NepMed Repository :: Browsing by Author "Sapkota, K"

Browsing by Author "Sapkota, K"

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Asymptomatic throat carriage rate and antimicrobial resistance pattern of Streptococcus pyogenes in Nepalese school children
(Kathmandu University, 2009) Dumre, SP; Sapkota, K; Adhikari, N; Acharya, D; Karki, M; Bista, S; Basnyat, SR; Joshi, SK
Abstract Background: Streptococcus pyogenes or Group A streptococcus (GAS) causes several suppurative and non suppurative infections. In addition to pharyngitis and skin infections, GAS are also the causative agent of post-streptococcal infection syndromes such as acute rheumatic fever (ARF) and post-streptococcal glumerulonephritis (PSG). GAS frequently colonises in the throat of an asymptomatic person. Pharyngeal carriage rates of GAS among healthy school children vary with geographical location and seasons. Objectives: We carried out this preliminary study to determine the throat carriage rate and antimicrobial resistance trend of Streptococcus pyogenes or Group A streptococcus (GAS) among the Nepalese school children. Materials and methods: Four schools situated at different locations of Kathmandu valley were included in the study. Throat swabs from 350 students of age group 5-15 years were collected, immediately transported to the laboratory and were processed for S. pyogenes following standard microbiological procedures. Antimicrobial susceptibility testing of the isolates was performed by Kirby Bauer disc diffusion method following CLSI guidelines. Results: S. pyogenes was isolated from 10.9% (38/350) of the screened children. The GAS colonisation rate was statistically insignificant (P>0.05) with sex and age sub-groups, although the rate was slightly higher among girls and age sub-group 9-12 years. No significant difference in carrier rate was observed among different schools (P>0.05). All isolates were susceptible to azithromycin. No resistance was detected for penicillin and its derivative antibiotic ampicillin. Highest resistance rate was observed for cotrimoxazole (71.0%) followed by chloramphenicol (7.8%), ciprofloxacin (5.2%) and erythromycin (5.2%). Conclusion: Antibiotic resistant GAS isolated from asymptomatic Nepalese school children is a public health concern. When screened and appropriately treated with antibiotics, carriers can be prevented from spreading of streptococcal infections in the school environment and the community. Preventing cross infections would ultimately reduce the incidence of life-threatening sequelae which are debilitating and difficult to treat. It is recommended to conduct regular screening and GAS surveillance in schools, and maintain rational use of antibiotics to minimise GAS carriage/infections and resistance. Key words: Streptococcus pyogenes, Antibiotics Resistance, Throat carriage, Children, Nepal.
Clinico-demographic Profile of Poisoning Cases Admitted in Intensive Care Unit of Bharatpur Hospital, A Tertiary Referral Center in Nepal
(Kathmandu University, 2020) Paudyal, N; Sapkota, K
ABSTRACT Background Poisoning is a major cause of death in young adults. The epidemiological factors such as geography, occupation, literacy rate can influence the clinical presentation and outcome of the poisoning patients. Poisoning has a significant impact on the economic and social life of individuals. Objective The main objective of this study is an effort to evaluate the characteristic of poisoning cases and identify the reasons for Intensive Care Unit (ICU) admission. Method This was a prospective observational study at Bharatpur Hospital ICU over a period of one year. Demographic profiles, poison characteristics, types and reasons for poisoning, duration of hospital stay, and outcome of the patients were studied. Result A total of 156 patients were admitted with poisoning. Females were affected more than males with a ratio of F:M= 1.6:1. The age group that consumed poison the most was 16-25 years, and the mean age group of males was 35±14 years and 29±11 years respectively. The main cause of poisoning was conflicts/quarrel. Organophosphorus compound was the most common poisoning with 53% of total cases due to it. There were 07 cases of accidental poisoning secondary to mushroom poisoning. The mean duration of stay in ICU of these patients was 04 days. The total fatality rate due to poisoning was 07%. Conclusion The significant proportion of Intensive Care Unit admission was due to organophosphorus compounds. It was more common among females and young age groups. This calls for special health education on chemical safety among vulnerable people along with efficient supervision in regulatory controls on chemicals and its use. KEY WORDS Conflicts, Intensive care unit, Organophosphorus, Poisoning, Young age
