Shital Bhandary

Bio: Shital Bhandary is an academic researcher from Patan Academy of Health Sciences. The author has contributed to research in topics: Medicine & Problem-based learning. The author has an hindex of 9, co-authored 51 publications receiving 300 citations.

Peripheral intravenous catheter related phlebitis and its contributing factors among adult population at KU Teaching Hospital

Abstract: Background : Peripheral intravenous catheter-related phlebitis is a common and significant problem in clinical practice. This study was carried out to determine the occurrence of peripheral intravenous catheter related phlebitis and to define the possible factors associated to its development. Materials and methods : Prospective observational study was carried out on 230 clients who were under first time peripheral infusion therapy during two months period: September - October, 2007. Peripheral infusion site was examined for signs of phlebitis once a day. Jackson Standard visual phlebitis scale was used to measure the severity of the phlebitis. SPSS software was used to enter, edit and analyze the data and t-test, chi-square test, binary logistic regression and ROC curve were used to draw the statistical inferences. Results : Phlebitis developed in 136/230 clients (59.1%). It was very mild in most cases. Increased incidence rates of infusion related phlebitis were associated with male sex, small catheter size (20 gauge), insertion at the sites of forearm, IV drug administration and blood product transfusions. The incidence rate of phlebitis rose sharply after 36 hours of catheter insertion. Conclusion : Peripheral Intravenous therapy related phlebitis at KUTH, Dhulikhel Hospital is a significant problem. Related risk factors as found in the present study were insertion site (forearm), size of catheter (20G) and dwell time (>= 36 hours). There were higher incident of phlebitis among the client with Intra venous drug administration and especially between ages 21 - 40 years. Therefore more attention and care are needed in these areas by the care provider. Key words: Phlebitis, Intravenous Therapy, Catheter, Risk Factors, KUTH, Nepal. doi: 10.3126/kumj.v6i4.1732 Kathmandu University Medical Journal (2008), Vol. 6, No. 4, Issue 24, 443-447

Nutritional status and morbidity pattern among governmental primary school children in the Eastern Nepal.

Abstract: Objective: To assess the nutritional status and morbidity pattern of primary school children. Methods: Descriptive, cross-sectional study was administered in the five governmental schools located in Dhankuta town (Dhankuta district) and Ineruwa town (Sunsari district). The schools were selected using simple random sampling technique. From these selected schools, a total number of 818 students studying from Grade I to V were enumerated in the study using census survey method. Results: Among 818 students, 61% of the students were found to be malnourished. The students were more stunted (21.5%) than wasted (10.4%). Only 5.4 % of the students were found to be both wasted and stunted. The collected blood and stool samples from the students revealed parasitic infestation of 65.8% and anaemia of 58%. The most common diseases in those schools were: skin diseases (20%), dental caries (19.8%), and lymphodenopathy (10.5%). Among skin diseases, pediculosis was more common among girls while ringworms and scabies were common among boys. Conclusion: The study revealed that high percentage of primary school students was malnourished. It was found that there was a high prevalence of parasitic infestation and anaemia. The study result revealed the urgent need for initiation of school health program with specific emphasis on prevention of diseases, improvement of personal hygiene and nutritional status with the collaboration of governmental and non-governmental institutions.

Effect of an educational intervention on knowledge and attitude regarding pharmacovigilance and consumer pharmacovigilance among community pharmacists in Lalitpur district, Nepal.

Abstract: Pharmacovigilance activities are in a developing stage in Nepal. ADR reporting is mainly confined to healthcare professionals working in institutions recognized as regional pharmacovigilance centers. Community pharmacists could play an important role in pharmacovigilance. This study was conducted among community pharmacists in Lalitpur district to examine their knowledge and attitude about pharmacovigilance before and after an educational intervention. Knowledge and attitude was studied before, immediately after and 6 weeks following the intervention among 75 community pharmacists. Responses were analysed using descriptive and inferential statistics. A pretested questionnaire having twelve and nine statements for assessing knowledge and attitude were used. The overall scores were obtained by adding the ‘knowledge’ and ‘attitude’ scores and ‘overall’ scores were summarized using median and interquartile range. Wilcoxon signed-rank test for repeated samples was used to compare the differences between knowledge and attitude of the pharmacists before and after the educational program. Knowledge scores [median (interquartile range)] improved significantly between pre-test [39 (44–46)], post-test [44 (44–44)] and retention period of 6 weeks after the intervention [46 (43–46)]. Knowledge score improved immediately post-intervention among both males [44 (41–47)] and females [44 (43–45)] but the retention scores (after 6 weeks) were higher [46 (42–48)] among males. Attitude scores improved significantly among females [46 (44–48)]. The overall scores were higher among pharmacists from rural areas. Knowledge and attitude scores improved after the educational intervention. Further studies in other regions of the country are required. The national pharmacovigilance center should promote awareness about ADR reporting among community pharmacists.

