Browsing by Author "Kayastha, B"
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Publication A Study on Obstetric Intensive Care in Dhulikhel Hospital, Kathmandu University Hospital(Kathmandu University, 2017) Shrestha, A; Kayastha, B; Kayastha, SABSTRACT Background Maternal mortality ratio in developing countries is high, depending upon the country and region. Many programmes have been launched in different parts of the world like “Safe motherhood Initiatives” under the WHO guidance. An alternative indicator of obstetric health care is obstetric transfer to an intensive care unit. Very few have been reported from developing countries in South East Asia. Objective To determine the intensive care unit (ICU) utilization by critically ill obstetric patients and to see the spectrum and outcome of disease. Method A prospective study performed on obstetric patients admitted to the intensive care unit of Kathmandu university hospital during a five year period (1st January 2010- 31st December 2015). A total of 56 patients were studied. Result The main cause of admission was hypertensive disorder in pregnancy (22 patients), bleeding disorders in pregnancy (18 patients), sepsis (8 patients), heart disease complicating the pregnancy (4 patients) and 4 others with respiratory problems encountered during delivery. These are the important causes of maternal mortality and morbidity. Conclusion In this study obstetric patients form a small percentage of the total patients admitted to ICU and majority of them were with preventable aetiology. In order to decrease the maternal mortality in developing countries better primary health care and efficient referral system is recommended. KEY WORDS Developing countries, Intensive care unit, Maternal morbidity, Maternal mortality, Obstetric patientsPublication Acceptance of Family Planning Amongst Patients Attending Dhulikhel Hospital Obstetrics and Gynecology Department(Kathmandu University, 2014) Shrestha, A; Kayastha, B; Manandhar, S; Chawla, CDABSTRACT Background Knowledge of contraceptive methods is an important factor for an individual to use or not use of family planning methods. In Nepal, at least one modern method of family planning is universal amongst both men and women. Objectives To assess the knowledge, attitude regarding various family planning methods and practice of contraceptives amongst couples attending Dhulikhel Hospital Obstetrics and Gynecology Department. Methods Five hundred and fifteen couples were interviewed. Their knowledge, attitude and practice of contraception were evaluated with the help of pre-evaluated questionnaire. The other variable used were the age of the couple, parity, educational status and economic status having effect on the contraceptive acceptance were taken into consideration. Descriptive analysis was conducted to obtain percentages. Results We observed that 74.98% of women were in the age group of 20-29 years and 59.22% of men were within the age group of 20-29 years. Teen age mothers were 17.86% and teen age fathers were 1.35%. In our study, we observed that higher the educational level better was the acceptance for family planning methods. The higher income group had less number of children compared to lesser income group. In our study, we noticed that all the couples knew about different methods of family planning, main sources of information were television, pamphlets and healthworkers. Only 16 males had undergone vasectomy and 32 women had undergone tubectomy. Fewer number of vasectomy was due to the belief that undergoing vasectomy will make the male partner weak physically. 13.20% of women preferred Depot medroxy progesterone as a temporary method of family planning, 13% of males preferred condom as a temporary method of family planning. Conclusion We conclude that education plays a vital role in the acceptance of family planning. As couples who have higher education level tend to have higher income and they have lesser number of children. They are more receptive towards counseling and agree upon the various methods of family planning. The easy accessibility to the various media like radio, television tend to make people aware of various methods of family planning. KEY WORDS Acceptance, education, family planning.Publication Predicting difficulties during laparoscopic cholecystectomy by preoperative ultrasound(Kathmandu University, 2007) Sharma, SK; Thapa, PB; Pandey, A; Kayastha, B; Poudyal, S; Uprety, KR; Ranjit, SBackground: The aim of this study was to determine whether the preoperative USG finding can predict the risk of conversion or difficulty during the laparoscopic cholecystectomy. Materials and methods: 200 patients undergoing Laparoscopic cholecystectomy at Kathmandu Medical College Teaching Hospital were included. Sonographic parameters like size of gall bladder, wall thickness, distance between hepaticoduodenal ligament and Hartmann’s pouch and the size of stone were taken into consideration and difficulties in terms of adhesions around gall bladder, anatomy of calot’s triangle and difficulty in peeling off gall bladder from the bed and retrieval were analyzed. Result: In 8 of 200 patients (4%), LC was converted to open procedure. In univariate analysis all the sonographic parameters we had included in this study were statically significant (p value <0.05). Conclusion: Preoperative sonographic signs can predict the difficulty in laparoscopic cholecystectomy