53 research outputs found

    Antibiotic sensitivity profile of Klebsiella isolates and it’s impact on clinical outcome

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    Background: Antimicrobials are the greatest discovery of the twentieth century. To limit the emergence and spread of resistance, antibiotic therapy should be adjusted according to the results of microbiological culture. Klebsiella isolates causes various types of infections and the incidence of antibiotic resistance is also high in Klebsiella infections. So, Authors plan this study to analyze how the results of microbiological cultures influence the antibiotic use in the treatment of Klebsiella infections.Methods: It is a record based observational prospective study which assessed the impact of Klebsiella positive culture results on antibiotic prescribing pattern and its impact on clinical outcome. Patients with empirical antibiotic therapy and Klebsiella positive were included and patients with inadequate data were excluded in this study and the data were recorded. Recorded data were entered and analyzed in Microsoft Office Excel-2013. Unpaired student t-test was used to compare the mean duration of hospital stay using Past software (version 3.20).Results: There were total 400 patients in our study. Amikacin was the most common drug (n=202) used as empirical therapy. Empirical antibiotic therapy was changed in 161(40.25%) patients. Meropenem was the most commonly used definitive drug. Mean duration of hospital stay is less in empirical sensitive antibiotic therapy as compared to empirical resistance antibiotic therapy having p value <0.0001 which shows significant difference between two groups showing better clinical outcome.Conclusion: Initial empirical therapy with broad-spectrum antimicrobials is a treatment strategy for severe Klebsiella infections

    Comparative analysis of national essential medicine list for children by Indian academy of pediatrics and pediatric drugs available at a tertiary care teaching hospital in Rajkot, Gujarat, India

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    Background: The better medicines for children initiative of the WHO began in December 2007 as a consequence of the World Health Assembly resolution 60.20, when there was evidence that nearly 50% of children under five were dying for preventable diseases for which medicines existed. There is a need to develop “child friendly” formulations and make them available.Methods: This cross sectional study was conducted during September 2015. The availability of essential medicine for children (drugs, strength, and dosage form) was noted down. Drugs which are not listed in the National list of Essential medicines (NLEMc) for children but available in the hospital pharmacy were also noted down.Results: Out of the drugs listed in NLEMc, 86.56% drugs were available in the pharmacy of tertiary care teaching hospital, Rajkot. 57.76% percent of these drug formulations were available as specified in NLEMc and 44.36% of the available drugs had the same strength as specified in NLEMc. For those drugs which are mentioned in NLEMc but not available in the hospital pharmacy, alternative drugs are available for the same indication.Conclusions: Majority of the drugs available in hospital pharmacy of tertiary care teaching hospital, Rajkot are in accordance to NLEMc. However hospital pharmacy is deficient in paediatric formulations and strength in accordance to NLEMc

    Development of UVM based Reusabe Verification Environment for SHA-3 Cryptographic Core

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    In this work, an industry standard methodology for ASIC verification domain, SystemVerilog (SV) with Universal Verification Methodology (UVM) is introduced with its features and application to Keccak SHA-3 Cryptographic Core. The ASIC verification flow for SHA-3 core is followed with creation of UVM based verification environment. By application of UVM on the core, horizontal and vertical re-use can be achieved in standard projects. Proposed verification environment uses OOPs concepts from SV UVM to develop layered testbench. In this approach initial learning curve is slow, considering overhead to learn new verification methodology. But, once full fledge working environment is created, re-usability feature from SV UVM can be achieved with less amount of time. Also coverage results give effectiveness of the proposed verification environment. DOI: 10.17762/ijritcc2321-8169.15057

    Retrospective study for the results of proximal femoral nailing in subtrochanteric fractures

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    Background: Subtrochanteric fractures are prevalent in young and old age groups and one of the most notorious to achieve a stable fixation which allows early union and mobilization. This was a retrospective study to analyse the outcomes of proximal femur nailing in subtrochanteric fractures and assess the functional outcome, radiological union and compare that with studies of other modalities.Methods: This was a retrospective study of 40 patients with sub trochanteric fractures classified by Sienshiemer classification and operated by proximal femoral nail implant. Clinical evaluation was done by Harris hip score.Results: The average union time in our study was 5.12 months lower than some of the union rates of series with other implants (AO blade plate 7.7%). The conducive environment provided by proximal femoral nail (PFN) allows early mobility, independence to the patient and lessens the complications due to the bed ridden state and decrease the time in returning to work.Conclusions: Our study suggests that PFN being and intramedullary implant gives stable fixation and early union as compared to extramedullary implants with less blood loss and less complications

