Subjects -> MEDICAL SCIENCES (Total: 8690 journals)
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MEDICAL SCIENCES (2415 journals)            First | 3 4 5 6 7 8 9 10 | Last

Showing 1201 - 1400 of 3562 Journals sorted alphabetically
Journal of Evaluation In Clinical Practice     Hybrid Journal   (Followers: 6)
Journal of Evidence-Based Healthcare     Open Access   (Followers: 1)
Journal of Evidence-Based Integrative Medicine     Open Access   (Followers: 18)
Journal of Evidence-Based Medicine     Partially Free   (Followers: 4)
Journal of Exercise Science & Fitness     Open Access   (Followers: 29)
Journal of Experimental and Clinical Anatomy     Open Access   (Followers: 2)
Journal of Family and Community Medicine     Open Access   (Followers: 3)
Journal of Family Medicine and Primary Care     Open Access   (Followers: 11)
Journal of Foot and Ankle Research     Open Access   (Followers: 6)
Journal of Forensic Science and Research     Open Access   (Followers: 2)
Journal of Gandaki Medical College-Nepal     Open Access  
Journal of Generic Medicines     Hybrid Journal   (Followers: 2)
Journal of Geographical Sciences     Hybrid Journal   (Followers: 1)
Journal of Global Antimicrobial Resistance     Hybrid Journal   (Followers: 3)
Journal of Hand Therapy     Hybrid Journal   (Followers: 19)
Journal of Head & Neck Physicians and Surgeons     Open Access   (Followers: 2)
Journal of Health & Medical Informatics     Open Access   (Followers: 62)
Journal of Health and Biological Sciences     Open Access   (Followers: 1)
Journal of Health Design     Open Access   (Followers: 1)
Journal of Health Economics and Outcomes Research     Open Access   (Followers: 1)
Journal of Health Promotion and Behavior     Open Access  
Journal of Health Research and Reviews     Open Access  
Journal of Health Science and Medical Research     Open Access  
Journal of Health Science Research     Open Access  
Journal of Health Sciences     Open Access   (Followers: 1)
Journal of health sciences     Open Access  
Journal of Health Sciences / Sağlık Bilimleri Dergisi     Open Access  
Journal of Health Sciences and Medicine     Open Access  
Journal of Health Sciences and Medicine     Open Access   (Followers: 6)
Journal of Health Sciences and Surveillance System     Open Access  
Journal of Health Sciences Scholarship     Open Access  
Journal of Health Specialties     Open Access  
Journal of Health Studies     Open Access  
Journal of Healthcare Informatics Research     Hybrid Journal   (Followers: 1)
Journal of Heavy Metal Toxicity and Diseases     Open Access  
Journal of Helminthology     Hybrid Journal   (Followers: 2)
Journal of Herbs Spices & Medicinal Plants     Hybrid Journal  
Journal of HIV for Clinical and Scientific Research     Open Access   (Followers: 2)
Journal of Hospital Medicine     Hybrid Journal   (Followers: 11)
Journal of Huazhong University of Science and Technology [Medical Sciences]     Hybrid Journal  
Journal of Human Hypertension     Hybrid Journal   (Followers: 3)
Journal of Human Rhythm     Open Access  
Journal of Human Transcriptome     Open Access  
Journal of Ideas in Health     Open Access  
Journal of Inflammation     Open Access   (Followers: 2)
Journal of Inflammation Research     Open Access  
Journal of Injury and Violence Research     Open Access   (Followers: 6)
Journal of Innovation in Health Informatics     Open Access   (Followers: 17)
Journal of Institute of Medicine     Open Access  
Journal of Insulin Resistance     Open Access   (Followers: 1)
Journal of Interactional Research in Communication Disorders     Hybrid Journal   (Followers: 5)
Journal of Interferon & Cytokine Research     Hybrid Journal   (Followers: 3)
Journal of International Medical Research     Open Access   (Followers: 3)
Journal of Interventional Medicine     Open Access   (Followers: 1)
Journal of Investigative Medicine     Hybrid Journal   (Followers: 3)
Journal of Islamabad Medical & Dental College     Open Access   (Followers: 2)
Journal of Istanbul Faculty of Medicine     Open Access  
Journal of Karnali Academy of Health Sciences     Open Access   (Followers: 1)
Journal of Kathmandu Medical College     Open Access   (Followers: 1)
Journal of King Abdulaziz University : Medical Sciences     Open Access   (Followers: 2)
Journal of Laboratory Medicine     Hybrid Journal   (Followers: 27)
Journal of Laryngology and Voice     Open Access   (Followers: 11)
Journal of Lasers in Medical Sciences     Open Access  
Journal of Law, Medicine & Ethics     Hybrid Journal   (Followers: 28)
Journal of Legal Medicine     Hybrid Journal   (Followers: 7)
Journal of Limb Lengthening & Reconstruction     Open Access  
