Journal Issue: Volume: 60, No. 252 (2022) AUGUST
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Volume
Number
Issue Date
2022
Journal Title
Journal ISSN
JNMA Print ISSN: 0028-2715; Online ISSN: 1815-672X
Journal Volume
Articles
Positive Bacterial Culture among Suspected Orthopedic Infections in a Tertiary Care Centre: A Descriptive Cross-sectional Study
(Nepal Medical Association, 2022) Pradhan, Ishor; Regmi, Subhash; Kunwar, Meena; Basukala, Bibek; Joshi, Amit
Abstract
Introduction: A hospital-based investigation of bacteriological isolates helps to identify common causative bacteria and their antibiotic sensitivity patterns. This helps in formulating presumptive antibiotic therapy and in reducing antibiotic misuse. The aim of this study was to find out the prevalence of positive bacterial culture isolates among suspected orthopaedic infections in a tertiary care centre.
Methods: A descriptive cross-sectional study was conducted from the electronic data record of the Department of Microbiology of a tertiary care centre from 1 January 2017 to 31 December 2021. The study was conducted following ethical approval from the Institutional Review Committee (Reference number: IRC-2021-11-09-1). Culture reports of suspected orthopaedic infections were evaluated, and those with missing data were excluded. A convenience sampling method was used. Point estimate and 95% Confidence Interval were calculated.
Results: Out of 6201 specimens, positive bacterial culture were found in 2957 (47.69%) (46.45-48.93, 95% Confidence Interval). Among them, 1561 (56.01%) were gram-negative organisms and 677 (24.29%) were gram-positive. A total of 2787 (94.25%) were wound/pus swab cultures and 170 (5.74%) were tissue cultures.
Conclusions: The prevalence of positive bacterial culture among suspected orthopaedic infections was lower than in other international studies. Among bacteriological isolates, gram-negative organisms are more than gram-positive organisms.
Meconium-stained Amniotic Fluid among Term Deliveries in a Tertiary Care Centre: A Descriptive Cross-sectional Study
(Nepal Medical Association, 2022) Shakya, Pawan; Yadav, Manoj Kumar; Poudel, Sagar
Abstract
Introduction: Although the precise aetiology of meconium-stained amniotic fluid is still unclear, risk factors include advanced gestational age at delivery, mode of delivery, the prolonged second stage of labour, and intrauterine infection. It has been associated with poor perinatal outcomes including low Apgar scores, increased incidence of neonatal intensive care admission, and a high rate of perinatal death. The objective of the study was to find out the prevalence of meconium-stained amniotic fluid in term deliveries in a tertiary care centre.
Methods: A descriptive cross-sectional study was done among term deliveries in the Department of Obstetrics and Gynaecology, in a tertiary care centre from inpatient records starting from 1 November 2019 to 1 November 2020 after obtaining ethical approval from the Institutional Review Committee (Reference number: PMG1911281316). Convenience sampling was done. Point estimate and 95% Confidence Interval were calculated.
Results: Out of 1699 term deliveries, meconium-stained amniotic fluid was seen in 91 (5.35%) (4.28-6.42, 95% Confidence Interval). Among these 69 (75.82%) newborns were delivered through lower segment caesarean section and 61 (67%) newborns had Grade II meconium-stained amniotic fluid.
Conclusions: The prevalence of meconium-stained amniotic fluid was similar to the studies done in similar settings.
Pseudomonas aeruginosa Isolates among Clinical Samples showing Growth in a Tertiary Care Centre: A Descriptive Cross-sectional Study
(Nepal Medical Association, 2022) Maharjan, Nabina
Abstract
Introduction: Carbapenems resistance due to metallo-beta-lactamase production in Pseudomonas aeruginosa is a major concern which is increasing globally resulting in limited therapeutic choices. This study aimed to find out the prevalence of Pseudomonas aeruginosa isolates among clinical samples showing growth of a tertiary care centre.
