Browsing by Author "Pant, Subash"
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Publication Extensive Drug Resistant Acinetobacter Species Isolates in Sputum Sample of Patient Admitted in Intensive Care Unit of a Tertiary Care Centre: A Descriptive Cross-sectional Study(Nepal Medical Association, 2021) Prasai, Astha; Pant, Abhishek; Neupane, Asmita; Pant, Subash; Pradhan, SaileshAbstract: Introduction: Increasing antibiotic resistance has created a global public health threat worldwide. Acinetobacter species is one of the important pathogenic organisms in the hospital setting due to its ability to persist in the hospital environment for long. Its resistance to commonly used antibiotics can prolong hospital stay, increase financial burden, and increase morbidity and mortality. This study aims to find the prevalence of extensive drug resistant Acinetobacter species in the sputum sample of Intensive Care Unit patients admitted in a tertiary care center. Methods: A descriptive cross-sectional study was conducted in a tertiary care center among the hospital records from May 2017 to May 2021, after ethical approval (Reference number: 2104202101). All the Intensive Care Unit patients with isolated acinetobacter species in their sputum samples within the past four years were collected and Statistical Package for Social Sciences version 25 was used for analysis. Point estimate at 95% Confidence Interval was calculated along with frequency and proportion for binary data. Results: Of the total 409, 196 (47.9%) (95% Confidence Interval= 43.06-52.74) of Acinetobacter species in the sputum sample had extensive drug resistance. Of these, 193 (98.5%) and 1 (0.5%) of the extensive drug resistant Acinetobacter species were resistant to carbapenem and polymyxin respectively. Conclusions: Prevalence of extensive drug resistant acinetobacter was found higher compared to other studies.Publication Functional Status and Comorbidities in Older Patient Attending Outpatient in a Tertiary Care Hospital: An Observational Study(Nepal Medical Association, 2024) Aryal, Ananta; Aryal, Anil; Pokharel, Rhijuta; Timsina, Shrinkhala; Gautam, Shirjan; Jha, Saurav; Pant, SubashAbstract Introduction: With the increasing geriatric population, the demand of the geriatric care has been increasing worldwide. Numerous comorbidities like hypertension, COPD, diabetes mellitus, arthritis, are seen commonly in the older population of Nepal, affecting their quality of life. Assessing functional status of individual using Basic Activities of Daily Living and Instrumental Activities of Daily Life scoring is beneficial in predicting the mortality and morbidity among the group. This study hence focuses on determining the comorbidities and functional status of older population. Methods: This descriptive cross-sectional study was conducted from February 2024 to May 2024 in tertiary care hospital at Kathmandu among population of age group above 60 years, after taking ethical approval from Institutional Review Committee (Reference number: 19012024/04). A total of 423 individuals were taken for the study. Data collection for socio-demographic information, comorbidities, functional assessment via Katz and Lawton scale was done and analysed using IBM SPSS. Results: Among the total 423 participants visiting the outpatient department, 188 (44.44%) were males and 235 (55.56%) were females. Basic Activity of Daily Living using Katz scoring, suggested that 377 (89.13%; 95% CI: 85.76%-91.93%)) were independent. Using Lawton scoring for the assessment of Instrumental Activities of Daily Living, it was seen that 170 (40.19%; 95% CI: 35.48%-45.03%) were independent. There were 184 (43.50%) individual with comorbidities. Conclusions: Most of the patients were independent in Basic Activities of Daily Living as per Katz Index of independence and almost half were independent in Instrumental Activities of Daily Living as per Lawton-Brody scale.Publication Mean Six Minute Walk Distance of Healthy Healthcare Workers of a Tertiary Care Centre: A Descriptive Cross-sectional Study(Nepal Medical Association, 2022) Pant, Subash; Basnet, Krity; Shrestha, Prinsa; K.C., MathuraAbstract Introduction: The six-minute walk test is a sub-maximal exercise test used in clinical populations to determine functional exercise capacity. It is a safe, simple, and inexpensive test. There are a number of reference equations described for estimating six-minute walk distance in healthy subjects in different countries. However, there is a lack of standard reference value for six minute walk distance in healthy Nepalese population. The aim of the study was to find the mean six minute walk distance of healthy healthcare workers of a tertiary care centre. Methods: A descriptive cross-sectional study was conducted among healthy health care workers of a tertiary care centre from 1 August 2021 to 30 November 2021 after taking ethical approval from Institutional Review Committee (Reference number: 1507202105). Convenience sampling was done. Point estimate and 95% Confidence Interval were calculated. Results: The mean six-minute walk distance of the 162 healthy health care workers was 486.74±74.73 (475.23–498.24, 95% Confidence Interval) m. Men walked 519.61±79.19 m and women walked 474.12±75.62 m. The mean age of the participants was 29.25±8.25 years. Conclusions: The mean six-minute walk distance was found to be lower when compared to similar studies conducted in similar settings.Publication Obstructive Lung Disease among Patients Performing Spirometry in a Tertiary Care Centre: A Descriptive Cross-sectional Study(Nepal Medical Association, 2022) Shrestha, Prinsa; Pant, SubashAbstract Introduction: Obstructive lung disease is a leading cause of morbidity and mortality worldwide which causes economic and social burdens. Spirometry is a standard test for screening and evaluating patients with symptoms of chronic respiratory diseases and is the investigation of choice for identifying airflow obstruction. Chronic obstructive lung disease prevalence, mortality, and morbidity vary across different countries. The study aimed to find out the prevalence of obstructive lung disease among the patients performing