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Article: Clinical vignette-based interactive discussion sessions: feedback from residents.

Piryani, Rano Mal / Piryani, Suneel

Advances in medical education and practice

2019 Volume 10, Page(s) 829–833

Abstract: Introduction: A clinical vignette is a useful tool for teaching both clinical and basic sciences courses. The clinical vignette-based interactive discussion sessions were conducted for residents in the internal medicine department of Universal College ... ...

Abstract	Introduction: A clinical vignette is a useful tool for teaching both clinical and basic sciences courses. The clinical vignette-based interactive discussion sessions were conducted for residents in the internal medicine department of Universal College of Medical Sciences( Bhairahawa, Nepal) with aim to link the residents to clinical practice setting. The objective of this study was to assess the feedback of participant. Methods: The sessions were done five days a week between January 16 and February 26, 2019. Each session was between 45 and 60 minutes. The clinical vignettes related to internal medicine were downloaded using Google. Each vignette was divided into sections, related questions with responses were developed and the discussion was updated referring to the latest articles on subject. Eleven residents participated in the session. At the end of last session feedback was taken on a validated semi-structured questionnaire. The data was analyzed using SPSS version 21. Results: Residents rated the clinical vignette-based interactive discussion sessions on the scale 1 = poor to 10= excellent; usefulness (9.45±1.04), content (9.27±0.90), relevance of session (9.18±1.08), facilitation (9.27±1.10), and overall (9.36±0.81). Participants rated the structure of vignettes discussed (3.73±0.47), the questions related to vignettes discussed (3.82±0.40), and discussion related to vignettes done (3.64±0.50) on a Likert scale 1-4 (4= extremely important, 3= moderately important, 2= slightly important, 1= not important). The two-way interaction, the approach toward differential diagnosis, diagnosis and management, choosing appropriate investigation, clinical relevancy of vignettes, boosts understanding, enhances thinking power and thinking outside the box, improving clinical approach and academic learning were among the strengths of sessions shared by residents. All residents proposed to continue these sessions and develop vignettes of our patients. The majority of the residents recommended conducting session on alternate days. Conclusion: This method of learning allowing the residents to follow and construct clinical outcome in a logical and systematic sequence that may be applicable in real-life clinical practice settings. This method enhances the thinking power of residents and their problem-solving capacity.
Language	English
Publishing date	2019-09-24
Publishing country	New Zealand
Document type	Journal Article
ZDB-ID	2578539-4
ISSN	1179-7258
ISSN	1179-7258
DOI	10.2147/AMEP.S218157
Database	MEDical Literature Analysis and Retrieval System OnLINE

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Article ; Online: Conflict Management in Healthcare.

Piryani, Rano Mal / Piryani, Suneel

Journal of Nepal Health Research Council

2019 Volume 16, Issue 41, Page(s) 481–482

Abstract: The conflict is a disagreement within oneself or differences or dispute among persons that has potential to cause harm. It is inevitable and may occur in any profession including healthcare. It could be among any group of healthcare professionals or ... ...

