scholarly journals Antibiotic Resistance to Escherichia coli among Urine Culture-Positive Patients in a Tertiary Care Hospital in Nepal: A Descriptive Cross-sectional Study

2021 ◽  
Vol 59 (233) ◽  
Author(s):  
Anu Kushwaha ◽  
Khilasa Pokharel ◽  
Anuj Raj Kadel
Keyword(s):  
Escherichia Coli ◽  
Urine Culture ◽  
Tertiary Care ◽  
Cross Sectional Study ◽  
Point Estimate ◽  
Care Hospital ◽  
Sectional Study ◽  
Cross Sectional ◽  
Sensitivity Pattern ◽  
Culture Positive

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.

scholarly journals Complications and Success Rate of Percutaneous Nephrolithotomy in Renal Stone: A Descriptive Cross-sectional Study

2019 ◽  
Vol 57 (220) ◽  
Author(s):  
Robin Joshi
Keyword(s):  
Success Rate ◽  
Percutaneous Nephrolithotomy ◽  
Renal Stone ◽  
Tertiary Care ◽  
Cross Sectional Study ◽  
Point Estimate ◽  
Care Hospital ◽  
Success Rates ◽  
Sectional Study ◽  
Cross Sectional

Introduction: Renal stone disease has been affecting people for centuries. Percutaneous nephrolithotomy is one of the five interventions offered to a patient with renal stone. With the continuous development of noninvasive or minimally invasive techniques, these surgical procedures have been refined over time. This study was conducted to find the success rate of percutaneous nephrolithotomy in renal stone using Guy’s score and complication by Modified Clavien score. Methods: This descriptive cross-sectional study was done among 114 patients who underwent percutaneous nephrolithotomy in a tertiary care hospital, from September 2016 to December 2018 after receiving ethical approval from the Institutional Review Committee. Convenient sampling was done. All patients were informed about the potential benefits and risks of the percutaneous nephrolithotomy procedure and patients signed an informed written consent form. Point estimate at 95% Confidence Interval was calculated along with frequency and proportion. Statistical analysis was done by using Statistical Package for Social Sciences version 22.2. Results: Forty-six (40.3%) patients had Guy’s stone score I, 43 (37.71%) patients had a score of II, 15 (13.6%) patients had a score of III and 10 (8.77%) patients had a score of IV. The success rates of stone clearance were 97.8 %, 95.3%, 80% and 50% for Guy’s stone score 1, 2, 3 and 4 respectively. A total of 114 patients were enrolled in the study out of which 66 were male and 48 were female. Eighteen patients experienced some form of complications out of which 3 patients needed surgical intervention with Modified Clavien score of III. Conclusions: Using Guy’s scoring system for percutaneous nephrolithotomy we evaluated the success rate. It is reproducible, easy and proves to be a useful tool to counsel patients about stonefree rate and prognosis for the surgical procedure. Modified Clavien score was helpful in evaluating complication rate.

scholarly journals Acute Poisoning among Patients Presenting to the Emergency Department of a Tertiary Care Center: A Descriptive Cross-sectional Study

2020 ◽  
Vol 58 (227) ◽  
Author(s):  
Sameer Thapa ◽  
Bishwa Raj Dawadi ◽  
Anup Raj Upreti
Keyword(s):  
Emergency Department ◽  
Binary Data ◽  
Tertiary Care ◽  
Public Health Problem ◽  
Cross Sectional Study ◽  
Acute Poisoning ◽  
Point Estimate ◽  
Care Hospital ◽  
Sectional Study ◽  
Cross Sectional

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.

scholarly journals Tuberculosis among Patients Admitted to the Department of Medicine of a Tertiary Care Center in Nepal: A Descriptive Cross-sectional Study

2021 ◽  
Vol 59 (238) ◽  
Author(s):  
Suman Thapa ◽  
Anupam Bista ◽  
Prashant Subedi ◽  
Aaradhana Adhikari ◽  
Sunil Pokharel
Keyword(s):  
Pulmonary Tuberculosis ◽  
Binary Data ◽  
Care Center ◽  
Extrapulmonary Tuberculosis ◽  
Tertiary Care ◽  
Cross Sectional Study ◽  
Point Estimate ◽  
Care Hospital ◽  
Sectional Study ◽  
Cross Sectional

