Browsing by Author "Lamsal, M"
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Publication A Study of Occupational Characteristics and their Association with Cardiovascular Disease among Industrial Workers in Eastern Nepal(Kathmandu University, 2017) Pyakurel, P; Karki, P; Lamsal, M; Ghimire, A; Pokharel, PKABSTRACT Background An understanding of occupational characteristics of a worker is essential to establish policies, legislation in order to protect the health of the worker. The concept of Occupational Safety and Health is in initial stage in our country. Work-related cardiovascular disease (CVD) is caused by occupational factors that increase the oxygen requirements of the heart or decrease the capacity of the heart to use oxygen. It can be very difficult to link a specific work-related exposure to the development of cardiovascular disease in an individual person. This is because of issues of latency, multiple possible risk factors, lack of specific work-related features and various factors that influence diagnosis. Objective To study occupational characteristics and their association with cardiovascular disease among relatively young male industrial workers between 20-59 years of age in Sunsari-Morang industrial corridor of Eastern Nepal. Method A cross sectional study was conducted among men between 20 -59 years of age in two randomly selected industries in the Sunsari-Morang corridor of Eastern Nepal from July 2012 to July 2013. The data was collected using a pre-tested semi-structured questionnaire. Systematic random sampling was done to select the required number of samples. Chi-square and Fisher Exact tests were used. Crude and adjusted analyses were done. Result Majority (85%) were day shift workers. About 40% of the workers worked for 70-80hrs/ week. Most of them have stress sometimes at work. Noise was experienced by 40.9% of the workers. Earplug was used by only 5% of the workers. Hypertriglyceridaemia was seen in 49.3% of the workers. Long working hours, not using earplug and financial stress were seen to be associated with cardiovascular disease on bi-variate analysis. However, only earplug was significant in multivariate analysis. Conclusion Risk of cardiovascular disease was seen more among those who worked for more hours; those who did not use earplug and those who had financial stress. The results need further exploration to establish a causal association between occupational characteristics of the workers and cardiovascular disease in industrial set-up of eastern Nepal. KEY WORDS Cardiovascular disease, Industrial workers, Occupational characteristicsPublication Altered serum levels of thyroxine, triiodothyroinine and thyroid stimulating hormone in patients with depression(Kathmandu University, 2007) Das, BKL; Baral, N; Shyangwa, PM; Toora, BD; Lamsal, MObjective: To assess serum level of Thyroxine (T4), Triiodothyronine(T3) and thyroid stimulating hormone(TSH) in patient with depression. Methods: Thirty one clinically diagnosed depressed patients and equal number of healthy, age and sex matched control subjects were included in this study. Ham-D scale was used to classify the degree of depression into mild, moderate and severe grades. The biochemical parameters (T3, T4 and TSH) were estimated using commercially available kits. The data were analyzed by using (SPSS-10 software), one way ANOVA and χ2 test. Result: Female depressed (n = 17) cases outnumber the male depressed cases. The distributions of patients in mild, moderate and severe categories were similar. The T3 and T4 level were found to be significantly raised in the moderate depression as compared to the healthy controls. ANOVA with multiple comparisons testing among the patient group showed a significant high TSH level (F> 3.17) at 5% level of significance. A total of six depressive patients were found to have thyroid abnormalities. Conclusion: This study therefore points towards presence of thyroid dysfunction among the depressive which most often characterized as a “Lower Thyroid Syndrome”. Thus inclusion of thyroid screening test among depressive patients may be helpful in proper management of cases.Publication Effect of Teachers Training Workshop Outcomes on Real Classroom Situations of Undergraduate Medical Students(Kathmandu University, 2015) Baral, N; Nepal, AK; Paudel, BH; Lamsal, MABSTRACT Background Faculty development by conducting regular training, workshops and research related to medical education has been a key feature to upgrade quality of medical education. Objective The aim of this study was to explore responses of the health science teachers, students and peers after the workshop after providing training on student assessment tools and teaching-learning methods. Method Two teacher-training workshops were conducted to the faculty members of B.P. Koirala Institute of Health Sciences from the departments of basic, clinical and allied sciences in Oct. 2010 and Jan. 