Browsing by Author "Shakya, YL"
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Publication Drug prescribing pattern and disease pattern in KMC Duwakot Health Center(Kathmandu University, 2004) Bajracharya, S; Pandey, S; Shakya, YLObjective To ascertain the disease pattern and drug prescribing pattern of the patients attending Kathmandu Medical College Health Center, Duwakot. Methods It is a cross sectional study conducted at Kathmandu Medical College (KMC) health Center, Duwakot during the month of Ashad to Mangshir, 2060. The sample size included was 292 patients attending the Health Center during this period. Prescription details were used as study tools to acquire information regarding patient’s name, age, complaints for which consultation was sought, investigations, diagnosis, name of the drug which is prescribed and instruction for diet. Results Age of patients in this study ranged from 0-80 years. A total of 165 (56.50%) were male and 127 (43.49%) were female. Out of 165 male of different age group ranging from 0-80 years, most of the patient i.e. 25(15.15%) were suffering from viral fever followed by cut/injury, allergy, diarrhoea, abdomen pain, fungal infection, HTN (hypertension), cold/cough/sore throat, sinusitis, muscular skeletal pain, joint pain, contact dermatitis, acute peptic disease (APD), headache, worm infestation, tonsillitis, pharyngitis, dizziness, eye infection, chest infection, calf and backache, viral rashes, hypo pigmentation, tension/depression, Urinary tract infection (UTI), coliolilethis, diabetes, p/r bleeding and insect bite poisoning. Out of 127 female of different age group ranging from 0-80 years 21 (16.54%) patients were suffering from viral fever, followed by backache, cold/cough / sore throat, allergy, weakness, acne, diarrhoea, sinusitis, flue, pneumonia, headache, acid peptic disease, dysmenorrhoea, Lower Respiratory Tract Infection and Upper Respiratory Tract Infection, muscular skeletal pain, joint pain, eye infection, Urinary Tract Infection, hypertension, abdomen pain, tonsillitis, tinea corporis, rhinitis, ear problems, insect bite poisoning, CSOM, trichiasis, uteric colic, otitis media, entropion and epiphora, worm infestation and pharyngitis. All together 384 drugs (23 category) were distributed to the different patient of different age group ranging from 0- 80 years, to cure the different types of diseases. Among the different categories of drugs prescribed antipyretic (31.8%), antibiotics (17.2%) and (Non steroid Antiinflammatory Drugs (NSAIDs) (11.2%) were the most common. Conclusion The assessment of the existing prescribing practices in a health facility helps to identify the specific drug use problems, which need to be understood before any meaningful intervention can take place. A prescription provides an insight into a prescriber’s attitude to the disease being treated and the nature of health care delivery system in the community3. The average number of drugs per prescription is an important index of a prescription audit. It is preferable to keep the number of drugs per prescription as low as possible to minimize the risk of drug interactions, development of bacterial resistance and hospital costs 9. Key words: drug prescribing, health centre, disease patternPublication Knowledge, Attitude and Practice regarding Diabetes among Diabetes Patients at a Tertiary Teaching Hospital in Nepal(Institute of Medicine, 2018) Gupta, SK; Yadav, RS; Gupta, RK; Shrestha, S; Shakya, YL; Prasad, PNAbstract Introduction: Diabetes is a chronic metabolic disease which is prevalent all over the world. Its burden has immensely increased in the last two decades. The problem in young people is equally worrisome. Its number in Nepal is estimated to reach 6,38,000 by the year 2025. Many lifestyle and environmental factors have contributed to its rapid rise. It has several microvascular and macrovascular along with systemic complications. There is lack of public awareness on diabetes in our communities. This study aims to assess knowledge, attitude and practice about diabetes among diabetic patients. Methods: This study was conducted in Tribhuvan University Teaching Hospital General Practice OPD. All the diabetic cases attending to OPD were taken for a sample size of 120. Diabetic cases were followed and informed written consent was taken from each patient. All statistical tests were performed using 0.05 as level of significance. Results: Among 120 study patients, 59.16% were male and 40.83% were female. Majority of cases belonged to 41-60 years. More male (40.83%) were literate than female (10%). Knowledge regarding dryness of mouth, urinary frequency, kidney failure as complication, effect of high blood pressure, blood pressure measurement, foot care and exercise was 36.67%, 19.17%, 47.5%, 73.33%, 85%, 19.17% and 43.33% respectively. Practice of diet plan was found in 56.67%. Practice of blood pressure monitoring and eye checkup at an interval of one month was 30% and 20% respectively whereas 41.67% had never had their eye checkup. Compliance to antidiabetic medicines was found in 71.66%. Knowledge on exercise among age group (P=0.032), knowledge on effects of high blood pressure among male and female (P=0.009) as well as literacy among male and female (P=<0.001) were found statistically significant. Conclusion: This study shows that patient’s knowledge about foot care and practice of diet plan was not appreciable. Patient’s attitude and practice about diabetes was also not significant. Diabetes health knowledge need to be improved for better health promotion. Key words: Diabetes; diet; foot care; KAPPublication Pattern of toxicology cases in Emergency, Tribhuvan University Teaching Hospital(Institute of Medicine, 2018) Raut, S; Shakya, YL; Maharjan, RK; Shrestha, TM; Neupane, RPAbstract Background: Acute poisoning is one of the major contributors of heath problem causing morbidity and mortality in the emergency of the hospital. The study focused on the demographic and epidemiological aspects of all the poisoning cases that came to Emergency of TUTH. Methods: The study was a cross-sectional retrospective data collection of all poisoning cases recorded in hospital from April 2016 to March 2018. Hospital records of all poisoning cases were used to extract demographic and other data such as poisonous agents used, circumstance of poisoning, route and outcome of poisoning. The data analysis was done in Microsoft Excel. Results: The total number of cases was 641 out of which 40 cases were excluded from the study. Of 601 cases, males were 42.09% and females were 57.90%. The most common age group for both male and female was 16-26 years group and male to female ratio was 1:1.3. The most common circumstance of poisoning was deliberate self-harm which was 91.68% followed by accidental which was 4.6%. The common route of administration was ingestion at 99.91%. The mortality in the Emergency was 5.15% and total of 75.04% cases were admitted in observation after primary management in ER and discharged from the observation after improvement and psychiatric evaluation. The most common toxicology agent was pesticide at 52.57%followed by pharmaceuticals at 25.45%. Conclusions: Pesticides are the major cause of poisoning and accounts for majority of cases of toxicology followed by pharmaceuticals. The study also concludes that the young age group is more vulnerable to poisoning, hence strong regulatory measures are required for control of easy accessibility of these substances. Keywords: Toxicology, Poisoning, TUTH