Papers by Sanjib Upadhyay
MedS Alliance Journal of Medicine and Medical Sciences
INTRODUCTION: Diabetes is a pandemic of public health importance, and prediabetes has also emerge... more INTRODUCTION: Diabetes is a pandemic of public health importance, and prediabetes has also emerged as a major public health concern. Unfortunately, one-third of individuals with diabetes are identified only after developing complications, and nearly three-fourths are unaware of their raised blood sugar status. Opportunistic screening at an earlier stage has good prognosis. The study aimed at an opportunistic screening of raised plasma glucose levels of outpatients and diagnosing prediabetes and diabetes among them. MATERIALS AND METHODS: This descriptive cross-sectional study was conducted among patients visiting an Eye ENT hospital in Bhaktapur, Nepal, between January to December 2019. Outpatients aged 40-79 years with unknown history of diabetes were invited for free hyperglycemia screening. Descriptive analysis was computed for patients participating in random plasma glucose (RPG) screening and patients coming for definitive tests for diabetes with elevated RPG levels. RESULTS: A...
Use of telemedicine and artificial intelligence in Eye and ENT: a boon for developing countries
2022 4th International Conference on Artificial Intelligence and Speech Technology (AIST)
MedS Alliance Journal of Medicine and Medical Sciences
INTRODUCTION: Tele-otology is one of the least explored areas of telehealth in Nepal. The objecti... more INTRODUCTION: Tele-otology is one of the least explored areas of telehealth in Nepal. The objective image findings and live virtual specialist consultation using synchronous data exchange can address the different barriers to basic otological care in low-resource settings like Nepal. This study was conducted to explore the acceptability and feasibility of community management of ear patients through tele-otology. MATERIALS AND METHODS: It was a cross-sectional descriptive study conducted at a tertiary level ENT hospital in Bhaktapur and three outreach clinics of the hospital in the periphery of Kathmandu valley from 1st April to 31st May 2021. Trained community ear health workers (CEHWs) used mobile data in fields and communicated with ENT consultants at the base hospital with fiber-to-the-home internet connection for teleconsultation. The satisfaction was measured using a 5-point Likert scale. RESULTS: This study has shown satisfactory acceptance among beneficiaries and service pro...
Journal of Nepal Medical Association
Introduction: Diabetes mellitus is a chronic metabolic disease characterised by elevated blood su... more Introduction: Diabetes mellitus is a chronic metabolic disease characterised by elevated blood sugar levels and is a pandemic of public health importance. Screening programs can help reduce morbidity and mortality by preventing or delaying complications. This study aimed to find out the prevalence of diabetes mellitus among adult outpatients visiting a tertiary care centre. Methods: This descriptive cross-sectional study was conducted among outpatients visiting a tertiary care centre between 1 January 2019 to 31 December 2019. Ethical approval was obtained from the Ethical Review Board (Registration number: 408/2020 P). Patients with unknown history of diabetes participating in free random blood sugar examinations were included in the study. Systematic random sampling was used. Point estimate and 95% Confidence Interval were calculated. Results: Among 385 adult outpatients, 17 (4.42%) (2.37–6.47, 95% Confidence Interval) had diabetes. The mean random blood sugar level of the diabeti...
MedS Alliance Journal of Medicine and Medical Sciences, 2022
INTRODUCTION: Tele-otology is one of the least explored areas of telehealth in Nepal. The objecti... more INTRODUCTION: Tele-otology is one of the least explored areas of telehealth in Nepal. The objective image findings and live virtual specialist consultation using synchronous data exchange can address the different barriers to basic otological care in low-resource settings like Nepal. This study was conducted to explore the acceptability and feasibility of community management of ear patients through tele-otology.
MATERIALS AND METHODS: It was a cross-sectional descriptive study conducted at a tertiary level ENT hospital in Bhaktapur and three outreach clinics of the hospital in the periphery of Kathmandu valley from 1st April to 31st May 2021. Trained community ear health workers (CEHWs) used mobile data in fields and communicated with ENT consultants at the base hospital with fiber-to-the-home internet connection for teleconsultation. The satisfaction was measured using a 5-point Likert scale.
RESULTS: This study has shown satisfactory acceptance among beneficiaries and service providers. The sound quality rating was 4.5±0.8 at field-site and 4.5±0.9 at base hospital. The video quality ratings were 4.4±0.8 and 4.0±1.1 at field-site and base hospital, respectively; this difference was statistically significant (p=0.017).
