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1.
Indian J Med Microbiol ; 2006 Jul; 24(3): 208-11
Article Dans Anglais | IMSEAR | ID: sea-53807

Résumé

Increasing resistance to third generation cephalosporins has become a cause for concern especially among Enterobacteriaceae that cause nosocomial infections. The prevalence of extended spectrum beta-lactamases (ESBLs) among members of Enterobacteriaceae constitutes a serious threat to current beta-lactam therapy leading to treatment failure and consequent escalation of costs. A detailed study was initiated to identify the occurrence of ESBLs among the Enterobacteriaceae isolates at a tertiary care hospital using the double disk potentiation technique. Antibiogram profiles were determined to commonly used antibiotics and confirmation of ESBLs production was carried out by the disk diffusion assay using ceftazidime and cefotaxime in the presence and absence of clavulanic acid. Our results indicate that the majority of ESBLs were expressed in Escherichia coli.


Sujets)
Antibactériens/pharmacologie , Céfotaxime/pharmacologie , Enterobacteriaceae/effets des médicaments et des substances chimiques , Infections à Enterobacteriaceae/microbiologie , Humains , Tests de sensibilité microbienne , Résistance aux bêta-lactamines , bêta-Lactamases/métabolisme
2.
Article Dans Anglais | IMSEAR | ID: sea-118188

Résumé

BACKGROUND: Successful treatment of acute myocardial infarction is dependent on early presentation of the patient to the hospital. The factors that contribute to delay in seeking treatment have not been systematically evaluated in the Indian milieu. METHODS: Patients admitted with acute myocardial infarction to a 125-bed urban community hospital were evaluated prospectively. A record of admission characteristics, prior medical history, pre-hospital symptoms and treatment patterns was completed within 48 hours of each admission. Independent predictors of delayed admission were identified by logistic regression. RESULTS: Of 144 consecutive admissions with myocardial infarction, 133 had completed data as per the protocol [mean (SD) age 59 (12.7) years; 79.6% men]. The distribution of presentation times was skewed, with the mode, median and mean being 1, 3 (interquartile range 1.25-11) and 10.9 (SD 20.5) hours, respectively. Seventy-nine patients (59.4%) consulted a general practitioner prior to hospital referral and 48 patients (36.1%) delayed admission to hospital by more than 6 hours from the onset of symptoms. On multivariate analysis, individuals who were initially seen by a general practitioner (OR 5.57; 95% CI 1.84-16.8) and those over the age of 65 years (OR 3.24; 95% CI 1.06-9.89) were identified as 'delayers', while patients with severe symptoms (OR 0.32; 95% CI 0.12-0.87) or prodromal angina (OR 0.25; 95% CI 0.08-0.82) minimized delay. CONCLUSION: Though 50% of patients with acute myocardial infarction present to hospital within 3 hours, about 36% delay seeking treatment by more than 6 hours. Besides age and the pattern and severity of symptoms, visits to the general practitioner were found to be an independent correlate of delay.


Sujets)
Adulte , Facteurs âges , Sujet âgé , Sujet âgé de 80 ans ou plus , Analyse de variance , Femelle , Hôpitaux urbains , Humains , Inde , Modèles logistiques , Mâle , Adulte d'âge moyen , Infarctus du myocarde/diagnostic , Mesure de la douleur , Acceptation des soins par les patients , Études prospectives , Facteurs socioéconomiques , Facteurs temps
3.
Article Dans Anglais | IMSEAR | ID: sea-119497

Résumé

BACKGROUND: Survival after cardiopulmonary resuscitation depends upon the quality of pre-hospital support, availability of resuscitation equipment and the competence of the resuscitator. There are few data on the prognosis of patients undergoing such resuscitation in India. METHODS: In a retrospective analysis of 215 resuscitations done in a 125-bed community hospital between January 1995 and November 1997, return of spontaneous circulation and survival to discharge were evaluated. Multivariate methods were used to identify the predictors of successful outcome. RESULTS: Of all the patients, 14.4% were alive at discharge. Survival after a cardiorespiratory arrest in the hospital was 18.4%, which was significantly better than survival after pre-hospital events (5.9%; p = 0.027). Multivariate predictors of survival at discharge were resuscitation duration of less than 20 minutes [odds ratio (95% confidence limit): 32.6 (6.5-164.3)], presentation with ventricular tachycardia or fibrillation [odds ratio: 18.5 (4.4-77.9)], in-hospital cardiorespiratory arrest [odds ratio: 5.2 (1.2-21.6)] and female sex [odds ratio: 3.2 (1.1-9.6)]. Bystander resuscitation, though rarely provided, increased survival at discharge (p = 0.026). CONCLUSIONS: With 5.5 resuscitation attempts needed for one live discharge after in-hospital cardiorespiratory arrest and 17 attempts to save a life after pre-hospital events, our outcomes are comparable to those reported from developed nations. A return of pulse after shorter durations of cardiopulmonary resuscitation, ventricular fibrillation or tachycardia as the abnormal presenting rhythm, in-hospital location of cardiorespiratory (CR) arrest and female sex were independent predictors of live discharge. Age and aetiology of CR arrest did not influence the outcome.


Sujets)
Sujet âgé , Réanimation cardiopulmonaire/mortalité , Femelle , Humains , Inde/épidémiologie , Mâle , Adulte d'âge moyen , Pronostic , Études rétrospectives , Taux de survie , Services de santé en milieu urbain
6.
Indian J Biochem Biophys ; 1991 Feb; 28(1): 65-7
Article Dans Anglais | IMSEAR | ID: sea-28473

Résumé

The products of CO2 fixation by heterotrophically grown Haloferax mediterranei were analysed. The main 14C-labelled alpha-ketoacid detected following incubation with NaH14CO3 and pyruvate or propionate was pyruvate. In presence of these organic acids and NH4+, 14CO2 was incorporated into glutamic and aspartic acids and alanine.


Sujets)
Alanine/métabolisme , Acides aminés/métabolisme , Ammoniac/métabolisme , Archéobactéries/métabolisme , Acide aspartique/métabolisme , Hydrogénocarbonates/métabolisme , Dioxyde de carbone/métabolisme , Glutamates/métabolisme , Acide glutamique , Cétoacides/métabolisme , Propionates/métabolisme , Pyruvates/métabolisme , Acide pyruvique , Sodium/métabolisme , Hydrogénocarbonate de sodium
15.
J Indian Med Assoc ; 1967 Nov; 49(9): 439-40
Article Dans Anglais | IMSEAR | ID: sea-105648
18.
J Indian Med Assoc ; 1961 May; 36(): 470-2
Article Dans Anglais | IMSEAR | ID: sea-105484

Sujets)
Artérite
19.
J Indian Med Assoc ; 1960 Jan; 34(): 16-7
Article Dans Anglais | IMSEAR | ID: sea-105071
20.
J Indian Med Assoc ; 1958 Aug; 31(4): 171-2
Article Dans Anglais | IMSEAR | ID: sea-95899
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