Pub Date : 2021-09-06DOI: 10.3126/mjsbh.v20i2.35505
N. Shrestha, Moon Thapa, K. Subedi, S. Karki, S. Adhikari, Anuradha Pandey
Introduction: Hypocalcaemia is common metabolic manifestation in neonates and associated with both maternal and foetal conditions. Hypocalcaemia is labeled if term neonate’s total serum calcium is < 8 mg/dl and preterm has < 7 mg/dl. Association of neonatal and maternal hypovitaminosis D is very common. . Methods: One year retrospective study was conducted in a tertiary level private children hospital of Kathmandu, Nepal from 2018 June to 2019 July. Total 299 cases were selected and serum calcium were sent and analysed for its association with illness, associated maternal hypovitaminosis D and other relevant maternal tests. Result: Among 686 NICU cases, calcium level was sent for 299 cases. Among these, 254 were term and 45 were preterm babies and male to female ratio was 4:1. Mean calcium in term babies were 8.6 mg/dl and in preterm it was 8.1 mg/dl. Hypocalcaemia was found in 19% of cases with mean calcium level was 7.1 ± 0.84 mg/dl and severe hypocalcaemia accounted for 12%. There was no significant presence of hypocalcaemia in relation to gestation of newborn (p value 0.798). We found higher incidence of late onset hypocalcemia than early onset hypocalcemia but was not of statistical significance (p value 0.771). Associated disease were perinatal asphyxia, congenital heart diseases and prematurity. Among 27 late onset hypocalcaemia, 22% had hypovitaminosis D both in neonates and mother. Conclusions: Neonatal hypocalcaemia is a common condition associated with sick newborns. In late hypocalcaemia both newborn and mother should be screened for associated lab tests like vitamin D, magnesium, PTH as there may be association between the two.
{"title":"Occurrence of Hypocalcaemia in Admitted Neonates in NICU","authors":"N. Shrestha, Moon Thapa, K. Subedi, S. Karki, S. Adhikari, Anuradha Pandey","doi":"10.3126/mjsbh.v20i2.35505","DOIUrl":"https://doi.org/10.3126/mjsbh.v20i2.35505","url":null,"abstract":"Introduction: Hypocalcaemia is common metabolic manifestation in neonates and associated with both maternal and foetal conditions. Hypocalcaemia is labeled if term neonate’s total serum calcium is < 8 mg/dl and preterm has < 7 mg/dl. Association of neonatal and maternal hypovitaminosis D is very common. . \u0000Methods: One year retrospective study was conducted in a tertiary level private children hospital of Kathmandu, Nepal from 2018 June to 2019 July. Total 299 cases were selected and serum calcium were sent and analysed for its association with illness, associated maternal hypovitaminosis D and other relevant maternal tests. \u0000Result: Among 686 NICU cases, calcium level was sent for 299 cases. Among these, 254 were term and 45 were preterm babies and male to female ratio was 4:1. Mean calcium in term babies were 8.6 mg/dl and in preterm it was 8.1 mg/dl. Hypocalcaemia was found in 19% of cases with mean calcium level was 7.1 ± 0.84 mg/dl and severe hypocalcaemia accounted for 12%. There was no significant presence of hypocalcaemia in relation to gestation of newborn (p value 0.798). We found higher incidence of late onset hypocalcemia than early onset hypocalcemia but was not of statistical significance (p value 0.771). Associated disease were perinatal asphyxia, congenital heart diseases and prematurity. Among 27 late onset hypocalcaemia, 22% had hypovitaminosis D both in neonates and mother. \u0000Conclusions: Neonatal hypocalcaemia is a common condition associated with sick newborns. In late hypocalcaemia both newborn and mother should be screened for associated lab tests like vitamin D, magnesium, PTH as there may be association between the two.","PeriodicalId":33963,"journal":{"name":"Medical Journal of Shree Birendra Hospital","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-09-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43555320","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}
Pub Date : 2021-09-06DOI: 10.3126/mjsbh.v20i2.36502
Sunil Basukala, Punit Yadav, A. Chatterjee, R. K. Ranyal, M. Baidya
