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21 results on '"Parajuli, Surya B."'

5. May Measurement Month 2019: an analysis of blood pressure screening results from Nepal

Author

Bhattarai, Harikrishna, primary, McLachlan, Craig S, additional, Khanal, Pratik, additional, Adhikari, Tara Ballav, additional, Ranabhat, Kamal, additional, Koirala, Sweta, additional, Parajuli, Surya B, additional, Pokharel, Yashashwi, additional, Paudel, Santosh, additional, Soti, Pabitra Babu, additional, Subedi, Bishal, additional, Wagle, Chetan Nidhi, additional, Mahato, Sweta, additional, Pandey, Ghanashyam, additional, Gyawali, Pawan, additional, Pandey, Sadhana, additional, Gyawali, Vivek, additional, Devkota, Surya, additional, Lohani, Guna Raj, additional, Koirala, Bhagawan, additional, Xia, Xin, additional, Beaney, Thomas, additional, and Neupane, Dinesh, additional

Published
2021
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9. Acute Severe Anaphylaxis in Nepali Patients with Neurotoxic Snakebite Envenoming Treated with the VINS Polyvalent Antivenom

Author

Sharma, Sanjib Kumar, Alirol, Emilie, Ghimire, Anup, Shrestha, Suman, Jha, Rupesh, Parajuli, Surya B., Shrestha, Deekshya, Shrestha, Surya Jyoti, Bista, Amir, Warrell, David, Kuch, Ulrich, Chappuis, Francois, Taylor, Walter Robert John, and Tanner, Marcel

Subjects
lcsh:Arctic medicine. Tropical medicine, Article Subject, lcsh:RC955-962, Clinical Study, ddc:610, ddc:613
Abstract

Diagnosing and treating acute severe and recurrent antivenom-related anaphylaxis (ARA) is challenging and reported experience is limited. Herein, we describe our experience of severe ARA in patients with neurotoxic snakebite envenoming in Nepal. Patients were enrolled in a randomised, double-blind trial of high vs. low dose antivenom, given by intravenous (IV) push, followed by infusion. Training in ARA management emphasised stopping antivenom and giving intramuscular (IM) adrenaline, IV hydrocortisone, and IV chlorphenamine at the first sign/s of ARA. Later, IV adrenaline infusion (IVAI) was introduced for patients with antecedent ARA requiring additional antivenom infusions. Preantivenom subcutaneous adrenaline (SCAd) was introduced in the second study year (2012). Of 155 envenomed patients who received ≥ 1 antivenom dose, 13 (8.4%), three children (aged 5−11 years) and 10 adults (18−52 years), developed clinical features consistent with severe ARA, including six with overlapping signs of severe envenoming. Four and nine patients received low and high dose antivenom, respectively, and six had received SCAd. Principal signs of severe ARA were dyspnoea alone (n=5 patients), dyspnoea with wheezing (n=3), hypotension (n=3), shock (n=3), restlessness (n=3), respiratory/cardiorespiratory arrest (n=7), and early (n=1) and late laryngeal oedema (n=1); rash was associated with severe ARA in 10 patients. Four patients were given IVAI. Of the 8 (5.1%) deaths, three occurred in transit to hospital. Severe ARA was common and recurrent and had overlapping signs with severe neurotoxic envenoming. Optimising the management of ARA at different healthy system levels needs more research. This trial is registered with NCT01284855.

