OALib Journal期刊

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匹配條件: “ P Shrestha” ,找到相關結果約201452條。
Foot Care Knowledge and Practice among Diabetic Patients Attending General Outpatient Clinic in Tribhuvan University Teaching Hospital  [PDF]
Tirtha Man Shrestha, Ramesh P. Aacharya, Rabina Shrestha, Madhav KC
Open Journal of Endocrine and Metabolic Diseases (OJEMD) , 2017, DOI: 10.4236/ojemd.2017.78015
Abstract: Background: Diabetes Mellitus results in several serious complications and among them foot problem is one of the commonly ignored complications. This study is an attempt to find out the level of patient’s awareness and practice in Nepalese context. Objective: The aim of this study is to determine the knowledge and practice of foot care among patients with diabetes in Nepal. Methods: This is a six-month long cross-sectional study done in the General Practice Clinic of Tribhuvan University Teaching Hospital. Diabetic patients were given structure questionnaires on knowledge, foot care practices, and demographic information. Results: Illiteracy was found be significantly associated with poor knowledge and practice of foot care. Those who have no education are more likely to have poor knowledge and foot care practice. The odds of having poor knowledge is 6.414 (3.075, 13.379) in those who have no education/primary education compared to those who have education and the odds of poor foot care practice is 4.5180 (2.077, 8.411) in those who have no education/primary education compared to those who have education with significance of <0.001. Conclusion: This study has highlighted the need of appropriate education intervention for the patients with diabetes who have no education background to prevent from foot complications. Health education materials such as graphics, photos are needed to make them comprehensible for the illiterate patients.
Policy initiatives for drug control in Nepal
Shrestha P
theHealth , 2011,
Abstract: The abuse of heroin or smack has become an increasingly serious national problem in Nepal. The use of marijuana and heroin together with misuse of psychoactive and sedative drugs like nitrosun have caused a poly drug culture of great national concern.
Knowledge about Tuberculosis among Drug Users in Kathmandu Valley
P Shrestha
Health Prospect , 2013, DOI: 10.3126/hprospect.v12i1.8719
Abstract: Background Drug use is a significant risk factor for acquiring tuberculosis (TB) infection and progressing to active TB due to high Human Immunodeficiency Virus (HIV) seroprevalence, low socio-economic status, poor environmental conditions and problems of access to health care. Illicit drug users are at high risk for TB. Objective To assess the knowledge about TB among drug users whereas the specific objectives are to assess the knowledge about how TB is acquired, transmitted and prevented, the signs and symptoms of TB including diagnosis, curability and the source of information. Methodology Descriptive cross sectional study among 45 male and 18 female drug users in two centers each of Kathmandu and Lalitpur. Semi structured interview schedule was used to collect data. In Depth Interview (IDI) was conducted among 5 drug service providers using IDI guidelines. Results Majority of users (42%) were between 25-29 years and male (71%). About 13% respondents had family history of drug use. Major source of information was print media. Only 33% respondents had the correct knowledge about the causes of TB; however knowledge regarding signs and symptoms was found to be good. About 64% respondents had correct knowledge regarding transmission and 44% about its diagnosis. About 97% respondents knew that TB can be cured but not about the medications and treatment duration. Most users (71%) were familiar with preventive measures. In-depth Interview with drug service providers revealed that drug users are at high risk of acquiring TB as their knowledge regarding TB was poor and drug users ignored about TB. Conclusion Although drug users are at high risk for contracting and spreading TB, the level of knowledge about TB was low. It is necessary to provide them with TB related information and education to reduce the burden of TB. DOI: http://dx.doi.org/10.3126/hprospect.v12i1.8719 ? Health Prospect: Journal of Public Health Vol.12(1) 2013: 1-6
