Browsing by Author "Rajbhandari, Bibek"
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Publication Academic Stress among Adolescents of Rural Nepal: A Community-based Cross-Sectional Study(Nepal Health Research Council, 2023) Pant, Suman; Rajbhandari, Bibek; Gurung, Minani; Poudel, Lisasha; Maharjan, Ashmita; Nepal, Sujita; Thapa, Tek Bahadur; Malla, Nabina; Lama, Tashi; Sharma, Dikshya; Gurung, Chandani; Parajuli, Yubraj; Panta, NiranjanAbstract Background: Adolescents are in the transition phase between childhood and adulthood. Their mental health influences many aspects in their life as they go through many physical and emotional changes. Adolescent mental health is harmed by changes in emotional and physical state, as well as increased academic pressure. This study aimed to assess academic stress and its associated factors among adolescents in rural Nepal. Methods: A community-based cross-sectional survey was conducted among 424 adolescents residing in Karnali Province, Nepal. Academic stress was measured using Student Assessing Academic Stress. Multivariate logistic regression analysis was used to examine associated factors at the significance level of 0.05. Results: Of the total students, 19.8% had moderate academic stress and 2.4% of them had high academic stress. Female students had thrice higher odds of having academic stress as compared to male students (Adjusted Odds Ratio:3.47; 95% Confidence Interval:1.91to 6.31, p-value:<0.001). Grade 10 students had higher odds of having academic stress as compared to grade 9 (Adjusted Odds Ratio:2.02; 95% Confidence Interval:1.13 to 3.61, p-value:0.017). Students of literate mothers were more likely to experience academic stress than those with illiterate mothers (Adjusted Odds Ratio:0.53; 95% Confidence Interval:0.29 to 0.96, p-value:0.036). Students with unsatisfactory academic performance had thrice higher odds of having academic stress as compared to students with satisfactory academic performance (Adjusted Odds Ratio:3.12; 95% Confidence Interval:1.46 to 6.67, p-value:<0.003). Conclusions: The findings of the study showed that high school students have academic stress, which is related to many factors at home and school. Understanding academic stress and parents and teachers providing the best support to the students could help lessen the burden. Keywords: Academic stress; adolescents; Nepal; prevalencePublication Cartap Poisoning with Paroxysmal Supraventricular Tachycardia: A Case Report(Nepal Medical Association, 2024) Shah, Newton Ashish; Rajbhandari, Bibek; Banstola,Santosh; Acharya, Manish; Joshi, Rupesh; Luitel, Shree Krishna; Yadav, ManishAbstract Cartap, a nereistoxin derivative from the marine annelid Lumbriconeresis heteropoda, is widely used as a pesticide, targeting pests like caterpillars. While the WHO classifies it as moderately hazardous, with a recommended daily intake of 0.05 mg/kg, human toxicity reports are limited. A 34-year-old female was admitted after consuming an unknown poison. She reported epigastric pain, burning sensations, sweating, vomiting, dyspnea, palpitations, and restlessness, compounded by alcohol intake. Initially treated for organophosphate poisoning, her cholinesterase level was 8.91. It was later confirmed she ingested 100 ml of 50% concentration cartap. Treatment included amiodarone for supraventricular tachycardia and intravenous N-acetylcysteine, magnesium sulfate, and midazolam for general tonic clonic seizure. Cartap, toxic through ingestion and skin contact, can cause symptoms such as vomiting, convulsions, and cardiac issues like supraventricular tachycardia. Supportive care is crucial, and awareness of its risks is necessary.Publication Epidemiological Study of Stroke Cases Presenting to the Emergency Department of a Tertiary Hospital: An Observational Study(Nepal Medical Association, 2025) Rajbhandari, Bibek; Man Shakya, Yogendra; Maharjan, Ramesh Kumar; Shakya, Yagya Laxmi; Aryal, Shiva Sharma; Bhandari, Pratiksha; Shilpakar, Olita; Neupane, Ram Prasad; Nakarmi, Rajan Narayan; Shrestha, CimonaIntroduction: Stroke remains a major global health burden, ranking as the second leading cause of death and third