Browsing by Author "Bhattarai, Stuti"

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    Analysis of Caesarean Sections according to Robson’s Ten Group Classification System at a Tertiary Care Hospital in Lumbini Province
    (Rapti Academy of Health Sciences (RAHS), 2024) Lamichhane, Basant; Darlami, Radha; Bhattarai, Stuti
    Abstract: Introduction: A Caesarean section (CS) is a common surgical operation in obstetrics. There is an alarming concern regarding rising rate of CS worldwide. This study was conducted to align with the Robson classification, an international standard for tracking and comparing CS rates within an institution. The study also identifies the CS rates within each group according to Robson’s ten-group classification system (RTGCS). Methods: This cross-sectional study, conducted over six months from October 2022 to March 2023, took place in the Department of Obstetrics and Gynecology at Rapti Academy of Health Sciences, a tertiary care center in Province 5. Descriptive analysis was performed on various variables according to the Robson’s Ten Group Classification System (RTGCS), and the Caesarean sections (CS) were subsequently categorized. Results: Out of 1780 total deliveries, 1060 (59.55%) were vaginal deliveries while 720 (40.45%) were CS. According to the Robson classification, group 1 was the predominant contributor at 34.2%, followed by group 5 at 21.1% and group 3 at 16.1% respectively. In regards to the indication of CS, cephalo-pelvic disproportion was the top most indication for CS. Conclusions: As per the study as group 1 and group 5 are the leading group of CS in the institute, measures such as following evidence based labour care guide and promoting instrumental deliveries and vaginal birth after caesarean (VBAC) could help address the increasing CS rates.
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    Practice of Surgical Dressing among Health Care Workers at a Teaching Hospital, Chitwan
    (Rapti Academy of Health Sciences (RAHS), 2024) Bhattarai, Stuti; Thulung, Bedantakala; Gautam, Ajaya Raj
    Abstract: Introduction: With growing concern over antimicrobial resistance and nosocomial infections, wound dressing techniques are required to prevent infection and shorten the healing time after surgery. Implementing a surgical wound dressing checklist can prevent surgical site infections and enhance healthcare professionals’ practices related to surgical wound dressing. This study aims to identify the practice of surgical dressing among health care workers at a teaching hospital, Chitwan. Methods: A descriptive observation study was conducted at a Teaching Hospital in Chitwan. Using non-probability convenience sampling, 50 health care workers practicing surgical dressing from the Surgery, Gynaecology/Obstetrics, Neurosurgery, and Orthopaedic wards were selected as a sample. Data were collected using an observation checklist. Ethical approval was obtained from the Institutional Review Committee of Chitwan Medical College (IRC-CMC) with Ref. No. 198. Data analysis was performed using the Statistical Package for the Social Sciences (SPSS). Results: The study revealed that only 28% of the health care workers had good practice (≥ 90% of total score without missing critical steps). There was significant association between working unit and level of practice of surgical dressing (p=0.005). Conclusions: Majority of health care workers have poor practice of surgical dressing. Hence, there is need to provide in-service training for health care workers to enhance their skills. Further, procedure manual related to dressing should be made available in all wards.
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    Pulmonary Tuberculosis and its Associated Factors among HIV Positive Individuals attending Antiretroviral Therapy Clinic of Tertiary Care hospital in Ghorahi, Dang
    (Rapti Academy of Health Sciences (RAHS), 2025) Lamichhane, Bikash; Darlami, Radha; Bhattarai, Stuti
    Abstract: Introduction: Human immunodeficiency virus (HIV) weakens the immune system by targeting CD4 cells. Pulmonary tuberculosis (PTB) is a bacteriologically confirmed or clinically diagnosed tuberculosis infection of the lung parenchyma or tracheobronchial tree. Prevalence of PTB is significantly high among HIV positive individuals. This study assessed the Pulmonary Tuberculosis and its associated factors among HIV positive individuals. Methods: A descriptive cross-sectional study was conducted at ART clinic of Rapti Academy of Health Sciences (RAHS). After obtaining ethical approval from the Institutional Review Committee of RAHS, records of 299 HIV positive individuals attending the ART clinic from January to December 2024 were consecutively sampled and retrieved. Data analysis was performed using the Statistical Package for the Social Sciences version 16. Results: Out of 299 HIV positive individuals, the majority (53.5%) were aged 40–59 years, with a median age of 41 years, and near-equal gender distribution. Most were Janajati (39.1%), married (69.6%), literate (73.6%), and unemployed (77.6%), with spouses of migrants (40.1%) and migrants (20.4%) being the key risk groups. Clinically, over half (51.2%) were in Stage I HIV, 94.3% had viral load testing, and 98.2% of those tested showed viral suppression. Pulmonary tuberculosis (PTB) was prevalent in 7.4% of HIV positive individuals. Among 47 individuals with other associated diseases, infections (29.7%) were most common. Conclusion: This study highlights the ongoing challenge of PTB associated with HIV infection in Nepal, necessitating targeted interventions and integrated services. Further multi-center research is recommended to explore socioeconomic and clinical determinants of PTB among HIV-positive individuals.
