in comparison to natural polymer (Sodium alginate).

Blunt Pulmonary Contusion: Admission Computed Tomography Scan Predicts Mechanical Ventilation

INTRODUCTION Road traffic injury is one of the fastest growing health problems in Nepal with increasing number every year leading to morbidi- ty and mortality. Blunt pulmonary contusion may not be seen in the initial plain radiographs as they evolve over 12-24 hours. Thus CT (Computed Tomography) scan can provide detailed information about the contusion and predict the need for mechanical ventilation. MATERIAL AND METHODS This is a prospective, observational longitudinal study conducted at Universal College of Medical Sciences, Bhairahawa from 1st January 2020 to 31st December 2020. The predictors for requirement of mechanical ventilation like Abbreviated Injury Scale (AIS), Injury Severity Score (ISS), GCS score and number of fractured ribs at the time of admission were recorded. RESULTS In this study, 100 cases with blunt pulmonary contusion were evaluated. Average age of patients with blunt pulmonary contusion was around 39.10±17.56 years with male predominance (82%). Total of 7 patients required mechanical ventilation among whom the AIS chest was 3.0±0.82, ISS score was 29.14±6.89, and GCS 9.14±3.13. The ROC curve showed that ISS score predicted significantly about the requirement of mechanical ventilation with sensitivity of 85.5% and specificity of 99.8 %. CONCLUSION Initial CT done in patients can show the presence or absence of pulmonary contusion and associated thoracic injuries and along with AIS, ISS and GCS scores we can predict early the requirement of mechanical ventilation.

Depression and Its Determinants among Postpartum Mothers Attending at Universal College of Medical Sciences and Teaching Hospital, Bhairahawa, Rupandehi, Nepal.

Postpartum depression is a serious mental health issue linked to maternal morbidity and negative effects for infant's normal growth, development, and well-being. This study is aimed at assessing the prevalence and factors associated with postpartum depression among mothers attending a tertiary hospital in Nepal. A hospital-based cross-sectional study was conducted among 173 postpartum mothers (<6 weeks postdelivery) who were receiving care either at the postnatal ward or immunization clinic of Universal College of Medical Sciences and Teaching Hospital in Bhairahawa, Rupandehi district, Nepal. The study was carried out from October 2020 to February 2021 by using purposive sampling technique for selecting respondents. The variables that showed significant association with the dependent variable having p value < 0.05 in bivariate analysis were entered into multivariate logistic regression model to find the final associated factors. The prevalence of postpartum depression was 20.2% among mothers attending a tertiary hospital in Nepal. The mean age of the respondents was 24.77 ± 3.47. Factors such as mothers having female child (AOR = 6.39, CI = 1.54 - 26.46), unplanned pregnancy (AOR = 10.08, CI = 2.91 - 34.94), pregnancy-induced health problems (AOR = 9.68, CI: 3.51-26.64) were associated with an increased risk of postpartum depression. Similarly, mothers having formal education (AOR = 0.28, CI: 0.08-0.91), whose spouses have secondary and above education (AOR = 0.16, CI: 0.03-0.85), and who have ≥4 ANC visits (AOR = 0.15, CI = 0.05 - 0.40) were significantly associated but have a protective effect with postpartum depression. Sex of newborn, mother's and spouse's education, intention of pregnancy, ANC visits, and pregnancy-induced health problems were found to be significantly associated with postpartum depression. Hence, specific health education program regarding maternal and child health integrating mental health should be provided to pregnant women, mothers, and their husbands, focusing on gender discrimination. Similarly specific orientation program should be provided to local health worker about the importance of planned pregnancy, in order to reduce pregnancy related health problems during ANC visits and to mothers after their delivery to reduce further chances of postpartum depression.

