scholarly journals Re-Emargence of Susceptibility to Conventional First Line Drugs in Salmonella Typhi and Paratyphi a Isolated from Enteric Fever Patients in a Tertiary Care Hospital of Northern Bangladesh.

2017 ◽  
Vol 11 (1) ◽  
pp. 3-5
Author(s):  
Maiz Ul Ahad Suman ◽  
Md Abdullah Siddique ◽  
SM Shamsuzzaman ◽  
Abu Rayhan Khandakar
Keyword(s):  
Enteric Fever ◽  
Health Care Cost ◽  
Tertiary Care ◽  
Empirical Therapy ◽  
Salmonella Typhi ◽  
Care Hospital ◽  
First Line ◽  
College Hospital ◽  
Cross Sectional ◽  
Medical College

Enteric fever is endemic in Bangladesh and involves significant health care cost. The first-line drugs chloramphenicol and co-trimoxazole have not been the part of empirical therapy for decades due to development of multidrug resistant Salmonella strains. The objective of this study was to determine the antibiogram pattern of Salmonella strains isolated from the blood of clinically suspected enteric fever patients. A cross sectional study was conducted in Rajshahi Medical College Hospital & Dhaka Medical College from August 2014 to July 2015. Total 323 blood samples were collected from suspected enteric fever patients and isolation rate of Salmonella was 9.29% [S.typhi (3.41%), and S.paratyphi A (5.88%)]. Among isolated S.typhi, 9.09% were resistant to chloramphenicol, cotrimoxazole and cefixime and there were no S.typhi resistant to azithromycin and cefotaxime. Among the isolated S.paratyphi A, 5.26% were resistant to chloramphenicol, co-trimoxazole, azithromycin, cefotaxime, and cefixime. There were no ceftriaxone resistant Salmonella. Low proportion of resistance to first line antibiotics (chloramphenicol, co-trimoxazole) suggests that these drugs can be used once again. Bangladesh J Med Microbiol 2017; 11 (1): 3-5

scholarly journals Re-emergence of susceptibility to conventional first line drugs in Salmonella isolates from enteric fever patients in Nepal

2014 ◽  
Vol 8 (11) ◽  
pp. 1483-1487 ◽  
Author(s):  
Hari Jung Chand ◽  
Komal Raj Rijal ◽  
Biswas Neupane ◽  
Vijay Kumar Sharma ◽  
Bharat Jha
Keyword(s):  
Nalidixic Acid ◽  
Enteric Fever ◽  
Tertiary Care ◽  
Empirical Therapy ◽  
Salmonella Typhi ◽  
Fluoroquinolone Resistance ◽  
Diffusion Method ◽  
Care Hospital ◽  
First Line ◽  
Isolation And Identification

Introduction: Enteric fever is endemic in Nepal and poses a significant public health burden. The first-line drugs ampicillin, chloramphenicol, and cotrimoxazole have not been part of empirical therapy for two decades due to the development of multidrug-resistant Salmonella strains. The objective of this study was to determine the antibiogram pattern of Salmonella serovars isolated from the blood of clinically suspected enteric fever patients. Methodology: A cross sectional study was carried out in a tertiary care hospital in Lalitpur, Nepal, between July 2011 and February 2012. Standard microbiological procedures were followed during collection and processing of blood samples, isolation and identification of Salmonella serotypes. The antimicrobial sensitivity of ampicillin, chloramphenicol, cotrimoxazole, nalidixic acid, and ciprofloxacin was determined using a modified Kirby-Bauer disk diffusion method as per the guidelines of the Clinical and Laboratory Standards Institute. Results: Out of 86 Salmonella isolates, 56 (65.1%) were Salmonella Typhi and 30 (34.9%) were Salmonella Paratyphi A. Salmonella Typhi were 100% sensitive to chloramphenicol, cotrimoxazole, and ciprofloxacin and 98.2% sensitive to ampicillin. Similarly, Salmonella Paratyphi A isolates were 100% sensitive to ampicillin and cotrimoxazole and 96.7% sensitive to chloramphenicol and ciprofloxacin. More than 90.0% of isolates were nalidixic acid resistant and none of the Salmonella isolates were multi-drug resistant. Conclusions: This study revealed the increasing frequency of nalidixic acid-resistant Salmonella isolates, indicating the possibility of fluoroquinolone resistance in near future. Furthermore, re-emergence of susceptibility to conventional first-line drugs ampicillin, chloramphenicol, and cotrimoxazole supports the possibility of using these drugs in empirical therapy.