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    Quality of Life of Chronic Myeloid Leukemia Patients receiving Tyrosine Kinase Inhibitor (TKI): Comparison with Healthy Population
    (Rapti Academy of Health Sciences (RAHS), 2024) Gautam, Ajaya Raj; Bhattarai, Stuti
    Abstract: Introduction: Development of tyrosine kinase inhibitors (TKIs) has changed the therapeutic landscape of chronic myeloid leukemia (CML) patients with an improved 10 years’ survival rate approximately from 20% to 90%. So, Quality of life (QoL) is an aspect of CML disease management that is gaining prominence in recent years. In Patan Hospital also, an increased 10 years’ survival rate has been seen among CML patients receiving TKIs under Glivec International Patient Assistance Program (GIPAP). So, the aim of this study was to compare the QoL of CML patients under treatment in Patan Hospital with the apparently healthy population. Methods: This is a cross sectional comparative study done at Patan Academy of Health Sciences (PAHS) from October 2018 to September 2019. Short Form 36 (SF-36) questionnaire was used for QoL assessment. Ethical approval was obtained. Data analysis was done using epi info version 7.2.2. Results: Total of 192 participants was included in this study. (98 in each CML group and apparently healthy population). Mean age of the study population was 47.42 years with 33.67% being females. Physical QoL was significantly poor in CML patients. (p value 0.01) but no difference regarding mental QoL between two groups. Conclusions: Identification of symptom burdens of TKI therapies in routine practice is needed so as to lessen these burdens to effectively improve physical QoL in CML patients. Similarly, for improvement of mental QoL in younger patients (18-39 years’ age group), assessment of psychological impact of the disease and proper counseling in these patients is required.
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    Trend of Teenage Pregnancy and its Adverse Outcome at Rapti Academy of Health Sciences, Dang District, Lumbini Province
    (Rapti Academy of Health Sciences (RAHS), 2024) Lamichhane, Bikash; Lamichhane, Basant; Darlami, Radha; Kunwar, Shishir; Bhattarai, Stuti; Gautam, Ajaya Raj; Pokhrel, Bishal
    Abstract: Introduction: Teenage pregnancy is defined as a pregnancy in a girl who is 10-19 years of age. In Nepal, adolescents aged 10 to 19 comprise 6.4 million of the population. The most common maternal complications in teenage pregnancy were hypertensive disorders, preterm birth and low birth weight. Teenage pregnancy has negative effects on the health outcomes of both the mother and the newborn. So, this study was conducted to describing the trend of teenage pregnancy and its outcome at a tertiary care hospital in the Dang district. Methods: A retrospective, cross-sectional study was conducted at Rapti Academy of Health Sciences (RAHS). Ethical approval was taken from the Nepal Health Research Council (NHRC). Data was retrieved from January 2018 to December 2022 from the hospital Central Admission Register and maternity register record. The total 1097 records of teenage deliveries were taken as a whole sampling. Data entry was done in Microsoft Excel and point estimate at 95% CI was calculated along with frequency and percentage. Results: Total 1097 teenage deliveries were conducted in five years where maximum teenage deliveries were of 19 years (41.2%). Among teenage delivery, live birth delivery was 89.9%. Significant tear was found in 264 teenage deliveries (95.0%) as a maternal complication. Conclusion: The trend of teenage pregnancy was in decreasing trend over five years in RAHS, Dang. Preterm delivery, Perineal tear, and Spontaneous abortion were common complications seen in pregnancy. Further awareness and health education programs helps to reduce the teenage pregnancy

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