Browsing by Author "Singh, N"
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Publication Knowledge, Attitude and Practice in Recurrent Shoulder Dislocation: an analysis of patients presenting at a tertiary referral centre(Kathmandu University, 2023) Joshi, A; Gurung, S; Basukala, B; Rijal, N; Sharma, R; Bista, R; Singh, N; Pradhan, IABSTRACT Background Early diagnosis and treatment of recurrent shoulder dislocation are crucial to avoid complications associated with multiple dislocations. Little is known about knowledge, attitude, and practice of recurrent shoulder dislocation among patients. Objective To assess the knowledge, attitude, and practice among patients regarding recurrent shoulder dislocation. Method A retrospective study of prospectively collected data from December 2019 to November 2022 among patients seeking treatment for recurrent shoulder dislocation at a tertiary care centre was conducted. A 16-item questionnaire, including 5 items regarding patients’ knowledge, 2 items regarding attitude, and 2 items regarding practice on recurrent shoulder dislocation, was devised and responses were recorded. Continuous data were reported as mean ± standard deviation and categorical data were reported as number (percentage). Comparative analysis was done using student t-test. Result A total of 220 patients completed the questionnaire. Out of 220, 159 (72.27%) were not informed about recurrence after first dislocation, 146 (66.36%) felt that they were not properly counselled regarding treatment, and 172 (78.18%) responded that they did not know that recurrent shoulder dislocation can be treated. Among 220 patients, 171 (77.73%) responded that their quality of life was affected by recurrent shoulder dislocation, and first dislocation was relocated by doctors in 116 (52.73%), self in 78 (35.45%), and relatives in 26 (11.82%). The number of dislocations was significantly higher among patients who did not visit the hospital after their first dislocation. Conclusion Majority of the patients have positive attitude, but poor knowledge and practice regarding recurrent shoulder dislocation. The findings would be useful for planning strategies to improve patients counselling regarding recurrent shoulder dislocation. KEY WORDS Knowledge gap, Practice gap, Recurrent shoulder dislocationPublication Nuchal cord and perinatal outcome(Kathmandu University, 2007) Shrestha, NS; Singh, NObjective: to find out the incidence of nuchal cord at delivery, intrapartum complication and perinatal outcomes in the cases with nuchal cord. Materials and methods: A prospective, cross-sectional, comparative study done at Kathmandu Medical College Teaching Hospital (KMCTH) between March 2006 to September 2006. Total 512 deliveries occurred during this period that were enrolled in the study and were analyzed for presence of nuchal cord at the time of delivery, number of coils whether loose or tight, intrapartum complications and perinatal outcome. The cases with nuchal cord at the time of delivery were taken as study group and the cases without nuchal cord served as control group. Outcome variables between the two groups were compared. Outcome variables used were meconium staining of liquor, rate of instrumental and caesarean delivery, intrapartum fetal heart rate (FHR) irregularities. As a measure of perinatal outcome Apgar score < 7at 1 minute and 5 minutes and incidence of neonatal unit admission was taken. Results: Incidence of nuchal cord at the time of delivery was 22.85%. Incidence of single nuchal cord was highest (18.95%). Intrapartum complications like FHR irregularities and meconium staining of liquor were increased in nuchal cord group but statistically not significant. Instrumental delivery rate was high in nuchal cord group but statistically not significant (0.108). However, caesarean section rate was high in the group without nuchal cord (p=0.029). Apgar score < 7 at 1 minute was significantly low in nuchal cord group (p=0.010) but apgar score at 5 minutes and admission to neonatal unit was not more common. Conclusion: Nuchal cord is not associated with adverse perinatal outcome.Publication Participant’s Knowledge and Perception of Health Research Methodology before and after a Hands-on Workshop in a Medical College in Lalitpur, Nepal(Kathmandu University, 2023) Jha, N; Dhakal, AK; Singh, N; Pandey, S; Mukhia, R; Acharya, G; Bajracharya, S; Sharma, MR; Shankar, PRABSTRACT Background The basic principles of research methodology are very important for the successful conduct of research. Objective To evaluate the knowledge and perceptions before and after a three-day workshop on health research methodologies conducted at a medical college in Lalitpur, Nepal. Method The pre-post study was conducted during the workshop. There were 31 participants comprising of doctors (interns and residents), medical officers and dental surgeons and faculties. A questionnaire containing two sections related to various themes of the workshop was developed to measure the respondents’ knowledge and perception of different concepts. Feedback regarding each session was also obtained. The median knowledge and perception scores before and after the workshop were compared using appropriate statistical tests (p < 0.05). Result More than half of the participants, [18 (58.1%)] were of 20-30 years of age. The total knowledge scores improved significantly after the workshop. The increase in the perception scores after the workshop was also significant. Feedback was positive. The highest feedback score was for the session on critical analysis of a published article. Conclusion Knowledge and perceptions increased significantly indicating such workshops can be effective and contribute to the capacity building of the early-stage researchers. KEY WORDS Ethics, Medical research, PublicationPublication Simple Oncoplastic Breast Conserving Surgery for Breast Cancer in a University Hospital(Kathmandu University, 2023) Khanal, S; Singh, N; Singh, YPABSTRACT Background The principle of oncoplastic surgery is the removal of tumors with negative margins as well as maintaining the contour of the breast. The goals are to achieve local control and best cosmesis. Objective The objective of this study was to assess patients’ satisfaction with different techniques of simple oncoplastic breast conserving surgery (BCS) for early breast cancer. Method This was a retrospective study of early breast cancer cases operated during the period 2009 to 2017. All the patients were under regular follow up for at least five years after surgery. Original Harvard/NSABP/RTOG scale was used to evaluate cosmesis at one year after surgery. Result Median age of the patients was 43 years with median size of tumor being 2.5 cm. All of the patients had good to excellent cosmetic outcome. One patient (4.5%) had margin positivity. All patients were disease free and happy with the cosmesis at five years although one patient did not have whole breast radiotherapy. Conclusion Simple oncoplastic breast conserving surgery techniques in upper part of breast are simple, feasible and improve cosmetic outcome with low margin positivity and good disease-free five-year survival. KEY WORDS Breast cancer, Breast conserving surgery, Mammaplasty