Changing uveitis patterns in South India - Comparison between two decades

Purpose: Changing pattern of uveitis in a subset of a population is an important ocular health indicator. Methods: A comparative study was done between uveitis patients of 2013 and 1995 using two proportions Z-test. Results: In 2013, 352 new uveitis cases were examined. Males 56%, females 44%; unilateral 30.4%; bilateral in 69.6%. A specific diagnosis achieved in 66.2%. Anterior uveitis was seen in 35.22%, intermediate uveitis in 30.11%, posterior uveitis in 25%, and panuveitis in 9.65%. There was no significant difference in the incidence of new uveitic cases (1.04% vs. 1.8%). A decline in male preponderance from 64% to 56% (P = 0.0187) was observed. In both studies, anterior uveitis was the most common but human leukocyte antigen-B27 positivity uveitis had increased (29.83% vs. 14.5%; P < 0.05). Intermediate uveitis was the second-most common type instead of posterior uveitis (P = 0.0006). In posterior uveitis cases, etiology was established in 88.6% versus 56.06% cases (P < 0.05). The most common cause of posterior uveitis was tuberculosis (TB) (35.2%). Viral retinitis had increased to 6.81% from 0.76% (P < 0.05). However, a declining trend in cases of toxoplasmosis was observed (P = 0.0545). The cause of panuveitis was comparable in both studies. The prevalence of TB has significantly increased in the present era (22.5% vs. 0.64%; P < 0.0001) and was the proven etiological cause of uveitis in overall 22.5% of which 4.8% cases were of anterior uveitis cases, 7.1% cases of intermediate uveitis cases, 8.8% cases of posterior uveitis cases, and 1.8% of panuveitis cases. Conclusion: A shifting paradigm of uveitis over the past two decades was observed.

Analysis of clinically isolated bacterial tendency and drug resistance from neonatal ward in a tertiary children's hospital in Chongqing during 2010-2015 / 中国感染与化疗杂志

Objective The changing patterns of pathogenic isolates and antibiotic susceptibility in Chongqing's neonates between 2010 and 2015 were investigated for the purpose to provide evidence for rational use of antibiotics and control of nosocomial infections.Methods The distribution of pathogenic bacteria and antibiotic susceptibility were analyzed.Identification and antibiotic susceptibility testing were carried out using BD Phoenix 100 automated system and the conventional Kirby-Bauer method.The results were interpreted in accordance with the breakpoints of the Clinical and Laboratory Standards Institute.Results A total of 10 569 pathogenic bacterial strains were isolated during the period,most of which were gram-negative bacteria (80.8 ％,8 540/10 569),primarily Klebsiella pneumoniae (29.3 ％),followed by Escherichia coli (16.7 ％),Acinetobacter baumanmii (9.9 ％),Enterobacter cloacae (8.6 ％) and Pseudornonas aeruginosa (3.3 ％).Gram-positive strains accounted for 14.1％ (1 490/10 569),mainly Staphylococcus aureus (7.8％),Staphylococcus epidermidis (2.2 ％),and Staphylococcus haemolyticus (1.8 ％).Imipenem and meropenem showed high activity against Enterobacteriaceae (＜ 10％ resistant),followed by P.aeruginosa (＞ 10 ％ resistant),and A.baumannii (＞20％ resistant).The prevalence of carbapenem-resistant strains was 8,4 ％ in K.pneumoniae and 2.9 ％ in E.coli isolates,No gram-positive isolates were resistant to vancomycin,teicoplanin or linezolid.Conclusions K.pneumoniae was the most frequently isolated pathogen in the neonates treated in Children's Hospital of Chongqing Medical University.The prevalence of A.baumannii isolates is increasing.Carbapenem-resistant Enterobacteriaceae strains are emerging.

Changing pattern of prescribing antidiabetic agents in patients suffering from diabetes mellitus.

