Browsing by Author "Jha, N"
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Publication A comparative study of coronary and contributory risk factors in rural and urban type 2 diabetics(Kathmandu University, 2004) Jha, NA prospective study of various coronary and contributory risk factors in urban and rural diabetic population is presented. For the coronary risk factors, smoking prevalence was high for urban diabetics (27%), also high TC levels (57%), and low levels of HDL cholesterol (17%) were comparatively greater in urban diabetics. Prevalence of hypertension was higher, (40%) in rural diabetics. High LDL levels were (>130mg/dl) were observed in 20% of rural subjects and 47% of urban diabetics. High TG levels (34%) were seen in rural diabetics. 54% of urban diabetics were centrally obese and 57% were obese from the rural study site. From this study, it was seen that, illiteracy percentage was found to be higher in rural subjects. Also, greater number of people (70%) were in inadequate status for the needed patient awareness. 77% of patients belonging to the rural study area were found to be unaware for the hypoglycaemia. Low patient compliance was seen in urban diabetics as compared to their rural counterparts, and 34% of patients belonging to both study sites were found to have no knowledge for diabetic complications. High total cholesterol was found to be the commonest lipid profile abnormality in this study. Second commonest lipid abnormality was high LDL levels. Low HDL cholesterol was found to be more commonly in patients of age > 60 years than <60 years (21.42% vs. 18.18%). More female patients were overweight and obese as compared to male (33.33% vs. 19.23%). A Large population of diabetics was found to have a sedentary lifestyle. Rural patients were progressing towards more coronary risk factors as compared to the urban ones, mainly with the lipid profile abnormalities. Although our type 2 diabetic patients share similar coronary risk factors as compared to diabetic patients from different countries, our type 2 patients have got high prevalence of hypertension. Male diabetics had high prevalence of smoking habits. Keywords: Coronary risk factors, Contributory risk factors, Lipid profile abnormalitiesPublication A study of sensitivity and resistance of pathogenic micro organisms causing UTI in Kathmandu valley(Kathmandu University, 2005) Jha, N; Bapat, S KA retrospective study was conducted in five hospitals to observe the prevalence of organisms causing UTI and their sensitivity to antibiotics. Methodology: Altogether, data from five hundred samples of urine from five hospitals in Kathmandu was collected for this study from January 2005 to April 2005. Result: A total of 244 samples were found to be positive. Altogether six types of organisms were isolated as the causative factors. E. coli (49%), S. aureus, (coagulase positive) (23%), Proteus species (3.6%), Klebsiella (9.71%), Pseudomonas (0.8%) and Citrobacter (2.8%). Analysis of the samples showed that UTI was more common in females of younger age group as comp ared to males. The common age group for females was 21-30 years, whereas that for males was 31-40 years in all the hospitals except in hospital A, where the maximum number of females was from 31-40 years and males were between 71-80 years. The most common organism to cause UTI was found to be E. coli (49%), followed by S. aureus (23%) and Klebsiella (9.71%). All the organisms causing UTI were sensitive to nitrofurantoin and amoxycillin and ciprofloxacin was found to be least effective. Similarly, in three hospitals, B (88.2%), D (64.7%) and E (65.3%), amoxycillin was found to be most effective, amikacin and gentamycin (92.5%) was most effective in hospital C, and nitrofurantoin in hospital A (78%). The second commonest organism, i.e., S. aureus (23%) was most sensitive to cephalosporin (88.8%) of second generation, followed by nitrofurantoin (77.7%), amikacin (80.6%) and norfloxacin (65.5%). The third common organism, Klebsiella (9.71%) was most sensitive to norfloxacin (75%) and nitrofurantoin (75%). Lastly, Pseudomonas was resistant to all the antibiotics in hospital A, D and E, nil in hospital B and sensitive to amikacin (100%) in hospital C. Keywords: UTI, common pathogens, antibiotics sensitivity, resistance profilePublication Academic detailing(Kathmandu University, 2010) Shankar, PR; Jha, N; Piryani, RM; Bajracharya, O; Shrestha, R; Thapa, HSAbstract There are a number of sources available to prescribers to stay up to date about medicines. Prescribers in rural areas in developing countries however, may not able to access some of them. Interventions to improve prescribing can be educational, managerial, and regulatory or use a mix of strategies. Detailing by the pharmaceutical industry is widespread. Academic detailing (AD) has been classically seen as a form of continuing medical education in which a trained health professional such as a physician or pharmacist visits physicians in their offices to provide evidence-based information. Face-to-face sessions, preferably on an individual basis, clear educational and behavioural objectives, establishing credibility with respect to objectivity, stimulating physician interaction, use of concise graphic educational materials, highlighting key messages, and when possible, providing positive reinforcement of improved practices in follow-up visits