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Background: Chronic obstructive pulmonary disease (COPD)is a nonreversible lung condition that includes both chronicbronchitis and emphysema. Smoking is the most important riskfactor for the development of COPD. Hence; the present studywas undertaken for assessing risk factors of COPD amongpatients reporting to tertiary care centre.Materials & Methods: A total of 50 COPD patients wereanalysed during the study period. Written consent wasobtained from all the patients before the starting of the studyafter explaining in detail the entire study protocol. Completedemographic and clinical profile of all the patients wasobtained. Complete clinical examination of all the patients wascarried out. Risk factors of COPD were recorded separatelyand were analysed. All the results were recorded and analysedby SPSS software. Chi- square test was used for evaluation oflevel of significance.Results: Significant results were obtained while assessing theage-wise distribution of patients. 58 percent of the patientswere males while the remaining were females. Non-significantresults were obtained while assessing the gender-wisedistortion of patients. Smoking history was found to bepresent in 72 percent of the patients. Significant results wereobtained while assessing smoking as a risk factor for COPD.Positive family history of COPD was found to be present in 60percent of the patients. Rural residence was found to bepresent in 58 percent of the patients.Conclusion: Old age and smoking were found to be significantrisk factors of COPD.
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Background: Asthma is characterized by the action of airwayleading to reversible airflow obstruction in association withairway hyperresponsiveness and airway inflammation. It is oneof the most common chronic conditions affecting both childrenand adults, yet much remains to be learned of its etiology.Hence; the present study was undertaken for assessing theincidence and profile of Asthma patients among knownpopulation.Materials & Methods: A total of 769 patients were screenedduring the study period. Asthma was suspected if the patienthad a positive medical history of recurrent dry coughing,especially at night, rhonchus, wheezing, chest tightness, orshortness of breath. Lung function testing confirmed thediagnosis if an airway obstruction was found reversible basedon an FEV1 (Forced expiratory Volume in 1 second) increase of>12 % and >200 ml (in adults) after administering 200–400 µgsalbutamol. Complete demographic details of all the patientsfound positive for Asthma was obtained. A Performa was madeand clinical details of all the patients were recorded separately.All the results were recorded in Microsoft excel sheet and wereanalysed by SPSS software.Results: Therefore; the overall incidence of asthma was foundto be 17.94 percent. 38.41 percent of the patients were maleswhile the remaining were females. Out of 138 patients, positivefamily history of asthma was found to be present in 69.57percent of the patients. 64.50 percent of the patients were ofrural residence while the remaining 35.50 percent of thepatients were of urban residence.Conclusion: Asthma is a world-wide common disease,thereby affecting a significant proportion of patient population.If not treated properly, it carried significant morbidity.
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Background: Sepsis is one of the most common cause of neonatal deaths globally more so in low and middle-income countries. The key to management is high degree of clinical suspicion and prompt initiation of empirical antibiotic therapy pending investigations' results. Knowledge of one's own NICU flora and antimicrobial susceptibility pattern guides in choosing correct antibiotic therapy to pediatrician. If this data is standard and comparable across different sites, then it also helps in formulating regional and National treatment guidelines. Present study was therefore undertaken to study microbial flora of present NICU and analyze their antimicrobial susceptibility pattern and formulate antimicrobial policy.Methods: Data of blood culture isolates sent from suspected cases of neonatal sepsis received from January 2017 to July 2018 was analysed by 'WHONET'.Results: One hundred ninety-three non-repeat isolates were obtained from 992 blood culture samples. Coagulase negative Staphylococcus and K. pneumoniae were the most common isolates. Non albicans Candida were responsible for majority of fungal infection. There was an outbreak of C. pelliculosa for six months. Most of the bacteria were multidrug resistant (MDR). However, except one all other Candida isolates were sensitive to antifungal drugs.Conclusions: WHO guidelines suggest use of penicillin and gentamicin for neonatal sepsis. But in present study, they were not found useful, instead amikacin, netilmicin and piperacillin-tazobactam were found useful and changes were made in antibiotic policy. Authors therefore recommend regular monitoring of antimicrobial susceptibility pattern followed by necessary changes in antibiotic policy for reasonable empirical therapy.
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Acute liver failure (ALF) is a clinical condition with high mortality. The most common cause of death in ALF is cerebral edema. We present a 12-year-old boy with hepatitis A-related acute liver failure in grade IV hepatic encephalopathy successfully managed in the ICU using continuous hypertonic saline as the preferred osmotherapy.
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Background: Invasive fungal infections are a significant cause of morbidity and mortality in immunocompromised populations. Aims: To evaluate the susceptibility pattern of our isolates against amphotericin B, itraconazole, and voriconazole and to compare the antifungal activities of these agents with each other against the Aspergillus species tested. Settings and Design: A prospective study was designed to include clinical and environmental isolates of Aspergillus species. Materials and Methods: 420 sputum samples, 70 bronchoalveolar lavage fluids, 160 oral washings, and 47 environmental samples were collected. Direct microscopy by potassium hydroxide and lactophenol cotton blue mounts followed by culture on Sabourad`s dextrose agar (SDA) was done. Susceptibility testing was performed by the broth microdilution technique as per Clinical Laboratory Standards Institute standards (M-38A). Additionally, all the isolates were also tested by the colorimetric microdilution technique using Alamar Blue dye. Statistical Analysis: It was done by the Chi-square test and Z-test using SPSS statistical software version 12.0. Results and Conclusion: Twenty-seven isolates (47.3%) were recovered from patients with chronic bronchial asthma followed by fibrocavitary pulmonary tuberculosis in 9 (15.7%), allergic bronchopulmonary aspergillosis (ABPA) in 6 cases (10.5%), bronchiectasis in 3 (5.2%), bronchogenic carcinoma in 5 (8.7%) and those receiving radiotherapy for head and neck cancer 7 (12.2%). Thirteen environmental isolates were also included in the study. The most common isolate was A. fumigatus 28 (40%), followed by A. niger 22 (31%), A. flavus 13 (19%), and A. terreus 7(10%). All isolates were susceptible to amphotericin B, itraconazole, and voriconazole. Among the three agents tested, voriconazole exhibited lowest MICs (≤1 μg/ml) against all Aspergillus species.