Journal of Lumbini Medical College     Open Access   (Followers: 1)
Journal of Mahatma Gandhi Institute of Medical Sciences     Open Access  
Journal of Manipulative and Physiological Therapeutics     Hybrid Journal   (Followers: 6)
Journal of Manmohan Memorial Institute of Health Sciences     Open Access   (Followers: 1)
Journal of Marine Medical Society     Open Access  
Journal of Materials Science : Materials in Medicine     Hybrid Journal   (Followers: 4)
Journal of Maternal and Child Health     Open Access  
Journal of Mechanics in Medicine and Biology     Hybrid Journal  
Journal of Medical and Biological Engineering     Hybrid Journal   (Followers: 4)
Journal of Medical and Biomedical Sciences     Open Access   (Followers: 2)
Journal of Medical Case Reports     Open Access   (Followers: 1)
Journal of Medical Cases     Open Access   (Followers: 6)
Journal of Medical Colleges of PLA     Full-text available via subscription  
Journal of Medical Disorders     Open Access  
Journal of Medical Economics     Hybrid Journal   (Followers: 8)
Journal of Medical Education and Curricular Development     Open Access   (Followers: 6)
Journal of Medical Ethics     Partially Free   (Followers: 27)
Journal of Medical Ethics and History of Medicine     Open Access   (Followers: 19)
Journal of Medical Humanities     Hybrid Journal   (Followers: 21)
Journal of Medical Hypotheses and Ideas     Open Access  
Journal of Medical Imaging and Health Informatics     Full-text available via subscription   (Followers: 1)
Journal of Medical Investigation and Practice     Open Access  
Journal of Medical Laboratory and Diagnosis     Open Access  
Journal of Medical Law and Ethics     Full-text available via subscription   (Followers: 17)
Journal of Medical Microbiology     Full-text available via subscription   (Followers: 6)
Journal of Medical Sciences     Open Access  
Journal of Medical Sciences     Open Access  
Journal of Medical Screening     Hybrid Journal   (Followers: 6)
Journal of Medical Signals and Sensors     Open Access   (Followers: 3)
Journal of Medical Society     Open Access  
Journal of Medical Systems     Hybrid Journal  
Journal of Medical Toxicology     Hybrid Journal   (Followers: 6)
Journal of Medical Ultrasound     Open Access   (Followers: 2)
Journal of Medicinal Botany     Open Access  
Journal of Medicinal Chemistry     Hybrid Journal   (Followers: 208)
Journal of Medicine     Open Access   (Followers: 1)
Journal of Medicine and Biomedical Research     Open Access   (Followers: 1)
Journal of Medicine and Philosophy     Hybrid Journal   (Followers: 9)
Journal of Medicine and the Person     Hybrid Journal  
Journal of Medicine in Scientific Research     Open Access  
Journal of Medicine in the Tropics     Open Access  
Journal of Medicine Research and Development     Open Access   (Followers: 3)
Journal of Medicine, Physiology and Biophysics     Open Access   (Followers: 5)
Journal of Medicines Development Sciences     Open Access   (Followers: 1)
Journal of Metabolomics & Systems Biology     Open Access   (Followers: 2)
Journal of Mind and Medical Sciences     Open Access   (Followers: 1)
Journal of Molecular Medicine     Hybrid Journal   (Followers: 11)
Journal of Movement Disorders     Open Access   (Followers: 2)
Journal of Multidisciplinary Research in Healthcare     Open Access   (Followers: 3)
Journal of Muscle Research and Cell Motility     Hybrid Journal   (Followers: 1)
Journal of Nanotechnology in Engineering and Medicine     Full-text available via subscription   (Followers: 6)
Journal of Nanotheranostics     Open Access   (Followers: 1)
Journal of Natural Medicines     Hybrid Journal  
Journal of Natural Science, Biology and Medicine     Open Access   (Followers: 3)
Journal of Nature and Science of Medicine     Open Access   (Followers: 4)
Journal of Negative and No Positive Results     Open Access  
Journal of Nepalgunj Medical College     Open Access  
Journal of Neurocritical Care     Open Access  
Journal of Neurodegenerative Diseases     Open Access   (Followers: 2)
Journal of Neurorestoratology     Open Access  
Journal of Neuroscience and Neurological Disorders     Open Access  
Journal of Nobel Medical College     Open Access  
Journal of Obesity and Bariatrics     Open Access   (Followers: 2)
Journal of Occupational Health     Open Access  
Journal of Occupational Therapy Education     Open Access   (Followers: 12)
Journal of Ocular Biology, Diseases, and Informatics     Hybrid Journal  
Journal of Oral Biology and Craniofacial Research     Full-text available via subscription  
Journal of Oral Health and Craniofacial Science     Open Access  
Journal of Orofacial Sciences     Open Access  
Journal of Otorhinolaryngology, Hearing and Balance Medicine     Open Access   (Followers: 1)
