Clinical efficacy and tolerability of 1.5 g/day oral amoxicillin therapy without probenecid for the treatment of syphilis

2021 ◽  
pp. sextrans-2020-054823
Author(s):  
Kazuhiko Ikeuchi ◽  
Kazuaki Fukushima ◽  
Masaru Tanaka ◽  
Keishiro Yajima ◽  
Akifumi Imamura
Keyword(s):  
Clinical Efficacy ◽  
Treatment Duration ◽  
Tertiary Care ◽  
Treponema Pallidum ◽  
Latex Agglutination ◽  
Hiv Treatment ◽  
Penicillin G ◽  
Care Hospital ◽  
Clinical Records ◽  
Latent Syphilis

ObjectivesIntramuscular benzathine penicillin G is not available in certain countries. In a previous report, 3 g/day amoxicillin with probenecid was shown to be effective in treating syphilis in patients with HIV; however, 7.3% of patients changed their therapy owing to adverse events. The objective of this study was to assess the clinical efficacy and tolerability of 1.5 g/day amoxicillin without probenecid for the treatment of syphilis.MethodsThe routine clinical records of patients diagnosed with syphilis and treated with 1.5 g/day amoxicillin at a tertiary care hospital between 2006 and 2018 were retrospectively analysed. Syphilis was diagnosed if serum rapid plasma reagin (RPR) titres were ≥8 RU and the Treponema pallidum latex-agglutination test was positive. Serological cure was defined as a ≥fourfold decrease in the RPR titre within 12 months in symptomatic early syphilis and within 24 months in latent syphilis.ResultsOverall, 138 patients (112 with HIV) were analysed. The percentages of primary, secondary, early latent, late latent and latent syphilis of unknown duration were 8.0%, 50.0%, 25.4%, 5.8% and 10.9%, respectively. The median treatment duration was 4.5 weeks (IQR 4–8 weeks), which was not related to the stage of syphilis. Two patients (1.5%) changed treatment due to skin rash. The rate of serological cure was 94.9% (131/138; 95% CI 89.8% to 97.9%) overall; 93.8% (105/112; 95% CI 87.5% to 97.5%) in patients with HIV and 100% (26/26; 95% CI 86.8% to 100%) in patients without HIV. Treatment duration was not related to the treatment efficacy.ConclusionThe regimen of 1.5 g/day amoxicillin without probenecid is highly effective with a low switch rate in patients with and without HIV.

scholarly journals Prevalence and antibiotic susceptibility of Streptococcus pyogenes isolated from pyoderma in a tertiary care hospital, Hyderabad, South India

2021 ◽  
Vol 8 (4) ◽  
pp. 274-278
Author(s):  
Pendru Raghunath ◽  
L N Rao Sadanand
Keyword(s):  
Teaching Hospital ◽  
Antibiotic Susceptibility ◽  
Group A Streptococcus ◽  
Tertiary Care ◽  
Great Majority ◽  
Latex Agglutination ◽  
Penicillin G ◽  
Diffusion Method ◽  
Care Hospital ◽  
Chloramphenicol Resistance

Pyoderma is a common acute superficial bacterial skin infection which is highly contagious. In the great majority of cases, pyoderma is caused by , , or both. The present study was carried out to determine the prevalence and antibiotic susceptibility of isolated from pyoderma in Dr. VRK Women’s Teaching hospital. Swabs or pus samples were collected from 250 patients attending Dermatology, outpatient department (OPD) of Dr. VRK Women’s Teaching hospital. Samples were inoculated onto 5% sheep blood agar plates and incubated for 24 h at 37°C in a candle jar. BHS isolates were phenotypically identified by standard microbiological techniques, all the isolates presumptively identified as BHS were tested for Bacitracin susceptibility. Presumptive identification of a strain as a Group A Streptococcus (GAS) was also made by PYRase test. Presumptively identified GAS isolates were serogrouped by Lancefield grouping using a commercially available latex agglutination test. isolates were subjected to antimicrobial susceptibility testing by Kirby-Bauer disc diffusion method. BHS were isolated from 30% of samples. Prevalence of BHS was more among 0-10 years age group (38%). BHS were isolated more frequently from males (38.8%). were isolated from 52 (20.8%) samples. All 52 isolates were found to be susceptible to Penicillin G, amoxicillin, ceftriaxone, azithromycin and vancomycin. Erythromycin and clindamycin showed good activity with sensitivity rates of 92.3% & 96.1%, respectively. Resistance to tetracycline (59.6%) and chloramphenicol (23.1%) was commonly seen in . This study reports the prevalence and antibiotic susceptibility of isolated from pyoderma in Dr. VRK Women’s Teaching hospital. Results of this study suggests the peak incidence of pyoderma in children aged 0 to 10 years and male preponderance. Our study also reports high prevalence of tetracycline and chloramphenicol resistance in .

