Browsing by Author "Bista, B"
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Publication Awareness of Thyroid Disorders among Nepalese Women: A Cross-Sectional Study(Kathmandu University, 2019) Singh, DR; Bista, B; Yadav, BK; Karki, K; Ghimire, S; Singh, SABSTRACT Background Thyroid disorders are emerging public health issues. Clients’ awareness is crucial for prevention, early diagnosis, and treatment of the thyroid disorders. Studies, assessing knowledge on thyroid disorders among Nepalese population, is lacking. Objective To assess the awareness of thyroid disorders among women, a susceptible subgroup, and find the correlates of poor knowledge. Method A cross-sectional study was conducted among 423 women at the gynecological outpatient department of Tribhuvan University Teaching Hospital. Eighteen-item scale, with a Cronbach’s Alpha of 0.913, was developed to assess participant’s knowledge on various constructs of thyroid disorder. A linear regression model with Bootstrap approach was used to identify the predictors of the total knowledge score. Result The mean (±SD) age of the participant was 29.2 ± 7.0 years. About 49% of the women had inadequate knowledge, defined at or below the mean cumulative knowledge score. In linear regression, the total knowledge score was significantly lower among participants who were Janajati (β=-2.87, BCa 95%CI=-4.61, -1.11), illiterate (β=- 6.37, BCa 95%CI =-9.14, -3.21), and low income (β=-3.76, BCa 95%CI=-5.68, -1.83). Likewise, a university education (β=5.94, BCa 95%CI=3.50, 8.26), working status (β=4.04, BCa 95%CI=2.19, 5.81), urban residence (β=2.06, BCa 95%CI=0.02, 3.96) and family history (β=2.20, BCa 95%CI=0.71, 3.63) of thyroid disorder predicted higher knowledge score. Conclusion This study identified a poor level of knowledge on thyroid disorders among Nepali women and thus proposes them to be an important subgroup for an intervention or policy aimed at promoting awarenessof thyroid disorders. The findings also warrant increased awareness among these population through hospital and community- based behavior change communication campaigns. KEY WORDS Awareness, Thyroid disorders, WomenPublication Clinical Profile and Survival Rate of Interstitial Lung Disease in a Tertiary Care Center of Eastern Nepal(Kathmandu University, 2019) Ghimire, RH; Ghimire, A; Bimali, A; Bista, BABSTRACT Background The clinical profiles of interstitial lung diseases are reported mainly from developed world. There have been no data from Nepal. Objective The objective of this study is to describe clinical profile and survival in Eastern Nepal. Method Prospectively collected clinical, radiological and laboratory data of consecutive patients with Interstitial lung disease from an eastern regional tertiary care center were analyzed. The recommended official criteria for diagnosing different types of interstitial lung diseases were followed accordingly. Result The study revealed that, 68.0% of the patient’s age was of above 60 years with male predominance (66.0%). Idiopathic pulmonary fibrosis (79.5%) was the commonest interstitial lung disease followed by connective tissue disease associated interstitial lung disease. Persistent cough (97.7%) and dyspnea (95.5%) were the commonest presentations. Renal impairment, ischemic Heart Disease and anasarca were significant co morbidities contributing to mortality. Survival rate of the patients was found to be maximum at 5 months (95%) and minimum at 24 months (42%) from the diagnosis of the disease. Conclusion Widespread use of High-resolution computed tomography has made early recognition of interstitial lung disease in elderly patients. Well planned large scale multicenter prospective studies are needed to broaden our understanding about this serious pulmonary disorder. KEY WORDS Clinical profile, Interstitial lung disease, SurvivalPublication Public Awareness and Attitude towards COVID-19 Infection and Vaccines: A cross-sectional national survey in Nepal(Kathmandu University, 2023) Pant, S; Bhattarai, S; Ranabhat, K; Dumre, SP; Rajbhandari, B; Mudvari, A; Bista, B; Bhandari, R; Adhikari, SK; Dhimal, M; Gyanwali, PABSTRACT Background To combat COVID-19, high vaccination rates are essential. However, challenges such as vaccine denial, lack of knowledge, and negative attitudes hinder progress. Assessing public understanding of vaccination is crucial to promote acceptance and reducing reluctance. Objective To understand people’s awareness and attitude regarding COVID-19 infection and vaccines in Nepal. Method A cross-sectional web-based survey was conducted among the Nepali population of age 18 years and above in April 2021 during the early phase of vaccination deployment. A structured questionnaire was used to collect awareness data, and a five-point Likert scale was employed to assess participants’ attitudes. The survey categorized participants into two groups based on whether their awareness level or attitude score was above or