Journal of Ovarian Research     Open Access  
Journal of Ozone Therapy     Open Access  
Journal of Palliative Medicine     Hybrid Journal   (Followers: 47)
Journal of Paramedical Sciences & Rehabilitation     Open Access  
Journal of Parkinsonism and Restless Legs Syndrome     Open Access   (Followers: 2)
Journal of Parkinson’s Disease and Alzheimer’s Disease     Open Access   (Followers: 1)
Journal of Participatory Medicine     Open Access  
Journal of Patan Academy of Health Sciences     Open Access  
Journal of Pathogens     Open Access   (Followers: 1)
Journal of Patient Experience     Open Access  
Journal of Patient Safety and Risk Management     Hybrid Journal   (Followers: 2)
Journal of Patient-Centered Research and Reviews     Open Access  
Journal of Patient-Reported Outcomes     Open Access  
Journal of Periodontal Research     Hybrid Journal  
Journal of Personalized Medicine     Open Access   (Followers: 3)
Journal of Pest Science     Hybrid Journal   (Followers: 1)
Journal of Pharmaceutical Policy and Practice     Open Access   (Followers: 4)
Journal of Physiobiochemical Metabolism     Hybrid Journal   (Followers: 2)
Journal of Physiology-Paris     Hybrid Journal   (Followers: 2)
Journal of Pioneering Medical Sciences     Open Access  
Journal of Postgraduate Medicine     Open Access  
Journal of Pregnancy     Open Access   (Followers: 4)
Journal of Prevention & Intervention Community     Hybrid Journal   (Followers: 7)
Journal of Preventive Medicine and Public Health     Open Access  
Journal of Primary Prevention     Hybrid Journal   (Followers: 7)
Journal of Prosthodontic Research     Full-text available via subscription   (Followers: 1)
Journal of Prosthodontics     Hybrid Journal   (Followers: 2)
Journal of Receptor, Ligand and Channel Research     Open Access   (Followers: 1)
Journal of Regenerative Medicine     Partially Free   (Followers: 4)
Journal of Research in Medical Sciences     Open Access   (Followers: 2)
Journal of Science and Applications : Biomedicine     Open Access   (Followers: 1)
Journal of Science and Technology (Ghana)     Open Access   (Followers: 3)
Journal of Scientific Innovation in Medicine     Open Access  
Journal of Scientific Perspectives     Open Access   (Followers: 1)
Journal of Sensory Studies     Hybrid Journal   (Followers: 4)
Journal of Shaheed Suhrawardy Medical College     Open Access  
Journal of Shoulder and Elbow Arthroplasty     Open Access  
Journal of Sleep Disorders : Treatment & Care     Hybrid Journal   (Followers: 10)
Journal of South American Earth Sciences     Hybrid Journal   (Followers: 5)
Journal of Spinal Cord Medicine     Hybrid Journal   (Followers: 5)
Journal of Spinal Disorders & Techniques     Hybrid Journal   (Followers: 2)
Journal of Sports Medicine and Allied Health Sciences : Official Journal of the Ohio Athletic Trainers Association     Open Access   (Followers: 1)
Journal of Stem Cell Therapy and Transplantation     Open Access   (Followers: 1)
Journal of Stomal Therapy Australia     Full-text available via subscription   (Followers: 1)
Journal of Strength and Conditioning Research     Hybrid Journal   (Followers: 77)
Journal of Substance Use     Hybrid Journal   (Followers: 15)
Journal of Surgical Academia     Open Access   (Followers: 1)
Journal of Surgical and Clinical Research     Open Access  
Journal of Surgical Case Reports     Open Access  
Journal of Surgical Education     Full-text available via subscription   (Followers: 3)
Journal of Surgical Technique and Case Report     Open Access  
Journal of Systemic Therapies     Full-text available via subscription   (Followers: 3)
Journal of Taibah University Medical Sciences     Open Access  
Journal of Telemedicine and Telecare     Hybrid Journal   (Followers: 12)
Journal of The Academy of Clinical Microbiologists     Open Access  
Journal of the American Association for Laboratory Animal Science     Full-text available via subscription   (Followers: 9)
Journal of the American College of Certified Wound Specialists     Hybrid Journal   (Followers: 2)
Journal of the American College of Clinical Wound Specialists     Hybrid Journal   (Followers: 2)
Journal of the American Medical Directors Association     Hybrid Journal   (Followers: 5)
Journal of the American Medical Informatics Association : JAMIA     Hybrid Journal   (Followers: 36)
Journal of the American Podiatric Medical Association     Full-text available via subscription   (Followers: 7)
Journal of the Anatomical Society of India     Full-text available via subscription  
Journal of the Anus, Rectum and Colon     Open Access  
Journal of The Arab Society for Medical Research     Open Access  