scholarly journals A STUDY ON ADVERSE DRUG REACTIONS IN PATIENTS ON ANTIRETROVIRAL THERAPY IN A TERTIARY CARE HOSPITAL AT JAIPUR, RAJASTHAN

2021 ◽  
Vol 5 (8) ◽  
Author(s):  
Vishnu Gupta ◽  
Abhishek Agarwal
Keyword(s):  
Nervous System ◽  
Peripheral Nervous System ◽  
Early Recognition ◽  
Tertiary Care ◽  
Hiv Treatment ◽  
Research Review ◽  
Care Hospital ◽  
Medical College ◽  
The Status ◽  
Definition Of

Background: The present study was conducted to know the status of ADRs caused due to the first line ART in the ART center of SMS Hospital Jaipur, Rajasthan. This study would be beneficial to the HIV infected patients, with the ultimate goal of improving the tolerability and effectiveness of HIV treatment by promoting the early recognition of potentially serious adverse effects. Methods: Hospital based Prospective, Observational study conducted after approval by research review board and ethics committee SMS Medical College Jaipur (Rajasthan). WHO definition of ADR was used (any response to a medicine which is noxious and unintended and which occurs at doses normally used in man). The detail of ADRs collected including suspected drug involved, treatment given for ADRs and outcome. Results: Majority of ADRs were related to central and peripheral nervous system related 55 (47%) followed by gastro intestinal 28 (23.9%), dermatological 15 (12.8%), musculoskeletal 9 (7.7%) and metabolic 5 (4.3%). Conclusion: Majority of ADRs were related to central and peripheral nervous system related followed by gastro intestinal. Keywords: ADRs, HIV, WHO.

scholarly journals Prevalence and the risk factors for the carriage of beta-haemolytic streptococci among women visiting a tertiary care hospital in South India

2021 ◽  
Vol 8 (4) ◽  
pp. 308-312
Author(s):  
Pendru Raghunath ◽  
LN Rao Sadanand
Keyword(s):  
Risk Factors ◽  
Teaching Hospital ◽  
Tertiary Care Hospital ◽  
Tertiary Care ◽  
Latex Agglutination ◽  
Research Centre ◽  
Care Hospital ◽  
Microbiological Techniques ◽  
History Of ◽  
Group B

