Background Despite political promise to reduce out-of-pocket (OOP) expenditure on healthcare thro... more Background Despite political promise to reduce out-of-pocket (OOP) expenditure on healthcare through the National Health Insurance Program (NHIP) of Nepal, its implementation is challenging with low enrolment and high drop-out rates. Program performance can often be linked with political economy considerations and interests of stakeholders. This study aimed to develop an in-depth understanding of organizational and systemic challenges in implementing NHIP. Methods We conducted a structured narrative review of available literature on the NHIP in Nepal. We analysed data using a political economy analysis for health financing reform framework. The findings were explained under six broad categories: interest groups, bureaucracy, budgets, leadership, beneficiary and external actors. In addition, we triangulated and further presented the literature review findings using expert opinions (views expressed in public forums). Results Nepal has formulated acts, rules, regulations, and policies ...
Introduction: Anti-thrombotic, statins and antihypertensive drugs are commonly used for the manag... more Introduction: Anti-thrombotic, statins and antihypertensive drugs are commonly used for the management of acute ischemic stroke in Nepal but there is no evidence regarding their efficacy in our context. This study aims to explore the efficacy of these combined medications (anti-thrombotic, statins and antihypertensive drugs) in acute ischemic stroke patients for the first time and to assess the risk factors present in those patients.
Background: Microalbuminuria is an indicator of diabetic nephropathy as well as a marker for card... more Background: Microalbuminuria is an indicator of diabetic nephropathy as well as a marker for cardiovascular diseases. The aim of this study was to determine the prevalence of microalbuminiuria and identify the associated risk factors in patients with type 2 diabetes in a private hospital of Nepal. Methods: Cross-sectional study design was used for the collection of data. The study sample consists of 282 type 2 diabetes patients who met the inclusion criteria. The study was conducted for a duration of 3 months from July, 2014 to September, 2014 at the Endocrine Department of Alka Hospital Pvt. Ltd., Nepal. Ethical approval was taken from the institutional review board of Alka Hospital. Results: A total of 363 patients were included in this study.Microalbuminuria was observed in 35.5% of the patients who met the inclusion criteria of the study. Parameters such as duration of diabetes and systolic and diastolic blood pressure were higher in patients with microalbuminuria as compared to...
The principal objectives of this study were to determine the prescribing pattern, risk factors an... more The principal objectives of this study were to determine the prescribing pattern, risk factors and cost estimation of the drugs commonly employed to treat acute gout in Nepal. Acute gout is one of the most common rheumatic diseases in the world. The incidence of gout has also risen rapidly in Nepal in the past decades. A prospective and descriptive study was conducted to assess the risk factors of acute gout, prescribing patterns and cost estimation of drugs used to treat acute gout in patients receiving treatment at nepal Arthritis and Rheumatic Diseases Treatment Center, Jawlakhel, Nepal over a period of three months (July 2015 -September 2015).A total of 103 cases were studied. Hospitalized patients were excluded from this study. The results revealed that majority of the patients were males and fell under the age group 40-49 years. The majority of patients were alcohol consumers (62.1%), consumers of purine rich diet (84.5%), and hyperlipidemia (33%), hypertensive (6.8%).38.8% of...
The objective of this study is to investigate the causes of an ovulatory infertility, its managem... more The objective of this study is to investigate the causes of an ovulatory infertility, its management and outcome in an urban Nepalese population. An observational study conducted was among 58 couples visiting the department of Infertility Centre Pvt. Ltd. from November 2010 to May 2011. Infertile patients were mostly of middle reproductive stage ages from 24-39 years .The major contributing factors for female infertility were menstrual disorders due to hormonal disorders, premature ovarian failure and polycystic ovarian syndrome. The main menstrual disorders were amenorrhea (15.5%), oligomenorrhea (10.3%) and menorrhagia (3.4%). The various types of female infertility observed were PCOS (75.9%), premature ovarian failure (3.40%) and poor ovarian reserve (20.70%). Male causes of infertility were mainly oligospermia (10.7%), azoospermia (13.8%), asthenospermia (3.4%) and teratospermia (10.4%). The different types of infertility observed were primary infertility (48.3%) and secondary i...
