scholarly journals Clinical Characteristics and Outcome of Staphylococcus aureus Prostate Abscess From Ten Years of Experience at a Tertiary Care Center

2019 ◽  
Vol 6 (10) ◽  
Author(s):  
Bryan Walker ◽  
Eric Heidel ◽  
Mahmoud Shorman
Keyword(s):  
Staphylococcus Aureus ◽  
Rare Complication ◽  
Care Center ◽  
Tertiary Care ◽  
Care Hospital ◽  
Risk Patients ◽  
History Of ◽  
A Site ◽  
Lost To Follow Up

Abstract Objective Prostatic abscess (PA) is an uncommon infection that is generally secondary to Escherichia coli and other members of the Enterobacteriaceae family. In recent years, although rare, more reports of Staphylococcus aureus (S. aureus) PA have been reported, especially with increasing reports of bacteremia associated with injection drug use (IDU). Method This was a retrospective review of adult patients admitted to a tertiary care hospital between 2008 and 2018 and who had a diagnosis of S. aureus PA. Results Twenty-one patients were included. The average age was 46 years. Fourteen (67%) patients presented with genitourinary concerns. Main risk factors included concurrent skin or soft tissue infections (52%), history of genitourinary disease or instrumentation (48%), IDU (38%), and diabetes mellitus (38%). Methicillin-resistant Staphylococcus aureus (MRSA) was identified in 57% and concomitant bacteremia in 81% of patients. Surgical or a radiologically guided drainage was performed in 81% of patients. Antibiotic treatment duration ranged from 3 to 8 weeks. Six patients were lost to follow-up. Clinical resolution was observed in the remaining 15 (81%) patients who had follow-up. Conclusions S. aureus PA continues to be a rare complication of S.aureus infections. In most published reports, MRSA is the culprit. In high risk patients with persistent bacteremia, physicians need to consider the prostate as a site of infection.

Nosocomial Transmission of Methicillin-Resistant Staphylococcus aureus: A Blinded Study to Establish Baseline Acquisition Rates

2003 ◽  
Vol 24 (6) ◽  
pp. 415-421 ◽  
Author(s):  
Joel T. Fishbain ◽  
Joseph C. Lee ◽  
Honghung D. Nguyen ◽  
Jeffery A. Mikita ◽  
Cecilia P. Mikita ◽  
...  
Keyword(s):  
Staphylococcus Aureus ◽  
Transmission Rate ◽  
Tertiary Care ◽  
Pediatric Intensive Care ◽  
Nosocomial Transmission ◽  
Surveillance Culture ◽  
Care Hospital ◽  
Average Hospital ◽  
Methicillin Resistant ◽  
History Of

AbstractObjective:To define the extent of nosocomial transmission of methicillin-resistant Staphylococcus aureus (MRSA) in patients admitted to a tertiary-care hospital.Design:A blinded, prospective surveillance culture study of patients admitted to the hospital to determine the transmission (acquisition) rate of MRSA Risk factors associated with the likelihood of MRSA colonization on admission were investigated.Setting:Tertiary-care military medical facility.Participants:All patients admitted to the medicine, surgery, and pediatric wards, and to the medical, surgical, and pediatric intensive care units were eligible for inclusion.Results:Five hundred thirty-five admission and 374 discharge samples were collected during the study period. One hundred forty-one patients were colonized with methicillin-susceptible S. aureus (MSSA) and 20 patients (3.7%) were colonized with MRSA on admission. Of the 354 susceptible patients, 6 acquired MRSA during the study for a transmission rate of 1.7%. Patients colonized with MRSA on admission were more likely to be older than non-colonized or MSSA-colonized patients, to have received antibiotics within the past year, to have been hospitalized within the prior 3 years, or to have a known history of MRSA. Patients acquiring MRSA had an average hospital stay of 17.7 days compared with 5.3 days for those who did not acquire MRSA. Pulsed-field gel electrophoresis of the 6 MRSA isolates from patients who acquired MRSA revealed 4 distinct band patterns.Conclusions:Most patients colonized with MRSA were identified on admission samples. Surveillance cultures of patients admitted may help to prevent MRSA transmission and infection.

scholarly journals Psychiatric Illnesses among the Patients Admitted for Self-poisoning in a Tertiary Care Hospital of Nepal