Evaluation of Knowledge, Attitude, Practice and Hospital Experience Regarding COVID-19 among Post-partum Mothers at a Tertiary Care Center: A Cross-sectional Study
(Kathmandu University, 2020) Adhikari, SP; Pariyar, J; Sapkota, K; Gurung, TK; Adhikari, SR
ABSTRACT Background Pregnant and breastfeeding women are more susceptible to viral infection and in the year 2020 they have to face the COVID-19 pandemic. Since, no successful treatment and vaccine has been developed so far, efforts to enhance the knowledge, attitudes, and practice of the public, especially the high-risk groups like pregnancy and post- partum period are crucial to manage COVID-19 pandemic. Objective To analyze the knowledge, attitude, practice and hospital experience regarding COVID-19 among post-partum mothers at a tertiary care center of Nepal Method The data collection was based on direct interview after receiving written consent from the research participants, using a semi-structured questionnaire. The questionnaire consisted of 4 major domains- knowledge (8 questions), attitude (6 questions), practice (5 questions) and experience (5 questions). Standard descriptive statistics were used for the data, mean and standard deviation for continuous variables whereas frequencies and percentages for categorical variables. Result A total of 203 post-partum women participated in the study. Almost all the participants had heard about COVID-19 (96.6%). A majority of them were aware about how COVID-19 gets transmitted and its preventive measures. Most of the participants (88.2%) knew that COVID-19 has effects on pregnancy. Almost all of participants (97%) wore mask during hospital stay. All of the women washed their hands with soap water or alcohol based sanitizer. A majority of the mothers (79.3%) wore mask while breastfeeding their baby. Conclusion The post-partum mothers have good knowledge, attitude, practice and experiences regarding the COVID-19 pandemic. KEY WORDS Attitude, COVID-19, Experience, Knowledge, Post-partum
Prevalence and Associated Factors of Dental Caries among School Children in Bharatpur, Chitwan
(Kathmandu University, 2024) Poudel, S; Sapkota, D; Poudel, L; Poudel, S; Khatri, E; Sapkota, K
ABSTRACT Background The burden of dental caries among children is increasing due to consumption of sugary substances, poor oral care practices, and inadequate health service utilization. This study aimed to identify the prevalence and associated factors of dental caries among school children. The objectives of the study were to assess the prevalence of dental caries and associated factors among school children of private school of Bharatpur metropolitan city. Objective To assess the prevalence of dental caries and associated factors among school children of private school of Bharatpur metropolitan city. Method A descriptive cross-sectional study was carried out among 150 children of two different private schools of Chitwan by using multi-stage probability sampling technique. The data was collected from 22nd November 2019 to 4th December 2019. Data were collected by using a semi-structured questionnaire to identify the prevalence of and associated factors of dental caries and decayed, missing and filled Permanent teeth (DMFT) index criteria. Result Out of total 150 children, 68% had dental caries. Among them, 64.5 % had caries in deciduous teeth, 17.6 % in permanent teeth and 17.6% had caries on both types of dentition. Only 40.7% of children had received dental check-ups. The mean Decayed, missing and filled primary teeth (DMFT)/ decayed, missing and filled Permanent teeth (DMFT) was 1.91 and 0.54 respectively. 83.3% and 57.1% of children had low severity caries in permanent and deciduous dentition respectively. The educational level, brushing habits, sugar consumption, and snack consumption, bottle feeding at infancy and mother’s occupation was found to be associated with dental caries. Conclusion The study showed high prevalence of dental caries among school children. Less than 50% of children had a dental checkup in case of dental problems only. Association of dental caries was found with level of education, brushing habits, sugar consumption, snack consumption bottle feeding at infancy and mother’s occupation. KEY WORDS Children, Dental caries, Prevalence, Severity
