Browsing by Author "Pradhan, P"
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Publication Assessment of Symptomatic Dry Eye Disease among Postgraduate Medical Students of KIST Medical College and Teaching Hospital using an Ocular Surface Disease Index Questionnaire(Kathmandu University, 2024) Basnet, A; Thapa, S; Ghising, K; Shah, SK; Pathak, SB; Pradhan, PABSTRACT Background Symptomatic dry eye disease is a growing public health challenge especially among those who are visual display unit users and other long-time near activity workers. Increased screen time, prolonged use of face mask and shortage of sleep among resident doctors increases the risk of developing dry eye disease that can affect their learning and social abilities. Data is insufficient on the prevalence of dry eye disease among postgraduate medical students in Nepal. Objective To find out the prevalence of symptomatic dry eye disease using an ocular surface disease index questionnaire among postgraduate medical students of KIST Medical College and Teaching Hospital. Method A cross-sectional study was conducted among three batches postgraduate medical students until 2023 of KIST Medical College and Teaching Hospital, Imadol, Lalitpur. A single validated symptom-based questionnaire with 12 questions was used to assess symptomatic dry eye disease. Result Total of 110 post-graduate medical students with mean age of 30.4 years, 67 males and 43 females were enrolled. Among them, 68 (61.8%) had dry eye disease. Severe dry eye was the commonest followed by mild dry eye. There was statistically significant association between dry eye disease with the increased screen time and suboptimal durations of sleep. Conclusion About half of postgraduate students faced symptomatic dry eye disease. It is advisable for residents to have optimum sleep as possible, limit screen time and establish regular break time along their exposure. KEY WORDS Ocular surface disease index questionnaire, Postgraduate medical students, Symptomatic dry eye diseasePublication Developing tool and Measuring Integration Characteristics of Basic Science Curriculum to Improve Curriculum Integration(Kathmandu University, 2018) Maharjan, BR; Bhandary, S; Upadhyay, S; Ghimire, S; Shrestha, I; Joshi, M; Vaidya, S; Pradhan, PABSTRACT Background Integrated curriculum enhances students’ learning and the retention of knowledge. At Patan Academy of Health Sciences, integrated organ system based curriculum is used with Problem Based Learning as the principle teaching learning method to foster students’ learning. In addition, other approaches of integration were under taken such as integrated assessment; logical arrangement teaching learning methods (lectures and practicals); joint effort of faculty in curriculum planning and delivery; conducive environment to foster hidden curriculum. This study describes the perception of faculty and students on integration characteristics of Basic Science curriculum. Objective To measure the integration characteristics of Basic Science Curriculum. Method Tool was developed to measure integration characteristics of Basic Science Curriculum and ensure whether such planned integration has been achieved. Mixed method was used to measure the perception of the integration characteristics i) quantitatively by questionnaire survey to faculty and students ii) qualitatively by in-depth interview of students. Result Both faculty and students perceived that all the blocks in Basic Science was well integrated in the quantitative questionnaire survey. But, in the in-depth interview, students perceived integration of curriculum in organ system blocks were better integrated compared to Principle of Human Biology blocks where fundamentals of basic science disciplines were delivered. Students reflected that Problem Based Learning not only integrated Basic Science disciplines but also with clinical sciences and the social context. But, students perceived that Community Health Sciences curriculum was not so well integrated with Basic Science subjects. Conclusion Overall, this study showed that planned integration in Basic Science curriculum was successfully executed during curriculum implementation. KEY WORDS Basic Science, Integration characteristic, Integrated curriculum, PBLPublication Dietary Salt Intake in a Suburban Nepali Community: A Cross-sectional Study Using 24-Hour Urinary Sodium(Kathmandu University, 2025) Bhatt, RD; Shrestha, A; Karmacharya, BM; Timalsena, D; Dhimal, MN; Pradhan, P; Oli, N; Bista, D; Pyakurel, M; Barakoti, R; Mishra, R; Risal, PABSTRACT Background High dietary salt intake is a recognized contributor to hypertension and cardiovascular diseases, particularly in low- and middle-income countries. Despite the high burden of hypertension in Nepal, robust estimates of salt intake using the gold standard 24- hour urinary sodium collection remain scarce, especially in suburban populations. Objective To accurately assess dietary salt intake using 24-hour urinary sodium excretion and evaluate factors influencing salt consumption in a suburban Nepali population. Method A cross-sectional study was conducted in 2023-2024 as part of the Dhulikhel Heart Study’s second phase. A total of 381 adult participants were recruited from randomly selected wards of Dhulikhel Municipality. Data on sociodemographic characteristics, dietary habits, salt-related knowledge, and anthropometry were collected. Salt intake was estimated from 24-hour urinary sodium excretion. Generalized Estimating Equations (GEE) and multivariate analyses were used to identify associated factors. Result The mean age of the participants was 49.9 ± 15.5 years and average salt consumption was 9.55 ± 3.2 g/day. The mean dietary salt intake significantly