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Background: Aframomum species are routinely used as spices in many traditional Cameroonian meals due to their sweet fragrance. Many species of the Aframomum species are also used to treat cancer, pain, arthritis, and stomach disorders. This work was performed to determine the chemical composition, antiandrogenic, and estrogenic properties of Aframomum subsericeum and Aframomum alboviolaceum leaf essential oils. Methods: The chemical components of A. subsericeum and A. alboviolaceum essential oils were identified by gas chromatography-mass spectroscopy. The anti-androgenic and estrogenic properties were investigated in vivo in physically and chemically castrated Wistar rats, respectively. Results: Fifteen compounds versus nine compounds were identified in A. subsericeum and A. alboviolaceum essential oils, respectively. The main compounds of Aframomum subsericeum were cyclohexene, 1-methyl-4-(1-methylethylidene) (10.03%), ?-terpine (12.22%), and myrtenyl acetate (8.52%), while those of Aframomum alboviolaceum were ?-terpinene (20.07%), caryophyllene (11.58%), myrtenyl acetate (7.22%), and (1R)2, 6, 6 trimethylbicyclo [3.1.1] hept-2-ene (6.97%). The results of the anti-androgenic test reveal that both A. subsericeum and A. alboviolaceum induced a significant decrease in androgen-dependent organs, especially the prostate and seminal vesicle, at doses of 200 mg/kg and 100 mg/kg. Interestingly, A. alboviolaceum showed oestrogen synergic effects on the above organs. Conclusions: So, this study reveals mainly the presence of diterpenoids in both A. subsericeum and A. alboviolaceum, which are potential candidates for prostate cancer treatment. The in vivo results show that Aframomum leaf essential has antiandrogenic and oestrogen synergic properties, suggesting that the oils could provide a safe natural drug for prostate cancer treatment.
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Middle cerebral artery (MCA) stroke describes the sudden onset of a focal neurologic deficit resulting from hemorrhagic or ischemic disruption of the MCA's blood supply. Ischemic stroke is frequently divided into several etiological categories, including atherosclerotic, cardio embolic, lacunar, and cryptogenic. Chronic heart failure (CHF) is also common cause of ischemic stroke. A 66-year-old male patient came to the emergency room at Kasih Ibu Gianyar Hospital with complaints of suddenly not being able to talk since 8 hours before entering the hospital. There is weakness on the right side of the upper extremities, and weakness on the right and left lower extremities. The patient has a history of chronic heart failure since 3 years. A thorax X-ray showed atherosclerosis. Computed tomography (CT) scan showed acute thromboembolic ischemic infarction in the left temporoparietal lobe in the left MCA territory. The causal relation between CHF and ischemic stroke represent manifestations of similar underlying risk factors, such as hypertension and diabetes mellitus. The pathophysiological mechanism of chronic heart failure can be at risk of causing a stroke infarction in large blood vessels in the brain such as the MCA, and patient MCA Stroke with CHF has high risk of recurrent stroke.
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Background: Hypertension, often referred to as the "silent killer," usually presents no symptoms, making many people unaware of their condition. Fishing, as a profession, poses unique health risks due to harsh environmental conditions, irregular work patterns, and strenuous physical demands. Fishermen are particularly vulnerable due to unhealthy diets, sleep disturbances, physical inactivity, tobacco and alcohol use, and obesity. Estimating the prevalence of hypertension among fishermen is crucial for understanding the extent of this hidden health issue within this high-risk group and for implementing targeted interventions to improve their health outcomes. Methods: A cross-sectional study was conducted among Chennai's fishermen using systematic random sampling. Data were collected using a semi-structured questionnaire, and blood pressure was recorded following JNC criteria. Results: The study included 180 fishermen with a mean (SD) age of 49 (12). The prevalence of hypertension was 38.9%. Significant associations were found between hypertension, age, and years of fishing experience. Notably, 77.2% of fishermen lacked knowledge about hypertension, and 86.1% were unaware of its risk factors. Isolated systolic hypertension was found in 16% of participants, while 36% had isolated diastolic hypertension. Conclusions: In Chennai, hypertension is highly prevalent among fishermen and is significantly associated with age, years of fishing experience and smoking. There was no significant association with family history of hypertension, stress, or fried fish consumption. Awareness and knowledge about hypertension were very low among the fishermen. Although isolated systolic and diastolic hypertension were relatively minimal, regular hypertension screening for this community is essential.
