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 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, Ultrasound