Any condition of the body or mind that makes it more difficult for the person with the condition to do certain activities and interact with the world around them is known as a disability. Despite the various efforts being done to ensure their rights and equity of the disabled, they still suffer more during various crises like conflicts, natural disasters and pandemics. The purpose of this narrative review is to access the impact that the COVID-19 pandemic has had on People with disability (PWD). For writing this narrative review, Google, Google Scholar, Pub Med and online news portals were searched by using various combination of the following terminologies; “Disability”, “Differently “Disabled”, “Disable”, “People with Disability”, “PWD” “Impact”, “COVID-19”, “Corona Pandemic”, “Challenges”, “Issues”, “Policies”, “Social”, and “increased risk”. The pandemic has created many challenges for people with disability. They not have greater risk of contracting COVID-19, but also have problems accessing health services. It has also had various social impacts like problems related to education, employment as well as discrimination. The COVID pandemic has exposed gaps in the health system that make the poor, marginalized and disabled population more vulnerable to neglect and mistreatment. Proper implementation and monitoring of policies should be done to ensure that PWD feel included and respected. It is important to continually integrate PWD into the mainstream society while minimizing their risks of contracting COVID-19. The caretakers should use the necessary PPE when attending to their needs.
{"title":"Impact of COVID-19 on People with Disabilities","authors":"S. Pant, Saugat Koirala, M. Subedi","doi":"10.46405/ejms.v3i2.294","DOIUrl":"https://doi.org/10.46405/ejms.v3i2.294","url":null,"abstract":"Any condition of the body or mind that makes it more difficult for the person with the condition to do certain activities and interact with the world around them is known as a disability. Despite the various efforts being done to ensure their rights and equity of the disabled, they still suffer more during various crises like conflicts, natural disasters and pandemics. The purpose of this narrative review is to access the impact that the COVID-19 pandemic has had on People with disability (PWD). For writing this narrative review, Google, Google Scholar, Pub Med and online news portals were searched by using various combination of the following terminologies; “Disability”, “Differently “Disabled”, “Disable”, “People with Disability”, “PWD” “Impact”, “COVID-19”, “Corona Pandemic”, “Challenges”, “Issues”, “Policies”, “Social”, and “increased risk”. The pandemic has created many challenges for people with disability. They not have greater risk of contracting COVID-19, but also have problems accessing health services. It has also had various social impacts like problems related to education, employment as well as discrimination. The COVID pandemic has exposed gaps in the health system that make the poor, marginalized and disabled population more vulnerable to neglect and mistreatment. Proper implementation and monitoring of policies should be done to ensure that PWD feel included and respected. It is important to continually integrate PWD into the mainstream society while minimizing their risks of contracting COVID-19. The caretakers should use the necessary PPE when attending to their needs.","PeriodicalId":254508,"journal":{"name":"Europasian Journal of Medical Sciences","volume":"12 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2021-10-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"132057180","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
S. Shanker, S. P. Wasti, J. Ireland, P. Regmi, P. Simkhada, Edwin Roland van Teijlingen
Worldwide there is a growing interest in multidisciplinary and interdisciplinary research. This overview paper addresses some of the pitfalls and barriers to being an interdisciplinary researcher. Being involved in interdisciplinary research is not an easy option for an individual discipline expert. It requires individual skills, ability to see beyond one’s discipline and perhaps personality characteristics such as a great team player. Interdisciplinary research may involve a mixed-methods approach underpinned by conflicting, and according to some incommensurable, research philosophies. The paper uses some examples from our own experiences of working in interdisciplinary teams to illustrate its potential.
