Neonatal hypothermia is the fourth leading causes of neonatal death in Nepal. Thus, it is the caregivers' responsibility to identify the hypothermia by using valid and less time consuming method like hand-touch method. Therefore, we examined the diagnostic validity of hand-touch method against low-reading mercury (LRM) thermometer for detecting neonatal hypothermia. We assessed neonate's temperature first by hand-touch method, then by LRM thermometer and tympanic thermometer among 100 full-term neonates, delivered within 24 h in Maternity Ward of Tribhuvan University Teaching Hospital, Nepal. We used World Health Organization (1997) criteria for classification of neonatal hypothermia. The sensitivity and specificity of the hand-touch method for detection of neonatal hypothermia were 95.6% and 70.1% against LRM thermometer and 76.6% and 83% against the tympanic thermometer, respectively. Touching method is practical and therefore has a good diagnostic validity; it can be introduced in essential newborn care package after giving adequate training to caregivers.
Introduction: Gram negative bacteria are commonly involved in wound infections and are significantly associated with morbidity and mortality because of increasing resistance to commonly used antibacterial agents. This study aims to evaluate the pattern of antibacterial sensitivity of the gram negative bacteria from wound swabs of accidental trauma cases. Methods: This retrospective study was done by collecting all the culture positive reports for wound swabs of accidental wounds from the microbiology laboratory and analyzing the reports showing growth of gram negative bacteria for frequency of sensitivity to commonly used antibacterial agents. Results: Culture positivity rate was 21.95% with growth of gram negative bacteria in 79.7% of cases. The most commonly isolated organism was Escherichia coli being 41.3% among gram negative isolates. Highly resistant bacteria were E. coli, Klebsiella pneumoniae and Acinetobacter spp. Conclusions: As there is low culture positivity rate for wound swabs obtained before washing the wounds inflicted by accidental trauma, prolonged routine use of prophylactic antibiotic is not justified. Thoroughly washing the wound is very likely to decrease the rate of wound infection further and reduces the need of antibacterial agents. Culture and sensitivity test should guide the treatment when wound is infected because highly resistant gram negative organism may be involved in such cases.
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