Effectiveness of narrative health message on attitude towards gaming disorder among adolescents at selected school of Patna

Background: Games are generally seen to be beneficial activities but recently it gave rise concern towards people who play digital/video games for prolong hours as it interferes with personal, professional and academics, which is defined as symptoms of internet gaming disorder, that has been recently added in ICD-11 and DSM-5 for further study. Knowledge regarding IGD will help to prevent further prevalence of IGD and manage its harmful physical and mental issue. This study aimed to assess the prevalence of Internet gaming disorder among adolescent students at selected school of Patna, to evaluate the effectiveness of narrative health message on attitude towards gaming disorder among adolescents at selected school of Patna and to determine the association between demographical variables and pre-test attitude score. Methods: A quantitative research approach and pre-experiment (one group pre-test post-test) research design was used. About 76 participants were selected for the study using convenient sampling technique from class 8, 9 and 10 from selected school of Patna. Data was analysed by using descriptive and inferential statistics. Results: In pre-test 88.2% participants had positive attitude and 11.8% had negative attitude regarding internet gaming disorder. After implementation of narrative health message there were 92.1% participants had positive attitude and 7.9% had negative attitude The mean post-test attitude score of 76.91±11.717 was higher than the mean pre-test attitude score of 71.62±9.874. The calculated ‘t’ valve 4.421 was significant at p value 0.001. Conclusions: The study concludes that narrative health message regarding internet gaming disorder was effective.

Seed Quality Enhancement through Different Priming Treatments in Onion (Allium cepa L.)

In a meticulously executed experiment at the Department of Horticulture, College of Agriculture, Jawaharlal Nehru Krishi Vishwa Vidyalaya, Jabalpur, Madhya Pradesh, during the Rabi season of 2022-23, In the experiment, treatments were arranged in a Factorial Randomized Block Design (FRBD) with two factors concepts. The first factor was mobilized with twelve distinct seed priming treatments i.e.; KNO3 (2%), TiO2 (500ppm), PEG (1MPa), Salicylic acid (50ppm), Pseudomonas (1%), along with water as a control treatment. The second factor assigned to onion varieties i.e., Phule Samarth and B780) Among the findings, the combination of B2A1 (TiO2@ 500 ppm + Phule Samarth) significantly influenced radicle emergence time, while B2A2 (TiO2 @500 ppm + B780) exhibited a noteworthy impact on initial germination counts and final germination counts. Moreover (TiO2 @ 500ppm + B780) recorded distinct effects on plumule length and radicle length. In terms of vigour, variety A2 (B780) demonstrated the highest vigour I with TiO2 @ 500ppm. The results highlighted TiO2 @ 500ppm as the most effective priming agent, with PEG -1Mpa showing less efficacy in promoting seed Vigour II. Additionally, KNO3 @ 2% emerged as a promising agent, and the Phule Samarth variety exhibited a slightly higher mean dry weight compared to B780. Notably, the combination B6A1 (Water + Phule Samarth) resulted in the highest mortality %, while B1A1 (KNO3 @ 2% + Phule Samarth) was particularly associated with intensified pyruvic acid synthesis. Furthermore, the maximum TSS content was observed for B1A1 (KNO3 @ 2% + Phule Samarth), underscoring the intricate interplay between priming and genetic factors.

A study to assess the quality of sleep among medical students of Mysuru, Karnataka, India

Background: Every individual requires a period of rest to enhance and empower his/her work ability. Adequate quality of sleep is a prerequisite for optimal functioning of the students� mind and body. Sleep problems are common in the general population. Medical students are one subgroup who are more vulnerable to poor sleep quality owing to multiple factors in their lifestyle. To assess the quality of sleep in a population of medical students of Mysore Medical College and Research Institute, Mysuru and to study the determinants affecting it. Methods: An institution-based cross-sectional study was conducted using convenience sampling among 132 medical students of Mysore Medical College and Research Institute. A pre-designed and pre-tested structured questionnaire developed using the Pittsburgh quality of sleep index (PQSI) Score and Epworth daytime sleepiness scale (EDSS) was used. The data collected was compiled in MS- Excel and analysed using statistical package of social sciences (SPSS)Version 20.0. Results: Out of 132 medical students who were enrolled in the study, 55.3% (73/132) had an abnormal PSQI score. Males had better quality of sleep compared to females. Abnormal PSQI scores were associated with stress, alcohol and smoking. Conclusions: Sleep quality plays a major role in maintaining a medical student抯 physical, mental and working capacity.

