RESUMEN
Background: Diabetic foot infections are the predominant complications of diabetes mellitus with uncontrolled hyperglycemia levels. Multiple microbial invasion is the primary cause and the causative organism are aerobic gram positive cocci, gram negative bacilli such as Pseudomonas species, Escherichia coli, Klebsiella species, Proteus species and anaerobes.Methods: This is a prospective, observational study conducted in the Department of General Surgery. 50 patients constituted the sample in our study. Patients pus and wound swab samples were collected using sterile and moist swab sticks under aseptic conditions and processed.Results: More gram negative bacteria (66%) were isolated than gram positive bacteria (34%). E. coli (38%) is the major isolated microorganism. Among the isolated organisms many of them are susceptible to amikacin (60%), imipenem (52%) and ciprofloxacin (46%) respectively.Conclusions: E. coli is the most common cause of infection. The antibiogram study showed an incidence of multiple resistant microorganisms to commonly used antibiotics.
RESUMEN
Background: Post-operative infections in obstetrics and gynecological settings have been higher compared to other specialties. Women undergoing caesarean section have 5 to 20-fold greater risk for infection compared with vaginal delivery. Many studies reported antimicrobial prophylaxis prevent post-operative infections. Hence this study concentrates the evaluation of the prescribing antimicrobial use and to assess the frequency of post-operative morbidity related to infection in subjects undergoing caesarean section. The aim of the study was to analysis the effectiveness, prophylactic antibiotics (amoxicillin versus ceftriaxone) and to evaluate the post-operative (caesarean) infections in patients undergoing lower segment caesarean section (elective and emergency).Methods: This is a prospective observational study which assessed the effectiveness and use of prophylactic antibiotics in patients undergoing cesarean section at department of obstetrics and gynecology. The study was conducted over a period of one year.Results: The corresponding mean age of all the study population in amoxicillin group (n=113) was 56.5±28.5 and in ceftriaxone group (n=97) was 48.5±26.5 respectively. The participant who underwent previous cesarean section in amoxicillin group is 65.48% similarly in ceftriaxone group is 47.42%. The patients with fetal distress in ceftriaxone group are 14.77% and in amoxicillin group is 8.92%. Failed induction in amoxicillin group is 9.82% and in ceftriaxone group is 6.81%. The number of days in hospital stay in amoxicillin group is 42.42% and in ceftriaxone group is 45.94%. The post-operative complications in amoxicillin group reported, with Febrile Illness are 40% and wound Infection is 60%.Conclusions: Administration of pre-operative antibiotics significantly reduce post-operative infections. Use of ceftriaxone as a prophylactic antibiotic in patients undergoing lower segment caesarean section (elective and emergency) is more effective than Amoxicillin in preventing post-operative infections.
RESUMEN
Background: Renal impairment is the primary cause of mortality and morbid conditions in patients. Inappropriate drug use in patients who are with risk of renal damage causes harmful and deleterious effects. Adjusting doses based on renal function is necessary for renal risk drugs, primarily to avoid adverse reactions of medications. Aim of the present study was to assess the risk of incidence on ADRs with drugs lowering the renal function.Methods: This is a cross-sectional observational study conducted in General Medicine department. 230 Patients constituted the sample in the study. The study was conducted for a period of one year and prescriptions with renal risk drugs were evaluated. Changes in the renal functional tests were compared to the normal range and adverse drug responses were monitored.Results: A total of 230 patients who fulfilled the inclusion criteria were included in the study. The meanage of the study subjects were 50.9±15.2 respectively. 56.39% patients were men and 43.6% were women. Renal risk drugs included in the study are anti-hypertensive, antibiotics, and analgesics. Paracetamol (24.77%) followed by telmisartan (20.85%) are the predominantly prescribed renal risk drugs with high incidence of adverse drug reactions. Causality assessment by Naranjo ADR probability scale showed out of 211 ADRs, 51.6% were possible, 25.59% were doubtful, 21.8% were probable and 0.94% was definite.Conclusions: The current study signifies that patients under high risk of renal damage require continuous monitoring and optimized therapy for better disease management.