Abstract	The conflict is a disagreement within oneself or differences or dispute among persons that has potential to cause harm. It is inevitable and may occur in any profession including healthcare. It could be among any group of healthcare professionals or healthcare team between different group of healthcare professionals or between patient and any of the member of healthcare team. The conflict has a critical effect on the competence, confidence, and morale of healthcare professionals. Consequently, it affects patient care too. To prevent or limit the conflict, emphasis must be focused on proper and impartial implementation of a professional code of conduct, ground rules and discipline. The sources of conflict could real or imagined differences in values, dissimilar goals among individuals, improper communication and personalization of generic or organizational issue. Generally, there are four types of conflicts, intrapersonal, interpersonal, intragroup and intergroup.The conflict usually goes through four phases, frustration of one or more parties involved in conflict, conceptualization or rationalization of cause, expression of behaviors and behaviors resulting in negative outcome. Thomas and Kilmann postulated a matrix explaining five distinct responses or styles to conflict resolution or management varying along the axis of assertiveness and cooperativeness. These five styles are avoiding, accommodating, compromising, competing and collaborating. The issue in conflict is not its existence, rather its management. When it is managed poorly, the outcome will be uncomplimentary with counterproductive results and if managed properly, it encourages competition, recognize legitimate differences and becomes powerful source of motivation. Keywords: Conflict, healthcare, management of conflict, source of conflict, type of conflict.
MeSH term(s)	Conflict (Psychology) ; Delivery of Health Care/organization & administration ; Health Personnel/organization & administration ; Health Personnel/psychology ; Humans ; Interpersonal Relations ; Negotiating/methods
Language	English
Publishing date	2019-01-28
Publishing country	Nepal
Document type	Journal Article
ZDB-ID	2551251-1
ISSN	1999-6217 ; 1727-5482
ISSN (online)	1999-6217
ISSN	1727-5482
Database	MEDical Literature Analysis and Retrieval System OnLINE

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Article ; Online: Nepal's Response to Contain COVID-19 Infection.

Piryani, Rano Mal / Piryani, Suneel / Shah, Jay Narayan

Journal of Nepal Health Research Council

2020 Volume 18, Issue 1, Page(s) 128–134

Abstract: Nepal is a landlocked country bordering two most populous countries, India and China. Nepal shares open border with India from three sides, east, south and west. And, in north with China, where the novel coronavirus infection (CVOVID-19) began in late ... ...

Abstract	Nepal is a landlocked country bordering two most populous countries, India and China. Nepal shares open border with India from three sides, east, south and west. And, in north with China, where the novel coronavirus infection (CVOVID-19) began in late December 2019. The first confirmed imported case in Nepal was reported in 2nd week of January 2020. The initial response of Nepal to COVID-19 were comparably slow but country geared efforts after it was declared a 'global pandemic' by WHO on 11 March, 2020. Government of Nepal's steps from 18 March, 2020 led to partial lock down and countrywide lockdown imposed on 24 March, 2020. Government devised comprehensive plan on 27 March, 2020 for quarantine for peoples who arrived in Nepal from COVID-19 affected countries. This article covers summary of global status, South Asian Association of Regional Cooperation (SAARC) status, and Nepal's response to contain COVID-19 infection discussed under three headings: Steps taken before and after WHO declared COVID-19 a global pandemic and lab services regarding detection of COVID-19. Nepal has documented five confirmed cases of COVID-19 till the end of March 2020, first in second week of 15 January, 2020 and 2nd case 8-weeks thereafter and 3rd case two days later, 4th on 27 March and 5th on 28 March. Four more cases detected during first week of April. Non-Pharmacological interventions like social distancing and excellent personal habits are widely practiced. Country has to enhance testing and strengthen tracing, isolation and quarantine mechanism and care of COVID-19 patients as Nepal is in risk zone because of comparably weak health system and porous borders with India. The time will tell regarding further outbreak and how it will be tackled. Keywords: COVID-19; lockdown; Nepal; pandemic; response.
MeSH term(s)	Adult ; Aged ; Betacoronavirus ; COVID-19 ; Coronavirus ; Coronavirus Infections/epidemiology ; Coronavirus Infections/transmission ; Disease Outbreaks/prevention & control ; Humans ; Middle Aged ; Nepal/epidemiology ; Pandemics/prevention & control ; Pneumonia, Viral/epidemiology ; Pneumonia, Viral/transmission ; Quarantine ; SARS-CoV-2 ; Young Adult
Keywords	covid19
Language	English
Publishing date	2020-04-20
Publishing country	Nepal
Document type	Journal Article
ZDB-ID	2551251-1
ISSN	1999-6217 ; 1727-5482
ISSN (online)	1999-6217
ISSN	1727-5482
DOI	10.33314/jnhrc.v18i1.2608
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Article: Nepal's Response to Contain COVID-19 Infection