Streptococci are gram positive cocci arranged in chains and are part of normal flora of humans and animals. The present study is carried out to determine the prevalence and risk factors for the carriage of beta-haemolytic streptococci (BHS) among women visiting Dr. VRK Women’s Teaching Hospital & Research Centre, Hyderabad. Vaginal swabs were collected from 250 patients attending outpatient department (OPD) of Dr. VRK Women’s Teaching hospital. Swabs were inoculated onto 5% sheep blood agar plates and incubated for 24 h at 37°C in a candle jar. BHS isolates were phenotypically identified by standard microbiological techniques, all the isolates presumptively identified as BHS were tested for Bacitracin susceptibility. Sensitive isolates were presumptively identified as GAS and resistant isolates were identified as non-group A BHS (NGABHS). Presumptively identified GAS & NGABHS isolates were serogrouped by Lancefield grouping using a commercially available latex agglutination test. BHS were isolated from 12.4% of samples. As many as 12 BHS isolates were identified as GAS and 19 were identified as NGABHS. Ten of nineteen were identified as group B (GBS), 4 (12.9%) were identified as group C (GCS) and 5 (16.12%) were identified as group G (GGS). Among six clinical groups, the prevalence of GAS is highest i.e. 7.5% in female patients visiting Gynaecology OPD with history of white discharge. Prevalence of NGABHS was more among post insertion (18%) IUCD group compared to pre insertion (8%) IUCD group. GBS were isolated from 7% of samples from IUCD group and 4% of samples from prostitutes.This study reports the prevalence of BHS among women visiting a tertiary care hospital in Hyderabad. This study also identified certain risk factors such as IUCD usage and working as a FSW are associated with the increased prevalence of NGABHS especially GBS.

The rise and fall of epidemic Neisseria meningitidis from a tertiary care hospital in Delhi, January 2005–June 2007

2008 ◽  
Vol 38 (4) ◽  
pp. 222-224 ◽  
Author(s):  
Surinder Kumar ◽  
Bineeta Kashyap ◽  
Preena Bhalla
Keyword(s):  
Neisseria Meningitidis ◽  
Tertiary Care Hospital ◽  
Tertiary Care ◽  
Latex Agglutination ◽  
Meningococcal Meningitis ◽  
Agglutination Test ◽  
Latex Agglutination Test ◽  
Care Hospital ◽  
Gram Staining ◽  
Health Goals

Meningococcal meningitis is endemic in India. There has been a sudden surge of cases of meningococcal meningitis in 2005 in Delhi. Present study was undertaken to find out changing trends in incidence of this disease from a tertiary care hospital in New Delhi over a period of two and half years. All samples from suspected cases of meningococcal meningitis were subjected to Gram staining, culture and latex agglutination test for detection of Neisseria meningitidis ( N.meningitidis). Antimicrobial susceptibility of all isolates was performed using the disc diffusion test. 78.6%, 71.4% and 100% of the samples were positive for N.meningitidis by smear examination, culture and latex agglutination test respectively. Except for resistance to Penicillin and Erythromycin in 8.8% and 5.9%, the isolates were sensitive to the commonly used antibiotics. Using simple, rapid and reliable methods for diagnosis, defining risk factors and continuing surveillance remain important public health goals for the control of meningococcal disease.

Compliance with Postexposure Screening and Treatment of Latent Tuberculosis Infection among Healthcare Workers in a Tertiary Care Hospital in Saudi Arabia

2014 ◽  
Vol 35 (2) ◽  
pp. 176-181 ◽  
Author(s):  
Hanan H. Balkhy ◽  
Thaddeus L. Miller ◽  
Saira Ali ◽  
Jennifer B. Nuzzo ◽  
Karine Kentenyants ◽  
...  
Keyword(s):  
Saudi Arabia ◽  
Healthcare Workers ◽  
Tertiary Care ◽  
Latent Tuberculosis ◽  
Care Hospital ◽  
Respiratory Therapists ◽  
Occupationally Exposed ◽  
Medical City ◽  
Latent Tb Infection ◽  
Clinical Records

