Introduction: As antibiotic sensitivity pattern to common pathogen has been changing day by day, so it has been necessary to study about bacteriological analysis and antibiotic sensitivity pattern. Therefore, the purpose of this study was to analyze on data on bacteremia in children, the pathogen involved and sensitivity pattern. Objectives: The aim of this study was to determine the bacteriological profile and antibiotic sensitivity pattern of blood culture isolates from Kanti Children Hospital. Method: All blood culture reports (n=9856) during one year period (April 2007 to March 2008 included in the study were analyzed and the sensitivity pattern were recorded. In this retrospective study, we reviewed records of patients from Kanti Children Hospital from April 2007 to March 2008. Results: The positivity of blood culture was 4.2% (414/9856). Out of them, 269 (65%) were positive for Staphylococcus aures, 121(29.3%) E coli, 13(3.1%) Klebsiella pneumonia, 6(1.4%) Streptococcus pneumonia and 5(1.2%) Streptococcus viridence. Staphylococcus aureus was found most sensitive to Chloramphenicol (88.8%) followed by Amikacin (87.5%), Ofloxacin (76.5%), Ciprofloxacin (72%) and least sensitive to Ampicillin, Cloxacillin and Penicillin. E.coli was found most sensitive to Amikacin (74.7%) followed by Ofloxacin (69.9%), Ciprofloxacin (56.4%) and least sensitive to Cephalexin, Gentamycin and Ampicillin. Klebsiella pneumoniae was found most sensitive to Amikacin (91.7%) followed by Ofloxacin (87.5%), Chloramphenical (81.8%) and least sensitive to Cotrimoxazole and Gentamycin. It is 100% resistance to Ampicillin and Erythromycin. Streptococcus pneumoniae was most sensitive to Penicillin, Chloramphenical (100%) followed by Ampicillin and Erythromycin (83.3%) and least sensitive to Cotrimoxazole. Streptococcus viridence was most sensitive to Chloramphenical (100%) followed by Erythromycin (80%), Penicillin (75%) and least sensitive to Cotrimoxazole. Conclusion: This highlights the variable nature of antibiotic susceptibility patterns both in time and location around different geographical locations and within the same country as well. Therefore, it is advisable to continuously evaluate the sensitivity-resistance pattern of isolates so as to make a rational use of antibiotics.

BackgroundIndia has a growing burden of cardiovascular disease (CVD), yet data on the quality of outpatient care for patients with coronary artery disease, heart failure, and atrial fibrillation in India are very limited. We collected data on performance measures for 68 196 unique patients from 10 Indian cardiology outpatient departments from January 1, 2011, to February 5, 2014, in the American College of Cardiology’s PINNACLE (Practice Innovation and Clinical Excellence) India Quality Improvement Program (PIQIP). PIQIP is India’s first national outpatient CVD quality-improvement program.Methods and ResultsIn the PIQIP registry, we estimated the prevalence of CVD risk factors (hypertension, diabetes, dyslipidemia, and current tobacco use) and CVD among outpatients. We examined adherence with performance measures established by the American College of Cardiology, the American Heart Association, and the American Medical Association Physician Consortium for Performance Improvement for coronary artery disease, heart failure, and atrial fibrillation. There were a total of 68 196 patients (155 953 patient encounters), with a mean age of 50.6 years (SD 18.2 years). Hypertension was present in 29.7% of patients, followed by diabetes (14.9%), current tobacco use (7.6%), and dyslipidemia (6.5%). Coronary artery disease was present in 14.8%, heart failure was noted in 4.0%, and atrial fibrillation was present in 0.5% of patients. Among eligible patients, the reported use of medications was as follows: aspirin in 48.6%, clopidogrel in 37.1%, and statin-based lipid-lowering therapy in 50.6% of patients with coronary artery disease; RAAS (renin–angiotensin–aldosterone system) antagonist in 61.9% and beta-blockers in 58.1% of patients with heart failure; and oral anticoagulants in 37.0% of patients with atrial fibrillation.ConclusionsThis pilot study, initiated to improve outpatient CVD care in India, presents our preliminary results and barriers to data collection and demonstrates that such an initiative is feasible in a resource-limited environment. In addition, we attempted to outline areas for further improvement in outpatient CVD care delivery in India.