Introduction: Lateral Epicondylitis has been found to be the second most frequently diagnosed mus... more Introduction: Lateral Epicondylitis has been found to be the second most frequently diagnosed musculoskeletal disorder. A wide range of symptomatic treatments are available such as use of anti-inflammatory analgesic drugs, steroids, physiotherapy. This study aims to know about the diagnosis, prescription pattern and current practice on management of tennis elbow in Nepal. Methods: This is a hospital based observational study carried out at Bir Hospital, Kathmandu, Nepal. Patients diagnosed with tennis elbow were purposively selected through prospective sampling technique from Orthopedic Department. Questionnaire and patient medication files were used as tools for data collection. Results: A total of 97 patients were found to be suffering from tennis elbow affecting mostly 41-50 years of age group and seen mostly in female (62%). Further, it was found that housewives (31%) were mostly affected. Diagnosis of tennis elbow was done commonly by clinical evaluation (61%) and X-ray (39%). ...
The purpose of this study was to evaluate the use of ceftriaxone in a Private Hospital. Cross sec... more The purpose of this study was to evaluate the use of ceftriaxone in a Private Hospital. Cross sectional descriptive study was used to assess rational use of ceftriaxone. The study was conducted by reviewing medication records of 180 patients who received ceftriaxone during hospitalization from June 2014 to August 2014. Descriptive research design was used for the research. The study involved the collection of data at time of drug being used during the course of treatment of patient during hospitalization using structured data collection form by reviewing the in-patient prescription and medication record and then evaluated for the various purposes. Among 180 patients male (55.6%) were more than female (44.4%). Maximum number of patients fell under age range 21-30 years (20.0%). The duration of therapy was found to be high in the range 2-7 days (76.11%). Most of the patients were prescribed with dose 1gm (69.4%) and most prescribed frequency was BD (76.1%). The mean daily prescribed d...
The purpose of this study was to evaluate the use of ceftriaxone in a Private Hospital. Cross sec... more The purpose of this study was to evaluate the use of ceftriaxone in a Private Hospital. Cross sectional descriptive study was used to assess rational use of ceftriaxone. The study was conducted by reviewing medication records of 180 patients who received ceftriaxone during hospitalization from June 2014 to August 2014. Descriptive research design was used for the research. The study involved the collection of data at time of drug being used during the course of treatment of patient during hospitalization using structured data collection form by reviewing the in-patient prescription and medication record and then evaluated for the various purposes. Among 180 patients male (55.6%) were more than female (44.4%). Maximum number of patients fell under age range 21-30 years (20.0%). The duration of therapy was found to be high in the range 2-7 days (76.11%). Most of the patients were prescribed with dose 1gm (69.4%) and most prescribed frequency was BD (76.1%). The mean daily prescribed d...
The objective of this study is to investigate the causes of an ovulatory infertility, its managem... more The objective of this study is to investigate the causes of an ovulatory infertility, its management and outcome in an urban Nepalese population. An observational study conducted was among 58 couples visiting the department of Infertility Centre Pvt. Ltd. from November 2010 to May 2011. Infertile patients were mostly of middle reproductive stage ages from 24-39 years .The major contributing factors for female infertility were menstrual disorders due to hormonal disorders, premature ovarian failure and polycystic ovarian syndrome. The main menstrual disorders were amenorrhea (15.5%), oligomenorrhea (10.3%) and menorrhagia (3.4%). The various types of female infertility observed were PCOS (75.9%), premature ovarian failure (3.40%) and poor ovarian reserve (20.70%). Male causes of infertility were mainly oligospermia (10.7%), azoospermia (13.8%), asthenospermia (3.4%) and teratospermia (10.4%). The different types of infertility observed were primary infertility (48.3%) and secondary infertility (27.6%). For the management of anovulatory infertility, female patients with hormonal disorders were prescribed hormonal replacement therapy (48.3%) and those who failed to ovulate were prescribed Clomiphene Citrate (27.6%) for medical ovulation induction. Letrozole (17.2%) prescribed as an aromatase inhibitor used in whom ovulation induction with Clomiphene Citrate had failed. Hyponid, a herbal formulation was given as insulin sensitizing agents. M2 tone was given in managing functional menstrual disorders of adolescents. Vitamin B complex along with Clomiphene Citrate and folic acid prescribed for prevention of fetus neural tube defect. Calcium was prescribed for treating the disturbances with premenstrual symptoms .The majority of the patients who have undergone ovulation induction with Clomiphene Citrate were conceiving mainly by Intrauterine Insemination technique. Infertility is considered as a disgraceful condition, and something that is not discussed freely in developing countries like Nepal. With timely detection and proper therapeutic management an ovulatory infertility can be avoided.
