Journal Issue: No 1, Issue 21, JAN-MAR, 2008
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Volume
Number
Issue Date
2008
Journal Title
Journal ISSN
1812-2027
Journal Volume
Articles
Uncorrected refractive errors (URE): The preventable blindness
(Kathmandu University, 2008) OK, Malla
NA
Changing spectrum of antibiotic sensitivity in enteric fever
(Kathmandu University, 2008) Neopane, A; Singh, SB; Bhatta, R; Dhital, B; Karki, DB
Abstract
Aims and objectives: The study was designed to analyze clinical profile and Antibiotic sensitivity pattern in case of
culture positive typhoid fever and compare response of quinolones in vitro and in vivo.
Methodology: Forty eight cases of culture positive enteric fever presented in outpatient and emergency department
of Kathmandu Medical College, Sinamangal, and Kathmandu were included in the study. Sensitivity pattern of
isolates from blood culture was done by antibiotic disc diffusion method and this was compared with clinical
response.
Results: Response was based on Fever Clearance Time (FCT) and it was found that mean FCT was 3.58 days with
standard deviation of 1.84 .Comparison was made separately for FCT ≥5 days and it was found that vomiting as the
symptom and stool occult blood positive as the investigation to predict prolong FCT. Nalidixic acid as compared
with other quinolones showed that other quinolones (ciprofloxacin, ofloxacin) are effective even in Nalidixic acid
resistant cases when FCT was taken as the criteria of response, and it doesn’t include the relapse rate.
Conclusion: Enteric fever is one of the leading causes of fever in Nepal. The diagnosis in most of the cases is done
empirically by clinical features, but culture and sensitivity of blood or bone marrow is the gold standard way of
diagnosis and providing treatment. The antibiotic sensitivity pattern is changing and resistance cases are emerging
with indiscriminate use of drugs.
Key words: Enteric fever, Salmonella typhi, fever clearance time (FCT), antibiotic sensitivity test (AST)
Acquaintance with the actuality: Community diagnosis programme of Kathmandu Medical College at Gundu village, Bhaktapur, Nepal
(Kathmandu University, 2008) Vaidya, A; Pradhan, A; Joshi, SK; Gopalakrishnan, S; Dudani, I
Abstract
Introduction: In Nepal, various field programs such as community diagnosis programmes (CDP) have been
initiated to make the education of doctors, nurses and dentists more community oriented and relevant and suited to
the health care scenario. Community diagnosis refers to the identification and quantification of the health problems
in a community and identification of their correlates for the purpose of defining those individuals or groups at risk or
those in need of health care. The article presents the main activities of community diagnosis as a core component of
community-based education for the medical students at Kathmandu Medical College, Kathmandu, Nepal.
Methodology: A 4 weeks’ Community Diagnosis Programme was conducted by MBBS II students (9 th Batch) of
the Kathmandu Medical College under the supervision of the Department of Community Medicine in November
2006 in the rural community of Gundu VDC (village development committee). The tools used included pre-tested
questionnaires, weighing machines, measuring tapes, stethoscopes and sphygmomanometers. After the data
collection and compilation, the students presented their findings in oral presentations, accompanied by a written
report, including essential recommendations for improving the health status of these communities.
Results: The students benefited from the necessary process of integrating clinical skills and a public health
approach, so as to enhance their epidemiological thinking and be of greater use to the communities where they will
practice. The community also benefited by achievement of behavioral changes leading to healthier lifestyles and
increased awareness of health-related matters and their role in quality of life.
Conclusions: CDP is a way to practically demonstrate that the link between a medical college and society is
possible. That is, a medical college can serve the community and thus society, with specific activities to improve
health and the skills of students who will serve as future health professionals.