MY EXPERIENCE IN TREK

Trekking is activity of going for long walks in the country for pleasure, knowledge and exercise. Few year back I went hiking with my friends to Ghandruk. It was full of excitements. Since then I felt that trekking is really good for us. 

My country Nepal is rich in natural beauties. I have heard about Manang Mustang since childhood. So, I have been talking about trekking to Mustang with my friends since many years. And then we formed the hiking group consisting 5 members including me, my sister Jeena, my friends Sangarshila, Sachin and Chetna. We planned our trip for October 2^nd 2015 but unfortunately we postponed it. Now we added Manang to our trip this time and that was our wonderful decision. At first we were so confused to start our trek and we did lots of research and collected so many information from our relatives, friends and internet. Then we started shopping for our trek that was a fun, we were so excited to start our trek. My parents was not happy by my decision and they tried to stop me but I didn’t.

We left our home at around 2 pm on Friday October 30 and get into the microbus and headed toward Lamjung, we were so happy. But our bad luck, our microbus was trapped in checking at Aaptari, Chitwan and we were carried to police station from check post. Our fault was we didn’t asked for ticket, we were in problem now. We had a bad experience with police inspector on that day. Finally, we caught bus for Dumre as we didn’t have direct bus to Lamjung. Fortunately we met some good people and reached to our destination safely at around 10 pm. We stayed at Hotel Mongolian, Besishar, Lamjung on that day which was booked by Raju Dai who was my neighbour. I called to my parents after reaching there, they were so worried about me because they loves me so much.

Next morning we hired a jeep to go to Chame and luckily we got chance to mix up with other group. On the way we did lunch together at hotel waterfall guest house and restaurant. After some time we reached Syange and saw waterfall which was so beautiful and we stopped there for some time, took photos.  From there we walked short distance and that was really a fun walking with new members. We introduced with each other during the walk. Among them one was DSP from Kathmandu named Arjun Timilsina, next was Surendra KC who was his friends, another was Rajendra Adhikari and he was inspector from lamjung, next was Hom dai, Barun dai, Bikas dai, Niranjan dai, Avivandhana Di and Shaswat dai who used to keep silent. After few minutes we found another waterfall which was amazing and was on the side of a road.

As we didn’t knew its name we named it Bahubali Jharana as we have seen such type of waterfall in the movie Bahubali.  After going ahead, we have reached to a place named Taal, which was a piece of heaven. We crossed so many beautiful places n views on the way that was my best experience. But road was very scary, so this trip was full of adventure for us. In this way we reached Chame, it took about 8 hours. After reaching there we stayed in another hotel had a dinner. On that day fortunately we got chance to watch cultural dance of Manang district as well.

On third day, we headed to Upper Manang with new group in jeep again. Today’s way was much better than yesterday. On the way we saw snow and stopped our jeep and played snow for the first time. This was an awesome experience of my life. We crossed Humde airport and lots of mesmerizing views as well. After 4-5 hour drive we reached Upper Manang and from there we started walking and went to Gongapurna Lake, took some photos there. After reaching there, I realized that Nepal is really a rich country, it’s a heaven on earth.

We spend some time at Gongapurna glacier and we went for lunch at Hotel Yeti. After lunch I felt uneasy, I thought I have been caught by altitude mountain sickness (AMS). So took some medicine and headed toward Khangsar. That walk was very difficult for me as I had a severe headache, so I couldn’t enjoy that time. On the way he had to cross a bridge and that was a tough job for me because I am afraid of heights. I got help of my friends and crossed that bridge. After the bridge now we have to walk through snowy cliff and that was tough again but we have to cross it anyway, we don’t have other option and we did it with the help of Shaswat Shrestha and his friends. We were so impressed with their helpful nature. In this way we reached Khangsar and stayed there.  We had a fun, cracked jokes, my friends played cards but I don’t know how to play card so I just watched TV and talked with friends. After sometime while playing cards my sister Jeena had a severe headache. So I was thinking to go back home from there as we thought we could not walk ahead because of my health condition but Arjun dai convinced us and we made our mind to go ahead. We had a dinner, as I was not feeling well I ate wai wai garlic soup and slept.