Introduction: Catheter Acquired Urinary Tract Infection (CAUTI) is one of the most common Health Care Acquired Infections (HCAI); most of these infections are attributable to use of an indwelling urethral catheter. The aim of this study was to investigate patients with catheter-associated urinary tract infection over three years at a single hospital’s Intensive Care Unit (ICU) and to identify meaningful risk factors and causative organisms. Methods: A retrograde analysis was performed on patients with indwelling catheters in ICU of Armed Forces Medical College, Pune, India. CAUTI was defined as isolated bacterial growth of 100,000 colony-forming units or more either 48 hours after transfer to the ICU if a urinary catheter was placed before the transfer or 48 hours after insertion if the catheter was inserted in the ICU. Only the patients whose culture results were negative before ICU admission were included. Result: Among 350 samples collected in medical and surgical ICU, 38 patients (10.85%) had CAUTI. Using multivariate logistic regression analysis, the study showed that those with diabetes were 4.51 (p＜0.001) times likely to have occurrences of CAUTI than those without and also showed an increased incidence of CAUTI > 1.19 fold (p＜0.01) among patient with longer duration of an indwelling catheter. Conclusions: CAUTI is a preventable HCAI and thus the risk factors and causative organisms contributing to its development in the management of ICU patients must be considered to prevent the occurrence of UTIs in this setting.
{"title":"Clinical significance of Catheter-Associated Urinary Tract Infection (CAUTI) in Intensive Care Units: Three Year Experience at a Single Centre","authors":"Sunil Basukala, Punit Yadav, A. Chatterjee, R. K. Ranyal, M. Baidya","doi":"10.3126/mjsbh.v20i2.36502","DOIUrl":"https://doi.org/10.3126/mjsbh.v20i2.36502","url":null,"abstract":"Introduction: Catheter Acquired Urinary Tract Infection (CAUTI) is one of the most common Health Care Acquired Infections (HCAI); most of these infections are attributable to use of an indwelling urethral catheter. The aim of this study was to investigate patients with catheter-associated urinary tract infection over three years at a single hospital’s Intensive Care Unit (ICU) and to identify meaningful risk factors and causative organisms. \u0000Methods: A retrograde analysis was performed on patients with indwelling catheters in ICU of Armed Forces Medical College, Pune, India. CAUTI was defined as isolated bacterial growth of 100,000 colony-forming units or more either 48 hours after transfer to the ICU if a urinary catheter was placed before the transfer or 48 hours after insertion if the catheter was inserted in the ICU. Only the patients whose culture results were negative before ICU admission were included. \u0000Result: Among 350 samples collected in medical and surgical ICU, 38 patients (10.85%) had CAUTI. Using multivariate logistic regression analysis, the study showed that those with diabetes were 4.51 (p＜0.001) times likely to have occurrences of CAUTI than those without and also showed an increased incidence of CAUTI > 1.19 fold (p＜0.01) among patient with longer duration of an indwelling catheter. \u0000Conclusions: CAUTI is a preventable HCAI and thus the risk factors and causative organisms contributing to its development in the management of ICU patients must be considered to prevent the occurrence of UTIs in this setting.","PeriodicalId":33963,"journal":{"name":"Medical Journal of Shree Birendra Hospital","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-09-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44596508","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}
Pub Date : 2021-09-06DOI: 10.3126/mjsbh.v20i2.32856
Chander Mohan Singh, Mohit Thapa Magar, A. Sud
Osteochondromas seldom arise from the interosseous border of the distal tibia and may progress to involve the distal fibula. We present the case of a 14-year-old teenager with a stress fracture of the distal fibula, secondary to an osteochondroma arising from the distal tibia. Early excision of this deforming distal tibial osteochondroma was necessary in order to avoid a progressive deformity which would affect the biomechanics of the ankle joint resulting in gait disturbances.