Correlation between gestational weight gain and birth weight of the infants.

Abstract: Birth weight is an important determinant of infant's well being as low birth weight is known to increase the risk adult onset of diseases like type-2 diabetes and ischemic heart disease. Maternal weight gain is one of the most important independent predictors of infant birth weight. Institute of Medicine of the National Academics, USA has recommended that total weight gain of mothers should be according to their prepregnancy body mass index (BMI). Therefore, this study was conducted to observe the total weight gained by the pregnant women and the correlation between the weights gained by them with the birth weight of their infants. 98 women who delivered full term single baby at Patan hospital were included after taking their verbal consent. The details of the newborn and the history of the pregnant women were taken from the hospital records. The information about the family income, dietary habit, birth spacing and the type of work done by the pregnant women was obtained from the women themselves. The mean weight gain of the mothers was 9.48 (SD = 3.41) kilograms and the mean birth weight of the infants was found to be 2965.66 (SD = 364.37) grams. Multiple Liner Regression Models showed the effect of Gestational weight gain (GWG), Age and Parity on birth weight of the infant. Step-wise multiple regressions gave rise to models that showed effect of GWG and age on birth weight of the infants. This study concluded that gestational weight gain has positive linear relationship (correlation) with the birth weight of infants.

Prevalence of intestinal parasitic infections among public school children in a rural village of Kathmandu Valley.

Abstract: Intestinal parasitic infections (IPI) are one of the most prevalent infections in humans residing in developing countries and its burden is high among school aged children. This cross-sectional study was conducted to determine the prevalence of intestinal parasitic infection and types of intestinal parasites in rural public school children of Nepal. It included students from Nursery to Class X of a rural public school located in the northeast part of the Kathmandu Valley, Nepal. Among the 194 participating children, prevalence of intestinal parasitic infection was found as 23.7%; (28.2% for boys; 20.2% for girls). Amongst the infected children, single and mixed parasitic infection was detected in 43 (93.5%) and 3 (6.5%) children respectively. Among protozoan parasites, Giardia lamblia was the most common (58.6%) whereas Hymenolepis nana was the most common (21.7%) among the helminths. Statistically different prevalence of intestinal parasitic infection was observed among children aged above 10 years and children aged below 6 years as well as 6 to 10 years. Gender-wise, there was no statistical difference in prevalence of intestinal parasitic infection. This study suggests the need of health education program in schools along with regular screening of intestinal parasites and treatment for effective management of the intestinal parasites among school children in Nepal.

Problem-Based Learning: An Approach to Medical Education

Abstract: When there are many people who don't need to expect something more than the benefits to take, we will suggest you to have willing to reach all benefits. Be sure and surely do to take this problem based learning an approach to medical education that gives the best reasons to read. When you really need to get the reason why, this problem based learning an approach to medical education book will probably make you feel curious.

Medicine, rationality, and experience: an anthropological perspective.

Abstract: Inevitably, reading is one of the requirements to be undergone. To improve the performance and quality, someone needs to have something new every day. It will suggest you to have more inspirations, then. However, the needs of inspirations will make you searching for some sources. Even from the other people experience, internet, and many books. Books and internet are the recommended media to help you improving your quality and performance.

Accepted but unacceptable: peripheral IV catheter failure.

Abstract: Peripheral intravenous (IV) catheter insertion, the most common invasive hospital procedure performed worldwide, is associated with a variety of complications and an unacceptably high overall failure rate of 35% to 50% in even the best of hands. Catheter failure is costly to patients, caregivers, and the health care system. Although advances have been made, analysis of the mechanisms underlying the persistent high rate of peripheral IV failure reveals opportunities for improvement.

The Nutritional Status of School-Aged Children: Why Should We Care?

Abstract: BackgroundThe nutritional status of school-aged children impacts their health, cognition, and subsequently their educational achievement. The school is an opportune setting to provide health and nu...