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Browsing by Author "Shrestha, Reshika"

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    A Five-year Study of Spinal Disorders among Patients Presenting to the National Trauma Center of Nepal: An Observational Study
    (Nepal Medical Association, 2024) Rijal, Badri; Adhikari, Min Chandra; Bhusal, Suzit; Shrestha, Reshika; Chaudhary, Ashlesha; Pandey, Dipendra; Phuyal, Mandish Prasad; Prasai, Akanshya; Chaudhary, Aashutosh
    Abstract Introduction: Spinal cord injuries result in severe neurological impairments and disabilities. With an estimated 15.4 million cases globally in 2021, spinal cord injuries are more common in low- and middle-income countries, yet research in these areas is limited. This study aimed to find the pattern of spinal injuries and outcomes associated with spine injuries over a five-year duration at a tertiary trauma care center. Methods: This observational cross-section study was conducted at the National Trauma Center, Kathmandu from 2075 to 2080 B.S. with ethical clearance from the Nepal Health Research Council (Reference number: 968). Total-population sampling was used. A structured proforma was employed as the primary data collection tool. Data was analyzed using SPSS. Results: Of the 20843 patients, 2070 (9.93%) had spinal injuries. The median age was 43 (IQR 32-56) years, with 1391 (67.20%) male patients. The median hospital stay was 12 (IQR 7-20) days. Falls accounted for 1221 (58.99%) cases, and road traffic accidents for 195 (9.42%). Spinal fractures were present in 1076 (51.98%) patients with 456 (42.38%) in lumbar vertebra. There were 225 (10.87%) cases of subluxation with 214 (95.11%) in cervical level. Conclusions: The study provides insights into the patterns and outcomes of spinal injuries over five years of time. The mortality rate and cases of patients leaving against medical advice highlight areas for improvement in patient care and follow-up
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    Anaemia among Pregnant Women Visiting Obstetric Department of a Tertiary Care Centre: A Descriptive Cross-sectional Study
    (Nepal Medical Association, 2023) Joshi, Padam Raj; GC, Saroj; Sah, Sushil; Shrestha, Reshika; Pathak, Niharika; Maharjan, Sujata; Paudyal, Pooja
    Abstract Introduction: Anaemia is one of the common health problems of pregnant women and children in developing countries. Anaemia in pregnancy is related to poor foetal and maternal outcomes contributing to significant morbidity and mortality. Anaemia is a treatable and preventable condition. The objective of this study was to find out the prevalence of anaemia in pregnant women visiting the Obstetric Department of a tertiary care centre. Methods: A descriptive cross-sectional study was conducted among the pregnant women visiting the Department of Obstetrics and Gynecology of a tertiary care centre for their antenatal checkup. The study was conducted from 2 November 2022 to 11 November 2022 after obtaining ethical approval from the Institutional Review Committee (Reference number: 11(6-11)E2/079/080). Pregnant women with a history of blood transfusion, anaemia of chronic disease like chronic kidney disease, history of recurrent bleeding, and referral cases from other centres were excluded from the study. Serum haemoglobin was used for diagnosing anaemia according to criteria given by the World Health Organization. Convenience sampling was used. Point estimate and 95% Confidence Interval were calculated. Results: Among 442 pregnant women, the prevalence of anaemia was 24 (5.43%) (3.32-7.54, 95% Confidence Interval). Conclusions: The prevalence of anaemia among pregnant women was lower in comparison to other studies done in similar settings.
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    Building Curriculum Vitae as a Medical Student
    (Nepal Medical Association, 2023) GC, Saroj; Shrestha, Reshika
    Abstract The curriculum vitae is the standard means of communication of accomplishments that are relevant to the academic realm. The purpose of this is to provide a brief, digestible summary of one's personal and professional life. The quality of a curriculum vitae is more important than the quantity, and it takes skill to write one that is organized, clear, and brief. From their first year of medical school, medical students can get involved in research and publishing, plan activities that develop their leadership and management abilities, pursue their interests, and attend national and international conferences. At the end, it’s all about working on yourself and developing a distinct professional and personal identity which can be effectively reflected in your curriculum vitae.
