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Knowledge and Practice on Over-the-Counter Medicines among Undergraduate Nursing Students of Rapti Academy of Health Sciences, Ghorahi, Dang
(Rapti Academy of Health Sciences (RAHS), 2025) Yogi, Ishu; Sharma, Sharmila; Dhital, Puja Sharma; Belbase, Geeta
Abstract: Introduction: OTC Medications are those medications that can be obtained over the counter without prescription. OTC medicines is not always safe, as it may be related to incorrect self-diagnosis. Methods: This study's primary goals were to evaluate participants' knowledge and practice of over-the-counter medications, among undergraduate nursing students of Rapti Academy of Health Sciences in which descriptive cross-sectional study design was utilized among 116 nursing undergraduates pursuing a Bachelor of Science in Nursing (BSc Nursing) and Bachelor of Nursing Science (BN). The study area was chosen using a non-probability purposive sampling technique, and the respondents were chosen using an enumerative sampling technique. A structured questionnaire and self-administered technique was utilized for data collection and data analysis was done by utilizing SPSS 20.0 version. Results: Larger part of respondents belongs to age group 18 to 26 years with Mean ±SD=21.92±3.992. More than fifty percent (68.1 %) respondents had adequate knowledge and more than one third (31.9%) had inadequate knowledge and more than fifty percent (52.2%) had inappropriate practice and less than fifty percent (44.8%) had appropriate practice. Result showed that there was significant association between level of knowledge and age group, marital status and level of students. There was no significant association between level of practice and independent variables and between level of knowledge and level of practice. Conclusion: Level of knowledge is appropriate but level of practice is inappropriate. There is need of making aware to the respondents about practicing OTC medicines.
Pulmonary Tuberculosis and its Associated Factors among HIV Positive Individuals attending Antiretroviral Therapy Clinic of Tertiary Care hospital in Ghorahi, Dang
(Rapti Academy of Health Sciences (RAHS), 2025) Lamichhane, Bikash; Darlami, Radha; Bhattarai, Stuti
Abstract: Introduction: Human immunodeficiency virus (HIV) weakens the immune system by targeting CD4 cells. Pulmonary tuberculosis (PTB) is a bacteriologically confirmed or clinically diagnosed tuberculosis infection of the lung parenchyma or tracheobronchial tree. Prevalence of PTB is significantly high among HIV positive individuals. This study assessed the Pulmonary Tuberculosis and its associated factors among HIV positive individuals. Methods: A descriptive cross-sectional study was conducted at ART clinic of Rapti Academy of Health Sciences (RAHS). After obtaining ethical approval from the Institutional Review Committee of RAHS, records of 299 HIV positive individuals attending the ART clinic from January to December 2024 were consecutively sampled and retrieved. Data analysis was performed using the Statistical Package for the Social Sciences version 16. Results: Out of 299 HIV positive individuals, the majority (53.5%) were aged 40–59 years, with a median age of 41 years, and near-equal gender distribution. Most were Janajati (39.1%), married (69.6%), literate (73.6%), and unemployed (77.6%), with spouses of migrants (40.1%) and migrants (20.4%) being the key risk groups. Clinically, over half (51.2%) were in Stage I HIV, 94.3% had viral load testing, and 98.2% of those tested showed viral suppression. Pulmonary tuberculosis (PTB) was prevalent in 7.4% of HIV positive individuals. Among 47 individuals with other associated diseases, infections (29.7%) were most common. Conclusion: This study highlights the ongoing challenge of PTB associated with HIV infection in Nepal, necessitating targeted interventions and integrated services. Further multi-center research is recommended to explore socioeconomic and clinical determinants of PTB among HIV-positive individuals.
