Browsing by Author "Basnet, S"
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Publication 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