Mean Brixia Severity Scores among Symptomatic COVID-19 Patients in a Tertiary Care Centre: A Descriptive Cross-sectional Study.

Introduction: COVID-19 is a highly contagious viral disease which escalated into a global pandemic since its outbreak on 31 December 2019. Chest X-rays are the most common investigation in suspected cases to diagnose and manage pneumonia. The aim of this study was to find out the mean Brixia severity scores among symptomatic COVID-19 patients in a tertiary care centre. Methods: A descriptive cross-sectional study was conducted among the chest X-rays of symptomatic COVID-19-positive patients of a tertiary care centre. Data from 1 May 2021 to 31 July 2021 were collected between 1 August 2022 and 1 January 2023 from the hospital records. Ethical approval was taken from Institutional Review Committee (Reference number: 01-079/080). Patients with reverse transcriptase polymerase chain reaction with symptoms of COVID-19 were included in this study. Convenience sampling method was used. Point estimate and 95% Confidence Interval were calculated. Results: Among the total of 300 patients, the mean Brixia severity score was 7.15±5.07 and out of 235 patients with abnormal chest X-ray, the mean Brixia severity score was 9.13±3.84. A total of 68 (22.66%) patients had mild, 115 (38.33%) had moderate and 52 (17.33%) had severe scores. Conclusions: The mean Brixia severity score among symptomatic COVID-19 patients was found to be higher than the other studies done in similar settings. Keywords: COVID-19; Nepal; pneumonia; prevalence; x-ray.

Klippel-Feil Syndrome Associated with Renal and Cardiac Anomalies in an Infant: A Case Report.

Klippel-Feil syndrome is a rare congenital bone disorder characterised by a triad of short neck, low posterior hairline and limited lateral bending of the neck with an annual incidence of 1 in 40,000 live births. It has remained an obscure term in the medical literature because of its variability in presentation and wide spectrum of anomalies involving multiple organ systems. It is unusual to find a case that has all three classical triad features. Here, we present a case of a 9-month-old infant who manifests not only all three classical triad features associated with Klippel-Feil syndrome but also demonstrates the presence of congenital heart disease, scoliosis, and renal ectopia. An early comprehensive evaluation of a suspected case is essential for diagnosis and counselling which impacts its prognosis, helps minimize social stigma and affords parents the opportunity to consider cosmetic surgery as an option, should they choose to pursue it. Keywords: case reports; congenital; heart diseases; Klippel-Feil syndrome; scoliosis.

Sinusitis among Patients Undergoing CT Scan of Paranasal Sinuses in a Tertiary Care Centre: A Descriptive Cross-sectional Study.

Introduction: Computed tomography imaging provides detailed information about the paranasal sinuses and is now well established as an alternative to standard radiographs in evaluating patients with sinusitis. Sinusitis can have dangerous complications which can even lead to death if not diagnosed and treated on time. This study aimed to find the prevalence of sinusitis among the patients undergoing Computed Tomography scan of paranasal sinuses in a tertiary care centre. Methods: A descriptive cross-sectional study was conducted in the Department of Radiology at a tertiary care hospital from 1 October 2021 to 30 April 2022 after taking ethical approval from the Institutional Review Committee (Reference Number: 023-078/079). The patients undergoing Computed Tomography paranasal sinuses and meeting the eligibility criteria were enrolled for the study after taking informed consent. Convenience sampling was done. Point estimate and 95% Confidence Interval were calculated. Results: Among 113 patients, 109 (96.46%) (93.05-99.87, 95% Confidence Interval) patients had sinusitis. The most common subtype was found to be acute sinusitis in 63 (57.79%) individuals. Conclusions: The prevalence of sinusitis was higher than in other studies done in similar settings. Keywords: computed tomography; paranasal sinuses; sinusitis.

Study of the impact of a telemedicine service in improving pre-hospital care and referrals to a tertiary care university hospital in Nepal.

Background: Telemedicine is a process which involve medical experts to exchange valid information for diagnosis, clinical management, treatment and counseling for both healthcare workers and patients remotely in rural setting from urban healthcare center. Providing quality healthcare services in Nepal is challenging due to many reasons such as difficult geographic terrain, limited availability of funding and many other issues. Methods: The study design was a cross sectional and will adopt an interpretative case study approach which supports the researcher to develop a deep insight in to study phenomenon and outcomes. Study was conducted at in two rural-telemedicine programme implementation sites, namely Patle, Fikkal Bazaar and one central consultation site BPKIHS Dharan. Result: A total of 315 patients were undergone teleconsultation process during the study period. The total patients consulted after teleconsultation program in each of center were 1386 (Phikal) and 508 (Patle). Among them 205 (Phikal) and 110 (Patle) were called on the teleconsultation day. Among the patients who were seen via teleconsultation, 36 (2.6 %) from Phikal and 22 (4.3%) from Patle were referred to BPKIHS. The total number of referred patient from those center to other center were 327(Phikal) and 208 (Patle) among those referred 205 (Phikal) and 110 (Patle) came during teleconsultation Process. Conclusion: Telemedicine can be used as a critical component in the solution of the healthcare crisis. Telemedicine will be the best as a substitute to improve the access to healthcare, to provide the healthcare cost-effectively. The current paradigm of care can be taken by telemedicine due to which improved health outcomes can be achieved in cost effective Ways.