Browsing by Author "Ghimire, RH"
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Publication Antenatal Care Practices in Tamang Community of Hilly Area in Central Nepal(Kathmandu University, 2011) Sanjel, S; Ghimire, RH; Pun, KABSTRACT Background Antenatal care is provided during pregnancy to save lives of mother and foetus. World Health Organization recommends four focused visits as sufficient for normal pregnancy. Objective The objective of the study was to find out antenatal care practices in Tamang community of hilly areas of central Nepal. Methods Descriptive cross-sectional study was conducted in Tamang community of Lalitpur district. Systematic random sampling method was used to collect data from April to May 2011. Data of 194 women having ≥3 years of children was collected and analyzed in descriptive and inferential ways. Results Antenatal visits were made by 78.9% (153) of women but only 46.4% (71) completed four antenatal visits. Mean visit was of 3.5 ± 1.13 times. Ninety four (61.4%) of first antenatal visits attainders completed the fourth visit. Age of women and antenatal visits, taking tetanus toxoid injection and knowledge on work of iron tablets exhibited significant association at 95% level of confidence (p <0.05). There was also significant association between numbers of childbirth and antenatal visits at 95% level of confidence (p <0.05). Conclusions There was a high rate of early marriage and early pregnancy in the Tamang communities. Women did not place high importance on antenatal visits. A large percentage did not complete all four recommended antenatal visits. Use of necessary medicine like iron, albendazole tablets and tetanus toxoid injection was often incomplete. KEY WORDS antenatal visits, central Nepal, hilly areas, TamangPublication Clinical Profile and Survival Rate of Interstitial Lung Disease in a Tertiary Care Center of Eastern Nepal(Kathmandu University, 2019) Ghimire, RH; Ghimire, A; Bimali, A; Bista, BABSTRACT Background The clinical profiles of interstitial lung diseases are reported mainly from developed world. There have been no data from Nepal. Objective The objective of this study is to describe clinical profile and survival in Eastern Nepal. Method Prospectively collected clinical, radiological and laboratory data of consecutive patients with Interstitial lung disease from an eastern regional tertiary care center were analyzed. The recommended official criteria for diagnosing different types of interstitial lung diseases were followed accordingly. Result The study revealed that, 68.0% of the patient’s age was of above 60 years with male predominance (66.0%). Idiopathic pulmonary fibrosis (79.5%) was the commonest interstitial lung disease followed by connective tissue disease associated interstitial lung disease. Persistent cough (97.7%) and dyspnea (95.5%) were the commonest presentations. Renal impairment, ischemic Heart Disease and anasarca were significant co morbidities contributing to mortality. Survival rate of the patients was found to be maximum at 5 months (95%) and minimum at 24 months (42%) from the diagnosis of the disease. Conclusion Widespread use of High-resolution computed tomography has made early recognition of interstitial lung disease in elderly patients. Well planned large scale multicenter prospective studies are needed to broaden our understanding about this serious pulmonary disorder. KEY WORDS Clinical profile, Interstitial lung disease, SurvivalPublication Psychiatric Comorbidity among Type 2 Diabetes Mellitus Patients(Kathmandu University, 2024) Acharya, M; Ghimire, RH; Karki, D; Poudel, SABSTRACT Background The co-occurrence of psychiatric conditions and diabetes mellitus is frequently observed. This coexistence manifests in various ways, leading to a diminished quality of life, heightened healthcare expenses, reduced treatment compliance, suboptimal blood sugar control, and an upsurge in visits to the emergency room. Objective To evaluate the prevalence of psychiatric comorbidity in patients with type 2 diabetes at a specialized medical center. Method We conducted a cross-sectional study, enrolling eligible type 2 diabetes patients who sought outpatient services. To evaluate the cognitive and emotional aspects of their illness, we employed the Mini International Neuropsychiatric Interview and ICD-10 guidelines. Convenience sampling method was used and 200 patients were included in the study. Their socio-demographic profile, presence of depression, and other psychiatric illnesses were studied. Result Among the total screened type 2 diabetes patients, 200 eligible individuals were included in the study. Depression emerged as the most prevalent psychiatric comorbid condition, affecting 30.5% of the patients. Notably, depression rates were slightly higher in female patients and those over 50 years of age. Furthermore, individuals with longer diabetes durations displayed a greater prevalence of depressive episodes, followed by other psychiatric illnesses. Conclusion A noteworthy proportion of diabetic patients exhibited comorbid psychiatric conditions. Depression was the most common among diabetics followed by other psychiatric illnesses. The presence of neuropsychiatric illness was commonly seen in diabetics at a later age of life, peaking after 6th decade. KEY WORDS Comorbidity, Diabetes mellitus type II, PsychiatryPublication Spontaneous Pneumothorax: Follow up Treatment Outcome in a Tertiary Care Center of Eastern Nepal(Kathmandu University, 2020) Ghimire, RH; Ghimire, A; Bista, B; Yadav, S; Shreewastav, RKABSTRACT Background Spontaneous pneumothorax is not an uncommon medical emergency in pulmonary practice. Related data are not available in our setting. In emergency departments, clinical presentation is often confused with other cardiopulmonary problems. Follow up outcome is important for better patient care. Objective To study clinical profile and outcome after non surgical intervention in a tertiary care center. Method This was a prospective observational study carried out in Nobel Medical College, Biratnagar over last 3 years. We enrolled consecutive spontaneous pneumothorax patients over 15 years of age. Each data related to individual patients were collected in predefined proforma. To study follow up outcome of management, we used OPD attendance or if not possible took, at least two telephone numbers from the patients. All patients were followed for recurrences. Data was statistically analyzed using SPSS software. Result Over the last 3 years, we enrolled 65 spontaneous pneumothorax patients. Secondary spontaneous pneumothorax was more common (92.3%). Commonest presentations were acute pleuritic chest pain (92.3%), dyspnea (84.62%) and cough (92.3%). COPD (46.14%), PTB sequelae (15.38%), bronchiectasis (23.07%) and bullous lung disease (23.07%) were common risk factors. Tube thoracostomy (95.38%) with pleurodesis with iodopovidone (84.61%) led to lung expansion in 92.3% cases. During follow up, only 4.61% had recurrences of pneumothorax. There was one mortality. Conclusion Spontaneous pneumothorax is a common pulmonary emergency. Meticulous and careful assessment of the patients may help reach the diagnosis even in primary care setting. Tube thoracostomy followed by pleurodesis with iodo-povidone suffices in most circumstances leading lower future recurrences. KEY WORDS Nepal, Spontaneous pneumothorax, Treatment outcome