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Browsing by Author "Gautam, Swotantra"

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    Facemasks Readily Available in Common Stores used by Nepalese, How much Protection is Enough Protection against COVID-19?
    (Nepal Medical Association, 2021) Sunuwar, Neela; Twayana, Anu Radha; Katuwal, Santosh; Gautam, Swotantra
    Abstract: During the COVID-19 pandemic, the Centers for Disease Control and Prevention and World Health Organization strongly recommend that people wear face masks to cover their mouths and noses while they are out and about in any other public area. There are a lot of masks available on the market, and people get a lot of mixed messages about what is safe. This article explores what kind of facemasks are readily available in Nepali General stores and what are the things to keep in mind before buying a mask. We will also discuss how many times a face mask can be used, proper ways to store them, correct ways to use facemasks, and the rationale behind its use.
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    Hereditary Vitamin-D Dependent Rickets Type II: A Case Report
    (Nepal Medical Association, 2021) Sunuwar, Neela; Gautam, Swotantra; Twayana, Anuradha; Yadav, Saroj Adhikari; Anjum, Firoz; Kandel, Kriti
    Abstract: Hereditary vitamin D dependent rickets type II is a rare genetic disorder in children characterized by early onset of rickets and deranged biochemical parameters. Low serum calcium level, high alkaline phosphatase, high parathyroid hormone, and high values of 1,25-dihydroxy vitamin D are characteristic biochemical findings. We are reporting a rare case of Vitamin D Dependent Rickets and subsequent improvement after addition of cinacalcet. This is a case report of a 2.5-year-child with Hereditary Vitamin D Dependent Rickets type II receiving cinacalcet as adjunct to oral calcium and calcitriol. Oral cinacalcet (0.25mg/kg/day) was added to the regimen as an adjunct after treatment failure with high dose of oral calcium and calcitriol. A significant improvement in radiological findings and normal homeostasis of calcium, phosphate and parathyroid hormone was achieved after initiation of cinacalcet.
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    Intestinal Obstruction among Patients Admitted in the Department of Surgery of a Tertiary Care Centre: A Descriptive Cross-sectional Study
    (Nepal Medical Association, 2022) Poudel, Sajana; Panthi, Sagar; Gautam, Swotantra; Bhandari, Siddhartha; Bhattarai, Bharosha; Pokharel, Sandip; Sedhai, Swastika; Ghimire, Manoj; Khanal, Bhawani; Joshi, Brikh Raj
    Abstract Introduction: Although intestinal obstruction is a very common surgical emergency, there is a dearth of evidence regarding its prevalence at our institute. The objective of this study is to find out the prevalence of intestinal obstruction among patients admitted to the Department of Surgery of a tertiary care centre. Methods: A descriptive cross-sectional study on a total of 6735 admitted patients' in Department of Surgery a tertiary care centre was conducted from 1st January, 2014 to 31st March, 2015. Data were collected retrospectively with ethical approval from Institutional Review Committee (Reference number: 106/071/072). All patients admitted to the surgery ward of the hospital with an age of 18 and above were included in the study. Convenience sampling was used. The data were recorded and analyzed using Microsoft Excel and Statistical Package for Social Sciences version 16.0. Point estimate at 95% Confidence Interval was calculated along with frequency and proportion for binary data. Results: Out of the 6735 admitted cases, the prevalence of intestinal obstruction among the admitted patients in the surgery department of the tertiary care centre was found to be 100 (1.48%) (1.19-1.77 at 95% Confidence Interval). The most common presentations were pain in the abdomen 93 (93%), vomiting 74 (74%), and abdominal distension 55 (55%). Conclusions: The prevalence of intestinal obstruction in our study was lower than the similar studies done in similar settings.