On fourth day, we waked up had a breakfast and walked ahead to Shree Khadga, again we have to cross a bridge and that was so scary for me but any how I passed it with the help of Surendra KC to whom I used to call mamashree as he was from my mawali place Banepa. We reached Shree khadga, took rest clicked some pictures of mountains and Annapurna range which was so near to us as if I can touch it.. Those views were really awesome. Our team member had a lunch there they ate rice and we five girls ate thukkpa as we didn’t liked rice. After lunch we headed toward Tilicho base camp (TBC). On that day I was fresh and enjoyed our walk. I was surprised of my sister as I thought she couldn’t walk but she was doing well, was enjoying the trek and was leading our group. I was always scared of bridge and every time I took help of friends. Now this time we had to cross landslide area and the route was very dangerous. We had to walk through Marsyangdi River and if we fall down from our trail we have to swim in that river, but the views were lovely and that was a thrilling experience for us. On that way I was with my Surendra mama, Shaswat Dai n Shangarshila, they helped me a lot. Anyhow we crossed that trail and reached base camp safely after walking about 10 hours. That place was so pleasant, surrounded by snow and snow-capped mountains. We drink hot water and ginger garlic soup after reaching there. We started planning to go to Tilicho Lake which is situated at highest altitude (5200 meter). Arjun dai was now confused to take us up to Tilicho Lake as we were not well prepared, we don’t have cramp-pones which was essential to walk on snow as the way was slippery. So all of us were tensed, I loosed my confidence to go there, I thought Tilicho Lake is next to impossible for me. So I was convinced not to go there. My other friends those who don’t have cramp-pones were also so confused, but they decided to go anyhow. We had a lunch, played card, sang a song sitting beside wood fire, as it was very cold weather. And all of us slept at dining hall including foreign tourist. Hall was so crowded, there was not sufficient blanket and pillow, so could not sleep well. Niranjan dai is very humorous person, he always crack jokes and make us laugh. He said I need a pillow, and everybody started laughing and barun dai said “तपाईं को ससुरली होर भनेको भनेको जस्तो गरी बस्न पाउनलाई”, we start to laugh again. But internally I was very sad as I have decided not to go Tilicho Lake, tears were rolling down from my eyes whole night and couldn’t sleep.

This was fifth day, everybody waked up and was getting ready. Poor me, I was not going so I was sitting on the bed. But Shaswat dai n Bikas dai gave confidence, encouraged me and told they will take me there. I was so happy and made my mind to go. And we moved ahead at around 5 am, I was following Shaswat dai, trail was very dangerous, it was covered by snow, slippery, very narrow and again we have to cross landslide area. Stones were falling down, so we had to cross it as soon as possible, and I was hited by stone badly. I slipped down 2-3 times due to slippery snowy way, so Shaswat dai gave his cramp-pone and his original stick without thinking about own self. I was so grateful to him at that time, I felt as if god has send him there just to save me. He is really helpful, responsible, and humble. He is very strong, for me he is a super hero. On the way, we saw the board 35 minutes more to Tilicho Lake. At that time I was with Shaswat dai and Jeena. In this way we reached our destination Tilicho Lake after walking about 5 hours, it collects the glacial melt of the entire northern slopes of Annapurna and Thorang Peak, which is claimed to be the highest lake in the world. In 2001, Hindu pilgrims from around the world flocked to the lake convinced it is a holy spot mentioned in the Ramayan - a holy book of the Hindus. Tilicho Lake was so beautiful, offering us spectacular and majestic view of white Himalayas.

We were so happy, feeling proud to be at highest altitude. We clicked so many photos, enjoyed with nature. And after few minutes I felt uneasy, I had a severe headache and nausea. I couldn’t drink or eat anything at that place, I guess I was caught by AMS. So Shaswat dai told us to move down and we headed back from there. Every time he was with me so that he can take care of me, this time also I was using his cramp-pone and his stick. On the way he told that today is his special day and I asked is it your birthday? He just smiled and said I will tell you tomorrow. After some time we met Bikas dai who was walking in front of us and Shaswat dai said Bikas dai to take care of me and he walked ahead. Now I was walking with Bikas dai, he was also very good person, every time he used to encourage me. Avee di was resting on the way as she was suffering from migrain headache. Finally we get back to TBC safely. I thanked god for helping me by sending peoples like Shaswat dai and his friends in my life. When we reached TBC I found Arjun dai sleeping on the floor, as he was caught by AMS, my sister gave him blanket and some medicine. Now I was fine and ate wai wai soup. But Arjun dai was not feeling well so we decided to stay at TBC. After having dinner, we sat down around wood fire and start our regular chitchats and songs. Some of my friends were playing card. Suddenly, Sangsharshila asked Shaswat dai his cast and he said Shrestha, I was shocked as he didn’t look like newar. During our chitchat he told his house was in Thamel, Kathmandu. And I asked him do u have a sister named Laghu and he said yes, than I was confirmed that he is my relative. He asked my father’s name and I told him his name is Ganesh Lal Shtrestha. At that time I was so glad to find my mama at that unknown place. All my family members knows him only I have never met him before so I didn’t recognized him. At that time I realized that I am very lucky girl. I was so excited and I called to my home and told about Shaswat dai who was my mama. My parents were also happy and now they were relaxed. I could not sleep that night also, may be because of high altitude and excitement. 