Background.Controlling tuberculosis (TB) infection among occupationally exposed healthcare workers (HCWs) may be challenging.Methods.We retrospectively reviewed clinical records of HCWs who were exposed to patients diagnosed with infectious TB at King Abdulaziz Medical City, Riyadh, Saudi Arabia, between 2008 and 2010. The collected data included baseline tuberculin skin test (TST) status, potential predictors of TST positivity, postexposure diagnosis of latent TB infection (LTBI), and postexposure compliance with LTBI therapy.Results.Thirteen patients were diagnosed with infectious pulmonary TB during the study period. A total of 298 HCWs met our definition for exposure. Exposed HCWs tended to be female (62.9%), non-Saudi (83.9%), nurses (68.6%), or respiratory therapists (24.0%) working in critical care locations (72.8%). Baseline (preemployment) TST documentation existed for 41.3% (123/298). Among those with documented baseline TSTs, 51.2% (63/123) were positive, representing 21.1% (63/298) of all HCWs. Only 48.9% (115/235) of exposed HCWs who had negative or unknown preexposure TST status had their TST tested after exposure. Approximately 46.1% (53/115) of them were diagnosed with postexposure LTBI, and 92.5% (49/53) of them were prescribed LTBI therapy. Among those, 93.9% (46/49) started LTBI therapy; however, 82.6% (38/46) failed to complete the recommended course.Conclusions.We found low rates of baseline TST documentation and postexposure screening among exposed HCWs. Compliance with initiating postexposure isoniazid prophylaxis among HCWs was fair, but only a small fraction of those who started prophylaxis completed the recommended course of therapy. These findings suggest substantial opportunities to implement administrative measures to enhance LTBI management among HCWs.

scholarly journals Study of symptomatology and presentations of COVID-19 in pregnancy at a tertiary care hospital

2020 ◽  
Vol 9 (11) ◽  
pp. 4410
Author(s):  
Ankita M. Metkari ◽  
Tushar T. Palve
Keyword(s):  
Tertiary Care Hospital ◽  
Tertiary Care ◽  
Signs And Symptoms ◽  
Common Symptom ◽  
Care Hospital ◽  
Mild Disease ◽  
Moderate Disease ◽  
Different Populations ◽  
Clinical Records ◽  
In Pregnancy

Background: Objectives of this study were to study the incidence of SARS-CoV-19 positivity and the incidence of different signs and symptoms associated with COVID-19 in pregnancy and comparison of the same with studies done in different populations previously.Methods: In this retrospective study, antepartum and postpartum parameters were integrated into the clinical records and total 205 ANC and PNC SARS-CoV-19 positive patients were evaluated for the signs and symptoms of COVID -19 over 2 months.Results: In our study, of all patients tested SARS-CoV-19 positive only 14.65% were symptomatic and rest were incidentally tested positive on admission. Of the symptomatic patients 50% had breathlessness followed by fever (13.33%). 92% patients had mild disease; approximately 8% had moderate disease and 6 out of 205 patient needed ICU care.Conclusions: The present study shows that 85.35% SARS-CoV-19 positive ANC and PNC patients were asymptomatic while only 14.65% symptomatic with breathlessness being the most common symptom at our institute.

scholarly journals Implementation and adherence to the Bedside Paediatric Early Warning System (BedsidePEWS) in a pediatric tertiary care hospital

2020 ◽  
Author(s):  
Orsola Gawronski ◽  
Federico Ferro ◽  
Corrado Cecchetti ◽  
Marta Luisa Ciofi Degli Atti ◽  
Immacolata Dall'oglio ◽  
...  
Keyword(s):  
Early Warning ◽  
Tertiary Care ◽  
Vital Signs ◽  
Hospital Inpatient ◽  
Care Hospital ◽  
Transcutaneous Oxygen ◽  
Transcutaneous Oxygen Saturation ◽  
Clinical Records ◽  
Hospital Wards ◽  
Score Range

