Health Problem In Terms Research Articles

Magnitude and Its Associated Factors of Urinary Tract Infection among Adult Patients Attending Tigray Region Hospitals, Northern Ethiopia, 2019.

Background Urinary tract infection is a major public health problem in terms of morbidity and mortality worldwide. It ranks as the number one infection which leads to an antibiotic prescription after a physician's visit. However, there are limited studies done on UTI in Ethiopia. Hence, this study was aimed to assess the magnitude of urinary tract infection and its associated factors among adult patients attending hospitals of the Tigray region, Ethiopia. Methods and Material. A hospital-based cross-sectional study was conducted from April to May 2019. Systematic random sampling technique was used to select 472 participants from five randomly selected hospitals in Tigray region. A pretested structured questionnaire through face-to-face interview and patient chart review checklist was used to collect data. Data were analyzed by SPSS version 21. A binary logistic regression model was used to test the association between dependent and independent variables. Result The magnitude of urinary tract infection was 86 (18.2%) (95% CI: 14.6%–21.6%). After adjustment of the independent variables, the significant factors associated with urinary tract infection were being female (AOR = 3.50; 95% CI: 1.88–6.51), urine passing frequency < five times in a day (AOR = 2.32; 95% CI: 1.08–4.96), having diabetes mellitus (AOR = 4.03; 95% CI: 1.69–9.63), history of urinary tract infection (AOR = 4.40; 95% CI: 2.31–8.39), <7 glasses of water intake per day (AOR = 2.16; 95% CI: 1.02–4.58), and history of urinary obstructive diseases (AOR = 2.67; 95% CI: 1.03–6.90). Conclusion and Recommendation. The magnitude of urinary tract infection was considerably high. The factors associated with urinary tract infection were sex, less urine passing frequency, diabetes mellitus, low water intake, history of urinary tract infection, and urinary obstructive diseases. Therefore, patients having DM, previous history of UTI, and urinary obstructive diseases should be routinely screened for urinary tract infection and provided with education on voiding urine at least five times a day and on increasing daily water intake.

Effects of Relaxation Exercises Combined with Breathing Exercises on Psychological Conditions in Psychiatric Patients

Aim: Psychiatric disorders have been known for centuries as a serious individual and public health problem in terms of suicide, job loss and relapse. The aim of this study was to investigate the effects of relaxation and breathing exercises on anxiety and depression in psychiatric patients.Method: This study was conducted with 40 (18 females, 22 males) inpatients in Psychiatry Clinic of Hatay Mustafa Kemal University According to the power analysis results, Type1 error = 0.05 alpha Type2 error beta 80% was calculated to make a significant difference in the 1st and 2nd evaluations. Health Application and Research Hospital. Individuals have been enrolled in a relaxation exercise program combined with breathing exercises every day for 3 weeks accompanied by a physiotherapist. Individual’s levels of psychological symptoms have been assessed with Symptom Check List-90-R Psychological Symptoms Screening Test.Results: The mean age of the participants was 30.45, standard deviation value 8.63 years. A significant recovery has been observed in the psychological symptoms of individuals in all sub-parameters of SCL-90-R screening test after the exercise program (p&amp;lt;0.05).Conclusion: In this study, it was found that breathing and relaxation exercises applied to psychiatric patients contributed to the reduction of psychiatric symptoms. In addition, it was found that breathing and relaxation exercises performed with physiotherapists positively affect the treatment process of psychiatric patients and may contribute to the early discharge of these patients.

Housing, planning and urban health: Historical and current perspectives from South Africa

Abstract Globally, policymakers often describe informal settlements and slums in terms of health problems. In this paper we trace the way housing and planning have been linked to health concerns in the history of South Africa and we assess post-apartheid literature on the topic. We note that researchers continue to rely on a biomedical understanding of the relationship between housing, planning and health although, we argue, the links between them are tenuous. We propose the capabilities approach as a way to understand this relationship. Reframing the relationship between housing, planning and health within the capabilities approach may improve the current understanding of this link. Aim This paper discusses the historical links between housing, planning and health in South Africa, assesses post-apartheid policy, and reviews post-apartheid literature on the relationship between housing, planning and health. Results and conclusions We find it is assumed that the link between housing, planning and health is a biomedical concern and not a social concern. We argue that scholars thinking about this relationship should consider the opportunities embedded in the capabilities approach to understand health outside the biomedical frame.

