Browsing by Author "Basnet, S"
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Publication Analysis of Lung Cancer Cases Presenting in Outpatient Department of University Hospital of Nepal(Kathmandu University, 2022) Karmacharya, RM; Singh, AK; Vaidya, S; Tuladhar, SM; Devbhandari, M; Lama, B; Kharel, BB; Basnet, SABSTRACT Background Lung cancer is one of the leading cause of cancer related death. Most common histopathology of lung cancer is non-small cell carcinoma of which adenocarcinoma is the most common. There are limited number of studies done in Nepal to know different aspects of lung cancer. Objective To know demographic parameters of patients diagnosed as lung cancer in a university hospital. The study also aims to know the different histopathological diagnosis of lung cancer. Method All the patients presenting to outpatient department (Cardio Thoracic and Vascular unit) of Dhulikhel Hospital, if are diagnosed as cancer of lung/bronchus will be included in the study. The duration of the study was January 2017 to December 2021. The details on age, gender, presenting symptoms, histopathology of lung cancer, operability will be included in database and will be analyzed. Result There were total of 127 patients diagnosed as lung cancer. Male:female ratio was 1.7:1. Overall mean age was 63.23 years (SD 13.5 years, Range 19-89 years). Non small cell carcinoma was the most common type of lung cancer with 83.7%. In non small cell carcinoma, most common type was Squamous cell carcinoma followed by undifferentiated and Adenocarcinoma. Only five (3.93%) cases were in operable stage. Conclusion Despite the fact that lung cancer is one of the most common cancer, patients usually present late and moslty are not in operable stage. This study shows that squamous cell carcinoma is the most common histopathology in lung cancer cases. KEY WORDS Lung Cancer, Smoker, ThoracotomyPublication Clinico-epidemiological Profile of Children with Chronic Kidney Disease in Tertiary Care Referral Center in Nepal: Prospective observational study(Kathmandu University, 2022) Poudel, DR; Basnet, S; Shrestha, LPABSTRACT Background Chronic kidney disease in children has been increasing over the years and is associated with high degree of morbidity and mortality. The cost of treating children with chronic kidney disease is also substantial. Prevention of this disease is the only long term solution in our context. Till date, there is limited data on chronic kidney disease in Nepalese children. Objective To study the epidemiological, clinical and etiological profile of children with Chronic Kidney Disease from 2 to 16 years of age presenting for the first time in tertiary care hospital. Method This is the prospective observational study carried out at the tertiary care hospital over a period of 3 years. Children between 2-16 years who were first time diagnosed of chronic kidney disease and had estimated glomerular filtration rate < 60 ml/ min/1.73 m2 for last 3 months were enrolled. Result There were total of 124 patients, of whom 78 were male with male to female ratio of 5:3 with mean age of 11.8±2.2 years. Chronic glomerulonephritis (23%), reflux nephropathy (23%) and nephrolithiasis (16%) were the commonest etiological diagnosis. Rapidly progressive glomerulonephritis and systemic lupus erythematous accounted for 85% cases of chronic glomerulonephritis. Vesicoureteric reflux and posterior urethral valve accounted for 85% cases of reflux nephropathy. In 32%, the cause could not be determined. Swelling (45%) and dyspnea (20%) were the chief presenting complaints. Pallor were seen in all cases (100%) followed by hypertension in 68% and short stature in 64%. Majority (60%) of the patients with chronic kidney disease presented in the stage V. Conclusion Chronic glomerulonephritis and reflux nephropathy were the commonest etiologies of chronic kidney disease, majority of them following rapidly progressive glomerulonephritis, systemic lupus erythematosis, vesicoureteric reflux and posterior urethral valve. The commonest clinical features were swelling, dyspnea, pallor and hypertension. KEY WORDS Chronic kidney disease, Clinical profile, Epidemiological profile, ESRD, Etiology of CKD, Nepalese childrenPublication Current Understanding of Emergency Medicine and Knowledge, Practice, and Attitude toward Disaster Preparedness and Management among Healthcare Workers in Nepal(Kathmandu University, 2024) Shakya, YR; Patel, JN; Shrestha, R; Shrestha, SS; Dangal, R; Pradhan, B; Pandya, J; Basnet, SABSTRACT Background Disasters are serious disruptions to a community’s functioning that exceed its capacity to cope using its resources. Natural, man-made, technological hazards and other factors may cause disasters and influence a community’s exposure and vulnerability. Objective To assess the knowledge, practice, and attitude of healthcare workers in Nepal regarding disaster preparedness and management for emergencies. Method A retrospective study was conducted among healthcare workers in Nepal registered for the 1st World Academic Council of Emergency Medicine- Table-top