scholarly journals Detection Of Mutated gyrA Gene From Nalidixic Acid Resistant Salmonella Typhi And Paratyphi A Isolated From Enteric Fever Patients In A Tertiary Care Hospital Of Bangladesh

2017 ◽  
Vol 10 (1) ◽  
pp. 3-7
Author(s):  
Maiz-ul Ahad Suman ◽  
Md. Abdullah Siddique ◽  
S. M. Shamsuzzaman ◽  
Abu Rayhan Khandakar ◽  
Faiz Ahmed Khondaker ◽  
...  
Keyword(s):  
Nalidixic Acid ◽  
Enteric Fever ◽  
Tertiary Care ◽  
Brain Heart Infusion ◽  
Salmonella Typhi ◽  
Care Hospital ◽  
Biochemical Tests ◽  
Gyra Gene ◽  
Cross Sectional ◽  
Medical College

A cross sectional study for the detection of empirically used antibiotic resistant Salmonella was carried out in the department of microbiology of Rajshahi Medical College (RMC) and PCR and DNA sequencing were done in the department of microbiology of Dhaka Medical College during the period from August 2014 to July 2015.Total 323 blood samples were collected from suspected enteric fever patients from medicine and paediatric units of RMC hospital and cultured on brain heart infusion broth for isolation of Salmonella. Identification of Salmonella was done by biochemical tests and final identification was done by specific antisera. Antimicrobial sensitivity test was done by disc diffusion technique. PCR was used to detect gyrA gene. Sequencing of the gyrA gene was done to see mutation. Culture yielded growth of Salmonella typhi in 11 (36.67%) and Salmonella paratyphi A in 19(63.33%) samples. Among 11 Salmonella typhi, 8(72.73%) were resistant to nalidixic acid, 2(18.18%) to ciprofloxacin and one (9.09%) to ofloxacin. Among 19 Salmonella paratyphi A, all (100%) were resistant to nalidixic acid, 4(21.05%) to ofloxacin, and 3 (15.79%) to ciprofloxacin. All the Salmonella typhi and Salmonella paratyphi A were gyrA gene positive. All the nalidixic acid resistant strains of Salmonella typhi and Salmonella paratyphi A were mutated at amino acid position 83 by replacing serine with phenylalanine. None of the nalidixic acid sensitive Salmonella strain had mutated gyrA gene.Bangladesh J Med Microbiol 2016; 10 (1): 3-7

scholarly journals Satisfaction of women with health service provider in outpatient department of Obstetrics and Gynecology at a Tertiary care hospital

2017 ◽  
Vol 6 (2) ◽  
pp. 79-81 ◽  
Author(s):  
Ashia Khatun ◽  
Khairun Nahar ◽  
Mst Nurunnahar Aktar ◽  
Fatema Mahbooba Akter ◽  
Habibur Rahman
Keyword(s):  
Tertiary Care Hospital ◽  
Tertiary Care ◽  
Hospital Environment ◽  
Obstetrics And Gynecology ◽  
Care Hospital ◽  
Health Service Provider ◽  
College Hospital ◽  
Cross Sectional ◽  
Patient’S Satisfaction ◽  
Medical College

Background: Patient's satisfaction over the health care services is very important issue in Bangladesh.Objective: The purpose of present study was to find out the level of satisfaction of women attending in the OPD of Obstetrics and Gynecology department at a tertiary care hospital in Dhaka.Methodology: This descriptive type of cross sectional study was carried out in the OPD of Obstetrics and Gynecology department at Dhaka Medical College from September 2011 to October 2011 for a period of one month. All the women attending in Obstetrics and Gynecology department in outdoor service at Dhaka Medical College Hospital, Dhaka with the age group of 22 to 40 years were selected as study population. A purposive sampling method was used to collect the data.Results: A total number of 200 cases were taken for this study. Highly satisfied over the services delivered by the doctors was reported in 135 (65.8%) cases and service of nurses was satisfied 111(55.8%) of cases. Satisfactory waiting time (two hours) was 143(7l.9%) of cases and the satisfactory hospital environment was 127 (63.8%) of cases.Conclusion: In conclusion most of the women are satisfied to the treatment delivered by the doctors at the OPD of a tertiary care hospital.J Shaheed Suhrawardy Med Coll, 2014; 6(2):79-81

scholarly journals Cough Variant Asthma in Medical Outpatient Department of a Tertiary Care Hospital in Bangladesh