Hospital-based community cataract surgery: comparison of visual outcomes between conventional extra-capsular cataract extraction and small incision cataract surgery
P Karki,JK Shrestha,JB Shrestha
Nepalese Journal of Ophthalmology , 2009, DOI: 10.3126/nepjoph.v1i2.3686
Abstract: Introduction: The small-incision cataract surgery is gaining popularity among the ophthalmic surgeons. Objective: To compare the visual outcome of conventional extra-capsular cataract extraction (ECCE) and small-incision cataract surgery (SICS) in a hospital based community cataract program. Materials and methods: A prospective interventional study without randomization was carried out including the patients undergoing cataract surgery by either conventional ECCE or manual SICS. They were followed up for 6 weeks postoperatively. The visual outcomes were compared between the two groups. Statistics: The statistical program Epi-Info version 2000 was used to analyze the data. Mean values with standard deviations, 95% CI and p value were calculated. The p value of <0.05 was considered significant. Results : Of 85 patients, 44 (M: F=10:34) underwent ECCE and 41 (M: F=15:26) SICS (RR= 0.71, 95% CI=0.42-1.2, p value=0.16). Unaided visual acuity on the 1st postoperative day in the ECCE group was e"6/ 18 in 22.7%,<6/18-6/60 in 63.6 %,< 6/60 in 13.7%, whereas in the SICS group, the same was e"6/18 in 70.7%,<6/18-6/60 in 22 %,< 6/60 in 7.3% (95% CI = 0.23 - 0.48, p=0.001). Best corrected visual acuity on the 6th week follow-up in the ECCE group was e"6/18 in 79.5%,<6/18-6/60 in 18.2 %,< 6/60 in 2.3% and in the SICS group the same was 6/18 in 90.5% and <6/18-6/60 in 4.9% (95% CI=0.44 - 0.73; p=0.0012). Conclusion: Both ECCE and SICS are good procedures for hospital based community cataract surgery but within the 6 weeks postoperative period SICS gives better visual outcome. Remarkably higher number of female patients can be provided service in a hospital based community cataract programme as compared to males. Keywords : cataract; small incision; extra-capsular DOI: 10.3126/nepjoph.v1i2.3686 Nep J Oph 2009;1(2):118-122
Intraoral cysticercosis of the masseter muscle- A rare finding; correlation of histopathology with MRI and USG
M Shrestha,P Shakya,S Shrestha
Journal of Chitwan Medical College , 2014, DOI: 10.3126/jcmc.v4i2.10864
Abstract: Cysticercosis refers to infection of tissues after exposure of eggs of pork tapeworm Taenia solium. The authors report a rare case of a solitary intraoral cysticercosis in a thirty-four year female who presented with a mass in the left buccal mucosa of two months duration. The attending dentist could not have an impression of the lesion and sent for ultrasonography. The ultrasonographic report described a well defined hypoechoic lesion with central hypoechoic mural nodular area in left buc-cal region with muscle plane along with posterior enhancement suggestive of cystic nature. The impression was of benign cystic lesion in left buccal region (muscle plane). The MRI report revealed a 12 mm diameter T2 high signal intensity area noted in the anterior aspect of the left masseter muscle that showed iso to low signal in T1 weighted images. An ill margin-ated T2 high signal intensity was seen in left masseter muscle which also showed slight enlargement. The impression was of cystic lesion in left masticator space with edema in surrounding soft tissue plane. The lesion was enucleated and the histological findings revealed a cystic lesion containing parasitic larva. The cystic cavity was surrounded by a collagenous capsule of multinucleated foreign body giant cells with admixture of lymphocytes, plasma cells and histiocytes. The para-sitic larva showed thick integument with projections and a myxomatous inner stroma. Thus a definitive diagnosis of “oral cysticercosis” was given. Oral cysticercosis rarely involves the oral cavity. This case reports a rare involvement of cysticer-cosis involving the masseteric space. DOI: http://dx.doi.org/10.3126/jcmc.v4i2.10864 Journal of Chitwan Medical College 2014; 4(2): 44-47
Prevalence of Pulmonary Tuberculosis among the suspected patients visiting tertiary care hospital in Birgunj, Nepal
S Shrestha,B Shakya,P Shrestha
