The Journal of the Association of Physicians of India
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J Assoc Physicians India · Sep 2009
Multi-drug resistant Pseudomonas aeruginosa and Acinetobacter baumannii infections among hospitalized patients: risk factors and outcomes.
Pseudomonas aeruginosa [PA] and Acinetobacter baumannii [AB] are important nosocomial pathogens in health care settings. Treatment is complicated by multi-drug resistance [MDR]. Increasing resistance to carbapenems mediated by metallobetalactamase [MBL] and other mechanisms is a cause for concern because they adversely affect clinical outcomes and add to treatment costs. This study was undertaken to determine the prevalence of MBL production in carbapenem-resistant isolates and to study the factors influencing the clinical outcomes of infections. ⋯ MBL-mediated carbapenem resistance in PA and AB is a significant threat in hospitalised patients. It should be addressed with infection control measures, surveillance and alternative new therapeutic strategies.
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We present a rare disease condition Hermansky-Pudlak syndrome in a 33-year-old male. He was born of a consanguineous marriage, had occulo-cutaneous albinism, nystagmus, decreased visual acuity, refractory errors, pulmonary fibrosis and granulomatous inflammation of the colon. In spite of all the classical features of this genetic disorder he was labeled to have disseminated tuberculous infection with a drug resistant strain for many years till the actual diagnosis was made on the basis of a strong clinical suspicion. We report this rare condition which might be misdiagnosed as tuberculosis.
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In patients with abnormalities of cell-mediated immunity, strongyloides hyperinfection syndrome may occur producing pulmonary infection that may manifest as asthma, chronic bronchitis, haemoptysis, eosinophilia and pulmonary infiltrates. We report a case of an uncontrolled asthma patient who presented with fever and haemoptysis. She had no evidence of immunosuppression and CT chest showed a lesion suspicious of malignancy, sputum cytology showed strongyloides larvae and the patient had complete recovery with treatment.
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The importance of the renin angiotensin system (RAS) in blood pressure and electrolyte regulation has been well established. High RAS activity results in over-activation of the angiotensin AT1-receptor by its substrate, angiotensin II (AII), leading to increases in BP and direct growth-promoting effects on tissues that result in end-organ damage. ⋯ Thus renin inhibition has been identified as the preferred pharmacologic approach to blockade of the renin-angiotensin system. The advantages of inhibiting renin in the RAS have been recognized for almost half a century; however major advances in the development of potential clinically effective renin inhibitors have been made only in the past few years with the approval of Aliskiren for clinical use.