Browsing by Author "Khanal, S"
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Publication Alarm Fatigue among Nurses Working in Critical Care Setting in a Tertiary Hospital, Nepal(Kathmandu University, 2023) Regmi, B; Shrestha, B; Khanal, S; Moktan, S; Byanju, RABSTRACT Background Alarm fatigue is a well-recognized patient safety concern in critical care settings. It occurs when nurses become overwhelmed by the total number of alarm signals which can result in alarm desensitization and eventually contributes to missing of serious and important changes in a patient’s condition, thus failing to respond properly. Objective To find out alarm fatigue and its associated factors among nurses working in critical care setting. Method A cross-sectional study design with convenient sampling technique was used to select 56 nurses working at different critical care settings in Dhulikhel Hospital. A self- constructed semi structured questionnaire and nurses alarm fatigue questionnaire was used for the survey. Frequency, percentage, mean and standard deviation were used for descriptive statistics whereas Independent t-test and One-way ANOVA were used for inferential statistics. Result The result shows that more than half of the nurses were less than 25 years, single and more than two-third of the participants worked in Adult Intensive Care Unit. Out of total obtainable score 44, the overall mean score of the Alarm Fatigue was 28.03±12.813. The result showed that there was no significant difference between alarm fatigue and selected socio-demographic and work related characteristics. Conclusion The alarm fatigue among nurses working in critical care settings was found to be higher in this study. Since alarm fatigue is directly related to patients’ safety, the effective management of medical device alarms can reduce alarm fatigue and prevent potentially dangerous outcomes. KEY WORDS Alarm fatigue, Critical care settings, NursesPublication Extended Spectrum β-lactamase (ESBL) Producing Multi Drug Resistant (MDR) Urinary Pathogens in a Children Hospital from Nepal(Kathmandu University, 2018) Sharma, KR; Bhandari, P; Adhikari, N; Tripathi, P; Khanal, S; Tiwari, BRABSTRACT Background Multidrug resistant in clinical bacterial isolates has increasingly been reported through out the world and is associated with high morbidity, mortality and increased health care costs. It is important to determine the status of multidrug resistance pattern to understand the current resistance trend so that appropriate antibiotics can be used in practice. Objective To determine the antibiotic resistant profile and prevalence of extended spectrum β-lactamase producing multidrug resistant strains in pediatric patients of Kanti Children’s Hospital, Kathmandu, Nepal. Method Urine sample was cultured by standard microbiological techniques and bacterial isolates were identified using different biochemical tests. Antibiotic susceptibility testing was performed by Kirby Bauer disc diffusion method and extended spectrum β-lactamase detection was carried out using combined disc method as recommended by Clinical Laboratory Standard Institute guidelines. Result All together 65 different bacteria were isolated and subsequently identified. E. coli was the most common isolate with 46 (71%) isolates 63% of these isolates were multidrug resistant. Gram negative isolates were most resistant to nalidixic acid (81.97%) followed by ampicillin (69.35%) and co-trimoxazole (69.35%). The extended spectrum β-lactamase producing isolates were 43% among total isolates. Conclusion Higher rate of Extended Spectrum β-lactamase production among multidrug resistant isolates suggested routine extended spectrum β-lactamase testing in clinical isolates. KEY WORDS Antimicrobial, Multidrug resistant, Urinary tract infectionPublication Pharmacovigilance: Urgent need in midwestern region of Nepal(Kathmandu University, 2009) Khanal, S; Gyawali, S; Kanodia, R; Rathor, RSNAPublication Regarding the article “Irrational fixed dose combinations in Nepal: Need for intervention”(Kathmandu University, 2008) Poudel, A; Khanal, S; Alam, K; Palaian, SNAPublication Round Block Technique in Management of Breast Lesions(Kathmandu University, 2019) Khanal, S; Singh, YP; Sharma, R; Pandit, KABSTRACT The basic tenets of oncoplastic surgery essentially includes volume displacement and volume replacement. The round block technique, so-called donut mastopexy or Benelli mastopexy, is frequently used as a volume displacement technique in breast conserving surgery for benign multicentric fibroadenomas and early breast cancers. Such techniques are still underused in Nepal. In this article we present on four cases managed with original round block technique and followed prospectively with their outcome. KEY WORDS Breast cancer, Fibroadenoma, Oncoplasty, Sentinel lymph nodePublication Self-Perception of Halitosis among Undergraduate Students of Kathmandu University School of Medical Sciences - A Questionnaire Based Study(Kathmandu University, 2018) Humagain, M; Dixit, S; Bhandari, B; Khanal, S; Singh, PKABSTRACT Background Halitosis is a frequently reported oral health problem worldwide with a prevalence rate of 10-30% in the general population. It is defined as the disagreeable or foul smelling breath originating consistently from a person’s oral cavity. It not only effects the normal daily life activities of the patient but also bring humiliation, reduced self- esteem, ultimately resulting into decreased quality of life. Objective To determine the self-perception of halitosis among undergraduate students of different medical branches of Kathmandu University School of Medical Sciences (KUSMS); Kavre, Nepal. Method A descriptive cross-sectional epidemiological survey was conducted among undergraduate students of Physiotherapy, B.Sc Nursing, Bachelor of Nursing Sciences (BNS), MBBS and BDS program of Kathmandu University School of Medical Sciences, Dhulikhel. A self-administered questionnaire was developed and were distributed among 500 undergraduate students. Result Out of total 500 distributed questionnaires, 406 were completely filled and returned giving an overall response of 81.2%, in which 70 (89.7%) male and 280 (85.4%) female students from different medical branches were aware of the term halitosis. Among them 29 (7.14%) of students think that they suffer from halitosis. Similarly 178 (43.84%) students had severe impact of halitosis on their social life while 153 (37.68%) and 62 (15.27%) students had moderate and mild impact respectively. Conclusion Due to the multifactorial complexity of halitosis, further longitudinal studies including objective assessment of malodor are required to determine its prevalence and to further investigate the association of this problem with other etiological factors in the context of Nepal. Also, curriculum of different fields should be modified to include this simple but very necessary topic. KEY WORDS Halitosis, Multifactorial complexity, Self-perceptionPublication Simple Oncoplastic Breast Conserving Surgery for Breast Cancer in a University Hospital(Kathmandu University, 2023) Khanal, S; Singh, N; Singh, YPABSTRACT Background The principle of oncoplastic surgery is the removal of tumors with negative margins as well as maintaining the contour of the breast. The goals are to achieve local control and best cosmesis. Objective The objective of this study was to assess patients’ satisfaction with different techniques of simple oncoplastic breast conserving surgery (BCS) for early breast cancer. Method This was a retrospective study of early breast cancer cases operated during the period 2009 to 2017. All the patients were under regular follow up for at least five years after surgery. Original Harvard/NSABP/RTOG scale was used to evaluate cosmesis at one year after surgery. Result Median age of the patients was 43 years with median size of tumor being 2.5 cm. All of the patients had good to excellent cosmetic outcome. One patient (4.5%) had margin positivity. All patients were disease free and happy with the cosmesis at five years although one patient did not have whole breast radiotherapy. Conclusion Simple oncoplastic breast conserving surgery techniques in upper part of breast are simple, feasible and improve cosmetic outcome with low margin positivity and good disease-free five-year survival. KEY WORDS Breast cancer, Breast conserving surgery, Mammaplasty