Browsing by Author "Singh, A"
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Publication A Comparative Study of Rapid SARS-Cov-2 Antigen Detection Assay against RT-PCR Assay for Diagnosis of COVID-19 in a Tertiary Hospital of Kathmandu(Kathmandu University, 2022) Chaudhary, R; Bhatta, S; Singh, A; Pradhan, M; Moktan, B; Duwal, S; Pandit, RABSTRACT Background The Coronavirus disease 2019 (COVID-19) pandemic caused by the severe acute respiratory syndrome coronavirus (SARS-CoV-2) has spread worldwide since its first recorded case in the city of Wuhan, China, in December 2019. SARS-CoV-2 infection causes asymptomatic to sever pneumonia. Severe cases may develop acute respiratory disease symdrome (ARDS), with an average mortality rate of 6.9%. Real Time Reverse Transcriptase Polymerase Chain Reaction (rRT-PCR) assay is the current reference standard laboratory method for the diagnosis of SARS-CoV-2 infection. However, it takes around 6-8 hours to get the result and is time consuming. Therefore, rapid and accurate tests for SARS-CoV-2 screening are essential to expedite disease prevention and control. Lateral flow immunoassay using monoclonal anti SARS-CoV-2 antibodies which target for SARS-CoV-2 antigen can be complimentary screening test if their accuracy were comparable to that of the real time reverse transcription- polymerase chain reaction (RT-PCR) assay. Objective To find the sensitivity and specificity of a rapid antigentest kit in comparison to reverse transcription-polymerase chain reaction (RT-PCR). Method A cross-sectional hospital based study was carried out at Shree Birendra Army Hospital, Kathmandu for a period of four months. Result Our finding shows sensitivity and specificity of rapid diagnostic tests (RDT) Ag kit as 60.6% and 96.4% respectively. Positive and negative predictive value was 83.7% and 89.0%. Likewise, positive and negative likelihood ratio was 17.0 and 0.4. The overall accuracy of the antigen kit was 88.1% in comparison to reverse transcription- polymerase chain reaction (RT-PCR) as the gold standard. Conclusion Our study concluded the use of rapid antigen kit is mainly useful for screening purposes. KEY WORDS RDT Ag Kit, RT-PCR, SARS-CoV-2Publication Endodontic Management of Radix Paramolaris with Six Canals: A Clinical Case Report(Kathmandu University, 2013) Acharya, N; Singh, A; Samant, PS; Gautam, VABSTRACT Endodontic therapy of mandibular molars is a challenging task due to its varied root canal morphology. A mandibular first molar with additional buccal root (Radix paramolaris) and additional distolingual root (Radix Entomolaris) is an example of its varied anatomy. A successful management of atypical root canal configurations is an important aspect in determining the success rate of root canal therapy. The detail knowledge of the root morphology and canal anatomy allows the clinician for accurate location of the extra roots and canals and accordingly the refinement of the access cavity for the stress free entry of complex anatomy. Hence, for a successful root canal therapy, clinician must be aware of the external and internal anatomic variations .The aim of this clinical case report is to present and describe the unusual presence of two separate mesial roots and six root canals in mandibular first molar, detected during routine endodontic therapy. KEY WORDS Atypical configurations, extra root, mandibular first molar, radix paramolaris, radix entomolarisPublication Impact of Community Diagnosis Programme on Undergraduate Students at BP Koirala Institute of Health Sciences(Kathmandu University, 2019) Singh, A; Subedi, K; Shrestha, A; Bhagat, T; Pyakurel, P; Agrawal, SKABSTRACT Background Community Diagnosis Programme (CDP) aims to demonstrate the importance of teamwork in health care to understand the comprehensive health needs of the rural people and conceive about the research. Objective To assess the impact of community diagnosis program on undergraduate students of BP Koirala Institute of Health Sciences (BPKIHS), Dharan, Nepal. Method A cross sectional study with mixed design (quantitative and qualitative) was conducted among the undergraduate students of batch 2017 participating in community diagnosis programme of BP Koirala Institute of Health Sciences, Dharan, Nepal. Eight questions assessed the students’ perceptions regarding their abilities about community diagnosis program using six point Likert Scale and four open ended questions were used to know the students’ experience and perception of community diagnosis programme. Result Overall mean ± SD score for pre-exposure response was 30.47 ± 6.18 and for the post- exposure response was 40.49 ± 5.16. The overall mean ± SD score of the students categorized according to streams showed similar results in both pre-exposure response and post-exposure responses. Qualitative analysis revealed the themes like “Research, a reflection of community and new method of learning to medical students”; “method of developing confidence and good communication skills”, “learning to work as a team” and “exposure to rural area”; “Research an adjunct to medical profession”. Conclusion Community diagnosis programme had a positive impact on the students about basic survey process, learnt to communicate with rural people, understood the type of data and were willing to participate in similar projects in future. Qualitative analysis showed most of the students had positive experience with some negative experience of community diagnosis programme. KEY WORDS BPKIHS, Community Diagnosis Programme, Undergraduate StudentsPublication Platelet Count-to-platelet Distribution Width Ratio and other Platelet Indices as Cost-effective Markers of Preeclampsia: a case control study(Kathmandu University, 2024) Bashyal, R; Singh, A; Maharjan, S; Tuladhar, S; Bhattarai, B; Sharma, PKABSTRACT Background Platelet indices, like platelet count (PC), plateletcrite, mean platelet volume (MPV) and platelet distribution width (PDW), and their ratios have shown to