Papers by sudarshan paudel
Journal of Biosciences and Medicines, 2017
Background: The incumbent of medical professional is expected to be socially responsible and emot... more Background: The incumbent of medical professional is expected to be socially responsible and emotionally empathetic along with good communication propensity to fasten the doctor-patient relationship. Whilst doctor's proficiency to recognize a patient's perspectives, and convey such an understanding back to the patient; in our case, the empathy and compassion level of promising medical professional is unknown in Nepal. Thus, this study aimed to analyze the compassion and empathy score of final year's undergraduate students of four medical colleges in Nepal. Methods: Self-reported empathy measures were obtained using the Jefferson Scale of Physician-Student version. Results: The degree of empathy for the participants was 97.28 (SD = 14.44) with a median score of 96.00 and a range of 44 (min) to 133 (max). There was a significant difference on scores of the Jefferson scale of physician empathy between NMC Nepalgunj and BPKIHS (p = 0.00) and between NMC Nepalgunj and Manipal Pokhara (p = 0.00), as well as between UCMS and Manipal Pokhara (p = 0.044). These results were significant at the 95% confidence interval. Conclusions: The mean empathy score for the Nepali students is lower than medical students from developed countries but almost similar to medical students from other Asian medical students. The female Nepali medical students scored slightly higher than their male counterparts. Thus colleges have to develop academic programs to improve empathy and compassion among medical students through providing adequate time to consult with patient and faculties.
Journal of Electrocardiology, Mar 1, 2017
Infusion pump related electrocardiographic artifact Electrocardiographic artifacts are commonly e... more Infusion pump related electrocardiographic artifact Electrocardiographic artifacts are commonly encountered in daily practice. Equipment related artifacts are well documented, and can mimic arrhythmias. Dialysis machines, infusion pumps, and cardio-pulmonary bypass machines are examples of such equipment. It is believed that cyclic pinching and releasing of infusion pump plastic tubing creates a piezoelectric effect that is transmitted through the fluid column and detected by surface ECG electrodes. 1,2 The electrocardiographs shown in panels A and B are of a 63-year old morbidly obese woman who underwent a myocardial perfusion stress testing with Dipyridamole for atypical chest pain. Dipyridamole (Persantine) is typically infused over a 4 min-period. Our patient's baseline ECG showed normal sinus rhythm. After infusion is started, electrocardiographic changes were noted as shown in panel A, with two distinctive patterns, patient's baseline (blue arrows) and a rhythmic artifact (gray arrows). These changes persisted throughout the infusion period and disappeared immediately after the infusion was completed, panel B.
Journal of Biosciences and Medicines
Background: The incumbent of medical professional is expected to be socially responsible and emot... more Background: The incumbent of medical professional is expected to be socially responsible and emotionally empathetic along with good communication propensity to fasten the doctor-patient relationship. Whilst doctor's proficiency to recognize a patient's perspectives, and convey such an understanding back to the patient; in our case, the empathy and compassion level of promising medical professional is unknown in Nepal. Thus, this study aimed to analyze the compassion and empathy score of final year's undergraduate students of four medical colleges in Nepal. Methods: Self-reported empathy measures were obtained using the Jefferson Scale of Physician-Student version. Results: The degree of empathy for the participants was 97.28 (SD = 14.44) with a median score of 96.00 and a range of 44 (min) to 133 (max). There was a significant difference on scores of the Jefferson scale of physician empathy between NMC Nepalgunj and BPKIHS (p = 0.00) and between NMC Nepalgunj and Manipal Pokhara (p = 0.00), as well as between UCMS and Manipal Pokhara (p = 0.044). These results were significant at the 95% confidence interval. Conclusions: The mean empathy score for the Nepali students is lower than medical students from developed countries but almost similar to medical students from other Asian medical students. The female Nepali medical students scored slightly higher than their male counterparts. Thus colleges have to develop academic programs to improve empathy and compassion among medical students through providing adequate time to consult with patient and faculties.
Civil Medical Journal
Introduction: Assessment of the quality of life is an important aspect of managing skin diseases.... more Introduction: Assessment of the quality of life is an important aspect of managing skin diseases. The tools to measure the health related quality of life are still scarce in our country. We have planned to add one useful and widely used tool in the local language. The main objective of this study was to translate English version of skindex-16 in Nepali language and evaluate its psychometric properties. Methods: Standard protocol was followed to translate the English version of Skindex-16 into Nepali language after due permission from the Mapi Trust. The translated version was completed by the patients in the out-patient unit of dermatology department, which was subjected to statistical validation. Some participants completed the same questionnaire in seven to ten days gap. Cronbach’s, Intra-Class correlation, Pearson’s correlation and factor analysis were performed for validation of newly translated Skindex-16 version. Results: In total 190 people were enrolled in this study, 92 (48...
