NepMed Repository :: Browsing by Author "Shrestha, Merina"

Browsing by Author "Shrestha, Merina"

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Breastfeeding Pattern and its Associated Factors Among Mothers Working at Two Hospitals in Kathmandu
(Nepal Paediatric Society (JNPS), 2020) Basnet, Srijana; Shrestha, Merina; Adhikari, Tulashi; Shakya, Aarati
Abstract: Introduction: Breastfeeding practices of women working at the hospital are likely to be modified by the facilities and support that they receive at the hospital. This study was done to evaluate the breast feeding practices and to analyse important factors that are associated with exclusive breast feeding till six months among women working at hospitals in Kathmandu, Nepal Methods: A total of 110 women, with a young child between the ages of six months and two years were recruited from two hospitals in Kathmandu. A predesigned structured, interviewer-administered questionnaire was used for data collection. Results: The mean age of the mothers was 29.85 ± 3.68 years. Ninety seven (88.2%) women were aware about initiation of breastfeeding within first hour of birth but only 64 (58.2%) women could practice it. Most women 100 (90.9%) were aware about exclusive breastfeeding but only 18 (16.3%) could practice exclusive breastfeeding till six months. Mean duration of exclusive breastfeeding was 2.86 ± 2.00 months and 20 (18.2%) mothers practiced mixed feeding since birth. The participants whose babies had prelacteal feeding had significantly shorter duration of mean exclusive breast feed {1.92 ± 2.18 (S.D)} compared to those who did not have prelacteal feed {3.33 ± 1.74 (S.D)} (p = 0.001). Those who delivered by normal vaginal delivery, initiated breastfeeding within first hour of delivery, expressed breast milk and got feeding breaks were associated with longer duration of mean exclusive breast feed. Conclusion: The breast feeding practices among working women at hospital is quite low compared to national statistics on IYCF. Breast milk expression and feeding breaks for lactating working women could improve feeding practices.
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, Bijaya
Abstract 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.
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, Merina
Abstract: 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 visit
Leigh Syndrome in an Adolescent Girl: A Case Report
(Institute of Medicine, 2020) Shrestha, Merina; Bajracharya, Luna; Basnet, Sudha
ABSTRACT Leigh syndrome (LS) is a disorder of infancy and rarely late childhood. It presents with regression of mental and motor skills. Here, we present LS in an adolescent girl who presented with generalized dystonia and cognitive decline. Her infective, metabolic, endocrinal and autoimmune work up was normal. The neuroimaging showed progressive symmetric involvement of basal ganglia with focal intensity over bilateral lentiform nucleus and thalamic region. The cerebrospinal fluid (CSF) lactate level was elevated. Genetic test could not be performed; however the history of neuro-regression with extrapyramidal involvement with CSF and neuroimaging finding led to the diagnosis of Leigh’s syndrome. Keywords: neuro-metabolic, regression, MRI
Neurodevelopmental Outcome of High Risk Babies at One Year of Age Born in a Tertiary Centre
(Nepal Paediatric Society (JNPS), 2017) Shrestha, Merina; Bajracharya, Luna; Shrestha, Laxman
Abstract: Introduction: With increasing survival of high risk babies, children with different developmental disabilities have emerged as a challenge for the baby, family as well as for physicians. With limited awareness and resources, follow-up and interventions for these babies are difficult. The study was carried out to find out the development of high risk babies in different developmental domains at one year of age. Material and Methods: NICU graduates who visited high risk clinic at one year of age were assessed. ASQ-3 was used to screen development. Children with major congenital anomalies and syndromes were excluded from the study. Results: Out of 28 high risk babies, about 29% had global delay. Those babies who had seizure during neonatal period could not score even in single item of ASQ-3. Conclusion: All high risk babies are at risk of developing delay hence should be followed up regularly. Timely early intervention needs to be started to minimize delay.
Predictors of Uncontrolled Seizure in Children Presenting in Tertiary Level Hospital in Nepal: A Prospective Study
(Institute of Medicine, 2021) Shrestha, Merina; Bajracharya, Luna
ABSTRACT Introduction: About one third of the children with seizure do not achieve complete seizure control. We aimed to find the predictive factors for uncontrolled seizure in children. Methods: This prospective study was conducted from October 2018 to September 2020 at Tribhuvan University Teaching Hospital, Kathmandu, Nepal. Children aged 12 months to 16 years with seizure and who were under regular follow up visits for at least once in past 3 months time were included and followed up for one year. Uncontrolled seizure was defined when seizure frequency was 2 or more in a year during the study period. Various factors were analyzed and when they were significantly different between the groups on bivariate analysis using the Chi square test, they were further analyzed with binary logistic regression model to find out the true predictors. Results: Total of 110 children were enrolled. Forty children (36.4%) had their seizure onset before one year of age. About one third of patient had family history of seizure. The most common type of seizure was generalized type (60%). Of the total, 56% had uncontrolled seizure. Three true predictors of uncontrolled seizure were found. They were (i) age of onset before 12 months of age (OR 2.94; 95% C.I 1.32- 6.55), (ii) abnormal findings in neuroimaging (OR 26.5; 95% C.I 8.72-80.07) and (iii) frequency of seizure (OR 40.9; 95% CI 9.05-184.9). Conclusion: Seizure onset in infancy, abnormal neuroimaging findings and frequent seizure are predictors for uncontrolled seizure in children. Thus, we suggest that these factors be considered while managing the children with seizure. Keywords: Children, Kathmandu, predictors, seizure, uncontrolled
Sensory Profile of Nepalese Children with or without Autism
(Nepal Paediatric Society (JNPS), 2022) Shrestha, Merina; Shrestha, Rena
Abstract: 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.
Substitute for the Breast Milk (Sale, Distribution and Control) Act 2049: Revisited
(Nepal Paediatric Society (JNPS), 2016) Shrestha, Merina; Basnet, S.; Shreshta, P.S.
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Browsing by Author "Shrestha, Merina"

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