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Bacteriology of neonatal septicaemia in a tertiary care hospital of northern India  [cached]
Roy I,Jain A,Kumar M,Agarwal S
Indian Journal of Medical Microbiology , 2002,
Abstract: To study the bacteriology of neonatal septicaemia in a tertiary care hospital of Northern India we prospectively enrolled all the suspected cases of neonatal septicaemia, which were not on antimicrobials. One to two millilitre of blood from these neonates was cultured in brain heart infusion broth. Out of 728 cases, 346 (47.5%) were positive on blood culture. The most frequent offender was Klebsiella spp. (24.5%) followed by Enterobacter spp. (22.8%). There was an overall predominance of gram negative organisms. Coagulase negative staphylococci (CONS) were more frequently isolated (16.5%) than Staphylococcus aureus (14%). More than 89% of the Staphylococci isolated were resistant to penicillin. None were resistant to vancomycin or teicoplanin. More than 95% of enterobacteria were resistant to anti gram negative penicillin group of drugs and more than 40% were resistant to extended spectrum cephalosporins. Ciprofloxacin and amikacin resistance was infrequent. Thus, initial therapy in our hospital may be aimed at Gram negative organisms and amikacin and ciprofloxacin may be used as first line drugs.
High prevalence of multidrug-resistant MRSA in a tertiary care hospital of northern India
Hare Krishna Tiwari, Darshan Sapkota, Malaya Ranjan Sen
Infection and Drug Resistance , 2008, DOI: http://dx.doi.org/10.2147/IDR.S4105
Abstract: h prevalence of multidrug-resistant MRSA in a tertiary care hospital of northern India Original Research (10189) Total Article Views Authors: Hare Krishna Tiwari, Darshan Sapkota, Malaya Ranjan Sen Published Date November 2008 Volume 2008:1 Pages 57 - 61 DOI: http://dx.doi.org/10.2147/IDR.S4105 Hare Krishna Tiwari1, Darshan Sapkota2, Malaya Ranjan Sen1 1Department of Microbiology, Institute of Medical Sciences, Banaras Hindu University, Varanasi, UP, India; 2Department of Microbiology, Universal College of Medical Sciences, Bhairahawa, Nepal Abstract: Methicillin-resistant Staphylococcus aureus (MRSA) is an important nosocomial and community pathogen. The objectives of this study were to estimate the prevalence of multidrug-resistant MRSA strains in clinical specimens and to investigate the sensitivity pattern of these strains against various antibiotics used for treating hospitalized and out patients. Strains were identified using standard procedures, and their sensitivity pattern was investigated using such techniques as disc diffusion, minimum inhibitory concentration (MIC), and the mecA gene PCR. Among 783 isolates of S. aureus, 301 (38.44%) were methicillin-resistant, of which 217 (72.1%) were found to be multidrug-resistant. Almost all MRSA strains were resistant to penicillin, 95.68% were resistant to cotrimoxazole, 92.36% were resistant to chloramphenicol, 90.7% were resistant to norfloxacin, 76.1% were resistant to tetracycline, and 75.75% were resistant to ciprofloxacin. Vancomycin was the most effective drug, with only 0.33% of MRSA strains being resistant to it. It is concluded that antibiotics other than vancomycin can be used as anti-MRSA agents after a sensitivity test so as to preclude the emergence of resistance to it and that prevailing problems in chemotherapy will escalate unless indiscriminate and irrational usage of antibiotics is checked.