spirometry in a tertiary care centre. Methods: A descriptive cross-sectional study was conducted in the pulmonary function test clinic of the Department of Internal Medicine of a tertiary care hospital between 1 October 2021 and 31 March 2022 from hospital records. Ethical approval was taken from the Institutional Review Committee (Reference number: 200320203). Convenience sampling was done. Point estimate and 95% Confidence Interval were calculated. Results: Among 401 patients, obstructive lung disease was present in 173 (43.14%) (38.29-47.99, 95% Confidence Interval). The mean age was 55.78±18.54 years. The most common symptom for referral was dyspnea seen in 151 (87.30%). Conclusions: The prevalence of obstructive lung disease in our study was higher compared to other studies from the similar setting. Spirometry should be used more frequently for diagnosis and to stratify patients for appropriate treatment.Publication Organophosphorus Poisoning among Patients Admitted to the Intensive Care Unit of the Department of Internal Medicine in a Tertiary Care Centre: A Descriptive Cross-sectional Study(Nepal Medical Association, 2022) Bhusal, Suzit; Bhandari, Rupa; Dahal, Sujata; Niroula, Aliska; Basnet, Krity; Chaudhary, Ashlesha; Pant, SubashAbstract Introduction: Organophosphates are potent cholinesterase inhibitors that when ingested in excessive amounts can be fatal. Organophosphorus poisoning has become an important clinical problem with increased mortality in the country from accidental or intentional ingestion of, or exposure to the pesticide. This study aimed to find out the prevalence of organophosphorus poisoning among patients admitted to the Intensive Care Unit of the Department of Internal Medicine in a tertiary care centre. Methods: A descriptive cross-sectional study was conducted among patients admitted to the Intensive Care Unit of the Department of Internal Medicine of a tertiary care centre after receiving ethical approval from the Institutional Review Committee (Reference number: 2003202205). The study was conducted between 1 February 2021 and 1 February 2022 using hospital records. Convenience sampling was done among the patients who met the eligibility criteria. The diagnosis of organophosphorus poisoning was made based on the patient’s history, clinical examination and the measurement of serum acetylcholinesterase levels. Point estimate and 95% Confidence Interval were calculated. Results: Among 1108 patients admitted, organophosphorus poisoning was seen in 50 (4.15%) (3.29-5.73, 95% Confidence Interval). Conclusions: Our study found that the prevalence of organophosphorus poisoning was lower when compared to similar studies done in similar settings.Publication Scrub Typhus in Intensive Care Unit in Kathmandu – A case series from a tertiary center(Nepalese Respiratory Society, 2022) Rajkarnikar, Ruja; Paudyal, Bidhan Raj; Awale, Ayushi; Shrestha, Sanjeev; Sharma, Lucky; Pant, Subash; Shrestha, Sanjeet KAbstract: Scrub typhus is a rickettsial zoonosis caused by Orientia tsutsugamushi which can cause focal or disseminated vasculitis & perivasculitis in various body systems. It is endemic in many parts of Nepal & has been neglected & under-detected. We clinically assessed six patients from a intensive care unit in a tertiary hospital in Nepal that tested positive for scrub typhus using IgM ELISA & analyzed their profiles. Out of six patients, three were male & three were female with a mean age of 44.6 years. All six patients had chief complaints of fever & myalgia. Four patients presented with eschar. Three patients presented with septic shock while one presented with septicemia and meningoencephalitis. Only one patient had elevated white cell counts. Four out of six patients had transaminitis. Thrombocytopenia was present in two patients. Hypoalbuminemia was present in three patients. All cases tested negative for dengue, malaria, brucella, Leptospira, leishmania, salmonella & tuberculosis. This study points out the need for raising the index of suspicion & early screening of scrub typhus in patients with fever & laboratory findings of liver dysfunction or thrombocytopenia even with normal white cell counts.Publication Sputum Eosinophil Level among Healthy Individuals Visiting Medicine Outpatient Department of a Tertiary Care Centre: A Descriptive Cross-sectional Study(Nepal Medical Association, 2022) Pant, Subash; Shrestha, Prinsa; Acharya, Rajat; Gurung, Pranita; Neopane, ArpanaAbstract Introduction: Sputum differential is the most comprehensive, and non-invasive investigation for evaluating airway inflammation because of its reliability, reproducibility and responsiveness. The interpretation of the results of induced sputum examination depends on knowledge of normal values from a healthy population. So far, the reference values of sputum differential cells in Nepalese population are not reported. Neutrophil and eosinophil are used to assess the inflammatory response of the airway. The aim of our study was to detect the eosinophil level in the sputum of healthy individuals with normal pulmonary function. Methods: A descriptive cross-sectional study was conducted in a tertiary care hospital, from November 1, 2021 to December 31, 2021 after taking ethical clearance from Institutional Review Board (Reference number: 1507202106). Convenience sampling was done. Collected data was entered and analysed using Statistical Package for the Social Sciences version 24.0. Point estimate at 95% was calculated along with mean and standard deviation for continuous data. Results: Among 139 induced sputum samples, 7 (5.03%) had eosinophils present in their sputum (1.40 to 8.67 at 95% Confidence Interval). The age range of the participants was 18 years to 79 years with mean age of 39.5 ± 15.06. Prevalence of eosinophilia (percentage of eosinophil ≥3) was 4 (2.88%). Conclusions: The prevalence of eosinophilia in our study was found to be similar to published literature. The results of the present study show that there is a paucity of eosinophils with predominance of neutrophils, macrophages and lymphocytes in induced sputum samples of healthy non-smoker adults with normal pulmonary function test.