Journal Issue: Volume: 2, No. 1 (2025)
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Volume
Number
Issue Date
2025
Journal Title
Journal ISSN
ISSN 3059-9156 (Print), ISSN 3059-9164 (Online)
Journal Volume
Articles
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. ...
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.
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.
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.
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.