BackgroundAntibiotic resistance is a major global public health concern, particularly in settings where few treatment options are available. Limited research has been done on antibiotic resistance in Escherichia coli of Indian children at community level. Therefore we studied antibiotic resistance patterns in E. coli isolates from stool samples of children aged 3-14 years from Ujjain, Central India, to investigate associations of resistance with demographic variables.MethodsChildren, 3-14 years of age, were included from 30 randomly selected villages of Palwa demographic surveillance site, Ujjain, India. Parents were interviewed using a questionnaire, and stool samples were collected from participating children. E. coli were isolated from stool samples (n = 529), and susceptibility testing to 18 different antibiotics was done using standard methods.ResultsThe proportions of isolates resistant to various antibiotics were, nalidixic acid, (45%), tetracycline (37%), ampicillin (37%), sulfamethoxazole/trimethoprim (29%) and amoxicillin/clavulanic acid (29%). No isolates were resistant to imipenem. Overall, 72% of isolates were resistant to at least one antibiotic and 33% were multi-drug resistant. High rates of cross-resistance were seen for 15 (83%) of the antibiotics studied. E. coli isolates from children with literate mothers were more resistant to penicillins and fluoroquinolones. ESBL-producers comprised 9% of the isolates.ConclusionAntibiotic resistance and cross-resistance were common in E. coli from stools of children. Resistance rates were associated with maternal literacy.

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Posterior reversible encephalopathy syndrome is a condition occurring  in majority of case of  hypertensive encephalopathy mainly due to vasogenic  edema in parieto occipital region in neuroimaging. It is reversible if timely treatment is done .Here we are reporting a 11 year old female child with acute post streptococal glomerulonephrtitis leading to typical clinical and radiological features of posterior reversible encephalopathy syndrome

Background: Dual anti-platelet therapy is cornerstone in the management of patients with acute coronary syndrome (ACS). The most commonly prescribed combination is aspirin (A) and clopidogrel (C). However, both drugs have the problem of drug resistance (5-40% and 30%, respectively), resulting into vascular events. Prasugrel (P), the newer antiplatelet agent is supposedly better because of different pharmacokinetic profile. However, it is not approved for use in patients with ACS not undergoing intervention. Aim: The present study was aimed at evaluating the effects of P and C on recurrent angina, MI, and stroke within 30 days in patients with ACS managed conservatively, with similar background therapy. Methods: This study was done on 63patients presenting with ACS, diagnosed on the basis of clinical history, ECG findings and cardiac enzymes changes, managed conservatively. The patients were randomized in a1:1 fashion in two groups. The group 1 patients received P (60 mg loading followed by 10 mg P.O. daily, dose was reduced to 30 mg loading and 5 mg maintenance dose in patients aged > 75 years and weight < 60 kgs) and the group 2 patients received C (300mg loading followed by 75 mg P.O. daily). Patient in both the groups received aspirin (325 mg loading followed by 75 mg P.O. daily), atorvastatin (40 mg P.O. daily), weight adjusted enoxaparin and antianginal therapy as appropriate. There were no significant demographic differences between patients in the two groups. Result: The study showed that patients on P responded better, irrespective of age, sex, presence or absence of diabetes, dyslipidemia, ECG changes, and troponin positivity. There was a relative risk reduction of 35.61% (relative risk (RR), 0.64; 95% confidence interval (CI), 0.44-1.01; P=0.05) in the incidence of composite of primary end points in the group receiving prasugrel. No major or minor bleeding episodes were seen in any patient. Although our study is under powered, it creates space for a larger study with prasugrel to find out the true significance of our observation. Conclusions: The present study concluded that prasugrel significantly reduces the incidence of composite of refractory ischemia, MI and CV death and non-significantly reduced refractory ischemia, MI and CV death in patients of ACS managed conservatively.