Grande International Hospital

Introduction: In times of disaster in rural settings, helicopter rescue is crucial. Since the 1990s, helicopters without any medical support have been used to transport patients from remote areas to tertiary care centers. In 2013, private organizations improved pre-hospital care by adding medical teams and equipment, making Helicopter Emergency Medical Services (HEMS) a critical part of emergency care, particularly in remote areas. Methods: This retrospective observational study analyzes patients who were transferred by helicopter to Grande International Hospital (one of the tertiary centers in Kathmandu, Nepal) between May 10, 2018, and May 9, 2024. Patient’s demographics (age, gender, ethnicity), medical conditions/outcomes, and geographic origins were analyzed. Data was analyzed using SPSS version 25. Results: The 782 helicopter rescues show that 68.8% of the participants were men, with a mean age of 47.21 years. Of them, 90.92% were Nepalese, and the majority of cases (42.23%) were transferred from Province 4 of the country. Pneumonia (211 cases), trauma (107), neurological emergencies (85), cardiovascular emergencies (44), and COVID pneumonia (140) were among the major medical reasons for transfer. The COVID pandemic highlighted the importance of HEMS. 40.4% of cases were self-landed, whereas 59.6% of cases were accompanied by HEMS physicians. Interhospital transfers and a sizable portion of high-altitude operations were part of many rescues. With an average hospital stay of 13.73 days and a 14.3% mortality rate, the majority of patients were admitted to the intensive care unit. Conclusion: HEMS has significantly saved lives over the years at a particular tertiary hospital. This data allows for advancing HEMS use in a rural setting like Nepal, especially during times of disaster, to provide acute medical and rescue care. It is imperative to address and evaluate HEMS accessibility and its importance regarding infrastructure, cost, geographic diversity, and the country’s vulnerability to disaster.

Role ambiguity is a multidimensional construct with diverse manifestations that negatively influences the job satisfaction of software product managers in Nepal. This study examines the relationship between different manifestations of role-based ambiguities and their subsequent impact on levels of job satisfaction for software product managers in Nepal. This study has applied a cross-sectional survey research design together with descriptive statistics and multiple-regression analysis to analyze and evaluate the relationships between task-based, responsibility-based, procedural, and authority-based role ambiguities and their negative effects on job satisfaction. This study finds that among different dimensions of role ambiguities, procedural and task-based role ambiguities significantly and negatively affect the job satisfaction of software product managers. Besides, negative effects of both types of task-based and procedural-based ambiguity underline critical areas for organizational interventions. This study has an originality value, as it is the first of its kind of research that examined the impact of different dimensions of role ambiguities on job satisfaction of software product managers recognizing their job design, specifications, and specializations.

Foreign body aspiration (FBA) in children can often present with subtle symptoms that closely resemble common respiratory conditions such as asthma or pneumonia, leading to potential misdiagnosis. This case report is about a four-year-old boy who had ongoing breathing problems and was treated for almost a year before the real cause was diagnosed: a yak bone stuck in his airway. The diagnosis was ultimately made at Grande International Hospital, a year after the initial aspiration. This case underscores the diagnostic challenges in resource-limited settings and highlights the importance of maintaining a high index of suspicion when standard treatments fail to resolve symptoms.

Cage Retropulsion is an uncommon complication following transforaminal lumbar interbody fusion (TLIF) surgery. The estimated rate of cage retropulsion has reportedly been < 1% in previous studies. Risk factors for cage retropulsion after lumbar interbody fusion surgery includes patient related factors, radiological findings, surgical procedure-related factors and postoperative factors. In the event of retropulsion, revision surgery should be performed for patients with neurologic deficits or clinically symptomatic, and conservative treatment is encouraged in patients who are asymptomatic.