2013 ◽  
Vol 3 (1) ◽  
pp. 29-31
Author(s):  
Swapna Bhattacharjee ◽  
Shekhar Bhattacharjee ◽  
Rukhsana Parvin
Keyword(s):  
Chronic Cough ◽  
Tertiary Care ◽  
Complete Recovery ◽  
Cross Sectional Study ◽  
Outpatient Department ◽  
Care Hospital ◽  
College Hospital ◽  
Cross Sectional ◽  
Cough Variant Asthma ◽  
Medical College

Background: Cough variant asthma (CVA) is a subset of asthma where the only symptom is chronic persistent cough. Many cases go unrecognized due to lack of proper evaluation. Response to asthma medication with features supportive of airway hypersensitivity helps in management of this disease. Objective: To find out the proportion of cough variant asthma among the patients attending medicine outpatient department of Enam Medical College, Savar, Dhaka. Materials and Methods: This cross sectional study was conducted in Enam Medical College Hospital, Savar, Dhaka over a period of two years from July 2009 to July 2011. Cough variant asthma was diagnosed mainly on clinical ground as chronic cough without wheezing, fever, weight loss, shortness of breath or sputum or any other apparent cause that persisted for more than eight weeks with absolutely normal physical examination of chest, normal chest radiography and blood count except raised eosinophil count and IgE level. Patients who met these criteria were given 2 weeks course of inhaler beclomethasone propionate and were assessed for improvement. Those who improved after steroid inhalation were categorised as having cough variant asthma. Results: Out of purposively selected 148 patients complaining only of chronic dry cough for more than eight weeks, 92 patients met the primary selection criteria for cough variant asthma. These 92 patients were given 2 weeks trial of 250 ìgm beclomethasone inhalation twice daily. Seventy nine patients reported almost complete recovery from chronic cough after 2 weeks and were categorized as having CVA. Thirteen patients did not improve and were not categorized as CVA. Conclusion: These findings suggest that cough variant asthma is the most common among the patients with chronic cough not due to any apparent cause. The efficacy of inhaled corticosteroid suggests that early intervention is effective in the treatment of this disease. DOI: http://dx.doi.org/10.3329/jemc.v3i1.13871 J Enam Med Col 2013; 3(1): 29-31

scholarly journals Clinical evaluation of total abdominal hysterectomy - a prospective study in a tertiary care hospital

2015 ◽  
Vol 6 (2) ◽  
pp. 76-77
Author(s):  
Shirin Akhter ◽  
Rumana Nazneen
Keyword(s):  
Tertiary Care Hospital ◽  
Tertiary Care ◽  
Total Abdominal Hysterectomy ◽  
Abdominal Hysterectomy ◽  
Care Hospital ◽  
College Hospital ◽  
Cross Sectional ◽  
Medical College ◽  
Before And After ◽  
A Prospective Study

Total abdominal Hysterectomy are gradually rising in our country. This study has been designed to find out the common indications of abdominal hysterectomy in a tertiary care hospital,. to know the clinical characters of the patients and. o elucidate postoperative complication of abdominal hysterectomy.Methodology : Cross- sectional observational study was done during 1st October 2007 to 30th September 2008. Holy Family Red Crescent Medical College Hospital (HFRCMCH). Total 100 patients were selected following enclusion & exclusion criteria hyperposive sampling. Data were recorded before and after operation and analyzed by SPSS version 15.Result : In the present study patients with leiomyoma of uterus was found to be the major indication of hysterectomy followed by dys functional uterine bleeding (DUB) 18.0%, Pelvic inflammatory disease (PID) 14.0%, chronic cervicitis 10.0%, adenomyosis 10.0%, pelvic endometriosis 6.0%, cervical polyp 2.0%, ovarian cysts 1.0% and chriocarcinoma 1.0%. Mean duration of operation (hour) and hospital stay was 1.15 hours and 7.48 days respectively. Most common complication of present series was fever 20.0% followed by 13.0% had wound infection, 6.0% UTI and 2.0% wound dehiscence.Conclusion : Hysterectomy is now the most widely performed major operation in gynaecology. Indication and post operative complications of hysterectomy varies from region to region.Northern International Medical College Journal Vol.6(2) 2015: 76-77

