Background: Clostridium difficile infection (CDI) is a common cause of diarrhea in hospitalized patients worldwide however it is uncommonly reported from Indian hospitals and clinical profile of Indian patients with CDI is not well studied. Methods: This was a retrospective study done in a tertiary care centre of South India between March 2016 and May 2017. Case records of all patients for whom stool samples were sent for either C. difficile toxin assay or GeneXpert C. difficile were analysed. Coloured immunoassay (CerTech) was used for detecting Glutamate dehydrogenase (GDH) and Toxin A and B and nucleic acid amplification assay (Xpert, Cepheid) were used. Results: A total of 112 were analyzed, out of which 18 were positive and negative cases (n = 94) were taken as controls. Prevalence of CDI was 16%. Presence of fever (OR = 8.5), tenesmus (OR = 8.5), hematochezia (OR = 4.5), cramps (OR = 8.27), use of immunosuppressive agents (OR = 3.62) and duration of antibiotics (7.38±6.50 vs 4.54±6.57 days; p=0.019) was significantly higher among cases. Conclusion: Although the prevalence of CDI is low in India compared to the west, it still contributes to significant morbidity in hospitalized patients as it is responsible for more than 1 in 6 cases of diarrhea in hospitalized patients. Fever, cramps, tenesmus, hematochezia, use of immunosuppressants and antibiotic therapy of more than 7 days suggest a diagnosis of CDI, and should trigger testing and treatment. Outcomes are good with appropriate therapy.
Objective: To comparatively evaluate ICU requirement, length of stay and mortality between single dose vaccinated and non-vaccinated hospitalized COVID-19 patients.
Design: Retrospective, observational study from 1st April 2021 till 30th June 2021 carried out in a tertiary care hospital in Western Indian region.
Results: Of the 569 patients enrolled in the study based on the eligibility criteria, 137 (24.08%) patients had received a single dose of ChAdOx1 nCoV-19 vaccine while 432 (75.92%) patients had not received any form of vaccination. Overall length of stay in the hospital was similar for both groups however a significant difference was seen in length of stay in ward and ICU. Vaccinated patients were admitted for 6.21 ± 3.204 days in the ward while non-vaccinated patients were admitted for 5.56 ± 4.55 days (p<0.001). ICU stay of the 21 vaccinated patients was a mean length of 4.47 ± 2.3 days while for the 145 non-vaccinated patients was 6.29 ± 2.19 days (p<0.001). Mortality was observed in 4 patients in the vaccinated group and 95 patients in the non-vaccinated group.
Conclusion: A single dose of ChAdOx1 nCoV-19 vaccination compared with no vaccination was associated with a significantly lower severity of SARS-CoV-2 infection.
Cerebral phaeohyphomycosis is an infection caused by a number of dematiaceous fungi, characterised by the presence of melanised hyphae in the invaded tissue. Cladophialophora bantiana is the most common species affecting the humans, which has a predilection for causing the central nervous system infections resulting in high mortality. We hereby report a success story of two cases of brain abscess caused by C. bantiana who were treated with surgical source reduction and voriconazole therapy.
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