The outcome of Radial Neck Fracture Treated with Closed/ Open Reduction and Retrograde Kirschner Wires Fixation in the Paediatric Age Group
(Kathmandu University, 2022) Sapkota, K; Ranjeet, N; Onta, PR; Thapa, P
ABSTRACT Background Radial neck fractures in children are rare injuries, representing 1 to 5% of all elbow pediatric fractures. Most of them are non-displaced or slightly displaced and treated conservatively. Severely displaced or angulated radial neck fractures (Judet type III and IV fractures or O’Brien type III radial neck fractures) requires surgical treatment. Objective To study the clinical and radiological outcomes of fractures following closed or open reduction and percutaneous intramedullary stabilization of the displaced radial neck fracture in children. Method There were 24 children with displaced radial neck fracture Judet type II, III and IV fractures O’Brien type II, III who underwent closed reduction and retrograde intramedullary stabilization with Kirschner wires. Functional outcomes were evaluated based on of Mayo Elbow Performance Score. Result The mean age of patients was 8.42 ± 1.82 years with boys 15(62.5%) and girls 9(37.5%) in number. An excellent result was seen in 5(20.8%) cases and good results in 15(62.5%) cases according to the Mayo elbow performance score. Analyzing a passive and active range of motion, 5 had excellent results, 15 had good results and 4 had fair results compared to the normal side. Radiological evaluation showed fracture healing in excellent or good alignment according to Ursei radiological evaluation classification. Conclusion Closed reduction and retrograde intramedullary Kirschner wires stabilization for the displaced radial neck fracture provide excellent clinical and radiological results with few complications. KEY WORDS Kirschner wires fixation, Paediatric elbow, Radial neck fracture
Throat carriage rate and antimicrobial resistance trend of Streptococcus pyogenes among the asymptomatic Nepalese school children
(Kathmandu University, 2009) Dumre, SP; Sapkota, K; Adhikari, N; Acharya, D; Karki, M; Basnyat, SR; Joshi, SK
Abstract Background: Streptococcus pyogenes or Group A streptococcus (GAS) causes several suppurative and non suppurative infections. Since the 1980s there has been re-emergence in the incidence of invasive S. pyogenes infections and rheumatic heart disease all over the world and hence throat carriage has assumed of great importance. Objectives: We carried out this preliminary study to determine the throat carriage rate and antimicrobial resistance trend of Streptococcus pyogenes or Group A streptococcus (GAS) among the Nepalese school children. Materials and methods: Four schools situated at different locations of Kathmandu valley were included in the study. Throat swabs from 350 students of age group 5-15 years were collected, immediately transported to the laboratory and were processed for S. pyogenes following standard microbiological procedures. Antimicrobial susceptibility testing of the isolates was performed by Kirby Bauer disc diffusion method following CLSI guidelines. Results: S. pyogenes was isolated from 10.9% (38/350) of the screened children. The GAS colonisation rate was statistically insignificant (P>0.05) with sex and age subgroups, although the rate was slightly higher among girls and age subgroup 9-12 years. No significant difference in carrier rate was observed among different schools (P>0.05). Highest resistance rate was observed for Cotrimoxazole (71.05%) followed by Chloramphenicol (7.8%), Ciprofloxacin (5.2%) and Erythromycin (5.2%). All isolates were susceptible to Azithromycin. No resistance was detected for penicillin and its derivative and Azithromycin. Conclusion: Antibiotic resistant GAS isolated from asymptomatic Nepalese children is a concern. When screened and appropriately treated with antibiotics, carriers can be prevented from spreading of streptococcal infections in the community. This would ultimately reduce the incidence of life-threatening sequelae which are debilitating and difficult to treat. It is recommended to conduct regular screening programs and GAS surveillance, and maintain rational use of antibiotics to keep GAS carriage/ infections and resistance in check. Key words: Streptococcus pyogenes, Antibiotics Resistance, Children, Throat carriage, Nepal

Browsing by Author "Sapkota, K"

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