Browsing by Author "Shrestha, S"
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Publication A Case of Acute Flaccid Paralysis: An Uncommon Presentation of a Common Disease(Nepal Paediatric Society (JNPS), 2007) Shrestha, S; Regmi, Subodh KrNAPublication A comparison of haemodynamic responses with pethidine vs. butorphanol in open cholecystectomy cases(Kathmandu University, 2004) Tabedar, S; Maharjan, SK; Shrestha, BR; Shrestha, SObjective: The present study was undertaken to compare the haemodynamic responses with pethidine vs. Butorphanol intraoperatively in open cholecystectomy cases in KMCTH. Method: In this randomized study, all together 40 patients undergoing routine cholecystectomy surgery were included. Group A received Pethidine 1mg/kg and Group B received Butorphanol 0.04mg/kg intraoperatively. Heart rate and blood pressure were recorded before injection of the drug, after injection, before intubation, after intubation, before skin incision, after incision, before extubation and after extubation Data analysis was done using independent sample “t” test. Result: Our study showed no statistical significance in haemodynamic responses with either pethidine or Butorphanol in open cholecystectomy cases. Conclusion: Both drugs appear equally good analgesics in our study. Key words: analgesics, pethidine, Butorphanol, haemodynamic responses, surgery, cholecystectomy.Publication A statistical analysis of patient deaths in NMC teaching hospital(Nepal Health Research Council, 2006) Upadhyaya, S; Chhetri, M R; Aryal, U R; Dhakal, P; Shrestha, SPublication A Study of Early Neonatal Deaths at Kathmandu Medical College Teaching Hospital(Nepal Paediatric Society (JNPS), 2007) Shrestha, S; Bajracharya, BL; Manandhar, DSAbstract: Over 9 million deaths occur each year in the perinatal and neonatal periods globally. 98% of these deaths take place in the developing world. Nepal has a high neonatal mortality rate (NMR) of 38.6 per 1000 live births (2001). Two thirds of the newborn deaths usually occur in the first week of life (early neonatal death). Newborn survival has become an important issue to improve the overall health status and for achieving the millennium developmental goals of a developing country like Nepal. Aims and Objectives: This study was carried out to determine the causes of early neonatal deaths (ENND) at KMCTH in the two-year period from November 2003 to October2005 (Kartik 2060 B.S. to Ashoj 2062). Methodology: This is a prospective study of all the early neonatal deaths in KMCTH during the two-year study period. Details of each early neonatal death were filled in the standard perinatal death audit forms of the Department. Results: Out of the 1517 total births in the two-year period, there were 10 early neonatal deaths (ENND). Early neonatal death rate during the study period was 6.7 per 1000 live births and early neonatal death rate (excluding less than 1 kg) was 6.1 per 1000 live births The important causes of early neonatal deaths were extreme prematurity, birth asphyxia, congenital anomalies and septicaemia. During the study period, there was no survival of babies with a birth weight of less than 1 kg. Among the maternal characteristics, 80% of the mothers of early neonatal deaths were aged between 20-35 years. 50% of the mothers were primigravida. 50% of the mothers of ENNDs had delivered their babies by caesarean section. Discussion: Most of the early neonatal deaths were due to extreme prematurity. Birth asphyxia was the second most important cause of early neonatal deaths. 70% of ENNDs were among LBW babies. Prevention of premature delivery, proper management of very low birth weight babies and early detection and appropriate management of perinatal hypoxia have become important interventional strategies in reducing early neonatal deaths in KMCTH. Conclusion: Early neonatal mortality at KMCTH is fairly low. Good care during pregnancy, labour and after the birth of the baby has helped to achieve these results. Low cost locally made equipments were used to manage the sick newborns. Reduction of early neonatal deaths require more intensive care including use of ventilators, surfactant and parenteral nutrition and prevention of preterm births Key words: Early neonatal death (ENND), neonatal mortalityPublication Acute haemorrhagic conjunctivitis: an epidemic in august/ September 2003(Kathmandu University, 2003) Karki, DB; Shrestha, CD; Shrestha, SObjective: