scholarly journals Culture Positive Cases of Ophthalmia Neonatorum in a Tertiary Care Centre of Nepal: A Descriptive Cross-sectional Study

2021 ◽  
Vol 59 (236) ◽  
Author(s):  
Sabina Shrestha ◽  
Sunil Raja Manandhar ◽  
Om Krishna Malla

Introduction: Ophthalmia neonatorum although runs a benign course mostly, sometimes may progress to sight threatening complications. The study was conducted to find the prevalence of culture positive cases of opthalmia neonatorum. Methods: It was a descriptive cross-sectional study conducted at a tertiary care center from January to December 2019. Ethical clearance was obtained from institutional review committee of Kathmandu Medical College. Convenience sampling was done. All data were entered into excel and, then for analysis, exported to Statistal Package for Social Sciences version 21. Point estimate at 95% Confidence Interval was calculated along with frequency and proportion for binary data. Results: The prevalence of culture positive cases of opthalmia neonaturum is 10 (55.55%) (32.61-78.49 at 95% Confidence Interval). The causative organisms were coagulase negative Staphylococcus 4 (40%), Staphylococcus aureus 3 (30%), Klebsiella 2 (20%) and Pseudomonas 1 (10%). Culture sensitivity of the isolated organisms were different according to the patient even in case of the same organism. Vancomycin 7 ( 70%) was the most sensitive antibiotic followed by Ciprofloxacin 6 (60%), Amikacin 5 (50%) and Cloxacillin 5 (50%) while Azithromycin 1 (10%), Cefixime 1 (10%) and Cotrimoxazole 1 (10%) were the least sensitive. Conclusions: Staphylococcus species was the most common organism isolated from neonates with ophthalmia neonatorum and vancomycin was the most sensitive antibiotic.

2019 ◽  
Vol 57 (219) ◽  
Author(s):  
Anmol Purna Shrestha ◽  
Roshana Shrestha ◽  
Sanu Krishna Shrestha ◽  
Alok Pradhan ◽  
Samjhana Basnet

Introduction: Dyspnea is a common presenting complaint in the emergency department worldwide and a diagnostic challenge for emergency physicians. Our study aims to find the prevalence of dyspnea among patients attending emergency department in our hospital. Methods: A descriptive cross-sectional study was conducted in the emergency department of Dhulikhel hospital from May 2019 to July 2019 after ethical approval from the institutional review committee. Total 1200 samples were collected by consecutive sampling method. All patients were triaged in the emergency department as a part of regular protocol. The participants were included in the study after obtaining an informed consent from the patient or caretaker (if the patient were not able to provide it). Point estimate at 95% confidence interval was calculated along with frequency and proportion for binary data. The statistical analysis was done using R version 3.5.3 (2019-03-11). Results: The prevalence of dyspnea among patients attending emergency department of a tertiary care hospital was 107 (8.9%) (4.6%-13.2%) at 95% confidence interval. The patients triaged into red, orange and yellow categories were 14 (13.1%), 50 (46.7%) and 43 (40.2%) respectively. Median age was 64 years and 74 (69%) were ≥60 years. Sixty-seven (62.6%) were females and 40 (37.4%) were males. Forty-four (41.1%) arrived by ambulance. Most commonly associated symptoms were cough and fever 59 (51.1%) and 44 (41.1%) respectively. Conclusions: The prevalence of dyspnea among patients attending emergency department of our hospital is higher compared to that of other studies. This warrants structured and prompt management of dyspnea for quality improvement.


2021 ◽  
Vol 59 (237) ◽  
Author(s):  
Beena Jha ◽  
Manisha Sharma ◽  
Sagar GC ◽  
Jyotshna Sapkota

