Study of clincial profile and outcome of Klebsiella sepsis in neonates at a tertiary care centre

Background: Objective of the study is to study clinical profile and outcome of Klebsiella sepsis in neonates.Methods: A retrospective observational study from January 2018 to Sep 2018. After getting approval of institute ethics committee, admitted neonates whose blood culture showed Klebsiella growth were enrolled. A detailed history, birth weight, sex , age, APGAR, need for resuscitation at birth, distress at birth, ventilator support, CPAP, central line, blood products, species of Klebsiella and drug sensitivity and outcome-discharge or death were taken. Data were entered into Microsoft excel data sheet and was analyzed using SPSS 23 version software.Results: Out of the total 252 positive blood culture, 110 (43%) grew Klebsiella in blood culture. 92 cases were included in the study. Male to female ratio was 1.24:1. Mean age at admission was 1.22 days. 40 (43.5%) died and 52(56.5%) were discharged. Birth weight was 1.635'802 gm for babies who died and 2211'939 gm among discharged. Mean gestational age were 32.5 weeks in died and 34.8 weeks among discharged. Mortality was 23(57.5%) in males, low birth weight babies 23(59%), thrombocytopenia 28 (78%), invasive mode of ventilation 19(67%). By Univariate analysis, it was found that pregnancy induced hypertension (PIH), premature rupture of membrane (PROM), abnormal APGAR, Birth weight, shock, invasive ventilation, DIC, inotropes, blood products, abnormal total count, thrombocytopenia, umbilical venous catheterization were factors which influenced outcome. Regression analysis identified only thrombocytopenia and umbilical venous catheterization as factors that influenced outcome in Klebsiella sepsis. Klebsiella isolated was uniformly sensitive to Meropenam.Conclusions: No single risk factor was ascertained but thrombocytopenia and umbilical venous catheterization possibly influence the outcome of Klebsiella sepsis. Mortality is high in neonates.

Cytodiagnosis in Upper Gastrointestinal Malignancy.

Introduction: The role of exfoliative cytology as an adjunctto endoscopic biopsy in the detection of upper gastrointestinalmalignancy is controversial insofar as some claim that its useis of little clinical benefit. To evaluate the diagnostic accuracyof upper gastrointestinal with brush cytology as compared toconventional endoscopic biopsies.Material and Methods: A prospective observational studywas conducted prospectively at Dhanalakshmi Srinivasanmedical college and hospital in perambalur. Total 45 Patientswith clinical signs and symptoms of benign and malignantlesions of the upper gastrointestinal tract was included in thestudy. The data was collected between April 2018 to March2019.Results: The brush cytology had a sensitivity of 72.73% inpredicting gastric malignancy of biopsy and Specificity was75.00%, false positive rate was 25.00%, false-negative ratewas 27.27, positive predicting value was 88.89%, negativepredictive value was 50.00%, diagnostic accuracy was 73.33%,positive likelihood ratio was 2.91 and negative likelihoodratio was 0.36. In predicting esophageal malignancy in biopsySpecificity was 83.33%, the false positive rate was 16.67%,false-negative rate was 11.11%, the positive predicting valuewas 88.89%, negative predictive value was 83.33%, diagnosticaccuracy was 86.67%, positive likelihood ratio was 5.33 andnegative likelihood ratio was 0.13 of brush cytology.Conclusion: The study concluded that Prompt earlyendoscopic examination with cytological and biopsy studiesin patients with early symptoms may help very much in theearly diagnosis and improves the survival rate.

In vitro anticancer activity of vitis vinifera

Vitis vinifera was evaluated for in vitro anticancer activity using Dalton's lymphoma ascites cells. Its dried seeds aqueous extract [10-200 microg/ml] induced dose dependent cytotoxicity with an IC50 value of 150 microg /ml favoring its anti-cancer action