Nitrofurantoin susceptibility profile versus other antibiotics tested in uropathogens- a retrospective study from India

Introduction. Urinary Tract Infection (UTI) is one of the most common bacterial infections encountered by clinicians worldwide. The emergence of multidrug-resistant uropathogens necessitates a review of their susceptibility profiles. This study aims to assess the susceptibility trends of uropathogens to a panel of drugs, with special emphasis on Nitrofurantoin (NFT). Methods. A retrospective analysis was conducted on 2,099 mid-stream clean catch urine samples processed by standard microbiological methods. Clinical and Laboratory Standards Institute (CLSI) guidelines (2019) were followed. Statistical analysis was performed. Results. Out of all samples, 212 were culture positive. Escherichia coli (34.9%) and Enterococcus spp. (15.1%) were the most common Gram-negative and Gram-positive organisms, respectively. Gram-negative isolates were most susceptible to Colistin (97.38%), followed by NFT (69.35%). Gram-positive uropathogens were most sensitive to Linezolid (100%), followed by Vancomycin and NFT, each with 92.45% susceptibility. Conclusion. The increase in antibiotic resistance among various uropathogens underscores the need for surveillance data to inform the appropriate selection of antibiotics. Our study highlights that, among the panel of antibiotics tested, NFT appears to be a viable alternative for treating multidrug-resistant uropathogens

Post-partum intrauterine contraceptive device: acceptability and safety

Background: Antenatal period is the ideal time for counselling regarding contraception. PPIUCD is a long term reversible method for unmet need of contraception in women of reproductive age. The objectives of this study were to determine proportion of women accepting PPIUCD insertion, their socio-demographic, obstetrics characteristics, reason for acceptance, denial, rates of expulsion, complications and continuation rate till 10 weeks after insertion.Methods: A prospective descriptive study on 300 consented women was done in 2012-2013. A structured questionnaire and performa were used to obtain data. PPIUCD (CuT380A) was inserted in these women and were followed up till 10 weeks post insertion.Results: Out of 300 women counselled, only 85 accepted PPIUCD giving an acceptance rate of 28.33%. Women who had short inter-conceptional period or those who had previously used interval IUCD were significantly associated with greater acceptance. Fear of pain, heavy bleeding and infertility when planning next pregnancy were the most common reasons for denial. Continuation rate was 86.89% at 10th week after insertion. No major complication was observed i.e. perforation, infection and pregnancy.Conclusions: PPIUCD is quite safe method of contraception. Adequate counselling and clarification of myths associated with PPIUCD use can help acceptance and meet the unmet needs of contraception in post-partum period and even later in reproductive age women

A retrospective study of emergency obstetric hysterectomy in a tertiary care center for a period of 5 years

Background: The study was conducted to determine the frequency, demographic characteristics, indication and fetomaternal outcome associated with emergency obstetric hysterectomy in a tertiary care center.Methods: Thirty cases of emergency obstetric hysterectomy performed during the five-year period from April 2011 to April 2016 were analyzed in the dept. of Gynae and obs. in Shri Guru Ram Rai Institute of Medical Sciences in Dehradun.Results: During the study period there were 30 cases of obstetric hysterectomy out of 8084 deliveries giving an incidence of 0.37%. Majority of the patients (60%) were unbooked and were in the age group of 26-30 (43.3%). Common parity group were 3, 4 and 5. Morbid adherent placenta was the most common indication contributing to 40% of the cases. There were four maternal deaths in the study. All were unbooked and three of them died of hypovolemic shock with cardiopulmonary arrest and one died of septicemia. Whereas there were 60% perinatal mortality and 26.66% NICU admissions.Conclusions: Emergency obstetric hysterectomy is a potentially lifesaving procedure which often puts obstetrician in dilemma at the time of decision making

Serum β HCG and lipid profile in early second trimester as predictors of hypertensive disorders of pregnancy

