Journal Issue: Volume: 20, No 1, Issue 81, JANUARY - MARCH, 2023
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Volume
Number
Issue Date
2023
Journal Title
Journal ISSN
1812-2027
Journal Volume
Articles
Does Work-related Stress among Doctors Deserve a Public Debate?
(Kathmandu University, 2023) Kunwar, D
NA
Evaluation of Latex Agglutination Test for Rapid Identification of Staphylococcus aureus Isolated from Pyogenic Wound Infections at a Tertiary Care Hospital
(Kathmandu University, 2023) Shah, P; Sah, R; Sharma, A; Khanal, B; Bhattarai, NR
ABSTRACT
Background
Staphylococcus aureus infections are increasingly reported worldwide. It is a major
clinical problem and imposes significant morbidity and mortality due to widespread
emergence of multidrug resistant pathogens like methicillin resistant Staphylococcus
aureus. Thus, rapid and reliable identification of Staphylococcus aureus is essential
for timely and effective management of patient.
Objective
The performance of Latex agglutination test (Staphaurex Plus) was compared
to conventional method tube coagulase test which is gold standard too for the
identification of Staphylococcus aureus.
Method
This study was conducted at B.P. Koirala Institute of Health Sciences. Following
standard microbiological methods, isolation and identification was done in the
Department of Microbiology. MRSA detection was performed following Clinical and
Laboratory Standard Institute. All the isolates of Staphylococci were subjected for
Latex agglutination test and was performed according to manufacturer’s instructions
using Staphaurex Plus kit.
Result
Out of 377 (methicillin sensitive Staphylococcus aureus – 142; methicillin resistant
Staphylococcus aureus - 233; Coagulase Negative Staphylococci –2) isolates of
Staphylococci, Latex agglutination test was found to be positive in 138 (97.1%) of
methicillin sensitive Staphylococcus aureus (MSSA) and 220 (94.4%) of methicillin
resistant Staphylococcus aureus (MRSA). Overall sensitivity, specificity, positive
predictive value and negative predictive value of Latex agglutination test was found
to be 95.46%, 100%, 100%, 10.52% respectively.
Conclusion
In conclusion, Latex agglutination test is a rapid and reliable test for the identification
of Staphylococcus aureus.
KEY WORDS
Latex agglutination test, Staphylococcus aureus, tube coagulase test
Arthroscopic Debridement for Mucoid Degeneration of Anterior Cruciate Ligament - A Single Institution Experience from Nepal
(Kathmandu University, 2023) Shrestha, R; Khadka, SK; Maharjan, S; Basi, A; Dahal, A; Chaudhary, A; Acharya, SP; Malla, M
ABSTRACT
Background
Mucoid degeneration of anterior cruciate ligament is characterized by infiltration of
mucoid-like material scattered throughout the anterior cruciate ligament substance.
It is an uncommon condition, but previously, underdiagnosed or often misdiagnosed
as an anterior cruciate ligament tear.
Objective
To present our early experiences with mucoid degeneration of anterior cruciate
ligament in last five years in terms of clinical presentation and the outcomes of
arthroscopic management.
Method
This was a retrospective descriptive cross-sectional study on patient who received
arthroscopic debridement for mucoid degeneration of anterior cruciate ligament in
Dhulikhel Hospital over five years period (2017 May to 2022 April). Western Ontario
and McMaster Universities Osteoarthritis Index (WOMAC) scale that has been
translated and validated to be used in local (Nepali) language and context was used
for evaluation of outcome evaluation.
Result
Twenty-one patients of mean age 44.21 years, predominantly females (18), were
managed in five years period. The mean Western Ontario and McMaster Universities
Osteoarthritis Index score was 16.33±10.47 with a range of 0 to 36 (11.57 to 21.09
at 95% confidence interval). The mean Western Ontario and McMaster Universities
Osteoarthritis Index score converted on a scale of 0 to 100 was 17. Thirteen patients
had isolated Mucoid degeneration of anterior cruciate ligament whereas nine others
had associated either meniscal tear or chondral lesions.
