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  • 1
    Online Resource
    Online Resource
    Image_1.JPEG
    Frontiers Media SA ; 2023
    In:  Frontiers in Public Health Vol. 11 ( 2023-5-24)
    Details
    In: Frontiers in Public Health, Frontiers Media SA, Vol. 11 ( 2023-5-24)
    Abstract: The Public-Private Mix (PPM) approach is a strategic initiative that involves engaging all private and public health care providers in the fight against tuberculosis using international health care standards. For tuberculosis control in Nepal, the PPM approach could be a milestone. This study aimed to explore the barriers to a public-private mix approach in the management of tuberculosis cases in Nepal. Methods We conducted key informant interviews with 20 participants, 14 of whom were from private clinics, polyclinics, and hospitals where the PPM approach was used, two from government hospitals, and four from policymakers. All data were audio-recorded, transcribed, and translated into English. The transcripts of the interviews were manually organized, and themes were generated and categorized into 1. TB case detection, 2. patient-related barriers, and 3. health-system-related barriers. Results A total of 20 respondents participated in the study. Barriers to PPM were identified into following three themes: (1) Obstacles related to TB case detection, (2) Obstacles related to patients, and (3) Obstacles related to health-care system. PPM implementation was challenged by following sub-themes that included staff turnover, low private sector participation in workshops, a lack of trainings, poor recording and reporting, insufficient joint monitoring and supervision, poor financial benefit, lack of coordination and collaboration, and non-supportive TB-related policies and strategies. Conclusion Government stakeholders can significantly benefit by applying a proactive role working with the private in monitoring and supervision. The joint efforts with private sector can then enable all stakeholders to follow the government policy, practice and protocols in case finding, holding and other preventive approaches. Future research are essential in exploring how PPM could be optimized.
    Type of Medium: Online Resource
    ISSN: 2296-2565
    URL: Article
    URL: Article
    DOI: 10.3389/fpubh.2023.1132090
    DOI: 10.3389/fpubh.2023.1132090.s001
    Language: Unknown
    Publisher: Frontiers Media SA
    Publication Date: 2023
    detail.hit.zdb_id: 2711781-9
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  • 2
    Online Resource
    Online Resource
    Prognostic Value of RV Tissue Annular Velocity in Chronic Pulmonary Artery Hypertension
    Scientific Research Publishing, Inc. ; 2017
    In:  OALib Vol. 04, No. 05 ( 2017), p. 1-11
    Details
    In: OALib, Scientific Research Publishing, Inc., Vol. 04, No. 05 ( 2017), p. 1-11
    Type of Medium: Online Resource
    ISSN: 2333-9721 , 2333-9705
    URL: Article
    DOI: 10.4236/oalib.1103295
    Language: Unknown
    Publisher: Scientific Research Publishing, Inc.
    Publication Date: 2017
    detail.hit.zdb_id: 2777820-4
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  • 3
    Online Resource
    Online Resource
    Outcome of Humeral Shaft Fracture Treated with Anteromedial Plating through an Anterolateral Approach
    Annapurna Neurological Institute & Allied Sciences ; 2021
    In:  Annapurna Journal of Health Sciences Vol. 1, No. 2 ( 2021-08-08), p. 26-30
    Details
    In: Annapurna Journal of Health Sciences, Annapurna Neurological Institute & Allied Sciences, Vol. 1, No. 2 ( 2021-08-08), p. 26-30
    Abstract: Introduction: Humerus shaft fracture is a common injury representing 1.2-3% of all fractures. It can be managed both conservatively and operatively with various modalities. Among operative, plate osteosynthesis is the most widely accepted method of treatment when conservative treatment is not adequate to achieve union with good functional outcome. Anteromedial plating through anterolateral approach is a safe and reliable approach in plate osteosynthesis. Methods: A prospective study was conducted in the Department of orthopaedics, Nepal APF hospital, Kathmandu from 2015 February to 2020 February. Forty-four patients who underwent anteromedial plating for humeral shaft fracture were included in the study. Patients were evaluated for functional recovery and progress of fracture healing. Rodrigeuz-Merchan criteria was used to grade the functional outcome. Results: A total of 44 patients were included in the study with mean age of 36. There were 31 males and 13 females. The majority of patients 31 (70.45%) sustained injury due to road traffic accident followed by fall from height 11 (25%) and direct injury 2(4.55%). The most common fracture pattern was AO /OTA Type A. The mean duration of surgery was 60±15min. Fracture union occurred in less than 4 months in 36 patients (81.81%). Rodriguez Merchan criteria showed majority of the patients had excellent 23(52.27%) and good 15 (34.1%) functional outcomes. Conclusion: Anteromedial plating provides a safe form of fixation of humeral shaft fracture. It has benefit of supine positioning of the patient during operation with good union rate, less fixation time, lesser complications leading to better functional outcome.