Prevalence of Anemia among Pregnant Women in Tertiary Care Teaching Hospital in Nepal
(Rapti Academy of Health Sciences (RAHS), 2025) Gurung, Prashansa; Gurung, Narayan Singh; Kunwar, Shishir; Tiwari, Shikha; Gurung, Roshni; Sigdel, Madhu
Abstract: Background: Anaemia in pregnancy is condition in which the blood doesn't have enough healthy red blood cells to carry oxygen resulting in poor maternal and fetal outcome. The primary objective of this study was to determine the prevalence of anaemia in pregnant women in tertiary care teaching hospital in Nepal. Methods: A retrospective study was conducted among pregnant women who had delivered (vaginal or cesarean) at Rapti Academy of Health Sciences (RAHS) between April 14, 2023 to April 13, 2024. Ethical clearance from the Institutional Review Committee of RAHS was obtained and then data on participant’s age, ethnicity, obstetric history, and hemoglobin level were collected from the hospital records. Results: Hospital records of 2,501 pregnant women were analyzed in this study, and the prevalence of anaemia was found to be 19.75%. Prevalence of anaemia was found to be highest among the pregnant women from Terai Madhesi ethnic background (45%). Among 484 women who had history of abortions, 110 had anaemia i-e. 23%. The more number pregnancies there were in a woman, the higher the prevalence of anaemia, from 19% in the first and second pregnancies to 41% in women with six pregnancies. Prevalence was seen lowest among women from age group of 15-19 years (0.4%) and highest among women aged 35 and above (24.3%). Conclusions: The prevalence of anaemia in pregnant women was low (19.75%) compared to that of national data (46%). However, the prevalence varied across different ethnic groups. Anaemia was more prevalent among older women, those with higher gravidity, and those with a history of abortion, indicating a need for targeted antenatal monitoring in these groups.
Antimicrobial Resistance among Older Patients Attending Rapti Academy of Health Sciences: A Retrospective Study
(Rapti Academy of Health Sciences (RAHS), 2025) Kandel, Ramesh; Pokhrel, Subrata; Sharma, Damodar
Abstract: Introduction: Antimicrobial resistance (AMR) is an escalating global health concern, particularly in developing countries like Nepal. Older adults are disproportionately affected due to immunosenescence, frequent hospital admissions, and repeated antibiotic exposure. However, limited region-specific data exist on AMR patterns among older adults in Nepal. This study aims to evaluate the microbiological profile and antibiotic resistance patterns, including the prevalence of multidrug-resistant organisms (MDROs), in individuals aged 60 years and above in a tertiary care center in Lumbini Province. Methods: A retrospective descriptive analysis was conducted on 495 clinical culture samples obtained from patients aged ≥60 years over a one-year period. Data were retrieved from microbiology records and analyzed using SPSS version 16. Descriptive statistics were used to determine organism prevalence, sample sources, and resistance patterns. MDROs were defined as resistance to at least one antimicrobial in three or more drug classes. Results: The mean age of patients was 71.8 years(SD±8.0), with females comprising 77% of the sample. Urine was the most common specimen (94.3%). Escherichia coli(59.6%) was the predominant isolate, followed by Klebsiella spp.(8.9%) and Acinetobacter spp.(5.9%). MDROs accounted for 62% of isolates. E. coli and Klebsiella exhibited high resistance to penicillins(85–92%) and cephalosporins(70–77%). Acinetobacter demonstrated extensive resistance across multiple antibiotic classes. Conclusion: This study reveals a high burden of MDROs among older adults, highlighting the urgent need for targeted antimicrobial stewardship, infection control, and development of localized treatment protocols to combat AMR in this vulnerable population.
Pattern of Childbirth in Tertiary Hospital in Dang; A Retrospective Study
(Rapti Academy of Health Sciences (RAHS), 2025) Tiwari, Shikha; Lamichhane, Basant; Kunwar, Shishir; Gurung, Prashansa; R.C, Jharana; Poudel, Rakesh
Abstract: Background: Childbirth itself is a complicated process. Conduction of delivery is challenging task. Spontaneous vaginal delivery as well as operative delivery, both requires skilled clinician, well-equipped hospital setting with the services of anesthesiology as well as neonatology. In past few decades, there is increasing trend of cesarean section and decreasing trend of instrumental as well as spontaneous vaginal delivery. Methods: This descriptive retrospective study was conducted in the department of Obstetrics and Gynaecology in Rapti Academy of Health Sciences. Hospital based medical records from 2023 May 1st to 204 April 30th were retrieved. Data regarding demography, characteristics of delivery of newborn, maternal and fetal morbidity associated with all the deliveries were collected. Result: The frequency of vaginal delivery was found to be 62.16% whereas cesarean section comprised 37.84%. Out of 62.16% vaginal delivery, 4.11% were the cases of instrumental vaginal delivery. Common age group was 20 to 24 years and 93.1% cases were delivered at term.Most common maternal complication was 2nd degree tear (4.95%) , primary PPH (1.41%), paraurethral tear ,cervical tear, shoulder dystocia.2% of the total cases received blood transfusion. 2 cases underwent peripartum hysterectomy. 2 cases of maternal mortality were recorded. Fetal complications includes perinatal asphyxia(2.13% in single born and 6.12% in twins),early onset neonatal sepsis (1.63% in single born and 12.24% in twins), neonatal jaundice( 1.26%), meconium aspiration syndrome(0.79%),late onset neonatal sepsis(0.2% ),fresh still birth(0.24% ),HIE( 0.2%). Conclusion: This study focuses the existing pattern of childbirth in the tertiary hospital of Dang showing the significant trends of mode of delivery, maternal demographics, maternal comorbidity and associated fetomaternal outcomes. The findings emphasizes the need for necessary interventions to ensure maternal and neonatal care.
