Pratima Thapa

Bio: Pratima Thapa is an academic researcher from Kathmandu University. The author has contributed to research in topics: Medicine & Cross-sectional study. The author has an hindex of 3, co-authored 6 publications receiving 13 citations. Previous affiliations of Pratima Thapa include Dhulikhel Hospital.

Nursing students' attitude on the practice of e-learning: A cross-sectional survey amid COVID-19 in Nepal.

Abstract: Introduction In present days, the use of information technology (IT) in education is unquestionable. The mounting advancement of IT has changed the scenario of education. With the emergence of the current COVID-19 situation, it has undoubtedly provided a solution to most of our educational needs when all educational institutions remained closed due to the pandemic. This study aims to identify the nursing students' attitude towards the practice of e-learning amidst COVID-19. Methods A descriptive web-based cross-sectional study was conducted among nursing students with a sample size of 470. A self-administered validated questionnaire along with a standard tool to measure the attitude was used for data collection. Data were analyzed using SPSS. Results The mean ± SD age of the respondents was 20.91± 1.55 years. The majority (76.4%) of the respondents used mobile for their study and 90.4% used Wi-Fi for the internet source. The main advantage of e-learning was stated as the ability to stay at home (72.1%) followed by the reduced cost of accommodation and transport (51.3%) whereas the internet problem (81.7%) was the major disadvantage followed by technical issues (65.5%). Only about 34% of the students found e-learning as effective as traditional face-to-face learning. The mean scores for the domains: perceived usefulness, intention to adapt, distant use of e-learning, ease of learning, technical support, and learning stressors were 3.1, 3.1, 3.8, 2.9, 2.9, and 2.5 respectively. Overall, 58.9% had a favorable attitude regarding e-learning. There was no significant association of overall attitude regarding e-learning with selected socio-demographic variables whereas it was positively associated with all of its six domains. All the domains were positively correlated with each other except for ease of learning with technical support and distant use, and technical support with learning stressor and distant use. Learning stressor versus distant use was negatively correlated with each other. Conclusion Though e-learning was implemented as a substitute during the pandemic, almost half of the nursing students showed a positive attitude regarding e-learning. The majority of the students had internet problems and technological issues. If e-learning can be made user-friendly with reduced technical barriers supplemented with programs that can enhance practical learning abilities, e-learning can be the vital alternative teaching method and learning in the nursing field.

A study on complication and monitoring of warfarin in post-valve surgery.

Abstract: Introduction:This study was carried out to determine the incidence of complication related to warfarin in patients with valve surgery and identify potential risk factors for complication and study its monitoring aspects. Methods:A combined retrospective and prospective observational study including a total of 185 patients who underwent mechanical valve replacement in Shahid Gangalal National Heart Centre. The study was conducted from 4 November 2006 till 1 February 2007. Results:There were a total of 141 episodes of bleeding. Among them signifi cant bleeding occurred in 15.7% patients, major bleeding was 3.2 per 100 patient-years (3.8%) and minor bleeding was 11.8 per 100 patient-years (11.9%). Epistaxis (16.8%) was the most common bleeding complication. Menorrhagia was the most common bleeding complication in females with 20.5 per 100 patient-years (27.4%). Thromboembolic complications occurred at the rate of 2.3 per 100 patient-years. Patients on warfarin were outside the INR target range 67.8% of the time, with 21% INR values above range and 46.8% INR values below range. However, dose adjustment was done only 31.8% of times when INR was outside range. Conclusions:There is high incidence of bleeding complication in patients on warfarin and hypertension is signifi cantly associated with bleeding. Diffi culty in tightly controlling INR probably is related to high incidence of bleeding. Better patient education, stricter adjustment of INR, frequent monitoring of INR at peripheral hospitals and standardization of the test at different hospitals are suggested to reduce the warfarin related complications. Key Words: bleeding complication, heart valve surgery, warfarin

Study of Arteriovenous Fistula Cases in a Tertiary Care Hospital: A Descriptive Cross-sectional Study.

