Berthelsenballe5982
None of our patients had underlying infective endocarditis or colonic malignancy. Penicillin sensitivity was 81.2% while all the isolates were susceptible to ceftriaxone. Clozapine N-oxide in vivo Ampicillin resistance was seen in only one of the isolates. link2 In-hospital mortality was 12.5%.
subsp.
is the commonest subspecies of
isolated in our population. Unlike previous studies, colonic neoplasia and infective endocarditis were rare in our patients. Type II diabetes mellitus and chronic liver disease were the commonest risk factors identified in patients with
bacteremia.
Niyas VKM, Arjun R, Sasidharan A, Palakunnath GA.
Bacteremia An Experience from a Tertiary Center in South India. Indian J Crit Care Med 2020;24(10)943-945.
Niyas VKM, Arjun R, Sasidharan A, Palakunnath GA. Streptococcus gallolyticus Bacteremia An Experience from a Tertiary Center in South India. Indian J Crit Care Med 2020;24(10)943-945.
High utilization of antimicrobial agent (AMA) and inappropriate usage in an intensive care unit (ICU) intensifies resistant organism, morbidity, mortality, and treatment cost. Prescription audit and active feedback are a proven method to check the irrational prescription. To analyze and compare the utilization of drugs, the World Health Organization (WHO) proposed daily defined dose (DDD)/100 patient days and days of therapy (DOT)/100 patient days to measure utilization of AMAs. Data of AMAs utilization are required for planning an antibiotic policy and for follow-up of intervention strategies.
A prospective observational study was conducted for 1 year from July 2018 to June 2019 and the data obtained from ICU of a tertiary care hospital. The demographic data, the disease data, and the utilization of different classes of AMAs [WHO-Anatomical Therapeutic Chemical (ATC) classification] as well as their cost were recorded. Total number of patient days, DDD, DDD/100 patient days, and DOT/100 patient days werentensified with increasing prevalence of multidrug resistance bacteria and associated comorbidities. High treatment cost is responsible for higher utilization of restricted antibiotics in ICU.
Patra SK, Mishra SB, Rath A, Samal S, Iqbal SN. Study of Antimicrobial Utilization and Cost of Therapy in Medicine Intensive Care Unit of a Tertiary Care Hospital in Eastern India. Indian J Crit Care Med 2020;24(10)938-942.
Patra SK, Mishra SB, Rath A, Samal S, Iqbal SN. Study of Antimicrobial Utilization and Cost of Therapy in Medicine Intensive Care Unit of a Tertiary Care Hospital in Eastern India. Indian J Crit Care Med 2020;24(10)938-942.
Post-intensive care survivors have decreased quality-of-life scores and prolonged cognitive dysfunction due to baseline factors and events related to intensive care unit admission, which remain largely unrecognized.
A prospective observational cohort study to assess the quality of life and occurrence of cognitive dysfunction, 3 and 6 months following discharge from the intensive care unit, was carried out. We enrolled 136 adults presenting to the intensive care unit with no prior cognitive dysfunction or depression and followed up and assessed them with repeatable battery for the assessment of neuropsychological status (RBANS) and quality of life with short Form-36 (SF-36) health survey.
The incidence and prevalence of cognitive dysfunction was 100% at 3 and 6 months, respectively, as assessed by RBANS with a global cognition scores at 3 and 6 months of 71 (IQR 68.5-73) and 74 (IQR 72-86), respectively. Higher Charlson's comorbidity score, increased severity of illness, longer duration of mechanical venri JC, Ish P, Gupta N, Behera D, Gupta P,
Neurocognitive and Quality-of-life Outcomes Following Intensive Care Admission A Prospective 6-month Follow-up Study. Indian J Crit Care Med 2020;24(10)932-937.
Balasubramanian V, Suri JC, Ish P, Gupta N, Behera D, Gupta P, et al. Neurocognitive and Quality-of-life Outcomes Following Intensive Care Admission A Prospective 6-month Follow-up Study. Indian J Crit Care Med 2020;24(10)932-937.
About 5% of hospitalized coronavirus disease 2019 (COVID-19) patients will need intensive care unit (ICU) admission for hypoxemic respiratory failure requiring oxygen support. The choice between early mechanical ventilation and noninvasive oxygen therapies, such as, high-flow nasal oxygen (HFNO) and/or noninvasive positive-pressure ventilation (NPPV) has to balance the contradictory priorities of protecting healthcare workers by minimizing aerosol-generation and optimizing resource management. This survey over two timeframes aimed to explore the controversial issue of location and noninvasive oxygen therapy in non-intubated ICU patients using a clinical vignette.
An online survey was designed, piloted, and distributed electronically to Indian intensivists/anesthetists, from private hospitals, government hospitals, and medical college hospitals (the latter two referred to as first-responder hospitals), who are directly responsible for admitting/managing patients in ICU.
Of the 204 responses (125/481 in ps to Manage Confirmed COVID-19 Patients in Indian Intensive Care Units A Survey. Indian J Crit Care Med 2020;24(10)926-931.
Subramaniam A, Haji JY, Kumar P, Ramanathan K, Rajamani A. Noninvasive Oxygen Strategies to Manage Confirmed COVID-19 Patients in Indian Intensive Care Units A Survey. Indian J Crit Care Med 2020;24(10)926-931.