Experience of Respectful Maternity Care during Labor and Childbirth among Women Admitted in Postnatal Ward of a Hospital of Siddharthanagar Municipality
(Rapti Academy of Health Sciences (RAHS), 2025) Khatri, Binita; Gurung, Saraj; Bajracharya, Srishti
Abstract: Introduction: Respectful Maternity Care (RMC) involves upholding a woman’s dignity, privacy, informed decision-making, and emotional support throughout childbirth. However, many women worldwide, including in Nepal, continue to experience mistreatment such as neglect, verbal abuse, and inadequate privacy, which undermines their trust in healthcare. This study explores postnatal mothers’ experiences with RMC during labor and childbirth. Methods: The qualitative study was conducted in the postnatal ward among 13 mothers who had normal vaginal deliveries. Using a non-probability purposive sampling technique, researchers conducted in-depth interviews after obtaining ethical and administrative approvals. Participants gave written consent, and interviews were held privately to ensure confidentiality. Interviews were transcribed, translated, and thematically analyzed. Field notes were coded, and transcripts reviewed to identify key concerns. Results: The findings of the study are summarized in seven key themes: informed consent, right to information, privacy & confidentiality, freedom from abuse, freedom from discrimination, neglect & abandonment and dignity & respect. Interpretation of the data showed that women reported positive experiences when informed about procedures. However, issues regarding pain relief options and privacy were noted, where some women felt their privacy was not maintained during examinations, which is a crucial aspect of respectful maternity care. Conclusion: This study reveals strengths and gaps in RMC. While verbal consent and non-discriminatory care were noted, key aspects like informed decision-making, communication, privacy, and emotional support were often missing. Neglect and mistreatment highlight systemic issues, calling for better training, staffing, and a respectful, accountable care environment.
The Great ICU Debate: One Unit, Two Philosophies – to Open or Not to Open?
(Rapti Academy of Health Sciences (RAHS), 2025) Joshi, Deepika
Abstract: The debate between open and closed Intensive Care Units (ICUs) remains unresolved, with each model offering distinct advantages and challenges. Open ICUs allow primary physicians to manage their patients, promoting continuity of care but risking fragmented decision-making. In contrast, closed ICUs ensure standardized, evidence-based management by intensivists, leading to improved efficiency and better patient outcomes. A hybrid ICU model offers a compromise, balancing flexibility with structured care. In Nepal, ICU structures vary based on resource availability, with tertiary centers favoring closed or hybrid models. Ultimately, the ideal ICU model depends on institutional policies, staffing, and patient needs, prioritizing optimal care delivery.
Personalized Medicine: Are We Ready in Nepal?
(2025) Shrestha, Binaya
Abstract: The concept of personalized medicine, often referred to as precision medicine, has revolutionized healthcare in developed nations, providing patient-specific medical treatment based on their personal attributes. This approach considers factors such as genetic makeup, lifestyle, and environment to develop effective and targeted therapies for improved patient outcomes. For over five millennia, the practice of medicine has revolved around providing care tailored to everyone. As personalized medicine begins to reshape global healthcare, it is time to reflect on its relevance, feasibility, and readiness in the context of Nepal. ...
