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1. Antiseptic Chitosan-Poly(hexamethylene) Biguanide Hydrogel for the Treatment of Infectious Wounds

Author

Irine Rose Antony, Aathira Pradeep, Anoop Vasudevan Pillai, Riju Ramachandran Menon, Vasudevan Anil Kumar, and Rangasamy Jayakumar

Subjects
chitosan hydrogel, poly(hexamethylene) biguanide, antibacterial activity, antiseptic, antibiofilm, infectious wounds, Biotechnology, TP248.13-248.65, Medicine (General), R5-920
Abstract

Topical wound infections create the ideal conditions for microbial colonization and growth in terms of moisture, temperature, and nutrients. When they are not protected, numerous types of bacteria from the internal microbiota and the external environment may colonize them, creating a polymicrobial population. Treatment of these wounds often necessitates the use of antibiotics that may have systemic harmful effects. Unlike antibiotics, topical antiseptics exhibit a wider range of activity and reduced systemic toxicity and resistance. In order to address this issue, we developed an antiseptic Chitosan-Poly (hexamethylene) Biguanide (CS-PHMB) hydrogel. The prepared hydrogel was characterized using Fourier Transform Infrared Spectroscopy (FTIR) and Scanning Electron Microscopy (SEM). SEM images showed the smooth morphology and characteristic FTIR peaks of PHMB and confirmed the incorporation of the antiseptic into the chitosan (CS) hydrogel. A Water Vapor Permeation Rate study confirms the moisture retention ability of the CS-PHMB hydrogel. Rheological studies proved the gel strength and temperature stability. The prepared hydrogel inhibited the growth of S. aureus, P. aeruginosa, E. coli, methicillin-resistant Staphylococcus aureus (MRSA), and K. pneumoniae, which confirms its antibacterial properties. It also inhibited biofilm formation for S. aureus and E. coli. CS-PHMB hydrogel is also found to be hemo- and cytocompatible in nature. Thus, the developed CS-PHMB hydrogel is a very potent candidate to be used for treating infectious topical wounds with low systemic toxicity.

Published
2023
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5. Use of the WHO Access, Watch, and Reserve classification to define patterns of hospital antibiotic use (AWaRe): an analysis of paediatric survey data from 56 countries