{"title":"Osteochondroma of the Distal Tibia Leading to Deformity and Stress Fracture of the Fibula - A Case Report","authors":"Chander Mohan Singh, Mohit Thapa Magar, A. Sud","doi":"10.3126/mjsbh.v20i2.32856","DOIUrl":"https://doi.org/10.3126/mjsbh.v20i2.32856","url":null,"abstract":"Osteochondromas seldom arise from the interosseous border of the distal tibia and may progress to involve the distal fibula. We present the case of a 14-year-old teenager with a stress fracture of the distal fibula, secondary to an osteochondroma arising from the distal tibia. Early excision of this deforming distal tibial osteochondroma was necessary in order to avoid a progressive deformity which would affect the biomechanics of the ankle joint resulting in gait disturbances.","PeriodicalId":33963,"journal":{"name":"Medical Journal of Shree Birendra Hospital","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-09-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"47383207","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}
Pub Date : 2021-09-06DOI: 10.3126/mjsbh.v20i2.31755
Gurushantappa Yalagachin, P. S
Introduction: Breast cancer is the second most common cancer in the world. One of the reasons for its increasing prevalence, especially in younger women has been attributed to lifestyle changes. All these factors also have a strong association with lipid metabolism. More evidence is coming forward to emphasise the protective effect of lifestyle modification to lower lipid levels and thus decreasing the risk of breast cancer. Methods: It is a retrospective, case control study. The patients with carcinoma breast and normal controls were taken as subjects. The data for this study includes clinical profile and lipid profile measured in early morning fasting sample of the subjects. The patients of carcinoma breast, normal control aged > 18 years were included, while patients with diabetes, thyroid disorders, on treatment for hyper-lipidaemia, dieting or anorexic, pregnant patients were excluded. Results: There was no statistically significant differences in age (p = 0.920) and BMI (p = 0.137) between study and normal control group. Total Cholesterol (TC) and Triglycerides (TG) levels were significantly elevated (p = 0.009 and 0.000 respectively) in carcinoma breast group compared to normal controls, however no significant differences (p > 0.05) observed in the levels of HDL-C, LDL-C. Conclusions: There is a significant alteration in lipid metabolism in carcinoma breast patients in comparison to normal controls.
{"title":"A Retrospective Case-Control Study of Lipid Profiles in Carcinoma Breast in Comparison with Normal Controls","authors":"Gurushantappa Yalagachin, P. S","doi":"10.3126/mjsbh.v20i2.31755","DOIUrl":"https://doi.org/10.3126/mjsbh.v20i2.31755","url":null,"abstract":"Introduction: Breast cancer is the second most common cancer in the world. One of the reasons for its increasing prevalence, especially in younger women has been attributed to lifestyle changes. All these factors also have a strong association with lipid metabolism. More evidence is coming forward to emphasise the protective effect of lifestyle modification to lower lipid levels and thus decreasing the risk of breast cancer. \u0000Methods: It is a retrospective, case control study. The patients with carcinoma breast and normal controls were taken as subjects. The data for this study includes clinical profile and lipid profile measured in early morning fasting sample of the subjects. The patients of carcinoma breast, normal control aged > 18 years were included, while patients with diabetes, thyroid disorders, on treatment for hyper-lipidaemia, dieting or anorexic, pregnant patients were excluded. \u0000Results: There was no statistically significant differences in age (p = 0.920) and BMI (p = 0.137) between study and normal control group. Total Cholesterol (TC) and Triglycerides (TG) levels were significantly elevated (p = 0.009 and 0.000 respectively) in carcinoma breast group compared to normal controls, however no significant differences (p > 0.05) observed in the levels of HDL-C, LDL-C. \u0000Conclusions: There is a significant alteration in lipid metabolism in carcinoma breast patients in comparison to normal controls. ","PeriodicalId":33963,"journal":{"name":"Medical Journal of Shree Birendra Hospital","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-09-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49287781","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}
Pub Date : 2021-09-06DOI: 10.3126/mjsbh.v20i2.33226
M. Jha, Hakam Singh, Amulyajeet Kaur
Introduction: Tuberculosis of the breast is a rare entity, especially in elderly females. Moreover, the disease is overlooked and misdiagnosed as malignancy or pyogenic abscess. Here we report a case of an elderly female who presented with a lump in her left breast which resembled malignancy. Fine needle aspiration cytology followed by histopathological examination confirmed the diagnosis of breast tuberculosis. Patient underwent excision of the lump followed by six months of anti tubercular therapy to which she responded well. Key words: breast; mastitis; tuberculosis
