Cyclic vomiting syndrome (CVS) shares many features with migraine headache, including auras, photophobia, and antimigrainous treatment response being traditionally viewed as a migraine variant. Aims. To determine whether CVS is associated with the same disorders as migraine headache, and compare these associations to those in healthy control subjects. Methods. Cross-sectional study of patients utilizing the ODYSA instrument, evaluating the probability of 12 functional/autonomic diagnoses, CVS, migraine, orthostatic intolerance (OI), reflex syncope, interstitial cystitis, Raynaud's syndrome, complex regional pain syndrome (CRPS), irritable bowel syndrome, functional dyspepsia, functional abdominal pain, fibromyalgia, and chronic fatigue syndrome. Control subjects were age-matched gender-matched friends. Patients had to fulfill criteria for CVS or migraine, while control subjects could not. Results. 103 subjects were studied, 21 with CVS, 46 with migraine and 36 healthy controls. CVS and migraine did not differ in the relative frequencies of fibromyalgia, OI, syncope, and functional dyspepsia. However, CVS patients did demonstrate a significantly elevated frequency of CRPS. Conclusions. Although CVS and migraine clearly share many of the same comorbidities, they do differ in one important association, suggesting that they may not be identical in pathophysiology. Since OI is common in CVS, treatment strategies could also target this abnormality.
Background: Gram negative organisms are the leading cause of Urinary tract infections with increasingly prevalent antimicrobial resistance. Thereby an observational cross sectional study was conducted to determine the rate of isolation, evaluation of the risk factors and antimicrobial resistance pattern of these organisms. Methods: In the prospective analysis, 72 urine samples with significant bacteriuria and culture positive for gram negative bacteria confirmed biochemically, among inpatients were taken into consideration. In addition presence of risk factors was evaluated. Antibiotic susceptibility test was performed using Kirby Bauer's disk diffusion method. Results: E. coli accounted for 56.9% followed by Klebsiella species (23.6%). Enterobacter, Pseudomonas and Acinetobacter species were 5-8% prevalent. The risk factors like diabetes mellitus and pregnancy were 20.8% and 13.8%. Other risk factors like recurrent UTI, renal stones, presence of indwelling catheter, smoking, use of OCP/IUCD and post menopausal oestrogen deficiency were 1-7%. The antimicrobial resistance for Enterobacteriaceae group of organisms were 70-90% for cefuroxime, ceftriaxone, cefepime and co-trimoxazole, 50-53% for ciprofloxacin and norfloxacin, 32.2% for ampicillin-sulbactum, 19.3% for nitrofurantoin, 8.1% for amikacin, 20.9% for piperacillin-tazobactum and 14.5% for imipenem. The antimicrobial resistance for Pseudomonas and Acinetobacter species was 50% for ceftazidime and cepepime, 20% for amikacin, piperacillin-tazobactum and imipenem, and 0% for meropenem. Conclusion: The present study confers Escherichia coli as the predominant bacterial isolate and diabetes mellitus as the predominant risk factor causing UTI. Amikacin, piperacillin-tazobactum and imipenem are the most sensitive drugs.
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