Contemporary image of nursing profession: an explorative study of Bihar state

Background: Nurses currently contributing more than half of the manpower in the health sector and play a significant role in it, that is why the health sector is largely dependent on them but still they are largely invisible among people and their capabilities are limited in the field of their work that under-represents them. It has also been observed that many people have positive perception towards image of nursing profession which has become widely evident during COVID-19. The study aimed to determine the college students� perception towards the contemporary image of the nursing profession. Methods: A quantitative research approach and descriptive cross-sectional research design were used. By adopting the purposive sampling technique, 420 college students were selected from the colleges and universities of Bihar. Data collected via online Based-Google form and analysed by using descriptive and inferential statistics. Results: Out of 420 student participants, 97.4% have positive perception and 2.6% students have negative perception towards contemporary image of nursing profession. Most of the responses were in positive feedback such as, nurses are hardworking, knowledgeable, they are vital to health care delivery system whereas few were in contrary. There was a statistically significant association found between socio-demographic variables and perceived image of nursing profession as depicted in domiciliary (p= 0.010) and educational status of father (p= 0.058), at the p-value <0.05 (typically ?0.05). Conclusions: The study concluded that there is a positive perception among college students towards contemporary image of nursing profession.

Clinical features of neonates born to mothers with coronavirus disease-2019: a systematic review of 403 neonates

The COVID-19 pandemic emerged and spread fast affecting countries across the world consequently becoming a public health crisis. The impact of the virus on the health of adults and children has been increasingly understood but its effects on neonates born to infected mothers remain still unclear. This study aimed to throw light on the impact of novel SARS CoV-2 on pregnant patients and to examine maternal and neonatal outcomes along with the analysis of the extent of maternal-foetal transmission. A comprehensive literature search was conducted on PubMed and Google scholar till April 3 2022 using keywords COVID-19, SARS-CoV-2 and pregnancy, neonate, newborn and infant. 8 articles were reviewed, and clinical characteristics of 400 COVID-19-infected pregnant women and 403 neonates born to them were considered. Almost half of the women (56.5%) were asymptomatic. ICU admission was required by 3.75% of mothers and 1.75% mortality was reported. Out of 257 tested neonates, the positivity rate was 4.7%. Most of the neonates were asymptomatic (87.14%) and the neonatal mortality rate was 2.97%. To conclude, current evidence suggests most neonates born to covid infected mothers are not much affected by morbidity or mortality. As samples of breast milk or amniotic fluid were not tested so chances of vertical transmission cannot be ascertained. Nevertheless, considering the positivity rate in neonates as 4.7% we suggest further study in this regard. So, such infants should receive tests for SARS-CoV-2 and appropriate treatment should be initiated when needed.

