Browsing by Author "Shrestha, U"
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Publication Cytogenetic analysis of children with suspected genetic disorder(Kathmandu University, 2009) Shrestha, U; Bhattacharya, S; Bhatta, NK; Jha, CBAbstract Objectives: To analyze chromosomes in children with suspected genetic disorder and to categorize the chromosomal basis of genetic disorder Materials and methods: Thirty children were selected from the patients attending genetic clinic, Department of Pediatrics, B.P. Koirala Institute of Health Sciences presenting with dysmorphic feature, mental retardation, short stature, congenital malformations and ambiguous genitalia with age between 0-15 years. Cytogenetic analysis was carried using standard peripheral blood lymphocyte culture method and G-banding technique in Cytogenetic laboratory of Department of Anatomy, B.P. Koirala Institute of Health Sciences. Results: Chromosomal disorders were identified in 33.34% (10) of children. The most common chromosomal abnormality was Down syndrome (26.67%) followed by Turner syndrome (6.67%). Conclusion: The cytogenetic analysis of children with suspected chromosomal aberration is important to uncover the contribution of chromosomal disorder in genesis of dysmorphisms, mental retardation, short stature, sexual ambiguity and congenital malformation in children and prevent further potentially unpleasant investigation being undertaken. Key words: Chromosome, suspected genetic disorder, dysmorphic feature, mental retardation, short stature, congenital malformations, ambiguous genitaliaPublication Drug Utilization Study in Outpatient Department of Ophthalmology in Tertiary Care Hospital(Kathmandu University, 2022) Shrestha, U; Shakya Shrestha, S; Shrestha, A; Poudel, U; Manandhar Shrestha, JTABSTRACT Background The advancement in drug development and availability of newer drugs has improved overall health services including decrease in mortality and hospital stay. Along, it has brought negative impacts such as polypharmacy and associated adverse drug reactions and antimicrobial resistance. Drug utilization research is an essential approach to understand the drug use pattern, identify the early signs of such irrational drug use and to improve quality of drug use. Objective To study the drug utilization pattern in the Ophthalmology Outpatient department (OPD) of Dhulikhel Hospital, Kathmandu University Hospital (DH-KUH). Method A descriptive, cross sectional study was conducted from March 2019 to August 2019 in patients attending OPD of Ophthalmology in Dhulikhel Hospital, Kathmandu University Hospital. Prescriptions of 311 patients were analyzed using World Health Organization (WHO) International Network of Rational Use of Drug (INRUD) and additional other indices. The descriptive data was presented in mean and standard deviation. Result The average number of drugs per prescription was 2.10±1.35. Out of total 311 prescriptions, drugs prescribed in generic name were 152 (23.30%). Total antibiotics encountered were 247 (37.90%) and total drugs prescribed from National Essential Medicine List (NEML) were 371 (56.90%). Antibiotics 247 (37.90%) were the most commonly prescribed drugs followed by lubricants 146 (22.40%). Conclusion Practice of polypharmacy was very high. Most of the drugs were prescribed in brand names and antibiotics were the most frequently used drugs. KEY WORDS Drug utilization, Ophthalmology OPD, Rational drug use, WHO-INRUDPublication Indications of Cesarean Section in a rural referral Hospital(Institute of Medicine, 2018) Aryal, B; Shrestha, UAbstract Introduction: There is a huge difference in cesarean section rate between rural (3.5%) and urban (15%) areas of Nepal. The national CS rate is around 5% whereas global CS rate is 26%. The objective of this study is to find out the delivery profile and rate and indications of CS in a rural university hospital. Methods: This is a three -year’s retrospective cross-sectional study done from January 2016 to January 2019 (Magh 2072 to Poush 2075) at Karnali Academy of Health Sciences, Jumla. The data was retrieved from hospital birth profile records and analyzed using SPSS 20. Permission was taken from Institutional review committee (IRC) to conduct the study. Results: Total number of delivery during this period was 1841 out of which 172 were Cesarean delivery giving a CS rate of 9.3%. The most common indication of CS were fetal distress (33.7%), previous CS (9.3%), failed induction of labor (9.3%). Non progress of Labor (8.1%) and post term pregnancy (8.1%). Majority of the CS were done as an emergency procedure. Conclusion: The CS rate at KAHS teaching hospital was within WHO recommendation of between 5-15% and was very low in comparison to other centers situated in urban areas of the country. The indications of CS was also similar to the other national and international statistics. Key words: Cesarean section, Indications, Nepal, Maternal health, rural area, Global