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Background: Type 2 diabetes mellitus (T2DM) is known to be associated with cognitive impairment, but the Impact of the timing of diagnosis on cognitive function remains unclear. This pilot project aims to assess the cognitive function of people diagnosed with T2DM at an early vs. late stage. The study will examine several cognitive domains, such as attention, memory, executive function, visuospatial skills, and sensorimotor abilities. Methods: We recruited 80 adults diagnosed with T2DM, evenly split into 2 groups-one with early diagnosis (?5 years) (n=40) and other with late diagnosis (?6 years) (n=40) depending on when their disease was identified. Both groups underwent evaluation for demographic and clinical factors. Cognitive function was assessed using mini-mental state examination (MMSE), Montreal cognitive assessment (MoCA), and Addenbrooke's cognitive examination (ACE-III). Specific domain of cognition wasmeasured as span of attention (Tachitoscope), memory (PGI Battery scale), executive function (Stroop test), visuospatial function (Corsi block test), sensorimotor abilities (auditory /visual reaction time), and intelligence (Koh抯 Block design test). Results: Preliminary findings suggest that the early diagnosis group showed significantly average cognitive performance compared to the late diagnosis group. They also showed improved metabolic control and increased levels of physical activity. Individuals in the early diagnosis group had higher educational levels and socioeconomic status, potentially leading to improved disease detection and more effective health management. Conclusions: These findings indicate that identifying T2DM at an early stage, help in preserving cognitive function as compared to a diagnosis made at a later stage.
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Idiopathic condylar resorption (ICR) also known as cheerleader’s syndrome, progressive condylar resorption, idiopathic condylysis, and condylar atrophy can be defined as chronic ongoing changes of condylar shape and decrease in mass. It is characterized by an excessive physical stress to the articular structures of the temporomandibular joint (TMJ) that exceeds the normal adaptive capacity. Consequently, leading to decrease condylar head volume, decrease ramus height, progressive mandibular retrusion in adults, or decreased growth rate in adolescents. A case report of a 30-year-old female based on the history, clinical, and radiographic examination has class II skeletal relationship secondary to bilateral ICR, receded chin, vertical maxillary excess (VME) and canting. Surgical treatment plan was established using 3D Systems, Inc., (“3DS”) VSP® and case was managed by bilateral total alloplastic temporomandibular joint reconstruction (BATMJR) with orthognathic surgery to do LeFort I, bilateral condylectomy, genioplasty, and inferior border osteotomy. The case report includes one-year follow-up which shows stable outcome, emphasizing long-term success of comprehensive treatment strategy in addressing skeletal class II malocclusion associated with ICR.
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Background: Hypertension is a major public health problem. Globally 1.28 billion adults aged 30-79 years have hypertension and among this 46% were undiagnosed. Kerala is one state undergoing epidemiological transition and having high prevalence of hypertension. So, we did this study to estimate the proportion of hypertension among non-medical employees of Medical College Thiruvananthapuram. Methods: A cross-sectional study was conducted among 202 non-medical employees of medical college Thiruvananthapuram. Data was collected using an investigator administered questionnaire. Anthropometric indices were measured and recorded. Blood pressure (BP) was recorded twice in a gap of 15 min for each participant in sitting position using mercury sphygmomanometer. Mean systolic BP (SBP) and diastolic BP (DBP) was calculated to confirm hypertension. Participants those who were already detected as hypertensive and on treatment were also noted. Data was analysed using SPSS software version 27. Results: Prevalence of hypertension in the study population was 61/202 (30.19%). Among the hypertensive 39 (63.9%) were already detected and on treatment and 22 (36.1%) were undiagnosed. Among already detected hypertensive 13 (33.3%) were found to be inadequately treated. Hypertension was found to be associated with waist circumference and BMI. Conclusions: The study population was found to have high prevalence of hypertension and having association with waist circumference and BMI. The rule of halves for depicting the trend of hypertension in study population can be used as a tool to deduce various interventions in the community.
