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  1. Article ; Online: Role of Biofilm in Bacterial Infection and Antimicrobial Resistance

    Khilasa Pokharel / Bishwa Raj Dawadi / Lok Bahadur Shrestha

    Journal of Nepal Medical Association, Vol 60, Iss

    2022  Volume 253

    Abstract: Biofilm refers to the complex, sessile communities of microbes found either attached to a surface or buried firmly in an extracellular matrix as aggregates. Microbial flora which produces biofilm manifests an altered growth rate and transcribes genes ... ...

    Abstract Biofilm refers to the complex, sessile communities of microbes found either attached to a surface or buried firmly in an extracellular matrix as aggregates. Microbial flora which produces biofilm manifests an altered growth rate and transcribes genes that provide them resistance to antimicrobial and host immune systems. Biofilms protect the invading bacteria against the immune system of the host via impaired activation of phagocytes and the complement system. Biofilm-producing isolates showed greater multidrug resistance than non-biofilm producers. Biofilm causes antibiotic resistance through processes like chromosomally encoded resistant genes, restriction of antibiotics, reduction of growth rate, and host immunity. Biofilm formation is responsible for the development of superbugs like methicillin-resistant Staphylococcus aureus, vancomycin-resistant Staphylococcus aureus, and metallo-beta-lactamase producing Pseudomonas aeruginosa. Regular monitoring of antimicrobial resistance and maintaining hygiene, especially in hospitalized patients are required to control biofilm-related infections in order to prevent antimicrobial resistance.
    Keywords antibiotic resistance ; bacterial infections ; biofilm ; MRSA ; Medicine (General) ; R5-920
    Subject code 616
    Language English
    Publishing date 2022-08-01T00:00:00Z
    Publisher Nepal Medical Association
    Document type Article ; Online
    Database BASE - Bielefeld Academic Search Engine (life sciences selection)

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  2. Article ; Online: Side Effects after Second Dose of Covishield Vaccine among Health Care Workers

    Khilasa Pokharel / Bishwa Raj Dawadi / Anup Karki

    Journal of Nepal Medical Association, Vol 59, Iss

    A Descriptive Cross Sectional Study

    2021  Volume 238

    Abstract: ABSTRACT Introduction: COVID 19 vaccination will protect us from getting COVID-19. Some side effects are common which are signs that our body is building protection. This side effects will go away in a few days. The aim of this study is to find out side ... ...

    Abstract ABSTRACT Introduction: COVID 19 vaccination will protect us from getting COVID-19. Some side effects are common which are signs that our body is building protection. This side effects will go away in a few days. The aim of this study is to find out side effects seen among health care workers after second dose of covishield vaccination. Methods: This was a descriptive cross-sectional study conducted at Kathmandu medical college and Teaching Hospital from 22nd April 2021 till 30th April 2021. Ethical approval was revceived from Institutional Commitee of Institiute. Convienient sampling was done. The second dose of covishield vaccine was administered 12 weeks after its first dose. The vaccine was administered intramuscularly (IM) into deltoid muscle. Statistical Package for the Social Sciences were used for analysis. Results: Out of 220 cases taken, 135 were male and 85 were female. In our study 178 (80.90%) complaint of pain at injection site after second dose of covishield vaccine followed by 97 (44.09%) complaint of fatigue, 43 (19.54%) complaint of headache, 18 (8.18%) complaint of chills, 11 (5.00%)complaint of fever, 6 (2.72%) complaint of dizziness and 5 (2.27%) complaint of nausea. Conclusions: Pain at injection site, fatigue and headache were common side effects seen after second dose of Covishield vaccination.
    Keywords Keywords: dizziness ; fatigue ; pain ; site ; Medicine (General) ; R5-920
    Language English
    Publishing date 2021-07-01T00:00:00Z
    Publisher Nepal Medical Association
    Document type Article ; Online
    Database BASE - Bielefeld Academic Search Engine (life sciences selection)

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  3. Article ; Online: Acute Poisoning among Patients Presenting to the Emergency Department of a Tertiary Care Center

    Sameer Thapa / Bishwa Raj Dawadi / Anup Raj Upreti

    Journal of Nepal Medical Association, Vol 58, Iss

    A Descriptive Cross-sectional Study

    2020  Volume 227

    Abstract: Introduction: Acute poisoning is a major global public health problem contributing to one of the leading causes for a visit to an emergency department. This study aims to analyse the demographic and psychosocial characteristics of patients with acute ... ...

