14 results on '"Basnyat, Buddha"'
Search Results
2. Impact of a package of diagnostic tools, clinical algorithm, and training and communication on outpatient acute fever case management in low- and middle-income countries: protocol for a randomized controlled trial
- Author
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Salami, Olawale, Horgan, Philip, Moore, Catrin E., Giri, Abhishek, Sserwanga, Asadu, Pathak, Ashish, Basnyat, Buddha, Kiemde, Francois, Smithuis, Frank, Kitutu, Freddy, Phutke, Gajanan, Tinto, Halidou, Hopkins, Heidi, Kapisi, James, Swe, Myo Maung Maung, Taneja, Neelam, Baiden, Rita, Dutta, Shanta, Compaore, Adelaide, Kaawa-Mafigiri, David, Hussein, Rashida, Shakya, Summita Udas, Kukula, Vida, Ongarello, Stefano, Tomar, Anjana, Chadha, Sarabjit S., Walia, Kamini, Kelly-Cirino, Cassandra, and Olliaro, Piero
- Published
- 2020
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3. A high prevalence of multi-drug resistant Gram-negative bacilli in a Nepali tertiary care hospital and associated widespread distribution of Extended-Spectrum Beta-Lactamase (ESBL) and carbapenemase-encoding genes
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Manandhar, Sulochana, Zellweger, Raphael M., Maharjan, Nhukesh, Dongol, Sabina, Prajapati, Krishna G., Thwaites, Guy, Basnyat, Buddha, Dixit, Sameer Mani, Baker, Stephen, and Karkey, Abhilasha
- Published
- 2020
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4. Drug-resistant enteric fever worldwide, 1990 to 2018: a systematic review and meta-analysis
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Browne, Annie J., Kashef Hamadani, Bahar H., Kumaran, Emmanuelle A. P., Rao, Puja, Longbottom, Joshua, Harriss, Eli, Moore, Catrin E., Dunachie, Susanna, Basnyat, Buddha, Baker, Stephen, Lopez, Alan D., Day, Nicholas P. J., Hay, Simon I., and Dolecek, Christiane
- Published
- 2020
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5. The role of active case finding in reducing patient incurred catastrophic costs for tuberculosis in Nepal
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Gurung, Suman Chandra, Dixit, Kritika, Rai, Bhola, Caws, Maxine, Paudel, Puskar Raj, Dhital, Raghu, Acharya, Shraddha, Budhathoki, Gangaram, Malla, Deepak, Levy, Jens W., van Rest, Job, Lönnroth, Knut, Viney, Kerri, Ramsay, Andrew, Wingfield, Tom, Basnyat, Buddha, Thapa, Anil, Squire, Bertie, Wang, Duolao, Mishra, Gokul, Shah, Kashim, Shrestha, Anil, and de Siqueira-Filha, Noemia Teixeira
- Published
- 2019
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6. Melioidosis: misdiagnosed in Nepal
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Shrestha, Neha, Adhikari, Mahesh, Pant, Vivek, Baral, Suman, Shrestha, Anjan, Basnyat, Buddha, Sharma, Sangita, and Sherchand, Jeevan Bahadur
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- 2019
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7. Tuberculosis in South Asia: a tide in the affairs of men
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Basnyat, Buddha, Caws, Maxine, and Udwadia, Zarir
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- 2018
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8. Co-trimoxazole versus azithromycin for the treatment of undifferentiated febrile illness in Nepal: study protocol for a randomized controlled trial.