Piryani, Rano Mal / Piryani, Suneel / Shah, Jay Narayan

J Nepal Health Res Counc

Abstract	Nepal is a landlocked country bordering two most populous countries, India and China. Nepal shares open border with India from three sides, east, south and west. And, in north with China, where the novel coronavirus infection (CVOVID-19) began in late December 2019. The first confirmed imported case in Nepal was reported in 2nd week of January 2020. The initial response of Nepal to COVID-19 were comparably slow but country geared efforts after it was declared a 'global pandemic' by WHO on 11 March, 2020. Government of Nepal's steps from 18 March, 2020 led to partial lock down and countrywide lockdown imposed on 24 March, 2020. Government devised comprehensive plan on 27 March, 2020 for quarantine for peoples who arrived in Nepal from COVID-19 affected countries. This article covers summary of global status, South Asian Association of Regional Cooperation (SAARC) status, and Nepal's response to contain COVID-19 infection discussed under three headings: Steps taken before and after WHO declared COVID-19 a global pandemic and lab services regarding detection of COVID-19. Nepal has documented five confirmed cases of COVID-19 till the end of March 2020, first in second week of 15 January, 2020 and 2nd case 8-weeks thereafter and 3rd case two days later, 4th on 27 March and 5th on 28 March. Four more cases detected during first week of April. Non-Pharmacological interventions like social distancing and excellent personal habits are widely practiced. Country has to enhance testing and strengthen tracing, isolation and quarantine mechanism and care of COVID-19 patients as Nepal is in risk zone because of comparably weak health system and porous borders with India. The time will tell regarding further outbreak and how it will be tackled. Keywords: COVID-19; lockdown; Nepal; pandemic; response.
Keywords	covid19
Publisher	WHO
Document type	Article
Note	WHO #Covidence: #127826
Database	COVID19

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Article: COVID-19 testing: Essential for tracking infection and helping authority to overcome the challenges of spread

Piryani, Rano Mal Piryani Suneel Piryani Shomeeta Dangal Ganesh Huq Muzaherul Shakya Dhana Ratna

Journal of Chitwan Medical College

Abstract: COVID-19 is mainly transmitted through droplet infection and spread very fast compared to SARS-CoV and MERS-CoV For the countries, it is important to know at what stage the COVID-19 epidemic is? So, as to take appropriate steps to contain the epidemic ... ...

Abstract	COVID-19 is mainly transmitted through droplet infection and spread very fast compared to SARS-CoV and MERS-CoV For the countries, it is important to know at what stage the COVID-19 epidemic is? So, as to take appropriate steps to contain the epidemic This will only be known by testing the suspects and contacts of confirmed cases If there is poor testing, then most of the infected people may remain undetected, however they could spread the virus to hundreds of other people and potential contacts, which could not be known and quarantined in time continuing the spread If there is quality assured, highly sensitive and specific testing along with adequate isolation and quarantine, then the spread will be limited There are two types of tests available for COVID-19: the tests directly detecting the viral ribonucleic acid (RNA) collected in nasopharyngeal or throat swabs, and tests detecting antibodies from the blood sample At this point in time, the polymerase chain reaction (PCR) tests are used for confirmation of the disease while antibodies tests may provide information regarding the prevalence of infection World Health Organization advices the countries to increase the testing and get to know the level of epidemic and act accordingly for containment of infection
Keywords	covid19
Publisher	WHO
Document type	Article
Note	WHO #Covidence: #926606
Database	COVID19

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Article ; Online: Use of mask in COVID-19 era

Piryani, Rano Mal / Piryani, Suneel / Shah, Jay Narayan

Journal of Patan Academy of Health Sciences; Vol 7 No; 89-90 ; 2091-2757 ; 2091-2749

absence of evidence is not evidence of absence

2020 Volume 1

Abstract: World Health Organization (WHO) in its interim guidance of 6 April 2020 advises policy makers on the use of masks for healthy people in community settings. The rationale for mask use by healthy person is prevention from COVID-19, when there is risk of ... ...

