Threat of multidrug resistant bacterial pathogens in COVID-19 pandemic

Coronavirus disease 2019 (COVID-19) is caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). The disease first emerged in Wuhan, China in December 2019 and since then, has been spreading worldwide.1 On March 11, 2020, the World Health Organization (WHO) declared the disease a pandemic.2 This pandemic has been described as the greatest threat to global health since the Spanish Influenza pandemic in the 20th century.

Exploring the Gap between Content and Larning Outcomes in Nepalese Technical Educantion

I have come across that some people with technical education who are being unemployed in the domestic job market is curious which made me selecting this issue. Very few researches have conducted on this issue in Nepalese context, so it becomes important to carry out a research to explore the reality. This study attempts to explore various themes in between the content and learning outcomes of technical education. While developing this paper I have prepared the research question as why there is a gap between content and learning outcomes in TVET programs. As methodological approach I used interpretive paradigm i.e. qualitative approach. First, I raised the issue then interviewed the participant, transcribe the record, generate themes and interpret the themes with the support of literature and theory. This research was delimited to content verses learning outcomes component and other issues were ignored. It was limited to CTEVT programs only. Primary data were collected based on interview. After interpreting the data I came to conclude that improper allocation of budget, weak linkage in education, improper management, traditional approaches of teaching, not upgraded curriculum, and the learning environment is affected by politics. Based on the findings and conclusion, I have suggested some implications to cater the problems as to adopt new technology like ICT, encourage small business activities, meet employers expectation, enhance councils staff capacity, allocate sufficient economic resources, connect training to work experience, decentralize and institutionalize the management

Comparative evaluation of analgesic efficacy of tramadol and diclofenac-sodium in post-operative orthopedic patients

Background: Post-operative pain management is an important consideration in the orthopedic department. The purpose of this study was to compare the analgesic efficacy of tramadol with diclofenac sodium in patients with postoperative orthopedic pain.Methods: A hospital based, prospective, observational study was undertaken in Department of Orthopedics for a period of one year. A group of 60 patients having post-operative pain intensity assessed as 6cm or more on a 10cm visual analogue scale (VAS) were assigned to receive either tramadol thrice a day (n=30) or diclofenac sodium thrice a day (n=30). Both drugs were administered parenterally for initial 24hr, then orally for next 96 hr. The primary efficacy outcome measures were pain intensity difference assessed at 2hr, 4hr, 8hr, 16hr, 24hr, 32hr, 40hr, 48hr, 56hr, 64hr, 72hr, 80hr, 96hr, 104hr, 112hr and 120hr using a VAS and sum of pain intensity differences assessed at 8hr, 24hr, 48hr, 72hr, 96hr and 120hr whereas secondary efficacy measures included maximum fall in pain intensity, number of patients who required rescue medication and their quality of sleep in the night.Results: Mean pain intensity differences assessed on 10cm VAS were significantly better for tramadol group compared to diclofenac group at all the time points except 88 hr. Sum of pain intensity differences over 8hr, 24hr, 48hr, 72hr, 96hr and 120 hr for the tramadol group was significantly superior than diclofenac group. Maximum fall in pain intensity score was also significantly superior in the tramadol group as compared to the diclofenac group. However, no patients required rescue medication in either of the groups. Patient’s quality of sleep improved with both drugs but tramadol produced significantly better quality of sleep every night than did diclofenac. Both the study medications produced effective analgesia and were well tolerated with no incidence of serious adverse effects throughout the study.Conclusions: Tramadol has a more pronounced analgesic effect than diclofenac. Thus, tramadol can be considered as an effective alternative to traditional NSAIDs in the treatment of post-operative pain

Neonatal Septicemia in Nepal: Early-Onset versus Late-Onset

Introduction. Neonatal septicemia is defined as infection in the first 28 days of life. Early-onset neonatal septicemia and late-onset neonatal septicemia are defined as illnesses appearing from birth to three days and from four to twenty-eight days postnatally, respectively. Methods. In this cross-sectional study, blood samples from the suspected infants were collected and processed in the bacteriology laboratory. The growth was identified by standard microbiological protocol and the antibiotic sensitivity testing was carried out by modified Kirby-Bauer disk diffusion method. Results. Among total suspected cases, the septicemia was confirmed in 116 (12.6%) neonates. Early-onset septicemia (EOS) was observed in 82 infants and late-onset septicemia (LOS) in 34 infants. Coagulase-negative staphylococcus (CoNS) (46.6%) was the predominant Gram-positive organism isolated from EOS as well as from LOS cases followed by Staphylococcus aureus (14.6%). Acinetobacter species (9.5%) was the predominant Gram-negative organism followed by Klebsiella pneumoniae (7.7%). Conclusions. The result of our study reveals that the CoNS, Staphylococcus aureus, Acinetobacter spp., and Klebsiella pneumoniae are the most common etiological agents of neonatal septicemia. In particular, since rate of CoNS causing sepsis is alarming, prompting concern to curb the excess burden of CoNS infection is necessary