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Pokharel, Sunil, Basnyat, Buddha, Arjyal, Amit, Pathak Mahat, Saruna, Raj Kumar, K. C., Bhuju, Abhusani, Poudyal, Buddhi, Kestelyn, Evelyne, Shrestha, Ritu, Dung Nguyen Thi Phuong, Thapa, Rajkumar, Karki, Manan, Dongol, Sabina, Karkey, Abhilasha, Wolbers, Marcel, Baker, Stephen, Thwaites, Guy, Mahat, Saruna Pathak, Kc, Raj Kumar, and Phuong, Dung Nguyen Thi
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TYPHOID fever treatment , *CO-trimoxazole , *AZITHROMYCIN , *FLUOROQUINOLONES , *RANDOMIZED controlled trials , *DIAGNOSIS of fever , *ANTIBIOTICS , *CLINICAL trials , *COMPARATIVE studies , *DRUG resistance in microorganisms , *EXPERIMENTAL design , *FEVER , *RESEARCH methodology , *MEDICAL cooperation , *RESEARCH protocols , *ORAL drug administration , *RESEARCH , *RESEARCH funding , *TIME , *TYPHOID fever , *EVALUATION research , *TYPHUS fever , *TREATMENT effectiveness , *BLIND experiment , *DIAGNOSIS ,TYPHOID fever diagnosis - Abstract
Background: Undifferentiated febrile illness (UFI) includes typhoid and typhus fevers and generally designates fever without any localizing signs. UFI is a great therapeutic challenge in countries like Nepal because of the lack of available point-of-care, rapid diagnostic tests. Often patients are empirically treated as presumed enteric fever. Due to the development of high-level resistance to traditionally used fluoroquinolones against enteric fever, azithromycin is now commonly used to treat enteric fever/UFI. The re-emergence of susceptibility of Salmonella typhi to co-trimoxazole makes it a promising oral treatment for UFIs in general. We present a protocol of a randomized controlled trial of azithromycin versus co-trimoxazole for the treatment of UFI.Methods/design: This is a parallel-group, double-blind, 1:1, randomized controlled trial of co-trimoxazole versus azithromycin for the treatment of UFI in Nepal. Participants will be patients aged 2 to 65 years, presenting with fever without clear focus for at least 4 days, complying with other study criteria and willing to provide written informed consent. Patients will be randomized either to azithromycin 20 mg/kg/day (maximum 1000 mg/day) in a single daily dose and an identical placebo or co-trimoxazole 60 mg/kg/day (maximum 3000 mg/day) in two divided doses for 7 days. Patients will be followed up with twice-daily telephone calls for 7 days or for at least 48 h after they become afebrile, whichever is later; by home visits on days 2 and 4 of treatment; and by hospital visits on days 7, 14, 28 and 63. The endpoints will be fever clearance time, treatment failure, time to treatment failure, and adverse events. The estimated sample size is 330. The primary analysis population will be all the randomized population and subanalysis will be repeated on patients with blood culture-confirmed enteric fever and culture-negative patients.Discussion: Both azithromycin and co-trimoxazole are available in Nepal and are extensively used in the treatment of UFI. Therefore, it is important to know the better orally administered antimicrobial to treat enteric fever and other UFIs especially against the background of fluoroquinolone-resistant enteric fever.Trial Registration: ClinicalTrials.gov, ID: NCT02773407 . Registered on 5 May 2016. [ABSTRACT FROM AUTHOR]- Published
- 2017
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9. High-throughput bacterial SNP typing identifiesdistinct clusters of Salmonella Typhi causingtyphoid in Nepalese children.
- Author
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Holt, Kathryn E., Baker, Stephen, Dongol, Sabina, Basnyat, Buddha, Adhikari, Neelam, Thorson, Stephen, Pulickal, Anoop S., Yajun Song, Parkhill, Julian, Farrar, Jeremy J., Murdoch, David R., Kelly, Dominic F., Pollard, Andrew J., and Dougan, Gordon
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SALMONELLA typhi ,TYPHOID fever ,PUBLIC health ,BIOMARKERS - Abstract
Background: Salmonella Typhi (S. Typhi) causes typhoid fever, which remains an important public health issue in many developing countries. Kathmandu, the capital of Nepal, is an area of high incidence and the pediatric population appears to be at high risk of exposure and infection. Methods: We recently defined the population structure of S. Typhi, using new sequencing technologies to identify nearly 2,000 single nucleotide polymorphisms (SNPs) that can be used as unequivocal phylogenetic markers. Here we have used the GoldenGate (Illumina) platform to simultaneously type 1,500 of these SNPs in 62 S. Typhi isolates causing severe typhoid in children admitted to Patan Hospital in Kathmandu. Results: Eight distinct S. Typhi haplotypes were identified during the 20-month study period, with 68% of isolates belonging to a subclone of the previously defined H58 S. Typhi. This subclone was closely associated with resistance to nalidixic acid, with all isolates from this group demonstrating a resistant phenotype and harbouring the same resistance-associated SNP in GyrA (Phe83). A secondary clone, comprising 19% of isolates, was observed only during the second half of the study. Conclusions: Our data demonstrate the utility of SNP typing for monitoring bacterial populations over a defined period in a single endemic setting. We provide evidence for genotype introduction and define a nalidixic acid resistant subclone of S. Typhi, which appears to be the dominant cause of severe pediatric typhoid in Kathmandu during the study period. [ABSTRACT FROM AUTHOR]