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Similar Journals
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Journal of Karnali Academy of Health Sciences
Number of Followers: 1  

  This is an Open Access Journal Open Access journal
ISSN (Print) 2616-0064 - ISSN (Online) 2676-1327
Published by Karnali Academy of Health Sciences Homepage  [1 journal]
  • Needs, Challenges, and Opportunities in Establishing and Maintaining
           Medical Education in Karnali Academy of Health Sciences (KAHS)

    • Authors: Kiran Regmi, Kapil Amgain
      Abstract: The constitution of Nepal (2015), article 35 (Right relating to health) stated that every citizen shall have the right to free basic health services from the State, and no one shall be deprived of emergency health services. According to the World Bank report (collection of development indicators compiled from various official sources, 2016), Nepal has 81% rural and remote populations. Health service delivery is a complex reality for the rural and remote populations and faces enormous challenges. One of them is insufficient and uneven distribution of health workforce. The World Health Report concluded that "the severity of the health workforce crisis is in some of the world's poorest countries, of which 6 are in South East Asia out of 57 countries having critical shortages of health workforce."1Even after 13 years situation has not much improved. Nepal faces a critical shortage of trained health workforce, especially in rural and remote areas. Health workforce recruitment and retention in rural and remote areas is a difficult task challenged by the preferences and migration of health workforce to urban areas in country, or even abroad for better life and professional development.2 One of the most effective strategies for health workforce recruitment and retention for rural and remote areas could be that of establishing and maintaining Medical Education in rural and remote areas decentralized from urban academic medical centers. Rural and remote medical education is designed to enroll local students or others from rural and remote backgrounds. Medical literature suggests that the students from rural and remote backgrounds work experience are more likely than urban students inclined to practice in a rural and remote community after graduation. 3,4Greater exposure to diverse learning opportunities in rural and remote areas will make graduates confident to work anywhere. 5,6Further, extended and early exposure to rural and remote experience has a strong association to long-term rural and remote service. 7This could be the long-term solutions to long standing problems of recruitment and retention of doctors for underserved populations. In line with this, the Government of Nepal has established KAHS in Jumla. Karnali Academy of Health Sciences was established in October 20, 2011 (2068/07/03), by an Act of parliament of Nepal with the mission to prepare health professionals to deliver quality health care to marginalized /backward areas through educational excellence, innovative research, patient-centred care, public health and community. Karnali Academy of Health Sciences is the only one Stand Alone rural Academy of this kind in remote and rural Nepal. Establishing and maintaining a rural and remote Medical Educational requires a holistic approach fulfilling the needs of both the student and the community. This article describes the Needs, Challenges, and Opportunities in Establishing and Maintaining Medical Education in KAHS. Keywords: Karnali Province, Medical Education, KAHS (Karnali Academy of Health Sciences), MBBS Program, MDGP Program, MD/MS Program, Needs, Challenges, Opportunities
      DOI : http://doi.org/10.3126/jkahs.v2i2.25165
      PubDate: 2019-08-13
      Issue No: Vol. 2, No. 2 (2019)
       
  • Prevalence of HIV, Syphilis, Hepatitis-B, and Hepatitis-C among People
           with Injecting Drugs in Western Terai Highway districts, Nepal

    • Authors: Tarun Poudel, Bir Rawal, Keshab Deuba, Sampurna Kakchapati, Kapil Amgain, Pratima Neupane, Sesananda Sanjel
      Abstract: Introduction: HIV epidemic has become the major problems among people with injecting drugs (PWIDs) in Nepal. The study was carried out to assess the prevalence of sexually transmitted diseases including HIV/AIDS among PWIDs. Methods: This descriptive cross-sectional survey was conducted in male PWIDs of age more than 16 years residing in Western to Far West Terai Districts of Nepal who had been injecting drugs for three months prior to the date of the survey" March-April 2017. A two-stage cluster sampling was used to recruit 300 PWIDs from seven Districts. HIV was diagnosed by using standard techniques approved by WHO.  Similarly, Syphilis was tested using the "Rapid Plasma Reagin" and Hepatitis C, as well as Hepatitis B, was tested by using rapid test kits. Demographic data were collected by using a structured questionnaire and the data obtained were entered in MS excel was transformed into the SPSS version 21 for the descriptive as well as inferential analysis. Results: Prevalence of HIV, HBV, HCV, and STI among PWIDs were 5.3%,   2.7%,  23.7%,  and 2.0% respectively. Majority of the PWIDs were literate (93.7%) and their age was below 35 years. Among the married PWIDs, 32.4% had got married before the age of 19. Similarly, 53.7% of them were living with their female sexual partner, and 95.0% were living with their wife. Ninety-six per cent of the respondents reported to be ever involved in sexual activity, 77.1% of them initiated the sexual intercourse before the age of 20 years and 41.9% of them had more than one female sexual partner. The survey indicated that 36.3% had been injecting drugs for more than 5 years while 27.7% had been injecting for last 2-5 years and 55.0% of the respondents had injected for the first time at the age of 16-24 years. About one in 10 respondents had started injecting drugs recently. Conclusion: There is a high prevalence of HIV, HCV, HBV and active syphilis among the PWIDs. Co-infection of HIV and HCV, as well as Hepatitis B and C, were also prevalent among PWIDs. Comprehensive education and awareness program is required to reduce the prevalence. Keywords: Prevalence, people with injecting drugs, HIV/AIDS, Nepal
      DOI : http://doi.org/10.3126/jkahs.v2i2.25168
      PubDate: 2019-08-13
      Issue No: Vol. 2, No. 2 (2019)
       
