title: Evaluation of Etiology of Epistaxis and its Management in Dhulikhel Hospital.
abstract: BACKGROUND
  Epistaxis is one of the most common and most difficult emergencies presenting in 7-14% of the general population each year. Although its lifetime incidence is about 60%, only 6% require formal medical intervention but they can be serious and even life threatening.
  
  
  OBJECTIVE
  The main objectives are to study different etiology, types, modality of treatment of epistaxis. Specific objective is also to find out if the modality of treatment is associated with age, site, amount of bleeding and etiology.
  
  
  METHODS
  It is a prospective, cross sectional, longitudinal, analytical study done in Department of ENT, Dhulikhel hospital, Kathmandu University School of Medical Sciences (KUSMS) from Aug. 2010 to Aug. 2013. Data was collected. This study was cleared through institutional review committee of hospital. Statistical analysis was done using SPSS 16.0.
  
  
  RESULTS
  487 patients were studied during the period. There was significant association between age group with type of treatment (p value 0.002); and with admission (p value < 0.001). Significance in the study was also shown in the correlation between site of bleeding and the type of treatment and also with alcohol intake with site of bleeding (p value < 0.001).However there was no significance between hypertension and the type of treatment methods chosen (p value > 0.01).
  
  
  CONCLUSIONS
  Management of epistaxis is challenging. Most are managed by non surgical means whereas some by surgical treatment. Non surgical treatment is still useful, safe and cost effective. Type of treatment and need for hospital stay is related to age and site of bleeding.
authors.affiliation: Department of ENT, Head & Neck Surgery Dhulikhel Hospital, Kathmandu University School of Medical Sciences (KUSMS), Dhulikhel, Kavre, Nepal.
authors.forename: I
authors.initials: I
authors.lastname: Shrestha
authors.affiliation: Department of ENT, Head & Neck Surgery Dhulikhel Hospital, Kathmandu University School of Medical Sciences (KUSMS), Dhulikhel, Kavre, Nepal.
authors.forename: M
authors.initials: M
authors.lastname: Pokharel
authors.affiliation: Department of ENT, Head & Neck Surgery Dhulikhel Hospital, Kathmandu University School of Medical Sciences (KUSMS), Dhulikhel, Kavre, Nepal.
authors.forename: B L
authors.initials: BL
authors.lastname: Shrestha
authors.affiliation: Department of ENT, Head & Neck Surgery Dhulikhel Hospital, Kathmandu University School of Medical Sciences (KUSMS), Dhulikhel, Kavre, Nepal.
authors.forename: A
authors.initials: A
authors.lastname: Dhakal
authors.affiliation: Department of ENT, Head & Neck Surgery Dhulikhel Hospital, Kathmandu University School of Medical Sciences (KUSMS), Dhulikhel, Kavre, Nepal.
authors.forename: R Cm
authors.initials: RC
authors.lastname: Amatya
mesh_terms: D000328:Adult; D000368:Aged; D015897:Comorbidity; D003430:Cross-Sectional Studies; D004632:Emergency Medical Services / Q000706:statistics & numerical data; D004844:Epistaxis / Q000453:epidemiology* / Q000628:therapy*; D005151:Facial Injuries / Q000453:epidemiology; D005260:Female; D006801:Humans; D006973:Hypertension / Q000453:epidemiology; D015994:Incidence; D007902:Length of Stay / Q000706:statistics & numerical data*; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D009303:Nasopharyngeal Neoplasms / Q000453:epidemiology; D009390:Nepal / Q000453:epidemiology; D011446:Prospective Studies; D055815:Young Adult