Coronavirus Disease 2019 (COVID-19) burden is often underestimated when relying on case-based inc... more Coronavirus Disease 2019 (COVID-19) burden is often underestimated when relying on case-based incidence reports. Seroprevalence studies accurately estimate infectious disease burden by estimating the population that has developed antibodies following an infection. Sero-Epidemiology of COVID-19 in the Kathmandu valley (SEVID-KaV) is a longitudinal survey of hospital-based health workers in the Kathmandu valley. Between December 3-25, we sampled 800 health workers from 20 hospitals and administered a questionnaire eliciting COVID-19 related history and tested for COVID-19 IgG antibodies. We then used a probabilistic multilevel regression model with post-stratification to correct for test accuracy, the effect of hospital-based clustering, and to establish representativeness. 522 (65.2%) of the participants were female, 372 (46%) were between ages 18-29, and 7 (0.9%) were 60 or above. 287 (36%) of the participants were nurses. About 23% of the participants previously had a PCR positive ...
There are many clinical scoring systems that measure the severity in sepsis and septic shock. The... more There are many clinical scoring systems that measure the severity in sepsis and septic shock. Therefore, our study aims to calculate prognostic accuracy of commonly used scoring system SOFA and qSOFA in emergency department as a predictor of mortality among sepsis patients.This was prospective observational study conducted in an emergency department for a period of seven months. 156 patients were studied and descriptive statistical analysis was done. The most common source of infection was respiratory. A positive and moderate correlation was seen between initial SOFA score and qSOFA score. The AUC of SOFA score and qSOFA for predicting the mortality were 0.978 and 0.886 with sensitivity of 96.9% and specificty of 57% for SOFA and sensitivity of 96.9% and specificity of 76.1% for qSOFA.SOFA and qSOFA both proved to be similar as a simple prognostic tool with discriminatory capacity in predicting prognosis in septic patient presenting to emergency department. 1Department of General Pr...
Introduction: Injury is one of the major global public health problems causing significant number... more Introduction: Injury is one of the major global public health problems causing significant number of death and disability. The study aims to study the epidemiological and clinical profile of patients presented in emergency department with injury. Methods: This was a descriptive cross-sectional study conducted in a tertiary care hospital from September 2019 to February 2020 after obtaining ethical approval from Institutional review board (reference number 007-076/077). A convenient sampling method was applied. Epidemiological factors, chronological factors, causes of injury, anatomical distribution, pattern of injury were studied. Statistical analysis was done using statistical package for the social sciences version 20. Point estimate at 95% Confidence Interval was calculated along with frequency and proportion for binary data. Results: Out of 197 patients, 72 (36.5%) patients had fall followed by road traffic accident 57 (28.9%). Of total, 80 (40.6%) had injury at home and 80 (40.6...
Introduction: Injury is one of the major global public health problems causing significant number... more Introduction: Injury is one of the major global public health problems causing significant number of death and disability. The study aims to study the epidemiological and clinical profile of patients presented in emergency department with injury. Methods: This was a descriptive cross-sectional study conducted in a tertiary care hospital from September 2019 to February 2020 after obtaining ethical approval from Institutional review board (reference number 007-076/077). A convenient sampling method was applied. Epidemiological factors, chronological factors, causes of injury, anatomical distribution, pattern of injury were studied. Statistical analysis was done using statistical package for the social sciences version 20. Point estimate at 95% Confidence Interval was calculated along with frequency and proportion for binary data. Results: Out of 197 patients, 72 (36.5%) patients had fall followed by road traffic accident 57 (28.9%). Of total, 80 (40.6%) had injury at home and 80 (40.6...
Drug interaction may cause an increase in the toxicity of a drug, increases the likelihood of adv... more Drug interaction may cause an increase in the toxicity of a drug, increases the likelihood of adverse drug reactions, or cause a reduction in the efficacy of particular drug therapy, which may worsen the patient’s condition directly or indirectly. This study aims to assess the potential drug-drug interactions (pDDIs) and their associated factors in the Medical Intensive Care Unit (MICU). We carried out a descriptive retrospective study based on the hospital records of 100 MICU patients. Micromedex Interaction application, designed by Truven Health Analytics Inc., was used to screen prescribed medications. We found 219 drug interactions out of 856 drugs prescribed. The average number of drug interactions per patient was 2.19. The frequency of drugs prescribed, the number of days in MICU, and age had a positive correlation with the occurrence of pDDIs. There were 44.7% major pDDIs; pharmacodynamic being the commonest mechanism for it. Most patients in MICU were at the risk of developi...