Exercise and Communication in Disaster Medicine conference as participants or faculty. Information was collected using total enumeration sampling and a questionnaire developed from a literature review and the questionnaire was adapted from the Emergency Preparedness Information Questionnaire (EPIQ). Percentages, means, and medians were calculated for socio-demographic data, knowledge, practices, and attitudes toward emergency preparedness. A chi-square test assessed associations between socio-demographic characteristics, emergency procedures, and familiarity scores on the preparedness questionnaire. Result A total of 118 participants took part in the study, most with over six months of emergency department experience. There was a significant association between work experience and emergency procedure status ((ꭓ2=6.982, p=0.008), and between education level and familiarity with disaster management (ꭓ2=5.507, p=0.019). However, there was a low correlation (r=0.140, p=0.129) between emergency procedure status and disaster management familiarity. Conclusion Emergency preparedness is crucial for life-saving in disasters. The availability of emergency services and skills related to emergency preparedness and disaster management are crucial for saving lives in emergency conditions. The hospital should provide emergency preparedness and disaster management training to all healthcare workers. In addition, the hospital authority should perform disaster exercises/tabletop simulation exercises or drills periodically. KEY WORDS Attitude, Disaster management, Emergency preparedness, KnowledgePublication First Reported Death of a Postpartum Woman Due to Coronavirus Disease 2019 in Nepal: A Lesson Learnt(Kathmandu University, 2020) Shrestha, AP; Bhushal, N; Shrestha, A; Tamrakar, D; Adhikari, P; Shrestha, P; Shrestha, A; Karmacharya, B; Basnet, S; Tamrakar, SR; Shrestha, R; Shrestha, RABSTRACT The first case of coronavirus disease 2019 was reported on December 31, 2019 in Wuhan, China where the average case fatality rate was 6.1 ± 2.9%. There are 453 deaths as of September 24, 2020 in Nepal. We report the first death of a 29-years-old postpartum woman due to COVID-19 in Nepal who was referred from a rural health center to Dhulikhel Hospital. On arrival, she was taken to the acute respiratory zone of the emergency department to provide immediate lifesaving procedures. Despite the repeated resuscitative measures, return of spontaneous circulation could not be achieved. The real time polymerase chain reaction test was positive. Our case report highlights the importance of early clinical suspicion, importance of “safety first” in healthcare settings, and the chain of management in such patients. We consider the fact that a postpartum woman registered as the first case of COVID-19 related death in Nepal to be an area of further study. KEY WORDS Coronavirus, Emergency department, Personal protective equipment, Postpartum death, Real time polymerase chain reaction, ResuscitationPublication Knowledge, Attitude, and Practices Related to COVID-19 among Healthcare Personnel in a Tertiary Care Hospital in Nepal: A Cross-sectional Survey(Kathmandu University, 2020) Basnet, S; Dahal, S; Tamrakar, D; Shakya, YR; Jacobson, C; Shrestha, J; Shrestha, SKABSTRACT Background COVID-19 is significantly affecting the healthcare system globally. As a result, healthcare workers need to be updated on the best practices for the proper management of the disease. Objective The purpose of this study was to assess the knowledge, attitude, and practices (KAP) related to COVID-19 among healthcare personnel. Method This was a cross-sectional study conducted among medical personnel at Dhulikhel Hospital Kathmandu University Hospital using a semi-structured questionnaire on KAP related to COVID-19 from May 8th to June 8th, 2020. We analyzed survey data by using descriptive statistics. Spearman rank correlation, chi-square test and binary logistic analysis were used to examine the association between sociodemographic characteristics with KAP related to COVID-19. Result Among 220 participants, the majority were nurses (60%) followed by doctors (27.7%), paramedics (10%) and technicians (2.3%). The results showed that 68.6% of healthcare personnel had a good knowledge with appropriate practices (98.5%) and negative attitude (59.3%). In the multivariate binary logistic analysis, the healthcare workers with the clinical experience level of one to five years (OR:.42, 95% CI:.19- .96) and more than 5 years (OR: .16, 95% CI: .04-.63) were significantly associated with negative attitude. The confidence score for managing COVID-19 (OR:1.16, 95% CI:1.02-1.34) was significantly associated with an optimistic attitude. Conclusion Healthcare workers are knowledgeable about COVID-19 and proactively practising to minimize the spread of infection but lack optimistic attitudes. Hence, the constantly updated educational programmes related to COVID-19 for targeted groups will contribute to improving healthcare workers’ attitude and practices. KEY WORDS Awareness, COVID-19, Infectious