Browsing by Author "Joshi, P"
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Publication Comparative Analyses of Clinical, Laboratory, and Radiological Findings between COVID-19 Deceased and Recovered Patients(Kathmandu University, 2023) Shrestha, MR; Basnet, A; Joshi, P; Bhat, DS; Maharjan, R; Thapa, R; Joshi, RD; Maharjan, R; Jha, RKABSTRACT Background Understanding the coronavirus disease 2019 (COVID-19)-specific indices has become important with increasing cases of COVID-related in-hospital mortality. Objective This case-control study compared clinical, laboratory, and radiological findings between deceased and recovered COVID-19 patients and identified the significant biomarkers associated with deceased patients. Method An analysis of clinical, laboratory, and radiological findings of COVID-19 patients admitted to the COVID-dedicated wards of Nepal Armed Police Force Hospital between March and December 2021 was performed using SPSS version 17.0, with statistical significance considered at p < 0.05. Result A total of 187 COVID-19 patients, comprising deceased [n=95, median (interquartile range, IQR) age: 66 (53–76) years, male: 61 (64.2%) (p=0.024)] and recovered [n=92, median (IQR) age: 51 (38–61) years, male: 44 (47.8%)], were included in the study. Compared to recovered COVID-19 patients, deceased patients had increased median respiratory (20 versus 29.5 breaths/minute) and pulse (83 vs. 86 beats/minute) rates; multiple co-morbidities (≥ 2) (11.9% vs. 32.6%) (p < 0.001); significantly (p < 0.05) lowered alkaline phosphatase (ALP), total protein (TP), albumin, lymphocytes, monocytes, eosinophil, hemoglobin and significantly (p < 0.05) elevated glucose, lactate dehydrogenase (LDH), alanine transaminase (ALT), aspartate aminotransferase (AST), leucocytes, neutrophils, D-dimer and C-reactive protein (CRP); and chest abnormalities including bilateral (p < 0.001), peripheral (p < 0.001) interstitial (p < 0.001) and ground glass opacity (GGO) (p=0.002). Conclusion Elderly, male sex, increased respiratory and pulse rate, presence of multiple co- morbidities, lowered levels of ALP, TP, albumin, lymphocytes, monocytes, eosinophils, hemoglobin, elevated levels of glucose, LDH, ALT, AST, leucocytes, neutrophils, D-dimer, CRP, and chest X-rays showing bilateral, peripheral interstitial and GGO abnormalities were the significant indices associated with deceased COVID-19 patients. KEY WORDS Biomarkers, Comorbidity, COVID-19, Laboratory, Radiology, Signs symptoms, VitalsPublication Efficacy and tolerability of Ketotifen in Nepalese asthmatic children: a clinical study(Kathmandu University, 2003) Shakya, KN; Joshi, P; Piya, A; Baral, MRObjective To assess the efficacy of Ketotifen in asthmatic children and to record its adverse effects, if any. Design Prospective clinical trial. Setting Pediatric asthma follow up clinic of a teaching hospital. Participants 23 asthmatic children between 3 and 15 years; 100% completed the trial on full protocol. Interventions Ketotifen 1mg (adjusted according to body weight, 50 mcg/kg/dose) orally twice daily for 9 months. Main Outcome measures Primary outcome: Decrease in frequency of asthmatic attacks and severity of exacerbations with improvements in peak expiratory flow rates (PEFR). Other measures included decrease in bronchodilator requirement, steroid doses and parental perception regarding patient quality of life. Results 34.78% children were symptom free by the end of 2nd 3 months and 65.21% had no further attack by the end of 3 rd 3 months of Ketotifen prophylaxis. Those children with activity and sleep ‘affected’ (8.69%) and ‘may be affected’ (30.43%) together improved to ‘may be affected’ group (21.73%) by the end of 2nd 3 months and further reduced to 8.69% by the conclusion of 3 rd 3 months. The duration of exacerbations was reduced in the remaining cases. Variability of PEFR decreased from 26.08% to 8.69% of children after the 3 rd 3 months of Ketotifen prophylaxis. No significant adverse effect of therapy was observed during the study. Conclusion Oral Ketotifen is effective and well tolerated for use in prophylactic treatment of bronchial asthma in children. Key Words: Ketotifen, Asthma, Prophylaxis, Efficacy.