Browsing by Author "PB, Khadka"
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Publication Common pathogens isolated in diabetic foot infection in Bir Hospital(Kathmandu University, 2006) VK, Sharma; PB, Khadka; A, Joshi; R, SharmaAim: Foot ulcers are a frequent complication of patients suffering with diabetes mellitus, accounting for up to 20% of diabetes-related hospital admission6. Secondary infection of these ulcers is by far the leading cause of amputation of feet and legs and the polymicrobial nature of diabetic foot infection has been well documented in the literature. The present study sought to reveal the bacterial etiology of diabetic foot ulcer in patients presenting to Bir Hospital. Method: A 1 year retrospective study was carried out to analyse the bacterial isolates of all patients admitted with diabetic foot infection presented with Wagner grade 2 -5 ulcers. Bacteriological diagnosis and antibiotic sensitivity profiles were carried out and analysed using standard procedures. Results: Diabetic polyneuropathy was found to be common in (51.1%) and gram positive bacteria were isolated more often than gram-negative ones in the patients screened. The most frequent bacterial isolate were Staphylococcus aureus (38.4%), Pseudomonas aeruginosa (17.5%), and Proteus (14%). Imipenem was the most effective agent against gram-negative organisms. Vancomycine was found to be most effective against gram- positive organisms. 13 Conclusion: Staph aureus and Pseodomonas aeruginosa were the most common causes of diabetic foot infections in Bir Hospital. Theses wounds require use of combined antimicrobial therapy for initial management, repeated dressing and wound debridements were done.Publication Superficial sural artery island flap for management of exposed achilles’ tendon - Surgical techniques and clinical results(Kathmandu University, 2005) MA, Kalam; SR, Faruquee; SK, Karmokar; PB, KhadkaObjective: Superficial Sural artery island flap is a “island flap” based on vascular axis of the sural nerve which gets reverse blood flow through communication with the perforating branch of the peroneal artery situated in the region of lateral malleolar gutter. Achilles Tendon can be exposed due to trauma, post-operative wound dehiscence, infec- tion etc. This exposed tendon requires immediate coverage to avoid complications. This versatile flap provides an excellent coverage for the exposed tendoachilles and has definitive advantages such as being easy to raise, having a wide range of arc of rotation, not compromising major arteries of the leg, requiring minimal expertise and infra- structural facilities, and having less morbidity to donor site and being a single staged surgery. Methodology: Thirty patients with exposed Achilles’ tendon were treated with Superficial Sural Island Flap with excellent outcome. The present study was carried out in the Department of Plastic and Reconstructive Surgery, Na- tional Institute of Traumatology and Orthopaedics Rehabilitation (NITOR), Sher-e-Banglanagar, Dhaka, Bangladesh between January 2001 to December 2004