Browsing by Author "Adhikari, Shree Prasad"
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Publication Knowledge and Attitude Towards Human Papilloma Virus and Human Papilloma Virus Vaccine(Nepal Health Research Council, 2024) Poudel, Sandesh; Rai, Snigdha; Adhikari, Shree Prasad; Dhakal, Sheela; Rai, Nisha; Upadhyaya, Preetam Chandra; Shah, PushkalBackground: Human papilloma virus is the leading cause of cervical cancer with Human papilloma virus 16 and 18 being the commonest variants. The primary prevention by vaccination against HPV is finally gaining its momentum. This study aimed to evaluate the knowledge and attitude towards Human papilloma virus and Human papilloma virus vaccine and highlighted on the setback of their inadequate knowledge. Methods: This was a community based cross sectional study done among 120 women who attended cervical cancer screening camp at satellite clinic of Paropakar Maternity and Women`s Hospital at Bhaisepati of Kathmandu district. The interview was done one on one with a preformed questionnaire. Data was primarily entered in an individual form and analysis was done using SPSS version 23 program and was depicted in tables, diagrams and chart. Results: The mean age of the women was 41.8±9.9 with majority belonging to age group 41-50 years (47.16%), 88 (74%) women were multiparous,59 (49%) were uneducated and 50 (33%) were previously screened for cervical cancer. Among 27 (22%) of the women who had heard about HPV and knew that it causes cervical cancer, most of them have heard from social media while 110(91.6%) did not know about its vaccine and its availability while 100% of the participants had positive attitude towards receiving the information and keen on vaccinating their daughters. Conclusions: Knowledge and awareness of Human Papilloma Virus and its vaccine still remains low among the women in our society. However, there was high acceptance of HPV vaccine, indicating potentially high uptake rates in these communities. Keywords: Attitude; human papilloma virus; knowledge; vaccine.Publication Obstetric Characteristics and Functional Outcomes in Women with Obstetric Anal Sphincter Injury(Nepal Health Research Council, 2024) Adhikari, Shree Prasad; Poudel, Sandesh; Baidhya, Sapana Amatya; Yadav, ManishaBackground: Obstetric anal sphincter injury is a complication of vaginal delivery, if left untreated, causes significant maternal morbidities; urinary problems and fecal/ flatus incontinence. The aim of this study was to determine the incidence and describe the obstetric characteristics and functional outcomes of women who had vaginal delivery at Paropakar Maternity and Women’s Hospital Nepal and sustained Obstetric anal sphincter injury. Methods: This retrospective descriptive study included women who had vaginal delivery, irrespective of parity, in the labor room or birthing unit of Paropakar Maternity and Women’s Hospital from April 2018 to September 2020, and sustained Grade III or IV Obstetric anal sphincter injury after 28 weeks period of gestation. Maternal characteristics, obstetric details and perineal status after vaginal delivery were noted after review of hospital records. The patients were further inquired via telephone for their current status of fecal and/or urinary incontinence. Results: The incidence of OASI was 106 (0.33%) among 31, 786 Nepalese women with vaginal birth over a 2-year period. The mean age women with Obstetric anal sphincter injury was 24.6 ± 4.3 years and 45(52.9%) cases belonged to Janajati ethnicity. Fifty two (61.2 %) were primipara and 77 (90.6%) had spontaneous vaginal deliveries. Episiotomy was not performed on most of the patients (63, 74.1%). Problems with flatus holding, stool holding and urine holding was reported by 28.3%, 13.2% and 22.6% women respectively. Conclusions: The incidence of Obstetric anal sphincter injury among Nepalese women with vaginal birth over a 2-year period was 0.33%, which was lower than other South Asian studies. Grade III Obstetric anal sphincter injury was the frequent most type. The injuries were more common in women with Janajati ethnicity, primipara and women who did not have episiotomy. Problems with flatus holding and urine holding were present in almost one-fourth of the women with Obstetric anal sphincter injury at follow up. Keywords: Augmentation; episiotomy; induction; obstetric anal sphincter injury.Publication Persistent Mullerian Duct Syndrome in an Adult Infertile Male: A Case Report(Nepal Medical Association, 2024) Sedhain, Nesuma; Adhikari, Shree Prasad; Pradhan, Hema Kumari; Parajuli, RakshyaAbstract Persistent Müllerian duct syndrome is a rare autosomal recessive disorder of sex development characterized by the presence of Müllerian duct derived structures in a normally virilized, genotypical (46, XY) and phenotypical male. Here we describe a case of male partner of the couple who presented with primary subfertility and was diagnosed with persistent müllerian duct syndrome during investigations. Persistent Müllerian duct syndrome is a rare disease and in developing countries like Nepal, because of unaware of the disease condition and lack of proper health care facilities, such cases are diagnosed later in adult males. Therefore, this case highlights the importance of awareness and knowledge for early detection and treatment of such conditions to conserve fertility and prevent malignancy of testis and other remnant mullerian structures.Publication The Impact of Body Mass Index on Semen Parameters: A cross sectional study(Rapti Academy of Health Sciences (RAHS), 2024) Sedhain, Nesuma; Adhikari, Shree Prasad; Pradhan, Hema Kumari; Thapa, Jwala; Parajuli, RakshyaAbstract Introduction: Infertility is an emerging health issue across the world/. Obesity is another growing health concern, which is seen associated with adverse health outcomes. Several people had investigated the effects of obesity on male infertility, with inconclusive findings. Hence the present study aimed to assess the relationship between Body Mass Index (BMI) and the various parameters of semen (volume, sperm count, vitality, motility and morphology). Methods: This was a cross-sectional study involving 272 men aged 20 – 52 years. The participants were categorized into four BMI groups as underweight, normal weight, overweight, and obese. Semen samples were analyzed. In the correlation study, Spearman’s correlation was used. Independent variables were tested on the dependent variables using Analysis of Variance (ANOVA) and Multivariate Analysis of Variance (MANOVA) to find out the effects of BMI on semen parameters while controlling effects of various covariates (age, smoking and alcohol consumption, occupation, ethnicity and education). Results: Correlation analysis showed no statistically significant correlations between BMI and semen parameters. However, comparing the BMI groups revealed statistically significant differences in semen parameter (p<0.05). The normal weight, overweight and obese groups had better semen quality than underweight. Underweight men had sperm count(16±20.78 million/ml), vitality(13.6±7.09%), progressive motility(4.33±4.93%) and morphology(1.33±0.57%). The effect of BMI on semen parameters was further confirmed by MANOVA study with Wilks’ Lambda=0.802, F=3.273, p<0.05. Conclusions: Semen quality was adversely affected in underweight groups compared to other groups. Thus emphasizing importance of keeping healthy BMI in order to have a better reproductive health. Keywords: BMI, Semen parameters, Underweight.