    Drug reaction with eosinophilia and systemic symptom induced by carbamazepine: a case report

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    Drug reaction with eosinophilia and systemic symptoms (DRESS) syndrome is a severe, potentially life-threatening acute adverse drug reaction (ADR), typically characterized by a long latency period (2-6 weeks to 3 months) from drug exposure. DRESS syndrome is defined by the presence of fever, cutaneous eruption, lymphadenopathy, systemic or asymptomatic internal organ involvement (e.g. Hepatitis, carditis, interstitial nephritis, interstitial pneumonitis, etc.) and haematological abnormalities, mainly leucocytosis, eosinophilia and sometimes atypical lymphocytosis. There are around 50 culprit drugs which cause DRESS syndrome e.g. carbamazepine, phenytoin, allopurinol, sulfa derivatives, antidepressants, antiepileptics, non-steroidal anti-inflammatory drugs and antimicrobials. The incidence of DRESS syndrome has been estimated to be between 1 in 1,000 and 1 in 10,000 drug exposures. There are many reported cases of DRESS syndrome due to carbamazepine, phenytoin, vancomycin, levitiracitam, ceftriaxone etc. Author presented a case of DRESS syndrome by carbamazepin. RegiSCAR and Japanese consensus group have developed specific criteria for making the diagnosis of DRESS syndrome. The patient described here met the majority of criteria according to RegiSCAR scoring guidelines for a diagnosis of DRESS syndrome induced by carbamazepine. As per RegiSCAR diagnostic criteria author had concluded that this was a “Definite” case of DRESS (Drug Reaction with Eosinophilia and Systemic Symptom) syndrome induced by carbamazepine. Carbamazepine is most common broad-spectrum antiepileptic drugs so, this case report will raises awareness among physician to suspect DRESS syndrome in patients who present unusual complaints and skin findings after starting antiepileptic drugs

    Subacute toxicity study of an aqueous extract of dried leaves of Gymnosporia spinosa on albino rats

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    Background: Leaves of Gymnosporia spinosa have been used by people for treatment of jaundice. Traditional herbal drugs are popular all over the world and it is presumed that herbal medicines have lesser or no side effects. This generalized belief and no information available regarding toxicity study of G. spinosa with search from limited available information prompted us to carry out work on subacute toxicity study of aqueous extract of dried leaves of G. spinosa.Methods: Subacute toxicity study was carried out using aqueous extract of G. spinosa leaves. 30 rats of either sex were randomly divided in to 4 groups. First group received distilled water (control). Second, third and fourth groups received single daily dose of drug orally as 40, 120 and 240 mg/100 g of body weight respectively for 3 weeks. Animals were observed for various parameters. After 21 days blood was collected for blood counts and biochemical parameters. Liver, lungs and kidney were subjected to histo-pathological studies.Results: Throughout study there was no mortality in any group. Degenerative changes in the liver. Other organ does not show any changes. Analysis of biochemical data showed serum glutamic pyruvic transaminase and s. alkaline phosphatase levels were decreased. Serum bilirubine, blood urea and serum creatinine level were increased significantly.Conclusions: The data showed that there was hepato-renal toxicity at higher dose level which is about 100x human therapeutic dose.