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Background: There are attendant socio-cultural challenges of social distancing in controlling COVID-19 in developing countries which must be overcome. The objectives of this study was to assess knowledge, attitude and practice on social distancing, to determine the socio-cultural challenges and assess the coping mechanisms to the socio-cultural challenges of social distancing as a means of COVID-19 control in Lagos state, Nigeria. Methods: This was a cross-sectional descriptive study that assessed the socio-cultural challenges of social distancing as a means of COVID-19 control in Lagos state, Nigeria. The study population included adults ?18 years that have resided in Lagos state for more than six months. Respondents were recruited through the internet, using the social media platforms. A total of 500 responses were analysed. Quantitative analysis was done using IBM SPSS version 22. Results: Overall, about 98.2% of the participants had adequate knowledge of social distancing as a means of COVID-19 control, 51% of the participants had positive attitude towards social distancing as a means of COVID-19 control, and about 98.2% of the participants practised social distancing. About a quarter (27.2%) saw social distancing as a violation of human right and 97% agreed that it affected education in schools. Internet-based communication, teleworking, financial compensation, support groups, health education and special attention to the vulnerable were indicated coping strategies. Conclusions: The findings showed significant socio-cultural challenges in implementing COVID-19 mitigating measures such as social distancing and recommended mass health education plus a good socio-economic support system will help promote the adoption of preventative guidelines.
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Background: Infectious disease pandemic of COVID-19 continues to be a global & public health challenge. The knowledge, attitudes and practices of the people towards COVID-19 is critical to the understanding the epidemiological dynamics of the disease. This study sought to assess the awareness of Knowledge, attitudes and practices towards COVID-19. Methods: A cross-sectional quantitative survey was conducted in Mombasa between September-October, 2020. A validated questionnaire was used to collect data. Data collected were analysed using analysis of variance (ANOVA), and Pearson’s correlation and multivariate linear regression tests. A total of 422 participants completed the survey questionnaire. A p<0.05 was statistically significant. Results: The mean age was 29.55?years (SD: 10.7), 252 (59.72%) were female, and 170 (40.28%) were male. Majority 255 (60.4%) were aged between 18-29 years while 200 (47.38%) and 162 (38.39%) were educated up to secondary and university level respectively. Knowledge scores significantly differed across genders, age-groups, categories of marital status, education levels (p<0.05). The mean COVID-19 knowledge score was 7.45 (SD: 1.51), suggesting an overall 62% (7.45/12×100) correct rate on this knowledge test. The majority of the respondents agreed that COVID-19 will finally be successfully controlled (66.35%) and this was significant (p<0.05). The vast majority of the participants had not visited any crowded place (88.35%) and wore masks when going out (74.31%) in recent days. Conclusions: The knowledge about COVID-19 in the Mombasa County population during the outbreak was acceptable, attitudes have been mostly favourable and the practices are mostly adequate.
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Background: Atopic dermatitis (AD) is a common skin condition in infants, and breastfeeding has been proposed as a potential protective factor. The study aims to investigate the prevalence of AD in infants based on guardians' reports and the impact of exclusive breastfeeding (EBF) and formula feeding on the incidence of AD among Saudi infants in the Al Madinah region. Methods: A cross-sectional survey of 200 mothers with infants was conducted using a structured questionnaire. Data collected included demographics, breastfeeding practices, infant characteristics, allergies, and AD diagnosis. Statistical analysis employed chi-square. Results: There were a total of 200 infants, out of which 145 (72.5%) had AD, as confirmed by pediatricians. Gender was significantly associated with the prevalence of AD. Based on their nutritional source, 62 (42.8%) were on EBF, and 83 (57.2%) were non-EBF. Infant nutrition was found to be significantly associated with the hospitalization time of infants because of AD. Other AD risk factors, such as parental allergies, feeding frequencies, and frequency of AD episodes, were not significantly associated with the type of feeding. Conclusions: This study found that AD is quite prevalent in the Al Madinah region of Saudi Arabia. AD was more prevalent in male infants than in females. It suggests that EBF may be a protective factor against hospitalization of Saudi infants because of AD.