Next morning (sixth day), we did breakfast and headed back to Shree khadga. As I have already described the way was very dangerous but this time I was with my own mama so I was feeling safe. On the landslide area as the trail was so narrow, I was scared to step my feet but I crossed it with my two mama. Infront of me I have Surendra mama n Shaswat mama at my back.

Beside them Sudip bhai who has joined us from Shree khadga, Jeena and Arjun dai was also walking with me. Shangarshila and Barun dai was walking ahead. Other group members were at my back. We had lunch at Shree khadka and headed toward Yak Khadka. On the way we can see forts and snow-capped mountains, below there was Marsyangdi River.

Again we have to use cramp-pone, and I got it from Shaswat mama. This day we walked for about 10-11 hours. Now my feet started hurting I felt as if I couldn’t walk more. Finally we found one small restaurant and I thought we were staying there as it was already dark. But Barun dai told we have to walk more, and I was tired and was scared to walk at night so I said no. I could not control myself and I started crying and that was my most embracing moment. Oh my god how could I cry infront of my friends and other member of our group like a small baby. So ever body stayed there but Arjun dai, Surendra mama and Sudip bhai had already gone so me missed them, they stayed at Yak Khadga. We did camp fire, and had a lunch. I found caring and sweet Avee di, who was making me comfortable, we shared our dinner that night. At that moment I felt as if I am being burden to my group members. My sister and Shangarshila were also confused and finally we decided to come back from there, but we were not happy at that moment. There was no sufficient space and bedding so it was very difficult for us to sleep, this was all because of me. I couldn’t sleep that night also.

On seventh day, as we had decided to go home, I discussed our decision with my mama and sadly he said as you wish. But at last Jeena changed her mind and she decided to go ahead. Now Sangarshila and I was confused what to do, I could not go back without my sister and I also wanted to pass Thorong-la peak, so we decided to move ahead.We were walking and the way was not so tough now, so my mama walked ahead leaving me behind. We were moving ahead, but after some time I became alone as other walked faster than me, suddenly there was two trail and no directions. Now I was confused where to go, so I shouted calling Shaswat Mama and my sister Jeena. But nobody replied, and I was afraid and start to cry again. I just don’t know what to do, I start calling God, and after few minutes may be about 10 minutes I saw my other friends Chetna, Sachin, Niranjan dai and Avee di. They were just at my back and I asked them which one is the way and they showed me the way. I moved ahead alone and few meter ahead I saw my mama waiting for me and I was happy to see him waiting for me. He asked me did u called me and I answered yes, and we start our walk talking with each other. He told that day was his Birthday, and we shared so many things with each other. In this way we crossed that trail and after some time Jeena also joined us and reached Yak Khadka. We had a breakfast, charged our mobile and camera, also we bought Cramp-pone at that hotel. After some time we again started our journey. Again we have to cross the bridge and I was afraid to cross it. This time Bikas dai encouraged me to cross it by myself and I boost up my confidence and I did it. Now I have overcome my fear of bridge and credit goes to Bikas dai. Our friends were waiting for us at Leddar for lunch and we joined them, I didn’t liked rice so ate thukkpa. After lunch we moved ahead. Again we have to cross the bridge and this time I did it myself and I was very glad. On the way there was a snow fall and I was really enjoying that weather. I met Arjun dai, Surendra mama and Sudip bhai on the way, and found them confused because of snow fall. I tried to convince them to move ahead as we were so close to our goal. All my group members were behind and I was waiting them at Thorong-la-base camp. After some time I found Bikas dai in-front of my eye and after that Chetna and Sachin joined us. But my eyes was searching for my sister and I was worried for her. After waiting sometime I saw Shangarshila and I asked where is Jeena. Finally I found her there and I hugged her tightly in excitement. Slowly everyone joined us except three peoples (Arjun dai, Surendra mama and Sudip). I asked mama about them and he told they returned back home, I felt sad for them. Now we started planning for Thorong-la Pass sitting beside wood fire, we planned to move at 4:30 am, had dinner and went to our room. Jeena was not feeling well on that day, and mama was observing her, and he was worried for her. I couldn’t sleep whole night, I was just thinking about Thorong-la pass.

Finally, the day has come and its eighth day, we packed our bags and get ready to go. All of us climbed up steeply with torch lights on our hand. After sometime we crossed High camp and we stopped for tea, at first tea shop after high camp. And mama also arrived there, we three had a tea and moved ahead.

