Browsing by Author "Sharma, Mohan Raj"
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Publication Clinical Characteristics and Outcome of Patients with Distal Anterior Cerebral Artery Aneurysms(Nepal Health Research Council, 2024) Bohara, Sandeep; Pradhanang, Amit Bahadur; Sedain, Gopal; Sharma, Mohan RajBackground: Distal anterior cerebral artery aneurysms account for 3% to 7% of intracranial aneurysms. They have increased risk of premature rupture during surgery and tend to have a higher morbidity. We aim to determine the clinical characteristics, management strategies and outcomes of patients with these aneurysms who underwent microsurgical clipping at a major university hospital in Nepal. Methods: This is a retrospective study of patients with distal anterior cerebral artery aneurysms who underwent microsurgical clipping between 2012-2022. Demographic data and clinical-radiological factors like Hunt and Hess grade, aneurysm location, and modified Rankin scale score at three, six, and 12 months were collected. Results: A total of 26 aneurysms were microsurgically clipped in 20 patients in ten years. Most patients presented with Hunt and Hess grade II. Of the 26 aneurysms, 16 (62%) were in A3 segment. Six patients had associated anterior communicating artery aneurysm, two patients had middle cerebral artery aneurysm and two patients had associated arteriovenous malformation. Sixteen patients (80%) had a favorable outcome (modified Rankin scale ?2) at 12 months follow-up. Conclusions: Aneurysms in the distal anterior cerebral artery locations are a challenging subset of aneurysms to treat. The majority of the patients had aneurysms in A3 segment and 80% patients had a favourable outcome at 12 months follow up period. Keywords: Aneurysm; distal anterior cerebral artery; outcome; subarachnoid haemorrhage.Publication Nature of Research Proposals Submitted to Institute of Medicine Institutional Review Committee: A Retrospective Review(Nepal Health Research Council, 2025) Tiwari, Ashish; Sharma, Mohan Raj; Shrestha, Lava; Bali, Kanchana; Bhatta, Om PrakashAbstract Background : Efficient evaluation of research proposals is crucial for ensuring ethical standards and scientific rigor in healthcare. This study aims to analyze the proposals submitted to the Institutional Review Committee (IRC) of the Institute of Medicine (IOM) to determine the trends in health-related research conducted in a major institute. Methods: This is a retrospective review of research proposals submitted to the IRC of IOM from May 2019 to April 2021. The analysis focused on the institutional/departmental affiliation of investigators, gender of the principal investigator (PI), funding sources, ethical issues, types of proposals, and research design. Results: Out of 769 proposals submitted, seven were rejected (acceptance rate of 99.1%). There was a steady increase in the number of submissions over the study period. Descriptive cross-sectional studies were the most frequent 630 (82.6%) followed by randomized controlled trials. More than half [403, 52.9%] proposals were related to health promotion. The clinical departments contributed 443 (58.1%) submissions. Males outnumbered females (54.2% vs 45.8%) and only 53 (7.0%) were funded. Conclusions: Cross-sectional studies with a focus on health promotion were the most common submissions for ethical approval at the IOM. Policymakers in our institute and other institutions can use this research to set priorities for promoting research. Keywords: Ethical review, Institutional Review Board, Researchers, research proposalPublication Pre-hospital care, pre-hospital delay, and in-hospital delay in patients with traumatic brain injury in getting neurosurgical care in a tertiary care center: A Cross-Sectional study.(Nepal Medical Association, 2024) Regmi, Milan; Bhatta, Om Prakash; Sharma, Mohan RajAbstract Introduction: Timely institution of pre-hospital therapies aimed at damage control and the appropriately timed decision of transfer to higher centers for definitive neurosurgical management are crucial in determining the outcome of patients following traumatic brain injury. This study aimed to evaluate the factors determining pre-hospital care and delay in patients with traumatic brain injury. Methods: This was a descriptive cross-sectional study conducted in a tertiary care center after obtaining ethical approval from the Institutional Review Board (approval number 392 (6-11) E2). All patients with traumatic brain injury who presented to the emergency department from 1 July, 2018 to 15 June, 2019 were enrolled. Data related to patient demographics, the primary cause of the incident, grading of traumatic brain injury on admission, pre-hospital care, and variables that cause pre-hospital delay were collected. Results: In this study of 144 patients with traumatic brain injury, we found that 70 (48.61%) experienced transfer delays exceeding one hour. There were 71 (49.31%) patients aged 15-44 years, and 100 (69.44%) were males , with falls being the primary cause of 119 (82.64%). Most patients had mild traumatic brain injury 80 (55.56%). Out of 144, 20 (13.89%) received prehospital care, and 28 (19.44%) underwent a computed tomography scan of the head before arrival. Conclusions: Our study highlights the challenges in pre-hospital care and delays in reaching for neurosurgical care in patients with traumatic brain injury. Falls, road accidents, and physical assaults were the leading causes.Publication Publication Status of Theses among Post-graduate Students in Nursing from Institute of Medicine(Nepal Health Research Council, 2024) Khatri, Pratima; Chapagain, Bigya; Sharma, Mohan RajBackground: Publication of the research work done during the master’s program is highly desirable. However, there is a paucity of data on the number of publications, especially from low-income countries. The objective was to find out the status of the publication of the theses of post-graduate students in Nursing from the Institute of Medicine, Tribhuvan University, Nepal from 2015-2019. Methods: Cross-sectional analytical design with a structured interview via telephone was done for data collection. Independent variables were age, marital status, current work status, current working organization, type of research, year of graduation, and facilitators and barriers to publication, whereas dependent was the publication status of the thesis. Results: Two hundred five (76.2%) out of 269 participated in the study. The age group ranged from 27 to 50 years (mean ± SD = 36.6±4.8). The majority 89.3% were married. Currently working in academic institutions was 51.7%. One hundred ninety-eight (96.6%) respondents performed a cross-sectional descriptive study. Only 2.9% of studies were cross-sectional analytical and 0.5% were qualitative. Seventy-five (36.6%) respondents published their theses. Twenty-seven (36.0%) were published in PubMed-indexed journals. The most common facilitator for publication was academic satisfaction [59 out of 75(78.7%)] followed by encouragement from supervisors 52.0% and peers 40.0%, whereas the commonest barrier to publication was lack of interest [80 out of 124 (64.5%)] followed by lack of confidence 51.6%. Conclusions: Based on the results, more than one-third of the participants published their theses in national and international journals including those indexed in PubMed. Provision of university research grants, development of publication culture among post-graduate students, and making a provision of academic publication before degree awards should be encouraged for more academic publication. Keywords: Journals; Nepal; nursing; publication status; thesis.Publication Publication Status of Theses among Post-graduate Students in Nursing from Institute of Medicine(Nepal Health Research Council, 2024) Khatri, Pratima; Chapagain, Bigya; Sharma, Mohan RajBackground: Publication of the research work done during the master’s program is highly desirable. However, there is a paucity of data on the number of publications, especially from low-income countries. The objective was to find out the status of the publication of the theses of post-graduate students in Nursing from the Institute of Medicine, Tribhuvan University, Nepal from 2015-2019. Methods: Cross-sectional analytical design with a structured interview via telephone was done for data collection. Independent variables were age, marital status, current work status, current working organization, type of research, year of graduation, and facilitators and barriers to publication, whereas dependent was the publication status of the thesis. Results: Two hundred five (76.2%) out of 269 participated in the study. The age group ranged from 27 to 50 years (mean ± SD = 36.6±4.8). The majority 89.3% were married. Currently working in academic institutions was 51.7%. One hundred ninety-eight (96.6%) respondents performed a cross-sectional descriptive study. Only 2.9% of studies were cross-sectional analytical and 0.5% were qualitative. Seventy-five (36.6%) respondents published their theses. Twenty-seven (36.0%) were published in PubMed-indexed journals. The most common facilitator for publication was academic satisfaction [59 out of 75(78.7%)] followed by encouragement from supervisors 52.0% and peers 40.0%, whereas the commonest barrier to publication was lack of interest [80 out of 124 (64.5%)] followed by lack of confidence 51.6%. Conclusions: Based on the results, more than one-third of the participants published their theses in national and international journals including those indexed in