Methods: A descriptive cross-sectional study was conducted on various clinical samples which showed growth in the Department of Microbiology of a tertiary care centre between 1 September 2020 to 28 February 2021 after receiving ethical approval from the Institutional Review Committee (Reference number: 03-G/020). Convenience sampling was done. All timely received clinical specimens were inoculated and incubated at 37°C for 48 hours and identified by standard microbiological techniques. Point estimate and 95% Confidence Interval were calculated.
Results: Among 1049 clinical samples showing growth, 68 (6.48%) (4.99-7.97, 95% Confidence Interval) Pseudomonas aeruginosa were isolated. Among them, 6 (8.82%) were found to be metallo-beta-lactamase positive.
Conclusions: The prevalence of Pseudomonas aeruginosa was similar to the studies done in similar settings. As metallo-beta-lactamase production was detected among isolated species which can be spread very rapidly and may develop a problematic scenario in treatment procedures, regular surveillance along with judicious use of carbapenems should precede.
Preoperative Anxiety among Patients Undergoing Elective Surgery in a Tertiary Care Centre: A Descriptive Cross-sectional Study
(Nepal Medical Association, 2022) Lakhe, Gajal; Shrestha, Binod Bade; Subedi, Anil
Abstract
Introduction: Preoperative anxiety is universal in patients before surgery. It is mostly unaddressed by health professionals due to a lack of time. The objective of this study was to find out the prevalence of preoperative anxiety among patients undergoing elective surgery in a tertiary care centre.
Methods: A descriptive cross-sectional study was conducted on 385 surgical patients in the Department of Anaesthesia, from 27 November 2021 to 20 April 2022 in a tertiary care hospital posted for elective surgery. Ethical approval was obtained from the Institutional Review Committee (Reference number: MEMG/481/IRC). A convenience sampling was used. The level of anxiety and need for information was assessed using the Amsterdam Preoperative Anxiety and Information Scale questionnaire in a preoperative holding area. Point estimate and 95% Confidence Interval were calculated.
Results: Out of 385 patients posted for elective surgery, preoperative anxiety was present in 88 (22.85%) (18.66-27.04, 95% Confidence Interval) patients. The mean Amsterdam Preoperative Anxiety and Information Scale score for total anxiety and need for information was 13.59±2.47 and 5.91±3.06 respectively. Anxiety was present in 60 (68.18%) females, 45 (51.13%) young patients aged <30 years and 50 (56.81%) patients without prior experience with surgery and anaesthesia.
Conclusions: The prevalence of preoperative anxiety among surgical patients was lower than in previous studies done in similar settings. Preoperative anxiety was common in females, young patients and patients without previous experience with anaesthesia and surgery.
Chronic Obstructive Pulmonary Disease among Patients Visiting the Emergency Department of a Tertiary Care Centre: A Descriptive Cross- sectional Study
(Nepal Medical Association, 2022) Thakali, Kabir; Lamsal, Dinesh; Thapa, Sabitra; Karki, Iswor; Paudel, Ashok; Gautam, Manish K.C.
Abstract
Introduction: Chronic obstructive pulmonary disease is characterised by persistent airflow limitation which is usually progressive and is the primary global cause of morbidity and mortality. It is the third leading cause of Years Lived with Disability, the second most common cause of death after ischemic heart disease, and the fourth most common cause of premature death. The aim of this study was to find out the prevalence of chronic obstructive pulmonary disease among patients visiting the emergency department of a tertiary care centre.
Methods: A descriptive cross-sectional study was done in the Department of Emergency Medicine of a tertiary care centre from 4 July 2022 to 11 July 2022. Ethical approval was obtained from the Institutional Review Committee (Reference number: 24). Data from 348 patients were collected from the hospital records. Convenience sampling method was used. Point estimate and 95% Confidence Interval were calculated.
Results: Among 348 patients visiting the emergency department, 23 (6.60%) (6.57-6.63%, 95% Confidence Interval) had chronic obstructive pulmonary disease. The mean age of these patients was 73.50±2.76 years.
Conclusions: The prevalence of chronic obstructive pulmonary disease was lower than in the previous studies done in similar settings. The study could provide a general idea of the burden of the disease.