Browsing by Author "Gupta, Atul Kumar"
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Publication Culture and Sensitivity Pattern of Sepsis in Ventilated Newborns(Nepal Paediatric Society (JNPS), 2016) Sur, Somen; Dr Pallavi,; Mondal, Sanjib; Gupta, Atul KumarAbstract: Introduction: Neonatal sepsis is a major cause of mortality and morbidity in modern neonatal intensive care units (NICU). Increasing trend of antibiotic resistance makes this problem more difficult to tackle, at present. Haemodynamically compromised neonates, particularly those requiring ventilator support, often suffer from multidrug resistant sepsis. The objectives of this study were to determine micro-organisms causing sepsis in those neonates requiring ventilator support and the sensitivity patterns of those micro-organisms. Material and Method: During 18 months of study period, 48 neonates, who had fulfilled the chosen inclusion criteria were included in this study. They were investigated with blood culture, urine culture, CSF culture, and endotracheal tube tip culture (taken within 48 hours of starting ventilation), as per relevance. Those who were found positive to any micro-organism, were also explored. They were studied further for antimicrobial sensitivity pattern. Data obtained from this study were analysed using SPSS-20.0. Results: 15(31.3%) neonates were found to be culture positive. Klebsiella sp. was most common (33.3%) organism isolated, followed by Pseudomonas aeruginosa (20%). Most common antibiotic found to be sensitive was Meropenem (86.67%), followed by Colistin and Tigecycline (80% each). Conclusion: Nowadays, all NICUs throughout the world face a common problem of multidrug resistant sepsis. There is always a doubt regarding choice of second line antibiotics, when one considers for upgradation. As per this study, authors considered Meropenem as second line antibiotic of choice, as other sensitive antibiotics like Colistin, Tigecycline wield more adverse effects on neonates.Publication Scrub Typhus in Children Authors(Nepal Paediatric Society (JNPS), 2018) Zainab, Madiha; Gupta, Atul Kumar; Guha, SuparnaAbstract: Introduction: Scrub typhus is an acute febrile illness caused by infection with rickettsial bacilli Orientia tsutsugamushi. This was a retrospective observational study to study the clinical profile of paediatric scrub typhus, its associated complications and response to treatment Material and Methods: Record files of all patients diagnosed with positive Weil felix (OXK>1:80) and Scrub IgM positive over a period of one year were analysed. Total of 10 cases were diagnosed as scrub with median age of presentation 4.1 years. Results: Fever was present in all followed by pain abdomen (50%), rash. Anaemia (90%), lymphadenopathy (70%) hepatomegaly (100%), Leukopenia was present in those cases with fever <1 week while leucocytosis was found thereafter. Most common complication were hepatitis (100%) shock (50%), acute kidney injury (AKI) 30%, DIC in 20% cases. Secondary HLH was found in 20% and pancarditis in one case. All the cases showed dramatic response to doxycycline. Conclusion: So a high index of suspicion is required to diagnose scrub and early initiation of treatment is essential to prevent mortality from the disease.