BackgroundViolence against women and girls with disabilities remains a serious, yet underexplored, global concern. This paper aims to investigate the prevalence and factors associated with life-time experience of violence within this vulnerable population in Nepal.MethodsThis cross-sectional study was conducted in 28 municipalities representing all seven provinces as well as all three ecological regions of Nepal. A total of 1,294 women and girls with disability aged 15–59 years participated in this study. Data were collected in the period August to October 2021. This was done by trained enumerators using the KoBo application on smartphones or tablets. Both written and oral informed consent was sought from all participants. Each participant was assured of utmost confidentiality and privacy. Cross-tabulations were performed in STATA 18 to determine the distribution of the prevalence of violence. Also, bivariable and multivariable logistic regression models were fitted to establish association between the participants’ characteristics and odds of experiencing violence.ResultsOverall, 457 (35.32%) women living with disabilities had ever experienced violence at a point in their lifetime. Psychological/emotional violence was the most prevalent violence (74.40%) followed by physical violence (31.07%) and denial of services (28.67%). Age was positively associated with the likelihood of experiencing violence. Women belonging to the Brahman/Chhetri ethnic group had reduced odds of violence [AOR = 0.56; 95%CI: 0.37–0.85] compared to Hill Dalits. Divorced or separated women showed a markedly higher likelihood of experiencing violence [AOR = 6.69; 95%CI: 2.31–19.40] compared to currently married women. Participants who had not witnessed violence against other women exhibited significantly higher odds of experiencing violence [AOR = 1.86; 95%CI: 1.20–2.89]. Women living in the Koshi province [AOR = 4.04; 95%CI: 2.54–6.42], Madhesh province [AOR = 2.16; 95%CI: 1.15–4.08] and Bagmati province [AOR = 2.21; 95%CI: 1.41–3.46] reported significantly higher odds of experiencing violence compared to those in Karnali.ConclusionThe study concludes that age, ethnicity, marital status, and provincial residence are significant predictors of violence among women living with disability in Nepal. Interventions aimed at addressing violence against women living with disability in Nepal must prioritize older women and those who were previously married. Also, priority must be given to Koshi, Madhesh and Bagmati provinces where the prevalence and risk of experiencing violence is highest.

Proficiency in academic writing, particularly in journal article composition, is a critical skill for researchers, educators, and postgraduate students in higher education. This study evaluates the effectiveness of a targeted writing workshop conducted by Academia International College, a private institution, designed to enhance journal article writing skills among faculty members and postgraduate students. Despite the increasing prevalence of such workshops, limited empirical evidence exists regarding their impact in private college contexts. Adopting a descriptive survey design, data were collected through structured questionnaires incorporating Likert-scale items across five key dimensions: content, delivery, engagement, learning outcomes, and logistics. The findings indicate that 93% of participants found the workshop content highly relevant, with practical applications for academic writing. The majority reported clear and engaging instruction supported by visuals and case-based examples, though some participants noted issues related to pacing. High engagement levels were observed, with 93.4% affirming that the workshop was interactive and well-timed. Regarding learning outcomes, 86.6% of respondents reported increased confidence in writing journal articles, while 93.3% expressed willingness to recommend the workshop to others. Feedback on logistics was generally positive, with minor suggestions for improving workshop materials. Overall, the workshop effectively addressed its objectives by delivering skill-based, context-specific training tailored to the needs of a private higher education audience. This study contributes to the discourse on academic writing pedagogy by highlighting the value of targeted professional development initiatives in under-researched private college environments.

Pseudomonas aeruginosa is known to cause hospital-acquired infections. This bacterium produces β-lactamase enzymes that enzymatically degrade β-lactam drugs, reducing their efficacy. The objective of this investigation was to examine the occurrence, susceptibility, and production of various β-lactamases by multidrug-resistant P. aeruginosa (MDR-PA) and to determine the risk factors associated with extensively drug-resistant P. aeruginosa (XDR-PA) and their β-lactamases. A descriptive cross-sectional study was conducted to investigate the occurrence, susceptibility, and β-lactamase production of MDR-PA and the risk factors associated with XDR-PA. The study involved collecting and analyzing 390 specimens from different 390 participants over a period from August 2021 to April 2023. The study utilized standard methodologies to screen and characterize P. aeruginosa. The antimicrobial-resistant patterns and presence of MDR-PA and XDR-PA were determined following standard guidelines supported by the Clinical Laboratory Standards Institute (CLSI) using various methods such as the disk diffusion method and colistin disk elution tests. Combined disk and inhibitor-based tests were used to determine extended-spectrum β-lactamases (ESBL), Metallo-β-lactamases (MBL), and AmpC-β-lactamases (AmpC) using two different methods. Clinical data were extracted from the medical records and patient requisition forms provided by clinicians. Clinical data were extracted for XDR-PA and β-lactamases applying binary logistic regression by adjusting for the confounding factors. In our study, the antimicrobial-resistant pattern showed significant differences (p < 0.05) in the antibiotic-resistant pattern among β-lactamase and non-β-lactamase. The prevalence of MBL-P. aeruginosa was determined to be 13.5%, while ESBL accounted for 23.8%, and AmpC accounted for 20.5%. Coexistence of MBL + ESBL, ESBL + AmpC, MBL + AmpC, and MBL + ESBL + AmpC was determined to be 5.3%, 2.8%, 2.3%, and 4.1%, respectively. Among the nine assessed risk factors in a multivariate regression model, prolonged hospital stays (odd ratio = 11.2, 95% CI 3.7-33.8) provided substantial risk compared to other risk factors for the colonization of XDR-PA. Similarly, in a multivariate model, previous therapy with immunosuppressant drugs (OR = 6.7, 95% CI 1.5-29.3) was found to be the leading risk factor for the colonization of β-lactamase producers P. aeruginosa. Identification of XDR-PA and β-lactamases among MDR-PA isolates is crucial to prevent the use of unnecessary antibiotics. Early and prompt diagnosis of drug-resistant pathogens prevents treatment failure and encourages proper antibiotic therapy. Therefore, it is necessary to implement strict policies on the use of antibiotics without proper diagnosis.

