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Background: Chronic suppurative otitis media (CSOM) is an inflammation of the middle ear irrespective of the etiology or pathogenesis. CSOM is a disease of multiple etiologies and is well known for its persistence and recurrence in spite of treatment. It is renowned for its arrival suffering disease. Aim: This study aims to study the bacterial pathogens and their antibiotic sensitivity pattern of ear infections in patients with chronic otitis media.Materials and Methods:This prospective study was conducted at the Department of ENT and Department of Microbiology, Medical College and Hospital, India, over a period of 1 year from January 2018 to December 2018. A total of 100 patients were included in this study. The ear discharge which is collected with sterile swabs is subjected to Gram’s staining and culture of the causative organism. Antibiotic sensitivity test of cultured bacterial growth is undertaken to know the susceptibility of the causative organism.Results: Of 100 samples, 72 were positive for microbial growth and 28 showed no growth. The most common bacteria causing CSOM was Pseudomonas aeruginosa in 43 (54.43%) of samples followed by Staphylococcus aureus 12 (15.19%), coagulase-negative staphylococci 9 (11.39%), Klebsiella pneumoniae 7 (8.86%), Escherichia coli 4 (5.06%), Proteus vulgaris 2 (2.53%), and Proteus mirabilis and Streptococcus pneumoniae 1 (1.27%) each. Susceptibility test was done for known the best antibiotic agents which can be used as a proper treatment to CSOM infection.Conclusions: In the present study, the most effective antibiotics agents for most of bacterial isolates were gentamicin, ciprofloxacin, amikacin, and chloramphenicol.
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Allergic bronchopulmonary aspergillosis (ABPA) is a hypersensitivity pulmonary disease occurring in individuals with asthma or cystic fibrosis. In these patients, it is characterized by transient pulmonary infiltrates, reversible airway obstruction, eosinophilia
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Background: The use of glucocorticoids in various forms of administration is complicated by their systemic side effects. Although intravenous pulse therapy is considered to have lesser systemic side effects, there are few studies in literature comparing the effects of intravenous pulse glucocorticoids versus oral daily glucocorticoids on bone mineral density. Aim: To compare the effects of intravenous pulse glucocorticoids and oral daily glucocorticoids on bone mineral density with the aim of finding any site-specific osteopenic side effect. Methods: The study was conducted by the department of dermatology of Postgraduate Institute of Medical Education and Research, Chandigarh, India. The study comprised of two groups of patients. Group A consisted of 28 patients with pemphigus vulgaris who received intravenous pulses of dexamethasone at 4 weekly intervals. Group B consisted of 21 patients with airborne contact dermatitis who received oral daily prednisolone therapy. All the patients had a dual X-ray absorptiometry scan at baseline, and at 3 and 6 months of follow-up. The results were analyzed as changes in bone mineral density. Results: There was loss of bone mineral density at lumbar spine and the head of radius in both the groups. At the lumbar spine, Group B showed more reduction in bone mineral density at 3 months whereas in Group A it was more at the head of radius. In patients on oral steroids, the lumbar spine was significantly more affected than the head of radius at both 3 and 6 months of follow-up. However, in patients on intravenous pulse steroids, both the sites were equally affected at 3 and 6 months. Limitations: In our study, we used different glucocorticoids in the two groups: prednisolone in the oral daily group and dexamethasone in the intravenous pulse steroids group. A similar reduction in bone mineral density in both the groups may have been due to a longer half-life or more bone-directed side effects of dexamethasone as compared to prednisolone. Conclusion: Dermatologists need to be aware of the detrimental effects of high-dose intravenous pulsed glucocorticoids on bone mineral density and assessment of this parameter should be done before the initiation of therapy and also at regular intervals thereafter. During follow up, either the lumbar spine or the head of radius can be used to assess the osteopenic effect of intravenous pulse steroids, whereas the lumbar spine is a better site for this evaluation in patients on oral steroids.
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The study aims to evaluate the sensitivity and specificity of different methods for diagnosis of malarial infection. Total 200 blood samples were collected in ethylenediaminetetraacetic acid (EDTA) Vacutainer tube from clinically suspected malaria patients. Each sample was processed as thick and thin smear stained with Leishman’s stain for light microscopic examination, quantitative buffy coat test and rapid malarial antigen (HRP II and pLDH) test. The detection rate of malarial parasites by microscopic examination was 13.5%, quantitative buffy coat test was 18% and rapid malarial antigen (HRP II and pLDH) test was 20%. Thus, findings of microscopic examination must be compared with other more sensitive methods for confirmation of malaria. This will help early detection, proper diagnosis and treatment of malaria.
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We report a two year old child who developed a large esophageal diverticulum over a period of ten months following ingestion of a multispiked leaf of Quercus semicarpipholia.Though the endoscopic removal of foreign body was successful, it did not relieve the symptoms and patient required surgical resection of the diverticulum. Patient is asymptomatic after 4 months of follow up.
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In the present study, we studied the various reasons for conversion in laparoscopic cholecystectomy; and recommended various methods and measures to decrease the incidence of conversion and associated complications with this procedure. One hundred and seventy six patients in age group of 20-55 years, M:F ratio as 1:9 with body weight in range of 45-65 kilogram, who were having cholelithiasis without choledocholithiasis and contraindication for general anaesthesia underwent laparoscopic cholecystectomy between Jan 2002 and Dec 2003. There were a total of ten surgeons performing laparoscopic cholecystectomy out of which two surgeons had experience of more than 200 laparoscopic cholecystectomies. Twenty one patients (11.93%) out of a total of one hundred and seventy six (11.93%) had to be converted to open cholecystectomy for reasons which included dense omental or visceral adhesions- 5(2.84%), postoperative adhesions with parieties and viscera (intestines) - 3 (1.70%), uncontrollable bleeding from liver bed - 3 (1.70%), uncontrollable bleeding from cystic artery - 2(1.14%) unclear anatomy - 2(1.1.4%), cholecysteoduodenal fistula - 1(0.57%), common bile duct injury - 1 (0.57%), cirrhotic liver with shrunken gallbladder - 1(0.57%), spillage of stone - 1(0.57%), pneumoperitoneum related complications - 1(0.57%), instrument/equipment failure - 1 (0.57%). Good Laparoscopic skill, adequate experience and innovations are prerequisites for safe and cost-effective laparoscopic cholecystectomy thereby reducing conversion rate.