To clinically analyze 400 cases of red eye attending Nepal Eye Hospital in August/ September 2003 and to study the aetiology of the disease on the clinical basis with available laboratory resources. Materials and methods: It is a prospective study of 400 cases of acute conjunctivitis visiting Nepal Eye Hospital during the epidemic of acute haemorrhagic conjunctivitis in August/September 2003. Result: 30.5% presented in the age group of 20-29 years. Males presented predominantly (73.3%). Maximum number of patients presented at two days of onset of symptoms. All 400 cases had red eye, 89.8% had pain, 86.3% had foreign body sensation and 87.5% had discharge. Bilateral involvement was seen in 73.5% and unilateral involvement in 26.5%, 4.3 % of the total cases had corneal involvement and 20% of the cases had associated fever and preauricular lymphadenopathy. Conclusion: Based on clinical presentation and the report of available laboratory results, picorna virus was found to be responsible for this epidemic of acute haemorrhagic conjunctivitis. Keywords: Haemorrhage, Conjunctivitis, Superficial Punctate Keratitis, Lymphadenopathy, Picorna virus.Publication Admission Cardiotocography in Predicting Perinatal Outcome(Kathmandu University, 2019) Shrestha, S; Shrestha, IABSTRACT Background Antepartum assessment of the fetus is very important to prevent intra-uterine demise, birth asphyxia, neurological defect of newborns and neonatal mortality. Cardiotocography is the best indicator for fetal surveillance during labour in low resource country. Objective To assess on admission cardiotocography and predict perinatal outcome of antenatal mothers admitted to labour room for delivery at Dhulikhel Hospital, Kathmandu University Hospital. Method A prospective, observational study was conducted from 1st January 2016 to 31st December 2017. Antenatal mothers were evaluated in admission cardiotocography for 20 minutes. Cardiotocography studies were interpreted and categorized according to the classification proposed by National Institute of Clinical Excellence (NICE)- clinical guidelines 2007. Result Total 204 mothers were enrolled, the mean age is 24.06±4.331. Cardiotocography interpretation shows, 81.4% of Normal, 13.7% suspected and only 4.9% accounts pathological. Mother having CTG of pathological had more operative delivery 80% compare to normal and suspicious (0.0001). Similarly, more meconium stained liquor fall in pathological group with p value of 0.002. Fetal distress in labour is seen in all groups, showing 13.3% in normal, 32.1% in suspicious and 80% in pathological with p value 0.000. The duration of on admission cardiotocography to occurrence of fetal distress found to be mean hour of 9.57. Conclusion The admission cardiotocography test is useful to detect fetal distress which is already present at the time of test and can predict fetal wellbeing during the next few hours of labour. This test might lead to higher incidence of operative delivery at low resource countries because of lack of fetal blood sampling test to confirm fetal hypoxia during labour. KEY WORDS Admission cardiotocography, Perinatal outcome, Obstetrical outcomePublication Adolescent Health Risk and Behavior Survey: A School Based Survey in Central Nepal(Kathmandu University, 2017) Thapa, B; Powell, J; Yi, J; McGee, J; Landis, J; Rein, L; Kim, S; Shrestha, S; Karmacharya, BABSTRACT Background A comprehensive study of adolescent health risk specific to the Dhulikhel catchment area has not been performed. Objective This survey assesses trends in demographics, nutrition, hygiene and related infrastructure, causes of injury, violence, mental health, substance abuse, and menstrual hygiene. Method A 40 question survey was adapted from the Center for Disease Control (CDC) Youth Risk Behavior Surveillance System, translated into the Nepali language, and administered to 1200 students in eight different schools in central Nepal. Descriptive statistics were used to summarize the data. Result The data has identified nutrition, infrastructure, mental health, and menstrual hygiene as areas for improvement. The number of adolescents who reported going hungry some, most, or all of the time (30.5%, 25.8%, 13.9%) reveals a need for better food access. Approximately 44.5 % of students had no access to soap and water at school. Students who endorse dissatisfaction with themselves was 6.5% and