Browsing by Author "Shah, Sangam"
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Publication Knowledge, Attitudes, and Practices Concerning COVID-19 in Nepal(Nepal Health Research Council, 2023) Bhattarai, Anil; Ranabhat, Kamal; Saud, Bhuvan; Bhattarai, Suraj; Paudel, Kiran; Acharya, Devaka Kumari; Tripathi, Sangita; Shah, Sangam; Bhatta, Nikita; Das, Santa KumarAbstract Background: Coronavirus disease-2019 (COVID-19) severely affects patients with chronic diseases. Adequate knowledge, attitudes, and practice related to COVID-19 is associated with decrease morbidity and mortality. Therefore, this aimed to assess knowledge, attitudes, and practice toward COVID-19 disease among chronic diseases patients visiting tertiary hospitals in Kathmandu. Methods: A cross-sectional study was conducted among chronic disease patients who visited Tribhuvan University Teaching Hospital and Manmohan Cardiothoracic Vascular and Transplant Center, Kathmandu. Structured questionnaire was used to collect patients’ socio-demographic data and perspectives on COVID-19. Results: Four hundred chronic disease patients participated in the study, with 53.2% female and 46.8% male, and 56.8% of age ?50 years. Overall, 55.5% of the participants had good knowledge, 56.2% had good practice, and 30.7% had positive attitude towards COVID-19. Younger patients, 18-34 years, were found to have higher odds of having good knowledge compared to other age groups (aOR: 2.5; 95% CI: 1.3-6.0). The patients with less than average family income and those unable to read and write had lower odds of having positive attitude towards COVID-19 (aOR: 0.6; 95% CI: 0.4-0.9 and aOR: 0.4; 95%CI: 0.2-0.9, respectively). A statistically significant correlation was found between the patients’ knowledge and practice, knowledge and attitude, and attitude and practice (p <0.001). Conclusions: Nearly half of the chronic disease patients in Nepal had poor knowledge and practice whereas more than two-third had negative attitude towards COVID-19 disease. Older age of the patient was significantly associated with poor knowledge and practice. Keywords: Attitudes; chronic diseases; COVID-19; knowledge; practicePublication Mini-thoracotomy Approach for Heart Surgery in Tertiary Care Hospital of Nepal(Nepal Health Research Council, 2024) Bhattarai, Anil; Shah, Sangam; Ranabhat, Kamal; Chand, Swati; Thapa, Sangharsha; Khakural, PrabhatBackground: The usual surgical technique for heart surgery has been median sternotomy, which provides excellent exposure of all cardiac structures and facilitates the establishment of cardiopulmonary bypass with central cannulation. A number of alternative surgical techniques, including the right anterolateral thoracotomy, posterolateral thoracotomy, and partial sternotomy, have been suggested. We want to share our experience with right anterior mini-thoracotomy versus right axillary mini-thoracotomy for closing an atrial septal defect. Methods: The study was a retrospective cross-sectional study conducted in a hospital. The study comprised patients with atrial septal defect admitted to Green City Hospital in Kathmandu, Nepal. From May 2016 until September 2021. Data was extracted to MS excel sheet, and then transported to the STATA version 17 for analysis. First, we computed descriptive analysis which included calculation of frequency, percentage, mean and median for presentation of socio-demographic variables. Continuous data were tested for normality using Shapiro-Wilk test. Results: A total of 25 patient were included in the study with median age 26 years (20-32). The median aortic cross clamp time was 25 minutes ranging 20-35 min. The median duration of cardiopulmonary bypass time ranging from 31to 161 minutes. The median time of Ax was 25 minutes and 26 minutes for right anterior mini-thoracotomy and right axillary mini-thoracotomy respectively. The median duration of hospital stay was 4 days ranging from 3-4 days. Nearly 36% study participants were associated with abnormal body mass index. (Either under nutrition or over nutritional status). Conclusions: There were no significant differences between the duration of intensive care unit and hospital stays, aortic cross clamp time, and complications between the two groups. However, the possibility of less blood loss during surgery and of cosmetic appearance in axillary incision is of special importance. Keywords: Heart surgery; mini-thoracotomy; Nepal; right anterior; right axillary.