Journal of the Institute of Medicine最新文献_第10页

Comparison of Sevoflurane and Isoflurane for Myocardial Protection During Coronary Artery Bypass Surgery in a Tertiary Care Center in Nepal 尼泊尔三级保健中心冠状动脉搭桥术中七氟醚和异氟醚心肌保护作用的比较

Journal of the Institute of Medicine Pub Date : 2019-08-26 DOI: 10.3126/jiom.v41i2.26550

P. Bastola, B. Pradhan, M. Basnet

{"title":"Comparison of Sevoflurane and Isoflurane for Myocardial Protection During Coronary Artery Bypass Surgery in a Tertiary Care Center in Nepal","authors":"P. Bastola, B. Pradhan, M. Basnet","doi":"10.3126/jiom.v41i2.26550","DOIUrl":"https://doi.org/10.3126/jiom.v41i2.26550","url":null,"abstract":"IntroductionMyocardial protection during Coronary Artery Bypass Graft (CABG) has always been an area of concern so weaimed to evaluate the level of release of Creatine Phosphokinase (CPK-MB) and Troponin I (cTnI) at varioustime intervals in the first 24 hours after on pump CABG in patients receiving either Sevoflurane or Isoflurane.Furthermore clinically relevant patient outcomes were also evaluated in patients undergoing on pump coronaryartery bypass grafting.MethodsThis was a prospective randomized trial in patients undergoing on pump coronary artery bypass graft surgery,which was conducted from January 2016 till June 2017. A total of 105 patients were enrolled out of whichthere were 53 in Isoflurane and 52 in Sevoflurane group who received the respective volatile anesthetic agentsthroughout the surgery except during bypass at 1-1.5 MAC. The primary outcome was comparison of the CPK MBand cTnI levels at 0 hr, 6 hr, 12 hr and 24 hr after surgery from baseline, whereas the secondary outcomes wereduration of intensive care unit stay, usage of vasopressors and inotropes, renal dysfunction, stroke.ResultsNo significant difference in CPK MB and cTnI levels at all time intervals in both the groups, the other secondaryoutcome parameters were comparable.ConclusionThe study found no difference in the cardiac markers between the two anesthetics. Based on the data, Sevofluraneand Isoflurane might be used equivalently in patients undergoing coronary artery bypass graft surgery withextracorporeal circulation without any difference in their myocardial protection function.KeywordsCoronary artery bypass graft, isoflurane, myocardial injury, myocardial protection, sevoflurane","PeriodicalId":85033,"journal":{"name":"Journal of the Institute of Medicine","volume":"41 1","pages":"45-49"},"PeriodicalIF":0.0,"publicationDate":"2019-08-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.3126/jiom.v41i2.26550","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44659910","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 1

Knowledge and Practice on Prevention of Complications of Diabetes Mellitus among Patients with Diabetes in a Tertiary Hospital 某三甲医院糖尿病患者预防糖尿病并发症的认识与实践

Journal of the Institute of Medicine Pub Date : 2019-08-26 DOI: 10.3126/jiom.v41i2.26551

O. Acharya, Takma Kc, K. Shrestha

{"title":"Knowledge and Practice on Prevention of Complications of Diabetes Mellitus among Patients with Diabetes in a Tertiary Hospital","authors":"O. Acharya, Takma Kc, K. Shrestha","doi":"10.3126/jiom.v41i2.26551","DOIUrl":"https://doi.org/10.3126/jiom.v41i2.26551","url":null,"abstract":"IntroductionDiabetes is a major contributing factor for overall health status, morbidity, mortality and quality of life. Adequateknowledge and sufficient practice can prevent many possible diabetic complications. Hence, the objective ofthis study was to find out the knowledge and practice regarding prevention of complications of diabetes amongdiabetic patients.MethodsA descriptive, cross sectional design was carried out in Tribhuvan University Teaching Hospital Kathmandu (TUTH).A total 124 diabetic patients who came for follow-up in endocrine Out Patient Department were selected throughpurposive sampling technique by using pre-tested structured interview schedule during four weeks. Data wasanalyzed by using the descriptive and inferential statistics with the help of Statistical Package of Social Science(SPSS) version 16.ResultsThe study findings showed that 24.2% respondents had adequate knowledge about complications . Morethan half of the respondents had sufficient practice (52.4%) regarding prevention of diabetic complications.Association between knowledge and selected variables showed that sex and education level tends to besignificantly associated and regarding practice, area of residence and duration of illness were significantlyassociated (p<0.05). There was a statistically significant (p<0.001) and average positive relationship (r=0.605)was found between knowledge and practice.ConclusionThe study concluded that though only few respondents had adequate knowledge, more than half of therespondents had sufficient practice regarding preventing complications. This finding suggests awarenessprogram regarding prevention of compilcations of diabetes mellitus should be launched periodically to increaseknowledge and sufficient practice on prevention of diabetic complications.KeywordsDiabetic complications, diabetes mellitus, knowledge, practice","PeriodicalId":85033,"journal":{"name":"Journal of the Institute of Medicine","volume":"41 1","pages":"50-55"},"PeriodicalIF":0.0,"publicationDate":"2019-08-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.3126/jiom.v41i2.26551","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41520486","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 1