2013 ◽  
Vol 2 (1) ◽  
pp. 10-13 ◽  
Author(s):  
Ajay Risal ◽  
Pushpa Prasad Sharma ◽  
Rajkumar Karki
Keyword(s):  
Tertiary Care Hospital ◽  
Organophosphorus Compounds ◽  
Care Center ◽  
Tertiary Care ◽  
Psychiatric Evaluation ◽  
Care Hospital ◽  
Age Group ◽  
Psychiatric Illnesses ◽  
History Of ◽  
One Year

Background and Aims- Self-poisoning is the commonest mode of suicide in our part of the world. Patients attempting suicide by self-poisoning usually land up in the Emergency. They are admitted for management of medical complications and subsequently referred to Psychiatry for evaluation of possible Psychiatric illnesses. The aim of this study was to explore the patterns of psychiatric illnesses in the patients admitted for self-poisoning in a tertiary care center in Nepal. Methods- The study population included those patients who were admitted and being managed for self-poisoning and brought for psychiatric evaluation during the period of one year (1st June 2011- 30th June 2012) at Dhulikhel Hospital, Nepal. Each patient underwent a detailed psychiatric evaluation by a consultant psychiatrist once they were medically stable. Details including sociodemographic data, psychiatric diagnosis, and treatment offered and outcome was tabulated and analyzed using SPSS-16. Results- Among the total patients (N=100), 43 were in the age group 21-40 years, median age being 27.5. There was almost equal gender distribution. Majority was of Mongolian ethnicity, homemaker by occupation and married. More than 90% were single-attempters, suicidal attempt using organophosphorus compounds. Almost 50% had depression; family dispute (19%) and marital disharmony (17%) were the most common psychosocial precipitant. Conclusion- Patients with history of self-poisoning are commonly brought to the Emergency Department of any tertiary care hospital. It is widely prevalent on younger age group. It is usually by the use of Organophosphorus compound in our setting and most commonly associated with depression. Hence, psychiatric care is essential for these patients. Journal of Advances in Internal Medicine 2013;02(01):10-13 DOI: http://dx.doi.org/10.3126/jaim.v2i1.7630

scholarly journals A follow-up study on fertility and menstrual pattern in infertile patients after laparoscopy in a tertiary care hospital in Bangladesh

2020 ◽  
Vol 10 (2) ◽  
pp. 125-129
Author(s):  
Naushaba Tarannum Mahtab ◽  
Nusrat Mahmud ◽  
Tanzeem Sabina Chowdhury ◽  
TA Chowdhury ◽  
Tanjima Begum
Keyword(s):  
Diagnostic Laparoscopy ◽  
Tertiary Care ◽  
Care Hospital ◽  
Chi Square ◽  
Laparoscopic Ovarian Drilling ◽  
Ovarian Drilling ◽  
Chi Square Test ◽  
Menstruating Women ◽  
Lost To Follow Up

Background: Routine use of diagnostic laparoscopy for the evaluation of all cases of female infertility is under debate. Until now, laparoscopy has been widely used as a diagnostic and therapeutic means of treating infertility. This study investigates the fertility outcome for women 2 to 3 years after laparoscopic management. It assessed the benefit and effectiveness of both diagnostic and laparoscopic ovarian drilling regarding reproductive outcome and menstrual regularity. Methods: From May 2013 to November 2014, a total of 303 infertile women undergoing laparoscopy at BIRDEM Hospital, were asked to participate in the study. Sixty subjects were lost to follow up making the study sample size 243. Results: Mean age at the time of laparoscopy was 29.86 ± 4.6 (range 21 - 43) years, 61.7% of women (150 cases) were nulliparous, 38.3% (93 cases) had one child, abortion or ectopic pregnancy. From the time of index surgery to follow-up, 40.3% (98) of women who had tried to conceive had home pregnancy test positive and 25.5% (62) had a live birth following their surgery. Among these 62 subjects, 33 underwent Laparoscopic Ovarian Drilling (LOD) and other 29 had diagnostic laparoscopy along with or without other laparoscopic manipulations. A Chi-square test has revealed that there was significant increase in regularization of menstrual cycle among irregularly menstruating women after laparoscopy indicating regular ovulatory cycles. Conclusion: Laparoscopic procedures can lead to positive results while treating infertility as well as menstrual disturbances, thus establishing a defined position in current fertility practice. Birdem Med J 2020; 10(2): 125-129

scholarly journals Outcomes of pleural decortication in a tertiary care hospital of Telangana state