Drug utilization pattern in Schizophrenia

Background: Pharmacotherapy is the mainstay of treatment in schizophrenia. The economic impact of this illness is wide ranging, long lasting and huge. The emergence of newer antipsychotics has changed the prescribing pattern. Purpose of this study is to determine the prescription pattern of antipsychotic drugs and to analyse the drug utilization in patients with schizophrenia based on WHO prescribing indicators.Methods: A descriptive study was conducted for a period of 1-year duration at inpatient Department of Psychiatry of a Government Medical College in Kerala, India among 230 schizophrenic patients. The case sheets of patients meeting inclusion criteria were scrutinised to find out the antipsychotic prescription pattern and drug utilization was analysed using WHO prescribing indicators. Analysis was done using descriptive statistics.Results: Newer antipsychotics (55.2%) were prescribed slightly more in preference to older antipsychotic (44.8%) drugs. Out of the newer drugs prescribed olanzapine (20.9%) was prescribed the most followed by risperidone (18%). Haloperidol (22.9%) was the most frequently prescribed older antipsychotic. Majority (71.3%) of the patients were given more than one antipsychotics during the hospital stay. Trihexyphenidyl (27.9%) was the most frequently co-prescribed drug with antipsychotics. Average number of drugs per encounter was 4.19, 73.4% of the drugs were prescribed in their generic name, 50.4% of the encounters were with an injection prescribed. 44.4%of the drugs were prescribed from the EDL (WHO-19th edition). Average drug cost per encounter was Rs.45.43. Percentage of drug cost spent on injections was 8.44%.Conclusions: Newer antipsychotics were more prescribed for schizophrenia of which olanzapine was the commonest. Newer antipsychotics are preferred because of their propensity to cause less side effects and more efficacy. Study of pattern of drug utilization is useful for measuring the economic impact of drug use among patients thereby facilitating rational prescribing.

Predictive accuracy of CURB-65 as comparedto PSI scorein the severity assessment of community acquired pneumonia

Introduction: Pneumonia Severity Index (PSI) and CURB-65 rule for community acquired pneumonia (CAP) have been developed to stratify patients based on mortality. Lack of a risk stratifying score like PSI or CURB-65 can lead to significant delay in starting treatment. This study was conducted to find out the ability of CURB-65 score and PSI to predict clinically relevant outcomes. Methods: 78 patients diagnosed as CAP admitted to a tertiary care hospital were enrolled into the study. Detailed clinical history was noted and CURB-65 and PSI scores were given with the help of a structured questionnaire in <24 hours of admission. The patients were revisited at day 3 and at discharge and data collected. Results:Out of 78 patients included in the study, 60 were males and 18 were females. Of the 78 patients, 14 died accounting for aninhospital mortality of 17.94%. Mortality in the mild, moderate and severe groups of CURB-65 were 0%, 16.7% and 47.8% respectively. Mortality in the mild, moderate and severe groups of PSI were 1.8%, 50% and 80% respectively. Area under the curve (AUC) for CURB-65 and PSI in terms of inhospital mortality were 0.935 and 0.920 respectively. Conclusion:The CURB-65 and PSI scores correlated well with mortality and other severity indicators. The CURB-65 has a better discriminatory power than PSI inour study. Because of its simplicity in addition to its better discriminatory power than PSI, CURB-65 may be better suited as a severity scoring system in CAP.

Cytomegalovirus reactivation and disease amongst patients with allogeneic haematopoietic stem cell transplantation in Eastern India: Epidemiology, outcome and healthcare cost

Purpose: Data from developing countries about incidence, prognosis and healthcare cost of cytomegalovirus (CMV) reactivation amongst patients with allogeneic hematopoietic stem cell transplantation (AHSCT) remain scarce. The purpose of the study was to describe the epidemiology, outcome and cost implications of CMV reactivation and CMV disease amongst patients with AHSCT in cancer hospital in Eastern India. Materials and Methods: The study design was a retrospective audit of clinical records. Results: Ninety-nine per cent of patients and 94% of the donors were found to be CMV seropositive. CMV reactivation rate was 43.8% amongst patients with AHSCT (n = 130 patients). CMV reactivation occurred 118 days after AHSCT (median; range: 28–943 days). Patients with any grade of graft-versus-host disease (GVHD) had higher CMV reactivation rate than patients without GVHD. Patients with CMV reactivation had more frequent GVHD than patients without CMV reactivation. Use of steroids was associated with CMV reactivation. We found no differences in overall survival of patients with or without CMV reactivation. The cost of in-house CMV-polymerase chain reaction at our centre was USD $57 (Rs. 3650), cost for intravenous ganciclovir was USD $26 (Rs. 1665) per infusion and oral valganciclovir USD $8 (Rs. 512)/900 mg tablet. The median duration of anti-CMV therapy was 14 days (interquartile range: 14–28 days) and the average cost per patient per month directed towards CMV management ranged between USD $800 and USD $1,300 (Rs. 51,238–Rs. 83,264). Three patients (2.3%) in this series had CMV disease, all of whom died. Conclusion: In an increasingly globalised world, where medical tourism is common, data from developing countries regarding cost and outcome of CMV infections in AHSCT patients are of relevance.