Abortion Law awareness and Abortion Services Utilization among reproductive age women of Inarwa municipality of Eastern Nepal

Introduction: Globally, reproductive health and quality of life among female population has been found to be unsatisfactory in developing world. Until 1963, Nepal’s 1854 legal code known as MulukiAin was revised numerous times that banned abortion exempting risk of women’s life. Enactment of New Abortion Policy from 2003 brought landmark reforms to the women’s choice in family planning methods and ended the sufferings of lengthy prison sentences for abortion crimes. This study was conducted to explore the level of awareness about abortion law with regard to health care utilization among women of reproductive age group along with its association with socio-demographic characteristics. Methodology: A cross-sectional study was conducted in March 2014, in Inarwa Municipality among women of reproductive age group (16 to 49 years). Convenient sampling was done to collect data from households. Data was entered and analyzed in SPSS 11.5 and presented in tabular form. Chi-square test was used to show association of awareness of abortion law and socio-demographic variables. Results: education, age at first marriage and age at 1st pregnancy was found to be significant (p value: <0.005). Conclusion: As media was the most used source of information, more education on awareness of abortion law and health care utilization should be disseminated through this medium

Childhood Septicemia in Nepal: Documenting the Bacterial Etiology and Its Susceptibility to Antibiotics

Introduction. Children are among the most vulnerable population groups to contract illnesses. The varying microbiological pattern of septicemia warrants the need for an ongoing review of the causative organisms and their antimicrobial susceptibility pattern. Therefore, the objective of this study was to document the bacterial etiology of childhood septicemia and its antibiotic susceptibility profile. Methods. Cross-sectional type of study in 1630 suspected patients was conducted at CMCTH from January 2012 to December 2013. Blood samples were collected aseptically for culture. The organisms grown were identified by standard microbiological methods recommended by American Society for Microbiology (ASM) and subjected to antibiotic susceptibility testing by modified Kirby-Bauer disk diffusion method. Methicillin resistance was confirmed using cefoxitin and oxacillin disks methods. Results. Septicemia was detected in 172 (10.6%) cases. Among Gram-positive organisms, coagulase negative staphylococci (CoNS) were leading pathogen and Acinetobacter spp. were leading pathogen among Gram-negative isolates. Vancomycin, teicoplanin, and clindamycin were the most effective antibiotics against Gram-positive isolates while amikacin was effective against Gram-positive as well as Gram-negative isolates. Methicillin resistance was detected in 44.4% of Staphylococcus aureus. Conclusions. This study has highlighted the burden of bacterial etiology for septicemia among children in a tertiary care center of central Nepal

Distribution and academic significance of learning approaches among pre-clinical medical students at Trinity School of Medicine, St Vincent and the Grenadines

This study aimed to characterize the learning strategies of medical students at Trinity School of Medicine and to explore potential correlations between deep learning approach and the students’ academic scores. The study was a questionnaire-based, cross-sectional, observational study. A total of 169 medical students in the basic science years of training were included in the study after giving informed consent. The Biggs’s Revised Two-Factor Study Process questionnaire in paper form was distributed to subjects from January to November 2017. A total of 169 questionnaires were distributed and 132 students (response rate of 78.1%) responded

Burden of human metapneumovirus infections among children with acute respiratory tract infections attending a Tertiary Care Hospital, Kathmandu

Abstract Background Acute respiratory infections (ARIs) are one of the most common causes of mortality and morbidity worldwide. Every year millions of children suffer from viral respiratory tract infections (RTIs) ranging from mild to severe illnesses. Human Metapneumovirus (HMPV) is among the most frequent viruses responsible for RTIs. However, HMPV infections and their severity among children have not been explored yet in Nepal. Purpose Therefore, the study was focused on HMPV infections and other potential viral etiologies or co-infections using multiplex PCR among children attending Kanti Children’s Hospital and assessed the clinical characteristics of the infections as well as found the co-infections. A hospital-based cross-sectional study was designed and a convenience sampling method was used to enroll children of less than 15 years with flu-like symptoms from both outpatients and inpatients departments over three months of the study period. Results HMPV infection (13.3%) was the most predominant infection among the different viral infections in children with ARIs in Kanti Children’s Hospital. The HMPV was more prevalent in the age group less than three years (21.8%). Cough and fever were the most common clinical features present in all children infected with HMPV followed by rhinorrhea, sore throat, and wheezing. HMPV-positive children were diagnosed with pneumonia (42.9%), bronchiolitis (28.5%), upper respiratory tract infections (14.3%), and asthma (14.3%). The prevalence of HMPV was high in late winter (14.3%) followed by early spring (13.5%). Conclusions This study provides the baseline information on HMPV and associated co-infection with other respiratory viruses for the differential diagnosis based on molecular methods and also the comparison of clinical presentations among the different respiratory syndromes