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

INTRODUCTION: Urinary tract infection is treated by the antibiotic sensitivity pattern of uropathogens in our population. Present infection cases have been showing an increase in resistance to the current first-line of antibiotics. The objective of this study is to determine the resistance of antibiotics in Escherichia coli in a tertiary care center. METHODS: This is a descriptive cross-sectional study done in Kathmandu Medical College Teaching Hospital from October 2018 to February 2019. The sample size was calculated, and convenient sampling was done. Patients with urine culture positive (i.e., Colony-forming unit >105) were included in the study. All positive samples were tested for antibiotics sensitivity and resistance. The resistance to the antibiotics was recorded using Statistical Package for Social Sciences version 20. Point estimate at 95% confidence interval was calculated along with frequency and proportion for binary data. RESULTS: Out of 100 samples, the highest number of organisms isolated was Escherichia coli, 71 (71%). Escherichia coli showed the highest resistance to drugs like Norfloxacin, 37 (52.11%), AmoxicillinClavulanic acid 37 (52.11%), followed by Co-trimoxazole 32 (45.1%), Ceftriaxone, 24 (33.8%), and Ciprofloxacin 23 (32.3%). CONCLUSIONS: Escherichia coli showed the highest resistance to commonly used antibiotics like Norfloxacin, Amoxicillin-Clavulanic acid, Co-trimoxazole, Ceftriaxone, and Ciprofloxacin.

Prevalence of Type 2 Diabetes Mellitus among People Attending Medical Camp in a Community Hospital.

INTRODUCTION: Diabetes is a health problem on the rise in developing countries like Nepal. Often in the suburban and rural areas, patients are diagnosed in the late stages with complications. The aim of this study is to find out the prevalence of diabetes type 2 in a community hospital of Nepal. METHODS: This is a descriptive cross-sectional study done in a community hospital from January to March of 2019 after ethical clearance (Registration number: 150320192) from the institutional review committee of Kathmandu Medical College. Convenient sampling technique was used. Glucometer using glucose sticks is used to measure random blood sugar level and relevant questions were asked in a short interview. The data were analyzed using the Statistical Package for the Social Sciences 20 version. RESULTS: Out of a total of 114 people, the prevalence of type 2 diabetes mellitus was 5 (4.38%). Among those 5 (4.385%) people with type 2 diabetes mellitus, 2 (1.75%) were female and 3 (2.63%) were male. The minimum age of the patient was 17 years and the maximum age was 92 years. Five out of 95 patients with mild physical activity had random blood sugar more than 200 mg/dl and five out of 46 alcoholic patients had random blood sugar levels more than 200 mg/dl. Only 1 out of 26 smokers had a random blood sugar level of more than 200 mg/dl. CONCLUSIONS: Prevalence of diabetes mellitus type 2 in our study population is quite high. Early detection of diabetes mellitus type 2 can be a good screening tool for early treatment and prevention of complications.

The Pattern of Injury from Road Traffic Accident Presenting at Emergency Department of Kathmandu Medical College.

BACKGROUND: Road traffic accidents are the major public health problem. The objective of the study was to analyze road traffic accidents presenting in Kathmandu Medical College Emergency Department. METHODS: The data from all consecutive road traffic accident cases brought to Emergency Department Kathmandu Medical College Teaching Hospital were collected from 2018 Jan-2018 June. Factors like age of the patients, time of the accident, influence of illicit substances and type of injury were documented. RESULTS: Males (74) were common victims than the females (26). Eldest patient was 65 years of the age while youngest patient was 4 years. Most common type of injury was fracture in male 28 (37%)and laceration in females8 (38%). Alcohol intoxication was evident by positive alcohol smell test in 10 (13.6%) males and 6(23%) females. CONCLUSIONS: Road traffic accidents are major health concern in Kathmandu Medical College Teaching Hospital and preventive measures should be considered to reduce such health burden.

Attitude of Interns towards Family Medicine as a Career in a Tertiary Care Hospital.

INTRODUCTION: Family medicine is a relatively overlooked specialty in Nepalese medical education. It is unclear how many interns are actually interested in Family medicine as a career and how many non-medical individuals are aware of its existence. The aim of this study is to assess information, expectation and perception among interns regarding family medicine and its choice as a career. METHODS: This is a descriptive-cross sectional study carried out in Kathmandu Medical College Teaching Hospital from July 2018 to December 2018. Whole sampling was done. All interns of Kathmandu Medical College Teaching Hospital posted in different departments during the time period was the inclusion criteria. Chronic absentees was the exclusion criteria. Factor like age, sex, their residency of choice, and whether they consider family medicine as a potential career were considered. Data was entered in with Statistical Package for Social Services version 16 and necessary calculations were done. RESULTS: Thirty three interns preferred internal medicine as their career of choice, 20 preferred surgery while only three preferred in family medicine. Eighty eight interns, including the three who had family medicine as their career of choice, said that they could consider family medicine as a potential career. Eighty eight out of the 100 interns in the study mentioned that their family had knowledge that a specialty called family medicine existed. CONCLUSIONS: Despite being the career of choice of only a few, majority considered family medicine as a potential career for them. And the knowledge about existence of family medicine was high among families of interns.

Acceptability and feasibility of medical abortion in Nepal.

OBJECTIVE: To test the feasibility and acceptability of a simplified mifepristone-misoprostol regimen for early abortion in 2 tertiary teaching hospitals and 2 family planning clinics in Nepal. METHODS: Consenting pregnant women (n=400) with amenorrhea of 56 days or less seeking termination of pregnancy received 200 mg of oral mifepristone followed 48 hours later with 400 microg of oral misoprostol, administered either at home or at the clinic. Prospective data were collected to determine the women's experience, abortion outcome, and the operational requirements for providing the method. RESULTS: Most (91.3%) of the 367 women with known outcomes had successful medical abortions. Given the option, most (89.7%) women elected to administer the misoprostol at home. CONCLUSION: A simplified medical abortion protocol, including home administration of misoprostol, can be successfully integrated into clinical services in Nepal, where abortion services were recently legalized.