J Postgrad Med
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This study aimed to determine the bacterial profile and their antibiotic spectrum in patients with ventilator-associated pneumonia (VAP) and investigate the risk factors for VAP and the presence of multidrug-resistant (MDR) pathogens. ⋯ The study revealed a high prevalence of Gram-negative among VAP patients. A significant prevalence of MDR pathogens was observed in early and late-onset VAP, along with high resistance to carbapenems. This necessitates a reassessment of the current use of antibiotics and highlights the need for further studies to choose alternative treatments for empirical antibiotic coverage.
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Tricuspid valve pathology is a relatively common anomaly. In patients with mechanical tricuspid valve replacement, implantation of a permanent pacemaker can be challenging due to the risk of valve damage, failure, and lead fracture associated with right ventricular endocardial leads. Epicardial leads may be an option, but they require a surgical procedure and are not preferred in patients with prior thoracotomy. ⋯ Due to the complications and contraindications of traditional approaches, Lead implantation via the CS was utilized. This method allowed for successful pacemaker implantation, demonstrating the feasibility and safety of LV pacing in such complex cases. The use of CS-guiding catheters and specialized leads facilitated effective cannulation and stable, reliable pacing, avoiding the need for further invasive surgeries.
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Analysis of deaths due to gender-based violence: An autopsy-based cross-sectional study from Mumbai.
Gender-based violence (GBV), including domestic violence, honor killings, and dowry deaths, represents one of the most extreme forms of violence against women. These deaths are often misclassified as accidents or suicides due to societal biases, leading to underreporting and obscuring the true impact of GBV on women's mortality. ⋯ The study emphasizes the need for improved investigation and classification of unnatural female deaths. Domestic violence emerged as the most common factor in these deaths, with intimate partners being primary perpetrators, with most incidents occurring within the home. It also stresses on enhanced protocols to accurately identify and address GBV-related fatalities.
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A 76-year-old male patient, who underwent a post-aortic valve replacement with a mechanical valve in 2006, was on oral anticoagulant therapy with warfarin, maintaining a stable therapeutic level of anticoagulation until 2022. He had a new diagnosis of ulcerative colitis in 2022, following which he was started on mesalamine. ⋯ The evaluation revealed severe depletion of vitamin K-dependent coagulation factors. In this report, we discuss the possible drug-drug interactions between mesalamine and vitamin K antagonists, which went unrecognized leading to life-threatening gastrointestinal bleeding.
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The World Health Organization added methicillin-resistant S aureus (MRSA) to the list of "priority pathogens," given its capacity to cause life-threatening infections. Clindamycin is a preferred treatment for non-complicated S aureus-induced skin and soft tissue infections. Its good tissue penetration and oral absorption make it suitable for outpatient therapy. However, the emergence of inducible and constitutive (MLS B ) resistance led to clinical challenges, primarily due to the potential oversight of inducible resistance in routine antimicrobial sensitivity testing. ⋯ To prevent clindamycin treatment failures, the D-test must be implemented to detect ICR in MRSA isolate. Neglecting simple and cost-effective tests may lead to inaccurate susceptibility reporting, jeopardizing treatment success.