An evaluation of bacteriological quality of drinking water from the catchment area of a tertiary care teaching hospital.

Background: It is well-appreciated that many communities in developing countries face severe public-health problems relating to drinking-water. The supply of safe water is important to protect the health of the community people. Aim: The study aimed to evaluate the bacteriological quality of drinking water from various active sources of water utilized in the catchment area of a tertiary care teaching hospital. Material and methods: The present cross sectional study was carried out by the Department of Microbiology and Community Medicine, MSDS Medical College, Fatehgarh during 2013-14. Randomly selected 100 active water sources which were being used for drinking purpose and a fairly good number of people using that water source for drinking purpose were included in the study. National Environmental Engineering Research Institute (NEERI) guidelines for drinking water quality assessment were adopted. Culture and bacteriological tests of drinking water were performed as per standard protocols. After compilation of collected data, analysis was done using Statistical Package for Social Sciences, version 21 (IBM, Chicago, USA). Results: Out of one hundred water samples collected, fifty one, twenty seven and twenty two samples of water were collected from municipal tap water, government hand pump and water cooler respectively. Almost half of the samples were found to be unsatisfactory. E. coli was found to be responsible for 26% of samples whereas Pseudomonas in 20% of collected samples. E. coli and Klebsiella tested positive with Methyl Red whereas Pseudomonas sp. and Klebsiella tested positive with Citrate test reagent. E. coli showed positive result with Indole reagent whereas Klebsiella tested positive with Urease. Regarding mix population organisms, Escherichia coli, Klebsiella Sp. and Pseudomonas Sp. were found to be positive in 3 samples whereas Klebsiella Sp. and Pseudomonas Sp. were found to be positive only in 1 sample Conclusion: The study highlighted unsafe nature of current active sources in the study area with regard to drinking water purpose which are not fit for consumption of water. Surveillance of water sources and regular bacteriological assessment of all water sources for drinking is recommended on regular basis.

An evaluation of role of sinusitis as focal sepsis in chronic otitis media active mucosal disease: A cross-sectional survey.

Background: Sinusitis causes inflammation of the middle ear mucosa with increased and persistent mucoid/ mucopurulent discharge and remains as a active mucosal disease. Without correcting the sinusitis the management of ear including surgery has frequently led to failures and poor prognosis Objectives: To establish the role of Sinusitis as Focal sepsis in Chronic Otitis media active mucosal disease. An additional objective was to accentuate the need of proper diagnostic endoscopic evaluation and improvement in middle ear mucosal disease status after functional endoscopic sinus surgery. Material and methods: A total of 50 patients aged 18-49 years with Chronic otitis media active mucosal disease (Tubotympanic type of C.S.O.M.) patients with persistent ear discharge even following culture directed topical and systemic antibiotics with 3 months and more of ear discharge seeking care at Otorhinolaryngology outpatient department were included in this study. Results: Mean age of patients was 42.5 ± 10.6 years. 76% subjects were found having septal deviation/ turbinoseptal deformity which was the most common anatomical variant, 34% had enlarged middle turbinate, 32% had medialised uncinate, 30% had enlarged bulla, 22% had enlarged bulla with prominent agger and 18% had paradoxical middle turbinate. Of these 22 patients had the accessory ostium in the posterior fontanel and 10 patients had accessory ostium in the anterior fontanel. Majority (26, 52%) of subjects had Grade I disease i.e. minimal disease limited to Osteo Meatal Complex followed by Grade II 24% i.e. moderate incomplete opacification of one or more sinuses. On otoendoscopy, 36 patients (72%) had a large central perforation, while 14 patients (28%) had a subtotal central perforation Conclusion: A thorough diagnostic nasal evaluation of all Chronic Otitis Media active mucosal type of patients is essential in comprehensive management of the disease. Deviated nasal septum, enlarged middle turbinate, medialised uncinate predispose to sinusitis.

Bony fusion of the maxilla and mandible as a sequelae of noma: A rare case report

Noma is a gangrenous disease of the orofacial region that leads to severe facial tissue destruction and is a significant cause of death among children. With the advent of modern antibiotics and improved nutrition, children with noma may survive into adulthood, but must face the challenge of undergoing repair of the sequelae of noma. This report describes a case of bony fusion of the maxilla and mandible in a 28-year-old female patient, which was a sequelae of a childhood case of noma.

Fact-finding Survey of Nosocomial Infection Control in Hospitals in Kathmandu, Nepal—A Basis for Improvement

The purpose of this study was to investigate the actual conditions of nosocomial infection control in Kathmandu City, Nepal as a basis for the possible contribution to its improvement. The survey was conducted at 17 hospitals and the methods included a questionnaire, site visits and interviews. Nine hospitals had manuals on nosocomial infection control, and seven had an infection control committee (ICC). The number of hospitals that met the required amount of personal protective equipment preparation was as follows: gowns (13), gloves (13), surgical masks (12). Six hospitals had carried out in-service training over the past one year, but seven hospitals responded that no staff had been trained. Eight hospitals were conducting surveillance based on the results of bacteriological testing. The major problems included inadequate management of ICC, insufficient training opportunities for hospital staff, and lack of essential equipment. Moreover, increasing bacterial resistance to antibiotics was recognized as a growing issue. In comparison with the results conducted in 2003 targeting five governmental hospitals, a steady improvement was observed, but further improvements are needed in terms of the provision of high quality medical care. Particularly, dissemination of appropriate manuals, enhancement of basic techniques, and strengthening of the infection control system should be given priority.