Background Little is known about the use of guideline-directed medical therapy (GDMT) in outpatients with heart failure (HF) and a left ventricular ejection fraction (EF) ≤40% (HFrEF) in India. Our objective was to understand the use of GDMT in outpatients with HFrEF in India. Methods Practice Innovation and Clinical Excellence India Quality Improvement Program (PIQIP) is a registry for cardiovascular quality improvement in India supported by the American College of Cardiology Foundation. Between January 2008 to September 2014, we evaluated the documentation of the use of angiotensin-converting-enzyme-inhibitors (ACE-I)/angiotensin-receptor-blockers (ARB) and beta-blockers (BB) or both among outpatients with HFrEF seeking care in 10 centers enrolled in the PIQIP registry. Results Among 75,639 patients in the PIQIP registry, 34,995 had EF reported and 15,870 had an EF ≤40%. The mean age was 56 years (23% women). Hypertension, diabetes, coronary artery disease and myocardial infarction were present in 37%, 23%, 27% and 17%, respectively. ACE-I/ARB, BB, and both were documented in 33.5%, 34.9%, and 29.6% of patients, respectively. The documentation of GDMT was higher in men, and in patients ≥65 years and those with presence of hypertension, diabetes or coronary artery disease. The documentation of GDMT gradually increased over the study period. Conclusions Among patients enrolled in the PIQIP registry, about two-thirds of patients with EF ≤40% did not have documented receipt of GDMT. This study is an initial step towards improving adherence to GDMT in India, and highlights the feasibility of examining quality of care in HFrEF in a resource-limited setting.

In COVID 19 pandemic, delivery and access of health care services have become challenging. Telemedicine services can be considered for management of patients with hematological diseases. This study included all patients who enrolled for telemedicine facility for hematology from May 15 to July 15, 2020. Patient's demographic and disease related parameters were recorded during the teleconsultation call. Overall satisfaction of attending doctor and patients were also recorded. A total of 1187 teleconsultation appointments were taken, of which 944 (79.6%) were successfully attended. Median age of patients was 38 years (range-0.5-78 years), with 38% females. 55% of successful calls were from patients suffering a malignant hematological disorder. 24% had an active complaint pertaining to their disease or treatment. Of these, 162 (17%) were asked for a physical consultation. A significant association was found between the requirement of physical consultation and diagnosis (p \ 0.001),

Introduction: Thyroid hormone is critical for normal brain development in the early postnatal months. Biochemical diagnosis must be made soon after birth and effective treatment must be initiated promptly to prevent irreversible brain damage. Early diagnosis and adequate treatment from the first weeks of life result in normal linear growth and development. This study was conducted to find out the clinical features suggestive of congenital hypothyroidism and also its causation. Materials and Methods: This was a hospital based retrospective study of 40 congenital hypothyroid children conducted at endocrine unit of Kanti Children’s hospital from 2067 to 2072. All congenital hypothyroid children were reviewed in detail and frequency of signs/symptoms was calculated and also the possible causes were established using ultrasonography and scintigraphy.Results: Out of 40 congenital hypothyroid children 55% were male and 45% were female with M: F ratio of 1.23:1.Common age of presentation of congenital hypothyroidism was 6 to 12 months. The most frequent symptoms were decreased activity/ lethargy (78.9%) followed by stunted height (68.4%) and hypotonia (65.8%).Technetium thyroid scan was performed in 19 cases among which thyroid agenesis was the most common cause of congenital hypothyroidism (42.1%) followed by dyshormonogenesis (31.6%) and ectopic thyroid (26.3%).Conclusion: Early diagnosis of congenital hypothyroidism is possible in some children based on clinical features followed by biomedical investigation soon after birth.J Nepal Paediatr Soc 2016; 36(2):126-130