2020 ◽  
Vol 7 (4) ◽  
pp. 1009
Author(s):  
Madhusudan Kummari ◽  
Amaresh Rao Malempati ◽  
Surya S. Gopal Palanki ◽  
Kaladhar Bomma ◽  
Chakravarthy Goutham
Keyword(s):  
Postoperative Complications ◽  
Tertiary Care ◽  
Care Hospital ◽  
Medical Sciences ◽  
Air Leak ◽  
History Of ◽  
The Common ◽  
Lung Infections ◽  
Surgery Outcomes

Background: The objective of the study was to study the clinical profile, incidence of postoperative complications in patients undergoing pleural decortication.Methods: The subjects for the study were selected from the cases admitted in a single unit of Department of Cardiothoracic Surgery, Nizam’s Institute of Medical Sciences, Hyderabad during the period of 2016 to 2018 and due ethics committee approval was taken.  Collection of data is done from the database including admission record, ICU charts, discharge records and follow-up records. 50 patients underwent surgery. Outcomes and complications were analyzed for 3 years duration.Results: 50 patients were included in this study with different aetiologies that required pleural decortication. The average age of patients in our study was 34 years. Most patients in our study were male (80%) and had history of infection with tuberculosis (42%) and pyogenic (28%) infection. A few patients had history of trauma (12%). Most of the patients suffered from cough (88%), dyspnoea (74%), fever (82%) and haemoptysis (22%). The common postoperative complications we encountered were pleural air leak (37.5%) bleeding (25%) infection (25%) and recurrence (2%). Overall morbidity from pleural decortication was seen in 16 patients, and there was no mortality.Conclusions: The most common reason for pleural decortication is still empyema thoracis secondary to infection in the developing countries. Tuberculosis is still the most common cause leading to fibrothorax requiring pleural decortication followed closely by pyogenic lung infections and trauma.

scholarly journals Rhino Orbital Cerebral Mucormycosis in settings of Covid-19 infection: A Case Series of Thirteen Patients

2022 ◽  
Author(s):  
Rajesh Verma ◽  
Rajarshi Chakraborty ◽  
Keerthiraj DB ◽  
Kingzang Wangda ◽  
Veerendra Verma ◽  
...  
Keyword(s):  
Amphotericin B ◽  
Public Awareness ◽  
Tertiary Care ◽  
Case Series ◽  
Care Hospital ◽  
Imaging Features ◽  
Initial State ◽  
Northern India ◽  
History Of

Abstract Background Rhino-Orbital-Cerebral Mucormycosis (ROCM) is an important infectious disease encountered in huge number in this recent post-covid 19 era. An alteration in defence immune system during covid-19 illness, in the presence of uncontrolled hyperglycaemia has led to the new epidemic of ROCM especially in developing nations like India. Method This case series of thirteen patients illustrates the various clinical presentation, laboratorical parameters, imaging features and outcome of patients of ROCM admitted in a tertiary care hospital in Northern India. Result In our case series, a total of 13 newly diagnosed cases of Rhino-Orbital-Cerebral Mucormycosis were studied. History of covid-19 illness was observed in 7 cases (53.8%), use of steroid during Covid-19 illness was seen in 5 cases (38.5%), oxygen therapy was given in 4 cases (30.8%). Co-morbid state in the form of diabetes mellitus was present in 12 cases (92.3%) with mean duration 16.69 months with an important finding of 6 cases (46.2%) having new-onset diabetes; hypertension in present in 3 cases (23.1%). Magnetic resonance imaging of paranasal sinuses showed involvement of multiple sinuses in all the 13 cases(100%), including maxillary and ethmoidal sinuses, with frontal in 12 cases (92.3%), sphenoidal in 11 cases (84.6%), symmetric in 9 cases (69.2%), mastoiditis in 4 cases (30.8%), maxillary space involvement in 4 cases (30.8%), palatal involvement in 1 case (7.7%). Multi-speciality approach treatment was given in the liposomal amphotericin B therapy in all the patients along with thorough endo-nasal debridement done in all cases, transcutaneous retrobulbar amphotericin B in 6 cases (46.2%) with exenteration done in 7 patients (53.9%). At 3 months of follow-up, there was substantial clinical improvement in all the cases. Conclusion There should be definite emphasis on high suspicion of mucor clinically for early diagnosis and aggressive management at initial state of diagnosis for better outcome. The need for sustained proper glycemic control during covid 19 era along with judicious use of steroid and public awareness for early symptoms and manifestations of mucor can curb the magnitude of such potentially opportunistic epidemic to a substantial rate. The longer the infection remains undetected, the greater the devastation ROCM can impose, of which blindness is an important hazard.

