Browsing by Author "Shrestha, RK"
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Publication Cold Pressor Test in Borderline Hypertensive University Students(Kathmandu University, 2016) Hada, S; Amatya, S; Shrestha, RKABSTRACT Background Hyperactive sympathetic reaction is an important factor for development of hypertension in young individuals. The stress induced increase in blood pressure recovers within very short period of time and those with exaggerated stress induced cardiovascular response at young age have a high risk of blood pressure elevation in future. Objective To determine the cardiovascular reactivity in response to cold and to correlate its relation with factors such as smoking, family history and physical activity. Method Study was conducted in the Department of Pharmacy, Kathmandu University from July to November, 2015. Resting blood pressure was recorded using sphygmomanometer in sitting position after 5 minutes of rest. Out of 130 volunteers, 34 were found to be prehypertensive and equal number of normotensive were recruited randomly to perform the test. The subjects were directed to immerse his/her right hand up to the wrist in cold water of 10˚C for 1 minute. The blood pressure was recorded just before the hand was taken out of the water and then 1.5 minutes and 4 minutes after the withdrawal. Data was analyzed by Student’s t test using Microsoft Excel 2007. Result Systolic and diastolic blood pressure increased significantly after cold pressor test in both normal (systolic blood pressure from 110±6.46 to 119±9.45 mmHg and diastolic blood pressure from 71±4.63 to 78±6.15 mmHg) and prehypertensive group (systolic blood pressure from 122±6.75 to 126±8.05 mmHg and diastolic blood pressure from 79±6.78 to 85±7.76 mmHg). Maximum recovery in both systolic and diastolic blood pressure was observed in 2.5 minutes of removal of hand from cold water. Though sharp drop was observed in blood pressure at the end of 2.5 minute in both groups of individuals, the recovery in case of prehypertensive individual was not sharper. In the present study, significant rise in diastolic blood pressure was observed in prehypertensive smoking males. Also the difference was significant (p<0.02) in recovery of diastolic blood pressure between smoker and non smoker prehypertensive group. Conclusion This study suggests that prolonged elevation in blood pressure in response to stress in young individual can be used as marker of development of hypertension in future. Adopting a healthier lifestyle can help to delay the development of hypertension in later life. KEY WORDS Cold pressor test, hyperreactors, hypertensionPublication Prevalence Survey of Antimicrobial Use among Admitted Patients in Tertiary Care hospital: An observational study(Kathmandu University, 2025) Aryal, S; Joshi, M; Uprety, BN; Shrestha, RK; Gupta, M; Shah, P; Rajbhandari, P; Amatya, R; Shrestha, P; Ojha, ARABSTRACT Background Monitoring the antimicrobial use is one of the key strategies to address the growing global threat of antimicrobial resistance. Objective To find out antimicrobial usage at tertiary care hospital of Lalitpur, Nepal. Result An observational cross-sectional study was carried out at the Patan Academy of Health Sciences, Lalitpur, Nepal on September 25 and 26, 2023. World Health Organization point prevalence survey methodology was used with minor modification to meet hospital’s context. The data on antimicrobial usage were collected from the medical records of patients admitted at or before 08:00 am on the day of the study in the acute care ward. Result The study involved 324 inpatients, with females comprising 176 (54.3%) and males 148(45.7%). The mean age was 37.89 years ± 24.87. Antibiotics usage was 78.1%. A total of 471 drug was prescribed of which 312 (66.2%) was used for therapeutic purpose and 159 (33.8%) for prophylaxis. Of 312 antibiotics, 283 (90.7%) were utilized empirically. Majority of prescribed medications belonged to watch group 16 (48.5%). Ceftriaxone was the most frequently prescribed antibiotic 142 (30.1%) and was the preferred choice for surgical prophylaxis 68 (94.4%). A total of 24 (72.7%) drugs were prescribed from the National List of Essential Medicines and 432 (91.7%) prescriptions were written using generic names. Conclusion The use of antibiotic was high, with good adherence to essential medicines and generic prescribing. Strengthening antimicrobial stewardship and evidence-based practices can further optimize prescribing, enhance patient safety and help combat antimicrobial resistance effectively. KEY WORDS Antibiotic, Nepal, Point prevalence survey, Tertiary care hospitalPublication Quality of Life Among HIV Positive Individuals in Kathmandu Valley and Eastern Region of Nepal(Kathmandu University, 2012) Agrawal, H; Mourya, R; Shrestha, RK; Agrawal, SABSTRACT Background The alarming increase of HIV/AIDS, inability to afford highly active anti-retroviral therapy, disability and stigma associated with the disease, loss of productivity due to illness, and chronic nature of the disease has made HIV/AIDS one of the most important public health problems in developing countries. The Quality of life assessment is focused on humanistic element and intervention resulting from this result may lead to better overall patient well being. Objective The aim of our study was to assess and compare the quality of life among HIV positive individuals in Kathmandu Valley & Eastern region. Methods The study was conducted among 228 HIV positive individuals from Eastern Nepal and 213 from Kathmandu valley and they were compared with an equal number of age-sex matched controls from the community. The instrument used was the WHO QOL-BREF Nepali questionnaire. Results The HIV positive individuals had significantly lower (P<0.001) QOL scores than the controls in the overall QOL and all the domains of life: Physical, Psychological, Social and Environmental. HIV positive individuals from Kathmandu valley scored significantly better (P<0.001) scores in the Physical and Environmental domains when compared to HIV positive individuals from Eastern region. HIV positive females had a significantly higher (P<0.02) QOL scores for overall QOL and overall perception of health than the males. Conclusion These findings suggest that HIV positive individuals have a poorer quality of life than the general population in Kathmandu valley & Eastern region of Nepal and interventions could be targeted to improve this aspect of their health. KEY WORDS HIV/AIDS, QOL, NEPAL, WHO QOL-BREF