Background: Drug utilization studies are powerful exploratory tools to ascertain the role of drugs in society. They create a sound sociomedical and health economic basis for healthcare decision making. The study was aimed to find out the changing pattern of prescribing the antidiabetic agents in patients suffering from diabetes mellitus type 1 and 2. Methods: It was a cross sectional study done on 200 patients suffering from type 1 and 2diabetes. Indoor patients and diabetes mellitus due to secondary cause were excluded. Each patient was followed up over a period of 1 year and the analysis of the prescriptions was done during that period. At end of study only 129 patients could be included for analysis. Results: In this study the maximal change in medicine was with pioglitazone which was discontinued as a 1st change in 6.2% of patients followed by metformin [5.4%], insulin [4.6%], and glipizide [3.8%]. The drug most commonly added as a first change was glipizide [11.6%] followed by metformin [10.0%] and pioglitazone [7.7%]. In order of 2nd change the most common drug discontinued was insulin [4.6%] followed by pioglitazone [3.8%] whereas drug commonly added as second change was insulin [2.3%] followed by glipizide [1.5%] and pioglitazone [1.5%]. In our cross sectional study average onset of 1st change was found to be at 4.38±2.75 months for discontinuation of drug and 3.75±2.42 months in adding the drugs. Conclusions: Due to lack of certain records, it is envisaged that the change of medicine both discontinuation as well as addition was done because of blood glucose control, cost factor [in case of pioglitazone] as well as patient’s compliance.

Changing Patterns of Human Parasitic Infection in Korea / 한양의대학술지

Parasitic infections in Korea have been well controlled during the last 40 years. Soil-transmitted helminthes, Ascaris lumbricoides, Trichuris trichiura and hookworm infections are almostly removed in this country. Recently, filariasis by Brugia malayi disappeared and no lymphatic filariasis in Korea was announced by WHO in 2008. However, foodborne parasitic infection, such as clonorchiasis and anisakiasis are prominent, recently. Indigenous malaria by Plasmodium vivax has been eradicated in 1970s, and a re-emerged vivax malaria from demilitary zone (DMZ) was reported in 1993. Above 1,000 cases of vivax malaria were reported annually in soldiers and civilians. Imported parasitic diseases, including malaria would be increased by travelers going abroad. This review focused on the changing patterns of human parasitic infections in Korea.

A 10-year Retrospective Study on Changing Pattern of Sexually Transmitted Infections in Hospital Kuala Lumpur, Malaysia

Background Sexually transmitted infections (STIs), and HIV especially, are a major health problem in Malaysia. The emergence of HIV infection has increased the importance of early and effective treatment of STIs as any delay may lead to enhance transmission or acquisition of HIV infection. A proper understanding of the patterns of STIs is necessary for effective planning and control strategies. The present study is designed to determine the changing pattern of STIs in the Genito-urinary Medicine Clinic (GUM), Hospital Kuala Lumpur (HKL). Objective To study the sociodemographic characteristics of patients with STIs attending the GUM Clinic in HKL and to analyze any changes in the pattern of STIs seen between the 2 study periods of 1995-1999 and 2001-2005. Method A retrospective review of case notes of new patients with STIs attending the GUM clinic, HKL was done during two study periods of 1995-1999 (Poster presentation on “Pattern of STDs” at 14th RCD, Asia-Australasia, 26-30 July 2000, KL, Malaysia by HB Gangaram et al) and 2001-2005. Results In 1995-1999, a total of 3150 STI patients were studied. Among them, 2016 (64%) were males and 1134 (36%) were females. In 2001-2005, a total of 2909 STI patients were examined, of which 1862 (64%) were males and 1047 (36%) were female. There was a decrease of 8.3% in the total number of cases seen in 2001-2005 as compared to 1995-1999. The decline was more evident with bacterial STIs which included syphilis, gonorrhoea, NGU and chancroid. Viral STIs which consisted of herpes genitalis, genital warts and HIV showed an increasing trend. A younger age group (20-39 years old) appeared to be infected with STIs in 2001-2005. Males outnumbered females in the ratio of 1.8:1, which remained unchanged in both the study periods. Based on ethnicity, there was an increase in the percentage of Malays being infected in STIs in the later study period. Syphilis was the commonest STI seen in both the study periods. The second commonest STI seen in 1995-1999 was gonorrhoea and non-gonococcal urethritis (NGU). In 2005, there were 184 patients with syphilis; 64% were heterosexuals; 39.6% homosexuals and 1.6% bisexuals. Majority (82%) were asymptomatic (latent syphilis with positive syphilis serology at presentation. Symptomatic patients with early infectious syphilis constituted 15% (Primary 8%; Secondary 7%). Screening for HIV was positive in 31 (16.8%) patients. HIV infection was noted to be the commonest STI associated with syphilis. Conclusion was an overall decline in the number of patients with STIs attending the GUM clinic, HKL. The decline was more evident with bacterial STIs; viral STIs however showed an increasing trend. Syphilis was still the commonest STI seen in the two study periods although the percentage has declined. Non specific urethritis has superseded gonorrhoea as the second commonest STI. HIV was found to be the commonest STI seen in association with syphilis.