scholarly journals Craniomegaly in Neonate and Infants Requiring Neurosurgical Intervention: An Experience at Tertiary Care Center

2022 ◽  
Author(s):  
Sangh Mittra ◽  
Hanuman Prasad Prajapati ◽  
Raj Kumar
Keyword(s):  
Head Circumference ◽  
Care Center ◽  
Tertiary Care ◽  
Dandy Walker Malformation ◽  
Improved Outcomes ◽  
History Of ◽  
The Mean ◽  
Walker Malformation ◽  
Age Range

Abstract Background The identification of neurosurgical causes of craniomegaly and early institution of therapy requires for better clinical and functional outcomes. Aims and Objectives The aim of this study was to evaluate the neurosurgical causes, managements, and outcomes of craniomegaly in neonate and infants. Materials and Methods The cases with a history of head enlargement from neonatal period were included in this study. Their causes, managements, and outcomes were recorded retrospectively during the period of January 2010 to February 2013, in neurosurgery department at SGPGIMS Lucknow, and June 2018 to June 2020, at UPUMS, Saifai, Etawah, UP, India. Results Out of 41 cases, there were 30 (73.14%) cases of hydrocephalus, 4 (9.76%) Dandy-Walker malformation, 2 (4.88%) subdural collection, 2 (4.88%) arachnoid cyst, 1 (2.44%) craniosynostosis, and 2 (4.88%) with tubercular meningitis. The age range of our cases was 18 to 178 days and the mean age was 102.54 ± 50.73. Preoperative head circumference range was 39 to 62 cm (mean: 55.27 ± 6.58cm). Majority of the cases (n = 32, 78.05%) were managed with ventriculoperitoneal shunt surgeries. Out of 41 cases, 33(80.49%) had improved outcomes, 7 (17.07%) stabilized, and mortality occurred in 1 (2.44%) case. Postoperatively, there was improvement in the head circumference (range: 39–60 cm and mean: 46.15 ± 5.83 cm) on 6 to 24 months (mean: 17.85 ± 5.18 months) of follow-up. Conclusion Hydrocephalus was the commonest neurosurgical cause of head enlargement in neonate and infants. Shunt surgery was the most common form of management of these cases. Early detection, institution of therapy, and periodic follow-up program for diagnosing and treating complications were the key to successful outcomes in these patients.

scholarly journals Is hormonal contraceptive risk for congenital malformation?

2019 ◽  
Vol 6 (4) ◽  
pp. 1784
Author(s):  
Prabhuswami Hiremath ◽  
R. P. Patange ◽  
J. A. Salunkhe ◽  
Vaishali R. Mohite ◽  
Prakash Naregal
Keyword(s):  
Congenital Malformation ◽  
Birth Control ◽  
Cleft Lip ◽  
Chromosomal Abnormalities ◽  
Care Center ◽  
Tertiary Care ◽  
Hormonal Contraceptives ◽  
Care Hospital ◽  
History Of ◽  
Birth Control Pills