trendsPublication Knowledge and Attitude of Undergraduate Students on Use of Topical Corticosteroids in a Medical School in Nepal: A cross-sectional study(Kathmandu University, 2025) Shrestha, U; Shakya Shrestha, S; Shrestha Manandhar, JT; Shrestha, RABSTRACT Background Topical corticosteroids are widely used for their anti-inflammatory and immunosuppressive properties. However, proper knowledge of health professionals is key to appropriate and rational use of such topical corticosteroids to minimize multitude of their adverse effects. Objective To study knowledge and attitude of medical students regarding use of topical corticosteroid use. Method A cross-sectional study was conducted from September 2024 - November 2024, among the undergraduate students of Kathmandu University, School of Medical Sciences. A total of 387 students were included in the study. The students were surveyed using a structured questionnaire. Statistical analysis was performed using Statistical Package for Social Science version 21. Result Among 387 participants 217 (44.2%) were male and 171 (55.8%) were female. The mean (± SD) age of the patients was 21.73 years (± 2.06). The highest number of participants - 258 (66.7%) - were aware about atopic dermatitis as the most common indication of topical corticosteroids. Majority of the participants - 350 (90.4%) agreed that topical corticosteroids can cause cutaneous adverse effects. Similarly most of the participants 324 (83.7%) agreed that topical corticosteroids can produce systemic adverse effects as well. Likewise, most of the participants, 287 (74.2%), were aware of the fact that treatment with topical corticosteroids should not be stopped abruptly or without medical guidance. Conclusion Majority of the students had reasonable knowledge and attitude towards the use of Topical corticosteroids. However more than half were unaware of some topical adverse effects of Topical corticosteroids. Adequate educational training should be provided to future doctors regarding proper prescribing and usage of topical corticosteroids. KEY WORDS Adverse effects, Attitude, Knowledge, Medical students, Topical corticosteroidsPublication Multiple arterial anomalies in upper limb(Kathmandu University, 2009) Baral, P; Vijayabhaskar, P; Roy, S; Kumar, S; Ghimire, S; Shrestha, UAbstract An isolated neurovascular variation is common but multiple vascular anomalies on same upper limb is a very rare case. We observed an unusual variations in right upper limb during routine dissection of a Nepali cadaver . The variations were observed in Axilla, Forearm and Palm. In axilla, first part of axillary artery did not give any branch, the second part of axillary artery gave off only two branches - (a) thoracoacromial artery and (b) a large common trunk which later gave off lateral thoracic, thoracodorsal, subscapular, posterior circumflex scapular and then continued as posterior circumflex humeral artery. The third part of axillary artery gave off only anterior circumflex humeral artery. In forearm, the ulnar artery runs downward superficial to flexor muscles. Here, radial artery gave off common interosseous artery. In palm radial artery did not give any contribution to superficial palmar arch which is solely formed by the continuation of ulnar artery. This type of anomalies are very rare and is not reported in Nepalese cadaver at all. These anomalies are described in detail and their clinical relevance is highlighted. Key words : Axillary artery, Brachial artery, Radial artery, Ulnar artery, Palmar arch, VariationsPublication Perceptions and Attitudes towards Evidence Based Practice among Nurses and Nursing Students in Nepal(Kathmandu University, 2015) Karki, S; Acharya, R; Budhwani, H; Shrestha, P; Chalise, P; Shrestha, U; Gautam, K; Wilson, LABSTRACT Background As the evidence based practice (EBP) movement expands, there is a need for health leaders and educators in each country to assess the extent to which health professional students and practitioners are prepared to locate, evaluate, and apply evidence to guide their practice. Objective The study objective was to explore nurses’ and nursing students’ perceptions and attitudes towards EBP. Method This was a descriptive cross-sectional survey administered to all 273 nurses and nursing students from Nepal who attended an EBP conference. The survey instrument that was used by Majid in Singapore was adapted for use in this study with permission from the author. Result In total, 121 nurses participated in the study. The majority (93%) of respondents reported that they had no previous training in EBP. The respondents’ perceptions of their EBP knowledge and skills were variable, but most of them demonstrated positive attitudes toward EBP. Respondents identified a number of barriers that limit the implementation of EBP in Nepal. The greatest barriers were lack of time and resources, difficulty understanding research articles and translating the findings to practice, and