Introduction: Injury is one of the major global public health problems causing significant number... more Introduction: Injury is one of the major global public health problems causing significant number of death and disability. The study aims to study the epidemiological and clinical profile of patients presented in emergency department with injury. Methods: This was a descriptive cross-sectional study conducted in a tertiary care hospital from September 2019 to February 2020 after obtaining ethical approval from Institutional review board (reference number 007-076/077). A convenient sampling method was applied. Epidemiological factors, chronological factors, causes of injury, anatomical distribution, pattern of injury were studied. Statistical analysis was done using statistical package for the social sciences version 20. Point estimate at 95% Confidence Interval was calculated along with frequency and proportion for binary data. Results: Out of 197 patients, 72 (36.5%) patients had fall followed by road traffic accident 57 (28.9%). Of total, 80 (40.6%) had injury at home and 80 (40.6...
Introduction: Acute poisoning is a major global public health problem contributing to one of thel... more Introduction: Acute poisoning is a major global public health problem contributing to one of theleading causes for a visit to an emergency department. This study aims to analyse the demographicand psychosocial characteristics of patients with acute poisoning presented to the emergencydepartment. Methods: This was a descriptive cross-sectional study conducted in a tertiary care hospital fromJune to December 2019 after obtaining ethical approval from Institutional review board (referencenumber. 041-075/0760). A convenient sampling method was applied. Epidemiological factors, typesof poison consumed, reason, motive, and place to take poison, time elapse in the presentation to thehospital were studied. Statistical analysis was done using statistical package for the social sciencesversion 20. Point estimate at 95% Confidence Interval was calculated along with frequency andproportion for binary data. Results: Out of 76 cases of acute poisoning, the organophosphorus poisoning was 18 (23.7%...
IntroductionSevere sepsis and septic shock, is a common cause of emergency room admission and is ... more IntroductionSevere sepsis and septic shock, is a common cause of emergency room admission and is associated with high morbidity and mortality worldwide. This study inspects the prediction of mortality in severe sepsis and septic shock with increased lactate/albumin ratio.Objective The objective of the study was to predict the serum lactate albumin ratio as an indicator of mortality in severe sepsis and septic shock.MethodologyIt was a hospital based cross sectional study done at Tribhuvan University Teaching Hospital, Kathmandu from November 2015 to October 2016. The consent was taken from patients. Acute Physiology and Chronic Health Evaluation II score, serum lactate and serum albumin levels on first day of arrival in emergency room were calculated. Patients were classified as severe sepsis and septic shock and treated according to Surviving Sepsis Campaign 2012 guideline. The patient were follow up at 28 day, The associations of 28-day outcome with Acute Physiology and Chronic He...
Coronavirus Disease 2019 (COVID-19) burden is often underestimated when relying on case-based inc... more Coronavirus Disease 2019 (COVID-19) burden is often underestimated when relying on case-based incidence reports. Seroprevalence studies accurately estimate infectious disease burden by estimating the population that has developed antibodies following an infection. Sero-Epidemiology of COVID-19 in the Kathmandu valley (SEVID-KaV) is a longitudinal survey of hospital-based health workers in the Kathmandu valley. Between December 3-25, we sampled 800 health workers from 20 hospitals and administered a questionnaire eliciting COVID-19 related history and tested for COVID-19 IgG antibodies. We then used a probabilistic multilevel regression model with post-stratification to correct for test accuracy, the effect of hospital-based clustering, and to establish representativeness. 522 (65.2%) of the participants were female, 372 (46%) were between ages 18-29, and 7 (0.9%) were 60 or above. 287 (36%) of the participants were nurses. About 23% of the participants previously had a PCR positive ...
There are many clinical scoring systems that measure the severity in sepsis and septic shock. The... more There are many clinical scoring systems that measure the severity in sepsis and septic shock. Therefore, our study aims to calculate prognostic accuracy of commonly used scoring system SOFA and qSOFA in emergency department as a predictor of mortality among sepsis patients.This was prospective observational study conducted in an emergency department for a period of seven months. 156 patients were studied and descriptive statistical analysis was done. The most common source of infection was respiratory. A positive and moderate correlation was seen between initial SOFA score and qSOFA score. The AUC of SOFA score and qSOFA for predicting the mortality were 0.978 and 0.886 with sensitivity of 96.9% and specificty of 57% for SOFA and sensitivity of 96.9% and specificity of 76.1% for qSOFA.SOFA and qSOFA both proved to be similar as a simple prognostic tool with discriminatory capacity in predicting prognosis in septic patient presenting to emergency department. 1Department of General Pr...
Introduction: Injury is one of the major global public health problems causing significant number... more Introduction: Injury is one of the major global public health problems causing significant number of death and disability. The study aims to study the epidemiological and clinical profile of patients presented in emergency department with injury. Methods: This was a descriptive cross-sectional study conducted in a tertiary care hospital from September 2019 to February 2020 after obtaining ethical approval from Institutional review board (reference number 007-076/077). A convenient sampling method was applied. Epidemiological factors, chronological factors, causes of injury, anatomical distribution, pattern of injury were studied. Statistical analysis was done using statistical package for the social sciences version 20. Point estimate at 95% Confidence Interval was calculated along with frequency and proportion for binary data. Results: Out of 197 patients, 72 (36.5%) patients had fall followed by road traffic accident 57 (28.9%). Of total, 80 (40.6%) had injury at home and 80 (40.6...
