Background: Chronic obstructive pulmonary disease (COPD) is a condition with high morbidity and cost to health services due to a high number of exacerbations necessitating multiple and prolonged hospitalizations. The length of hospital stays and hospital readmission rate is related to patient age, sex, disease severity, current smoking status, comorbidities, dyspnea grade, carbon dioxide partial pressures, use of mechanical ventilation, previous exacerbation, long-term oxygen therapy, and inpatient diuretics use. The purpose of the study was to identify the differential effects of patient and treatment-related factors on the length of hospital stay and hospital readmission for COPD exacerbation-related admissions. Methods: A hospital-based retrospective cross-sectional study was conducted among 151 patients with acute exacerbation of COPD admitted at Civil Service Hospital, Kathmandu from August 2021 to March 2022. Ethical approval was taken from the Institutional Review Committee, Civil Service Hospital (Reference no. 18/ 2022). A convenience sampling method was followed. Data regarding different clinical factors were collected in a semi-structured questionnaire. The data were entered and analyzed through Microsoft Excel 365 and SPSS version 22.0 using a binary regression model. Results: Comorbidities, current smoking, dyspnea grade mMRC IV, mechanical ventilation, and long-term oxygen therapy were significantly associated with prolonged hospital stays for COPD exacerbation-related admissions. The corresponding odd ratio is (OR 3.4, 95% CI: 1.24–9.29); (OR 21.4, 95% CI: 6.17–74.57); (OR 2.5, 95% CI: 1.20–5.45); (OR 5.6, 95% CI: 1.20–26.35); (OR 2.4, 95% CI: 1.02–5.90), respectively. Conclusions: The effect of clinical factors such as comorbidities status, current smoking habits, higher grade of mMRC dyspnea scale, mechanical ventilation, and long-term oxygen therapy needed to be considered to optimize care for COPD patients needing hospital admissions and hence decrement in hospital costs.
Introduction: Dengue virus incidence has been increasing trends in every year due to the expansion of the vectors Aedes aegypti and Aedes albopictus. The objective of this study was to find out the prevalence of dengue among suspected patients admitted to the department of medicine of a tertiary care centre. Methods: A descriptive cross-sectional study was conducted among patients admitted to the medicine department from 30 September 2022 to 30 December 2022 after obtaining ethical approval from the Institutional Review Committee (Reference number: 019/2022). Demographic, clinical characteristics and laboratory profiles were collected from dengue patients by using a structured questionnaire. Convenience sampling method was used. Point estimate and 95% Confidence Interval were calculated. Results: Among 500 patients, 242 (48.40%) (40.66-56.14, 95% Confidence Interval) were found to be dengue positive. The average age of the enrolled patients was 39.13±20.64 years. Most dengue fever patients were diagnosed in the category of dengue with a warning sign of 234 (96.69%). The mean hospital stay of dengue patients was 4.05±2.03 days, 229 (94.62%) of patients stayed less than 7 days before discharge. Conclusions: The prevalence of dengue among suspected patients admitted to the department of medicine is found to be higher than in other similar studies done in similar settings. Patients with clinical symptoms and laboratory findings corroborating with dengue should undergo early diagnosis and facilitate prompt treatment in individual patients.
Background: Anemia is a principal public health concern. Worldwide one-third of women of reproductive age are affected. A 2016 survey showed that 41% of women in Nepal had anemia with the highest prevalence in Pradesh two. A complex interaction among socio-political, biological, and ecological elements determines anemia. Assessing the factors would help in minimizing anemia and its consequences. The study aimed to determine the prevalence of anemia in the reproductive age group and the factors affecting anemia. Methods: A hospital-based cross-sectional study was conducted among women of the reproductive age group (15–45) from 15th April to 15th June 2022 after ethical clearance was obtained from the Nepal health research council (Ref. 2737/2022). Regarding data collection, 375 women participants were selected via a simple random sampling technique. Participants underwent an interview after informed written consent followed by blood sample collection. Through a semi-structured questionnaire, the data was obtained. Then data entry and its analysis were performed via Microsoft Excel 2019 and Statistical Package for Social Sciences version 22.0. Results: The study showed that 229 (61.3%) females of the reproductive age group had anemia. Inadequate nutrition (OR 3.0, 1.9–5.0), breastfeeding (OR 7.3, 4.5–11.9), and rural place of residence (OR 4.2, 2.5–7.0) were significantly associated with anemia, with a corresponding odds ratio at 95% confidence each. Conclusions: The prevalence of anemia was higher among women of the reproductive age group compared to provincial and national prevalence. The interventions should be focused on breastfeeding, nutrition, and rural women to combat anemia.
Background: Acute myeloid leukemia is a common malignant disorder of bone marrow, accounting for 23.1% of total leukemia cases globally in 2017. This study aimed to know the prevalence of acute myeloid leukemia in a tertiary hospital center in Nepal and assess the associated etiological factors in the causation of acute myeloid leukemia. Materials and methods: A hospital-based retrospective cross-sectional study was conducted among patients with acute leukemia admitted to a tertiary care center in Kathmandu from April 1, 2021, to April 30, 2022. 310 participants with acute leukemia were selected via a convenience sampling technique. The data were entered into Microsoft Excel 365 and then analyzed using Statistical Packages for Social Sciences version 22.0. Results: 145 (46.7%) out of 310 acute leukemia patients had acute myeloid leukemia. Most of the cases were male (104, 71.7%) and aged 40-49 years (36, 24.8%). The most common signs and symptoms were pallor (115, 79.3%), fever (n=92, 63.4%), and lethargy/weakness (78, 53.8%). 91 (62.8%) of patients underwent multiple cycles of chemotherapy while 51 (35.2%) had supportive care only, and 3 (2.1%) went bone marrow transplants. Conclusion: The prevalence of AML was higher as compared to AML in other studies done in a similar setting. Early diagnosis and treatment are key to good prognosis and cure in most cases.
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