{"title":"The Interdisciplinary Research Team not the Interdisciplinarist","authors":"S. Shanker, S. P. Wasti, J. Ireland, P. Regmi, P. Simkhada, Edwin Roland van Teijlingen","doi":"10.46405/ejms.v3i2.317","DOIUrl":"https://doi.org/10.46405/ejms.v3i2.317","url":null,"abstract":"Worldwide there is a growing interest in multidisciplinary and interdisciplinary research. This overview paper addresses some of the pitfalls and barriers to being an interdisciplinary researcher. Being involved in interdisciplinary research is not an easy option for an individual discipline expert. It requires individual skills, ability to see beyond one’s discipline and perhaps personality characteristics such as a great team player. Interdisciplinary research may involve a mixed-methods approach underpinned by conflicting, and according to some incommensurable, research philosophies. The paper uses some examples from our own experiences of working in interdisciplinary teams to illustrate its potential.","PeriodicalId":254508,"journal":{"name":"Europasian Journal of Medical Sciences","volume":"38 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2021-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"132048254","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Background: Preterm infants (PTIs) are vulnerable to morbidity, mortality, disability. They require special treatment and care in neonatal care units (NCUs) for survival and developmental potential. Nurses have the significant responsibility for providing quality care to these infants. To find out the care status, it is necessary to have a valid and reliable instrument.Objective: The study was conducted to develop and test an instrument to assess PTI care practice by nurses in NCUs.Methods: The instrument was developed based on literature review and the finding of the focus group discussion (FGD). The instrument was developed in August 2020 and pretested among 30 nurses working in NCUs of two private teaching hospitals of Kathmandu during September 2020. Measures were used to ensure the validity of the instrument. The content validity index (CVI) scores for items and scale were calculated from the scores given by the eight experts. The Cronbach alpha (α) was calculated considering the acceptable α-value > 0.7. Results: The instrument having four domains, 47 items and 5 sub-items was developed to assess PTI care practice. The instrument had a satisfactory CVI score for each item (>0.75) and overall scale (>0.9). The Cronbach alpha value for the subscales were between 0.79 and 0.88 and the overall scale was >0.93. Conclusion: The instrument to assess preterm infant care practice provided by nurses in NCU was developed with adequate theoretical and contextual background. Necessary validity and reliability processes and criteria were also employed. Therefore, the instrument might be useful to assess the PTI care practice of nurses in NCUs in Nepalese context.
{"title":"Development and Testing of Instrument to Assess Preterm Infant Care Practice in Neonatal Care Units","authors":"T. Shrestha, Archana Pandey Bista","doi":"10.46405/ejms.v3i2.260","DOIUrl":"https://doi.org/10.46405/ejms.v3i2.260","url":null,"abstract":"Background: Preterm infants (PTIs) are vulnerable to morbidity, mortality, disability. They require special treatment and care in neonatal care units (NCUs) for survival and developmental potential. Nurses have the significant responsibility for providing quality care to these infants. To find out the care status, it is necessary to have a valid and reliable instrument.Objective: The study was conducted to develop and test an instrument to assess PTI care practice by nurses in NCUs.Methods: The instrument was developed based on literature review and the finding of the focus group discussion (FGD). The instrument was developed in August 2020 and pretested among 30 nurses working in NCUs of two private teaching hospitals of Kathmandu during September 2020. Measures were used to ensure the validity of the instrument. The content validity index (CVI) scores for items and scale were calculated from the scores given by the eight experts. The Cronbach alpha (α) was calculated considering the acceptable α-value > 0.7. Results: The instrument having four domains, 47 items and 5 sub-items was developed to assess PTI care practice. The instrument had a satisfactory CVI score for each item (>0.75) and overall scale (>0.9). The Cronbach alpha value for the subscales were between 0.79 and 0.88 and the overall scale was >0.93. Conclusion: The instrument to assess preterm infant care practice provided by nurses in NCU was developed with adequate theoretical and contextual background. Necessary validity and reliability processes and criteria were also employed. Therefore, the instrument might be useful to assess the PTI care practice of nurses in NCUs in Nepalese context.","PeriodicalId":254508,"journal":{"name":"Europasian Journal of Medical Sciences","volume":"40 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2021-08-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"122643017","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