CONCLUSIONS: With trained grassroots level workers and quality internet connections, tele-otology can play a significant role in the early identification and diagnosis of ear diseases, including middle ear pathologies, as well as bridging the ear care service gap in resource constraints settings like Nepal.
Journal of Nepal Medical Association, 2022
Introduction: Abdominal obesity, as abnormal fat accumulation that presents a risk to health, is ... more Introduction: Abdominal obesity, as abnormal fat accumulation that presents a risk to health, is a global epidemic. There is evidence to support a trait of abdominal adipose deposition despite normal body mass index in south asian populations with greater cardiometabolic risks. Thus, this study aimed to find out the prevalence of abdominal obesity using the waist to height ratio among outpatients in a tertiary level hospital. Methods: This descriptive cross-sectional study was conducted among outpatients at a tertiary level hospital in Nepal from January 2016 to December 2018. Ethical approval was taken from the Ethical Review Board of Nepal Health Research Council (Reference no. 207/2019). Convenience sampling was done. The data were entered into excel and analyzed using Statistical Package for Social Sciences version 24. Point estimate at 99% confidence interval was calculated along with frequency and proportion for binary data. Results: Among 25,511 participants, 21,834 (85.6%) (...
Revolutionizing healthcare systems of a developing country using Blockchain
2018 IEEE International Conference on Computational Intelligence and Computing Research (ICCIC), 2018
In present days, data security and citizen privacy are the vulnerable areas globally. Amongst the... more In present days, data security and citizen privacy are the vulnerable areas globally. Amongst them, healthcare systems are the most targeted ones. In Nepal, among the few e-health systems available, most are disconnected, fragmented and cyber security aspect is overlooked, creating even more risk. To effectively guide health care systems and make it more citizen-centric, centralized secured online healthcare system is essential. This study proposes a centralized, permissioned Blockchain based secured healthcare system using hyperledger for developing countries. This system follows distributed storage technology to facilitate better availability, redundancy and strong confidentiality using cryptographic encryption. Besides, this technique creates a transparent yet secure and immutable data storage and sharing platform. It optimally and effectively contributes to the transfer of health information that is cost effective. Regarding it, a pilot study was performed taking a tertiary care hospital; Hospital for Children, Eye, ENT and Rehabilitation Services (CHEERS) and its community hospital at Chapagaun. It was validated using the balanced scorecard to confirm its cost-effective performance. Nineteen most essential key progress indicators were chosen for study. From this study, it was deduced that transforming internal business process of a hospital setting by implementing proposed healthcare system results in 75% customer satisfaction as well as 63% financial gain. This approach uplifts the healthcare organizations and their financial status. It, in turn, sets a benchmark for a secured health care system of developing countries as a whole.
BackgroundObesity has become a global epidemic and an important risk factor for non-communicable ... more BackgroundObesity has become a global epidemic and an important risk factor for non-communicable diseases. Earlier thought to be a problem of developed world, it has now become a problem of low- and middle-income countries like Nepal. In absence of a routine surveillance or a registry system, the actual burden and trend of obesity in Nepal is unknown. Obesity and overweight are recognized risk factors for hypertension and associated with cardiovascular disease. The aim of the study was to find out burden of obesity, using three commonly employed metrics in hospital outpatient setting of a low-income country as predictors of hypertension, and compare ability of different anthropometric measurements through a non-inferiority study to predict hypertension.MethodsThis cross-sectional study was conducted among 40-69 years outpatients in a tertiary Eye and ENT hospital in a semi-urban area of Nepal among randomly selected 2,256 participants from 6,769 outpatients who were evaluated in Hea...
Indian journal of otolaryngology and head and neck surgery : official publication of the Association of Otolaryngologists of India, 2004
A study of community- oriented multilaleral study was carried out in rural community of eastern N... more A study of community- oriented multilaleral study was carried out in rural community of eastern Nepal where in total of 2564 patients were screened out and it revealed that multi nutritional deficiency comprised of 20% along with unsatisfactory or incomplete immunization was recorded in 45%. Children up-to 14 years of age (1223) were considered for this study. 5-14 years of age were the must vulnerable for ear diseases (50.16%). 61% children were living in over crowded dwellings. The hearing analysis established that the number of conductive deafness were prevalent in 62.46% in comparison to sensory-neural hearing loss 2.40% and mixed hearing loss (0.18%). Due to better ear care, Otorrhoea was under control in 67% cases and so was the conductive deafness improved.
