Prevalence of Helicobacter pylori in Dhulikhel Hospital, Kathmandu University Teaching Hospital: a retrospective histopathologic study.

OBJECTIVE: The main objective of this study was to determine prevalence of Helicobacter pylori infection in Dhulikhel Hospital, Kathmandu University Teaching Hospital. METHODOLOGY: Endoscopic antral biopsies from January 1, 2004 to August 31, 2005 were studied retrospectively. Hematoxylin and eosin and Giemsa stained histological sections were examined. RESULTS: Out of 224 patients (Male 125 and female 99) who underwent endoscopic biopsy and included in the study, a total of 76 (33.9%) patients (Male 50 and female 26) were infected by H. pylori. The mean age of the H. pylori infected patients was 40.2 years (SD 16.0). The infection by H. pylori was significantly higher in males than females (p<0.05) with male to female ratio of 1.9:1. The most common (31.3%) histopathologic finding was chronic superficial gastritis followed by normal histology (30.8%). A total of 10 cases (4.5%) of adenocarcinoma and 16 cases (7.1%) of intestinal metaplasia were detected and neither of them showed presence of H. pylori. Two cases (0.9%) were diagnosed as suspected malignancy and both were negative for H. pylori infection. Among gastritis, H. pylori was most frequently observed in chronic active gastritis (86.1%). Two of 69 cases (2.9%) of normal gastric mucosa showed H. pylori.

An outbreak of El Tor cholera in Kavre district, Nepal.

Outbreak of cholera still remains major public health problem in most of the developing countries including Nepal. A prospective study was carried out at Dhulikhel Hospital, Kathmandu University Teaching Hospital, Kavrepalanchok during 1st May 2004 to 31st October 2004. A total of 148 stool samples from patients with acute diarrhea were collected and further investigated for cholera. The study was conducted to establish the causes of the outbreak of acute diarrheal disease, antimicrobial profiles of the stool isolates and parasitic co-infection in cholera cases. The samples were subjected to standard recommended microbial procedures and confirmation of the isolates was done by seroagglutination using V.cholerae polyvalent O1 and 0139 antisera and monovalent Ogawa and Inaba antisera. Out of the 148 stool samples, 46 cases (31%) were found to be positive for V.cholerae serogroup O1, biotype ElTor, serotype Ogawa. Both sexes were equally affected. Young age group of less than 30 years were mostly affected. Brahmin was the most affected ethnic group. The isolates were sensitive to all the antibiotics tested except co-trimoxazole. Among the laboratory confirmed cholera cases 30% exhibited co-infection with other parasites among which Giardia lamblia and Ascaris lumbricoides were the most common.

Prevalence of Moraxella catarrhalis infections of the lower respiratory tract in elderly patients.

OBJECTIVES: To determine: *rate of isolation of Moraxella catarrhalis in elderly patients having lower respiratory tract infection *The antibiotic susceptibility pattern of Moraxella catarrhalis isolates. *The predisposing factors responsible for Moraxella catarrhalis infections of lower respiratory tract. MATERIAL AND METHOD: This is a prospective study carried out at Manipal Teaching Hospital, Pokhara during May 2002 to April 2003. A total of 716 sputum samples collected from patients with suspected lower respiratory tract infection were investigated. The samples were subjected to Gram stain, culture and sensitivity. Sputum samples were inoculated on blood and chocolate agar and incubated at 37 degrees C for 18 to 24 hours in candle jar containing 3-5% Co2. For the identification of bacterial isolates, the cultural and colonial characteristics were recorded and identified with the use of biochemical test. The susceptibility of bacterial isolates to antimicrobial agent was performed following Kirby-Bauer method. RESULT: Out of the 716 samples, 355 (49.58%) grew normal commensals of the upper respiratory tract. Respiratory pathogens were recovered from 361 (50.41%) samples. The most common respiratory pathogen was H. influenzae (26. 86%), followed by S. pneumoniae (21.16%). Moraxella catarrhalis accounted for 6.90%. Rate of isolation of Moraxella catarrhalis was higher in males than in females. Out of 25 isolates 16 were from males and 9 were from females. Frequency of isolation of Moraxella catarrhalis was more frequently seen in age group 61-70 years. It was most commonly recovered in winter. The most effective antibiotics were amoxicillin-clavulanate and ceftriaxone and least was ampicillin. CONCLUSION: Moraxella catarrhalis isolation from sputum especially in persons above 60 years of age and in the absence of other well established pathogens should not be disregarded as they can cause lower respiratory tract infection in these individuals.