Browsing by Author "Parajuli, Surya Bahadur"
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Publication Promising Response of Paclitaxel in Metastatic Transitional Cell Carcinoma of Distal Ureter Complicated with Hydroureteronephrosis: A Case Report(Nepal Medical Association, 2023) Khan, Sajjad Ahmed; Sah, Santosh; Parajuli, Surya Bahadur; Sapkota, Sulav; Rayamajhi, AsmitaAbstract Ureteric carcinoma is the rarest of all urothelial malignancies, and little attention has been given to it. Palliation in these groups of patients is a dilemma in the clinics. Use of chemotherapeutic agents in ureteric carcinoma is a double edged sword, as these patients had already impaired renal function due to post-renal failure and nephrotoxic nature of most of the chemotherapeutic agents can further deteriorate the renal function, making the management approach, a relatively visionary task. Here, we present a case of a 77-year-old female with metastatic ureteric carcinoma locally complicated with hydroureteronephrosis, coming to us with gross haematuria, lower abdominal pain along with cough. Apart from age factor of the lady, presence of hydroureteronephrosis and pulmonary metastases was another challenge for us. Paclitaxel remains the mainstay of our treatment.Publication Respectful Maternity Care during labour and postpartum in a tertiary hospital: A Descriptive Cross-sectional Study(Nepal Medical Association, 2024) KC, Heera; Parajuli, Surya Bahadur; Gurung, Alina; Mishra, AnjaliAbstract Introduction: Respectful maternity care (RMC) is a fundamental human right for women globally. Providing respectful care during labor and postpartum is crucial for the health and well-being of both mothers and newborns. The interactions between healthcare providers and women play a significant role in shaping their future healthcare decisions. Therefore, this research aims to evaluate the prevalence of RMC during labor and postpartum from the patient's perspective at a tertiary care center. Methods: We conducted a descriptive cross-sectional study at a tertiary center from February 20, 2023, to September 30, 2023. Ethical approval was obtained from the Institutional Review Committee of the same institution. A total of 217 patients were included using consecutive sampling techniques. Data were collected through interviews using a structured questionnaire on respectful maternity care. The point estimate was calculated with a 95% Confidence Interval. Results: The prevalence of overall respectful maternity care (RMC) score was 81%. The score for right to confidentiality and privacy during labor was 91.7%, treated with dignity and respect was 90.87%, received equitable care free of discrimination was 86.41%, protection from physical harm and ill treatment was 84.02%, while protection of right to information/informed consent and choice'preference was 72.55%. Conclusions: This study demonstrated a high prevalence of respectful maternity care, with most patients experiencing protection of confidentiality, dignity, equitable treatment, safety, and informed consent, indicating effective implementation of RMC practices at our tertiary care center.Publication Vitamin B12 Deficiency among Metformin Treated Type 2 Diabetic Mellitus Patients Visiting the Department of Medicine of a Tertiary Care Centre(Nepal Medical Association, 2023) Yadav, Anil; Jyoti, Sabita; Mehta, Ram Kumar; Parajuli, Surya BahadurAbstract Introduction: About 424.9 million people worldwide are affected by Diabetes mellitus. Prevalence among people 20–79 years old in Nepal was 4% in 2017. It is associated with microvascular and macrovascular complications such as peripheral neuropathy leading to risk of foot ulcers and amputation, and impaired sensation in their feet. The study aimed to find the prevalence of vitamin B12 deficiency among metformin-treated type 2 diabetic patients visiting the Department of Medicine of a tertiary care centre. Methods: A descriptive cross-sectional study was conducted in a tertiary care centre between 24 May 2021 to 24 May 2022 after obtaining ethical approval from the Institutional Review Committee. Patients who visited the Department of Medicine and gave informed consent were included in the study. Patients with underlying comorbidities were excluded from the study. A convenience sampling method was used. The point estimate was calculated at a 95% Confidence Interval. Results: Among 330 patients, vitamin B12 deficiency was seen in 33 (10%) (6.76-13.24, 95% Confidence Interval). Among them, 27 (81.82%) were male and 6 (18.18%) were female. Conclusions: The prevalence of vitamin B12 deficiency was found to be higher than other studies done in similar settings.