B. Mishra, J. Chowdhury, R. Raman, Dipmalya Chakraborty, Tanmoy Karmakar
Background: Different treatment regimens of analgesia, nerve blocks and epidurals are used for pain relief in Total Knee Arthroplasty (TKA). Local infiltration analgesia (LIA) is one of the modalities in which a cocktail combination of different medicines is infiltrated locally into the capsule, surrounding tissues or intraarticular joint space. This study aims to analyze the effectiveness of periarticular injection of combination drugs (Bupivacaine, Ketorolac and Morphine) during TKA for postoperative pain management. Methods: Total of 150 patients who underwent primary unilateral TKA were randomly categorized into 2 groups (75 each). Group A (control group) didn’t receive intraoperative periarticular injection but Group-B received the intraoperative injection of combined local analgesics and anaesthetics (Bupivacaine, Ketorolac and Morphine). Pain following surgery at 0, 1, and 2 postoperative days were recorded with visual analogue scale (VAS) whereas Knee Society Score was used to evaluate the pain and function pre-operative and 3 months’ post-operative. Statistical analysis was done using SPSS software. Results: Patients receiving periarticular infiltration of combination drugs intraoperatively had lower VAS for postoperative pain (p < 0.001) and this group also showed reduced need of analgesia postoperatively. Conclusions: Periarticular infiltration of knee during Total Knee Arthroplasty is effective in management of postoperative pain Keywords: Periarticular; Total Knee Arthroplasty; combination drugs; postoperative pain
背景:在全膝关节置换术(TKA)中，不同的镇痛、神经阻滞和硬膜外治疗方案被用于缓解疼痛。局部浸润镇痛(局部浸润镇痛)是一种将不同药物的鸡尾酒组合局部浸润到胶囊、周围组织或关节内关节间隙的方式。本研究旨在分析关节周注射联合药物(布比卡因、酮罗拉酸和吗啡)用于TKA术后疼痛管理的有效性。方法:150例原发性单侧TKA患者随机分为两组，每组75例。A组(对照组)术中不给予关节周注射，b组术中给予局部镇痛麻醉剂(布比卡因、酮罗拉酸、吗啡)联合注射。采用视觉模拟评分法(VAS)记录术后0、1、2天的疼痛，采用膝关节社会评分法(Knee Society Score)评估术前和术后3个月的疼痛和功能。采用SPSS软件进行统计分析。结果:术中关节周浸润联合用药组患者术后疼痛VAS降低(p < 0.001)，术后镇痛需求减少。结论:全膝关节置换术中膝关节关节周浸润是治疗术后疼痛的有效方法。全膝关节置换;组合药物;术后疼痛
{"title":"Effectiveness of Periarticular Infiltration of the Knee during Total Knee Arthroplasty for Postoperative Pain Management","authors":"B. Mishra, J. Chowdhury, R. Raman, Dipmalya Chakraborty, Tanmoy Karmakar","doi":"10.46405/ejms.v3i2.341","DOIUrl":"https://doi.org/10.46405/ejms.v3i2.341","url":null,"abstract":"Background: Different treatment regimens of analgesia, nerve blocks and epidurals are used for pain relief in Total Knee Arthroplasty (TKA). Local infiltration analgesia (LIA) is one of the modalities in which a cocktail combination of different medicines is infiltrated locally into the capsule, surrounding tissues or intraarticular joint space. This study aims to analyze the effectiveness of periarticular injection of combination drugs (Bupivacaine, Ketorolac and Morphine) during TKA for postoperative pain management. \u0000Methods: Total of 150 patients who underwent primary unilateral TKA were randomly categorized into 2 groups (75 each). Group A (control group) didn’t receive intraoperative periarticular injection but Group-B received the intraoperative injection of combined local analgesics and anaesthetics (Bupivacaine, Ketorolac and Morphine). Pain following surgery at 0, 1, and 2 postoperative days were recorded with visual analogue scale (VAS) whereas Knee Society Score was used to evaluate the pain and function pre-operative and 3 months’ post-operative. Statistical analysis was done using SPSS software. \u0000Results: Patients receiving periarticular infiltration of combination drugs intraoperatively had lower VAS for postoperative pain (p < 0.001) and this group also showed reduced need of analgesia postoperatively. \u0000Conclusions: Periarticular infiltration of knee during Total Knee Arthroplasty is effective in management of postoperative pain \u0000Keywords: Periarticular; Total Knee Arthroplasty; combination drugs; postoperative pain","PeriodicalId":254508,"journal":{"name":"Europasian Journal of Medical Sciences","volume":"6 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2021-08-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"126883240","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Peer review (PR) is a relatively recent development though it has become an established part of academic publishing. PR started becoming common in the 1960s and 70s. Peer review can be of different types. It can be blinded or open. The process can be done before publication or after a manuscript is published. Portable reviews, impact neutral PR, collaborative PR, and registered reports are also used. There are challenges with peer review which remains a largely subjective process. Due to increasing number of journals and submissions there is an urgent need for more reviewers, especially from the developing nations and from women. Academic publishing is a lucrative business dominated by a few big publishers. Reviewers should be rewarded financially either directly or through processing charge waivers or through journal and database subscription for their efforts.
