Discussion on Clinical Pharmaceutical Care in Out-patient Department of Maternity and Children’s Hospital

2021 ◽  
2021 ◽  
Vol 9 (1) ◽  
pp. 8-17
Author(s):  
Bidhya Maharjan ◽  
Shovana Thapa Karki ◽  
Roshani Maharjan

A wound gets infected when the organism gets invaded through the breached skin, proliferated and production of various enzymes, toxins, etc. In order to treat the wound infection, antibiotic susceptibility pattern of organism should be determined before the prescription of the medicine. The present study was conducted from September 2017 to March 2018 with an aim to determine antibiotic susceptibility pattern of Staphylococcus aureus identified from the pus/wound swab among the patients visiting the International Friendship Children's Hospital, Kathmandu, Nepal. Total 270 sample were processed, isolated and identified using standard microbiological procedure and biochemical test. Antibiotic susceptibility test was carried out by using Modified Kirby Bauer's Disc Diffusion Method. Out of total sample, 51.48% (139) showed growth. The growth distribution was found to be high in out-patient department 84.9% (118) than in-patient department 15.1% (21). Among 139 positive growth, 83.5% were gram positive and 16.5% were gram negative. All together 12 different organisms were identified, among which S. aureus was found to be predominant organism 105 (75.5%). S. aureus was found to be sensitive towards Linezolid followed by Doxycycline whereas it was found resistant towards Ciprofloxacin. Among S. aureus identified, 50% were Multidrug resistant (MDR) S. aureus and 55% were Methicillin resistance S. aureus (MRSA). MRSA was found to be sensitive towards Linezolid followed by Doxycycline and resistant towards Ciprofloxacin. The association between MDR and MRSA was found positively significant (i.e. p-value = 0.000). All strains of S. aureus were found to be sensitive towards Vancomycin.  22.86% were double disk diffusion test (D-test) positive. The prevalence of D-test was found to be high in MRSA (75%). The relationship between D-test and MRSA was found to be significantly correlated with each other (r = 0.39). Linezolid, Chloramphenicol, Vancomycin and Doxycycline is a drug of a choice for both S. aureus and MRSA infection.


1941 ◽  
Vol 87 (369) ◽  
pp. 545-571 ◽  
Author(s):  
T. A. Ratcliffe

Although Selter (1) appears to have described examples of this disease in 1903, it was not given its present name, nor was it generally recognized, until 1914, when Swift (2) in Australia described fourteen cases of a clinical disease entity and gave it the name of “erythroedema.”Since then a number of other cases and series of cases have been described and much work has been done in investigating its possible pathology and aetiology.Byfield (1920) (3), Parkes Weber, Thursfield and Patterson (1922) (4), Findlay and Stern (1929) (5), and Wylie and Stern (1931) (6) have contributed papers in the English language.In 1923 Patterson and Greenfield (10) published a review of the disease and discussed in particular the pathology and causation of its polyneuritic aspect.A description of the disease is to be found in most works on paediatrics, in particular those of Findlay (7) and Hutchinson (8), whilst Still (9) gives a series of 17 cases observed by him. A further description is given by Brain (12), whilst Rocaz (11) has published a monograph summarizing our knowledge of the disease. Reference to this and further literature will be made later in this paper as various points are discussed.In the present investigation 15 cases of pink disease are considered. Of these 7 were obtained from the records of cases admitted to the Sheffield Children's Hospital in the two years 1931 and 1932. One was personally seen by the writer at St. Thomas's Hospital, London, in 1933, and 7 more have been personally investigated in the Sheffield Children's Hospital between October, 1933, and March 1, 1935. In addition many of the old cases have been seen and followed up in the Out-Patient Department by the writer. Some other investigations which bear upon the subject are also described.


Author(s):  
Donald W. Winnicott

This essay considers Winnicott’s clinic at Paddington Green Children’s Hospital (a medical out-patient department) and describes how it has a proportion of cases needing hostel management. Two broad categories of such children exist in peacetime: (1) homeless children or those whose parents cannot form a stable background where a child can develop and (2) children with a mentally ill parent. Such children need what children who were difficult to billet needed: environmental stability, personal management, and continuity. Winnicott describes his work with the hostels, and the importance of finding a link between the child, the parents, and the hostel wardens. He regrets the closing of wartime hostels, causing the loss of accommodation for the early antisocial cases, and the current existence of practically no provision for mad children.


2021 ◽  
Vol 17 (1) ◽  
pp. 55-60
Author(s):  
Anupama Kumari Yadav ◽  
Subhana Thapa Karki

Introduction: The causes of Short Stature in children are different in different countries. It can vary from endocrine to non-endocrine. This study was conducted to identify the causes of short stature in children who are brought in Endocrine Out Patient Department of Kanti Children’s Hospital. Methods: This is a retrospective study done at Endocrine Out Patient Department of Kanti Children’s Hospital for ten year duration. One Hundred and Twenty five Children who were brought with chief complain of not gaining height were included.  Children’s were evaluated for causes of short stature. Results: Male and Female ratio was 1.2:1. The commonest cause seen was Familial Short Stature 41(32.8%), Constitutional 22(17.6%), Hypothyroidism 20 (16%), Syndromic 13 (10.4%), Skeletal Dysplasia 10 (8%), Malnutrition 10 (8%), Chronic Diseases 7 (5.6%) and Growth Hormone Deficiency 2 (1.6%). Conclusions: This study showed  Familial and Constitutional short stature as leading cause of short stature.  Hypothyroidism and Malnutrition account for significant percentage which are treatable cause. Down’s syndrome(40%) and Turner Syndrome(7.6%) are the main genetic causes of short stature.


2008 ◽  
Vol 18 (2) ◽  
pp. 76-86 ◽  
Author(s):  
Lauren Hofmann ◽  
Joseph Bolton ◽  
Susan Ferry

Abstract At The Children's Hospital of Philadelphia (CHOP) we treat many children requiring tracheostomy tube placement. With potential for a tracheostomy tube to be in place for an extended period of time, these children may be at risk for long-term disruption to normal speech development. As such, speaking valves that restore more normal phonation are often key tools in the effort to restore speech and promote more typical language development in this population. However, successful use of speaking valves is frequently more challenging with infant and pediatric patients than with adult patients. The purpose of this article is to review background information related to speaking valves, the indications for one-way valve use, criteria for candidacy, and the benefits of using speaking valves in the pediatric population. This review will emphasize the importance of interdisciplinary collaboration from the perspectives of speech-language pathology and respiratory therapy. Along with the background information, we will present current practices and a case study to illustrate a safe and systematic approach to speaking valve implementation based upon our experiences.


Author(s):  
Patrick J. McGrath ◽  
Garry Johnson ◽  
John T. Goodman ◽  
John Schillinger ◽  
Jennifer Dunn ◽  
...  

Sign in / Sign up

Export Citation Format

Share Document