those with suicidal ideation or attempt was 11.8% of the surveyed population. A significantly greater percentage of students who reported suicidal ideation also reported engaging in behaviors related to physical violence, substance abuse, being dissatisfaction with themselves, insomnia due to anxiety, and loneliness. Of the female students, 40.1% reported missing school at least once in the last three months due to their period. Conclusion This data shows a need for better food access, improved infrastructure in schools in central Nepal, and the need to address the prevalence of mental health issues through program interventions. KEY WORDS Adolescent health, School health, SurveyPublication Allergic Fungal Rhinosinusitis in Chronic Rhinosinusitis(Nepal Health Research Council, 2011) Shrestha, S; Kafle, P; Akhter, J; Acharya, L; Khatri, R; KC, TBackground: Rhinosinusitis is the inflammation of nasal and paranasal sinus mucosa and is associated with mucosal alteration ranging from inflammatory thickening or gross nasal polyp formation.The main objective of this study is to etermine the prevalence of allergic fungal rhino sinusitis among the patients having chronic rhino sinusitis with or without polyps who under goes functional endoscopic sinus surgery. Methods: The patient with chronic rhinosinusitis with or without polyp who FESS were studied. Surgical specimens were sent for mycology and histopathological analysis for identification of fungus. Results: Headache 41(82%) and nasal block 45(90%) were the commonest clinical presentation. Out of 50 patients,fungal elements were detected by KOH in 8(16%) of cases and histopathological examination in 11(22%) of cases. Conclusions: Allergic Fungal Rhinosinusitisis a common disorder in patients with chronic rhinosinusitis, it needdifferent specific tests for the diagnosis, a more specific diagnostic tests are fungus culture, and IgE to fungal antigen and skin test are needed for definite diagnosis. Keywords: allergy, fungus, rhinosinusitis, sinusitisPublication Analysis of 400 cases of posterior segment diseases visiting retina clinic of Nepal eye hospital(Kathmandu University, 2003) Karki, DB; Malla, OK; Byanju, RN; Shrestha, SObjective: To determine the disease pattern of 400 patients attending Nepal Eye Hospital for strategic planning. Materials and methods: A retrospective hospital based analysis of 400 cases visiting Retina Clinic of Nepal Eye Hospital (NEH) over a period of one year was carried out in order to know the disease pattern for planning purpose. Results: Males slightly outnumbered females (58% versus 42%). The diseases were more common in age group 50 to 59 years. Diabetes mellitus with or without retinopathy was the commonest cause (20.25 %) for attendance in retina clinic followed by hypertensive retinopathy and venous occlusive disorders. Keywords: Posterior segment disease pattern, diabetic retinopathy, hypertension, venous occlusive disease.Publication Analysis of Post Earthquake Disease Pattern in a Camp at Gyampesal Gorkha(Kathmandu University, 2016) Malla, T; Malla, KK; Singh, SK; Shrestha, SABSTRACT Background A major earthquake occurred in Nepal on 25th April 2015 with magnitude of 7.8 causing mass panic amongst people. Objective To analyze scenario, experience and disease pattern of Post Earthquake camp at Gyampesal, Gorkha. Method A prospective observational study done on 13th and 14th June 2015 in a population who attended the health camp at health post, Gyampesal Gorkha. Analysis was done for age, sex, and disease pattern. Medicines for their health problems was provided by Manipal Teaching Hospital, Pokhara, Nepal Pediatric Society and Children Welfare in Nepal, Kathmandu. Result Total 159 patients [80.5% children and 19.5% adults] had attended the health camp. The mean age of children was 6.18±4.27 SD with maximum between 2-5 years (39%) and mean age of adults was 37.87±14.07 SD. Among the children males were more (50.8%) than females but in adult group females (83.9%) were more. Most common complaints were earthquake related fear (Children- 60.23% / adults -71%), insect bite [children -25.8% /adults -35.5%], pain abdomen (children- 64.1% / adult -38.7%) and decreased appetite (children- 83.6% / adults - 16.1%). Pain abdomen and decreased appetite was significantly high in children with p <0.009 and 0.001 respectively. The common disease patterns noted in children were