NepMed Repository :: Browsing by Author "Maharjan, B"

Browsing by Author "Maharjan, B"

Now showing 1 - 5 of 5

A National Equity Initiative to Address Noncommunicable Diseases and Injuries: Findings and Recommendation from the Nepal NCDI Poverty Commission
(Kathmandu University, 2022) Koirala, B; Adhikari, SR; Shrestha, A; Vaidya, A; Aryal, KK; Kalaunee, SP; Shrestha, A; Mishra, SR; Sharma SK; Karki, A; Maharjan, B; Singh, S; Schwarz, D; Gupta, N; Bukhman, G; Karmacharya, BM
ABSTRACT We aimed to assess the burden of NCDIs across socioeconomic groups, their economic impact, existing health service readiness and availability, current policy frameworks and national investment, and planned programmatic initiatives in Nepal through a comprehensive literature review. Secondary data from Global Burden of Disease estimates from GBD 2015 and National Living Standard Survey 2011 were used to estimate the burden of NCDI and present the relationship of NCDI burden with socioeconomic status. The Commission used these data to define priority NCDI conditions and recommend potential cost-effective, poverty-averting, and equity-promoting health system interventions. NCDIs disproportionately affect the health and well-being of poorer populations in Nepal and cause significant impoverishment. The Commission found a high diversity of NCDIs in Nepal, with approximately 60% of the morbidity and mortality caused by NCDIs without primary quantified behavioral or metabolic risk factors, and nearly half of all NCDI-related DALYs occurring in Nepalese younger than 40 years. The Commission prioritized an expanded set of twenty-five NCDI conditions and recommended introduction or scale-up of twenty-three evidence-based health sector interventions. Implementation of these interventions would avert an estimated 9680 premature deaths per annum by 2030 and would cost approximately $8.76 per capita. The Commission modelled potential financing mechanisms, including increased excise taxation on tobacco, alcohol, and sugar-sweetened beverages, which would provide significant revenue for NCDI-related expenditures. Overall, the Commission’s conclusions are expected to be a valuable contribution to equitable NCDI planning in Nepal and similar resource-constrained settings globally. KEY WORDS NCDI Poverty Commission, Noncommunicable diseases and injuries
Health Care Associated Infection and Trend of Antimicrobial Resistance in Tertiary Care Hospital -A Study in Low Income Setting
(Kathmandu University, 2019) Shrestha, R; Koju, P; Xinliang, Liu; Maharjan, B; Madhup, S; Shah, P; Hao, Li
ABSTRACT Background Antimicrobial resistance (AMR) and healthcare-associated infections (HAIs) are among the most serious public health problems and overall estimate indicates that at any point, over 1.4 million people are suffering from health care associated infection globally. According to the WHO report, the frequency of nosocomial infection is 10% in South East Asia where as 7% in developed countries. The increasing trend of AMR in pathogenic bacteria leads to complication to treat HAIs and failure in treatment and rise in mortality. Objective The study was conducted with the objective of to explore the incidence of different types of HAIs and AMR pattern in the patients admitted in a tertiary care hospital. Method The cross-sectional study was conducted at the tertiary care hospital and the patient who are one year or older and admitted for more than 48 hours were included in this study. The criteria for classification of HAIs were adapted from Centers for Disease Control. All the samples were collected then antibiotic sensitivity testing was conducted according to CLSI standards. Data were collected using a structured data collection form. Data were entered in EpiData software and analyzed using SPSS version 22. Result Among 2326 patients, female was slightly higher than male patients, where 77 (3.3%) patients experienced at least one episode of HAIs. The surgical site infection (71.42%) is the most common infection followed by Catheter Associated Urinary Tract Infection (18.18%) and Health Care Associated Pneumonia (6.49%). Mean hospitalization days is higher with HAI (14.5 days) compared to non-HAI (6.6 days). Out of 909 specimens, urine, sputum and blood were higher in numbers, where 217 bacterial isolates were isolated with Escherichia coli (83 isolates) was the most common bacteria. It is found that Escherichia coli bacterial isolates were resistance to most common antibiotics. Conclusion The study concludes that surgical site infection is the most common healthcare- associated infection and Escherichia coli is the most common bacteria responsible for HAIs. Further, surgical site infection being the most common infection, there is an urgent need to take effective infection prevention and control prevention. KEY WORDS Antimicrobial resistance, Healthcare-associated infections, Surgical site infection
Incidence and Associated Risk Factors of Postoperative Sore Throat in Tertiary Care Hospital
(Kathmandu University, 2017) Shrestha, S; Maharjan, B; Karmacharya, RM