Nephron Sparing Surgery for Small Renal Mass at a University Teaching Hospital: A Six Years Retrospective Review 一所大学教学医院小肾脏肿块保留肾单位手术的六年回顾性研究

Journal of the Institute of Medicine Pub Date : 2019-08-26 DOI: 10.3126/jiom.v41i2.26537

B. D. Rai, S. Poudyal, P. Dhital, M. Pradhan, S. Chapagain, B. Luitel, P. Chalise, U. Sharma, P. Gyawali

{"title":"Nephron Sparing Surgery for Small Renal Mass at a University Teaching Hospital: A Six Years Retrospective Review","authors":"B. D. Rai, S. Poudyal, P. Dhital, M. Pradhan, S. Chapagain, B. Luitel, P. Chalise, U. Sharma, P. Gyawali","doi":"10.3126/jiom.v41i2.26537","DOIUrl":"https://doi.org/10.3126/jiom.v41i2.26537","url":null,"abstract":"IntroductionNephron-sparing surgery (NSS) is the standard of care for clinical T1 (cT1), renal mass less than 7 cm, wheneverintervention is indicated. It has oncological outcome equivalent to radical nephrectomy in small renal massesand it also minimizes the progression to chronic kidney disease. However, there is paucity of data on outcomesof NSS in Nepalese population.MethodsA six years retrospective review of medical records of patients undergoing partial nephrectomy from Jan 2012 toDec 2017 in Department of Urology and Kidney Transplant Surgery at Tribhuvan University Teaching Hospital wasdone to determine its demographics and outcomes.ResultsTwenty eight patients underwent nephron sparing surgery for clinical T1 renal masses in the past six years.Complications occurred in three cases. Five of the lesions were benign and 23 malignant on final histology. Clearcell carcinoma was the commonest variant of renal cell cancer. Margin was positive in two cases and both werekept in close surveillance. There was no local recurrence and renal impairment during five to 60 months followup.ConclusionNephron sparing surgery is a safe procedure with good oncological outcome for clinical T1 renal mass. It preventsunnecessary nephrectomy in benign lesions as well as chronic renal impairment at the same time.KeywordsNephron sparing surgery, small renal mass","PeriodicalId":85033,"journal":{"name":"Journal of the Institute of Medicine","volume":"41 1","pages":"1-3"},"PeriodicalIF":0.0,"publicationDate":"2019-08-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.3126/jiom.v41i2.26537","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44594222","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Hemodialysis Catheter-Related Infection in a Teaching Hospital of Central Nepal 尼泊尔中部某教学医院血液透析导管相关感染

Journal of the Institute of Medicine Pub Date : 2019-08-26 DOI: 10.3126/jiom.v41i2.26541