Helicobacter pylori incidence of patients with gastritis in endoscopic biopsies

Aim: H. pylori is the most common permanent bacterial infection worldwide and an important health problem in terms of the diseases it causes. The aim of this study was to determine H. pylori incidence according to age and gender in biopsy materials of patients who were diagnosed with gastritis. Methods: This was a cross-sectional study which examined the endoscopic and pathological reports of 1240 patients who were diagnosed with gastritis between June 2014 and October 2019 and underwent biopsy from the antrum. The incidence of H. pylori infection was evaluated according to age and gender. Based on the Sydney classification, the patients were scored as none (-), low (+), medium (++) and high (+++) in the pathological records. Patients were divided into 5 age groups: 18-34, 35-44, 45-64, 65-74 and ≥75 years. Results: A total of 1240 patients, 664 (53.5%) females and 576 (465%) males were included in the study. The mean age of the patients was 49.9 (16.2). A total of 422 (34.0%) patients were H. pylori (+), while 818 (66.0%) were H. pylori (-). H. pylori density was low in 123 (29.1%) patients, medium in 207 (49.1%) patients, and high in 92 (21.8%) patients. There was no difference in terms of H. pylori positivity with regards to age and gender (P=0.296, P=0,812, respectively). The number of H. pylori (+) and (-) patients in the groups were as follows: Group 1: 71 (16.8%) vs. 160 (19.6%), Group 2: 125 (29.6%) vs. 186 (22.7%), Group 3: 134 (31.8%) vs. 281 (34.4%), Group 4: 60 (14.2%) vs. 120 (14.7%) and Group 5: 32 (7.6%) vs. 71 (8.7%). H. pylori positivity rates were as 30.7%, 40.2%, 32.3%, 33.3% and 31.1% for groups 1, 2, 3, 4 and 5, respectively. Although the Group 2 (35-44 years) had the highest rate, it was not statistically significant (P=0.117). Conclusion: In our study, the incidence of H. pylori was 34%, and this rate is pleasing in terms of decreasing H. pylori incidence in our country compared to previous studies

Mechanisms underlying the protective effect of leukotriene receptor antagonist montelukast against doxorubicin induced testicular injury in rats

The obligatory use of cytotoxic drugs to face the malignant tumors results in survivors that suffer from long term health problems. Fertility problems, especially in young boys, exert one of the major consequences of chemotherapy treatment that needs resolution. We investigate the potential effect of the cysteinyl leukotriene receptor antagonist montelukast on doxorubicin-induced testicular damage. Five groups of adult Wistar male rats were subjected to the following treatment; vehicle for the control group, montelukast (20 mg/kg orally daily for 10 days) for the drug control, doxorubicin (12 mg/kg intraperitoneal injection once at 5th day) for the toxic group, montelukast at 10 mg/kg + doxorubicin, montelukast at 20 mg/kg + doxorubicin. The period of the experiment was 10 days administration of montelukast, while doxorubicin was injected at the 5th day. Results of serum testosterone, testicular lipid peroxidation, antioxidant status, and histopathology revealed protection of montelukast against doxorubicin-induced testicular damage. The pro-apoptotic caspase 3 and the pro-inflammatory tumor necrosis factor-alpha were examined immunohistochemically and showed a significant decrease with montelukast treatment as compared to doxorubicin group. Doxorubicin increased gene expression of matrix metalloproteinase 9 and decreased peroxisome proliferator activated receptor gamma. Montelukast treatment restored their expressions to normal values.In conclusion, montelukast administration can ameliorate the testicular damage induced by doxorubicin based on its anti-inflammatory, antioxidant and anti-apoptotic effects as well as by of modulation of important genes expression.

