Browsing by Author "Pant, A"
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Publication A Cross-Sectional Study of Medication Adherence Pattern and Factors Affecting the Adherence in Chronic Obstructive Pulmonary Disease(Kathmandu University, 2015) Shrestha, R; Pant, A; Shakya Shrestha, S; Shrestha, B; Gurung, RB; Karmacharya, BMABSTRACT Background Chronic obstructive pulmonary disease (COPD) is considered as a major health problem, associated with mortality and morbidities. Various disease management strategies have been established to optimize patient’s longevity and functional status where patient adherence to the prescribed treatment plays a key role. Poor adherence to medication is common among COPD patients and is affected by number of factors like number of medicines, delivery devices and patient-related factors. Objective This study aims to investigate the adherence pattern in the management of COPD and factors affecting patient adherence to the prescribed treatment. Method This study is a cross-sectional study which was conducted in a tertiary care hospital. Those patients suffering from COPD of all age were enrolled in this study and prior informed consent was obtained from patients. The structured questionnaire was used to interview those patients. Result Total 100 patients were enrolled in this study, among which most patients (45%) were of age groups 60-70 years. Unintentional non-adherence to medication attributed for 65% of patients and the major reason was forgetfulness (52.3%). Most patients had discontinued the medication due to experience of side effects (63.3%). The result showed significant association between adherence and polypharmacy (p=0.00). However, there was no significant association between adherence and age, sex, mode of administration of drugs, technics to use delivery devices etc. Conclusion Majority of COPD patients were elderly (mean age= 68.4 years). Forgetfulness was associated with medication non-adherence. Most of the patients had discontinued medication because of side effects. Polypharmacy is one of the major factors associated with non-adherence to medication in COPD. KEY WORDS Adherence, COPD, Dhulikhel Hospital, non-adherence, polypharmacyPublication Apocrine Carcinoma Developing in a Naevus Sebaceous of Scalp(Kathmandu University, 2012) Paudel, U; Jha, A; Pokhrel, DB; Gurung, D; Parajuli, S; Pant, AABSTRACT Apocrine skin carcinoma is an aggressive cutaneous tumour. We report a case of apocrine carcinoma developing in a naevus sebaceous of scalp in a 45 years old male. Malignant transformation of Naevus sebaceous is a rare complication usually found in elderly patients. Most of these tumours are basal cell carcinoma or squamous cell carcinoma. Only few cases of apocrine carcinoma on naevus sebaceous have been previously reported. This report highlights the potential of naevus sebaceous for malignant transformation. KEY WORDS Apocrine, Basal cell carcinoma, carcinoma, hamartoma, nevus, Sebaceous of Jadassohn, skin.Publication Klippel -Trenaunay Syndrome: A Case Report(Society of Dermatologists, Venereologists and Leprologists of Nepal (SODVELON), 2012) Paudel, U; Gupta, Sonia; Pant, A; Bagaria, R S; Shrestha, D PNA Keywords: Klippel -Trenaunay Syndrome, capillary- venous malformationPublication Study of Pre-disposing Factors of Acute Exacerbation of Chronic Obstructive Pulmonary Disease and Antibiotic Prescribing Pattern with Reference to Antibiotic Sensitivity Test(Kathmandu University, 2015) Shrestha, R; Shrestha, B; Shakya Shrestha, S; Pant, A; Prajapati, B; Karmacharya, BMABSTRACT Background Chronic Obstructive Pulmonary Disease (COPD) affects about 329 million people worldwide, which is nearly 5% of the entire global population. In the context of Nepal, COPD accounts for 43% of the non-communicable disease burden and 2.56% of hospitalizations. Various pre-disposing factors like bacterial, viral, fungal, smoking, occupational exposures and genetic factors have been proposed to precipitate COPD and its exacerbation though, the definitive pre-disposing factors and factors related to acute exacerbation have not been determined in the context of Nepal. Objective To find out the pre-disposing factors and the related causative agents for COPD. Method A cross sectional study was conducted in a tertiary care hospital. Patients of all age group who were diagnosed as COPD and admitted in the hospital were included in this study. Patients were interviewed using structured questionnaire. The socio- demographic data including personal and medical history were recorded from those participants. In addition, sputum from those patients was sent for culture to investigate the possible responsible pathogens as well as its antibiotic sensitivity pattern. Result A total of 150 patients having Acute Exacerbation of Chronic Obstructive Pulmonary Disease (AECOPD) who have admitted from either emergency or out-patient department of the hospital were included in this study. Among the total number of patients, more than half of them were female (n=82). In addition, analysis of occupations shows that most of them were either farmer (36.0%) or housewife (30.7%). In total studied patients (n=150), most of them were using traditional firewood (83%) for cooking purpose and majority of patients (91%) were smokers. Most of the sputum samples show growth of gram-positive cocci (26.7%) and gram negative bacilli (27.5%). Considering the overall sensitivity pattern, the higher sensitivity was recorded for Co-trimoxazole and Ciprofloxacin while higher rate of resistance was noted for Penicillin group of drugs. The most widely used antibiotics were found to be Cephalosporin group of drugs (68%). Conclusion The present study revealed that the case of COPD is more in female and the commonest pre-disposing factor is found to be smoke/firewood. Cephalosporin group of drugs is the most commonly prescribed drug. KEY WORDS AECOPD, firewood, pre-disposing factor and therapy of COPD