Background: The use of neuraxial anesthesia for caesarean section has dramatically increased in last 2 decades because it is easier to perform, safe to the mother and the fetus, and has a high degree of success rate. However, post-dural puncture headache is a well-known complication of spinal anesthesia. It is a common and incapacitating compliation following dura-arachnoid puncture and results in increased morbidity, prolonged hospital stay, increased cost, and patient dissatisfaction.Methods: It was a double-blinded comparative study conducted on 75 consecutive pregnant patients meeting the inclusion criteria of the study. Patient and anesthesiologist involved in collection of data were blinded to the gauge of the needle used. Standard anesthesia protocol was followed in all the patients and spinal anesthesia performed using 25G Quincke needle in 38 patients and 27G Quincke needle in 37 patients.Results: we included 75 consecutive patients in the age group 20-35 years in the study. Overall incidence of PDPH was 14.67% (11/75) in present study. 23.68% (9/38) and 5.4% (2/37) patients who received spinal anesthesia with 25G and 27G needles respectively developed PDPH. Difference was statistically insignificant.Conclusions: The incidence of PDPH was less in patients who underwent caesarean section under spinal anesthesia with 27G needle compared to that of patients in whom block was performed using 25G needles. However, there was no definite advantage of 27G Quincke needle over 25G Quincke needle as far as the incidence of PDPH is concerned.

An immunocompromised patient with a known history of cerebrovascular accident (CVA) with right-sided hemiparesis of long duration, type 2 diabetes mellitus, and hypertension presented with signs of rhabdomyolysis and later acute kidney injury (AKI). He subsequently developed Guillain Barre syndrome. Initially, hemodialysis was followed by plasmapheresis. After hemodialysis, the patient presented with multiple episodes of vomiting and weakness of all limbs. A culture showed growth of Enterococcus faecalis, and on Day 6, a bloodstream infection with Candida kefyr and a urinary tract infection with Enterococcus faecalis were diagnosed. We report a rare case of bloodstream infection due to C. kefyr .

Non-typhoidal Salmonella (NTS) are generally associated with self-limiting gastrointestinal disease, often acquired through the ingestion of contaminated food and it seldom requires antimicrobial therapy for treatment. Extra-intestinal manifestations could be localised infection leading to septic arthritis, osteomyelitis. In complicated invasive disease, there could be bronchopneumonia with or without bacteraemia leading to mortality. Invasive NTS infections are infrequently reported in India. The S. Typhimurium is one of the common serovars associated with invasive disease and its virulence factors are responsible for causing the disease. S. enteridies, S. Dublin are the other serovars which are commonly responsible for invasive NTS infection. It is difficult to diagnose invasive disease without appropriate bacteriological culture based method. With emergence to resistance to antimicrobials the treatment of this condition is also becoming challenging. In this case report, a five-month-old infant presented with cough fever, stuffed nose dyspnoea and was diagnosed as bronchopneumonia. Mechanical ventilation was required for five days along with admission to intensive care unit. Invasive NTS infection was diagnosed using automated blood culture and the child responded to intravenous antimicrobial chemotherapy.

Journal homepage: http://www.ijcmas.com Urinary Tract Infections (UTIs) are very common in clinical settings and many organisms are ground to be multi-drug resistant. Therefore, analyzing antibiotic susceptibility patterns will not only help in therapeutic difficulties but also decrease the indiscriminate use of antibiotics which are causing the development of MDR. Bacterial Isolates with a colony count of more than 10 5 /ml were included in the study. The uropathogens were isolated using Urochrome UTI agar and MacConkey agar. Identification was done by standard biochemical reactions and then subjected to antibiotic susceptibility testing against 18 antibiotics of different classes using Kirby-Bauer's disc diffusion method. Out of a total of n=4385 urine samples processed 974 (22.2%) were found to have significant bacteriuria and n=3413(77.8%) were found to be negative. Gram-negative bacteria were found to be 78.7% while gram-positive cocci accounted for the remaining 21.3 % of the total pathogens, E. coli (54%), Enterococcus spp (18%), K. pneumoniae (15%). Regular monitoring and surveillance is the need of the hour given the constantly rising drug resistance. It is necessary to make a local antibiogram about the hospital environment in discussion with the physicians to provide an updated and effective empirical treatment of UTIs.

Pseudomonas aeruginosa is a Gram-negative, rod-shaped and asporogenous bacterium. It has a pearlescent appearance and grape-like odour. P. aeruginosa grows well at 25°C to 37°C, and its ability to grow at 42°C helps distinguish it from many other Pseudomonas species. P. aeruginosa is a ubiquitous microorganism which has the ability to