Background Urinary tract infections (UTIs) are the common cause of bacterial infection. Recently UTI become more complicated and difficult to treat because of appearance of pathogen with increasing resistance to antimicrobial agents. Objective To determine the etiology of the urinary tract infections and their susceptibility to antimicrobial agents. Methods This study was carried out in Kathmandu Medical College, at department of microbiology. Total 3,460 urine samples were tested microbiologically by standard procedure. Antibiotic susceptibility test was performed for all the isolates by Kirby Bauer disc diffusion method and result was interpreted according to National Committee for Clinical Laboratory Standards (NCCLS) guide line. Results Out of 3,460 urine samples 680 (19.7%) showed the significant bacteriuria. The most common pathogens isolated were Escherichia coli 75.7% followed by Klebsiella pneumoniae 10.7%, Acinetobacter spp 5.5%, Proteus spp 3.5% and Pseudomonas aeruginosa 1.2%. Most susceptible antibiotic was Amikacin, Ceftriaxone and Ciprofloxacin for most of the isolates. E. coli which was the main isolate was found to be most susceptible to Amikacin 96.1%, Nitrofurantoin 91.3% and Gentamicin 77.7% followed by Ceftriaxone 65.8% and Ciprofloxacin 64.1%. ConclusionRegular surveillance of the resistance rate among uro-pathogens is needed to ensure the appropriate therapy of UTI.DOI: http://dx.doi.org/10.3126/kumj.v9i4.6348 Kathmandu Univ Med J 2011;9(4):295-7
Gastric volvulus is defined as an abnormal rotation of the stomach. Classical textbook presentation may not always be present. Meticulous assessment and broadened differential diagnosis are thus crucial. Various types have been described in literature. Low threshold for detection with aggressive resuscitation and immediate surgical exploration on suspected incarceration or perforation are mandatory. We report a case of 16-years-female who had atypical presentation of mesenteroaxial gastric volvulus. Emergency exploratory laparotomy with wedge resection and primary repair of stomach with anterolateral gastropexy was performed. She had uneventful recovery with discharge on fifth postoperative day.
Introduction: Central Venous Pressure is a valuable parameter in the management of critically ill surgical patients in the ICU. Non-invasive methods to extrapolate the volume status of the patient can aid clinicians in expediting proper treatment. The objective of this study is to find a correlation between Inferior Vena cava (IVC) diameter and collapsibility index (CI) with Central venous pressure (CVP) in critically ill surgical patients. Methods: This cross-sectional study included 60 critically ill patients from September 2020 – 31st February 2021. We recorded the patient's age, sex, heart rate, blood pressure, CVP, volume status, IVC minimum, and maximum diameter. After taking consent and explaining the procedure to the patient, the maximum IVC anteroposterior diameter was noted at the end of inspiration and end of expiration in centimeters. IVC collapsibility index was calculated using the formula ([IVCdmax-IVCdmin]/IVCdmax*100%). Following this, the CVP of the patient was measured. Results: Among the patients evaluated, 32 were females. The mean age of the participants was 44.90 ± 15.76 years. The mean central venous pressure maintained was 11.10 ± 2.11cm H2O with an inferior vena cava collapsibility index of 29.69 ± 8.75. There was a negative correlation between CVP and IVC collapsibility index (%), which was statistically significant (r = -0.701, n = 60, p < 0.01). A strong positive correlation between CVP and maximum IVC diameter (r = 0.712, n = 60, p < 0.01) and minimum IVC diameter (r = 0.796, n = 60, p < 0.01) was found. Conclusion: Inferior Vena Cava diameter and IVC Collapsibility Index can be used as a reliable substitute to central venous pressure to determine the patient's volume status.
When dealing with cases of sharp force penetrating injuries, survival of the victim depends on injury to major blood vessels or major organs resulting in internal or external hemorrhage. Stab with intention of homicide although common, self inflicted stab injuries are less reported. We present an unusual self inflicted stab injury over an abdomen extending from front to back of the abdomen over epi-gastric region by a 52 years old male who managed to survive as it missed all the major blood vessels and solid organs that lied in between. On observation of characteristics of the wound, we have made an attempt to opine that the incident was self- inflicted with suicidal intentions.
Objectives: This study was aimed to evaluate different water samples in terms of Total bacterial load and Total Coliform Load in comparison with different parameters such as pH, type of samples, chlorination status, turbidity, temperature and collection areas. Methods: Altogether 250 water samples were collected; 110(44%) were ground water samples, 60(24%) were public tap water samples and 80(32%) were bottled water samples. Total Coliform load was evaluated using Membrane Filtration Technique and Total Bacterial Load was evaluated using Aerobic Plate Count Technique. pH was measured using pH meter, turbidity was measured using nephelometer, temperature was measured using temperature probe and bottled water were considered chlorinated. Results: Among these 250 samples, the highest mean bacterial load was seen in public tap water samples (137×103 cfu/ml) and least mean bacterial load was seen on bottled water sample (28×103). Similarly, highest mean coliform load was seen on ground water samples (81 cfu/ml) and least mean coliform load was seen on bottled water samples (6 cfu/ml). Conclusion: This study has concluded that ground water samples contain large number of coliforms which suggest it might be fecally contaminated. Also the result had shown even bottled water contained coliforms. Therefore, it is recommended to treat ground water before using. Proper care must be taken during manufacture of bottled water.
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