Journal Issue: Volume: 36, No. 2 (2014) August
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Volume
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2014
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ISSN (Print) : 1993-2979 | ISSN (Online) : 1993-2987
Journal Volume
Articles
Re-emergence of the deadly Ebola virus disease: A Global Health Threat
(Institute of Medicine, 2014) Sherpa, K
NA.
Use of five different tests for Helicobacter pylori infection in Nepal
(Institute of Medicine, 2014) Sharma, RP; Yamaoka, Y; Shrestha, PK; Khadga, P; Sharma, S; Shrestha, KB
Abstract
Introduction: The prevalence of Helicobacter pylori (H.pylori) has declined rapidly in Asia. This has been shown in both sero-prevalence-based and endoscopy-based studies. The present study was conducted to determine the current prevalence of H.pylori infection in Nepali population referred for upper gastrointestinal endoscopy and its relation with gastro-duodenal diseases.
Method: Total of 146 patients (71 males and 75 females with the mean age of 42, 43 yrs, range 16-90yrs) underwent endoscopy at endoscopy services in Tribhuvan University Teaching Hospital (TUTH), Nepal. The diagnosis of H.pylori infection was determined non-invasively by serology and invasively by rapid urease test, culture, histology and immunohistochemistry.
Results: The overall prevalence of H.pylori infection was 48.6%. The sero-prevalence was 43.8%. Gastritis was the predominant finding (76.7%), followed by duodenal ucler (4.1%), gastric ulcer (4.8%), gastric adenocarcinoma (3.4%) and normal mucosa (10.9%).
Conclusion: The present study revealed the prevalence of H. pylori infection measured by serology was higher than that with other studies conducted in Nepal, the present study of the first study to use several tests at the same time to determine H. pylori prevalence.
Keywords: Helicobacter pylori, infection, test, Nepal
Does Stone Culture Predict Systemic Inflammatory Response after Percutaneous Nephrolithotomy?
(Institute of Medicine, 2014) Luitel, BR; Chalise, PR; Gyawali, PR; Sharma, UK; Shrestha, GK; Joshi, BR
Abstract
Introduction: Systemic inflammatory response syndrome (SIRS) is a common and important complication after percutaneous nephrolithotomy (PNL). This study was carried out with the objective of finding out the association between stone culture and PostPNL- SIRS.
Methods: A prospective study was done in the urology unit, Tribhuvan University Teaching Hospital from July 2009 to June 2011. Preoperative midstream urine, intraoperative pelvic urine and stone fragments were sent for culture in all patients undergoing PNL. The primary outcome was SIRS on second postoperative day. Data analysis was done using Statistical Package for Social Sciences (SPSS) 17.0 version.
Results: Out of 47 patients 22 (46.8%) patients developed SIRS on second postoperative day. Stone and pelvic urine culture positivity rate was 8(17%) and 6(12.8%) respectively with P. aeruginosa E. coli and Proteus spp being the common organisms isolated, most of which were sensitive to amikacin. Positive stone culture was the significant risk factor for SIRS (P=0.018).
Conclusion: Positive stone culture is an important risk factor for SIRS after PNL. Routine stone culture is beneficial in patients undergoing PNL for the subsequent postoperative management.
Keywords: Percutaneous nephrolithotomy, Stone culture, Systemic Inflammatory Response Syndrome (SIRS)
Skin Diseases and Impact on Quality of Life in the Central Development Region Of Nepal: A Major Public Health Problem
(Institute of Medicine, 2014) Shrestha, DP; Gurung, D; Shrestha, R; Rosdahl, I
Abstract
Introduction: Skin diseases are one of the most common health problems in Nepal. The objectives of this study are to determine the prevalence of skin diseases and impact on quality of life in the rural areas of central development region of Nepal.
Methods: The study was conducted in the 10 VDCs of 4 districts – Dolakha, Kavre, Makawanpur and Chitwan – of the central development region. A house-to-house survey was carried out to obtain socio-demographic data and identify individuals with skin diseases. Then a dermatologic health camp was conducted in each VDC. During the health camp, the skin diseases diagnosed were recorded and villagers with skin diseases more than 1 month duration were interviewed with skin disease disability index, to assess the impact on the quality of life.
Results: A total of 7348 inhabitants (male – 3651, female – 3787) were surveyed. Of 2586 individuals with skin disease attending the health camps, 1862 (male – 721 and female – 1141, mean age 31.4yrs, range 6 months – 90years) were included in the study. The overall prevalence of skin diseases was 25%. The most common SD categories were eczemas, pigment disorders, fungal infections, nevi and urticarial. The mean skin disease disability index score in the central development region was 13.7, indicating very large impact on the quality of life.
Conclusion: The prevalence of skin diseases and impact on quality of life is very high in the rural areas of the central development region of Nepal. It is a major public health problem. Targeted intervention at the primary health care level should help to reduce the burden.
Keywords: skin disease, prevalence, impact, qyality of life
Antibiogram and Plasmid profiling of clinical multidrug resistant Escherichis coli
(Institute of Medicine, 2014) Shrestha, S; Mali, NM; Tiwari, KB; Adhikari, N; Shrestha, UT; Basnyat, SR
Abstract
Introduction: Multiple antibiotic resistances among common bacterial pathogens have been established as an alarming public health problem elsewhere. This study was aimed to explore prevalence of Extended-spectrum beta-lactamase (ESBL) producers among multi drug resistant (MDR) and plasmid profiling patterns of Escherichia coli isolated in Kathmandu Model hospital, Nepal over three months period.
Methods: Altogether 49 isolates were randomly selected among the reported MDR E. coli and retested for the susceptibility pattern and ESBL production by Kirby- Bauer disc diffusion test. Minimum Inhibitory Concentration of the isolates towards (fluro) quinolones was determined by agar dilution method. Plasmids from isolates were extracted by alkaline lysis method.
Results: All isolates were completely resistant to Amoxycillin but sensitive to Imipenem. A very high prevalence (44, 89.8%) of ESBL was detected. Most of the isolates were resistant to commonly uses antibiotics such as Quinolones, Tetracyclines and Cotrimoxazole. Among Quinolones, the Minimum Inhibitory Concentration (MIC) range for Nalidixic acid, Ciprofloxacin and Ofloxacin were 512->4093, 8-4096 and 1-256 µg/ml respectively. All 31 (63.3%) plasmid- harboring isolates contained a>33.5 kb sized plasmid. Among them, seven isolates possessed multiple (2 – 7) plasmids. Overall, twelve different resistance patterns were observed among the bacteria. Based on the patterns, the high molecular weight plasmid seemed to contain most of the resistance genes.
Conclusion: It is suspected that multi drug resistance and ESBL production in E. coli with resistance to Quinolones may be due to their high molecular weight plasmids. So, continuous antibiotic susceptibility test and surveillance of the plasmid and chromosome of E. coli is essential as plasmid analysis has been applied to determine the evolution and spread of antibiotic resistance among isolates.
Keywords: escherichia coli, antibiotic resistance pattern, multidrug resistant (MDR), extended spectrum beta- lactamases (ESBL), plasmid profiling