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1.
Artículo | IMSEAR | ID: sea-217750

RESUMEN

Background: Bacterial multidrug resistance (MDR) is particularly common in Gram-negative bacilli (GNB), with important clinical consequences regarding their spread and treatment options. The prevalence of drug-resistant cases is increasing globally. MDR has become a major problem for the treatment of bacterial infections and is becoming greatest challenge to public health. Quantification of the prevalence and the common antimicrobial coresistance patterns of MDR GNB (MDRGNB) isolates would have important implications for patient care. Aim and Objective: The aim of this study was to know the prevalence of multidrug resistant Gram-negative bacteria. Materials and Methods: This retrospective study was done from January 2021 to December 2021 at the Department of Microbiology, GMERS Medical College and Hospital, sola, Ahmedabad, Gujarat. Species identification was done by bacterial growth and standard biochemical reaction. Drug susceptibility testing of isolates was done by Kirby–Bauer disk diffusion method following Clinical Laboratory Standards Institute guidelines. MDR was defined as acquired resistance to at least one agent in three or more antimicrobial categories. Stool samples were not included in this study. Results: The 1-year records of a total of pathogens were studied. The highest number of pathogens were isolated from blood cultures (19%), followed by wound swabs (19%) then urine (10.3%) then sputum and pleural fluid (8.5%). The most frequently isolated pathogens were Klebsiella spp. (32.8%), Escherichia coli (28.8%), Acinetobactor spp. (20.8%), and Pseudomonas spp. (9.6%). Gram-negative isolates exhibited high overall resistance to all used antibiotic classes. All isolates showed 100% susceptibility to colistin. Conclusion: The results of the study showed that the most common MDR-GNB isolate is Klebsiella Pneumonii in intensive care units department in blood, pus, and sputum sample. The study findings will be part of a strict antibiotic stewardship (AMS) program and also indicate that AMS should begin at primary and secondary health-care centers to prevent antimicrobial resistance.

2.
Indian J Med Sci ; 2003 Dec; 57(12): 556-8
Artículo en Inglés | IMSEAR | ID: sea-67849

RESUMEN

A few cases of necrotizing myelitis have been reported in adults since its first description in 1973. No case has been described in the pediatric age group. A 12-year-old boy, who presented with acute flaccid paraplegia, loss of sphincter control and sensory loss showed features suggestive of necrotizing myelitis on magnetic resonance imaging. Investigations carried out could not reveal a specific etiological or pre-disposing factor. No clinical improvement occurred despite the therapy.


Asunto(s)
Niño , Humanos , Inmunocompetencia , Masculino , Mielitis Transversa/diagnóstico
3.
J Postgrad Med ; 2003 Apr-Jun; 49(2): 154-6
Artículo en Inglés | IMSEAR | ID: sea-116110

RESUMEN

This communication reports prenatal diagnosis of partial trisomy 21 resulting from balanced translocation (21q;22q) in a 36-year-old gravida 7, para 1 woman. The lady had only one living child and there was history of recurrent spontaneous first trimester abortions. Triple test was abnormal in the present conception. In addition, the woman had pericentric inversion of chromosome 9, a finding scarcely reported previously with carrier status in Indian literature. A few cytogeneticists consider this as a normal variant. However, many reports in the recent literature link pericentric inversion of chromosome 9 with infertility, recurrent abortions and a number of other abnormal conditions. A review of the relevant literature pertinent to the case is provided.


Asunto(s)
Adulto , Cromosomas Humanos Par 21/genética , Cromosomas Humanos Par 22/genética , Cromosomas Humanos Par 9/genética , Síndrome de Down/genética , Femenino , Humanos , Inversión Cromosómica , Embarazo , Diagnóstico Prenatal , Translocación Genética/genética
4.
J Postgrad Med ; 2003 Jan-Mar; 49(1): 72-4
Artículo en Inglés | IMSEAR | ID: sea-115843

RESUMEN

Kawasaki disease (KD) is an acute systemic vasculitis of unknown aetiology that has largely replaced rheumatic heart disease as a cause of acquired heart disease in children of many developed countries. We report a case of incomplete KD in a five-year-old girl. The diagnosis of incomplete KD was made after exclusion of conditions with similar presentation. She was treated with intravenous immunoglobulin following which she made an uneventful recovery but demonstrated thrombocytosis in the second week of convalescence. During the six-month follow up period, she had two episodes of recurrent skin peeling a phenomenon, which is recently reported with KD but not with atypical or incomplete KD. It is important for the treating physicians to become aware of the incomplete KD as prompt diagnosis and early treatment of these patients with intravenous immunoglobulin is vital for the prevention of lethal coronary complications. Physicians need to have a "high index of suspicion" for KD and even, higher for IKD.