Introduction: Onychomycosis is a fungal disease of the nail apparatus caused by dermatophytes, non-dermatophytes and yeasts. Although onychomycosis is rarely life threatening, its high incidence and the associated morbidity makes it an important public health problem. This study was aimed to find the prevalence of onychomycosis among clinically suspected patients attending the outpatient department of Dermatology and Venereology. Methods: A descriptive cross-sectional study was done in a total of 200 clinically suspected cases of onychomycosis attending the Dermatology outpatient department of a tertiary care hospital within the period of one year from 1st September 2019 to 31st August 2020. Ethical approval (Reference: 150320196) was taken and convenience sampling was done. Data were analyzed using Statistical Package for Social Sciences version 19. Point estimate at 95% Confidence Interval was calculated along with frequency and proportion for binary data. Results: Out of 200 clinically suspected cases prevalence of onychomycosis was found to be 40 (20%) (Confidence Interval = 19.94-20.06) by both direct microscopy and culture. Onychomycosis was commonest among age group of 21-40 years and more predominant among male patients 60 (65.21%). The fingernails were frequently involved i.e., 58 (63%) cases followed by toenails 34 (21%). Dermatophytes were the most common type of fungal infection accounting for 25 (62.5%). Conclusions: The study highlighted dermatophytes as the most common clinical pattern of onychomycosis and Trichophyton rubrum as the most common aetiological agent causing onychomycosis.


2021 ◽  
Vol 59 (233) ◽  
Author(s):  
Anu Kushwaha ◽  
Khilasa Pokharel ◽  
Anuj Raj Kadel

Introduction: Urinary tract infection is treated by the antibiotic sensitivity pattern of uropathogensin our population. Present infection cases have been showing an increase in resistance to the currentfirst-line of antibiotics. The objective of this study is to determine the resistance of antibiotics inEscherichia coli in a tertiary care center. Methods: This is a descriptive cross-sectional study done in Kathmandu Medical College TeachingHospital from October 2018 to February 2019. The sample size was calculated, and convenientsampling was done. Patients with urine culture positive (i.e., Colony-forming unit >105) wereincluded in the study. All positive samples were tested for antibiotics sensitivity and resistance. Theresistance to the antibiotics was recorded using Statistical Package for Social Sciences version 20.Point estimate at 95% confidence interval was calculated along with frequency and proportion forbinary data. Results: Out of 100 samples, the highest number of organisms isolated was Escherichia coli, 71 (71%).Escherichia coli showed the highest resistance to drugs like Norfloxacin, 37 (52.11%), AmoxicillinClavulanic acid 37 (52.11%), followed by Co-trimoxazole 32 (45.1%), Ceftriaxone, 24 (33.8%), andCiprofloxacin 23 (32.3%). Conclusions: Escherichia coli showed the highest resistance to commonly used antibiotics likeNorfloxacin, Amoxicillin-Clavulanic acid, Co-trimoxazole, Ceftriaxone, and Ciprofloxacin.


2020 ◽  
Vol 58 (222) ◽  
Author(s):  
Nabina Maharjan ◽  
Narayani Maharjan ◽  
Rui Li

Introduction: Hypertension is one of the leading causes of death and disability in both developed and developing countries. The prevalence of hypertension is increasing rapidly worldwide. The aim of the study was to determine the knowledge of diet and exercise among hypertensive patients. Methods: This descriptive cross-sectional study was conducted using a structured questionnaire among 169 hypertensive patients at Kathmandu diabetes and thyroid center from May 2017 to July 2017 after taking ethical clearance from Nepal Health Research Council, Nepal. A convenience sampling method was used. Data was collected and entry was done in Statistical Package for the Social Sciences version 16.0 point estimate at 95% confidence interval was calculated along with frequency and proportion for binary data. Results: Out of total 169 participants enrolled in this study, only 79 (46.7%) had good knowledge and 90 (53.3%) had poor knowledge regarding diet and exercise. The mean age of participants was 54.68±13.91 years. Conclusions: This study revealed that the knowledge about diet and exercise among hypertensive patients is poor and this study suggests the need for a proper educational intervention to improve awareness and to control hypertension effectively.


2020 ◽  
Vol 58 (227) ◽  
Author(s):  
Sameer Thapa ◽  
Bishwa Raj Dawadi ◽  
Anup Raj Upreti

Introduction: Acute poisoning is a major global public health problem contributing to one of theleading causes for a visit to an emergency department. This study aims to analyse the demographicand psychosocial characteristics of patients with acute poisoning presented to the emergencydepartment. Methods: This was a descriptive cross-sectional study conducted in a tertiary care hospital fromJune to December 2019 after obtaining ethical approval from Institutional review board (referencenumber. 041-075/0760). A convenient sampling method was applied. Epidemiological factors, typesof poison consumed, reason, motive, and place to take poison, time elapse in the presentation to thehospital were studied. Statistical analysis was done using statistical package for the social sciencesversion 20. Point estimate at 95% Confidence Interval was calculated along with frequency andproportion for binary data. Results: Out of 76 cases of acute poisoning, the organophosphorus poisoning was 18 (23.7%) followedby unknown 12 (15.8). Of total, 28 (36.8%) had quarrel before taking poison and 41 (53.9 %) hadintention to commit suicide. Sixty-seven (88.2%) took a poison at home. The average elapsed time tothe visit of the emergency department was 110±80 minutes.   Conclusions: The most common poisoning was organophosphorus with a suicide being the mostcommon intention. Quarrel was the most frequent reason to take poison and the home was the mostcommon place to take poison.