{"title":"Recognizing and Rewarding Peer-reviewers","authors":"Prabakaran Shankar","doi":"10.46405/ejms.v3i2.353","DOIUrl":"https://doi.org/10.46405/ejms.v3i2.353","url":null,"abstract":"Peer review (PR) is a relatively recent development though it has become an established part of academic publishing. PR started becoming common in the 1960s and 70s. Peer review can be of different types. It can be blinded or open. The process can be done before publication or after a manuscript is published. Portable reviews, impact neutral PR, collaborative PR, and registered reports are also used. There are challenges with peer review which remains a largely subjective process. Due to increasing number of journals and submissions there is an urgent need for more reviewers, especially from the developing nations and from women. Academic publishing is a lucrative business dominated by a few big publishers. Reviewers should be rewarded financially either directly or through processing charge waivers or through journal and database subscription for their efforts. ","PeriodicalId":254508,"journal":{"name":"Europasian Journal of Medical Sciences","volume":"48 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2021-08-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"128720487","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Shambhu Shah, P. Dahal, A. K. Sah, S. Parajuli, N. Shrestha
Background: Periodic assessment of morbidity and drug use at various levels of healthcare delivery system is important to recognize common prevalent morbidities and rationalize the use of medicines. The study was conducted to determine the common morbidities and audit prescription using WHO prescribing indicator in government operated tertiary hospitals of eastern Nepal. Methods: A cross-sectional study was carried out in government tertiary hospitals of Province 1, Nepal, from March 2019 to August 2019. For analysis, descriptive statistics were used. Prescribing characteristics were evaluated using recommended guidelines of the World Health Organization (WHO) prescribing indicators. Results: Six hundred prescriptions were analyzed. The most prevalent morbidity was endocrine, nutrition & metabolic diseases (21.5%) followed by diseases of the respiratory system (19.8%), circulatory system (17.6%), and digestive system (12.8%). The most frequently encountered individual disease entity were hypertension (18.7%), diabetes (15.5%), acid peptic disorders (14%). A total of 2072 drugs were prescribed with an average of 3.45 (± 1.39) drugs per consultation. About 30.2% of prescriptions encountered contain at least one antibiotics, whereas injectable were prescribed in 1.8%. Only 3.9% of total medicines were prescribed in generic name and 31.7% of drug prescribed were from essential medicine list. Conclusion: Among the prescriptions evaluated, diseases of the endocrine, respiratory, cardiovascular, and gastrointestinal systems were the most common morbidities. Polypharmacy was prevalent to some extent whereas prescribing in generic and essential medicine list was poor relative to standard WHO recommendations. However, the overall prescribing of antibiotics and injection were found to be satisfactory.