    Type of Medium: Online Resource
    ISSN: 2795-1502 , 2773-8019
    URL: Article
    DOI: 10.52910/ajhs.39
    Language: Unknown
    Publisher: Annapurna Neurological Institute & Allied Sciences
    Publication Date: 2021
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  • 4
    Online Resource
    Online Resource
    Laparoscopic Approach for Management of Hydatid Cyst of Liver
    Nepal Health Research Council ; 2017
    In:  Journal of Nepal Health Research Council Vol. 15, No. 1 ( 2017-08-13), p. 67-70
    Details
    In: Journal of Nepal Health Research Council, Nepal Health Research Council, Vol. 15, No. 1 ( 2017-08-13), p. 67-70
    Abstract: Background: Laparoscopy surgery trials are small and unconvincing at present and are limited to higher centers. The objective of the study is to determine the clinical features, prevalence of site of hydatid cyst and complications of this modality of this treatment.Methods: A cross sectional study was carried out in all patients with one or two hepatic hydatid cyst who underwent laparoscopic management in KMCTH from January 2013 to March 2015 were included in the study. Aspiration, deroofing and evacuation of the hydatid cyst were done.Results: Twenty six patients underwent laparoscopic management for liver hydatid cysts. Males were seven (65.38%) and females were 9(34.61%).The mean age was 35.5±13.1 years (range 21-55years.) The commonest complaint was pain and discomfort in 13(50%) patients and lump in 6(13.06%) patients. Twenty four (92.3%) patients were successfully treated with laparoscopic approach. Two (7.69%) patients had to be converted to laparotomy because of dense adhesions and bleeding. Mean operation time was 43.6±10.6 minutes. Two (7.69%) patients had port site infection. One (3.84%) patient had bile leak and no recurrence and mortality in our series.Conclusions: Laparoscopic management of liver hydatid cyst was safe and effective in selective group of patients in equipped hospital.
    Type of Medium: Online Resource
    ISSN: 1999-6217 , 1727-5482
    URL: Article
    DOI: 10.3126/jnhrc.v15i1.18017
    Language: Unknown
    Publisher: Nepal Health Research Council
    Publication Date: 2017
    detail.hit.zdb_id: 2551251-1
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  • 5
    Online Resource
    Online Resource
    Use of Statins as Lipid Lowering Agent in Hypercholesterolemia in a Tertiary Care Hospital: A Descriptive Cross-sectional Study
    Journal of Nepal Medical Association (JNMA) ; 2020
    In:  Journal of Nepal Medical Association Vol. 58, No. 232 ( 2020-12-31)
    Details
    In: Journal of Nepal Medical Association, Journal of Nepal Medical Association (JNMA), Vol. 58, No. 232 ( 2020-12-31)
    Abstract: Introduction: Lipids contribute to atherosclerosis and obesity that can lead to different cardiovascular diseases. Statins are hydroxymethylglutaryl reductase inhibitors that effectively lower the cholesterol level. It is widely prescribed in the treatment of hypercholesterolemia. Thus it optimizes the lipoprotein profile. The selection of a particular drug by the practitioner should be primarily based on clinical outcome. This study was conducted to find the type of statins that are most preferred by the doctors for treating dyslipidemia and preferred the fixed-dose in a tertiary care hospital. Methods: This was a descriptive cross-sectional study conducted among the practicing doctors of Kathmandu Medical College from July to August 2020. Ethical approval was taken from the Institutional Review Committee of the college (Ref: 207202006). Convenient sampling was done. A semi-structured questionnaire was used with consent. The data were analyzed with Social Statistical Package for the Social Sciences version 20. Results: Statins, with the score 4.25 was accounted for most preferred for the treatment of dyslipidemia. Among different statins, atorvastatin with a score of 4.48 was most popular followed by rosuvastatin 2.9 score and simvastatin 2.1 scores. Conclusions: Statins were the most preferred agents for the treatment of dyslipidemia. Although different types of statins ought to have similar efficacy in treating dyslipidemia, atorvastatin was found to be popular and the most commonly prescribed one. The most common side effect reported with statins was myopathy.