    Abstract Introduction: Acute poisoning is a major global public health problem contributing to one of the leading causes for a visit to an emergency department. This study aims to analyse the demographic and psychosocial characteristics of patients with acute poisoning presented to the emergency department. Methods: This was a descriptive cross-sectional study conducted in a tertiary care hospital from June to December 2019 after obtaining ethical approval from Institutional review board (reference number. 041-075/0760). A convenient sampling method was applied. Epidemiological factors, types of poison consumed, reason, motive, and place to take poison, time elapse in the presentation to the hospital were studied. Statistical analysis was done using statistical package for the social sciences version 20. Point estimate at 95% Confidence Interval was calculated along with frequency and proportion for binary data. Results: Out of 76 cases of acute poisoning, the organophosphorus poisoning was 18 (23.7%) followed by unknown 12 (15.8). Of total, 28 (36.8%) had quarrel before taking poison and 41 (53.9 %) had intention to commit suicide. Sixty-seven (88.2%) took a poison at home. The average elapsed time to the visit of the emergency department was 110±80 minutes. Conclusions: The most common poisoning was organophosphorus with a suicide being the most common intention. Quarrel was the most frequent reason to take poison and the home was the most common place to take poison.
    Keywords acute ; emergency ; organophosphates ; poisoning ; suicide ; Medicine (General) ; R5-920
    Subject code 310
    Language English
    Publishing date 2020-07-01T00:00:00Z
    Publisher Nepal Medical Association
    Document type Article ; Online
    Database BASE - Bielefeld Academic Search Engine (life sciences selection)

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  4. Article ; Online: Prevalence of Pseudomonas aeruginosa and its Antibiotic Sensitivity Pattern

    Khilasa Pokharel / Bishwa Raj Dawadi / Chandra Prakash Bhatt / Satish Gupte

    Journal of Nepal Health Research Council, Vol 17, Iss

    2019  Volume 01

    Abstract: Background: Pseudomonas aeruginosa is an opportunistic pathogen which causes most of the chronic infection in humans. This study was undertaken to determine the prevalence rate of Pseudomonas aeruginosa that is isolated from various clinical specimens ... ...

    Abstract Background: Pseudomonas aeruginosa is an opportunistic pathogen which causes most of the chronic infection in humans. This study was undertaken to determine the prevalence rate of Pseudomonas aeruginosa that is isolated from various clinical specimens along with its antibiotic susceptibility pattern. Methods: This descriptive cross sectional study was conducted in Kathmandu Medical College and Teaching Hospital (KMCTH) from February to May 2018. Pseudomonas aeruginosa isolated from various clinical specimens were processed in clinical laboratory, Department of Microbiology, KMCTH. Isolation, identification and sensitivity of Pseudomonas aeruginosa to antibiotics were measured. Results: A total of 7527 samples were been processed of which 46 isolates of Pseudomonas aeruginosa were obtained. Pseudomonas aeruginosa was isolated mainly from Pus, Wound swab, Sputum and Tracheal aspirate. Here 63.04% Pseudomonas aeruginosa isolates were resistant to Ceftazidime, 65.21% to Cefixime, 56.52% to Ceftriaxone and Cefotaxime followed by 56.52% to Piperacillin. Furthermore, the current study reveals antibiotics like Imipenem, Meropenem, Piperacillin/Tazobactam, Ciprofloxacin, Gentamicin, Amikacin and Tobramycin were found to be good choice for the treatment of infection caused by this organism. Conclusions: Continuous monitoring of antibiotic susceptibility pattern of Pseudomonas aeruginosa is essential and rational treatment regimens prescription by the clinicians is required to limit the spread of antimicrobial resistance. Keywords: Antibiotic resistance; clinical isolates; Pseudomonas aeruginosa.
    Keywords Public aspects of medicine ; RA1-1270
    Subject code 610
    Language English
    Publishing date 2019-04-01T00:00:00Z
    Publisher Nepal Health Research Council
    Document type Article ; Online
    Database BASE - Bielefeld Academic Search Engine (life sciences selection)

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  5. Article ; Online: A Case Of Vulvar Myiasis

    Bishwa Raj Dawadi / Mingma Temba Sherpa / Rakshya Shrestha

    Journal of Nepal Medical Association, Vol 53, Iss 200, Pp 288-

    2016  Volume 290

    Abstract: Myiasis is occurs in humans and vertebrate animals mostly due to dipterous  ies of the genera Chrysomyia and Cochliomyia. There have been reported cases of myiasis of skin, breast, intestine, eyes and ear but very few cases of vulvar myiasis have been ... ...

    Abstract Myiasis is occurs in humans and vertebrate animals mostly due to dipterous  ies of the genera Chrysomyia and Cochliomyia. There have been reported cases of myiasis of skin, breast, intestine, eyes and ear but very few cases of vulvar myiasis have been reported in the medical literature. We report a case of a 20 years old female with vulvar myiasis. A 20-year old unmarried girl presented to our hospital with complains of vaginal discharge and vulvar irritation for 3 days with evidence of some worms around her vulvar region. Her menstrual history revealed the use of folded cloths instead of sanitary pads during her menstruation. Moreover, she washed those clothes with water and hanged them in the clothesline outside to let them dry before reuse. Examination of the external genitalia multiple ulcers measuring 1X1 cm on the inner surface of the labia minora, heavily infested with large number of maggots. The patient was admitted for 4 days during which she was given antibiotics, analgesics and anti-in ammatory medication. Daily local asepsis of the wound with antiseptic solution (betadine) was done. We removed more than 30 larvae by the fourth day after which no more larvae were seen and she gradually recovered in the following days. It is our opinion that the cause of vulvar myiasis in our patient was her poor sanitary hygiene. Simple measures such as washing clothes thoroughly, drying and ironing of clothes are also necessary to reduce the risk of this human myiasis. Keywords: external genitalia; female; maggots; myiasis.
    Keywords Medicine (General) ; R5-920
    Subject code 590
    Language English
    Publishing date 2016-10-01T00:00:00Z
    Publisher Nepal Medical Association
    Document type Article ; Online
    Database BASE - Bielefeld Academic Search Engine (life sciences selection)

