Browsing by Author "Devkota, S"
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Publication An epidemiological study of injury among urban population(Kathmandu University, 2009) Ghimire, A; Nagesh, S; Jha, N; Niraula, SR; Devkota, SAbstract Background: Injuries are a focus of public health practice because they pose a serious health threat, occur frequently and are preventable. Injuries affect people of all ages and range from minor cuts and bruises to major catastrophes that take thousands of lives. Objectives: This paper aims to find out the prevalence of injuries and to study the various epidemiological factors related to the injuries in Dharan. Materials and methods: A sample of 1398 households was taken as study sample. A systematic random sampling technique was used to select the 10% households from each 19 wards. A pre-tested questionnaire was used to collect demographic information and information related to injuries to the persons suffered from injuries. Result: The prevalence of minor injury in Dharan was 3.5% per month. The injury was common in the age group, 40-49 years (4.6%) and majority of injured persons were farmers (6.9%). Home was the common place (55.6%) for the minor injury. Cut/stab (32.8%) was the most common types of minor injury. The prevalence of major injury was 0.7% per year and occurred more among 50-59 years age group (1.7%). The commonest place for major injury was at road (53.1%) and service holders were at more risk (1.4%). Falls from the height (46.9%) were the most common types of major injury. Conclusion: The injuries related to lifestyle profession and road traffic accidents (RTA) is the commonest burden revealed in the study sample. Promotion of safety and education for protection at work and safe driving can prevent the major socio-economic loss to the family and community at large. Key word: Minor injury, Major injury, RTA, Epidemiological factors.Publication An epidemiological study of injury among urban population(Kathmandu University, 2009) Ghimire, A; Nagesh, S; Jha, N; Niraula, SR; Devkota, SAbstract Background: Injuries are a focus of public health practice because they pose a serious health threat, occur frequently and are preventable. Injuries affect people of all ages and range from minor cuts and bruises to major catastrophes that take thousands of lives. Objectives: This paper aims to find out the prevalence of injuries and to study the various epidemiological factors related to the injuries in Dharan. Materials and methods: A sample of 1398 households was taken as study sample. A systematic random sampling technique was used to select the 10% households from each 19 wards. A pre-tested questionnaire was used to collect demographic information and information related to injuries to the persons suffered from injuries. Result: The prevalence of minor injury in Dharan was 3.5% per month. The injury was common in the age group, 40-49 years (4.6%) and majority of injured persons were farmers (6.9%). Home was the common place (55.6%) for the minor injury. Cut/stab (32.8%) was the most common types of minor injury. The prevalence of major injury was 0.7% per year and occurred more among 50-59 years age group (1.7%). The commonest place for major injury was at road (53.1%) and service holders were at more risk (1.4%). Falls from the height (46.9%) were the most common types of major injury. Conclusion: The injuries related to lifestyle profession and road traffic accidents (RTA) is the commonest burden revealed in the study sample. Promotion of safety and education for protection at work and safe driving can prevent the major socio-economic loss to the family and community at large. Key words: Minor injury, Major injury, RTA, Epidemiological factors.Publication Environmental noise induced hearing loss in Nepal(Kathmandu University, 2003) Joshi, SK; Devkota, S; Chamling, S; Shrestha, SIntroduction: Noise pollution in urban cities is a serious problem and steadily increasing over the years. This has direct and indirect affect to the people that can lead to the health hazard. Objectives: To find out environmental noise induced health effect on people residing in an urban community and to predict the risk of the environmental noise induced hearing loss Material and methods: One hundred fifty questionnaires were filled up for the environmental noise pollution survey. For the case control study, 36 exposed and 25 non-exposed residents of Kupondole were included. Based on the place of residence (main road and 20 min. walking distance from the main road), subjects were divided into exposed and non-exposed group concerning environmental noise. Demographic data and information about health problems was obtained by a structured interview. Audiometric test was