Antibiotic Sensitivity and Resistance Patterns of Salmonella Typhi in Rajshahi Medical College Hospital

2020 ◽  
Vol 33 (2) ◽  
pp. 10-14
Author(s):  
Md Azizul Haque ◽  
Laila Shamima Sharmin ◽  
KM Faisal Alam ◽  
Md Mohimanul Hoque ◽  
M Morsed Zaman Miah ◽  
...  
Keyword(s):  
Blood Culture ◽  
Enteric Fever ◽  
Antibiotic Sensitivity ◽  
Salmonella Typhi ◽  
Medical College Hospital ◽  
Personal Hygiene ◽  
Care Hospital ◽  
College Hospital ◽  
Medical College ◽  
Sensitivity Pattern

Typhoid and paratyphoid fevers, collectively known as enteric fever, is caused by Salmonella enterica subspecies serovars Typhi and Paratyphi A, B and C. Despite this declining global trend, enteric fever is still considered to be a major public health hazard in Bangladesh and other developing countries due to poor sanitation, inadequate food safety measures and poor personal hygiene. In Bangladesh, the incidence of typhoid fever was reported to be 200 episodes per 100,000 person-years during 2003–2004. Multidrug-resistant (resistance to the first-line antimicrobials ampicillin, cotrimoxazole, and chloramphenicol) strains of S. Typhi and S. Paratyphi are on the rise globally and even cases of extensively drug-resistant (XDR) typhoid cases resistant to chloramphenicol, ampicillin, trimethoprim-sulfamethoxazole, third generation cephalosporins and fluoroquinolones are being reported from many corners of the world. This descriptive, observational study was carried out in Rajshahi Medical College Hospital Hospital, Rajshahi, Bangladesh from July 2017 to June 2019. Antibiotic sensitivity pattern of total 76 cases of enteric fever due to Salmonella Typhi were studied. Blood culture was carried out by BACT ALERT-3D, Automated blood culture analyzer from BioMeriuex SA, France Patented FAN Plus method. Based on the minimum inhibitory concentration (MIC), the organism was categorized as sensitive, intermediate, and resistant against the respective antibiotics as per Clinical and Laboratory Standards Institute (CLSI) criteria. We are reporting antibiotic sensitivity and resistant patterns of S. Typhi documented in Rajshahi Medical College Hospital, a large tertiary care hospital in Northern Bangladesh. TAJ 2020; 33(2): 10-14

Phenotypic and Genotypic Isolation of MRSA from Burn Wound Infected Patients at a Tertiary Care Hospital in Bangladesh

2020 ◽  
Vol 7 (1) ◽  
pp. 12-17
Author(s):  
Anika Tasnim ◽  
AKM Shamsuzzaman ◽  
Md Shah Alam ◽  
Jannatul Ferdose ◽  
Fazlay Akbar Khan
Keyword(s):  
Culture Media ◽  
Tertiary Care ◽  
Meca Gene ◽  
Cross Sectional Study ◽  
Diffusion Method ◽  
Care Hospital ◽  
Burn Wound ◽  
College Hospital ◽  
Cross Sectional ◽  
Medical College

