Browsing by Author "Shrestha, Merina"
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Publication Cervical Cancer Screening Services in Nepal: A Descriptive Crosssectional Study(Nepal Medical Association, 2024) Lal, Bibek Kumar; Bhatta, Ghanshyam Kumar; Adhikari, Ramesh; Karn, Abhishek; K.C, Ranju; Nyaupane, Sujata; Adhikari, Anuska; Shrestha, Binita; Shrestha, Merina; Bhattarai, Pankaj; Sah, Sujit; Shrestha, BijayaAbstract Introduction: Cervical cancer, the most prevalent cancer among women, is also the primary cause of cancer-related deaths in reproductive age women in Nepal. The study aims to assess the situation of cervical cancer screening services in Nepal. Methods: This cross-sectional study used quantitative methods to understand the situation of cervical cancer screening in 572 health facilities of Nepal. The research was conducted to assess screening facilities, the allocation of separate screening rooms, the availability of screening services on a routine basis throughout the week, screening facilities that are free of charge, human resources, and the availability of treatment. It was conducted in October to December 2022. Results: The research was carried out among 572 healthcare facilities, out of which 134 (23.42%) had provision for cervical cancer screening services. Ethical approval was obtained from the Nepal Health Research Council (NHRC) under reference number 397/2022 P. Amongst those 134, 72 (53.73%) healthcare facilities had assigned separate rooms for screening intentions. One hundred and two (76.12%) healthcare facilities provided regular screening services throughout the week, while 112 (83.58 %) had free-of-charge screening services. Concerning trained personnel, 121 (90.30%) health facilities had personnel trained in visual inspection with Acetic acid, 9 (6.72%) had personnel trained in use of colposcopy, and 5 (3.73%) had personnel trained in use of Loop Electrosurgical Excision Procedure (LEEP). Lastly, 31 (23.13%) healthcare facilities offered treatment choices for cervical cancer. Conclusions: Most of the health care facilities did not have provision of cervical screening. Amongst those who had the provision, personnel trained in loop electrosurgical excision procedure colposcopy.Publication Feasibility of Telemedicine for Follow up of Children with Established Seizure Disorder- A Tertiary Care Center Prospective Study(Nepal Paediatric Society (JNPS), 2023) Bajracharya, Luna; Shrestha, MerinaAbstract: Introduction: Medical information exchanged via electronic communications to improve a patient’s clinical health status by a physician without in-patient visit is telemedicine. Control of seizures with antiepileptic drugs, reassurance for compliance to drugs, regular monitoring of adverse effects of drugs in patient with established seizure can be possible through telemedicine. The main objective of this study was to evaluate feasibility of telemedicine for follow up of children with established seizure disorder. Methods: This study was conducted among children of age one to 16 years with an established seizure due to any cause presenting to the Paediatric Neurodevelopmental OPD of Tribhuvan University Teaching Hospital (TUTH) between October 1, 2018 and September 30, 2020. Mobile phone as a modality of telemedicine was used to inquire about seizure every month for 12 months and whenever necessary. Results: When parameters as seizure control, total cost and time spent per hospital visit, distance to TUTH were analyzed, more than 75% caregivers were satisfied with telemedicine. Greater age, appropriate development, focal onset of seizure, normal electroencephalogram and seizure adequately controlled by single antiepileptic drug were the favorable factors in better seizure control in children using telemedicine. Conclusions: Telemedicine for follow up of children with established seizure disorder seems to be a feasible and satisfactory option when implemented with caution and proper patient selection as it decreases unnecessary high expenses and time to hospital visitPublication Sensory Profile of Nepalese Children with or without Autism(Nepal Paediatric Society (JNPS), 2022) Shrestha, Merina; Shrestha, RenaAbstract: Introduction: Sensory Integration Dysfunction (SID) is common in children with Autism Spectrum Disorder. If SID is detected early and intervened, there is a decrease in autistic mannerisms and an improvement in the areas of sensory processing and regulation, social-emotional function, and fine motor skills. Thus, this study was conducted to compare the sensory profile of children with or without autism spectrum disorder (ASD) in Nepal. Methods: Thirty five parents of children with ASD and 43 parents of children without ASD (non ASD) completed Short Sensory Profile (SSP) questionnaire. Results: Definitive sensory issue was identified in 66% in ASD and 23% in non ASD group. Common sensory issues in ASD group were auditory filtering sensitivity (74.3%), movement sensitivity (37%), under responsiveness / seeks sensation (45.7%). In non ASD group, common sensory issue was under responsive/seek sensation. The internal consistencies between the sub-scales ranged from 0.70 to 0.83. Conclusions: Two third of the children with ASD have sensory issues. Identifying different sensory problems with SSP would be helpful for further management of children with ASD.