The Journal of the Association of Physicians of India
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J Assoc Physicians India · Nov 2012
Incidence of Clostridium difficile associated diarrhoea in a tertiary care hospital.
Rampant and injudicious use of broad spectrum antibiotics in hospitalized patients has increased the incidence of Clostridium difficile associated diarrhoea (CDAD). Though antibiotic use is the best known risk factor for CDAD, the occurrence of community acquired C. difficile suggests the presence of other risk factors too. However CDAD is still under-recognized in India and Asia. Therefore we undertook a prospective study to determine the incidence of Clostridium difficile associated diarrhoea in our hospital. ⋯ The incidence of CDAD in our hospital was 10% of the 50 patients with AAD. The asymptomatic carriage rate was 6%. All the cases had mild to moderate diarrhoea and were responsive to metronidazole unlike the west where the incidence is higher and the disease more severe.
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We report a case of interrupted inferior vena cava (IVC) as a rare developmental defect. Inferior vena cava interruption is usually accompanied with azygos and hemiazygos continuation, and is asymptomatic. Consequently, venous blood from the caudal part of the body reaches the heart via the azygous vein and superior vena cava. ⋯ When computed tomography pulmonary angiography was done, showed dilated azygous vein without pulmonary embolism. Computed tomography of the abdomen demonstrated interrupted inferior vena cava. Such patients are at increased risk of deep vein thrombosis and pulmonary embolism.
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J Assoc Physicians India · Aug 2012
Comparative StudyThe outcome of treating ESBL infections with carbapenems vs. non carbapenem antimicrobials.
In India where the prevalence of extended spectrum beta lactamase (ESBL) producing organisms among gram negative organisms is 60-70% and Ertapenem was unavailable at the beginning of this study, exclusive use of Group 2 Carbapenems (Imipenem and Meropenem) for treatment raises issues of cost and development of resistance. Therefore the role of non-Carbapenem alternatives, chiefly Betalactam + Betalactamase inhibitors (BL-BLI) was explored in this prospective observational study at a private tertiary care teaching hospital. ⋯ It is possible to successfully treat at least the less serious infections due to ESBL producing gram negative organisms with non-Carbapenem antimicrobials. This will not compromise outcomes but will likely result in restricting the use of Carbapenems which may help preserve their efficacy against increasingly resistant organisms.