Asunto(s)
Aspirina/uso terapéutico , Preescolar , Femenino , Fibrinolíticos/uso terapéutico , Humanos , Inmunoglobulinas Intravenosas/uso terapéutico , Síndrome Mucocutáneo Linfonodular/clasificación , Enfermedades de la Piel/tratamiento farmacológico
5.
J Postgrad Med ; 2002 Oct-Dec; 48(4): 312-3
Artículo en Inglés | IMSEAR | ID: sea-117246
6.
J Postgrad Med ; 2001 Jul-Sep; 47(3): 188-90
Artículo en Inglés | IMSEAR | ID: sea-117351

RESUMEN

Morgagni hernia is a rare diaphragmatic hernia accounting for only 2% of the congenital diaphragmatic defects. A case of Morgagni hernia was diagnosed radiologically in a 12-months-old male with Down syndrome, with recurrent respiratory distress and chest deformity. The 2-dimensional echocardiography was normal. The diagnosis of Morgagni hernia was confirmed by barium studies. The patient underwent a corrective surgery at 18 months of age following which his symptoms subsided. Literature review revealed only 18 cases of Morgagni hernia with Down syndrome reported till date, with age of presentation varying from neonatal age group to 12 years of age. The mode of presentations varied from asymptomatic detection to severe respiratory distress. The possible mechanism of association and its clinical implication has been discussed. The case emphasises a need for diaphragmatic hernia to be looked for as a possible cause of respiratory distress in Down syndrome.


Asunto(s)
Anomalías Múltiples/diagnóstico , Síndrome de Down , Hernia Diafragmática/complicaciones , Humanos , Lactante , Masculino , Insuficiencia Respiratoria/etiología
7.
Indian J Pediatr ; 2001 May; 68(5): 459-61
Artículo en Inglés | IMSEAR | ID: sea-83229

RESUMEN

Primary hepatic tumors are uncommon in children and account for only three per cent of the tumors in children. Infantile hemangioendothelioma is a rare benign hepatic tumor arising from mesenchymal tissue. Most of the cases present before six months. An unusual presentation and progression of infantile hemangioendothelioma is reported in a 19-month-old female child. The diagnosis was arrived at by radiological and histopathological examination. The patient underwent excision surgery, following which made an uneventful recovery. On follow-up at six months, patient was asymptomatic with no evidence of recurrence.


Asunto(s)
Femenino , Hemangioendotelioma/diagnóstico , Humanos , Lactante , Neoplasias Hepáticas/diagnóstico
8.
J Postgrad Med ; 2001 Apr-Jun; 47(2): 113-5
Artículo en Inglés | IMSEAR | ID: sea-115350

RESUMEN

Autosomal translocations are rare in the patients with ovarian dysgenesis. An 18-year-old female who presented with primary amenorrhoea had hypergonadotropic hypogonadism and streak ovaries with hypoplastic uterus. Karyotype analysis revealed a balanced autosomal translocation involving chromosomes 1 and 11. The probable role of autosomal translocations in ovarian dysgenesis has been discussed.


Asunto(s)
Adolescente , Amenorrea/genética , Cromosomas Humanos Par 1/genética , Cromosomas Humanos Par 11/genética , Femenino , Disgenesia Gonadal/genética , Humanos , Cariotipificación , Ovario/anomalías , Translocación Genética/genética
11.
Indian J Pediatr ; 2001 Jan; 68(1): 95-7
Artículo en Inglés | IMSEAR | ID: sea-79858

RESUMEN

Adrenocortical carcinoma in children is a rare tumor of adrenal gland. An infant presented with signs of virilization due to selective testosterone hypersecretion. Diagnosis was established with the help of the computerized tomographic scan and histopathological examination. Following adrenalectomy patient made uneventful recovery and six months later does not have any clinical or laboratory evidence of recurrence or metastasis.


Asunto(s)
Neoplasias de la Corteza Suprarrenal/complicaciones , Adrenalectomía , Adenoma Corticosuprarrenal/complicaciones , Femenino , Humanos , Lactante , Testosterona/metabolismo , Virilismo/etiología
12.
J Postgrad Med ; 2001 Jan-Mar; 47(1): 19-23
Artículo en Inglés | IMSEAR | ID: sea-116479

RESUMEN

CONTEXT: Parental anxiety and apprehension is related to inadequate knowledge of fever and febrile convulsion. AIMS: To study the knowledge, attitude, and practices of the parents of children with febrile convulsions. SETTINGS AND DESIGN: Prospective questionnaire based study in a tertiary care centre carried over a period of one year. SUBJECTS AND METHODS: 140 parents of consecutive children presenting with febrile convulsion were enrolled. STATISTICAL ANALYSIS USED: Chi-square test. RESULTS: 83 parents (59.3%) could not recognise the convulsion; 90.7% (127) did not carry out any intervention prior to getting the child to the hospital. The commonest immediate effect of the convulsion on the parents was fear of death (n= 126, 90%) followed by insomnia (n= 48, 34.3%), anorexia (n= 46, 32.9%), crying (n= 28, 20%) and fear of epilepsy (n= 28, 20%). Fear of brain damage, fear of recurrence and dyspepsia were voiced by the fathers alone (n= 20, cumulative incidence 14.3%). 109 (77.9%) parents did not know the fact that the convulsion can occur due to fever. The long-term concerns included fear of epilepsy (n= 64, 45.7%) and future recurrence (n= 27, 19.3%) in the affected child. For 56 (40%) of the parents every subsequent episode of fever was like a nightmare. Only 21 parents (15%) had thermometer at home and 28 (20%) knew the normal range of body temperature. Correct preventive measures were known only to 41 (29.2%). Awareness of febrile convulsion and the preventive measures was higher in socio-economic grade (P< 0.05). CONCLUSIONS: The parental fear of fever and febrile convulsion is a major problem with serious negative consequences affecting daily familial life.