Indian journal of otolaryngology and head and neck surgery : official publication of the Association of Otolaryngologists of India, 2003
We report two cases of inverted papilloma of nose with malignant transformation and orbital invol... more We report two cases of inverted papilloma of nose with malignant transformation and orbital involvement in 60 year and 73 year male patients from Nepal. Medial maxillectomy and orbital exenteration were done in both cases. Histo- pathological examination showed areas of squamous cell carcinoma in inverted papilloma in both of the cases.The dilemma of diagnosis and treatment is discussed with review of literature.
Indian journal of otolaryngology and head and neck surgery : official publication of the Association of Otolaryngologists of India, 2002
Aneurysmal hone cyst is rare in paranasal sinuses. It may be uni or multilocutar It occurs alone ... more Aneurysmal hone cyst is rare in paranasal sinuses. It may be uni or multilocutar It occurs alone or with other benign bone lesions. The exact pathogenesis of it is still unknown. The aggressiveness of the disease needs early diagnosis and proper management to prevent recurrence. This report describes a case of aneurysmal bone cyst involving the ethmoid and maxillary sinuses which was successfully managed.
I N T R O D U C T I O N Nepal, though beautiful with its snow capped mountains and lustrous footh... more I N T R O D U C T I O N Nepal, though beautiful with its snow capped mountains and lustrous foothills is ridden with illiteracy, poverty and sociopolitical problems. It is one of the least developed countries of the world. The Incidence of hearing loss in Nepal as per earlier survey is 16.6% (BRINOS/TUTH report1991). India our immediate neighbour has its prevalence of heating loss to be around 10.7%(The ICMR report-1983, based on multi-centric study); a significant difference exists between the two neighbours. This along with the massive number of ENT patient, approximately 120 per day visiting the out patient department of B.P.Koirala Institute of Health Sciences (BPKIHS) provoked us to initiate a survey cum treatment (where Possible) in two of its (the lnstitute's.) neighborin~ villages (Madhuban and Kushaha) of Sunsari district, at eastern Nepal.
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Papers by Sanjib Upadhyay
MATERIALS AND METHODS: It was a cross-sectional descriptive study conducted at a tertiary level ENT hospital in Bhaktapur and three outreach clinics of the hospital in the periphery of Kathmandu valley from 1st April to 31st May 2021. Trained community ear health workers (CEHWs) used mobile data in fields and communicated with ENT consultants at the base hospital with fiber-to-the-home internet connection for teleconsultation. The satisfaction was measured using a 5-point Likert scale.
RESULTS: This study has shown satisfactory acceptance among beneficiaries and service providers. The sound quality rating was 4.5±0.8 at field-site and 4.5±0.9 at base hospital. The video quality ratings were 4.4±0.8 and 4.0±1.1 at field-site and base hospital, respectively; this difference was statistically significant (p=0.017).
CONCLUSIONS: With trained grassroots level workers and quality internet connections, tele-otology can play a significant role in the early identification and diagnosis of ear diseases, including middle ear pathologies, as well as bridging the ear care service gap in resource constraints settings like Nepal.
MATERIALS AND METHODS: It was a cross-sectional descriptive study conducted at a tertiary level ENT hospital in Bhaktapur and three outreach clinics of the hospital in the periphery of Kathmandu valley from 1st April to 31st May 2021. Trained community ear health workers (CEHWs) used mobile data in fields and communicated with ENT consultants at the base hospital with fiber-to-the-home internet connection for teleconsultation. The satisfaction was measured using a 5-point Likert scale.
RESULTS: This study has shown satisfactory acceptance among beneficiaries and service providers. The sound quality rating was 4.5±0.8 at field-site and 4.5±0.9 at base hospital. The video quality ratings were 4.4±0.8 and 4.0±1.1 at field-site and base hospital, respectively; this difference was statistically significant (p=0.017).
CONCLUSIONS: With trained grassroots level workers and quality internet connections, tele-otology can play a significant role in the early identification and diagnosis of ear diseases, including middle ear pathologies, as well as bridging the ear care service gap in resource constraints settings like Nepal.