Ventilator associated pneumonia: unravelling prevalence risk factor and antibiotic usage

Background: Hospital acquired infections, are a leading cause of mortality and morbidity. Ventilator associated pneumonia, one of the hospital acquired illnesses. The purpose of this study was to evaluate the prevalence, risk factors, causative organism, and antibiotic usage for the treatment of ventilator-associated pneumonia. Methods: Between May 2022 and October 2022, 50 patients participated in an ambispective and observational study conducted across several ICU departments at Adichunchanagiri Hospital, BG Nagara, Karnataka. Reviewing and evaluating daily patient case sheets, laboratory results, and treatment charts of participants who were hospital inpatients provided pertinent data needed for the study. Volunteers were enrolled after taking consent from each of them, a suitably designed data collection form was used to collect all the necessary information. Microsoft Excel was used to enter the data. Version 28 of SPSS was used to analyze the data. Statistical significance was determined by using a P-value of less than 0.05. Results: The study included 50 patients and discovered a 60% prevalence of ventilator-associated pneumonia in the general community. Staphylococcus aureus accounted for 26.7% of all gram-positive bacteria, whereas Enterobacter and Klebsiella species accounted for 16.7%. Metronidazole was given in 64% of instances, with accidents being the most frequent risk factor (40%). Conclusions: Within the specified population, the incidence of ventilator-associated pneumonia is 60%, with Staphylococcus aureus identified as the most predominant bacterial pathogen. Metronidazole is the most frequently prescribed antibiotic, and accidents are the key risk factors that cause ventilator-associated pneumonia.

Sero-prevalence of toxoplasmosis among pregnant women attending an ante-natal clinic at a teaching hospital in Al Kharj, Saudi Arabia

@#Toxoplasma gondii (T. gondii) is a zoonotic infection that may be transmitted to human beings either by consumption of raw or uncooked meat or by ingesting oocysts. Toxoplasma organisms can cross blood placenta barrier and may result in congenital toxoplasmosis. About 80% of immunocompetent individuals do not show any clinical manifestations and are silent carriers of this disease. Pregnant women especially in highly prevalent areas are recommended to be screened for this disease in order to prevent the potential vertical transmission. To our knowledge no such study has been conducted in this region of Saudi Arabia. This study attempted to carry out two objectives: first, to find out the seroprevalence of T. gondii infection in pregnant women attending prenatal care services in our hospital; second, to find out risk factors associated with T. gondii seroprevalence in our patients. It was carried out in Teaching Hospital in Al-Kharj over a period of one year. All 306 pregnant women attending antenatal clinic were involved in the study. A pretested selfexplanatory questionnaire was filled out by the patients and their sera were collected to be tested for IgG and/or IgM against T. gondii. The results were then statistically analyzed using SPSS software and p-value was calculated using Pearson Chi Square test. Out of the 306 blood samples tested, 99 (32.4%) were seropositive for specific anti T. gondii IgG antibodies and 3(1%) were seropositive for IgM. This show that seroprevalence of T. gondii antibodies was high among pregnant women and the prevalence showed a significant association with age. The study recommends conducting educational programs to raise awareness among women about risk factors and precautions to be taken.

Atypical mucocutaneous involvement with Leishmania donovani.

Mucocutaneous leishmaniasis has rarely been reported from India. The usual causative organisms of this infection are Leishmania braziliensis and L. tropica. Another species, L. donovani, which usually causes visceral leishmaniasis, has recently been reported to cause mucocutaneous disease in a few patients from Sri Lanka. We report two patients who had undiagnosed chronic skin lesions for several years. Skin biopsies revealed Leishmania and the species was characterized as L. donovani in both patients. There was considerable improvement in the skin lesions following treatment with liposomal amphotericin B.