Prescribing pattern of antibiotics in the department of pediatrics in a tertiary care medical college hospital in Northern India  [PDF]
Ravika Kanish, Kanchan Gupta, Shivani Juneja, HS Bains, Sandeep Kaushal
Asian Journal of Medical Sciences , 2014, DOI: 10.3126/ajms.v5i4.10213
Abstract: Background: Systemic antibiotics account for more than one?third of all prescriptions in children; hence, antibiotic prescriptions in children are a major public health concern. Moreover, data regarding rational antibiotic use in children is very limited. Hence, it is essential that the antibiotic prescribing pattern be evaluated periodically for its rationality of use and cost. The aim of our study is to identify the prescribing pattern and to carry out direct cost analysis of antibiotic use in the patients admitted in pediatrics department of a tertiary care hospital of North India. Methods: The study was conducted for two months (June, July, 2012) in pediatric ward and ICU. The data regarding patient demographics and antibiotic use was collected daily in a structured proforma. A descriptive analysis of the data was done. Results: A total of one hundred and ninety one patients were enrolled, most of them belonging to the age group 2?14 years. Majority of them were male pediatric patients (75.9%) with mean age of 4.6 years. On an average 1.9 AMAs were prescribed per patient. The most common AMAs prescribed were cephalosporins followed by aminoglycosides. The preferred route of administration was injectable (92%). The average direct cost of treatment per patient was estimated to be Rs. 3338. The percentage of drugs prescribed by generic name was 58%. Conclusions: Male pediatric patients have better access to tertiary medical care as compared to female pediatric patients. The average number of anti?microbials prescribed is 1.9 which is not too high. Newer generation of antibiotics are more commonly prescribed leading to increased cost of therapy. This baseline study will help in formulating an antibiotic policy and standard treatment guidelines for appropriate use of antibiotics. DOI: http://dx.doi.org/10.3126/ajms.v5i4.10213 Asian Journal of Medical Sciences 2014 Vol.5(4); 69-72
High prevalence of multidrug-resistant MRSA in a tertiary care hospital of northern India  [cached]
Hare Krishna Tiwari,Darshan Sapkota,Malaya Ranjan Sen
Infection and Drug Resistance , 2008,
Abstract: Hare Krishna Tiwari1, Darshan Sapkota2, Malaya Ranjan Sen11Department of Microbiology, Institute of Medical Sciences, Banaras Hindu University, Varanasi, UP, India; 2Department of Microbiology, Universal College of Medical Sciences, Bhairahawa, NepalAbstract: Methicillin-resistant Staphylococcus aureus (MRSA) is an important nosocomial and community pathogen. The objectives of this study were to estimate the prevalence of multidrug-resistant MRSA strains in clinical specimens and to investigate the sensitivity pattern of these strains against various antibiotics used for treating hospitalized and out patients. Strains were identified using standard procedures, and their sensitivity pattern was investigated using such techniques as disc diffusion, minimum inhibitory concentration (MIC), and the mecA gene PCR. Among 783 isolates of S. aureus, 301 (38.44%) were methicillin-resistant, of which 217 (72.1%) were found to be multidrug-resistant. Almost all MRSA strains were resistant to penicillin, 95.68% were resistant to cotrimoxazole, 92.36% were resistant to chloramphenicol, 90.7% were resistant to norfloxacin, 76.1% were resistant to tetracycline, and 75.75% were resistant to ciprofloxacin. Vancomycin was the most effective drug, with only 0.33% of MRSA strains being resistant to it. It is concluded that antibiotics other than vancomycin can be used as anti-MRSA agents after a sensitivity test so as to preclude the emergence of resistance to it and that prevailing problems in chemotherapy will escalate unless indiscriminate and irrational usage of antibiotics is checked.Keywords: multidrug-resistant MRSA, prevalence, India
Prevalence and Determinants of Vaginal Discharge among Women of Reproductive Age Group in Tertiary Care Hospital of Northern India  [PDF]
Varsha Chaudhary, Rajeev Kumar, Vijender K Agrawal, Arun Singh, Ramesh Narula, Mahendra Sharma
National Journal of Community Medicine , 2012,
Abstract: Background: The complaint of vaginal discharge is very common, particularly in south East Asia it is associated with considerable disability, health seeking, and associated costs. Objective: To estimate the hospital based prevalence of vaginal discharge, to find out socio-demographic variables associated with the complaint of vaginal discharge, perceived causes of vaginal discharge and association of vaginal discharge with other gynaecological problems among the women of reproductive age. Methods: The present cross sectional study was conducted in one of the tertiary care hospital of Bareilly district. The respondent were the female in reproductive age group (15-49yrs) attending Obst. & gynae OPD. Sample size of 590 was calculated, for sample to be more representative of population, a total of 1100 female in reproductive age group were included in the study. . Odds ratio (OR) and their 95% confidence interval (CI) were calculated to estimate the strength of association between vaginal discharge and other gynaecological symptoms. Chi square test was applied as test of significance for data analysis. Results: Prevalence of vaginal discharge was found to be 24.6%. Factors like increasing age, married (26.2%), illiteracy (60.1%), Muslim religion (28.7%), low socioeconomic status, high parity, history of induced abortion and place of delivery were found to be significantly associated with vaginal discharge. Internal gynaecological problem was perceived as a main cause for vaginal discharge (73.3%). Vaginal discharge was found to be significantly associated with other gynaecological problems. Recommendation: There is need for creating community awareness about health care facilities and instills self concern in women for their own health needs.
