Browsing by Author "Shrestha, Rabina"
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Publication Oral Glucose Tolerance Test for Universal screening for Gestational Diabetes Mellitus(Nepal Health Research Council, 2024) Shrestha, Abha; Shakya, Rajani; Shrestha, Rabina; Karki, Sulata; Das, Seema; Shrestha, Priya; Rai, Anisha; Thapa, Saroj; Shrestha, Abha; Karmacharya, BirajBackground: Gestational Diabetes Mellitus increased almost 30% in many countries, including underdeveloped countries and same in Nepal. Hospital-based studies in Nepal reported Gestational Diabetes Mellitus cases, with prevalence 2.48% in 2010 to 4.47% in 2019 emphasising on necessity of universal screening for Gestational Diabetes Mellitus. Methods: As part of implementation of Electronic Decision support System for Antenatal Care, in formative study clinical vignettes on Gestational Diabetes Mellitus case presented to six healthcare providers ( Incharges, Auxiliary Nurse, Midwives and Lab Assistants) from 3 primary healthcare facilities in Kavre and Dolakha districts, Nepal from October-December 2019. 19 Auxiliary Nurse, Midwives from 19 HCF of 4 districts (Kavre, Dolakha, Sindhuli, and Sindhupalchok, including where clinical vignette were applied trained to perform Oral Glucose Tolerance Test for 4 hours. In-depth Interviews conducted with 16 Auxiliary Nurse, Midwives (8 trained & 8 peer coached from selected 4 HCF to explore their perception & experiences of conducting Oral Glucose Tolerance Test and continuing it for future. Clinical vigenttes compared with PEN protocol and IDIs analyzed thematically. Results: Only 4/6 HCPs made probable diagnosis of Gestational Diabetes Mellitus. 217 Oral Glucose Tolerance Test performed, 24 found to have Gestational Diabetes Mellitus. In-depth Interviews showed Auxiliary Nurse, Midwives enthusiasts on implementing tests for Gestational Diabetes Mellitus and to continue what has been learnt in training. Some challenges; clients hesitate to stay 2 hours at facilities due to unavailability of transport and household work. Oral Glucose Tolerance Test trained Auxiliary Nurse, Midwives seem more confident in counselling and conducting Oral Glucose Tolerance Test than those peer coached. Conclusions: Administering Oral Glucose Tolerance Test seemed feasible in HCF settings despite some challenges. Training and continuing logistics supply from municipality level seems promising. Keywords: GDM: Nepal: OGTT:Publication Severity of Stress in Acne Patients Attending Dermatology Outpatient Department of Tertiary Hospital in Kathmandu(Society of Dermatologists, Venereologists and Leprologists of Nepal (SODVELON), 2021) Shrestha, Amrita; Pokhrel, Dinesh Binod; Parajuli, Sudip; Chapagain, Manisha; Shrestha, RabinaAbstract: Introduction: Stress persists when a person is unable to cope with the situations of the past, present or future. Stress may be associated with physical and psychological abnormalities. Acne vulgaris is a chronic inflammatory disease of the pilo-sebaceous units with prevalence of more than 85% in adolescent age group. Materials and Methods: Three hundred one patients were recruited in the study. Inclusion criteria included new acne patients of age 16 years and above as well as those who were using but not improving with topical or oral acne therapies. Exclusion criteria included patients receiving sedatives, antidepressants, or glucocorticoids, patient suffering from chronic illnesses like diabetes, hypothyroidism, chronic kidney disease, migraine and other diseases. This questionnaire included biodata of the patients, clinical history and their perceived stress scale. Global Acne Grading System (GAGS) was used to assess acne severity in relation to stress using the Perceived Stress Scale (PSS). Results: The results indicated an increase in stress severity positively correlated with an increase in acne severity, which was statistically significant (p<0.01). Most of the patients were students. Subjects with higher stress scores, determined using the PSS, had higher acne severity when examined and graded using the GAGS. Conclusions: The results showed that there is a positive correlation between severity of stress and grade of acne. Stress management should be a part of acne management. Keywords: Acne, Severity, Stress