No abstract

Background: Liver diseases are one of the common disorders encountered in clinical practice. Investigations in liverassociated diseases are used to detect type of hepatic abnormality, to measure its severity, to define its structural effect on the liver, to find out etiology of disorder, to assess prognosis, and to evaluate therapy. One should aim at a diagnosis with simple and possibly noninvasive means, avoiding extensive examinations. De Ritis ratio (the ratio of serum aspartate aminotransferase to serum alanine aminotransferase) has been proposed a valuable diagnostic marker to screen liver disorder. Objective: To assess the significance of De Ritis ratio as a diagnostic marker in population of hepatic disorder. Materials and Method: This is a retrospective study performed on records of 102 patients with liver diseases who were treated at the outpatient clinic or admitted to Nobel Medical College, Biratnagar, Nepal, between June 15, 2015 and July 15, 2015. De Ritis ratio of all the patients were calculated from documented biochemical tests of AST and ALT. De Ritis ratio and demographic profile of all the patients were analyzed by independent t-test and one-way ANOVA using software SPSS 20 version. Results: De Ritis ratio was significantly decreased (p < 0.05) in viral hepatitis (0.8006 ± 0.14811) than the control group (1.0934 ± 0.13508) and markedly increased (p = 0.000) in alcoholic liver disorder. Similarly, It is significantly increased (p < 0.05) in nonalcoholic fatty liver disorder (1.2204 ± 0.17954), whereas insignificantly increased (p = 0.408) in cholestasis (1.1378 ± 0.18045). Conclusion: De Ritis ratio can be used as a prognostic marker of liver disorder and can be considered as a noninvasive, cost-effective means of screening liver diseases.

Abstract:Intestinal parasitosis is highly prevalent among the general population in Nepal. This study aimed to evaluate the distribution of intestinal parasites among patients attending Nobel Medical College Teaching Hospital, Biratnagar, Nepal. A total of 5,524 stool samples examined by direct smear and Formal-Ether concentration technique were reported.The overall prevalence of intestinal parasitic infection was found to be 15.17% (M=15.65% vs F=14.62%). The overall prevalence of intestinal parasitosis was found to be highest among patients aged 5-14 years (20.66%), followed by elderly people aged > 45 years (16.20%) and least among children aged < 5 years (9.09%). Among various parasites detected, the most common was Entamoeba histolytica (44.86%) followed by Giardia lamblia (33.65%), hookworm (10.50%), Ascaris lumbricoides (5.72%), Strongyloides stercoralis (4.77%), Hymenolepis nana (3.34%), Trichuris trichiura (0.95%) and Enterobius vermicularis (0.23%) respectively.

No abstract

Introduction: Post cesarean surgical site infection (SSI) is one of the common complications diagnosed in 2.5%-16% of the cases and is associated with significant increase in maternal morbidity, hospital stay, costs, and psychological stress to the new parents. This study was designed to study the incidence of SSI and the antimicrobial resistance pattern in our hospital.   Methods: This was a prospective observational study conducted from July 2015 to December 2015, in which all patients who were admitted with post cesarean SSI or developed SSI during their stay were included.  Wound specimens were collected and susceptibility testing was carried out using disc diffusion technique.   Results: The incidence of post cesarean SSI was 6.07% (47/774). Out of the 47 patients who had SSI, 35 (74.75%) had positive swab culture. The most important organism isolated was Staphylococcus aureus (82.85%) out of which 17 (58.62%) were MRSA strain. The resistance of Staphylococcus to penicillin was 84.6% whereas amikacin was found to be highly sensitive (>96%). Among the MRSA strain, resistance to ciprofloxacin, which is the currently used drug for prophylaxis, was 94%. Resistance to penicillins, cephalosporins, and clavulanate was also high. Resistance to vancomycin was also high (53%). Amikacin and chloramphenicol were found to be highly sensitive  (94% and 90% respectively) in the MRSA group.   Conclusion: MRSA is the leading cause of post cesarean SSI and is a matter of great concern. Amikacin and chloramphenicol were found to be highly sensitive in this group but unlike other studies, resistance of vancomycin was showing an increasing trend.