Síndrome de Kartagener em um cão (Canis lupus familiaris) da raça Cocker Spaniel Inglês / Kartagener's syndrome in an English Cocker Spaniel dog (Canis lupus familiaris)

Kartagener is syndrome is a rare disorder described in dogs determined by the triad situs inversus totalis, chronic sinusitis, and bronchial disease. The clinical signs of chronic respiratory and other less common presentations (such as hydrocephalus and subfertility) are due to a concomitant ciliary dysfunction. This article describes the clinical, radiographic, and computed tomography findings and treatment in a dog affected by Kartagener is syndrome since early months of life. This is the first case report of this syndrome in a domestic dog in Brazil and the only known scientific report in the English Cocker Spaniel.

Risk factors for acquiring Strongyloides stercoralis infection among patients attending a tertiary hospital in south India.

Purpose: Strongyloides stercoralis causes persistent and fatal disseminated infections in immunocompromised hosts. In this study, we aimed to determine the risk factors for acquiring strongyloidiasis and the associated morbidity in south India. Materials and Methods: The study was carried out in two parts. This included a 6-month chart review of cases with strongyloidiasis and randomly selected controls conducted to determine the association with immunocompromised states. Secondly, a cross-sectional study was conducted to investigate hyperinfection in human immunodeficiency virus (HIV)-infected adults where the stool and sputum samples were examined by microscopy for Strongyloides larvae. Results: In the chart review, 118 cases were compared with 240 controls. A higher proportion of patients on corticosteroids [8 (53.3%)] and with HIV infection [3 (60%)] had the risk of acquiring strongyloidiasis than not, although the difference was not statistically significant in this population. In the cross-sectional study, 14/239 HIV-positive individuals had Strongyloides larvae in the stool samples but none had Strongyloides detectable in their sputum samples. The CD4 cell counts were significantly lower in cases with Strongyloides compared with HIV-infected individuals with no parasites in their stool samples (P < 0.001). Conclusions: In this setting, strongyloidiasis was seen more often in patients on corticosteroid therapy and with HIV infection. In HIV, an association with lower CD4 counts indicates the need for inclusion of Strongyloides as an opportunistic parasite. Gram negative sepsis was an important complication of strongyloidiasis hyperinfection in both HIV and steroid therapy. Further prospective studies on the risk of developing complicated Strongyloides infection are required.

[Evaluation at ginseng on lipid profiles, liver and renal markers in diabetic rats]

Diabetes is a metabolic disorder that occurs as a consequence of decrease in insulin secretion or resistance to insulin. Most diabetes related treatments have problems with adverse reactions. Natural therapeutics have been in use from long time ago up to present time. Ginseng is a traditional drug used for treatment of many dieses particularly diabetes. The aim of this study was to find out the effect of oral Ginseng on the serum glucose and other biochemical parameters such as lipid profile. In this study 30 male rats with a body weight of 250 +/- 25 gr and age of 4-6 months was used. Each animal was housed under controlled temperature [21 +/- 2 C] and standard conditions with free access to food and water. Blood test was carried out to measure glucoses and other biochemical parameters such as cholesterol, TG, ALT, AST and BUN. Animals were equally divided into three groups; 1-control group, 2-the STZ-induced-diabetes [60 mg/kg] group, 3-the STZ-induced-diabetes [60 mg/kg] and150 mg/kg oral ginseng. The study was lasted for 6 weeks. Blood samples were taken and tested for glucoses and other parameters. The average blood sugar in the control group was 131.1 +/- 7.9 mg/dl, but it was higher than 550mg/dl in streptozocine-received group. In group 3, which received ginseng, blood sugar decreased up to 50%. Cholestrol decreased up to 40% in the treatment group. Among the measured parameters HDL showed a 50%decrease in treatment group in comparison with diabetic group. AST and ALT values between the control and treatment groups did not show a significant difference. BUN values decreased from 71.6 +/- 6.6 in diabetic group to 50.1 +/- 5.7 mg dl in the treatment group. The results of this study revealed that ginseng can be considered as a substance which decreases blood glucoses, reduces diabetes adverse reactions, and consequently diminishing blood lipids in animal model. However, to apply these results to human, further studies are needed to be carried out