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Hydrops fetalis, characterized by abnormal fluid accumulation in fetal tissues, poses diagnostic challenges often leading to adverse outcomes. We present a case of a 26-year-old multigravida diagnosed with hydrops fetalis at 26 weeks, despite unremarkable antenatal visits. Detailed ultrasound revealed characteristic signs, prompting urgent intervention. Despite aggressive measures, the neonate succumbed shortly after birth. This case highlights the complexities of diagnosing and managing hydrops fetalis, emphasizing the need for heightened clinical awareness. Diagnostic steps, including fetal ultrasound and genetic testing, are pivotal for confirming diagnosis and guiding management, underlining the critical role of comprehensive prenatal care in improving outcomes.
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Wrist fractures are commonly encountered injuries during bicycle accidents. Wrist fractures represent the most prevalent upper extremity fractures and account for over a sixth of all fractures seen in emergency department visits. Despite their common occurrence, many cyclists wear wristwatches without considering the potential consequences this may have during an accident when they sustain an upper limb injury. We present a unique case involving a 59-year-old woman with a wristwatch-associated open distal radio-ulnar fracture sustained from a cycling road traffic accident with the crown of the wristwatch being found embedded in the ulna shaft. Currently, there exists a limited knowledge in the literature addressing the safety implications of wearing wristwatches while cycling. This case serves to highlight the hazards associated with wristwatch use during cycling and underscores the hypothesis that wristwatches may act as stress risers, potentially exacerbating fracture severity and necessitating more intricate surgical interventions and subsequent follow-up care.
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Background: Central venous catheter-related bloodstream infections (CRBSIs) are associated with significant morbidity and mortality in hospitalized patients. Understanding the incidence and risk factors associated with CRBSIs is crucial for implementing effective preventive strategies. The study aimed to examine the incidence and risk factors associated with central venous CRBSIs in a tertiary care hospital setting. Methods: A prospective observational study was conducted at a tertiary care hospital to investigate the incidence and risk factors of CRBSIs. Patients aged >18 years with a central venous catheter inserted for >48 hours were included. Clinical and microbiological data were collected, and CRBSI rates were calculated. Statistical analysis was performed using SPSS V 23.0. Results: A total of 50 patients were recruited, with 11 diagnosed with CRBSIs. The incidence of CRBSIs was 8.1 per 1000 central line days and 5.7 per 1000 inpatient days, with a Device Utilization Ratio (DUR) of 0.7. Male gender and older age (>40 years) were significantly associated with CRBSIs (p<0.05). Gram-negative microorganisms were the most commonly isolated pathogens (63.63%), followed by Gram-positive organisms (27.27%) and Candida species (9.09%). Immune system status (p=0.0372) and duration of catheterization (P=0.0035) were found to have a significant association with CRBSI. Mortality was higher in patients with CRBSIs compared to those without (45.45% vs. 28.21%). Conclusions: CRBSIs remain a significant concern in tertiary care hospitals, with Gram-negative organisms being the predominant pathogens. Male gender and older age were identified as risk factors for CRBSIs. Effective infection control measures targeting high-risk populations are warranted to reduce the incidence of CRBSIs and improve patient outcomes.
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Background: Acute coronary syndrome in very young adults (<35 yrs) was considered as an uncommon entity, recently shows rising incidence especially in India. Hence we planned this study with the aim, to investigate the incidence, clinical, angiographic profile and outcome of ACS in this population. Methods: This is a prospective analytical study included patient <35 yrs with ACS admitted to cardiology department in a tertiary hospital of South India. Risk factors, clinical, angiographic profile and follow up data were recorded and analyzed. Results: Among the total 2180 patients with ACS, 5.8% (n=127) were very young adults. Youngest one was 11 yrs old with coronary anomaly. Median age was 30yrs (SD� and only 8.6% (n=10) were obese. Smoking, male sex were the major conventional risk factors followed by low HDL (52%). Family history of premature coronary event seen in 12.9%, hyperhomocysteinemia, elevated LPA and high fibrinogen were observed in 15%, 20% and 3.5% respectively. Anterior wall MI with LAD occlusion was the commonest type (66.3%). Angiographically 31.4% (36/116) had recanalised vessels, coronary anomaly was seen in 3 (2.5%) patients and pure ectasia in 4 (3.4%) patients. Only 2 were undergone primary PCI (1.7%), 61% (n=71) received thrombolytic therapy. Median delay for angiogram was 72 hrs (3 days). In-hospital mortality was 3.4% and 4.5% (n=5) during follow up. Conclusions: The incidence of ACS among very young adults is on the rising trend (5.8%). Obstructive CAD in 56.9% patients implies the rapid progression of atherosclerosis. With little contribution of novel risk markers of atherosclerosis, smoking and dyslipidemia accelerate the process of premature vascular aging in Indian subcontinent.
