MANAGEMENT OF PNEUMONIA WITH MULTILOCULATED LEFT PLEURAL EFFUSION CAUSED BY EXTENDED SPECTRUM BETA-LACTAMASES PRODUCING KLEBSIELLA PNEUMONIAE

Increase in the mortality and morbidity in pleural infection is a concern worldwide due to increasing resistant Gram negative pathogens like Acinetobacter baumannii, Pseudomonas aeruginosa and Klebsiella species. Rise of pneumonia due to K. pneumoniae, is more likely observed in alcoholics, diabetics, hospitalized and patients receiving mechanical ventilation. In the present study, we discuss a case of a 59 year old male patient with pulmonary effusion infected with extended spectrum beta-lactamases (ESBL) producing K. pneumoniae with co-morbidities of uncontrolled Type II diabetes mellitus (DM), hypertension and coronary artery disease (CAD), treated with a newer antibiotic adjuvant entity: Elores (ceftriaxone/sulbactam/disodium edetate) and recovered well. KEYWORDS: Gram negative pathogens; Beta-lactamases; Elores

MANAGEMENT OF PNEUMONIA WITH MULTILOCULATED LEFT PLEURAL EFFUSION CAUSED BY EXTENDED SPECTRUM BETA-LACTAMASES PRODUCING KLEBSIELLA PNEUMONIAE

Increase in the mortality and morbidity in pleural infection is a concern worldwide due to increasing resistant Gram negative pathogens like Acinetobacter baumannii, Pseudomonas aeruginosa and Klebsiella species. Rise of pneumonia due to K. pneumoniae, is more likely observed in alcoholics, diabetics, hospitalized and patients receiving mechanical ventilation. In the present study, we discuss a case of a 59 year old male patient with pulmonary effusion infected with extended spectrum beta-lactamases (ESBL) producing K. pneumoniae with co-morbidities of uncontrolled Type II diabetes mellitus (DM), hypertension and coronary artery disease (CAD), treated with a newer antibiotic adjuvant entity: Elores (ceftriaxone/sulbactam/disodium edetate) and recovered well. KEYWORDS: Gram negative pathogens; Beta-lactamases; Elores

Ni-Cr textured substrates with reduced ferromagnetism for coated conductor applications

A series of biaxially textured Ni(1-x)Cr(x) materials, with compositions x = 0, 7, 9, 11, and 13 at % Cr, have been studied for use as substrate materials in coated conductor applications with high temperature superconductors. The magnetic properties were investigated, including the hysteretic loss in a Ni-7 at % Cr sample that was controllably deformed; for comparison, the loss was also measured in a similarly deformed pure Ni substrate. Complementary X-ray diffraction studies show that thermo-mechanical processing produces nearly complete {100} cube texturing, as desired for applications.Comment: PDF only; 19 pp., incl 10 figure

Current status of nanotechnology in urology

Nanotechnology has been investigated for its applications in medicine. The objective of this review was to summarize the current applications of nanotechnology in Urology. A systematic search of literature was performed and relevant articles were analyzed with specific reference to applications in Urology. Nanotechnology has applications in diagnostic urology like in uroimaging using nanoparticles and nanosensors. It has therapeutic applications in infections, malignancies, genetic disease using targeted drug delivery, gene transfers, nano device-based manipulations etc. Nanotechnology has many applications in Urology. More efforts are required to make these applications practically feasible and affordable

Gaucher's disease: a case report

Gaucher's disease (GD) is an autosomal recessive disorder, characterized by lack of acid β-glucosidase (glucocerebrosidase) enzyme resulting in accumulation of glucosylceramide in different organs. This enzyme is encoded by a gene on chromosome 1. Accumulation of glucosylceramide in tissues leads to multisystem organ involvement viz. liver, spleen, bone marrow, lungs and central nervous system. It is common in Ashkenazi Jews but rare in India. Around five hundred cases are identified and diagnosed in India. Serum β-glucosidase levels <15% of mean normal activity confirms the diagnosis, enzyme replacement being the only definitive treatment. Here we report a case of Gaucher’s disease

Severe acute malnutrition: seasonal variations in Southern Rajasthan, India

Background: Malnutrition is India’s one of the biggest health care challenge. India has some of the highest rates of child malnutrition. We performed a retrospective study of children admitted in Malnutrition Treatment Centre to find out any seasonal variations in the prevalence of severe acute malnutrition (SAM) in Southern Rajasthan, India.Methods: In this hospital based retrospective study, data were analysed for all children admitted at malnutrition treatment centre of a tertiary level hospital attached to a medical college from April 2014 to March 2016 to study the seasonal variations in the prevalence of SAM.Results: A total of 30,140 children were admitted during the last two years, out of which under five children other than new born were 4,942 in 2014-15 and 5,972 in year 2015-16. Total 1915 SAM children were admitted in our malnutrition treatment centre (MTC) in last 2 years. Among the under five children 840 (17%) children were admitted with SAM in 2014-2015 and 1075 (18%) in year 2015-2016. The number of SAM admission has increased in 2015-16 from the previous year (p0.05).Conclusions: The prevalence of SAM in admitted patients was high as compared to national and state data and this has increased over the year, but there are no month wise seasonal variations in prevalence of SAM in our children representing Southern Rajasthan, India.

Ring chromosome 15 presenting as short stature, intellectual disability and café-au-lait spots

Ring Chromosome 15 results from loss of genetic material from both ends of chromosome 15 and joining of the ends to form ring. Only 50 cases are reported in literature with none from India. We report a case of 17 years old female approached us for short stature and low intelligence. On examination we noticed childish facial features, microcephaly and cafe-au-lait spots in significant number and size. Her karyotype result was 46xx r15. CONCLUSION: Ring chromosome 15 syndromes should be considered in a case having short stature with cafe-au-lait spots. Timely recognition and hereditary tendency counselling is required

Correlation of liver enzymes with serum ferritin levels in β-thalassemia major

Background: Liver is the earliest site of iron deposition in transfusion dependent β -thalassemia major and iron induced liver injury is the common cause of morbidity. Liver enzymes are raised and indicative of liver injury in transfusion dependant β-thalassemia major patients. Objective of the study was to find out the correlation of serum ferritin with liver enzymes serum glutamic oxalocetic transaminase (SGOT) and serum glutamic pyruvic transaminase (SGPT) in thalassemia major children.Methods: Hospital based study of fifty five (55)  children of β-Thalassemia major in the age group of 4-20 years who were regularly transfused and were on oral iron chelators since at least one year were enrolled. Serum ferritin levels and serum SGOT and SGPT levels were estimated and results were correlated.Results: Out of total fifty five (55) children, most were in the age group of 4 to 8 years. Mean rate of blood transfusion in subjects was 157.01ml/kg/year and mean duration of chelation therapy was 2.34 years. Serum ferritin levels were increased in β-thalassemic children with average of 2130.33±859.85ng/ml.  The SGOT and SGPT were also raised significantly (p value &lt;0.05) with mean of 71.37±24.16 IU/L and 62.3 5±25.75 IU/L respectively. The values of SGOT &amp; SGPT becomes highly significant  (p value &lt;0.001) when serum ferritin  becomes more than 2000 ng/ml. Onset of liver enzyme derangement starts at serum ferritin level of more than 1000 ng/ml We found positive correlation between serum ferritin and deranged liver enzymes (Pearson’s bivariate correlation coefficient r = 0.84±84).Conclusions: As soon as the serum ferritin level crosses the value of 1000 ng/ml and number of transfusions are more than 30, derangement in liver enzymes starts occurring in β -thalassemia major.