  • Awareness Regarding Domestic Violence Among Reproductive Age Women

    • Authors: Gayatri Rana, Rajan Shrestha
      Abstract: Background: Violence is a significant public health, human rights and human development problem. The objective was to find out awareness regarding domestic violence among reproductive-age women. Methods:  A cross-sectional research design was adopted and a total of 100 reproductive-age women were selected by purposive sampling technique in Devchuli municipality -1, Nawalparasi from 27 July to 31 July 2015. A semi-structured questionnaire was used to collect data. Descriptive (Frequency, percentage, median & quartile) and inferential statistics (Chi-square) was used to analyze data. Results: There was a significant association between the level of awareness regarding domestic violence and caste: Dalit (p=0.002) and religion (p=0.019). Hinduism were 3.165 (OR) & 4.210 (AOR) times more likely to have awareness regarding domestic violence than Non-Hinduism, at {OR (p=0.023) & AOR (p=0.136) respectively}. Significant with level of education (p=0.005), reproductive age women who had basic level education were 1.111 (OR) & 1.319 (AOR) times more likely and who had secondary level were 0.867 & 0.921 times less likely to have awareness regarding domestic violence than women with non formal education, which was  statistically not significant {OR (p=0.869) & AOR (p=0.750) and significant at OR (p=0.014) & AOR (p=0.021) respectively}; significant with family income (p=0.023), reproductive age women who had family income sufficient to eat for >1 year and surplus were 2.627 (OR) & 2.494 (AOR) times more likely to have awareness regarding domestic violence than sufficient to eat up to 1 year, at {OR (p=0.024) & AOR (p=0.218) respectively}; and significant with not involved in woman group/organization/political party (p=<0.001), reproductive age women who had not involved in woman group/organization/political party were 7.667 (OR) & 6.958 (AOR) times more likely to have awareness regarding domestic violence than who involved, which was statistically significant {OR (p=<0.001) & AOR (p=0.021) respectively}.    Conclusion: Half of the reproductive age women have good awareness regarding domestic violence. There is a significant association between level of awareness and caste, religion, level of education, family income and not involved in woman group/organization/political party. To improve awareness in women, women should be involved in woman group/organization/political party/awareness programme.  Keywords: Awareness, Domestic violence, Reproductive age women
      DOI : http://doi.org/10.3126/jkahs.v2i2.25170
      PubDate: 2019-08-13
      Issue No: Vol. 2, No. 2 (2019)
       
  • Status of Perinatal Mortality in Karnali Academy of Health Sciences, Jumla
           Nepal

    • Authors: Namrata Sindan, Sandeep Shrestha, Bishnu Dutta Acharya, Purnima Rai, Niranjana Kayastha, Aadessh Bhandari, Namita Sindan
      Abstract: Introduction: Perinatal mortality rate is a sensitive indicator of the quality of obstetric and pediatric health services. It also helps us to evaluate the efficiency of health care provided by a particular hospital. The aim of this study was to evaluate the cause of perinatal death in a tertiary care medical centre, which may help to reduce the incidence of perinatal death and improve the quality of care. Methods: The two-year retrospective study of perinatal deaths was done at Karnali Academy of Health Sciences (KAHS), Jumla from March 2017 to April 2019. Data was collected from monthly perinatal audit and annual mortality reviews. Registers in the maternity ward, sick Neonate Care Unit, and files of dead newborns kept in the record section of the hospital were studied and reviewed. Results: A total of 1354 deliveries were conducted in the 24 months period at KAHS with a perinatal mortality rate of 36.08 per 1000 total birth and early neonatal death rate of 12.8 per 1000 live birth. The Perinatal mortality was higher in low birth weight and premature baby. The cause of stillbirth and early Neonatal death were identified. Most of the early neonatal death was due to Prematurity (41.17%) followed by Birth Asphyxia and Neonatal Sepsis. Conclusion: Prematurity and its related complication were the most common cause of early neonatal death followed by birth Asphyxia and Neonatal Sepsis. There is a need to improve antenatal, early identification of high-risk pregnancy as well as Neonatal Intensive Care Unit (NICU) to further reduce deaths due to prematurity and birth asphyxia.
      Keywords: Perinatal Mortality Rate; Early Neonatal Mortality Rate; Rural Areas; Jumla
      DOI : http://doi.org/10.3126/jkahs.v2i2.25178
      PubDate: 2019-08-13
      Issue No: Vol. 2, No. 2 (2019)
       
  • Nurses Knowledge on Management of Patient Receiving Spinal Anaesthesia in
           a Government Hospital