Abstract	World Health Organization (WHO) in its interim guidance of 6 April 2020 advises policy makers on the use of masks for healthy people in community settings. The rationale for mask use by healthy person is prevention from COVID-19, when there is risk of exposure, like working in close contact with public, people with comorbidities, where physical distancing cannot be maintained such as travelling in buses, staying in slum areas. Furthermore, WHO says the purpose and reason for mask use should be clear– whether it is to be used for source control (used by infected persons) or prevention of COVID-19 (used by healthy persons).1 Centers for Disease Control (CDC) United States of America (USA) updated its advisory on 4 Apr 2020, and recommended everyone (except some) should wear at least a cloth face covering when they have to go out in public. It will protect other people in case you are infected.2,3 This advisory of no strict demand on use of face masks could be possibly due to unavailability of disposable masks.
Keywords	covid19
Language	English
Publishing date	2020-04-30
Publisher	Patan Academy of Health Sciences
Publishing country	np
Document type	Article ; Online
Database	BASE - Bielefeld Academic Search Engine (life sciences selection)

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Article ; Online: Revisit the hospital policy in the era of COVID-19

Piryani, Rano Mal / Piryani, Suneel / Shah, Jay Narayan

Journal of Patan Academy of Health Sciences; Vol 7 No; 97-100 ; 2091-2757 ; 2091-2749

2020 Volume 1

Abstract: Patient with recent history of dry cough, fever and breathlessness (influenza-like or severe acute respiratory illness) without alternative explanation/diagnosis needs to be managed as COVID-19 unless proved otherwise. Suspected COVID-19 patient having ... ...

Abstract	Patient with recent history of dry cough, fever and breathlessness (influenza-like or severe acute respiratory illness) without alternative explanation/diagnosis needs to be managed as COVID-19 unless proved otherwise. Suspected COVID-19 patient having fever and recent loss of taste and smell be tested for COVID-19. Patient with severe acute respiratory illness of unknown aetiology be tested for COVID-19. Patient with bilateral consolidation on chest X-ray or ground glass appearance on chest CT or interstitial oedema on chest ultrasound (not fully explained by volume overload) be tested for COVID-19 in moderate to high risk communities/countries. Suspected COVID-19 patients with lymphopenia, high ESR or rise in C-reactive protein and suspected of viral fevers be tested for COVID-19. Screening of pregnant women for COVID-19 with rapid testing preferably with Elisa in moderate to high risk communities/countries. Screening with rapid testing preferably with Elisa prior to invasive interventions, including operations, in moderate to high risk communities/countries. Limit the exposure of hospital staff who are susceptible to develop severe complications of COVID-19. Hospitals provide PPE to staff depending upon exposure as per international/national/local guidelines. Hospitals implement infection prevention control measures meticulously in context of COVID-19.
Keywords	covid19
Subject code	360
Language	English
Publishing date	2020-04-30
Publisher	Patan Academy of Health Sciences
Publishing country	np
Document type	Article ; Online
Database	BASE - Bielefeld Academic Search Engine (life sciences selection)

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Book ; Online: Nepal's response to contain COVID-19 Infection

