Spectrum of diseases in a medical ward of a teaching hospital in a developing country

Communicable and respiratory tract diseases especially chronic obstructive pulmonary diseases are the main reasons of admission in medical ward of low and middle income countries. This is different from the developed countries where non communicable diseases are the main reasons of hospital admission. In developing countries the data of hospital admission are still lacking. Therefore this study will help us to assess the common patterns of diseases admitted in a medical ward, the average length of hospital stay etc. The record of 1040 hospitalized patients in medical ward was analyzed for the period of six months from Jan 2010 to Jun 2010. Patient’s medical records were retrieved and data analysis was done to obtain age, sex, common diagnosis, the affected system and the duration of the hospital stay. The data was analyzed by using SPSSV 16. After reviewing the data the most common age of patients being admitted were between 46-65 years (31.5%) followed by more than 65 years (25%) between 26-45 years (21.28%) and less than 25 years (21.28%). Among the admitted patients females were more than the males except in neurolog ward. The most effected system was respiratory (31.73 %),and the most common diagnosis was Chronic obstructive pulmonary diseases (23.17%). The next common system involved was gastroenterology including liver (18.64%) ,genitourinary (12.01%), cardiovascular ( 11.34%), neurology (9.23%), endocrine (4.80%) hematology (2.30%). The cause for hospital admission by infection in different system was (30.08%) The average duration of hospital stay of the patients was less than 7 days. The respiratory diseases and the infectious disease are the most common disease in Nepal. The communicable diseases still hold a greater position, while non communicable diseases are main reasons for admission to the medical wards in developed countries. Journal of College of Medical Sciences-Nepal,2012,Vol-8,No-2, 7-11 DOI: http://dx.doi.org/10.3126/jcmsn.v8i2.6831</a

The epidemiology of typhoid fever in the Dhulikhel area, Nepal: A prospective cohort study.

INTRODUCTION:Typhoid fever (TF) continues to cause considerable morbidity and mortality in Nepal, but only limited epidemiologic data is available about TF outside Kathmandu. METHODS:As part of an interventional trial, we performed a prospective cohort study of bacteremic TF patients in Dhulikhel Hospital between October 2012 and October 2014. Demographic, epidemiological, clinical, and microbiologic data were recorded. RESULTS:116 bacteremic typhoid patients were included in the study. Most were young, healthy, adults (mean age 27.9±12 years), 41.4% of whom were female. More than 70% of patients were employed in non-manual services or were university students. Salmonella Typhi accounted for 64/115 (55.7%) of all isolates, while Salmonella Paratyphi accounted for 51/115 (44.3%), of which 42 were Paratyphi A and 9 Paratyphi B. A significant proportion of TF cases occurred also during the dry season (48/116, 41.6%). The clinical presentation of Salmonella Typhi and Paratyphi infections was similar, except for a greater proportion of arthralgia in patients with Salmonella Typhi. Most Salmonella Typhi and Paratyphi isolates were resistant to nalidixic acid and susceptible to older antibiotics. One Salmonella Paratyphi isolate was resistant to ceftriaxone. CONCLUSIONS:TF remains common in the Dhulikhel area, even among those with a high level of education. Public health measures aimed at reducing the incidence of TF in the Dhulikhel area are warranted. The relative burden of TF caused by Salmonella Paratyphi is rising; a vaccine with activity against Salmonella Paratyphi is needed. Since Salmonella Paratyphi B was more prevalent in this cohort than in large cohorts of patients from Kathmandu, it is likely that there are significant regional variations in the epidemiology of TF outside Kathmandu