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    Chronic Liver Disease among Patients Admitted in the Department of Internal Medicine of a Tertiary Care Centre: A Descriptive Cross-sectional Study
    (Nepal Medical Association, 2023) Poudel, Sujan Chandra; Acharya, Abishkar; Maharjan, Sujata; GC, Saroj; Shrestha, Reshika; Thapa, Suraksha; Poudel, Shekhar
    Abstract Introduction: Chronic liver disease with cirrhosis is a significant cause of morbidity and mortality not only in developed but also in developing countries. Many patients already develop complications before hospital admission and require intensive medical care during hospital treatment. The main objective of the study was to find out the prevalence of the chronic liver disease among patients admitted in the Department of Internal Medicine of a tertiary care centre. Methods: A descriptive cross-sectional study was conducted among patients admitted to the Department of Internal Medicine of a tertiary care centre from 1 January 2022 to 31 March 2022. Ethical approval was obtained from the Ethical Review Board (Reference number: 2211202105). The patient admitted in the Department during the study period was included and those who do not gave consent were excluded. Convenience sampling method was used. Point estimate and 95% Confidence Interval were calculated. Results: Out of 447 patients, the prevalence of chronic liver disease was 93 (20.8%) (17.04-24.56, 95% Confidence Interval). The mean age of the patients was 49.69±10.94 years and among them, males were 64 (68.82%). Conclusions: The prevalence of the chronic liver disease among patients admitted to the Department of Internal Medicine of a tertiary care centre was lower than in other studies conducted in similar settings.
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    Hernia among Patients Admitted to the Department of Surgery of a Tertiary Care Centre: A Descriptive Cross-sectional Study
    (Nepal Medical Association, 2023) Deo, Kishor Kumar; Shrestha, Reshika; GC, Saroj; Maharjan, Sujata; Shrestha, Aishwarya; Neupane, Asmita
    Abstract Introduction: Hernia is one of the most common surgery-requiring conditions. Despite this, hernia still needs to be studied in more detail. The main objective of the study was to find out the prevalence of hernia among patients admitted to the Department of Surgery of a tertiary care centre. Methods: A descriptive cross-sectional study was conducted among patients admitted to the Department of Surgery of a tertiary care centre from 1 July 2021 to 31 December 2022. Ethical approval was obtained from the Institutional Review Committee (Reference number: 202/2079/80). The patient admitted to the Department of Surgery during the study period was included and those with incomplete data were excluded. A convenience sampling method was used. Point estimate and 95% Confidence Interval were calculated. Results: Among 3236 patients, the prevalence of hernia was 749 (23.14%) (21.69-24.59, 95% Confidence Interval). The inguinal hernia was the most common type found in 574 (77.25%), followed by an umbilical hernia in 64 (8.61%). A total of 79 (10.55%) had comorbidity among patients with hernia. Conclusions: The prevalence of hernia in our study was found to be higher than in other studies done in similar setting. Easily accessible health facilities, competent primary surgical care and health education should be taken into account by the policymakers to reduce the morbidity and mortality of this condition.
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    Histopathological Spectrum of the Upper Gastrointestinal Tract Endoscopic Biopsies at a Tertiary Hospital: A Descriptive Cross-sectional Study
    (Nepal Medical Association, 2024) Koirala, Shraddha; Khadka, Anu; Bhusal, Suzit; Shrestha, Reshika; Prasai, Akanshya
    Abstract Introduction: Upper gastrointestinal tract disorders are prevalent worldwide, encompassing neoplastic and non-neoplastic lesions like infections and inflammation. Endoscopic biopsies play a crucial role in diagnosis, treatment monitoring, and complication detection. Despite their routine use, comprehensive data on their histopathological spectrum is sparse. This study aimed to delineate this spectrum and assess the prevalence of non-neoplastic and neoplastic lesions in upper gastrointestinal tract endoscopic biopsies. Methods: This descriptive cross-sectional study at a tertiary care center analyzed upper gastrointestinal endoscopic biopsies from August 1, 2019, to July 31, 2021. After obtaining ethical clearance (reference number: 039-078/079), we collected all upper gastrointestinal endoscopic biopsies received during the two-year study period, excluding inadequate biopsies, resection specimens, therapeutic cases, and specific lesions.Histopathological examination was conducted using H&E, Giemsa, and Periodic acid-Schiff stains. Diagnoses were categorized into non-neoplastic and neoplastic lesions following WHO guidelines. Data were analyzed using SPSS 16.0 to determine the frequency of neoplastic and non-neoplastic cases. Results: Among 155 upper gastrointestinal biopsies, 124 (80%) were non-neoplastic (95% CI: 73.71-86.29%) and 31 (20%) were neoplastic (95% CI: 13.71-26.29%). Non-neoplastic lesions were predominantly chronic gastritis, with chronic active gastritis being the most frequent 34 (27.41%). Neoplastic lesions were mainly adenocarcinomas in the stomach 20 (64.51%) and squamous cell carcinomas in the esophagus 7 (22.58%). Conclusions: The prevalence of neoplastic lesions were found to lower compared to the published literature and showed predominance of adenocarcinoma in upper gastrointestinal neoplastic lesions.
