Browsing by Author "Singh, SB"
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Publication Changing spectrum of antibiotic sensitivity in enteric fever(Kathmandu University, 2008) Neopane, A; Singh, SB; Bhatta, R; Dhital, B; Karki, DBAbstract Aims and objectives: The study was designed to analyze clinical profile and Antibiotic sensitivity pattern in case of culture positive typhoid fever and compare response of quinolones in vitro and in vivo. Methodology: Forty eight cases of culture positive enteric fever presented in outpatient and emergency department of Kathmandu Medical College, Sinamangal, and Kathmandu were included in the study. Sensitivity pattern of isolates from blood culture was done by antibiotic disc diffusion method and this was compared with clinical response. Results: Response was based on Fever Clearance Time (FCT) and it was found that mean FCT was 3.58 days with standard deviation of 1.84 .Comparison was made separately for FCT ≥5 days and it was found that vomiting as the symptom and stool occult blood positive as the investigation to predict prolong FCT. Nalidixic acid as compared with other quinolones showed that other quinolones (ciprofloxacin, ofloxacin) are effective even in Nalidixic acid resistant cases when FCT was taken as the criteria of response, and it doesn’t include the relapse rate. Conclusion: Enteric fever is one of the leading causes of fever in Nepal. The diagnosis in most of the cases is done empirically by clinical features, but culture and sensitivity of blood or bone marrow is the gold standard way of diagnosis and providing treatment. The antibiotic sensitivity pattern is changing and resistance cases are emerging with indiscriminate use of drugs. Key words: Enteric fever, Salmonella typhi, fever clearance time (FCT), antibiotic sensitivity test (AST)Publication Exploring Medical Students’ Level of Empathy and its Correlation with Prosocial Behaviour in Jharkhand, India(Kathmandu University, 2025) Raj, A; Mittal, S; Sinha, S; Singh, SBABSTRACT Background Empathy was first introduced in the context of the doctor-patient relationship by Southard in 1918. It plays a crucial role in enhancing patient compliance and improving clinical outcomes. Recognizing its significance, there has been a global emphasis on integrating empathy into medical education. Objective To assess empathy levels among medical undergraduate students across different academic phases and to examine its relationship with self-reported social distancing behaviour during COVID-19. Method A multicentric cross-sectional, observational study was conducted among 459 undergraduate medical students from Phase one to Phase four of medical training across multiple medical schools in the state of Jharkhand, India. Empathy levels were assessed using the Jefferson Scale of Empathy – Student Version. Online data was analysed using SPSS Software version 24.0. Gender based score were tested with Student’s unpaired t-test, MBBS phase-wise comparisons with ANOVA, and correlations between empathy and social distancing with Pearson’s coefficient test. Result A total of 459 medical students participated in the study. The mean empathy score across all participants was 105.96 ± 16.55. A significant decline in empathy scores was observed up to the third phase of medical education, followed by an increase in the fourth phase. Correlation analysis revealed a positive but non-significant relationship (r = 0.079, p = 0.093) between empathy and self-reported social distancing behaviour. Conclusion The study findings highlight significant variations in empathy levels across different phases of medical education. Female students exhibited higher empathy levels than their male counterparts. Additionally, the ‘perspective-taking’ component of empathy showed a positive correlation with self-reported social distancing behaviour during COVID-19. KEY WORDS COVID-19 pandemic, Communication skills, Competency based medical education, Empathy, Jefferson scale of empathyPublication Two cases of severe falciparum malaria in KMCTH(Kathmandu University, 2006) Singh, SB; Chaudhary, D; Neopane, A; Karki, DBMalaria is the most important parasitic disease of man. It is the protozoan infection of RBCs transmitted by bite of blood feeding female anopheline mosquito. Until the 19th century malaria was found throughout Europe, North America and Russia. Since then, it has been eradicated from these areas but in tropics though initial efforts of eradication had been successful, there has been resurgence of disease1 accompanied by increasing resistance of the anopheline vector to insecticide and of the parasite to antimalarial drugs. We report two cases of falciparum malaria in which there was co-existent vivax malarial infection. These two cases were both exposed to highly endemic zone for malaria. Key words: Sequestration, malaria, falciparum.Publication Undiagnosed and Uncontrolled Hypertension and Access to Health Care among Residents of an Urban Area of Eastern Nepal: a Cross-sectional Study(Kathmandu University, 2022) Kasaudhan, SM; Ghimire, A; Sharma, SK; Baral, D; Jha, N; Singh, SBABSTRACT Background The burden and complication of hypertension is increasing as most of the people living with hypertension are unaware of their condition and those who are already diagnosed with it do not have their blood pressure under control. Objective To assess the prevalence of undiagnosed and uncontrolled hypertension among residents of Itahari sub metropolitan city of eastern Nepal, along with its associated socio demographic and behavioral risk factors and access to health care services. Method Cross sectional study was conducted in five wards of Itahari, among 1161 participants, using population proportionate to sample size sampling technique. Face to face interview was conducted with participants for data collection applying semi– structured questionnaire and physical measurement like blood pressure, weight and height. Result Prevalence of hypertension was 26.5% includingundiagnosed 11.0% and previously diagnosed 15.5%. Among diagnosed, 76.6% had uncontrolled blood pressure and 56.70% were taking anti-hypertensive medicine, and 7.8% were under Ayurvedic medicine. More than 70% participants preferred private health facility for treatment and 22.7% had faced financial barrier to seek healthcare. About 64% of participants did not visit health services or had visited only once in past six months. Increasing age, Body Mass Index (BMI), smoking status and positive family history were found to be significantly associated with hypertension at < 0.05 level. Conclusion Prevalence of hypertension is high and awareness regarding available health services in local primary health center and its utilization is lacking among participants. Regular screening program for hypertension and awareness program to disseminate the knowledge of availability of primary health center should be conducted. KEY WORDS Health care access, Undiagnosed hypertension, Urban area