performed using manual audiometer. Odds ratios (OR) and their 95% confidence intervals (95% CI) for noise induced hearing loss were estimated using logistic regression. Adjustment for occupational noise was done Results: The major health effect induced by the environmental noise was observed as lack of concentration followed by irritation, fatigue and headache. The crude OR and 95% CI for the exposed subjects was 4.2 (1.4, 12). After adjustment for occupational noise, the OR (95% CI) was 4.0 (1.2, 13). Conclusion: This study shows that exposure to noise causes wide range of health effects. For the exposed subjects there was an increased risk of noise induced hearing loss. The risk was significantly increased also after adjusting for occupational noise. Keywords: Environmental Noise, Noise Induced Hearing Loss (NIHL), Audiometric Test, Noise Pollution Survey, NepalPublication Fine needle aspiration (FNA) of soft tissue tumours (STT)(Kathmandu Unversity, 2007) Hirachand, S; Lakhey, M; Singha, AK; Devkota, S; Akhter, JObjectives: The cytological findings of 50 ST Ts were evaluated aiming to determine the role of FNA in diagnosis of STTs Methods: Fifty patients with soft tissue tumours underwent FNA in the preoperative investigation during a one year period. The smears were stained with Papanicolaou and May-Graunvald Giemsa stains. Results: Forty-four cases were reported as benign, whereas 2 were malignant. Four cases revealed insufficient material. The malignant STTs were small round cell tumour and malignant spindle cell tumour. Cytological and histological correlation could be achieved in 40 cases. The overall sensitivity and specificity were 25% and 100% respectively with overall accuracy of 80%. Conclusion: A reliable diagnosis of STTs can be made with FNA when supported by other clinical and other diagnostic data. Key words: FNA, soft tissue tumoursPublication Intraurethral Instillation of Ketamine and Lidocaine versus Lidocaine for Male Rigid Cystoscopy: A Prospective Randomized Controlled Trial(Kathmandu University, 2023) Pradhan, U; Chalise, PR; Luitel, BR; Kriti, S; Devkota, SABSTRACT Background Male rigid cystoscopy is one of the most common outpatient procedures in urology because of it lower cost, better optical area and better orientation compared with flexible devices. However, performing rigid cystoscopy is not only painful but equally apprehensive in awake male patients. Objective The study was conducted to evaluate the efficacy of lidocaine gel and ketamine solution together compared with lidocaine gel alone during male rigid cystoscopy. Method A total of 76 male patients who visited the hospital for rigid cystoscopy were randomized into two groups before undergoing cystoscopy. The experimental group received 15 ml lidocaine with 2 ml (100 mg) Ketamine solution while the control group received 15 ml lidocaine gel with 2 ml Normal saline. Patient’s heart rate and mean arterial pressure were recorded in five minutes interval till twenty minutes after completion of the procedure. The level of pain perception of all the patients was measured with Visual analogue scale (VAS) score, at the beginning, during and after cystoscopy. Independent sample t-test was used to compare outcome measures and p value of < 0.05 was considered statistically significant. Result Out of the total 70 patients analyzed at the end of study with 35 patients in each group, the VAS score in each stage were lower in lidocaine plus ketamine group compared to lidocaine gel alone. The difference was significant at the commencement and middle of the procedure (p < 0.05). Conclusion Intraurethral instillation of ketamine and lidocaine is more effective in reducing mean pain score during cystoscopy as compared to lidocaine alone. KEY WORDS Cystoscopy, Ketamine, Lidocaine, Visual analogue scale scorePublication Smoking Habit among Male Medical and Dental Students of B.P.Koirala Institute of Health Sciences, Nepal(Kathmandu University, 2013) Ghimire, A; Sharma, B; Niraula, SR; Devkota, S; Pradhan, PMSABSTRACT Background Smoking and health are intimately related and thus, smoking among future health care personnel is an important issue. As future physicians and dentists who will witness the continued burden of smoking-related diseases among their patients, represent a primary target for smoking prevention programs. Objectives To explore the magnitude of smoking problem and assess the major causes aggravating the burden of smoking among medical and dental students. Methods A cross sectional study was conducted between June and July 2009 among 345 medical and dental students. Pre-tested self-administered questionnaire containing questions regarding smoking and its various correlates were used to collect the data. Chi square test