Asymptomatic UTI in pregnancy attending at tertiary care of Nepal

Background: Urinary tract infections (UTI) during pregnancy issued by improper laboratory investigations situate women at risk of several detrimental complications. Untreated asymptomatic UTI (AUTI) may lead to pyelonephritis preterm birth, low birth weight, etc. Urine culture is used to confirm the diagnosis of UTI. Aim of this research was to carry out to find the prevalence of asymptomatic UTI and to establish antimicrobial drug susceptibility of the pathogens resulting asymptomatic UTI in pregnant women attending at tertiary care, Nepal.Methods: The urine samples were collected by mid-stream clean catch method from 600 pregnant women of age 15-45 years (mean age – 28.84 years) visiting for antenatal check up in the Department of Gynaecology and Obstetrics, Chitwan Medical College (CMC), a tertiary care of Nepal. All the urine samples were subjected to bio-physical, biochemical, microscopic, and microbiological analysis. The prevalence of UTI in three trimesters and in different age groups was obtained together with antimicrobial drug susceptibility tests.Results: On overall l51.83% of urine samples revealed with significant bacteriuria considered as the AUTI. On One- way ANOVA test, there was significant (P< 0.045) prevalence of AUTI when compared among different trimesters, though higher prevalence being in the first (40%) and second (45.33%) trimesters. The prevalence of AUTI was significant (P<0.004) among different age groups of the pregnancy. However, the most affectecd age groups were between 21-29 years. Escherichia coli were the most implicated organism (67.8%) followed by Klebsiella pneumonia (21.6%). The gram-negative bacteria (E. coli, K. pneumonia, and K. oxytoca) were more sensitive against Amikacin, Gentamycin, Meropenem, and Nitrofurantointhan. Other drugs whereas; gram positive bacteria (E. feacalis) had high susceptibility with Vancomycin.Conclusions: There was high incidence of AUTI among the pregnant ladies in the study region; therefore, microbial screening of urine of all pregnant women are must and should be included in the routine antenatal checkups to detect the AUTI to cut down and prevent the maternal and obstetric detrimental complications in them

Anger;it's impact on human body

Anger is one of our most powerful and vital emotions with behavioural manifestation. It is described as an intense feeling in response to frustration , hurt, disappointment, or threatening.The benefits of anger include overcoming fears and building confidence to counter dangerous phenomenon  or threats which leads to the fight or flight response while the disadvantages of anger consist of excess anger serving as a numbing agent emotionally, physically and cognitively.Physiologically, emotions is considered to commence  from  brain nucleus named as  amygdale , part of brain   responsible for identifying threats to our well-being, and  relaying out an alarm when threats are identified that result in taking steps to protect ourselves. It is important to recognize the physiological effects of anger especially with all the damage this emotion might produce to our body system.This review article examines the physiology, causes of anger and impact of anger on the body

CORONA VIRUS DISEASE-19 PANDEMIC - THERAPEUTICS AND NOVEL DEVELOPMENT

Every individual must follow the slogan of front line worker as “we stay at work for you, you stay at home,” This means to protect the healthcare worker who are working in the frontline to save life of the corona virus disease (COVID)-19 patient of the different phases, other should stay home safe and secured; however, if we could not protect them than the matter will be serious to everyone to control the situation of this pandemic and many life can be lost. Thus, it is suggested to the young asymptmatic people to remain quarantine and isolated until the incubation period be over, it could be as long as 41 days or as short as 6 days but average time necessary is 14 days. There are no drugs or other therapeutics presently working to knock out COVID-19 pandemic. However, drugs employed in the treatment of hospitalized patient are on the basis of previous exposure of congruent strain of virus; in addition, supportive care management such as supplemental oxygen and mechanical ventilation procedure is highly being used to the critical patient. This review highlights step to step treatment plan, employed therapeutics, mechanism, efficacy, and new development of the clinical trial results if any

