Browsing by Author "Timilsina, B"
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Publication Effectiveness of Mannheim Peritonitis Index in Predicting the Morbidity and Mortality of Patients with Hollow Viscus Perforation(Kathmandu University, 2018) Karki, OB; Hazra, NK; Timilsina, B; Kunwar, DABSTRACT Background Peritonitis due to hollow viscus perforation is one of common surgical emergency. Its accurate diagnosis and management is a challenge to every surgeon. This led to the development of disease severity grading systems that would aid in management and appropriately predict possible outcome. Objective Evaluation of Mannheim Peritonitis Index (MPI) score for predicting the morbidity and mortality in patients with peritonitis due to hollow viscus perforation. Method Prospective study of 126 patients operated for perforation peritonitis in Manipal College of Medical Sciences, Pokhara, Nepal from May 2015 to April 2018. Mannheim Peritonitis Index score was calculated for each patient. Data was analysed for predicting mortality and morbidity using SPSS 20. Pearson’s Chisquare was used as a statistical test and considered as significant difference if p ≤ 0.05. Result Perforated appendix (35.7%), peptic ulcer perforation (31%) and truma (19%) were common causes of perforation peritonitis. Mean score was 18.55. The overall mortality and morbidity was 9% and 43% respectively with Mannheim Peritonitis Index scores of ≤ 20, 21-29, and ≥ 30 had a mortality of 0%, 14%, and 46% respectively. Presence of generalized peritonitis, organ failure at time of admission, type of intra peritoneal exudate carried more significance in predicting the mortality and morbidity in the post op period than other variables. Conclusion Mannheim Peritonitis Index is a simple and specific scoring system for predicting the mortality in patients with secondary peritonitis. Increasing scores are associated with poorer prognosis, needs intensive management. KEY WORDS Mannheim peritonitis index, Morbidity, Mortality, Perforation peritonitisPublication Mobile Phone: A Possible Vector of Bacterial Transmission in Hospital Setting(Kathmandu University, 2017) Karkee, P; Madhup, SK; Humagain, P; Thaku, N; Timilsina, BABSTRACT Background Mobile phones of Health Care Workers (HCWs) are capable of harbouring microorganisms that can potentially cause nosocomial infections. Frequent movement of hospital staff inside and outside the hospital can augment bacterial transmission inside hospital and even to the community. Objective To screen the mobile phones of Health Care Workers for potential pathogens and perform microbiological study of the isolates. Methods A cross sectional study was conducted in 124 Health Care Workers of different departments of tertiary care hospital. Swabs were taken from their mobile phones, processed immediately and identified and their antibiotic suceptibility pattern was studied. Results This study revealed that bacterial growth was positive for pathogenic organisms in 89 out of 124 (71.8%) mobile phones out of which 33 (82.5%) were of male and 56 (66.7%) of female. However, there was no significant association between gender and isolation of pathogens. Single pathogen was isolated in 74 (59.7%) of mobile phones and multiple pathogens were isolated in 15(12.1%). Amongst them, most common pathogen isolated was Coagulase Negative Staphylococcus (CoNS) (56.7%) followed by Micrococcus spp., Escherichia. coli, Enterobacter spp., Acinetobacter spp., Staphylococcus. aureus, Klebsiella spp. and Enterococcus spp. Most of the Gram Positive Cocci (GPC) were sensitive to Vancomycin (81.9%) and Ciprofloxacin (88%) while were resistant to Penicillin(83.1%). For Gram negative bacteria sensitivity to ciprofloxacin ranged from 83.33% to 100% . Conclusion Mobile phones are possible vectors of bacterial transmission and therefore are constant threat to the lives of already seriously ill patients as well as healthy individuals visiting the hospital. So it is recommended to make infection control guidelines which target the use of suitable disinfectants to avoid mobile phone contamination. KEY WORDS Antibiotics, Health care workers, Mobile phones, Nosocomial infection