Assessment of Polypharmacy among Diabetic Patients in Tertiary Care Hospital of Nepal

Background &amp; Objective: Diabetes mellitus is a long-term metabolic condition that is accompanied by co-morbidities. Patients therefore use anti-diabetic medications in addition to other medications. Treatment with numerous drugs involves many hazards in addition to effectiveness. Therefore, diabetic people use multiple medications. The main aims of this study were to find out the prevalence of polypharmacy and the factors responsible for polypharmacy, and the consequences of polypharmacy. Material and Methods: A prospective observational study was conducted at the outpatient department of the Universal College of Medical Sciences and Teaching Hospital, Bhairahawa, Nepal from 12th February to 31st March 2021. A total of 150 patients who met the inclusion criteria and agreed to give written informed consent were enrolled in this study. A pre-validated questionnaire was used to assess polypharmacy among diabetic patients. The Statistical Package for Social Sciences (SPSS) software version 20 was used to enter and analyze data. Results: A total of 150 diabetic patients were included in this study. Among them, about 62.66% had polypharmacy. Age and duration of disease were highly significant with polypharmacy. Coexisting chronic conditions were highly associated with polypharmacy, like cardiovascular (AOR=5.552), musculoskeletal (AOR=5.050), mental (AOR=7.835), and digestive (AOR=3.778). The most common oral anti-diabetic agent was metformin. Conclusion: Polypharmacy was highly prevalent among diabetic patients. The rate of polypharmacy increases as the age and duration of disease increases. Polypharmacy has many consequences, like adverse drug events, increased costs, decreased compliance, and decreased quality of life.

Complications of Arterio-Venous Fistula in Patients Undergoing Haemodialysis.

Vascular access is required for hemodialysis and arterio-venous fistula is the preferred access. Various guidelines have recommended monitoring and surveillance of arterio-venous fistula as the standard of care. This study looked into usefulness of clinical examination to detect complications of arterio-venous fistula. The study was conducted in the from February 2022 till September 2022 under Nephrology unit, Departement of Internal Medicine at Universal College of Medical Sciences. Ethical clearance was taken. Patients undergoing hemodialysis were enrolled in the study. After informed and written consent, clinical examination of arterio-venous fistula was done by look, listen and feel method. Data was collected as per the approved performa. Statistical analysis was done using Statistical Package for the Social Sciences software version 17. Total enrolled study population was 73. Mean age of the study population was 47.45 years ± 14.60 years with a Male: Female ratio of 1.3:1. Complications were seen in a total of 33 patients with an overall rate of 45.2%. The mean duration of AVF creation was 32.68 ± 24.56 months. Most common complication of arterio-venous fistula was overall stenosis 18 (24.7%). There is a higher rate of complications of arterio-venous fistula. Monitoring and surveillance of arterio-venous fistula should be performed as a standard of care in every hemodialysis centre.

A Study of Management of Adverse Reaction to Iodinated Contrast Media used in Computed Tomography at UCMS-TH

INTRODUCTION: Iodinated contrast media is used in computed tomography imaging to enhance the visibility of blood vessels and tissues. They have distinct clinical effectiveness and toxicity profiles. Although low osmolar contrast media have made iodinated contrast media safer in recent years, adverse reactions can sometimes occur. The management of adverse reactions to iodinated contrast media is an important aspect of patient care during computed tomography examinations. The purpose of this study was to evaluate the management of adverse reactions to iodinated contrast media during contrast-enhanced computed tomography examinations at Universal College of Medical Sciences and Teaching Hospital, Bhairahawa, Nepal. MATERIALS AND METHODS: A prospective, observational study was conducted on 323 patients at Department of Radiodiagnosis and Medical Imaging, Universal College of Medical Sciences and Teaching Hospital, Bhairahawa, Nepal, from December 15, 2022 to May 15, 2023. All data was obtained from the Department of Radiodiagnosis and Medical Imaging, as per the study inclusion criteria. The data were analyzed with statistical package for the social sciences version 20. RESULTS: The mean age of study participants was 48.49±19.78 years. There were 34.67% male and 65.33% female patients involved in this study. Universal College of Medical Sciences and Teaching Hospital favoured a more strict approach, to determine the normal renal function and withhold metformin before iodinated contrast media exposure. 36.84% of patients had a history of previous adverse reactions, before undergoing contrast-enhanced computed tomography scans. Following iodinated contrast media administration, 94.74% experienced nausea and vomiting which was followed by mild urticarial (88.54%) and dyspnea (19.81%). Premedication protocol was predominantly implemented with antihistamine, pheniramine (73.1%), and corticosteroid, hydrocortisone (26.9%). Mild urticaria was treated with pheniramine (87.1%), nausea and vomiting was treated with metoclopramide (83.01%), dyspnea was treated by epinephrine, hydrocortisone and oxygen (9.38%). CONCLUSIONS: Universal College of Medical Sciences and Teaching Hospital has established a standard protocol for the management of adverse reactions experienced by patients during iodinated contrast media administration. Premedication with antihistamines and corticosteroids was recommended for highrisk patients.