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    Hydrocele among Patients undergoing Surgery in the Department of Surgery in a Tertiary Care Center: A Descriptive Cross-sectional Study
    (Nepal Medical Association, 2024) Deo, Kishor; Chaudhary, Arun Kumar; Shrestha, Reshika; Chaudhary, Aashutosh; Adhikari, Bindira; Bista, Apeksha; Jha, Devesh; Shakya, Niliza; Maharjan, Suresh; Shrestha, Manisha; Shrestha, Ashish; Dahal, Isha; Sutihar, Anshu
    Abstract Introduction: Hydrocele, an accumulation of serous fluid within the remnant of the processus vaginalis, is a common cause of painless scrotal enlargement. While prevalent, few studies have been conducted to assess the extent and risk factors of hydrocele in Nepal. This study aimed to assess the prevalence and associated factors of hydrocele among patients undergoing the surgery department at a tertiary care center in Nepal. Methods: This descriptive cross-sectional study was conducted at a tertiary care center. Data were retrospectively collected from medical records over one year (2021 July to 2022 June), including all patients undergoing surgery in the general surgery department. Ethical Approval was received from the Institutional Review Committee of the same institute (Reference number: 820/2080/81) Cases of hydrocele surgery were identified, and relevant data were extracted using a structured proforma. Descriptive analyses were performed using Microsoft Excel 2016. Results: Out of 1812 surgeries, 95 (9.72%) were hydrocele surgeries. Of these, 94 (98.95%) were non-communicating hydroceles, 79 (83.16%) were unilateral, and 90 (94.74%) showed positive transillumination tests. The mean age of patients was 50.84 ± 17.02 years, with the highest number of cases in the 46-55 age group (20%). Postoperative complications occurred in 19 (20%) patients, with seroma and surgical site infection being the most common (31.58% each). Conclusions: Hydrocele surgeries comprised a significant portion (5.24%) of surgical cases at the tertiary care center, with the majority being non-communicating and unilateral types.
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    Post-operative Unilateral Visual Loss and Ophthalmoplegia following Cervical Spine Surgery in Prone Position: A Case Report
    (Nepal Medical Association, 2024) Gautam, Samaj; Bhusal, Suzit; Chaudhary, Ashlesha; Shrestha, Reshika; Rijal, Badri; Darjee, Prakash; Lama, Surya Bajra
    Abstract Visual loss following a spine surgery in a prone position is a disastrous and irreversible complication. Moreover, the recommended treatment for such visual loss is lacking and the outcome is not so satisfactory. A 38-year-old gentleman developed profound right sided visual loss after an uneventful cervical spine surgery in a prone position that lasted approximately two and half hours. Immediate ophthalmic consultation was done and the case was diagnosed as right-sided central retinal artery occlusion. Despite the initiation of vasodilatation, anticoagulation, and adequate fluid infusion, satisfactory improvement was not achieved. Extensive review of pertinent literature highlighted limited efficacy of treatments for postoperative visual loss after prone spinal surgery, further emphasizing the importance of preventive measures as the cornerstone in such procedures.
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    Spectrum of Obstetrics Case Referrals
    (Nepal Health Research Council, 2025) Ghimire, Asmita; Shrestha, Reshika; Yadav, Jeshika; Thapaliya, Ishwor; Sapkota, Sangrila; Khatiwoda, Susmita; Ojha, Neebha
    Background: Maternal health is an important focus for ensuring the well-being of both mothers and their babies. Maternal and fetal mortality which is a burning issue especially in third world countries can be reduced significantly with right obstetric referral. This study reviewed the primary reasons, time, distance, and pattern of obstetric cases referred to a tertiary center. Methods: This descriptive study was conducted after taking ethical approval {Approval number 136 (6-11) E2} from the review board of Maharajgunj Medical Campus, Nepal, and data of three years from 1st August 2020- 31st September 2023 were analyzed from medical records. The study included all referral cases aged 18-45 years who were past 28 weeks of gestation till 42 days post-delivery. Women who had incomplete medical records were excluded from the study. A continuous convenience sampling method was used. The point estimate was calculated at a 95% confidence interval. Results: Among 174 referred cases, 84 (48.28%) were from the government district-level hospitals with the predominant reason being medical disorders complicating pregnancy 136 (78.17%). The majority of cases 94 (54.02%) were referred during the intrapartum period. Conclusions: Medical disorders complicating pregnancy were the primary cause for the referral in obstetrics cases, notably from district-level hospitals having less manpower to deal with those cases. Keywords: Hospital; maternal mortality; obstetric; pregnancy; referrals.

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