Approach to Fall Detection Technologies Developed for the Elderly

Introduction. The falls and subsequent injuries to the elderly are a major public health problem in terms of morbidity, mortality and high costs. A wealth of research based on Information and Communication Technologies (ICTs) has approached the issue from the point of view of the fall detection. Purpose. The purpose of the review is to search for available fall detection systems based on ICT. Methodology. A systematic literature review was carried out at PubMed, Cochrane Central, Embase databases from 2010 to 2018. The terms "fall detection", "sensor technologies", "smart homes", "ambient sensors" were searched. Results. Most of the fall detection systems have been developed on the same philosophy, namely to limit the serious impact of the elderly long staying on the ground after a fall. The main purpose of these systems is to distinguish between fall events and daily activities. Most algorithms are designed based on data sets containing a mixture of daily life activities and simulated falls. Various solutions are available with most include portable devices, while others include technologies embedded in the home environment Conclusions. The evaluation results of several fall detection technologies have shown that they can improve the autonomy of older people, extending their living in the community safely. keywords : fall detection, sensor technologies, smart homes, ambient sensors

Evaluation of poisoning cases applying to pediatric emergency service unit: Retrospective study

Aim: Poisoning cases have a significant place among childhood health problems in terms of morbidity and mortality. Cases involving children younger than five years of age constitute the most common poisoning cases that are caused by accidents or injuries. In this study, we attempted to determine the possible precautions by analyzing the age distribution in childhood poisoning cases.Material and Methods: The files of poisoning cases applying to the pediatric emergency service unit of the hospital between March 2018 and March 2019 have been retrospectively analyzed. Cases have been analyzed in terms of patients’ age, sex and nationality and also in terms of causes of poisoning and pharmacological agents that cause poisoning.Results: 120 poisoning cases admitted to emergency service throughout one-year period comprised 0.4% of all (24,942) applications. 57 of the patients (47.5%) were female while 63 (52.5%) were male. The youngest of the patients was 0-year-old and the oldest was 17 years old and the average age of the patients was 5.2±5.5. Poisoning cases were most frequently seen (70,8%) in children in 0-5 age range and male patients comprised the majority of them. The most common cause of poisoning was paracetamol and antipyretic type of medicines. Others were organophosphate (19.4%), rat poison (12.9%) and other substances (antipsychotics, antibiotics and vitamins) (8.1%) and caustic substances (6.7%). Conclusion: Most of the poisoning cases were caused by medicines that were left out in the open. We think such cases can be reduced through parent education.

Consumption of milk and dairy products as dominant factor of underweight among children aged 24–59 months in Java Island, Indonesia (IFLS 2014)

INTRODUCTION: Underweight is one of the most common forms of undernutrition suffered by children and has implications for both short and long term health problems. Characteristics of children, parents, and environment are factors affecting underweight in children, especially aged 24–59 months. OBJECTIVES: This study aimed to find out the dominant factors affecting underweight in children aged 24–59 months in Java Island. METHODS: This cross-sectional study used secondary data from Indonesia Family Life Survey (IFLS) 2014. There were 1,270 children aged 24–59 months who were involved in this study. We conducted univariate analysis, bivariate analysis using chi-square, and multivariate analysis using binary logistic regression. RESULTS: This study found that 20.2% of children in Java were underweight. Based on bivariate analysis, variables that significantly associated (p &lt; 0.05) with underweight were low birth weight (LBW), acute respiratory infection (ARI), diarrhoea, frequency of eating milk and dairy products, parental education level, and underweight father. Furthermore, based on multivariate analysis, low consumption of milk and dairy products was the dominant factor in this study (OR = 1.80). CONCLUSION: Factors related to underweight can be used to determine appropriate prevention and treatment in community levels, such as by promoting a balanced nutrition program and healthy behaviour.

