PREVALENCE OF CLOSTRIDIUM DIFFICILE INFECTION IN PATIENTS EXPOSED TO ANTIBIOTICS IN PREVIOUS 6 WEEKS AND ADMITTED WITH DIARRHEA IN A TERTIARY CARE HOSPITAL.

2021 ◽  
pp. 62-64
Author(s):  
Sanjay Kumar Singh ◽  
Ashwini Kumar Setya ◽  
Abhishek Deo ◽  
Vivek Raj ◽  
Suneel Chakravarty

Clostridium difficile is a signicant cause of morbidity and mortality among hospitalized patients, and the incidence of C. difficile infection (CDI) has dramatically increased due to frequent usage of broadspectrum antibiotics in these patients. The wide variation in the spectrum of clinical manifestations of CDI makes the diagnosis difcult. Further, the wide range of variability in the sensitivity and specicity of the various diagnostic methods and the high cost of these methods add to the difculty. It is a spore-forming gram-positive anaerobic organism. Until the 1970s, it was considered as a microorganism that is rarely present in normal intestinal microbiota. But it was not until 1978 that C. difcile was identied as a cause of [1] pseudomembranous colitis . Since then, C. difcile has been recognized as a common cause of antibiotic associated diarrhoea and nosocomial diarrhoea. The incidence of C. difcile infection (CDI) varies from place to place. In India, it is known to infect up to 25 % of [2] people taking antibiotics

2020 ◽  
Vol 70 (6) ◽  
pp. 1616-21
Author(s):  
Ayesha Batool ◽  
Saeed Zaman ◽  
Ammara Ayub ◽  
Kulsum Bilal ◽  
Qudratullah Malik

Objective:  To determine the frequency of a wide range of clinical presentations of inherited metabolic disorders diagnosed in infants and children at a tertiary care hospital in Rawalpindi, Pakistan. Study Design: Cross sectional study Place and Duration of Study: MH Rawalpindi, from June 2015 till June 2016. Material and Methods:  64 children diagnosed with metabolic disorders, reporting to the MH Rawalpindi, were enrolled in the study. History was taken with special reference to family history, consanguineous marriage, sibling’s death and clinical manifestations. Thorough physical examination was done in every patient to find out the clinical signs present. All the data was recorded on a proforma. SPSS-20 version was used to derive the results and p-value of <0.05 was taken as statistically significant. Results: In children with metabolic disorders, gastrointestinal manifestations were more significant 78·1% (p-value 0.022). Neurological signs were present in 60·9% (p-value 0.094) while respiratory manifestations were present in 15·6% children (p-value 0.251). 53·1% were males and 46·9% were females. The positive history of other affected children in family was significant (p-value 0.015), along with hypoglycaemia (p-value 0.001). Conclusion:  Pallor, failure to thrive, poor feeding, convulsions, lethargy and hypoglycemia were the most frequent clinical manifestations in children with metabolic disorders.


Mediscope ◽  
2021 ◽  
Vol 8 (2) ◽  
pp. 112-121
Author(s):  
Abu Md Mayeenuddin Al Amin ◽  
Shyamal Kumar Paul ◽  
Md Abdul Aziz ◽  
Anindita Paul ◽  
Syeda Noorjahan Karim ◽  
...  

Background: Rickettsial diseases are neglected, re-emerging vector borne zoonosis & increasingly considered as one of the most important causes of pyrexia of unknown origin (PUO). They are grossly underdiagnosed due to wide range of non-specific symptoms, low index of clinical suspicion, lack of widely available specific diagnostic tools, leading to significant morbidity & mortality. Appropriate diagnosis in early stages is therefore necessary to prevent fatal complications associated with this disease. Objective: Present study was attempted to assess the burden of rickettsial illness by Weil-Felix agglutination test, among the suspected febrile patients, visiting a tertiary care hospital as well as to analyze the demographic profile & clinical manifestations of the seropositive cases. Methods: This was a cross-sectional study, conducted at department of microbiology, Mymensingh Medical College from March 2018 to February 2019. A total of 453 febrile patients of suspected rickettsial illness, irrespective of age and sex, were enrolled in this study. Serum sample from all the enrolled cases were then analyzed for rickettsial antibodies by Weil-Felix slide agglutination test. Results: Out of 453 cases, a total of 260 (57.39%) showed significant agglutination by Weil-Felix test, of which 101 (38.84%) were reactive to OX2 (spotted fever group rickettsiae), 65 (25%) were reactive to OXK (Scrub typhus) & 13 (5%) showed significant titers to OX19 (typhus fever). Remaining 81 (31.15%) sera were reactive to more than one antigens (mixed reactivity). Seropositivity was higher among female subjects (142; 54.61%) & age group >15-30 accounted for highest number of cases (95; 36.53%). Positive cases showed diverse clinical manifestations like headache (55.76%), myalgia (50.76%), skin rash (10.38%), eschar (9.23%), oliguria (7.3%), jaundice (10.76%), splenomegaly (6.81%), hepatomegaly (7.30%) etc. Conclusion: Rickettsial diseases should be considered as an important etiology of PUO & early diagnosis should be done to initiate proper treatment to prevent fatal complications. Though it lacks sensitivity & specificity, in a resource constraint area like Bangladesh, Weil-Felix test still serves as the cheapest initial diagnostic tool for rickettsial illness to guide the physician for further approaches. Mediscope 2021;8(2): 112-121


