Browsing by Author "Subedi, Nuwadatta"
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Publication Emerging Antibiotic Resistance Pattern in a Neonatal Intensive Care Unit in Pokhara, Nepal(Nepal Health Research Council, 2025) Bastola, Ramchandra; Shrestha, Shree Krishna; Paudel, Rajan; Gurung, Laxmi; Sigdel, Bhawana; Neupane, Jamuna; Pradhan, Saugat; Basnet, Omkar; Subedi, NuwadattaBackground: Treating neonatal sepsis in Nepal remains difficult given the high rates of antimicrobial resistance. The objective of this study is to determine the antibiotic resistance pattern of culture-proven infections in neonates admitted to a neonatal intensive care unit. Methods: This cross-sectional prospective observational study was performed at the Neonatal Intensive Care Unit of Pokhara Academy of Health Sciences from 15th july 2022 to 15th july 2023. We included all neonates admitted with positive cultures grown from blood, cerebrospinal fluid, endotracheal tube, and pus. Demographic, clinical, and microbiologic data were collected from the medical record. We reviewed antimicrobial susceptibility testing of all isolates. Results: There were 51 culture-positive infections among 1327 neonates admitted, among which 23 cases from blood culture, 2 cases from cerebrospinal fluid, 14 cases from endotracheal tube samples, and 12 cases from pus samples. Gram-negative infections were predominant amounting to 35 (68.6%) including Pseudomonas in 12 (23.5%), and Acinetobacter species in 9 (17.6%) cases. Gram-positive infections were seen in 14 (27.4%) in which Methicillin-Resistant Staphylococcus aureus accounted for 6 (11.8%) cases. Yeast cells other than Candida albicans accounted for two (5.4%). For all Gram-negative isolates, resistance to Third-generation cephalosporin and aminoglycosides was reported in 75.0% (12 of 16 isolates tested) and 87.0% (24/31), respectively. Fluoroquinolone resistance was seen in 61% (8/13), resistance to penicillin was 59.3% (10/19), and resistance to carbapenem was in 100.0% (7/7) cases. Conclusions: There were high rates of antimicrobial resistance even with the reserved drugs among gram-negative pathogens. This alarms for the need for rationale prescribing of antimicrobials. Keywords: Antimicrobial resistance; bloodstream infection; meningitis, neonatal sepsisPublication Perception and Attitude of Second-year Medical and Dental Students regarding the Use of a Problem-based Learning(Nepal Health Research Council, 2024) Bista, Soni; Paudel, Sabita; Shrestha, Bijayata; Subedi, Nuwadatta; Basnyat, Rupesh Shingh; Chettri, PradipBackgrounds: Problem-based learning (PBL) is a learner-centered pedagogical approach in which a person learns about a subject by working in groups to solve an open-ended problem. The objective of the present study was to assess students' perceptions and attitudes toward Problem-based learning and the role of tutors in Problem-based learning. Methods: This quantitative study was conducted among second-year medical and dental undergraduate students from November 2022 to November 2023. The students were divided into eight groups, and each group was facilitated by tutors. A Problem-based learning tutor guide, with a case on the topic of diarrhea/dysentery, was designed as a module with six triggers and given to the groups. At the end of nine days of PBL sessions, feedback from students on the process of Problem-based learning and tutors was received using the 'Dolmans and Schmidt' and 'Dolmans and Ginns' questionnaires, respectively. The level of attitude of the students based on their feedback toward the Problem-based learning process and the tutors were also assessed. The data were entered into Microsoft Excel, and descriptive analysis was performed using the Statistical Package for Social Sciences (SPSS), version 21. Results: Among the 79 responses received, 72 (92.4%) students gave a good rating of the process of Problem-based learning, indicating a favorable attitude. The participants agreed with the themes based on the influence of discussion, content tested, course objectives, lectures, tutors, and reference literature. Similarly, 63 (81%) students gave a good rating of the tutorials’ performance, suggesting a favorable attitude. They agreed that tutors facilitated active, self-directed, contextual, and collaborative learning. Conclusions: This study revealed the positive perceptions and attitudes of medical and dental undergraduate students regarding the PBL process and the role of tutors in Problem-based learning. The outcomes of this study have provided a foundation for implementing Problem-based learning in Nepal's medical and dental undergraduate curricula. Keywords: Dental education; diarrhea; dysentery; medical education; problem-based learning.