Browsing by Author "Mishra, B"
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Publication Latex Agglutination Test for Early Detection of Causative Organism in Acute Bacterial Meningitis(Nepal Paediatric Society (JNPS), 2013) Mishra, B; Mahaseth, C; Rayamajhi, AAbstract: Introduction: Acute bacterial meningitis is one of the leading causes of mortality and morbidity in children. Identification of the causative organism is crucial to its management and outcome. The objective of this study was to see the usefulness of latex agglutination test in the early diagnosis of acute bacterial meningitis. Materials and Methods: A hospital based prospective cross-sectional study was conducted at Kanti Children’s Hospital during December 2004 to August 2005. Cerebrospinal fluid from 150 consecutive clinically suspected cases of acute bacterial meningitis between the age group of 2 months to 14 years were analyzed. Bacterial culture and latex agglutination test was done on cerebrospinal fluid obtained from all 150 suspected cases of acute bacterial meningitis. Latex agglutination test was done using the BD DirectigenTM Meningitis Combo test kit (Becton, Dickinson and company, USA) for Streptococcus pneumoniae, group B Streptococcus, Escherichia coli, Neisseria meningitidis group A,C and Y/ W135, and Hemophilus influenzae type b. Data was analysed by using SPSS Version 11.5. Results: Of the 150 Cerebrospinal fluid samples analysed bacterial culture identified only 4 meningitis cases giving an isolation rate of 1.3% whereas latex agglutination test identified 29 cases giving an isolation rate of 19.3% from 150 samples. Streptococcus pneumoniae, Hemophilus influenzae type b and Group B Streptococcus were the most common causative organism. Conclusion: Latex agglutination test has a better yield, higher sensitivity, provides microbiological diagnosis earlier than the traditional cerebrospinal fluid culture and is easy to perform.Publication Learning, education and satisfaction after compulsory rotating internship in Kathmandu University Medical School: A qualitative study of interns’ response(Kathmandu University, 2008) Shrestha, D; Mishra, BAbstract Background: Internship is an integral part of MBBS training programme and mandatory to all students. Kathmandu University Medical School has adopted a programme of compulsory one year rotating internship including 6 weeks community exposure in out reach clinics for the first batch of students. The purpose of the study is to evaluate interns’ feedback concerning learning, education and satisfaction. Materials and methods: A questionnaire with 47 items was administered to 30 interns who had finished one year rotating internship in Kathmandu University Medical School. Fourty-two responses were graded according in Likert scale and 5 open ended questions were analyzed for common themes. Results: The mean age of the interns was 24.77±0.67 yrs with female: male ratio of 1.5:1. Confidence level of communication of interns with faculties was lesser than with junior doctors and patients. Junior doctors and colleagues contributed more in interns’ learning than faculties. Community exposure for 6 weeks was considered lengthy and lacking of clear objectives. However, 53.3% interns agreed that achievement of objectives of community posting was high or very high. Of the interns, 50% perceived certain degree of physical or mental or sexual harassments during internship. Interns raised the issue of not involving them as a part of team during clinical posting. Clinical competencies for most of the skills were high or very high. Conclusion: Interns have learned clinical skills and patient care in one year internship programme but contribution of junior doctors and colleague are more than teachers. Clear objectives are needed before clinical and community postings. Process of providing regular feedback from interns and vice versa should be implemented to improve interns’ learning, education and satisfaction Key words: Clinical skills; Communication; Community postings; Education; Internship; HarassmentsPublication Prevalence of anaemia among females of the reproductive age group visiting Chisapani dispensary(Institute of Medicine, 1999) Bhatia, V; Manandhar, N; Mishra, B; Bista, S; Shah, MAbstract Anaemia is one of the major health problems in Nepal. Nutritional anaemia is one of the commonest forms of anaemia and affects chiefly the females in the reproductive age group. The available data from the hospital records and small-scale studies put the estimate to more than 50%. There are other figures that project the range from 60- 75% among this group. The present study was conducted on females of the reproductive age group visiting the dispensary attached to Nepalgunj Medical College, Chisapani. The total number of females included in the study was 71. Nearly 65% were less than 30 years of age. The literacy rate was around 39.4%. Among the 66 married females, the number of children ranged from 0-7. Among the subjects, 79% were found to be anaemic. The proportion of female with anaemia was not associated with increasing age or education of the subjects but some degree of association could be observed with increasing number of children. Usage of temporary contraceptive was also found to be associated with a larger proportion of females being anaemic. The degree of contribution made by hookworm infestation to the present figures of anaemia cannot be commented upon in numerical terms but could be high. Keywords: Anaemia, Reproductive age-group, femalesPublication Viral infections in sudden hearing loss. Do we have enough evidence?(Kathmandu University, 2005) Mishra, B; Panda, N; Singh, MP; Ratho, RKObjective: The aetiology of sudden deafness remains unknown even though some evidences suggest that it could be viral in origin. This study aimed to find out the relationship between viral infections and sudden sensorineural hearing loss. Methods: 32 patients presenting with sudden deafness and 10 healthy controls were included in the study. IgM antibodies to varicella zoster virus, measles, cytomegalovirus and herpes simplex virus were detected using micro ELISA. Results: Overall, 7(21.8%) patients showed seropositivity to one or more viruses. Virus specific IgM antibodies against measles and varicella zoster could be demonstrated in 4 (12.5%) and 3 (9.4%) patients respectively. None of the samples were found to be positive for herpes simplex virus (HSV) and human cytomegalovirus (HCMV) specific IgM antibodies. Controls were negative for all the viruses tested. The difference in seropositivity between the patient and control group was not statistically significant (p>0.05). Conclusion: Thus, this study suggests that sudden deafness is not commonly associated with a systemic viral infection. Key Words: Sudden deafness, viruses, serology.