    • Authors: Elisha Rijal, Suvekshya Silwal, Sheela Thapa, Saraswati Basnet, Subhadra Bhagat
      Abstract: Introduction: Spinal Anaesthesia (SA) is a form of regional anaesthesia involving injection of a local anaesthetic into the subarachnoid space. SA is directly related to nervous system, so its mismanagement may cause various complications hence, prevention and management of complication is a vital and complex aspect of critical nursing care. Therefore, the objective of this study was to assess the nurse’s knowledge on the management of patient receiving spinal anaesthesia. Methodology: A cross-sectional descriptive study was conducted among nurses of Koshi Zonal Hospital of Province no. 1, Biratnagar, Nepal from May to June 2017. Non-probability purposive sampling method was used where self-administered questionnaire was administered among 67 working nurses in the hospital. Results: The majority of the respondents (77.6%) belonged to 20-30 years of age group, nearly half (44.8%) of the respondents had completed PCL nursing. Only 67.2% explained the meaning of anaesthesia, and 58.2% had knowledge on physiological changes after SA. Regarding ambulation and cause of backache, 29.9% had knowledge whereas only 20.9% had knowledge about management of post spinal backache. Respondents facing problem to manage the complication after SA was 13.4%. This study also found that the overall knowledge regarding SA was adequate among 80.6% respondents. Conclusion: Nurses as the key personnel in management and prevention of complication, the obtained result was below the desired competence level among working nurses as it is the vital aspect of critical nursing care. Keywords: Knowledge, Nurses, Management, Spinal anaesthesia, Hospital
      DOI : http://doi.org/10.3126/jkahs.v2i2.25179
      PubDate: 2019-08-13
      Issue No: Vol. 2, No. 2 (2019)
       
  • Causes of Infertility amongst Couples Visited at Infertility Centre
           Kathmandu, Nepal

    • Authors: Pratima Neupane, Deepak Sharma, Prem Prasad Panta, Bijaya Aryal, Tarun Poudel, Kapil Amgain
      Abstract: Introduction: Infertility is being a common global problem affecting one couple in six.  Approximately 167 million ever-married women aged 15-49 years in developing countries were infertile. The problem of infertility has not given attention considering the fact that it is not life-threatening, but, it has substantial community health problems such as depression, anxiety domestic violence and social isolation. The purpose of the study was to explore the causes of infertility among couples who visited the infertility centre. Methodology: Hospital-based descriptive cross-sectional study had been carried out in infertility centre Kathmandu Nepal. One hundred and sixty-five married couple with infertility problem availing the infertility treatment was selected on first come first serve basic sampling method from the infertility treatment centre. Result: The infertility problem varied with the age. The problem was highest among the females of age group 26-30 years (51%), similarly, in males, it was predominant at the age of 31-35 years (45%). The most common causes of female infertility were ovarian cyst (37%) and heavy bleeding (18.7%), uterine fibroids (9%), Pelvic inflammation (9%), Thyroid disease (21.8%), whereas in males the infertility was mostly due to Oligospermia (17.5%), Azoospermia (5.5%), Hydrocele (7.8), Mumps orchids (6%).  Conclusion: Infertility was due to various causes in the male or/and the female partner, however, infertility among couples were mostly due to the problem in females. Infertility is a complex problem that should be considered carefully by the individual, community peoples, government and stakeholders in each country. Keywords: Male Fertility, Female Fertility, Causes, Couple, Infertility, Ovarian Cyst
      DOI : http://doi.org/10.3126/jkahs.v2i2.25180
      PubDate: 2019-08-13
      Issue No: Vol. 2, No. 2 (2019)
       
  • Anesthetic Management of Multiple Trauma with Humerus Fracture and
           Pneumothorax

    • Authors: Nirmal Kumar Gyawali, Prastuti Sharma
      Abstract: Abstract Background: Trauma is a significant health problem and a leading cause of death in all age group. Methodology: In this study, we describe anaesthetic management of polytrauma with pneumothorax in a 55 years old male with humerus fracture. Result: Patient with multiple trauma with pneumothorax was safely anaesthetized with regional anaesthesia. This procedure also prevented progression of pneumothorax to tension pneumothorax. Conclusion: Regional anaesthesia is a safe alternative of general anaesthesia in case of a patient with pneumothorax for the upper limb surgery. Keywords: Supraclavicular Brachial plexus block, Axillary Brachial plexus block, Pneumothorax
      PubDate: 2019-08-13
      Issue No: Vol. 2, No. 2 (2019)
       
  • Topiramate Adjunctive Therapy for Olanzapine Induced Weight Gain in
           Patients with Schizophrenia

    • Authors: Sanjib Pandit, Asha Sharma
      Abstract: In recent days, the prevailing use of second-generation antipsychotics (SGA) or atypical antipsychotics over conventional antipsychotics have shifted the concern of physician from extrapyramidal side effects to the weight gain in the patients receiving treatment for schizophrenia. Among others atypical anti-psychotics, the phenomenology of Olanzapine related weight gain is highly recognized in the clinical practice. However, the exact mechanism by which Olanzapine exerts weight gain effect is largely not understood and is very likely to be multi-factorial. Among other several risk factors, factors such as 5HT2c polymorphisms and H1 receptor affinity have also been purposed. Similarly, various neuro-endocrinal factors related in maintaining energy homeostasis have also been observed to be affected by Olanzapine treatment. However, no consistent findings are available to clearly explain the underlying psychopathology of disease spectrum in schizophrenia. However, though, recent finding from a clinical trial carried out in healthy male volunteers have suggested that the low baseline TSH profile predicts Olanzapine related weight gain and also interestingly relief by Topiramate adjuvant therapy. However, no such investigations were found in a schizophrenic patient. Keywords: Topiramate, Olanzapine, Weight Gain, Schizophrenia
      DOI : http://doi.org/10.3126/jkahs.v2i2.25183
      PubDate: 2019-08-13
      Issue No: Vol. 2, No. 2 (2019)
       