Perception of Medical Students Regarding TU-IOM MBBS Curriculum and Teaching Learning Methods in Nepal
(Kathmandu University, 2022) Gautam, N; Dhungana, R; Gyawali, S; Dhakal, S; Pradhan, PMS
ABSTRACT Background The present Bachelor of Medicine and Bachelor of Surgery (MBBS) curriculum under Tribhuvan University - Institute of Medicine (TU-IOM) was last revised twelve-years back. Though the curriculum was built upon internationally approved recommendations on curriculum design, it is ineffectively practiced in most medical schools of Nepal with major focus on didactic teaching-learning. The curriculum, hence, needs effective implementation and revision. Objective To identify the strengths, weaknesses, and areas of improvement in the medical curriculum through student-based feedback and outline the possibility of incorporating newer evidence-based teaching-learning methodologies in Nepal. Method This is a descriptive and cross-sectional study. With appropriate ethical approval, a questionnaire was developed and disseminated virtually to all medical students of Nepal under TU from MBBS fourth year onwards. The questionnaire comprised of Likert and close-ended questions. The data analysis was followed after receiving the filled questionnaire through Google forms. Result A total of 337 respondents participated in the study. The most effectively implemented components out of the SPICES model were Integrated learning (I) and Community- based learning (C), with 73.89% and 68.84% responses. There were 94.7% (319) students who favored the incorporation of research in the core curriculum. Only 34.2% (115) students found PowerPoint lectures, the most utilized form of teaching- learning in Nepal, as engaging. The respondents (84.6%) showed a high degree of readiness to incorporate newer evidence-based teaching-learning tools such as flipped learning, blended learning, and peer-to-peer learning. Conclusion This study shows that effective interventions must be rethought on various aspects of the curriculum, taking students’ feedback on the table while considering curricular revision. KEY WORDS Bachelor of Medicine and Bachelor of Surgery (MBBS) curriculum, Medical students, Problem based learning, Teaching learning methods
Dhulikhel Hospital Checklist Protocol for Temporal Bone Computed Tomography Scan Analysis: How We Do It?
(Kathmandu University, 2022) Shrestha, BL; KC, AK; Karmacharya, S
ABSTRACT The temporal bone is very complicated anatomical structure. Any disease process within this structure mandates thorough anatomical knowledge of the corresponding structure. The High resolution computed tomography (HRCT) temporal bone is the best way to look inside this complex bone. The importance of knowledge about how to read and look inside the CT scan temporal bone lead us develop the Dhulikhel Hospital Check list protocol. This protocol will help aspiring otologist and otolaryngologist to read and know details about the underlying structures. KEY WORDS High resolution computed tomography, Otologist, Temporal bone
Rhino-Orbital Mucormycosis in a COVID-19 Patient: A Dreadful Challenge
(Kathmandu University, 2022) Dhakal, A; Pokharel, M; Madhup, S; Khadka, L; Sapkota, B
ABSTRACT Coronavirus disease 2019 (COVID-19) is a pandemic disease caused by severe acute respiratory syndrome coronavirus 2 (SARS-COV-2). COVID-19 infections may be associated with a wide range of bacterial and fungal co-infections. Recent studies are reporting invasive fungal infection associated with severe COVID-19. Herein, we report a case of COVID-19 rhino-orbital mucormycosis infection caused by Rhizopus sps in a 32 year old diabetic patient who was successfully managed with early aggressive debridement of infected tissue endoscopically with extended ethmoidectomy by modified Denker’s approach along with orbital decompression and antifungal therapy with Liposomal Amphotericin B and Posaconazole. Serial diagnostic nasal endoscopy showed no evidence of progression of the infection. The patient was discharged on 21st day of hospitalization still on oral Posaconazole for a total of 3 months. KEY WORDS Amphotericin B, Covid-19, Mucormycosis, Surgical debridement
Nitrobenzene Induced Methemoglobinemia with Paroxysmal Atrial Fibrillation Treated with Single Volume Exchange Transfusions
(Kathmandu University, 2022) Sapkota, P; Vaidhya, N; Bhatt, S; Shrestha, P
ABSTRACT Methemoglobinemia is a potentially fatal condition if left untreated. Conventional treatment of nitrobenzene induced methemoglobinemia dictates the use of methylene blue, which is the antidote of choice. However, its availability in our setting is limited only to the laboratory use. We present a case of a 21-year-old female with intentional ingestion of nitrobenzene. Clinical history and supportive investigations revealed methemoglobinemia and it was successfully managed with single volume exchange transfusions in absence of specific antidote. While exchange transfusions are indicated for severe cases, it may be useful as an alternative treatment in acute life-threatening conditions where methylene blue is not available. KEY WORDS Exchange transfusion, Methylene blue, Nitrobenzene, Whole blood
