Objectives: To determine the incidence of tuberculous lymphadenitis in enlarged neck nodes. Materials and methods: Continuous prospective study is carried out in the department of otorhinolaryngology head & neck surgery, Kathmandu Medical College, Kathmandu, during two years, from January 2006 to January 2008. The study included a group of 155 patients with cervical lymphadenopathy. Each patient underwent a detail clinical Ear, Nose and Throat (ENT) examination and a battery of investigations which included Fine Needle Aspiration Cytology (FNAC) of the nodes, Montoux's test, blood Erythrocyte Sedimentation Rate (ESR) and chest X-ray. Those patients with tubercular lymphadenitis were referred to Directly Observed Therapy System (DOTS) clinic for anti-tubercular therapy. Others with reactive lymphadenitis were treated with antibiotic and those with metastatic neck nodes were treated accordingly. Results: Of the 155 cases with enlarged neck nodes, 83 (54%) had tubercular lymphadenitis. Fifty two (33%) cases had reactive lymphadenitis and 17 (11%) cases were diagnosed with metastatic neck nodes. Fine needle aspiration cytology was found to be highly effective in the diagnosis of tubercular lymphadenitis with 94% accuracy. Majority of patients were otherwise healthy adults, aged between 8 - 71 years. No difference was observed between male and female in this study. Posterior triangle (PT) nodes were most commonly affected group of nodes accounting for 35 (42%) cases and preauricular region 1 (1%) case being the least commonly affected site. Fifteen (18%) cases presented with abscess formation. Only 42 (50%) cases had family history of tuberculosis but 8 (9%) patients had previous history of various forms of tuberculosis. Twelve (14%) patients had positive chest X-ray findings suggesting of concurrent pulmonary tuberculosis. All the patients were referred to DOTS clinic and were treated with category (CAT) - III anti tubercular therapy (ATT). Others with concurrent pulmonary tuberculosis were treated with CAT I regime. None of the patients required surgical treatment. Conclusion: There is high incidence of tubercular cervical lymphadenitis in patients with enlarged neck nodes in developing countries like Nepal. Involvement of cervical lymphnodes are the most commonly affected group of nodes. Therefore, it is important that otolaryngologists are aware of tuberculosis in the head and neck region. Key words: Tuberculosis, Lymph node, Fine needle aspiration cytology, Lymphadenitis    doi: 10.3126/kumj.v7i1.1766       Kathmandu University Medical Journal (2009), Vol. 7, No. 1, Issue 25, 54-58

In teaching profession, distress has been linked to dissatisfaction with job and to negative affective and professional consequences. In the present study, the attempt was made to identify the level of job stress and job satisfaction among teachers in consideration with their gender differences along with age and experiences. Study comprised of randomly selected 69 school teachers from Pokhara, Nepal. Socio economic data of the subjects were collected by questionnaire. Modified TJSQ and Modified TARSO were applied to identify the Job satisfaction and Job stress of the subjects. Data from acceptable returned questionnaires were analyzed by SPSS 17. It can be concluded from the analysis that, the school teachers were partly satisfied and experiencing mild to moderate stress from their job overall. These can be the resultant of unfavorable job condition and job types for the school teachers. Key Words: School Teacher; Job Stress; Job Satisfaction DOI: http://dx.doi.org/10.3126/ijosh.v1i1.5226 International Journal of Occupational Safety and Health, Vol 1 (2011) 27-33

