Browsing by Author "Joshi, AB"
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Publication Characteristics and risk factors of Plasmodium falciparum malaria in Eastern and Central Nepal(Kathmandu University, 2009) Banjara, MR; Sirawaraporn, W; Petmitr, S; Imwong, M; Joshi, AB; Chavalitshewinkoon-Petmitr, PAbstract Background: Very limited information is available on epidemiology of falciparum malaria in Nepal. Such information is very important for malaria control programmes. It is believed that malaria in Eastern region is imported from border districts of India and local transmission follows whereas it is indigenous in Central region. Therefore, the characteristics and risk factors of malaria are believed to be different in Eastern and Central Nepal. Objective: The objective of the study is to describe and compare the characteristics and risk factors of falciparum malaria in Eastern and Central Nepal. Materials and methods: This cross-sectional study was conducted in falciparum malaria endemic districts of Eastern and Central Nepal, during the period 2007 to 2008. We identified and collected information from 106 patients (62 from Eastern and 44 from Central region). Patient examination, clinical and laboratory assessment were done and patients were interviewed using structured questionnaire for malaria related characteristics, risk factors and behaviours. Results: There were significant differences in risk factors and characteristics of falciparum malaria in the Central than the Eastern region. In the Central region, male, illiteracy and thatched roof hut were significant risk factors of falciparum malaria patients as compared to the Eastern region. Visits outside within one months, previous malaria within three months, taking antimalarial before confirmatory diagnosis were significantly higher in patients of the Eastern region as compared to the Central region. Conclusion: Falciparum malaria in Nepal should not be seen as similar entity, and different strategies for prevention and control is needed for its diverse characteristics and endemicity. Key words: Eastern and Central Nepal, falciparum malaria, risk factorsPublication Concomitant rectal and uterovaginal prolapse in the community(Institute of Medicine, 2006) A. Rana; Gurung, G; Amatya, A; Joshi, AB; Sayami, J; Shrestha, MI; Mishra, PAbstract Introduction: Concurrent occurrence of rectal and uterovaginal prolapse in many women living in the community with misery should be made aware that there is possible solution to this dual debilitating condition by surgical correction which can be acquired at the same sitting to bring changes in their quality of life. Case Report: We report here two ceses of concomitant rectal and uterovaginal prolapse.Publication Elimination of visceral leishmaniasis in Nepal: Pipe-dreams and possibilities(Kathmandu University, 2006) Joshi, AB; Banjara, MR; Pokhrel, S; Jimba, M; Singhasivanon, P; Ashford, RWIntroduction: Visceral Leishmaniasis (VL) re-emerged in the Indian subcontinent in the mid-1970s after an almost complete absence in the previous fifteen or so years. The disease was first noted in Nepal in 1978 and, since 1980, it has been reported regularly in increasing numbers. Elimination of visceral leishmaniasis by 2015 has been identified as regional priority program in the level of high political commitment. Objective: The objectives of this study are the comprehensive assessment of information related to VL on the basis of past research studies conducted in Nepal, and an assessment of the prospects of control measures. Materials and methods: This was time line comprehensive VL epidemiological assessment study based on the research conducted by main author during the past ten years. During the period the studies were conducted using cross sectional, case control and exploratory study design. The statistical analysis was done using qualitative and quantitative methods. Results: In our study in the visceral leishmaniasis endemic district, Siraha, in the population of 112,029, a total of 996 clinically suspected cases were reported (with fever of long duration and splenomegaly, with no malaria) during 1998-2002. In all, 283 subjects were found positive for visceral leishmaniasis by rK39 and 284 had positive bone marrow. There was no detectable difference in the density of Phlebotomus argentipes between high, and moderate incidence village development committees (VDC: the smallest administrative unit), but collections in the low incidence areas (in winter) were negative. P. argentipes was never numerous (maximum 4.4 females collected per man-hour), and was much less common than P. papatasi. Peaks of abundance were recorded in the March and September collections. We have found that the numbers of reported cases of visceral leishmaniasis in Nepalese villages was unaffected by indoor residual spray (IRS) indicated by parallel trends in case numbers by time series analysis in treated and untreated villages. A series of maps through ten years clearly showed that the infection can move rapidly between villages, and it is impossible to predict where transmission will occur from year to year. Conclusion: If maximum benefit in relation to cost is the goal, it may be preferable to put all possible efforts into active case detection (ACD) with free treatment. ACD should involve the network of Village Health Workers or Female Community Health Volunteers and the rK39 dipstick test at health centre level. Surveillance of disease and vector, communication for behavioural impacts and insecticide spraying should be important component of elimination program. If IRS is to be a part of the intervention, it is essential that it is carried out effectively, both in areas where the disease has been reported and in neighbouring areas. Integrated vector management need to be monitored for its application and effectiveness for