Background: Nosocomial infections are one of the leading causes of morbidity and mortality in hospitalized patients especially the critically ill patients in the intensive care unit (ICU) where a large number of drugs are administered to the patient’ which in turn leads to the generation of antibiotic resistant pathogens. The present study was conducted to identify the prevalence of predominant bacterial microorganisms and their drug sensitivity and resistance in ICU of a teaching hospital in Eastern India. Methods: A retrospective record based study was conducted in the ICU of Hi-Tech Medical College and Hospital, Odisha, Eastern India from November, 2011 to October, 2012. Patients who were clinically suspected of having acquired any infection after 48 hours of admission to the ICUs were included in the study. The clinically suspected laboratory samples were collected from the patients and subjected to testing and antibiotic sensitivity. Results: The rate of nosocomial infection was 28.2%. Urinary tract infection was the most common infection (54.9%). The predominant isolate was E. coli (52.7%) followed by P. mirabilis (15.4%) and Ps aeruginosa (13.2%). E. coli was highly sensitive to Polymyxin B, Gatifloxacin and Ceftriaxone and showed high degree of resistance to Cephalexin, Cefadroxil, Tobramycin and Prulifloxacin. Conclusions: Most of the bacterial isolates were resistant to third generation Cephalosporins and Aminoglycosides. Regular surveillance of antibiotic susceptibility pattern, judicious use of antibiotics are very important for reducing the nosocomial infection rate and antimicrobial resistance. [Int J Basic Clin Pharmacol 2013; 2(2.000): 153-159
BACKGROUND: Intestinal obstruction is a surgical emergency that causes confusion both in the diagnosis and the management. It is related by
important disease and mortality. The goal of this study was to classify the etiology, to analyse the methods of performance of acute duodenal
obstruction in different age groups, various therapeutic modalities of treatment, to accomplish operative management, anticipate the post-operative
complications and outcomes of patients with acute intestinal obstruction.
MATERIAL& METHODS: 82 patients of all age groups (except infants) presenting with acute intestinal obstruction were studied between June
2017 and December 2018 in a multispeciality hospital in Eastern India. Patients with history of subacute intestinal obstruction and paralytic ileus
were excluded from this study.
RESULTS: Males were found to be affected much more than females. Pain abdomen was the most common symptom found in 94% cases followed
by distension and vomiting in 86.6% and 68.3% cases respectively. Most common etiology of intestinal obstruction was due to adhesion and bands
(40.3%) followed by obstructed hernia (22%) and malignancy (17%). The most common procedure done in intestinal obstruction in present study
was release of adhesions and bands (37.8%) followed by resection and anastomosis (26.8%).
CONCLUSION: Bowel obstruction continues to be one of the most common abdominal problems faced by general surgeons. Success in the
treatment of intestinal obstruction depends largely upon early diagnosis, skilful management and treating the pathological effects of the obstruction
just as much as the cause itself.
A psoas (or iliopsoas) abscess is an accumulation of pus in the region of iliopsoas muscle compartment. In regions where Mycobacterium tuberculosis is endemic, this is a frequent cause of psoas abscess. When an inguinal mass in a patient with a psoas abscess is painless, tuberculosis is a more likely cause than a bacterial infection. Here, the author report a rare case of psoas abscess of tubercular origin in a 31-year-old patient who presented with back pain and limping, with features of inflammation. Diagnosis was done based on history, physical examination, ultrasonography, microbiological investigation and Contrast-Enhanced Computed Tomography (CECT) scan of abdomen which revealed a large psoas abscess caused by M. tuberculosis. Patient was diagnosed with a psoas abscess due to Mycobacterium tuberculosis with secondary infection and treated empirically with Directly Observed Treatment Short-Course (DOTS) category I and antibiotics. He presented again with a chest abscess due to Multidrug-Resistant (MDR) tuberculosis.
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