This study was carried out to find the prevalence of ear diseases in school-going children of the Sunsari and Morang district of Eastern Nepal. This is a prospective, cross sectional, clinical study in 3729 school going children of up to 15 years of the Sunsari and Morang district of eastern Nepal done in year 2014 and 2015 AD. Informed consent was obtained. 1346 (36.09%) children had different ear ailments. Ear wax 616 (45.76%) and otitis media with effusion 226 (16.79%) were the commonest diseases found. Chronic otitis media mucosal type was found in 104 (7.73%) children. Chronic otitis media squamous 6 (0.45%), Otomycosis 155 (11.51%), otitis externa 16 (1.19%), acute Otitis media 119 (8.84%), Eustachian tube dysfunction 92 (6.84%), Perichondritis 4(0.29%), Foreign body in the ear 2 (0.15%), Preauricular sinus 2 (0.15%) and sensorineural hearing loss 4 (0.29%) were the other diseases found. Ear diseases are important health problems among school-going children of the Sunsari and Morang district of eastern Nepal. Health education,nutrition, improvement of socioeconomic status and health care facilities should be helpful in reducing the prevalence of ear diseases.

Introduction: Episiotomy is a common obstetrical practice that is believed to prevent severe lacerations. Principles of evidence based medicine raises questions on the utility of routine episiotomy. Methods: A prospective observational study was conducted in primi gravidas coming to Tansen Mission Hospital for delivery who were not offered episiotomy sticking to the protocol of restrictive use of episiotomy and the subsequent perineal tear was evaluated in terms of its length, degree and complications. Risk factors associated with significant degrees of perineal tear was investigated. Results: The episiotomy rate during the time of study was only 22%. Among those included in the study, 16.2% of women had intact perineum and majority of women (43.2%) had first degree of tear. Only one (1.4%) had third degree tear without any long term complications. Having a baby weighing 2.5 kg increases the mean tear length significantly (P=0.019) and increases the risk of having second or third degree of tear by almost two times (Relative Risk=1.95). No clinically significant complications were observed in any of the women after the delivery. Conclusions: This study provides some evidence that the principle of restrictive use of episiotomy with a total episiotomy rate being around 20% can be carried out successfully even in an under¬resourced setting of our country.

Introduction:  Diabetes is one of the major public health problems in Nepal. Very few studies on correlation between waist hip ratio and random blood sugar have been done in remote areas of Nepal particularly in minor ethnic groups like Thami. This study attempted to compare waist hip ratio and blood sugar level in Thami community of Nepal.Methods: This cross sectional study was conducted in sub-health post of Lapilang village of Dolakha district of Nepal. A total of 243 local inhabitants from Thami Tribe participated in the study. Waist hip ratio was calculated after taking measurements of waist and hip using flexible measuring tape; and, blood glucose level was measured by glucometer.Results: The mean age of the participants was 46.02 years; among participants 126(51.9%) were males and 117(48.1%) were females. Mean waist hip ratio was 0.87, mean blood sugar level was 124.5mg%.Increase in Waist hip ratio correlated significantly with increase in  random blood sugar level both in males(p=0.008) and females(p=0.007).Conclusions:  Increase in waist hip ratio is associated with increase in random blood sugar level. Therefore, there is a need of public awareness program to reduce waist circumference thus reducing weight of people to prevent development of diabetes mellitus in long run.Keywords: blood sugar level; diabetes; Thami community; waist hip ratio

