Browsing by Author "Shrestha, Ashis"
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Publication Guiding Documents for Disaster Risk Reduction and Management in Health Care System of Nepal(Nepal Medical Association, 2020) Rijal, Suraj; Adhikari, Sunil; Shrestha, AshisAbstract: The incidence of disaster events has increased over the years. Nepal is vulnerable to various kinds of natural disasters especially earthquakes and floods and infectious disease outbreaks like Dengue and Covid-19 pneumonia. So, it is important to review and know our existing disaster risk reduction and management plans, rules, and regulations of our country to improve disaster risk management for resilience and enhancing disaster preparedness for effective response and to “Build Back Better: in recovery rehabilitation and reconstruction.†Nepal has sufficient guiding documents to guide disaster management.Publication Responding to a Hazardous Materials Incident in Nepal(Nepal Medical Association, 2025) Phuyal, Naveen; Shrestha, AshisAbstract Paper talks about hazardous materials incidents in Nepal that threaten health, safety and the environment. Rapid urbanisation and industrial growth have made chemical, biological, radiological and nuclear emergencies more likely, but there is still not a clear national plan or complete chemical inventory, leaving the health sector unprepared. Emergency responders rely on the Emergency Response Guidebook and the Wireless Information System for Emergency Responders, but many are not aware of these tools or trained to use them. The Nepalese Army has a dedicated chemical, biological, radiological and nuclear platoon, yet hospitals still lack decontamination protocols, equipment and trained staff. Coordination between agencies is weak, resources are limited and exercises are rare. It feels like the pieces do not fit together. We suggest developing national guidelines aligned with international standards, forming dedicated response teams, running regular training sessions and including chemical incident plans in hospital disaster plans to improve preparedness .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 Tracking Progress of National Health Summit Declarations - Health Policy Analysis: A Qualitative Study(Nepal Medical Association, 2025) Shrestha, Ashis; Poudel, Lisasha; Tikhatri, Dipesh; Regmi, Sushant; Jha, Jay Bhushan; Baniya, Shreya; Phuyal, Mandish Prasad; Prasai, Akanshya; Kunwar, Sunil; Chand, Amit; Karki, Prakriti; Tamrakar, Nurusha; Sapkota, Ritu; Yadav,k RamanAbstract Introduction: The National Health Summit is a policy discussion platform that advocates the policy statement stated by National Health Policy 2019 which results in a set of declarations to address issues in the health system. This study’s objective is to monitor the extent of declaration’s implementation, its facilitators-barriers, and to formulate recommendation for future National Health Summit declarations and implementation strategies. Methods: This is a qualitative study conducted by Nepal Medical Association. in November-December 2024. Ethical approval from Nepal Health Research Council, Ethical Review Board (Reference number: 1069). The study was designed using the Realistic Evaluation Framework to look into the “context” which are the external factors impacting implementation of the declarations, the “mechanism” which are key elements facilitating or hindering policy changes, and the “outcome” which were the tangible results of NHS declarations. Results: Review and analysis of the participant responses identified policy influene and advocacy as contexts. The mechanisms identified were political and bureaucratic challenges, collaboration, finaicial hurdles, commitment, accountability, leadership, evidence based practices. The outcome discussed were health system strengthening, health workforce, governance, innovation, advocacy and digaital transformations. Conclusions: Implementation of declaration is challenging, with fragmentation as major health issues, however, continuous advocacy has had a synergistic effect in implementation and prioritization of the policy.Publication Violence in Healthcare: Legal Measures, Systemic Challenges, and Collective Accountability(Nepal Medical Association, 2024) Shrestha, Ashis