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    Intestinal Obstruction among Patients Admitted in the Department of Surgery of a Tertiary Care Centre: A Descriptive Cross-sectional Study
    (Nepal Medical Association, 2022) Poudel, Sajana; Panthi, Sagar; Gautam, Swotantra; Bhandari, Siddhartha; Bhattarai, Bharosha; Pokharel, Sandip; Sedhai, Swastika; Ghimire, Manoj; Khanal, Bhawani; Joshi, Brikh Raj
    Abstract: Introduction: Although intestinal obstruction is a very common surgical emergency, there is a dearth of evidence regarding its prevalence at our institute. The objective of this study is to find out the prevalence of intestinal obstruction among patients admitted to the Department of Surgery of a tertiary care centre. Methods: A descriptive cross-sectional study on a total of 6735 admitted patients' in Department of Surgery a tertiary care centre was conducted from 1st January, 2014 to 31st March, 2015. Data were collected retrospectively with ethical approval from Institutional Review Committee (Reference number: 106/071/072). All patients admitted to the surgery ward of the hospital with an age of 18 and above were included in the study. Convenience sampling was used. The data were recorded and analyzed using Microsoft Excel and Statistical Package for Social Sciences version 16.0. Point estimate at 95% Confidence Interval was calculated along with frequency and proportion for binary data. Results: Out of the 6735 admitted cases, the prevalence of intestinal obstruction among the admitted patients in the surgery department of the tertiary care centre was found to be 100 (1.48%) (1.19-1.77 at 95% Confidence Interval). The most common presentations were pain in the abdomen 93 (93%), vomiting 74 (74%), and abdominal distension 55 (55%). Conclusions: The prevalence of intestinal obstruction in our study was lower than the similar studies done in similar settings.
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    Isolated Gall Bladder Perforation in a Tertiary Care Hospital in Eastern Nepal: A Descriptive Cross-sectional Study
    (Nepal Medical Association, 2020) Joshi, Brikh Raj; Gautam, Swotantra; Yadav, Saroj Adhikari; Dhakal, Sushil; Thapaliya, Rasmita; Gupta, Rakesh Kumar
    Abstract: Introduction: Cholelithiasisis is a common surgical problem worldwide. Gall bladder perforation is a rare life-threatening complication with considerable mortality. This study aims to find the etiology, demography, type of perforation, and outcome of gall bladder perforation. Methods: This descriptive cross-sectional study was done on patients above 18 years of age visiting the department of surgery of B. P. Koirala Institute of Health Sciences (BPKIHS) who were diagnosed with isolated gall bladder perforation. The study was done from 1st January 2006 till 30 December 2016. Ethical approval was obtained from the Institutional Review Committee (reference number. 34/074/075). The convenient sampling method was used. Data were entered in excel sheets and analyzed. Results: Out of 49 patients included in the study, 28 (57.14%) were females and the commonest age group was 36 to 50 years 22 (44.9%) followed by 51 to 65 years 16 (32.6%). Most of the patients presented in emergency with pain in their abdomen. Diabetes mellitus was the commonest co-morbidity present in 10 (20.41%) patients. Operative management was done in 45 (91.84%) of the patient and conservative management in 4 (8.16%). After surgery of 45 patients, 43 (95.56%) improved and 2 (4.44%) expired. The most common type of perforation was Niemeier Type I in 21 (46.67%) followed by Type III 14 (31.11%). The most common histopathological diagnosis was acute cholecystitis 20 (44.44%). Conclusions: Isolated gall bladder perforation is not an uncommon complication. The most common etiological factor was acute cholecystitis with a slight female predominance. Most of the patients needed surgical intervention and they had good outcomes when diagnosed and managed on time.
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    Lifestyle, behavior, perception and practices of Nepalese during lockdown due to COVID-19 pandemic
    (Nepal Medical Association, 2020) Kandel, Samikshya; Lamsal, Mahesh; Yadav, Saroj Adhikari; Bhandari, Dipak; Adhikari, Ganesh; Poudel, Sagar; Sharma, Pawan; Gautam, Swotantra
    Abstract: Introduction: COVID-19 infection is caused by a new strain of SARS CoV-2 virus, which transmits directly from person-to-person and has become a pandemic. To counteract this, actions related to mass quarantines or stay-at-home orders have been used termed as lockdown. This study aims to study lifestyle, behaviour, perception and practice of people regarding during the lockdown. Methods: An online survey was conducted with structured questionnaire in Google forms after ethical approval from Nepal Health Research Council (Ref-2631). The attributes of knowledge, attitude and practices were explored using multiple-choice questions and results were statistically analysed using Microsoft excel. Results: Five hundred fifty-five respondents completed the survey with 280 (50.5%) males and 275 (49.5%) female. The knowledge regarding viral pandemic was increased in 496 (89.3%) respondents. 424 (76.4%) people developed stress due to pandemic. Three hundred fifty three (63.6%) were adversely affected by professional works or suffered economic loss in business. More than 42% participants are using their time for study in personal development, online classes etc. Conclusions: The knowledge of viral pandemic as well as personal hygiene habits have improved in majority of people but many also developed stress. They were convinced that lockdown lowered transmission of infection which in turn affected lifestyle behaviour and practices. Practicing social distancing becomes too difficult for the poor in the absence of proper social security system and government support. E-Learning has become more acceptable due to lockdown. Further studies with in-person interviews are warranted.
