scholarly journals STUDY OF CLINICO-RADIOLOGICAL PARAMETERS IN DIAGNOSIS OF PEDIATRIC TUBERCULOSIS AT TERTIARY CARE HOSPITAL

2021 ◽  
pp. 1-3
Author(s):  
Bhanu Desai ◽  
Rushi Patel ◽  
Yashvi Vijaykumar Dattani ◽  
Tamannaben Rameshbhai Ninama ◽  
Amay Himanshu Khara ◽  
...  

Background: Global TB burden in India in children is about 2.2 lakh per year, among which pulmonary TB is most common presentation. Childhood TB contributes to about 10-20% of all TB in high burden countries and accounting for 8-20% TB related deaths. Children up to 14 years constitute about 35% of the population in our country and are expected to contribute about 10% of the case load. In order to achieve ‘Zero death by TB’, additional focus has to be directed towards TB in children. Paediatric clinical feature is variable in tuberculosis. Many cases of primary TB infection in children are asymptomatic and remain completely unnoticed or accidentally discovered at a later stage. In this study we looked for clinical and radiological presentation of childhood TB and its correlation in diagnosis within a period of 1 year in a tertiary care hospital. Methods: Total 254 children suspected of having tuberculosis were enrolled in the study and various microbiological, laboratory and radiological tests were used to diagnose the patients. Clinical samples were processed using standardized protocols. CBNAAT was the initial test of choice for microbiological confirmation. Results: Among 254 children, 69(27%) had pulmonary tuberculosis, extrapulmonary tuberculosis was found in 76(30%) children. Fever was the most common (in 100% cases) symptom in pulmonary TB. Most common radiological presentation was segmental consolidation (44%). Amongst 69 pulmonary TB patients, 16(23%) were Rifampicin resistant by CBNAAT method. Conclusion: Primary childhood TB being paucibacillary, makes microbiological diagnosis (gold standard) difficult. In relevant clinical setting, certain radiological lesions may be highly suggestive of tuberculosis: miliary pattern, hilar and/or paratracheal lymphadenopathy with or without parenchymal involvement and fibro-cavitatory lesions. All presumptive TB cases with these radiological patterns are considered to be probable TB and should be subjected to microbiological testing to confirm the diagnosis.

2017 ◽  
Vol 4 (3) ◽  
pp. 263-268
Author(s):  
Tanu Arora ◽  
◽  
Shailpreet K Sidhu ◽  
Pushpa Devi ◽  
Sita Malhotra ◽  
...  

2021 ◽  
Vol 49 (1) ◽  
Author(s):  
Aryatara Shilpakar ◽  
Mehraj Ansari ◽  
Kul Raj Rai ◽  
Ganesh Rai ◽  
Shiba Kumar Rai

Abstract Background The existence of multidrug-resistant organisms, including extended-spectrum beta-lactamases (ESBLs), is on rise across the globe and is becoming a severe problem. Knowledge of the prevalence and antibiogram profile of such isolates is essential to develop an appropriate treatment methodology. This study aimed to study the prevalence of Gram-negative isolates exhibiting ESBL at a tertiary care hospital and study their antibiogram profile. Methods A cross-sectional study was conducted at Shahid Gangalal National Heart Centre, Kathmandu, Nepal, from June 2018 to November 2018. A total of 770 clinical samples were collected and identified using the conventional biochemical tests following the Clinical and Laboratory Standard Institute (CLSI) guidelines. Antimicrobial susceptibility testing (AST) was performed using the standardized Kirby-Bauer disk diffusion method. The screening test for ESBL producers was performed as recommended by the CLSI and the confirmatory test was performed phenotypically using the E-test. Results Out of the 92 isolates, 84 (91.3%) were multidrug-resistant, and 47 (51.1%) were found to be potential ESBL producers. Of these, 16 isolates were confirmed ESBL producers by the E-test. Escherichia coli and Klebsiella pneumoniae were the predominant isolates and were also the major ESBL producers. Besides polymyxin B (100% sensitive), meropenem and imipenem showed high efficacy against the ESBL producers. Conclusion Multidrug resistance was very high; however, ESBL production was low. Polymyxin B and carbapenems are the choice of drugs against ESBL producers but should be used only as the last line drugs.