Purpose Cataract is the most prevalent cause of blindness in Nepal. Several epidemiologic studies have associated cataracts with use of biomass cookstoves. These studies, however, have had limitations, including potential control selection bias and limited adjustment for possible confounding. This study, in Pokhara city, in an area of Nepal where biomass cookstoves are widely used without direct venting of the smoke to the outdoors, focuses on pre-clinical measures of opacity, while avoiding selection bias and taking into account comprehensive data on potential confounding factors Methods Using a cross-sectional study design, severity of lenticular damage, judged on the LOCS III scales, was investigated in females (n=143), aged 20-65 years, without previously diagnosed cataract. Linear and logistic regression analyses were used to examine the relationships with stove type and length of use. Clinically significant cataract, used in the logistic regression models, was defined as a LOCS III score > 2. Results Using gas cookstoves as the reference group, logistic regression analysis for nuclear cataract showed the evidence of relationships with stove type: for biomass stoves, the odds ratio (OR) was 2.58 (95% confidence interval [CI]: 1.22-5.46) and, for kerosene stoves, the OR was 5.18 (95% CI: 0.88-30.38). Similar results were found for nuclear color (LOCS III score > 2), but no association was found with cortical cataracts. Supporting a relationship between biomass stoves and nuclear cataract was a trend with years of exposure to biomass cookstoves (p=0.01). Linear regression analyses did not show clear evidence of an association between lenticular damage and stove types. Biomass fuel used for heating was not associated with any form of opacity. Conclusions This study provides support for associations of biomass and kerosene cookstoves with nuclear opacity and change in nuclear color. The novel associations with kerosene cookstove use deserve further investigation.

Background and Objective: To determine the incidence and the types of various thyroid malignancies in multi-nodular goiter.Material and methods: This is a retrospective study, conducted in Department of ENT and Head and Neck Surgery, National Academy of Medical Sciences Bir Hospital Kathmandu and Alka Hospital Pvt. Ltd Lalitpur. The study period was 3 years from 11 January 2011 to 10 January 2014. The study population consisted of 100 patients who were diagnosed as a multinodular thyroid nodule.Result: The highest frequency was 50 (50%) in 31-40 years. Among the total cases, 28 (28%) were males and 72(72%) females. Histopathological analysis showed that benign multi-nodular goiter was present in 87 (87%) cases, and malignant thyroid lesion in 13 (13%) cases. Among malignancies, papillary carcinoma was found as the commonest malignancy 11 (84.61%) cases followed by follicular carcinoma 1 (7.69%) case and anaplastic carcinoma 1(7.69%) case.Conclusion: The risk of malignancy in multinodular goiter should not be underestimated as significant number of patients with thyroid malignancies present with multinodular goiter.JCMS Nepal 2014; 10(4):18-21

Neglected traumatic dislocation of the hip is extremely rare in children, and the preferred treatment remains unclear. This retrospective case series includes 8 children treated by open reduction. The mean age was 7.5 years (range, 2-16 years), and the mean follow-up was 7 years and 7 months (range, 4 month-16 years). Presenting complaints included pain (5/8) and gait disturbance (8/8). Traction failed to achieve a reduction in all cases. At follow-up, 6 hips remained reduced, and 2 achieved a non concentric reduction. All patients had evidence of avascular necrosis. Two patients, in whom a non concentric reduction was achieved, developed progressive flattening and joint space narrowing. Two patients had mild pain at follow-up, and 6 patients were able to squat. Range of motion was restricted both before and after open reduction, most notably in abduction and rotation. Postoperative improvement was seen in abduction (4 cases). Leg lengths were within 2 cm in 7 of 8 cases, and only 1 patient had a discrepancy greater than 2 cm. The results according to Garrett et al were good in 3, fair in 3, and poor in 2. The mean Harris hip score was 89. Patients with a concentric reduction had an adequate functional outcome despite evidence of avascular necrosis. The prognosis remains guarded, and we expect that a subset of patients will develop premature degenerative joint disease. However, we continue to offer patients an operative reduction, which we feel is preferable to other methods. A failed open reduction does not preclude options for salvage.