Published
2019
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13. Acute severe anaphylaxis in Nepali patients with neurotoxic snakebite envenoming treated with the vins polyvalent antivenom

Author

Tanner, Marcel, Sharma, Sanjib Kumar, Alirol, Emilie, Ghimire, Anup, Shrestha, Suman, Jha, Rupesh, Parajuli, Surya B., Shrestha, Deekshya, Shrestha, Surya Jyoti, Bista, Amir, Warrell, David A., Kuch, Ulrich, Chappuis, François, Taylor, Walter Robert John, Tanner, Marcel, Sharma, Sanjib Kumar, Alirol, Emilie, Ghimire, Anup, Shrestha, Suman, Jha, Rupesh, Parajuli, Surya B., Shrestha, Deekshya, Shrestha, Surya Jyoti, Bista, Amir, Warrell, David A., Kuch, Ulrich, Chappuis, François, and Taylor, Walter Robert John

Abstract

Diagnosing and treating acute severe and recurrent antivenom-related anaphylaxis (ARA) is challenging and reported experience is limited. Herein, we describe our experience of severe ARA in patients with neurotoxic snakebite envenoming in Nepal. Patients were enrolled in a randomised, double-blind trial of high vs. low dose antivenom, given by intravenous (IV) push, followed by infusion. Training in ARA management emphasised stopping antivenom and giving intramuscular (IM) adrenaline, IV hydrocortisone, and IV chlorphenamine at the first sign/s of ARA. Later, IV adrenaline infusion (IVAI) was introduced for patients with antecedent ARA requiring additional antivenom infusions. Preantivenom subcutaneous adrenaline (SCAd) was introduced in the second study year (2012). Of 155 envenomed patients who received ≥ 1 antivenom dose, 13 (8.4%), three children (aged 5−11 years) and 10 adults (18−52 years), developed clinical features consistent with severe ARA, including six with overlapping signs of severe envenoming. Four and nine patients received low and high dose antivenom, respectively, and six had received SCAd. Principal signs of severe ARA were dyspnoea alone (n=5 patients), dyspnoea with wheezing (n=3), hypotension (n=3), shock (n=3), restlessness (n=3), respiratory/cardiorespiratory arrest (n=7), and early (n=1) and late laryngeal oedema (n=1); rash was associated with severe ARA in 10 patients. Four patients were given IVAI. Of the 8 (5.1%) deaths, three occurred in transit to hospital. Severe ARA was common and recurrent and had overlapping signs with severe neurotoxic envenoming. Optimising the management of ARA at different healthy system levels needs more research. This trial is registered with NCT01284855.

Published
2019

21. Knowledge of Adverse Drug Reactions Reporting among Doctors and Nurses in a Tertiary Care Hospital: A Descriptive Cross-sectional Study.

Author

Shah R, Parajuli SB, and Pokharel S

Subjects
Adult, Cross-Sectional Studies, Humans, Surveys and Questionnaires, Tertiary Care Centers, Drug-Related Side Effects and Adverse Reactions epidemiology, Nurses, Physicians
Abstract

Introduction: Doctors and nurses have a significant role in the detection of serious and unusual drug reactions. Effective implementation of an adverse drug reaction reporting system is required to ensure patient safety and quality care. This study's objective was to find the prevalence of good knowledge of adverse drug reaction reporting among the Doctors and nurses working in a tertiary care hospital., Methods: A descriptive cross-sectional study was conducted among doctors and nurses from 15 February 2020 to 15 July 2020 at Birat Medical College and Teaching Hospital. The convenience sampling method was used to select 192 study participants. A semi-structured questionnaire was used to know the knowledge concept of adverse drug reaction reporting. Ethical clearance was taken from IRC (PA-047/2076-77) of Birat Medical College and Teaching Hospital. Written informed consent was taken from each study participant. Collected data were entered in Microsoft Excel 2010 and analyzed by Statistical Package for the Social Sciences v23., Results: In total, 192 doctors and nurses, the questionnaires were distributed to 52 (27.1%) doctors and 140 (72.9%) nurses. The mean age of study participants was 28.14 years (SD±4.5). To know the prevalence of knowledge, 15 knowledge related questions of adverse drug reaction had asked. The majority of doctors and nurses had good knowledge about adverse drug reaction reporting, 75% and 64%, respectively., Conclusions: Overall, doctors and nurses have had good knowledge of adverse drug reaction reporting. Data shows there is still more gap in training and experience on adverse drug reaction reporting systems.

Published
2021
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