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1.
JNMA, Journal of the Nepal Medical Association ; 60(255):982-984, 2022.
Article in English | CAB Abstracts | ID: covidwho-2164653

ABSTRACT

Facial paralysis is one of the common problems leading to facial deformation. COVID-19 virus rarely has been shown to be associated with facial palsy. Here we present a case of a 60-year-old woman who presented with features of left lower motor facial palsy signs along with common features suggestive of COVID-19 infection. Brain imaging did not reveal any pertinent pathology but her polymerase chain reaction for COVID-19 was positive. This case highlights the fact that acute COVID-19 infection can be considered a cause of motor neuron facial palsy in the ongoing pandemic of COVID-19. Cases with neurological features suggestive of facial palsy therefore should be suspected of acute COVID-19 infection based on other pertinent findings of COVID-19 infection and thus polymerase chain reaction testing should be done.

2.
Kathmandu University Medical Journal ; 20(79):186-192, 2022.
Article in English | EMBASE | ID: covidwho-2156556

ABSTRACT

Background Severe acute respiratory syndrome corona virus-2 (SARS-CoV-2) variants, which have emerged due to several mutations in spike protein, have a potential to escape immune protection provided by the first-generation vaccines, thereby resulting in breakthrough infections. Objective To identify the socio-demographic factors, clinical features, and outcomes in both vaccinated and unvaccinated hospitalized patients infected with SARS-CoV-2. Method Socio-demographic details, clinical features, and the outcomes among fully vaccinated (double for Covishield/AstraZeneca and BBIBP-CorV and single for Janssen), partially vaccinated, and unvaccinated hospitalized patients with coronavirus disease of 2019 (COVID-19) were collected and analyzed using SPSS version 17. Result Among the hospitalized COVID-19 patients (n=299), 175 (58.5%) patients received a single-dose, 82 (27.4%) double-dose, and 124 (41.5%) did not receive any dose of the COVID-19 vaccines. The risk of SARS-CoV-2 infection when compared between vaccinated and unvaccinated patients was found to be associated among professional degree holders (23.4% versus 9.7%) (p<0.05), professional workers (43.4% vs. 25.0%) (p<0.05), hospitalization to general ward (76.6% vs. 72.6%) (p<0.05), and presence of multiple symptoms (>=3) (86.8% vs. 75.0%) (p>0.05) and comorbidities (>=2) (15.5% vs. 13.7%) (p>0.05). Despite such approximate incidences, the risk of in-hospital mortality among the vaccinated patients was reduced (0.6% vs. 3.2%) (p>0.05), when compared to the unvaccinated patients. The risk of in-hospital mortality was associated with the older age and the presence of multiple comorbidities including bronchial asthma, diabetes, and hypertension. Conclusion Full or partial vaccination against the SARS-CoV-2 variants of concerns might be effective in preventing in-hospital mortality among COVID-19 patients. Copyright © 2022, Kathmandu University. All rights reserved.

3.
ACIAR Final Reports 2021. (FR2021/049):29 pp. 3 ref. ; 2021.
Article in English | CAB Abstracts | ID: covidwho-2011001

ABSTRACT

This project was originally envisaged as an 18-month development-oriented project based in Provinces 1 and 2 of the Nepal Terai. It aimed to build solidarity and teamwork around the drive for agri-mechanisation in each of these two provincial governments. Unfortunately, the short time frame paired with intensive efforts to establish new relationships and then the onset of COVID-19 meant that there was limited scope to deeply develop these new relationships and fully build the envisaged roadmap process and plans. Regardless of this, the project has made some essential steps in improving provincial agri-mechanisation planning and implementation, including: (1) substantial capacity developed though placement of engineering experts within the Nepal Agricultural Research Council (NARC), the Ministries of Agriculture, Land Management and Cooperatives (MoLMAC), various cooperatives and agricultural knowledge centres;(2) new and deepened relationships with and between key stakeholders, and particularly between NARC and provincial government, as well as with and between various cooperatives;(3) development of the first quantification of the status of agri-mechanisation on the Nepal Terai - indicating that there is high potential for rapid mechanisation if some key constraints are addressed;(4) publication of the learnings for a review of mechanisation in India and Bangladesh, and what that means for Nepal's agri-mechanisation planning;(5) regional learnings and new collaborations with various stakeholders in Nepal and West Bengal;(6) a national symposium on agri-mechanisation on the Nepal Terai, with a large number of supported individuals attending and learning from the national Agrimechanisation Fair;(7) development of a "roadmap" process that can be used more widely with additional further development;and (8) technical guidance and relationship building to improve the scaling of government supported custom hire centres in Province 1.