2021 ◽  
Vol 59 (243) ◽  
pp. 1075-1080
Author(s):  
Saraswoti Kumari Gautam Bhattarai ◽  
Roshana Ghimire ◽  
Sapana Duwadi ◽  
Rabin Khadka ◽  
Kanchan Gautam

Introduction: Perinatal mortality comprises the number of stillbirths and death of newborns within seven days of life which is the main contributor to infant and maternal mortality. The aim of this study was to find out the prevalence of perinatal mortality among all the deliveries in a tertiary care center of a remote part of Nepal. Methods: This was a descriptive cross-sectional study conducted in a tertiary care center located in Jumla among 3798 deliveries (childbirth) from August 2014 to April 2020. Ethical approval was taken from the institutional review committee (2076/2077/05) of the same institution. A convenience sampling technique was used and the data were collected from the medical record section and then entered and analyzed in Statistical Package for Social Sciences version 16. Point estimate at 95% Confidence Interval was calculated along with frequencies and percentages for binary data. Results: The prevalence of perinatal mortality was 187 (4.92%) (4.23-4.60% at 95% Confidence Interval) among 3798 deliveries. Regarding the primary causes; the highest proportion was intrapartum hypoxia 62 (33.3%), spontaneous preterm labor 40 (21.5%), and congenital anomalies 38 (20.4%). Similarly, about the final cause; the highest proportion was birth asphyxia 64 (34.2%), intrauterine fetal death 51 (27.3%), congenital anomalies 35 (18.7%), and complication of prematurity 32 (17.1%). Conclusions: The perinatal mortality was quite high in this study with respect to similar studies done in other countries. The finding of this study showed that quality antenatal care with rural ultrasound service is essential to reduce the causes of perinatal mortality.


2021 ◽  
Vol 59 (238) ◽  
Author(s):  
Suman Thapa ◽  
Anupam Bista ◽  
Prashant Subedi ◽  
Aaradhana Adhikari ◽  
Sunil Pokharel

Introduction: Tuberculosis has high burden in developing countries like Nepal. This study aims to determine the prevalence of tuberculosis among patients admitted in the department of medicine of a tertiary hospital. Methods: A descriptive cross-sectional study of all the patients admitted to the tertiary care hospital from 1st January 2017 to 31st December 2019 was done. Ethical approval was obtained from Institutional Review Committee (Ref: drs2006181387). Convenience sampling method was used. A descriptive analysis of demographic, clinical and laboratory profile of patients was made using Microsoft Excel version 2016. Point estimate at 95% Confidence Interval was calculated along with frequency and proportion for binary data. Results: Among 6829 patients admitted to the department of medicine, 209 (3.06%) (2.65-3.47 at 95% CI) patients were diagnosed with tuberculosis. Among them, 147 (70.33%) were males and the mean age was 49.77 years. Pulmonary and extra-pulmonary tuberculosis were present in 153 (73.20%) and 56 (26.79%) patients, respectively. Bacteriological confirmation was limited to 107 (70%) of pulmonary tuberculosis and 3 (5%) of extrapulmonary tuberculosis. Fever was the commonest presentation in 166 (79.42%) followed by cough in 164 (78.46%), anorexia in 108 (51.67%), weight loss 104 (49.76%), and others. Conclusions: The study showed that the prevalence of tuberculosis among admitted patients was higher than national prevalence.