below the mean. The secondary outcome was the association between socio-demographic factors and COVID-19 awareness or attitude. Result Of 475 eligible participants, 46% had a low level of awareness on COVID-19 infection whereas 56% had low awareness on COVID-19 vaccines. Every six out of ten participants had a positive attitude towards the national COVID-19 vaccination program. Most of the participants had high awareness of COVID-19 symptoms and preventive measures (hand hygiene, physical distancing, mask), but two-thirds had a false perception of vaccine safety and contraindications. People’s education status, occupation, province, and current/prior COVID-19 infection status were found to be significantly associated with their awareness regarding COVID-19 disease or vaccines. Conclusion The study revealed limited COVID-19 awareness among the Nepali population but a positive attitude toward the national vaccination program. Regular updates on COVID-19 and vaccines are important as new variants and vaccines emerge. KEY WORDS Attitude, COVID-19 virus, Public awareness, VaccinationPublication Spontaneous Pneumothorax: Follow up Treatment Outcome in a Tertiary Care Center of Eastern Nepal(Kathmandu University, 2020) Ghimire, RH; Ghimire, A; Bista, B; Yadav, S; Shreewastav, RKABSTRACT Background Spontaneous pneumothorax is not an uncommon medical emergency in pulmonary practice. Related data are not available in our setting. In emergency departments, clinical presentation is often confused with other cardiopulmonary problems. Follow up outcome is important for better patient care. Objective To study clinical profile and outcome after non surgical intervention in a tertiary care center. Method This was a prospective observational study carried out in Nobel Medical College, Biratnagar over last 3 years. We enrolled consecutive spontaneous pneumothorax patients over 15 years of age. Each data related to individual patients were collected in predefined proforma. To study follow up outcome of management, we used OPD attendance or if not possible took, at least two telephone numbers from the patients. All patients were followed for recurrences. Data was statistically analyzed using SPSS software. Result Over the last 3 years, we enrolled 65 spontaneous pneumothorax patients. Secondary spontaneous pneumothorax was more common (92.3%). Commonest presentations were acute pleuritic chest pain (92.3%), dyspnea (84.62%) and cough (92.3%). COPD (46.14%), PTB sequelae (15.38%), bronchiectasis (23.07%) and bullous lung disease (23.07%) were common risk factors. Tube thoracostomy (95.38%) with pleurodesis with iodopovidone (84.61%) led to lung expansion in 92.3% cases. During follow up, only 4.61% had recurrences of pneumothorax. There was one mortality. Conclusion Spontaneous pneumothorax is a common pulmonary emergency. Meticulous and careful assessment of the patients may help reach the diagnosis even in primary care setting. Tube thoracostomy followed by pleurodesis with iodo-povidone suffices in most circumstances leading lower future recurrences. KEY WORDS Nepal, Spontaneous pneumothorax, Treatment outcomePublication Tramadol along with local anaesthetics in the penile block for the children undergoing circumcision(Kathmandu University, 2005) Shrestha, BR; Bista, BObjective: This study was to find out the total duration of postoperative analgesia following circumcision in children when Tramadol was used as an adjunct to local anaesthetics in penile block. Methods: Forty children of age 5 – 13 yrs, ASA I & II were enrolled in this study. Patients were premedicated with ketamine and atropine intramuscularly prior to separation from their parents and IV cannulation. Penile block was then performed under strict aseptic precautions with paramedian approach by 3cm long 23g ordinary needle where 4 ml of mixture of local anaesthetics and tramadol was given on each side of the base of penis at 11 and 2 o~ clock positions. Duration of analgesia was recorded from the time of completion of surgery till the patients’ first complain of pain and when additional analgesic was given. Intraoperative analgesia duration achieved by the penile block was not included in this study due to unavoidable overlapping of sedation and analgesia produced by the premedicated IM Ketamine (4-5 mg/kg) ,which lasts for 25 minutes to 30 minutes. Unless complicated, this is the usual surgery time in our hospital for this procedure. Because of this reason, the sedation score was not used in this study. Moreover, paediatric sedation score remains too impractical and unreliable in our context. Results: Addition of Tramadol with local anaesthetics in penile block prolonged the postoperative analgesia even up to 40hours. Conclusion: Tramadol as an adjunct with Local Anaesthetics extends the duration of postoperative analgesia and can be used safely for this purpose in the children. Key words: Penile Block, Circumcision, Tramadol, Postoperative Analgesia.