ABSTRACT Background Postoperative sore throat is a relatively minor complaint but a frequent postoperative complication of anesthesia. The incidence of postoperative sore throat varies from 0-50% in most research studies, but some report the incidence is as high as 51-100% following general anesthesia. Objective The aim of this study was to obtain the incidence and determine the associated risk factors of postoperative sore throat in tertiary care hospital. Method Three hundred and seventy six patients who underwent various surgeries under general anesthesia in Dhulikhel Hospital during a four month period were included. Using a predesigned questionnaire with follow up after 24-30 hours after extubation, data was collected. Sore throat was identified using a four point scale (0-3). Result Overall incidence of postoperative sore throat was 50.8%. Patient with airway device endotracheal tubes had the highest incidence (52.2%, 176 of 337), and patient with i-gel had a lower incidence of sore throat (33.3%, 7 of 21). Female patients reported more sore throat than male, more common with older age group and duration of anesthesia more than two hours. Increased incidence of postoperative sore throat was not associated with the type of surgery, number of intubation attempts, category of personnel performing airway managementr and use of oropharyngeal airway. Conclusion Postoperative sore throat is a common complication of airway instrumentation in general anesthesia that can lead to discomfort. The overall incidence of postoperative sore throat in this study was 50.8%. Endotracheal tube, female patients and increased duration of anesthesia were associated with increased postoperative sore throat rates. KEY WORDS Airway device, anesthesia, complication, postoperative, sore throat
Laparoscopic Adrenalectomy for Adrenal Mass
(Kathmandu University, 2025) Adhikari, MB; Yadav, DK; Maharjan, B; Gautam, RK; Mishra, P; Basnet, B; Khadga, A
ABSTRACT Adrenal gland tumors, including both benign and malignant forms, are increasingly detected due to advancements in imaging techniques. This prospective study, conducted at Nepal Mediciti Hospital evaluated thirteen patients diagnosed with adrenal masses, all confirmed benign via contrast-enhanced computed tomography. Functional assessment, preoperative endocrinological and anesthesiological evaluations and pharmacological preparations were conducted as needed. All patients underwent successful lateral transperitoneal laparoscopic adrenalectomy, performed by a single surgeon. The study population had a female predominance (9 females, 4 males), with tumor sizes ranging from 2 to 9 cm. No surgeries required conversion to open procedures, and postoperative outcomes were favorable, with no mortality or re-operations. Complications were minimal, including transient blood pressure elevation in one pheochromocytoma case and one postoperative chest infection. Histopathological findings included aldosterone-producing adenomas, cortisol-producing adenomas, and pheochromocytomas. The study supports the continued use of laparoscopic adrenalectomy as the preferred surgical method for adrenal tumors. KEY WORDS Adrenal gland, Adrenal tumor, Laparoscopic surgery
Study of Neighborhood Environment for Cardiovascular Health in a Squatter Area in Nepal
(Kathmandu University, 2025) Oli, N; Vaidya, A; Rijal, D; Suwal, PS; Maharjan, B
ABSTRACT Background Behavioral risk factors for cardiovascular diseases are prevalent among the urban poor in Nepal. Understanding environmental factors such as the availability of retailers selling tobacco, alcohol, and junk food, as well as neighbourhood access to and the built environment’s support for physical activity is critical for addressing the rising burden of cardiovascular disease in the community. Objective To identify aspects of the community environment that contribute to behavioral risk factors, focusing on the food supply system, built environment, walkability, and the marketing, availability, and accessibility of tobacco and alcohol. Method Spatial data were collected in the Sinamangal-Minbhawan squatter area of Kathmandu using a mixed-method approach. Geographic Information System tool, direct field observations, including spot observation and transect walk, and Market Basket Surveys were done by a trained research team during the period March-May 2022. Data were analyzed using methodological triangulation, combining interviews, observations, GPS data, and Google Earth imagery in ArcMap 10.8. Thematic analysis of market basket survey interviews involved coding transcripts for cardiovascular disease-related behaviors, with codes refined into six key themes, including sociodemographic characteristics. Result We reported a few vegetable outlets and no fruit shops. There were 84 fast-food outlets and local restaurants with junk food and soft drinks available. We observed 77 tobacco outlets with a variety of tobacco products easily available to all. There were 48 alcohol outlets in the area, which, except for four outlets, were present together with tobacco and junk food outlets. Tobacco and alcohol products were largely consumed by men of all age groups. Conclusion Community-based health programs can raise awareness about the importance of healthy behavior. Advocacy efforts to promote policies that support improved access to healthy foods, smoke-free public spaces, and safe environments for physical activity are important to provide community members with healthy choices. KEY WORDS Food supply environment, Geographic information system, Market basket survey, Spatial analysis

Browsing by Author "Maharjan, B"

Results Per Page

Sort Options