A. Sedhain, A. Sapkota, N. Mahotra

{"title":"Hemodialysis Catheter-Related Infection in a Teaching Hospital of Central Nepal","authors":"A. Sedhain, A. Sapkota, N. Mahotra","doi":"10.3126/jiom.v41i2.26541","DOIUrl":"https://doi.org/10.3126/jiom.v41i2.26541","url":null,"abstract":"IntroductionInfection of the central venous catheter (CVC) is a major complication seen among patients undergoinghemodialysis. Identifying CVC related infection (CRI) and its risk factors and causative organisms is important for better implementation of preventive strategies.MethodsA prospective study was conducted at Chitwan Medical College for a duration of 2 years from January 2017to December 2018 among the patients undergoing hemodialysis via CVC. The data collected were related topatients’ demographics, site of catheter insertion, and duration, microbiological data including cultures fromcatheter sites, blood, and catheters’ tips and antibiotic sensitivity. Catheter related infection was divided intocatheter related local infection (CRLI) and catheter related blood stream infection (CRBSI). Data was analyzedusing IBM SPSS Statistics version 21.0.ResultsA total of 41 cases of CVC related infection (CRI) were documented with an incidence rate of 6.94 episodesper 1000 catheter days at risk. Out of the total CRI, 39.02% were CRLI and 60.98% were CRBSI. Fever with chillsand rigor were the most common clinical presentation. Risk factors for the development of CRI were durationof catheter in situ, repeated change of CVC and the use of CVC for indications other than hemodialysis (HD).Staphylococci and Klebsiella were the most common organisms isolated in culture.ConclusionThe rate of CRI among Nepalese patients undergoing hemodialysis is high. Prolonged duration of CVC usage,recent change of catheter and the use of the HD catheter for the purpose of institution of intravenous medication have been found as the risk factors for CRI.KeywordsCatheter related infection, central venous catheter, hemodialysis","PeriodicalId":85033,"journal":{"name":"Journal of the Institute of Medicine","volume":"41 1","pages":"11-16"},"PeriodicalIF":0.0,"publicationDate":"2019-08-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.3126/jiom.v41i2.26541","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"45880248","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 2

Mortality in Emergency Services in a University Teaching Hospital: A Retrospective Study 某大学教学医院急诊死亡率的回顾性研究

Journal of the Institute of Medicine Pub Date : 2019-08-26 DOI: 10.3126/jiom.v41i2.26542

T. Shrestha, R. Acharya, R. Neupane, Bigyan Prajapati

{"title":"Mortality in Emergency Services in a University Teaching Hospital: A Retrospective Study","authors":"T. Shrestha, R. Acharya, R. Neupane, Bigyan Prajapati","doi":"10.3126/jiom.v41i2.26542","DOIUrl":"https://doi.org/10.3126/jiom.v41i2.26542","url":null,"abstract":"IntroductionEmergency services are the gateway between the community and hospital that provides 24-hour access for mostneedy patients in critical and emergency conditions. Mortality rate varies in emergency department across theworld and even in different emergency units of the same hospital. This retrospective study was done in adultemergency services of a tertiary hospital to determine mortality rate and analyze causes of death.MethodsA retrospective observational study of mortality cases to analyze mortality rate and causes of death of patientsfor a period of 6 months between October 2017 to March 2018 was carried out in the adult emergency servicesof Tribhuvan University Teaching Hospital, Kathmandu. Data required were collected from copies of deathcertificates.ResultsDuring the study period, a total of 128 patients died in emergency, accounting 0.5% of total patient. Male deaths(52.3%) were slightly higher compared to female deaths (47.7%). Age group 66-75 years had the highest (24.2%)of total mortalities in the emergency. The most common immediate cause of death was sepsis/septic shock(21.9%) followed by cardiopulmonary arrest, aspiration, respiratory failure, other causes of shock and poisoning.The commonest antecedent cause of death was attributed to respiratory causes. Similarly, the most commoncontributory cause of death was chronic obstructive pulmonary disease.ConclusionOlder age group are prone to the mortality risk. Sepsis/septic shock was the most common immediate cause ofdeath. Pneumonia was the most common antecedent causes of death. Chronic obstructive pulmonary diseasewas the commonest contributory cause.KeywordsEmergency Department, mortality, Nepal, sepsis","PeriodicalId":85033,"journal":{"name":"Journal of the Institute of Medicine","volume":"41 1","pages":"17-20"},"PeriodicalIF":0.0,"publicationDate":"2019-08-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.3126/jiom.v41i2.26542","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"47100182","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 1

External Ventricular Drainage Infections: Experience from a Tertiary Care Center in Nepal 外心室引流感染:尼泊尔三级保健中心的经验

Journal of the Institute of Medicine Pub Date : 2015-07-26 DOI: 10.3126/NJN.V12I2.15896