was used for testing hypothesis. Results Prevalence of smoking was estimated as 38.4%, among whom majority started smoking during 15 to 19 years of life. Peer pressure was the major cause behind smoking (29.5%). Nearly one third of the participants used to consume alcohol along with smoking. Presence of parental smoking and use of other drugs were significantly associated with smoking among the students. Conclusion Tobacco smoking is a significant health problem among the male medical and dental students. Medical and dental students were approached as they are the treatment providers for smoking and disease related to it in the future. The results in our study are discouraging and reveal that the medical knowledge regarding ill effects of smoking has not been able to check its use. KEY WORDS Medical and dental students, smokingPublication Spontaneous Pneumothorax as Clinical Presentation in a Patient with COVID-19(Kathmandu University, 2022) Devkota, S; Shrestha, SABSTRACT Spontaneous pneumothorax as an initial presentation is very rare in COVID-19 patient. We present a case where the initial presentation was that of a mild disease and on investigation was found to have pneumothorax without any predisposing risk factors. KEY WORDS COVID-19, Spontaneous pneumothorax, Tube thoracotomyPublication The Burden of Injury in terms of Economic Loss and Disability Days: A Community Based Study from Eastern Nepal(Kathmandu University, 2011) Ghimire, A; Nagesh, S; Jha, N; Niraula, SR; Devkota, SABSTRACT Background Injuries are already a substantial public Health problem all over the world and are expected to increase in the 211st Century. They are major causes of deaths and disability in the population and also involve high societal costs. Objectives This study was designed to assess the economic loss due to the injury and the disability days due to different types of injuries. Methods A systematic random sampling technique was used to select 1388 households from 19 wards. A detailed questionnaire was used to collect information related to injuries to the persons suffered from injuries including treatment obtained, cost of treatment (direct/indirect cost) and length of disability. Results Among the minor injured persons, majority (93.2%) did not spend any indirect cost. 36.7% of the major inured persons spent Nepalese rupees 10,001 to NRs 100,000 as direct treatment costs. But 50% spent less than 5000 NRs as indirect cost for major injury treatment. Maximum number (67.4%) of major injured persons had disability days of 31 to 90 days. Conclusion The high incidence of injuries, especially road traffic injuries, adds a huge economic burden to nation. KEY WORDS injury, disability days, economic burdenPublication Ultrasound Guided Estimation of Skin to Subarachnoid Space Depth in Patients Scheduled for Elective Surgeries under Subarachnoid Block(Kathmandu University, 2023) Devkota, S; Baral, BK; Poudel, PRABSTRACT Background Subarachnoid block is one of the commonly used techniques of regional anesthesia and accurate placement of spinal needle is crucial. A conventional spinal needle may be too long for a lean patient or too short in obese patients leading to multiple attempts, inadvertent nerve injuries and patient discomfort. So a pre-procedural estimation of the skin to subarachnoid space depth may be beneficial. Objective To estimate the skin to subarachnoid space depth using ultrasound and correlate it with the length of spinal needle to be inserted during subarachnoid block. Method This was a prospective, observational study conducted at Bir Hospital, Kathmandu in patients undergoing elective surgeries under subarachnoid block. A pre-procedural ultrasound of lumbo-sacral spine using 2-5 Hz curvilinear probe was done to measure skin to subarachnoid space depth (SSD) at the level of L3-L4 interspace. Then under all aseptic precautions, subarachnoid block was performed and the length of spinal needle outside the skin was measured and that length was subtracted from the standard length of needle to get the inserted length of spinal needle. These two measurements were compared. Result In the fifty patients included in the study, ultrasound estimated skin to subarachnoid space depth was found to be 4.24 ± 0.48 cm and the inserted length of spinal needle was 4.24 ± 0.46 cm. A significant correlation r=0.96 (p < 0.05) was found between the two measurements in the study population. Conclusion Ultrasound estimated skin to subarachnoid depth in the study population was found to be 4.24 ± 0.48 cm which correlated with the inserted length of spinal needle. So, use of ultrasound can be very helpful in performing subarachnoid block. KEY WORDS Skin to subarachnoid space depth, Spinal needle, Subarachnoid block, Ultrasound