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   Table of Contents - Current issue
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July-December 2017
Volume 4 | Issue 3
Page Nos. 45-65

Online since Tuesday, August 28, 2018

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ORIGINAL ARTICLES  

An epidemiological study of health-care-associated infections and their antimicrobial sensitivity pattern in the Al-Qassim region of Kingdom of Saudi Arabia p. 45
Sanjay Kumar Gupta, Fahd Khaleefah Al Khaleefah, Ibrahim Saifi Al Harbi
DOI:10.4103/cai.cai_11_17  
Background: In the USA, up to 2 million health-care-associated infections (HAIs) per year are reported, of which 80,000 are lethal. Materials and Methods: This was a hospital-based observational (retrospective) study. Results: Hospital-wide rate of HAI ranges from 0.35 to 1.96 per thousand patients per day. The most common organism observed in the last 5 years is Acenatobacter (88 [27%]) followed by Pseudomonas aeruginosa (73 [22%]). Significant cases in these 5 years were reported from Intensive Care Unit (157 [48%]) followed by medical wards (males and females) (106 [32%]). The common site reported in the present study is catheter-associated urinary tract infection which was significantly higher (CA-UTI) (152 [46%]) followed by ventilator-associated pneumonia (VAP) (66 [20%]). The common organisms reported to cause UTI are P. aeruginosa (22%) followed by Escherichia coli (19%), and the most common microbial agent associated with VAP is Acenatobacter baumannii (48 [72%]) which was found to be significantly higher. The antibiogram of microorganism responsible for HAI was observed, and 56% isolates of Acinetobacter baumannii were sensitive to aztreonam followed by imipenem 54%, ceftazidime 47%, and amikacin 36%. Another common organism reported was P. aeruginosa, and the majority of isolates of this were sensitive to imipenem 79% followed by amikacin 68%, ceftazidime 53%, aztreonam, and ciprofloxacin 49% and least sensitive to meropenem 9%. Most of the Klebsiella pneumoniae strains during the same period were found to be sensitive to imipenem 94% followed by piperacillin/tazobactam 71%, amikacin 69%, cefepime 59%, and ceftriaxone 56% and least sensitive to nitrofurantoin 11% only. Conclusion: HAI is a big threat for patients' safety and prolongs patients' stay and cost of health care, so effective utilization of hospital data is crucial for prevention and control.
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Is there a silver lining in this cloud? Future expectations of adolescents with human immunodeficiency virus p. 51
Sukanya Rajan, Janardhana Navaneetham, GN Sanjeeva
DOI:10.4103/cai.cai_3_18  
Background and Objective: The life span of the children living with Hiv/AIDS has increased with the invention of Retroviral drugs. As they are entering in to late adolescents and early adulthood, it becomes necessary to understand their expectations. The study aimed to explore the future expectations among the adolescents with HIV/AIDs. Materials and Methods: An exploratory study design was adopted for the study. Semi structured interviews were undertaken with adolescents and interpretative phenomenological analysis was used to analyze the results. The universe of the study were HIV infected adolescents who are registered in the Pediatric ART Centre and are coming for follow up in Indira Ghandhi Institute of Child Health Hospital, Bangaluru. Results: Emergent themes demonstrated that, the adolescent with HIV/AIDS are concerned regarding their future. The themes emerged from the study was knowledge about the illness, physical health, future expectations about career and relationship and social support. Conclusion: Lives of the children adolescents being infected by HIV/AIDS, unlike those of their counterparts are complicated with stigma, adjustment problems, and many other psychosocial issues. While studies done in India bring to light the adjustment problems of these children, they fail to look at their future expectations and their dreams for them.
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CASE REPORTS Top

Necrotizing pneumonia or pulmonary gangrene p. 56
L Del Carpio-Orantes
DOI:10.4103/cai.cai_14_17  
We present the case of necrotizing pneumonia in a young patient without chronic comorbidities, who presented a torpid with subsequent death, highlighting in this case, subacute evolution, as well as the isolation of Staphylococcus epidermidis coagulase-negative resistant to vancomycin, acquired in the community, which finally resulted in a poor prognosis. The importance of the tomographic image is emphasized, as well as the evaluation for chest surgery, as it is important invasive surgical management or chest, coupled with broad-spectrum drugs according to targeted crops or pleuropulmonary expectoration secretions.
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Abdominal heaviness in malaria: An unusual splenic complication p. 59
Ankit Mittal, Animesh Ray, Raunak Bir, Surabhi Vyas, Nishant Verma
DOI:10.4103/cai.cai_1_18  
Splenic infarction as a complication in malaria is very sparsely reported despite having millions of cases of malaria every year. It appears to be an underreported complication and its recognition now can be attributed to the availability of better diagnostic and imaging modalities. It is important to look for splenic involvement in patients with malaria, especially in patients who complain of left hypochondrial pain as it might be associated with complications. Among the different species of malaria, like the case being reported here, it has been most commonly described with vivax malaria and outcomes have been almost always favorable with appropriate management of the infection.
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LETTERS TO EDITOR Top

World Health Organization intervenes to contain the 2017 cholera outbreak in the Borno State of Nigeria p. 62
Saurabh RamBihariLal Shrivastava, Prateek Sarabh Shrivastava, Jegadeesh Ramasamy
DOI:10.4103/cai.cai_10_17  
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Containing leishmaniasis in the war-affected Syria p. 64
Saurabh RamBihariLal Shrivastava, Prateek Saurabh Shrivastava
DOI:10.4103/cai.cai_13_17  
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