Journal of Dr. NTR University of Health Sciences最新文献

{"title":"Genotypic characterization of carbapenem-resistant enterobacterales and their antibiotic susceptibility pattern in a tertiary care hospital","authors":"Savitha Hiremath, B. Renushree","doi":"10.4103/jdrntruhs.jdrntruhs_132_21","DOIUrl":"https://doi.org/10.4103/jdrntruhs.jdrntruhs_132_21","url":null,"abstract":"Background: Carbapenems have been considered as a robust antibiotic to treat extended-spectrum β-lactamases (ESBLs) in the past ten years. Carbapenems, among the β- lactams, are the most effective against gram-positive and gram-negative bacteria presenting a broad spectrum of antibacterial activity. Detection of carbapenemase-producing isolates by clinical microbiology laboratories is essential to provide targeted therapy, antimicrobial stewardship, and to update local antibiotic guidelines for clinicians. Objectives: To identify and characterize carbapenem-resistant Enterobacterales (CRE) by phenotypic and genotypic methods, and the antibiotic sensitivity patterns of CRE isolated from the different clinical samples. Methods: The samples were collected for a period of one year. Enterobacterales strains were identified through standard biochemical reactions and subjected to phenotypic screening for detection of carbapenemase, and confirmed with multiplex PCR. Antibiotic sensitivity patterns were also studied. Results: A total of 447 strains of Enterobacterales species were isolated from various clinical samples over a period of one year. Out of these, 38 (8.5%) of them showed decreased susceptibility to carbapenems including 12 Escherichia coli, 11 Klebsiella pneumonia, 1 Klebsiella oxytoca, 6 Proteus mirabilis, 2 Proteus vulgaris, and 6 Citrobacter freundii. 20 isolates of them showed the presence of carbapenemase genes in Multiplex PCR, isolates included NDM, IMP, OXA-48. Two strains showed simultaneous co-existence of two genes including NDM with OXA-48 in Klebsiella pneumonia, and NDM with IMP in Proteus mirabilis. No KPC genes were detected in our study. 97% of isolates showed sensitivity to fosfomycin (for urine samples only), 73.68% of them to tigecycline, 36.84% of them to polymyxin B, 50% to colistin, 26.31% to amikacin, 18.42% to aztreonam, 21.05% to piperacillin-tazobactam, and 10.52% to cefoperazone + sulbactam combinations. There were seven isolates of urine sample, and the sensitivity of nitrofurantoin to these isolates was 42.85%. Conclusion: The frequency of CRE was found to be low. E. coli and K. pneumoniae were the most common isolates. NDM was the commonest gene detected. Highest sensitivity was found with fosfomycin and tigecycline.","PeriodicalId":15571,"journal":{"name":"Journal of Dr. NTR University of Health Sciences","volume":"112 1","pages":"295 - 300"},"PeriodicalIF":0.0,"publicationDate":"2022-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"87696793","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Ebbing axillary web syndrome the physical therapy way: A narrative review","authors":"Renu B Pattanshetty, B. Patel","doi":"10.4103/jdrntruhs.jdrntruhs_107_21","DOIUrl":"https://doi.org/10.4103/jdrntruhs.jdrntruhs_107_21","url":null,"abstract":"Axillary web syndrome (AWS) or cording is a clinical entity characterized by a palpable cord tissue or band generally extending from axilla to antecubital fossa with restricted shoulder mobility commonly occurring in both axillary surgical cases and nonaxillary surgeries. Exercises in the form of active and passive exercises, joint mobilizations, manual therapies in the form of massage therapy, myofascial release, manual lymphatic drainage, thermal therapy, and low level LASER therapy are found to be effective in patients with AWS. There is dearth in literature for manual therapy techniques used for AWS in breast cancer patients. Future research is recommended to conduct clinical trials using advanced manual therapy techniques like cupping, jade stone mobilization and matrix in addition to the exercise protocols in larger population for breast cancer survivors with axillary web syndrome.","PeriodicalId":15571,"journal":{"name":"Journal of Dr. NTR University of Health Sciences","volume":"45 1","pages":"265 - 270"},"PeriodicalIF":0.0,"publicationDate":"2022-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"90232278","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Prevalence of depression and its determinants among women of the reproductive age group in a rural area of Tamil Nadu - A community-based cross-sectional study","authors":"Sahaya Thresa, Logeswari Krishnamurthy, T. Swetha, Karthik Pandraveti, S. Bala","doi":"10.4103/jdrntruhs.jdrntruhs_108_22","DOIUrl":"https://doi.org/10.4103/jdrntruhs.jdrntruhs_108_22","url":null,"abstract":"Background: Mental health is a state of harmony between oneself and one's surrounding. According to the Indian Ministry of Health and Family Welfare, it is estimated that by 2020, depression will be the major cause of morbidity next to cardio-vascular disease in India. More than 90% of these cases remain untreated because of various factors such as social stigma, economical factors, and lack of