Papers by Prabha Adhikari
Advances in Agriculture
Amaranth is a nutritious traditional food and vegetable crop with incomparable health benefits. H... more Amaranth is a nutritious traditional food and vegetable crop with incomparable health benefits. However, very little research has been carried out to study diversity of amaranth in Nepal. An experiment was conducted in the research field of the Institute of Agriculture and Animal Science (IAAS) at Sundarbazar, Lamjung, Nepal, during 2021 growing season to assess twelve amaranth accessions based on agromorphological characters. Seed materials were collected from the Nepal Agriculture Genetic Resource Center (NAGRC), Khumaltar, and the experiment was conducted in alpha-lattice design with 3 replications. Early maturing accessions had inflorescence at 42.33 days while late maturing accessions were after 82 days. ANOVA test for quantitative traits revealed significant differences among the accessions for all traits studied except stem girth. Similarly, from frequency distribution of agromorphological characters, high variability was found in stem pigmentation, terminal inflorescence sha...
Biomedicine
Introduction and Aim: Large body of evidence suggests that oxidative stress has a crucial role to... more Introduction and Aim: Large body of evidence suggests that oxidative stress has a crucial role to play in diabetes and its related complications. In the present research we have tried to determine potential risk factors for oxidative stress in type 2 diabetes by conducting a cross-sectional study. Materials and Methods: We studied 238 patients with or without complications of diabetes, aged 40-75 years. Blood samples were analysed for fasting plasma glucose, glycated haemoglobin, malondialdehyde, total cholesterol, triglyceride, LDL-cholesterol and HDL-cholesterol. Each patient’s waist circumference, BMI, blood pressure was measured. Results: Participants mean age was 57.5 ± 8.9 years. Logistic regression analysis identified glycated haemoglobin (95% CI: 1.02-1.92; p=0.04), hypertension (95% CI: 0.99-4.08; p=0.05) and LDL-cholesterol (95% CI: 1.12-5.87; p=0.03) as independent risk factors for oxidative stress. Other contributors were age and presence of complications like nephro...
International Journal of Pharmacy and Pharmaceutical Sciences, 2016
Objective: To assess the prescription quality in a comprehensive geriatric clinic and to determin... more Objective: To assess the prescription quality in a comprehensive geriatric clinic and to determine the frequency of inappropriate prescription and polypharmacy. Methods: Both males and female patients above the age of 60 y attending a comprehensive geriatric clinic of a tertiary care hospital were included in the study. Medications taken by the patients, excluding vitamins, minerals and herbal medications were counted in each patient and analyzed by considering their medical history and using universally accepted tools like medication appropriateness index, START, STOPP & Beer’s criteria. In this study, polypharmacy was considered as having 6 or more medications per prescription. Results: A total of 120 patients were included in the study. Around 82 (68.33%) patients had less than 6 prescribed medications and 38 patients (31.66%) were on 6 or more than 6 medications. The number of medications used by the patients is 4.37±2.33. Around 21 (17.5%) were on medications that are not indic...
Journal of Clinical and Diagnostic Research, 2010
Context: Disseminated TB patients are invariably immunocompromised and are susceptible to opportu... more Context: Disseminated TB patients are invariably immunocompromised and are susceptible to opportunistic infections. Candidaemia is an under-recognised infection in India. Therefore, we planned to evaluate the prevalence, survival and risk factors for the development of this infection in disseminated TB patients in a tertiary care hospital in southern India. Aims: To assess the prevalence of invasive candidiasis / candidaemia in disseminated TB patients in India and to determine the survival of these patients and risk factors for the development of candidaemia in disseminated TB patients Settings and Design: A prospective study conducted after obtaining the institutional ethical committee's approval. Methods and Material: Disseminated TB patients who came between February 2005 and February 2006 were included in the study after obtaining informed consent from the patients with assured confidentiality. The sources of the fungal culture were blood and ascitic fluid. Statistical anal...
