PCMS and RC Bhopal

India

PCMS and RC Bhopal

India

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Bhongle N.N.,PCMS and RC Bhopal | Nagdeo N.V.,NKPSIMS and LMH Nagpur | Thombare V.R.,NKPSIMS and LMH Nagpur
Journal of Clinical and Diagnostic Research | Year: 2013

A splenic abscess which is caused by Salmonella typhi is a very rare complication of typhoid fever. We are reporting a case of a 14 year old female who presented with fever and pain in the abdomen. She was treated for fever of unknown origin in a rural hospital and was then admitted to our hospital after 15 days. She complained of fever and pain in the abdomen. On ultrasound, multiple splenic abscesses were seen. A USG guided aspiration was done and the aspirated material was received for culture, which was found to be positive for Salmonella typhi. A blood and stool culture which were done were negative and the Widal test showed a positive result with titres of TO 1:320 and TH 1:320. No predisposing factor was found in our case. Sickling was negative and HIV and HBsAg screening showed negative results. She responded favourably to the antibiotics which were given as per our antibiotic sensitivity report.


Bhongle N.N.,PCMS and RC Bhopal | Nagdeo N.V.,NKPSIMS and LMH Nagpur | Thombare V.R.,NKPSIMS and LMH Nagpur
Journal of Clinical and Diagnostic Research | Year: 2012

Introduction: Pseudomonas aeruginosa is most frequently responsible for nosocomial infections. The current isolates of P. aeruginosa are often multi-drug resistant. Objective: Thus, the present study was done to find out the prevalence of metallo-β-lactamases (MBL) in the clinical isolates of P. aeruginosa. Methods: A total 310 clinical isolates of Pseudomonas were identified and 200 clinical isolates were selected for the study, based on their resistance to at least the 2, third generation cephalosporins. Results: 29(9.35%) isolates of P. aeruginosa had a zone size of <28mm for imipenem, 27 were positive for MBL by the EDTA double-disc synergy test (EDTA DDST) and all 29 were positive by the modified Hodge test. The Minimum Inhibitory Concentrations (MICs) were determined by the agar dilution method and 26 isolates out of 29 were resistant, 2 were intermediate isolates and 1 was susceptible as per the Clinical and Laboratory Standards Institute (CLSI) breakpoints. Out of the 29 MBL producing isolates, 25 were sensitive to both polymyxin B and colistin, 3 isolates were resistant to polymyxin B but sensitive to colistin and 1 was resistant to polymyxin B and colistin both, by the disc diffusion method. The sensitivity of the MBL producing strains to polymyxin B was found to be 86% and that of colistin was found to be 96.55% in our study. Conclusion: The early detection of the MBL carrying organisms, together with the judicious use of antibiotics, help in extending the longevity of the carbapenems, the last resort antibiotic. MBLs are the major threats for the 21st century, which pertain to the bacterial drug resistance.


Goyal R.,PCMS and RC Bhopal | Mourya A.,PCMS and RC Bhopal | Qureshi S.,PCMS and RC Bhopal | Sharma S.,PCMS and RC Bhopal
Indian Journal of Otolaryngology and Head and Neck Surgery | Year: 2016

Chronic suppurative otitis media with cholesteatoma is a fairly common condition presenting in any ENT clinic and its surgery remains one of the most challenging surgeries in otology. The primary goal of cholesteatoma surgery is to clear the disease and produce a safe and stable ear but there is still debate on whether these goals are best achieved by canal wall down or canal wall up procedures. A retrospective study was done to access benefits of modified radical mastoidectomy (MRM) with type III tympanoplasty in terms of eradication of disease and hearing improvement. It consisted of 140 patients of chronic otitis media (attico-antral) who underwent MRM with type III tympanoplasty in 156 ears in a tertiary care centre. Temporalis fascia graft was used for tympanoplasty. Results were analyzed in terms of condition of cavity, condition of graft and gain in hearing. The study showed significant improvement in gain in air conduction (21.24 dB) and closure of AB gap (15.62 dB). In the Indian population with low socio-economic status and poor follow up, single stage canal wall down procedure (MRM) provides maximum benefit to patients in terms of eradication of disease and hearing improvement. © Association of Otolaryngologists of India 2015.

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