Journal of Nepal Health Research Council, 2021
BACKGROUND Steroid-modified tinea, also known as tinea incognito, is an infection by the dermatop... more BACKGROUND Steroid-modified tinea, also known as tinea incognito, is an infection by the dermatophytes, where the clinical morphology is modified due to corticosteroids, either systemic or topical. Rampant use of topical corticosteroids has led to increasing recurrence in tinea infections. METHODS All consenting cases of tinea presenting to outpatient department of dermatology department of Civil Service Hospital from March to August 2020 for a total of 6 months were included in this study. Tinea infection involving only the palms, soles, nails or scalp were excluded. RESULTS A total of 200 patients were included in this study. Among these, 175 patients (87.5%) were using topical corticosteroids. A significant association was noted between dermatophyte infection of more than one month and topical corticosteroids use (p<0.05). This study revealed that males were using super-potent topical corticosteroids more as compared to females (p<0.05). Moreover, no association was noted b...
Journal of Patan Academy of Health Sciences, 2018
Introduction: Evidence based practice (EBP) is the use of current best evidence in making decisio... more Introduction: Evidence based practice (EBP) is the use of current best evidence in making decisions about the care of individual patients. The aim of this study was to explore the practices, attitudes, knowledge and perceived barriers in relation to EBP among faculty members at Patan Academy of Health Sciences (PAHS), Nepal. Methods: This was a cross-sectional survey study. Participants were faculty members (both clinical and non-clinical) at PAHS. The main outcomes were attitude towards the usefulness of EBP, the frequency of use of EBP in practice, and the barriers to carrying out EBP. Results: One hundred and seventy-two faculty members participated in this survey. Ninety five percent knew it was used for clinical decision making and the majority used it for teaching. Senior faculty spent more time on searching for evidence and reading compared to junior faculty. There was no difference between clinical and non-clinical departments. The main barriers to EBP were inadequate teachi...
Nepal Journal of Dermatology, Venereology & Leprology, 2021
Introduction: Sexually transmitted infections (STIs) are the diseases that are transmitted by sex... more Introduction: Sexually transmitted infections (STIs) are the diseases that are transmitted by sexual contact if a partner is infected with agent known to cause infection of genitalia. This group of diseases pose a huge public health problem. This study aims to provide an insight on the prevalence of STIs in a tertiary care center dedicated to civil servants. Methods: This is a retrospective cross-sectional study. All patients diagnosed with STI in a dermatology out-patient of Civil Service Hospital, a tertiary care hospital situated in Kathmandu over a period of two years from January 1 2018 to December 30 2019 were included in the study. The diagnosis was made by clinical and laboratory investigations. Results: The total number 157 cases of STIs were enrolled in this study, of which 119 (75.8%) were males and 38(24.2%) were females. The mean age of patients was 27.8±8.8 years, ranging from 15 to 60 years. Seventy three (46.5%) patients were married, while 81 (51.6%) patients were u...
Dermatology Research and Practice, 2020
Chronic urticaria (CU) is a skin condition characterized by sudden and recurrent episodes of whea... more Chronic urticaria (CU) is a skin condition characterized by sudden and recurrent episodes of wheals, angioedema, or both and commonly associated with itching for a duration of more than six weeks. The available data indicate that urticaria markedly affects both objective functioning and subjective well-being of patients. A review of patients’ records with chronic urticaria attending Civil Service Hospital from January 2018 to December 2019 was done. A detailed demographic data of all patients with chronic urticaria was also retrieved. Dermatology Life Quality Index questionnaire (DLQI) Nepalese version was used for the assessment of the impact of disease on life quality. Mann–Whitney U-test was applied to compare means, and principle component analysis for factor analysis was used. A total of 149 patients were included, with a male-to-female ratio of 1 : 1.9. The mean age of the study population was 32.86 ± 12.837 years. The mean DLQI score was 8.30 ± 6.73 with men having a sign...
Middle East Journal of Nursing, 2019
Introduction: Health promoting lifestyle (HPL) of nurses may affect the quality of care in health... more Introduction: Health promoting lifestyle (HPL) of nurses may affect the quality of care in healthcare settings. Nursing students not only learn from curricular activities, but mentoring from faculty members and seniors also helps them to develop HPL skills and practices. Therefore, this study was undertaken to assess the HPL behaviors and examine factors related to HPL among all levels of nursing students.
World Family Medicine Journal/Middle East Journal of Family Medicine, 2019
This article explores patient consultation practices of physicians at Patan Academy of Health Sci... more This article explores patient consultation practices of physicians at Patan Academy of Health Sciences-Teaching Hospital. We assessed the communication practice of physicians when interacting with patients.