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.

scholarly journals Anatomical Positions of Superior Parathyroid Gland with regard to the Zuckerkandl Tubercle in Patients Undergoing Thyroidectomy in a Tertiary Care Centre: A Descriptive Cross-sectional Study

2021 ◽  
Vol 59 (234) ◽  
Author(s):  
Deepak Regmi ◽  
Rachana Baidhya ◽  
Ashik Rajak ◽  
Nain Bahadur Mahato ◽  
Sangita Shrestha ◽  
...  
Keyword(s):  
Thyroid Surgery ◽  
Binary Data ◽  
Care Center ◽  
Tertiary Care ◽  
Cross Sectional Study ◽  
Point Estimate ◽  
Care Hospital ◽  
Sectional Study ◽  
Cross Sectional ◽  
The Right

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.

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
Keyword(s):  
Confidence Interval ◽  
Binary Data ◽  
Tertiary Care ◽  
Cross Sectional Study ◽  
Point Estimate ◽  
Coagulase Negative Staphylococcus ◽  
Sectional Study ◽  
Cross Sectional ◽  
Ophthalmia Neonatorum ◽  
Culture Positive

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.

scholarly journals Prevalence of Sinew String in patients coming to a tertiary care hospital of Nepal: A descriptive cross-sectional study

2020 ◽  
Vol 3 (1) ◽  
pp. 16-20
Author(s):  
P Shrestha ◽  
K Shrestha ◽  
L Acharya ◽  
S Shakya
Keyword(s):  
Binary Data ◽  
Tertiary Care Hospital ◽  
Tertiary Care ◽  
Cross Sectional Study ◽  
Point Estimate ◽  
Care Hospital ◽  
Sectional Study ◽  
Cross Sectional ◽  
The Social ◽  
Study Population

Introduction: Sinew strings are frenum or wrinkle like entity of mandibular distal buccal mucosa which is frequently encountered in the population. Sinew strings play an important role in determining the width and buccal extension of the denture flange of mandibular complete denture. Materials and Methods: This descriptive cross-sectional study was conducted at a tertiary care hospital from 17th June 2020 to 20th September 2020. Convenient sampling (n=245) was done. Point estimate at 95% Confidence Interval was calculated along with frequency and proportion for binary data. Data analysis was done in Statistical Package for the Social Sciences version 21. Results: Among the study population (n=245 participants), sinew string was seen in 35% of the participants. The frequency of sinew string present bilaterally was 19% while it was present unilaterally in 16% of the population. Conclusions: The presence of sinew string in the sampled Nepalese population showed a higher prevalence than previous studies.  

scholarly journals Prevalence of Dyspnea among Patients Attending the Emergency Department of a Tertiary Care Hospital: A Descriptive Cross-sectional Study

2019 ◽  
Vol 57 (219) ◽  
Author(s):  
Anmol Purna Shrestha ◽  
Roshana Shrestha ◽  
Sanu Krishna Shrestha ◽  
Alok Pradhan ◽  
Samjhana Basnet
Keyword(s):  
Emergency Department ◽  
Confidence Interval ◽  
Binary Data ◽  
Tertiary Care Hospital ◽  
Tertiary Care ◽  
Cross Sectional Study ◽  
Point Estimate ◽  
Care Hospital ◽  
Sectional Study ◽  
Cross Sectional

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.

scholarly journals Mean Evan's Index among Patients with Normal Computed Tomography Scan visiting Radiology Department in a Tertiary Care Centre of Nepal: A Descriptive Cross-sectional Study

2021 ◽  
Vol 59 (240) ◽  
Author(s):  
Sagar Koirala ◽  
Prity Agrawal ◽  
Suresh Bishokarma ◽  
Pratyush Shrestha
Keyword(s):  
Computed Tomography ◽  
Tertiary Care Hospital ◽  
Tertiary Care ◽  
Cross Sectional Study ◽  
Radiology Department ◽  
Point Estimate ◽  
Care Hospital ◽  
Sectional Study ◽  
Cross Sectional ◽  
The Mean