{"title":"Morbidity profile and prescription audits using WHO core prescribing indicator in government hospitals of Province 1, Nepal","authors":"Shambhu Shah, P. Dahal, A. K. Sah, S. Parajuli, N. Shrestha","doi":"10.46405/ejms.v3i2.340","DOIUrl":"https://doi.org/10.46405/ejms.v3i2.340","url":null,"abstract":"Background: Periodic assessment of morbidity and drug use at various levels of healthcare delivery system is important to recognize common prevalent morbidities and rationalize the use of medicines. The study was conducted to determine the common morbidities and audit prescription using WHO prescribing indicator in government operated tertiary hospitals of eastern Nepal. \u0000Methods: A cross-sectional study was carried out in government tertiary hospitals of Province 1, Nepal, from March 2019 to August 2019. For analysis, descriptive statistics were used. Prescribing characteristics were evaluated using recommended guidelines of the World Health Organization (WHO) prescribing indicators. \u0000Results: Six hundred prescriptions were analyzed. The most prevalent morbidity was endocrine, nutrition & metabolic diseases (21.5%) followed by diseases of the respiratory system (19.8%), circulatory system (17.6%), and digestive system (12.8%). The most frequently encountered individual disease entity were hypertension (18.7%), diabetes (15.5%), acid peptic disorders (14%). A total of 2072 drugs were prescribed with an average of 3.45 (± 1.39) drugs per consultation. About 30.2% of prescriptions encountered contain at least one antibiotics, whereas injectable were prescribed in 1.8%. Only 3.9% of total medicines were prescribed in generic name and 31.7% of drug prescribed were from essential medicine list. \u0000Conclusion: Among the prescriptions evaluated, diseases of the endocrine, respiratory, cardiovascular, and gastrointestinal systems were the most common morbidities. Polypharmacy was prevalent to some extent whereas prescribing in generic and essential medicine list was poor relative to standard WHO recommendations. However, the overall prescribing of antibiotics and injection were found to be satisfactory.","PeriodicalId":254508,"journal":{"name":"Europasian Journal of Medical Sciences","volume":"64 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2021-08-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"128746962","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Addressing Antimicrobial Resistance in Nepal: A Call for Collaborative Efforts","authors":"S. Khadka, S. Giri","doi":"10.46405/ejms.v3i2.354","DOIUrl":"https://doi.org/10.46405/ejms.v3i2.354","url":null,"abstract":"Click on \"Download Full Text pdf\" to read","PeriodicalId":254508,"journal":{"name":"Europasian Journal of Medical Sciences","volume":"1 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2021-07-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"124390360","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Nepal earthquake of 2015, a massive earthquake that struck near the city of Kathmandu (Gorkha) in central Nepal on April 25, 2015. Nearly 9,000 people were killed, many thousands more were injured, and more than 600,000 structures in Kathmandu and other nearby 31 districts were either damaged or destroyed. The earthquake was felt throughout central and eastern Nepal, much of the Ganges River plain in northern India, and northwestern Bangladesh, as well as in the southern parts of the Plateau of Tibet and western Bhutan.
{"title":"Remembering Nepal Earthquake of 2015 and Updating Post-earthquake Reconstruction","authors":"G. Dangal, Ojash Dangal, Dharana Gelal","doi":"10.46405/ejms.v3i2.352","DOIUrl":"https://doi.org/10.46405/ejms.v3i2.352","url":null,"abstract":"Nepal earthquake of 2015, a massive earthquake that struck near the city of Kathmandu (Gorkha) in central Nepal on April 25, 2015. Nearly 9,000 people were killed, many thousands more were injured, and more than 600,000 structures in Kathmandu and other nearby 31 districts were either damaged or destroyed. The earthquake was felt throughout central and eastern Nepal, much of the Ganges River plain in northern India, and northwestern Bangladesh, as well as in the southern parts of the Plateau of Tibet and western Bhutan.","PeriodicalId":254508,"journal":{"name":"Europasian Journal of Medical Sciences","volume":"6 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2021-07-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"122193857","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Talal Alhouzani, Mohammad Saleem, Arun Sharma, S. Khadka, Ravi Prasad Gupta, P. Aryal
Background: The rampant use of antimicrobials in poultry farms is creating a global public health threat as antimicrobial resistance (AMR) in humans may arise from such practice. This study was conducted with the objective of quantification and hence assessment of the level of antimicrobial use in Pakistani poultry farms so that appropriate utilization of such agents can be assured. Methods: Six randomly selected poultry farms of Pakistan with ten production cycles with 20,000- 30,000 birds in every production cycle were selected for the study from 2018 to 2019. The average dosage utilized on-farm was described by the defined daily dose (DDD) and used daily dose (UDD). Results: It was found that enrofloxacin, amoxicillin, doxycycline, tylocin, and lincomycin were the antimicrobials commonly used by all poultry farms. However, only Enrofloxacin (UDD/DDD = 0.95) was being used within the rational therapeutic range. All the antimicrobials were used irrationally without proper indication and suggestion by the veterinarian. No records on antimicrobials use were found on any farm. Conclusion: The irrational use of antimicrobials in poultry farms may lead to antimicrobial resistance which has been a global public health threat. The speedy action should be implemented to discourage such rampant use of drugs in poultry farms in Pakistan and countries with similar farming practices for the effective use of antimicrobials in the proper indication.