Piryani, Rano Mal / Piryani, Suneel / Shah, Jay Narayan

Community Health Sciences

2020

Abstract	Nepal is a landlocked country bordering two most populous countries, India and China. Nepal shares open border with India from three sides, east, south and west. And, in north with China, where the novel coronavirus infection (CVOVID-19) began in late December 2019. The first confirmed imported case in Nepal was reported in 2nd week of January 2020. The initial response of Nepal to COVID-19 were comparably slow but country geared efforts after it was declared a 'global pandemic' by WHO on 11 March, 2020. Government of Nepal's steps from 18 March, 2020 led to partial lock down and countrywide lockdown imposed on 24 March, 2020. Government devised comprehensive plan on 27 March, 2020 for quarantine for peoples who arrived in Nepal from COVID-19 affected countries. This article covers summary of global status, South Asian Association of Regional Cooperation (SAARC) status, and Nepal's response to contain COVID-19 infection discussed under three headings: Steps taken before and after WHO declared COVID-19 a global pandemic and lab services regarding detection of COVID-19. Nepal has documented five confirmed cases of COVID-19 till the end of March 2020, first in second week of 15 January, 2020 and 2nd case 8-weeks thereafter and 3rd case two days later, 4th on 27 March and 5th on 28 March. Four more cases detected during first week of April. Non-Pharmacological interventions like social distancing and excellent personal habits are widely practiced. Country has to enhance testing and strengthen tracing, isolation and quarantine mechanism and care of COVID-19 patients as Nepal is in risk zone because of comparably weak health system and porous borders with India. The time will tell regarding further outbreak and how it will be tackled. Keywords: COVID-19; lockdown; Nepal; pandemic; response.
Keywords	COVID-19 ; Nepal ; Infection ; Response ; Community Health and Preventive Medicine ; Epidemiology ; Public Health ; covid19
Subject code	950
Publishing date	2020-04-20T07:00:00Z
Publisher	eCommons@AKU
Publishing country	pk
Document type	Book ; Online
Database	BASE - Bielefeld Academic Search Engine (life sciences selection)

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Article: Evaluation of teachers training workshop at Kirkpatrick level 1 using retro-pre questionnaire.

Piryani, Rano Mal / Dhungana, Govinda Prasad / Piryani, Suneel / Sharma Neupane, Mamata

Advances in medical education and practice

2018 Volume 9, Page(s) 453–457

Abstract: Background: Teacher training focusing on teaching learning methodologies, assessment tools, and approaches that motivate the teachers and enhance their confidence is one of the fundamental programs of faculty development. The objective of this study was ...

Abstract	Background: Teacher training focusing on teaching learning methodologies, assessment tools, and approaches that motivate the teachers and enhance their confidence is one of the fundamental programs of faculty development. The objective of this study was to assess the self-reported perceived confidence of faculty members after participating in a basic teachers training workshop. Methodology: The retrospective post-then-pre design questionnaire was used for evaluating the faculty members' self-reported perceived confidence at Kirkpatrick level 1 (evaluation of reaction) after completing basic teachers training workshops. The self-reported perceived confidence on 30 statements were analyzed by 3 categories (not confident, confident, and highly confident) on a Likert scale. Results: Out of 60 participants (18 in the 3rd and 21 each in the 4th and 5th teachers training workshops), 58 (96.67%) responded to all statements. The mean age of the participants was 34.14±5.15 years; 70.7% were male and 29.3% female. Overall, the self-reported perceived confidence level of the participants of the 3rd (pre-training median 57, post-training median 70, Conclusion: Overall, the self-reported perceived confidence level of the participants was significantly increased after teachers training workshop.
Language	English
Publishing date	2018-06-18
Publishing country	New Zealand
Document type	Journal Article
ZDB-ID	2578539-4
ISSN	1179-7258
ISSN	1179-7258
DOI	10.2147/AMEP.S154166
Database	MEDical Literature Analysis and Retrieval System OnLINE

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Article: Do Face-to-Face Training and Telephonic Reminder Improve Dry Powder Inhaler Technique in Patients with COPD?

Poudel, Ramesh Sharma / Shrestha, Shakti / Bhatta, Pawan / Piryani, Rano Mal

International journal of telemedicine and applications

2017 Volume 2017, Page(s) 5091890

Abstract: ... ...

Abstract	Introduction
Language	English
Publishing date	2017-03-13
Publishing country	Egypt
Document type	Journal Article
ZDB-ID	2397787-5
ISSN	1687-6423 ; 1687-6415
ISSN (online)	1687-6423
ISSN	1687-6415
DOI	10.1155/2017/5091890
Database	MEDical Literature Analysis and Retrieval System OnLINE

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