Browsing by Author "Duwal, S"
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Publication A Comparative Study of Rapid SARS-Cov-2 Antigen Detection Assay against RT-PCR Assay for Diagnosis of COVID-19 in a Tertiary Hospital of Kathmandu(Kathmandu University, 2022) Chaudhary, R; Bhatta, S; Singh, A; Pradhan, M; Moktan, B; Duwal, S; Pandit, RABSTRACT Background The Coronavirus disease 2019 (COVID-19) pandemic caused by the severe acute respiratory syndrome coronavirus (SARS-CoV-2) has spread worldwide since its first recorded case in the city of Wuhan, China, in December 2019. SARS-CoV-2 infection causes asymptomatic to sever pneumonia. Severe cases may develop acute respiratory disease symdrome (ARDS), with an average mortality rate of 6.9%. Real Time Reverse Transcriptase Polymerase Chain Reaction (rRT-PCR) assay is the current reference standard laboratory method for the diagnosis of SARS-CoV-2 infection. However, it takes around 6-8 hours to get the result and is time consuming. Therefore, rapid and accurate tests for SARS-CoV-2 screening are essential to expedite disease prevention and control. Lateral flow immunoassay using monoclonal anti SARS-CoV-2 antibodies which target for SARS-CoV-2 antigen can be complimentary screening test if their accuracy were comparable to that of the real time reverse transcription- polymerase chain reaction (RT-PCR) assay. Objective To find the sensitivity and specificity of a rapid antigentest kit in comparison to reverse transcription-polymerase chain reaction (RT-PCR). Method A cross-sectional hospital based study was carried out at Shree Birendra Army Hospital, Kathmandu for a period of four months. Result Our finding shows sensitivity and specificity of rapid diagnostic tests (RDT) Ag kit as 60.6% and 96.4% respectively. Positive and negative predictive value was 83.7% and 89.0%. Likewise, positive and negative likelihood ratio was 17.0 and 0.4. The overall accuracy of the antigen kit was 88.1% in comparison to reverse transcription- polymerase chain reaction (RT-PCR) as the gold standard. Conclusion Our study concluded the use of rapid antigen kit is mainly useful for screening purposes. KEY WORDS RDT Ag Kit, RT-PCR, SARS-CoV-2Publication A Study on Variations of Nutrient Foramen of Humerus with its Clinical Implications(Kathmandu University, 2016) Mansur, DI; Manandhar, P; Haque, MK; Mehta, DK; Duwal, S; Timalsina, BABSTRACT Background Nutrient foramen is an opening into shaft of humerus which gives passage to the blood vessels of medullary cavity. The knowledge of nutrient foramen is important in surgical procedures like bone grafting and more recently in microsurgical vascularized bone transplantation. Objective To determine the number, location and direction of nutrient foramen and whether the nutrient foramens obey the rule of ossification, that is directed away from the growing end of the bone or not. Method The present study consisted of 253 (108 right and 145 left) dried humeri excluding any fracture or pathological abnormalities during the period of 15th December 2014 - 14th February 2015. Number and direction of nutrient foramen was observed in each humerus. Location of nutrient foramen in relation with surfaces and zones of humeri was determined. Result It has been observed that 60.87% of the humeri had a single nutrient foramen, 28.85% double foramen, 6.32% triple foramen and 1.98% of humeri had four nutrient foramina where as 1.98% humeri did not have any nutrient foramina. It was concluded that the majority (88.86%) of the nutrient foramina were present on the antero-medial surface, 6.52% on the anterolateral surface and 4.62% on the posterior surface of the shaft of humeri. It was also concluded that most (94.84%) of the foramina present in the zone II followed by zone III (4.62%) then by zone I (0.54%). All foramina were directed toward the lower end of humeri. Conclusion By knowing the number and location of the nutrient foramina in humerus would be useful in preventing intra-operative injury of nutrient artery during orthopedic, plastic and reconstructive surgery and will also be relevant in medico legal practice. KEY WORDS Clinical implications, foraminal index, humerus, nutrient foramenPublication Massive Hemoptysis and Pulmonary Thromboembolism in a Patient with Pulmonary Tuberculosis: A Therapeutic Conundrum Managed with Bronchial Artery Embolization(Kathmandu University, 2022) Vaidya, N; Karmacharya, RM; Vaidya, S; Bade, S; Bade, S; Paudel, K; Kandel, G; Thapa, P; Maharjan, R; Duwal, S; Karki, YABSTRACT Hemoptysis is a crucial entity taking into account its morbidity and mortality. Pulmonary tuberculosis is the leading cause for massive hemoptysis in our part of the world, which if left untreated may be life threatening. We present a case of a 37-year-old male patient with pulmonary tuberculosis with concurrent pulmonary thromboembolism presenting with massive hemoptysis, which was successfully managed with Bronchial Artery Embolization. This case represents that this measure can be a viable therapeutic choice for a patient with a severe life- threatening hemoptysis, particularly when other treatment options are unavailable or ineffective. KEY WORDS Bronchial arteries, Embolization, Hemoptysis, TherapeuticPublication Utilization of Cervical Cancer Screening and Associated Factors among Women in Bhaktapur, Nepal(Kathmandu University, 2022) Nepal, J; Poudyal, AK; Duwal, S; Gyawali, S; Basel, PABSTRACT Background Cervical cancer is the most common cancer among women in Nepal causing highest cancer mortality among women of reproductive age. However, it can be prevented through early and regular screening. Objective To assess utilization of cervical cancer screening, its awareness and perception among women, and associated factors. Method A cross-sectional study was conducted where 360 women of age 30-60 years were randomly selected and interviewed from five administrative wards of Bhaktapur municipality. Result Utilization of cervical cancer screening through Pap test or Visual Inspection with Acetic acid was found in 32.2% women and 47.8% were aware of cervical cancer and its screening tests. 100% of them had high level of perceived benefits and facilitators. More than 80% of them had low level of perceived barriers and susceptibility. Women of age group 51-60 years were more likely to perform the screening test (AOR=13.14) whereas unemployed women were at higher odds of performing the test (AOR=3.29). Women who were aware of cervical cancer and its screening were more likely to perform the screening (AOR=53.65). Women having low level of perceived barriers (AOR=5.83) and high level of perceived seriousness (AOR=6.67) were more likely to perform the screening. Conclusion Only one third of women had performed Pap test/VIA and those who were aware of cervical cancer and had high level of perception were more likely to perform the screening. Thus, more rigorous and tailor-made awareness programs should be developed by health program planners to increase the screening rate among younger and working women. KEY WORDS Awareness, Cervical cancer screening, Perception, Utilization