Browsing by Author "Shah, S"
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Publication Effect of Breastfeeding on Relieving Pain during Immunization in Infant(Kathmandu University, 2020) Bhurtel, R; Yadav, U; Chaudhary, R; Shah, S; Poudel, P; Pokhrel, RP; Sharma, SABSTRACT Background Advantages due to immunization are numerous and cannot be avoided but at the same time pain inflicted on babies needs to be addressed when possible. Pain associated with immunization injections has often been overlooked when remedies are available. Objective To find out the effect of breastfeeding on relieving pain during immunization injection in infants. Method An experimental study was conducted at Immunization clinic of B.P. Koirala Institute of Health Sciences (BPKIHS). Total 124 subjects were divided randomly into two groups. Experimental subjects were allowed to breastfeed for 5-10 minutes before immunization while control group was immunized without breastfeeding. Interview Questionnaire was used to obtain demographic variables and measurements were obtained. Measures of pain was recorded using duration of cry and Modified Behavior Pain Scale, by Taddio et al. Data was analyzed by using SPSS 20.0 where variables were assessed with frequency tables, Pearson’s Chi-Square test, independent t test and Mann Whitney U test. Result The mean pain score in experimental group was 7.10 and in control group 7.56 which was statistically significant (p=0.001). The median duration of cry was significantly shorter in experimental group i.e. 25 seconds (IQR: 20-30) than control group 42.5 seconds (IQR: 30-61.5) (p < 0.001). Conclusion Breastfeeding before immunization is effective in reducing pain in infants. KEY WORDS Breastfeeding, Immunization, Infants, PainPublication Evolving Experience in The Management of Empyema Thoracis(Kathmandu University, 2011) Shrestha, K; Shah, S; Shrestha, S; Thulung, S; Karki, B; Pokhrel, DPABSTRACT Background Empyema thoracis a disease of significant morbidity and mortality, especially in the developing world. However, the optimal management of empyema thoracis remains controversial. Objective To analyse evolving experience in clinical presentation, management, outcome and factors contributing to adverse morbidity in empyema thoracis. Methods This is hospital based retrospective study of patients who were diagnosed with empyema thoracis in cardiothoracic and vascular surgery (CTVS) unit, Bir Hospital, Kathmandu, Nepal over a period of one year (July 2009 to June 2010). A total of forty-six adult cases were categorized into two treatment groups: (i) thoracotomy for decortication (ii) segmentectomy, lobectomy and redo-thoracotomy for pneumonectomy. The median duration of illness prior to hospital admission was compared. The presence of loculated pleural fluid determined the need for thoracotomy. Results Out of forty-six cases, twenty- nine (63.04%) who had early thoracotomy (<22 days) had prompt symptomatic recovery. Forteen out of seventeen (82.35%) of the patients who were initially treated with thoracocentesis or tube thoracostomy eventually needed thoracotomy. There was a positive shift in management towards early thoracotomy resulting in prompt symptomatic recovery. Significant complications were noted in eight patients who had delayed thoracotomy. Complications included recurrent empyema with lung abscess (n = 3), restrictive lung disease (n = 3), bronchopleural fistula (n = 1) and scoliosis (n=1). Conclusion Early thoracotomy and decortication was found to be an excellent surgical procedure with good functional results and high patient satisfaction rate. KEY WORDS empyema, thoracotomy, complicationsPublication Sonographic Assessment of the Normal Dimensions of Liver, Spleen, and Kidney in Healthy Children at Tertiary Care Hospital(Kathmandu University, 2015) Thapa, NB; Shah, S; Pradhan, A; Rijal, K; Pradhan, A; Basnet, SABSTRACT Background Ultrasonography is one of the most common imaging modality to measure dimensions of visceral organs in children. However, the normal limit of size of visceral organs according to age and body habitus has not been specified in the standard textbooks. This might result in under detection of organomegaly in pediatrics population. Objective The objective of this study was to determine the normal range of dimensions for the liver, spleen, and kidney in healthy children. Method This is prospective cross-sectional, hospital-based study done at Tertiary-care teaching hospital. Participants included 272 pediatric subjects (152 male and 120 female) with normal physical or sonographic findings who were examined because of problems unrelated to the measured organs. The subjects were one month to 15 year (180 months) old. All measured organs were sonographically normal. Relationships of the dimensions of these organs with sex, age, body weight and height were investigated. Limits of normal dimensions of these organs were defined. Result Normal length of liver, kidneys and spleen were obtained sonographically for 272 children (152 male [55.9%] and 120 female [44.1%]) in the age group from 1 months to 15 (180 months) years. The mean age was 45.78 months (SD, 44.73). The measured dimensions of all these organs showed highest correlation with height and age so the descriptive analysis of the organ dimensions (mean, minimum, and maximum values, SD and 5th and 95th percentiles) were expressed in 10 age groups along with height range of the included children. The mean length of right kidney was shorter than the left kidney length, and the difference was statistically significant (p = 0.001). Conclusion This study provides practical and comprehensive guide to the normal visceral organ dimension in pediatric population. The normal range limit of the liver, spleen, and kidney determined in this study could be used as a reference in daily practice in local radiology clinics. KEY WORDS Children, kidneys, liver, spleen, ultrasonographyPublication Status of Hypertension and Its Associated Factors Among Undergraduate Medical Students of a Private Medical College in Lalitpur District(Kathmandu University, 2025) Sah, SK; Singh, N; Pandey, S; Sherpa (Lama), AT; Panta, PP; Shah, S; Ghising, K; Rai, NABSTRACT Background Hypertension, a significant global health concern, warrants exploration within the unique context of medical student populations. Hypertension is a silent killer and is a leading cause of premature morbidity and mortality particularly in developing countries including Nepal. Medical students are prone to stress, long working hours, unsteady and unhealthy lifestyles such as lack of exercise, eating unhealthy food which are high risk factors contributing to hypertension. Objective To assess the prevalence of hypertension and its associated risk factors among undergraduate medical students. Method A Cross-sectional study was conducted between August to November 2023 among the undergraduate medical students from first-year to final-year and interns at a teaching hospital after obtaining ethical approval from the Institutional Review Committee. A total enumeration sampling technique was used. Chi square test was used to determine the association between variable and P value less than 0.05 was fixed for statistically significant. Result Out of 500 participants, 234 (46.80%) were reported to have hypertension according to the classification of the American Heart Association, 2023. Among them, 169 (72.22%) were male and 65 (27.78%) were female, with a male-to-female ratio of 2.6:1. Male participants had significantly higher odds of developing hypertension compared to females, with a crude odds ratio (COR) of 3.116 (95% CI: 2.144–4.53, p < 0.001) and an adjusted odds ratio (AOR) of 2.815 (95% CI: 1.914–4.139, p < 0.001). Participants categorized as “Obese” also had significantly higher odds of developing hypertension compared to “Non-obese” individuals, with a COR of 1.862 (95% CI: 1.189–2.916, p = 0.006) and an AOR of 1.636 (95% CI: 1.026–2.607, p = 0.039). Conclusion The high frequency of hypertension in this study could indicate a hidden epidemic among medical students. The results suggest that effective health screening and routine examinations are necessary, in addition to measures that support healthy lifestyles. KEY WORDS Alcohol consumption, Blood pressure, Hypertension, Obesity, Sex, Smoking habit