Objective Understanding the regional blood group distribution is essential for safe transfusion practice and efficient blood bank inventory management, as local variations in the ABO and Rh blood group systems guide donor recruitment and minimise shortages and transfusion incompatibilities. This study aimed to determine the prevalence and distribution of ABO and Rh blood groups among individuals attending a tertiary care hospital in Lalitpur, Nepal.Design Retrospective cross-sectional study.Setting Department of Transfusion Medicine and Blood Bank of KIST Medical College and Teaching Hospital.Participants All individuals attending a tertiary care hospital between 17 July 2018 and 31 July 2023 who underwent ABO and Rh blood group testing were included in this study. Individuals younger than 4 months of age and those with discrepant blood group results were excluded.Outcome measures Frequency and distribution of ABO and Rh blood groups among different categories.Methods A retrospective cross-sectional study was conducted among individuals attending a tertiary care hospital after obtaining ethical approval from the Institutional Review Committee (reference number: 2080/81/91) of KIST Medical College and Teaching Hospital. The blood grouping and sociodemographic data of individuals were analysed using SPSS V.17.0, and statistical significance was established at p<0.05.Results Out of 20 966 individuals, 12 956 (61.80% (95% CI 61.14% to 62.45%)) were female, and 8010 (38.20% (95% CI 37.55% to 38.86%)) were male. The most common blood group was A+ 6629 (31.62% (95% CI 30.99% to 32.25%)), while AB− was the least common blood group 49 (0.23% (95% CI 0.17% to 0.30%)). The RhD+ cases were 20 432 (97.45% (95% CI 97.24% to 97.67%)) and the RhD− cases were 534 (2.55% (95% CI 2.33% to 2.76%)). O+ blood (OR 1.25 (95% CI 1.18 to 1.32), p<0.001) was most common in the males, whereas A+ was common in the females (OR 1.22 (95% CI 1.15 to 1.30), p<0.001).Conclusions Of the two major blood group systems, the ABO and RhD systems, A+ and RhD+ blood groups were the most prevalent among individuals attending a tertiary care hospital. Understanding the regional distribution of blood groups supports effective blood bank management and transfusion services, ultimately improving patient care.
Impetigo is a common, contagious superficial bacterial skin infection predominantly affecting children aged two to five years. Severe presentations are rare but can be diagnostically and therapeutically challenging, particularly in rural, resource-limited settings. We report a 7-year-old girl from rural Nepal with severe non-bullous impetigo contagiosa unresponsive to initial therapy with topical mupirocin and oral cephalexin. Due to the absence of culture and sensitivity facilities and the high regional prevalence of methicillin-resistant Staphylococcus aureus (MRSA), empirical oral doxycycline was initiated. Marked improvement occurred within 48 hours, with complete resolution by day 7. This case underscores the importance of flexible, evidence-based empirical therapy for suspected MRSA in pediatric patients when diagnostic resources are unavailable, and highlights the short-term safety and efficacy of doxycycline in children.
Background: Patient satisfaction reflects the extent to which individuals perceive that their needs and expectations have been met in relation to the cost and quality of healthcare services received. Satisfied patients are more likely to adhere to treatment plans, seek continued care, and provide constructive feedback, all of which are particularly important in the management of children with Cerebral Palsy (CP), a lifelong condition requiring long-term rehabilitation. As children with CP are often unable to adequately express their perceptions of care, parental perspectives serve as a crucial proxy for assessing satisfaction with healthcare services. Objective: To determine the level of satisfaction with physiotherapy services among parents of children with Cerebral Palsy attending rehabilitation centers in Kathmandu Valley and to examine the relationship between individual questionnaire items and overall satisfaction. Methods: The MedRisk Instrument for Measuring Patient Satisfaction (MRPS) with physiotherapy services was administered to 82 parents of children with Cerebral Palsy receiving care at rehabilitation centers in Kathmandu Valley. Results: Parents reported a high level of satisfaction with physiotherapy services as measured by the MRPS (Mean = 4.37, SD = 0.38). Bivariate correlation analysis was conducted to examine the relationship between individual item scores and global satisfaction. Internal factors demonstrated the strongest correlations with global satisfaction, while external factors showed weak to moderate correlations. Conclusion: Patient satisfaction is a key indicator of the quality of physiotherapy services and should be assessed regularly to ensure optimal care delivery. This study found a high level of satisfaction with physiotherapy services among parents of children with Cerebral Palsy attending rehabilitation centers in Kathmandu Valley.
Background: Tuberculosis (TB), a leading global infectious killer caused by Mycobacterium tuberculosis, significantly impacts public health, especially in regions like Nepal where a large portion of the population harbors latent infection. Diagnosing pulmonary TB, particularly in sputum smear-negative cases, presents a challenge due to low bacterial loads. This study aims to evaluate high-resolution computed tomography (HRCT) findings in sputum smear-negative presumptive pulmonary tuberculosis (SNPT) cases, utilizing the Xpert MTB/RIF assay as the microbiological benchmark for bacteriological confirmation and comparing these with clinically diagnosed instances. Methods: This cross-sectional study included 71 patients diagnosed with new onset SNPT between December 2021 and December 2022. Demographic, clinical, and HRCT data were recorded and analyzed using Microsoft Excel and SPSS. HRCT findings were assessed, and the Xpert MTB/RIF test results were noted. Statistical analysis used the Fisher’s Exact test to determine significant associations, with a p-value <0.05 considered significant. Results: Among the 71 patients, centrilobular nodules, lymphadenopathy, consolidations, and tree-in-bud patterns were the predominant HRCT features. Bacteriologically confirmed SNPT cases exhibited a higher prevalence of centrilobular nodules, tree-in-bud patterns, and macronodules compared to clinically diagnosed cases. The apical, posterior, and superior segments were the most commonly affected lung segments. HRCT diagnostic criteria, combining multiple features, effectively ranked TB risk, with higher ranks correlating with bacteriologically confirmed cases. Conclusion: HRCT plays a pivotal role in diagnosing SNPT, revealing critical markers like centrilobular nodules and tree-in-bud patterns, especially in bacteriologically confirmed cases. Despite limitations, this study highlights HRCT’s diagnostic value, advocating for its broader application in TB-endemic regions to improve diagnostic accuracy and patient management.