Journal of Biosciences and Medicines, 2017
Introduction: In 21 st century, road traffic accidents (RTA) are considered as increasing epidemi... more Introduction: In 21 st century, road traffic accidents (RTA) are considered as increasing epidemic of non-communicable disease which is abandoned and needs special attention to prevent them. The aim of this study was to assess the factors and pattern of injuries associated with road traffic accidents. Methods: A cross sectional study was conducted among 112 RTA victims and 56 drivers in Palpa District of Nepal. The association of factors and pattern of injuries with exposure to accidents was assessed using Fisher's exact test. Bivariate logistic regression examined the association between driving and socio-demographics factors and exposure to road accidents. Results: Of 112 RTA victims, 50% were in the age group of 21 to 40 years and 71.4% were male. Drivers who were in the age less than or equal to 30 years were more likely (OR: 3.6; 95% CI: 1.0, 14.3) to expose to an accident than those who were above 30 years. Similarly, those having driving speed less than 40 km/hr were less likely to expose to an accident than those with speed 40-60 km/hr (OR: 6.0; 95% CI: 0.8, 73.5) and those with speed more than 60 km/hr (OR 7.8; 95% CI: 1.0, 100.1). Moreover, the driving experience was also found positively associated (OR: 5.6; 95% CI: 1.1, 35.5) with the exposure to an accident. Conclusion: Being in younger age group, male gender, morning time, the driving speed, driving experiences, and driving hours on the road were positively associated with RTA. The efforts should be made to enforce laws in control of speed targeting experienced drivers and those with younger age groups.
Sleep and Hypnosis - International Journal, 2017
Background: Nepal is known for its exquisite natural beauty, with the iconic Himalayas running ac... more Background: Nepal is known for its exquisite natural beauty, with the iconic Himalayas running across the northern and western part of the country. Kathmandu valley, which is the capital of the country and the main hub for trade, commerce, education and administration, is considered as one of the earthquake prone areas. It is a highly populated area with an estimated population of about 2 million. After 82 years on April 25 th at 11:56 am local time, an earthquake of magnitude 7.8 struck Nepal, with an epicenter 77 kilometers northwest of Nepal's capital Kathmandu in the Gorkha district. As of May 15 th , 8,316 people had been reported killed and 17,866 people injured. A study was carried out to assess psychological distress among the adult survivors of Kathmandu valley from Nepal's 2015 earthquake. Methodology: A cross sectional study was conducted among 304 adult survivors with an objective to identify the psychological distress among the adult survivors of Kathmandu valley from Nepal's 2015 earthquake. This study was carried out in Kathmandu valley; there are three districts in Kathmandu valley which are Kathmandu, Bhaktapur and Lalitpur. Among the three districts, Kathmandu district and Kathmandu metropolitan city was selected purposively. There are 35 wards in Kathmandu metropolitan city. Results: Among the total of 304 respondents interviewed for the study, nearly half of them were female (54.6%) and males (45.4%). Considering the age group 30.6% of them belonged to age group of 26 to 35 years. Out of the total 304 respondents, 18.1 % were suffering from moderate anxiety and 21.7 % were having moderate depression, 16.1 % had mild anxiety and 21 .1% had mild depression, 12.5% were having severe anxiety and 13.5 % were suffering from severe depression. Depression was seen significantly higher in businessmen, middle income family, patients with behavior changes, injured people and in those people who lost their family members in the earthquake (p=<0.05). Those who live in second floor, who had changed personal habits, injured during earthquake and those who lost their family members in the earthquake were found significantly associated with anxiety (p=<0.05). The analysis shows person aged above 55 years had 2.3 times higher chance to have anxiety than those below aged 55 years (adj. OR=2.3, 95% CI: 0.458-12.039). Conclusion: This suggests that to reduce negative health impacts of the earthquake adequate psychological counseling is needed for those who survived the tragedy.