Finally we were at 5416 meter height that means we achieved Thorong-la Peak, it was marked by chortens and prayer flags. That was awesome feeling for us as we reached their safely.I felt as if I was rewarded by magnificent view on the top. Now we had a cup of tea and clicked some pictures at the top for memory. As that place was so windy it was difficult for us to stay there and wait for others to come. So we stepped down toward holy town Muktinath.

Among whole trip, for me this part was wonderful. We could see awesome Dhaulagiri mountain range, I had a fun with snow, I was not scared walking on the snow, we made snow man but it looked like snow ganesh. It took about 4 hours to reach a restaurent at Muktinath for us, after reaching there we ordered some drinks and I called at my home, proudly I told them that we crossed thorong-la pass and they were really happy. We stopped there until all our friends came. Finally all other friends joined us, ordered food for them, after eating we left that place. We booked a guest house and we stayed there.  We did dinner together, and as everybody was tired we went to our room and I had a sound sleep that day.

On nineth day, we headed toward Muktinath Temple. Muktinath means place of Nirvana and is home to the Muktinath temple as well as several monasteries. It is said that all sorrows you feel are relieved when visiting the Temple, which is a scared pilgrimage site to both Hindus and Buddhists. The main pilgrimage normally takes place in September. The Temple is dedicated to Lord Vishnu and has 108 waterspouts around it from which Holy water pours. Another attraction nearby is the Jwala Mai Temple this contains a spring and an eternal flame fed by natural underground gas. We did holy bath under 108 waterspouts, and worshipped temple, clicked photos and came back to hotel. On the way I bought a shawl for my grandmom, and some dried apples. We had a lunch at hotel and hiked toward Kagbeni. Shangarshila was tired, her knees were hurting so she went by bus and reached Jomsom. I found Mustang as a desert, it was very dry, we couldn’t see greenery, but the scenery was spectacular. After 4-5 hours of walk, we reached Kagbeni, can hear sound of flowing water and that was Kali Gandaki River. We stopped there, Shaswat mama asked a priest about “Tarpan” as he wanted to do it for his late father. Priest told him to do it in early morning so we decided to stay at Kaagbeni.  Kaagbeni it was beautiful old city and one of the gateways to upper Mustang. At that time Shaswat mama, Bikas dai, Jeena and I was there, our other friends was on the way. We waited them at guest house and ordered dal bhat for our group. Everyone joined us except Shangarshil as she had reached Jomsom. That night I enjoyed most, my mama who used to keep quiet, opened up and was singing songs. He was forcing Jeena to sing a song, everyone was having fun. At last we had a dinner, watched our photos in my camera and slept, except me. I couldn’t sleep whole night, don’t know why.

It was a 10^th day, everyone waked up and mama was ready for tarpan. We went to Kali Gandaki River with priest, mama did tarpan, Bikas dai was there to help him.  After finishing all rituals we came back to hotel and had breakfast. Leaving Kaagbeni we travelled down the Kali Gandaki river valley to Jomsom. We collected some saligram on the river bank, we were enjoying beautiful landscape as well.

We walked for about 3 hours and reached Jomsom, where Shangarshila was waiting for us at Hotel Majestry. We had a delicious lunch and headed toward Tatopani by bus and the way was very scary. Some of my friends started drinking marpha in bus and they were enjoying at that moment but I was so scared because of the way. After 7-8 hours of travel we reached Tatopani and we had hot water bath and enjoyed a lot. We had a dinner and slept.

Next morning (11^th day) we did breakfast, packed our bags and left Tatopani. We reached Beni after traveling for 4 hours and had our lunch, all of us were very tired at that time. My sister’s feets were swollen as if she was suffering from elephantiasis because of exhaustion. We booked a bus to Pokhara, reached there at around 8 pm and get off from bus at Prithivichowk. From there we headed toward our hotel and took rest. After some time we had delicious dinner at Thakali hotel with all our friends including Bikas dai’s wife and his son who joined us at Pokhara. We went to busy bee after dinner enjoyed live music, played pushball, spent some memorable time as that was our last night with soulful trekkers and get back to hotel and slept.

Finally on 12^th day we packed our bags and headed toward buspark with Chetna, Sangarshila and Jeena. Actually we were not happy to go home as we were leaving our soulful trekkers back at Pokhara. After reaching park Jeena and me get into the bus and came back home and Chetna and Sangarshila went Kathamndu.

We felt that our trekking was really fruitful. We have widened and depended our knowledge and experiences. Heartily writing, it is a piece of heaven. I have realized that all of us should visit these places once in order to illuminate our heart.