2021 ◽  
Vol 59 (242) ◽  
pp. 868-871
Author(s):  
Alisha Thapa ◽  
Susmita Nepal ◽  
Garima Malla ◽  
Sushma Pokhrel

 Introduction: Childhood obesity, caused due to excessive fat accumulation, is one of the leading causes of preventable deaths associated with several non-communicable diseases. In Nepal, there is limited data available on the status of overweight and obesity among school children. The objective of this study was to find out the prevalence of childhood overnutrition among school going children in a municipality. Methods: A descriptive cross-sectional study was conducted from June 2019 to July 2019, in four schools of a municipality selected by simple random sampling. Ethical approval was obtained from Nepal Health Research Council (Registration number 380/2019). Data was collected using census sampling from children aged 5-18 years through self-administered questionnaires to the children’s parents. The data was entered into the Statistical Package for Social Sciences for analysis. Point estimate at 95% confidence interval was calculated along with frequency and proportion for binary data. Results: Out of 379 school children, the prevalence of overnutrition was found to be 38 (10.03%) (95% Confidence Interval= 7.01-13.05). Prevalence of overnutrition was highest in children of age group 10-13 years 23 (60.5%), in females 27 (71.1%), those consuming junk food 4-6 times weekly 14 (36.8%) and those performing daily physical activity less than 60 minutes 24 (63.2%). Conclusions: The prevalence of childhood overnutrition is similar in comparison to other studies done in similar settings.


2021 ◽  
Vol 59 (234) ◽  
Author(s):  
Deepak Regmi ◽  
Rachana Baidhya ◽  
Ashik Rajak ◽  
Nain Bahadur Mahato ◽  
Sangita Shrestha ◽  
...  

Introduction: Zuckerkandl tubercle is a prominent anatomical structure of the thyroid lobe. Identification and preservation of recurrent laryngeal nerve and parathyroid glands during thyroid surgery can be made easier through assessment of their relationship with the Zuckerkandl tubercle. This study aims to determine the anatomical relationship between Zuckerkandl tubercle and superior parathyroid in patients who underwent thyroidectomy in a tertiary care center. Methods: This descriptive cross-sectional study was conducted at a tertiary care hospital of Nepal following ethical clearance from the Institutional Review Committee (Reference no: 0106201804) among patients who underwent thyroid surgery between July 2018 to February 2020. Convenience sampling was used for collecting data and was entered in Statistical Package for the Social Sciences version 20. Point estimate at 95% confidence interval was calculated along with frequency andproportion for binary data. Results: Out of 59 cases, 27 (96.4%) of superior parathyroid on the left were at the 1-2 o’clock position, and 28 (90.3%) of superior parathyroid on the right were at 10-11 o’clock position. On the left side, the superior parathyroid was adhered to Zuckerkandl tubercle in 10 (35.7%), was within 5 mm in 16 (57.1%), and was >5 mm away from Zuckerkandl tubercle in 2 (7.14%). On the right side, the superior parathyroid was adhered to Zuckerkandl tubercle in 12 (38.7%), was within 5 mm in 13 (41.93%), and was >5 mm away from Zuckerkandl tubercle in 6 (19.3%). Conclusions: Zuckerkandl tubercle has a consistent relationship with the superior parathyroid and can be used as an important landmark for identifying superior parathyroid during thyroid surgery.


2020 ◽  
Vol 58 (230) ◽  
Author(s):  
Apar Pokharel

Introduction: Laryngomalacia is one of the most common causes of stridor in young children. It can be a serious concern to both parents and caregivers. The main objective of this study is to find the prevalence of laryngomalacia among young children presenting with stridor in a tertiary care hospital in central Nepal. Methods: A descriptive cross-sectional study was carried out form 1st December 2017 to 1st May 2020 in children less than two years of age in a tertiary care hospital. Ethical approval was taken from the Institutional Review Committee of the hospital (reference number: 2020/23). Convenient sampling was done. Detailed demography, clinical examination, and video laryngoscopy findings were evaluated to find the prevalence of laryngomalacia among all children with stridor. Data were analyzed by using Statistical Package for the Social Sciences version 20. Point estimate at 95% confidence interval was calculated along with frequency and proportion for binary data. Results: Out of 430 participants who presented with stridor, the laryngomalacia was found in 234 (66%) (58.7-74.07) cases at a 95% confidence interval. The male: female ratio was 1.7:1. Most children, 192 (67.6%), presented with a milder form of laryngomalacia. The most common type was a mixed type of laryngomalacia in 159 (56%). Sleep-disordered breathing was seen in 113 (39.79%) of children diagnosed with laryngomalacia. Conclusions: Our study concluded that laryngomalacia was the most common cause of stridor in children less than two years of age. However, in most cases, the problem is not serious and a regular follow-up with weight monitoring is warranted.


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