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Terahertz (THz) waves, occupying a unique position bridging microwave and infrared wavelengths, exhibit promising potential across diverse domains, particularly in medicine. With attributes such as non-ionizing nature and notable resolution capabilities, THz waves offer avenues for non-invasive medical applications. In cancer diagnosis, THz spectroscopy emerges as a pivotal tool for qualitative and quantitative analysis of biomarkers, enabling swift and accurate differentiation of substances based on molecular structure. Despite challenges such as limited penetration depth in tissue, THz imaging proves invaluable in discriminating cancerous tissues from normal ones during surgery. In this paper we have summarized recent research results on practical implementation of THz waves in medicine. Recent advancements in in vivo imaging showcase promising results, although challenges persist in human-based studies due to tissue complexity. Integration of advanced algorithms enhances the accuracy of cancerous tissue identification. Additionally, THz spectroscopy finds versatile applications in pharmaceuticals and life sciences, offering insights into molecular interactions critical for drug efficacy and understanding protein conformations. Further advancements in THz systems, including enhanced light sources and detectors, are crucial to propel biomedical research forward. Establishment of a comprehensive THz spectrum database will augment existing data, emphasizing the potential of THz waves to revolutionize medical diagnostics and treatment modalities.
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Antiplatelet therapy used in preventing cardiovascular events in chronic kidney disease may be associated with higher risks of bleeding, low efficacy from fewer occlusive atherosclerotic disease), attenuation of the inflammatory process, and changes in the haemogram. We prospectively determined the kidney function, the haemogram, and the lipid profile of participants with and without antiplatelet therapy. The population with a mean age of 69.21 ± 11.73 years, had more women (65.88%), p=0.001. Participants' age was positively correlated with the CKD stage, p<0.001. Bleeding was more common with clopidogrel than aspirin and, less common with advancing CKD. Cardiovascular events were more common in CKD stage 5. The men had higher eGFR but lower platelet count and platelet neutrophil ratio (PNR) than the women, p=0.004, p<0.001, and p<0.001 respectively. The eGFR, bicarbonate, and HDL cholesterol were higher with versus without antiplatelets, p=0.04, p<0.001, and p=0.001 respectively. The platelet count and PNR were higher with antiplatelet therapy and with higher CKD stage, p<0.001 and p<0.001 and, p<0.001 and p<0.001 respectively. Higher platelet count (OR-0.410, 95% CI-0.02-1.04), lower uric acid levels (OR-0.550, 95% CI-0.271-0.948), higher HDL-C (OR-0.486, 95% CI-0.093-1.013), lower LDL-C (OR-0.572, 95% CI-0.082-1.002) and lower triglycerides (OR-1.274, 95% CI-0.755-1.493) were independently associated with antiplatelet therapy. The benefits of antiplatelet therapy in CKD are anchored on its anti-inflammatory, lipid-lowering, and kidney function-improving effects, these synergistically lead to lower cardiovascular events. The increased risk and consequences of bleeding, and reductions in leucocytes and erythrocytes population should be borne in mind to prevent heightening morbidity and mortality rates.
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The interest in integrative oncology is growing worldwide. Patients with cancer are seeking traditional complementary and integrative medicine to mitigate the symptoms and enhance their well-being. Though there is supporting evidence for inter-disciplinary team care in oncology, the integrative oncology models in a resource-poor setting have not been explored. The current manuscript provides an overview of the integrative oncology model focusing on how complementary therapies such as psychosocial services, dietetics, yoga, and wellness programs could be integrated in clinical oncology care in a cost-effective way in a resource poor settings. Manuscript also discusses examples where such a model of care has currently been implemented for patients as well as caregivers.