Abstract: Introduction: Arteriovenous fistulas are a preferred choice for hemodialysis access in chronickidney disease patients. There is increased adoption of arteriovenous fistula creation in Nepal.Our objective is to study various arteriovenous fistulas that have been created in our center. Methods: This is a descriptive cross-sectional study conducted in a tertiary care hospital includingall cases of arteriovenous fistula creation from January 2018 to December 2019. We obtained theethical clearance from the institutional review committee of Kathmandu University School ofMedical sciences. Convenient sampling method was used. Detailed vascular mapping and colordoppler ultrasonography was done in the bilateral upper limb as preoperative preparation and tochoose a site for arteriovenous fistula creation. Data were entered into the Statistical Package for theSocial Sciences version 20 for analysis. Results: Among 50 patients, the most common location was brachiobasilic 20 (40%) patients followedby brachiocephalic 18 (36%), radiocephalic 11 (22%), and arteriovenous graft between the brachialartery and axillary vein 1 (2%). The mean duration of hospital stay was 1.44 days. Three (6%) patientsrequired re-intervention, all within 24 hours. Two (4%) patients had a failure of arteriovenous fistularequiring the creation of a new arteriovenous fistula. Conclusions: Brachiobasilic was the most common location for arteriovenous fistula creation.Reintervention was not common.

Case report of eventration of diaphragm due to an unknown febrile illness causing phrenic nerve palsy and other multiple nerve palsies.

Abstract: Introduction Diaphragmatic eventration can be congenital or acquired. Diagnosis is delayed due to no symptoms or very mild ones and is generally done by imaging modalities. This condition is managed by plication of the affected part of diaphragm by various surgical approaches. Presentation of case A forty seven years lady presented with one year long history of abdominal pain, bloating and fullness after meals who was being treated in line of peptic acid disorder. She had developed bilateral foot drop after typhoid fever at seventeen years of age. Clinical examination and imaging with chest x-ray, chest ultrasound and computed tomography scan suggested eventration of left hemidiaphragm. Plication of eventration of left hemidiaphragm was done via mini thoracotomy of the left thorax. There were no postoperative complications and she was discharged on the sixth postoperative day. Discussion Acquired eventration of diaphragm is commonly due to traumatic phrenic nerve palsy but rarely can be associated with a history of infection causing nerve palsies. Thoracic ultrasound is an emerging modality for diagnosis supporting X-rays and CT Scans. Plication of eventration with minimally invasive techniques has less number of hospital stay and less pain compared to open approaches. Conclusion Non-traumatic diaphragmatic eventration due to acquired phrenic nerve palsy following an unknown febrile illness is a rare case to be reported in Nepal. The aim of treatment is expansion of intra-thoracic space which is done by plication of the diaphragm.

Quality of life of postmenopausal women in rural area, Nepal.

Abstract: BackgroundMenopause is one of the natural phenomena in every woman’s life. The transition phase gradually brings lots of changes in the life of women, both physically and mentally. In Nepal, these ...

Academic stress, COVID‐19 anxiety, and quality of life among nursing students: The mediating role of resilience

Abstract: Abstract Aim This study investigated the mediating role of resilience in the relationship between academic stress, COVID‐19 anxiety, and quality of life (QoL) among Filipino nursing students during the COVID‐19 pandemic. Background The COVID‐19 pandemic has impacted the QoL of nursing students who are experiencing mental health issues. The mediating role of resilience in mitigating the effects of academic stress and COVID‐19 anxiety on nursing students’ QoL remains understudied. Methods This study employed a correlational cross‐sectional design, with a convenience sample of 611 Filipino nursing students. Data were collected using the scales Connor and Davidson Resilience, Brunnsviken Brief Quality of Life, COVID‐19 Anxiety, and Perception of Academic Stress and analyzed using Pearson's r, bivariate analysis, and multistage regression analyses. Results Academic stress and COVID‐19 anxiety negatively correlated with QoL and resilience. Resilience was positively associated with QoL and reduced the effect of academic stress on QoL, indicating that resilience is a crucial mediating variable between academic stress and QoL. Finally, resilience had a significant mediating influence on QoL, as evidenced by a reduction in the effect of COVID‐19 anxiety on QoL among nursing students. Conclusions Filipino nursing students' QoL was affected by academic stress and COVID‐19–related anxiety. However, resilience mediated this impact, preserving QoL. Implications for nursing and health policy Nursing colleges and affiliated hospitals must collaborate to monitor academic stress and pandemic‐related anxiety. Nursing students should be provided with programs such as seminars and team‐building activities to enhance their resilience.