    A drug utilization study of analgesics for management of postoperative pain in patients admitted at a tertiary care teaching hospital

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    Background: Postoperative pain is very common and develops naturally as a warning. After surgery, its development can be predicted and should be prevented and treated. Besides the disagreeable aspects and physiological repercussions of postoperative pain, it delays ambulation and hospital discharge. Despite the drugs and anesthetic techniques available, the prevalence of postoperative pain is still high.Methods: Pain assessment was done by BP cuff inflation method and Numerical rating scales both pre and postoperatively.Results: Complain of postoperative pain is more in female patient. Over all complain of postoperative pain was observed more in 31-45 year age group. Complain of postoperative pain was more at 18 hour time interval. Postoperative pain complains was more in patients undergoing general surgery. Postoperatively out of 310 patients 298 patients were received diclofenac only and 18 patients were received diclofenac + tramadol combination of these 112 and 13 patients complained of post-operative pain respectively.Conclusions: 112 patients from diclofenac only received group and 13 patients from diclofenac + tramadol received group complain of post operative pain. Post-operative pain control at 12 hours is sufficient but high post-operative pain scores at 18 hour of post-operative time interval suggesting needs of additional pain control. Majority of study patients received single analgesic (Diclofenac sodium)

    Evidence for the existence of powder sub-populations in micronized materials : Aerodynamic size-fractions of aerosolized powders possess distinct physicochemical properties

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    This article is distributed under the terms of the Creative Commons Attribution License which permits any use, distribution, and reproduction in any medium, provided the original author(s) and the source are credited.Purpose: To investigate the agglomeration behaviour of the fine ( 12.8 µm) particle fractions of salmeterol xinafoate (SX) and fluticasone propionate (FP) by isolating aerodynamic size fractions and characterising their physicochemical and re-dispersal properties. Methods: Aerodynamic fractionation was conducted using the Next Generation Impactor (NGI). Re-crystallized control particles, unfractionated and fractionated materials were characterized for particle size, morphology, crystallinity and surface energy. Re-dispersal of the particles was assessed using dry dispersion laser diffraction and NGI analysis. Results: Aerosolized SX and FP particles deposited in the NGI as agglomerates of consistent particle/agglomerate morphology. SX particles depositing on Stages 3 and 5 had higher total surface energy than unfractionated SX, with Stage 5 particles showing the greatest surface energy heterogeneity. FP fractions had comparable surface energy distributions and bulk crystallinity but differences in surface chemistry. SX fractions demonstrated higher bulk disorder than unfractionated and re-crystallized particles. Upon aerosolization, the fractions differed in their intrinsic emission and dispersion into a fine particle fraction (< 5.0 µm). Conclusions: Micronized powders consisted of sub-populations of particles displaying distinct physicochemical and powder dispersal properties compared to the unfractionated bulk material. This may have implications for the efficiency of inhaled drug deliveryPeer reviewe

    Impact of the COVID-19 pandemic on individuals with nystagmus and an exploration of public assumptions about the condition: an electronic questionnaire study

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    Purpose Nystagmus is a disorder characterized by uncontrolled, rhythmic oscillations of the eyes. It often causes reduced visual function beyond reduced visual acuity alone. There is a paucity of literature regarding the public understanding of nystagmus, and there are no published data on the impact of the COVID-19 pandemic on people living with the condition. This study explores the self-reported impact of the COVID-19 pandemic on those with nystagmus, and examines both public understanding of how nystagmus affects people who have it and the perceptions of public understanding by those with the condition and their carers. Methods A qualitative questionnaire was designed following a stakeholder engagement process. This questionnaire was advertised via social media platforms and charity websites to achieve widespread recruitment. Data were collected between November and December 2020. Participants were divided into two groups based on their response to the question: “Do you, or anyone you know well, have nystagmus?”. Questions were posed to participants in a purpose-built, branching survey. The resulting data were analyzed using descriptive and inferential statistical methods. Results One thousand six hundred forty-five respondents were recruited, of which 849 (51.6%) answered “Yes” to the initial filtering question. Analysis showed that, broadly, public understanding of nystagmus differs from the perception of it by those with nystagmus and their carers, that the COVID-19 pandemic has had a significant impact on those with nystagmus, and that respondents who have met someone with nystagmus, even briefly, tend to have a greater understanding of the impact of the condition. Conclusion This study highlights the lack of public awareness regarding nystagmus and suggests opportunities to increase the awareness of nystagmus without the need for extensive knowledge of the condition. The COVID-19 pandemic has posed additional difficulties for those living with nystagmus, which is likely to be comparable among those with similar ocular disorders. Peer Review report
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