LOWER RESPIRATORY TRACT PATHOGENS AND THEIR ANTIMICROBIAL SUSCEPTIBILITY PATTERN IN A MEDICAL HOSPITAL OF CENTRAL NEPAL

 Sony Shrestha*1, Anju Acharya2, Hari Prasad Nepal3, Rajendra Gautam4, Shamshul Ansari5, Goma Upadhyay6 and Avisekh Gautam7

1,5Lecturer, 2Associate professor, 3,4Assistant Professor, 6Assistant Lecturer, Department of Microbiology, Chitwan Medical College (CMC), Chitwan, Nepal. 
7Lecturer, Department of Microbiology, St. Xavier’s College, Kathmandu, Nepal.

Abstract

Background: Lower respiratory tract infection (LRTI) is one of the major causes of morbidity and mortality in young children and elderly people. It is among top ten diseases of Nepal and accounts for deaths of 2.6 million people per year.

Objectives: To identify causative agents of lower respiratory tract infection and to determine their susceptibility to antimicrobial agents, with special interest to multidrug resistance (MDR).


Materials and Methods: The study was carried out in 240 sputum specimens received in the Microbiology Laboratory of Chitwan Medical College Teaching Hospital within a period of 6 months (April- September, 2010).  Results: Total positive result was observed in 73 specimens (30.42%). Infection rate in males (58%) was higher than in females (42%). LRTI was mostly seen in age group of 61-75 years. Altogether 9 different species of bacteria were identified, majority of which were Gram-negative bacteria (73%). On performing antimicrobial susceptibility testing, Gram-positive organisms exhibited maximum sensitivity to gentamicin (100%) while Gram-negative bacteria showed variable response towards different antimicrobials. Prevalence of MDR was higher in Enterobacter spp (100%) followed by Escherichia coli (90%).



Conclusion: Varieties of pathogens are responsible for LRTI and antimicrobial resistance has become significant public health problem in central Nepal.


Keywords: Antimicrobial susceptibility, bacterial isolates, LRTI, MDR, Nepal  

BACTERIOLOGICAL PROFILE OF NEONATAL SEPTICEMIA CASES AND THE ANTIMICROBIAL RESISTANCE PATTERN IN A TERTIARY CARE HOSPITAL OF CENTRAL NEPAL

Hari Prasad Nepal^1*, Anju Acharya², Rajendra Gautam³, Sony Shrestha⁴, Rama Paudel⁵

^1,3Assistant Professor, ²Associate Professor, ⁴Lecturer, Department of Microbiology, Chitwan Medical College (CMC) Teaching Hospital; ⁵Resident, Department of Pharmacology, College of Medical Sciences, Chitwan, Nepal

ABSTRACT

Background: Neonatal septicemia is an important cause of morbidity and mortality. Knowledge of bacteriological profile and antimicrobial susceptibility is very important for management of such infection.

Objective: To determine the bacteriological profile of neonatal septicemia and the antimicrobial resistance pattern.

Materials and Methods: A total of 377 neonatal blood cultures samples were processed in the Department of Microbiology, Chitwan Medical College Teaching Hospital, Nepal in one year period. Isolation, identification and antimicrobial susceptibility was determined by standard microbiological methods.

Results: Of 377 specimens studied, bacterial growth was obtained in 80 specimens (2.1%). Gram-positive organisms were isolated in 35 (43.7%)  and Gram-negative in 45 (56.3%) specimens. Staphylococcus aureus was the most common organism (23/70 isolates) isolated in early-onset septicemica followed by Acinetobacter species (18/70 isolates) and Klebsiella species. However, late-onset septicemia was primarily  associated with Acinetobacter species (4/10 isolates).

On performing antimicrobial susceptibility testing, Gram-positive organisms exhibited maximum resistance to Cotrimoxazole (100%) followed by Penicillin (75%) and Cephalexin (50%) while Gram-negative organism to Norfloxacin (100%) followed by Cefixime (90.6%), Cotrimoxazole (80%) and Ceftriaxone (78.5%) among all antibiotics tested.

Conclusion: A wide spectrum of antimicrobial resistant bacterial agents are responsible for neonatal septicemia in our set up. A longitudinal surveillance program coupled with good infection control practices and rational use of antibiotics is important to reduce infection rate and ensure better therapeutic success.

Keywords: Neonatal septicemia, bacteriological profile, antimicrobial resistance, Nepal

Demonstration of Bacterial Biofilms in Chronic Otitis Media

Abstract

Objective: To establish the presence of biofilms in surgical tissue specimens from patients with chronic otitis media.

