Browsing by Author "Gautam, Ajaya Raj"
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Publication 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 RajAbstract: 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.Publication 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, StutiAbstract: 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.Publication 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, BishalAbstract: 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 pregnancyPublication Writer’s Bump: A Case Report Authors(Rapti Academy of Health Sciences (RAHS), 2025) Phuyal, Navindra; Pandey, Niraj; Pandeya, Anup; Ghimire, Kundan Kishore; Gautam, Ajaya RajAbstract: Defined as a plaque of hyperkeratosis, callosities develop as an adaptive response to physical forces like pressure and friction. Racial and genetic factors are supposed to determine the response to mechanical forces that may lead to the formation of callus. Considered as a “badge of trade,” calluses are given many names. Here we report a case of a bump on the thumb that was diagnosed as writer’s bump, a form of callus caused by pens and pencils. In this case, the pressure from lifting dumbbells aggravated the bump. The patient was counseled and suggested to use gloves as padding and paring and use moisturizers to prevent ulcerations of the bump. Keratolytic agents, laser therapy, and excision by scalpel are other treatment methods available. Occupational stigmata like writer’s bump and milker’s calluses are prevalent, and clear definitions are needed for proper identification and management.