Journal of Biosciences and Medicines, 2017
Objectives: This descriptive study of 219 undergraduate medical students at Patan Academy of Heal... more Objectives: This descriptive study of 219 undergraduate medical students at Patan Academy of Health Sciences in Nepal was conducted to evaluate the relationships of their demographic variables with a health-promoting lifestyle profile. Methods: The Health Promoting Lifestyle Profile (HPLP) questionnaire was used to study students' lifestyles. We compared the HPLP scores according to gender, residence type, school background and year of study. One-way analysis of variance (ANOVA) and multiple comparison test were conducted to identify significant differences among university year (first, second, third and fourth) groups. Multiple regression analysis was used to analyze the effects of various demographics on the overall HPLP score and the six health-promoting lifestyle subscales. Results: The overall HPLP mean score of participants was 2.60 ± 0.29, with the highest mean scores being for spiritual growth (2.99 ± 0.42) and interpersonal relations (2.90 ± 0.35), and the lowest mean scores being for health responsibility (2.39 ± 0.39) and physical activity (2.25 ± 0.54), respectively. The overall HPLP score of the students was the highest for the first year students at 2.65 ± 0.26. The male students had a better overall HPLP score, although female students obtained better score in some sub-scales such as health responsibility, interpersonal relations and nutrition. The students from a public school background had significantly higher scores for health responsibility, physical activity and stress management than those who graduated school level education from a private school. Conclusions: The results of this study reveal that the status of health promoting behaviors among the students was acceptable with ample room for improvement. Implementation of health education and promotion programs with an
Journal of Biosciences and Medicines, 2017
Disability is an accident waiting to happen in population. Large numbers of population in world a... more Disability is an accident waiting to happen in population. Large numbers of population in world are disabled and its prevalence is on the rise. Disabled people have to face two additional challenges namely, limitation in body and social stigmatization on top of other social happening to general public. The stipulation of disability will be subjective because social and physical condition is directly related to it. The study was also envisioned to develop a disability screening approach. The objective was to focus on how disabled has been included in the government's health plans in Nepal. The study has presented data of 894 disabled people from randomly selected seven VDCs of Makwanpur district. The total population in studied VDCs was 87,502. The study was conducted in coordination with local governing bodies and health development partners during August-October in 2012. The study revealed 1.02 percent prevalence of disability among study population. The majority were suffering physical disability (60.6 percent) followed by deaf (19.7 percent). Based on age group, young adults (15-19 years) group was more (31 percent) vulnerable. Out of total, the number of male was higher due to their high exposure in external environment and risk taking behaviour.
Journal of Electrocardiology, 2017
Infusion pump related electrocardiographic artifact Electrocardiographic artifacts are commonly e... more Infusion pump related electrocardiographic artifact Electrocardiographic artifacts are commonly encountered in daily practice. Equipment related artifacts are well documented, and can mimic arrhythmias. Dialysis machines, infusion pumps, and cardio-pulmonary bypass machines are examples of such equipment. It is believed that cyclic pinching and releasing of infusion pump plastic tubing creates a piezoelectric effect that is transmitted through the fluid column and detected by surface ECG electrodes. 1,2 The electrocardiographs shown in panels A and B are of a 63-year old morbidly obese woman who underwent a myocardial perfusion stress testing with Dipyridamole for atypical chest pain. Dipyridamole (Persantine) is typically infused over a 4 min-period. Our patient's baseline ECG showed normal sinus rhythm. After infusion is started, electrocardiographic changes were noted as shown in panel A, with two distinctive patterns, patient's baseline (blue arrows) and a rhythmic artifact (gray arrows). These changes persisted throughout the infusion period and disappeared immediately after the infusion was completed, panel B.
Birat Journal of Health Sciences, 2017
Introduc on Many Nepali adolescents (10-19 years) are undernourished, which increases the risk of... more Introduc on Many Nepali adolescents (10-19 years) are undernourished, which increases the risk of morbidity and mortality. Inadequate nutri on during adolescence can retard physical growth and sexual matura on and increases the risk of adult lifestyle diseases. There is a dearth of research on the socio-demographic factors associated with the nutri onal status of adolescents in Nepal. Objec ve To assess the nutri onal status of adolescents (10-19 years) in Dukuchhap Viillage of Lalitpur, Nepal Methodology A community based descrip ve cross-sec onal study was carried out by medical students during their field placement for nd community diagnosis in Dukuchhap Village of Lalitpur from 22 th November-19 December 2017. All 10-19 years adolescent popula on was included in the study. Among the total popula on (2545) study, 474 were adolescent. The data were collected using semi-structured ques onnaire. Physical and anthropometric measurement were done. Data were analyzed using of WHO Z-scores criteria and cut offs points. All the findings were compared with Nepal Demographic and Health Survey, 2011 and other researches published in different journals on related topic. Excel version 2010 and SPSS version 13.0 were used to enter and analyze data. Results The prevalence of stun ng was found out to be 36.28%.More males (16.51%) than females (12.60%) were severely stunted and 21.70% of male and 22.14% of female were moderately stunted. Among total respondents, 14.4% were severely stunted and 21.9% were moderately stunted. More numbers of male (38.2%) were stunted than female (34.7%). Conclusion Prevalence of malnutri on among adolescent was more in 10-12 years age group. The prevalence of moderate stun ng was slightly high in females than males. Adolescents with extended family type, increasing number of family members & agriculture, labourer and local business as main family occupa on are more prone to suffer from malnutri on.
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Papers by sudarshan paudel