Material and Methods: 22 patients with chronic otitis media scheduled for tympanomastoid surgery were enrolled in this study between September 2007 and January 2008. Biopsies of the middle ear mucosa and cultures were taken at the time of surgery. Tissues were cultured using conventional methods for Haemophilus influenzae, Pseudomonas

aeruginosa, Streptococcus pneumoniae and Staphylococcus aureus. Bacteria identification was performed using the Becton Dickinson automatic identification system. Slime forming ability was tested on congo red agar for culture positive bacteria. The presence of icaA and icaD DNA

were detected by polymerase chain reaction using forward and reverse primers for icaA and icaD for staphylococcus aureus.

Results: 6 of 22 patients’ tissue specimens were culture-positive(72.7%). 5 Staphylococcus aureus and 11 Pseudomonas aeruginosa were identified on 16 specimens. Bacterial biofilms were present on 9 of 16(56.2%) culture-positive specimens. 2 of 5(40%) Staphylococcus aureus and 7 of 11(63.6%) Pseudomonas aeruginosa produced bacterial biofilms.

Conclusion: Pseudomonas aeruginosa was the most commonly bacteria in chronic otitis media. Biofilm forming ability was higher in Pseudomonas aeruginosa compared with other bacteries. The presence of biofilms on the mucosa of patients with chronic otitis media offers a possible cause of antimicrobial therapy failure.

source:  Mediterr J Otol 2008; 4: 64-68

Polymerase Chain Reaction (PCR) a diagnostic tool.

What is PCR?

Sometimes called "molecular photocopying," the polymerase chain reaction (PCR) is a fast and inexpensive technique used to amplify, or make many copies of, small segments of DNA. This is necessary because methods used for analyzing DNA (determining the DNA base pair sequence) require more DNA than may be in a typical sample. A particularly useful feature of PCR is that it allows the amplification process to be limited to specifically targeted segments of the DNA mixture--such as the Y chromosome markers used in genealogical testing.

When your vials of cheek cells arrive at the lab for testing, they are first mixed with a detergent which causes the cells to burst open and release their DNA along with other cell contents. The mixture is then washed with a phosphate containing buffer (mild salt) solution to dilute cellular debris. With minimal preparation, the sample is ready and the DNA on the targeted area of a chromosome can be amplified.

How does PCR work?

PCR is a process based on the ability of a DNA polymerase enzyme that can synthesize a complementary strand to a targeted segment of DNA in a test tube mixture of the four DNA base. In addition, the mixture must also contain two DNA fragments, each about 20 bases long, called primers, that have sequences complementary to areas adjacent to each side of the target sequence. (To do PCR, you need to know the DNA sequence around the region you want to amplify.) These primers can be constructed in the lab, or purchased from commercial suppliers. If chosen well, the 20-25 base pair sequence will be unique in the entire human genome so will match only the place specifically chosen thus limiting and defining the area to be copied.

The mixture is first heated to denature (separate) the sides of the double- stranded DNA and then cooled to allow (1) the primers to find and bind to their complementary sequences on the separated strands and (2) the polymerase to extend the primers into new complementary strands. Repeated heating and cooling cycles multiply the target DNA exponentially, since each new double strand separates to become two templates for further synthesis. In about 1 hour, 20 PCR cycles can amplify the target by a millionfold. In 32 cycles at 100% efficiency, 1.07 billion copies of targeted DNA region are created.

From: The National Human Genome Research Institute Office of Science Education and Outreach

The entire cycling process of PCR is automated and can be completed in just a few hours. It is directed by a machine called a thermocycler, which is programmed to alter the temperature of the reaction every few minutes to allow DNA denaturing and synthesis. To avoid the destruction of needed enzymes in the mixtures by the high temperatures needed to denature the DNA, enzymes from bacteria that thrive in hot springs are used for the process.


Why is PCR useful?

Once amplified, PCR products can be used in many different laboratory procedures; for example, most mapping techniques in the Human Genome Project rely on PCR.

PCR is also valuable in a number of newly emerging laboratory and clinical techniques, including DNA fingerprinting, detection of bacteria or viruses (particularly AIDS), and diagnosis of genetic disorders and preparing samples for genealogical DNA testing.

source: contexo.info

        nhgri.nih.gov

Tips for Effective PowerPoint Presentations

Fonts

1. Select sans-serif fonts such as Arial or Helvetica.  Avoid serif fonts such as Times New Roman or Palatino as they are sometimes more difficult to read.
2. Use no font size smaller than 24 point.
3. Clearly label each screen.  Use a larger font (35-45 points) or different color for the title.Use a single sans-serif font for most of the presentation.  
4. Use different colors, sizes and styles (bold, underline) for impact.
5. Avoid italicized fonts as they are difficult to read quickly.
6. No more than 6-8 words per line.
7. For bullet points, use the 6 x 6 Rule.  One thought per line with no more than 6 words per line and no more than 6 lines per slide.
8. Use dark text on light background or light text on dark background.  However, dark backgrounds sometimes make it difficult for some people to read the text. 
9. Do not use all caps except for titles.