Janaki Medical College Journal of Medical Science , 2013, DOI: 10.3126/jmcjms.v1i1.7886
Abstract: Background and Objectives : Mycobacterial disease continues to cause high morbidity and mortality and is a major public health problem in Nepal. Bacteriological examination of sputum is the cornerstone in the diagnosis of pulmonary tuberculosis in the developing world. This prospective study was carried out with an objective to evaluate the prevalence of pulmonary tuberculosis among the patients visiting National Medical College Teaching Hospital by Ziehl- Neelsen (Zn) staining microscopy. Material and Methods: The study was cross-sectional study. Three consecutive early morning sputum collected from 626 patients were subjected to Zn staining and observed under oil immersion. Results: Among 626 patients, 85 (13.57%) were found to be Acid fast positive by Zn staining microscopy. Of total suspected patients,16.0% of male and 8.7% of female were infected, common among 41-60 years group (17.2%) followed by 21-40 years (12.6%) and multibacillary cases was 71.8%. Conclusion: The prevalence of pulmonary tuberculosis among National medical college teaching hospital was found to be higher than the Nation pulmonary tuberculosis detection rate, most commonly infecting males. DOI: http://dx.doi.org/10.3126/jmcjms.v1i1.7886 Janaki Medical College Journal of Medical Sciences (2013) Vol. 1 (1):48-52
Retrograde intubation: An alternative way for the management of difficult airway
P Lama,BR Shrestha
Kathmandu University Medical Journal , 2008, DOI: 10.3126/kumj.v6i4.1748
Abstract: Inserting a retrograde wire into the pharynx through a cricothyroid puncture can facilitate tracheal intubation in difficult situations where either a flexible fiber-optic bronchoscope or an expert user of such a device is not available. Even in cases when fibropric can not be negotiated for the purpose,this method has been claimed to be useful to manage the airway. Some mouth opening is essential for the oral or nasal retrieval of the wire from the pharynx. Here, a case of post mandibular reconstructed wound infection required surgical debridement and plate removal from reconstructed lower mandible under general anesthesia. We retrieved the guide wire passed through a cricothyroid puncture and subsequently accomplished wire-guided oro-tracheal intubation. In the absence of a flexible fiber-optic bronchoscope, this technique is a very useful aid to intubate patients with limited mouth opening. Key words: cricothyrotomy, guide wire, retrograde endotracheal intubation (REI), surgery. doi: 10.3126/kumj.v6i4.1748 ? ? Kathmandu University Medical Journal (2008), Vol. 6, No. 4, Issue 24, 516-519 ??
Dermatologic Manifestations In Chronic Kidney Disease Patients On Hemodialysis
P Shrestha,M Mathur
Nepal Journal of Dermatology, Venereology & Leprology , 2014, DOI: 10.3126/njdvl.v12i1.10594
Abstract: Introduction:? Dermatologic changes are frequently seen in chronic kidney disease (CKD) patients. Early identification of these manifestations helps timely institution of treatment and prevention of progression of CKD. Objectives: ?The aim of this study was to evaluate the frequency and pattern of dermatologic problems among CKD patients who are on maintenance hemodialysis in our population. Material and Methods:? A hospital based cross sectional comparative study was conducted. Fifty patients with CKD on hemodialysis were compared with the same number of non CKD patients. All the patients were clinically examined. Complementary diagnostic measures such as skin biopsy, gram stain, potassium hydroxide mounting and culture sensitivity of the lesions were carried out when necessary. Results:? ?At least one dermatologic manifestation was present in 86% of the patients and changes were seen commonly in CKD patients who had GFR <15ml/min (83.8%). Cutaneous manifestations were significantly associated with CKD patients than control (p<0.001)??but??not with the duration of CKD and duration of hemodialysis. Thirty seven patients (74%) were having??cutaneous lesions, commonest being xerosis (52%) followed by pruritus (40%) and hyperpigmentation (32%). Nail, mucous membrane and hair changes were present in 56%, 22% and 12% respectively, commonest being white nail (30%), furred tongue (18%), telogen effluvium (10%) respectively. Conclusion:? In our study, dermatologic manifestations were common in CKD patients with GFR <15ml/min. Cutaneous and nail changes were seen in 74% and 56% of the CKD patients undergoing??hemodialysis, commonest changes being xerosis and white nail respectively. DOI: http://dx.doi.org/10.3126/njdvl.v12i1.10594 Nepal Journal of Dermatology, Venereology & Leprology Vol.12(1) 2014 pp.34-40
