Browsing by Author "Paudel, D"
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Publication Analysis of Prognostic Factors of Bell’s Palsy in a Tertiary Care Centre of Eastern Nepal(Kathmandu University, 2021) Paudel, D; Chettri, ST; Sah, BP; Dahal, R; Pyakurel, PABSTRACT Background Bell’s palsy is the most common cause of acute facial peripheral neuropathy commonly encountered in otolaryngology clinics. Studies regarding epidemiology, risk factors, treatment and prognosis of Bell’s palsy are sparse in our settings. Objective To analyze the prognostic factors of Bell’s palsy in tertiary care Centre of eastern Nepal. Method A retrospective chart review of patients diagnosed with Bell’s palsy from 1st January 2005 to 31st December 2018 was done. Records of the patients were obtained from medical record section of BP Koirala Institute of Health Sciences. Result A Total of 208 patients were included for analysis. After six months 72.6% patients had complete recovery. Patients who presented with lower House Brackmann (HB) grade had significantly better complete recovery than those with high grade (89.1% vs 45.6%). The complete recovery was 80.3%, 73.8%, 63.5% and 50% for the patients of more than 30 yrs, 31-45 years, 46-60 years and more than 60 years respectively and the difference was significant (p= 0.012). Alcohol significantly reduced the complete recovery (p= 0.043). Multivariate analysis showed high HB grade score at presentation to be significant predictor of poor prognosis. (p= 0.001 odds ratio 11.262). Conclusion Old age, use of alcohol and the severity of facial nerve palsy at the time of presentation were the bad prognostic factors, severity of the palsy was found to be most significant predictor. KEY WORDS Bad prognostic factors, Bell’s palsy, House brackmann gradePublication Digital Health in Nepal: A Perspective on Overcoming Challenges and Leveraging Opportunities(Kathmandu University, 2025) Paudel, S; Paudel, D; Boucher, FABSTRACT Digital Health, which encompasses eHealth and mHealth, has revolutionized health care with input from information technology, computer science, and data. With the addition of client-centered content, digital health offers to low- and middle- income countries like Nepal the ability to gather, analyze and disseminate health information regardless of geographic and socioeconomic challenges. Nepal has enacted policies to improve the health system while overcoming the barriers of difficult terrain, internet capability, and low education. This paper will survey Nepal’s health policy in telecommunication and digital health technology, outline successful interventions, note challenges and make recommendations for future activities. KEY WORDS Digital Health, Health system, NepalPublication Knowledge, Attitude and Practice towards COVID-19 among Private School Teachers of Chitwan, Nepal(Kathmandu University, 2021) Dhakal, RD; Paudel, D; Shrestha, P; Adhikari, PABSTRACT Background The coronavirus disease (COVID-19) pandemic has brought life to a standstill across the world, with nearly 178 countries reporting school closures. As the schools have started reopening slowly, precautions are utmost necessary to prevent the potential spread of COVID-19 in school and community settings. Objective To assess knowledge, attitude and practice towards COVID-19 among private school teachers. Method A web based cross-sectional analytical study design was undertaken. Currently working private school teachers of Chitwan District were included as a unit of analysis. The snowball sampling technique was employed to identify the eligible participant. Collected data was entered in SPSS version 20 and analyzed using the Chi-square test, Pearson correlation, and binary logistic regression. Result Of 344 participants, the majority were male (52.9%), most of the participants were from age group 26-30 years (38.4%). Regarding knowledge, attitude and practice, 57% had good knowledge, 53.2% had favorable attitude and 51.7% had good practice towards COVID-19. Logistic regression analysis demonstrated gender (OR 0.475, 95% CI: 0.256-0.818) and COVID-19 training (OR 25.687, 95% CI 5.354-123.226) were significant with good knowledge. Conclusion Knowledge about COVID-19 among private schools teacher was good, attitudes have been mostly favorable, and the practices were mostly adequate. However, good knowledge is not the only factor for better attitude and good practices. It is necessary to implement massive education campaigns, trainings and information via school authorities and health authorities by developing and adopting appropriate guidelines on COVID-19. KEY WORDS Attitude-practice, COVID-19, Knowledge, School teacherPublication Outcomes of Microvascular Free Flap Reconstruction after Major Head and Neck Ablative Surgery at a Tertiary Teaching Hospital in Eastern Nepal(Kathmandu University, 2023) Sah, BP; Paudel, D; Sarraf, DPABSTRACT Background Reconstruction with free flaps has significantly changed the outcome of patients with head and neck cancer. Microsurgery is still considered a specialized procedure and is not routinely performed in the resource-constrained environment of developing country like Nepal. Objective To evaluate the clinical outcomes in patients who underwent different microvascular free flap reconstructions of head and neck defects after major ablative surgery. Method A retrospective study was conducted to review and analyze the data of patients with head and neck cancer who underwent microvascular free flap reconstruction after major ablative surgery from November 2017 to April 2021. The descriptive statistics were calculated using Microsoft Excel 2010. Result Out of 207 patients, 129 (62.32%) were males. Mean age was of 55.17±13.44 years. About 133 (64.25%) tumors were on gingivobuccal complex. Anterolateral thigh flap was the most common flap 112, (54.11%) used for the reconstruction. Facial artery was used in 174 (84.06%) patients for anastomosis. The overall success rate was 97.5%. Re-exploration was done in 22 (10.63%) cases out of which 11 (50%) cases were having flap compromise. Delayed flap failure occurred in 5 cases (2.5%) and salvage surgery was done with pectoralis major myocutanuos flap with a salvage rate of 54%. Minor complications were observed in 39 cases (18.84%) out of which donor site graft loss was observed in 19 (9.18%) patients. Conclusion In spite of advanced set up, with trained dedicated manpower the microvascular free flap reconstruction of head and neck defects is safe with high success rate even in resource constrained country like Nepal. KEY WORDS Free flap, Head and neck cancer, Microsurgery, ReconstructionPublication Tobacco Use among Adolescent Students in Secondary Schools of Pokhara Sub Metropolitan City(Nepal Health Research Council, 2003) Pathak, R P; Paudel, D