- Published
- 2010
- Full Text
- View/download PDF
10. The sensitivity of real-time PCR amplification targeting invasive Salmonella serovars in biological specimens.
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Nga, Tran Vu Thieu, Karkey, Abhilasha, Dongol, Sabina, Thuy, Hang Nguyen, Dunstan, Sarah, Holt, Kathryn, Tu, Le Thi Phuong, Campbell, James I., Chau, Tran Thuy, Chau, Nguyen Van Vinh, Arjyal, Amit, Koirala, Samir, Basnyat, Buddha, Dolecek, Christiane, Farrar, Jeremy, and Baker, Stephen
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TYPHOID fever ,SALMONELLA diseases ,POLYMERASE chain reaction ,PATHOGENIC microorganisms ,BIOMEDICAL materials - Abstract
Background: PCR amplification for the detection of pathogens in biological material is generally considered a rapid and informative diagnostic technique. Invasive Salmonella serovars, which cause enteric fever, can be commonly cultured from the blood of infected patients. Yet, the isolation of invasive Salmonella serovars from blood is protracted and potentially insensitive. Methods: We developed and optimised a novel multiplex three colour real-time PCR assay to detect specific target sequences in the genomes of Salmonella serovars Typhi and Paratyphi A. We performed the assay on DNA extracted from blood and bone marrow samples from culture positive and negative enteric fever patients. Results: The assay was validated and demonstrated a high level of specificity and reproducibility under experimental conditions. All bone marrow samples tested positive for Salmonella, however, the sensitivity on blood samples was limited. The assay demonstrated an overall specificity of 100% (75/75) and sensitivity of 53.9% (69/128) on all biological samples. We then tested the PCR detection limit by performing bacterial counts after inoculation into blood culture bottles. Conclusions: Our findings corroborate previous clinical findings, whereby the bacterial load of S. Typhi in peripheral blood is low, often below detection by culture and, consequently, below detection by PCR. Whilst the assay may be utilised for environmental sampling or on differing biological samples, our data suggest that PCR performed directly on blood samples may be an unsuitable methodology and a potentially unachievable target for the routine diagnosis of enteric fever. [ABSTRACT FROM AUTHOR]
- Published
- 2010
- Full Text
- View/download PDF
11. The facilitators of and barriers to antimicrobial use and misuse in Lalitpur, Nepal: a qualitative study.
- Author
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Udas S, Chand OB, Shrestha B, Pathak S, Syantang S, Dahal A, Karkey A, Giri A, Shilpakar O, Basnyat B, Salami O, Nkeramahame J, Olliaro P, and Horgan P
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- Humans, Nepal, Male, Female, Adult, Health Knowledge, Attitudes, Practice, Interviews as Topic, Medication Adherence statistics & numerical data, Medication Adherence psychology, Health Personnel psychology, Health Personnel statistics & numerical data, Middle Aged, Qualitative Research, Anti-Bacterial Agents therapeutic use
- Abstract
Background: Antimicrobial resistance (AMR) is a pressing global health concern driven by inappropriate antibiotic use, which is in turn influenced by various social, systemic, and individual factors. This study, nested within FIND's AMR Diagnostic Use Accelerator clinical trial in Nepal, aimed to (i) explore the perspectives of patients, caregivers, and healthcare workers (HCWs) on antibiotic prescription adherence and (ii) assess the impact of a training and communication (T&C) intervention on adherence to antibiotic prescriptions., Methods: Using qualitative, semi-structured interviews, pre-intervention and Day 7 follow-up components, and the Behaviour Change Wheel process, we investigated the facilitators of and barriers to the use and misuse of antibiotic prescriptions., Results: Results of the study revealed that adherence to antibiotic prescriptions is influenced by a complex interplay of factors, including knowledge and understanding, forgetfulness, effective communication, expectations, beliefs and habits, attitudes and behaviours, convenience of purchasing, trust in medical effectiveness, and issues of child preferences. The T&C package was also shown to play a role in addressing specific barriers to treatment adherence., Conclusions: Overall, the results of this study provide a nuanced understanding of the challenges associated with antibiotic use and suggest that tailored interventions, informed by behaviour frameworks, can enhance prescription adherence, may be applicable in diverse settings and can contribute to the global effort to mitigate the rising threat of AMR., (© 2024. The Author(s).)
- Published
- 2024
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12. High altitude pulmonary edema (HAPE) in a Himalayan trekker: a case report.
