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Introduction: Neonatal sepsis remains an important causeof neonatal mortality and morbidity despite the tremendousadvances in the field of neonatology over the last two decades.Current research aimed to study the profile of neonatal sepsis& its antimicrobial sensitivity pattern.Material and methods Two year prospective observationalstudy was conducted at NICU of NMCH Patna from May2018 to April 2020. Neonates with clinical diagnosis ofneonatal sepsis as per IMCI and WHO clinical criteria forneonatal sepsis and/or >2 risk factors associated with EONSwere enrolled in study.Results: Out of the 341 cases enrolled, blood culture waspositive in only 130(38%). Incidence of EONS was 67%and that of LONS was 33%. Majory of the septic neonateswere preterm (64%). 55% of such neonates were of malesex. Gram negative bacteria accounted for 55% of all cases,61% of EONS and 44% of LONS cases. The most commonisolate was Staph. aureus closely followed by Klebsiella sp.Gram negative bacteria, esp. Klebsiella had a high incidenceof resistance to the empirical antibiotic used and to most ofthe commonly used antibiotics. Culture positive group had asignificantly higher mortality as compared to culture negativegroup(p<0.001).Conclusion: Blood culture though gold standard was notpositive in majority of the cases. Neonatal sepsis was morecommonly associated with prematurity. Gram negativeorganisms were the commonest etiologic agents. Emergenceof strains resistant to even the newest antibiotics poses a greatconcern.
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Context: Due to limited resources and/or affordability by majority of the patients, many centers in low- and middle-income countries are still not able to adapt three-dimensional image-based brachytherapy planning in their routine practice. Aim: The aim of the study was to see the feasibility of using computed tomography (CT)-based plan of the first fraction to treat successive fractions of intracavitary brachytherapy based on the estimation of the physical dosimetric differences between successive applications. Materials and Methods: CT image-based brachytherapy plans of 38 patients who received three insertions of intracavitary application with high-dose-rate brachytherapy have been analyzed. Revised plans for the second and third insertions were generated by adapting dwell time and dwell position of the first insertion plan. The dose to point “A” and maximum doses to 2, 1, and 0.1 cc volumes of the rectum and bladder have been used for dosimetric comparison. Results: The statistical differences of mean point “A” doses were observed insignificant except between original and revised plans for the second insertions. The dosimetric differences between consecutive original and revised plans for the bladder and rectum have not shown any significance except minimum dose to 0.1 cc volume of the rectum for the third insertions. Conclusions: Dosimetric deviation for tumor and organs at risk is within acceptable limit while using CT image-based brachytherapy plan of the first fraction for treating successive fractions
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A new impurity was detected during high performance liquid chromatographic (HPLC) analysis of eslicarbazepine acetate active pharmaceutical ingredient. The structure of unknown impurity was postulated based on liquid chromatography mass spectrometry using electrospray ionization and ion trap analyzer (LC/ESI-IT/MS) analysis. Proposed structure of impurity was unambiguously confirmed by synthesis followed by characterization using 1H, 13C nuclear magnetic resonance spectrometry (NMR), 1H-1H correlation spectro-scopy (COSY) and infrared spectroscopy (IR). Based on the spectroscopic and spectrometric data, unknown impurity was characterized as 5-carbamoyl-10,11-dihydro-5H-dibenzo[b,f]azepin-10-yl propionate.
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Most cases of permanent form of neonatal diabetes mellitus (PNDM) are due to dominant heterozygous gain of function (activating) mutations in either KCNJ11 or ABCC8 genes, that code for Kir 6.2 and SUR1 subunits, respectively of the pancreatic β-cell KATP channel. We describe the interesting case of an infant with PNDM, in whom a compound heterozygous activating/ inactivating mutation was found with clinically unaffected parents, each carrying a heterozygous mutation in ABCC8, one predicting gain of function (neonatal diabetes) and the other a loss of function (hyperinsulinemia).