We evaluated rates of clinically confirmed long-term-care facility-onset Clostridium difficile infections from April 2014 through December 2016 in 132 Veterans Affairs facilities after the implementation of a prevention initiative. The quarterly pooled rate decreased 36.1% from the baseline (P<.0009 for trend) by the end of the analysis period. Infect Control Hosp Epidemiol 2018;39:343-345.
Mucormycosis is an angioinvasive infection caused by ubiquitous filamentous fungi of the order Mucorales. It is a rapidly progressive fatal infection mostly reported in susceptible individuals, such as those with poorly controlled diabetes or those with defects in phagocytic function. Rhinocerebral mucormycosis is the most common type of mucormycosis in diabetic patients. This case report describes a 17-year-old girl with type 1 diabetes mellitus presenting with rhinocerebral mucormycosis. The patient presented with a history of toothache and facial pain with oedema of left half of face, periorbital oedema and depressed conciousness. She had hyperglycaemia with diabetic ketoacidosis and rapidly developed hemiparesis progressing to quadriparesis and died within 3 days of admission. The current report emphasises the importance of having a high index of suspicion when dealing with patients with diabetes presenting with facial pain or cellulitis and prompt initiation of medical therapy along with surgical debridement for control of rhinocerebral mucormycosis.
Background:
Pancytopenia is a triage of anemia, leukopenia, and thrombocytopenia. The etiology causing pancytopenia varies depending upon factors such as age, sex, occupation, and geographical distribution. Unfortunately, the major treatises of hematology have not given emphasis on the hemorrhagic manifestation of different etiologies causing pancytopenia.
Objective:
This observational study was carried out with the aim to identify hemorrhagic manifestation in patients with pancytopenia in eastern India.
Design:
This study was conducted over a period of two years at the Department of Medicine of a tertiary care teaching institute in eastern India. All the patients with features of anemia, thrombocytopenia, or leukopenia were screened for pancytopenia and a total of 214 cases were selected. Patients were divided into two groups as patients with age more than 14 years constitute group one and the patients less than 14 years constitute the second group. A detailed physical examination, hematological, and biochemical investigation was done to ascertain the hemorrhagic manifestations in pancytopenia patients.
Results:
In the groups, the most common cause of hemorrhagic manifestation in patients with pancytopenia was aplastic anemic, leukemia, myelodysplastic syndrome, and myelofibrosis. No bleeding manifestation was seen in patients with megaloblastic anemia, kala-azar, hypersplenism, and other causes of pancytopenia.
Conclusions:
Patients with pancytopenia caused by aplastic anemia, acute leukemia, and myelodysplastic syndrome have more chances of bleeding manifestation as compared with pancytopenia caused by megaloblastic anemia, kala-azar, or hypersplenism.
Background: There are enormous studies on various aspect of Diabetes and Metabolic syndrome, majority of studies are on urban population, few in rural area but very few for the population living in far flung hilly region of Himalaya. The aim was to find the prevalence of different components of metabolic syndrome in Type 2 diabetics living in the hills of Himalaya and to find correlation with obesity.Methods: All the Type 2 Diabetic patients age 35 years and above attending the inpatients and out patient’s department of V. C. S. G. G. M. C and RI Srinagar, Uttarakhand from October 2012 to March 2013 were enrolled and were evaluated for metabolic syndrome by IDF (International Diabetes Federation) criteria.Results: 128 diabetics were enrolled (76 males and 52 females), the prevalence of obesity in patients of type 2 diabetics was 45.3%. There was poor correlation between obesity and type 2 diabetes (correlation coefficient 0.08) The prevalence of metabolic syndrome was 40.6 % and high percentage (62%) had all five components of the syndrome.Conclusions: The prevalence of obesity and Metabolic syndrome is relatively lower in Type 2 Diabetics of Shivalik range of Himalaya (Uttarakhand).
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