Browsing by Author "Joshi, Rijuta"
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Publication Dengue among Patients Visiting Department of Medicine in a Secondary Care Centre: A Descriptive Cross-sectional Study(Nepal Medical Association, 2023) Tamang, Basanta; Basnet, Ajaya; Khadka, Sudip; Joshi, Pramod; Jha, Roshan Kumar; Joshi, Rijuta; Rai, Shiba KumarAbstract Introduction: Dengue, caused by the dengue virus, has a wide range of clinical features, including fever, body ache, lethargy, nausea, and vomiting. Blood-based biomarkers in patients with dengue virus infection reflect a variety of clinical spectrums, from bleeding manifestations to liver abnormalities, and can serve as an essential tool for clinicians. This study aimed to determine the prevalence of dengue among patients visiting the Outpatient Department in a secondary care centre. Methods: A descriptive cross-sectional study was conducted among patients visiting the Outpatient Department from 16 May 2022 to 15 November 2022. Ethical approval was obtained from the Institutional Review Committee (Reference number: 20790202). The socio-demographic details and biochemical and haematological findings of dengue virus-infected patients diagnosed with rapid diagnostic tests were collected. Convenience sampling was done. Point estimate and 95% Confidence Interval were calculated. Results: Out of 706 individuals, the prevalence of dengue was 83 (11.76%) (9.38-14.14, 95% Confidence Interval). The median age of dengue virus-infected patients was 40 years, and the majority were males 54 (65.06%). Conclusions: The prevalence of dengue was found to be lower than in other studies done in similar settings.Publication Three Delays Model and its Determinants for Maternal Death: A Descriptive Cross- Sectional Study Authors(Nepal APF Hospital, 2025) Joshi, Rijuta; Jaiswal, Ekta; Timalsina, Gyanu; Byanjankar, SunitaAbstract: Background: Despite significant improvements in reducing maternal mortality in Nepal, preventable deaths persist due to gaps in timely care-seeking, access, and service delivery. The ‘Three Delays Model’ offers a framework to examine delays contributing to maternal mortality and guide targeted interventions. This study was done to analyze the types of delays and determinants contributing to these maternal deaths. Methods: A retrospective cohort study of maternal deaths was conducted Patan Hospital, Nepal, from July 2021 to July 2024. Data were extracted from hospital records and maternal mortality audit reports. The ‘Three Delays Model’ was applied to categorize barriers: delay 1-decision to seek care, delay 2-reaching care, and delay 3-receiving adequate care. Descriptive analysis was performed using Microsoft Excel. Results: This study identified 16 maternal deaths over three years, with highest mortality among primigravida women in late pregnancy and postpartum periods. Indirect causes were predominant than direct obstetric causes. Dealy in seeking health care was the predominant followed by the delay in receiving care. Discussion: The main determinants of the Delay 1 were poor health literacy, cultural norms, and institutional mistrust. Comparative evidence from Nepal and other low-resource settings highlighted overlapping delays and facility-level gaps that compounded the risk. In order to reduce preventable maternal deaths, culturally responsive health education, improved community engagement, and strengthened hospital facilities may be helpful. Conclusion: Maternal deaths in Nepal remain influenced by behavioral and systemic factors, with Delay 1 as the most prevalent underlying cause followed by Delay 3.