Cytomegalovirus (CMV) infection is associated with adverse clinical outcomes in immunosuppressed persons. The incidence and association of CMV reactivation with adverse clinical outcomes in critically ill persons lacking evidence of immunosuppression at ICU admission has received great attention in the practice of critical care medicine. Critically ill patients in ICU who had associated risk factors such as mechanical ventilation, severe sepsis, or blood transfusion are more prone to CMV activation, which in turn led to increased mortality and morbidity in terms of increased ICU stay, longer duration of mechanical ventilation, and higher rates of nosocomial infections. However, severe CMV as initial presentation mimicking dengue infection is rare. We recently came across seven cases with positive CMV serology at ICU admission, which we discuss in the light of current literature.
<p class="abstract"><strong>Background:</strong> <span lang="EN-IN">Allergic rhinitis is a common cause for recurrent rhinosinusitis. The microbiology in allergic nasal mucosa has not been much documented. The aim of the study is to identify the microbes in the middle meatus in patients with allergic rhinitis and to compare with the normal nasal flora. </span></p><p class="abstract"><strong>Methods:</strong> <span lang="EN-IN">A cross sectional study was conducted in our institute to study the nasal microbial pattern in 50 patients with allergic rhinitis and was compared with 50 normal healthy nasal flora. Nasal swabs were taken from middle meatus under endoscopic guidance in both the groups and sent for microbial analysis. </span></p><p class="abstract"><strong>Results:</strong> <span lang="EN-IN">Organisms like <em>Klebsiella</em>, <em>E.coli</em>, and <em>Staphylococcus aureus</em> were predominant isolates in patients with allergic rhinitis, whereas Staph epidermidis were predominant in controls. </span></p><p class="abstract"><strong>Conclusions:</strong> <span lang="EN-IN">This alteration in microbial flora could possibly explain recurrent sinonasal infections in patients with allergic rhinitis.</span></p>
<p class="abstract"><strong>Background:</strong> Ear pain can be because of pathologies in the ear or in the surrounding head and neck region. This is because of rich innervations of the ear. Sometimes it poses a diagnostic challenge.</p><p class="abstract"><strong>Methods:</strong> A cross sectional study was conducted in our institute where patients with ear pain were evaluated. Those with non otogenic causes were included in the study. 59 patients were identified and studied for the underlying cause. The sociodemographic profiles of the patients with varying etiologies were studied. </p><p class="abstract"><strong>Results:</strong> The most common cause for referred pain was temporomandibular joint dysfunction. This was more common in 15-45 years and in older age group cervical spondylosis was more common. There was no significant sex predominance.</p><p><strong>Conclusions:</strong> Careful detailed evaluation of the patient should be done to identify the exact underlying cause and treat effectively.</p>
belonged to the age group of 0 to 12 years. Of these, 52 patients presented with headache and 40 had vomiting. Blurring of vision was seen in 22 patients. Most common midline posterior fossa tumor was medulloblastoma. Postoperative hydrocephalus and seizures were seen in six patients. Out of 60 patients, 12 patients had poor outcome versus 48 patients with good outcome on the Karnofsky performance status.Conclusion: Midline posterior fossa tumors were more common in males. Symptoms of raised ICP and cerebellar symptoms were most common presentations. Headache and histopathology of tumor: high grade or low grade shows statistically significant correlation with outcome of patients as measured with the Karnofsky performance scoring. As our study was of small duration, long-term study can give better results Introduction: The advent of intraoperative magnetic resonance imaging (IOMRI) represents a substantial improvement in ensuring complete removal of intracranial lesions but poses specific challenges to the neurosurgical OT team. KeywordsMethodology/Description: This observational study was conducted to assess our learning curve of resource utilization and conduct of 3T-IOMRI at our hospital for the first month. Every time we performed an IOMRI, we collected data and noted mistakes and processes we could improve next time. Data collected included time required to move patients into the MRI room and back to OT, number of personnel required, changes made to our checklist, and standard operating procedures for equipment utilization and patient transfer. We also collected data regarding number of patients with residue who underwent resurgery, quality of scans, and surgeon satisfaction. patients allocated into three equal groups to receive either sevoflurane (n = 22), desflurane (n = 22), or propofol (n = 22). Standard anesthesia protocol was followed. Patients with preoperative MMSE ≤ 23 were excluded. Each patient was assessed thrice with battery of cognitive tests in preoperative period (baseline), after 72 hours (early POCD), after 3 months (delayed POCD) of surgery. Serum levels of IL-6, TNF-α, and S-100β were measured before surgery and 72 hours after surgery.Results: Mean score of various psychometric tests was improved slightly in early postoperative period which was not significant (p > 0.5). In delayed postoperative period, there was significant improvement in cognitive scores as compared with baseline (p < 0.5) in all the groups. There was nonsignificant change in the levels of biomarkers S-100β, TNF-α, and IL-6 between baseline and postoperative period in all the groups.Conclusion: In young patients, there is no effect of anesthesia on postoperative cognitive functions. As far as inflammatory markers are concerned, they do not relate to patient's cognitive status.Keywords: anesthesia, sevoflurane, desflurane Postoperative cognitive dysfunction in middle-aged patients.
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