Objective: Aim of the study was to know the microorganisms profile and determine the antibiotic resistance pattern of the LRT isolates from mechanically ventilated (MV) patients admitted to the ICU. This prospective observational study was done in Department of Critical Care Medicine (ICU) of BIRDEM General Hospital Dhaka from July, 2011 to December, 2011.Methods: Blind Tracheal Aspirate or Broncho Alveolar Lavage or both from 110 consecutive patients (total 130 samples) admitted to the ICU requiring MV were cultured, identified, and antibiotic sensitivity was performed by standard methods.Results: A total of 130 samples were analyzed. Growth was obtained in 93.8% of the samples yielding 143 organisms. Many (21 samples) yielded more than one organism. The major organism isolated were Acinetobacter sp. (54.5%), Pseudomonas sp.(14.7%), Klebsiella sp. (7.7%).Candida sp. (7.0%), Staphylococcus aureus(7.0%), Escherichia coli (4.9%).Proteus and Flavobacterium accounted for 4.2% of the isolates. All the isolates were highly resistant (>90%) to cephalosporins and >70% to fluoroquinolones. The frequency of third generation cephalosporin resistant E. coli, Klebsiellaand imipenem resistant Pseudomonas and Acinetobacter were>90%. Acinetobacter was remarkably resistant to most antibiotics including imipenem (>90% resistant) and Piperacillin+Tazobactum (>85% resistant), but most of the members of the Enterobacteriacae group and Acinetobacter showed maximum sensitivity to colistin (80%-100%).Conclusion: Nonfermenters Gram Negative Bacilli (GNB)-Acinetobacter sp. & Pseudomonas sp. are the most common etiological agents of LRT infections in ICU. There is an alarmingly high rate of resistance to cephalosporin and ²â-lactamase inhibitor group of drugs. Colistin was found to be the most sensitive drug against all GNB.J MEDICINE July 2016; 17 (2) : 91-94
Aims: Aim of the study was to know the clinical presentations of biliary ascariasis.
Materials and Methods: It was a cross-sectional observational study had been carried out on 50 patients over a period from January 2017 to December 2018 at the Department of Medicine, Sadar Hospital, Cox’s bazar. The clinical presentation, ultrasonographic findings, management and follow up of patients diagnosed to have biliary ascariasis were recorded in a pre-designed case record form and finally all the relevant data were processed and analyzed.
Results: This study revealed that maximum patients of biliary ascariasis belonged to 31-40 yrs age group. Number of female patients was more (86%) in comparison to male patients (14%). Among female patients, 20.93% patients were pregnant. Most of the patients 92%came from rural areas. All patients in this study presented with upper abdominal pain. Other complaints were nausea, vomiting, fever and jaundice. Most of the patients (38%) had history of passage of worm with vomitus. Ultrasonographic profile of this study revealed that ascaris was most commonly entrapped in the common bile duct (80%). The percentage of complications was 38%. Acute acalculous cholecystitis was the commonest. The percentage of Cholangitis and acute pancreatitis was also significant.
Conclusion: Bangladesh is an endemic zone for ascaris lumbricoides infestations. Ultrasonography is the investigation of choice for diagnosis and follow up of the patient of biliary ascariasis. Majority of the patient can be managed with conservative treatment and mechanical removal of worms by endoscopy. This study recommends that proper hygiene and regular deworming can prevent biliary ascariasis.
J Dhaka Med Coll. 2021; 29(1): 87-93
Background: Infestation with Ascaris lumbricoides is worldwide. About one fourth of the world’s population is known to be infected by ascariasis. It is endemic in various parts of Bangladesh.
Objectives: To study the various types of clinical presentations, socio-demographic background and sonographic patterns of biliary ascariasis.
Materials and Methods: Fifty cases of biliary ascariasis were studied over a period of 2 years, July 2011 to June 2013. All the patients were adult with age 18 years or above. Clinically suspected and ultrasonography evidenced cases of biliary ascariasis were taken as sample in this study.
Results: Mean age (mean ± SD) of presentation was 35.3 ± 15.9 years and female were 80%. Ninety percent of patients were from rural areas and 80% were bearing a lower class socioeconomic background. The most common presentation was upper abdominal pain in 100% of patients. History of worm emesis was present in 34% and previous biliary tree pathology in 24% of patients. Ultrasonography demonstrated the commonest site of worm entrapment was common bile duct in 76% of patients and the commonest pattern was stripe sign pattern in 56% of patients.
Conclusion: In endemic countries, ascariasis should to be suspected in patients with biliary disease, especially if there is history of emesis of worm or previous history of biliary tree pathology. Ultrasonography is a reliable, easily available and relatively inexpensive modality of investigation for suspected biliary ascariasis.
J Dhaka Med Coll. 2021; 29(1): 61-67
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