The objective of the study was to identify the microbiological spectrum and drug-sensitivity pattern of peritonitis in patients on continuous ambulatory peritoneal dialysis. This was a prospective study done over a period of a year-and-a-half at a tertiary-care hospital in a hilly state of India. The effluent dialysate bags from 36 consecutive patients with peritonitis were studied. One hunderd ml dialysate fluid was processed under aseptic conditions by lysis centrifugation method. Microscopy and culture was done from the deposits for bacteriological, fungal, and mycobacterial isolates. They were identified by colony morphology and their biochemical reactions. Drug susceptibility testing was done by Kirby-Bauer disc diffusion method. In 36 dialysates, 33 (91.6%) dialysates were culture-positive and in 3 (8.4%), the culture was negative. A total of 36 microorganisms were isolated in 33 cultures. Among the 36 microorganisms, 19 (52.8%) isolates were gram-positive, 10 (27.8%) were gram-negative, 5 (13.9%) were fungi, and 2 (5.6%) were mycobacterial isolates. All gram-positive organisms were sensitive to ampicillin, amoxi-clavulanic acid, cefazolin, clindamycin, and vancomycin. Neither a methicillin-resistant Staphylococci aureus nor a vancomycin-resistant Enterococcus was isolated in gram-positive isolates. Gram-negative organisms were sensitive to ciprofloxacin, ceftriaxone, ceftazidime, cefepime, gentamicin, piperacillin–tazobactam and imipenem. One of the gram-negative isolate was an extended spectrum beta-lactamase producer. Gram-positive peritonitis was more frequent than gram-negative peritonitis in our continuous ambulatory peritoneal dialysis patients. Mycobacterial causes were responsible for peritonitis in patients with culture-negative peritonitis which was not responding to the conventional antimicrobial therapy.
Alexander (1921) was one of the first who attempted to find a relationship between ABO blood group and disease. He fo und that group B and AB were peculiarly susceptible to various fo rms of neoplasms. Buchnan and Higley (1921) reported in the same year that there was no relationship between the blood groups and a disease. Johannsen (1925) stated that A and AB individuals were more susceptible to external influences provoking carcinoma of uterus while those of 0 and B were resistant. Mitra (1933)
Recently endoscopic septoplasty has emerged as an effective alternative to traditional 'headlight' approaches to septoplasty. Endoscopic septoplasty as a minimal invasive technique can limit the dissection and minimize trauma to nasal septal flap under excellent visualization. The present prospective study was conducted at the Department of ENT at Government Medical College, Rajindra Hospital, Patiala. Fifty cases of either sex in age group of 18 to 50 years suffering from deviated nasal septum were included in the study from May 2010 to November 2012. Among the prevalence of type of nasal septal deviation (Mladina classification), the most common type of nasal septal deviation was type 5 (46%) followed by type 6 (16%), type 2 (10%), type 4 (10%), type 3 (8%), type 7 (8%) and type 1 (2%). Among chief complaints most common was nasal obstruction in 38 (76%) followed by nasal discharge in 10 (20%), headache in 10 (20%), bleeding in 6 (12%) and postnasal discharge in 4 (8%) patients. There was improvement in nasal obstruction in 78%, nasal discharge in 60% and postnasal drip in 75% patients. On objective assessment at last follow-up (3 months), persistent inferior turbinate hypertrophy in 14%, and persistent deviation was seen in 4% of cases. Synechiae formation was seen in 4% of cases.
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