Asian Journal of Pharmaceutical and Clinical Research, 2018
Objective: The objective of this study is to evaluate the antihypertensive drug usage and dosage ... more Objective: The objective of this study is to evaluate the antihypertensive drug usage and dosage differences between geriatric and non-geriatric diabetics with reference to the duration of hypertension and creatinine clearance (Crcl).Methods: In this observational study, patients with type 2 diabetes mellitus were grouped into geriatric (age ≥60 years) and non-geriatric (age <60 years). Patients’ demographic data, duration of hypertension, drugs prescribed, and serum creatinine were recorded after the patients had a stabilized antihypertensive dose for 6 months. Crcl was calculated using Cockcroft–Gault formula. The dosages of antihypertensives were converted into equivalent doses for easy comparison within a group. For angiotensin-converting enzyme inhibitors (ACEIs), enalapril was considered as prototype, and for angiotensin receptor blockers (ARBs) losartan, beta-blocker atenolol, and calcium channel blockers (CCBs), amlodipine was considered as prototype. Univariate analysis ...
Iranian Journal of Pharmacology and Therapeutics
International Journal of Diabetes in Developing Countries, 2008
BACKGROUND: To evaluate the prescription of aspirin for primary and secondary prevention of cardi... more BACKGROUND: To evaluate the prescription of aspirin for primary and secondary prevention of cardiovascular disorders in diabetic patients, in the light of American Diabetes Association guidelines. MATERIALS AND METHODS: In this retrospective analysis, presence of any cardiovascular disease or cardiovascular disease risk factor as deÞ ned in American Diabetes Association guidelines and the use of aspirin and other medication data were extracted from the case Þ les of 100 patients with type 2 diabetes mellitus visiting two teaching hospitals. RESULTS: Of 100 patients studied, 58% were men and 42% women and all were ≥ 40 years of age. 45% had at least one cardiovascular disease and all (100%) were on aspirin for secondary prevention; 45% had one or more risk factors, of which 11% (05/45) had aspirin prescribed for primary prevention; remaining 10% had neither risk factors nor cardiovascular disease (but age ≥ 40 years) and no aspirin documentation. Reasons for not using aspirin/antiplatelet drug were not recorded. CONCLUSIONS: American Diabetes Association recommendations for aspirin use for secondary prevention of cardiovascular diseases were strictly adhered to, in contrast to that for primary prevention. Under-prescription of aspirin could be attributed to the physicians' concern about the burden of poly-pharmacy and toxic effects of aspirin on longterm use. Extensive efforts are necessary to enhance aspirin use in this regard.
Impact of KCNJ11, TCF7L2, SLC30A8, IGF2BP2, PPARG, SLC47A1, STK11, HHEX, KCNQ1, CDKAL1, FTO, CYP2C9, ADIPOQ, CAPN10 gene polymorphisms on risk of type 2 diabetes and therapeutic response to sulfonylurea and metformin therapy Molecular Cytogenetics, 2014
gene polymorphisms on risk of type 2 diabetes and therapeutic response to sulfonylurea and metfor... more gene polymorphisms on risk of type 2 diabetes and therapeutic response to sulfonylurea and metformin therapy. Molecular Cytogenetics 2014 7(Suppl 1):P100.
Indian Journal of Nephrology, 2010
C peptide is an active peptide hormone with potentially important physiological effects. C peptid... more C peptide is an active peptide hormone with potentially important physiological effects. C peptide has the capacity to diminish glomerular hyperfiltration and reduce urinary albumin excretion in both experimental and human type 1 diabetes. The present study is aimed at correlating the serum C peptide level with that of renal clearance, urinary albumin excretion and duration of diabetes. This is a prospective cross sectional study. Patients with diagnosis of type 2 diabetes mellitus were evaluated for their baseline clinical and laboratory profile. Both males and females above the age of 18 years were included in the study. The laboratory investigations include fasting serum C peptide, HbA 1C , serum creatinine, blood urea nitrogen, urine albumin and creatinine. Creatinine clearance was calculated using modification of diet in renal disease formula from serum creatinine value. A total of 168 patients were included in the study, among them 90 were females (53.57%) and 78 males (46.43%). Mean age of the patients was 57.64 years. Pearson correlation test showed negative correlation of serum C peptide level with creatinine clearance, though statistically not significant. Negative correlation was also seen between serum C peptide, and urine albumin, urine albumin creatinine ratio, HbA 1C and duration of diabetes. Mean urine albumin was higher in patients with subnormal C peptide level. Duration of disease was more in patients with lower serum C peptide level. The study has shown weak association of serum C peptide level with microalbuminuria and creatinine clearance. Risk of albuminuria is more in patients with low serum C peptide level.