recurrent abdominal pain (25%), acute gastroenteritis (19.5%), upper respiratory tract infections (15.6%), Impetigo (15.6%), Dental caries(10%), Pityriasis alba (10%). In adults Acid peptic disease (51.6%), Headache (32.5%), hypertension, Upper respiratory infections, scabies and Urinary tract infection (16%), Acute gastroenteritis (13%) was common. Conclusion Earthquake related fear, insect bite and Communicable diseases both airborne and water borne were the commonest findings observed. Therefore basic needs and services like safe water and sanitation, adequate shelter, primary healthcare services and vector-control campaigns are crucial and essential for these displaced populations. KEY WORDS Children, disease pattern, earthquakePublication Antibiogram and Plasmid profiling of clinical multidrug resistant Escherichis coli(Institute of Medicine, 2014) Shrestha, S; Mali, NM; Tiwari, KB; Adhikari, N; Shrestha, UT; Basnyat, SRAbstract Introduction: Multiple antibiotic resistances among common bacterial pathogens have been established as an alarming public health problem elsewhere. This study was aimed to explore prevalence of Extended-spectrum beta-lactamase (ESBL) producers among multi drug resistant (MDR) and plasmid profiling patterns of Escherichia coli isolated in Kathmandu Model hospital, Nepal over three months period. Methods: Altogether 49 isolates were randomly selected among the reported MDR E. coli and retested for the susceptibility pattern and ESBL production by Kirby- Bauer disc diffusion test. Minimum Inhibitory Concentration of the isolates towards (fluro) quinolones was determined by agar dilution method. Plasmids from isolates were extracted by alkaline lysis method. Results: All isolates were completely resistant to Amoxycillin but sensitive to Imipenem. A very high prevalence (44, 89.8%) of ESBL was detected. Most of the isolates were resistant to commonly uses antibiotics such as Quinolones, Tetracyclines and Cotrimoxazole. Among Quinolones, the Minimum Inhibitory Concentration (MIC) range for Nalidixic acid, Ciprofloxacin and Ofloxacin were 512->4093, 8-4096 and 1-256 µg/ml respectively. All 31 (63.3%) plasmid- harboring isolates contained a>33.5 kb sized plasmid. Among them, seven isolates possessed multiple (2 – 7) plasmids. Overall, twelve different resistance patterns were observed among the bacteria. Based on the patterns, the high molecular weight plasmid seemed to contain most of the resistance genes. Conclusion: It is suspected that multi drug resistance and ESBL production in E. coli with resistance to Quinolones may be due to their high molecular weight plasmids. So, continuous antibiotic susceptibility test and surveillance of the plasmid and chromosome of E. coli is essential as plasmid analysis has been applied to determine the evolution and spread of antibiotic resistance among isolates. Keywords: escherichia coli, antibiotic resistance pattern, multidrug resistant (MDR), extended spectrum beta- lactamases (ESBL), plasmid profilingPublication Anxiety on Primigravid Women Attending Antenatal Care: A Hospital Based Cross-sectional Study(Kathmandu University, 2018) Shrestha, S; Pun, KDABSTRACT Background High levels of anxiety during pregnancy have adverse effects on mother and baby. Objective To assess anxiety on primigravid women attending Antenatal Care. Method Analytical cross-sectional study was carried out on the primigravid women attending Antenatal Care out-patient department of Dhulikhel Hospital. Perinatal Anxiety Screening Scale (PASS) was used to assess anxiety on 502 women. Data were collected through face-to-face interview using Systematic Random Sampling Technique from May 2017 to December 2017. Chi-square test was applied to test the association between selected variables. All p- values less than 0.05 were considered statistically significant. Result The mean (± Standard deviation [SD]) age of the participants was 23.17±3.9 years. More than half (57.6%) of the women were from the age group 20-25 years. Just above two-fifth (41.4%) of the participants were in the third trimester of pregnancy. Out of 502 pregnant women, nearly half (46.4%) of them were at high risk of anxiety. High risk of anxiety was significantly associated with age and type of family. However significant associations were not seen between high risk of anxiety during pregnancy and residence, educational status, occupation, husband’s occupation