    Type of Medium: Online Resource
    ISSN: 1815-672X , 0028-2715
    URL: Article
    DOI: 10.31729/jnma.5444
    Language: Unknown
    Publisher: Journal of Nepal Medical Association (JNMA)
    Publication Date: 2020
    detail.hit.zdb_id: 2209910-4
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  • 6
    Online Resource
    Online Resource
    Visualisation of Rouviere’s Sulcus during Laparoscopic Cholecystectomy
    Journal of Nepal Medical Association (JNMA) ; 2015
    In:  Journal of Nepal Medical Association Vol. 53, No. 199 ( 2015-09-30), p. 188-191
    Details
    In: Journal of Nepal Medical Association, Journal of Nepal Medical Association (JNMA), Vol. 53, No. 199 ( 2015-09-30), p. 188-191
    Abstract: Introduction: Safe dissection of Calot’s Triangle is important during the performance of laparascopic cholucystectomy. The purpose of the study is to determine the frequency of demonstrable Rouviere’s sulcus in patients with symptomatic gall stones and its role in safe dissection in Calot’s triangle. Methods: This is a prospective descriptive study design done in Department of surgery, Kathmandu Medical College Teaching Hospital from Jan 2013 to Jan 2015. Patients who were posted for laparoscopic cholecystectomy were included. During laparoscopy, Rouviere’s sulcus was noted in the operative note and classified according to following: Type I: Open type was defined as a cleft in which the right hepatic pedicle was visualized and the sulcus was opened throughout its length. Type II: if the sulcus was open only at its lateral end. Type III If the sulcus was open only at its medial end. Type IV: Fused type was defined as one in which the pedicle was not visualized. Results: A total of 200 patients underwent laparoscopic cholecystectomy during period of 2 years. Out of which Rouviere’s sulcus was visualized in 150 patients (75 %).Type I (open type) was commoner in 54%, type II in 12%, Type III in 9% and type IV (fused type) in 25%. Conclusions: Rouviere’s Sulcus is an important extra biliary land mark for safe dissection of Calot’s triangle during laparoscopic cholecystectomy.  Keywords: Rouviere’s Sulcus, laparoscopic cholecystectomy, bile duct injury.
    Type of Medium: Online Resource
    ISSN: 1815-672X , 0028-2715
    URL: Article
    DOI: 10.31729/jnma.2789
    Language: Unknown
    Publisher: Journal of Nepal Medical Association (JNMA)
    Publication Date: 2015
    detail.hit.zdb_id: 2209910-4
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  • 7
    Online Resource
    Online Resource
    Scrub typhus associated acute kidney injury in a 33-year-old male
    Medip Academy ; 2021
    In:  International Journal of Advances in Medicine Vol. 8, No. 9 ( 2021-08-21), p. 1427-
    Details
    In: International Journal of Advances in Medicine, Medip Academy, Vol. 8, No. 9 ( 2021-08-21), p. 1427-
    Abstract: Scrub typhus or bush typhus is caused by Orientia tsutsugamushi. An eschar at the site of bite is evidentiary of scrub typhus. Increased mortality is seen in cases presenting with acute kidney injury (AKI), acute respiratory distress syndrome (ARDS), pneumonitis, meningitis, myocarditis and multi-organ dysfunction. Renal impairment in scrub typhus should be identified and management initiated early to prevent the progress of the damage. Scrub typhus if left undiagnosed and untreated results in high morbidity and mortality. Here we report a case of a 33-year-old male with AKI following scrub typhus fever. In our case early diagnosis and management led the patient to recovery.