Asunto(s)
Adulto , Actitud Frente a la Salud , Distribución de Chi-Cuadrado , Niño , Preescolar , Escolaridad , Femenino , Conocimientos, Actitudes y Práctica en Salud , Humanos , Incidencia , India/epidemiología , Lactante , Recién Nacido , Masculino , Padres/psicología , Estudios Prospectivos , Encuestas y Cuestionarios , Convulsiones Febriles/epidemiología , Factores Sexuales , Factores Socioeconómicos , Estrés Psicológico/etiología
14.
J Postgrad Med ; 2000 Jul-Sep; 46(3): 184-6
Artículo en Inglés | IMSEAR | ID: sea-115236

RESUMEN

Enteric fever is a common infectious disease of the tropical world, about 80% of these cases occur in Asian countries. Enteric fever presenting with isolated cerebellar ataxia or nephritis is rare. We report three cases of enteric fever that presented with these complications. Isolated cerebellar ataxia usually occurs in the second week, whereas in our cases it presented within first four days of fever. The common complications of enteric fever related to the urinary tract are cystitis, pyelitis, and pyelonephritis. Glomerulonephritis is uncommon. Most patients with enteric glomerulonephritis present with acute renal failure, hypertensive encephalopathy, or nephritic syndrome. In comparison, our case had milder manifestations. All three patients were treated with parenteral ceftriaxone and showed a prompt recovery.


Asunto(s)
Ceftriaxona/administración & dosificación , Ataxia Cerebelosa/diagnóstico , Niño , Diagnóstico Diferencial , Femenino , Glomerulonefritis/diagnóstico , Humanos , India , Lactante , Fiebre Tifoidea/diagnóstico
15.
J Postgrad Med ; 2000 Apr-Jun; 46(2): 130-1
Artículo en Inglés | IMSEAR | ID: sea-116783
16.
J Postgrad Med ; 2000 Apr-Jun; 46(2): 91-3
Artículo en Inglés | IMSEAR | ID: sea-116731

RESUMEN

Scleredema adultorum is a rare connective tissue disorder reported usually following streptococcal infection, influenza, measles, and mumps. It has been reported occasionally following trauma and tuberculous lymphadenitis. This is a report of scleredema adultorum developing after chicken pox in an eight-year-old male child. The diagnosis was established by characteristic picture on skin biopsy using special stain. The patient had a benign course and a spontaneous recovery in two weeks. The case has been reported as the first case of scleredema adultorum developing after chicken pox.


Asunto(s)
Varicela/complicaciones , Niño , Humanos , Masculino , Escleredema del Adulto/diagnóstico
17.
J Postgrad Med ; 2000 Apr-Jun; 46(2): 98-100
Artículo en Inglés | IMSEAR | ID: sea-115148

RESUMEN

Neurofibromatosis (NF), Noonan syndrome (NS), and LEOPARD syndrome are all autosomal dominant conditions, each being a distinct clinical entity by itself. Rarely, one encounters cases with features of NF and NS and is termed as the 'Neurofibromatosis-Noonan syndrome' (NF-NS). The authors report a clinical dilemma with major clinical features of the NF-NS syndrome and LEOPARD syndrome co-existing in the same patient. Also, features of Noonan syndrome and LEOPARD syndrome are compared with the case reported.


Asunto(s)
Humanos , Lactante , Masculino , Neurofibromatosis/complicaciones , Síndrome de Noonan/complicaciones
18.
J Postgrad Med ; 2000 Jan-Mar; 46(1): 29-30
Artículo en Inglés | IMSEAR | ID: sea-116009

RESUMEN

A case of parkinsonism is reported in a 5-years-old male child following prolonged use of chloroquine. The patient presented with reduced spontaneous movements and speech with an expressionless face and a parkinsonian gait but no tremors. His investigations including CT scan brain, CSF study and serum ceruloplasmin were normal. Chloroquine was discontinued and the patient was started on oral trihexyphenidyl. The patient showed gradual recovery and the drug was successfully withdrawn. The toxic manifestations were only transient and reversible.


Asunto(s)
Antimaláricos/envenenamiento , Preescolar , Cloroquina/envenenamiento , Humanos , Masculino , Enfermedad de Parkinson Secundaria/inducido químicamente
20.
Indian J Pathol Microbiol ; 1978 Jul; 21(3): 251-3
Artículo en Inglés | IMSEAR | ID: sea-72906
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