NepMed Repository :: Browsing by Author "Manandhar, S"

Browsing by Author "Manandhar, S"

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Acceptance of Family Planning Amongst Patients Attending Dhulikhel Hospital Obstetrics and Gynecology Department
(Kathmandu University, 2014) Shrestha, A; Kayastha, B; Manandhar, S; Chawla, CD
ABSTRACT 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.
Analysis of Factors Associated with Thyroid Dysfunction: A Hospital Based Study
(Kathmandu University, 2019) Risal, P; Adhikari, B; Shrestha, R; Manandhar, S; Bhatt, RD; Hada, M
ABSTRACT Background Thyroid dysfunction (TD) is one of the major public health concerns in Nepal. This study intends to identify factors in association with thyroid dysfunction and its hospital based prevalence. Objective To determine hospital-based prevalence of thyroid dysfunction and to identify and analyze factors in association with thyroid dysfunction. Method A retroprospective cross-sectional study was conducted among patients attending Dhulikhel Hospital-Kathmandu University Hospital (DH,KUH) from January to December, 2015 with prospective part carried out from July to December 2015 in the patients visiting Dhulikhel hospital for health check-up and requested for Thyroid Function Tests (TFTs). Thyroid Function Tests of 1530 subjects were performed in the biochemistry laboratory and semi-structured questionnaire were introduced to 312 participants with convenient sampling method and their anthropometric measurements were taken. Chi-square test, Pearson’s correlation and student-t test were used as a measure to analyze factors. Result Out of total 1530 subjects, 35.3% were having thyroid dysfunction with the prevalence of overt hyperthyroidism, subclinical hyperthyroidism, overt hypothyroidism and subclinical hypothyroidism to be 2.5%, 2.4%, 5.6% and 24.8% respectively. The distribution of thyroid dysfunction was preponderant among females and among older age. The prevalence of thyroid dysfunction was highest among Terai/Madhesi (40.0%) and lowest among Newars (28.5%) with higher fraction of hypothyroidism in each ethnic group. There were significant correlation between Thyroid Stimulating Hormone (TSH) with waist-hip ratio (p<0.05) and weight (kg) with free thyroxine (fT4) (p<0.05). Direct pesticide exposure (p<0.05) was significantly associated with hypothyroidism. The serum fT4 was significantly different (p<0.05) among vegetarian and non-vegetarian whereas TSH and free triiodothyronine (fT3) were not significantly different. Smoking, alcoholism, dietary food habits, diabetes and hypertension were not significantly associated with thyroid dysfunction. Conclusion Thyroid dysfunction was highly prevalent among participants with higher proportion of subclinical hypothyroidism. Besides, direct pesticide exposure found to be factor in association with hypothyroidism, this study could not find significance relation with other established risk factors. KEY WORDS Hyperthyroidism, Hypothyroidism, Thyroid dysfunction, Thyroid function test
Awareness Regarding Diabetes Mellitus among General Population of Banepa Municipality
(Kathmandu University, 2021) Manandhar, S; Buddhacharya, M; Maharjan, S