Background: Little research is conducted in the safety of emergency contraceptives so the potential for developmental toxicity has not been evaluated.Methods: This hospital based descriptive study was conducted at tertiary care center, Krishna Hospital. Mothers who are diagnosed to have congenital birth defected fetus through antenatal examinations, delivered baby with diagnoses of congenital malformation, congenital malformed admitted neonates at Tertiary care hospital or came for reference services were assessed from September 2016 to August 2017.Results: The prevalence with number of birth, it is 1.4% and calculating with number of neonates admitted its prevalence rate is 5.3%. Overall in the hospital the prevalence noted is 0.2%. 283 mothers were diagnosed to have congenital malformation baby, among these, 264 (93.3%) mothers not had any history of birth control pills use and only 19 (6.7%) mothers stated that they used the birth control pills. Those used birth control pills in those 4 babies (1.4%) born with nervous system defects, 3 babies (1.1%) had cleft lip and cleft palate, and 2 (0.7%) babies had digestive system, musculoskeletal system and chromosomal abnormalities. Association between congenital malformation and history of Use of birth control pills shows strong association.Conclusions: The problem of conclusively proving a small increase in the incidence of rare abnormalities is very formidable. This may be due in part to the fact that the anomalies associated with hormonal contraceptives may occur primarily in those children who are predisposed genetically.

One Year Retrospective Study of Ocular Infection in a Tertiary Care Hospital from Timisoara

2018 ◽  
Vol 69 (10) ◽  
pp. 2910-2912
Author(s):  
Iulia Cristina Bagiu ◽  
Delia Ioana Horhat ◽  
Simona Popescu ◽  
Florin George Horhat ◽  
Ciprian Pilut ◽  
...  
Keyword(s):  
Staphylococcus Aureus ◽  
Staphylococcus Epidermidis ◽  
Care Center ◽  
Tertiary Care ◽  
Diffusion Method ◽  
Ocular Infection ◽  
Care Hospital ◽  
Exclusion Criteria ◽  
Ocular Infections ◽  
Department Of Ophthalmology

Eye is the most important sensory organ concerned with the perception of vision. Ocular infections are one of the common diseases of the eye. Ocular infections as blepharitis, conjunctivitis, canaliculitis, dacryocystitis, keratitis, scleritis, orbital cellulitis, endophthalmitis, panophthalmitis and other infections which are responsible for increased incidence of morbidity and blindness worldwide, their morbidity vary from self-limiting trivial infection to sight threatening infection. To identify the bacterial profile of ocular infections in patients attending Ophthalmology Department. After clinical diagnosis of ocular infection made by Ophthalmologist, specimens were collected with the help of Ophthalmologist. Samples like eyelid swab, pus from dacryocystitis, corneal scrapings, corneal swab, and tissue specimens from 189 patients attending Ophthalmology Department were analyzed from 01.01.2014 to 01.01.2015. Using predefined inclusion and exclusion criteria, samples were collected according to the standard protocol. Inclusion criteria: 1. Clinically diagnosed cases of ocular infections attending Outpatient Department and Inpatient Department of Ophthalmology, Tertiary Care Center from Timisoara 2. Patients not on antibiotics (systemic or either topical) will be included in the study. 3. Patients not responding to antibiotics. Exclusion criteria: 1. Non-infectious etiology of ocular diseases. The material was examined Gram staining. The specimens were cultured on sheep�s blood agar, Chocolate agar and MacConkey agar, Chapman agar, Sabouraud dextrose agar. Drug susceptibility was tested using disc diffusion method (Kirby Bauer).The most common bacterial pathogen isolated were Staphylococcus aureus (29.7%) followed by Staphylococcus epidermidis (22.1%), other organisms isolated are Streptococcus pneumonia (17.9%), Klebsiella spp. (6.3%), Escherichia coli (4.7%), Pseudomonas aeruginosa (3.4%). Among the opportunistic pathogens, Staphylococcus epidermidis, (22.1%) were the most common isolate followed by Staphylococcus saprophyticus (0.45%). Bacterial isolates were highly susceptible to Vancomycin (100%), Gentamicin (92.1%) among Gram positive organisms. The Gram negative organisms are highly susceptible to Tobramycin (95.4%) and Imipenem (87.9%). The study suggests that Staphylococcus aureus and Staphylococcus epidermidis are the most common etiological agents of Ocular infections. Most of the strains were sensitive to Vancomycin and Tobramycin. Persistent efforts should be put for continuous surveillance and epidemiological characterization which are imperative to treat and prevent morbidity and blindness of population at risk.

scholarly journals Neurological outcomes of untreated brainstem cavernous malformations in a prospective observational cohort and literature review

