Introduction: Patient satisfaction is an important component of quality nursing care and is often determined by the nursing care in any health institution. The aim of the study is to find the presence of satisfaction among in-ward patients of five major wards at a tertiary care hospital regarding the quality of care provided by nursing staff. Methods: A descriptive cross-sectional study was conducted among 105 patients of Patan Hospital from 3rd July to 3rd August, 2015 after obtaining ethical clearance from Institutional Review Committee. Sample size was calculated and stratified random sampling was done. Data was collected in Microsoft Excel and analyzed in Sta 13.0. Point estimate at 95% Confidence Interval was calculated and frequency and percentage was calculated for binary data. Subgroup analysis was done on the basis of demographic variables. Results: Among 105 patients, 99 (94.3%) [94.93-95.07 at 95%CI] were satisfied with the nursing care provided at a tertiary care center in Nepal. Among them, 60 (60.6%) were females and 39 (39.4%) were males. Age of the patients ranged from 1 year to 85 years. The length of the stay in the hospital ranged from 2 to 17 days (mean = 5.6 days). Conclusions: Most of the patients were satisfied with the nursing care provided in a tertiary care centre. Routine nursing care surveys and immediate feedbacks would keep the authorities updated and deliver good health care.

Introduction: Epistaxis is a common medical emergency with 5% to 15% of patients admitted for epistaxis will require surgical management as nasal packing has high failure rates. A modern endoscopic technique like Endoscopic Sphenopalatine Artery Ligation has increased in popularity for managing intractable posterior epistaxis. It has less complication and a high success rate. The study conducted to estimate the success rate of Endoscopic Sphenopalatine Artery Ligation of refractory posterior epistaxis among admitted patients in a tertiary care hospital. Methods: This is a descriptive cross-sectional study conducted from June 2019 to June 2020 at the Department of Otorhinolaryngology, Nobel Medical College and Teaching Hospital among the patient with refractory posterior epistaxis with the help of retrospective data. A convenient sampling method was used. These patients underwent endoscopic sphenopalatine artery cauterization for recurrent/intractable posterior epistaxis. Ethical clearance was taken from the Institutional Review Board. Data were analyzed in Statistical Package for the Social Sciences. Results: Out of the total patient with refractory posterior epistaxis who underwent Endoscopic Sphenopalatine Artery Ligation, the overall success rate was 39 (95.12%). Among them, 25 (60.97%) males and 16 (39.02%) females underwent endoscopic sphenopalatine artery ligation. Twenty (48.78%) of them were unilateral whilst 21 (51.21%) were bilateral disease. About 2 (4.8%) cases had re-bleeding within 48 hours which was managed conservatively. Hypertension was found to be the most common comorbid condition followed by diabetes, chronic kidney. Conclusions: From our study, we conclude that the success rate for Endoscopic Sphenopalatine Artery Ligation in a patient with refractory posterior epistaxis was high.

Background: Deviated nasal septum (DNS) is easily caused by trauma and septal surgeries have evolved from forceful fractures to endoscopic surgery being the leading trend now. Endoscopic surgery has lots of advantage over the conventional headlight method in alleviating symptoms and reducing complications. Endoscopic septoplasty without the nasal packing significantly shorten the surgery time and hospital stay thus reducing the financial burden. Hence this prospective study done in Nobel Hospital and Teaching Center was an Endeavour to see the indications, technique and outcome of the new surgical procedure. Materials and Methods: Sixty-five patients irrespective of sex in the age group of 18-60 years were enrolled in the study from December 2017 to December 2018. All symptomatic DNS confirmed by 00 and 300 rigid endoscope were enrolled. Informed consent from patients and ethical clearance was taken. Results: The maximum patients were in the age group of 18-30 years. The commonest symptoms of the patient was nasal obstruction in 51(78.46%), followed by post-nasal drip in 20(30.76%), hyposmia in 17(26.15%), headache in 15(23.07%) and epitasis in 10(15.38%). According to Mladina classification, the commonest deviated septum was type V in 29(45%), followed by type VI in12(18%), type II and IV in 7(11%) each, type VII in 6(9%) and least being type III in 4(6%) patients. There were no patients with Mladina type I DNS in this study. The improvement in symptoms were 90% in nasal obstruction, 88% in hyposmia, 85% in post nasal drip, 90% inepistaxis and 100% in headache. The complications were haemorrhage in 1(1.5%), synechia2(3.07%), mucosal tear 5(7.69%), haematoma 1(1.5%) and persistant DNS 5(7.69%). The average hospital stay was 48 hours. Conclusion: Endoscopic septoplasty without post-operative packing is very convenient to the patient. Endoscopic septoplasty with trans- septal suture is safe, cost effective and a better alternative.