  • Can the Delhi Government’s ‘Mohalla’ clinic overcome its challenges
           and provide quality health services to the urban poor population'

    • Authors: Bhuvan KC, Pathyil Ravi Shankar, Sunil Shrestha
      Abstract: The ‘Mohalla’ clinics were set up by the Delhi state (provincial) government in India in 2014 to provide basic health services to people of Delhi city and its vicinity, especially targeting the urban poor. The Mohalla clinics are staffed by a doctor, a nurse, a pharmacist and a laboratory technician and they provide basic health services including immunisation, family planning and counselling services. The Mohalla clinic program had a good start and its operation was cost-effective; however, it is still struggling to increase its coverage to entire Delhi state as it had planned. The program got caught up in the central government and state government bureaucratic tussle, especially on the issue of acquiring land for setting up such clinics and on the implementation front due to the lack of operational plan and collaboration with the government line agencies. Thus, despite political will and funding a potentially viable urban health program may have got stuck in the operational procedural complexities and political-bureaucratic tussle. This commentary article tries to discuss the challenges faced by the Delhi government’s ‘Mohalla’ clinics and a possible way forward to scale it up as a model urban health program. Keywords: Access; Delhi government; health services; ‘Mohalla’ clinics; urban health
      DOI : http://doi.org/10.3126/jkahs.v2i2.25185
      PubDate: 2019-08-13
      Issue No: Vol. 2, No. 2 (2019)
       
  • Clinical Presentation in Chronic Kidney Disease Patients on Regular
           Haemodialysis Attending in Tribhuvan University Teaching Hospital
           Emergency Services

    • Authors: Tirtha Man Shrestha, Pratap Narayan Prasad, Ram Prasad Neupane, Laxman Bhusal, Rajan Ghimire
      Abstract: Background: Chronic kidney disease is increasing day by day and so is condition of renal replacement therapy; mainly hemodialysis. Emergency visit of the patients under maintenance hemodialysis is frequent. The objective of the study is to study clinical parameters of these patients so that in future these deranged parameters can be focused during patient management and decrease their emergency visit. Methods: A prospective cross sectional study was conducted in emergency services of Tribhuvan University Teaching Hospital from 1st May 2018 to 31st October 2018 among the adult chronic kidney disease patients under maintenance hemodialysis. Ethical approval was taken from Institutional review board, Institute of medicine, TribhuvanUniversity.Nonprobability sampling method was used. Total of 300 patients were enrolled in the study. Patients’ age, sex, causes, laboratory parameter during emergency visit, need of emergency hemodialysis, and need of blood transfusion were studied. Results: Out of total 300 patients, mean age was 45.64 years (S.D =17.15). 190 (63.3 %) were male and 110(36.70%) were female. 152(50.70%) of patients had hypertension. Diabetes and Glomerulonephritis both had equal prevalence of 63(21%). Mean hemoglobin was 6.52gm% (S.D = 1.93). Mean pH was 7.17 (S.D =0.154). Mean serum potassium and creatinine level were 5.77 mEq/L (S.D =0.76) and 1076.03 mmol/l (S.D =367.25) respectively. Area under the Receiver Operating Curve was 0.660 for potassium and 0.598 for serum creatinine. Conclusions: Causes of chronic kidney disease, decreased hemoglobin level, increased serum creatinine and potassium level and metabolic acidosis are causes of frequent emergency room visit among CKD patients.  So these conditions need to be addressed to decrease emergency visit of these patients. Keywords: chronic kidney disease; emergency presentation; mortality.
      DOI : http://doi.org/10.3126/jkahs.v2i2.25167
      PubDate: 2019-08-01
      Issue No: Vol. 2, No. 2 (2019)
       
  • Adolescent pregnancy and its outcome in rural teaching hospital, Karnali
           Academy of Health Science Jumla

    • Authors: Purnima Rai, Namrata Sindan, Bishnu Dutta Acharya, Rajiv Shah, Sandeep Shrestha
      Abstract: Introduction: Nepal is a low socioeconomic country and adolescent pregnancy can have a deleterious effect on the mother, child and the community. The aim of this study was to know the incidence of teenage pregnancy and its outcomes in the mid-western region of Nepal Method: This was a retrospective study conducted in Karnali Academy of Health Science, Jumla, Nepal. Data were collected from the hospital records from October 2017 to September 2018. Result: The incidence of teenage pregnancy was 22.6% among total deliveries. Most of them were Primigravida (84.9%). Majority of them were 18 years of age (47.5%). Caesarean section accounted for 10.8%. In perinatal outcome, the incidence of preterm birth was 15.1%, and extremely low birth weight was 2.2%, very low birth weight was 1.4% and low birth weight was 12.2%. Maternal complication accounted for 33.09%.   Conclusion: The study concluded that the incidence of teenage pregnancy is considerably high and it is associated with an increases risk of an adverse outcome to both mother and newborn. Therefore, education and awareness can be helpful in reducing adolescent pregnancy and its adverse outcomes. Keyword: Adolescent pregnancy, teenage pregnancy, Karnali Academy of Health Science, Jumla, Nepal, Intrauterine Fetal Death, World Health Organization (WHO)
      DOI : http://doi.org/10.3126/jkahs.v2i2.25169
      PubDate: 2019-07-30
      Issue No: Vol. 2, No. 2 (2019)
       
  • Base Deficit as a Predictor of Mortality in Sepsis and Septic Shock.

