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Shriyan A.,Ajinstitute Of Medical Science | Devan P.P.,Aj Institute Of Medical Science And Research Center
Journal of Clinical and Diagnostic Research | Year: 2011

Purpose: To analyze whether the current reforms are the right answer to the shortcomings of traditional medical training. To study the preferences of the teaching aids and the methods used by the postgraduate students. Methods: A study was conducted at the A.J. Institute of Medical Sciences, Mangalore, Karnataka. The participants were postgraduates from various medical colleges in and around Mangalore. A questionnaire was distributed among 100 randomly selected postgraduate students who came to attend the Postgraduate CME Program on scientific writing, publication and presentation skills. The students were asked to tick appropriately the teaching aids and the methods which were preferred. Results: The postgraduate students were of the opinion that problem based learning and group discussions were preferred over other teaching methods and that Powerpoint presentations were preferred by 82% of the postgraduates as their teaching visual aid, over 14% who preferred blackboard teaching and 2% the overhead projector. 60%-70%of the postgraduates preferred problem based learning. Only 36% of the students felt that it was necessary to have interactions with other departments to treat a patient. Conclusion: Definitely newer teaching methods would be more helpful than the traditional curriculum with didactic lectures. Visual aids like Power-point presentations will motivate the students to learn their subjects, thus making the learning process an enjoyable experience.

Kumar B.H.,Aj Institute Of Medical Science And Research Center | Jain K.,Pathology | Jain R.,Medicine
Medical Journal Armed Forces India | Year: 2014

Background: Intestinal worm infestation is a global health problem. Soil-transmitted helminth (STH) infections form the most important group of intestinal worms affecting two billion people worldwide, causing considerable morbidity and suffering, though entirely preventable. The present study was undertaken to measure the parasite load in the target population and evaluate the efficacy of anthelminthic drugs. Methods: Current study was undertaken from 01 July 2012 to 30 June 2013. All outdoor as well as indoor patients advised stool examination formed the study population and it included 2656 males and 76 females (including 6 children). Investigations included stool examination and blood counts. A single-oral dose of anthelminthic drug was given to all positive cases. Stool tests were repeated after 14e21 days to evaluate cure rate. Results: Overall prevalence of intestinal worm infection was found to be 49.38%. Ascaris was the most common parasite (46.88%), followed by Taenia (2.1%) and Hymenolepis nana (0.21%). Cure rate was found to be 66% for Ascaris and 100% in other cases. Conclusion: The study reveals high prevalence of intestinal helminths in our subject population and calls for immediate control measures, including preventive chemotherapy and treatment of entire 'at risk' population and improvement of their living conditions including provision of potable water. © 2014, Armed Forces Medical Services (AFMS). All rights reserved.

Gupta S.,Sanjay Gandhi Post Graduate Institute of Medical Sciences | Mallya S.P.,Aj Institute Of Medical Science And Research Center | Bhat A.,Manipal University India | Baliga S.,Manipal University India
Journal of Clinical and Diagnostic Research | Year: 2016

Introduction: Aerobic bacterial infections often complicate vascular access in patients receiving haemodialysis, leading to Catheter-Related Blood Stream Infections (CRBSI). Various studies report Gram - positive bacteria, Staphylococcus aureus (S. aureus) in particular, as the most common aetiologic agent. Studies on microbiological analysis in this subset of population from India are very few. Aim: To examine clinical and bacteriological profiles of haemodialysis patients developing CRBSI, the antibiotic susceptibility of the bacteria isolated from these patients and determine nasal carriage of S. aureus in the study subjects. Materials and Methods: Using a prospective observational design 127 patients receiving haemodialysis (84 males; 43 females) from October 2011 to March 2013 were enrolled in this study. At each dialysis session, catheters were examined for any evidence of infection. In case of suspicion for infection, pus swab, blood culture and the catheter tips were sent to microbiology laboratory for site specific investigations. Vancomycin injection was empirically administered to these patients pending culture results. Data obtained was examined for relationship of CRBSI with clinical and socio-demographic risk factors. Results: Out of 127 patients, 19 developed CRBSI, 10 developed exit-site infections and 33 patients were noted to have colonization of their catheters. The most common organisms included S. aureus in 24 (45.2%) catheter tips, followed by Pseudomonas aeruginosa in 9 (17%), Acinetobacter spp. in 5 (9%), Enterobacter spp. in 4 (7.5%) and Klebsiella pneumoniae in 3 (5.6%) catheter tips. Bacteraemia was found in 19 (20.7%) patients and P. aeruginosa was the most commonly isolated organism amongst them (38.8%). Staphylococcal nasal carriage was seen in 60 (69%) patients and 36 (41.4%) of these isolates were methicillin-resistant. Significant factors associated with CRBSI included history of bacteraemia, presence of diabetes mellitus, long duration (>15 days) of catheterization and antibiotic use within three months (p<0.05 for all). Conclusion: Although S. aureus was the most common colonizer of non-tunnelled central access catheters among haemodialysis patients, CRBSI was most frequently caused by P. aeruginosa, which may have a bearing on our current antibiotic policy. © 2016. Journal of Clinical and Diagnostic Research. All rights reserved.

