Browsing by Author "Shrestha, Ujma"
Now showing 1 - 2 of 2
Results Per Page
Sort Options
Publication Elevated Risk for Obstructive Sleep Apnea in Patients presenting for Surgeries at a Tertiary Hospital in Nepal: A STOP-BANG Questionnaire Study(Institute of Medicine, Tribhuvan University, 2025) Shrestha, Ujma; Kunwar, PrakritiAbstract: Introduction: Obstructive sleep apnea (OSA) can lead to significant perioperative risks like difficult airway management, prolonged hospital stays and increased incidence of morbidity and mortality. We aimed to estimate the proportion of surgical patients with elevated risk for OSA during pre-anesthesia checkup at a tertiary hospital in Nepal. Methods: This was a cross-sectional study which was conducted among 318 surgical patients presenting for Pre-anaesthetic checkup at PAC clinic. Two validated screening tools, the STOP-BANG questionnaire and Epworth Sleepiness Scale (ESS), were used. Data on demographics, comorbidities, and OSA risk factors were collected and analyzed. STOP-BANG score ≥3 was defined as elevated risk for OSA. Those patients who complained of daytime somnolence were further assessed for its severity with ESS. Statistical analysis was done with independent sample t-test, chi-square test and logistic regression. Results: It was found that 23.58% of the participants had elevated risk for OSA (STOP-BANG >3). The risk was significantly associated with advancing age, males, obesity, increased neck circumference, hypertension, diabetes and hyperlipidemia. A weak but significant correlation was found between ESS and STOP-BANG scores (r=0.412, p=0.045). Conclusions: Proportion of patients with elevated risk for OSA was high in our surgical population. Undiagnosed OSA can have various perioperative complications, hence, we should routinely screen patients using questionnaires like STOP-BANG.Publication Ultrasonographic Measurement of Skin to Lumbar Epidural Space Depth in Pregnant Women Undergoing Elective Cesarean Section: An Observational Study(Nepal Medical Association, 2025) Moktan, Sushila Lama; Thapa, Milan Kumar; Shrestha, Ujma; Subedi, PrabinAbstract Introduction: Neuraxial anesthesia is commonly used during cesarean delivery and is preferred for its effectiveness and minimal risks. Accurate identification of the depth of the lumbar epidural space is crucial to ensure successful block and minimize complications. However, this can be challenging in pregnant women due to physiological changes that affect the anatomy of the lumbar spine. Ultrasound is a helpful device for providing real-time visualization of the relevant anatomical structures and facilitating accurate needle insertion. In this study, we evaluated the utility of ultrasound in determining the depth from the skin to the lumbar epidural space in pregnant women undergoing elective caesarean section. Methods: This is an observational cross-section study performed after approval from Institutional Review Committee (Reference number:09062023/03). Using a curvilinear ultrasound probe, imaging of spine at lumbar third and fourth intervertebral space was performed. The measurements were performed in the sitting position with the patients' backs flexed in the parasagittal oblique and transverse median view to determine the distance from the skin to the lumbar epidural space. Results: The mean depth from the skin to the lumbar epidural space/posterior complex in the parasagittal oblique view was 46.84±7.18 mm (95% CI: 45.48-48.20), and transverse median view was 45.27±8.16mm (95% CI: 43.73-46.81). Conclusions: The skin-to-lumbar epidural space depth in pregnant women undergoing elective cesarean section was comparable to other studies conducted in similar settings.