Browsing by Author "Pandey, R"
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Publication Knowledge Status on Mental Health among Health Professionals of Chitwan District, Nepal(Institute of Medicine, 2015) Gortoulla, P; Pantha, S; Pandey, RAbstract Introduction: Mental health issues are not openly shared by people due to the negative stigma that it carries. In addition, health professionals lack adequate knowledge on mental health issues. This prevents effective management of patients with mental illness. Methods: A descriptive cross-sectional study was carried out among hundred health professionals working in government health institutions of Chitwan District in order to determine the knowledge, attitude and practices on different aspects of mental illness. Knowledge score was added for each domain and changed to categorical variable. Chi- square and fisher-exact test was done accordingly. P-value of less than 0.05 was considered as significant. Results: Age of respondents ranged from 18 to 59 years. A significant number of respondents had very little knowledge on mental health issues and its causes. Majority of them identified neurosis as types of mental illness followed by personality disorder, psychosis and substance abuse. Only a quarter had better knowledge about the treatment. Age group, being male or female, high or low income, knowledge on mental illness, knowledge on type, causes, signs and symptoms, attitudes and practices of mental illness was significantly different between four levels of health professionals namely Health Assistants (HA), Staff Nurse (SN), Community Medical Assistants (CMA) and Auxillary Nurse Midwife (ANM). Conclusions: The findings suggest that further information regarding mental illness, its sign/ symptoms, causes and treatment modalities should be provided to health workers along with actions to reduce stigma related to mental illness among them. Keywords: Chitwan district, cross sectional study, health professional, mental healthPublication Use of Non Invasive Ventilation in Patients with Respiratory Failure in Nepal(Kathmandu University, 2011) Pandey, R; Chokhani, R; KC, NBABSTRACT Background Non-invasive ventilation (NIV) has become an integral tool in the management of acute and chronic respiratory failure. Studies have shown that use of NIV decreases the length of hospital stay, improves symptoms and also reduces the need for invasive mechanical ventilation in patients with respiratory failure. However, NIV is not used sufficiently in our country. Objective To find out the outcome of Non Invasive Ventilation in Respiratory failure in Nepal. Methods Retrospective analysis of data of 28 patients in between June 2010- November 2010 was done. All the patients selected had respiratory failure. Records were analysed for documentation of clinical diagnosis. Arterial blood gases were assessed prior to, after starting and after discontinuation of NIV. The outcome of NIV and the need for domiciliary oxygen was evaluated at discharge. Results Thirty four patients received NIV out of which 6 were excluded from the study due to insufficient documentation. Out of these 28 patients, 27 received bi-level and one patient received Continuous Positive Airway Pressure. Mean age of patients was 66.5 years and ranged from 42-87 years. Majority (19, 79%) were from age group 60-80 years. Most common cause for the use of bi-level ventilation was chronic obstructive pulmonary disease with type 2 respiratory failure in 19 patients (67.8%). Others included obesity hypoventilation syndrome two, acute interstitial pneumonia two, cardiogenic pulmonary oedema two, Interstitial lung disease one, bronchogenic carcinoma one, and bronchiectasis one. Arterial blood gas analysis was done on admission and 12 hours or earlier after the onset of bi-level ventilation. At the time of admission, 89.3% of the patients had type 2 respiratory failure, of which 60.6% had respiratory acidosis and 67.9% of patients had pCO2 above 60 mm Hg. Arterial blood pH prior to admission ranged from 7.19 to 7.50. Twelve hours after bi-level ventilation, only 21.3% had pH <7.35 and 42.8% had pCO2 above 60 mm Hg. Non invasive ventilation was successful in 27 patients (96.4%). All patients were advised domiciliary oxygen and all patients had respiratory follow up arranged. Conclusions COPD patients with type 2 respiratory failure were seen to benefit most with NIV. It is a very cost effective and safe method of treatment and should be used first in patients with COPD with type 2 respiratory failure. KEY WORD respiratory failure, non invasive ventilation