and gestational period of women. Conclusion The high risk of anxiety on primigravid women was quite up. Anxiety during pregnancy was more likely to fall on younger women (age <20 years) and joint families in comparison to those women from age twenty and above and nuclear families respectively. KEY WORDS Antenatal care, Anxiety, Primigravid womenPublication Assessment of Health Service Delivery to Address Cardiovascular Diseases in Nepal(Kathmandu University, 2021) Suwal, PS; Prajapati, D; Bajracharya, S; Shrestha, A; Maharjan, R; Shrestha, S; Jha, N; Koju, RP; Vaidya, AABSTRACT Background A health care delivery system is the organization of people, institutions, and resources designed to deliver health services. A comprehensive study to explore cardiovascular health service delivery in Nepal is lacking. Objective This study attempted to assess Nepal’s health system gap on organization and delivery of cardiovascular disease prevention and management services. Method This mixed-method study used the six building blocks of the World Health Organization health system framework: organization; access; coverage, utilization and demand; equity; quality of services; and outcomes. We conducted the desk reviews of national and international documents, performed several key informant interviews, calculated the relevant indicators, and assessed the Strengths, Weaknesses, Opportunities, and Threats of the cardiovascular health service delivery. Result We found that most of the cardiovascular services are concentrated in urban areas, and suffer from poor access, quality, utilization, and coverage in most of the areas resulting in poor health outcomes. Though the services have recently improved due to increased primary care interventions, there is scope for the development of competent human resources, advancement of technologies, development of national protocols, and improved monitoring and supervision. Improved disease system including the medical recording and reporting mechanism to incorporate and reflect the true burden of CVD in Nepal is lacking. Conclusion Despite having health facilities from grassroots to the central level, availability, access, and quality of cardiovascular health services are poor. Further improvement and equitable expansion of promotive, preventive, diagnostic, referral, and rehabilitative cardiovascular services are needed to ensure universal health coverage. KEY WORDS CVDs, Health-service delivery, Infrastructure, Needs-assessment, NepalPublication Assessment of Level of Expectation and Awareness towards Dental Implants among Complete Denture Patients and Partial Denture Prostheses Wearers(Kathmandu University, 2020) KC, Basnyat S; Sapkota, B; Shrestha, S; Rimal, UABSTRACT Background Among many options to replace missing teeth, dental implant is widely popular but willingness to have implant treatment and its success depends on patients’ knowledge and expectations as well as the care, skill, and judgment of clinicians. Objective The main objective of this study was to assess awareness, expectation and source of information about dental implant among complete and removable partial denture wearers and to find association between them. Method A questionnaire consisting of 6 close-ended questions was used to assess the level of knowledge and awareness among patients visiting Dental Outpatient Department of Dhulikhel Hospital regarding dental implants as a treatment option for replacing missing teeth. Chi-square test was used to study the association between demographic variables and awareness about implantation. Statistical software SPSS 20.0 was used for data analysis. Result Our results revealed significant difference in age (p=0.001), education level (p=0.03) and occupation (p=0.004) in awareness of dental implant and no significant difference in gender (p=0.567), compared between complete and removable partial denture wearers. Due to lack of awareness, lower educational status and advanced age the patients responded that they “did not know “ in answer to almost all the questions. Conclusion The awareness level of dental implant was low among complete and removable denture patients and this was associated with a low level of education and lack of accurate information about dental implants. KEY WORDS Awareness, Complete denture, Dental implant, Expectation, Partial denturesPublication Assessment of nutritional status among children