Background: The emergence of multidrug-resistant (MDR) and extended-spectrum beta-lactamase (ESBL)producing uropathogens has complicated the treatment of urinary tract infections (UTI). Paediatric UTI is a common illness, which if not treated properly, may lead to acute and long-term complications, such as renal abscess, septicaemia, and renal scarring. This study aimed to determine the prevalence of MDR and ESBL-producing uropathogens among children. Methods: During the study period (April 2017-April 2018), midstream urine samples were collected following aseptic procedures from children < 16 years in Siddhi Memorial Hospital. Standard culture and biochemical tests were performed to identify uropathogens and antimicrobial susceptibility test was done by modified Kirby-Bauer disc diffusion method following Clinical and Laboratory Standard Institute (CLSI) guidelines. ESBL-producing uropathogens were screened by ceftazidime (30 μg) and cefotaxime (30 μg) discs, and confirmed by the combination disc tests: ceftazidime + clavulanic acid (30/10 μg) or cefotaxime + clavulanic acid (30/10 μg) as recommended by CLSI. Results: We processed 5545 non-repeated urine samples from the children with symptoms of UTI. A significant growth of uropathogens was observed in 203 samples (3.7%). The median age of the children was 24 months (interquartile range (IQR), 12-53 months). Escherichia coli (n = 158, 77.8%) and Klebsiella pneumoniae (n = 30, 14.8%) were common among the uropathogens. Among them, 80.3% were resistant to amoxycillin and 51.2% were resistant to cotrimoxazole. Most of them were susceptible to amikacin, nitrofurantoin, and ofloxacin. MDR was detected in 34.5% (n = 70/203) and ESBL producers in 24.6% (n = 50/203) of them. The proportion of MDR isolates was higher in children < 5 years (n = 59/153, 38.6%) than children ≥ 5 years (n = 11/50, 22%) (P = 0.03). Conclusions: Nitrofurantoin, ofloxacin, and amikacin can be used for the empirical treatment for UTI in children in Bhaktapur, Nepal. MDR and ESBL-producing uropathogens are prevalent; this warrants a continuous surveillance of antimicrobial resistance.

Background: Diabetes mellitus is the most prevalent metabolic condition and one of the major health and socioeconomic problems worldwide. Awareness of risk factors and prevention of diabetes plays a major role for prevention of diabetes mellitus in general population.Objectives: To assess level of awareness regarding diabetes mellitus risk factors and preventive measures among individuals who attended General Practice outpatient department at Kathmandu Medical College Teaching Hospital, Duwakot, Bhaktapur.Methodology: This is a descriptive study conducted in Department of General Practice and Emergency of Kathmandu Medical College Teaching Hospital. The study included 370 patients attending General Practice outpatient department from November 2018 to April 2019. The data collected was entered in the Statistical Package for the Social Sciences software and analysed for results. Ethical clearance was taken from Institutional Review Committee of Kathmandu Medical College.Results: The study included 370 participants; the mean age was 40.83±12.21 years. More than half of the participants (56.5%) were females and 43.5% were males. The most commonly mentioned risk factor was lack of physical activity and obesity. Almost 80% participants correctly stated that physical activity could help prevent diabetes mellitus. There was no statistical significance between awareness and educational level of participants.Conclusion: This study showed that proper awareness programs need to be carried out in rural and urban communities to prevent diabetes and its complications. In this study, patient awareness about risk factors and preventive measures was not appreciable. Association of awareness with age, sex and education level was not statistically significant.

Background: Dyslipidemia, a well-known major risk factor for coronary heart disease, is commonly associated with macro-vascular complications in patients with diabetes mellitus. Increased level of triglycerides and reduced levels of HDL cholesterol are common lipid abnormalities in diabetes. Objectives: The aim of the study was to study the prevalence and pattern of lipid abnormalities among diabetic patients attending general practice outpatient department in Kathmandu Medical College Teaching Hospital. Methodology: This is a descriptive cross-sectional study conducted in the Department of General Practice and Emergency of Kathmandu Medical College Teaching Hospital, Duwakot, Bhaktapur. Convenience sampling technique was used.After obtaining informed consent, 120 diabetic patients from January 2020 to March 2020 were included. The data collected was entered in the Statistical Package for the Social Sciences software and analyzed. Ethical clearance was taken from the Institutional Review Committee of Kathmandu Medical College.   Results:The average TC, HDL, TG and LDL level among the female participants were 186.18 mg/dl, 41.91 mg/dl, 194.63 mg/dl, 111.88 mg/dl respectively and 186.30 mg/dl, 38.80 mg/dl, 205.60 mg/dl, 125.80 mg/dl among the male participants respectively.Eighty-five (71%) patients had a low HDL level. Total cholesterol was found to be high in 38(32%) participants. LDL cholesterol was high in 77(64%) participants. The triglyceride level was high in 85(71%) participants. Conclusion: This study showed that some diabetic individuals have a lipid abnormality while others did not. This shines light on the importance of regular testing for lipid profile in diabetic individuals because we cannot reasonably predict when a patient will develop dyslipidemia.

Introduction: Hypertension is a common physical condition with high blood pressure for a prolonged period. Long risk factors like age, overweight, high dietary salt intake, smoking, sedentary lifestyle, and term hypertension might lead to various cardiovascular diseases. The normal blood pressure, systolic, is 90-119 mm Hg and diastolic 60-79 mm Hg. The objective of this study is to find out the prevalence of hypertension among current cigarette smokers patients in an outpatient department of a tertiary care centre. Methods: A descriptive cross-sectional study was done on 385 outpatient department patients in a tertiary care centre from September, 2021 to February, 2022. The sample was collected by a convenience after approval from the Institutional Review Committee (Reference number: 0505202105). Outpatient department patients who had past history of smoking cigarette>100 cigarettes and who is still smoking were included in the study. Data were analysed by using the Statistical Package for the Social Science software version 16.0. Point estimate at 95% Confidence Interval was calculated along with frequency and percentage for binary data and mean and standard deviation for continuous data. Results: Among 385 patients, 209 (54.28%) (47.64-60.92 at 95% Confidence Interval) were hypertensive patients. One hundred fifty-six (40.51%) males and 53 (13.76%) females were hypertensive. Conclusions: The prevalence of hypertension was higher when compared to other studies done in similar settings.