can increase success of AD initiatives. AD is common in developed countries and certain examples have been cited in this review. In developing countries the authors have come across reports of AD in Pakistan, Sudan, Argentina and Uruguay, Bihar state in India, Zambia, Cuba, Indonesia and Mexico. AD had a consistent, small but potentially significant impact on prescribing practices. AD has much less resources at its command compared to the efforts by the industry. Steps have to be taken to formally start AD in Nepal and there may be specific hindering factors similar to those in other developing nations. Key words: Academic detailing, pharmaceutical industry, evidence-based informationPublication An epidemiological study of injury among urban population(Kathmandu University, 2009) Ghimire, A; Nagesh, S; Jha, N; Niraula, SR; Devkota, SAbstract Background: Injuries are a focus of public health practice because they pose a serious health threat, occur frequently and are preventable. Injuries affect people of all ages and range from minor cuts and bruises to major catastrophes that take thousands of lives. Objectives: This paper aims to find out the prevalence of injuries and to study the various epidemiological factors related to the injuries in Dharan. Materials and methods: A sample of 1398 households was taken as study sample. A systematic random sampling technique was used to select the 10% households from each 19 wards. A pre-tested questionnaire was used to collect demographic information and information related to injuries to the persons suffered from injuries. Result: The prevalence of minor injury in Dharan was 3.5% per month. The injury was common in the age group, 40-49 years (4.6%) and majority of injured persons were farmers (6.9%). Home was the common place (55.6%) for the minor injury. Cut/stab (32.8%) was the most common types of minor injury. The prevalence of major injury was 0.7% per year and occurred more among 50-59 years age group (1.7%). The commonest place for major injury was at road (53.1%) and service holders were at more risk (1.4%). Falls from the height (46.9%) were the most common types of major injury. Conclusion: The injuries related to lifestyle profession and road traffic accidents (RTA) is the commonest burden revealed in the study sample. Promotion of safety and education for protection at work and safe driving can prevent the major socio-economic loss to the family and community at large. Key word: Minor injury, Major injury, RTA, Epidemiological factors.Publication An epidemiological study of injury among urban population(Kathmandu University, 2009) Ghimire, A; Nagesh, S; Jha, N; Niraula, SR; Devkota, SAbstract Background: Injuries are a focus of public health practice because they pose a serious health threat, occur frequently and are preventable. Injuries affect people of all ages and range from minor cuts and bruises to major catastrophes that take thousands of lives. Objectives: This paper aims to find out the prevalence of injuries and to study the various epidemiological factors related to the injuries in Dharan. Materials and methods: A sample of 1398 households was taken as study sample. A systematic random sampling technique was used to select the 10% households from each 19 wards. A pre-tested questionnaire was used to collect demographic information and information related to injuries to the persons suffered from injuries. Result: The prevalence of minor injury in Dharan was 3.5% per month. The injury was common in the age group, 40-49 years (4.6%) and majority of injured persons were farmers (6.9%). Home was the common place (55.6%) for the minor injury. Cut/stab (32.8%) was the most common types of minor injury. The prevalence of major injury was 0.7% per year and occurred more among 50-59 years age group (1.7%). The commonest place for major injury was at road (53.1%) and service holders were at more risk (1.4%). Falls from the height (46.9%) were the most common types of major injury. Conclusion: The injuries related to lifestyle profession and road traffic accidents (RTA) is the commonest burden revealed in the study sample. Promotion of safety and education for protection at work and safe driving can prevent the major socio-economic loss to the family and community at large. Key words: Minor injury, Major injury, RTA, Epidemiological factors.Publication Are we progressing towards elimination of diphtheria, pertusis, tetanus from Nepal?(Kathmandu University, 2008) Jha, N; Kumar, SAbstract Diphtheria, Pertussis and Tetanus (DPT) are the vaccine preventable diseases of childhood. The published literatures and reports related to DPT immunization coverage are relatively more than DPT diseases. The striking reduction in deaths and in the incidence of these diseases has been closely associated with the introduction of specific vaccination program. Expanded Program on Immunization (EPI) is a priority program in the country. Nepal has been running country-wide immunization program since 1989. However, there is no doubt that the program has contributed significantly towards reduction of infants and child mortality. Effective and efficient surveillance system and strengthening the routine immunization against DPT are the key steps for elimination of DPT diseases. Key words: DPT, Diphtheria, Pertussis, Tetanus, Immunization, DPT Vaccine, surveillance, vaccine coverage, Nepal.