Background: Hypertension is a modifiable risk factor for cardiovascular diseases. Various studies conducted in the world showed high prevalence of hypertension, which is in increasing trend in Nepal also. The aim of this study was to assess hypertension status and risk behaviours among adult population in Kirtipur Municipality. Methods:A cross sectional descriptive study was conducted among 580 adults of age 20 -59 from December 2015 to April 2016. Data was collected by observation method to determine hypertension prevalence and Body Mass Index. Questionnaire was used to assess exposure to the risk factors.Results: Among all hypertension prevalence was 37.0% (215 out of 580). The prevalence was 41.6% (110 out of 264) among male and 32.2% (105 out of 316) among female (P <0.03 at 95% CI). Among 215 hypertensives, 37.2% were not aware about themselves having hypertension. Within last 12 months, 453 (78.1%) participants had checked their blood pressure. Proportion of hypertension was increasing with higher BMI and advancing age. Among all, 136 (23.7%) were current smokers, and 58.1% among them had hypertension. Conclusions:This study indicated that hypertension prevalence was high among adults in Kirtipur municipality. Prevalence of smoking was also high, and among them hypertension prevalence was very high. About one-third participants with hypertension were not aware that they had hypertension. Habit of doing regular physical exercise was very low.

This study aimed to determine the occurrence of antibiotic resistance genes for β-lactamases; blaTEM and blaCTX-M in uropathogenic Escherichia coli isolates from urinary tract infection (UTI) suspected diabetic and nondiabetic patients. A hospital-based cross-sectional study was conducted in Kathmandu Model Hospital, Kathmandu, in association with the Department of Microbiology, GoldenGate International College, Kathmandu, Nepal, from June to December 2018. A total of 1,267 nonduplicate midstream urine specimens were obtained and processed immediately for isolation of uropathogens. The isolates were subjected to antibiotic susceptibility testing and extended spectrum β-lactamase (ESBL) confirmation. In addition, blaTEM and blaCTX-M genes were detected using specific primers. The overall prevalence of UTI was 17.2% (218/1,267), of which patients with diabetes were significantly more infected; 32.3% (31/96) as compared with nonpatients with diabetes, 15.9% (187/1,171). A total of 221 bacterial isolates were obtained from 218 culture-positive specimens in which E. coli was the most predominant; 67.9% (150/221). Forty-four percent (66/150) of the total E. coli was multidrug resistant and 37.3% (56/150) were ESBL producers. Among 56 isolates, 92.3% (12/13) were from patients with diabetes, and 83.0% (44/53) were from nondiabetics. Furthermore, 84.9% of the screened ESBL producers were confirmed to possess either single or both of blaTEM and blaCTX-M genes. The blaTEM and blaCTX-M genes were detected in 53.6% and 87.5% of the phenotypically ESBL confirmed E. coli, respectively. Higher rates of ESBL producing uropathogenic E. coli are associated among patients with diabetes causing an alarming situation for disease management. However, second-line drugs with broad antimicrobial properties are still found to be effective drugs for multidrug resistance strains.

Introduction: Antibiotic resistance of urinary tract pathogens has increased globally. Updated knowledge of the antibiotic resistance patterns of uropathogens in the health institutes is important for the selection of an appropriate empirical antimicrobial therapy. The aim of this study was to evaluate the multi drug resistant urinary isolates in the children from 1 to15 years and evaluate the options for empiric antibiotic therapy. Materials and Methods: The study was conducted from December 2011 to May 2012 in the Bacteriology laboratory, Kathmandu Model Hospital. Urine samples received in the laboratory were processed for routine, culture and its sensitivity. The antimicrobial susceptibility of bacterial isolates was determined following Clinical and Laboratory Standard Institute (CLSI) recommended Kirby-Bauer Disc Diffusion method. Results: Of the total 372 urine samples received in the laboratory, 60 (16.13%) showed significant growth; of which 55.0 % (33/60) were MDR isolates. Escherichia coli were the predominant isolate from urine sample. Out of 49 Escherichia coli isolates, 27 (45.0%) were Multi drug resistant. Enterococcus faecalis (N=3) was the most predominant Gram positive isolate and 66.67 % (2/3) of this organism were multi drug resistant. Among the first line drugs used against gram negative isolates, nitrofurantoin was the most effective drug followed by quinolones, while among the second line drugs; meropenem was the most effective drug followed by chloramphenicol and amikacin, whereas; nitrofurantoin (100%) was the most effective drug for Gram positive isolates followed by norfloxacin and cefotaxime. Conclusion: High percentages of multi drug resistant uropathogens were revealed in children. Nitrofurantoin was found to be the most effective drug for gram positive, gram negative and multi drug resistant isolates.

Background: Mid-clavicle fractures were traditionally managed by non-operative means which led to stiffness and painful shoulder. Surgical treatment on the other hand had the advantage of reducing malunion and allowing early shoulder movements, but also had incidences of infection. This study was carried out with the objectives of comparing functional outcome, fracture union rates, patient satisfaction rates and complications of both treatments. Methods: In this observational study done from October 2020 to September 2021 in the Orthopedics and Emergency department of KIST Medical College Teaching Hospital, Lalitpur, Nepal, 40 patients with mid-clavicle fractures were treated either conservatively or operatively according to their choice. 20 patients in each group were assessed functionally in each follow-up using the Constant and Murley score and union and complications were also assessed. Data collection and entry was done using the statistical package for social science version 22 and analyzed by using statistical tools like mean, frequency and Independent samples t-test. Results: At 6 months, there was no statistical difference in the Constant and Murley score between the two groups, but the scores were statistically better in the operative group at 6 weeks. Mean fracture union time in operative group (12.67 weeks) was statistically better than that in conservative group (14.89 weeks). Complications in operative group were mainly hardware related while stiffness was more common in conservative group. Conclusions: Operative treatment led to earlier fracture union, regain of shoulder function and return to work, but had the disadvantage of high cost and risk of infection as compared to conservative treatment.