A Rare Case of Large Hydatidiform Mole Mimicking a Term Pregnancy
(Kathmandu University, 2022) Shrestha, A; Bastakoti, R; Pandey, N; Poudel, R; Ranjit, S; Makaju, R
ABSTRACT Molar pregnancy is a type of abnormal pregnancy that usually presents with amenorrhea, vaginal bleeding and elevated serum ß-hCG levels. We report a rare case of complete hydatidiform mole occurring in a 46-year-old P2L2 lady who presented with a term size uterus and elevated serum ß-hCG level (> 15,00,000 per deciliter, anemia (hemoglobin: 8.1 g/dL), difficulty in breathing and minimal vaginal bleeding. During the course of her evaluation, she had profuse vaginal bleeding, she underwent suction and evacuation, but bleeding was not controlled despite measures to control it. She was given uterotonics and antifibrinolytic agents and uterine artery ligation. But was proceeded with emergency hysterectomy for uncontrolled hemorrhage. The content of suction and evacuation was vesicles with blood clots and histopathology was reported as complete hydatidiform mole. The patient received a total of 4 units of packed red blood cells. She was discharged from hospital on 5th postoperative day and was followed up serial serum ß-hCG level. Therefore, complete mole can present with enlarged uterus, vaginal bleeding and anemia. It is also important to note that intractable bleeding following suction and evacuation not being controlled with uterotonics and antifibrinolytic agents and uterine artery ligation may require hysterectomy to save the patient’s life. KEY WORDS Elevated serum ß-hCG level, Suction and evacuation, Term size uterus, Vaginal bleeding
Platelet Satellitism in a Patient with Bronchial Asthma
(Kathmandu University, 2022) Koju, S; Vaidhya, N; Twitwi, R; Shankhadev, R; Pote, N
ABSTRACT Platelet satellitism is uncommon phenomenon characterized by formation of platelet rosette around polymorphonuclear leucocytes in blood smear prepared from Ethylenediaminetetraacetic acid anticoagulated blood. This phenomenon may cause reporting of spurious thrombocytopenia unless proper examination of blood smears. Here we describe a case of platelet satellitism in a 29 year old female which has been incidentally found on evaluation of eosinophilia in a bronchial asthma patient. KEY WORDS Ethylenediaminetetraacetic acid, Platelet satellitism, Pseduothrombocytopenia
Nevus Lipomatosus Cutaneous Superficialis of Hoffmann and Zurhelle: a rare cutaneous hamartoma
(Kathmandu University, 2022) KC, S; Aryal, A; Jha, A; Karn, D
ABSTRACT Nevus lipomatosus cutaneous superficialis (NLCS) is a rare idiopathic cutaneous hamartoma characterized by ectopic clusters of mature adipose tissues in dermis. It is classified into two types. Classical type presenting as multiple lesions with onset at birth or within third decade of life and solitary type with onset between third to sixth decade of life. Here we present a case of 45 years female with adult onset, asymptomatic, grouped, skin colored, soft sessile growth in zosteriform pattern on left buttock. We here intend to report rare case of classical Nevus Lipomatosus Cutaneous Superficialis. KEY WORDS Hoffmann, Nevus lipomatosus cutaneous superficialis, Zurhelle
Teenage Pregnancy and Associated Risk Factors and Outcome in Nepal From 2000-2020: A Systematic Review and Meta-Analysis
(Kathmandu University, 2022) Shrestha, DB; Budhathoki, P; Shrestha, O; Karki, S; Thapa, N; Dangal. G; Baral, G; Itani, S; Poudel, A
ABSTRACT Background Teenage pregnancy is considered a high-risk pregnancy in terms of reproductive outcome and the subsequent financial constraint. Objective To assess the prevalence of teenage pregnancy, associated risk factors, and outcomes in the context of Nepal. Method We searched electronic databases to search relevant articles published from January 2000 till October 2020 using the keywords with appropriate Boolean operators. All the data were extracted into a standardized form designed in Excel. We conducted a statistical analysis using Comprehensive Meta-Analysis Software (CMA) version 3. Data pooled for proportion with 95% confidence interval (CI). A Forest plot was used to visualize the degree of variation between studies. Result Fourteen studies were included in the analysis after the rigorous screening of 4425 studies. Prevalence of teenage pregnancy was 13.2% (Proportion, 0.132; CI, 0.077- 0.215). Among teenage pregnancies, 11.8% were already multigravida (Proportion, 0.118; CI, 0.029-0.374). Among teen pregnancies, 18.6% were illiterate; among the literate, only 25.9% were of education above grade 10,31.9% were unaware of contraceptive methods, and only 3.2% reported using any contraception methods. 