Prescribing Pattern of Antibiotics among Hospitalized Patients with Urinary Tract Infection.

BACKGROUND: Urinary tract infection is one of the most common bacterial infections worldwide. It has become one of the most common cause for the hospitalization and sepsis. It is generally treated with antimicrobial agents and fluids. This study was conducted to study the prescribing pattern of antibiotic among hospitalized patients with urinary tract infection. METHODS: A descriptive cross-sectional study was conducted in Nepal Medical College Teaching Hospital, Attarkhel, Kathmandu from January 2022 to April 2022. Patients aged 18 years or above of both sex, admitted to various departments with the provisional diagnosis of urinary tract infection prescribed with antibiotics were included in the study. RESULTS: Out of 146 patients admitted with a diagnosis of urinary tract infection, the most commonly prescribed antibiotics during hospital stay were cephalosporin in 102 (69.9%) patients followed by combination of penicillin and beta-lactamase inhibitors (31, 21.2%) and fluoroquinolones (15, 10.3%). Ceftriaxone (78, 53.4%) alone was the most commonly prescribed antibiotic as empirical therapy followed by combination of piperacillin and tazobactam (22, 15.1%). One hundred and forty four (78.6%) patients were prescribed antibiotics from the watch group followed by the access group (21, 11.5 %). E. coli was the most common organism isolated in 29 (76.3%) patients. CONCLUSIONS: Cephalosporin was the commonest antibiotic group prescribed in hospitalized patients among which ceftriaxone was commonly prescribed as an empirical therapy. Among AWaRe classification, antibiotics from the watch group were commonly prescribed.

Antibiotics Self-Medication Practice Among Medical Students.

BACKGROUND: Self-medication of antibiotics is common among healthcare students due to their knowledge of pharmacology of antibiotics, which produces a false sense of confidence in self-diagnosis of disease conditions. Hence, this study was conducted to assess the practice of self-medication with antibiotics among medical students. METHODS: This questionnaire based descriptive, cross-sectional study was conducted in Nepal Medical College Teaching Hospital, Attarkhel, Kathmandu from September 2019 to February 2020 on the Bachelor of Medicine and Bachelor of Surgery students. RESULTS: Out of 405 students, 214 (52.8%) students had practiced antibiotics self-medication. The most commonly self-medicated antibiotics were azithromycin 126(58.9%), amoxicillin 67(31.3%), metronidazole 35(16.4%) and ciprofloxacin 14(6.5%) that were most commonly used for sore throat 93(43.5%), fever 82(38.3%), common cold 59(27.6%) and cough 43(20.1%).The common sources for self-medication were previous prescription 66 (30.8%), followed by own pharmacological knowledge 58 (27.1%). The most common reasons for practicing antibiotics self-medication were stated as previous experience of same illness 165 (77.1%), doctor's advice not deemed necessary 21 (9.8%) and save time 14 (6.6%). Large number of students agreed that antibiotics self-medication was not an acceptable practice 308(76.1%) and can lead to antimicrobial resistance 363(89.6%). CONCLUSIONS: More than half of the respondent medical students had practiced antibiotics self-medication. Sore throat was the commonest cause for it while the most commonly self-medicated antibiotic was azithromycin. Self-medication with antibiotics in medical students is concerning because they are future prescribers of antibiotics; who are supposed to promote rational use of antibiotics.

Prevalence and Associated Risk Factors of Tooth Wear.

INTRODUCTION: Tooth wear is described as loss of hard tooth tissue with no occurrence of dental caries or trauma. Basic Erosive Wear Examination, a new scoring system, is a partial scoring system recording the most severely affected surface in a sextant and the cumulative score guides the management of the condition for the practitioner. The objectives of this study were to determine the prevalence of tooth wear and its association with its risk factors like gender, oral hygiene, diet, general health and life style. METHODS: A cross-sectional study was done in 364 dental patients of Kathmandu Medical College. A questionnaire was filled by interview and Basic Erosive Wear Examination was done. The data so collected were entered in Statistical Package for Social Sciences. Descriptive statistical analysis and Chi-square tests were done at confidence interval of 95% and statistical significance was set at P=0.05. RESULTS: The prevalence of tooth wear was 218 (60.1%) with no significant gender difference. A significant association was observed between tooth wear and age group (P<0.01), duration of brushing (P=0.05), method of brushing (P<0.01), swishing of soft drinks before swallowing (P<0.01) and tobacco chewing (P=0.02). CONCLUSIONS: The prevalence of tooth wear in the study population was high.

Understanding the experiences and needs of female commercial sex workers in Kathmandu, Nepal.

Through this exploratory study, we sought to better understand Nepali female commercial sex workers' (FCSWs') experiences in order to inform HIV prevention and health promotion interventions for this vulnerable and hard-to-reach population. Data were collected through phenomenological interviews with eight FCSWs. Through analysis we reveal promising intervention points to enhance FCSW health, empowerment, and overall well-being. Researchers suggest a combination of structural and individual programs is essential to improving the circumstances of Nepali FCSWs and preventing the spread of HIV. Given Nepal's limited resources and complex environment, it is imperative future prevention programs are focused and guided by FCSWs' lived experiences.

Unveiling the silence: women's sexual health and experiences in Nepal.

