Browsing by Author "Jha, BK"
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Publication Case of necrotizing fasciitis of breast in a young lactating mother(Institute of Medicine, 2018) Jha, P; Jha, BKAbstract Introduction: Necrotizing fasciitis is an infection of soft tissues associated with a high risk of mortality. Primary necrotizing fasciitis of breast is an extremely rare condition with very few cases reported in literature. Case presentation: This case report describes a 19 year old Hindu female with necrotizing fasciitis of left breast. Patient was managed with intravenous antibiotics, early aggressive debridement, daily dressing followed by split thickness skin grafting. Conclusion: Though necrotizing fasciitis of breast is a rare condition, it should be suspected in a patient with pain and swelling of breast. Keywords: Necrotizing fasciitis, BreastPublication Characterization of candida species isolated from cases of lower respiratory tract infection(Kathmandu University, 2006) Jha, BK; Dey, S; Tamang, MD; Joshy, ME; Shivananda, PG; Brahmadatan, KNObjectives: (1) To identify and characterize the Candida species isolates from lower respiratory tract infection. (2) to determine the rate of isolation of Candida species from sputum samples. Methods: This study was carried out in the Department of Microbiology, Manipal Teaching Hospital, Pokhara, Nepal from June 2002 to January 2003. A total of 462 sputum samples were collected from patients suspected lower respiratory tract infection. The samples were processed as Gram staining to find out the suitability of the specimen, cultured on Sabouraud’s Dextrose Agar (SDA) and also on blood agar and chocolate agar to identify the potential lower respiratory tract pathogens. For the identification of Candida, sputum samples were processed for Gram stain, culture, germ tube test, production of chlamydospore, sugar fermentation and assimilation test. For the identification of bacteria, Gram stain, culture, and biochemical tests were performed by standardized procedure. Result: Out of 462 samples, 246 (53.24%) samples grew potential pathogens of lower respiratory tract. Among them Haemophilus influenzae 61(24.79%) and Streptococcus pneumoniae 57 (23.17%) were the predominant bacterial pathogens. Candida species were isolated from 30 samples (12.2%). The majority of Candida species amongst the Candida isolates were Candida albicans 21(70%) followed by Candida tropicalis 4(13.33%). Candida krusei 3(10%), Candida parapsilosis 1(3.33%) and Candida stellatoidea 1(3.33%). The highest rate of isolation of Candida was between the age of 71 and 80. Conclusion: Candida isolation from sputum samples is important as found in the present study in which Candida species were the third most common pathogen isolated from patients with lower respiratory tract infection. Key words: Candida albicans, Pulmonary candidiasis, NepalPublication Extraintestinal Gastrointestinal Stromal Tumor arising from parietal wall: A rare entity(Institute of Medicine, 2018) Jha, BK; Jha, P; Vaidya, P; Kansakar, PBS; Manandhar, SAbstract Extraintestinal gastrointestinal stromal tumors (E-GIST) are rare types of GIST most commonly involving the mesentry, omentum and retroperitoneum. Parietal wall E-GIST are very rare. Very few cases have been reported in the literature. Keywords: GIST, parietal wallPublication Prenatal diagnosis of congenital anomalies and their outcome in Tribhuvan University Teaching Hospital(Institute of Medicine, 2017) Jha, BK; Jha, P; Dahal, GR; Pokharel, RPAbstract Introduction: Congenital anomalies represent defects in morphogenesis during early fetal life. The proportion of perinatal deaths due to congenital anomalies is increasing in developing countries like Nepal as a result of reduction of mortality due to other causes. Methods: A retrospective study was conducted in the Pediatric Surgery Unit, Department of Surgery, Tribhuvan University Teaching Hospital (TUTH). Data were collected from patients’ hospital files from 2013 to 2015 AD. Result: A total of 33 patients who had congenital anomalies either diagnosed and referred from outside or diagnosed at TUTH were included. Various types of anomalies involving different body systems were identified during the prenatal period. But surgery was performed in only seven cases. Conclusion: Due to widespread availability of ultrasound the number of patients with congenital anomalies who are being detected is on the rise. The proper management of these children in the intrauterine and neonatal period is a challenge in our context. Lack of proper policy and resources is a big hindrance to the proper management of these group of patients. Keywords: Congenital anomalies, Surgery, NepalPublication Prevalence of asymptomatic bacteriuria among elderly diabetic patients residing in Chitwan(Kathmandu University, 2009) Jha, BK; Singh, YI; Khanal, LK; Yadab, VC; Sanjana, RKAbstract Background: A retrospective study was done on Asymptomatic Bacteriuria (ASB), among elderly diabetic patients residing in Chitwan, Nepal from 1st January 2006 to 12th December 2006. Diabetic patients above 40 years of age were included in this study where as below 40 years of age group