Browsing by Author "Prasad, Pravin"
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Publication Attitude and Perception of Preclinical Undergraduate Medical Students about Problem Based Learning in Medical College of Nepal: A Descriptive Cross-sectional Study(Nepal Medical Association, 2024) Karki, Naresh; Joshi, Lokraj; Prasad, Pravin; Kandel, Kamal; Shakya, Raju PrasadAbstract Introduction: Problem-based learning is a student-centered learning method. Assessing students’ understanding, settled way of thinking and interpretation towards problem-based learning is essential. The objective of the study was to understand the attitude and perception of preclinicalM.B.B.S. students about problem-based learning. Methods: A descriptive cross-sectional study was conducted from July 5, 2023 to September 4, 2023 for the duration of two months after duly approval from Institutional Review Committee (Protocol No: IRC-LMC-04/Q-23). First and second year M.B.B.S. students who had good experience of attending problem-based learning sessions in integrated basic science subjects were included in the study. Fifteen close-ended questions related to attitude and perceptions were designed in Google Form. The responses were taken on five point Likert scale ranging from strongly disagree (1), disagree (2), neutral (3), agree (4), and strongly agree (5). Data were expressed as frequency and percentage. Results: Among 164 participants, 92 (56.09%) strongly agreed and 67 (40.87%) agreed that problem based learning enhances self-directed learning on the topic. Similarly, 103 (62.80%) strongly agreed and 59 (35.98%) agreed that problem based learning improves communication skills. Likewise, 78(47.57%) agreed and 53 (32.32%) strongly agreed that this learning method improves confidence in decision-making. Moreover, 89 (54.28%) agreed and 58 (35.36%) strongly agreed that tutors motivate students to learn themselves through problem based learning. Conclusions: Majority of the students have positive attitude and good perception towards problem based learning. This method helps in generating skills like communication skills, group discussion, constructive critical reasoning, decision–making.Publication Bacteriological Profile of Surgical Site Infection Following Gastrointestinal Surgery and Their Antibiogram(Nepal Health Research Council, 2023) Shrestha, Neha; Sharma, Sangita; Ghimire, Bikal; Prasad, Pravin; Das, Debashis; Sherchand, Jeevan BahadurAbstract Background: Surgical site infection is one of the common complication following abdominal surgery. It causes great morbidity and mortality, further increasing prevalence of multidrug resistant bacteria have made its management very challenging. The current study aims to identify causative agent responsible for surgical site infection and their antibiotic resistance patterns. Methods: This study was conducted among patients developing surgical site infection following gastrointestinal surgery in Tribhuvan university teaching hospital over a period of one year. The samples were collected and processed according to standard methods. The bacterial pathogens with their antimicrobial susceptibility were determined and resistant pattern like methicillin resistant Staphylococcus aureus and extended spectrum beta lactamase were further detected. Results: A total of 832 patients had under gone gastrointestinal surgery during the study period. Among them, 162 cases (19.5%) developed surgical site infection and 125 cases showed growth in culture. A total of 160 aerobic bacteria were isolated; Escherichia coli (29.9%) was the commonest organism with 40.8% being extended spectrum beta lactamase producer and 47.4% of Staphylococcus aureus were methicillin resistant. About 75.9% (85/112) of gram negative bacteria and 60.4% (29/48) gram positive bacteria were multi drug resistant. Conclusions: The burden of multi drug resistant bacteria causing surgical site infection is high which needs to be addressed timely. Good surveillance of bacterial antibiogram and rational antimicrobial use is necessary to reduce emergence and spread of resistant bacteria. Keywords: Extended Spectrum beta lactamase; gastrointestinal surgery; methicillin resistant staphylococcus aureus; multi drug resistance; surgical site infectionPublication Combination Therapy in Diabetes Mellitus Patients Attending Outpatient Department in a Tertiary Care Centre: A Descriptive Cross-sectional Study(Nepal Medical Association, 2022) Karki, Naresh; Kandel, Kamal; Shah, Kyushu; Prasad, Pravin; Khanal, JeevanAbstract Introduction: Assessing anti-diabetic drug use patterns in hospitals is an important activity which helps to promote the rational use of drugs and may suggest measures to change prescribing habits for the better. This study aimed to find the use of combination therapy in diabetes mellitus patients attending the outpatient department of a tertiary care centre. Methods: A descriptive cross-sectional study was conducted among 201 diabetes mellitus patients in the internal medicine department from 2 March 2022 to 30 June 2022 for a duration of four months after approval from the Institutional Review Committee (Protocol No: IRC-LMC-01/R-022). Diabetic patients prescribed at least one anti-diabetic drug in prescription forms were included. Socio-demographic profiles, clinical characteristics and anti-diabetic drug use pattern-related data were collected. Convenience sampling was used. Point estimate and 95% Confidence Interval were calculated. Results: Among 201 patients, 134 (66.66%) (60.14-73.18, 95% Confidence Interval) patients were given combination therapy. The most common combination therapy was metformin 500 mg and sitagliptin 50 mg. A total of 324 anti-diabetic drugs were used. The average number of drugs prescribed per patient was 1.6±0.7. The number of anti-diabetic drugs prescribed by generic name and from the national essential drugs list was 74 (22.83%) and 188 (58.02%) respectively. Biguanides were used in 176 (87.56%) patients. Conclusions: These findings were similar to some other studies conducted in similar settings. In most patients, combination drug therapy was more prevalent. Among combination therapy, two drug combinations were more prevalent.Publication Pharmacotherapy of Hospitalized Patients with COVID-19 at a Tertiary Care Hospital in Nepal(Institute of Medicine, Tribhuvan University, 2025) Mudvari, Anish; Prasad, Pravin; Pokharel, Akritee; Thapaliya, Sabin; Maharjan, Bindira; Khadka, Rebanta; Lamsal, Arun Batsa; Ghimire, Ranjeet; Bista, ApekshaABSTRACT: Introduction The COVID-19 pandemic poses a major health threat with no standardized treatments for SARS-CoV-2. This study evaluates pharmacotherapy trends in COVID-19 patients during the second wave at a tertiary care facility. Methods A retrospective, observational, cross-sectional study was conducted in a tertiary care centre, utilising patient data from April 2021 to July 2021. The sample included 310 patients admitted with a confirmed diagnosis of COVID-19. Patients were classified based on oxygen requirement levels, and data were analysed using descriptive statistics. Results Of the 310 patients, 59% were male and 41% female, with a mean age of 53.37 ± 17.01 years. The average hospital stay was 10 ± 7.15 days. Most patients (66.8%) required supplemental oxygen, and 7.4% required mechanical ventilation. The majority received antibacterial therapy (307, 99.03%), with ceftriaxone being the most commonly prescribed antibiotic (73.22%). Remdesivir was the predominant antiviral, and dexamethasone was used in 88.39% of patients. Conclusion Antibiotic use was extensive among hospitalised COVID-19 patients, with ceftriaxone being the most common. Antiviral use was less frequent, with Remdesivir being the preferred choice. Dexamethasone played a crucial role in managing severe cases.