Indian Journal of Medical Sciences, 2007
Indian Journal of Medical Sciences, 2008
Indian Journal of Critical Care Medicine, 2007
Introduction: The frequency of invasive mycoses has increased dramatically during the past two de... more Introduction: The frequency of invasive mycoses has increased dramatically during the past two decades owing to medical advances such as intensive cancer chemotherapy, broad-spectrum antimicrobial therapy, invasive medical devices, organ transplantation, human immunodeÞ ciency virus (HIV) disease epidemic and an expanding aging population. There were few Indian studies regarding the incidence and risk factors for candidemia. Hence the aim of this work was to evaluate the changes in the prevalence of candidemia and invasive candidiasis in a tertiary care hospital and also to assess the risk factors and predictors of mortality Materials and Methods: Nonsystematic review of patients with candidemia/invasive candidiasis was done during the period 1999 to 2004. All in-patients who had shown signs and symptoms of nosocomial blood stream infection were screened for candidial infection. Among these, 29 patients had candidemia/invasive candidiasis. Demographic and clinical data of these patients were recorded on a standardized form, which included age, sex, site of isolation, infectious diagnosis, underlying conditions, predisposing factors, catheter status and clinical outcome. The data were collected during the years of 1999 to 2004, which is divided into two time periods (1999-2001 and 2002-2004). Data collected during these different time spans are compared with each other. Results: A total of 255 patients were screened during the study period. Among these, 100 patients were screened during the period 1999-2001 and 155 patients were screened during the year 2002-2004. Out of these patients, 29 showed positive cultures in blood or other sterile site (ascitic ß uid, bronchial aspirate and urine from suprapubic puncture). Out of these, 24 were males and Þ ve were females. The most common risk factor was use of intravenous canulae (62.1%), followed by prolonged use of antibiotics (34.5%) and HIV infection (24.1%). There were no statistically signiÞ cant differences in the risk factors during the two different study periods. Candida was mainly isolated from blood (75.9%). Other sources included ascitic ß uid (10.4%), bronchial aspirate (3.4%), sputum (3.4%) and urine (6.9%). Distributions of sources were comparable during the two study periods. Candida albicans, Candida tropicalis and Candida parapsilosis caused 89.7%, 3.4%, 6.9% of the candidemia episodes respectively. The overall mortality was 51.7%. Conclusion: The present study emphasizes the importance of candidemia among hospitalized patients. Continued surveillance of candidemia will be important to track trends of this serious infection and to document changes in its epidemiological features. More active screening in high-risk groups should be done to avoid diagnostic delay. Risk factors like prolonged use of multiple antibiotics, central venous catheters, mechanical ventilation and prolonged hospital stay should be restricted whenever possible. Timely use of antiretroviral drugs and other measures to improve the immunity of HIV patients may help to decrease the incidence of candidemia in this patient population.
Complementary Therapies in Clinical Practice, 2012
Present study aims to evaluate the effect of diaphragmatic breathing on anthropometry, blood pres... more Present study aims to evaluate the effect of diaphragmatic breathing on anthropometry, blood pressure, glycemic control and oxidative stress in patients with type 2 diabetes on standard care in comparison with standard care alone. Study involved 123 patients who were assigned to receive either standard care or with additional diaphragmatic breathing for 3 months. In comparison with the control group, diaphragmatic breathing resulted in significant reduction in body mass index, waist-hip ratio, fasting and post prandial plasma glucose, glycated hemoglobin, malondialdehyde, superoxide dismutase and improvement in glutathione and vitamin C. There was no difference in waist circumference, blood pressure and vitamin E in intervention group at follow-up. It can be concluded that diaphragmatic breathing can be employed as an effective therapy in reducing the oxidative stress while it can be incorporated as an add-on therapy to standard care in improving the anthropometry and glycemic parameters in type 2 diabetes.