Rising rates of HIV in Nepal signal an impending epidemic. In order to develop culturally appropriate and effective actions and programmes to reduce HIV transmission, it is necessary to understand attitudes, behaviours and norms surrounding sexual networking and safer-sex practices in Nepal. Nepali women are thought to be at increased risk of sexually transmitted infections (STIs) and HIV, sexual violence and exploitation and other sexual health disparities due to cultural scripts limiting access to education, ability to control sexual relationships and acceptability in discussing sex and sexual health. The present study comprises a series of interviews with 25 women living in Kathmandu (13 individual interviews and 2 focus-group discussions) about their knowledge and experiences related to sex and sexual health. Interviews were translated and transcribed and two independent coders conducted a thematic analysis. Overall, the women described sex as primarily a male domain. Sex and sexual health were viewed as taboo discussion topics and formal sex education was perceived as minimally available and far from comprehensive in its scope. This formative study can inform future interventions aimed at reducing the spread of STIs/HIV in Nepal and empowering women on issues of sexual health and well-being.

Evaluation of the "let's talk" safer sex intervention in Nepal.

This study is an evaluation of a pilot of the Let's Talk Intervention for Nepali women for effectiveness in increasing sexual health communication between women and the men in their lives. The intervention included 88 women in Kathmandu and spanned three 2-hour group sessions. Baseline, posttest, and follow-up knowledge, attitude, and behavior surveys were completed. Results showed women at posttest and follow-up spoke with more women and men about sex than they had at baseline. Attitudes regarding gender norms about sex improved as a result of the intervention, and shame about sex and sexuality for women decreased after intervention. Women also reported greater comfort discussing sex after the intervention. HIV knowledge scores increased after intervention but dropped again at follow-up, likely because of time constraints in addressing this topic in sufficient detail. This is the first program in Nepal that addresses communication about sexual health while focusing on education and prevention for HIV/STIs for women.

Effect of sodium ascorbate on degree of conversion and bond strength of RealSeal SE to sodium hypochlorite treated root dentin.

The aim of this study was to investigate the effect of sodium ascorbate (Sa) on degree of conversion (DC) and bond strength (BS) of RealSeal SE to sodium hypochlorite (NaOCl) treated root dentin. Two hundreds simulated canals were prepared and irrigated with Distilled water(DW), 1.3% NaOCl (1.3% N), 5.2% NaOCl (5.2% N), MTAD, 17% EDTA (EDTA), 10% Sa, 1.3% NaOCl/MTAD (N-M), 1.3% NaOCl/Sa/MTAD(N-Sa-M), 5.2% NaOCl/EDTA(N-E), and 5.2% NaOCl/Sa/EDTA (N-Sa-E) respectively. They were subsequently bulk filled with RealSeal SE and analyzed with micro-Raman spectroscopy and universal testing machine for DC and BS respectively. One-way ANOVA and post hoc Tukey's test showed DC of 1.3% N, 5.2% N, N-M and N-E were significantly lower (p<0.01) than other six groups. BS of DW, Sa, N-M were significantly lower than 1.3% N, 5.2% N, MTAD, EDTA, N-Sa-M and N-E (p<0.01), and group N-Sa-E achieved the highest BS among all groups (p<0.01). NaOCl negatively affected DC and BS of RealSeal SE, which could be reversed with 10% Sa.

Let's talk about sex: development of a sexual health program for Nepali women.

The purpose of this study was to develop and test the feasibility of conducting a sexual health intervention for women in Nepal, a country with high political and economic instability and strong patriarchal systems. Of the 88 women enrolled, 100% retention was obtained over three sessions, and 85% completed a 1-month follow-up. Recruitment was so effective that some women were placed on a waitlist. All participants embraced the content and actively engaged in the intervention. Baseline results indicate HIV knowledge of the sample of educated women was low, and they did not often speak to other women about sex. Low knowledge about HIV and being comfortable discussing sex were associated with less frequent communication with others about sex. This study identified a great need for sexual health programs for women in Nepal, and we were able to effectively develop and implement an intervention to target this need.

Degree of conversion of a methacrylate-based endodontic sealer: a micro-Raman spectroscopic study.

INTRODUCTION: Recently, a methacrylate-based obturation system, Resilon/RealSeal SE, has been developed to replace gutta-percha and traditional sealers. As a resin-based material, degree of conversion (DC) is one of the most important characteristics. The aim of this study was to investigate the time-dependent change of DC of RealSeal SE as well as the influence of canal moisture and root canal depth on it. METHODS: DC of RealSeal SE, either self-cured or dual-cured (n = 8 in each group), was calculated according to the Raman spectra obtained at different times after mixing. Thirty extracted teeth with single canal were instrumented and divided randomly into 2 groups in terms of different canal drying methods. In the ethanol group, excess distilled water in root canal was removed with paper points followed by 95% ethanol. In the paper points group, root canals were blot-dried with paper points until the last one appeared dry. DC of RealSeal SE was calculated from serial cross sections (2, 5, and 8 mm from the apex) obtained 1 week after obturation with Resilon/RealSeal SE. RESULTS: Significant increase in DC of RealSeal SE was observed in 1 week (P < .01), with little change afterwards (P > .05). DC of sealer in ethanol group was significantly higher than in paper points group (P < .01). However, DCs of RealSeal SE at different levels of tooth sections were not significantly different (P > .05). CONCLUSIONS: Both self-cured and dual-cured RealSeal SE achieved stable DC after 1 week. Root canal moisture was a critical factor in determining DC of RealSeal SE.