{"title":"Tubercular Mastitis in an Elderly Female: A Rare Entity","authors":"M. Jha, Hakam Singh, Amulyajeet Kaur","doi":"10.3126/mjsbh.v20i2.33226","DOIUrl":"https://doi.org/10.3126/mjsbh.v20i2.33226","url":null,"abstract":"\u0000\u0000\u0000\u0000Introduction: Tuberculosis of the breast is a rare entity, especially in elderly females. Moreover, the disease is overlooked and misdiagnosed as malignancy or pyogenic abscess. Here we report a case of an elderly female who presented with a lump in her left breast which resembled malignancy. Fine needle aspiration cytology followed by histopathological examination confirmed the diagnosis of breast tuberculosis. Patient underwent excision of the lump followed by six months of anti tubercular therapy to which she responded well.\u0000Key words: breast; mastitis; tuberculosis\u0000\u0000\u0000\u0000","PeriodicalId":33963,"journal":{"name":"Medical Journal of Shree Birendra Hospital","volume":"1 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-09-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42163284","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}
Pub Date : 2021-09-06DOI: 10.3126/mjsbh.v20i2.33507
B. Bajracharya, A. Dahal, R. Deo
Introduction: The incidence of oral cancer in South Asian countries, including Nepal is increasing despite the fact that all of its risk factors are modifiable. This can be attributed to lack of awareness regarding oral cancer and its risk factors among general public. This study was conducted among subjects attending Dental OPD of a tertiary hospital to assess the knowledge and attitude regarding oral cancer and also practices of risk factors associated with it. Methods: This is a questionnaire based cross-sectional study conducted from July 2020 to October 2020. Subjects attending Dental OPD of a tertiary hospital in Kathmandu were asked to fill a structured close-ended Questionnaire. Section one of the questionnaire focused on the demographic data of the subjects, second part elicited information pertaining to knowledge of oral cancer, third part focused on attitude and fourth part on practices of participants towards risk factors of oral cancer. Result: Out of 300 subjects, 65% were males. Most were in the age group 41 - 50 years and 75.6% were literate. Majority mentioned smokeless tobacco as the risk factor, followed by smoking and alcohol. Regarding signs and symptoms, most of the participants mentioned non-healing ulcer, followed by lump and pain. Most of the participants responded tongue as the most common site of oral cancer. Majority answered that oral cancer can be prevented by not chewing tobacco. Among the total, 55.3% said oral cancer is non-contagious. Only 25% had undergone oral examination in the last one year. 31.7% had habit of tobacco and / or alcohol. Conclusions: The awareness level and knowledge about risk factors and early signs of oral cancer in this cross-section of dental patients were satisfactory. Key words: awareness; oral cancer; risk factors; tobacco
{"title":"Oral Cancer Awareness among Dental Patients","authors":"B. Bajracharya, A. Dahal, R. Deo","doi":"10.3126/mjsbh.v20i2.33507","DOIUrl":"https://doi.org/10.3126/mjsbh.v20i2.33507","url":null,"abstract":"Introduction: The incidence of oral cancer in South Asian countries, including Nepal is increasing despite the fact that all of its risk factors are modifiable. This can be attributed to lack of awareness regarding oral cancer and its risk factors among general public. This study was conducted among subjects attending Dental OPD of a tertiary hospital to assess the knowledge and attitude regarding oral cancer and also practices of risk factors associated with it. \u0000Methods: This is a questionnaire based cross-sectional study conducted from July 2020 to October 2020. Subjects attending Dental OPD of a tertiary hospital in Kathmandu were asked to fill a structured close-ended Questionnaire. Section one of the questionnaire focused on the demographic data of the subjects, second part elicited information pertaining to knowledge of oral cancer, third part focused on attitude and fourth part on practices of participants towards risk factors of oral cancer.\u0000Result: Out of 300 subjects, 65% were males. Most were in the age group 41 - 50 years and 75.6% were literate. Majority mentioned smokeless tobacco as the risk factor, followed by smoking and alcohol. Regarding signs and symptoms, most of the participants mentioned non-healing ulcer, followed by lump and pain. Most of the participants responded tongue as the most common site of oral cancer. Majority answered that oral cancer can be prevented by not chewing tobacco. Among the total, 55.3% said oral cancer is non-contagious. Only 25% had undergone oral examination in the last one year. 31.7% had habit of tobacco and / or alcohol.\u0000Conclusions: The awareness level and knowledge about risk factors and early signs of oral cancer in this cross-section of dental patients were satisfactory.\u0000Key words: awareness; oral cancer; risk factors; tobacco","PeriodicalId":33963,"journal":{"name":"Medical Journal of Shree Birendra Hospital","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-09-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44530326","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}
