Browsing by Author "Shrestha, L"
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Publication A Case of Precocious Puberty in a Setting with Limited Resources(Kathmandu University, 2011) Paudel, KP; Giri, S; Shrestha, PS; Shrestha, L; Thapa, SB; Shrestha, MABSTRACT Precocious puberty is a rare condition characterized by the development of secondary sexual characteristics before the median age for the sex. It is either gonadotropin dependent also called as central or gonadotropin independent also known as peripheral type. Hypothalamamic Hamartoma is a common cause of the central or precocious puberty due to organic brain lesion. Here we present a two year male who presented us with precocious puberty due to a hypothalamic Hamartoma. KEY WORDS hypothalamic hamartoma, precociuos pubertyPublication Antibiotic Resistance Pattern in Intensive Care Unit of a Tertiary Care Hospital, Nepal(Kathmandu University, 2024) Chaudhary, R; Bhatta, S; Pant, C; Pathak, P; Phuyal, N; Shrestha, LABSTRACT Background Intensive care unit (ICU) is the especial department of the hospital where critically ill patients are treated with the unique type of technologies to revert back to functional by body’s own mechanism. Therefore, there are lots of external intervention with chance of getting bacterial infections. Antibiotics are medicines used to prevent and treat such bacterial infections. However, due to selective broad spectrum antibiotic pressure there is great chances to develop antimicrobial resistance at any time during hospital stay in intensive care unit. Objective To find out the antibiotic resistance pattern among Gram negative bacteria in Intensive Care Unit. Method A Descriptive cross-sectional study was conducted in Department of Microbiology of Tertiary care center for 18 months On the basis of previous sample load census method was used to include 500 sample from intensive care unit during study period. Among them only Gram negative bacteria were included in the study. All the samples were processed following standard methodology. Result Out of 500 samples, growth was observed in 451 (90.2%) samples. Among all the isolates Escherichia coli (29.6%) was predominant organism. It had shown high resistance towards Ciprofloxacin (93.5%) even in urine sample Ciprofloxacin (86.9%). Conclusion Our study showed Escherichia coli as a major organism in intensive care unit. This was resistant to commonly used oral antibiotic leaving restricted option for use of higher antibiotics. Therefore, continuous surveillance of such bacterial pathogen is warranted with implementation of effective Infection Prevention and Control measures in Health Care setting with emphasis to critical care units. KEY WORDS Antibiotic resistance, Escherichia coli, Intensive care unitPublication Intrinsic Capacity of Older People in Panchkhal Municipality of Nepal: A cross-sectional study(Kathmandu University, 2024) Shrestha, L; Neupane, R; Paudel, L; Manandhar, NABSTRACT Background With the global trend of rising ageing population, health care to the elderly needs special focus as absence of disease merely does not mean that older people are healthy and have full functional ability. So, WHO introduced intrinsic capacity to define healthy ageing. Objective To find the prevalence of decline in intrinsic capacity in older people of Panchkhal Municipality. Method A community based cross-sectional observational study was conducted in 5 simple randomly selected wards of Panchkhal Municipality of Nepal. Total sample sizes of 848 data were collected using proportionate convenience sampling. Data collection techniques were interview with observation using predesigned proforma containing WHO (Integrated Care for Older People-ICOPE) tool. Result The prevalence of decline in intrinsic capacity of older people in Panchkhal Municipality was 86.9%. The decline in individual domains was visual acuity 58.0 % followed by cognition 48.9%, locomotion 48.8%, hearing ability 38.6%, vitality 38.0% and psychology 28.5%. The mean age was 71.18 ±8.769 years (60-100). The majority of older people were male 55.8%, Hindu 91.7%, had joint family 77.7% and illiterate 60.3%. There was significant moderate positive correlation of age with decline in locomotion (r=0.469, p=0.029), hearing ability (r=0.312, p=0.032), cognitive ability(r=0.209, p=0.034) and low negative correlation of age with vitality (r=-0.161, p=0.035), psychology (r=-0.130, p=0.034),visual acuity (r=-0.126, p=0.034). Conclusion There was a high prevalence of decline in intrinsic capacity of the older people from Panchkhal Municipality. Special and