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This review explores the impact of electronic prescribing (e-prescribing) systems on clinical pharmacy practice, highlighting the potential benefits and challenges associated with their use. Medication errors, a significant concern within healthcare settings, have been shown to decrease with the adoption of e-prescribing, offering a promising tool to enhance patient safety and reduce adverse drug events. However, the transition from traditional handwritten prescriptions to electronic methods introduces new challenges, including the emergence of new types of errors, such as incorrect drug selection, and potential increases in mortality rates, as observed in pediatric patient. Furthermore, it discusses the limited exploration of e-prescribing in primary care and community pharmacy settings, areas that require further investigation to fully understand the benefits and burdens of e-prescribing use. By examining barriers related to person, tasks, environment, tools and technologies, and organizational factors, this review emphasizes the importance of considering various aspects that influence the efficacy and safety of e-prescribing systems. The findings suggest a critical need for incorporating human factors principles in the design and evaluation of these systems to ensure they effectively support clinical pharmacy practice and enhance patient care.
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This comprehensive review delves into the profound impact of digital health technologies on the landscape of pharmacy services and patient care. The integration of electronic prescribing medication adherence apps, and tele-pharmacy services has revolutionized medication management in pharmacies. This amalgamation has not only streamlined processes but has also significantly minimized errors, leading to enhanced operational efficiency. Pharmacists, equipped with wearable devices, now engage in remote patient monitoring, allowing for personalized interventions and proactive healthcare strategies. The incorporation of genomic data, data analytics, and clinical decision support systems marks a transformative shift towards precision medicine within pharmacies. These technologies empower pharmacists to design tailored treatment plans based on individual genetic profiles, thereby optimizing therapeutic outcomes. As pharmacies increasingly embrace these digital tools, they metamorphose into dynamic healthcare hubs. Beyond traditional roles, pharmacies now offer virtual consultations and actively participate in patient education initiatives. This paradigm shift underscores a commitment to patient-centered care, exemplified by improved medication safety and a more interconnected healthcare ecosystem. The ongoing integration of digital health technologies holds promise for continued advancements in pharmacy services. This trajectory signifies a significant departure towards a more proactive, personalized, and technologically driven approach to patient care. The review underscores the transformative potential of digital health technologies in redefining the role of pharmacies and elevating the standards of patient-centered healthcare delivery.
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Solitary fibrous tumors of the pleura (SFTP) are uncommon neoplasms. We present the case of a 73-year-old male diagnosed with SFTP, exhibiting two masses measuring 20×18 cm and 9×8 cm in diameter, resulting in a notable cardio mediastinal shift towards the right side. The patient underwent successful surgical resection without experiencing any postoperative complications and was discharged in favorable condition. Although complete resection diminishes the risk of recurrence in both malignant and benign SFTP cases, long-term follow-up is necessary.
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Background: Many types of bacteria can produce septicemia. The most common infections that lead to septicemia are urinary tract infections, pneumonia, nephritis and abdominal infections. Methods: The study aims to assess the pattern of antimicrobial drugs used in septicemia and to assess the etiological organisms and their drug sensitivity and resistance pattern. Study participants admitted to tertiary health care centre and who are having septicemia were included in this prospective observational study. Blood culture, bronchial secretions were subjected to microbiological analysis. The etiological organisms, their drug sensitivity and resistance pattern and the outcome of drug therapy were recorded. The clinical course of the study participants was monitored till cure either the resolution of pneumonia. Qualitative data were analyzed using the chi-square test or Fischer's exact test and quantitative data using the independent t test. Results: Mean duration of hospital stay in all patients 13.22±0.45 days and in resistance cases it was found 19.22±0.45 days. Mean duration of ICU stay in all patients was 4.34±0.45 days and in resistant cases mean duration of ICU stay was 8.18±0.45 days. Clinical outcome in overall admitted patients recovered was 97 patients (80.83%) death was 16 patients (13.33%). Clinical outcome in resistant patients recovered 16 patients (13.33%) and death 26 patients (21.66%). Conclusions: The organisms had a varied sensitivity and resistance pattern. The clinical outcome was multifactorial.