    • Authors: Laxman Bhusal, Pratap Narayan Prasad, Yogendra Man Shakya, Ramesh Prasad Acharya
      Abstract: Introduction: Sepsis is a common problem encountered in the emergency room which needs to be intervened early. It is always difficult to have the quick prognostic marker of sepsis in busy emergency. So this study was conducted to determine whether base deficit can be used as an indicator of mortality among septic patients in emergency room set up like ours. Methods: It was a hospital-based descriptive cross-sectional study done at Tribhuvan University Teaching Hospital, Kathmandu from March 2018 to December 2018.  Acute physiology and chronic health evaluation II score(APACHE II), Base deficit, Sequential Organ Failure Assessment(SOFA)score on first day of arrival in the emergency room were calculated. The association of 28-day outcome with Acute physiology and chronic Health Evaluation II score, Base deficit value and SOFA score were derived. Results: Out of 229 patients with septic shock 62 died (27%) and among 71 patients without septic shock,12 died(16.9%) .Overall mortality was 24.66 %(n= 74).The area under the ROC curve for Base deficit(0.864;95% C.I.=0.822-0.906), APACHE II( 0.782;95%C.I=0.718-0.848;,SOFA(0.689;95% C.I=0.620-0.757) were greater than 0.7 except for SOFA which signifies these test to  have fair efficacy to predict mortality. Conclusions: High base deficit value predicts mortality in patients with sepsis and septic shock. Keywords: Base Deficit; Sepsis; Septic Shock, Predictor, Mortality
      DOI : http://doi.org/10.3126/jkahs.v2i2.25166
      PubDate: 2019-07-28
      Issue No: Vol. 2, No. 2 (2019)
       
  • Comparison of High Resolution Computed Tomography with Intraoperative
           Findings in Patient with Chronic Suppurative Otitis Media, NAMS, Bir
           Hospital, Kathmandu, Nepal

    • Authors: Yagya Bahadur Rokaya, Prakash Shahi
      Abstract: Introduction: Chronic suppurative otitis media (CSOM) is an important cause of middle ear disease and its complications challenge both otologist and radiologist. The major benefit of HRCT is an excellent visualization of the osseous structure by means of special algorithms. This study compares the HRCT with intraoperative findings in patients with CSOM. Methods: This is an observational descriptive study conducted at NAMS Bir Hospital. Total of 30 patients, referred for HRCT from the department of ENT were studied. Comparison of HRCT findings was done with intraoperative findings regarding the status of EAC, ossicular chain, bony plate, inner ear structure and facing nerve canal was done, considering intraoperative findings as the gold standard. Results: Out of 30 patients, 16 patients had CSOM with cholesteatoma and 14 patients had CSOM without cholesteatoma.HRCT presented sensitivity, specificity, positive predictive value, negative predictive value and accuracy of 87.5%, 85.7%, 87.5%, 85.7% and 86.7% respectively in diagnosing CSOM with cholesteatoma. HRCT presented sensitivity and specificity of 85.7% and 87.5% in identification of malleus erosion, sensitivity and specificity of 86.7% and 80%, in the identification of incus erosion. HRCT showed the specificity of 85% with relatively low sensitivity of 70% in identification of erosion of stapes. HRCT showed a sensitivity of 100% and specificity of 85.7%. HRCT presented sensitivity and specificity of 83.3% and 95.8% in diagnosing tegmen tympanum erosion. HRCT showed the highest sensitivity (100%) and specificity (100%) in diagnosing erosion of sigmoid sinus plate and mastoid cortex. HRCT showed relatively low sensitivity of  66.7% and 75% in diagnosing erosion of LSCC and facial canal respectively.HRCT detected soft tissue mass in the middle ear/mastoid in all 30 patients of CSOM. Hence, the sensitivity, specificity, positive predictive value and negative predictive value of HRCT for soft tissue mass in the middle ear and mastoid, all were 100%. Conclusion: The HRCT has a valuable role in preoperative evaluation of a case of CSOM. It has high sensitivity in diagnosing CSOM with cholesteatoma. However, HRCT has relatively low sensitivity for LSCC and facial nerve canal erosion. Keywords: HRCT, CSOM, Cholesteatoma, Preoperative evaluation
      DOI : http://doi.org/10.3126/jkahs.v2i2.25181
      PubDate: 2019-07-28
      Issue No: Vol. 2, No. 2 (2019)
       
 
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