Fortification of expressed breast milk (EBM) is widely recommended for preterm feeding. Fortification of EBM results in increased caloric density and osmolarity, both of which may retard gastric emptying. As gastric emptying is a major determinant of feed tolerance, we investigated the effect of fortification (with Lactodex HMF) of EBM on gastric emptying in preterm neonates. The half gastric emptying time was measured using real time ultrasonography in 25 consecutive preterm neonates first on EBM alone, then on EBM + Lactodex HMF. Each baby served as its own control. The students t-test was used for statistical analysis. The mean gestation age was 34.48 +/- 0.77 weeks. The mean birth weight was 1.92 +/- 0.14 kg. The mean half gastric emptying time at an age of 5.4 +/- 0.86 days on EBM was 24.00 +/- 5.00 min and 24.40 +/- 5.06 min on EBM + human milk fortifier (HMF). The same at 2nd assessment (15.2 +/- 1.79 days), with EBM was 22.80 +/- 4.58 min vs. 23.60 +/- 4.89 min when given EBM + HMF. These differences were not statistically significant. Fortification of EBM with Lactodex HMF does not affect the gastric emptying in preterm neonates and therefore is unlikely to affect feed tolerance in them.
Kocher-Debre-Semelaigne syndrome (KDSS) is a rare association of muscular pseudohypertrophy and long-standing moderate-to-severe hypothyroidism in the pediatric age group. It may be confused with primary muscle disorders, lest one is cautious enough to investigate for hypothyroidism. The striking clinical features, availability of a simple treatment and a good prognosis for the condition makes it worthwhile to report the case so that all practitioners be aware of the condition and its management.
Neonatal sepsis is a significant cause of morbidity and mortality in the neonatal intensive care unit. The epidemiology of neonatal infections is complex; however, they are in large part secondary to developmentally immature host defence mechanisms. These immunodeficiencies, which are exaggerated in premature and sick neonates, include quantitative and qualitative deficits in phagocytes, complement components, cytokines and immunoglobulins. Therapies that modulate or augment host defences may attenuate the virulence of neonatal infections. In this paper, we have reviewed immunotherapies that modulate the immune system of the neonate, including intravenous immunoglobulins and myeloid haematopoietic growth factors. Future studies should focus on investigating other abnormalities of neonatal host defence and/or combined immunotherapy approaches in an attempt to circumvent the immaturity of host defence and potentially reduce both the incidence and severity of neonatal sepsis.
The current study was aimed to find out whether the COVID-19 virus is detectable upon the fruits and vegetables after coming in close contact with a patient suffering from nSARS-CoV-2. We included ten subjects, who tested positive for nSARS-CoV-2 RNA within seven days of the experiment. After explaining the experiment, a tray filled with seasonal vegetables and fruits were placed in front of them. The tray remained within their reach, for next thirty minutes. The subjects were requested to remove their face masks and remain so throughout the task. They were requested to manipulate the food articles the way they liked. Subjects were instructed to cough into their hands and then to manipulate each item at least 5 times, during the experiment. Thereafter, the trays were moved into an open and shaded area with free flow of natural air but no direct sunlight. After 1-hour, swabs were taken from surfaces of items by thoroughly rubbing over each of them. Samples were sent immediately to our RT-PCR lab. The nSARS-CoV-2 RNA was not detected, from the samples collected from the fruit/vegetable, at the end of one hour of the direct exposure to the COVID-19 patients. Our results suggest, even after direct exposure to and significant handling by the COVID-19 patients the nSARS-CoV-2 RNA remains undetected after one hour of storage in open. The fruits and vegetables, in real-life situations, are unlikely to act as a fomite and play any significant role in the spread of this disease.
Objective: To study the prevalence, causative organisms, and antimicrobial sensitivity pattern of Urinary Tract Infection (UTI)at a tertiary care center in Central India. The study was undertaken from September 2021 to May 2022 at t Methods: he Department of Nephrology, SAIMS, Indore. Clean catch midstream urine samples were collected from patients suspected of UTI from patients on OPD basis and inpatients from various departments. The urine samples were processed for Culture and Antibiotic Susceptibility testing after Culture in Mac Conkey/Blood Agar for 24 hours. The interpretation of the bacterial isolates was carried out by VITEK2 automated system. A total of 3241 samples (Females= 1705 Results : and Males=1536) were processed for urine culture and sensitivity. 1022 samples (Females=522, Males=500) were positive for bacterial infection (31.53% positivity rate). Positive isolates were further divided into Outdoor (OPD=315) and Indoor patients (IPD=707) (Wards=480, ICU=227). E. coli was the most common organism in all groups. However, in ICU most common organism was Pseudomonas. Enterococcus was the most common gram-positive organism. ESBL-producing bacteria among Gram-negative bacteria was 67.4%. Carbapenemase-producing bacteria among Gram-negative bacteria were 60.8%. Among Gram-negative oral drugs sensitivity pattern was: Nitrofurantoin (66.1%), Cotrimoxazole (51.65%), Fosfomycin (48.5%), Amoxycillin+Clavulanic acid (41.15%), Ciprooxacin (38.25%), Cexime (20.5%). Pseudomonas was resistant to most oral drugs. Among Intravenous drugs, the sensitivity pattern was: Colistin (89.2%), Amikacin (64.7%), Gentamycin(55.1%), Piperacillin + Tazobactum (44.8%), Tigecycline (43.9%), Meropenam (35.1%), Cefepime (30.1%), Ciprooxacin (24.71%), Cefoperazone+Sulbactum (20.61%). The sensitivity of Klebsiella was lower than E.coli for most of the drugs. Sensitivity for Fluoroquinolones and Cephalosporins is very low. Among Gram-positive oral medications, the sensitivity pattern was: Linezolid (67.8%) and Nitrofurantoin (65.9%). Among Intravenous drug sensitivity pattern was: Teicoplanin (69.27%), Vancomycin (68.5%), Tigecycline (66.15%), and Linezolid(62.05%). The sensitivity of Enterococcus was higher than Staphylococcus for all drugs. The sensitivity of drugs was higher in OPD patients, followed by wards and least in ICU patients indicating multidrug-resistant strains in ICU are more common. Empirical Conclusion: Antibiotics based on regional antibiotic sensitivity patterns should be started and changed as per Culture reports afterwards. It is need of hour to conduct research on the bacteria's culture and sensitivity patterns considering bacterial resistance and multidrug-resistant strains.
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