Medical Officers’ Certificate Programme (MOCP) Competencey Based Curriculum Of Public Health, Maharashtra.

Background: We herewith describe a novel methodology of teaching Medical Officers working at the Primary Health Centers under the Public Health Dept. of Maharashtra State. This course intends to develop competencies to manage adult and pediatric patients with common emergencies at primary health centre. There has been an immense shortage of Pediatricians & Physicians for the last 5 years due to 50-60% vacancies. Besides this, many of the patients in rural areas need to be addressed by a Pediatrician or Physician. With this in mind a short term certificate programme for the Medical Officers was designed. Method: Medical Officers working at Primary Health Centers were deputed like resident doctor for 6 months in the Pediatric/ Medicine Dept. of a Medical College. The methodology used was videoconferencing lectures, motivational lectures by renowned Pediatricians and Physicians, Professors, Padma Awardees from Mumbai, Nagpur, Pune and Aurangabad. The sessions were interactive with active involvement of the Doctors . They also attended all postgraduate programmes of the Department of the Medical College. They attended night duties, speciality clinics like resident doctors. An examination was taken at the end of 6 months after they had learnt state-of-the-art techniques in the subject. 169 students were taught from 2011 in 4 batches till date. The passing percentage varied from 88 to 96%. Result : At the end of the training, the students had acquired sound knowledge of theory and practicals in Medicine/ Pediatrics, had acquired necessary hands on skills, learnt state-of-the-art methodology and had established linkages with teachers in Medical Colleges. Conclusion: MOCP is thus a unique course successfully working only in the State of Maharashtra in India.

ICON 2013: Practical consensus recommendations for hormone receptor-positive Her2-negative advanced or metastatic breast cancer.

The management of hormone receptor‑positive Her2‑negative breast cancer patients with advanced or metastatic disease is a common problem in India and other countries in this region. This expert group used data from published literature, practical experience, and opinion of a large group of academic oncologists, to arrive at practical consensus recommendations for use by the community oncologists.

Clinico-pathological impact of cytogenetic subgroups in B-cell chronic lymphocytic leukemia: Experience from India.

BACKGROUND: The present study of 238 B‑cell Chronic Lymphocytic Leukemia (B‑CLL) patients were undertaken to seek the prevalence and to evaluate clinico‑pathological significance of recurrent genetic abnormalities such as del(13q14.3), trisomy 12, del(11q22.3) (ATM), TP53 deletion, del(6q21) and IgH translocation/deletion. MATERIALS AND METHODS: We applied interphase – fluorescence in situ hybridization (FISH) on total 238 cases of B‑CLL. RESULTS: Our study disclosed 69% of patients with genetic aberrations such as 13q deletion (63%), trisomy 12 (28%), 11q deletion (18%), 6q21 deletion (11%) with comparatively higher frequency of TP53 deletion (22%). Deletion 13q displayed as a most frequent sole abnormality. In group with coexistence of ≥2 aberrations, 13q deletion was a major clone indicating del(13q) as a primary event followed by 11q deletion, TP53 deletion, trisomy 12, 6q deletion as secondary progressive events. In comparison with del(13q), trisomy 12, group with coexistence of ≥2 aberrations associated with poor risk factors such as hyperleukocytosis, advanced stage, and multiple nodes involvement. In a separate study of 116 patients, analysis of IgH abnormalities revealed either partial deletion (24%) or translocation (5%) and were associated with del(13q), trisomy 12, TP53 and ATM deletion. Two of 7 cases had t(14;18), one case had t(8;14), and four cases had other variant IgH translocation t(?;14). CONCLUSION: Detail characterization and clinical impact are necessary to ensure that IgH translocation positive CLL is a distinct pathological entity. Our data suggests that CLL with various cytogenetic subsets, group with coexistence of ≥2 aberrations seems to be a complex cytogenetic subset, needs more attention to understand biological significance and to seek clinical impact for better management of disease.