Drug Utilization Pattern in Pneumonia among Pediatric Patients at a Tertiary Care Hospital

INTRODUCTION: Pneumonia remains the leading cause of hospitalization and mortality in young children in low and middle-income countries like Nepal. Antibiotics are commonly prescribed for pediatric pneumonia patients. To prevent antimicrobial resistance, antibiotics must be prescribed rationally. Therefore, the purpose of this study was to evaluate the drug utilization pattern in pediatric pneumonia patients at a tertiary care hospital by using World Health Organization (WHO) prescribing indicators. MATERIALS AND METHODS: A descriptive cross-sectional study was conducted among pediatric pneumonia patients at Universal College of Medical Sciences, Bhairahawa, Nepal from December 2022 to May 2023. Ethical approval was taken from the Institutional Review Committee (UCMS/IRC/191/22) and the purposive sampling method was used. Data were collected from pro-forma to assess WHO prescribing indicators and analyzed in Statistical Package for Social Sciences (SPSS) version 20 program and expressed as frequency and percentage for all variables. RESULTS: A total of 1408 drugs were prescribed to 196 prescriptions or patients. The average number of drugs per prescription was 7.18. The most common 51.5% of prescriptions contain 4-5 drugs per prescription. The percentage of prescriptions with antibiotics and injections was 100% respectively. Drugs prescribed by generic name were 44.24% and those matched to the national Essential Drugs List of Nepal were 53.19%. Cephalosporins (86.7%) were the most frequently prescribed antibiotics followed by aminoglycosides (79.1%). All the antibiotics were given parenterally (100%). CONCLUSIONS: The study reported inadequate compliance with WHO prescribing indicators and recommended policy formulation and application by regulatory agencies to promote the drug utilization study.

Drug Utilization Pattern and Cost Analysis of Drugs used at Dermatology Out Patient Department in a Tertiary Care Hospital

INTRODUCTION&#x0D; The irrational prescription of drugs is highly prevalent among patients suffering from skin diseases. Since it has a serious impact on health and economy, there is an urgent need to study drug utilization pattern in hospital settings. Therefore, this study aims to investigate drug utilization pattern and its cost analysis in Dermatology Out Patient Department in a tertiary care teaching hospital.&#x0D; MATERIAL AND METHODS&#x0D; A four-month, prospective, cross-sectional descriptive study was conducted from 10th February 2022 to 10th June 2022 in newly diagnosed cases attending Out Patient Department of dermatology at Universal College of Medical Sciences, Bhairahawa, Nepal. Ethical approval was obtained from the Institutional Review Committee (UCMS/IRC/037/22). Purposive consecutive sampling technique was used. The data were collected from patient cards and details were filled in predesigned proforma. The collected data were analyzed in Statistical Package for Social Sciences version 20.&#x0D; RESULTS&#x0D; A total of 601 prescriptions were scrutinized. The common skin condition found was eczema (9.98%) while the common classes of drugs prescribed were antifungals (31.94%). The number of drugs per prescription varied from one to five with an average of 3.11. It was observed that 3.95% of prescription was by generic names. The maximum of drugs (36.06%) was prescribed in tablet form. The percentage of antibiotics prescribed and drugs prescribed from the WHO Essential Drugs List were 12.31% and 27.88% respectively. The average cost per prescription calculated was 739.39 Nepali Rupees.&#x0D; CONCLUSION&#x0D; A drug utilization study can help to rationalize prescriptions, reduce errors, and improve cost-effective treatment.