Indian Journal of Pharmacology, 2010
Journal of the Indian Academy of Geriatrics, 2020
Objective: To examine caregiver burden among caregivers of hospitalised geriatric patients with p... more Objective: To examine caregiver burden among caregivers of hospitalised geriatric patients with palliative care design. Method: Caregivers of 330 geriatric patients with various chronic end-stage diseases were assessed using BSFC-s questionnaire. Results: Majority of caregivers were spouses (26%). The caregiver burden across the categories was more than 60% across all the questions asked in the BSFC-s questionnaire. Maximum in the caregiver with end-stage renal disease (60.3%) and a minimum of frail elderly (50.2%). Conclusion: Caregiver burden was common in caregivers of geriatric patients with end-stage chronic diseases. The burden was associated with the caregiver’s report of need for greater help with daily tasks but not with objective measures of the patient’s need for assistance, such as symptoms or functional status, suggesting that burden may be a measure of the caregiver’s ability to adapt to the caregiving role.
Global Mental Health, 2019
Background. An essential strategy to increase coverage of psychosocial treatments globally is tas... more Background. An essential strategy to increase coverage of psychosocial treatments globally is task shifting to non-medical counsellors, but evidence on its effectiveness is still scarce. This study evaluates the effectiveness of lay psychosocial counselling among persons with psychological distress in a primary health care setting in rural Nepal. Methods. A parallel randomized controlled trial in Dang, rural Nepal (NCT03544450). Persons aged 16 and older attending primary care and with a General Health Questionnaire (GHQ-12) score of 6 or more were randomized (1:1) to receive either non-medical psychosocial counselling (PSY) or enhanced usual care (EUC). PSY was provided by lay persons with a 6-month training and consisted of 5-weekly counselling sessions of 35–60 min with a culturally adapted solution-focused approach. EUC was provided by trained primary health workers. Participants were followed up at 1 (T1) and 6 months (T2). The primary outcome, response to treatment, was the re...
Complementary Therapies in Clinical Practice, 2016
Diabetes mellitus has many complications; one of the most important ones is diabetic foot ulcer (... more Diabetes mellitus has many complications; one of the most important ones is diabetic foot ulcer (DFU). Due to the increasing prevalence of diabetes in the world and evidences of the role of honey in treatment of DFU, we decided to review the effect of honey on DFU. We searched the keywords of "honey", "diabetic foot ulcer", "treatment", "diabetes mellitus", "wound dressing" and "wound healing" in indexing systems of PubMed, Scopus and ISI Web of Science between 2007 to 1 Jun 2017, in English and Persian languages. Out of 120 articles published, 20 articles met the inclusion criteria, including one in vivo study, four in vitro studies and 15 human studies. The results showed the efficacy of honey as a wound healing agent in some types of wounds. Mechanisms of healing methods included hyper osmosis, stimulating cytokine production, producing transforming growth factor-β1 and etc. In some articles, honey was used in combination with other medications like Commiphora molmol, Nigella sativa and povidone iodine. Honey showed minor side effects, in some studies, like mild burning or minor sensation. Despite these complications, the treatment was not stopped and in some cases the disorder was resolved by changing the combination ingredients. Although, the reviewed studies showed healing effect for honey in DFU, more studies are needed to confirm the efficacy.