Genotyping of Fasciola hepatica Isolated from Domestic Animals in the West of Iran.

The most common parasites responsible for fascioliasis are F. hepatica and F. gigantica. Fascioliasis is an important problem in terms of health and economics. The western part of Iran is one of the major hubs of animal husbandry and the prevalence of fascioliasis is high. The aim of the current study was to determine the Fasciola spp. present in the western part of Iran. In the present study, 45 samples were collected from slaughterhouses in three provinces in the western part of Iran, including Ilam, Lorestan and Kermanshah. The flukes were detected using morphological methods and the DNA of all samples was extracted. The ribosomal internal transcribed spacer (ITS1) was identified by PCR and PCR-RFLP techniques using the Rsa1 restriction enzyme. Then, 15% of the samples were sequenced. Based on their ITS1 sequence, all samples showed 700 bp bands. The results of sequencing showed a similarity of 99% to 100% across samples. Using the Rsa1 restriction enzyme, all samples produced three distinct bands (60 bp, 100 bp, and 360 bp). These results demonstrated that the most common fasciola in the western part of Iran in sheep and cattle is F. hepatica. The results of the present study showed that only the species F. hepatica is parasitizing livestock in the western part of Iran. Further studies using new molecular markers for more accurate identification of fasciola-causing species will be useful in the control and prevention of fascioliasis.

Survey of Changes in the Erythrocyte Sedimentation Rate at the Different Stages of Therapy by Westergren Method in the Patients of Pulmonary Tuberculosis in the Malwa Region of Madhya Pradesh

Background&#x0D; Tuberculosis, an ancient disease of man remains the most important specific communicable disease in the world caused by Mycobacterium tuberculosis. Tuberculosis continues to be the biggest public health problem in terms of morbidity &amp; mortality.&#x0D; Aims &amp; Objective&#x0D; To study the changes in erythrocyte sedimentation rate at the different period of therapy in Pulmonary tuberculosis.&#x0D; Material &amp; Method&#x0D; A total of 50 untreated sputum positives well as negative cases of pulmonary tuberculosis admitted in TB chest department as well as out patients of Pulmonary Medicine department of Index Medical College Hospital &amp; Research Centre, Indore were included. Under aseptic precautions 5ml of blood collected from sputum positive cases of pulmonary tuberculosis as well as sputum negative in EDTA vacutainers &amp; erythrocyte sedimentation rate were analysed using westergren tube at different period of therapy.&#x0D; Result&#x0D; The study was conducted on 50 subjects of different age group. The sputum positive cases shows rise in ESR with different degree of mild, moderate &amp; severe, While it decreases &amp; comes to normal at different period of therapy as sputum negative cases which has already normal ESR range. So there was a significant post treatment improvement in ESR.&#x0D; Conclusion&#x0D; Blood changes in pulmonary tuberculosis are common in the form of increased ESR with degree of mild, moderate &amp; severe rise at the beginning of therapy, Which decreases &amp; comes to normal range at the different period of therapy, which can be used as a guide to assess the improvement of TB patients after therapy.

Mystery Shopping and Well-Being of Service Workers in South Korea.

BackgroundMystery shopping is a method in which a company monitors quality of service and employee conduct and compliance with regulations using an evaluator posing as a customer. It is a typical tool of customer-centered bureaucratic control insofar as it provides overall and standardized evaluation of intangible elements of customer service as well as physical elements of service environments. The purpose of this study is to examine how mystery shopping is related to the health status of service workers in South Korea.MethodsData from semistructured interviews with 15 workers were collected from January to April 2019 to obtain information on service worker experiences with mystery shopping. Data were analyzed using the constant comparison method.ResultsMystery shopping limits worker autonomy and stiffens the workplace environment by standardizing and monitoring labor processes for service workers. In addition, mystery shopping heightens work stress through increased labor intensity. Five mechanisms by which mystery shopping affects service worker health are identified and comprise (1) multifaceted and multilayered surveillance, (2) evaluator subjectivity and irrational requirements, (3) standardized rules combined with high pressure to achieve sales, (4) self-esteem degradation because of evaluator results, and (5) musculoskeletal disorders because of strict adherence to labor processes based on evaluator results.ConclusionMystery shopping as an evaluation method should be reconsidered not only in terms of health problems but also in terms of organizational efficiency and issues of human rights.