Pub Date : 2021-09-06DOI: 10.3126/mjsbh.v20i2.30777
Raksha Shrestha, S. Adhikari
Introduction: Health service delivery systems that are safe, accessible, high quality, people-centred, and integrated are critical for moving towards universal health coverage. World Health Organisation is supporting to improve the efficiency and effectiveness of health service delivery systems to all the population not only the patients. This study aims to identify the factors affecting the choice of health care facilities among the adults of an urban community and its association with the selected socio-demographic variables. Methods: A descriptive cross-sectional study was conducted among the community residence with 120 respondents using non-probability purposive sampling technique. Data was collected using semi-structured interview schedule that was analysed by using descriptive statistical methods such as frequency, percentage, mean, standard deviation and inferential statistics such as chi-square test. Result: The findings of the study revealed that majority (60.8%) of the respondents used private health care facilities and there was significant association of the choice of health care facility with the health care services related factors whereas no significant association was found with the selected socio-demographic variables. Conclusions: Based on the study findings, it concluded that various health care services related factors like availability, affordability, acceptability and accessibility factors tends to affect the choice of health care facility
{"title":"Factors Affecting Choice Of Health Care Facilities Among The Adults of an Urban Community","authors":"Raksha Shrestha, S. Adhikari","doi":"10.3126/mjsbh.v20i2.30777","DOIUrl":"https://doi.org/10.3126/mjsbh.v20i2.30777","url":null,"abstract":"Introduction: Health service delivery systems that are safe, accessible, high quality, people-centred, and integrated are critical for moving towards universal health coverage. World Health Organisation is supporting to improve the efficiency and effectiveness of health service delivery systems to all the population not only the patients. This study aims to identify the factors affecting the choice of health care facilities among the adults of an urban community and its association with the selected socio-demographic variables. \u0000Methods: A descriptive cross-sectional study was conducted among the community residence with 120 respondents using non-probability purposive sampling technique. Data was collected using semi-structured interview schedule that was analysed by using descriptive statistical methods such as frequency, percentage, mean, standard deviation and inferential statistics such as chi-square test. \u0000Result: The findings of the study revealed that majority (60.8%) of the respondents used private health care facilities and there was significant association of the choice of health care facility with the health care services related factors whereas no significant association was found with the selected socio-demographic variables. \u0000Conclusions: Based on the study findings, it concluded that various health care services related factors like availability, affordability, acceptability and accessibility factors tends to affect the choice of health care facility","PeriodicalId":33963,"journal":{"name":"Medical Journal of Shree Birendra Hospital","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-09-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49085658","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}
Pub Date : 2021-09-06DOI: 10.3126/mjsbh.v20i2.33399
B. Jha, S. Gautam, J. Sharma, Manisha Sharma