Introduction: Injury is one of the major global public health problems causing significant number... more Introduction: Injury is one of the major global public health problems causing significant number of death and disability. The study aims to study the epidemiological and clinical profile of patients presented in emergency department with injury. Methods: This was a descriptive cross-sectional study conducted in a tertiary care hospital from September 2019 to February 2020 after obtaining ethical approval from Institutional review board (reference number 007-076/077). A convenient sampling method was applied. Epidemiological factors, chronological factors, causes of injury, anatomical distribution, pattern of injury were studied. Statistical analysis was done using statistical package for the social sciences version 20. Point estimate at 95% Confidence Interval was calculated along with frequency and proportion for binary data. Results: Out of 197 patients, 72 (36.5%) patients had fall followed by road traffic accident 57 (28.9%). Of total, 80 (40.6%) had injury at home and 80 (40.6...
Drug interaction may cause an increase in the toxicity of a drug, increases the likelihood of adv... more Drug interaction may cause an increase in the toxicity of a drug, increases the likelihood of adverse drug reactions, or cause a reduction in the efficacy of particular drug therapy, which may worsen the patient’s condition directly or indirectly. This study aims to assess the potential drug-drug interactions (pDDIs) and their associated factors in the Medical Intensive Care Unit (MICU). We carried out a descriptive retrospective study based on the hospital records of 100 MICU patients. Micromedex Interaction application, designed by Truven Health Analytics Inc., was used to screen prescribed medications. We found 219 drug interactions out of 856 drugs prescribed. The average number of drug interactions per patient was 2.19. The frequency of drugs prescribed, the number of days in MICU, and age had a positive correlation with the occurrence of pDDIs. There were 44.7% major pDDIs; pharmacodynamic being the commonest mechanism for it. Most patients in MICU were at the risk of developi...
Introduction: Injury is one of the major global public health problems causing significant number... more Introduction: Injury is one of the major global public health problems causing significant number of death and disability. The study aims to study the epidemiological and clinical profile of patients presented in emergency department with injury. Methods: This was a descriptive cross-sectional study conducted in a tertiary care hospital from September 2019 to February 2020 after obtaining ethical approval from Institutional review board (reference number 007-076/077). A convenient sampling method was applied. Epidemiological factors, chronological factors, causes of injury, anatomical distribution, pattern of injury were studied. Statistical analysis was done using statistical package for the social sciences version 20. Point estimate at 95% Confidence Interval was calculated along with frequency and proportion for binary data. Results: Out of 197 patients, 72 (36.5%) patients had fall followed by road traffic accident 57 (28.9%). Of total, 80 (40.6%) had injury at home and 80 (40.6...
Introduction: Acute poisoning is a major global public health problem contributing to one of thel... more Introduction: Acute poisoning is a major global public health problem contributing to one of theleading causes for a visit to an emergency department. This study aims to analyse the demographicand psychosocial characteristics of patients with acute poisoning presented to the emergencydepartment. Methods: This was a descriptive cross-sectional study conducted in a tertiary care hospital fromJune to December 2019 after obtaining ethical approval from Institutional review board (referencenumber. 041-075/0760). A convenient sampling method was applied. Epidemiological factors, typesof poison consumed, reason, motive, and place to take poison, time elapse in the presentation to thehospital were studied. Statistical analysis was done using statistical package for the social sciencesversion 20. Point estimate at 95% Confidence Interval was calculated along with frequency andproportion for binary data. Results: Out of 76 cases of acute poisoning, the organophosphorus poisoning was 18 (23.7%...
IntroductionSevere sepsis and septic shock, is a common cause of emergency room admission and is ... more IntroductionSevere sepsis and septic shock, is a common cause of emergency room admission and is associated with high morbidity and mortality worldwide. This study inspects the prediction of mortality in severe sepsis and septic shock with increased lactate/albumin ratio.Objective The objective of the study was to predict the serum lactate albumin ratio as an indicator of mortality in severe sepsis and septic shock.MethodologyIt was a hospital based cross sectional study done at Tribhuvan University Teaching Hospital, Kathmandu from November 2015 to October 2016. The consent was taken from patients. Acute Physiology and Chronic Health Evaluation II score, serum lactate and serum albumin levels on first day of arrival in emergency room were calculated. Patients were classified as severe sepsis and septic shock and treated according to Surviving Sepsis Campaign 2012 guideline. The patient were follow up at 28 day, The associations of 28-day outcome with Acute Physiology and Chronic He...
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