Clinico-Etiological Profile and Outcome of Neonatal Seizures - A Hospital-Based Cross-Sectional Study in Western Nepal

INTRODUCTION&#x0D; Neonatal seizure, a common problem encountered in neonatal intensive care unit (NICU) setting, is an important determinant of outcome of neurological disorders in newborn period. The aim of the study was to study the clinical and etiological profile of neonatal seizures along with their outcomes.&#x0D; MATERIAL AND METHODS&#x0D; A prospective observational study was conducted in the NICU of Department of Pediatrics at Universal College of Medical Sciences, Bhairahawa, Nepal from November 2019 to March 2021. Babies with neonatal seizures were enrolled in the study after obtaining written consent from parents.&#x0D; RESULTS&#x0D; Out of 870 admitted neonates, 9.7% (n=85) developed clinical seizures where 62.4% were males. Most cases (87.1%) had seizures within 48-hour of life with subtle seizures (92.9%) being the commonest. About 43.5% cases had single episode of seizure followed by multiple episodes. Perinatal asphyxia (92.9%) either alone and/or associated with hypocalcemia (80%) followed by sepsis (40%) and hyponatremia (18.8%) were common etiologies for neonatal seizures. Most of the seizures (76.5%) were aborted with use of single anti-epileptic drug. About 86% (n=73) survived and rest expired.&#x0D; CONCLUSION&#x0D; Subtle seizures were common and perinatal asphyxia was the predominant etiology for neonatal seizures. Thus, strengthening the healthcare facility during delivery of the newborn, proper newborn care and nutrition must be emphasized to decrease the incidence of seizures in developing nations like Nepal.

Impact of parent’s knowledge and attitude about pediatric dental treatment during the Covid-19 pandemic in Bhairahawa City, Nepal

A new type of coronavirus that causes pneumonia was first detected in December 2019, in Wuhan. It was first denoted as the 2019 novel coronavirus (2019-nCoV). The International Committee on Taxonomy of Viruses, Wuhan in December 2019, referred to a new coronavirus capable of infecting humans as SARS-CoV-2. At the same time, the World Health Organization declared the official name of the disease caused by this virus as COVID-19.In this cross-sectional questionnaire survey, 180 participants out of 190 participants were included to evaluate the knowledge and attitude about the pediatric dental treatment during covid-19 pandemic among parents, who visited the department of Pedodontics and Preventive Dentistry, of Universal College of Medical Sciences, during covid-19 pandemic for three months (February 2021 to April 2021), in Bhairahawa, Nepal.In this study out of 180 participants, 105(58.33%) were male and 75(41.66%) were female. All parents were concerned and aware of COVID-19. Every child was explained about covid-19 viruses by their parents.Even though the parents were aware of the Covid-19 pandemic and had discussed it with their children, still they do not prefer any kind of dental treatment even in severe pain. As they thought that other places are less infectious than a pediatric dental clinic.Thus, the aim of this study was to evaluate the knowledge and attitude of pediatric dental patients’ parents’ towards COVID-1 9 in Bhairahawa, Nepal.

Perception towards Online MCQ Test for MBBS and BDS Students’ As an Assessment Method during the Covid-19 Pandemic

INTRODUCTION Universal College of Medical Sciences, Nepal conducted online multiple choice question test as a formative assessment method during COVID-19 pandemic. The aim of this study was to assess the MBBS and BDS students’ perception towards online assessment test conducted during COVID-19 lock down period. MATERIAL AND METHODS A descriptive, cross-sectional study was conducted on medical and dental students by administering online Google Forms questionnaire among 1st year and 2nd year MBBS and BDS students at Universal College of Medical Sciences, and College of Dental Surgery, during 2 October, 2021 to 30 December, 2021. General information proforma that elicits the socio-demography and a questionnaire on the lines of Likert’s summated rating scale to assess the perception of MBBS and BDS students towards online assessment test was constructed. The collected data were entered into Microsoft excel and exported to SPSS version 22 for analysis. Simple frequency tables, cross tables and standard deviation have been used to analyze data. RESULTS The overall mean and standard deviation for medical students’ perception of online assessments were 3.17 ± 0.65, respectively. Dental students’ perception of online assessment tests had an overall mean and standard deviation of 3.31 ± 0.77, respectively. There was no significant difference in mean perception score towards online assessment test between the MBBS and BDS students (p value 0.1401). The results indicate that both medical and dental students were satisfied with online assessment tests. CONCLUSION Online assessment tests were well received by both MBBS and BDS students. The online assessment tests enhance student learning by allowing immediate feedback. Online tests should be conducted in MBBS and BDS colleges on a regular basis.