ABSTRACT Background Diabetes is a silent disease and many people with diabetes may become aware of it only after life-threatening complications. The presence of knowledge of diabetes could contribute in early diagnosis and minimize the occurrence of complications. Hence, healthcare and public policy makers are putting extensive efforts to aware them on diabetes. Objective To assess the level of diabetes knowledge and its risk among the general public of Banepa municipality. Method A Cross sectional study was conducted to assess the awareness about diabetes among the general public of Banepa municipality. During the period of November 2019 to January 2020, 273 respondents of Banepa municipality were included with informed consent. Data was collected using a pre-tested structured questionnaire through one-to-one interviews. Indian Diabetes risk score (IDRS) was used to identify the risk of diabetes among them that consists of four elements i.e. age, abdominal obesity, physical activity, and family history. Data entry and analysis was done using SPSS version 20. Result It was found that 61.9% had a higher level of knowledge of diabetes. IDRS score shows more than half percent (53.5%) of respondents were in high risk, 39.2% were in medium risk and 7.3% were in low risk. Conclusion This study implies that there was good knowledge about diabetes among people. However, the majority of them are at risk for developing diabetes in future which may be due to lack of practical implication of knowledge. It reflects the necessity to educate and reinforce the public regarding prevention of diabetes which further postpones its complications. KEY WORDS Awareness, Diabetes, IDRS, Knowledge, Risk factors
Bacteriological Profile of Neonatal Sepsis in a Tertiary Level Hospital of Nepal
(Nepal Paediatric Society (JNPS), 2014) Khanal, R; Manandhar, S; Acharya, GP
Abstract: Introduction: Neonatal sepsis is one of the most common reasons for admission to neonatal units in developing countries. It is also a major cause of mortality in both developed and developing countries. This study was done to determine the bacterial profile causing neonatal sepsis and to assess their susceptibility pattern to various antimicrobial agents. Materials and Methods: A cross-sectional prospective study was conducted in Paropakar Maternity and Women’s Hospital, Kathmandu, Nepal among 340 neonates suspected of neonatal sepsis. Blood culture was performed and organisms were identified with Gram staining and conventional biochemical methods. Antimicrobial susceptibility testing was performed by Kirby-Bauer disk diffusion method according to the Clinical and Laboratory Standards Institute (CLSI). Results: The prevalence rate of neonatal sepsis was 20.3%. Among 340 neonates, 52.17% were males and 47.82% were females. Gram positive cocci were the most predominant isolates (88.40%). Among Gram positive cocci Staphylococcus epidermidis was the most common isolates (72.46%) followed by Staphylococcus aureus (7.24%), Staphylococcus saprophyticus (4.34%) and Enterococcus fecalis (4.34%). Gram negative bacilli were found in 11.60% of the growth positive samples of which E.coli and Klebsiella spp were found in 10.14% and 1.44% respectively. Sensitivity to Amikacin was highest among all types of organisms isolated. Vancomycin and Gentamycin sensitivity was highest for Gram positive and Gram negative organisms respectively. Ampicillin resistance was highest among isolates. Among the 69 isolates 48 were Multiple drug resistant. Conclusion: The predominance of Gram positive cocci particularly Coagulase negative Staphylococci is shown. Empirical antibiotic therapy should be reviewed for Multiple drug resistant strains.
Brain tumours in children
(Kathmandu University, 2008) Shah, GS; Paudel, P; Srivastav, M; Sagar, K; Manandhar, S; Singh, MK
Abstract A 10 years old, female patient presented with symptoms of abnormal movement of the body for 5 years, deviation of mouth to left side for 12 days and difficulty in walking for 12 days. We report a very rare case of Brain Stem gliomas. Clinical and imaging findings were suggestive of Brain Stem gliomas. Key words: Brain tumours, Intracranial space occupying lesion.