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    Low Cluster of Differentiation 4+ T Cell Count in People Living with HIV/AIDS Undergoing Antiretroviral Therapy Visiting a Reference Laboratory: A Descriptive Cross-sectional Study Authors
    (Nepal Medical Association, 2021) Kandel, Samikshya; Khadka, Sundar; Lamsal, Mahesh; Jha, Bimlesh; Paudyal, Sunil; Gautam, Swotantra; Poudel, Sagar; Sharma, Mukunda; Amatya, Jeena
    Abstract: Introduction: Human Immunodeficiency Virus is a lentivirus that causes human immunodeficiency virus infection and over time, acquired immunodeficiency syndrome. Cluster of Differentiation 4+ T cell count of people living with this infection play a vital role to determine infection progression and necessary treatment changes. This study was conducted to find out the prevalence of low Cluster of Differentiation 4+ T Cell Count in the People Living with human immunodeficiency virus/ acquired immunodeficiency syndrome. Methods: A descriptive cross-sectional study was conducted between June to August 2018 in the Human Immunodeficiency virus and Hepatitis Reference Unit of National Public Health Laboratory, Ministry of Health and Population Teku. Ethical approval was taken (Reference Number 2912) and a total of 550 seropositive cases of Human Immunodeficiency Virus-1 undergoing antiretroviral therapy were studied. Convenient sampling technique was used. Data was analysed by Statistical Package for the Social Sciences. Results: Seventeen (3.1%) of patients had Cluster of Differentiation 4+ T cell counts below 100 cells/mm3 of blood. The mean Cluster of Differentiation 4+ T cell count was 509.3 cells/mm3 of blood. Of the total samples, 280 (50.9%) were males, 268 (48.7%) were females, and the rest 2 (0.4%) were of other gender. Conclusions: Majority of people living with human immunodeficiency virus/ acquired immunodeficiency syndrome were found immune-competent.
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    Perception of Health Care Practitioners of Government Designated COVID-19 Hospitals of Nepal towards the Management of COVID-19 Pandemic: A Descriptive Cross-sectional Study Authors
    (Nepal Medical Association, 2022) Panthi, Sagar; Jaishi, Amrit Raj; Gautam, Swotantra; Bhandari, Siddhartha; Bhatt, Navin; Basnet, Lila Bahadur; Sharma, Sanjib Kumar
    Abstract: Introduction: Amidst the chaos of COVID-19, health care practitioners are persistently providing services and experiencing many challenges. This study aimed to determine the perception of health care practitioners of government designated COVID-19 hospitals of Nepal towards the management of COVID-19 pandemic. Methods: A descriptive cross-sectional study was conducted among the frontline health care practitioners working in the government designated COVID-19 hospitals in Nepal from 21st June, 2020 to 15th August, 2020. Ethical approval was obtained from the Ethical Review Board of the Nepal Health Research Council (Reference number: 347/2020 P). A total of 252 health care practitioners (doctors, nurses, and paramedics) working at the forefront in the emergency ward, general wards, intensive care units, isolation centers, fever clinics, laboratory, quarantine centers, help desks, etc. in the designated hospitals who consented to participate were included in the study. Convenience sampling was used. The data was analyzed using Statistical Package for the Social Sciences version 16.0. Point estimate at 95% confidence interval was calculated along with frequency and proportion for binary data. Results: Only 41 (16.3%) (11.73-20.86 at 95% Confidence Interval) of the health care practitioners were found to have satisfactory perception towards the management of COVID-19 pandemic in Nepal. Conclusions: The satisfactory perception of the health care practitioners in our study towards the management of COVID-19 pandemic in Nepal is lower as compared to the other studies in Nepal and abroad.
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    Practicing Medicine Wisely: Routine Use of Urine Legionella in Suspicious Pneumonia – Are we Overdoing?
    (Nepal Medical Association, 2024) Gautam, Swotantra; Neupane, Aakash; Mercado, Luis Isea; Nguyen, Phuong; Bhusal, Suzit
    Abstract Legionella spp. is an underreported cause of Community Acquired pneumonia that affects significant population specially in urban areas and its prevalence is on an increasing trend. The routine practice of testing for urinary antigen of Legionella in all suspected cases of pneumonia is prevalent is resource rich western countries. Although several studies have shown no distinct advantage of performing routine urinary antigen testing, this practice continues to be preferred by clinicians. In this viewpoint, we have discussed the advantages and disadvantages of urinary antigen testing, its relevance in current practice and its impact on clinical outcomes.

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