2011. Qualitative questionnaire based study was conducted, and the questions were validated before the study by expert peer review process. The effect of the training workshop in real classroom outcomes was assessed incorporating student’s feedback, evaluation by peers and the self-evaluation by the teacher trainees. Result Pre-test and post-test scores of the participating teachers, before and after the workshop were 62.53 and 71.17 respectively. Among the participants 90.3% teachers expressed enhanced in their role as a teacher for medical undergraduates after the workshop. Conclusion In present study, the faculty members showed accrued interest to participate in teacher’s training workshops. The peer evaluation of teacher’s performance in their real classroom situations were rated higher than evaluation by the students. Therefore, such training workshops will have a greater impact on the ability of teachers in effective teaching in real classroom situations. KEY WORDS Medical education, Nepal, teachers training.Publication Effectiveness of Teachers’ Training in Assessment Techniques: Participants’ Perception(Kathmandu University, 2011) Baral, N; Gautam, A; Lamsal, M; Paudel, BH; Das, BK Lal; Aryal, MABSTRACT Background Medical education has experienced a rapidly changing scenario especially during the past three decades. Teachers’ training programs have emerged in recent years as a more in depth and comprehensive mechanisms for strengthening instructional skills and formulating assessment techniques among faculty members. Objective The present study was carried out with the aim of assessing effectiveness of teacher’s training workshop on assessment techniques at B.P. Koirala Institute of Health sciences (BPKIHS), Dharan, Nepal. Methods: In this prospective questionnaire based study, the 26 entry level teachers were enrolled. They were requested to fill the questionnaire before and after the workshop on the assessment techniques at BPKIHS, Dharan. Methods Twenty six teachers majority of whom were entry level teachers comprising of medical, dental, nursing and allied sciences participated in pre- and post test analysis on the various components of written and oral examinations. A two and half days long training was conducted having 9 hours of teaching interactive sessions, 6 hours of group exercises, daily evaluation and 3 hours of presentation by participants. There was high degree of agreement with most topics of the assessment training. Results There was a significant gain in knowledge (p< 0.001) by the participants. All the participants (100%) agreed upon the training being informative and learned new things about assessment. More practice session with longer duration with invited resource persons were also suggested for an effective session. Conclusion Thereis an immense opportunity for a better and comprehensive training in evaluation techniques in medical education.. KEY WORDS evaluation system, faculty development, medical education, teacher training.Publication Subclinical hypothyroidism in eastern Nepal: A hospital based study(Kathmandu University, 2010) Rohil, V; Mishra, AK; Shrewastwa, MK; Mehta, KD; Lamsal, M; Baral, N; Majhi, SAbstract Background: Subclinical hypothyroidism itself is associated with serious complications and also there is a known risk of subclinical hypothyroidism patients getting converted into overt disease. Objectives: The objective of the present study was to find out the prevalence of subclinical hypothyroidism in the suspected cases i.e. amongst the cases attending the thyroid laboratory at B.P. Koirala Institute of Health Sciences, Dharan, Nepal. Materials and methods: It was a retrospective cross sectional study. Data of the free T3, free T4 and TSH estimations of the year 2007 of the Thyroid lab at BPKIHS, Dharan, Nepal was analyzed. ELISA based free T3, free T4 and TSH tests in the serum had been performed in all the cases. Results: Total cases were 1714 including 24.446% males and 75.554% females. Cases with raised TSH levels were 26.021%, cases with normal TSH levels were 54.66% and cases with low TSH levels were 19.316%. Total 350 cases (20.42 %) had subclinical hypothyroid dysfunction which includes 84 (4.901 %) males and 266 (15.519%) females. And the maximum percentage of cases in either gender was between the age groups 20 -59 years. Conclusion: The prevalence of subclinical thyroid hypothyroidism amongst the suspected cases was 20.42 % which is much higher compared to the other parts of the world. The highest percentage was found in the female age group 20 – 59 years. The routine screening of the whole population is not cost effective and on the basis of the present study it is suggested that there may be routine screening of the selected populations, especially women between 20 to 59 years of age in Nepal region. The preferred screening method advised is a sensitive ELISA based TSH test. Key words: Subclinical hypothyroidism