under five years of age in Manamaiju VDC of Kathmandu District, Nepal(Institute of Medicine, 2017) Gautam, N; Shrestha, SAbstract Introduction: The nutritional status among under the age of five in terms of stunting, underweight and wasting and to find the association between nutritional status with selected variables. A descriptive cross-sectional study was done to determine prevalence of stunting, underweight and wasting among under five children and factors associated with that. Descriptive, univariate indices such as stunting, underweightandwasting determined as Height for Age, weight for age and respectively. Methods: The study was conducted in Manamaiju VDC with 56440 populations with 3742 under 5 children. Research design was descriptive cross sectional. Total sample size was 190 tools used are semi structured and face to face interview. Data collection was within 4 week (23rd chaitra 2070 to 20th Baisakh 2071). Data was analyzed by SPSS version 13.0 for Windows and ENA for SMART. Similarly, Chi square test was applied at 5% level of significance to show the association between nutritional status and selected variables as age group of children, occupation of mother, education of mother, immunization, vitamin A capsule supplementation, deworming tablets and colostrum milk feeding. Results: This study finding is that the nutritional statuses of children in term of stunting were 32 %, in term of underweight 26% and wasting were 22% so the wasting found to be double in reference to current scenario. Similarly, associations of the variables with nutritional status were analyzed. The study found that Vitamin A supplementation, deworming tablets and colostrum milk feeding had statistically significant effect on wasting status and feeding of colostrum milk had statistically significant effect on underweight status. Conclusion: From this study it can be showed the prevalence of stunting, underweight and wasting among under five children in Manamaiju VDC. National average given by NDHS, 2001 except the prevalence of wasting which is almost similar. Similarly regarding the association within selected variables i.e. Age group of children, Immunization, Mother’s Education level, Vitamin A supplementation, Deworming tablets and Colostrum feeding practices have significant effect on wasting status and underweight too but not on stunting and underweight. This analysis shows further need of research to explore the more regarding the nutritional status among the under five children in this community.This study showed that 41%, 29% and 11% children were stunted, underweight and wasted. Keywords: stunting, underweight and wasting, nutritional statusPublication Association Between use of Interdental Cleansing Aids Gingival Conditions in Fixed Dental Prosthesis Patients(Kathmandu University, 2020) KC Basnyat, S; Sapkota, B; Shrestha, S; Rimal, UABSTRACT Background The fixed dental prosthesis are one of the most commonly used prosthesis which are difficult for cleansing in dental clinical practice especially the interproximal areas. As a result, periodontal disease most commonly develops in interproximal areas. The efficacy of using dental floss and interdental brushing in addition to tooth brushing reduce plaque and gingival inflammation. Objective To assess gingival condition in patients after placement of fixed dental prosthesis for a period of 3 months who regularly use or do not use dental floss and interdental brushing. Method Patients visiting the Dental Outpatient Department of Dhulikhel Hospital were selected for study. The examination was conducted using basic diagnostic tools (Mouth mirror, periodontal probe and explorer). The total number of patients involved in the study were 200. Teeth and gingiva were examined using the Plaque (Silness and Loe) and Gingiva Index (Löe and Silness). The examinations were conducted after 15 days and 3 months of placement of fixed dental prosthesis along with the oral hygiene instructions. Chi-square test and McNemar Bowker test were done to find statistical association using SPSS 20.0. Result Statistical analysis showed that there was association between frequency of interdental cleaning and plaque index (p=0.012) and gingival index (p=0.036) examined in 15 days and 3 months. Conclusion Use of Interdental cleansing aids was statistically significant to oral hygiene outcomes i.e. plaque index and gingival index. Oral hygiene