REsEaRCH aBstRaCtBackground: To study the prevalence of various type of breast lesions in a tertiary care centre.Methods : The period of study was one year , from 1 st January 2015 to 31 st December 2015. Patients with breast lesions who came to department of pathology for Fine needle aspiration cytology were included in the study. There were 55 patients who came to the department for Fine needle aspiration cytology during one year period. Information pertaining to patients were taken from the medical record section and department of pathology of National medical college.Results: Out of 55 cases 17 patients (9.35%) were diagnosed with fibroadenosis, which was the highest followed by fibroadenoma (12 cases-6.6%) . Ductal hyperplasia was the least diagnosed disorder which was seen in only one patient (0.5%).Carcinoma of breast was diagnosed in three patients (1.65%).There were three (1.65%) male patients with breast lesions who were diagnosed with gynaecomastia. Conclusion:This study revealed that fibroadenosis was the most common disorder among the patients who came for fine needle aspiration cytology of the breast.
Introduction: There is a variation in risk factors and outcome of delirium in surgical patients in different studies. This study was conducted to determine the incidence, risk factors, and outcome of delirium in the surgical semiclosed intensive care unit in a developing country. Materials and Methods: This descriptive study was done in 82 patients of age≥18 years that underwent non-neurological surgery and admitted for more than 24 hours in a level three intensive care unit of medical college from January 10, 2021 to January 9, 2022. The whole sampling method was used in our study. The Confusion Assessment Method-ICU and Richmond Agitation Sedation Scale were used to diagnose delirium and sedation, respectively, along with a checklist to assess risk factors. All data was transferred to the excel sheet and transferred to a statistical package for the social sciences-16. Chi-square test and Fisher’s exact probability test were used to detect the difference between groups in the univariate analysis, as appropriate. The risk factors were analysed using binary logistic regression. Result: Of the 82 ICU admissions 28(34.1%) developed delirium. Hyperactive delirium was the most common motor subtype 12(42.8%). The mean duration of delirium was 4.69±5.06 days. Hypertension and alcohol were identified as risk factors for delirium. Delirious patients had a longer length of stay in the ICU (10.1 ±12.7 vs 5.1 ±4.2 days) with no impact on the duration of mechanical ventilation, mortality, reintubation, and unplanned extubation. Conclusion: Early recognition of risk factors for delirium in surgical patients can decrease the mortality and morbidity of surgical patients.
Background: COVID-19 is a highly infectious disease caused by SARS-CoV2 virus. It's psychological distress would be a major obstacle towards social normalcy to pre-COVID era. There were lacks of studies to assess these distresses. The aim of this study was to study psychological distress related to COVID-19 among Nepalese professionals. Methods: This online cross-sectional survey was conducted from 12th-20th, June-2020. Questionnaires were based on Corona-virus Anxiety Scale (CAS) and Obsession with COVID-19 scale (OCS). Results: Among 244 participants, majority were in the age group of 20-45 years with male female ratio of 2.1:1. About one third were health workers, 46% were teachers and service holders and remaining were from other professions. Majority of participants had subclinical obsessive (83.2%) and sub-clinical anxiety symptoms (69.3%). Law enforcement professionals (30.0%) and journalists 18.2% had highest prevalence of problematic obsessive symptoms. Law enforcement professionals (40%) had highest prevalence of problematic anxiety symptoms followed by health care workers (28.4%). About 35% of participants opted for multiple positive methods to cope with their obsessive and anxiety symptoms. Participants with higher obsession score had higher anxiety symptoms (r=0.592, p=<0.001). Conclusion: Majority of participants only had sub-clinical obsession and anxiety related to COVID. But, health workers, law enforcement and journalism professionals were having problematic symptoms. Thus, efforts need to be concentrated towards formulation of policies for safe and productive environment for these professionals.
Background: Medical students are taught the internationally accepted approach to acute diarrhoea, viz. adequate fluid and electrolyte replacement is the fundamental management of acute diarrhoea. Antibiotics should be restricted to specific indications, such as acute dysentery. Despite the well known rationale, there has been a high rate of prescription of antibiotics for acute diarrhoea presenting to Emergency. Methods:The pre and post intervention data was collected in the following way. All Emergency case records were routinely scrutinized in the Dept of Family Medicine after discharge with the exception of cases that were admitted to the wards. All cases with a discharge diagnosis fitting the clinical criteria of acute diarrhoeal syndrome: diarrhoea, gastroenteritis, dysentery and cholera were separated, analysed and recorded sequentially.Results: Initially doctors were prescribing antibiotics for 52.8% of case of non-bloody diarrhoea. In the 2nd intervention period there were few cases, but it is remarkable how few were prescribed antibiotic (20%) while the survey of prescribing habits was underway. In the 3rd intervention period when an education event took place, it was the peak of the diarrhoea season. Prescribing increased somewhat to 29%. In the 4th intervention a letter was sent out to the doctors describing the results so far, and pointing out the lower prescribing by "senior doctors". The overall changes in prescribing behaviour after the educational interventions were statistically significant. The reduction in prescribing noted when comparing intervention 1 and intervention 4, is highly significant (antibiotic p < 0.0001, anti-protozoal p<0.0001). In the 5th intervention period when appropriate prescribing was no longer actively promoted, the rate of prescribing increased again to 41.4% of cases. A similar pattern is noted for antiprotozoal prescribing. The increase in prescribing noted in the 5th period was still less than in the 1st period (antibiotic p=0.041, anti-protozoal p=0.055). The increase in prescribing from periods 4 to 5 was significant. (Antibiotics p<0.0001, anti-protozoal p = 0.012).
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