Abstract Background Escalation of care in deteriorating children admitted to hospital wards in relation to pediatric early warning scores has been rarely reported. The aim of this study is to examine adherence to the vital signs and BedsidePEWS escalation protocol at a large tertiary care children’s hospital.Methods This is a prospective observational study. A 6-month audit on adherence to BedsidePEWS was performed on the wards in 2018. Data on the frequency and accuracy of BedsidePEWS score calculations, escalation of patient observations, monitoring and medical reviews were recorded.Two research nurses performed weekly visits to the hospital wards to collect data on BedsidePEWS scores, medical reviews, type of monitoring and vital signs recorded. Data were described through means or medians according to the distribution. Inferences were calculated either with Chi-square, Student’s t test or Wilcoxon-Mann–Whitney test, as appropriate (P <0.05 considered as significant).Results A total of 522 Vital Signs (VS) and score calculations on 177 patient clinical records were observed from 13 hospital inpatient wards. Frequency of VS and score documentation occurred <3 times per day in 33% of the observations. Adherence to the VS documentation frequency according to the hospital protocol was observed in 54% for all patients; for children with chronic health conditions (CHC) it was significantly lower than children admitted for acute medical conditions (47%, P=0.006). The BedsidePEWS score was correctly calculated and documented in 84%, systolic blood pressure was recorded in 79% and temperature in 91% of the VS recording events. Patients within a 0-2 BedsidePEWS score range were all reviewed at least once a day by a physician. Only 50% of the patients in the 5-6 score range were reviewed within 4 hours and 42% of the patients with a score ≥7 within 2 hours. Transcutaneous Oxygen Saturation continuous monitoring was applied to 60% of the children at higher risk (BedsidePEWS ≥5).Conclusions Escalation of patient observations, monitoring and medical reviews matching the BedsidePEWS is still suboptimal. Children with CHC are at higher risk of lower compliance. Impact of adherence to predefined response algorithms on patient outcomes should be further explored.

scholarly journals How do repeat suicide attempters differ from first timers? An exploratory record based analysis

2016 ◽  
Vol 7 (01) ◽  
pp. 91-96 ◽  
Author(s):  
Vikas Menon ◽  
Shivanand Kattimani ◽  
Siddharth Sarkar ◽  
Kaliaperumal Mathan
Keyword(s):  
Stressful Life Events ◽  
Suicide Attempts ◽  
Short Form ◽  
Care Center ◽  
Tertiary Care ◽  
Clinical Variable ◽  
Care Hospital ◽  
Suicide Attempters ◽  
Clinical Records ◽  
Clinical Measures

ABSTRACT Background: Evidence indicates that repeat suicide attempters, as a group, may differ from 1st time attempters. The identification of repeat attempters is a powerful but underutilized clinical variable. Aims: In this research, we aimed to compare individuals with lifetime histories of multiple attempts with 1st time attempters to identify factors predictive of repeat attempts. Setting and Design: This was a retrospective record based study carried out at a teaching cum Tertiary Care Hospital in South India. Methods: Relevant data was extracted from the clinical records of 1st time attempters (n = 362) and repeat attempters (n = 61) presenting to a single Tertiary Care Center over a 4½ year period. They were compared on various sociodemographic and clinical parameters. The clinical measures included Presumptive Stressful Life Events Scale, Beck Hopelessness Scale, Coping Strategies Inventory – Short Form, and the Global Assessment of Functioning Scale. Statistical Analysis Used: First time attempters and repeaters were compared using appropriate inferential statistics. Logistic regression was used to identify independent predictors of repeat attempts. Results: The two groups did not significantly differ on sociodemographic characteristics. Repeat attempters were more likely to have given prior hints about their act (χ2 = 4.500, P = 0.034). In the final regression model, beck hopelessness score emerged as a significant predictor of repeat suicide attempts (odds ratio = 1.064, P = 0.020). Conclusion: Among suicide attempters presenting to the hospital, the presence of hopelessness is a predictor of repeat suicide attempts, independent of clinical depression. This highlights the importance of considering hopelessness in the assessment of suicidality with a view to minimize the risk of future attempts.

scholarly journals Prevalence of Syphilis among People living with HIV (PLHIV) attending a tertiary care hospital in coastal south India

2015 ◽  
Vol 6 (6) ◽  
pp. 77-79
Author(s):  
Deepak Madi ◽  
Basavaprabhu Achappa ◽  
Poonam Vernakar ◽  
Unnikrishnan Bhaskaran ◽  
John T Ramapuram ◽  
...  
Keyword(s):  
South India ◽  
Tertiary Care Hospital ◽  
Venereal Disease ◽  
Tertiary Care ◽  
Treponema Pallidum ◽  
Cross Sectional Study ◽  
Heterosexual Transmission ◽  
People Living With Hiv ◽  
Care Hospital ◽  
Cross Sectional