Background: Patients of burn wound are generally more susceptible to infection due to concurrent status of malnutrition and immunosuppression. Among many bacteria, MRSA has appeared as a challenging pathogen irrespective of effective antibiotic therapy. Objective: The purpose of the present study was to detect the prevalence and antibiogram of MRSA in burn wound infected patients. Methodology: The present cross sectional study was conducted at Department of Microbiology in Rajshahi Medical College, Rajshahi, Bangladesh. The samples were collected from Burn and Plastic Surgery Unit of Rajshahi Medical College Hospital, for a period of one year. Phenotypic detection of MRSA were done by cefoxitin disc diffusion method and genotype (mecA gene) was detected by PCR which was conducted at Dhaka Medical College, Dhaka among all the S. aureus isolates. Result: A total of 212 wound swabs were subjected to bacteriological culture media for isolation of MRSA and other organisms. As a whole 89.62% samples yielded growth in culture of which Pseudomonas aeruginosa was the predominant pathogen (34.18%). Out of 21 S.aureus isolates, 07(33.33%) were detected as MRSA by cefoxitin resistance and presence of mecA gene. Although over 85% MRSA were resistance to ciprofloxacin and ceftriaxone, but the present study could not detect any vancomycin resistant MRSA. Conclusion: The high prevalence and decreased sensitivity of MRSA to commonly used antibiotics has been observed in Burn Unit of RMCH. Therefore it is necessary to establish an antimicrobial surveillance system in hospital settings to prevent the spread of MRSA. Bangladesh Journal of Infectious Diseases 2020;7(1):12-17

scholarly journals Estimation of Serum Copper in Post-menopausal Women Attending in a Tertiary Care Hospital, Bangladesh

2019 ◽  
Vol 10 (2) ◽  
pp. 110-113
Author(s):  
N Ferdous ◽  
Farzana Akonjee Mishu ◽  
Shamsunnahar ◽  
Syed Md Tanjilul Haque ◽  
ANM Ashikur Rahman Khan ◽  
...  
Keyword(s):  
Clinical Symptoms ◽  
Tertiary Care ◽  
Premenopausal Women ◽  
Serum Copper ◽  
Copper Level ◽  
Care Hospital ◽  
College Hospital ◽  
Cross Sectional ◽  
Medical College ◽  
Significant Difference

Background: Nutritional needs change throughout the various stages of life. While overall caloric needs tend to decrease with age, the requirements for individual micronutrients do not decrease. In fact, the needs for some micronutrients actually increase with age. The risk of nutritional disturbances mainly trace elements deficiencies is high during postmenopause causing or intensifying serious clinical symptoms. Methods: This cross sectional study was carried out in the Department of Biochemistry, Mymensingh Medical College in collaboration with the Department of Obstetrics and Gynecology, Mymensingh Medical College Hospital during the period from July 2013 to June 2014. A total of 100 subjects were included in this study. Among them 50 apperantly healthy postmenopausal women (Case) aged between 45-60 years were considered as case and another 50 regular menstruating premenopausal women(Control) aged between 30-40 years were selected as control. Results: The mean age of cases and control groups was 50.5±2.3 years and 36.5±4.4 years respectively. In this study we found Serum Copper levels in cases and controls were 115.36±8.836 µg /dl and 90.58 ±6.315 µg/dl respectively had (p< 0.01) significant difference. Conclusion: Serum Copper level was significantly increased in postmenopausal group in comparison to premenopausal women (p< 0.01). Estimation of serum Cu level might be incorporated in every postmenopausal woman for prevention of complications. Anwer Khan Modern Medical College Journal Vol. 10, No. 2: July 2019, P 110-113

scholarly journals Multimorbidity Patterns Among Hospitalized Geriatric Patients in Medicine Wards of a Tertiary Care Hospital in Dhaka City

2021 ◽  
Vol 7 (1) ◽  
pp. 56-59
Author(s):  
Sumiya Bent Kalam ◽  
Sadia Islam ◽  
Mohammad Abdullah Az Zubayer Khan ◽  
Tanjina Akhter
Keyword(s):  
Diabetes Mellitus ◽  
Elderly Patients ◽  
Tertiary Care Hospital ◽  
Tertiary Care ◽  
Medical College Hospital ◽  
Care Hospital ◽  
College Hospital ◽  
Cross Sectional ◽  
Female Ratio ◽  
Medical College