awareness among the general public. Hence, this study was planned owing to the emerging mental health problems especially among women with an aim to estimate the prevalence of depression among women in rural areas and to identify the various determinants of depression. Materials and Methods: A community-based cross-sectional analytical study was conducted among women of the reproductive (15–45 years) age group residing in Sembakkam village for a period of 2 years using a semi-structured validated schedule after obtaining informed consent. Becks depression inventory scale was used for estimating the prevalence of depression. Data were analyzed using the Statistical package for social sciences (SPSS) version 23.0. Results: The prevalence of depression was found to be 17.9%. Socio-economic statuses of the respondents and religion were found to be statistically significant with depression. Among women with depression, 96.1% of them did not have any disputes with their family members, but 19.4% of their family members were alcoholics. Conclusion: Psycho-social and socio-demographic determinants were found to be important determinants of depression. Interventions focused on tackling these determinants and maintaining a positive outlook will help in averting depression.","PeriodicalId":15571,"journal":{"name":"Journal of Dr. NTR University of Health Sciences","volume":"8 1","pages":"344 - 350"},"PeriodicalIF":0.0,"publicationDate":"2022-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"90935779","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Hand foot skin reaction with multikinase inhibitor sorafenib - A rare case report","authors":"Y. Kumari, S. Gulabi, A. Sushma, M. Sindhu","doi":"10.4103/jdrntruhs.jdrntruhs_109_21","DOIUrl":"https://doi.org/10.4103/jdrntruhs.jdrntruhs_109_21","url":null,"abstract":"Various metastatic solid tumors including renal cell carcinoma are treated with multikinase inhibitors like sorafenib and sunitinib which produce various cutaneous side effects. We report a case of sorafenib induced hand foot skin reaction, in a 75 year old female presented with complaints of bullae over palms and soles preceded by pain and burning sensation after first cycle of sorafenib chemotherapy 400mg BD for metastatic renal cell carcinoma. On examination, multiple tense, well defined tender bullae with surrounding erythema and with yellowish tinge on both palms and soles. She was advised for dose reduction of sorafenib to 200mg BD, topical clobetesol propionate and to avoid friction. She completed five cycles of sorafenib with said dose and was doing well. HFSR is a dose limiting cutaneous toxicity occurs within 3-6 weeks of treatment, dose reduction and simple treatment are sufficient to overcome. As the drug is excreted in the sweat glands it results in dose dependant direct skin toxicity .The differential diagnosis were hand foot syndrome, erythema multiforme, chemotherapy induced raynaud's disease, erythromelalgia, other cutaneous drug reactions. Awareness about the adverse cutaneous reaction to sorafenib is important to alert the clinicians which can be tackled successfully.","PeriodicalId":15571,"journal":{"name":"Journal of Dr. NTR University of Health Sciences","volume":"46 1","pages":"369 - 372"},"PeriodicalIF":0.0,"publicationDate":"2022-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"83667664","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Study of sensitivity pattern of antimicrobial agent in a tertiary care hospital in tribal area","authors":"A. Tarai, S. Dash, Sabitri Beshra, P. Panda","doi":"10.4103/jdrntruhs.jdrntruhs_24_21","DOIUrl":"https://doi.org/10.4103/jdrntruhs.jdrntruhs_24_21","url":null,"abstract":"Background: The pharmaceutical companies are flooded with newer and numerous antimicrobial agents. At the same time, bacterial resistance is more challenging and problematic and the biggest threat to Global health of India. Therapeutic failure complicates presentation and sensitivity patterns create a dilemma for the prescriber, and sometimes, the patients respond erratically to antimicrobial agents. This problem will cause 10 million deaths per year by 2050. Culture and sensitivity reports will benefit both the doctors and patients simultaneously. It can affect anyone at any age, and in any country. Therefore, a study was conducted in the new medical college to establish own sensitivity and resistance pattern of this instituition. At the same time, it prevents inappropriate or irrational use of antibiotics, rapid emergency of resistance, adverse drug reaction, higher cost to the patient, longer hospital stays and increases mortality. Aim and Objective: To know the sensitivity and resistance and sensitivity patterns of antimicrobial agents; regulate and promote the appropriate use of antimicrobial agents in PRMMCH, Baripada, Mayurbhanj. Materials and Methods: This prospective study was conducted from May to October 2019 in PRMMCH, Baripada, Department of Pharmacology, in collaboration with the Department of Microbiology. The data were collected from culture sensitivity reports of all positive samples of urine, throat swab, and blood