CORONAVIRUS DISEASE - 19 – A SERIOUS THREAT TO PUBLIC HEALTH

The year 2020 is a public health emergency period declared globally by the WHO when on March 11, 2020, the deadly novel coronavirus-2019 causing severe acute respiratory syndrome (SARS) extended its stride in almost 150 countries commenced from Wuhan wet market, China led to declare globally as pandemic disease. Till date, more than 3 million are worldwide infected and the number is still in progression and nearly 200,000 people have succumbed, nearly 50,000 people only in United State died of this virus. Hence, this virus has brought global disaster. Therefore, this review is attempting to present a picture on coronavirus disease (COVID)-19 in terms of epidemiology, pathophysiology, and diagnosis, treatment, on the basis of available literature after search from the renowned database, especially focusing on public health impact. Treatment strategy is most essential part to focus for public health management and to save more life from this pandemic. As of date, there are no specific drugs for its treatment only repurpose drugs are employed for the hospitalized patient in present scenario, for example, Remdesivir made for Ebola is being use now in Covid-19 which inhibit replicase enzyme and reduced viral load, chloroquine and hydroxychloroquine an antimalarial drugs which prevent binding of S1 domain of Spike protein of SARS coronavirus 2 with Angiotensin Converting Enzyme-2 receptor and prevent fusion by S2 subunit thus overall prevent entering into the human susceptible cells along with it increases endosomal unstability by increasing pH. In addition, supportive care management such as supplemental oxygen and mechanical ventilation procedure is highly supportive to the critical patient. There infected more than 10 million people with more than 0.5 million death, the observation of July 7, 2020

Analysis of cardiac autonomic modulation in normotensive obese and eutrophic adults of Nepal

Background: Obese people have a higher prevalence of cardiovascular disease, though unknown mechanism, supposed to be due to autonomic dysfunction which is still in controversy. This study aimed to assess and compare heart rate variability (HRV) between normotensive obese and adults.Methods: The study was conducted on 30 normotensive obese adults (mean age 32.07±7.25 years) with BMI>30 and 29 age- and sex-matched normal weight controls (mean age 30.48±8.01 years) with BMI: 18-24 Kg/m2. Short-term HRV variables were assessed using standard protocol. The data were compared between the groups using Mann Whitney ‘U’ test.Results: In obese group, there was significant increase in the mean heart rate [79.17±8.80 Vs 71.48±8.41 beats/min, p=0.001], systolic blood pressure [121.20±9.89 Vs 113.24±11.07, mmHg, p=0.004] and diastolic blood pressure [84.97±7.87 Vs 74.83±10.31 mmHg, p=0.000]. The HRV parasympathetic indicators were less [RMSSD {28.75(16.72-38.35) Vs 41.55(30.6-56.75) ms, p=0.018}, NN50 {15.5(2-39) Vs 83.5(32.75-116.25), p=0.010}], and sympathetic indicator LF/HF ratio [1.2(0.65-2.20) Vs 0.79(0.5-1.02), p=0.004] was more in obese group.Conclusions: Obese persons have increased sympathetic activity with a reduction in parasympathetic (vagal) tone indicating poor autonomic cardiac rhythm control. Moreover, the altered autonomic activity could be the reason for increased mean heart rate and blood pressures in normotensive obese persons

Asymptomatic UTI in pregnancy attending at tertiary care of Nepal

Background: Urinary tract infections (UTI) during pregnancy issued by improper laboratory investigations situate women at risk of several detrimental complications. Untreated asymptomatic UTI (AUTI) may lead to pyelonephritis preterm birth, low birth weight, etc. Urine culture is used to confirm the diagnosis of UTI. Aim of this research was to carry out to find the prevalence of asymptomatic UTI and to establish antimicrobial drug susceptibility of the pathogens resulting asymptomatic UTI in pregnant women attending at tertiary care, Nepal.Methods: The urine samples were collected by mid-stream clean catch method from 600 pregnant women of age 15-45 years (mean age – 28.84 years) visiting for antenatal check up in the Department of Gynaecology and Obstetrics, Chitwan Medical College (CMC), a tertiary care of Nepal. All the urine samples were subjected to bio-physical, biochemical, microscopic, and microbiological analysis. The prevalence of UTI in three trimesters and in different age groups was obtained together with antimicrobial drug susceptibility tests.Results: On overall l51.83% of urine samples revealed with significant bacteriuria considered as the AUTI. On One- way ANOVA test, there was significant (P&lt; 0.045) prevalence of AUTI when compared among different trimesters, though higher prevalence being in the first (40%) and second (45.33%) trimesters. The prevalence of AUTI was significant (P&lt;0.004) among different age groups of the pregnancy. However, the most affectecd age groups were between 21-29 years. Escherichia coli were the most implicated organism (67.8%) followed by Klebsiella pneumonia (21.6%). The gram-negative bacteria (E. coli, K. pneumonia, and K. oxytoca) were more sensitive against Amikacin, Gentamycin, Meropenem, and Nitrofurantointhan. Other drugs whereas; gram positive bacteria (E. feacalis) had high susceptibility with Vancomycin.Conclusions: There was high incidence of AUTI among the pregnant ladies in the study region; therefore, microbial screening of urine of all pregnant women are must and should be included in the routine antenatal checkups to detect the AUTI to cut down and prevent the maternal and obstetric detrimental complications in them