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Walia K.,Indian Council of Medical Research | Ohri V.C.,Indian Council of Medical Research | Mathai D.,Apollo Institute of Medical science and Research
Indian Journal of Medical Research | Year: 2015

A survey was conducted to ascertain practice of antimicrobial stewardship programme (AMSP) in India for 2013. A total of 20 health care institutions (HCI) responded to a detailed questionnaire. All the institutions contacted were tertiary care HCI, of which 12 were funded by government (GHCI) and 8 were corporate/private HCI (PHCI). Further, all catered to both rural and urban populations and were spread across the country. Written documents were available with 40 per cent for AMSP, 75 per cent for hospital infection control (HIC) and HIC guidelines and 65 per cent for antimicrobial agents (AMA) prescription guidelines. Records were maintained for health care associated infections (HCAI) by 60 per cent HCI. Antimicrobial resistance (AMR) data were being analysed by 80 per cent HCI. AMA usage data were analysed by only 25 per cent HCI and AMA prescription audit and feedback by 30 per cent. PHCI performed better than GHCI across all fields of AMSP. The main contributory factor was possibly the much higher level of accreditation of PHCI hospitals and their diagnostic laboratories. The absence of infectious diseases physicians and clinical pharmacists is worrying and demands careful attention. © 2015, Indian Council of Medical Research. All rights reserved.

Anuradha M.,Apollo Institute of Medical science and Research
Journal of Clinical and Diagnostic Research | Year: 2014

Leclercia adecarboxylata is usually isolated as a part of polymicrobial cultures in immunocompetent patients, and as a pure culture in immunocompromised persons. Although generally sensitive to most antibiotics, there are reports of resistant strains. Two case reports of L. adecarboxylata isolation in the lab in pure culture in immunocompetent persons are presented here, L adecarboxylata being isolated from a vaginal swab in the first case and from a gluteal abscess in the second case. Both the isolates were sensitive to most of the antibiotics tested. © 2014, Journal of Clinical and Diagnostic Research. All ights reseved.

Krishna Veni D.V.,Apollo Institute of Medical science and Research
International Journal of Pharma and Bio Sciences | Year: 2013

The study was undertaken to observe the gender based variation in serum bilirubin levels in neonatal Hyperbilirubinemia. A total of seventy nine healthy full term infants (50 females and 29 males) in age group of 1-7 days, who presented with visible nonhemolytic hyperbilirubinemia were analyzed. There was no significant difference in maternal age, gestational age, birth weight and perinatal age in between male and female infants. Total bilirubin levels were high both in female and male infants and there was no significant difference between them. But the direct bilirubin levels were significantly high in female infants compared to male infants during the neonatal period.

Aleksandrowicz L.,University of Toronto | Malhotra V.,University of Toronto | Dikshit R.,Tata Memorial Hospital | Gupta P.C.,Healis Sekhsaria Institute for Public Health | And 10 more authors.
BMC Medicine | Year: 2014

Background: Verbal autopsy (VA) has been proposed to determine the cause of death (COD) distributions in settings where most deaths occur without medical attention or certification. We develop performance criteria for VA-based COD systems and apply these to the Registrar General of India's ongoing, nationally-representative Indian Million Death Study (MDS).Methods: Performance criteria include a low ill-defined proportion of deaths before old age; reproducibility, including consistency of COD distributions with independent resampling; differences in COD distribution of hospital, home, urban or rural deaths; age-, sex- and time-specific plausibility of specific diseases; stability and repeatability of dual physician coding; and the ability of the mortality classification system to capture a wide range of conditions.Results: The introduction of the MDS in India reduced the proportion of ill-defined deaths before age 70 years from 13% to 4%. The cause-specific mortality fractions (CSMFs) at ages 5 to 69 years for independently resampled deaths and the MDS were very similar across 19 disease categories. By contrast, CSMFs at these ages differed between hospital and home deaths and between urban and rural deaths. Thus, reliance mostly on urban or hospital data can distort national estimates of CODs. Age-, sex- and time-specific patterns for various diseases were plausible. Initial physician agreement on COD occurred about two-thirds of the time. The MDS COD classification system was able to capture more eligible records than alternative classification systems. By these metrics, the Indian MDS performs well for deaths prior to age 70 years. The key implication for low- and middle-income countries where medical certification of death remains uncommon is to implement COD surveys that randomly sample all deaths, use simple but high-quality field work with built-in resampling, and use electronic rather than paper systems to expedite field work and coding.Conclusions: Simple criteria can evaluate the performance of VA-based COD systems. Despite the misclassification of VA, the MDS demonstrates that national surveys of CODs using VA are an order of magnitude better than the limited COD data previously available. © 2014 Aleksandrowicz et al.; licensee BioMed Central Ltd.

Ramanathan K.,Unit 1 and Infectious Diseases | Mathai D.,Apollo Institute of Medical science and Research | Baruah K.,National Vector Borne Diseases Control Program
Indian Journal of Medical Microbiology | Year: 2013

Incidence of dengue is reported to be influenced by climatic factors. The objective of this study is to assess the association of local climate with dengue incidence, in two geographically distinct districts in Tamil Nadu. The study uses climate data, rainfall and mean maximum and minimum temperature to assess its association if any, with dengue incidence in two districts of Tamil Nadu, South India. According to this study while precipitation levels have an effect on dengue incidence in Tamil Nadu, non-climatic factors such as presence of breeding sites, vector control and surveillance are important issues that need to be addressed.

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