Intraoperative Findings during Canal Wall Down Mastoidectomy in Children
S Shrestha,P Kafle
Journal of Nepal Paediatric Society , 2011, DOI: 10.3126/jnps.v31i3.5357
Abstract: Objective: The main objective of this study is to assess the intraoperative finding during canal wall down mastoidectomy in paediatric patients undergoing surgery for unsafe type of chronic suppurative otitis media (CSOM) attending ENT OPD of Kathmandu Medical College. Materials and Methods: Fifty patients of age group 4 to 13 years who were suffering from unsafe type of CSOM with or without cholesteatoma were taken for the study. The study period was two years from April 2007 to March 2009. The operative findings like extent of cholesteatoma in different location of middle ear cleft, mastoid bony landmarks, and ossicular chain condition and otogenic complication were identified during canal wall down mastoidectomy. Result: Of the 50 patients 32 (64%) were boys and 18(36%) were girls. The age ranged from 4 years to 13 years. Majority of patients had cholesteatoma with granulation diseases (72%) followed by granulation diseases (16%). Involvement of disease in attic, aditus, antrum and mesotympanum were found to be high in majority of cases (82%) with high percentage of necrosis of incus (56%). Conclusion: The primary disease found in patients undergoing canal wall down mastoidectomy (CWDM) was cholesteatoma combined with granulation in72%, granulation in 16% and cholesteatoma in12%. Key words: Canal Wall Down; ENT; Mastoidectomy; Chronic Suppurative Otitis Media (CSOM) DOI: http://dx.doi.org/10.3126/jnps.v31i3.5357 J Nep Paedtr Soc 2011;31(3):184-187
Knowledge & Practice of Nursing Ethics and Laws
S Shrestha,P Jose
Journal of Universal College of Medical Sciences , 2014, DOI: 10.3126/jucms.v2i3.11825
Abstract: INTRODUCTION : Nurses are responsible for the well-being and quality of life of many people, and therefore must meet high standards of technical and ethical competence. Values are the belief and attitude that influence individual behavior and process of decision making. Personal values are what nurses hold significant and true for themselves, while professional ethics involve principles that have universal applications and standards of conduct that must be upheld in all situations. From the previous study it was found that most of the nurses have the knowledge regarding nursing ethic and law but have lack of practice. MATERIAL AND METHODS : A descriptive cross? ?sectional study was conducted among the selected nurses of Universal College of Medical Sciences and Teaching Hospital (UCMS TH) Bhairahawa Nepal. Population for the study was selected on random basis and total sample size was 60. A self-administered structured questionnaire about knowledge of nursing ethics and law was devised, tested and distributed to the nurses and practice of same sample was assessed through checklist by observing the activities of nurses by the researcher herself. RESULTS : Among the total 60 respondents only 45% had adequate knowledge of ethics and rest of them had inadequate knowledge regarding nursing ethics whereas most of the respondents i.e. 53% had adequate knowledge of nursing law and only 46% had inadequate knowledge of it. On the other hand half of the respondents do practice on nursing ethics and law and another half do less practice. As a whole it has been identified that respondents had more knowledge of nursing law than that of nursing ethics and half of them do practice on it. CONCLUSION : Findings of the study showed that knowledge of law was greater than knowledge of ethics. Overall they had no satisfactory knowledge of ethics and law. Whereas 50% of respondents does adequate practice. DOI: http://dx.doi.org/10.3126/jucms.v2i3.11825 Journal of Universal College of Medical Sciences Vol.2(3) 2014: 30-33

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