Introduction: Chronic urticarial (CU) is the condition characterized by the occurrence of itchy, erythematous and evanescent wheals for prolonged duration, usually more than 6 weeks. Its recurrence and flares have been linked to decreased quality of life and work productivity in vast majority of patients. Herein, we have attempted to delve into prevalence and association of this chronic yet intractable entity. This will aid in assessing concomitant factors associated with this chronic condition and facilitate holistic treatment for this chronic condition. Methods: A total of 125 patients with diagnosis of CU were included in this hospital-based observational study. Demographic details of the patients along with the associated factors were recorded in a pre-formed proforma and analyzed. Results: More than three fourth of our patients had Chronic Spontaneous Urticaria (CSU), and amongst them, generalized wheal was present in 92% of them. Angioedema was present in 40% the CU patients. An increased incidence of CU was seen in almost three fourth (72%) of our patients in age group of 16-45 years with predilection in females with a ratio of 1.7:1. Forty eight percent of our patients had severe itch and the mean duration of CU in our patient was 34.98 ± 5.26 months. Our study also showed an increased incidence of ASST positivity in 48% of CU subjects studied. Conclusions: This study re-iterates clinic-epidemiological and associated factors in chronic urticaria. Thus, relevant associated factors such as angioedema, severity of itch, thyroid dysfunction, helminthic co-infestation, exacerbating factors and atopiform predilection can be identified and managed timely to treat this recalcitrant and chronic entity which often takes a toll on patient’s quality of life and daily activities.

Abstract Background: This study examines the prevalence of nasal septum and cavity variants in the Nepali population at our hospital. Method A retrospective cross-sectional study of 342 adults (aged &gt; 13) at a private hospital in Nepal assessed CT scans for nasal septum variants, deviation angles, and nasal turbinate and pneumatized uncinate process variants. Deviations were graded I-IV, with gender-specific prevalence and mean deviation angle calculated. Statistical significance was tested using chi-squared, t-tests, and ANOVA. Results The prevalences were as follows: nasal septum deviation (76.68%), septal spur (41.98%), septal pneumatization (40.23%), hypertrophied inferior turbinate (38.48%), lamellar concha (34.11%), concha bullosa (19.83%), supreme turbinate (9.33%), paradoxical middle turbinates (9.33%), and pneumatized uncinate process (8.45%). Nasal septum deviation was right-sided in 34.11%, left-sided in 34.40%, and S-shaped in 8.16%. The prevalences of nasal septum types were: type I (30.9%), type II (48.1%), type III (16.91%), and type IV (4.08%). The mean septal deviation angle was 6.77° (SD 4.52°), and considering cases with a deviated septum only, the mean was 8.64° (SD 3.2°). Significant associations were found between deviated septum and septal spur, concha bullosa, hypertrophied inferior turbinate, and paradoxical middle turbinate (p &lt; 0.001, 0.012, 0.001, 0.016). Additionally, there were significant associations between types of nasal septal deviation and the sides of concha bullosa, hypertrophied inferior turbinate, and septal spur (p = 0.006, &lt; 0.001, &lt; 0.001). The prevalence of concha bullosa was significantly higher in females (p = 0.001), and a significant association was found between nasal septum types and concha bullosa (p = 0.003). There was a significant difference in the deviation angle among the variants of deviated nasal septum (p = 0.048), particularly between left-sided deviation and S-shaped nasal septum (p = 0.024). Conclusion Recognizing variants of nasal septum and nasal cavities is crucial to prevent surgical complications.