Background: Elderly people are posing a significant health burden in our country for their multi morbidity as economic growth has increased our life expectancy. Pattern of multi morbidity of this older people varies according to geography, ethnicity, culture and life style. Aim: The aim of this study was to identify the prevalence and pattern of multi morbidity of elderly patients admitted in a tertiary care hospital. Method: 50 random cases of elderly patients aged more than 60 years admitted in medicine and allied wards of Dhaka medical college hospital were observed at this cross-sectional study from January 2017 to June 2017(total 6 months period). Data were reviewed and analyzed using simple frequency and percentage. Protocol was reviewed by institutional ethical board (IRB) of Dhaka medical college hospital. Result: A total number of 50 elderly patients with age ranging from 60 to 95 years were observed with male and female ratio 1.3:1 having multi morbidity among 92.0% patients and female is more affected than male. Hypertension, ischemic heart disease, diabetes mellitus and stroke were found most common diseases as individual. Hypertension and diabetes mellitus was found as the most common multi morbidity pattern followed by hypertension and IHD, stroke & diabetes mellitus. Conclusion: This study sheds light on priority needs of elderly patients in terms of medical facility in tertiary care hospital of Bangladesh. Journal of National Institute of Neurosciences Bangladesh, January 2021, Vol. 7, No. 1, pp. 56-59

Pattern of Skin Diseases in Patients Attending OPD of Dermatology and Venereology in a Tertiary Care Hospital in Bangladesh

2018 ◽  
Vol 4 (2) ◽  
pp. 116-122
Author(s):  
Mohammad Niamat Alahi ◽  
Md Anowar Hossain ◽  
Abu Sayeed Mohammad
Keyword(s):  
Skin Diseases ◽  
Tertiary Care ◽  
Cross Sectional Study ◽  
Outpatient Department ◽  
Care Hospital ◽  
Transmitted Infection ◽  
College Hospital ◽  
Cross Sectional ◽  
Sexually Transmitted ◽  
Medical College

Background: Skin diseases account for a higher proportion of outpatient department in developing countries including Bangladesh.Objective: The purpose of the present study was to evaluate the pattern of skin diseases in patients attending OPD of Dermatology and venereology in a tertiary care hospital.Methodology: This cross-sectional study was conducted in the outpatient department of medical college hospital of Kishoreganj in Bangladesh from 2013 to 2016 for a period of four (4) years. All the patients at any age and sex who were attended in the OPD of the hospital selected as study population. Only newly diagnosed cases were included in the study. The socio-demographic profiles and diseases pattern were recorded in a data sheet. Diagnosis was made on clinical basis by expert dermatologist. Lab investigations were restricted to the cases where it carried diagnostic importance.Result: A total number of 119228 patients (near about 82/day) were recruited for this study. Out of them 57825 (48.5%) cases were male and 61403 (51.5%) cases were female. Infective diseases were more common than non-infective diseases which were (65409; 54.9%) and (53819; 45.1%) cases respectively. In cases of infective diseases; parasitic, fungal, bacterial, viral, sexually transmitted infection and other nonspecific infections were 20408(31.2%), 17464(26.7%), 12166(18.6%), 8503(13.0%), 3597(5.5%) and 3271(5.0%) respectively. Out of 20408 parasitic diseases of which 20061(98.3%) cases were scabies and 1347(1.7%) cases were pediculosis. Out of 17464 fungal diseases tinea capitis, tinea corporis, tinea cruris, candidiasis, onychomycosis and pityriasis versicolor were found in 2655(15.2%) cases, 3737(21.4%) cases, 3423(19.6%) cases, 3127(17.9%) cases, 1031(5.9%) cases and 3492(20.0%) cases respectively. Out of 12166 bacterial diseases Impetigo was found in 4745(39.0%) cases, pyoderma in 4282(35.2%) cases, folliculitis in 3103(25.5%) cases, leprosy in 24(0.2%) cases and skin TB in 12(0.1%) cases. Among the viral diseases verruca was found in 4056(47.7%) cases. In case of non-infective diseases, eczema, papulo-squamous disease, acne, urticarial, drug reaction, vitiligo, chronic arsenicosis, neoplastic skin disorder, genodermatoses and others were 16953(31.5%), 9903( 18.4%),7696( 14.3%), 8019( 14.9%), 4682( 8.7%), 2099( 3.9%), 269(0.5%), 161(0.3%), 431(0.8%) and 3606( 6.7%) respectively.Conclusion: In conclusion, we found that a huge burden of skin diseases are present in the OPD. Infective skin diseases mostly bacterial and parasitic still predominant in Bangladesh though it is less frequent in developed countries.Journal of National Institute of Neurosciences Bangladesh, 2018;4(2): 116-122

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