Breech Presentation Among Nullipara at Term: An Indication for Caesarean Section
(Kathmandu University, 2012) Dongol, A; Regmi, S; Manandhar, S; KC, S
ABSTRACT Background Breech is the commonest malpresentation. Vaginal breech delivery in a nulliparous lady carries higher risk than in multiparous ladies. Poor neonatal outcome following vaginal delivery has made the mode of delivery a matter of controversy. Objective To evaluate the outcome of planned caesarean section among nullipara ladies with breech presentation. Method This is a prospective, analytical study conducted in Dhulikhel Hospital Kathmandu University Hospital from January 2008 to June 2012 among 102 nullipara ladies at term gestation with breech presentation. All cases underwent caesarean section either elective or emergency. During section cause of breech presentation was searched for. Neonatal condition was evaluated using APGAR Score, need for resuscitation and admission in NICU. Post partum status was also recorded for evaluation of maternal morbidity and mortality. Results These Nullipara ladies often had some reason for breech presentation, the most common being cord around the neck. Perinatal outcome was uneventful in 97(95%) neonates, there were two (2%) still birth and three (3%) needed NICU care. APGAR was good in 92 neonates, average in eight and poor in two. Total 16(15.6%) ladies stayed hospital for more than eight days. Among them 11(10.7%) developed wound infection and five stayed in hospital waiting for baby. Conclusion Nullipara ladies with breech presentation should have elective caesarean section as a preferred route of delivery. KEY WORDS Caesarean delivery, mode of delivery, primi breech, vaginal delivery
Chest CT Scan Findings in Symptomatic Patients Infected with COVID-19 in Norvic International Hospital, Nepal
(Kathmandu University, 2021) Shahi, RR; Sapkota, MR,; Budhathoki, L; Manandhar, S; Regmi, D
ABSTRACT Background Coronavirus disease (COVID-19) is the recent global health emergency making it crucial for rapid diagnosis and intervention. Computed tomography (CT) is important for screening, diagnosis and evaluating severity and disease progress. Objective To assess the CT changes in COVID patients and study its relationship with various factors. Method A retrospective study was conducted at Norvic International hospital from August 2020 to November 2020 among RT-PCR positive symptomatic COVID cases who had positive CT changes. CT imaging data were analyzed by radiology expertise. Statistical analysis was carried out with the help of SPSS 16. Result Out of 120 patients, 75% were males and mean age was 54.70±15.56 years. The mean CT severity score was 18.35±6.87. Pure ground glass opacities was seen in 74(61.7%), reticulations 89(74.2%) and crazy-paving pattern 28(23.3%). CT scans with bilateral 118(98.3%) and peripheral involvement 109(90.8%) in all five lobes. CT- severity score was positively correlated with oxygen and mechanical ventilation requirement (P-value < 0.05 and 0.011 respectively). Conclusion CT findings including pure ground glass opacities, reticulations, bilateral and peripheral involvement involving all five lobes were more frequent. Our data suggest that CT-severity score significantly correlates with oxygen and mechanical ventilation requirements. KEY WORDS Coronavirus disease (COVID-19), Computed tomography, Ground glass opacity, Severity score
Enteric Parasitosis in Patients with Human Immunodeficiency Virus (HIV) Infection and Acquired Immunodeficiency Syndrome (AIDS) in Nepal
(Nepal Health Research Council, 2004) Manandhar, S; Sapkota, D; Ghimire, P
Extraintestinal Gastrointestinal Stromal Tumor arising from parietal wall: A rare entity
(Institute of Medicine, 2018) Jha, BK; Jha, P; Vaidya, P; Kansakar, PBS; Manandhar, S
Abstract Extraintestinal gastrointestinal stromal tumors (E-GIST) are rare types of GIST most commonly involving the mesentry, omentum and retroperitoneum. Parietal wall E-GIST are very rare. Very few cases have been reported in the literature. Keywords: GIST, parietal wall
Microbial Quality of Ice Cream Sold in Kathmandu
(Nepal Health Research Council, 2004) Sharma, S; Banmali, P; Joshi, D R; Shah, P K; Manandhar, S
Mothers’ Experience of Febrile Convulsions in Their Children
(Kathmandu University, 2025) Prajapati, R; Karki, S; Shrestha, B; Manandhar, S
ABSTRACT Background Febrile convulsion is the most common convulsive disorder in under five children. About 1 in 25 children have suffered from febrile convulsion in at least one episode. It is a very difficult condition for parents to handle their children during convulsion and they worry about the future health of the child. It is one of the frightening, emotionally traumatic, and anxiety conditions experienced by parents. Objective This study intended to explore the experience of mothers on febrile convulsion in their children. Method The qualitative research design was used for the study. A purposive sampling technique was applied. An in-depth interview technique was used for data collection with in-depth interview guide. A total of ten mothers were included whose children were admitted with the