Journal Issue: Volume: 30, No. 3, December, 2008
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2008
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ISSN (Print) : 1993-2979 | ISSN (Online) : 1993-2987
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Articles
Indwelling catheter associated urinary tract infection
(Institute of Medicine, 2008) Poudel, CM; Baniya, G; Pokharel, BM
Abstract
Background: The objective of the study is determined the microbiological profile and the resistance pattern of the strains causing Foley’s Catheter Associated Urinary Tract Infection.
Materials and methods: It was a prospective study conducted in catheterized patients admitted in medical ward in Tribhuvan University Teaching Hospital (TUTH). A total of 100 adult patients above 16 years in whom an indwelling Foley‘s catheter inserted for short to intermediate term purpose were taken in the study. Quantitative culture of urine sample was done at the time of catheterization and was repeated on 3rd-5th day, 7th day, 10th day, 14th day and then every weekly until catheter removal or patient develops bacteriuria or until discharge of the patient at Microbiology Department Laboratory TUTH. Three ml of urine specimen were obtained aseptically and were sent to laboratory within 1 hour of collection. Antibiotic sensitivity test was done by Disk-Diffusion Technique.
Results: The most common organism causing CAUTI was found to be E.Coli in 40% of cases, followed by Klebsiella, Enterococcus, Streptococcus faecalis, Pseudomonas, Staphylococcus aureus, Acinetobacter sp.and multiple bacteria. Ninety percent of E. coli isolates tested were found to be resistant to Amphicillin, Ciprofloxacin and Cephalexin, 86% were resistant to Cotrimoxazole, Coamoxiclav, 68% to Gentamycin, 41% to Ceftazidime, 36.4% to Amikacin, 22% to Nitrofurantoin, 9% to Piperacillin and non of them were resistant to Imepenem.
Conclusion: E. coli was the most common organism causing CAUTI. E. coli was found to be resistant to most of the antibiotics. The organism was not resistent to Imepenem.
Local and systemic eosinophilia in patients with nasal polyps
(Institute of Medicine, 2008) Pradhan, RB; Shrestha, A; Pradhan, B; Adhikari, RC
Abstract
Background: To determine the presence of local and systemic eosinophilia in patients with nasal polyps and to correlate between them.
Materials and Methods: Patients of all age group, presented in ENT OPD during October 2004 to May 2006, with ethmoidal polyps were studied. Patients using steroids in last one month, antrochoanal polyps and histopathological diagnosis other than nasal polyps were excluded. The local eosinophils count in nasal polyp tissue of study group and inferior turbinate mucosa of control group were evaluated and analyzed. Similarly absolute blood eosinophil counts in both study and control group were evaluated. The association between local and systemic eosinophilia were analysed.
Results: Out of 78 patients with nasal polyps systemic eosinophilia was seen in 28 patients (35.9%) and local eosinophilia was seen in 50 (64.1%) patients. Among 30 patients of control group only 2 patients (6.7%) had systemic and none had local eosinophilia. On analyzing the results, the presence of systemic and local eosinophilia in patients with polyps were statistically significant with p value 0.005 and 0.0001 respectively. The association between them was also significant (p <0.025).
Conclusion: There is significant local and systemic eosinophilia in patients with nasal polyps and also significant correlation between them.
Keywords: Nasal polyps, Absolute blood eosinophilia, Local eosinophilia
Overview of Nasal masses
(Institute of Medicine, 2008) Pradhananga, RB; Adhikari, P; Thapa, NM; Shrestha, A; Pradhan, B
Abstract
Background: This study was performed to determine distribution of various nasal masses and correlate between clinical and histopathological diagnosis.
Methods: A prospective study of 143 cases of nasal masses were done in patients of > 13 years undergoing surgery over 2 years period (Apr.2004 to Apr.2006). All the patients with suggestive symptoms were examined and diagnosed clinically. All the patients were posted for surgical treatment and the specimens were sent for histopathological examination postoperatively, and reports were noted. The age and sex distribution with patients of various nasal masses and correlation between clinical and histological diagnosis also were analyzed.
Results: There were 78 male and 65 female operated for nasal masses. Among the nasal masses operated, the commonest was the ethmoidal polyps (53 patients, 37.06%). The ethmoidal polyps, polyps, bleeding polypus of septum and fungal polyps were common in age group of <40 years whereas inverted papilloma and malignancy were common in >40 years. The ethmoidal polyps and AC polyps were common in male whereas bleeding polypus of septum were in female. A case of venous haemangioma (histopathology) was clinically diagnosed as angiofibroma. In one clinically suspected case of ethmoidal polyps was reported as inverted papilloma. Similarly clinically diagnosed five cases of inverted papilloma were histopathologically reported as inflammatory polyps in two, angiofibroma in one and Squamous cell carcinoma in two cases.
Conclusion: The commonest nasal masses operated was ethmoidal polyps. A discrepancy between the pre-operative clinical diagnosis and final histopathological diagnosis was found in 6.3% of the patients.
Keywords: nasal masses, ethmoidal polyps, AC polyps
Enteropathogenic microorganisms in children
(Institute of Medicine, 2008) Tandulkar, S; Sherchand, O; Singh, A; Sherchand, JB
Abstract
Introduction: Diarrhoeal disease is a leading cause of mortality and morbidity in the developing world. It is one of the most important causes of death in childhood and is still a considerable public health problem in developing countries especially among less than five years old.
Materials and Methods: Stool samples from children attending both ORT centre and OPD of Kanti Children’s Hospital below 10 years of age were collected and simultaneously data on predisposing factors associated with gastroenteritis along with acute diarrhoea were collected according to the questionnaire designated. The collected stool samples were brought immediately to the laboratory. Upon arrival the stool samples were processed according to the standard laboratory methods.
Result: The distribution of enteropathogens showed that rotavirus was found highest constituting 27% of the total cases. Among parasites, protozoan (12.2%) dominated over helminthes (3.0%). Among the protozoa, Entamoeba. histolytica (7.0%) was major causative agent of dysentery followed by Giardia lambia (3.8%), Cyclospora cayetanensis (1.2%), and Entamoeba coli (0.3%). Among the helminthes, Ascaris lumbricoices was the major pathogen constituting 1.3% followed by Trichuris trichiura (0.8%), Hookworm (0.5%) and Hymenolepis nana (0.3%) of the total cases. Similarly, among bacteria Shigella spp. was highest of the total cases. Shigella dysenteriae in 2.0% (12 out of total 607); followed by Shigella flexneri in 1.0% and Shigella boydii in 0.3%. In case of Vibrio cholera it constitutes about 2.0% and Salmonella spp. in 1.3% of total cases. The study shows that the prevalence of Salmonella Paratyphi A in 0.3% (2 out of 607) followed by Salmonella Paratyphi B in 0.3% and Salmonella Typhi in 0.6%.
Conclusion: It can be concluded that lots of enteropathogens were involved in children diarrhoea. Among them rotavirus were predominant followed by parasites and bacteria. Children under 2 years were more affected age groups.
Keywords: Diarrhoea, Enteropathogens, Rotavirus, Bacteria and Parasites