Browsing by Author "Shrestha, SS"
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Publication Current Understanding of Emergency Medicine and Knowledge, Practice, and Attitude toward Disaster Preparedness and Management among Healthcare Workers in Nepal(Kathmandu University, 2024) Shakya, YR; Patel, JN; Shrestha, R; Shrestha, SS; Dangal, R; Pradhan, B; Pandya, J; Basnet, SABSTRACT Background Disasters are serious disruptions to a community’s functioning that exceed its capacity to cope using its resources. Natural, man-made, technological hazards and other factors may cause disasters and influence a community’s exposure and vulnerability. Objective To assess the knowledge, practice, and attitude of healthcare workers in Nepal regarding disaster preparedness and management for emergencies. Method A retrospective study was conducted among healthcare workers in Nepal registered for the 1st World Academic Council of Emergency Medicine- Table-top Exercise and Communication in Disaster Medicine conference as participants or faculty. Information was collected using total enumeration sampling and a questionnaire developed from a literature review and the questionnaire was adapted from the Emergency Preparedness Information Questionnaire (EPIQ). Percentages, means, and medians were calculated for socio-demographic data, knowledge, practices, and attitudes toward emergency preparedness. A chi-square test assessed associations between socio-demographic characteristics, emergency procedures, and familiarity scores on the preparedness questionnaire. Result A total of 118 participants took part in the study, most with over six months of emergency department experience. There was a significant association between work experience and emergency procedure status ((ꭓ2=6.982, p=0.008), and between education level and familiarity with disaster management (ꭓ2=5.507, p=0.019). However, there was a low correlation (r=0.140, p=0.129) between emergency procedure status and disaster management familiarity. Conclusion Emergency preparedness is crucial for life-saving in disasters. The availability of emergency services and skills related to emergency preparedness and disaster management are crucial for saving lives in emergency conditions. The hospital should provide emergency preparedness and disaster management training to all healthcare workers. In addition, the hospital authority should perform disaster exercises/tabletop simulation exercises or drills periodically. KEY WORDS Attitude, Disaster management, Emergency preparedness, KnowledgePublication Medication Adherence to Oral Hypoglycemic Agents Among Type II Diabetic Patients and Their Clinical Outcomes with Special Reference to Fasting Blood Glucose and Glycosylated Hemoglobin Levels(Kathmandu University, 2013) Shrestha, SS; Shakya, R; Karmacharya, BM; Thapa, PABSTRACT Background Oral hypoglycemic agents (OHAs) are the major treatment for people with type 2 diabetes mellitus (DM2). However, non-adherence to OHAs remains as one of the main reasons for poor glycemic control. Objectives To assess the adherence pattern to OHAs and clinical outcomes with special reference to fasting blood glucose (FBG) level and glycosylated hemoglobin (HbA1c) levels. Methods Informed consent was obtained from patients fulfilling the criteria and from the patient party in case of incapacitated patients. Information was obtained by interviewing them and filled in the appropriate questionnaire. All the medical information of the patients was obtained from the medical case records and laboratory reports. Results OHAs had been discontinued by 25% of patients. Overall 38% had ever discontinued and/ or often missed OHAs. Intentional discontinuation of OHAs attributed for 72% of the patients, followed by forgetfulness (42.9%), carelessness (30.6%), and hypoglycemia, (24%). There were 50.50% patients who had uncontrolled FBG (>130 mg/dl) level and 39% had uncontrolled HbA1c (≥ 7%) level. Taking reference age group 51-60 years, control of FBG level was found to be statistically associated with the decreasing age group (p = 0.006, OR = 4.8) as well as increasing age group (p = 0.008, OR = 4.034). There was significant association between controlled HbA1c level and patients’ knowledge about the precautions to be taken while using OHAs (p = 0.044, OR = 4). However, there was no significant association between glycemic control and OHAs adherence. Conclusion Majority of the patients who had missed OHAs attributed it to forgetfulness. Hypoglycemia may also be one of the contributing factors for poor adherence to OHAs. However no association was found between adherence and various other factors like age groups, treatment complexity, health literacy and social or family support. KEY WORDS Adherence, diabetes, HbA1c, hypoglycemia, non-adherence