Publications by authors named "Rajesh D Joshi"
Article Synopsis
- Chronic obstructive pulmonary disease (COPD) is a major health concern and was studied to understand the bacterial causes during acute episodes.
- A review of patient records from Kathmandu Model Hospital over five years found that the most common bacteria in sputum cultures were Pseudomonas aeruginosa, Klebsiella pneumoniae, and Escherichia coli, with varying levels of antibiotic resistance.
- The study concluded that certain antibiotics like Polymyxin B and Colistin were effective against the isolated bacteria, which are commonly associated with acute exacerbations of COPD.
BACKGROUND: Optimal thromboprophylaxis for hospitalized patients with coronavirus disease 2019 (Covid-19) is uncertain. METHODS: In an open-label, adaptive platform trial, we randomly assigned hospitalized adults with Covid-19 to low-dose low-molecular-weight heparin thromboprophylaxis or intermediate-dose or low-dose plus aspirin. In response to external evidence, the aspirin intervention was discontinued and a therapeutic-dose arm added.
View Article and Find Full Text PDFPurpose: The morbidity and mortality due to typhoid fever can be significantly reduced with the use of effective antibiotics. At present, fluoroquinolones, third generation cephalosporins, and azithromycin are widely used to treat typhoid fever. However, changing antibiotic susceptibility among Typhi and Paratyphi poses a particular challenge to the therapeutic management of enteric fever.
View Article and Find Full Text PDFArticle Synopsis
- The study investigated the prevalence of antibiotic resistance genes (blaTEM and blaCTX-M) in E. coli isolates from urinary tract infections (UTI) among diabetic and non-diabetic patients at a hospital in Kathmandu, Nepal.
- A total of 1,267 urine samples were analyzed, revealing a 17.2% UTI rate, with a significantly higher infection rate in diabetic patients (32.3%) compared to non-diabetic patients (15.9%).
- Among the E. coli isolates, a notable portion (44%) were multidrug resistant and 37.3% produced extended spectrum β-lactamases (ESBL), with a striking association of ESBL producers in diabetic patients, highlighting the need for effective disease management
Antimicrobial stewardship (AMS) programs can decrease non-optimal use of antibiotics in hospital settings. There are limited data on AMS programs in burn and chronic wound centers in low- and middle-income countries (LMIC). A post-prescription review and feedback (PPRF) program was implemented in three hospitals in Nepal with a focus on wound and burn care.
View Article and Find Full Text PDFGlobally, medical errors are associated with an estimated $42 billion in costs to healthcare systems. A variety of errors in the delivery of healthcare have been identified by the World Health Organization and it is believed that about 50% of all errors are preventable. Initiatives to improve patient safety are now garnering increased attention across a range of countries in all regions of the world.
View Article and Find Full Text PDFCapacity building is needed in low- and middle-income countries (LMICs) to combat antimicrobial resistance (AMR). Stewardship programs such as post-prescription review and feedback (PPRF) are important components in addressing AMR. Little data are available regarding effectiveness of PPRF programs in LMIC settings.
View Article and Find Full Text PDFAntimicrobial Sensitivity Trend in Blood Culture Positive Enteric Fever.
J Nepal Health Res Counc
July 2018
Background: For diagnosis of enteric fever, the culture of the organism from different body fluids is the gold standard. After diagnosis, it is important to treat with the right antibiotic before any complications can occur. The retrospective study is designed to explore the antibiotic sensitivity trend in blood culture positive typhoid fever cases and the extent of drug resistance before treatment is administered.
View Article and Find Full Text PDFBackground: Lower respiratory tract infection is a common cause of morbidity and mortality worldwide. A cross-sectional study was carried out with an objective to study the antibiogram of Gram-negative isolates of patients with lower respiratory tract infection visiting Kathmandu Model Hospital.
Methods: A total of 274 specimens including sputum, endotracheal aspirates, suction tips were cultured as per standard microbiological technique.