International Journal of

Current Pharmaceutical Review and Research

e-ISSN: 0976 822X

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1. Clinical and Microbiological Profile of Ventilator-Associated Pneumonia in Intensive Care Unit of Tertiary Care Hospital
Sahib Noor Singh, GurinderMohan, Sarbjeet Sharma
Abstract
Introduction: Ventilator-associated pneumonia (VAP) is a common hospital-acquired infection in mechanically ventilated patients, leading to increased mortality, ICU stays, and healthcare costs. VAP is primarily caused by the aspiration of oropharyngeal organisms into the distal bronchi, either directly or via reflux from the stomach. Less common routes include hematogenous spread from remote infections or contamination from medical equipment. The incidence of VAP ranges from 6.8% to 44%, significantly impacting hospital stay length, mortality rates, and financial burden. Effective preventive strategies are crucial in managing this condition. Methods:  This study was conducted in SGRDIMSR, Vallah, Amritsar. Patients were selected from ICUs based on inclusion and exclusion criteria. Clinically suspected patients, according to CDC criteria, were scored using the Chronic Pulmonary Infection Score (CPIS), considering clinical, microbiological, and radiological signs. Variables noted for each patient included age, gender, CPIS, diagnosis at ICU admission, duration of ventilation, antibiotics received, samples submitted for confirmation of etiological agents, endotracheal aspirate, suction tip culture, type of organism recovered, susceptibility profile, and clinical outcome. Results: Out of 362 patients, 231 (63.8%) were males and 131 (36.2%) were females, with a male-to-female ratio of 1.76:1. The most common comorbidities observed were hypertension (53.9%), type 2 diabetes mellitus (52.8%), coronary artery disease (19.06%), obstructive sleep apnea (14.08%), cerebrovascular accident (6.4%), chronic obstructive pulmonary disease (4.14%), and bronchial asthma (3.59%). Supine position was a risk factor in 99.7% of patients, with nasogastric tube use at 99.44%, and sedation at 98.1%. While 39.2% of patients had a CPIS score greater than 6, the majority (60.8%) had a CPIS score less than 6. Among the patients, 39.23% developed VAP after being intubated and mechanically ventilated for 48 hours or more. The majority of isolates obtained were gram-negative bacteria (98.44%), with only 1.56% being gram-positive. Among the 128 organisms isolated, the most common was Klebsiella Pneumoniae (41.40%), followed by Acinetobacter Baumannii (21.09%). Among the 142 patients who developed VAP, 42.25% had successful outcomes, while 57.74% did not survive. The most common clinical features of VAP included fever, crepitation, and tachypnea. The mean duration of mechanical ventilation for patients who developed VAP was 9.09 ± 2.747 days, compared to those who did not develop VAP. Patients with VAP had notably longer ICU and hospital stays compared to those without VAP. Conclusion: This study provides a comprehensive analysis of ventilator-associated pneumonia (VAP), including its epidemiology, microbial etiology, antibiotic resistance, and patient outcomes. Key prognostic indicators such as body temperature, total leukocyte count (TLC), inotropic support, tracheal secretion characteristics, and the presence of VAP are identified. The findings underscore the importance of tailored prevention and management strategies to improve patient outcomes and advocate for ongoing surveillance and evidence-based approaches to address this challenging infection.

DOI: 10.5281/zenodo.

2. Sensorineural Hearing Loss in Inflammatory Bowel Disease
Aman Madaik, Tulika S. Madaik, Anju Madan Gupt
Abstract
Background: Inflammatory bowel disease (IBD) is an immune mediated chronic intestinal disease. It is of two major types, Ulcerative Colitis (UC) and Crohn’s Disease (CD). Though IBD is primarily an intestinal disease, it involves various organ systems such as eyes, skin, musculoskeletal and hepatobiliary systems. Sensorineural hearing loss is one of such extraintestinal manifestations which is attributed to the autoimmune inner ear disease. The objective of this study is to find the prevalence of sensorineural hearing loss in patients of inflammatory bowel disease. Materials and Methods: 28 patients of inflammatory bowel disease in the age group of 18-50 years visiting outdoor patient department or admitted in the Department of Gastroenterology, IGMC Shimla over a period of one year (August 2014 to July 2015) fulfilling the inclusion and exclusion criteria were included for the study. The subjects were then subjected to a battery of audiological tests: Tuning fork tests, Pure Tone Audiometry and Brain Stem Evoked Response Audiometry (BERA). The data was tabulated in Microsoft Excel spread sheet and Epi Info version 3;4,3 statistical software was used for statistical analysis. Results: A total of 28 patients were included in the study, 15 of the which were females and 17 males. Mean age of the study population was 37.79 ± 8.14years. 23 (82.14%) patients were diagnosed to have Ulcerative Colitis while 5 (17.85%) patients were diagnosed to have Crohn’s disease on endoscopy and further histopathological examination. A total of 8 (28.57%) patients were found to have sensorineural hearing loss. Out of these 8 patients of SNHL, 6 (75%) had UC and 2 (25%) had CD. 6 (75%) patients had Cochlear type of hearing loss while 2 (75%) had Retrocochlear type of hearing loss. The mean Duration of IBD of the patient population with SNHL was 6.37 ± 4.90 years while that of the patients without SNHL was 1.34 ± .82 years. Conclusion: Inflammatory bowel disease is a treatable cause of otherwise permanent sensorineural deafness. Early audiometric evaluation may be advised in all inflammatory bowel disease patients.

DOI: 10.5281/zenodo.

3. A Study of Correlation of NLR Ratio with Severity of Covid 19 Positive Patients
Vivek Garg, Kalpesh Moradiya, Yatharth Jain, Faraz Lirani
Abstract
Coronavirus is a huge virus family which includes Middle East respiratory syndrome and severe acute respiratory syndrome. All of these are recognized to be the root of the common cold and more severe infections. On 30 January 2020, the World Health Organization (WHO) declared that the outbreak of SARSCoV-2 constituted a Public Health Emergency of International Concern (PHEIC). Compared to seasonal flu, covid 19 is more contagious, has a much longer incubation period, and is association with higher hospitalization, and mortality rates. There is a rapid unpredictable deterioration of the patient, therefore it requires timely prediction of the course and severity of the illness. Due to their simplicity of measurement, availability, affordability, and reliability, the differential blood cell counts can be employed as a measure of the intensity of the immune response. Neutrophil- lymphocyte ratio (NLR) plays a predictive function in a number of inflammatory illnesses and oncological processes.For Covid-19 patients, NLR has been demonstrated to be an independent risk factor for severe disease. The elevated NLR may be due to dysregulated expression of inflammatory cytokines.In this study we aim to study the correlation of NLR ratio with Covid 19 Positive patients.

DOI: 10.5281/zenodo.

 

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