JNMA; journal of the Nepal Medical Association
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JNMA J Nepal Med Assoc · Jan 2020
Prevalence of Covert Hepatic Encephalopathy in A Tertiary Care Centre.
Among patients with Hepatic Encephalopathy, prevalence of Minimal HE varies between 30-50%. Identifying patients with MHE has been shown to improve with medications and delay development of Overt HE, however only limited clinicians screen for MHE in patients due to time consuming neuropsychological and neurophysiological tests. The Number Connection Test is an easy way to evaluate patients to diagnose MHE. The aim of this study is to find out the prevalence of covert hepatic encephalopathy. ⋯ Our study showed that although the prevalence of minimal HE is quite high among cirrhotics, they are usually missed in clinical practice due to absence of symptoms. Active screening with easy-to-administer tests, like Number Connection tests, can help identify patients with minimal HE and hence treat them early.
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JNMA J Nepal Med Assoc · Jan 2020
Satisfaction Level among Patients Treated with Fixed Dental Prosthesis in a Tertiary Care Hospital: A Descriptive Cross-sectional Study.
Dental treatment aims at correction of existing disease; prevention of future disease with rehabilitation of patient's lost functional capacity and aesthetics. Fixed dental prosthesis is any prosthesis that is cemented to a natural tooth or dental implants abutments that cannot be removed by patient. The success of prosthodontic treatment is related to prosthesis survival, with its ability to fulfil biologic and patient-evaluated objectives with patient satisfaction. This study is aimed to find the patient satisfaction with fixed prosthodontic treatment. ⋯ Several factors (chewing ability, appearance, speech, cleansibility of fixed prosthesis) had positive impact on overall satisfaction in majority of the patients. Dentists should continue to emphasise on the significance of maintaining good oral hygiene and use of interdental aids for the longevity of fixed prosthesis.
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The development of health system in Nepal dates back from ancient period to the modern period starting from ayurvedic medicine to today's modern allopathic treatment. With regard to the different rulers in different time period, the number of improvements and changes in the health system of Nepal has been made. Moreover, the health system is further strengthened by the involvement of people and better management of health information and drug supply. Keywords: Bir Hospital; Community health; Health; Nepal.
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JNMA J Nepal Med Assoc · Jan 2020
Case ReportsCongenital Adrenal Hyperplasia with Salt Wasting Crisis: A Case Report.
Congenital Adrenal Hyperplasia is a group of autosomal recessive disorders due to deficiencies of enzymes involved in steroidogenesis. The most common form is a 21-hydroxylase deficiency which can be classical or non-classical. The severe form also called Classical Congenital Adrenal Hyperplasia is usually detected after birth to infant period. ⋯ The diagnosis was based on an elevated level of 17-hydroxyprogesterone. He was managed and life long oral Prednisolone and Fludrocortisone were prescribed. Keywords: 21-hydroxylase, congenital adrenal hyperplasia, case report.