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  6. Article ; Online: A Case Of Vulvar Myiasis

    Bishwa Raj Dawadi / Mingma Temba Sherpa / Rakshya Shrestha

    Journal of Nepal Medical Association, Vol 53, Iss 200, Pp 288-

    2015  Volume 290

    Abstract: Myiasis is occurs in humans and vertebrate animals mostly due to dipterous flies of the genera Chrysomyia and Cochliomyia. There have been reported cases of myiasis of skin, breast, intestine, eyes and ear but very few cases of vulvar myiasis have been ... ...

    Abstract Myiasis is occurs in humans and vertebrate animals mostly due to dipterous flies of the genera Chrysomyia and Cochliomyia. There have been reported cases of myiasis of skin, breast, intestine, eyes and ear but very few cases of vulvar myiasis have been reported in the medical literature. We report a case of a 20 years old female with vulvar myiasis. A 20-year old unmarried girl presented to our hospital with complains of vaginal discharge and vulvar irritation for 3 days with evidence of some worms around her vulvar region. Her menstrual history revealed the use of folded cloths instead of sanitary pads during her menstruation. Moreover, she washed those clothes with water and hanged them in the clothesline outside to let them dry before reuse. Examination of the external genitalia multiple ulcers measuring 1X1 cm on the inner surface of the labia minora, heavily infested with large number of maggots. The patient was admitted for 4 days during which she was given antibiotics, analgesics and anti-inflammatory medication. Daily local asepsis of the wound with antiseptic solution (betadine) was done. We removed more than 30 larvae by the fourth day after which no more larvae were seen and she gradually recovered in the following days. It is our opinion that the cause of vulvar myiasis in our patient was her poor sanitary hygiene. Simple measures such as washing clothes thoroughly, drying and ironing of clothes are also necessary to reduce the risk of this human myiasis. Keywords: external genitalia; female; maggots; myiasis.
    Keywords Medicine (General) ; R5-920
    Subject code 590
    Language English
    Publishing date 2015-12-01T00:00:00Z
    Publisher Nepal Medical Association
    Document type Article ; Online
    Database BASE - Bielefeld Academic Search Engine (life sciences selection)

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  7. Article ; Online: Resistance Pattern of Carbapenem on Enterobacteriaceae

    Khilasa Pokharel / Bishwa Raj Dawadi / Chandra Prakash Bhatta / Satish Gupte / Beena Jha

    Journal of Nepal Medical Association, Vol 56, Iss

    2018  Volume 214

    Abstract: Introduction: Gram negative bacilli are the important causes of common clinical infections. Carbapenem resistant Enterobacteriaceae are considered as important public health threat and is classified as urgent by the Centers of Disease Control and ... ...

    Abstract Introduction: Gram negative bacilli are the important causes of common clinical infections. Carbapenem resistant Enterobacteriaceae are considered as important public health threat and is classified as urgent by the Centers of Disease Control and Prevention because of their progressive geographic dissemination and limited therapeutic alternatives. This study was done to find out the resistance pattern of Carbapenem among Enterobacteriaceae. Methods: The descriptive cross-sectional study was carried out in Clinical Microbiology laboratory from February 2018 to May 2018 after ethical approval. Organism was identified on the basis of its microscopic observation by performing Gram’s stain and by identification of morphology after its growth in culture media followed by its biochemical reactions. Antibiotic sensitivity test of isolated pathogens was done using Muller Hinton Agar by the standard disk diffusion technique of Kirby-Bauer method. Results: In our study, total 1055 sample belongs to the family Enterobacteriaceae. From the family Enterobactericeae, 348 (27%) of the bacilli were found to be Carbapenem resistant. Among which most common bacteria was Klebsiella pneumoniae followed by Escherichia coli. All strains of Carbapenem resistant Enterobacteriaceae were sensitive to Colistin, Polymyxin B and Tigecycline. Conclusions: Among Enterobacteriaceae, around one-third of the bacterial isolates were Carbapenem resistant. However, to reduce drug resistance antimicrobial stewardship programme and proper infection control measures is required.
    Keywords Medicine (General) ; R5-920
    Subject code 630
    Language English
    Publishing date 2018-12-01T00:00:00Z
    Publisher Nepal Medical Association
    Document type Article ; Online
    Database BASE - Bielefeld Academic Search Engine (life sciences selection)

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