Prasana Khatiwoda - Academia.edu (original) (raw)

Uploads

Papers by Prasana Khatiwoda

Research paper thumbnail of Facilitators and Barriers to Naloxone Kit Use Among Opioid-Dependent Patients Seeking Treatment at Medication Assisted Therapy Clinics in North Carolina, USA ABSTRACT Facilitators and Barriers to Naloxone Kit Use Among Opioid-Dependent Patients Seeking Treatment at Medication Assisted Therapy Cli...

Naloxone-an opioid antagonist that reverses the effects of opioids, including potential death fro... more Naloxone-an opioid antagonist that reverses the effects of opioids, including potential death from overdose-is increasingly being distributed in non-medical settings. We conducted a mixed methods study administering a survey to 100 treatment seekers and pursuing observant participation at four methadone/buprenorphine

Research paper thumbnail of Citation

Dermatomyositis (DM) is a chronic inflammatory disorder that can affect the skin, muscle, and oth... more Dermatomyositis (DM) is a chronic inflammatory disorder that can affect the skin, muscle, and other organs and is associated with significant morbidity and mortality.1-6 The prevalence of DM is not well-defined, as it is historically

Research paper thumbnail of Facilitators and Barriers to Naloxone Kit Use Among Opioid-Dependent Patients Seeking Treatment at Medication Assisted Therapy Clinics in North Carolina, USA

Research paper thumbnail of Attitudes and behaviors that differentiate clergy with positive mental health from those with burnout

Journal of Prevention & Intervention in the Community, 2019

Research paper thumbnail of Low knowledge and perceived Hepatitis C risk despite high risk behaviour among injection drug users in Kathmandu, Nepal

International Journal of Drug Policy, 2016

In Nepal, prevalence of Hepatitis C (HCV) among injecting drug users (IDUs) has been measured at ... more In Nepal, prevalence of Hepatitis C (HCV) among injecting drug users (IDUs) has been measured at 50% and knowledge of the virus is low. Rehabilitation and harm reduction attendees constitute populations to whom health care providers can deliver services. As such, characterizing their drug use and risk profiles is important for developing targeted service delivery. We measured drug use and risk patterns of IDUs participating in residential rehabilitation as well as those contacted through needle exchanges to identify correlates of drug use frequency, risky injection practices as well as HCV testing, knowledge and perceived risk. We collected cross-sectional data from one-on-one structured interviews of IDUs contacted through needle-exchange outreach workers (n=202) and those attending rehabilitation centres (behaviour immediately prior to joining rehabilitation) (n=167). Roughly half of participants reported injecting at least 30 times in the past 30 days and individuals with previous residential rehabilitation experience reported frequent injection far more than those without it. About one in fourteen respondents reported past week risky injection practices. Participants were over three times as likely to report risky injection if they consumed alcohol daily (17.2%) than if they did not (5.0%) (p=0.002). Those who reported injecting daily reported risky injection practices (11.9%) significantly more than non-daily injectors (1.8%) (p<0.001). Respondents reported high HCV infection rates, low perceived risk, testing history and knowledge. HCV knowledge was not associated with differences in risky injecting. Treatment centres should highlight the link between heavy drinking, frequent injection and risky injecting practices. The link between rehabilitation attendance and frequent injection may suggest IDUs with more severe use patterns are more likely to attend rehabilitation. Rehabilitation centres and needle exchanges should provide testing and education for HCV. Education alone may not be sufficient to initiate change since knowledge did not predict lower risk.

Research paper thumbnail of Mucormycosis in diabetes mellitus

Journal of Advances in Internal Medicine, 2012

Mucormycosis is an opportunistic fulminant fungal infection, which mainly infects immunocompromis... more Mucormycosis is an opportunistic fulminant fungal infection, which mainly infects immunocompromised patients. Infection with mucormycosis can cause devastating rhino-orbital-cerebral and pulmonary infection with an extremely poor prognosis. The infection begins in the nose and paranasal sinuses due to inhalation of fungal spores. We report a case of mucormycosis in an uncontrolled diabetic patient to emphasize early diagnosis of this potentially fatal fungal infection. Rhino-orbitalcerebral mucormycosis is the most common manifestation in patients with diabetes mellitus. We also review the current concepts in management of mucormycosis. Mucormycosis remains difficult to treat and requires a multifaceted approach involving elimination of predisposing factors, surgical debridement, and anti-fungal therapy. Lipid formulations of Amphotericin B are the treatments of choice. DOI: http://dx.doi.org/10.3126/jaim.v1i2.6531 Journal of Advances in Internal Medicine 2012;01(02):73-75

Research paper thumbnail of A Fatal Presentation of Dermatomyositis

Kathmandu University Medical Journal, 2013

Dermatomyositis (DM) is an autoimmune disease that mainly affects the skin, muscle, and lung. The... more Dermatomyositis (DM) is an autoimmune disease that mainly affects the skin, muscle, and lung. The pathogenesis of skin inflammation in DM is not well understood. We present a 40-year-old male who presented with four months history of generalized skin lesion, pain and weakness. He had elevated transaminases with detectable muscle weakness. This case highlights the need to consider dermatomyositis with skin lesion and weakness; and the use of aggressive immunosuppressive therapies due to its associated vasculopathies. Kathmandu University Medical Journal | VOL.10 | NO. 3 | ISSUE 39 | JUL- SEP 2012 | Page 78-82 DOI: http://dx.doi.org/10.3126/kumj.v10i3.8027

Research paper thumbnail of Facilitators and Barriers to Naloxone Kit Use Among Opioid-Dependent Patients Enrolled in Medication Assisted Therapy Clinics in North Carolina

North Carolina Medical Journal, 2018

Research paper thumbnail of Facilitators and Barriers to Naloxone Kit Use Among Opioid-Dependent Patients Seeking Treatment at Medication Assisted Therapy Clinics in North Carolina, USA ABSTRACT Facilitators and Barriers to Naloxone Kit Use Among Opioid-Dependent Patients Seeking Treatment at Medication Assisted Therapy Cli...