4.
Journal of the Nepal Medical Association ; 60(252):727-731, 2022.
Article in English | EMBASE | ID: covidwho-1979940

ABSTRACT

The in-hospital mortality in patients with COVID-19 could be correlated with severe acute respiratory syndrome coronavirus-2 induced hyper-inflammation, which is attributed to an unconstrained inflammatory cytokine storm. The pro-inflammatory cytokine, specifically, interleukin-6 plays a prominent role in the cytokine storm and may result in alveolar-capillary blood-gas exchange dysfunction. Therefore, the method to block the signal transduction pathway of interleukin-6 could be a potential treatment for severe COVID-19 patients. In this case series of three patients with severe COVID-19, we focus on the rationale for utilization of tocilizumab, an anti-interleukin-6 receptor antibody, which could block the signal transduction pathway of interleukin-6. The observations from this study allowed us to hypothesize that the infusions of tocilizumab may not reduce the elevated level of interleukin-6, and hence may not be a significant therapeutic for reducing in-hospital mortality associated with COVID-19. Additionally, it could also be speculated that interleukin-6 may not be a potentially actionable target cytokine to treat COVID-19-associated cytokine storms.

5.
Gastroenterology ; 162(7):S-120-S-121, 2022.
Article in English | EMBASE | ID: covidwho-1967246

ABSTRACT

Background Telehealth has become an important part of medical care during the COVID- 19 pandemic. Previous studies have demonstrated patient preference for telehealth care due to convenience and time and cost savings related to travel. The increased ease of access for patients with telehealth may improve the attendance rate. Improving clinic attendance could increase clinic efficiency, decrease cost, and possibly improve patient outcomes. We intended to assess if telehealth in gastroenterology (GI) clinic improves the attendance rate. Methods We performed a retrospective observational cross-sectional study using data from the electronic health record (EHR) of patients scheduled for an appointment at the adult gastroenterology/ hepatology clinic from February 1st to May 1st, 2020. Continuous variables were compared using the independent t-test and categorical variables were compared using the chi-square test or Fisher's exact test, where applicable. Multivariate logistic regression analysis was performed for the missed appointment using the variable visit type as the predictor of interest and patient demographics, and appointment-related factors as covariates. Results Of 2,258 patients scheduled for appointment, 210 (9.3%) missed their appointment. Before COVID-19 pandemic response (before March 13, 2020), all 1,133 appointments were inperson visits. During the COVID-19 era (after March 13, 2020), 806 (71.6%) appointments were televisits, conducted via telephone. In the pre-COVID era, the non-attendance rate was 7.7%;this increased to 10.9% during the COVID era (P=0.008). There was no significant difference in the non-attendance rate between televisits and in-person visits (10.7% and 8.5%;P=0.09). In the multivariate analysis, there was no significant association between visit type and attendance (adjusted odds ratio [AOR] 1.11 [0.73-1.69]). There was no significant difference in attendance before and after March 13, 2020 (AOR 1.50 [0.99-2.27]). Conlcusion The use of telehealth increased significantly during the COVID era. Televisit was not associated with an improved attendance rate in GI clinic. Further studies are needed to investigate the impact of telehealth in clinical practice. (Table Presented) (Table Presented)