Introduction: The spread of COVID-19 pandemic has gripped the entire world and caused widespread public health concerns, hampered economics and education system immensely. Online classes have been an alternative to give continuity to the theory classes. The objective of this study is to assess the various aspects of online classes and perception of Bachelor of Dental Surgery (BDS) students of Kathmandu University (KU) during COVID-19 pandemic. Materials and Method: Cross-sectional, questionnaire based descriptive study using online Google form was distributed among the BDS students of KU. The questionnaire was distributed via social media. Frequency distribution of the descriptive data was done. Chi-square test was done to assess the difference in perception about online classes between the basic science and clinical science students. Result: 89% of the students had never attended any online classes before online education due to COVID-19 pandemic. 76.9% agreed that the online class is distracting. 57.5% used smartphone for seeking online class and medium most frequently used was Zoom platform. 70.2% students could ask questions, communicate & receive response during online class. 55.4% students disagreed that online classes are more effective. Statistical significant differences were seen in students submitting assignments, communication and practical simulation among basic science and clinical science students. Conclusion: Online class can serve as an alternative effective educational tool. With more practice, system upgrading, capacity building of the student-teacher; it is bound to be more effective as well as efficient. The online class should be designed in such a way that student can focus and find it more interesting and should introduce various strategies to increase the interaction between students and teachers. Further, training on online class is required for both course recipients and providers.

INTRODUCTION: Nurses are responsible for the well-being and quality of life of many people, and therefore must meet high standards of technical and ethical competence. Values are the belief and attitude that influence individual behavior and process of decision making. Personal values are what nurses hold significant and true for themselves, while professional ethics involve principles that have universal applications and standards of conduct that must be upheld in all situations. From the previous study it was found that most of the nurses have the knowledge regarding nursing ethic and law but have lack of practice. MATERIAL AND METHODS: A descriptive cross   sectional study was conducted among the selected nurses of Universal College of Medical Sciences and Teaching Hospital (UCMS TH) Bhairahawa Nepal. Population for the study was selected on random basis and total sample size was 60. A self-administered structured questionnaire about knowledge of nursing ethics and law was devised, tested and distributed to the nurses and practice of same sample was assessed through checklist by observing the activities of nurses by the researcher herself.RESULTS: Among the total 60 respondents only 45% had adequate knowledge of ethics and rest of them had inadequate knowledge regarding nursing ethics whereas most of the respondents i.e. 53% had adequate knowledge of nursing law and only 46% had inadequate knowledge of it. On the other hand half of the respondents do practice on nursing ethics and law and another half do less practice. As a whole it has been identified that respondents had more knowledge of nursing law than that of nursing ethics and half of them do practice on it.CONCLUSION: Findings of the study showed that knowledge of law was greater than knowledge of ethics. Overall they had no satisfactory knowledge of ethics and law. Whereas 50% of respondents does adequate practice.DOI: http://dx.doi.org/10.3126/jucms.v2i3.11825 Journal of Universal College of Medical Sciences Vol.2(3) 2014: 30-33

Background & Objectives: Worldwide, 60 to 90% of school children have experienced dental caries with higher prevalence in Asian and Latin American countries and poor dental and oral health and untreated oral disease can have a significant impact on quality of life according to WHO report. The objectives of the study were to assess the prevalence of dental caries both in deciduous and permanent teeth and to compare total decayed, filled teeth surfaces among primary school children of Kathmandu from both government and private schools and to find the percentage of first permanent molars affected with dental caries.Materials & Methods: A cross sectional study was conducted among two Government and two Private Primary School Children in Kathmandu district. Total sample were 468 children. Required permission were obtained from concerned authorities. WHO accepted indices for assessing caries designed by Henry T Klein, Carrole E Palmer and Knutson J.W was used. SPSS 20 version software was used for data analysis. Results: Among 468 primary school children examined, 224 were from Government and 244 were from Private school. The prevalence of dental caries was 62 % and more deciduous teeth were decayed. The decayed, filled teeth surfaces in Private and Government school was statistically significant (p=0.000) but gender wise prevalence was statistically insignificant (p=0.303). Among 1st Permanent Molars teeth examined 85% were decayed.Conclusion: This pilot study shows prevalence of dental caries more in deciduous teeth. Among the permanent teeth affected, first permanent molars are in high number.