Browsing by Author "Shrestha, Asmita"
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Publication Correlation of Status of Mastoid with Outcomes of Myringoplasty with Cortical Mastoidectomy in Mucosal Otitis Media with High Risk Perforation(Institute of Medicine, 2021) Shrestha, Asmita; Bhattarai, Hari; Rayamajhi, Pabina; Pradhananga, Rabindra BABSTRACT Introduction: Chronic mucosal otitis media is one of the common disease prevalent in our society. This study was done to correlate the status of mastoid with outcomes of myringoplasty with cortical mastoidectomy in mucosal otitis media with high risk perforation. Methods: This prospective, observational study was done at Department of Otorhinolaryngology and Head and Neck Surgery, Tribhuvan University Teaching Hospital. Thirty-four patients of ag|e 15 and above with chronic mucosal otitis media having high-risk perforation undergoing cortical mastoidectomy with myringoplasty were included. The status of middle ear, aditus, and mastoid air cells were assessed. Post-operatively, patients were assessed for graft uptake and hearing after three months. The post-operative graft uptake and hearing results were correlated with the peroperative status. Four patients who had preoperative sensorineural hearing loss were studied in terms of graft uptake only. Results: The graft success rate in patients with normal mastoid air cells was 90% whereas in diseased cases was 71.4% which was statistically not significant with p value 0.20. The success rate in terms of hearing was 68.8% in normal mastoid whereas it was 64.3% in diseased mastoid which was statistically not significant with p-value of 1. Conclusion: In correlation with the status of mastoid air cells with graft uptake and hearing result, the observed differences were not statistically significant. However, averages of post-operative air conduction threshold and air-bone gap of all cases were better as compared to preoperative levels. Keywords: Chronic mucosal otitis media, cortical mastoidectomy, high-risk perforationPublication Hysteroscopy among Patients Attending the Outpatient Department of Gynaecology in a Tertiary Care Centre: A Descriptive Cross-sectional Study(Nepal Medical Association, 2023) Ghimire, Asmita; Ghimire, Sailaja; Shrestha, Asmita; Pant, Samridhha Raj; Subedi, Nilam; Pant, Padam RajAbstract Introduction: Hysteroscopy is a procedure used widely for diagnostic and therapeutic purposes. Hysteroscopy enables visualisation of the endometrial cavity and if possible treatment in the same setting avoiding invasive procedure. The objective of the study was to find out the prevalence of hysteroscopy among gynaecological patients attending the outpatient department of Obstetrics and Gynaecology in a tertiary care centre. Methods: A descriptive cross-sectional study was done among gynaecological patients from 1 January 2016 to 1 January 2020 visiting the outpatient Department of Obstetrics and Gynaecology in a tertiary care centre after ethical approval from the Institutional Review Committee (Registration number: 029/2021). Convenience sampling was used. Data regarding demographic parameters, hysteroscopy findings, procedures performed, histopathological findings and complications were retrieved from the electronic database of the hospital. Point estimate and 95% Confidence Interval were calculated. Results: Among 319 gynaecological patients, hysteroscopy was done in 72 (22.57%) (17.98-27.16, 95% Confidence Interval) patients. Conclusions: The prevalence of hysteroscopy among gynaecological patients was higher to the studies done in similar settings.Publication Outcome of Pulmonary Rehabilitation on Post-Covid Pneumonia Survivors with Residual Lung Fibrosis(Nepalese Respiratory Society, 2025) Suvedi, Rashmi; Gyawali, Manju; Shahi, Reema; Shrestha, Asmita; Thapa, Anisha; Adhikari, Shradha; Tarmakar, Suraj; Chaudhary, Deepak; Karthak, Ashish; Gurung, Naresh; Shrestha, Sanjeet KrishnaAbstract: Background: A significant proportion of COVID-19 survivors develop residual pulmonary fibrosis, leading to persistent dyspnea, reduced exercise capacity, and impaired quality of life. Pulmonary rehabilitation (PR) may help address these sequelae, but evidence remains limited, particularly in low-resource settings. Objective: To evaluate the effect of an 8-week pulmonary rehabilitation program on functional outcomes in post-COVID pneumonia patients with residual lung fibrosis at Nepal Mediciti Hospital. Methods: This prospective cohort study was done from June 2020 to June 2021 and included adult patients with confirmed residual pulmonary fibrosis on imaging after COVID-19 pneumonia. Participants underwent a structured PR program comprising supervised aerobic and resistance training, breathing exercises, and patient education. Functional status was assessed using the 6-Minute Walk Test (6MWT), Modified Medical Research Council (MMRC) dyspnea scale, and ergometer pre- and post-intervention. Results: Participants showed statistically significant improvements in all key outcomes. Mean MRC total score increased from 49.03 to 56.66 (mean difference 7.63, p < 0.001). Mean 6MWT distance improved substantially from 177.6 meters to 276.9 meters (mean difference 99.3 meters, p < 0.001). Significant reductions were observed in perceived fatigue and dyspnea, both at rest and after the 6MWT (p ≤ 0.003 for all Borg scale comparisons). The distribution of improvements varied among individuals, but most showed positive gains. Age showed a slight, non-significant negative correlation with the magnitude of 6MWT improvement. Conclusion: Pulmonary rehabilitation significantly improves functional capacity, dyspnea, and quality of life in patients with post-COVID residual lung fibrosis. These findings highlight the importance of integrating PR into post-COVID care pathways in resource-limited settings like Nepal.