Potential use of NOACs in developing countries: pros and cons

Abstract: Purpose Although vitamin K antagonists (VKAs) are effective for long-term thromboprophylaxis in atrial fibrillation (AF), their limitations have led to widespread underutilisation, especially in the developing world. Novel oral anticoagulants (NOACs) have emerged as promising alternatives to VKAs, although there are some particular considerations and challenges to their introduction in developing countries. This review summarises the current state of antithrombotic management of AF in the developing world, explores the early evidence for the NOACs and describes some of the special considerations that must be taken into account when considering the role of the NOACs within developing countries’ health care systems.

Iranian nursing students experiences regarding the status of e-learning during COVID-19 pandemic

Abstract: Introduction With the emergence of the COVID-19 pandemic, universities immediately responded to protect students’ lives by implementing e-learning in order to stop the spread of the communicable disease within the academic population. This study aimed to describe iranian nursing students’ experiences of e-learning during the COVID-19 pandemic. Materials and methods The current study used a qualitative descriptive study. Ten nursing undergraduate students from a single Iranian university identified using purposive sampling methods. Face-to-face semi-structured interview conducted from May to July 2021 and analyzed through thematic analysis. Lincoln and Goba criteria were used to obtain data validity and reliability. Results Four themes emerged including"novelty of e-learning","advantages of e-learning", "disadvantages of e-learning"and"passage of time and the desire to return to face education". Participants evaluated e-learning as a novel method without proper infrastructure, it was initially confusing but became the new normal as their knowledge of the way to use it improved. Advantages included self-centered flexible learning and reduction in their concerns experienced with face-to-face learning. Disadvantages including changing the way they interact with teachers, decreasing interactions with classmates, problems with education files, superficial learning, hardware problems, family members’ perceptions of the student role, interference of home affairs with e-learning, cheating on exams and assignments and being far away from the clinical context. Conclusion The findings revealed that e-learning has been introduced as a new method for the current research participants and despite the perceived benefits, these students believed that e-learning could supplement face education but not replace it.

FLOWER: An Approach for Enhancing E-Learning Experience Amid COVID-19

Abstract: The worldwide COVID-19 pandemic has forced higher institutions to shift towards electronic (e) learning. Despite a plethora of research on the responses of higher education institutions to COVID-19 and their shift towards e-learning, research often focuses on the opportunities and/or challenges of e-learning amid COVID-19. Notwithstanding this, limited research has addressed how e-learning experiences can be enhanced among medical students, who often need conventional leaning, especially for practical courses. This research addresses a gap in the knowledge and examined medical students’ perceptions of e-learning using the Blackboard platform, and the elements or predicators that affect their e-learning experience amid COVID-19 in the Kingdom of Saudi Arabia. An online survey was transmitted to medical students in three main public universities. Based on the findings, a FLOWER model was proposed for improving e-learning experience using Blackboard among medical students. This model includes six dimensions: feedback, leverage to remain motivated, open resources and information, working together, evaluation, and reflection and knowledge. These dimensions are interrelated, and enable the creation of a positive e-learning experience. The results showed that four of the six dimensions have high positive and significant path coefficients: open sources and information; leverage to remain motivated; working together; and reflection and knowledge construction. Two of the six dimensions have low positive, but significant, path coefficients (feedback and evaluation), which require further consideration by policymakers and educators. The results have several theoretical and practical implications, which are elaborated upon.