75.4% of teenage pregnancies had a vaginal delivery with or without episiotomy, 6.5% by instrumental deliveries, and 21.5% by cesarean section. Preterm delivery was 12.0%, and post-term delivery was 8.2%. Abortion was reported in 11.1% of teenage pregnancies. Major tears were reported in 52.9%, obstructed labor was in 4%, and pre-labor rupture of the membrane was in 7.0% of teenage pregnancies. The low birth weight of newborns was 19.4%. Stillbirth and neonatal deaths were 1.7% and 1.4%, respectively. Conclusion The prevalence of teenage pregnancy in Nepal was 13.2%. The majority of them did not use any form of contraceptives; and had low education. Several maternal and neonatal complications were reported among teenage pregnancies. KEY WORDS Cesarean section, Contraception, Delivery, Infant, Low birth weight, Obstetric, Pregnancy in adolescence
Isolation and Intensive Care (ICU) Service, Surge Capacity and Pandemic Training in Government Designated COVID-19 Clinics and Hospitals of Nepal
(Kathmandu University, 2022) Bhattarai, S; Neopane, AK; Shrestha, B; Dangol, SR; Shrestha, SKD; Dutta, A; Adhikari, G; Dahal, S
ABSTRACT Background The coronavirus pandemic preparedness and response activities began in Nepal after the detection of the first case on 24 January 2020. Highest daily case record in June 2020 was 671, but it reached above 5,000 in October 2020. Objective This study assessed preparedness and response status of government designated COVID-19 clinics and various level hospitals. Method A web-based survey was conducted among government designated COVID-19 clinics and Level hospitals in June 2020. The Medical Operations Division of the COVID-19 Crisis Management Center (CCMC) retained contact list of focal person in each facility for regular updates. Forty-nine out of 125 clinics and all level hospitals (five Level-1, 12 Level-2, three Level-3) provided responses. Result There were 25 or less isolation beds in the majority of COVID-19 clinics (83.7%) and Level-1 hospitals (60%), whereas the majority of Level-2 (92%) and Level-3 hospitals (67%) had arranged >25 beds. Only five clinics, one Level-1 hospital, six Level-2 and two Level-3 hospitals had a surge capacity of additional 20 or more isolation beds. Only one-fourth of the designated health facilities had arranged separate isolation facility for vulnerable population. Majority of the designated clinics and Level-1 hospitals had five or less functional ICU beds and functional ventilators. Very few Level-2 hospitals had > 10 ICU beds and > 10 ventilators. Healthcare workers in the majority of facilities were trained on donning/doffing, hand washing, swab collection, and healthcare waste management, but, a very few received formal training on patient transport, dead body management, epidemic drill, and critical care. Conclusion This study revealed insufficient preparation in COVID-19 facilities during the initial phase of pandemic. The findings were utilized by the government stakeholders at central, provincial and local levels for scaling up surge capacity and improving health services at the time of case surge. As the pandemic itself is a dynamic process, periodic assessments are needed to gauze preparedness and response during different phases of disease outbreak. KEY WORDS COVID-19, Crisis Management Center (CCMC), Outbreak, Pandemic
Ocular Survey in Kathmandu University Medical Students
(Kathmandu University, 2022) Shrestha, P; Kaiti, R; Shyangbo, R; Dhakal, K
ABSTRACT Background Medical students spend long time in academic activities that increases the risk of developing refractive errors and dry eyes that can affect their learning and social abilities. Only a few studies are available regarding ocular problems and its contribution to visual impairment among medical students in Nepal. Objective To evaluate the ocular problems among the medical students in a University hospital. Method An observational, descriptive, cross-sectional study was conducted among five batches undergraduate medical students until 2022 of Kathmandu University School of Medical Sciences, Dhulikhel, Kavre. A self-administered questionnaire was used to obtain demographic data and information on visual problems followed by a detailed ocular examination that included refraction, color vision and Schirmer test. Result Total of 284 medical students (with 568 eyes) with mean age of 22.8 years, 179 males and 105 females were enrolled. Among them, 270 (47.5%) eyes were emmetropic. Simple Myopia was the commonest followed by Compound Myopic Astigmatism. The mean spherical equivalent in right and left eye were -0.914 ± 1.54 and -0.886 ± 1.53 respectively. Approximately 18% students had some form of dry eye. Nineteen students (6.7%) had color vision deficiency and 13 (4.6%) had deuteranomalia, 3(1.1%) had deuteranopia and 3(1.1%) had protanomalia. Conclusion Eye defects, like refractive errors, dry eyes and color blindness, are common among medical students. They need to be advised for frequent eye check up in order to diagnose eye defects timely and arrest visual impairment at early stage. KEY WORDS Color vision, Dry eye, Medicals students, Refractive errors