Relevance of opt-out screening for HIV in emergency and pre-surgery patients in a tertiary care center in Northern India: A pilot study  [cached]
Minz Ranjana,Singh Surjit,Varma S,Mathuria S
Indian Journal of Pathology and Microbiology , 2010,
Abstract: Objective: A preliminary opt-out screening study for HIV was conducted in a tertiary care hospital in India according to Center for Disease Control (CDC) guidelines. A total of 876 cases were screened for HIV during August 2007 to December 2007 using tests approved by the National AIDS Control Organization (NACO). Results: Data indicates that the prevalence of HIV in emergency and pre-surgical setting was 21 per thousand at the tertiary care center. Positivity rate in the pediatric population was 20.9 per thousand while in adults it was 21.4 per thousand. Most patients were totally unsuspected. Nearly 40000 patients seek admission annually to the emergency department alone. Thus nearly 700 to 800 patients may be missed every year if one does not resort to such a practice. Conclusion: Since India has the second largest number of HIV cases in the world, opt-out screening program and testing in an emergency setting, as recommended by CDC, is extremely relevant. Logistics of implementation of this policy need to be worked out at a national level.
Prevalence of parafunctional habits and temporomandibular dysfunction symptoms in patients attending a tertiary headache clinic
Fragoso, Yára Dadalti;Alves, Heloísa Helena Carvalho;Garcia, Sidney Oliveira;Finkelsztejn, Alessandro;
Arquivos de Neuro-Psiquiatria , 2010, DOI: 10.1590/S0004-282X2010000300009
Abstract: objetive: to investigate the most prevalent forms of headache in a tertiary outpatient service, and to assess the frequency of associated parafunctional habits and temporomandibular dysfunction symptoms (tmd). method: all new patients referred to the headache outpatient service in unimes during 2008 were prospectively assessed by the neurologist and the dental surgeon. results: eighty new patients were assessed; chronic migraine and episodic migraine without aura were the most prevalent conditions, accounting for 66.3% of all cases. there was significantly higher use of analgesics/days for the chronic migraine patients. the prevalence of parafunctional habits was 47.5% and the prevalence of tmd symptoms was 35%. conclusion: the high prevalence of primary headaches, parafunctional habits and tmd symptoms and the inadequate use of analgesic drugs suggest that primary healthcare units need further training in the field of headache and orofacial pain.
Outcome of combined modality treatment including neoadjuvant chemotherapy of 128 cases of locally advanced breast cancer: Data from a tertiary cancer center in northern India  [cached]
Raina V,Kunjahari M,Shukla N,Deo SVS
Indian Journal of Cancer , 2011,
Abstract: Background: Breast cancer is now the most common cancer in many parts of India and the incidence varies from 12 to 31/100000, and is rising. Locally advanced breast cancer (LABC) accounts for 30 - 35% of all cases of breast cancers in India. LABC continues to present a challenge and imposes a major health impact in our country. Materials and Methods: We carried out a analysis of our LABC patients who received neoadjuvant chemotherapy (NACT) at our hospital over a 10-year period, from January 1995 to December 2004. We analyzed the response to NACT, disease-free survival (DFS), and overall survival (OS). Results: Patients with stages IIIA, IIIB, and IIIC were included. LABC comprised of 26.24% (609 patients) of new patients. One hundred and twenty-eight (31.1%) patients received NACT. Median age was 48 years and estrogen receptor was positive in 64%. Chemotherapy protocol was an FEC (5-Fluorouracil, Epirubicin, Cyclophosphamide) regimen in the following doses: Cyclophosphamide 600 mg/m2, 5-FU 600 mg/m2, and Epirubicin 75 mg/m2 given every three weeks, six doses, followed by modified radical mastectomy (MRM) and locoregional radiotherapy. The overall response rate (complete response (CR) + partial response (PR)) was 84.4%, clinical CR (cCR) was 13.3% and pathological CR (pCR) was 7.8%. Median DFS and OS were 33 and 101 months, respectively. The disease-free survival (DFS) and overall survival (OS) at five years were 41 and 58%, respectively. Conclusions: This study analyzes the outcome in patients who received NACT, in the largest number of LABC patients from a single center in India, and our results are comparable to the results reported from other centers.
