Publications by authors named "Alok Pradhan"
Article Synopsis
- Ring-shaped DNA sliding clamps are crucial for DNA replication and maintenance, requiring clamp loader complexes (CLCs) to open and position them on DNA.
- The study presents six detailed structures of E. coli CLC with open and closed clamps before and after DNA binding, highlighting key steps in the loading process.
- Findings reveal that the ATP-bound CLC first 'grabs' the clamp, then opens it enough for DNA to enter, ultimately allowing the clamp to close around the DNA.
Introduction: Road traffic accidents are a public health problem and have emerged as the leading cause of mortality and morbidity. Head is the most commonly affected site of road traffic accidents. The aim of this study was to find out the prevalence of road traffic accidents among patients presenting to the emergency department of a tertiary care centre.
View Article and Find Full Text PDFIntroduction: Pediatric abdominal trauma presents a major challenge for first-line responders in the Emergency Department for assessment and management. The Focused assessment sonography for trauma is a readily available, easy-to-use, and affordable tool for detecting hemoperitoneum during the initial assessment of trauma in the Emergency Department for adult traumatic patients. The aim of this study was to find the prevalence of hemoperitoneum among pediatric abdominal trauma patients visiting the Emergency Department of tertiary care centre through Focused assessment with sonography for trauma examination technique.
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- * After implementing the guideline, the rate of CT head scans significantly decreased from 92% to 70%, and guideline adherence improved by 20.3 points, indicating better compliance with recommended practices.
- * Attending physicians showed marked improvement in confidence levels post-intervention, and the NICE guideline demonstrated higher sensitivity and accuracy in detecting intracranial lesions compared to clinical judgment.
Tubercular Pericardial Effusion Presenting as Cardiac Tamponade.
J Nepal Health Res Counc
January 2021
Pericardial effusion is an uncommon extra-pulmonary manifestation of tuberculosis, tamponade being even rarer. Here, a 14-year female presented with cough, chest pain and fever. She had raised jugular venous pressure, hypotension, and muffled heart sound, suggestive of cardiac tamponade, confirmed by echocardiogram.
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- Thoracoabdominal trauma poses a diagnostic challenge for emergency physicians, but bedside ultrasonography (EFAST) helps in quickly identifying severe injuries like hemoperitoneum and pneumothorax during the initial assessment.
- A study conducted at Dhulikhel Hospital in Nepal evaluated the accuracy of EFAST performed by first responders on trauma patients and compared its results against more traditional imaging methods.
- The findings showed high sensitivity (94.8%) and specificity (99.5%) of EFAST, confirming its effectiveness in detecting major injuries, but noted that operator dependence could lead to potential errors, warranting a monitoring period for negative cases.
Purpose: Point-of-care ultrasound (POCUS) is a quick bedside tool that has the potential to improve emergency care in resource-limited settings due to its relatively low cost and accessibility. Effort to disseminate the knowledge and skills about POCUS is inadequate in low and middle income countries like Nepal. We conducted a two-day interdisciplinary advanced emergency ultrasound workshop that targeted physicians working in emergency department and primary care, especially in rural Nepal.
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- * Out of the patients assessed, 107 (8.9%) presented with dyspnea, with a median age of 64 years; a significant majority (69%) were aged 60 or older.
- * The findings highlight a higher prevalence of dyspnea compared to other studies, suggesting a need for better management protocols in the emergency setting to improve patient care.
Background: Simulation is well established as an effective strategy to train health care professionals in both technical and nontechnical skills and to prevent errors. Despite its known efficacy, adequate implementation is restricted due to the financial burden in resource-limited settings like ours. We therefore pursued to introduce cost-effective in situ simulation (ISS) in the emergency department (ED) to explore its impact on perception and learning experience among multidisciplinary health care professionals and to identify and remediate the latent safety threats (LST).
View Article and Find Full Text PDFObjective: Setting priorities in health research is a challenge at the global and national levels. Use of evidence-based approach is uncommon and needs to be promoted in low-and middle-income countries (LMIC). We describe profile of Cochrane systematic reviews focussing on participation from LMIC.
View Article and Find Full Text PDFChlorhexidine skin or cord care for prevention of mortality and infections in neonates.
Cochrane Database Syst Rev
March 2015
Background: Affordable, feasible and efficacious interventions to reduce neonatal infections and improve neonatal survival are needed. Chlorhexidine, a broad spectrum topical antiseptic agent, is active against aerobic and anaerobic organisms and reduces neonatal bacterial colonisation and may reduce infection.
Objectives: To evaluate the efficacy of neonatal skin or cord care with chlorhexidine versus routine care or no treatment for prevention of infections in late preterm or term newborn infants in hospital and community settings.