Background Despite political promise to reduce out-of-pocket (OOP) expenditure on healthcare thro... more Background Despite political promise to reduce out-of-pocket (OOP) expenditure on healthcare through the National Health Insurance Program (NHIP) of Nepal, its implementation is challenging with low enrolment and high drop-out rates. Program performance can often be linked with political economy considerations and interests of stakeholders. This study aimed to develop an in-depth understanding of organizational and systemic challenges in implementing NHIP. Methods We conducted a structured narrative review of available literature on the NHIP in Nepal. We analysed data using a political economy analysis for health financing reform framework. The findings were explained under six broad categories: interest groups, bureaucracy, budgets, leadership, beneficiary and external actors. In addition, we triangulated and further presented the literature review findings using expert opinions (views expressed in public forums). Results Nepal has formulated acts, rules, regulations, and policies ...
Introduction: Anti-thrombotic, statins and antihypertensive drugs are commonly used for the manag... more Introduction: Anti-thrombotic, statins and antihypertensive drugs are commonly used for the management of acute ischemic stroke in Nepal but there is no evidence regarding their efficacy in our context. This study aims to explore the efficacy of these combined medications (anti-thrombotic, statins and antihypertensive drugs) in acute ischemic stroke patients for the first time and to assess the risk factors present in those patients.
Background: Microalbuminuria is an indicator of diabetic nephropathy as well as a marker for card... more Background: Microalbuminuria is an indicator of diabetic nephropathy as well as a marker for cardiovascular diseases. The aim of this study was to determine the prevalence of microalbuminiuria and identify the associated risk factors in patients with type 2 diabetes in a private hospital of Nepal. Methods: Cross-sectional study design was used for the collection of data. The study sample consists of 282 type 2 diabetes patients who met the inclusion criteria. The study was conducted for a duration of 3 months from July, 2014 to September, 2014 at the Endocrine Department of Alka Hospital Pvt. Ltd., Nepal. Ethical approval was taken from the institutional review board of Alka Hospital. Results: A total of 363 patients were included in this study.Microalbuminuria was observed in 35.5% of the patients who met the inclusion criteria of the study. Parameters such as duration of diabetes and systolic and diastolic blood pressure were higher in patients with microalbuminuria as compared to...
The principal objectives of this study were to determine the prescribing pattern, risk factors an... more The principal objectives of this study were to determine the prescribing pattern, risk factors and cost estimation of the drugs commonly employed to treat acute gout in Nepal. Acute gout is one of the most common rheumatic diseases in the world. The incidence of gout has also risen rapidly in Nepal in the past decades. A prospective and descriptive study was conducted to assess the risk factors of acute gout, prescribing patterns and cost estimation of drugs used to treat acute gout in patients receiving treatment at nepal Arthritis and Rheumatic Diseases Treatment Center, Jawlakhel, Nepal over a period of three months (July 2015 -September 2015).A total of 103 cases were studied. Hospitalized patients were excluded from this study. The results revealed that majority of the patients were males and fell under the age group 40-49 years. The majority of patients were alcohol consumers (62.1%), consumers of purine rich diet (84.5%), and hyperlipidemia (33%), hypertensive (6.8%).38.8% of...
The objective of this study is to investigate the causes of an ovulatory infertility, its managem... more The objective of this study is to investigate the causes of an ovulatory infertility, its management and outcome in an urban Nepalese population. An observational study conducted was among 58 couples visiting the department of Infertility Centre Pvt. Ltd. from November 2010 to May 2011. Infertile patients were mostly of middle reproductive stage ages from 24-39 years .The major contributing factors for female infertility were menstrual disorders due to hormonal disorders, premature ovarian failure and polycystic ovarian syndrome. The main menstrual disorders were amenorrhea (15.5%), oligomenorrhea (10.3%) and menorrhagia (3.4%). The various types of female infertility observed were PCOS (75.9%), premature ovarian failure (3.40%) and poor ovarian reserve (20.70%). Male causes of infertility were mainly oligospermia (10.7%), azoospermia (13.8%), asthenospermia (3.4%) and teratospermia (10.4%). The different types of infertility observed were primary infertility (48.3%) and secondary i...