Background: Chronic suppurative otitis media (CSOM) is the chronic inflammation of the middle ear cleft. The atticoantral type is called unsafe type because of the associated complications due to granulations and cholesteatoma which may be life-threatening. CSOM with central perforation (tubotympanic type) is usually not associated with major complications such as cholesteatoma formation.Aims and Objectives: To find out the intraoperative pathological findings in cases of CSOM with central perforation (tubotympanic type)Materials and Methods: This descriptive, cross sectional study has been conducted in the Department of Ear, Biratnagar Eye Hospital in Nepal over 2 years. Study group includes 172 patients having CSOM with central perforations in the tympanic membranes who underwent different types of procedures. Preoperatively, all the patients were evaluated with otoscopy, microscopy, pure-tone audiometry, and some patients with computed tomography scan. The pathological findings were confirmed with biopsy. The findings were tabulated and analysed.Results: 21(12.2%) patients were having dry central perforation with normal Eustachian tube function.  95 patients, i.e., 55.23% were having granulations in attic, aditus, antrum.  25 (14.53%) cases were having ossicular erosion.5 (2.9%) cases had tympanosclerosis in middle ear. 1 (0.58%) case had facial nerve dehiscence. 16 (9.3%) cases had oedema of middle ear mucosa/aural polyp from middle ear. Surprisingly 9 patients, i.e., 5.23% were having cholesteatoma which was confirmed by histopathological study.Conclusion: This study shows that cholesteatoma can be found in tubotympanic type of CSOM, along with other pathological findings. Hence it is on the part of the surgeon to be careful while planning surgery on their patients with CSOM (tubotympanic type), remembering that all safe CSOM might not always be safe. Asian Journal of Medical Sciences Vol.8(1) 2017 42-47

<p class="abstract"><strong>Background:</strong> Otitis media is one of the commonest infections in children. The present study was aimed to determine the sociodemographic profile and the associated factors of chronic otitis media along with the health related practices and beliefs among the family of rural children with otitis media in Morang district of eastern Nepal.</p><p class="abstract"><strong>Methods:</strong> This cross sectional study was done over one year in different ear camps conducted in the various rural areas of Morang district of eastern Nepal. The attending guardians of the children with chronic otitis media were interviewed according to the pretested questionnaire regarding their socioeconomic status, health related practices, beliefs and other related issues. All the collected data were tabulated and analyzed.  </p><p class="abstract"><strong>Results:</strong> A total of 102 attendants were interviewed. Most of the attending guardians were from low socioeconomic status with majority from medium sized family (4-7 persons). Most of them were illiterate. Most of the children lived in Kachha house. Inspite of only nearly 40% family having latrine, sanitation habits were satisfactory in above 80%. 53.92% of the children with chronic otitis media used to take bath in ponds and lake. Most of the guardians had the habit of cleaning ears in unsafe way. Nearly, a third of the guardians were not aware about importance of head position during breast feeding. Most of the guardians were not aware about the causes and treatment of otitis media. In case of ear discharge, most of them seeked help in health institutions. 14.7% would rely on house hold remedies like oil, herbs instilled in to ears and 2.94% would go to faith healer. However 75.5% of the attendants perceived that the use of antibiotics was the method to treat otitis media.</p><p><strong>Conclusions:</strong> The prevailing chronic otitis media in rural children is associated with several risk factors. The lack of appropriate knowledge, perception and erroneous practices stresses the importance of specific health education to the population. Early detection and preventive programs for better ear care can possibly help to alleviate this burden of chronic illness in the society. </p>

No abstract

Introduction Post operative wound infection continues to be the major concern even after the appropriate antibiotic coverage.Objective To find out the incidence of post operative wound infection following the use of antibiotics in clean contaminated head and neck surgery in a tertiary care centre in Eastern Nepal.Methodology It is a prospective study conducted at Department of Otorhinolaryngology and Head and Neck Surgery, Nobel Medical  College Teaching Hospital, Biratnagar from 14th April 2013 to 12th April 2015. Patient who underwent clean contaminated head and neck surgery were followed up on 1st, 3rd and 6th post–operative day (POD) and wounds were inspected for any signs of wound infection.Results A total of 144 patients undergoing various clean contaminated head and neck surgeries were included in this study. Tonsillectomy was the commonest surgery performed (40.27%). An overall wound infection rate was 11.80%. Serous discharge rd from the surgical site observed on 3rd post operative day was the most common presentation of wound infection (29.41%). Parotidectomy was the surgery presenting with highest rate of wound infection (31.25%).Conclusion This study concludes that even the best technique and appropriate antibiotic has not completely eliminated the problem of wound infection in clean contaminated head and neck surgery.Birat Journal of Health Sciences 2016 1(1): 51-55

No abstract