Introduction: Mycobacterium tuberculosis is the second most infectious cause of death in adults globally and is major health trouble in Nepal. The diagnosis of pulmonary tuberculosis is mainly carried by acid-fast bacilli smear microscopy, culture on Lowenstein–Jensen media, and GeneXpert MTB/RIF assay. This study aimed to evaluate the GeneXpert MTB/RIF and Acid-Fast Bacilli stain smear used for the diagnosis of pulmonary tuberculosis. Methods: A cross-sectional study was performed at Karnali Academy of Health Sciences, Jumla, from July 2021 to June 2022. Our study population comprised 390 probable cases of pulmonary tuberculosis from the ages of 2 to 92 years. A total of 390 sputum specimens from suspected presumptive tuberculosis sufferers were tested using the direct smear staining technique of Acid-Fast Bacilli stain smear and GeneXpert for the detection of MTB/RIF. The GeneXpert MTB/RIF technique was compared with the Acid-Fast Bacilli stain smear. Patient’s demographic details, sputum AFB smear, and GeneXpert test results were collected and entered in working Performa. Data were analyzed using SPSS 16.0. Results: Out of 390 samples 13.84% were positive for Mycobacterium tuberculosis via GeneXpert MTB/RIF assay while 5.12% were positive through AFB microscopy which was statistically significant (p<.0001). When compared with GeneXpert, taking GeneXpert as the gold standard in the rural setup of Nepal the sensitivity of AFB staining was 37.03%, while its specificity was 90.81%. Conclusions: GeneXpert MTB/RIF is a rapid test that can aid in the timely diagnosis of Mycobacterium tuberculosis, facilitating the timely treatment in the rural area.
Non-steroidal Anti-inflammatory Drugs (NSAIDs) are the most prescribed drugs all over the world. These are used in the treatment of pain and inflammation. Systematic evaluation of prescription patterns and monitoring of adverse drug reactions is required to increase the therapeutic benefit and decrease the adverse effects of these drugs. An observational, cross-sectional study was conducted for 6 months from September 2021 to February 2022 in 300 patients prescribed least one NSAID to assess the prescription patterns and adverse drug reaction profile (ADR) of NSAIDs prescribed in the orthopedic outpatient department. Among enrolled patients 52% were female and 48% were male. The most common age group was 20-39. The average number of drugs per prescription was 2.89. A total of 868 drugs were prescribed, out of which 402 were NSAIDs (46.31%). Naproxen was the most prescribed agent (45.02%), followed by Diclofenac (17.17%). ADR was reported in 12% of patients. Most of the ADRs were due to Naproxen (72.18%) followed by Ibuprofen (16.66%). The gastrointestinal system was involved in maximum patients and the most common ADR was abdominal pain. Most of the drugs were prescribed by brand name 95.18%. Naproxen was the most prescribed NSAID and responsible for most ADRs. There was a higher prevalence of irrational prescribing, polypharmacy, and underreporting of ADR. A strategy must be developed and implemented for prescribing and rational use of NSAIDs and monitoring their harmful effects.
Introduction: Urinary tract infections (UTI) is applied to clinical conditions which range from asymptomatic bacteriuria to severe infection of the kidney with the development of sepsis. The pharmacotherapy of UTIs is grounded on the predictable spectrum of causative agents and their antimicrobial susceptibility patterns. Thus, this study aims to assess the bacterial profile and antimicrobial susceptibility pattern of isolated bacteria among patients with urinary tract infection. Methods: A descriptive cross-sectional study was conducted from August to December 2021 among patients who came to various departments of Karnali Academy of Health Sciences (KAHS), Jumla with suspected urinary tract infection during the study period. Mid-stream urine specimens were collected from 365 individuals for bacteriological identification and antimicrobial susceptibility testing. Data on socio-demographic, clinical and risk factors were also collected using a structured proforma. Isolates were identified by standard microbiological methods and tested for in vitro antibiotic susceptibility by modified Kirby –Bauer disc diffusion method Results: Among the 365 Urine samples, 98(26.8%) showed significant bacteriuria. Escherichia coli (67.3 %), Enterococcus spp. (14.3%), Acinetobacter spp. (7.1%) were common bacterial isolates. The Gram-negative isolates were most resistant to Cefixime (67.4%), Ampicillin (65.06%) and most sensitive to Nitrofurantoin (98.7%). Gram-positive isolates were highly resistant to Ampicillin (66.6%) and most sensitive to Vancomycin (100%). Conclusions: Our study concluded that there is pronounced increase in cases of UTIs and antimicrobial resistance with commonly prescribed antibiotics has been observed.
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