exceeded WHO recommendations, with notable variations by sex, education, and frequency of eating out. Conclusion This study highlights alarmingly high salt intake in a suburban Nepali community and underscores the need for population-specific strategies to reduce sodium consumption. Policy action, public education, and promotion of healthier dietary behaviors are essential to combat the growing burden of salt-related non- communicable diseases. KEY WORDS Blood pressure, Dietary salt intake, 24-hours urine sodiumPublication Habitual Patella Dislocation in a patient with Osteogenesis Imperfecta(Kathmandu University, 2023) Vaidya, RK; Pradhan, PABSTRACT Habitual patella dislocation is a rare entity and its occurrence with osteogenesis imperfecta (OI) has not yet been documented. Various surgical techniques have been described in the literature for its treatment, but no single standard procedure is shown to be effective. A 24-year-old girl, diagnosed with osteogenesis imperfecta, presented with complaints of pain and instability in both knees, more on the right. She was diagnosed to have right habitual patella dislocation. She had prominent quadriceps muscle wasting and X-rays confirmed patella baja. CT scan and MRI suggested trochlear dysplasia, Dejour type A and a normal Tibial tuberosity (TT) - Trochlear groove (TG) distance. She was operated with lateral release, medial plication and tibial tuberosity transfer. She had a full knee range of motion (ROM) and pain-free ambulation in four months. In one year follow-up, she had good functional outcome. KEY WORDS Habitual patella dislocation, Lateral release, Medial plication, Osteogenesis imperfecta, Tibial tuberosity transferPublication Perception of Students on Online Assessment: A Descriptive Study among Medical Undergraduates at Basic Sciences(Kathmandu University, 2021) Maharjan, BR; Devbhandari, RP; Pradhan, P; Byanju, J; Aryal, SABSTRACT Background Assessment drives learning. Student assessment cannot be neglected in the long ongoing online learning during COVID-19 pandemic to motivate and assess students’ learning. Hence Patan Academy of Health Sciences (PAHS) conducted online assessment to medical undergraduates amidst limitations. Objective To measure the perception of online assessment of students which will provide applicable insights for the further improvement. Method This is a single center, cross-sectional and descriptive study. A Google form containing a semi-structured questionnaire was sent to MBBS students of Basic Science at PAHS who attended online classes and online examination. The responses from close ended questions expressed in percentage and Chi-square test was used to find the association. Open ended questions were analyzed using Braun and Clarke’s thematic analysis. Result Of 118 students that responded, 75% passed the online examination. A majority of students (73%) stated that online exam motivated them in learning process and it could be a good alternative during pandemic time. However the most of students (56%) were unsatisfied with the modality of online assessment and reasons that they mentioned were technical problems (89%), inadequate online proctoring (77%), insufficient examination time (58%), lack of orientation to exam, lack of computer skills. Technical problem was worse in rural areas. Conclusion Even though online assessment motivated students’ learning during online classes, a large number of students were unsatisfied with assessment modality. KEY WORDS Cheating, Online assessment, Online learningPublication Prevalence of Hepatic Hydrothorax in Patients with Chronic Liver Disease Presenting in Tertiary Center of Nepal(Kathmandu University, 2024) Shankhadev, A; KC, S; Karki, N; Sharma, D; Pradhan, PABSTRACT Background Hepatic hydrothorax is a common cause of pleural effusion in chronic liver disease. It is associated with poor outcome of the disease. Objective To study the prevalence of hepatic hydrothorax in patient with chronic liver disease. Method A hospital based prospective observational study conducted from July 15, 2022 to July 15, 2023. Diagnostic thoracentesis was performed to the patients presenting with pleural effusion at the time of admission. Chest x-ray was repeated at day 7 to assess the outcome of the appropriate treatment. Result Out of 752 enrolled participants, 105 were diagnosed with pleural effusion. The predominant cause was hepatic hydrothorax (80%), followed by tuberculosis (13.3%). 26.2% experienced spontaneous bacterial empyema. Most of the patients (74%) were classified as Child-Pugh C score. The prevalence of hepatic hydrothorax was 11.17%. Among 84 patients with hepatic hydrothorax, the mean age was 49.42±11.93 years, with a male predominance (male to female ratio, 68:32). Hepatic hydrothorax primarily occurred on the right side (78.6%), followed by left (15.5%) and bilaterally (6%). Mild hepatic hydrothorax was most common (48.8%), followed by moderate (31%) and massive (20.2%). About 65.5% were improved with treatment, while the mortality rate was 34.52%. Renal causes were the most common cause of death, accounting for 58.62% of mortalities. Conclusion Hepatic hydrothorax was prevalent in 11.17% of patients. It predominantly occurred on right side, with advanced Child Pugh score and often associated with spontaneous bacterial empyema (26.2%). The condition carried a mortality rate of 34.52%, with renal causes accounting for the majority of deaths (58.62%). All pleural effusions in chronic liver disease should undergo prompt evaluation because it is often associated with various complications and carries high mortality rate. KEY WORDS Ascites, Chronic liver disease, Hepatic hydrothorax, Prevalence, Spontaneous bacterial empyema, Tuberculosis