instructions play a vital role in improving overall oral health. KEY WORDS Fixed partial denture, Gingival index, Oral hygiene, Plaque indexPublication Association of Different Biochemical and Hemodynamic Characteristic with Type 2 Diabetes Mellitus and Hypertension in Nephrolithiasis Patients(Kathmandu University, 2023) Katwal, BM; Gautam, N; Shrestha, S; Adhikari, R; Baral, H; Jha, SK; Jha, GABSTRACT Background Although Nephrolithiasis is a common condition caused by a wide variety of metabolic or environmental disturbances, its being one of the major factor of morbidity. Incidence of kidney stone disease (KSD) is highly affected by metabolic disorders and change in blood pressure and glucose. Objective To find out association of different biochemical and hemodynamic parameters with various glycemic status and hypertension in kidney stone disease. Method A cross sectional study was conducted in patients diagnosed as nephrolithiasis by using re¬nal ultrasonography and underwent nephrectomy between January 2019 to January 2021 in Shahid Dharmabhakta National Transplant Centre (SDNTC). A total of 100 subjects with 60 male and 40 females were enrolled. Glycemic status was categorized based on criteria of American Diabetes Association (ADA) and hypertension was defined as BP ≥ 140/90 mm Hg in right arm supine position. All biochemical and hemodynamic profile was carried out following standard protocol. Result Out of 100 patients enrolled, pre-diabetes accounted for 31% followed by diabetes (4%). However, hypertension comprised of 66% in total subjects. Serum urea, cholesterol and triglyceride level were found to be increased by 84.6%, 67.7% and 64.7% respectively in diabetes followed by increase of 3.9%, 19.5% and 3.1% respectively in prediabetes when compared to normal glycemic condition in nephrolithiasis subjects. Serum fasting blood glucose, creatinine and uric acid level was observed significantly higher (p=0.003, p=0.004, p < 0.001 respectively) in hypertensive patients. Duration of hospital stay was also seen positively correlated with hypertension. Conclusion Not only diabetes, prediabetes also manifests the increased risk of kidney stone disease along with hypertension. There is significant impairment in renal function and lipid profile based on diabetes mellitus and hypertension. Early identifying these systemic diseases, different biochemical and hemodynamic parameters and proper treatment accordingly may minimize risk and prevent serious complication in these patients. KEY WORDS Diabetes mellitus, Hypertension, NephrolithiasisPublication Awareness of Burn First Aid Management among Undergraduate Medical Students at a Medical College Teaching Hospital(Kathmandu University, 2024) Thapa, S; Thapa, B; Shrestha, SABSTRACT Background First aid training, educational degree of health sector employee is linked to greater levels of knowledge, awareness and positive outcome in burn injury and its management but studies have shown insufficient level of awareness with unsatisfactory skills not only among professional healthcare workers but also in medical students. Objective To assess the knowledge and confidence of our medical students towards basic burn first aid and management. Method Cross sectional observational study was done using a structured, self-reported 16 multiple choice questionnaire with total marks of 30. Students was graded accordingly: more than 25 points: good, 16-25 points: satisfactory and less than 16 points: poor level of awareness about burn first aid management. Confidence in management of burn related victims, information on receiving of prior formal training in burns and sources of knowledge in students were also evaluated. Result Only a satisfactory level of awareness is seen in medical students 62.1%, 98.2% had not received any kind of formal training and the medical college curriculum was the main source of information (69.2%) followed by journals (47.1%) and internet (26%). 