Browsing by Author "Gupta, M"
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Publication Antibiotic Usage and its Culture Sensitivity Pattern in Urinary Tract Infections at Tertiary Hospital in Eastern Nepal(Kathmandu University, 2017) Panday, DR; Amar, A; Subedi, A; Hussain, Md S; Gupta, M; Rauniar, GPABSTRACT Background The presence of microbial pathogen in the urinary tract is Urinary Tract Infection (UTI). In BP Koirala Institute of Health Sciences (BPKIHS), each year there are around 1000 cases of UTIs. Antibiotic is empirically started after sending culture/sensitivity (c/s) with intention to change antibiotic if c/s demands. Objective To see the antimicrobial prescribing pattern and c/s pattern of UTI inpatients of BPKIHS together with their socio-demographic and laboratory profile. Method It was a Record-Based Retrospective Descriptive Study of past one-year. All available inpatient-records from Medical-Record Section were extensively searched for the keyword “UTI” diagnosis. The relevant data were entered in Microsoft Excel-sheet and analyzed with IBM SPSS 21. Ethical clearance was obtained from the IRC before study. Result There were 86 cases from four different wards. There was slight female preponderance (51.16%). Fifty-five (63.95%) cases were complicated. Fever (75.51%) was the most common symptom. Only 20% were tachycardic but 90% were tachypnic. Leucocytosis (59.26%), urine albumin within 30-100 mg/dl (33.85%) and >5 Urine WBC/hpf (80.26%) were seen. Ceftiaxone (53.16%) was the most commonly prescribed empirical antibiotic, followed by Cefixime (6.32%). Fourteen (16.27%) cases were culture positive. E. coli was the most (78.57%) common pathogen grown. In culture sensitivity study, Amikacin (42.85%) was the most sensitive antibiotic. Conclusion Eighty-six UTI inpatients were identified last year. Fever and Tachypnoea were very common. Leucocytosis, 1+ proteinuria and urine WBC>5/hpf were frequently seen. Ceftriaxone was the most common antibiotic prescribed. E. coli was the most common pathogen grown and Amikacin was the most sensitive antibiotic. KEY WORDS Antimicrobial, Inpatients, Urinary tract infectionPublication Prevalence Survey of Antimicrobial Use among Admitted Patients in Tertiary Care hospital: An observational study(Kathmandu University, 2025) Aryal, S; Joshi, M; Uprety, BN; Shrestha, RK; Gupta, M; Shah, P; Rajbhandari, P; Amatya, R; Shrestha, P; Ojha, ARABSTRACT Background Monitoring the antimicrobial use is one of the key strategies to address the growing global threat of antimicrobial resistance. Objective To find out antimicrobial usage at tertiary care hospital of Lalitpur, Nepal. Result An observational cross-sectional study was carried out at the Patan Academy of Health Sciences, Lalitpur, Nepal on September 25 and 26, 2023. World Health Organization point prevalence survey methodology was used with minor modification to meet hospital’s context. The data on antimicrobial usage were collected from the medical records of patients admitted at or before 08:00 am on the day of the study in the acute care ward. Result The study involved 324 inpatients, with females comprising 176 (54.3%) and males 148(45.7%). The mean age was 37.89 years ± 24.87. Antibiotics usage was 78.1%. A total of 471 drug was prescribed of which 312 (66.2%) was used for therapeutic purpose and 159 (33.8%) for prophylaxis. Of 312 antibiotics, 283 (90.7%) were utilized empirically. Majority of prescribed medications belonged to watch group 16 (48.5%). Ceftriaxone was the most frequently prescribed antibiotic 142 (30.1%) and was the preferred choice for surgical prophylaxis 68 (94.4%). A total of 24 (72.7%) drugs were prescribed from the National List of Essential Medicines and 432 (91.7%) prescriptions were written using generic names. Conclusion The use of antibiotic was high, with good adherence to essential medicines and generic prescribing. Strengthening antimicrobial stewardship and evidence-based practices can further optimize prescribing, enhance patient safety and help combat antimicrobial resistance effectively. KEY WORDS Antibiotic, Nepal, Point prevalence survey, Tertiary care hospitalPublication Ultrastructure of Chondrocytes in Osteoarthritic Femoral Articular Cartilage(Kathmandu University, 2013) Goyal, N; Gupta, M; Joshi, KABSTRACT Background Osteoarthritis (OA) is a common problem in elderly, but it is not an inevitable feature of ageing. About 80-90% of individuals of both sexes have radiographic evidence of OA by the time they reach an age of 65. But not all of them have the symptoms like pain and decreased joint motion. Objective The objective of the present study was conducted to find out whether the osteoarthritic changes in human articular cartilage are similar to the ageing process or not. Methods Femoral articular cartilage specimens obtained from 13 osteoarthritic patients (52-80years) undergoing total knee replacement and 9 cadavers of same age group (50-80years) (control) were processed and studied under electron microscope. The ultrastructure of the cartilage from the two groups was compared with each other. Results Under the electron microscope, articular cartilage from control group had chondrocytes having a secretary cell characteristic with prominent nucleus and well developed organelles. In osteoarthritic cartilage, degenerating or necrotic chondrocytes were found. Nuclei of these chondrocytes appeared lobulated or indented. Chondrocytes below the fibrillated surface had dilated and irregular endoplasmic reticulum. Electron dense lipid deposits in the extracelluar matrix as well as intracytoplasmic glycogen deposits were much increased in osteoarthritic cartilage as compared to the control group. Amount of perinuclear intracytoplasmic fine filaments was also increased in the chondrocytes of osteoarthritic cartilage. Conclusion Ultrastructural findings of the osteoarthritic articular cartilage were much different from the ageing non-osteoarthritic cartilage. Hence, OA should be considered a specific process and not simply an inevitable feature of ageing. KEY WORDS Chondrocyte, fibrillation, necrotic cells, osteoarthritis