Journal of Microbiology and Infectious Diseases, 2013
Objective: We investigated the expression of Extended Spectrum β-Lactamases (ESBLs), AmpC β lacta... more Objective: We investigated the expression of Extended Spectrum β-Lactamases (ESBLs), AmpC β lactamases and Carbapenemases in extraintestinal pathogenic Escherichia coli (ExPEC) isolates and correlated with treatment and outcome of the patients. Methods: Three hundred ExPEC infected patients were included in the study. Demographic data, antibiogram, treatment and outcome were collected. Production of ESBLs was detected by combination disk method; AmpC was detected by AmpC disk test. Carbapenemase production was detected by disk diffusion and confirmed by modified Hodge test. Identification of metallo-β-lactamase (MBL) activity was performed by the carbapenem-EDTA combined disk method and MBL E-test. Results: Out of 300 E. coli isolates, 212 (71%) were ESBL producers. AmpC β lactamase production was seen in 95 (32%) isolates; 16 (17%) isolates were pure AmpC producers whereas 79 (83%) were ESBL co-producers. Twenty nine (9.5%) isolates were carbapenemase producers of which 15 (5%) were MBL producers. For treatment, most widely prescribed antibiotics were β-lactam+β-lactamase inhibitor combinations (39%). Sixty seven percent patients improved; relapse/ re-infection was seen in 18% of patients and 11% patients expired. Increased mortality was seen in patients with blood stream infection and more number of relapses was seen in urinary tract infection. Conclusion: ExPEC producing ESBL or AmpC along with carbapenemases are particularly challenging for clinicians and are a major threat worldwide. Early use of appropriate antibiotics like β-lactam+β-lactamase inhibitor combinations will probably reduce complications in these patients.
Journal of Applied Pharmaceutical Science, 2016
Objective of this study is to evaluate the cost and antibiotic utilization of pneumonia patients ... more Objective of this study is to evaluate the cost and antibiotic utilization of pneumonia patients admitted in intensive care unit. It was a retrospective study. Details required for antibiotic utilization and cost analysis were acquired from hospital files. Out of 320 cases evaluated 110 cases were of pneumonia.28.2% of people had pneumonia as their primary diagnosis and 71.8% had hospital acquired/aspiration pneumonia. The mean length of ICU stay was 3.30± 1.91 days. 21.8% patients were put on ventilator. The mortality rate was 34.5%. Betalactum along with betalactamase inhibitor antibiotics were prescribed for 91% patients, Carbapenams for 20%, anti-staphylococcal antibiotic for 51% of patients and macrolides and miscellaneous antibiotics were prescribed in 25.5% and 36.4% patients respectively. Betalactum antibiotic along with betalactamase inhibitor and clindamycin combination was most commonly prescribed antibiotic. Average cost per patient who was not put on ventilator was Rs 27,123 where as ventilated patient per cost was Rs44, 812. This study showed that one third of ICU admissions was due to pneumonia. Highest numbers of pneumonia were hospital acquired/aspiration pneumonia. Cost of ventilator supported pneumonia was two times more than non-ventilated pneumonia. Ventilator support was the most expensive intervention adding to the cost of care followed by cost of antibiotics and investigations.
The American Journal of Tropical Medicine and Hygiene, 1999
As part of the clinical validation process of a new working seed of a licensed yellow fever vacci... more As part of the clinical validation process of a new working seed of a licensed yellow fever vaccine (new working seed PV26, Stamaril; Pasteur Mérieux Connaught, Lyon, France), the immunogenicity and safety of two batches of this vaccine (PM-YF) were compared with those of another commercially available vaccine (Arilvax; Evans Medical-Wellcome, Liverpool, United Kingdom) in 211 healthy adults. While the geometric mean titer values at days 10-14 and day 28 after vaccination were higher in the PM-YF group, the vaccines provided equivalent seroprotection (titers Ն1/10) one month after a single vaccine dose (100% PM-YF versus 99% W-YF; P ϭ 0.001, by one-sided equivalence test). Both vaccines were safe. There were no serious local or systemic reactions reported, nor any clinically significant hepatic function abnormalities associated with the use of either vaccine. These two 17D yellow fever vaccines from different European vaccine manufacturers were highly immunogenic and safe, and provided equivalent seroprotection.
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Papers by Prabha Adhikari