Clinical, Microbiological Profile and Antibiotics Use in Admitted Patients of Urinary Tract Infection
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Urinary tract infections (UTI) can vary from simple cystitis to pyelonephritis with severe sepsis. The objective of this study is to provide information about the clinical and microbiological profile of admitted patients of urinary tract infection, patterns of organisms isolated, antibiotic sensitivity pattern and antibiotics use. It was a prospective observational study conducted on 40 patients age >14 years admitted with diagnosis of UTI based on clinical and microbiological criteria over 8 months at a tertiary care hospital in North India. Data was collected for the clinical, microbiological profile, empirical and definite antibiotics use with duration of stay and outcome of patients. Among 40 cases of UTI; male to female ratio was 1:1 with mean age of 51.3± 16.32 years. Fever was present in almost all (97.5%) of the patients and three-fourth (75%) of them had dysuria. Type-2 Diabetes Mellitus was most common (55%) underlying condition and mean HbA1c was 9.37±2.27 followed by obstructive uropathy (17.50%). Most of cases (82.5%) were of complicated UTI; where Pyelonephritis was 42%, Emphysematous Pyelonephritis 12.5% and Renal Abscess 7.5%. Most common (37.5%) organism isolated from urine/ pus culture was Escherichia coli. More than half of the patients (55%) were given empirical antibiotics injection piperacillin tazobactam and carbapenems was used in more than one third (35%) of patients. The mean duration of antibiotics use was 14.55±4.94 days. Two (5.0%) patients expired out during the study period. Uncontrolled Diabetes Mellitus remains the major underlying condition in cases of complicated UTI. E coli is the most common organism isolated from urine/ pus culture. Most of the patients had favourable outcome with guided antibiotics and interventions. Bangladesh Med J. 2023 May; 52(2): 15-19Cite
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Seperti pada dewasa, teknik regional anestesi pada pediatrik kini makin popular digunakan oleh ahli anestesikarena keuntungannya. Namun demikian selalu ada risiko dan kemungkinan timbulnya komplikasi dari setiap tindakan yang dilakukan, termasuk tindakan anestesi regional pada pediatrik. Insidensi komplikasi anestesi regional pada pediatrik tidak banyak, dan kalaupun terjadi komplikasi adalah minor. Komplikasi bisa diakibatkan dari identifikasi ruang saraf, alat, obat, teknis tindakan anestesi regionalnya dan komplikasi lainnya.Walaupun tidak banyak kejadian komplikasi regional anestesi yang dilaporkan pada pediatrik, dan bukanlah komplikasi yang fatal, teknik regional anestesi pada pediatrik harus dilakukan dengan lebih hatihati, pertimbangan risiko dan keuntungannya untuk menghindari terjadinya komplikasi, terlebih karena kebanyakan komplikasi dapat dihindari dengan mempelajari teknik yang benar, menggunakan peralatan yang sesuai, dan sangat menerapkan prinsip keamanan pada pasien dengan baik.
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Genentech is partnering with the German cancer company Affimed to develop immunotherapies for multiple kinds of solid and blood cancers. Affimed is developing therapies that engage natural killer cells of the innate immune system to help direct them to attack cancer cells. Genentech will pay Affimed $96 million up front and up to $5 billion more in potential payments.
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ABSTRACT Airway management is particularly difficult in children with severe congenital anomalies. Such patients are extre- mely sensitive to the respiratory depressant effects of anaesthetic agents. We describe the successful and safe app- lication of caudal anaesthesia for inguinal hernia repair in three cases with severe congenital anomalies (Joubert syndrome, I-cell syndrome). The three patients concerned had congenital anomalies including serious facial defor- mity, respiratory failure and cardiovascular defects. They were administered a single dose of caudal epidural anaest- hesia for inguinal hernia surgery in order to avoid complications associated with general anaesthesia. Caudal block was performed and 1 mL/kg levobupivacaine 0.25% administered. We conclude that caudal epidural anaesthesia can be an effective, suitable and safe anaesthetic technique for inguinal herniotomy without the need for general anaesthesia or endotracheal intubation in children with severe congenital anomalies. Key Words: Caudal anaesthesia, children, congenital anomaly OZET Havayolu yonetimi, ciddi konjenital anomalileri olan cocuklarda ozellikle zordur. Bu tur hastalar anestezik ilaclarin solunum depresan etkilerine karsi asiri derecede duyarlidir. Kaudal anestezinin inguinal herni onarimindaki basarili ve guvenli uygulamasi konjenital anomalileri (Joubert sendromu, I-cell hastaligi) olan uc olguda gosterilmistir. Ilgili uc cocuk hastada, ciddi yuz deformitesi, solunum yetmezligi ve kardiyovaskuler bozukluk dahil konjenital bozuk- luklar vardi. Genel anesteziyle iliskili komplikasyonlari onlemek icin inguinal herni cerrahisinde tek doz kaudal epi- dural anestezi uygulandi. Kaudal anestezide %0.25 levobupivakain 1 mL/kg kullanildi. Kaudal epidural anestezinin, ciddi konjenital bozukluklari olan cocuklarda inguinal herni onarimi acisindan genel anesteziye veya endotrakeal entubasyona gerek duyulmadan etkili, uygun ve guvenli bir alternatif anestezi teknigi olabilecegi sonucuna varildi. A na h ta r Sozcukler: Kaudal anestezi, cocuk, konjenital bozukluk
Levobupivacaine
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Budd–Chiari syndrome
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