be cost- effective and better predictors of preeclampsia (PE). However, platelet count/platelet distribution width ratio was not studied. Objective To compare platelet indices and their ratios between pregnant women with and without predictors of preeclampsia. Method An analytical, comparative, case-control study. Two groups were compared; pregnant women with preeclampsia (case, n=24) and without preeclampsia (control, n=72). Multivariable linear regression analysis for hematological parameters was performed to assess the effect of gestational age. Logistic regression was performed to calculate odds ratio. Receiver operating characteristic curve was used to determine sensitivity, specificity and cutoff values. P < 0.05 was considered significant. Result There was statistically significant reduction in values of platelet count, plateletcrit, platelet count/mean platelet volume, and platelet count/platelet distribution width among the pregnant women with preeclampsia compared to control group, while significant increase was noticed in platelet distribution width and mean platelet volume. platelet count/platelet distribution width had the highest area under the curve (AUC) of 0.767, followed by platelet distribution width (AUC=0.752). At the cutoff of 15.1 (p<0.001) for platelet count/platelet distribution width, sensitivity was 70.8%, and specificity was 81.9%. The odds of diagnosing true positive cases of preeclampsia was 11.02 (95% CI =3.79-31.99, p=<0.001) times higher compared to values below it at this cutoff. Conclusion Platelet indices are economical tests that can act as indicators of risk of preeclampsia. Among these, platelet count/platelet distribution width has the highest sensitivity and specificity in the detection of preeclampsia at the cutoff of 15.1 and has emerged as better predictor of preeclampsia. KEY WORDS Platelet count, Platelet distribution width, Platelet indices, PreeclampsiaPublication Radial club hand deformity – The continuing challenges and controversies(Kathmandu University, 2005) Banskota, AK; Bijukachhe, B; Rajbhandary, T; Pradhan, I; Singh, AThe records of 27 patients with Radial club hand deformity attending the Hospital and Rehabilitation Centre for Disabled Children (HRDC) were reviewed. This longitudinal intercalary deficiency of forearm growth has a varied clinical presentation and the goals of management are both improved function and cosmesis. We present the results of our treatment and review the current world literature on this challenging orthopaedic deformity. Key words: Radial Club Hand, Challenges, Controversies.Publication Sensitivity and Specificity of Lateral Flow Antigen Test Kits for COVID-19 in Asymptomatic Population of Quarantine Centre of Province 3(Kathmandu University, 2020) Shrestha, B; Neupane, AK; Pant, S; Shrestha, A; Bastola, A; Rajbhandari, B; Thapa, A; Singh, AABSTRACT Background Nearly after 6 months of the spread of Corona Virus Disease 19, along with the world Nepal is still trying to control the spread and prevent general population from acquiring it. With limited resources in manpower, technology and evidence it has been a difficult battle. But with time and more understanding of the virus new technology to detect the virus are coming up. It is a major breakthrough in the diagnostic field as this helps us in not only detecting the virus but also helps us to mobilize our human resources. This comes in a time where the cases are increasing at an alarming rate. Although numbers of Polymerase Chain Reaction testing have increased but due to the time consuming and the cost wise, we need a faster and equally reliable alternative. Antigen test approved by different countries can be used for point of care, screening and surveillance depending upon the requirements after calculating its sensitivity, specificity and accuracy. Objective To find out sensitivity and specificity of the Antigen test kit for COVID-19. Method Antigen tests were compared with Reverse Transcription Polymerase Chain Reaction as a reference standard in calculated sample size of 113 subjects in a high risk population. Both Reverse Transcription Polymerase Chain Reaction and antigen test were performed in a same subject with in maximum of 2 days’ interval. Convenience sampling technique was used to select the subjects. Ethical approval was taken from Nepal Health Research Council before data collection. Study was done from August to September 2020 from Quarantine center of Province 3. Result There were total of 113 test carried out, among those 47 were positive and 66 were negative in Reverse Transcription Polymerase Chain Reaction. After preparing two by two table, Sensitivity and specificity of the tested was calculated which came out to be 85% and 100% respectively, with accuracy of 93.80%. Conclusion Even though the sensitivity and specificity came to be higher, this test should be interpreted cautiously depending upon the prevalence of Corona Virus Disease 19 in that particular community and the clinical and epidemiological context of the person who has been tested. When in doubt by clinical correlation should be confirmed with Reverse Transcription Polymerase Chain Reaction. KEY WORDS Asymptomatic, Coronavirus Disease 19, Lateral flow antigen test, SensitivityPublication Solving the Mystery of Giant Intrathoracic Mass(Kathmandu University, 2022) Karmacharya, RM; Singh, A; Devbhandari, M; Napit, D; Ghimire, K; Mahat, C; Vaidya, SABSTRACT Intrathoracic schwannoma are highly vascular nerve sheath benign tumors arising from neural crest derived schwann cells of the intercostal nerves. Common clinical presentation is palpable mass but in our case patient presented with shortness of breath which is rare presentation in Schwannoma. Imaging studies of the patient showed the lesion in left lung, however surgical finding showed mass to arise from chest wall and it was confirmed to be schwannoma by histopathological examination. KEY WORDS Chest wall mass, Intrathoracic mass, Schwannoma