Introduction: Surgical site wound infections (SSI) are the third most commonly reported nosocomial infection and they account for approximately a quarter of all nosocomial infections. Apart from bacterial contamination of wound, various patient and environment related factors play a role in development and outcome of SSI. The present study is undertaken to study the frequency of SSI and the antimicrobial resistance pattern of the causative organisms isolated. Methods: This cross-sectional prospective study was carried out over a period of one year. A total of 245 pus samples from suspected cases of surgical site infections were processed for gram staining, culture, biochemical identification tests and antimicrobial susceptibility testing using standard microbiological protocol. Data was analysed using software word version SPSS 19. Results: The overall frequency of SSI was 13.87%. Most common isolates were staphylococcus aureus and Escherichia coli. All four staph aureus strains were resistant to penicillin and cefixime but were 100% sensitive to vancomycin and cloxacillin. Two out of four stains were methicillin resistant Staph. aureus (MRSA). Another concern in recent time is the isolation of acinetobacter from surgical wounds. Conclusions: Preoperative antibiotics, reduced hospital stay and proper control of co-morbidities decrease the incidence of post-operative infections. Marked resistance of isolates to commonly used antibiotics signifies the need for judicious and rational use of these drugs to prevent the emergence of antibiotic resistant strains.
{"title":"Bacteriological Profile and Antimicrobial Resistance Pattern in Surgical Site Infection in a Tertiary Care Hospital, Central Nepal","authors":"B. Jha, S. Gautam, J. Sharma, Manisha Sharma","doi":"10.3126/mjsbh.v20i2.33399","DOIUrl":"https://doi.org/10.3126/mjsbh.v20i2.33399","url":null,"abstract":"Introduction: Surgical site wound infections (SSI) are the third most commonly reported nosocomial infection and they account for approximately a quarter of all nosocomial infections. Apart from bacterial contamination of wound, various patient and environment related factors play a role in development and outcome of SSI. The present study is undertaken to study the frequency of SSI and the antimicrobial resistance pattern of the causative organisms isolated. \u0000Methods: This cross-sectional prospective study was carried out over a period of one year. A total of 245 pus samples from suspected cases of surgical site infections were processed for gram staining, culture, biochemical identification tests and antimicrobial susceptibility testing using standard microbiological protocol. Data was analysed using software word version SPSS 19. \u0000Results: The overall frequency of SSI was 13.87%. Most common isolates were staphylococcus aureus and Escherichia coli. All four staph aureus strains were resistant to penicillin and cefixime but were 100% sensitive to vancomycin and cloxacillin. Two out of four stains were methicillin resistant Staph. aureus (MRSA). Another concern in recent time is the isolation of acinetobacter from surgical wounds. \u0000Conclusions: Preoperative antibiotics, reduced hospital stay and proper control of co-morbidities decrease the incidence of post-operative infections. Marked resistance of isolates to commonly used antibiotics signifies the need for judicious and rational use of these drugs to prevent the emergence of antibiotic resistant strains.","PeriodicalId":33963,"journal":{"name":"Medical Journal of Shree Birendra Hospital","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-09-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42615651","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}
Pub Date : 2021-09-06DOI: 10.3126/mjsbh.v20i2.33048
Ravi Bhandari, M. Magar, Sushil Shrestha, R. Sinha, N. Kayastha, B. B. Thapa
Introduction: Orthopaedic surgical activity has been significantly affected by COVID-19 pandemic. The decision to perform operative interventions is based on balancing risk to benefit to the patient and health care workers. Though different guidelines have been published, there is a lack of reliable data on orthopaedic surgical activities. Our study aimed to evaluate the impact of the COVID-19 pandemic on Orthopaedic surgeries comparing with the previous year. Methods: This was an epidemiological retrospective comparative study conducted at Shree Birendra Hospital, Nepal after taking ethical approval from the Institutional Review Committee of NAIHS. Data of the first four month of orthopaedic surgeries after National lockdown (from March 24 to July 23, 2020) and the same four month period of the previous year (The year 2019) were retrieved. The demographic profiles and operations categories (trauma, elective and infections) were compared between two periods using SPSS 21. Result: Out of total of 651 patients enrolled, 169 patients operated during the pandemic compared with 482 patients before the pandemic. There was a 65% reduction in total surgical procedures, 94% reduction in elective cases and trauma cases were reduced by 29% (P < 0.05). Implant removal (107, 42.8%) constituted the highest elective cases in the year 2019. Conclusions: The orthopaedic surgical procedures were decreased in frequency during COVID-19 because of a decrease in elective cases. The total trauma patients remained more equable during pandemic despite strict lock-down. Health care facilities should consider this during post pandemic recovery.