{"title":"Irrational Use of Antimicrobials in Poultry Farms and Antimicrobial Resistance: A Cross-Sectional Study","authors":"Talal Alhouzani, Mohammad Saleem, Arun Sharma, S. Khadka, Ravi Prasad Gupta, P. Aryal","doi":"10.46405/ejms.v3i2.316","DOIUrl":"https://doi.org/10.46405/ejms.v3i2.316","url":null,"abstract":"Background: The rampant use of antimicrobials in poultry farms is creating a global public health threat as antimicrobial resistance (AMR) in humans may arise from such practice. This study was conducted with the objective of quantification and hence assessment of the level of antimicrobial use in Pakistani poultry farms so that appropriate utilization of such agents can be assured. \u0000Methods: Six randomly selected poultry farms of Pakistan with ten production cycles with 20,000- 30,000 birds in every production cycle were selected for the study from 2018 to 2019. The average dosage utilized on-farm was described by the defined daily dose (DDD) and used daily dose (UDD). \u0000Results: It was found that enrofloxacin, amoxicillin, doxycycline, tylocin, and lincomycin were the antimicrobials commonly used by all poultry farms. However, only Enrofloxacin (UDD/DDD = 0.95) was being used within the rational therapeutic range. All the antimicrobials were used irrationally without proper indication and suggestion by the veterinarian. No records on antimicrobials use were found on any farm. \u0000Conclusion: The irrational use of antimicrobials in poultry farms may lead to antimicrobial resistance which has been a global public health threat. The speedy action should be implemented to discourage such rampant use of drugs in poultry farms in Pakistan and countries with similar farming practices for the effective use of antimicrobials in the proper indication.","PeriodicalId":254508,"journal":{"name":"Europasian Journal of Medical Sciences","volume":"54 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2021-07-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"130906002","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Background: Intestinal tuberculosis is often difficult to diagnose due to its insidious onset and nonspecific and protean manifestations. Delay or failure of diagnosis is associated with significant complications like perforation, abscess, fistula and strictures. The objective of the study was to provide a descriptive analysis of clinical, endoscopic, radiological and pathological findings in these patients. Methods: A prospective study including 52 hospitalized patients was done between April 2018 to 2020 at Tribhuwan University Teaching Hospital. Statistical analyses were done by Microsoft excel version 16. Results: Males were 63% while females were 37 %. The average age was 37 years. 84% had abdominal pain followed by abdominal distension (50%), chronic diarrhea (51%) and cough (21%). Abnormal chest X-Ray was found in (37%) among whom (53%) had sputum positive for tubercular Bacilli. Common CT scan findings were thickening and heterogenous enhancement of bowel loops (79%), lymphadenopathy (56%) and ascites (44%). Endoscopically, commonly involved sites were terminal Ileum (95%), cecum (77%) and ascending colon (42%). Frequent finding were ulcers (83%), patulous and deformed Ileocecal valve (33%), mucosal nodularity (38%), hypertrophic mucosa (21%) and strictures (11%). Biopsies revealed granulomas in (77%) specimens. (65%) of them had central caseous necrosis. Among 10 subjects undergoing needle aspiration of lymphnodes, (70%) had central caseous necrosis. Those with coexisting peritoneal involvement had a mean ascitic fluid adenosine deaminase level of 73 ± 8 IU/L. Conclusion: Intestinal tuberculosis remains a major concern in developing countries. A composite analysis of the clinical manifestations, CT scan, endoscopic findings and pathological examination of the biopsies aid in making a proper and timely diagnosis so as to prevent complications and mortality.