leading cause of disability worldwide. Low- and middle-income countries, including Nepal, face a disproportionate share of this burden, characterized by delayed treatment and limited healthcare infrastructure. This study aimed to determine the epidemiological profile of stroke cases presenting to the emergency department of a tertiary hospital in Nepal. Methods: A cross-sectional study was conducted using medical records of stroke patients presenting to the General Practice and Emergency Department from August 2022 to September 2023. Data on demographics, stroke type, clinical outcomes, and management were collected and analyzed descriptively using STATA version 17. Results: Of 39,702 emergency department visits, 1,174 (2.96%) were stroke cases. Ischemic stroke occurred in 896 (76.34%) patients, hemorrhagic stroke in 175 (14.89%), and transient ischemic attack in 103 (8.82%). The mean age was 61.79 ± 15.76 years, and 704 (60.00%) patients were male. Admission to the general ward occurred in 1,011 (86.10%) patients, and 43 (3.65%) patients were admitted to the ICU. Thrombolysis was administered to 22 (1.87%) patients, and 11 (0.93%) were referred for thrombectomy. A total of 151 (12.90%) patients arrived within 4.5 hours of symptom onset. Conclusions: The study highlights the predominance of ischemic stroke, delayed hospital presentations, and limited use of thrombolysis among stroke patients in a high-volume ED in Nepal.Publication Nepal Introduces Free thrombolytic drugs for Acute Ischemic Stroke: A Revolutionary Step in Acute Stroke Care(Nepal Medical Association, 2025) Rajbhandari, Bibek; Gajurel, Bikram P; Devkota, BikashPublication Paraquat Toxicity Leading to Acute Kidney Injury: A Case Report in an Adult Patient(Nepal Medical Association, 2024) Shah, Newton Ashish; Yadav, Manish; Sah, Rupesh; Rajbhandari, BibekAbstract Paraquat poisoning poses a significant and emerging public health challenge in developing countries. The distribution and usage of Paraquat, a potent herbicide, remain unrestricted in many regions despite its high fatality rate and absence of a specific antidote. Paraquat mostly involves lungs but can also involve the kidneys and liver. Diagnostic challenges and a lack of available samples at presentation contribute to underreporting and limited awareness among healthcare providers, making paraquat poisoning a neglected toxicological emergency. Herein, we present a case of a 40-year-old male who presented to the emergency department on the fourth day after ingesting paraquat in a suicidal attempt. Upon presentation, he had erosion on the tongue and posterior pharyngeal wall, along with deranged renal function tests and elevated serum creatinine levels. The patient developed acute kidney injury, with serum creatinine levels rapidly rising from normal to 3.85 mg/dl, accompanied by a decrease in daily urine output. He was managed conservatively, and his hospital stay was uneventful.Publication The Intersection of Neuroscience and Criminology: Role of Brain Mapping in Addressing Criminal Behavior by Nepal Police(Nepal Medical Association, 2024) Rajbhandari, Bibek; Regmi, Sushant; Dahal, Kanchan; Shrestha, SandeshAbstract Neuroscience is being integrated into criminal investigations, offering new opportunities for understanding, predicting, and potentially preventing criminal behavior. In Nepal, brain-mapping techniques like P300 wave tests and Brain Electrical Oscillation Signature profiling were used in a murder investigation in 2024. However, ethical concerns include privacy concerns, false positives, and the potential for false positives. Consent regarding neurobiological evidence in criminal cases is crucial, as intrusive procedures may require individuals to be informed. The legal implications of using neurobiological evidence could be severe if it serves to wrongfully accuse or convict an individual. Therefore, the use of neuroscience in criminology must be carefully balanced to ensure ethical considerations. This viewpoint interprets the potential of neuroscience in criminal investigations, addressing ethical, privacy, consent, and legal issues within the Nepal Police and criminal justice system.