Naloxone-an opioid antagonist that reverses the effects of opioids, including potential death fro... more Naloxone-an opioid antagonist that reverses the effects of opioids, including potential death from overdose-is increasingly being distributed in non-medical settings. We conducted a mixed methods study administering a survey to 100 treatment seekers and pursuing observant participation at four methadone/buprenorphine

Research paper thumbnail of Citation

Dermatomyositis (DM) is a chronic inflammatory disorder that can affect the skin, muscle, and oth... more Dermatomyositis (DM) is a chronic inflammatory disorder that can affect the skin, muscle, and other organs and is associated with significant morbidity and mortality.1-6 The prevalence of DM is not well-defined, as it is historically

Research paper thumbnail of Facilitators and Barriers to Naloxone Kit Use Among Opioid-Dependent Patients Seeking Treatment at Medication Assisted Therapy Clinics in North Carolina, USA

Research paper thumbnail of Attitudes and behaviors that differentiate clergy with positive mental health from those with burnout

Journal of Prevention & Intervention in the Community, 2019

Research paper thumbnail of Low knowledge and perceived Hepatitis C risk despite high risk behaviour among injection drug users in Kathmandu, Nepal

International Journal of Drug Policy, 2016

In Nepal, prevalence of Hepatitis C (HCV) among injecting drug users (IDUs) has been measured at ... more In Nepal, prevalence of Hepatitis C (HCV) among injecting drug users (IDUs) has been measured at 50% and knowledge of the virus is low. Rehabilitation and harm reduction attendees constitute populations to whom health care providers can deliver services. As such, characterizing their drug use and risk profiles is important for developing targeted service delivery. We measured drug use and risk patterns of IDUs participating in residential rehabilitation as well as those contacted through needle exchanges to identify correlates of drug use frequency, risky injection practices as well as HCV testing, knowledge and perceived risk. We collected cross-sectional data from one-on-one structured interviews of IDUs contacted through needle-exchange outreach workers (n=202) and those attending rehabilitation centres (behaviour immediately prior to joining rehabilitation) (n=167). Roughly half of participants reported injecting at least 30 times in the past 30 days and individuals with previous residential rehabilitation experience reported frequent injection far more than those without it. About one in fourteen respondents reported past week risky injection practices. Participants were over three times as likely to report risky injection if they consumed alcohol daily (17.2%) than if they did not (5.0%) (p=0.002). Those who reported injecting daily reported risky injection practices (11.9%) significantly more than non-daily injectors (1.8%) (p<0.001). Respondents reported high HCV infection rates, low perceived risk, testing history and knowledge. HCV knowledge was not associated with differences in risky injecting. Treatment centres should highlight the link between heavy drinking, frequent injection and risky injecting practices. The link between rehabilitation attendance and frequent injection may suggest IDUs with more severe use patterns are more likely to attend rehabilitation. Rehabilitation centres and needle exchanges should provide testing and education for HCV. Education alone may not be sufficient to initiate change since knowledge did not predict lower risk.

Research paper thumbnail of Mucormycosis in diabetes mellitus

Journal of Advances in Internal Medicine, 2012

Mucormycosis is an opportunistic fulminant fungal infection, which mainly infects immunocompromis... more Mucormycosis is an opportunistic fulminant fungal infection, which mainly infects immunocompromised patients. Infection with mucormycosis can cause devastating rhino-orbital-cerebral and pulmonary infection with an extremely poor prognosis. The infection begins in the nose and paranasal sinuses due to inhalation of fungal spores. We report a case of mucormycosis in an uncontrolled diabetic patient to emphasize early diagnosis of this potentially fatal fungal infection. Rhino-orbitalcerebral mucormycosis is the most common manifestation in patients with diabetes mellitus. We also review the current concepts in management of mucormycosis. Mucormycosis remains difficult to treat and requires a multifaceted approach involving elimination of predisposing factors, surgical debridement, and anti-fungal therapy. Lipid formulations of Amphotericin B are the treatments of choice. DOI: http://dx.doi.org/10.3126/jaim.v1i2.6531 Journal of Advances in Internal Medicine 2012;01(02):73-75

Research paper thumbnail of A Fatal Presentation of Dermatomyositis

Kathmandu University Medical Journal, 2013

Dermatomyositis (DM) is an autoimmune disease that mainly affects the skin, muscle, and lung. The... more Dermatomyositis (DM) is an autoimmune disease that mainly affects the skin, muscle, and lung. The pathogenesis of skin inflammation in DM is not well understood. We present a 40-year-old male who presented with four months history of generalized skin lesion, pain and weakness. He had elevated transaminases with detectable muscle weakness. This case highlights the need to consider dermatomyositis with skin lesion and weakness; and the use of aggressive immunosuppressive therapies due to its associated vasculopathies. Kathmandu University Medical Journal | VOL.10 | NO. 3 | ISSUE 39 | JUL- SEP 2012 | Page 78-82 DOI: http://dx.doi.org/10.3126/kumj.v10i3.8027

Research paper thumbnail of Facilitators and Barriers to Naloxone Kit Use Among Opioid-Dependent Patients Enrolled in Medication Assisted Therapy Clinics in North Carolina

North Carolina Medical Journal, 2018