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PLoS One ; 17(8): e0272636, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-35947595


INTRODUCTION: The post-coronavirus disease 2019 (COVID-19) syndrome is defined as the persistence of symptoms after viral clearance and the emergence of new symptoms after a few months following recovery from COVID-19. This study aimed to assess the prevalence of post-COVID-19 syndrome and the risk factors that contribute to its development. METHODS: This study was conducted prospectively in Tribhuvan University Teaching Hospital (TUTH), located in Maharajgunj, Kathmandu. The patients were followed up for three months. RESULTS: The post-COVID status of 300 patients admitted to the COVID emergency of TUTH was studied. The mean age of the patients was 46.6±15.7 years, and the proportion of male (56%) was slightly higher than female (44%). Most of the patients (81.7%) had fever on their presentation to the emergency which was followed by fatigue (81.3%) and cough (78.3%). During the post-COVID phase, fatigue was the most common persistent symptom, with 34% experiencing fatigue after 60 days and 28.3% even after 90 days from the onset of symptoms. Univariate logistic regression showed sore throat (OR 4.6; 95% CI (2.8-7.6)), rhinitis (OR 3.6; 95% CI (2.1-5.9)), fatigue (OR 3.7; 95% CI (1.8-7.6)), diarrhea (OR 4.1; 95% CI (2.4-6.9)), anosmia (OR 6.7; 95% CI (3.9-11.3)), ageusia (OR 7.8; 95% CI (4.5-13.4)) and shortness of breath (OR 14.9; 95% CI (1.8-119.6)) at admission were all predictors of post-COVID syndrome after three months. CONCLUSION: Even after recovering from COVID-19, people with COVID-19 may develop symptoms. As a result, COVID-19's long-term consequences should not be neglected, as they may lead to increased morbidity among patients, consumption of financial resources, and added burden on the health system.

COVID-19 , Adulto , COVID-19/complicações , COVID-19/epidemiologia , Fadiga/etiologia , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Nepal/epidemiologia , Estudos Prospectivos , SARS-CoV-2 , Centros de Atenção Terciária
Clin Case Rep ; 10(5): e05840, 2022 May.
Artigo em Inglês | MEDLINE | ID: mdl-35540719


Dravet syndrome is rare genetic epilepsy syndrome and epileptic encephalopathy. The patient initially has normal developmental profile with plateau or regression that begins after seizure onset. We report a case of two-year-old child diagnosed as dravet syndrome with moderate cerebral atrophy and ventricular dilatation as rare MRI finding.

JNMA J Nepal Med Assoc ; 59(237): 437-441, 2021 May 25.
Artigo em Inglês | MEDLINE | ID: mdl-34508431


INTRODUCTION: Scrub typhus is a mite borne infectious disease caused by Orientia tsutsugamushi, obligate intracellular bacteria, transmitted by chigger mites. Scrub typhus is an emerging febrile illness with clinical suspicion being the only key to diagnosis. This study was conducted to find out the prevalence of Scrub typhus among febrile children in a tertiary care center of central Nepal. METHODS: A descriptive cross-sectional study was conducted from January 2018 to December 2019 in the pediatric inpatients of a tertiary care hospital after obtaining ethical clearance from Institutional Review Committee of Institute (Reference number 2020-105). Convenient sampling method was used. Data was analyzed using Statistical Packages for the Social Science version 16. Point estimate at 95% Confidence Interval was calculated along with frequency and proportion for binary data. RESULTS: Out of 1024 febrile patients, prevalence of scrub typhus among febrile children was 55 (5.37%) (3.66-7.08 at 90% Confidence Interval). Of 55 patients, mean age was 9.2 years with 52 (94.6%) of cases diagnosed between July to November. Among 55 patients, other symptoms were vomiting 33 (60%), headache 22 (40%), abdominal pain 19 (34.5%), cough 15 (27.3%), nausea (25.5%), seizure 11 (20 %), and dyspnea 6 (10.9%). Major clinical signs was lymphadenopathy 29 (52.7%). Major complication noted was meningitis 11 (20%). CONCLUSIONS: The prevalence of scrub typhus is considerably high during July to November so it should be considered as a differential diagnosis of fever particularly in this period.