A. Pradhanang, M. Sharma, G. Sedain, S. Shilpakar

{"title":"External Ventricular Drainage Infections: Experience from a Tertiary Care Center in Nepal","authors":"A. Pradhanang, M. Sharma, G. Sedain, S. Shilpakar","doi":"10.3126/NJN.V12I2.15896","DOIUrl":"https://doi.org/10.3126/NJN.V12I2.15896","url":null,"abstract":"External Ventricular Drainage (EVD) related infection is one of the most dreaded infections in neurosurgical practice. The primary aim of this study was to assess the incidence of EVD infections in our hospital. In addition, we have made an attempt to evaluate the indication for EVD placement, influence of total drainage time in the risk of catheter infection, the most common bacterial spectra in cerebrospinal fluid (CSF) culture, and their antibiotic sensitivity pattern. This is a retrospective study of all patients who underwent EVD placement over a period of two years. Out of 60 patients who underwent EVD placement, 52 met the inclusion criteria for analysis. The ventricular catheters were in place from 1 to 23 days. Overall shunt infection rate was 36.5%. CSF cell count significantly correlated with the occurrence of a positive CSF culture (unpaired t test, p<0.05). The most common bacterial species isolated were Acinetobacter baumannii and Burkholderia cepacia. Despite many advances in care, there is still a significantly high incidence of EVD related infections. Contrary to earlier reports, the most common bacterial grown in our center were quite different and their antibiotic sensitivity varied accordingly. Nepal Journal of Neuroscience 12:67-71, 2015","PeriodicalId":85033,"journal":{"name":"Journal of the Institute of Medicine","volume":"1 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2015-07-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.3126/NJN.V12I2.15896","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"69323694","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Second Intervention in Obstetric Hemorrhage 产科出血的第二次干预

Journal of the Institute of Medicine Pub Date : 2013-11-09 DOI: 10.3126/JIOM.V34I1.9118

S. Rawal, A. Rana

{"title":"Second Intervention in Obstetric Hemorrhage","authors":"S. Rawal, A. Rana","doi":"10.3126/JIOM.V34I1.9118","DOIUrl":"https://doi.org/10.3126/JIOM.V34I1.9118","url":null,"abstract":"Introduction: Obstetric hemorrhage is still one of the dreaded complications that contribute to a maximum number of maternal morbidity and mortality till date. The management of obstetric hemorrhage involves early recognition, assessment and resuscitation. Though dealt with appropriate use of oxytocic agents, it may seldom require surgical techniques, including uterine tamponade, major vessel ligation, compression sutures, and even hysterectomy. Method: Prospective study of 20 cases of laparotomy for obstetrical hemorrhage carried out at Tribhuvan University Teaching Hospital, Kathmandu, Nepal, between Jan 2003 to Nov 2011. Results: Out of 20 cases, massive hemoperitoneum (more than a liter) was noted in 9 and associated risk factors in 10. Source of bleeding in 20 cases were from extensive hematoma (retroperitoneal and broad ligament) in 5, including a rectus sheath hematoma and with colporrhexis, oozing inverted T incision repaired in a single layer (1), placental bed (3) and 1 was from vessels in LUS. There was bleeding from uterine angle (4) and incision (1). Bleeding from tear at various sites were 3, from uterovesicle fold of peritoneum 1 and from the ruptured uterus following vacuum delivery in a case of VBAC (1). Uterine packing was done in 1, B-Lynch in 3 and 1 failed needing the uterine packing; uterine artery ligation in 2 including ovarian vessel ligation in 1, repair of ruptured uterus in 1 and subtotal hysterectomy in 5 cases. There were 3 mortalities due to DIC, pulmonary edema and ARF and rest were discharged in good health. Conclusion: Choosing of the right technique, complete hemostasis and meticulous closure of all surgical incisions will prevent the need for laparotomy following LSCS. Vigilant monitoring of all the post operative patients will lead to early diagnosis of intraperitoneal / pervaginal bleeding and its management, thus preventing morbidity and mortality owing to late diagnosis. DOI: http://dx.doi.org/10.3126/joim.v34i1.9118 Journal of Institute of Medicine, April, 2012; 34:1 18-24","PeriodicalId":85033,"journal":{"name":"Journal of the Institute of Medicine","volume":"34 1","pages":"18-24"},"PeriodicalIF":0.0,"publicationDate":"2013-11-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"69285415","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Knowledge about Tuberculosis in outpatients who visited College of Medical Sciences Teaching Hospital, Bharatpur, Nepal 尼泊尔巴拉特普尔医学院教学医院门诊患者对结核病的了解

Journal of the Institute of Medicine Pub Date : 2013-11-09 DOI: 10.3126/JIOM.V34I1.9120