Relative frequency of headache types: a longitudinal study in the tertiary care
Silva-Júnior, Ariovaldo Alberto da;Faleiros, Bruno Engler;Santos, Tales Michel dos;Gómez, Rodrigo Santiago;Teixeira, Ant?nio Lúcio;
Arquivos de Neuro-Psiquiatria , 2010, DOI: 10.1590/S0004-282X2010000600009
Abstract: in order to properly assess patients with primary headache, one needs to follow the cases up longitudinally. in brazil, there were no studies using this methodology published after the publication of the latest issue of the international classification of headaches in 2004 - ichd-2. this is especially important when we consider that it was only after such publication that we had the criteria used to classify some types of headaches which evolve with daily, or almost daily, spells, and which are very common in tertiary health care centers. objective: to assess the frequency of headache types in a tertiary health care center, in a longitudinal fashion. method: we assessed 95 consecutive patients. these patients were diagnosed and classified according to the icdh-2. the subjects were followed up for 18 months, they were treated and reassessed. results: most of the individuals had more than one type of headache. among those with episodic migraine in 2007, 6 developed chronic migraine in 2008, producing an incidence rate of 7.2%. among those with chronic migraine in 2007, 9 remitted, producing a remission rate of 75%. in 2007, 24 individuals abused analgesic agents and 17 no longer showed abuse criteria in 2008 - when 7 new cases were found. conclusion: the diagnosis of migraine remained stable. on the other hand, treatment brought about a reduction in the frequency of headaches caused by excessive use of analgesic, although the frequency of daily chronic headache was almost unaltered.
Hand hygiene amongst dental professionals in a tertiary dental clinic
J.J Omogbai, C.C Azodo, A.O Ehizele, A Umoh
African Journal of Clinical and Experimental Microbiology , 2011,
Abstract: Objective: To evaluate hand washing attitude and practices among Dentists and Dental Students treating patients in a Nigerian Tertiary Dental Clinic. Materials and Methods: A cross-sectional survey of Dentists and Dental Students treating patients in University of Benin Teaching Hospital was conducted between February and March 2010. Data collection tool was a 28-item, self-administered questionnaire, which elicited information on demography, handwashing practices, material used for handwashing, methods ofdrying hands after washing, attitudes towards prevention of spread of infection by handwashing measures in dental practice, barrier to regular hand washing, information need on handwashing and mode in which they would desire to receive the needed information. Results: One-quarter (25.7%) of the respondents washes their hands before wearing gloves and 98.1% wash their hands when they are visibly soiled. Less than half (46.7%) washed their hand when the worn gloves are torn. Majority strongly agreed that hand washing helps to prevent transmission of infection to patients (91.4%), health workers (92.4%) and health workers family members (89.5%). The main barriers to regular hand hygiene were inadequate facilities, forgetfulness and lack of time. About 69.5% desired more information on hand hygiene with the most indicated area of information needs being the indications and steps in hand washing in form of seminars and pamphlets. Conclusion: This study revealed positive attitude to hand washing, inadequate hand washing practices and poor monitoring of hand hygiene in the health institution. The studied dental professionals however know that hand washing plays an important role in the prevention of cross infection.
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