limited autonomy to change practice based on evidence. Conclusion Although respondents had positive attitudes towards EBP, their knowledge and skills were limited and barriers to implementation existed. Nursing faculty can use the findings to guide implementation of EBP into curricula, and nursing administrators and clinicians can use the findings to guide practice to promote EBP. KEY WORDS Evidence-based nursing, evidence-based practice, nursing researchPublication Study on Patient’s Perception on Medication Counseling at Community Pharmacy in Sub-urban Area of Nepal(Kathmandu University, 2022) Shrestha, U; Koju Shrestha, R; Biswokarma, AK; Koju, P; Shrestha, S; Shakya Shrestha, SABSTRACT Background Community pharmacists are the primary contact point in a healthcare system who provide medication information to the patients and enable them to make appropriate decision regarding their therapy. Hence, this study explored patients’ perception of community pharmacist based on medication counseling. Objective To study patient’s perception on medication counseling by community pharmacist at Manohara Municipality, Kathmandu, Nepal Method A cross sectional study was conducted from November 2020 to April 2021 in population visiting pharmacies of Kageshwori Manohara Municipality of Kathmandu valley. A total of 384 participants included in the study were surveyed using a structured questionnaire exploring the content of medication counseling, level of satisfaction on counseling and use of various means of counseling. Descriptive data were presented in frequencies and percentages using EXCEL 2016. Result This study enrolled 384 participants out of which 354, 92.19% received medication counseling. The main reason of pharmacy visit was to obtain over the counter medicines, 262, 68.23%. Majority of the participants rated satisfied with informations provided on use of medication 218, 56.77%, duration of therapy 261, 67.97%, about side effects 211, 54.95% and on action to be taken following side effects 246, 64.06%. Most of the participants rated satisfied with counseling on storage 189, 49.22% and for referral 250, 65.10% while 201, 52.34% participants rated highly satisfied with advice on lifestyle and dietary changes required. Conclusion This study concludes that the patients’ perception regarding the medication counseling by community pharmacist was acceptable. Thus pharmacists should be encouraged to support patients with their medication to promote patient care. KEY WORDS Community pharmacy, Medication counseling, Patient perceptionPublication Ultrasound Guided Stellate Ganglion Block with Dexmedetomidine as an Adjuvant in Complex Regional Pain Syndrome (CRPS)(Kathmandu University, 2021) Shrestha, BR; Lama, S; Shrestha, UABSTRACT This is a case report of successful use of ultrasound for stellate ganglion (SG) blocks in CRPS I in 11 patients using local anesthetic bupivacaine with injection dexmedetomidine as an adjunct. Ultrasound helped us to deposit Local anesthetics in target area without any noticeable side effects and trauma to adjacent structures. KEY WORDS Block, Complex regional pain syndrome, Dexmedetomidine, Stellate ganglion, UltrasoundPublication Utilization and Completeness of World Health Organization Surgical Safety Checklist in a Tertiary Hospital in Nepal(Kathmandu University, 2025) Shrestha, U; Ghimire, P; Khatri, GABSTRACT Background The World Health Organization Surgical Safety Checklist (WHO-SSC) reduces surgical complications and morbidity; however, its utilization remains low in low- and middle- income countries. Objective To assess the utilization and completeness of a modified WHO Surgical Safety Checklist at a tertiary hospital in Nepal. Method A descriptive, observational cross-sectional study was conducted in 300 surgeries at Kathmandu Medical College Teaching Hospital (February to May 2024) following ethical clearance. Utilization and completeness of the modified WHO Surgical Safety Checklist (Pre-procedure check, Sign-in, Time-out, Sign-out) were observed passively. Data were analyzed using Microsoft Excel and SPSS v 20. Data were presented in numbers and percentages and Chi-square/ Fisher’s exact test used for categorical variables. A p-value of < 0.05 was considered significant. Result WHO Surgical Safety Checklist was utilized in 48.7% of cases, with full compliance in only 8.7%. Utilization rate was seen to be 63% in the Pre-procedure check, while Sign-out was the least performed (29.3%). Highest utilization was seen in the General Surgery department, while the highest completion rate was seen in Neurosurgery (100%). Verbal confirmation (70.2%) was done more than written documentation. Conclusion Despite proven benefits, adherence to WHO Surgical Safety Checklist remains suboptimal. Targeted training and regular audits are essential to improve compliance and patient safety in resource-limited settings. KEY WORDS Completeness, Compliance, Utilization, WHO surgical safety checklist