6.
Journal of the Nepal Medical Association ; 60(251):608-611, 2022.
Article in English | EMBASE | ID: covidwho-1939706

ABSTRACT

Introduction: COVID-19 has emerged as a pandemic and has varied clinical presentation. Computed Tomography scans of the chest play an important role in evaluating the lung parenchymal changes and aids in better planning the management of COVID-19 patients. The purpose of this study was to find the prevalence of abnormal chest computed tomography findings among admitted symptomatic COVID-19 patients in a tertiary care centre. Methods: This descriptive cross-sectional study was conducted from 25 October 2020 to January 2021 in a tertiary care hospital. Ethical approval was taken from the Institutional Review Committee (Registration number: 348). Convenience sampling method was used. Chest computed tomography findings of the admitted symptomatic COVID-19 patients were evaluated for abnormal findings. Point estimate and 95% Confidence Interval were calculated. Results: Among 153 patients, abnormal chest computed tomography findings were seen in 147 (96.07%) (92.99-99.15, 95% Confidence Interval). The findings of ground-glass opacities with consolidations were seen in 78 (53.06%) patients. Conclusions: The prevalence of abnormal chest findings among symptomatic COVID-19 patients in our study was similar to the studies done in other countries in similar settings. Majority of the symptomatic COVID-19 patients showed abnormal chest computed tomography scan findings in the form of ground glass opacities and consolidations.

7.
PLoS Global Public Health ; 2(4), 2022.
Article in English | CAB Abstracts | ID: covidwho-1892274

ABSTRACT

The COVID-19 pandemic has affected many aspects of daily life worldwide, but the impact may be higher for impoverished populations. The main aim of this study is to describe the impact of the COVID-19 pandemic on different aspects of daily life in mothers in Nepal. We included 493 mothers of children aged 54-71 months participating in a randomized controlled trial on vitamin B12 supplementation. Mothers answered questions regarding the exposure and impact of the pandemic on their daily lives, and pandemic-related worries and sleep problems. We examined the extent to which worry, and sleep problems differed between mothers according to their exposure to COVID-19, socioeconomic status, and previous symptoms of depression. The mean age (SD) of the mothers was 32.3 (4.6) years and 54% had education below the secondary level. Of the mothers, 5.4% had either been exposed to someone who had tested positive or who had a family member with COVID-19. One-third of the participants responded that the pandemic had affected their economic situation, employment, and family life to a great deal. Both mothers and fathers with educational levels above 10 years or households with higher socioeconomic status had significantly higher average worry scores (maternal p = 0.020 and paternal p = 0.005). Mothers with a history of symptoms of depression had significantly more worry-related sleep problems during the pandemic (p = 0.020) than those without a history of depressive symptoms. Our study underlines the negative impact of the COVID-19 pandemic on diverse aspects of everyday life of mothers in Nepal.

8.
2021 International Symposium on Networks, Computers and Communications, ISNCC 2021 ; 2021.
Article in English | Scopus | ID: covidwho-1662220

ABSTRACT

In the situation of an epidemic outbreak, a contact tracing tool is preferred to alert the infection status of daily encountered people. Since we are in the era that smartphone is carried everywhere and embedded with Bluetooth technology, a Bluetooth-based mobile app is proposed in this paper for advanced contact tracing. The proposed app can not only trace the infectious people contacted with the user but also label the danger level by scanning the proximity and lingering time for each case. It is simple yet efficient to apply as it does not employ any new Bluetooth protocol but only requires basic inputs that are acquirable from any smartphone with Bluetooth 2.0 and above. This application is built using service-oriented architecture which helps mobile devices to communicate with a data collection server as well as each other. The collected data will be shown in a web application and used to further study the propagation characteristics of new infectious viruses. It also comprises a daily survey that users answer, and which will be used by health officials for early prognosis. The app is currently tested campus-wide and showed salient features in terms of scalability, mobility, and sensing inaccuracy-proof, which has the potential to be applied in larger populations with more complicated scenarios. © 2021 IEEE.

