Browsing by Author "Shrestha, Kriti"
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Publication A Quality Improvement Initiative to Shorten the Duration of Hospital stay of Preterm / Low Birth Weight Babies with Special Focus on Infant and Family Centered Developmental care(Perinatal Society of Nepal (PESON), 2025) Twanabasu, Sajal; Subedi, Bhusan Kumar; Homagain, Sushan; Maskey, Sujina; Shrestha, Anjana; Shrestha, KritiAbstract: Introduction: Infant and family-centered developmental care (IFCDC) incorporates neurodevelopment, parental involvement, parent-infant bonding, and enabling sensory environment. The focus is on minimizing the separation between child and parents and ensuring parental involvement in the care of babies right after birth. This not only helps in optimal neurodevelopmental outcomes but also early discharge of preterm babies as parents will be confident in taking care of their preterm, low birth weight (LBW) babies. IFCDC is not adopted by most neonatal units in Nepal. Aim statement: To reduce the duration of hospital stay of preterm/LBW babies from 10.5 days to 8 days (20% reduction) with a special focus on infant and family-centered developmental care. Methods: This is a hospital-based quality improvement project conducted at a 50-bed governmental district hospital located at a rural setup outside Kathmandu valley in Bagmati province of Nepal. Baseline data on infant length of stay (LOS) was evaluated using the hospital records. Problems were identified using a fishbone diagram. Process and outcome indicators were formulated and analyzed. Multiple Plan-Do-Study-Act (PDSA) cycles were conducted to achieve the desired target. Results: The average duration of the hospital stay was reduced from the pre-intervention period of 10.5 days to 8 days after incorporating IFCDC which persisted during the post-intervention of 4 weeks. Conclusion: Our study has shown that the duration of hospital stay of preterm babies is reduced when IFCDC is adopted. IFCDC is a win-win approach and needs to be adopted in all the neonatal units across the country.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 Variations in the Root Form and Root Canal Morphology of Permanent Mandibular canine(Nepal Health Research Council, 2023) Shrestha, Kriti; Shubham, Snigdha; Ahmed, Sageer; Gautam, VanitaAbstract Background: Mandibular canines are recognized as usually having one root and one root canal in most cases. However, many investigators have reported the anatomical variations associated with mandibular canines. Thus; the objective of this study is to determine the number of roots and morphology of the root canal system of permanent mandibular canine in a Nepalese population. Methods: Cone Beam Computerized Tomography images of 390 patients in a Nepalese population were selected, and a total of 780 mandibular canines were analyzed. The number of root and the canal configurations were investigated. Data were analyzed with descriptive analysis and Chi-square tests using the Statistical Package for the Social Sciences (SPSS) software version 20 (SPSS Inc, Chicago, IL, USA). Results: Out of the 780 mandibular canines, 741(95%) were single-rooted canines while only 39 (5%) were double-rooted canines. The most common type of Vertucci in single-rooted canines was Type I (1-1) in the percentage of 85.6% and the least type was Type IV (1-2) in the percentage of (2.5%). The Chi-square tests showed no significant association between gender and number of roots (P = 0.87) and gender and root canal configuration in single-rooted canine (P = 0.52). Conclusions: All mandibular permanent canines were single rooted but 5.2% of the permanent mandibular canines had two roots. Keywords: Canine; Cone Beam Computerized Tomography (CBCT); double root; root canals.