2021 ◽  
pp. svn-2020-000608
Author(s):  
Da Li ◽  
Jing-Jie Zheng ◽  
Jian-Cong Weng ◽  
Pan-Pan Liu ◽  
Ze-Yu Wu ◽  
...  
Keyword(s):  
Neurological Status ◽  
Neurological Deficits ◽  
Developmental Venous Anomaly ◽  
Cavernous Malformations ◽  
Neurological Outcomes ◽  
Scale Scores ◽  
Risk Patients ◽  
History Of ◽  
Lost To Follow Up

BackgroundHaemorrhages of brainstem cavernous malformations (CMs) can lead to neurological deficits, the natural history of which is uncertain. The study aimed to evaluate the neurological outcomes of untreated brainstem CMs and to identify the adverse factors associated with worsened outcomes.MethodsFrom 2009 to 2015, 698 patients (321 women) with brainstem CMs were entered into the prospective cohort after excluding patients lost to follow-up (n=43). All patients were registered, clinical data were collected and scheduled follow-up was performed.ResultsAfter a median follow-up of 60.9 months, prospective haemorrhages occurred in 167 patients (23.9%). The mean modified Rankin Scale scores at enrolment and at censoring time were 1.6 and 1.2. Neurological status was improved, unchanged and worsened in 334 (47.9%), 293 (42.0%) and 71 (10.2%) patients, respectively; 233 (33.4%) recovered to normal levels. Lesions crossing the axial midpoint (relative risk (RR) 2.325, p=0.003) and developmental venous anomaly (DVA) (RR 1.776, p=0.036) were independently significantly related to worsened outcomes. The percentage of worsened outcomes was 5.3% (18 of 337) in low-risk patients (neither DVA nor crossing the axial point) and increased to 26.0% (13 of 50) in high-risk patients (with both DVA and crossing the axial point). The percentage of worsened outcomes significantly increased as the number of prospective haemorrhages increased (from 1.5% (8 of 531, if 0 prospective ictus) to 37.5% (48 of 128, if 1 ictus) and 38.5% (15 of 39, if >1 ictus)).ConclusionsThe neurological outcomes of untreated brainstem CMs were improved/unchanged in majority of patients (89.8%) with a fatality rate of 1.7% in our cohort, which seemed to be favourable. Radiological features significantly predicted worsened outcomes. Our results provide evidence for clinical consultation and individualised treatment. The referral bias of our cohort was underlined.

scholarly journals Umbilical endometriosis in a 42 years old parous woman: A Case Report

2018 ◽  
Vol 28 (1) ◽  
pp. 48-51
Author(s):  
Mosammat Nargis Shamima ◽  
Mohd Alamgir Hossain ◽  
Shahela Jesmin ◽  
Nargis Jahan ◽  
Arpita Das
Keyword(s):  
Case Report ◽  
Tertiary Care ◽  
Previous History ◽  
Needle Aspiration ◽  
Care Hospital ◽  
History Of ◽  
Needle Aspiration Cytology ◽  
High Resolution Ultrasonography ◽  
Umbilical Endometriosis

Endometriosis is a common gynaecological condition and presents mainly with involvement of the pelvic organs. However umbilical endometriosis is uncommon. A correct differential diagnosis can be difficult and the use of epiluminescence and MRI is suggested for the accuracy of preoperative diagnosis. This case report was experienced at a tertiary care hospital at Rajshahi. The patient was 42 years old multigravid woman presented with umbilical swelling and pain during menstruation for last 6 years with cyclical bleeding from the umbilical region for same duration. The patient had regular menstrual bleeding since the time of menarche. The patient had no previous history of endometriosis, dysmenorrhea or dyspareunia. Physical examination showed a hyperpigmented tender paraumbilical swelling with bloody discharge through umbilicus. Clinical examination together with the use of high resolution ultrasonography and fine needle aspiration cytology led to an accurate pre-operative diagnosis of umbilical endometriosis. The surgical approach to umbilical endometriosis represented an important step in achieving a satisfying result. The lesion to be excised and adequate umbilical repositioning was done. The patient was asymptomatic at the follow-up visit (12 months after surgery). A natural-looking umbilicus was observed with minimal visible scars.TAJ 2015; 28(1): 48-51

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