ABSTRACT
Background: Drug resistant tuberculosis has frequently been encountered in India. The prevalence of extrapulmonary multi drug resistant tuberculosis in this country is found to be 3% in new cases and 12-17% in treated cases, which needs to be evaluated. Settings and Design: A retrospective analysis of processed extrapulmonary tubercular samples in Intermediate Reference Laboratory of Department of Microbiology, Goa Medical College, was carried out over a period of one year, from November 2013 to October 2014. Methods: Lowenstein Jensen Media was used for culture processing of 202 samples from clinically suspected cases of extra-pulmonary tuberculosis patients. Drug susceptibility testing was done on the isolated strains using the economic variant of proportion method. Results: Out of 202 samples, 30 (14.85%) were observed to be culture positive for Mycobacterium tuberculosis of which six (21.43%) were found to be resistant to both Isoniazid and Rifampicin. Conclusion: With the advent of immunocompromised states, one has to be aware of multi drug resistant extra-pulmonary tuberculosis as a double edged sword. The early detection in such cases is a need of the hour to initiate prompt treatment.
ABSTRACT
Background & objectives: Scrub typhus is one of the differential diagnoses of haemorrhagic fevers especially if associated with jaundice and/or renal failure. Goa State in the western region of India has been witnessing increased incidence of such fevers, therefore, the present study was undertaken to identify whether scrub typhus is the aetiological agent. Methods: Adult patients presenting with undiagnosed febrile illness between June 2009 to October 2010, were evaluated. Testing was done using a commercial ELISA kit for specific IgM antibodies against Orientia tsutsugamushi. Results: Of the 44 patients included in the study, 15 (34%) were found to be positive for IGM antibodies against O. tsutsugamushi. The cases were seen mainly in the months between July to November. The common symptoms noted were fever, myalgias, gastrointestinal complaints, followed by breathlessness, rash and jaundice. The pathognomonic features such as eschar and lymphadenopathy were seen only in two patients. Nearly two third of the patients had leukocytosis (67%) and low serum albumin (60%). The most common complication noticed was hepatitis (80%) followed by acute respiratory distress syndrome (ARDS) (60%), thrombocytopenia (40%) and acute renal failure (33%). Five patients died in the course of illness. Interpretation & conclusions: Our results showed that scrub typhus should be considered in the differential diagnosis of acute febrile illness associated with gastrointestinal symptoms, rash, myalgia , including those with organ dysfunctions such as hepatorenal syndrome, coagulopathy or ARDS. Empirical treatment with doxycycline or macrolides may be given in cases with strong suspicion of scrub typhus.
ABSTRACT
Em um asilo público, as necessidades são enormes; além da constatação do declínio do ser humano quando nos deparamos com idosos em estado de abandono. A instituição pesquisada pertence ao Estado e acolhe todo tipo de idoso, sem discriminação. O trabalho de Psicologia nesse local ainda é iniciante e cheio de possibilidades, as primeiras impressões já falam que um enorme campo aguarda profissionais dispostos e abnegados.
In a public asylum the necessites are enormous material lack, staff lack, beyond the constation of decline of the human being, when in we come across them with aged in abandonment state. The searched institution belongs to th State and receives the all type of aged, without discrimination. The work in Psychology in this place still is beginnig: and it's full of possibilities, the first impressions already speak that an enormous field waits made use end self-professionals.