A clinical and microbiological profile of urinary tract infection in patients with chronic kidney diseases

Background: Urinary tract infections (UTIs) are a major public health problem in terms of morbidity and financial cost in CKD patients in India. The resistance pattern of community acquired uropathogens in CKD patients has not been extensively studied. Thus, knowledge of local antimicrobial susceptibility patterns of common uropathogens is essential for prudent empiric therapy of community acquired UTIs.Methods: It is a cross sectional study conducted in a tertiary care hospital involving 65 chronic kidney disease patients with UTI who attended general medicine OPD and those admitted in wards after fulfilling the inclusion and exclusion criteria, after obtaining written informed consent. Blood sample and urine samples were collected from these patients and sent for blood analysis, urine analysis and urine culture and sensitivity.Results: Among 65 CKD participants with UTI who were studied, E. coli (47.7%) and K. pneumoniae (15.4%) were the most common isolates which were sensitive in order of colistin, polymyxin B, meropenem (carbapenem) and less sensitive to other commonly used antibiotics.Conclusions: The main purpose of this study was to find the various common local uropathogens in CKD patients and their antibiotic profile which will help in formulating antibiotic therapies. As previously stated, there are very few studies regarding profile and management of UTI in CKD patients. Hence this study can throw some light into this area.

Efficacy of a peer-led group program for unemployed people with mental health problems: Pilot randomized controlled trial.

People with long-term unemployment and mental health problems often find it difficult to take active steps toward help-seeking and job search and to navigate the complex system of available services. Likewise, job center staff would welcome interventions to improve the reintegration of long-term unemployed individuals with mental health problems into the labor market. To examine the efficacy of a peer-led group program that supports unemployed people with mental health problems in terms of help-seeking, job search and recovery. Based on participatory research, a four-session group program was designed and evaluated in a pilot randomized controlled trial (RCT) with 42 participants, randomized to the program ( n = 23) or treatment as usual ( n = 19). Outcomes were assessed at baseline (T0), 3 weeks (T1), 6 weeks (T2) and 6 months later (T3). There were no significant intervention effects on primary outcomes (job search self-efficacy and help-seeking). But compared to the control group, intervention participants showed significant improvements in depressive symptoms ( p = .02) and recovery ( p = .04) at T2 with medium effect sizes. There were trend-level positive program effects on self-stigma, hopelessness and secrecy. This pilot RCT provides initial evidence for the efficacy of a peer-led group program to improve symptoms and recovery among unemployed participants with mental health problems.

A join point regression analysis of trends in mortality due to osteoporosis in Spain

Osteoporosis is a major health problem in terms of fracture probability and disability. The aim of this ecological study is to identify the temporal trends in osteoporosis mortality in Spain from 1999 to 2015. Data on the Spanish population and number of deaths due to osteoporosis were obtained from the Spanish National Institute for Statistics. Age-adjusted mortality rates were estimated. Join point regression was used to identify the years when changes in mortality s and annual percentage change in mortality rates took place. Women presented a greater mortality rate decrease (p < 0.001), though this mortality difference by sex was reduced by half at the end of the period. The higher the age, the faster the mortality rate declined in women, while no clear pattern could be identified in men. In women, significant changes in trends were identified in three age groups (50–54, 60–64 and 80–84 years old). A sustained decrease in osteoporosis-associated mortality was found in women aged 75–79 and ≥85 years and men aged 60–64. In conclusion, mortality caused by osteoporosis in Spain is decreasing faster in the older age ranges especially in women.

Dengue Situation in Bangladesh: An Epidemiological Shift in terms of Morbidity and Mortality.