Histopathological audit of splenectomies received at a cancer hospital.

Background: There are few studies in the literature studying the yield of the diagnostic splenectomy in a suspicious lymphoma case. Moreover, their relevance is limited owing to low number of cases, the use of selection criteria, and the lack of modern ancillary studies. We present a histopathological review of splenectomy specimens referred as a case of lymphoma to our center. Materials and Methods: The medical charts and laboratory data on all patients of all splenectomy specimens between the years 2003 and 2008 were reviewed. Morphological and immunohistochemical features were analyzed and the lymphomas were sub-typed in accordance to 2008 WHO Classification of Hematolymphoid Neoplasms. Flow cytometry immunophenotyping available in few cases was correlated. Results: A total of 46 cases studied included splenic marginal zone lymphoma (SMZL) (19 cases), splenic diffuse large B-cell lymphoma (DLBCL) (14 cases), splenic diffuse red pulp B-cell lymphoma (DRP) (five cases), follicular lymphoma (three cases), hairy cell leukemia (HCL) (two cases), HCL variant (HCLv) (1 case), 1 case of hepatosplenic gamma delta T-cell lymphoma (TCL), and 1 cases of TCL (not otherwise specified). Conclusions: Predominantly splenic lymphoma is a biologically heterogeneous entity, ranging from low-grade SMZL to high-grade DLBCLs. TCLs constituted only 4% of all our cases. DRP, HCL, and HCLv have similar diffuse red pulp patterns of splenic involvement and are differentiated based on flow cytometric immunophenotyping. We had a large number of splenic DLBCL and none of these involved bone marrow (BM), while all other lymphoma subtypes had BM involvement (stage IV disease). Morphological and immunophenotypic (immunohistochemistry and flow cytometry) features of BM and splenectomy specimen need to be correlated to differentiate these rare though similar-looking entities with overlapping features.

Role of RT-PCR and FISH in diagnosis and monitoring of acute promyelocytic leukemia.

Background: Patients with a presence of Promyelocytic Leukemia-Retinoic Acid Receptor Alpha (PML-RARA) genes rearrangement predict a favorable response to all-trans retinoic acid (ATRA), and a significant improvement in survival. Therefore, establishing the presence of PML-RARA rearrangement is important for optimal patient management. Aim: The objective of this study is to compare and assess the role of fluorescent in situ hybridization (FISH) and reverse transcriptase polymerase chain reaction (RT-PCR) in the diagnosis and long-term monitoring of Acute Promyelocytic Leukemia (APL). Materials and Methods: We compared 145 samples received at different interval of times to analyze the sensitivity of RT-PCR and FISH. Results: The failure rate for RT-PCR was 4% at baseline, 13% at induction, and 0% at the end of consolidation. And for FISH it was 8% at baseline, 38% at induction, and 66% at the end of consolidation. The predictive values of relapse in the patients who were positive and negative by RT-PCR, at the end of induction, were 60 % and 3%, respectively, and at end of consolidation it was 67 % and 4%, respectively. On the other hand the predictive values of relapse in patients who were positive and negative by FISH at end of induction were 57 % and 6%, respectively; while at end of consolidation it was 14% who were negative by FISH. Conclusion: Both RT-PCR and FISH are important for the diagnosis of APL cases, as both techniques complement each other in the absence or failure of any one of them. However, RT-PCR is more sensitive than FISH for the detection of minimal residual disease in the long-term monitoring of these patients. The present study shows that the predictive value of relapse is more associated with minimal residual disease (MRD) results by RT-PCR than that by FISH.