{"title":"Impact of COVID-19 on Orthopaedic Surgery: Comparison Between Before and During COVID-19 Pandemic","authors":"Ravi Bhandari, M. Magar, Sushil Shrestha, R. Sinha, N. Kayastha, B. B. Thapa","doi":"10.3126/mjsbh.v20i2.33048","DOIUrl":"https://doi.org/10.3126/mjsbh.v20i2.33048","url":null,"abstract":"Introduction: Orthopaedic surgical activity has been significantly affected by COVID-19 pandemic. The decision to perform operative interventions is based on balancing risk to benefit to the patient and health care workers. Though different guidelines have been published, there is a lack of reliable data on orthopaedic surgical activities. Our study aimed to evaluate the impact of the COVID-19 pandemic on Orthopaedic surgeries comparing with the previous year. \u0000Methods: This was an epidemiological retrospective comparative study conducted at Shree Birendra Hospital, Nepal after taking ethical approval from the Institutional Review Committee of NAIHS. Data of the first four month of orthopaedic surgeries after National lockdown (from March 24 to July 23, 2020) and the same four month period of the previous year (The year 2019) were retrieved. The demographic profiles and operations categories (trauma, elective and infections) were compared between two periods using SPSS 21. \u0000Result: Out of total of 651 patients enrolled, 169 patients operated during the pandemic compared with 482 patients before the pandemic. There was a 65% reduction in total surgical procedures, 94% reduction in elective cases and trauma cases were reduced by 29% (P < 0.05). Implant removal (107, 42.8%) constituted the highest elective cases in the year 2019. \u0000Conclusions: The orthopaedic surgical procedures were decreased in frequency during COVID-19 because of a decrease in elective cases. The total trauma patients remained more equable during pandemic despite strict lock-down. Health care facilities should consider this during post pandemic recovery.","PeriodicalId":33963,"journal":{"name":"Medical Journal of Shree Birendra Hospital","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-09-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"45647802","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}
Pub Date : 2021-09-06DOI: 10.3126/mjsbh.v20i2.30726
C. Shrestha, S. Shrestha, A. Manoranjan, Reeta Rajbhandari
Introduction: Transconjunctival micro incision vitrectomy surgery (MIVS) with 23 or 25 gauge instrumentation is more advantageous than traditional 20 gauge surgery. We intended to evaluate the visual outcome, complications and indication of various vitreoretinal diseases using 27 Gauge vitrectomy systems. Methods: This study was a prospective, interventional, non-comparative study conducted in Nepal Eye Hospital from June 2017 to July 2018. Fifty-two patients with various vitreoretinal diseases were recruited. The main outcome measures included corrected distance visual acuity (CDVA) preoperative and postoperative, intraocular pressure (IOP) preoperative and postoperative, indication for vitreoretinal surgery, intraoperative complications, and postoperative complications. Results: Fifty two eyes of 52 patients (26 men and 26 women; mean age, 59 years) underwent 27-gauge pars planavitrectomy. Surgical indications included epiretinal membrane (n = 11), full-thickness macular hole (n = 11), rhegmatogenous retinal detachment [n = 14 (12 vitrectomy only and two vitrectomy with scleral buckle)], vitreous haemorrhage (n = 3), vitreous opacities (n = 3), silicon oil removal (n = 3), proliferative