Browsing by Author "Pradhan, R"
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Publication Are we really in safe hands? How safe is safe?(Kathmandu University, 2008) Pradhan, R; Shrestha, K; Gurung, SNAPublication Clinical Profile of Invasive Pneumococcal Disease in Patan Hospital, Nepal(Kathmandu University, 2011) Chhetri, UD; Shrestha, S; Pradhan, R; Shrestha, A; Adhikari, N; Thorson, S; Pollard, AJ; Murdoch, DR; Kelly, DFABSTRACT Background Pneumococcal infection is one of the leading causes of pneumonia, meningitis and septicemia in developing countries. It accounts for one million deaths each year in children. Objectives The objective of this study is to see the clinical profile of invasive pneumococcal disease, antibiotics sensitivity pattern and prevalent serotypes in children admitted at Patan Hospital. Methods This is a retrospective analytical study conducted in the department of Paediatrics, Patan hospital. The lab data of those children who grew pneumococci in their blood, cerebrospinal fluid or body fluids over a period of 3 years (January 2007 to Dec 2009) were collected and the case files were then studied. Results Out of 42 cases of invasive pneumococcal diseases studied admitted diagnoses included pneumonia, febrile seizure, bacteremia or septicemia, meningitis, acute gastroenteritis and glomerulonephritis. Twenty seven of them were children under five. The male to female ratio was 1.7:1. On investigation 64%, 52% and 5% of the patients had leucocytosis, anaemia, and leucopenia respectively. Twenty six of them had radiological changes suggestive of pneumonia. Streptococcus pneumoniae grew in 38 blood samples, 5 cerebrospinal fluid and 3 pleural fluids. Almost all of these isolates were sensitive to penicillin, cefotaxime, amoxycillin, choloramphenicol, erythromycin and ofloxacin and resistant to cotrimoxazole and gentamicin.Pneumococcal serotypes found in our study were 1, 14, 5, 23B, 6B, 8, 9A, 9V, 10A, 15 and 23F (11 serotypes). Conclusions Penicillin is still the most effective antibiotic for streptococcal infection in our study. Of the pneumococcal serotypes identified; 36% were covered by the 7-valent pneumococcal conjugate vaccine, 54% each by PCV-10 and PCV-13, and 72% by the e 23 valent vaccines. KEY WORDS Invasive Pneumococcal Disease, Serotypes, Streptococcus pneumoniae,Publication Incidence of Accidental Awareness with Recall during General Anaesthesia: A Prospective Observational Study in a Tertiary Care Hospital(Kathmandu University, 2024) Moktan, SL; Pradhan, R; Pradhan, AABSTRACT Background Accidental awareness during general anaesthesia, though rare, is a serious issue. It could lead to potential harmful psychological consequences. It has been reported that general surgical population has an incidence of awareness ranging from 0.1 to 0.2%. Objective To determine the incidence of awareness with recall under general anaesthesia by using modified Brice questionnaire in post-operative care unit. Method This was an observational study conducted on adult patients in a tertiary care hospital. A modified Brice questionnaire was used for the post-operative interview in 1,120 patients following the written informed consent. They were of American society of anaesthesiologists’ physical status I to III and had surgeries under general anaesthesia. The incidence of intraoperative awareness with recall was the primary outcome of the study. Result Among the total 1,120 patients, 678 patients were female and 442 were males. Most patients, 785 were of American society of anaesthesiologists’ physical status I, while 316 were II and 19 were III. While 1071 (95.6%) patients underwent elective surgery, 49 (4.3%) patients had emergency surgeries. The mean age of the study population was 40.31years with standard deviation of 12.12. Of the 1120 patients, two of them had definitive awareness. Conclusion The incidence of intraoperative awareness with recall after general anaesthesia in patients from a tertiary care hospital was 0.13%. KEY WORDS General anaesthesia, Intraoperative awareness, Modified brice questionnairePublication Single visit approach for Cervical Cancer Prevention in a mobile screening clinic(Institute of Medicine, 2016) Singh, M; Shrestha, S B; Manandhar, A; Ranjit, R; Pradhan, R; Shah, A; Verma, S; Malla, KAbstract Introduction: Cervical cancer is the third most common cancer in women worldwide, but the most preventable cancer. The objectives was to determine the feasibility and acceptability of immediately treating VIA positive women with thermocoagulation in a single-visit approach (SVA) in preventing cervical cancer. Method: This was a community-based programme organized in collaboration with Nepal Australian Cervical Cancer Foundation and Thermocoagulation unit donated by Tropical Health and Education Trust in a mobile screening camp set up in five different underserved areas in Gorkha, Nepal. Total women were 1071 aged 30-60 yearrs in 5 days in December, 2016, had come for cervical cancer screening. Women who were VIA positive had thermocoaculation for treatment. Results: Total screened women were 1071, the rate of VIA positive was 115(10.7%). 100% percent of positive result accepted treatment. All VIA positive patients except for one woman who was suspected of having invasive cervical cancer had treatment with thermocoagulation. Of all treated women only 5(4.38%) had minor side effect. Conclusion: For cervical cancer screening, the single-visit program was feasible and the degree of acceptability was 100% in this underserved population. Single visit programs provide an opportunity to increase the rate of immediate treatment of lesions with minimal side effect compared with delayed treatment after obtaining colposcopy guided biopsy report in later visit. Keywords: cervical cancer, mobile screening, VIA, SVA, thermocoagulation