Background: Syphilis and HIV are both transmitted sexually so people can be infected with both diseases. Co-infection of syphilis and HIV alters the course of both the diseases. Venereal disease research laboratory (VDRL) test is a non-treponemal test, used commonly in Antiretroviral Therapy Centres (ART) in India to detect syphilis. The aim of our study was to determine the prevalence of syphilis in HIV-infected patients attending a tertiary care hospital using VDRL test. Materials and Methods: Using a cross-sectional study design 113 HIV positive patients were included. VDRL test was used to screen for syphilis. The collected data was analyzed using SPSS version 11.5. Results: Among the 113 patients screened 69(61%) were males and 44(39%) were females. Majority of the patients had acquired the disease through heterosexual transmission (92.9%). VDRL test was negative in all 113 patients. Conclusion: The seroprevalence of syphilis in coastal South India using VDRL is very less. Specific tests like Fluorescent Treponemal Antibody Absorption test (FTA-ABS) or Treponema pallidum hemagglutination Assay (TPHA) would be beneficial to detect asymptomatic syphilis in ART centers.DOI: http://dx.doi.org/10.3126/ajms.v6i6.11623  Asian Journal of Medical Sciences Vol.6(6) 2015 77-79

scholarly journals Implementation and adherence to the Bedside Paediatric Early Warning System (BedsidePEWS) in a pediatric tertiary care hospital

2020 ◽  
Author(s):  
Orsola Gawronski ◽  
Federico Ferro ◽  
Corrado Cecchetti ◽  
Marta Luisa Ciofi Degli Atti ◽  
Immacolata Dall'oglio ◽  
...  
Keyword(s):  
Early Warning ◽  
Early Warning System ◽  
Tertiary Care ◽  
Vital Signs ◽  
Warning System ◽  
Hospital Inpatient ◽  
Care Hospital ◽  
Clinical Records ◽  
Hospital Wards ◽  
Score Range

Abstract BackgroundClinical deterioration in children admitted to hospital wards often manifests through signs of increasing illness severity that may lead to unplanned Pediatric Intensive Care Unit admissions or cardiac arrest, if undetected. The Bedside Pediatric Early Warning System (BedsidePEWS) is a validated Canadian scoring system used at a large tertiary care children’ hospital to prevent critical illness and standardize the response to deteriorating children on the wards.MethodsA 6-month audit was performed to evaluate the use of the BedsidePEWS, escalation of patient observations, monitoring and medical reviews on the wards in 2018.Two research nurses performed weekly visits to the hospital wards to collect data on BedsidePEWS scores, medical reviews, type of monitoring and vital signs recorded. Data were described through means or medians according to the distribution. Inferences were calculated either with Chi-square, Student’s t test or Wilcoxon-Mann–Whitney test, as appropriate (P <0.05 considered as significant).ResultsA total of 522 Vital Signs (VS) and score calculations on 177 patient clinical records were observed from 13 hospital inpatient wards. Frequency of VS and score documentation occurred <3 times per day in 33% of the observations. Adherence to the VS documentation frequency according to the hospital protocol was observed in 54% for all patients; for children with chronic health conditions (CHC) it was significantly lower than children admitted for acute medical conditions (47%, P=0.006). The BedsidePEWS score was correctly calculated and documented in 84% of the observed VS documentation events. Systolic blood Pressure was recorded in 79% and Temperature in 91% of the VS recording events. Patients within a 0-2 BedsidePEWS score range were all reviewed at least once a day by a physician. Only 50% of the patients in the 5-6 score range were reviewed within 4 hours and 42% of the patients with a score ≥7 within 2 hours. Transcutaneous Oxygen Saturation continuous monitoring was applied to 60% of the children at higher risk (BedsidePEWS ≥5).ConclusionsEscalation of patient observations, monitoring and medical reviews matching the BedsidePEWS is still suboptimal. Children with CHC are at higher risk of lower compliance. Impact of adherence to predefined response algorithms on patient outcomes should be further explored.

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