RESUMEN
Objective: To identify patients coming to Emergency Medicine Department (EMD) with drug related problems, classify the DRPs and calculate the direct cost spent for treating them. Methods: This was a prospective observational study conducted in emergency medicine department. The patients coming to EMD with DRPs were classified according to Cipolle’s classification and the direct medical and non-medical costs were calculated. Results: A total of around 107 patients identified with DRPs of which 99 patients were included in the study. In this study, 51% of the cases were due to ADR and 35% due to non-adherence and rest of the cases were due to overdose (10%), drug interaction (3%) and sub therapeutic dose (1%). Major portion for treatment was spent for direct medical cost in which cost for laboratory investigations have contributed the most, INR 10,93,992 (42%) followed by Health care professional cost INR 55,6814 (21%), Pharmacy cost INR 4,00,524.6 (15%), Admission cost INR 3,80,400 (15%). The direct non-medical cost includes cost for diet and travel which was found to be INR 1,68,443 and INR 71,947 respectively. Conclusion: The drug related problems adds a significant economic burden on the patients which can be reduced by imparting knowledge about the proper use of medicines and by improving collaborative efforts of the patients, physicians, pharmacists and caregivers.
RESUMEN
Introduction: Intensive Care Units (ICU’s) provides a suitable environment for the proliferation and persistence of multidrug organisms. The burden of nosocomial infections among critically ill patients is much higher in developing countries. Aims and Objectives: The present study was conducted to know the prevalence of bacterial pathogens from various ICU’s of a tertiary care hospital and to determine their resistance profile. Materials and methods: A retrospective study was done on 188 isolates collected over a period of 10 months from January 2018 to October 2018. The isolates were identified by the conventional biochemical method and antimicrobial susceptibility testing was performed by Kirby bauer disc diffusion method. Results: The most common gram negative isolate obtained in this study was Klebsiella spp. About 90/188 (47.87%), followed by Pseudomonas aeruginosa 22/188 (11.70%), Acinetobacter spp. 21/188 (11.17%), and E. coli 20/188 (10.64%). The predominant gram positive cocci isolated were Enterococcus spp. 9/188 (4.79%). All gram negative bacilli were sensitive to Imipenem. About 23.33% of Klebsiella isolates were resistant to Piperacillin tazobactam and 18.89% to Cefoperazone sulbactam. The most effective drugs against gram negative bacilli were Imipenem, Piperacillin tazobactam, and Cefoperazone sulbactam. Conclusion: This study showed the prevalence of multidrug resistant Klebsiella spp. from various ICU’s. These isolates were resistant to third generation cephalosporins, quinolones, and aminoglycosides and were sensitive to carbapenems. Among the non-fermenting gram negative bacilli, the resistant rates were higher for Acinetobacter isolates compared to Pseudomonas aeruginosa.
RESUMEN
Introduction: Urinary tract infections (UTI’s) are one of the most common bacterial infections in community and hospital settings and it is important to know the etiology and susceptibility pattern of uropathogens for optimum management of UTI’s.Aim & Objectives:This study was conducted to know the etiologyof UTI and to determine the antibiotic resistance pattern of these isolates.Materials & Methods: A prospective cross sectional study was done on 537 and 486 consecutive urine samples from January to May 2015 and 2016. Isolates obtained were identified by conventional biochemical methods and antimicrobial susceptibility testing was done by Kirby Bauer disk diffusion method as per CLSI guidelines.Results: The prevalence of UTI was 41.71% and 51.85% in 2015 and 2016 respectively. 129 (57.59%) and 148 (58.73%) females and 95(42.41%) and 104(41.27%) males were infected in 2015 and 2016 respectively.Escherichia coli (55.25%) was the predominant organism isolated. An increased resistance to norfloxacin ,ampicillin and cefotaxime were shown in 2016 compared to the antimicrobial resistance pattern obtained in 2015. All the gram negative bacilli studied were sensitive to Imipenem and Piperacillin- Tazobactam. Conclusion:Constant surveillance of resistance rate of uropathogens is necessary to formulate local antibiotic policy and to assist clinicians in the rational choice of antibiotic therapy. KEYWORDS:Urinary Tract Infection, E.coliAntibiogram ,Fluoroquinolone resistance.
RESUMEN
The gill which participate in many important functions in fish, such as respiration, osmoregulation and excretion. Electroplating industrial effluent nickel induced hyperplasia, multiple telangiectases (aneurysms), desquamation of the epithelial cells, complete fusion of secondary gill lamellae and congestion of blood sinuses were the significant histopathological lesions observed in the gill of Mystus cavasius.