diseasePublication Sonographic Assessment of the Normal Dimensions of Liver, Spleen, and Kidney in Healthy Children at Tertiary Care Hospital(Kathmandu University, 2015) Thapa, NB; Shah, S; Pradhan, A; Rijal, K; Pradhan, A; Basnet, SABSTRACT Background Ultrasonography is one of the most common imaging modality to measure dimensions of visceral organs in children. However, the normal limit of size of visceral organs according to age and body habitus has not been specified in the standard textbooks. This might result in under detection of organomegaly in pediatrics population. Objective The objective of this study was to determine the normal range of dimensions for the liver, spleen, and kidney in healthy children. Method This is prospective cross-sectional, hospital-based study done at Tertiary-care teaching hospital. Participants included 272 pediatric subjects (152 male and 120 female) with normal physical or sonographic findings who were examined because of problems unrelated to the measured organs. The subjects were one month to 15 year (180 months) old. All measured organs were sonographically normal. Relationships of the dimensions of these organs with sex, age, body weight and height were investigated. Limits of normal dimensions of these organs were defined. Result Normal length of liver, kidneys and spleen were obtained sonographically for 272 children (152 male [55.9%] and 120 female [44.1%]) in the age group from 1 months to 15 (180 months) years. The mean age was 45.78 months (SD, 44.73). The measured dimensions of all these organs showed highest correlation with height and age so the descriptive analysis of the organ dimensions (mean, minimum, and maximum values, SD and 5th and 95th percentiles) were expressed in 10 age groups along with height range of the included children. The mean length of right kidney was shorter than the left kidney length, and the difference was statistically significant (p = 0.001). Conclusion This study provides practical and comprehensive guide to the normal visceral organ dimension in pediatric population. The normal range limit of the liver, spleen, and kidney determined in this study could be used as a reference in daily practice in local radiology clinics. KEY WORDS Children, kidneys, liver, spleen, ultrasonographyPublication Sydenham’s Chorea with Silent Cardiac Lesions, Mimicking Encephalitis in a 13 Year Old Girl(Kathmandu University, 2021) Shakya, KN; Bhatta, A; Yadav, A; Gautam, U; Basnet, SABSTRACT Sydenham’s chorea is an uncommon neurological manifestation of rheumatic fever and has many and varied differential diagnosis. It may mimic encephalitis when presents as an isolated feature even when silent cardiac lesions are present. Early diagnosis, treatment and penicillin prophylaxis prevents recurrence and progression of cardiac lesions. Prompt symptomatic relief and alleviation of distress is obtained with therapeutic intervention. A case of rheumatic chorea with silent cardiac valve lesions which mimicked herpes simplex encephalitis with choreoathetosis, in a 13 year old girl is presented along with review of literature. KEY WORDS Chorea, Encephalitis, Rheumatic fever, Silent carditisPublication Variability of Presentations and CT-Scan Findings in Children with Neurocysticercosis(Kathmandu University, 2011) Gauchan, E; Malla, T; Basnet, S; Rao, KSABSTRACT Background Neurocysticercosis is one of the common neurological morbidities in childhood. Objectives To find the commonest mode of presentation of this disorder in children. The study also aims to find out the age at which it commonly occurs, commonest site affected in the brain and the ethnic group and region most commonly affected in Western Nepal. Methods Retrospective hospital based study carried out in the Department of Pediatrics, Manipal Teaching Hospital, Pokhara from June 2004 to June 2009. Results Over the period of five years, 678 patients were admitted for seizures; out of which 109 patients were diagnosed as having neurocysticercosis (16%). Out of them, 66 (60.5%) were males and 43 (39.4%) were females. The age of presentation varied from 18 months to 16 years, with mean age 9.77 years. The most common age of presentation was between 6-10 years (n=47; 43.1%) and 11-15 years (n=47; 43.1%). Maximum number of patients were from Kaski district (n=41; 37.6%) followed by Syangja (n=34; 31.1%).The commonest presentation was with seizures (n=85; 77.9 %); generalised seizures was present in 45 patients (52%). Psychiatric manifestations were present in 3 patients (2.7%). The lesions were found mostly in the parietal region (n=65; 59.6 %). Most of the lesions were single (n=89; 81.6%). Out of 109 patients, 74 patients (67.8%) improved without any recurrence of symptoms on two years follow-up. Conclusion Neurocysticercosis is a preventable zoonotic disease which results in significant morbidity in children where sanitary measures are inadequate. Any child presenting with a first episode, afebrile seizure should be screened for neurocysticercosis provided other common causes are ruled out. KEY WORDS neurocysticercosis, seizures