diabetic retinopathy [n = 6 (5 vitreous haemorrhage and one tractional retinal detachment)], posterior IOL dislocation (n = 1). Postoperative complications included transient ocular hypertension in eight eyes (15.39%), transient hypotony in five eyes (9.62%) and vitreous haemorrhage in five eyes (9.62%). No cases of postoperative endophthalmitis, sclerotomy - related tears, or choroidal detachments were encountered in the follow-up period. Mean corrected distance visual acuity improved from 20 / 796 (logarithm of the minimum angle of resolution, 1.60 ± 0.64) preoperatively to 20 / 49 (logarithm of the minimum angle of resolution, 0.42 ± 0.26) postoperatively (p = 0.000,) at final follow up. Conclusions: 27-gauge micro-incision vitrectomy surgery was found to be a safe and effective suture-less surgery with favourable outcomes, in terms of vision.
{"title":"A 27 - Gauge Microincision Vitrectomy Surgery for Posterior Segment Diseases in a Tertiary Centre, Nepal","authors":"C. Shrestha, S. Shrestha, A. Manoranjan, Reeta Rajbhandari","doi":"10.3126/mjsbh.v20i2.30726","DOIUrl":"https://doi.org/10.3126/mjsbh.v20i2.30726","url":null,"abstract":"Introduction: Transconjunctival micro incision vitrectomy surgery (MIVS) with 23 or 25 gauge instrumentation is more advantageous than traditional 20 gauge surgery. We intended to evaluate the visual outcome, complications and indication of various vitreoretinal diseases using 27 Gauge vitrectomy systems. \u0000Methods: This study was a prospective, interventional, non-comparative study conducted in Nepal Eye Hospital from June 2017 to July 2018. Fifty-two patients with various vitreoretinal diseases were recruited. The main outcome measures included corrected distance visual acuity (CDVA) preoperative and postoperative, intraocular pressure (IOP) preoperative and postoperative, indication for vitreoretinal surgery, intraoperative complications, and postoperative complications. \u0000Results: Fifty two eyes of 52 patients (26 men and 26 women; mean age, 59 years) underwent 27-gauge pars planavitrectomy. Surgical indications included epiretinal membrane (n = 11), full-thickness macular hole (n = 11), rhegmatogenous retinal detachment [n = 14 (12 vitrectomy only and two vitrectomy with scleral buckle)], vitreous haemorrhage (n = 3), vitreous opacities (n = 3), silicon oil removal (n = 3), proliferative diabetic retinopathy [n = 6 (5 vitreous haemorrhage and one tractional retinal detachment)], posterior IOL dislocation (n = 1). Postoperative complications included transient ocular hypertension in eight eyes (15.39%), transient hypotony in five eyes (9.62%) and vitreous haemorrhage in five eyes (9.62%). No cases of postoperative endophthalmitis, sclerotomy - related tears, or choroidal detachments were encountered in the follow-up period. Mean corrected distance visual acuity improved from 20 / 796 (logarithm of the minimum angle of resolution, 1.60 ± 0.64) preoperatively to 20 / 49 (logarithm of the minimum angle of resolution, 0.42 ± 0.26) postoperatively (p = 0.000,) at final follow up. \u0000Conclusions: 27-gauge micro-incision vitrectomy surgery was found to be a safe and effective suture-less surgery with favourable outcomes, in terms of vision.","PeriodicalId":33963,"journal":{"name":"Medical Journal of Shree Birendra Hospital","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-09-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49152224","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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