2.Trends in the Antibiotic Resistance Patterns of Enteric Fever Isolates – a Three Year Report from a Tertiary Care Centre
Varsha Gupta ; Nidhi Singla ; Neha Bansal ; Neelam Kaistha ; Jagdish Chander
Malaysian Journal of Medical Sciences 2013;20(4):71-75
Objectives: The incidence of multidrug resistant enteric fever is increasing alarmingly. This study was planned to determine the rate of isolation of Salmonella spp. and to compare the isolates for their epidemiological parameters and antimicrobial susceptibility patterns at our center.
Methods: The study was conducted over a span of three years with a total of 8142, 8134, and 8114 blood culture samples processed for the years 2008, 2009, and 2010 respectively. The minimum inhibitory concentration (MIC) for ciprofloxacin and chloramphenicol was determined using an agar dilution method. The MIC for ciprofloxacin was also confirmed by Epsilon-test (E -test) strips.
Results: Of the total 302 Salmonella spp. isolated, 257 were Salmonella enterica serotype Typhi (85.1%) and 45 (14.9%) were S. enterica serotype Paratyphi A. The majority of the isolates recovered were from the pediatric age group (54.6%) and males (60.6%). Complete susceptibility was observed to chloramphenicol, cefotaxime, ceftriaxone, and azithromycin over the last two years (2009 and 2010), with an increase in resistance to nalidixic acid (100%) and ciprofloxacin (13.6%).
Conclusions: In our study, we found augmentation of resistance to nalidixic acid and fluoroquinolones and complete sensitivity to ceftriaxone along with reemergence of chloramphenicol sensitivity for Salmonella isolates. This report emphasises the necessity of continuous surveillance of antibiograms of enteric fever isolates in an area.
Drug Resistance, Microbial
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Ceftriaxone
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Ciprofloxacin
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Typhoid Fever
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Salmonella
3.Comparison of Intraoperative Low-Dose Ketodex and Fentanyl Infusion for Postoperative Analgesia In Spine Surgery: A Prospective Randomized Double-Blind Study
Priya THAPPA ; Nidhi SINGH ; Ankur LUTHRA ; Pruthviraj DESHPANDE ; Rajeev CHAUHAN ; Shyam C. MEENA ; Vishal KUMAR ; Navneet SINGLA
Asian Spine Journal 2023;17(5):894-903
Methods:
The study included 60 patients graded American Society of Anesthesiologists I and II and scheduled for thoracolumbar spine surgery involving >3 vertebral levels. The patients were divided into two groups: group KD (ketodex) and group F (fentanyl). The primary objective was to compare the postoperative analgesic requirements among the groups. The secondary objectives included a comparison of the intraoperative anesthetic requirements, postoperative pain scores, hemodynamic parameters, side effects of the study drugs, and the duration of post-anesthesia care unit stay of both the groups.
Results:
Ketodex use prolonged the mean time to first rescue analgesia (22.00±2.30 hours vs. 11.69±3.02 hours, p <0.001) and reduced the requirement of rescue analgesics in the first 24 hours postoperatively compared to fentanyl use (70.00±8.16 μg vs. 113.31±36.65 μg, p =0.03). The intraoperative requirement of desflurane was comparable between the groups (p >0.05). The postoperative pain scores were significantly lower in the group KD than in group F at most timepoints (p <0.05). Patients in group KD had a shorter post-anesthesia care unit stay than group F did (p <0.001).
Conclusions
Low-dose ketodex could be a safe substitute for fentanyl infusion when employed as an anesthetic adjuvant for patients undergoing thoracolumbar spine surgeries involving >3 vertebral levels to achieve prolonged analgesia without any opioidrelated side effects.
4. Dengue in pregnancy: An under-reported illness, with special reference to other existing co-infections
Nidhi SINGLA ; Jagdish CHANDER ; Sunita ARORA ; Poonam GOEL ; Anju HURIA
Asian Pacific Journal of Tropical Medicine 2015;8(3):206-208
Objective: To keep the level of awareness high as far as incidence of dengue among pregnant women is concerned. Methods: A total of 300 blood samples of patients with fever in pregnancy were received in the Department of Microbiology to rule out dengue infection (January 2011 to December 2012). The samples were put up for presence of dengue IgM antibodies and NS1Ag by ELISA. The patients who turned out to be positive for dengue serology were retrospectively analysed with respect to patient's age, gestational age, clinical presentation, complications, platelet counts and maternal as well as foetal outcomes. Results: Out of 300 females tested, 22 (7.3%) were found positive for dengue infection during the said time period. Out of them 9 were positive for IgM antibodies against dengue and 10 were found to be positive for NS1Ag, while 3 were positive for both IgM antibody and NS1Ag. Five patients presented with dengue in first trimester, 9 in second trimester and 8 in third trimester. Two patients had coinfections. Patient with coinfection of dengue with malaria had intrauterine death of fetus at 37 weeks while the second one having dengue with typhoid had a preterm vaginal delivery at 35 weeks. Conclusions: Establishing diagnosis of dengue infection in pregnancy is important for effective management by the obstetricians particularly the mode of delivery due to the potential risk of hemorrhage for both the mother and the newborn. Co-infections seen in endemic areas may be more common than usually reported.
5.Prevalence and patterns of post-COVID-19 symptoms in recovered patients of Delhi, India: a population-based study
Nidhi BHATNAGAR ; Mongjam Meghachandra SINGH ; Hitakshi SHARMA ; Suruchi MISHRA ; Gurmeet SINGH ; Shivani RAO ; Amod BORLE ; Tanu ANAND ; Naresh KUMAR ; Binita GOSWAMI ; Sarika SINGH ; Mahima KAPOOR ; Sumeet SINGLA ; Bembem KHURAIJAM ; Nita KHURANA ; Urvi SHARMA ; Suneela GARG
Osong Public Health and Research Perspectives 2024;15(3):229-237
Objectives:
Post-coronavirus disease 2019 (COVID-19) symptoms were widely reported.However, data on post-COVID-19 conditions following infection with the Omicron variant remained scarce. This prospective study was conducted to understand the prevalence, patterns, and duration of symptoms in patients who had recovered from COVID-19.
Methods:
A prospective study was conducted across 11 districts of Delhi, India, among individuals who had recovered from COVID-19. Study participants were enrolled, and then returned for post-recovery follow-up at 3 months and 6 months interval.
Results
The mean age of study participants was 42.07 years, with a standard deviation of 14.89 years. The majority of the participants (79.7%) reported experiencing post-COVID-19 symptoms. The most common symptoms included joint pain (36.0%), persistent dry cough (35.7%), anxiety (28.4%), and shortness of breath (27.1%). Other symptoms were persistent fatigue (21.6%), persistent headache (20.0%), forgetfulness (19.7%), and limb weakness (18.6%). The longest duration of symptom was observed to be anxiety (138.75±54.14 days), followed by fatigue (137.57±48.33 days), shortness of breath (131.89±60.21 days), and joint pain/swelling (131.59±58.76 days). At the first follow-up visit, 2.2% of participants presented with abnormal electrocardiogram readings, but no abnormalities were noticed during the second follow-up. Additionally, 4.06% of participants exhibited abnormal chest X-ray findings at the first follow-up, which decreased to 2.16% by the second visit. Conclusion: The most frequently reported post-COVID-19 symptoms were joint pain, dry cough, anxiety and shortness of breath. These clinical symptoms persisted for up to 6 months, with evidence of multi-system involvement. Consequently, findings highlighted the need for long-term follow-up during the post-COVID-19 period.