Browsing by Author "Sijapati, Milesh Jung"
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Publication A brief narrative on work-related asthma (WRA)(Nepalese Respiratory Society, 2022) Piryani, Rano Mal; Piryani, Suneel; Sijapati, Milesh JungAbstract: Work related asthma (WRA) is caused by exposure at work known as occupational asthma (OA) or exacerbated or aggravated by exposure at workplace known as work-exacerbated asthma (WEA) or work-aggravated asthma (WAA). Worldwide, WRA remains under detected and undermanaged. Failure to detect or treat WRA leads to increased healthcare cost, morbidity and mortality. The diagnostic work-up includes clinical history and detailed occupational history, assessment of the causative agent and the objective measurements. Del Roio LC et al (2020) have developed algorithm for the diagnosis of WRA with three primary diagnostic criteria and five additional criteria. Better knowledge and understanding of clinicians and other healthcare providers about WRA is vital for early consideration of WRA diagnosis among adult patients with asthma. While Optimum awareness of general public about WRA may possibly help in initiating discussion by affected workers with their healthcare service providers. The primary prevention includes reducing the burden of WRA by evading the use of potential sensitizers and restricting their exposure and limiting to workplace asthma triggers when their use cannot be avoided.Publication Antibiotics Use in Hospitalised COVID-19 Patients in a Tertiary Care Centre: A Descriptive Cross-sectional Study(Nepal Medical Association, 2022) Thapa, Bibechan; Pathak, Samyam Bickram; Jha, Nisha; Sijapati, Milesh Jung; Shankar, Pathiyil RaviAbstract Introduction: Antimicrobial resistance is a global health problem. The widespread and improper antibiotics use is the leading cause of antimicrobial resistance. Bacterial co-infection in COVID-19 patients is the basis for the use of antibiotics in the management of COVID-19. COVID-19 pandemic has seriously impacted antibiotic stewardship and increased the global usage of antibiotics, worsening the antimicrobial resistance problem. The use of antibiotics among COVID-19 patients is high but there are limited studies in the context of Nepal. This study aimed to find out the prevalence of antibiotic use among hospitalised COVID-19 patients in a tertiary care centre. Methods: A descriptive cross-sectional study was conducted on hospitalised COVID-19 patients from April 2021 to June 2021 in a tertiary care centre. Ethical approval was taken from the Institutional Review Committee (Reference number: 2078/79/05). The hospital data were collected in the proforma by reviewing the patient’s medical records during the study period of 2 months. Convenience sampling was used. Point estimate and 95% Confidence Interval were calculated. Results: Among 106 hospitalised COVID-19 patients, the prevalence of antibiotic use was 104 (98.11%) (95.52-100, 95% Confidence Interval). About 74 (71.15%) of patients received multiple antibiotics. The most common classes of antibiotics used were cephalosporins, seen in 85 (81.73%) and macrolides, seen in 57 (54.81%) patients. Conclusions: The prevalence of antibiotic use among hospitalised COVID-19 patients was found to be higher when compared to other studies conducted in similar settings.Publication Asthma care during pregnancy in South Asia(Nepalese Respiratory Society, 2023) Piryani, Rano Mal; Piryani, Suneel; Sijapati, Milesh Jung; Karthak, AshishAbstract: Bronchial asthma is among the commonest chronic inflammatory respiratory diseases affecting women of reproductive age group. Adequate attention has not been given to the diagnosis and the management of asthma in countries of South Asia. Management of asthma in pregnant women is more or less same as that of in non-pregnant women and stepwise approach is recommended. To confirm the diagnosis of asthma during pregnancy, spirometry can be used. Patients suffering from very severe asthma or difficult-to control asthma are more prone to develop exacerbations during pregnancy needs hospitalization for care. Well-controlled asthma during pregnancy prevents complications of pregnancy and results in better pregnancy outcomes. It better to follow the guidelines for management of asthma during pregnancy. The pregnant women must be educated regarding the care of asthma during pregnancy, delivery, in postpartum period and thereafter.Publication Awareness of community about sound sleep, sleep disorders and its implications: a step towards sleep health(Nepalese Respiratory Society, 2022) Piryani, Rano Mal; Piryani, Suneel; Sijapati, Milesh JungAbstract: Sleep is a naturally cyclical state of the mind and body. It plays an indispensable role in sustaining the good health of an individual. Inadequate and poor-quality sleep upsets the people of all ages leading to widespread impact on the body and mind. Insufficient sleep can be due either to medical conditions or mental health disorders or sleep disorders. Worldwide, 30%-35% of adults are suffering from insomnia, and about 10% of the population fits in diagnostic criteria for sleep disorders. From 8 countries across Asia and Africa, 17% people reported trouble with their sleep. People have poor knowledge and awareness about the sleep disorders. There is scarcity of trained healthcare professionals and workers in sleep medicine in South Asia; trained and experienced health professionals need to enhance the services of sleep medicine to meet the needs of their population. Creating awareness among the public about sleep and sleep disorders is one of the step towards Sleep Health. It is recommended to the policy makers of countries of South Asia to develop National Sleep Health Policy to address the issue of Sleep Health as lack of sleep or inadequate sleep both in quantity and quality will have impacts on health of the people and consequently economy of the country.Publication Challenges of Diagnosis and Treatment of ANCA Associated Vasculitis in COVID-19 Pandemic - A Case Report(Nepalese Respiratory Society, 2022) Sharma, Prayush; Sijapati, Milesh Jung; Gautam, Santosh; Kandel, Ramesh; Simkhada, Suman; Regmi, Sneha BandhuAbstract: As COVID-19 pandemic is spreading worldwide with high infectivity rates of various strains, it is also challenging our healthcare system with its respiratory complications, and limited availability of healthcare providers. On the other hand, a huge vaccination program against COVID-19 is being conducted throughout the world. This viral infection and vaccination program has also brought into account the controversies of some neurological and autoimmune complications. Although the exact mechanism of these complications is still unknown, some autoimmune mechanisms have been predicted. These complications may further challenge the management of this novel viral infection. One of the rare complications of COVID-19 infection and its vaccination is de novo development or flare of ANCA-associated vasculitis, which has also been found in many recent case reports.Publication GLP-1 Receptor Agonists in Obstructive Sleep Apnea: New fronteirs in Metabolic and Respiratory Medicine(Nepalese Respiratory Society, 2024) Sijapati, Milesh JungNAPublication Impact of wildland fire smoke: Concern for Clinicians Worldwide(Nepalese Respiratory Society, 2023) Sijapati, Milesh JungNAPublication Launching a New Journal in Era of Evidence based medicine(Nepalese Respiratory Society, 2022) Sijapati, Milesh JungNAPublication New Updated GOLD 2023 guidelines: Insights, Implications and future Directives for Clinicians Authors(Nepalese Respiratory Society, 2023) Sijapati, Milesh JungNA