Orientia tsutsugamushi , Tifo por Ácaros , Criança , Estudos Transversais , Humanos , Nepal/epidemiologia , Tifo por Ácaros/diagnóstico , Tifo por Ácaros/epidemiologia , Centros de Atenção Terciária
J Nepal Health Res Counc ; 19(3): 587-595, 2021 Dec 15.
Artigo em Inglês | MEDLINE | ID: mdl-35140436


BACKGROUND: Pandemic of COVID-19 has engulfed Nepal as well. In this paper, we studied the demographic, clinical, laboratory findings as well as the treatment modalities, prognostic factors and outcome of patients admitted with COVID-19. METHODS: This was an observational cross-sectional study that included all patients admitted to the General Medicine Department of College of Medical Sciences, Bharatpur, during the first wave of COVID-19 from April 2020 to February 2021 after obtaining the ethical clearance. Data analysis was done using statistical packages for social sciences version 16. RESULTS: A total of 119 patients with mean age of 61.5 years were admitted. They had a mean duration of onset of symptoms of 7.1 days. Commonest symptoms were fever (70.6%), cough (67.2%) and dyspnea (64.7%). Severe COVID-19 at admission with a median CT severity score of 15 was found in 49.7% of them. Total 83.2% patients required ICU care and 10.9% required mechanical ventilation. ARDS and secondary infection occurred in 17.6% each. Median length of hospital stay was 6 days. In total, 56.3% recovered 27.7% left against medical advice and 16.0% expired. Severity of COVID at admission, CT severity score at presentation and D-dimer at admission were found to be significantly associated with mortality (P<0.05).Neither of the age, duration of illness, CRP at admission nor the use of remdesivir or convalescent plasma had significant relation with the mortality (P>0.05). CONCLUSIONS: Severity of illness at presentation, CT severity score and D-dimer level at admission are significantly associated with mortality of the patients admitted with COVID-19.

COVID-19 , COVID-19/diagnóstico , COVID-19/terapia , Estudos Transversais , Hospitais , Humanos , Imunização Passiva , Unidades de Terapia Intensiva , Pessoa de Meia-Idade , Nepal/epidemiologia , SARS-CoV-2
Public Health Genomics ; 22(3-4): 132-139, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31587001


Pharmacogenomics (PGx) is increasingly being recognized as a potential tool for improving the efficacy and safety of drug therapy. Therefore, several efforts have been undertaken globally to facilitate the implementation process of PGx into routine clinical practice. Part of these efforts include the formation of PGx working groups working on PGx research, synthesis, and dissemination of PGx data and creation of PGx implementation strategies. In Asia, the Southeast Asian Pharmacogenomics Research Network (SEAPharm) is established to enable and strengthen PGx research among the various PGx communities within but not limited to countries in SEA; with the ultimate goal to support PGx implementation in the region. From the perspective of SEAPharm member countries, there are several key elements essential for PGx implementation at the national level. They include pharmacovigilance database, PGx research, health economics research, dedicated laboratory to support PGx testing for both research and clinical use, structured PGx education, and supportive national health policy. The status of these essential elements is presented here to provide a broad picture of the readiness for PGx implementation among the SEAPharm member countries, and to strengthen the PGx research network and practice in this region.

Relações Interprofissionais , Farmacogenética/estatística & dados numéricos , Ásia , Ásia Sudeste , Doença Hepática Induzida por Substâncias e Drogas/prevenção & controle , Difusão de Inovações , Erupção por Droga/prevenção & controle , Humanos , Farmacogenética/economia
Phys Rev Lett ; 122(15): 150604, 2019 Apr 19.
Artigo em Inglês | MEDLINE | ID: mdl-31050528


We experimentally realize protocols that allow us to extract work beyond the free energy difference from a single-electron transistor at the single thermodynamic trajectory level. With two carefully designed out-of-equilibrium driving cycles featuring kicks of the control parameter, we demonstrate work extraction up to large fractions of k_{B}T or with probabilities substantially greater than 1/2, despite the zero free energy difference over the cycle. Our results are explained in the framework of nonequilibrium fluctuation relations. We thus show that irreversibility can be used as a resource for optimal work extraction even in the absence of feedback from an external operator.