were excluded. Objective: To study the prevalence of ASB among elderly diabetic patients for the Bacteriological profile and their antibiotic susceptibility pattern. Materials and methods: Urine sample was collected from 636 diabetic patients above 40 years age attending College of Medical Sciences Teaching Hospital for regular blood sugar estimation. Culture and Antibiotic susceptibility test (AST) were performed using standard microbiological technique. ASB was determined as presence of > 105 bacteria/ml in a culture of urine sample. Results: The prevalence of ASB among diabetic patients in Bharatpur was found to be 9.43% (12.07% in females and 5.08% in males). The most common bacterial isolate was Escherichia coli (41.66%). Nitrofurantoin, Cefotaxime and Chloramphenicol were the most effective drugs for the majority of isolates. Conclusion: The study shows necessity of regular urine culture to detect ASB, along with blood sugar estimation for diabetic patients to prevent them from further complications due to it. Key words: Diabetic, ASB, Common pathogen and ASTPublication Prevalence of asymptomatic bacteriuria in school going children in Pokhara valley(Kathmandu University, 2007) Jha, BK; Singh, YObjectives: There were mainly two objectives of the study. One was to detect bacteriuria in school going children in Pokhara valley and the other was to identify the causative organisms in various age groups in children. Materials and methods: This study was carried out in the Microbiology laboratory of The School of Pharmaceutical and Biomedical Sciences, Simalchaur, Pokhara University, Nepal. A total of 502 urine samples of 5 to 13 years children from different schools of Pokhara valley were screened to see asymptomatic bacteriuria during January 2005 to June 2005. A sterile wide mouth container was given to each student to collect mid- stream urine samples. All the urine samples were transported to the Microbiology laboratory within half an hour to one hour. The samples were processed for microscopical examination to observe for turbidity and the presence of protein and sugar by dipstick method, microscopical examination to see pus cells, RBCs, epithelial cells, casts and crystals, culture of urine samples on Blood agar and MacConkey agar to identify the potential pathogens. The antibiotic sensitivity test was performed for those bacteria which were grown on culture. The colony count was evaluated and organisms were identified by biochemical tests. Result: Out of 502 samples, 7(1.39%) samples grew the bacterial pathogens that are responsible to cause urinary tract infection. Among them Escherichia coli 4(57.14%) was the predominant bacterial pathogen. Conclusion: Study of asymptomatic bacteriuria is important as found in the present study in which Escherichia coli was the most frequently incriminated as the causative agents. Key words: Asymptomatic bacteriuria, Escherichia coli, childrenPublication Prevalence of Moraxella catarrhalis infections of the lower respiratory tract in elderly patients(Kathmandu University, 2005) Tamang, MD; Dey, S; Makaju, RK; Jha, BK; Shivananda, PG; Bhramadatan, KNObjectives: To determine: • rate of isolation of Moraxella catarrhalis in elderly patients having lower respiratory tract infection • The antibiotic susceptibility pattern of Moraxella catarrhalis isolates. • The predisposing factors responsible for Moraxella catarrhalis infections of lower respiratory tract. Material and Method: This is a prospective study carried out at Manipal Teaching Hospital, Pokhara during May 2002 to April 2003. A total of 716 sputum samples collected from patients with suspected lower respiratory tract infection were investigated. The samples were subjected to Gram stain, culture and sensitivity. Sputum samples were inoculated on blood and chocolate agar and incubated at 370C for 18 to 24 hours in candle jar containing 3-5% Co2. For the identification of bacterial isolates, the cultural and colonial characteristics were recorded and identified with the use of biochemical test. The susceptibility of bacterial isolates to antimicrobial agent was performed following Kirby-Bauer method. Result: Out of the 716 samples, 355 (49.58%) grew normal commensals of the upper respiratory tract. Respiratory pathogens were recovered from 361 (50.41%) samples. The most common respiratory pathogen was H. influenzae (26. 86%), followed by S. pneumoniae (21.16%). Moraxella catarrhalis accounted for 6.90%. Rate of isolation of Moraxella catarrhalis was higher in males than in females. Out of 25 isolates 16 were from males and 9 were from females. Frequency of isolation of Moraxella catarrhalis was more frequently seen in age group 61-70 years. It was most commonly recovered in winter. The most effective antibiotics were amoxicillin-clavulanate and ceftriaxone and least was ampicillin. Conclusion: Moraxella catarrhalis isolation from sputum especially in persons above 60 years of age and in the absence of other well established pathogens should not be disregarded as they can cause lower respiratory tract infection in these individuals. Key words: Moraxella catarrhalis, lower respiratory tract infection, Nepal, Gram negative diplococci