The escalating dengue situation in Bangladesh has been emerging as a serious public health problem in terms of morbidity and mortality. Results of analysis of 40,476 cases of Bangladesh occurring during 2000–2017 indicated that 49.73% of the dengue cases occurred during the monsoon season (May–August) and 49.22% during the post-monsoon season (September–December). However, data also showed that, since 2014, these trends have been changing, and dengue cases have been reported during the pre-monsoon season. During 2015–2017, in the pre-monsoon season, the dengue cases were reported to be more than seven times higher compared to the previous 14 years. The findings closely correlate with those of the pre-monsoon Aedes vector survey which revealed the presence of high density of larva and pupa of the dengue vectors in the environment all the year round. In our study, climate changes, such as average rainfall, humidity, and temperature, after 2014, and rapid unplanned urbanization were the strong predictors of an imbalance in the existing ecology that has led to increase in dengue cases in 2016 and the emergence of the chikungunya virus for the first time in Bangladesh in 2017. Although 2018 dengue data are relevant but not included in this study due to study time frame, it is interesting to report an increase in the number of dengue cases in pre (2016) and post (2018, which is highest within 18 years) chikungunya outbreak, which favors the study hypothesis. Despite the efforts to control dengue, based primarily on the vector control and case management, the burden and costs of the disease and similar vector-borne diseases will continue to grow in future in our country. Developing a cost-effective vaccine against all the 4 strains of dengue remains a challenge. The CDC, in collaboration with other research organizations, may come forward to initiate and coordinate a large-scale randomized clinical trial of an effective dengue vaccine in Bangladesh.

Work addiction is associated with increased stress and reduced quality of life: Validation of the Bergen Work Addiction Scale in Danish.

Addiction to work is defined as a compulsion or an uncontrollable need to work incessantly. Only few measures exist to identify work addiction and the health consequences are sparsely explored. The Bergen Workaholic Scale (BWAS) measures seven core elements of work addiction and has been used in Norway, Hungary, Brazil, Italy, USA and Poland. The aim of this study was to validate the BWAS in a Danish sample and to investigate if high risk of work addiction was associated with stress and reduced quality of life. We conducted an online screening survey with 671 participants aged 16-68 years with the Danish translation of the BWAS. We added the perceived stress scale (PSS) and the quality of life scale EQ-5D-5L. Those with high risk of work addiction reported significantly higher mean PSS scores (20.0 points) compared to those with low risk of addiction (12.5 points) and poorer quality of life (61.9) compared to the low risk group (81.3). Furthermore, work addiction was associated with more weekly working hours (44.0 vs. 35.6 hours/week) and having more leadership responsibility. A preliminary estimate of work addiction prevalence was 6.6%. The BWAS demonstrated good reliability (α = 0.83), and factor analyses pointed at a single factor structure. Work addiction seems to be associated with health problems in terms of stress and poorer quality of life. The BWAS is recommended as a reliable and valid tool to identify work addiction in Danish.

A Study to assess the effectiveness of Structured Teaching Programme on selected Health Problems in Terms of Knowledge and Knowledge on Practice among Orphan Children in a Selected Morphanage Home at Rajkot

Orphanage is the name to describe a residential institution devoted to the care and education of orphans-children whose parents are deceased or otherwise unable to care for them. Parents, and sometimes grandparents, are legally responsible for supporting children, but in the absence of these or other relatives willing to care for the children, they become a ward of the state and orphanages are a way of providing for their care, housing and schooling. Orphanage lifestyle is very different from normal lifestyle. The wear and tear over many years without proper maintenance is very evident. Funding is not available even for smallest repairs. Proper heat, hot water & electricity are often sporadically available during the harsh winter months.