Background: Hypertensive disorders complicating pregnancy are common (5-10%) and form one member of the deadly triad, along with haemorrhage and infection that contribute greatly to maternal morbidity and mortality rates. Although overt illness rarely appears until third trimester, there are multiple indications that the disease process begin early in the pregnancy. Since years there has been a search for an early predictor of PIH so that special antenatal care can be given to these patients. This prospective study was one of the efforts to predict preeclampsia by measuring serum beta HCG levels and lipid profile in 2nd trimester of pregnancy.Methods: This was a prospective study carried out on 200 pregnant women attending the outpatient antenatal clinic and estimating serum beta HCG and lipid profile in early second trimester.Results: Most of the women who entered the study were in the age group of 21-30 years. Out of 200 patients, 164 remained normotensive and 36 turned out to be hypertensive. 50% of patients in the normotensive group and 75% in the hypertensive group were primigravidas indicating that primigravidas have a higher risk of developing PIH compared to multiparas. No correlation was found between the residence and occurrence of hypertension. Among 45 patients with beta HCG >40,000mIU/mL, 30 developed hypertensions, whereas, among 155 patients who had levels 200 mg/dl. Among the hypertensive group, 83.4% cases had levels >250 mg/dl. A significantly higher number of hypertensive cases i.e.75% had serum VLDL >40 mg/dl. 83.4% of hypertensive patients had serum LDL >140 mg/dl. In our study, 5.5% of the cases among normotensive group had serum HDL <40 mg/dl whereas, 16.6% of cases among the hypertensive group had serum HDL <40 mg/dl.Conclusions: Women with raised serum beta HCG and/or dyslipidemia should be carefully followed up to achieve a more favourable outcome for both mother and the fetus

Pattern of odontogenic tumors in a single government teaching hospital in the state of Tamil Nadu: A retrospective study from the files of histopathology register.

OBJECTIVE : This institutional study was designed to determine the relative frequency of odontogenic tumors and to provide the information with reference to age, sex, anatomic location, and also to compare the data with the previous reports from other studies. MATERIAL AND METHODS : A total of 489 cases of odontogenic tumors registered over a period of 38 years (February 1970 - March 2008) in the Department of Oral and Maxillofacial Pathology of Tamil Nadu Government Dental College and Hospital, Chennai, India were retrieved from the files of histopathology registers and were retrospectively analyzed. RESULTS : Odontogenic tumors in the present study constituted 4.13% of all the 11843 registered biopsies. The mandible was the most commonly affected anatomic location with 362 cases (74.02%). Ameloblastoma with a predilection for posterior mandible was the most frequent odontogenic tumor (67.68%), followed by adenomatoid odontogenic tumor (9%), odontoma (7.77%) and calcifying odontogenic cyst (5.52%). The patients were affected over a wide age range of 5-75 years with a mean age of 32.64 years and peak occurrence in 2nd and 3rd decades of life. Among the 489 cases only 15 cases (3.07%) were malignant. CONCLUSION : The incidence of 4.13% of odontogenic tumors observed in this study is the largest series from this part of the world. Ameloblastoma formed the single most common tumor of all odontogenic tumors. This study observed both regional and geographic variations in the frequency and distribution of odontogenic tumors

A six year appraisal of caesarean delivery at a teaching hospital in Uttarakhand

Background: Caesarean section is one of the commonest surgical procedures worldwide. Its upward trend and its indications in low resource setting makes regular appraisal of the practice necessary.Methods: A retrospective study. Labour ward logbook and case records were looked into, and all information extracted.Results: The prevalence of caesarean section in the study population was 32.18%. The most common indication of caesarean section was previous caesarean section (33%) followed by fetal distress (26.2%).Conclusions: Risk appraisal and all efforts must be geared towards reducing caesarean section rate. Certain measures have been recommended.

Recent trends in uropathogenic infections in patients of a tertiary care center, New Delhi, India, – a topic of urgent attention

Urinary tract infections (UTIs) are the leading cause of outpatient visits and nosocomial infections worldwide resulting in increased healthcare costs. Information about the disease-associated pathogens and their susceptibility profile is of paramount importance for choosing antimicrobials and containing the alarming rise in microorganisms’ drug resistance. This study aimed to investigate the prevalence of gram-negative and gram-positive uropathogens in hospitalized adult patients, considering their sensitivity profile. The study retrospectively analyzed 2099 urine samples received from December 2019 to May 2020. The isolates were identified by standard microbiological methods, and sensitivity testing was done following the Clinical and Laboratory Standards Institute (CLSI) guidelines (2019). Out of the 2099 samples tested, 212 were positive. The vast majority of samples (97.6%) was received from women. Escherichia coli (34.9%) was the most common gram-negative pathogen, while Enterococcus spp. (15.1%) prevailed among gram-positive organisms. Among gram-negative organisms, a high susceptibility was observed for aminoglycosides (amikacin, netilmicin), nitrofurantoin, and carbapenems, while a high resistance was found towards co-trimoxazole, fluoroquinolones, and cephalosporins. We confirmed that nitrofurantoin, a traditional oral drug, still demonstrates good activity against uropathogens. Thus, there is an urgent need to study uropathogens and their susceptibility patterns to control the inadvertent use of antimicrobials and the spread of multidrug-resistant strains