78.4% students felt that the curriculum provided to them was inadequate and only 5.3% students were confident in managing burn first aid. Conclusion There was inadequacy in the knowledge of burn first aid amongst undergraduate students therefore clinical course in managing burns into the undergraduate curriculum is vital. KEY WORDS Awareness, Burns, First aid management, Medical students, PerceptionPublication Awareness Regarding Preventive Measures of Avian Influ- enza Among the Adult People of Thimi Municipality, Nepal(Kathmandu University, 2013) Manandhar, K; Chataut, J; Khanal, K; Shrestha, A; Shrestha, S; Shrestha, SABSTRACT Background Avian influenza is considered as a threat to global public health. Prevention and control depends on the awareness of the general population as well as high risk- groups. The avian influenza should be viewed more seriously because it may lead to pandemic influenza when the virus mutates its strain with the common human influenza. Thus, this study aims to explore the awareness regarding preventive measures of avian influenza among the adult population of Thimi Municipality. Objective The objective of this study was to explore awareness regarding preventive measures of avian influenza among the adult population of Thimi Municipality. Methods It is a cross-sectional, population based study. It was carried out in Thimi Municipality from May 15 to June 15, 2012. Pre tested structured questionnaire was used for face to face interview with randomly selected 250 subjects. Results Out of 250 subjects, 123 (49.2 %) were males. The mean age of subjects was 36 ± 11.8 year. Among total subjects, 94.4 percent had heard about avian influenza. The main source of information was television (94.1%). Majority of subjects (84.9 %) thought that keeping infected birds and poultry as the mode of transmission followed by eating not well cooked poultry meat (82.8 %). Out of total study subjects, 165 (66.0 percent) mentioned fever and 138 (55.2 percent) thought fatigue as the signs and symptoms. As for knowledge about preventive measures, majority (85.6%) stated that cleaning the surfaces that had come in contact with the poultry could prevent the disease and 83.2 % had knowledge that the infection could be prevented by washing hands with soap and water after poultry handling. Awareness regarding preventive measures was found significantly low in females, middle adults, illiterates, and house wives. Conclusion The awareness regarding avian influenza was quite satisfactory among the adult people of Thimi Municipality. However level of awareness was seen lower in female, illiterate and middle adult. So that along with large scale mass education, there should be specific health education program for the specific group of population. KEY WORDS Awareness, avian influenza, preventive measuresPublication Bacterial Isolates and its Antibiotic Susceptibility Pattern in NICU(Kathmandu university, 2013) Shrestha, S; Shrestha, NC; Dongol Singh, S; Shrestha, RPB; Kayestha, S; Shrestha, M; Thakur, NKABSTRACT Background Neonatal sepsis is one of the major causes of morbidity and mortality among the newborns in the developing world. Objectives To determine the common bacterial isolates causing sepsis in neonatal intensive care unit and its antibiotic susceptibility pattern. Methods A one year discriptive prospective study was conducted in neonatal intensive care unit to analyse the results of blood culture and to look into the sensitivity of the commonly used antibiotics. Results The blood culture yield by conventional method was 44.13% with nosocomial sepsis accounting for 10.79%. 84.08% were culture proven early onset sepsis and 15.95% were late onset sepsis. Klebsiella infection was the commonest organism isolated in early, late and nosocomial sepsis but statistically not significant. Gram positive organisms were 39.36% in which Staphylococcus aureus was the leading microorganism followed by coagulase negative staphylococcus areus. Gram negative organisms were 60.64% amongst them Klebsiella was the most often encountered followed by Pseudomonas. The most common organism Klebsiella was 87.5% and 78.3% resistance to ampicillin and gentamycin respectively. Among gram negative isolates 87.5% and 77.2% were resistance to ampicillin and gentamycin respectively. Among gram positive isolates 58.5% and 31.5% resistance were noted to ampicillin and gentamycin respectively. Resistance to cefotaxim to gram negative and gram positive isolates were 87.34% and 59.35% respectively. Conclusion Klebsiella is most common organism which is almost resistance to first line antibiotics. Resistance to both gram negative and gram positive isolates among firstline antibiotics and even with cefotaxim is emerging and is a major concern in neonatal intensive care unit. KEY WORDS Antibiotic susceptibility, bacterial isolates, neonates