背景:肠结核由于其隐匿的发病和非特异性和变异性的表现，往往难以诊断。延迟或诊断失败与穿孔、脓肿、瘘管和狭窄等严重并发症有关。该研究的目的是对这些患者的临床、内镜、放射学和病理结果进行描述性分析。方法:对2018年4月至2020年4月在特里布万大学教学医院住院的52例患者进行前瞻性研究。统计分析采用Microsoft excel version 16进行。结果:男性占63%，女性占37%。平均年龄为37岁。84%的患者有腹痛，其次是腹胀(50%)、慢性腹泻(51%)和咳嗽(21%)。37%的患者胸部x线检查异常，其中53%的患者痰液结核杆菌阳性。常见的CT扫描表现为肠袢增厚和异质强化(79%)，淋巴结病变(56%)和腹水(44%)。内镜下，常见受累部位为回肠末端(95%)、盲肠(77%)和升结肠(42%)。常见的发现是溃疡(83%)，回盲瓣扩张和变形(33%)，粘膜结节(38%)，粘膜肥厚(21%)和狭窄(11%)。活检显示肉芽肿(77%)。65%的患者为中心性干酪样坏死。在10例淋巴结穿刺患者中，有70%的患者出现了中枢性干酪样坏死。腹膜同时受累的患者腹水腺苷脱氨酶平均水平为73±8 IU/L。结论:在发展中国家，肠结核仍然是一个主要问题。综合分析临床表现、CT扫描、内窥镜检查和活检病理检查，有助于及时做出正确诊断，预防并发症和死亡。
{"title":"Clinicopathological, Endoscopic and Radiological Evaluation of Intestinal Tuberculosis among Nepalese Patients at a Tertiary Care Center","authors":"T. Sherpa, R. Pathak, Anurag Jha","doi":"10.46405/ejms.v3i1.291","DOIUrl":"https://doi.org/10.46405/ejms.v3i1.291","url":null,"abstract":"Background: Intestinal tuberculosis is often difficult to diagnose due to its insidious onset and nonspecific and protean manifestations. Delay or failure of diagnosis is associated with significant complications like perforation, abscess, fistula and strictures. The objective of the study was to provide a descriptive analysis of clinical, endoscopic, radiological and pathological findings in these patients. Methods: A prospective study including 52 hospitalized patients was done between April 2018 to 2020 at Tribhuwan University Teaching Hospital. Statistical analyses were done by Microsoft excel version 16. Results: Males were 63% while females were 37 %. The average age was 37 years. 84% had abdominal pain followed by abdominal distension (50%), chronic diarrhea (51%) and cough (21%). Abnormal chest X-Ray was found in (37%) among whom (53%) had sputum positive for tubercular Bacilli. Common CT scan findings were thickening and heterogenous enhancement of bowel loops (79%), lymphadenopathy (56%) and ascites (44%). Endoscopically, commonly involved sites were terminal Ileum (95%), cecum (77%) and ascending colon (42%). Frequent finding were ulcers (83%), patulous and deformed Ileocecal valve (33%), mucosal nodularity (38%), hypertrophic mucosa (21%) and strictures (11%). Biopsies revealed granulomas in (77%) specimens. (65%) of them had central caseous necrosis. Among 10 subjects undergoing needle aspiration of lymphnodes, (70%) had central caseous necrosis. Those with coexisting peritoneal involvement had a mean ascitic fluid adenosine deaminase level of 73 ± 8 IU/L. Conclusion: Intestinal tuberculosis remains a major concern in developing countries. A composite analysis of the clinical manifestations, CT scan, endoscopic findings and pathological examination of the biopsies aid in making a proper and timely diagnosis so as to prevent complications and mortality.","PeriodicalId":254508,"journal":{"name":"Europasian Journal of Medical Sciences","volume":"27 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2021-04-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"116797475","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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