Health Promoting Lifestyle during Covid-19 Pandemic among Residents of Gandaki Province, Nepal
(Kathmandu University, 2022) Shrestha, K; Acharya, S; Poudel, S
ABSTRACT Background Lifestyle is an important factor to individual’s health and quality of life. Although, the emergence of Corona virus disease 2019 (COVID-19) has forced billions of people to change their lifestyle overnight. Objective To identify health promoting lifestyle during COVID-19 pandemic among the residents of Gandaki Province, Nepal. Method Descriptive cross sectional web based study was conducted among 386 respondents from Gandaki Province. Adults from 18 years and above, who could fill the form online were included using purposive and snowball sampling technique. Data were collected using Health Promoting Lifestyle Profile II (HPLP II) scale and analysed using descriptive (frequency, percentage, median) and inferential statistics (Mann Whitney U test and Kruskal Wallis test). Result Only 18.7% of the respondents had an excellent health promoting lifestyle followed by good health promoting lifestyle among 60.4%. Highest median score was observed in spiritual 27(10-36), and interpersonal relationship subscale 27(9-36). Whereas, the lowest was observed in physical activity 21(8-32) followed by stress management 24(10-32). Statistically significant difference was observed in age and perception of own health status with spirituality; gender, chronic illness and perception of own health status with interpersonal subscale and age, gender, marital status, occupation and perception of own health status with physical subscale. Conclusion The study concludes the need of health education and awareness to promote healthy lifestyle behaviours with a particular emphasis on indoor physical activities and stress management skills with specific consideration to female and elderly. KEY WORDS Adult, COVID-19, Health promoting lifestyle/behaviour, Nepal
Clinico-epidemiological Profile of Children with Chronic Kidney Disease in Tertiary Care Referral Center in Nepal: Prospective observational study
(Kathmandu University, 2022) Poudel, DR; Basnet, S; Shrestha, LP
ABSTRACT Background Chronic kidney disease in children has been increasing over the years and is associated with high degree of morbidity and mortality. The cost of treating children with chronic kidney disease is also substantial. Prevention of this disease is the only long term solution in our context. Till date, there is limited data on chronic kidney disease in Nepalese children. Objective To study the epidemiological, clinical and etiological profile of children with Chronic Kidney Disease from 2 to 16 years of age presenting for the first time in tertiary care hospital. Method This is the prospective observational study carried out at the tertiary care hospital over a period of 3 years. Children between 2-16 years who were first time diagnosed of chronic kidney disease and had estimated glomerular filtration rate < 60 ml/ min/1.73 m2 for last 3 months were enrolled. Result There were total of 124 patients, of whom 78 were male with male to female ratio of 5:3 with mean age of 11.8±2.2 years. Chronic glomerulonephritis (23%), reflux nephropathy (23%) and nephrolithiasis (16%) were the commonest etiological diagnosis. Rapidly progressive glomerulonephritis and systemic lupus erythematous accounted for 85% cases of chronic glomerulonephritis. Vesicoureteric reflux and posterior urethral valve accounted for 85% cases of reflux nephropathy. In 32%, the cause could not be determined. Swelling (45%) and dyspnea (20%) were the chief presenting complaints. Pallor were seen in all cases (100%) followed by hypertension in 68% and short stature in 64%. Majority (60%) of the patients with chronic kidney disease presented in the stage V. Conclusion Chronic glomerulonephritis and reflux nephropathy were the commonest etiologies of chronic kidney disease, majority of them following rapidly progressive glomerulonephritis, systemic lupus erythematosis, vesicoureteric reflux and posterior urethral valve. The commonest clinical features were swelling, dyspnea, pallor and hypertension. KEY WORDS Chronic kidney disease, Clinical profile, Epidemiological profile, ESRD, Etiology of CKD, Nepalese children

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