To test the font, stand back six feet from the monitor and see if you can read the slide.

Graphics and Design

1. Keep the background consistent and subtle.
2. Use only enough text when using charts or graphs to explain clearly label the graphic.
3. Keep the design clean and uncluttered.  Leave empty space around the text and graphics.
4. Use quality clipart and use it sparingly.  The graphic should relate to and enhance the topic of the slide.
5. Try to use the same style graphics throughout the presentation (e.g. cartoon, photographs).
6. Limit the number of graphics on each slide.
7. Check all graphics on a projection screen before the actual presentation.
8. Avoid flashy graphics and noisy animation effects unless they relate directly to the slide.
9. Limit the number of transitions used.  It is often better to use only one so the audience knows what to expect.

Color

1. Limit the number of colors on a single screen.
2. Bright colors make small objects and thin lines stand out.  However, some vibrant colors are difficult to read when projected.
3. Use no more than four colors on one chart.
4. Check all colors on a projection screen before the actual presentation. They may project differently than what appears on the monitor.

General Presentation

1. Check the spelling and grammar.
2. Do not read the presentation.  Practice the presentation so you can speak from bullet points.  The text should be a cue for the presenter rather than a message for the viewer.
3. Give a brief overview at the start.  Then present the information.  Finally review important points.
4. It is often more effective to have bulleted points appear one at a time so the audience listens to the presenter rather than reading the screen.
5. Use a wireless mouse or pick up the wired mouse so you can move around as you speak.
6. If sound effects are used, wait until the sound has finished to speak.
7. If the content is complex, print out the slides so the audience can take notes.
8. Do not turn your back on the audience.  Try to position the monitor so you can speak from it.

 source: cheney268.com

Why study Microbiology?

WHAT IS MICROBIOLOGY?

Microbiology is the study of organisms of microscopic size, including bacteria, protozoa, viruses, and certain algae and fungi which affect every aspect of life on Earth. They have amazing diversity of form and can live in a wide range of habitats ranging from hot springs to the human body and the depths of the ocean. Although some microbes cause diseases, like measles, meningitis or AIDS, the majority are completely harmless. In fact these small life forms are essential to the cycling of nutrients in the ecosystems of the planet. If these processes did not occur, life on this planet would soon grind to a halt.
Activities of microbes can be harnessed in many ways to benefit humans, other animals, plants and the environment. Food, healthcare, chemical, and waste treatment industries rely heavily on the powers of microbes.
WHAT DO MICROBIOLOGISTS DO?

Microbiology is a vast subject which overlaps with other life sciences such as genetics, biochemistry, molecular biology and evenengineering. Microbiologists can be found at work in many different places, but they are normally based in a laboratory.
As there are many different types of microbes there are many different types of microbiologists: bacteriologists, mycologists (who study fungi) and virologists - all working within even smaller areas of specialisation; the variations are endless!

WHAT DOES IT TAKE TO BE A MICROBIOLOGIST?

Obviously you need to be interested in science and biology. An enquiring mind, a methodical approach and an enthusiasm for solving problems are equally important. You should be a good communicator, as you will need to describe your findings clearly to other people, and be able to work well as a part of a team. Scientists today seldom work alone and most are members of multi-disciplinary groups. In industry you will also have to liaise with staff from non-scientific departments.

WHERE DO MICROBIOLOGISTS WORK?

Industry

Food, pharmaceutical, agrochemical, biotechnological, biorefinery, environmental, pollution control and bioremediation, companies all need microbiologists to develop new products, monitor the production of existing ones and solve problems. 

In the Field

Agriculture - environmental and health specialists study the role of microbes in plant disease, pest control, nutrition and soil fertility, or monitor and control pollution and devise biological waste treatment approaches. The field of mariculture also relies on microbiologists to monitor production and solve problems.

Medicine & Health Care

Hospitals, public health laboratories, research institutes and pharmaceutical companies offer work in diagnosis, prevention and treatment of illnes.

source: nuigalway.ie

Enteric fever pathogens and their antimicrobial susceptibility pattern in Bharatpur, Nepal.