diagnosis of febrile convulsion. Content analysis was done for the interpretation of the experience of mothers. Result Mothers expressed febrile convulsion as a serious condition for the child which leads to developing stress, fear, and anxiety among them. The majority of the mothers worried about the child’s condition and they found it difficult to control themselves. Five themes emerged such as perceived threat, loss of control, need for support, utilizing health seeking behavior, and preventive measure. Conclusion Although the febrile convulsion is a life-threatening situation for children and parents. experience it as an extremely fearful and anxious condition health care professionals including nurses should be providing awareness program for preventing febrile convulsions and provide home management during that situation. KEY WORDS Children, Febrile convulsion, Fever, Mothers
Oral Solid Dosage form Modification in Community Pharmacies of Kavrepalanchok and Bhaktapur Districts of Nepal
(Kathmandu University, 2022) Shrestha, J; Shrestha, A; Shrestha, B; Gamal, K; Manandhar, S; Koju, S; Koju Shrestha, R
ABSTRACT Background People may modify their oral solid dosage form of medicine to deal with problem faced during medicine administration. The modification of dosage form may adversely affect the quality, safety and efficacy of the medicine. Objective To investigate the causes and practices of oral solid dosage form modification among the consumers going to community pharmacies. Method A descriptive, cross-sectional study was conducted in five community pharmacies of Kavrepalanchok and Bhaktapur districts of Nepal. The consumers visiting these pharmacies for their oral solid dosage form of medicine were invited to participate in interview using structured questionnaire. Result Among 419 participants,13.6% of participants reported having problem of taking intact medicine. Most of them (12.4% of total participants) experienced difficulty swallowing the medicine. The swallowing difficulty is significantly associated with age and sex (p < 0.05). Around one third (36.8%) of participant with medicine administration problem modified the dosage form of medicines. One quarter of medicine dosage form modifications (25.0%) were inappropriate. Medicine dosage form modification is associated with age and number of daily medicine intake (p < 0.05). Among participants modifying dosage form of medicines, 66.7% were advised to do so mainly by family and friends; 33.3% were modifying on their own and 76.2% were unaware of possible effects of medicine dosage form modification. About 62.3% of total participants were never asked about any problems on taking medicines by doctor/pharmacists. Conclusion Difficulty swallowing medicines and medicine dosage form modification were prevalent in the Nepalese population. Medicine dosage form modifications also involved inappropriate modifications due to specialized design of such dosage forms. So, it seems important to provide proper counseling while dispensing such dosage forms. KEY WORDS Capsules, Dosage forms, Medication error, Oral medicine, Pharmaceutical preparations, Tablets
Tetanus
(Kathmandu University, 2009) Poudel, P; Budhathoki, S; Manandhar, S
Abstract Tetanus is now a rare disease in developed world. However it remains an important cause of death worldwide and is associated with a high case fatality, particularly in the developing world. Tetanus is caused by contamination of wound by spores of Clostridium tetani. Neonatal tetanus results from contamination of the umbilical stump at or following delivery of a child born to a mother who did not possess sufficient circulatory antitoxin to protect the infant passively by transplacental transfer. It produces its clinical effects via a powerful exotoxin, tetanospasmin, which leads to uncontrolled disinhibited efferent discharges from motor neurons in the spinal cord and brainstem, causing intense muscular rigidity and spasm. Shorter incubation and onset times are associated with more severe disease and poorer prognosis. Four clinical forms of tetanus are recognised. They are generalised, localised, cephalic and neonatal tetanus. Tetanus is associated with several complications like respiratory failure, cardiovascular instability, renal failure and autonomic dysfunctions. Recovery from tetanus takes a long time. Diagnosis is established clinically. Symptomatic management, early recognition of complications, careful monitoring for dysautonomia and respiratory assistance are the anchors for successful outcome of patients. Tetanus is preventable through vaccination. Vaccination is highly safe and efficacious. Active immunisation should be instituted in all partially immunised, unimmunised persons and those recovering from tetanus. Passive immunisation is given as treatment of a case as well as prevention following high risk injury. Nepal has achieved neonatal tetanus elimination status on 2005 and is running different programs to sustain the status. Key words: Tetanus, neonatal tetanus, spasm, treatment, immunisation.

Browsing by Author "Manandhar, S"

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