Introduction: Evan's index is useful to objectively see if ventricles size is abnormal especially in borderline cases of hydrocephalus. Studying ventricular size in CT scan is essential in every pathology of the brain. Use of objective parameters to define hydrocephalus helps us not only to diagnose a case but also follow up the case following treatment. The aim of this study was to find out the mean even index among patients visiting the department of radiology of a tertiary care hospital. Methods: A descriptive cross-sectional study was conducted at a tertiary care hospital from 1st january 2020 to 31st December 2020. Ethical clearance was obtained from the Institutional Review Committee of Upendra Devkota Memorial Neurological and Allied Sciences (reference number: 116/2021). Computed tomography scans were done for various reasons in the hospital over a one year period and reported normal by the radiologists were included in the study. Convenient sampling was done. Statistical analysis was done using Statistical Package for the Social Sciences. Point estimate at 95% Confidence Interval was calculated along with mean and standard deviation for continuous data. Results: In this study, among the 216 cases, the mean Evan’s index was found to be 0.20±0.04. Conclusions: The mean evan’s index in our study population was lower than the normal cut-off value.

scholarly journals Onychomycosis among Clinically Suspected Cases Attending the Dermatology Out-patient Department of a Tertiary Care Centre: A Descriptive Cross-sectional Study

2021 ◽  
Vol 59 (237) ◽  
Author(s):  
Beena Jha ◽  
Manisha Sharma ◽  
Sagar GC ◽  
Jyotshna Sapkota
Keyword(s):  
Confidence Interval ◽  
Binary Data ◽  
Tertiary Care ◽  
Public Health Problem ◽  
Cross Sectional Study ◽  
Outpatient Department ◽  
Point Estimate ◽  
Care Hospital ◽  
Sectional Study ◽  
Cross Sectional

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.

scholarly journals Early experience of Retrograde Intrarenal Surgery for Renal stone: A Descriptive Cross-sectional Study

2020 ◽  
Vol 58 (227) ◽  
Author(s):  
Robin Joshi
Keyword(s):  
Binary Data ◽  
Renal Stone ◽  
Tertiary Care ◽  
Cross Sectional Study ◽  
Point Estimate ◽  
Care Hospital ◽  
Sectional Study ◽  
Retrograde Intrarenal Surgery ◽  
Cross Sectional ◽  
The Mean

Introduction: Retrograde intrarenal surgery with improving skill and knowledge may be consideredone of the first-line treatment options for removal of renal stones. The study is done to find theoutcome of retrograde intrarenal surgery in patients with renal stone. Methods: This descriptive cross sectional study was carried out on patients undergoingretrograde intrarenal surgery for renal stone at a tertiary care hospital December 2019 to March2020. Ethical approval was taken from the institutional review committee (Ref. no.200120202).The Convenient sampling method was applied. Data was collected and analyzed in StatisticalPackage for the Social Sciences version 20.0. Point estimate at 95% confidence interval wascalculated along with frequency and proportion for binary data. Results: Out of the 28 patients, the retrograde intrarenal surgery was successful in 27 (96.4%)cases. There were 16 (57.15%) females and 12 (42.86%) male patients with the mean age of37.86±11.47 years. Most of the stones were in renal pelvis 18 (64.28%) followed by lowercalyx 8 (28.57%). The mean diameter of the stone was 11.47 ±3.33mm whereas most ofthe stones were on the right side 16 (57.15%). The mean hardness was 1155.21±265.34Hounsfield units. Perioperative complications like failed access sheath placement in 2 (7.14%)cases, hematuria in 6 (21.43%) cases, fever in 6 (21.43%) cases, and septicemia in 4 (14.28%)cases. Conclusions: We found that the success rate of retrograde intrarenal surgery for the renal stonewas acceptable and similar to other published studies . Retrograde intrarenal surgery is feasiblefor the treatment of kidney stones with acceptable complications and success rates.

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