Objectives: To evaluate the various etiological factors contributing to the development of Ludwig's angina, factors affecting the prognosis, and various modalities that will help in the management of this potentially dangerous condition and further complications.
Introduction: Acute kidney injury (AKI) is one of the most common clinical condition with a significant economic burden worldwide. Objective: This study was conducted to determine the aetiology, clinical presentation and outcome of AKI from 2012-2014 and compared these findings with historical controls (2007-2011). Patients and Methods: This was an observational prospective comparative study with two groups - historical control group (group 1; 2007-2011) and prospective group (group 2; 2012-2014). Patients of either gender or aged between 18 and 70 years with AKI were included in the study. Demographic details, clinical signs and symptoms, and laboratory evaluations were noted. Outcomes evaluated were etiological parameters of renal failure, the outcome of renal failure and histology. Results: A total of 100 patients were included in the study (group 1, n=50; group 2, n=50). Overall, demographics were comparable between the two groups. Oliguria or anuria was the commonest presentation. Proteinuria was found in 12% and 6% of patients in group 1 and group 2, respectively. The mean (SD) serum creatinine at presentation was 5.39 (2.49) and 4.93 (2.99) in two groups, respectively. The medical causes were the most common etiological parameters of AKI (76% versus 94% in groups 1 and 2, respectively). Post-surgical and obstetrics causes were less prevalent in group 2. Acute interstitial Nephritis was common histology pattern in both group 1 and 2. The frequency of haemodialysis increased in group 2 and the mortality was decreased in both groups. Conclusion: Results showed that some etiological factors were slowly becoming less prevalent, while others were becoming more important factors in the genesis of AKI.
Background: Chronic rhinosinusitis (CRS) is a prevalent disorder affecting up to 2% of the world population with a significant impact on the quality of life. Not only is it common, it is also the type of nasal disease with greater propensity for morbidity. The study was done to identify bacteria causing CRS and to obtain information regarding the antibiotic sensitivity of the organism.
Materials and methods:A prospective study was done on 109 patients with CRS, undergoing endoscopic sinus surgery. Swabs were obtained from the maxillary sinuses and sent for bacterial cultures and sensitivity tests.Results: Hundred patients (91.7%) were positive for pathogenic organisms. Among them, Gram-positive cocci were seen in 77%, methicillin-sensitive Staphylococcus aureus was found in 49 patients and was the most common organism isolated. This was followed by methicillin-resistant S. aureus (MRSA) in 15 patients and coagulase-negative Staphylococcus (CoNS) in 13 patients. These organisms were most sensitive to Linezolid (96.1%) and least sensitive to Ampicillin and Clindamycin (54.4%). Gram-negative bacilli included Pseudomonas in 11 patients, Klebsiella in 5 patients, and Proteus, Enterobacter, and Fusobacterium one in each patient (3 patients). All the Gramnegative organisms were sensitive to Piperacillin-Tazobactam (100%) and showed 86.9% sensitivity to Amikacin, Imipenem, and Ceftazidime.
Conclusion:Our study showed there is rise in the number of methicillin-sensitive S. aureus (MSSA) cases compared to other studies. All organisms isolated in our study showed resistance to majority of the oral and parenteral antibiotics. We also observed an increase in the number of Gram-negative rods, mainly Pseudomonas aeruginosa, and Klebsiella spp., and hence, antibiotic prescription should be streamlined to minimize the chances of rising trend in antibiotic resistance.
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