Browsing by Author "Subedi, Bhusan Kumar"
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Publication A Quality Improvement Initiative to Shorten the Duration of Hospital stay of Preterm / Low Birth Weight Babies with Special Focus on Infant and Family Centered Developmental care(Perinatal Society of Nepal (PESON), 2025) Twanabasu, Sajal; Subedi, Bhusan Kumar; Homagain, Sushan; Maskey, Sujina; Shrestha, Anjana; Shrestha, KritiAbstract: Introduction: Infant and family-centered developmental care (IFCDC) incorporates neurodevelopment, parental involvement, parent-infant bonding, and enabling sensory environment. The focus is on minimizing the separation between child and parents and ensuring parental involvement in the care of babies right after birth. This not only helps in optimal neurodevelopmental outcomes but also early discharge of preterm babies as parents will be confident in taking care of their preterm, low birth weight (LBW) babies. IFCDC is not adopted by most neonatal units in Nepal. Aim statement: To reduce the duration of hospital stay of preterm/LBW babies from 10.5 days to 8 days (20% reduction) with a special focus on infant and family-centered developmental care. Methods: This is a hospital-based quality improvement project conducted at a 50-bed governmental district hospital located at a rural setup outside Kathmandu valley in Bagmati province of Nepal. Baseline data on infant length of stay (LOS) was evaluated using the hospital records. Problems were identified using a fishbone diagram. Process and outcome indicators were formulated and analyzed. Multiple Plan-Do-Study-Act (PDSA) cycles were conducted to achieve the desired target. Results: The average duration of the hospital stay was reduced from the pre-intervention period of 10.5 days to 8 days after incorporating IFCDC which persisted during the post-intervention of 4 weeks. Conclusion: Our study has shown that the duration of hospital stay of preterm babies is reduced when IFCDC is adopted. IFCDC is a win-win approach and needs to be adopted in all the neonatal units across the country.Publication Association between Serum Uric Acid Levels and Stroke Severity inAcute Ischemic Stroke: A Cross-Sectional Study(Nepal APF Hospital, 2026) Sah, Dayanand Prasad; Shah, Santosh Prasad; Subedi, Bhusan Kumar; Khatri, Ganga Ram; Poudyal, Himani; Sah, Muneshwar; Bastola, Basanta Kumar; Gaire, PrabinAbstract: Background: Ischemic stroke (IS) represents a significant global health burden, with multiple established risk factors. Studies have suggested a potential link between serum uric acid (SUA) levels and stroke risk. Some studies propose that elevated SUA may contribute to the pathophysiology of stroke through mechanisms such as oxidative stress and inflammation. This study explore the association between SUA and the incidence of acute ischemic stroke, taking into account confounding variables such as age, sex, comorbidities, lifestyles pattern. Methods: The hospital based cross sectional observational study conducted with sample size of 95 including patients of either sex above the age of 18 years with acute ischemic stroke within 7 days of presentation and confirmed by neuroimaging. The study excluded patients with hemorrhagic stroke, known malignancies, chemotherapy, recent surgery, trauma, or drugs affecting SUA level. SUA levels and National Institutes of Health Stroke Scale (NIHS score) were calculated to assess stroke severity. Results: The study found a higher incidence of stroke among males (56%), with smoking being the most common risk factor (64%) followed by hypertension (54%). The study found that 86.32% of patients had serum uric acid levels below 6.8mg/dl, while 13.68% had levels above 6.8mg/dl. Patients with low uric acid levels were seen having a higher risk of stroke as the severity of stroke was highest among those with serum uric acid levels (4.0-5.0 mg/dl) however there found statistically not significant association between serum uric acid level and NIHSS (p=0.52). Conclusion: The mean serum uric acid was 5.19 mg/dl (SD 1.48) and mean NIHSS was 11.24 (SD 3.9). There is no correlation between Serum uric acid and severity of ischemic stroke by NIHSS(p=0.52).Publication Vaccination Against Mumps, Aren’t We Late Already?(Nepal Medical Association, 2024) Twanabasu, Sajal; Homagain, Sushan; Tuladhar, Sucharita; Maskey, Sujina; Mahaseth, Ashika; Subedi, Bhusan Kumar; Regmi, DineshAbstract Mumps is a highly contagious viral infection caused by paramyxovirus. It usually presents with fever and parotid gland swelling. It may be associated with complications like aseptic meningitis, encephalitis, oophoritis, orchitis, pancreatitis. The incidence of mumps infection is increasing in Nepal. This paper aims to advocate for the introduction of vaccination against mumps in the national immunization schedule.