Browsing by Author "Dhital, Rolina"
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Publication Effectiveness of Lower Range of High-intensity Statin Therapy in Lowering LDL-C among STEMI Patients(Nepal Health Research Council, 2024) Prajapati, Dipanker; Adhikari, Chandra Mani; Timalsena, Birat Krishna; Maharjan, Nira Shrestha; Dhital, Rolina; Khatri, Anjali; Bogati, Amrit; Manandhar, Reeju; Dhungana, Murari; Safi, Md. Sajjad; Khan, Barkadin; Ghimire, Vijay; Roy, Rahul; Adhikari, Puja; Dhungana, Suraksha; Rajbhandari, SujeebBackground: Lipid-lowering is an important intervention to reduce cardiovascular morbidity and mortality after ST-Elevation myocardial infarction. This study aimed to assess the proportion of such patients achieving guideline-directed therapeutic low-density lipoprotein cholesterol targets while on lower-range high-intensity statin treatment. Methods: This is a cross-sectional study conducted in Shahid Gangalal National Heart Centre, a tertiary cardiac center in Kathmandu, Nepal, from November 2021 to July 2022 among admitted acute ST-Elevation myocardial infarction patients who were prescribed a lower range of high-intensity statin therapy, Atorvastatin 40mg and Rosuvastatin 20 mg. Clinical characteristics were collected, including lipid parameters at baseline during admission and three months after the treatment. The proportion attaining the guideline-recommended levels was calculated and compared between each statin group. Results: A total of 240 patients were included in this study. The target low-density lipoprotein cholesterol level of less than 1.4mmol/L was noted only in 16.3% and the target reduction by ?50% from baseline only in 7.1%. Just 3.3 % achieved a target of <1.4 mmol/L and ?50% reduction from baseline. However, 40.8% of the participants in our study met the 2012 European Society of Cardiology guidelines’ target achievement of less than 1.8 mmol/L. Conclusions: The overall proportion of patients attaining recommended low-density lipoprotein cholesterol levels after recent ST-Elevation myocardial infarction was low when patients were prescribed with a lower range of high-intensity statin, reflecting the need for rigorous follow up including monitoring of lipid levels and intensification of statin dose and type as recommended by international guidelines. Keywords: Low-Density Lipoprotein Cholesterol; secondary prevention; statin; statin intensity; ST-Elevation myocardial infarction.Publication Lived Experiences of Chronic Kidney Disease Patients undergoing Haemodialysis in a Tertiary Hospital of Nepal(Nepal Health Research Council, 2024) Sah, Bimala Kumari; Khan, Imran; Dhungana, Ashesh; Subedi, Madhusudan; Dhital, RolinaBackground: Chronic kidney disease (CKD) poses significant global health challenges, including in Nepal, where the increasing need for hemodialysis are influencing patient’s daily life. This study aimed to explore lived experiences of CKD patients undergoing hemodialysis. Methods: A qualitative, phenomenological research design was employed. In-depth interviews were conducted with 13 hemodialysis patients at Bir Hospital from December, 2023 to January, 2024. Analysis followed Colaizzi’s method, ensuring data quality through established credibility and transferability measures. Results: Four major themes emerged: (i) Journey to receive hemodialysis (ii) Financial Constraints (iii) Psychosocial support (iv) Seeking for special health services. Patients perceived hemodialysis as a hope for existence but faced financial troubles and inadequate special and psychosocial support. Conclusions: The lived experiences of the patients reflected both hope and challenges highlighting the need for improved health services and counseling in hemodialysis wards, along with enhanced governance in the healthcare system. Keywords: Chronic kidney disease; hemodialysis; lived experience; pilot; qualitative.