culture from the microbiology department on the prescribed format and finally be analyzed by percentage. Result: The total number of samples with positive culture was 100. Staph aureus was positive in 60%, E. coli 10%, Enterococcus sp and Klebsiella sp 7%, Pseudomonas 6%, Acinetobacter 5%, Citrobacter sp 3%, and Corynebacterium sp 2%. Conclusion: More studies are needed to evaluate the sensitivity and resistant pattern of the microorganisms to different antibiotics from different clinical specimens in this geographical area.","PeriodicalId":15571,"journal":{"name":"Journal of Dr. NTR University of Health Sciences","volume":"114 1","pages":"366 - 368"},"PeriodicalIF":0.0,"publicationDate":"2022-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"81500429","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Anxiety and depression in patients with acne vulgaris at tertiary care hospital: A cross-sectional study","authors":"S. Rayapureddy, Therissa Benerji, M. Kodali, Roshini Pallekona, Harsha Enamurthy, M. Ravi Kumar","doi":"10.4103/jdrntruhs.jdrntruhs_88_22","DOIUrl":"https://doi.org/10.4103/jdrntruhs.jdrntruhs_88_22","url":null,"abstract":"Context: Acne vulgaris is a chronic inflammatory disease of the pilosebaceous follicles, characterized by comedones, papules, pustules, nodules, and often scars. Patients with acne feel self-conscious about the recurrence of skin lesions, especially their redness and scarring and often describe feelings of embarrassment, low confidence, depression, stress, and anxiety. Aim: To assess the levels of anxiety and depression in patients with acne vulgaris. To assess the relationship between the severity of acne and anxiety and depression. Setting and Design: Designed as a cross-sectional study conducted at a tertiary care hospital. Methods and Material: This is a cross-sectional study involving 100 patients diagnosed with acne vulgaris in the dermatology venereology leprosy (DVL) outpatient department between 18 and 40 years of age. The Global Acne Grading System (GAGS) was applied to assess the severity of acne. The hospital Anxiety and Depression Scale (HADS) was used to assess the levels of anxiety and depression in patients with acne vulgaris. Statistical Analysis Used: Statistical analysis was done using the statistical package for social science (SPSS) version 25. Results: GAGS revealed 14 subjects to be having mild acne, 34 moderate, 40 severe, and 12 very severe acne. Symptoms of anxiety were observed in 74 subjects and depression in 48 subjects. A statistically significant association (P<.001) was found between the severity of acne and anxiety and depression. Conclusion: High proportion of patients with acne had anxiety and depression, which were found to be significantly associated with the severity of acne.","PeriodicalId":15571,"journal":{"name":"Journal of Dr. NTR University of Health Sciences","volume":"56 1","pages":"351 - 355"},"PeriodicalIF":0.0,"publicationDate":"2022-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"85965359","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Invasive squamous cell carcinoma on the mucosal surface of the leiomyomatous polyp, cervix - Report of an extremely rare occurrence","authors":"H. Nandyala, Chaitanya Balekuduru, J. Mekala","doi":"10.4103/jdrntruhs.jdrntruhs_44_21","DOIUrl":"https://doi.org/10.4103/jdrntruhs.jdrntruhs_44_21","url":null,"abstract":"Endocervical polyps constitute the most common new growths of the uterine cervix. They are most often found during the fourth to sixth decades and in multigravidas. The paucity of smooth muscles in the cervical stroma makes the leiomyomas uncommon in the cervix and accounts for less than 1% of all fibroids. Cervical leiomyomas or fibroids usually arise from the supravaginal portion of the cervix. Studies indicate that the prevalence of atypia, dysplasia, and malignancy in cervical polyps is none to very low. The occurrence of neoplastic change in the overlying mucosa of the leiomyomatous cervical polyp is extremely rare. There has been only a single case of squamous cell carcinoma (SCC) arising on the mucosal surface of a cervical leiomyomatous polyp. We are presenting a case of SCC arising from the mucosal surface of the cervical leiomyomatous polyp.","PeriodicalId":15571,"journal":{"name":"Journal of Dr. NTR University of Health Sciences","volume":"36 1","pages":"386 - 388"},"PeriodicalIF":0.0,"publicationDate":"2022-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"79710335","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Anemic status in patients requiring multiple extractions: A prospective study in rural population in South India","authors":"V. Vuyyuru, P. Batchu, Srinivas Gadipelly, P. Perumalla","doi":"10.4103/jdrntruhs.jdrntruhs_6_21","DOIUrl":"https://doi.org/10.4103/jdrntruhs.jdrntruhs_6_21","url":null,"abstract":"Context (Background): Long-term negligence of dental diseases results in development of chronic dental problems involving multiple teeth which has an impact on general health and nutrition. Aims: Our study aimed to evaluate the correlation between chronic dental conditions requiring multiple extraction and the anemic status of the patients. Settings and Design: This was a prospective study on hematological data obtained from outpatients over 1 year. Materials and Methods: The study was conducted on 200 patients over a period of 1 year who were divided into Group I (anemic) and Group II (normal) based on Hb values. Statistical Analysis: We used the t test and Chi-square test to find the significance. Results: Eighty-six of the 200 patients (43%) fell into Group I and 114 patients 57% of patients fell into Group II. In Group I the average Hb was 9.9 ± 0.86 g% for females and 10.5 ± 0.91 g% for males and the mean number of teeth extracted was 4.18± (2.64). 