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 Child Sexual Abuse among School Children of a Municipality: A Descriptive Cross-sectional Study(Nepal Medical Association, 2021) Shrestha, Sushma; Baskota, Swechhya; Karki, Urusha; Poudel, Lisasha; Bhandari, Niroj; Gurung, Minani; Rajbhandari, Bibek; Shrestha, PramitaAbstract: Introduction: Sexual abuse remains a hidden and underreported form of violence against children and a serious public health concern. Although it results in severe mental, physical, and psychological risks with consequences such as depression, fear, and low self-esteem, it is still an unexplored and less prioritized area in Nepal. The objective of this study was to determine the prevalence of Child Sexual Abuse among school children of a municipality. Methods: This was a descriptive cross-sectional study, conducted among 405 students, aged below 18 of Mandan-Deupur Municipality, Kavrepalanchowk from April to May 2018. Ethical clearance was taken from Nepal Health Research Council (Ref no 2506). A simple random sampling technique was used to select the schools. Collected data were then entered and analyzed using Statistical Package for Social Sciences version 16. Point estimate at 95% Confidence Interval was calculated along with frequency and percentage. Results: In overall, 64 (15.8%) (12.4-19.7 at 95% Confidence Interval) were found to be sexually abused, where a high prevalence of Child Sexual Abuse was reported for boys 46 (73.43%). Conclusions: According to the findings of this study, child sexual abuse is seen as a significant issue in the place studied. Awareness programs on child sexual abuse should be organized targeting children along with parents and community people.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 Prevalence of Type 2 Diabetes among Patients Visiting Nepal Police Hospital in Kathmandu: A Descriptive Cross-sectional Study(Nepal Medical Association, 2021) Rajbhandari, Bibek; Hyoju, Sundar Prasad; Poudel, Lisasha; Adhikari, Anurag; Rijal, Badri; Joshi, PramodAbstract: Introduction: The growing prevalence of diabetes mellitus (DM) is a critical threat for global health, including in Nepal, especially in Kathmandu District, where diabetic patients are increasing in hospitals catastrophically. This study tends to assess the prevalence rate of type 2 diabetes among admitted patients visiting a hospital in Kathmandu. Methods: An electronic chart review was done to assess the prevalence of type 2 diabetes in Nepal Police hospital, Kathmandu, Nepal. Ethical approval was taken from the Nepal Health Research Council. Considering eligibility criteria, 8631 cases from 4 May 2018 to 31 August 2020 were observed. The calculated sample size was 500. However, all diabetic cases, i.e., 576, were processed and analyzed using Python and later visualized using MS Excel. Results: The overall prevalence rate of type 2 diabetes was 6.67%. The prevalence rate was seen higher among males (7.5%). Similarly, a high prevalence rate was seen among 64-73 years, i.e., 15.10%. Conclusions: The findings showed a high prevalence rate of type 2 diabetes. Older age groups are at high risk. Urgent public health interventions including lifestyle modification measures are required to reduce the extra burden of type 2 diabetes.Publication Safe Abortion among Underprivileged Group Married Women of Low Resource Country: A Descriptive Cross-sectional Study(Nepal Medical Association, 2020) Budathoki, Sapana; Mali, Prajita; Khadka, Rakshya; Rajbhandari, BibekAbstract: Introduction: Unsafe Abortion is one of the leading causes of maternal death. The unhygienic and dangerous practice has been encountered in various geographical areas of Nepal. Despite its legalization, many women are still being not concerned and well informed regarding safe abortion and become victims of it. The main aim of this study was to assess the knowledge and practice regarding safe abortion among married women of reproductive (14 to 49) years of an underprivileged group of low resource country, Nepal. Methods: A descriptive cross-sectional study design was done in Rajbanshi community of Jhapa District. Data collection was done after taking ethical approval. Study population was selected conveniently. Data was collected by using a semi-structured questionnaire via face to face interviews among 420 married women of reproductive (14-49) years. All the extracted data were entered and analyzed using Statistical Package for the Social Services version 20. Descriptive analysis was doneand presented using frequency and percentage. Results: Out of 420 respondents, 388 respondents (92.4%) found to have poor knowledge, regarding safe abortion. Likewise, only 44 respondents (10.05%) had practiced abortion, of which only 2 respondents (0.05%) had an unsafe abortion and 42 respondents (10%) had practiced safe abortion. Conclusions: Practices of unsafe abortion were prevalent. Respondents with poor knowledge werefound to have done abortion. In this context, it can be concluded that knowledge regarding safe abortion can be increased by educating and providing awareness to the people of society.Publication Suspicious Case of a Body packer “Mule” in a Low Resource Country: A Case Report(Nepal Medical Association, 2021) Rajbhandari, Bibek; Shilpakar, Olita; Thapa, Subash; Singh, SumiAbstract: Body packing is the process of smuggling illicit drugs in the form of packages concealed within the gastrointestinal tract via ingestion or inserting into body orifices. These individuals are described as “body packers”, “stuffers”, “mules” or “swallowers” and resort to carrying drugs like heroin, cocaine and cannabis. They present to the hospital following the development of complications or brought dead due to the rupture of packets or directly from detention for further investigations. This case illustrates a suspected case detained from the airport who was found to be carrying 93 pellets of an illicit drug, heroin, weighing 900 grams, one of the highest quantity carried by any body packer in the country till date. This case further sheds light on the fact that a meticulous history, detailed clinical examination and radiographic investigations like abdominal radiograph and imaging are the keys to diagnose body packers in a resource limited setting.Publication Symptoms of COVID-19 Confirmed Cases Presenting to Emergency Department in a Tertiary Care Centre: A Descriptive Cross-sectional Study(Nepal Medical Association, 2020) Bajracharya, Sumana; Shrestha, Ashis; Rajbhandari, BibekAbstracts: Introduction: Clinical presentation of the patient with COVID-19 in an emergency department is very important. The proper assessment of the symptom allows correct intervention. So, this study is conducted specifically to find out the clinical spectrum of the patient on presentation to the emergency department. Methods: This was a cross-sectional descriptive study. A retrospective analysis of patient records was done. There were 258 COVID-19 positive cases admission from 13th April to 13th August 2020. Out of these cases, 57 cases were excluded as they did not have respiratory symptoms but were admitted for other medical conditions. So, 201 symptomatic patients were analyzed in this study. Symptoms of all patients with the confirmed diagnosis of COVID-19 admitted from the emergency department were analyzed. Data entry was done in an excel sheet and presenting symptoms of COVID-19 positive patients were described along with their comorbid conditions. Results: Two hundred and one symptomatic patients were analyzed in this study. The mean age of study population was 37.9 years (median 37) with a minimum age of 2 months and a maximum age of 83 years. There were 114 (56.7%) male and 87 (43.3%) female; 109 (54.2%) patients were from outside the and 92 (45.8%) were from inside of Kathmandu Valley. The most common presenting symptom was fever 131 (65.2%) and cardiovascular condition including hypertension was the most common comorbid condition. Conclusions: Fever was the most common symptom of the patient presenting to the COVID19 emergency of our hospital. Moreover, fever needs to be analyzed carefully in terms of its onset total duration and associated cough, and underlying comorbid condition.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.