ABSTRACT
Background: Neonatal sepsis is characterized by systemic signs and symptoms of generalised bacterial infection in the first four weeks of life. Early recognition and diagnosis of neonatal sepsis remains a challenge because of the variable and nonspecific clinical presentation. A combination of haematological and biochemical tests may provide a more rapid diagnosis of sepsis than blood culture which takes at least 24 to 48 hours for the results. Objectives: To study the correlation of parameters of sepsis screen with blood culture in neonates with clinical sepsis and or having significant risk factors for sepsis and To study the outcome of neonatal sepsis was our secondary aim.Material & Methods:The descriptive prospective study with cross sectional design was conducted on 100 neonates admitted with signs and symptoms of sepsis in the nursery ward and NICU of paediatric department of BebeNanki Hospital, GMC, Amritsar. Sepsis screen and blood culture (gold standard for neonatal sepsis diagnosis) and other relevant investigations were sent under strict aseptic conditions and treatment was started. S.CRP levels >1mg/dl, total leukocyte count < 5000 cells/cumm, platelets count < 1.5 lakhs/ µL were taken as positive significant (P <0.005) markers for neonatal sepsis. The data was tabulated and subjected to statistical analysis.Results:Positive CRP (>1mg/dl) were found to be highly significant (p<0.0001), Sensitivity, Specificity, PPV, NPV and Diagnostic accuracy were 93.33%,16.00%,76.92%,44.44% and 74.00% respectively. TLC <5000 were found to be significant (p<0.0001), Sensitivity, Specificity, PPV, NPV and Diagnostic accuracy were 65.33%,44.00%,77.78 %,29.73% and 60.00% respectively. Platelet count < 1.5 lakhs/ µL was found to be significant (p<0.0091), Sensitivity, Specificity, PPV, NPV and Diagnostic accuracy were 68.00%, 16.00%,70.83%,14.29% and 55.00% respectively.Conclusions:In developing countries like India, where blood culture investigations are limited, altered haematological parameters such as CRP, TLC, and Platelets counts can serve as quick, simple, economical methods to diagnose neonatal sepsis. Further studies with larger sample size are required to substantiate the results.
ABSTRACT
Background: If properly used in appendicitis, antibiotics can reduce the rate of infection by 50%. The use of post-operative antibiotics for preventing infective complications in non-perforated cases is still controversial.Methods: A randomised prospective study was conducted in the Department of Surgery, Vardhman Mahavir Medical College and Safdarjung Hospital, New Delhi with patients who presented acute appendicitis. A minimum number of 30 patients each in group A (pre-operative and post-operative antibiotics) and group B (only pre-operative antibiotics) were evaluated for 18 months, from January 2018 to June 2019.Results: The mean age of group A is 29.9±15.16 years and in group B is 25.97±9.470 years (p value=0.122, insignificant). There was male preponderance. The seroma formation in both the groups was 10.00% and no patients developed intra-abdominal abscess. The incidence of local site oedema was 10% in both the groups A and B and their p value is insignificant. In both the groups A and B, 10% of the people developed pus discharge from the stitch line and the p value is insignificant. In group A, 6.67% of the patients and in group B 10.00% of the patients developed stitch line inflammatory changes and the p value insignificant. In group A, 13.3% and in group B, 10.00% of the patients developed fever and their p value is 1. The mean length of hospital in case 1.23±0.5 days (group A) and is 1.17±0.45 days (group B) (p value=0.508).Conclusions: Hence we can conclude that a well-chosen and adequately-timed pre-operative antibiotics are adequate in preventing post-operative complications and post-operative antibiotics do not affect the same.
ABSTRACT
Mucormycosis is a rare infection which is largely diagnosed in immune-compromised patients. The infection can cause pulmonary, rhinocerebral, skin and soft tissue, central nervous system, gastrointestinal and disseminated disease, with gastrointestinal involvement being the rarest presentation. Outcome and mortality of zygomycosis varies with the underlying condition and site of infection, it is however very high in general. Diagnosis is usually delayed and delay in initiation of amphotericin B treatment leads to poor outcome. We report rare case of a malnourished young adult who presented with gastric perforation peritonitis due to mucormycosis infection.
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Background: Occupational exposure of farmers are known to cause many respiratory illness and manifestgreater rates of asthma and respiratory symptoms than other workers. The poultry farm workers are exposedto organic dust, endotoxins and hazardous gases. Longer the duration of exposure to the dust, greater thehealth hazard. Therefore, the objective of this study was to record and compare the various pulmonaryfunction parameters in poultry farm workers on the basis of duration of exposure to poultry dust. Methods:The study was conducted on 66 poultry farm workers after taking written informed consent. Pulmonaryfunction tests was performed using Autospirometer (Helios 701: Chandigarh). The workers were groupedaccording to duration of exposure into five sub groups (Group A upto 5 years, Group B >5-10 years, GroupC >10-15 years, Group D >15-20, Group E >20 years exposure). Data was analyzed using one way ANOVAand post-hoc by Bonferroni test. Results: We found that the pulmonary functions started deterioratinggradually in poultry farm workers after 5-10 years of exposure (Group B) to poultry dust with maximumdecrease on exposure to more than 20 years (Group E). There was statistically significant decrease in FVC,FEV0.5, FEV1, FEV3 with normal FEV1/FVC suggesting restrictive ventilatory changes in poultry workers.There was significant decrease in FEF25-75% and FEF0.2-1.2, PEFR suggesting early small and largeairway obstruction respectively. Conclusion: Poultry dust adversely affects the respiratory function and thisimpairment is associated with duration of exposure to poultry dust. The present study intends to raise publicawareness about occupational exposure to poultry dust in poultry farm workers.
ABSTRACT
No abstract available.