2016 ◽  
Vol 4 (1) ◽  
pp. 43-46
Author(s):  
Manisha Sharma ◽  
Narayan Dutt Pant ◽  
Pratikshya Pandey

The main objective of this study was to determine the prevalence of non-albicans Candida among the patients attending a tertiary care hospital in Kathmandu, Nepal. Candida spp. isolated from different clinical samples (sputum, urine, vaginal swab, blood, endotracheal (ET) secretion, pus) from 250 patients between the period of February 2013 and December 2015 were included in the study. Of those 250 patients, 20% were immunocompromised. Sabouraud dextrose agar was used for the isolation of Candida spp. and the identification was performed on the basis of colony morphology, Gram’s stain, India ink preparation, germ tube test, temperature tolerance test, characteristic color change in CHROMagar, chlamydospore production, sugar fermentation test and sugar assimilation test.Out of total 300 Candida spp., majority were isolated from sputum (43.33%) followed by urine (40%) and vaginal swab (6.67%). Of total 151 (50.33%) non-albicans Candida, the most common species isolated were C. tropicalis (62.25%) followed by C. glabrata (23.84%). High prevalence of non-albicans Candida among the patients attending a hospital in Kathmandu, Nepal was noted.


Author(s):  
Harsha Sreedharan ◽  
KB Asha Pai

Introduction: Methicillin-Resistant Staphylococcus aureus(MRSA) infection is a major global healthcare problem, the prevalence of which varies from 25-50% in India. It is known to cause Skin and Soft tissue Infections (SSI), endovascular infections, endocarditis, pneumonia, septic arthritis, osteomyelitis, and sepsis. Vancomycin is the drug of choice for treating severe MRSA infections. Ceftaroline, a fifth-generation cephalosporin has been approved by the United States Food and Drug Administration (US FDA) for treating acute bacterial SSI caused by susceptible micro-organisms including MRSA, Community acquired respiratory tract infection, MRSA bacteremia and endocarditis. Aim: To assess the susceptibility of clinical isolates of S. aureusto ceftaroline, in a Tertiary Care Hospital. Materials and Methods: This prospective study was conducted in the Department of Microbiology of a Tertiary Care Hospital over a period of two months from June 2019 to July 2019. S.aureus isolates from various clinical samples were screened for methicillin resistance by disc diffusion method using cefoxitin disc and ceftaroline susceptibility of these isolates was assessed by E-strip method. The isolates were classified as ceftaroline susceptible, Susceptibility Dose Dependent (SDD) and ceftaroline resistant respectively as per CLSI guidelines. A descriptive analysis of the data was done and the results were presented as frequencies and percentages. Results: All the S.aureus isolates were found to be susceptible to ceftaroline. Methicillin Sensitive Staphylococcus aureus(MSSA) isolates had lower Minimum Inhibitory Concentration (MIC) when compared to MRSA. The highest MIC among MRSA was 0.5 μg/mL. Conclusion: Ceftaroline can be considered as an effective alternative for treatment of infections caused by MRSA.


2020 ◽  
Vol 8 (1) ◽  
pp. 4-6
Author(s):  
Ashu Dogra

Porphyria cutanea tarda is the most frequent type of Porphyria worldwide & presents with skin symptoms mainly. Porphyrias can affect peripheral, autonomic and central nervous system. In Porphyria conditions there is accumulation of heme precursors 5 Aminolevulinic acid, Porphobilinogen and porphyrins which are associated with characteristic clinical feature with acute neurovisceral attacks and skin lesions. This case report summarizes Case of PCT that was successfully managed with Therapeutic Phlebotomy.


Author(s):  
Vijayashree V. ◽  
Saikeerthana D. ◽  
Prabha P.

Background: The genus Klebsiella of Enterobacteriaceae family is ubiquitous in nature. They cause many nosocomial infections like pneumonia, urinary tract infections, wound infections, bacteremia and septicemia. Multidrug resistance is seen in Klebsiella which serves as the most common cause of increased morbidity and mortality. This study reveals the prevalence and antibiotic sensitivity pattern of Klebsiella species from various clinical samples. The primary objectives are as follows: To isolate and characterize Klebsiella species from various clinical samples. To study the antibiotic susceptibility pattern of Klebsiella isolates.Methods: This prospective study was conducted in our tertiary care hospital during the period from August 2019 to October 2019. A total of 3521 samples were tested during this period. The samples include blood, sputum, urine, and pus.Results: Out of the total samples tested,1106 samples were showing the growth of the organisms. Among this,351 were identified as Klebsiella species and the highest rate of isolation of Klebsiella species is from the sputum sample and also the same was reported high in medical wards. The study also shows that the isolation of Klebsiella species shows male preponderance when compared to females. The antibiotic sensitivity pattern was done by Kirby-Bauer's disc diffusion method and the sensitivity was noted to be higher to amikacin and ciprofloxacin.Conclusions: Thus, this study shows the prevalence rate of Klebsiella species and sensitivity pattern of Klebsiella, which may help select appropriate antibiotics and prevent overuse and misuse of antibiotics.


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