Browsing by Author "Piryani, Rano Mal"
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Publication A brief narrative on work-related asthma (WRA)(Nepalese Respiratory Society, 2022) Piryani, Rano Mal; Piryani, Suneel; Sijapati, Milesh JungAbstract: Work related asthma (WRA) is caused by exposure at work known as occupational asthma (OA) or exacerbated or aggravated by exposure at workplace known as work-exacerbated asthma (WEA) or work-aggravated asthma (WAA). Worldwide, WRA remains under detected and undermanaged. Failure to detect or treat WRA leads to increased healthcare cost, morbidity and mortality. The diagnostic work-up includes clinical history and detailed occupational history, assessment of the causative agent and the objective measurements. Del Roio LC et al (2020) have developed algorithm for the diagnosis of WRA with three primary diagnostic criteria and five additional criteria. Better knowledge and understanding of clinicians and other healthcare providers about WRA is vital for early consideration of WRA diagnosis among adult patients with asthma. While Optimum awareness of general public about WRA may possibly help in initiating discussion by affected workers with their healthcare service providers. The primary prevention includes reducing the burden of WRA by evading the use of potential sensitizers and restricting their exposure and limiting to workplace asthma triggers when their use cannot be avoided.Publication Asthma care during pregnancy in South Asia(Nepalese Respiratory Society, 2023) Piryani, Rano Mal; Piryani, Suneel; Sijapati, Milesh Jung; Karthak, AshishAbstract: Bronchial asthma is among the commonest chronic inflammatory respiratory diseases affecting women of reproductive age group. Adequate attention has not been given to the diagnosis and the management of asthma in countries of South Asia. Management of asthma in pregnant women is more or less same as that of in non-pregnant women and stepwise approach is recommended. To confirm the diagnosis of asthma during pregnancy, spirometry can be used. Patients suffering from very severe asthma or difficult-to control asthma are more prone to develop exacerbations during pregnancy needs hospitalization for care. Well-controlled asthma during pregnancy prevents complications of pregnancy and results in better pregnancy outcomes. It better to follow the guidelines for management of asthma during pregnancy. The pregnant women must be educated regarding the care of asthma during pregnancy, delivery, in postpartum period and thereafter.Publication Awareness of community about sound sleep, sleep disorders and its implications: a step towards sleep health(Nepalese Respiratory Society, 2022) Piryani, Rano Mal; Piryani, Suneel; Sijapati, Milesh JungAbstract: Sleep is a naturally cyclical state of the mind and body. It plays an indispensable role in sustaining the good health of an individual. Inadequate and poor-quality sleep upsets the people of all ages leading to widespread impact on the body and mind. Insufficient sleep can be due either to medical conditions or mental health disorders or sleep disorders. Worldwide, 30%-35% of adults are suffering from insomnia, and about 10% of the population fits in diagnostic criteria for sleep disorders. From 8 countries across Asia and Africa, 17% people reported trouble with their sleep. People have poor knowledge and awareness about the sleep disorders. There is scarcity of trained healthcare professionals and workers in sleep medicine in South Asia; trained and experienced health professionals need to enhance the services of sleep medicine to meet the needs of their population. Creating awareness among the public about sleep and sleep disorders is one of the step towards Sleep Health. It is recommended to the policy makers of countries of South Asia to develop National Sleep Health Policy to address the issue of Sleep Health as lack of sleep or inadequate sleep both in quantity and quality will have impacts on health of the people and consequently economy of the country.Publication Prevalance of Elevated D-dimer Levels in Confirmed COVID-19 Cases in Intensive Care Unit of a Tertiary Care Centre of Western Nepal(Nepal Medical Association, 2021) Khatri, Prabin; Agrawal, Krishna Kumar; Chhetri, Pradip; Sharma, Dipesh; Neupane, Aryan; Piryani, Rano Mal; Baral, Pawan Puspa; Sapkota, Suman Raj; Banjade, Ashish; Chhetri, Ashmita; Bhandari, Subarna; Bharali, SwarajAbstract: Introduction: D-dimer is currently the best available marker for COVID-19 associated hemostatic abnormalities. This study aims to find out the prevelance of elevated D-dimer levels in confirmed COVID-19 cases in intensive care unit of a tertiary care hospital of western Nepal. Methods: This descriptive cross-sectional study was conducted among 95 patients admitted to COVID Intensive Care Unit of a teriary care centre from August 2020 to January 2021 after taking ethical clearence from Institutional Review Committee in order to determine the D-dimer levels in confirmed COVID-19 cases. D-dimer value was measured at the admission and the highest D-dimer value was recorded during the course of hospital stay with the risk of mortality in confirmed COVID-19 cases. The normal range of D-dimer was taken as <0.35 mg/dl as per our hospital laboratory standards. Convenience sampling method was used. Data entry and descriptive analysis were done in Statistical Package for the Social Sciences version 25.0, point estimate at 95% Confidence Interval was calculated along with frequency and proportion for binary data. Results: Out of total 95 cases of COVID-19 included in this study, 25 (89.3%) patients with age ≥65 years and 42 (62.69%) patients aged <65 years had elevated D-dimer on admission. Data showed that 29 (67.4%) patients having elevated D-dimer at admission had mortality. Conclusions: Elevated D-dimer levels was frequently seen in patients admitted in Intensive Care Unit with COVID-19. Our study suggested that measurement of D-dimer may guide in clinical decision making.