    Type of Medium: Online Resource
    ISSN: 2349-3933 , 2349-3925
    URL: Article
    DOI: 10.18203/2349-3933.ijam20213250
    Language: Unknown
    Publisher: Medip Academy
    Publication Date: 2021
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  • 8
    Online Resource
    Online Resource
    Data_Sheet_1.pdf
    Frontiers Media SA ; 2020
    In:  Frontiers in Cellular and Infection Microbiology Vol. 10 ( 2020-10-9)
    Details
    In: Frontiers in Cellular and Infection Microbiology, Frontiers Media SA, Vol. 10 ( 2020-10-9)
    Type of Medium: Online Resource
    ISSN: 2235-2988
    URL: Article
    URL: Article
    DOI: 10.3389/fcimb.2020.564565
    DOI: 10.3389/fcimb.2020.564565.s001
    Language: Unknown
    Publisher: Frontiers Media SA
    Publication Date: 2020
    detail.hit.zdb_id: 2619676-1
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  • 9
    Online Resource
    Online Resource
    Tailoring Microalgae for Efficient Biofuel Production
    Frontiers Media SA ; 2018
    In:  Frontiers in Marine Science Vol. 5 ( 2018-11-21)
    Details
    In: Frontiers in Marine Science, Frontiers Media SA, Vol. 5 ( 2018-11-21)
    Type of Medium: Online Resource
    ISSN: 2296-7745
    URL: Article
    DOI: 10.3389/fmars.2018.00382
    Language: Unknown
    Publisher: Frontiers Media SA
    Publication Date: 2018
    detail.hit.zdb_id: 2757748-X
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  • 10
    Online Resource
    Online Resource
    Product of Serum Calcium and Phosphorus (Ca x Pi) as a Predictor of Cardiovascular Disease Risk in Patients with Chronic Kidney Disease
    Nepal Journals Online (JOL) ; 2020
    In:  Journal of Universal College of Medical Sciences Vol. 8, No. 1 ( 2020-07-02), p. 23-26
    Details
    In: Journal of Universal College of Medical Sciences, Nepal Journals Online (JOL), Vol. 8, No. 1 ( 2020-07-02), p. 23-26
    Abstract: INTRODUCTION: Most of the chronic kidney disease (CKD) patients develop cardiovascular disease (CVD) in their later stages. Various traditional CVD risk factors are highly prevalent in CKD but mortality of these patients cannot be fully justified by these CVD markers. So this study was designed to determine serum calcium and phosphorus product (Ca×Pi) to predict CVD risk in CKD patients. MATERIAL AND METHODS We followed the guidelines of NKF-KDOQI for CKD diagnosis and staging. Further the patients were classified into 3 different groups based on Ca×Pi product; 〈 40 mg2/dl2 (group 1), 40-55 mg2/dl2 (group 2) and 〉 55 mg2/dl2 (group 3). We then evaluated CVD risk by various traditional risk factors like age, BMI, BP, smoking history, dyslipidemia, previous history of CVD, LVH, arrhythmia, VHD, cardiomyopathy, and IHD. RESULTS: Higher level of Ca×Pi was associated with presence of LVH (32.30% in group 1, 31.42% in group 2 and 46.66% in group 3), Arrythemia (13.84% in group 1, 28.57% in group 2 and 46.67% in group 3), VHD (5.71% in group 2 and 10.00% in group 3), Cardiomyopathy (1.53% in group 1, 8.57% I group 2 and 6.66% in group 3), IHD (6.15% in group1, 11.42% in group 2 and 13.33% in group 3) and hypercholesterolemia, hypertriglyceridemia and increased LDLc. CONCLUSION: This study found that higher Ca×Pi increases with decline in glomerular filtration rate (GFR) and associated with CVD risks and CVD. So, this study raise a potential need to evaluate the level of calcium and phosphorus in all CKD patients and the level should be monitored more thoroughly to prevent CVD.
    Type of Medium: Online Resource
    ISSN: 2350-8582 , 2091-2846
    URL: Article
    DOI: 10.3126/jucms.v8i1.29829
    Language: Unknown
    Publisher: Nepal Journals Online (JOL)
    Publication Date: 2020
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