focused care is required for older people from the government along with implementation of WHO-Integrated Care for Older People-ICOPEtool in every healthcare setting to promote healthy ageing. KEY WORDS Capacity, Integrated care for older people (ICOPE), Intrinsic, NepalPublication Maternal Health Services Utilisation in Panchkhal Municipality, Kavrepalanchok, Nepal(Kathmandu University, 2023) Paudel, L; Shrestha, L; Budhathoki, L; Zoowa, SB; Bhandari, G; Shrestha, KKABSTRACT Background Maternal Health is a priority program of Nepal. The low utilization of maternal health services is one of the major contributing factors for high maternal morbidity and mortality in developing countries like Nepal. Objective To explore various maternal health services utilized by women and identify various factors affecting the utilization of maternal health services in Panchkhal Municipality. Method A descriptive cross-sectional study was conducted among 355 reproductive-age women who have given birth in the last 2 years in Panchkhal Municipality. The data collection period was from May to July 2020. A convenient sampling method was used to select the study population. The data analysis was done by using Statistical Package for Social Sciences (version 20.0). Variables were defined by the frequency in numbers and percentages. Result The findings from the study showed that the coverage of the antenatal care (ANC) visit was 77% and among them, 25.6% visited at least 4 antenatal care visits as recommended by the government of Nepal. Out of 355 respondents, 52.4% were delivered in the health institution, and only 20% visited postnatal care after the delivery. Among various factors, lack of treatment facilities and health facilities at a far distance were the most common factors for the underutilization of maternal health services. Conclusion The coverage of maternal health services is still low despite free maternal health services with an incentive scheme. A further detailed investigation is required to find the real scenario of the Panchkhal municipality to under-utilization of maternal health services. KEY WORDS Maternal health service, Nepal, Reproductive-age, WomenPublication Neurophysiology of Mindfulness Meditation: A Narrative Review Based on Buddhist Perspective(Kathmandu University, 2025) Joshi, B; Jha, JP; Karn, A; Shrestha, LABSTRACT Meditation, an inward journey to explore profound levels of consciousness rooted in Buddhism, has significant physical and psychological benefits, including enhanced well-being, improved concentration, emotional stability, and positive cognitive shifts. This narrative review consolidates past two decades of research on the neurophysiological effects of Buddhist mindfulness meditation based on neuroimaging findings, and aims to examine the Buddhist view of mindfulness meditation in relation to the structural and functional changes in the brain areas in health and diseases. Meditation practices, such as Vipassana in Buddhism, emphasize mindfulness and non-judgmental awareness of oneself and surrounding. Neuroimaging studies have revealed its significant impact on brain regions including structural changes involving anterior cingulate cortex (ACC), temporal lobe, insula, hippocampus, amygdala, thalamus and other areas. Four fundamental mechanisms summarize the mindfulness meditation: attention regulation, body awareness, emotion regulation, and a transformed self- perspective. The scientific explanation of effects of meditation is challenging, and we are only beginning to understand in neurophysiological terms. Previous research on mindfulness meditation has employed diverse methodological approaches, including self-reported measures, behavioral tasks and neuroimaging techniques; but there lacks a standardization, making it difficult to compare the findings. However, the cognitive processes are thought to underlie the potential benefits of mindfulness meditation in promoting mental well-being on an individual and societal level. This review highlights the mechanisms of mindfulness meditation to improve cognitive flexibility and promote mental well-being, in relation to Buddhist philosophy, with implications for individual and societal benefits. KEY WORDS Buddhism, Cognition, Consciousness, Meditation, Mindfulness, NeurophysiologyPublication Oxygen Saturation of Hemoglobin in Healthy Children of 2- 14 Years at High Altitude in Nepal(Kathmandu University, 2012) Shrestha, S; Shrestha, S; Shrestha, L; Bhandary, SABSTRACT Background Individuals residing at higher altitude may have oxygen saturation of hemoglobin different to