Introduction: Lateral Epicondylitis has been found to be the second most frequently diagnosed mus... more Introduction: Lateral Epicondylitis has been found to be the second most frequently diagnosed musculoskeletal disorder. A wide range of symptomatic treatments are available such as use of anti-inflammatory analgesic drugs, steroids, physiotherapy. This study aims to know about the diagnosis, prescription pattern and current practice on management of tennis elbow in Nepal. Methods: This is a hospital based observational study carried out at Bir Hospital, Kathmandu, Nepal. Patients diagnosed with tennis elbow were purposively selected through prospective sampling technique from Orthopedic Department. Questionnaire and patient medication files were used as tools for data collection. Results: A total of 97 patients were found to be suffering from tennis elbow affecting mostly 41-50 years of age group and seen mostly in female (62%). Further, it was found that housewives (31%) were mostly affected. Diagnosis of tennis elbow was done commonly by clinical evaluation (61%) and X-ray (39%). ...
The purpose of this study was to evaluate the use of ceftriaxone in a Private Hospital. Cross sec... more The purpose of this study was to evaluate the use of ceftriaxone in a Private Hospital. Cross sectional descriptive study was used to assess rational use of ceftriaxone. The study was conducted by reviewing medication records of 180 patients who received ceftriaxone during hospitalization from June 2014 to August 2014. Descriptive research design was used for the research. The study involved the collection of data at time of drug being used during the course of treatment of patient during hospitalization using structured data collection form by reviewing the in-patient prescription and medication record and then evaluated for the various purposes. Among 180 patients male (55.6%) were more than female (44.4%). Maximum number of patients fell under age range 21-30 years (20.0%). The duration of therapy was found to be high in the range 2-7 days (76.11%). Most of the patients were prescribed with dose 1gm (69.4%) and most prescribed frequency was BD (76.1%). The mean daily prescribed d...
The purpose of this study was to evaluate the use of ceftriaxone in a Private Hospital. Cross sec... more The purpose of this study was to evaluate the use of ceftriaxone in a Private Hospital. Cross sectional descriptive study was used to assess rational use of ceftriaxone. The study was conducted by reviewing medication records of 180 patients who received ceftriaxone during hospitalization from June 2014 to August 2014. Descriptive research design was used for the research. The study involved the collection of data at time of drug being used during the course of treatment of patient during hospitalization using structured data collection form by reviewing the in-patient prescription and medication record and then evaluated for the various purposes. Among 180 patients male (55.6%) were more than female (44.4%). Maximum number of patients fell under age range 21-30 years (20.0%). The duration of therapy was found to be high in the range 2-7 days (76.11%). Most of the patients were prescribed with dose 1gm (69.4%) and most prescribed frequency was BD (76.1%). The mean daily prescribed d...
The objective of this study is to investigate the causes of an ovulatory infertility, its managem... more The objective of this study is to investigate the causes of an ovulatory infertility, its management and outcome in an urban Nepalese population. An observational study conducted was among 58 couples visiting the department of Infertility Centre Pvt. Ltd. from November 2010 to May 2011. Infertile patients were mostly of middle reproductive stage ages from 24-39 years .The major contributing factors for female infertility were menstrual disorders due to hormonal disorders, premature ovarian failure and polycystic ovarian syndrome. The main menstrual disorders were amenorrhea (15.5%), oligomenorrhea (10.3%) and menorrhagia (3.4%). The various types of female infertility observed were PCOS (75.9%), premature ovarian failure (3.40%) and poor ovarian reserve (20.70%). Male causes of infertility were mainly oligospermia (10.7%), azoospermia (13.8%), asthenospermia (3.4%) and teratospermia (10.4%). The different types of infertility observed were primary infertility (48.3%) and secondary infertility (27.6%). For the management of anovulatory infertility, female patients with hormonal disorders were prescribed hormonal replacement therapy (48.3%) and those who failed to ovulate were prescribed Clomiphene Citrate (27.6%) for medical ovulation induction. Letrozole (17.2%) prescribed as an aromatase inhibitor used in whom ovulation induction with Clomiphene Citrate had failed. Hyponid, a herbal formulation was given as insulin sensitizing agents. M2 tone was given in managing functional menstrual disorders of adolescents. Vitamin B complex along with Clomiphene Citrate and folic acid prescribed for prevention of fetus neural tube defect. Calcium was prescribed for treating the disturbances with premenstrual symptoms .The majority of the patients who have undergone ovulation induction with Clomiphene Citrate were conceiving mainly by Intrauterine Insemination technique. Infertility is considered as a disgraceful condition, and something that is not discussed freely in developing countries like Nepal. With timely detection and proper therapeutic management an ovulatory infertility can be avoided.
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