Effects of exergames on motor coordination and balance in convalescent drug addicts: a feasibility study

Background and objectives: Drugs are public health problem in terms of mental and physical impairments. As respect to the physical commitments, addicted people present severe motor coordination and balance disturbances. The aim of this study was to evaluate the effect of exergames on the rehabilitation of motor coordination and balance in recovering drug addicts. Participants and methods: This is a prospective non-randomized, self-controlled study. Nine male addicts aged 25.78 ± 6.76 years were recruited from the Rescuing Lives Center for Recovery from Alcohol and Drugs, Altamira, Brazil. The intervention consisted of sixteen 45-minute sessions involving the use of virtual reality games (Xbox 360 Kinect console). Evaluations were performed before and after the intervention. The static and dynamic balance was accessed by the Berg Balance Scale, Timed Up and Go test and 6-minute walk test. The motor coordination was assessed by the Senior Motor Scale. Gait was also analyzed using an inertial sensor (G-Walk). This study was conducted at the Rescuing Lives Center for Recovery from Alcohol and Drugs, Altamira, Brazil and received approval from the Human Research Ethics Committee of the Universidade do Estado do Para - XII Campus (certificate number: 2.129.360) on April 7, 2017. Written informed consent was obtained from each participant. Results: Significant improvements were found in the Berg Balance Scale, Senior Motor Scale and Timed Up and Go test (sitting and standing) after intervention (P 0.05). Conclusion: Virtual reality is a promising technology for improving motor coordination and balance in recovering drug addicts.

Antimicrobial resistance in the environment: The Indian scenario.

Antimicrobial resistance (AMR) continues to pose a significant public health problem in terms of mortality and economic loss. Health authorities of several countries including India have formulated action plans for its containment. In this fight against AMR, it is important to realize the contribution by all the following four spheres: humans, animals, food and environment. This review incorporates all the spheres of One Health concept from the Indian perspective. India has one of the highest rates of resistance to antimicrobial agents used both in humans and food animals. The environment, especially the water bodies, have also reported the presence of resistant organisms or their genes. Specific socio-economic and cultural factors prevalent in India make the containment of resistance more challenging. Injudicious use of antimicrobials and inadequate treatment of waste waters are important drivers of AMR in India. Use of sludge in agriculture, improper discard of livestock animals and aquaculture industry are considered AMR contributors in other countries but Indian data regarding these are lacking. Efforts to combat AMR have been initiated by the Indian health authorities but are still at preliminary stages. Keeping in view the challenges unique to India, future directions are proposed.

Bacteriological Profile of Urinary Tract Infections among Postmenopausal Women Visiting Alka Hospital, Lalitpur, Nepal

Urinary tract infection (UTI) is one of the most common diseases encountered worldwide and is a major public health problem in terms of morbidity and financial costs. A cross-sectional study was conducted in Alka Hospital, Lalitpur, Nepal from February to July, 2014. A total of 353 midstream urine samples were collected from postmenopausal women visiting Alka Hospital, Lalitpur, Nepal. The samples were examined by microscopically and culture methods. The isolated organisms were identified by conventional microbiological methods. Antibiotic susceptibility test was performed by modified Kirby-Bauer disc diffusion method according to CLSI (2011) guidelines. Among 353 urine samples processed, 32 % (113) showed significant bacteriuria. Out of 113 bacterial isolates, the prevalence of gram negative bacteria was 97.3% (110) while that of gram positive was 2.7% (3). The most predominating organisms causing UTI were Escherichia coli (84.9%) followed by Klebsiella pneumoniae (5.3%), Enterococcus faecalis (1.7%), Providencia spp. (1.7%), Klebsiella oxytoca (1.7%), Proteus mirabilis (1.7%), Proteus vulgaris (0.9%), Citrobacter freundii (0.9%) and Staphylococcus aureus (0.9%). Antibiotic susceptibility tests of the isolates showed that, most of the gram negative bacterial isolates were sensitive to Piperacillin+Tazobactam followed by Amikacin, Imipenem and Nitrofurantoin, while they were resistant to Amoxicillin. All gram positive isolates were sensitive to Amoxicillin and resistant to Gentamycin. This study showed that higher aged postmenopausal women (&gt;80 years) were at higher risk for UTI than those of lower aged ones (&lt;80 years).