Browsing by Author "Thapa, B"
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Publication Adolescent Health Risk and Behavior Survey: A School Based Survey in Central Nepal(Kathmandu University, 2017) Thapa, B; Powell, J; Yi, J; McGee, J; Landis, J; Rein, L; Kim, S; Shrestha, S; Karmacharya, BABSTRACT Background A comprehensive study of adolescent health risk specific to the Dhulikhel catchment area has not been performed. Objective This survey assesses trends in demographics, nutrition, hygiene and related infrastructure, causes of injury, violence, mental health, substance abuse, and menstrual hygiene. Method A 40 question survey was adapted from the Center for Disease Control (CDC) Youth Risk Behavior Surveillance System, translated into the Nepali language, and administered to 1200 students in eight different schools in central Nepal. Descriptive statistics were used to summarize the data. Result The data has identified nutrition, infrastructure, mental health, and menstrual hygiene as areas for improvement. The number of adolescents who reported going hungry some, most, or all of the time (30.5%, 25.8%, 13.9%) reveals a need for better food access. Approximately 44.5 % of students had no access to soap and water at school. Students who endorse dissatisfaction with themselves was 6.5% and those with suicidal ideation or attempt was 11.8% of the surveyed population. A significantly greater percentage of students who reported suicidal ideation also reported engaging in behaviors related to physical violence, substance abuse, being dissatisfaction with themselves, insomnia due to anxiety, and loneliness. Of the female students, 40.1% reported missing school at least once in the last three months due to their period. Conclusion This data shows a need for better food access, improved infrastructure in schools in central Nepal, and the need to address the prevalence of mental health issues through program interventions. KEY WORDS Adolescent health, School health, SurveyPublication Emerging trends of nosocomial Citrobacter species surgical wound infection: concern for infection control(Society of Dermatologists, Venereologists and Leprologists of Nepal (SODVELON), 2010) Thapa, B; Karn, D; Mahat, KAbstract Background Surgical wound infection is a common problem among patients who undergo operation. Several factors play important role in this infection process including endemic nosocomial infection without proper infection control measures. Objectives To study the occurrence of the pathogens in post-operative wound infections, their antibiotic resistance patterns, and comparison with published reports. Methods Various specimens obtained from the surgical wound during a period of four months were processed for bacteriological culture in the Department of Microbiology, Kathmandu Medical College, Kathmandu. Antibiotic susceptibility test was performed by Kirby-Bauer disk diffusion test for pathogens isolated. The relevant literatures were searched and compared with the present study. Results Among 79 culture positive cultures, Citrobacter sp. (n=23) was most frequently isolated from surgical wound infection. Twenty strains were multidrug resistant. In comparison with other studies, this study highlights the emergence multi-drug resistant Citrobacter sp. as a leading cause of surgical wound infection. E. coli, Staphylococcus aureus, Acinetobacter sp., Klebsiella pneumoniae, Pseudomonas aeruginosa, Proteus sp., and Enterobacter sp. were also isolated from 19, 13, 10, 8, 2, 2, and 2 cultures, respectively. More than 50% of these pathogens were resistant to most of the β-lactam antibiotics tested and most of them were multi-drug resistant while these pathogens showed variable level of resistance to fluroquinolones and amino glycosides. Conclusion The frequent isolation of multi-drug resistant nosocomial strains of Citrobacter sp. in surgical wound infection is a remarkable trend. This pathogen and their resistant genes could be endemic to the institution and can cause difficult-to-treat infection if infection control committee is not revitalized and infection control strategies are not implemented. Key words Citrobacter sp.; Multi-drug resistant; surgical wound infection.Publication Evaluation of fine needle aspiration cytology of lymph nodes in Kathmandu Medical College, Teaching hospital(Kathmandu University, 2009) Hirachand, S; Lakhey, M; Akhter, J; Thapa, BAbstract Background: Fine Needle Aspiration Cytology (FNAC) is a simple and rapid diagnostic technique. Because of early availability of results, simplicity, minimal trauma and complications, the aspiration cytology is now considered a valuable diagnostic aid and is part and parcel of a pathologist’s repertoire. Objectives: The aim of the study was to evaluate the results of fine needle aspiration cytology (FNAC) of lymph nodes in our institution in comparison to result of histopathology. Materials and methods: The present study on 130 patients of lymphadenopathy was conducted in the Department of Pathology Kathmandu Medical College Teaching hospital, Kathmandu from June 2006 to May 2008 (2 years). Results: In this series of FNAC cervical lymph nodes were 66 (50.76%), and axillary lymph nodes were 20 (15.38%). Male to female ratio of the patients was 1: 0.9. Th age of patients ranged from 3 to 85 years. FNAC diagnosis was found to be as follows : reactive hyperplasia 54( 41.55%), tubercular lymphadenitis 36 (28 %), metastatic carcinoma 16 (12.3%), granulomatous lymphadenitis 12 ( 9.2 % ), lymphoma 8 (6%) and suppurative lymphadenitis 4(3%) . Out of 28 cases of FNAC 26 (92.85%) were consistent with histopathological diagnosis of tubercular lymphadenitis. In metastatic carcinoma to lymph nodes sensitivity and specificity of FNAC were 100% each. Conclusion: FNAC is useful and reliable in diagnosing neoplastic and non- neoplastic lesions of lymph nodes. It helps in planning surgery for malignant cases, where definitive operative intervention can be performed in one session. Key words: FNAC, lymphadenopathy.Publication Factors Influencing Brain Drain among Nepalese Nurses(Kathmandu University, 2017) Thapa, B; Shrestha, KABSTRACT Background Brain drain means migration of technically skilled people from one country to another country. Migration of health workers including nurses are the result of interplay of many push and pull factors. Push factors are those conditions that influence the nurses’ decision to leave their own country. Conversely, pull factors are those conditions in a given country that attract nurses, influencing their movement to that country. Objective The objective of this study was to identify push and pull factors of brain drain among the Nepalese nurses. Method Descriptive cross sectional study was done among 228 Nepalese nurses working in five different countries in 2016 by using quota sampling technique. A self administered questionnaire consisting of structured four-point Likert scale was designed to collect information on push and pull factors of brain drain. Descriptive and inferential statistics were computed using SPSS version 16. Result Many of brain drained nurses had ranked very important push factor was personal ambition (72.8%) and very important pull factor was better job and career opportunity (77.2%). Majority of nurses working in Nepal had ranked very important push factor was lack of job and career opportunity (86.0%) and pull factor was better job and career opportunity (85.1%). All push and pull factors were significantly associated with brain drain. Conclusion Most of the Nepalese nurses were forced to go abroad due to personal ambition, followed by low salary, and lack of job and career opportunity. Nurse migration out of Nepal is likely to persist and even increase if underlying factors aren’t properly resolved. KEY WORDS Brain drain, nurses, pull factors, push factors