The pandemic coronavirus disease 2019 (COVID-19) is on the rise in our country and there is no specific treatment modality available presently. The treatment of the disease largely remains symptomatic but repurposed drugs used to treat other disease conditions are being used to treat moderate to severe form of the disease. As the clinical trials for these drugs are ongoing, we conducted this survey to know the physicians' medical treatment plan for COVID-19 patients.
It was a web-based questionnaire study. Institutional ethical committee clearance was taken before the commencement of the study. There were a total of 17 questions, the first 6 being about the demographics, place of work, and whether the clinician was involved in the care of COVID-19 patients. Subsequent 11 questions were to assess physician's awareness and plan of the medical management of the COVID-19 patients.
The majority of the clinicians were aware of the various treatment modalities available for the treatment of COVID-19. Regardingrequired. There is disaccord regarding the use of steroids in cytokine storm in COVID-19 and further guidelines and educational programs should address these issues.
Clinicians have to be made more aware of the possible adverse effects and drug interactions of the medications used for the treatment of COVID-19. The treatment of the serious, cytokine storm syndrome and the role of steroids must be elucidated as soon as it is feasible.
Maddani SS, Chaudhuri S, Deepa HC, Amara V. A Multicenter Questionnaire-based Study to Know the Awareness and Medical Treatment Plan of Physicians Involved in the Management of COVID-19 Patients. Indian J Crit Care Med 2020;24(10)919-925.
Maddani SS, Chaudhuri S, Deepa HC, Amara V. A Multicenter Questionnaire-based Study to Know the Awareness and Medical Treatment Plan of Physicians Involved in the Management of COVID-19 Patients. Indian J Crit Care Med 2020;24(10)919-925.
The World Health Organization (WHO) has declared SARS-CoV-2 as pandemic. Patients with COVID-19 present mainly with respiratory symptoms. Prone position has been traditionally used in acute respiratory distress syndrome (ARDS) to improve oxygenation and prevent barotrauma in ventilated patients. Awake proning is being used as an investigational therapy in COVID to defer invasive ventilation, improve oxygenation, and outcomes. Hence, we conducted a retrospective case study to look for benefits of awake proning with oxygen therapy in non-intubated COVID patients.
A retrospective case study of 15 COVID patients admitted from June 15 to July 1, 2020 to HDU in our hospital was conducted. Cooperative patients who were hemodynamically stable and SpO
< 90% on presentation were included. Oxygen was administered through facemask, non-rebreathing mask and noninvasive ventilation to patients as per requirement. Patients were encouraged to maintain prone position and target time was 10-12 hours/day. SpO
and P/fJain P, Deewan H. Awake Prone Positioning in COVID-19 Patients. Indian J Crit Care Med 2020;24(10)914-918.
With the Wuhan pandemic spread to India, more than lakhs of population were affected with COVID-19 with varying severities. Physiotherapists participated as frontline workers to contribute to management of patients in COVID-19 in reducing morbidity of these patients and aiding them to road to recovery. With infrastructure and patient characteristics different from the West and lack of adequate evidence to existing practices, there was a need to formulate a national consensus.
Recommendations were formulated with a systematic literature search and feedback of physiotherapist experiences. Expert consensus was obtained using a modified Delphi method.
The intraclass coefficient of agreement between the experts was 0.994, significant at
< 0.001.
This document offers physiotherapy evidence-based consensus and recommendation to planning physiotherapy workforce, assessment, chest physiotherapy, early mobilization, preparation for discharge planning, and safety for patients and therapist in acutec are COVID 19 setup of India. The recommendations have been integrated in the algorithm and are intended to use by all physiotherapists and other stakeholders in management of patients with COVID-19 in acute care settings.
Jiandani MP, Agarwal B, Baxi G, Kale S, Pol T, Bhise A,
Evidence-based National Consensus Recommendations for Physiotherapy Management in COVID-19 in Acute Care Indian Setup. Indian J Crit Care Med 2020;24(10)905-913.
Jiandani MP, Agarwal B, Baxi G, Kale S, Pol T, Bhise A, et al. Evidence-based National Consensus Recommendations for Physiotherapy Management in COVID-19 in Acute Care Indian Setup. Indian J Crit Care Med 2020;24(10)905-913.How to cite this article Lalgudi Ganesan S, Parameswaran N. Composite Outcomes for Clinical Trials in Critical Care The Devil is in the Detail. Indian J Crit Care Med 2020;24(10)903-904.Streptococcus bovis is an underrecognized agent of systemic infections. It underwent reclassification into different subtypes and is currently termed as Streptococcus gallolyticus. Bacteremia due to S. gallolyticus has been traditionally associated with colon cancer or hepatobiliary disease and can result in endocarditis. link3 Detection of S. gallolyticus in blood cultures prompts a thorough clinical evaluation in order to clarify the source of the bloodstream infection and the presence of complications. Subspeciation is crucial to understand the disease association, which is now possible with the use of phenotypic detection methods, such as, Vitek 2. The retrospective study by Niyas et al. serves to call attention to this organism and optimal approach to management. How to cite this article Soman R, Eashwernath R. Bacteremia due to Streptococcus gallolyticus A Name with an Ominous Significance? Indian J Crit Care Med 2020;24(10)901-902.