88.3% of patients in Group I underwent extraction of posterior teeth. In Group II the number of teeth extracted was 3.5± (2.14). Approximately 77.1% of patients underwent extraction of posterior teeth. The difference in the number of teeth extracted and the difference in the percentage of patients who had their posterior teeth extracted between Group I and Group II was found to be statistically significant (P = 0.024 and P = 0.0436). Conclusions: Chronic dental diseases involving multiple teeth and impacting the masticatory efficiency of the patient may cause systemic disorders like anemia.","PeriodicalId":15571,"journal":{"name":"Journal of Dr. NTR University of Health Sciences","volume":"57 1","pages":"271 - 275"},"PeriodicalIF":0.0,"publicationDate":"2022-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"75360104","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Prevalence and antibiogram of multidrug resistant Staphylococcus haemolyticus from various clinical samples in a tertiary care hospital in Hyderabad, India","authors":"K. Jigisha, L. Tadi","doi":"10.4103/jdrntruhs.jdrntruhs_53_21","DOIUrl":"https://doi.org/10.4103/jdrntruhs.jdrntruhs_53_21","url":null,"abstract":"Background: Staphylococcus haemolyticus (S. haemolyticus) is one of the important organisms in hospital-acquired infections. This strain comprises many enzymes, cytolysins, and surface substances which contribute to its virulence. We in the present study tried to evaluate the prevalence of methicillin-resistant S. haemolyticus causing nosocomial infections in a Tertiary Care Hospital. Methods: A total of n = 95 non-repeated S. hemolyticus were isolated in the Department of microbiology out of n = 2116 various clinical specimen present. The strains collected were initially identified by colony morphology on Nutrient agar, Sheep blood agar, Chocolate agar, Uri Chrom agar, gram staining, catalase, coagulase (both slide coagulase and tube coagulase), mannitol fermentation, Amino acid decarboxylation. Results: n = 95 (4.5%) samples of n = 2116 samples were positive for S. haemolyticus. Most positive cultures of S. haemolyticus were from pus samples n = 40 out of n = 95. The susceptibility pattern revealed none were susceptible to penicillin and 94% susceptibility was found with Linezolid and 100% susceptibility to Nitrofurantoin. The vancomycin Minimum Inhibitory Concentration (MIC) results showed 71.57% (68/95) strains were susceptible; out of these 12 (12.63%) were showing MIC < 1 μg/mL, n = 56 isolates (58.94%) were showing MIC value less than n = 2 μg/mL, and none of them were less than MIC 0.5 μg/mL. Conclusion: In this study, variable antimicrobial resistance susceptibilities were shown by S. haemolyticus isolates. Some clinical situations may require a single strain of S. haemolyticus to be identified up to the species level with their antibiogram. Critical and timely detection of drug-resistant S. haemolyticus in hospital settings will be a helpful guide in the management and prevent further proliferation of drug resistance.","PeriodicalId":15571,"journal":{"name":"Journal of Dr. NTR University of Health Sciences","volume":"32 1","pages":"276 - 280"},"PeriodicalIF":0.0,"publicationDate":"2022-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"83391448","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"COVID-19 and bullous pemphigoid: Coincidence or a true association?","authors":"T. Rao, Prathyusha Yakkala, Balaraju Tadikonda, S. Karri","doi":"10.4103/jdrntruhs.jdrntruhs_145_21","DOIUrl":"https://doi.org/10.4103/jdrntruhs.jdrntruhs_145_21","url":null,"abstract":"Various dermatological manifestations have been reported in this pandemic of COVID-19. COVID and autoimmunity is known. We report a case of Bullous pemphigoid associated with COVID-19. Clinical features were suggestive of Bullous pemphigoid which was confirmed by histopathology, direct immunofluorescence and salt split technique. Patient did not respond to conventional therapy for BP. However, she responded dramatically to COVID-19 treatment with antiviral therapy. Though rare, this association between COVID and BP needs to be kept in mind while evaluating BP lesions during this pandemic.","PeriodicalId":15571,"journal":{"name":"Journal of Dr. NTR University of Health Sciences","volume":"154 1","pages":"373 - 376"},"PeriodicalIF":0.0,"publicationDate":"2022-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"83526686","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}