VL elimination.Publication Financial status of medical students in Institute of Medicine(Institute of Medicine, 2007) Bhatta, VR; Joshi, AB; Jha, AJ; Parajuli, P; Koirala, SAbstract Background: Underrepresentation of students from low-income families at the Institute of Medicine in Maharajgunj (IOM) has been generally assumed. This study aims to assess the financial status of medical students at IOM to test the accuracy of that assumption. Methods: The study was conducted among 24th and 25th batch of students of IOM using pre-formed questionnaire. Results: The majority of students studying in IOM thought they have average to strong financial status and they felt little to no financial stress. Conclusion: Students from low income families are underrepresented in IOM. Keywords: Financial status, medical studentsPublication Genitourinary fistula affixed to uterovaginal prolapse(Institute of Medicine, 2007) Rana, A; Amatya, A; Gurung, G; Bista, DK; Joshi, AB; Sayami, JAbstract Case report: Obstetric genitourinary fistulas 3 [rectovaginal fistula (1), vesicovaginal fistula (2)] all as a consequences of difficult unattended labor in domiciliary settings (eventually with the imminent consecutive vaginal deliveries) congregated by uterovaginal prolapse in two cases giving dual problems of rectovaginal and vesicovaginal fistula with prolapse has been described. A difficult labor in the outset complicated with severe perineal trauma could form a basis for uterovaginal prolapse. Keywords: Obstetric genitourinary fistulas, uterovaginal prolapse, perineal traumaPublication Implementation of Active Case Detection of Visceral Leishmaniasis along with Leprosy through Female Community Health Volunteers in Sarlahi District, Nepal(Kathmandu University, 2019) Singh, VK; Joshi, AB; Gurung, CK; Banjara, MRABSTRACT Background Visceral leishmaniasis (VL) and leprosy are important public health problem in Nepal. Female Community Health Volunteers (FCHVs) play pivotal role to promote community based health services. Therefore, we designed an implementation research to assess the effectiveness of active case detection (ACD) and information education and communication (IEC) campaign of Visceral leishmaniasis cases along with leprosy cases through Female Community Health Volunteers in Visceral leishmaniasis endemic 10 Village Development Committees of both Visceral leishmaniasis and leprosy prevalent Sarlahi district of Nepal. Objective To determine the effectiveness of active case search strategy of visceral leishmaniasis along with leprosy through Female Community Health Volunteers in Sarlahi district. Method One hundred fifty one Female Community Health Volunteers of twelve Village Development Committees were oriented on detection, identification and referral of Visceral leishmaniasis and leprosy patients. They were oriented on referring the patients to district hospital for confirmatory diagnosis and treatment. The intervention was continued up to ten months after training of Female Community Health Volunteers. Data on number of Visceral leishmaniasis and leprosy patients detected and referred by Female Community Health Volunteers and detected through passively at district hospital were collected and indicators was calculated. Result Altogether 151 Female Community Health Volunteers were trained from 12 (Village Development Committees) VDCs of Sarlahi district. Their knowledge on leprosy and Visceral leishmaniasis related information subsequently increased after training. None of the Visceral leishmaniasis or leprosy cases were detected actively through Female Community Health Volunteers. However, two leprosy cases were detected through household screening. Conclusion Female Community Health Volunteers should be provided sufficient knowledge to use them in community based active case detection of Visceral leishmaniasis and leprosy. KEY WORDS Active case detection, Female community health volunteers, Information education and communication campaign, Leprosy, Visceral leishmaniasisPublication Monitoring Iodine Deficiency in a District Hospital, Nepal(Kathmandu University, 2020) Singh, VK; Joshi, AB; Gurung, CK; Pant, KR; Banjara, MRABSTRACT Background Iodine deficiency possesses serious threat to pregnant women and infants. During pregnancy, iodine deficiency can result in stillbirth while in infants it can lead to impaired brain development. Objective This study was conducted to assess the status of iodine deficiency among pregnant women and infants. Method Ninety seven pregnant women seeking antenatal check-up (ANC) from Chautara Hospital Sindhupalchowk were included to analyze urine iodine. Thirty one mothers and their children were followed-up for their clinical status. Additionally, the infants were assessed for their urine iodine excretion and the mothers were assessed for their awareness about iodine and iodine deficiency disorder (IDD). Result Urinary iodine excretion revealed 25.2% of pregnant women and 20% children below one year of age had insufficient iodine intake while 42.9% of pregnant women and 24% children had iodine level above normal. Almost all households were found using iodized salt, 80% respondents had heard about iodized salt, 13% mothers were aware of benefits of iodized salt, 41.9% had knowledge of iodine deficiency diseases and 38.4% cognized the source of iodine. Conclusion Though awareness about iodine and iodine deficiency disorder was satisfactory, pregnant women and children were at risk of iodine deficiency and excessive iodine disorder. Therefore, to improve health of pregnant women and newborn, their nutrition must be prioritized which ultimately will help reduce morbidity and mortality. KEY WORDS Infant, Iodine deficiency, Pregnant women, Urine iodinePublication Vaccination should be a priority approach for Japanese encephalitis prevention in Nepal(Institute of Medicine, 2006) Joshi, ABNA.