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Physiotherapist, MPH, PhD - passionate about empowering women through health education. My PhD focussed on the development and testing of an informational Flipchart on lifestyle strategies and pelvic floor muscle training for women who have a pelvic organ prolapse living in rural regions of Nepal.
August 2020 - November 2020
- Reducing the burden of pelvic organ prolapse in Nepal: how does normal anatomy affect risk and how can we communicate ways of strengthening pelvic floor muscles in remote communities?
February 2015 - July 2016
- MPhil Student
- This formative qualitative study involved interviewing Nepali women about their knowledge of pelvic organ prolapse and pelvic floor muscle exercise. We also conducted real time ultrasound to visualise their pelvic floor muscle contraction
A manuscript has been submitted to a peer-reviewed journal on this project
Background: Pelvic organ prolapse is a common disorder for women in Nepal causing symptoms and reduced quality of life. Pelvic floor muscle exercise is a conservative treatment option for pelvic organ prolapse but the effective way to teach women in Nepal is not known. The objective of this pilot study was to determine if an illustrative leaflet wi...
Women in Nepal who suffer from pelvic floor disorders often have limited access to health advice. In rural areas, auxiliary nurse midwives (ANMs) are responsible for maternal health counselling and services. We sought to investigate whether an educational workshop on pelvic floor muscle training (PFMT) for ANMs would improve their knowledge and ena...
Introduction and hypothesisPelvic floor muscle training (PFMT) and lifestyle advice are effective at improving the symptoms and severity of pelvic organ prolapse (POP) in a range of populations; however, the impact of these interventions in Nepali women is unknown. We aimed to evaluate the impact of an informational flipchart on PFMT and lifestyle...
Aim: To investigate whether pelvic floor muscle (PFM) morphological changes obtained through four-dimensional translabial ultrasound (4D TLUS) correlate with a PFM contraction as evaluated by digital palpation and PFM electromyographic activity evaluated by surface electromyography (sEMG). The secondary objective was to investigate which ultrasoun...
Objective: The beneficial effects of photobiomodulation (PBM) on cellular function are well characterized, principally deriving from the absorption of red to near-infrared radiation by chromophores such as cytochrome-c-oxidase. However, the effects and underlying mechanisms of PBM on non-mitochondria containing cells, such as red blood cells (RBCs)...
COVID-19 has significantly impacted the world and Nepal is no exception. The pandemic has caused a reduction in health service delivery, especially for women’s health conditions, resulting in an increase in challenges for an already vulnerable group. Maternity care, reproductive health services, preventive interventions, nutritional advice and ment...
COVID-19 has significantly impacted the world and Nepal is no exception. The pandemic has caused a reduction in health service delivery, especially for women's health conditions, resulting in an increase in challenges for an already vulnerable group. Maternity care, reproductive health services, preventive interventions, nutritional advice and ment...
Background Pelvic floor muscle (PFM) function has been shown to be inversely associated with pelvic organ prolapse (POP) in Western women, however differences have been documented between ethnic groups. Objective To determine if PFM strength and thickness and hiatal area (HA) are associated with POP in Nepali women. Methods This cross-sectional s...
Pelvic organ prolapse (POP) is a common condition for women in which increased soft tissue mobility allows one or more of the pelvic organs to descend into the vagina causing a variety of distressing symptoms. While POP is a global problem, there are additional challenges and considerations for women living in low- and middle-income countries (LMIC...
Introduction and hypothesisLimited existing evidence suggests that there is a high prevalence of female pelvic organ prolapse (POP) amongst Nepali women. However, to date, no comprehensive assessment of pelvic floor functional anatomy has been undertaken in this population. Our study aimed to determine functional pelvic floor anatomy in Nepali wome...
Objectives Pelvic organ prolapse is very common among women in Nepal, especially uterine prolapse. This would suggest a high rate of levator trauma, which is a strong predictor of such prolapse in the Western world. Hence, we decided to study the prevalence of maternal birth trauma in Nepali women. Methods In November 2016, we offered an interview...
Member of the Advisory Committee to update the guidelines for conservative treatment of Pelvic Organ Prolapse. This will involve a systematic review and consensus statement to be completed in 3 years. https://www.iuga.org/publications/iuc/chapter-3-conservative-treatment-of-the-patient-with-pelvic-organ-prolapse
In this study we are conducting 3D/4D real time ultrasound to determine Nepali women to determine the prevalence of POP, pelvic floor trauma and functional anatomy. The second part of this study is developing and testing a training program on pelvic floor muscle training for women living in remote regions of Nepal. We are designing a an informational flipchart for local health workers about the conservative strategies to manage symptomatic POP. We are conducting an RCT to determine the impact of the flipchart.