those living at lower altitude. Objectives To find out the baseline value of SpO2 in healthy Nepali children (2-14 years) living permanently at high altitude using pulse oximeter and also to study the relation of SpO2 with age, sex and ethnicity Methods A descriptive observational study was conducted at 4 different altitudes ranging from 2700 to 3800 m in Mustang district. The mean pulse oximery values at different altitudes were calculated and compared. Results One hundred six children were enrolled with the median age of 10 years. The mean SpO2 value of children permanently residing at altitude 2700m was 95.18%, at 2800m was 94.82%, at 3550m was 94.1% and 3800m was 93.1%.The difference in the SpO2 values at different altitude was statistically significant. No sex or age wise differences were noted on the mean SpO2 values in the study group. Conclusions The mean SpO2 values were higher than several other studies done in the altitude above 2500 meters. Enrollment of older children and the different ethnic background could be the contributing factors for the differences. KEY WORDS children, high altitude, Nepal, pulse oximetryPublication The Prevalence of Overweight and Obesity in Medical and Nursing Students of Institute of Medicine, Kathmandu(Institute of Medicine, 2018) Mahotra, NB; Shrestha, L; Pradhan, S; Bajimaya, M; Malla, N; Aryal, V; Bhat, NAbstract Introduction:Obesity has become one of the important global public health issues. It is significantly associated with the prevalence of diabetes, hypertension and coronary artery disease. Body Mass Index (BMI) assesses overweight and obesity based on statistical criteria. Methods:A cross-sectionaldescriptive study was carried out in young male medical and female nursing students in the department of Clinical Physiology, Maharajgunj Medical Campus, Institute of Medicine, Kathmandu from January 2019 to March 2019. Subjects were selected by convenient sampling and BMI was calculated in 116 medical and nursing students. Results:Out of 60 male medical students, 7(11.7%) were underweight, 48 (80%) were normal weight and 5(8.3%) were overweight. Similarly, out of 56 female nursing students, 1(1.8%) was underweight, 46(82.1%) were normal weight, 7(12.5%) were overweight and 2(3.6%) were obese. Conclusion:The prevalence of overweight and obesity is increasing worldwide in all age groups. Young Nepalese people are also affected and are at risk of developing non-communicable diseases. Adaptation of healthy life styles and healthy diets could prevent overweight and obesity. Key words: Body Mass Index (BMI), Obesity, overweightPublication The Postural Effects on Electrical Activities of Heart in Apparently Healthy Young Adults(Kathmandu University, 2021) Chaudhary, S; Ranamagar, R; Shrestha, L; Pun, DB; Karmacharya, P; Mahotra, NBABSTRACT Background The electrical activities of heart recorded as electrocardiogram (ECG) are mostly done in supine postures. The body postural changes have effects in these electrical activities in heart which needs to be properly recognized. Objective To find the variations in electrocardiogram during postural changes from supine to upright i.e. sitting and standing postures among apparently healthy young adults. Method A cross sectional study was carried out in Manipal College of Medical Sciences after the institutional ethical clearance. The apparently healthy 30 Nepalese male medical students between 18-25 years of age were enrolled. The electrocardiography was elicited in supine, sitting and standing postures in the participants after 5 minutes’ interval between each procedure in each participant. Result The highest mean amplitudes of Q wave were seen in sitting postures (0.12±0.04 mm), R wave in standing postures (1.46±0.55 mm) and S wave also in standing postures (0.23±0.2 mm). The mean amplitudes of Q and S waves showed statistically significant difference when compared between supine and upright postures. The maximum QRS duration was found while sitting (0.08±0.01 ms)and maximum heart rate in standing posture (82.43±10.59/min). The mean comparison of heart rate was statistically highly significant when compared between supine and standing postures. The mean QRS frontal axis was comparatively increased while standing (64.30±39.29). Conclusion The electrical activities of heart vary during postural changes among apparently healthy young adults. These changes are most prominent when compared between supine and standing postures which urges for careful interpretation of electrocardiogram if it is done in upright postures. KEY WORDS Electrocardiogram, Heart, Postures