Evaluation of ginseng on lipid profiles, liver and renal markers in diabetic rats

Diabetes is a metabolic disorder that occurs as a consequence of decrease in insulin secretion or resistance to insulin. Most diabetes related treatments have problems with adverse reactions. Natural therapeutics have been in use from long time ago up to present time. Ginseng is a traditional drug used for treatment of many diseases particularly diabetes. The aim of this study was to find out the effect of oral Ginseng on the serum glucose and other biochemical parameters such as lipid profile. In this study 30 male rats with a body weight of 250 +/- 25 gr and age of 4-6 months was used. Each animal was housed under controlled temperature [21 +/- 2 C] and standard conditions with free access to food and water. Blood test was carried out to measure glucoses and other biochemical parameters such as cholesterol, TG, ALT, AST and BUN. Animals were equally divided into three groups; 1-control group, 2-the STZ-induced-diabetes [60 mg/kg] group, 3- the STZ-induced-diabetes [60 mg/kg] and 150 mg/kg oral ginseng. The study was lasted for 6 weeks. Blood samples were taken and tested for glucoses and other parameters. The average blood sugar in the control group was 131.1 +/- 7.9 mg/dl, but it was higher than 550mg/dl in streptozocine- received group. In group 3, which received ginseng, blood sugar decreased up to 50%. Cholestrol decreased up to 40% in the treatment group. Among the measured parameters HDL showed a 50%decrease in treatment group in comparison with diabetic group. AST and ALT values between the control and treatment groups did not show a significant difference. BUN values decreased from 71.6 +/- 6.6 in diabetic group to 50.1 +/- 5.7 mg dl in the treatment group. The results of this study revealed that ginseng can be considered as a substance which decreases blood glucoses, reduces diabetes adverse reactions, and consequently diminishing blood lipids in animal model. However, to apply these results to human, further studies are needed to be carried out

Effects of Citrica Acid, Edta And Tetracycline Hydrochloride On Periodontally Involved Root Surface ( A SEM STUDY ).

Root debridement by scaling and root planing may not completely remove contaminated cementum particularly in more apical areas. The smear layer formed during root planing inhibits cell migration and attachment leading to impaired marginal periodontal healing. In the present study an attempt is made to compare the morphological effects of root surface demineralization using citric acid, TTC and EDTA as root conditioning agents. The findings obtained from this study could form the basis for future in vivo studies using the same agents for demineralization procedures.

Effect of Traditional Beer Consumption on the Iron Status of A Rural South African Population

Objective.To determine the effect of traditional beer consumption on the iron status of rural black subjects.Design. A cross-sectional study was undertaken.Setting. Dikgale field site and the surrounding villages in Limpopo Province; South Africa.Subjects. Eight hundred and forty-four non-alcohol consumers (738 women and 106 men) and 280 alcohol consumers (163 women and 117 men) aged 30 years and above; participated in the study.Outcome measures. Outcome measures included alcohol consumption; serum ferritin levels; percentagetransferrin saturation; total iron-binding capacity; haemoglobin and C-reactive protein levels.Results. Traditional beer fermented in either iron pots or plastic containers was found to have iron levels ranging from 15 mg/l to 67.8 mg/l and 6 mg/l to 17 mg/l; respectively. Iron status as measured by serum ferritin; serum iron; percentage transferrin saturation; and haemoglobin levels was significantly higher in alcohol consumers than in non-consumers; even after adjustment for age and C-reactive protein (CRP) levels. A high percentage of women (12.3) and men (8.2) consuming alcohol had iron overload.Conclusion. This study showed that consumption of traditional beer in a non-urban population in Limpopo Province was associated with high levels of markers of iron status. Traditional beer consumption seemed to prevent iron deficiency in those at risk of developing such deficiency; but appeared to precipitate iron overload in those at risk of developing iron overload