N. Manandhar, G. Krishna

{"title":"Knowledge about Tuberculosis in outpatients who visited College of Medical Sciences Teaching Hospital, Bharatpur, Nepal","authors":"N. Manandhar, G. Krishna","doi":"10.3126/JIOM.V34I1.9120","DOIUrl":"https://doi.org/10.3126/JIOM.V34I1.9120","url":null,"abstract":"Background: Now a days Tuberculosis is a major public health problem in the world. Number of deaths due to tuberculosis is highest among the infectious diseases. Methods: The cross sectional study was carried out from May 2008 to July 2008 in the different out patient departments of College of Medical Sciences Teaching Hospital. A total of 500 patients belong to age > 15 years who visited various departments of College of Medical Sciences Teaching Hospital were randomly selected for the present study. Interview technique was used to collect information on a pre-designed and pre-tested questionnaire. Results: Out of total patient’s interview, 59% and 41% were male and female respectively. Majority of the outpatients had heard about the Tuberculosis disease. 73.3% of the respondents opinioned that T.B. can be acquired by infection. Conclusion: The study population has satisfactory knowledge about the etiology and transmission of the disease. There was poor knowledge about proper disposal of sputum which is an important aspect in regard to transmission of disease. There is need of imparting knowledge to the people about proper disposal of sputum to reduce the spread of disease and mortality due to T.B DOI: http://dx.doi.org/10.3126/joim.v34i1.9120 Journal of Institute of Medicine, April, 2012; 34:1 33-36","PeriodicalId":85033,"journal":{"name":"Journal of the Institute of Medicine","volume":"34 1","pages":"33-36"},"PeriodicalIF":0.0,"publicationDate":"2013-11-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"69285500","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 1

An Adolescent with innumerable myomas 有无数肌瘤的青少年

Journal of the Institute of Medicine Pub Date : 2013-11-09 DOI: 10.3126/JIOM.V34I1.9122

J. Baral, G. Gurung, S. K. Mishra, N. Rai, P. Paudyal, B. Shrestha, A. Rana

引用次数: 0

Prevalence and Antibiotic Sensitivity Pattern of Methicillin- Resistant- Staphylococcus aureus in Kathmandu Medical College -Teaching Hospital 加德满都医学院-教学医院耐甲氧西林金黄色葡萄球菌的流行及药敏模式

Journal of the Institute of Medicine Pub Date : 2013-11-09 DOI: 10.3126/JIOM.V34I1.9117

S. Pandey, M. Raza, C. Bhatta

{"title":"Prevalence and Antibiotic Sensitivity Pattern of Methicillin- Resistant- Staphylococcus aureus in Kathmandu Medical College -Teaching Hospital","authors":"S. Pandey, M. Raza, C. Bhatta","doi":"10.3126/JIOM.V34I1.9117","DOIUrl":"https://doi.org/10.3126/JIOM.V34I1.9117","url":null,"abstract":"Introduction: Staphylococcus aureus is found to be a major source of community as well as hospital acquired infection. Staphylococcal isolates from tertiary care hospital are found to be resistant to commonly used antimicrobial agents. Methicillin resistant S. aureus (MRSA) with intrinsically developed antimicrobial resistance has been associated with an increase in morbidity and mortality of the patients in the hospital. This study was undertaken to know the antibiotic sensitivity pattern of staphylococcal isolates with special reference to Methicillin resistant S. aureus. Methods: Clinical specimens received from July 2009 to July 2010 in Kathmandu Medical college-Teaching Hospital were processed and all S. aureus isolates were included in the study. The isolates were identified by standard laboratory procedure. The antibiotic susceptibility pattern of all staphylococcal strain was determined by modified Kirby Bauer antibiotic sensitivity method. Results: Of 111 S .aureus isolates 29(26.12%) were identified to be MRSA. The rate of multi drug resistance was 75.86% for MRSA and 6.09% for MSSA. All the staphylococcal isolates were resistant to penicillin. However, all strains were sensitive to vancomycin. Conclusions: This study showed a high prevalence of MRSA in tertiary care hospital of Kathmandu valley. Regular surveillance of hospital-associated infection and monitoring of antibiotic sensitivity pattern is mandatory to reduce MRSA prevalence in hospital and its spread to community as well. Present study conclusively shows that vancomycin remains the first choice of treatment for MRSA infection. To preserve its value, use of vancomycin should be limited to those cases where there are clearly needed. DOI: http://dx.doi.org/10.3126/joim.v34i1.9117 Journal of Institute of Medicine, April, 2012; 34:1 13-17","PeriodicalId":85033,"journal":{"name":"Journal of the Institute of Medicine","volume":"34 1","pages":"13-17"},"PeriodicalIF":0.0,"publicationDate":"2013-11-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.3126/JIOM.V34I1.9117","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"69284740","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 33