Showing papers by "Dhulikhel Hospital published in 2015"
TL;DR: A tool presented as a phone app can be used by non-medical health workers to identify episodes as epileptic or not with good accuracy and has the potential to play a part in reducing the epilepsy treatment gap.
Abstract: Purpose Untreated epilepsy is a major global public health problem with more than 20 million people not being treated for an easily treatable disease. In part this is due to a lack of trained doctors. There are many more non-medical health workers than doctors and they could have an important role in diagnosis and treatment of epilepsy if they had some tools. We have previously described such a tool to distinguish epileptic episodes from other causes of altered consciousness and here present its validation in three new populations. Methods The tool was presented as a phone app where the answers to 11 questions provided a probability score which indicated whether episodes might be due to epilepsy or not. It was applied either by non-medical volunteers, health workers, or inexperienced doctors to 132 patients in three separate populations in India and Nepal and compared with the "gold standard" diagnosis of a neurologist with expertise in epilepsy. Results There was good agreement between the app score and the neurologists' diagnoses (weighted kappa=75.3%). An app score of 90 or greater had a sensitivity of 88% and a specificity of 100% for diagnosing epilepsy. The app was easy to use with little training and took about 5min to administer. Conclusion A tool presented as a phone app can be used by non-medical health workers to identify episodes as epileptic or not with good accuracy. It needs to be evaluated more widely but has the potential to play a part in reducing the epilepsy treatment gap.
30 citations
19 Mar 2015
TL;DR: High incidence of CSOM was observed between 1-10 years of age group, and S. aureus was the most predominant organism followed by Proteus spp.
Abstract: BACKGROUND: Chronic suppurative otitis media (CSOM) is an inflammation of the middle ear and mastoid mucosa with perforation of tympanic membrane. Mainly disease of developing countries like Nepal, CSOM results because of illiteracy, poverty and poor hygiene. Haphazard use of antibiotics and increasing use of newer one has led to persistent change in microbial flora. The aim of this study is to determine the incidence of CSOM and its causative agents. METHODS: The study included 123 samples from 105 patients attending ENT department of Dhulikhel hospital. Samples were processed in microbiology department for both bacteria and fungi using standard operating protocol. Antibiotic susceptibility testing was performed for all bacterial isolates by Kirby Bauer disc diffusion method and the result were interpreted according to clinical and laboratory standard institute (CLSI) guideline. RESULTS: Out of 105 patients, 55 were male and 50 female patients. Highest incidence of CSOM was observed between 1-10 years of age group. Of the total 123 samples taken from 105 patients, 106 showed microbial growth. Gram positive bacteria predominated and the most common bacteria isolated were S. aureus 54.55% followed by Proteus spp. 13.64% and P. aeruginosa 12.73%. Among the fungi, the most predominant was A. fumigatus 39% followed by A. niger 29%, C. albicans 26% and A. flavus 6%. Gentamycin was the most susceptible antibiotic. S. aureus were sensitive to Cloxacillin and Gentamycin, whereas Proteus spp. was most sensitive to Ceftriaxone and Norfloxacin. P. aeruginosa was 100% sensitive to Amikacin. CONCLUSION: S. aureus was the most predominant organism followed by Proteus spp. and the drug of choice was Gentamycin. DOI: http://dx.doi.org/10.3126/acclm.v1i1.12314 Ann. Clin. Chem. & Lab. Med. 1(1) 2015: 37-41
11 citations
TL;DR: It is concluded that there was significant difference in mean knowledge of ostomates with variables pre-operative teaching, training on stoma care, living with stoma for more than 12 months and training on Stoma Care should be provided frequently to further improve self care efficacy.
Abstract: Background : There are more than 1 million patients with a permanent colostomy and the number is increasing by the rate of 100 000 per year. Clients with a new stoma must master multiple psychomotor skills to remove their pouch, clean the stoma and peristomal skin and empty and dispose of effluent from the pouch. Stoma care self-efficacy has been positively related to ostomy adjustment. Objective : To assess knowledge and practice of stoma care among ostomates. Method : This is a simple descriptive cross sectional study. A total of 94 ostomates who met eligible criteria were purposively sampled. Stoma self care efficacy scale and semi-structured questionnaire was used and face to face interview was done. Data were analyzed using SPSS version 16 program. T test was used to see the mean difference. Result : The knowledge of ostomates on normal stoma and complication of stoma was adequate (61.7%). Majority (92.6%) respondents had good daily care practice like emptying pouch, hand washing before and after procedure and cleaning stoma. Majority of the ostomates suffered from physical problem (89.4%). Of which maximum 72.3% had peristomal skin irritation, then came leakage and odour. More than half (64.9%) of ostomates had higher efficacy. Conclusion : On the basis of findings, it is concluded that there was significant difference in mean knowledge of ostomates with variables pre-operative teaching, training on stoma care, living with stoma for more than 12 months. There was significant difference in mean self care efficacy with variables duration of living with stoma and training on stoma care. Thus training on stoma care should be provided frequently to further improve self care efficacy. Journal of Nobel College of Medicine Vol.4(1) 2015: 36-45
6 citations
Journal Article•
3 citations