The effect of age on the bacteria isolated and the antibiotic-sensitivity pattern in infections among cancer patients.

Background: Patients with cancer are predisposed to infections. Antimicrobial patterns and antibiotic sensitivity change with increasing age, making choice of empirical therapy more complicated. Materials and Methods: This single-center study aims to try and assess the influence of age on microbiology and antibiotic sensitivity of organisms causing infection in patients with malignant disease. Results : The five most common bacterial pathogens isolated were Pseudomonas sp (245, 26.2%) > Enterocococcus sp (109, 11.66%) > Staphylococcus aureus (107, 11.44%) > Escherichia coli (106, 11.34%) > Klebsiella sp (99, 10.59%). There was no significant change in the distribution of Gram-positive and Gram-negative bacteria with age. However, there was an increase in the occurrence of the Enterobacteriacea group and a decrease in infections caused by nonlactose fermenters with increasing age. The ESBL production increased from 10.52% (12-19 years) to 24.88% (>50 years) as did oxacillin resistance (from 14.3% to 28.1%) among S. aureus isolates. The activity of most antimicrobial agents decreased with increasing age. The decreasing trend of activity was statistically significant for meropenam (73.3-41.2%) against Pseudomonas sp. and for the activity of the aminoglycosides for Acinetobacter sp (61.1-17.4% for amikacin). Conclusions : This suggests that empirical antibiotic therapy needs to be changed on the basis of the age of the patient. It also appears that combination therapy is essential for the empirical treatment of infections in elderly patients with cancer.

Immunophenotyping of mature T/NK cell neoplasm presenting as leukemia.

Introduction : Mature T/NK cell lymphomas (MTNKL) presenting as leukemia are rare and show considerable overlapping of clinical, morphological and immunophenotypic features. AIM: Critical analysis of the morphology and immunophenotypic profile of MTNKL. Materials and Methods : We reviewed 380 consecutive cases of mature lymphoid neoplasm that presented as leukemia and were diagnosed on morphology and immunophenotyping of bone marrow and/or peripheral blood samples. Results : Peripheral blood and bone marrow involvement was seen in all cases. MTNKL constituted 4% (nine cases) of all mature lymphoid neoplasms presenting as leukemia. It included four cases of T-large granular leukemia (T-LGL), two of T-cell prolymphocytic leukemia small cell variant (T-PLL), two of adult T-cell leukemia/lymphoma (ATLL) and one of primary cutaneous gamma delta T-cell lymphoma (PCGDTCL). T-LGL revealed CD4-/CD8+ phenotype in three, and CD4+/CD8+ phenotype in one case. CD56 was absent in all the cases of T-LGL. One case of T- PLL small cell variant showed CD4+/CD8- phenotype, while the other revealed CD4-/CD8+ phenotype. Both cases of ATLL showed CD4+/CD8+/CD25+ phenotype. The single case of PCGDTCL showed CD4-/CD8- phenotype pattern. CD3 and CD5 were expressed in all MTNKL. CD7 was absent in three cases of T-LGL. TCRα/β was performed in three cases of T-LGL and was positive in all. TCRα/β was also seen in both the cases of T-PLL small variant. However, TCRα/β was seen in the single case of PCGDTCL. Conclusion : Mature nodal T/NK cell neoplasms are rare and MTNKL presenting as leukemia are even rarer. There is an overlap between the immunophenotypic profiles of different MTNKL subtypes and elaborate T/NK cell panels are required for their evaluation.

Blood stream infections in cancer patients: A single center experience of isolates and sensitivity pattern.