2019 ◽  
Vol 60 ◽  
pp. e11-e13 ◽  
Author(s):  
Sara Sintra ◽  
Filipe Taveira ◽  
Catarina Canha ◽  
Armando Carvalho ◽  
Adélia Simão

2019 ◽  
Vol 10 (3) ◽  
pp. 1818-1820
Author(s):  
Jagadeesan M ◽  
Mariraj I ◽  
Prasanna Karthik S ◽  
Kannan R ◽  
Nivaas M ◽  
...  

Worm infection is a public health problem, especially in developing and underdeveloped countries as it has a negative impact on the child’s development. Proper sanitation and personnel hygiene have to be emphasized and monitored to overcome the nutritional deprivement in children. The study is done to evaluate the knowledge and attitude about worm infestation and to assess the deworming practices employed among the caregivers of children aged between 5 – 12 years attending a tertiary care hospital. A cross-sectional descriptive study was conducted among 206 caregivers of pediatric age group after obtaining proper informed consent. The KAP parameters were assessed using a pretested structured questionnaire, and the results were analyzed. Out of 206 caregivers, 61% were mothers, 37% were fathers. Their mean age was 30 years. 41% belong to class III socioeconomic status. 23% were reported to play in the mud, 17% nail-biting and 6% keeping objects in mouth.12% Had open-air defecation practice, which is quite alarming in a developing country.67% were found to have the knowledge and 33% lacked the knowledge about worm infestation. Knowledge was directly proportional to the socioeconomic class. 88% were aware that worm infestation would cause clinical manifestations. 85% preferred allopathy medicines, while 15% preferred homemade remedy. 68% didn’t practice any prophylactic measures, where in 21% of the caregivers dewormed their kid once in 6 months and 11% once a year. The study provides information that most of the caregivers had a good knowledge regarding deworming but failed in practicing necessary measures to control and prevent it. Health education, frequent monitoring, and conducting interventional programs among parents and caregivers would be vital so that the prevalence of the disease can be minimized.


Author(s):  
Reetu Verma ◽  
Sasmita Panda ◽  
Rajeev Kumar Nishad

Introduction: Patients admitted in the Intensive Care Units (ICUs) experiences various discomforts which may be recognised or unrecognised. These discomforts may arise from the environment, may be related to the ICU care and discomfort related to the health status of the patient and critical care interventions. Aim: To identify the various discomforts in ICU patients, to classify them with respective causes, identify the most common cause among them and whether ICU sedation helps in reducing discomforts. Materials and Methods: This observational study was conducted from 15th July to 15th October 2018 on 120 mixed ICU patients in a Tertiary Care Hospital in India. Patients who were admitted to ICU for more than 24 hours, aged 18 years and above, those who gave written informed consent were observed and enquired for any discomfort. Discomforts have been identified and recorded by a fulltime intensivist by direct observation, by interacting with the patients and asking the family members and others (indirect approach). Through this study discomforts of critically ill patients were broadly classified into four categories 1. Due to existing illness, 2. Due to ICU interventions, 3. Due to improper nursing care and 4. Due to environmental factors. Results: Out of 120 patients studied, 84 patients (70%) reported some kind of discomfort during their ICU stay. Existing illness was the most common cause of discomfort, 80 patients (66.6%) suffered due to it. ICU interventions was the second most common cause, 71 patients (59.1%) had discomfort due to interventions. Thirty five patients (29.1%) suffered due to improper nursing care and 25 patients (20.8%) suffered due to the environmental factors. In this study, it was observed that sedation reduces all kind of discomforts. conclusion: In this study 70% of patients, who were admitted to ICU due to various illness reported some kind of discomfort. The most common cause of ICU discomforts was existing illness followed by ICU interventions. In this study it was observed that sedation reduces all kind of discomforts. Sedated patients tolerate the endotracheal tube better and they had less environmental and procedure related discomforts. With the present study observation it can be suggested that ICU charts of nurses and doctors can carry a separate column for mentioning discomforts in different duty shifts. However, with the use of appropriate analgesia and sedation discomfort can be reduced.


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