9.
American Journal of Gastroenterology ; 116(SUPPL):S1408, 2021.
Article in English | EMBASE | ID: covidwho-1534886

ABSTRACT

Introduction: Telehealth has become an important part of medical care during the COVID-19 pandemic. Previous studies have demonstrated patient preference for telehealth care due to convenience and time and cost savings related to travel. The increased ease of access for patients with telehealth may improve the attendance rate. Improving clinic attendance could increase clinic efficiency, decrease cost, and possibly improve patient outcomes. We intended to assess if telehealth in gastroenterology (GI) clinic improves the attendance rate. Methods: We performed a retrospective observational cross-sectional study using data from the electronic health record (EHR) of patients scheduled for an appointment at the adult gastroenterology/hepatology clinic from February 1st to May 1st, 2020. Continuous variables were compared using the independent t-test and categorical variables were compared using the chi-square test or Fisher's exact test, where applicable. Multivariate logistic regression analysis was performed for the missed appointment using the variable visit type as the predictor of interest and patient demographics, and appointment-related factors as covariates. Results: Of 2,258 patients scheduled for appointment, 210 (9.3%) missed their appointment. Before COVID-19 pandemic response (before March 13, 2020), all 1,133 appointments were in-person visits. During the COVID-19 era (after March 13, 2020), 806 (71.6%) appointments were televisits, conducted via telephone. In the pre-COVID era, the non-attendance rate was 7.7%;this increased to 10.9% during the COVID era (P=0.008). There was no significant difference in the non-attendance rate between televisits and in-person visits (10.7% and 8.5%;P=0.09). In the multivariate analysis, there was no significant association between visit type and attendance (adjusted odds ratio [AOR] 1.11 [0.73-1.69]). There was no significant difference in attendance before and after March 13, 2020 (AOR 1.50 [0.99-2.27]). Conclusion: The use of telehealth increased significantly during the COVID era. Televisit was not associated with an improved attendance rate in GI clinic. Further studies are needed to investigate the implications of telehealth in clinical practice..

10.
Kathmandu Univ Med J (KUMJ) ; 18(70): 48-52, 2020.
Article in English | MEDLINE | ID: covidwho-1089410

ABSTRACT

Background The frequent lockdown in Nepal during COVID-19 pandemic had brought various kinds of complexities such as stress among college students. This situation had created uncertainty of future academic career of undergraduate students in medical colleges. Some previously published literature showed gaming as a coping mechanism against stress. Objective To assess the gaming behavior of Medical college students during lockdown in COVID-19 pandemic. Method A cross-sectional study was conducted during lockdown period of July to August 2020. A total of 412 college students were enrolled. Online Google forms were shared to all the eligible students through email, viber and messenger with the help of class representative. Collected data were analyzed in SPSS version 20.0. Result The prevalence of gaming disorder was 8.5% among 260 internet gaming users. About 69.2% of the participants reported that their gaming behavior had increased due to stress of COVID-19 pandemic. Gender and spending more time online per day showed significant associations with greater scores on the internet gaming disorder. Conclusion During lockdown period of COVID-19 pandemic, the gaming behavior of medical college students has increased.


Subject(s)
Behavior, Addictive , COVID-19 , Communicable Disease Control , Cross-Sectional Studies , Humans , Nepal/epidemiology , Pandemics , SARS-CoV-2
11.
Kathmandu University Medical Journal ; 18(2 COVID-19 Special Issue):48-52, 2020.
Article in English | Scopus | ID: covidwho-1013315

ABSTRACT

Background The frequent lockdown in Nepal during COVID-19 pandemic had brought various kinds of complexities such as stress among college students. This situation had created uncertainty of future academic career of undergraduate students in medical colleges. Some previously published literature showed gaming as a coping mechanism against stress. Objective To assess the gaming behavior of Medical college students during lockdown in COVID-19 pandemic. Method A cross-sectional study was conducted during lockdown period of July to August 2020. A total of 412 college students were enrolled. Online Google forms were shared to all the eligible students through email, viber and messenger with the help of class representative. Collected data were analyzed in SPSS version 20.0. Result The prevalence of gaming disorder was 8.5% among 260 internet gaming users. About 69.2% of the participants reported that their gaming behavior had increased due to stress of COVID-19 pandemic. Gender and spending more time online per day showed significant associations with greater scores on the internet gaming disorder. Conclusion During lockdown period of COVID-19 pandemic, the gaming behavior of medical college students has increased. © 2020, Kathmandu University. All rights reserved.

12.
Kathmandu University Medical Journal ; 18(2):48-52, 2020.
Article in English | CAB Abstracts | ID: covidwho-942034

ABSTRACT

Background: The frequent lockdown in Nepal during COVID-19 pandemic had brought various kinds of complexities such as stress among college students. This situation had created uncertainty of future academic career of undergraduate students in medical colleges. Some previously published literature showed gaming as a coping mechanism against stress.

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