Background : Up to 10% of patients who develop a nosocomial blood stream infection (BSI) in the hospital have an underlying malignancy. The treatment of infections in patients with malignancy often relies on the use of established guidelines along with the consideration of the local microbiology and antibiotic sensitivity patterns of possible etiologic agents. AIMS: This study attempts to identify the likely etiologic agents and the antibiotic sensitivity profile of BSIs in cancer patients. Settings and Design: This was a retrospective study. Methods and Material: The study was conducted at a tertiary care center for cancer patients, in which samples representing blood stream infections sent from the Medical Oncology services of the hospital during the year of 2007 were analysed. The microbiological profile and antibiotic sensitivity pattern of these isolates was studied. Results: There were 484 isolates that represented BSIs. The most common bacterial isolates from patients with cancer were Pseudomonas spp. (30.37%), Staphylococcus aureus (12.6%) and Acinetobacter spp. (11.57%). Meropenem was the most effective antibiotic with 71.2% sensitivity to the bacterial isolates it was tested against. Oxacillin resistance was seen in 18% of S. aureus isolates. Conclusion: Gram-negative bacteria were more common as etiologic agents of BSIs in cancer patients. The poor activity of the primary empirical agents for infections in cancer namely ceftazidime and piperacillin-tazobactam is alarming.Strict regulation of vancomycin use should be considered in areas where there is a low prevalence of methicillin-resistant S. aureus (MRSA).

Comparison of in vitro activities of ceftazidime, piperacillin-tazobactam, and cefoperazone-sulbactam, and the implication on empirical therapy in patients with cancer.

Background: Infection is a common cause of morbidity and mortality in cancer patients. In most of these cases empirical treatment is provided because the focus of infection is not identified. Empiric antibiotics provided to these patients are based on isolates, sensitivity, and on guidelines. Here we have compared three antibiotics recommended as empirical treatment by the Infectious Disease Society of America (IDSA). Aims: To compare the three antibiotic sensitivities for gram negative isolates at our institute. Objective: To choose the optimal antibiotic as the empirical treatment for cancer patients developing infections. Materials and Methods: We collected the data on isolates and antibiotic sensitivity patterns of isolates for ceftazidime, piperacillin + tazobactum, and cefoperazone from the medical oncology department. We subsequently compared the sensitivity of these three antibiotics. Statistical Methods: The isolates were mapped using the WHONET 5.4 software. The analysis was conducted using SPSS 15.0 for Windows. McNemar Chi-square test was used to compare the sensitivity percentages between any two antibiotics. The agreement between the antibiotic and the gold standard was calculated using the Kappa statistic. Two tailed p values were reported. Results: The results showed that there was a difference among sensitivities for these antibiotics. It appears that the sensitivity of ceftazidime was inferior to the two other antibiotics. Also cefoperazone has better sensitivity as compared to piperacillin + tazobactum. Conclusion: In spite of these three antibiotics being recommended by IDSA our data suggest that it should not be followed blindly and local sensitivity data is important for formulating institutional guidelines for using antibiotics.

Positron emission tomography / computerized tomography evaluation of primary Hodgkin's disease of liver.

Occurrence of primary Hodgkin's lymphoma (PHL) of the liver is extremely rare. We report on a case of a 60-year-old male who presented with liver mass and B-symptomatology. Hepatoma or hepatic metastasis from a gastrointestinal primary was initially suspected. Tumor markers like AFP, CEA, Total PSA, and CA-19.9 were within normal limits. Positron Emission Tomography / Computerized Tomography (PET/CT) revealed a large hepatic lesion and a nodal mass in the porta hepatis. A liver biopsy was consistent with Hodgkin's lymphoma. There was complete regression of the hepatic lesion and evidence of shrinkage of the nodal mass following four cycles of chemotherapy. 18F Fluro -de-oxy Glucose (FDG) PET / CT in this case helped in establishing a primary hepatic lymphoma by demonstrating the absence of pathologically hypermetabolic foci in any other nodes or organs. PET / CT scan is a useful adjunct to conventional imaging and histopathology, not only to establish the initial diagnosis, but also to monitor treatment response in PHL.