PubMed. Provision of university research grants, development of publication culture among post-graduate students, and making a provision of academic publication before degree awards should be encouraged for more academic publication. Keywords: Journals; Nepal; nursing; publication status; thesis.Publication Status of Research Funding in Nepal: A Scoping Review(Nepal Medical Association, 2024) Sharma, Mohan Raj; Tuladhar, Sugat Rana; Adhikari, Abhishek; Khadga, Akriti; Singh, Shreejana; Ghimire, NamitaAbstract With the rapid advancement of health delivery, there has been a renewed interest in conducting research among healthcare professionals in Nepal. However, concern is there regarding availability of funds and mechanisms of awarding. The purpose of this scoping review is to map the available evidence regarding the evolution and current status of health research funding in Nepal and to highlight gaps and areas for future research. We searched three databases for empirical papers and several gray literature. Our search, conducted between March and April 2024 yielded 76 documents of which 30 that met the selection criteria were included in the scoping review. Almost all studies identified lack of funding as a deterrent to research. We found a paucity of research focusing on the role of researchers in funding decision-making. Our findings revealed that there are 12 national and four international organizations providing funds for research. University Grant Commission is the largest funder from Nepal whereas the Research Council of Norway is the biggest international funder. There were certain barriers and facilitators for obtaining funds identified by this scoping review. Further efforts are needed to increase the amount and availability of funds in Nepal to enable high-quality research.Publication Traumatic Injury among Patients Presenting to the Department of Emergency Medicine of a Tertiary Care Centre(Nepal Medical Association, 2024) Rijal, Suraj; House, Darlene Rose; Joshi, Nishant; Thapa, Barsha; Shrestha, Kriti; Sharma, Mohan RajAbstract Introduction: The majority of trauma-related deaths occur in low- and middle-income countries; however, limited data exists in these settings related to injury types and severity. The prevalence of trauma similar to our setting was less estimated. This study aimed to find the prevalence of traumatic injury among patients presented to the department of emergency medicine of a tertiary care centre. Methods: This is a descriptive cross-sectional study conducted among patients presented to the Department of Emergency Medicine from 15 September 2021 to 14 September 2022. Ethical approval was taken from the Institutional Review Committee. World Health Organization trauma minimum data set, injury mechanism, types and patient disposition data were collected and injury severity scores were calculated. A convenience sampling method was used. The point estimate was calculated at a 95% Confidence Interval. Results: Among 47,825 patients, 1,524 (3.19%) (3.03-3.34, 95% Confidence Interval) patients presented with a traumatic injury. A total of 967 (63.45%) were males and had a median age of 30 years (Interquartile range: 25). Most injuries were caused by falls 650 (42.65%), followed by road traffic accidents 411 (26.97%). A majority had minor Injury Severity Scores 1280 (83.99%). Conclusions: The prevalence of traumatic injury among patients presenting to emergency was found to be lower than other studies done in similar settings.Publication World Health Organization Tool for Benchmarking Ethics Oversight of Health-Related Research with Human Participants(Nepal Medical Association, 2024) Ghimire, Namita; Basnet, Rojina; Acharya, Richa; Adhikari, Santoshi; Verma,Shashi; Sharma, Mohan RajAbstract Benchmarking ethics oversight is a process of aligning comparing and evaluating the strengths and room for improvement of ethical review and approval process across different institutions or the country. The World Health Organization tool for benchmarking ethics oversight is designed to help countries assess and improve their systems for ethically overseeing health-related research involving human participants. It identifies gaps in legal frameworks, committee structures, resources, accountability and transparency while promoting best practices and policy alignment. Nepal has made progress through the research regulations body like the Nepal Health Research Council , but challenges such as inconsistent implementation, oversight of the implementation and resource limitations remain. The tool offers an opportunity to strengthen Nepal’s health research governance and regulation but it must be adapted to fit local contexts, emphasizing accountability, transparency, capacity-building, and improved communication.