ABSTRACT
Background:There is scarcity of essential medications, medical talent and health care facilities to treat covid-19, at remote places. This studyexplores various modalities in resource-limited settings for the management of COVID-19 patients.Methods: We retrospectively analysed data of 266 consecutive discharged and death Covid-19 patients from 26December 2020 to 29May 2021. All patients were admitted and received appropriate supportive care, regular clinical and laboratory monitoring.Results: Of total 266 patients the mean age of patients was 49.19 (SD 14.1) years and 185(69.54%) of them were males. 99(37%)cases were moderate, 83(31%)were severe cases remaining 84(32%)were mild cases. 16 (6.01%) patients expired and remaining 250 patients were subsequently discharged.Median duration of stay in the hospital was 9 (37) days. Of total 266 admitted patients� mortality rate was only 6.01%.Conclusions: We emphasize that even in healthcare facilities with limited resource, poor infrastructure and lack of ICU facilities, clinical observation-based managementt can help to reduce mortality considerably. Unique features of our study include; use of progesterone as an immunomodulator, use of dual antiviral agents, use of age-related lower limit of oxygen saturation.
ABSTRACT
Background: Asterion Introduction: Enteric fever is a major concern in developing country. It is predominantly caused by serovars typhi and paratyphi of Salmonella enterica. Recently, an upsurge in antimicrobial resistant strains has worsened the management of enteric fever. So, aim of present study is to evaluate the clinical profile, antibiotic sensitivity and prescription pattern in blood culture proven cases of enteric fever in pediatric and adult patients.Methods: Single centre, prospective study was conducted at a tertiary care hospital. Demographic and clinical details of blood culture proven enteric fever admitted in hospital were collected over the period from August 2016 to November 2018.Results: Total 58 blood cultures grew Salmonella spp. , amongst them 84.48 % had growth of Salmonella typhi. Blood culture was sent after a mean period of 9 days and 10 days of fever in pediatric and adult patients respectively. All isolates of S. paratyphi A were pansusceptible, whereas 36.73 % isolates of S. typhi were multidrug resistant and nalidixic acid resistant. 68.97% patients received antibiotics before admission. The difference between mean time to defervescence in patients who received ceftriaxone and those who received more than one antibiotic was not statistically significant. (P value 0.87)Conclusion: Blood cultures are the important diagnostic tool to identify multidrug resistant Salmonellae. Study showed that combination therapy was not statistically superior and awareness of local antimicrobial susceptibility pattern significantly helps for better management of the patients.