Browsing by Author "Sharma, Manoj"
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Publication Antimicrobial Sensitivity among Bacterial Isolates from Sputum Samples in a Tertiary level Hospital(Institute of Medicine, Tribhuvan University, 2024) Kaundinnyayana, Sammodavardhana; Chaudhary, Raina; Khadka, Anjan; Bhatta, Sabita; Rayamajhi, Heleena; Sharma, ManojAbstract: Introduction Emergence of antimicrobial resistance is a huge challenge in management of pneumonia especially health care associated ones. Culture and sensitivity test of the bacteria from sputum samples is not only useful for rational treatment of respiratory bacterial infections of individual cases but also for surveillance of changing sensitivity status of prevalent organisms. The aim of this study was to find the bacterial sensitivity pattern from the sputum samples and endotracheal aspirates. Methods This cross-sectional study was conducted in Shree Birendra Hospital, Kathmandu, Nepal. Standard guideline was followed for sputum culture and identification of the bacterial isolates. The antimicrobial susceptibility test was conducted using the Kirby-Bauer disc diffusion technique. Every bacterial isolate's sensitivity was studies and noted. Results The culture positivity rate was 9.87% (99/1003). Predominant isolates were gram-negative bacteria (97.4%). Pseudomonas spp. was the most frequent isolate (31%). Among the all isolates, 48.1% of Pseudomonas spp., 81.5% of Klebsiella pneumoniae, and 60% of Escherichia coli isolates showed meropenem resistance. Imipenem and meropenem resistance was observed in 91.7% of the isolates of Acinetobacter spp. Rate of resistance to carbapenems i.e. imipenem and meropenem was higher in comparison to rate of resistance to aminoglycosides in all of the gram-negative isolates. Conclusion The isolates belonging to Enterobacterales and the Acinetobacter spp. have been found to have high incidence of resistance to carbapenems in comparison to other groups of antibacterial agents.Publication Comparison of Oral Trichlophos and Intranasal Midazolam for Sedation in Minimally Invasive Paediatric Procedures (RAMT Study)(Nepal Paediatric Society (JNPS), 2018) Sharma, Manoj; Yenamandra, Kamal K.; Kalita, Jitu; Dash, Shaswat; Singh, DaljitAbstract: Introduction: Uncooperative child does not allow completion of procedures, denying valuable data required for clinicians. Material and Methods: An open labelled parallel group prospective randomized control study was conducted at zonal hospital Jorhat. We evaluated 200 children randomized into two groups using computer based randomization. Participants aged 3 months to 5 years (n=200) were randomized to receive 50 mg/kg Triclofos sodium orally or intranasal spray of midazolam 0.2 mg/kg. Results: Adequate sedation (Ramsay reactivity score of 3 and 4) was obtained in 86% children in midazolam group as compared to 80% in triclofos group with p value of 0.138. Mean duration for onset of sedation was 20 min ± 5.4 min in Trichlophos group and 12 min ± 4.5 min with Intranasal Midazolam which was statistically significant with p-value of <0.001. The mean duration of post procedural sedation was found to be 24.00 ± 9.21 min in midazolam group and 49.00 ± 16.99 min in triclofos group (p=<0.001) which was statistically significant. No significant difference was seen for side effects frequency between the two drugs (15% in Triclofos, 10% in Midazolam group; p=0.285). Conclusion: We conclude that intranasal midazolam is more effective than oral trichlophos with a comparable safety profile.