RESUMEN
Exogenous ochronosis is an infrequent skin disorder characterised by bluish-black or grayish brown pigmentation on dermis. It is the most common condition caused due to long term application of Hydroquinone skin preparations for melasma, skin brightening, cholasma, acne induced pigmentation etc. This report refers to a case of 39-year-old female patient who presented to the hospital with chief complaints of progressive formation of dark lesions over face, neck since one and half-year. She had history of usage of hydroquinone (4%) cream for skin brightening for a period of three months. Based on clinical findings and history she was diagnosed to have acquired exogenous ochronosis and was treated with microdermabrasion, cosmelan peel, yellow peel, glutathione tablets, topical sunscreen and kojic acid cream. Patient noted 50% improvement in her condition after 4 months of treatment. It is believed that application of high concentrations of hydroquinone for a prolonged period causes exogenous ochronosis. This case report suggests that exogenous ochronosis can occur after three months of application.
RESUMEN
Pemphigus Vulgaris (PV) is an organ-specific autoimmune disorder affecting skin and mucous membranes with a characteristic of intraepithelial blistering. The first common sign of this disease is involvement of oral mucosa followed by skin involvement. We here in report a rare case one such recently seen by us, where oral lesions and skin lesions in a 24 year old female patient presenting with a five months history of multiple fluid filled lesions all over the body, who is known case of psychosis finally diagnosed as having pemphigus vulgaris.
RESUMEN
Stevens-Johnson Syndrome (SJS) is an acute hypersensitive reaction and a life-threatening condition affecting both skin and mucous membranes. We report a case with SJS likely induced by Chlordiazepoxide. The patient undergoing treatment for acute pancreatits is prescribed with Chlordiazepoxide after administering the patient reported mild pyexia with lesions all over the body with redness. Mild peeling of the skin due to rupture of the lesions and pigmentation on the skin was observed for 3 days. Based on these finding he was diagnosed with Chlordiazepoxide induced Stevens-Johnson syndrome. The patient was administered systemic steroid therapy and treated symptomatically. Here we describe a case of Chlordiazepoxide induced SJS in acute p ancreatitis patient.
RESUMEN
Drug induced allergic reactions can be categorized into IgE-mediated and non-IgE mediated hypersensitivity reactions. Symptoms of IgE-mediated reactions are angioedema, bronchospasm, anaphylaxis, and urticaria that appears within 72 hours and those which are Non-IgE mediated hypersensitivity reactions include morbilliform eruptions, interstitial nephritis, hemolytic anemia, serum sickness, thrombocytopenia, and erythema multiforme, after 72 hours. TEN is defined as an extensive detachment of full-thickness epidermis most often related to an adverse drug reaction. We report a rare case of penicillin induced toxic epidermal necrolysis with Secondary Impetigination in a 38-year-old male patient with complaints of rashes all over the body, chest pain and dry tongue since seven days. Based on history and clinical examination patient was diagnosed as of penicillin induced toxic epidermal necrolysis with secondary impetigination and was successfully treated with antihistamines, parenteral antibiotics and corticosteroids.
RESUMEN
Stevens-Johnson Syndrome (SJS) is a life-threatening acute hypersensitive reaction affecting the skin and mucous membranes. We report a case with SJS likely induced by phenobarbitone during the switch of sodium valproate and phenobarbitone regimen. The patient reported fever with fluid-filled lesions all over the body and redness and burning sensation of both the eyes. Peeling of the skin due to rupture of the fluid-filled lesions and pigmentation on the skin for 10 days. Based on a physical examination and laboratory findings, he was diagnosed with Phenobarbital induced Stevens-Johnson syndrome. The patient was administered systemic steroid therapy and treated symptomatically and finally replaced with phenobarbitone and sodium valproate. During the hospital stay, the patient appeared normal and the skin lesions disappeared, after two weeks of treatment.
RESUMEN
Ofloxacin is a commonly used antimicrobial agent to combat various infections. The adverse profile of quinolones includes gastrointestinal symptoms, which are the most frequent, neuropsychiatric symptoms, hematologic abnormalities are less common. We report a rare case of ofloxacin induced hypersensitivity reaction in a 57 year old female patient with complaints of rashes over the axilla, upper limb and back, abdomen, thorax associated with exfoliation of skin all over the axilla associated with severe itching. Based on history and clinical examination patient was diagnosed as ofloxacin induced hypersensitivity reaction and was successfully treated with antihistamines and corticosteroids. Pharmacovigilance should be a part of patient care in order to reduce occurrence of adverse drug reaction and also encourage practitioners in reporting so as to gather more and more data regarding adverse drug reactions