Conclusion
Mucoid degeneration of anterior cruciate ligament could be a cause of knee pain
in middle-aged patients and arthroscopic debridement can improve the patient’s
symptoms and provide a good functional outcome.
KEY WORDS
Anterior cruciate ligament, Arthroscopy, Debridement, Mucoid degeneration,
WOMAC
Study of Serum Magnesium Levels in Patients Admitted with Sepsis in Intensive Care Unit
(Kathmandu University, 2023) Patil, PSG; Aslam, SS
ABSTRACT
Background
Magnesium plays an important role in sepsis, and this could be attributed to its
effects on the immune system, which are important in the pathogenesis of sepsis.
Magnesium deficiency, one of the underrated electrolyte abnormalities, is observed
in critically ill patients admitted to intensive care unit (ICU).
Objective
To find the association of serum magnesium with the outcome, duration, and need
for ventilation.
Method
The hospital-based prospective observational study included patients > 18 years
(N=150) with sepsis admitted to intensive care unit. Patients were divided into
normomagnesemia (n=75) and hypomagnesemia (n=75) groups. Sequential Organ
Failure Assessment Score (SOFA) score, length of intensive care unit stay, need and
duration of mechanical ventilatory requirement, and outcomes were compared
between the two groups.
Result
The mean Sequential Organ Failure Assessment score (5.87 ± 2.31 vs. 3.85 ± 1.75),
mean duration of intensive care unit stay (in days) (7.21 ± 1.74 vs. 5.24 ± 1.38), the
mean duration of mechanical ventilatory requirement (in days) (4.05 ± 3.47 vs. 1.13
± 1.98), and mortality rate were (33% vs. 4%) were higher in the hypomagnesemia
group when compared to the normomagnesemia group (p < 0.001 for all).
Conclusion
The study concludes that hypomagnesaemia is a significant electrolyte abnormality in
critically ill sepsis patients. Hypomagnesaemia, Sequential Organ Failure Assessment
Score, and mechanical ventilation are the factors that independently predicted
mortality in intensive care unit patients. Hence, clinicians should regularly monitor
the occurrence of hypomagnesemia in intensive care unit patients to reduce its poor
clinical outcomes.
KEY WORDS
Artificial, Critical care, Magnesium, Mortality, Organ dysfunction scores, Respiration,
Sepsis
Alarm Fatigue among Nurses Working in Critical Care Setting in a Tertiary Hospital, Nepal
(Kathmandu University, 2023) Regmi, B; Shrestha, B; Khanal, S; Moktan, S; Byanju, R
ABSTRACT
Background
Alarm fatigue is a well-recognized patient safety concern in critical care settings.
It occurs when nurses become overwhelmed by the total number of alarm signals
which can result in alarm desensitization and eventually contributes to missing
of serious and important changes in a patient’s condition, thus failing to respond
properly.
Objective
To find out alarm fatigue and its associated factors among nurses working in critical
care setting.
Method
A cross-sectional study design with convenient sampling technique was used to
select 56 nurses working at different critical care settings in Dhulikhel Hospital. A self-
constructed semi structured questionnaire and nurses alarm fatigue questionnaire
was used for the survey. Frequency, percentage, mean and standard deviation were
used for descriptive statistics whereas Independent t-test and One-way ANOVA were
used for inferential statistics.
Result
The result shows that more than half of the nurses were less than 25 years, single
and more than two-third of the participants worked in Adult Intensive Care Unit.
Out of total obtainable score 44, the overall mean score of the Alarm Fatigue was
28.03±12.813. The result showed that there was no significant difference between
alarm fatigue and selected socio-demographic and work related characteristics.
Conclusion
The alarm fatigue among nurses working in critical care settings was found to be
higher in this study. Since alarm fatigue is directly related to patients’ safety, the
effective management of medical device alarms can reduce alarm fatigue and
prevent potentially dangerous outcomes.
KEY WORDS
Alarm fatigue, Critical care settings, Nurses