- Author
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Shrestha P, Pun M, and Basnyat B
- Abstract
Introduction: High altitude pulmonary edema is a non-cardiogenic form of pulmonary edema that develops in unacclimatized individuals at altitudes over 2500 m. Early recognition of symptoms and immediate descent are important for successful treatment. Despite early signs and symptoms of high altitude illness, many trekkers tend to push themselves to the maximum limit. Some of them, such as the case reported here, choose to ascend on horse-back which is extremely dangerous and can be fatal., Case Presentation: A 55 years of age Indian ethnic South African lady was emergency air-lifted from 4410 m altitude in the Nepal Himalayas to Kathamandu (1300 m) with a suspected case of high altitude pulmonary edema. She had continued ascending despite experiencing mild altitude symptoms at Namche (3440 m), and these symptoms worsened considerably at Tengboche (3860 m). At the very start of her trek, just after Lukla (2800 m), she suffered from sore throat, and had consequently begun a course of antibiotics (azithromycin) for a suspected throat infection. She had planned to continue ascending on horse back to complete the trek, however her condition deteriorated further and she had to be medically evacuated.On admission to the clinic her axillary temperature was 99.4 F, blood pressure 120/60 mmHg, pulse rate 72/min, respiratory rate of 25 breaths/min, and pulse oximeter showed saturation of 90% on room air at rest. Right sided crackles on the axillary and posterior region were heard on chest auscultation. Heel to toe test showed no signs of ataxia. The chest radiograph showed patchy infiltrates on the right side. An echocardiogram was done which revealed a high pulmonary artery pressure of 50 mm of Hg. She was diagnosed as resolving high altitude pulmornay edema. She was treated with bed rest, supplemental oxygen and sustained release nifedipine 20 mg (orally) twice a day. On the third day her crackles had cleared significantly and repeat chest radiograph as shown showed remarkable improvement. She felt much better. A repeat echocardiogram revealed a normal pulmonary artery pressure., Conclusion: The case report highlights numerous points:1) Many high altitude trekkers have invested significant time, money and physical efforts in in their ventures and are determined to ascend despite early warning and illnesses. 2) Despite no history of altitude illnesses in previous altitude exposure,inter-current illness (in this case a nonspecific respiratory tract infection) may contribute to the development of high altitude pulmonary edema. 3) Continuing ascent using other transport means, whilst suffering from symptoms of high altitude illness, worsens the condition and could be life threatening. 4) Acetazolamide does not prevent high altitude pulmonary edema-perhaps more so in the cases that have inter-current illness. 5) Descent is the golden rule in all altitude illnesses. Actually 'descent' is advised in any undiagnosed illness at high altitude among sojourners. 6) Finally, an experienced guide who has mountain medicine training is essential. They can be crucial in noticing early signs and symptoms of altitude illnesses to inform the client's safety as in this case.
- Published
- 2014
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13. International hypoxia symposium XVIII: 26 February-02 March 2013.
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Pun M and Basnyat B
- Abstract
The 18th International Hypoxia Symposia, Lake Louise, Alberta, Canada, February 26-March 02, 2013, covered molecular basis of hypoxic responses (e.g., hypoxia inducible factor, nitrite, nitrate, and hemoglobin) and integrative physiology (e.g., exercise physiology, cerebral blood flow responses, live-high train-low, and population genetics). Free communications and poster sessions covered scientific areas from controlled lab settings to field settings of high altitudes (Andes to Himalayas).
- Published
- 2013
- Full Text
- View/download PDF
14. High-throughput bacterial SNP typing identifies distinct clusters of Salmonella Typhi causing typhoid in Nepalese children.
- Author
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Holt KE, Baker S, Dongol S, Basnyat B, Adhikari N, Thorson S, Pulickal AS, Song Y, Parkhill J, Farrar JJ, Murdoch DR, Kelly DF, Pollard AJ, and Dougan G
- Subjects
- Bacterial Proteins genetics, Child, Child, Preschool, Cluster Analysis, DNA Gyrase genetics, Drug Resistance, Bacterial, Female, Genotype, Haplotypes, High-Throughput Screening Assays, Humans, Infant, Male, Molecular Epidemiology, Nepal epidemiology, Salmonella typhi classification, Salmonella typhi isolation & purification, Bacterial Typing Techniques, DNA, Bacterial genetics, Polymorphism, Single Nucleotide, Salmonella typhi genetics, Typhoid Fever epidemiology, Typhoid Fever microbiology
- Abstract
Background: Salmonella Typhi (S. Typhi) causes typhoid fever, which remains an important public health issue in many developing countries. Kathmandu, the capital of Nepal, is an area of high incidence and the pediatric population appears to be at high risk of exposure and infection., Methods: We recently defined the population structure of S. Typhi, using new sequencing technologies to identify nearly 2,000 single nucleotide polymorphisms (SNPs) that can be used as unequivocal phylogenetic markers. Here we have used the GoldenGate (Illumina) platform to simultaneously type 1,500 of these SNPs in 62 S. Typhi isolates causing severe typhoid in children admitted to Patan Hospital in Kathmandu., Results: Eight distinct S. Typhi haplotypes were identified during the 20-month study period, with 68% of isolates belonging to a subclone of the previously defined H58 S. Typhi. This subclone was closely associated with resistance to nalidixic acid, with all isolates from this group demonstrating a resistant phenotype and harbouring the same resistance-associated SNP in GyrA (Phe83). A secondary clone, comprising 19% of isolates, was observed only during the second half of the study., Conclusions: Our data demonstrate the utility of SNP typing for monitoring bacterial populations over a defined period in a single endemic setting. We provide evidence for genotype introduction and define a nalidixic acid resistant subclone of S. Typhi, which appears to be the dominant cause of severe pediatric typhoid in Kathmandu during the study period.
- Published
- 2010
- Full Text
- View/download PDF
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