Acharya A¹, Nepal HP², Gautam R³ and Shrestha S⁴

 ¹Associate Professor, ^2,3,4Lecturer, Department of Microbiology, Chitwan Medical College Teaching Hospital, Bharatpur, Nepal.

             

ABSTRACT

Introduction:

Enteric fever is one of the common clinical conditions in patients presenting to the hospitals.  The study was carried out to assess the rate of isolation of common serotypes of enteric fever pathogens and their antimicrobial susceptibility pattern which is of utmost importance to institute effective therapy.

Methods:

A prospective study was carried out in the Department of Microbiology, Chitwan Medical College Teaching Hospital from 15^th June 2009 to 14^th June 2010. A total of 4355 blood culture samples from both admitted patients and outpatients of the hospitals were processed by standard microbiological technique to identify the causative agents and their susceptibility pattern to commonly used antimicrobial agents in compliance with CLSI guidelines.

Results:

Isolation rate of Salmonella species was 0.96%. Among a total of 42 Salmonella isolates, 24 (57.1%) isolates were Salmonella Paratyphi A and 18 (42.9%) were Salmonella Typhi. Male preponderances were seen in infections caused by both the organisms. On performing antimicrobial susceptibility by Kirby Bauer disc diffusion method, Salmonella Paratyphi A demonstrated 100% susceptibility to Amikacin, Chloramphenicol and Ofloxacin. Similarly, Salmonella Typhi was highly susceptible to Ceftriaxone (94.1%) followed by Ofloxacin (90.9%) and Cephotaxime (90%) and both were least susceptible to Ampicillin (S.Paratyphi A 21.7% and S.Typhi 29.4%). Multidrug resistance was found to be 16.66% among the Salmonella Typhi isolates.

Conclusion:

Isolation of Salmonella species is relatively low in Bharatpur. Salmonella Paratyphi A is the most common agent of enteric fever. Moreover, these pathogens have developed resistance to all commonly used antimicrobials.

Bacterial Involvement in Causing Lower Respiratory Tract Infection in Adults Visiting Tribhuvan University Teaching Hospital and their Antibiotic Susceptibility Pattern

Abstract

Introduction: Respiratory conditions impose enormous burden on society. Reports indicated that the top five respiratory diseases accounted for 17.4 percent of all deaths and 13.3 percent of all Disability-Adjusted Life Years (DALYs). Also, out of total acute respiratory disease, 20-24 percent of deaths are accounted for by Lower Respiratory Tract Infection (LRTI). In developing countries like Nepal the need for timely diagnosis of the cases and the administration of appropriate therapy based on the antibiotic susceptibility test of the causative agents is critical. However, emergence of resistant strains may occur during antibiotic therapy, which is one of the contributing factors for the increase in the frequency of LRTI in recent years in the adult population of Nepal as well.

 Objectives: The study was undertaken to have a better understanding on the current trend of microbial involvement in causing LRTI in adults and to determine the efficacy of antimicrobial agents in-use in treating the infections.

Method: A hospital based cross-sectional study was carried out from March 2002 to February 2003. Total 181 adults presenting with LRTI defined by a new or increasing cough, productive sputum, chest pain, fever, anorexia, haemoptysis, headaches and throat ache were enrolled with their consent. This is a prospective study which included bacteriological culture, microscopic examination and sensitivity testing of bacterial

isolates in vitro in Health Research laboratory following Standard Operating Procedures (SOPs).

Results: Lower Respiratory Infection was established in 75 cases (41.4%). Males (61.3%) were found more at risk to LRTI than females (38.7%). LRTI was found most prevalent in 50-59 year age groups (21.3%). Altogether 15 different types of bacteria were identified majority of which were Gram-negative bacteria (72.4%). Haemophilus influenzae was the commonest isolate at 23.0 percent followed by Klebsiella pneumoniae (18.3%). Among Gram- positive isolates Streptococcs pneumoniae was predominant (12.7%) followed by

Staphylococcus aureus(9.3%).The in vitro antibiotic susceptibility test of the isolates showed that Chloramphenicol(100%) was the most effective antibiotic against Gram-negative bacteria followed by Amikacin (79.1%) and Ciprofloxaxin (66.7%), and the least effective was Co-trimoxazole (20.6%). Similarly, for the Gram-positive bacteria Ciprofloxacin (79.2%) was the most effective antibiotic and the least effective was Co-trimoxazole.

Conclusion: The study shows increasing number of respiratory pathogens resistant to antimicrobials in-use to treat the infection.

Key words: LRTI, Antibiotic susceptibility pattern.

Source: Gauchan Pa, Lekhak B b and Sherchand JBc