Deepthi Shridhar P.,Aj Institute Of Medical Science And Research Center | Rai M.,Aj Institute Of Medical Science And Research Center | Fernandes A.,Aj Institute Of Medical Science And Research Center
Journal of Clinical and Diagnostic Research | Year: 2015

Objectives: A world without effective antibiotics is a terrifying but a real prospect. Overuse or misuse especially of newer and higher antimicrobials (AM) is of particular concern, as this contributes to development of resistance among microorganisms. To check this trend, the Reserve Drug Indent Form (RDIF) was introduced in our hospital and its impact on AM consumption, cost of therapy and the sensitivity pattern was studied in the medical intensive care unit (MICU). Materials and Methods: A retrospective descriptive study in the medical ICU of a tertiary care hospital from July 2012 to August 2013. From March 2013, RDIF was made mandatory to be filled up prior to prescribing reserve antimicrobials. AM consumption (expressed as DDD/100 bed days) and sensitivity pattern (expressed in percentage) six months prior to and six months after implementation of the form were analysed. Results: The total Reserve AM consumption was 125.79 per 100 bed days during the study period. Average occupancy index was 0.50 and length of ICU stay was 6 days. The total consumption reduced from 85.55/100 to 40.24/100 bed days after the introduction of the RDIF. However, Imipenem usage increased from 11.35/100 to 23.94/100 bed days, which can be attributed to sensitivity profile to Imipenem (82.1%) compared to Meropenem (65.7%). Cost of therapy reduced from Rs 6,27,951 to 4,20,469. Conclusion: Reserve AM consumption showed a declining trend after introduction of the RDIF. Hence, the RDIF served as an important tool to combat inappropriate use, reducing the cost burden and also helped to improve the sensitivity to reserve drugs. © 2015, Journal of Clinical and Diagnostic Research. All rights reserved.

Shriyan A.,Aj Institute Of Medical Science And Research Center | Sheetal R.,Aj Institute Of Medical Science And Research Center | Nayak N.,Aj Institute Of Medical Science And Research Center
Journal of Clinical and Diagnostic Research | Year: 2010

Purpose: Post-operative wound infections have been an important cause of morbidity and cost burden for the patients. [1] The objective of this study was to evaluate the antimicrobial susceptibility pattern among the most common bacteria which are associated with postoperative wound infections. Method: 84 isolates were obtained from 100 pus samples/wound swabs which were collected from clinically suspected post-operative wound infections. The bacteria were cultured on Blood agar, Mac Conkey's agar and Nutrient agar, followed by the identification of the isolates based on their cultural characteristics and their reactions in standard biochemical tests. All the isolates were tested for antimicrobial susceptibility by the disk diffusion technique according to the Clinical and Laboratory Standards Institute (CLSI) guidelines on Muller Hinton Agar. The screening for extended spectrum beta lactamase (ESBL) production was done by the phenotypic confirmatory test by using ceftazidime discs in the presence and absence of clavulanic acid.[2],[3],[4] Result: Staphylococcus aureus was the most frequently isolated pathogenic bacteria from post-operative wounds. A majority of the isolates were resistant to ampicillin and amoxicillin. 1.8% of the Staphylococcus aureus isolates were methicillin resistant Staphylococcus aureus (MRSA). Most of the gram-negative bacteria which were isolated, ie Escherichia coli, Proteus mirabilis, Klebsiella species and Pseudomonas aeruginosa were sensitive to quinolones and amino glycosides, but were resistant to cephalosporins (40%). ESBL production was noted in 64.2% of the isolates which were tested. ESBL production was detected in 60% strains of Escherichia coli and in 75% strains of Klebsiella species. All the extended spectrum beta lactamase (ESBL) producer isolates were found to be sensitive to the beta-lactam and beta lactamase inhibitor combinations. Conclusion: This study has shown that a majority of the isolates were gram positive bacteria and that there was an increase in the incidence of ESBL producing Escherichia coli and Klebsiella strains. Tests for the detection of ESBL producing bacteria should be carried out routinely and the use of third generation cephalosporins should be restricted. Hence, there is a need for continuous monitoring to determine the susceptibility pattern of the common isolates which are found in the hospital. To emphasize precise empiric therapy, policies on prescription patterns should be reviewed, which will ensure reduced patient stay, morbidity and cost per day in the hospital.

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