Author

Irwin, Adam, Akula, Akhila, Bamford, Alasdair, Chang, Amanda, da Silva, Andre, Whitelaw, Andrew, Dramowski, Angela, Vasudevan, Anil Kumar, Sharma, Anita, Justicia, Antonio, Chikkappa, Ashok, Slowinska-Jarzabek, Barbara, Rippberger, Bianca, Zhao, Changan, Tersigni, Chiara, Cheng, Chinglan, Harkensee, Christian, Jing, Chuamei, Zhu, Chunmei, Li, Chunyan, Tagliabue, Claudia, Epalza, Cristina, Jacqueline, Daglish, Tian, Daiyin, Jinka, Dasaratha, Gkentzi, Despoina, Dharmapalan, Dhanya, Benadof, Dona, Papadimitriou, Eleni, Iosifidis, Elias, Roilides, Emmanuel, Yarci, Erbu, Majda-Stanisławska, Ewa, Gowin, Ewelina, Chappell, Faye, Torres, Federico Martinon, Collett-White, Francis, Liu, Gang, Lu, Gen, Syrogiannopoulos, George, Pitsava, Georgia, Alvarez-Uria, Gerardo, Renk, Hana, Mahmood, Hana, Saxen, Harri, Finlayson, Heather, Green, Helen, Rabie, Helena, Kandraju, Hemasree, Zhang, Hong, Okokon, Ita, Cross, Jack, Herberg, Jethro, Li, Jianping, Zhang, Jiaosheng, Deng, Jikui, Liu, Jing, Qian, Jing, Yang, Jinhong, Sicińska, Joanna, Hübner, Johannes, Fukuoka, Kahoru, Yao, Kaihu, Cheung, Kaman, Ojeda, Karla, Kaffe, Katerina, Kreitmeyer, Katharina, Doerholt, Katja, Grimwood, Keith, Ledoare, Kirsty, Vazouras, Konstantinos, Shen, Kunling, Tang, Lanfang, Zhang, Lehai, Lin, Li, Ashkenazi-Hoffnung, Liat, Wu, Lijuan, Wang, Lijun, Teston, Lilian, Galli, Luisa, Speirs, Lynne, Tsolia, Maria, Hufnagel, Markus, Knuf, Markus, Duse, Marzia, Ding, Mingjie, Rozic, Mojca, Premru, Mueller, O'Connell, Natasha, Rieber, Nikolaus, Spyridis, Nikos, Tunga, Onkaraiah, Conejo, Pablo Rojo, McMaster, Paddy, Lumbiganon, Pagakrong, Pansa, Paola, D'Argenio, Patrizia, Moriarty, Paul, Nikolic, Petra, Wang, Ping, Paopongsawan, Pongsatorn, Cao, Qing, Deng, Qiulian, Laxminarayan, Ramanan, Kanithi, Ravishankar, Jimenez, Rodolfo, Cao, Sancheng, Singh, Sanjeev, Rees, Sarah, Praveen, Saroey, Kekomaki, Satu, Hackett, Scott, Ashkenazi, Shai, Chang, Si Min, Drysdale, Simon, Koning, Sonia, Subramanian, Sreeram, Murki, Srinivas, Vergnano, Stefania, Gandra, Sumanth, Esposito, Susanna, Anugulruengkitt, Suvaporn, Puthanakit, Thanyawee, Behrends, Uta, Papaevangelous, Vana, Jian, Victoria, Li, Wei, Zhao, Wei, Wang, Wei, Zhang, Wenshuang, Mu, Xiaoping, Dong, Xiaoyie, Jiang, Xiyuan, Chen, Xu, Wang, Yi, Zheng, Yuejie, Horikoshi, Yuho, Aboderin, Aaron, Olayinka, Adebola, Dedeic-Ljubovic, Amela, McCorry, Ann, Enimil, Anthony, Neubert, Antje, solano, antonio, Pignatari, Antonio, Poojary, Aruna, Kambaralieva, Baktygul, McCullagh, Bernadette, Carevi, Biljana, Van Herendael, Bruno, Gormley, Cairine, Carvajal, Camila, Ramírez, Carlos, Fitzgerald, David, Sabuda, Deana, Konopnicki, Deborah, Lacej, Denada, Pierard, Denis, Rios, Edgar, Marshall, Emily, Firre, Eric, van Elzakker, Erika, Shaqiri, Erjona, Darwish Elhajji, Feras, Gawrys, Gerard, Markovic, Goran, Kunsihima, Hiroyuki, Chen, Hui Hiong, Sviestina, Inese, Pristas, Irina, Hoxha, Iris, Korinteli, Irma, Mareković, Ivana, Soltani, Jafar, Labarca, Jaime, AlSalman, Jameela, Horvatic, Jasminka, Frimpong, Juliet Ampomah, Pagava, Karaman, Kei, Kasahara, Okinaka, Keiji, Iregbu, Kenneth, Ghazaryan, Lilit, Raka, Lul, Gessner-Wharton, Mallory, Aldeyab, Mamoon, Cooper, Mandelin, del Castillo, Marcelo, Hojman, Martin, Hudson, Melissa, Alshehri, Mohamed, Ling, Moi Lin, Greer, Nickie, Oduyebo, Oyinlola, Buijtels, Patricia, TEROL BARRERO, PEDRO, Zarb, Peter, Schelstraete, PEtra, Nwajiobi-Princewill, Princewill Ifeanyi Philip, Khanna, Priya, Quiros, Rodolfo, Simovic, Sanja, Thompson, Sarah, Chan, Si Min, Burokiene, Sigita, Rachina, Svetlana, Usonis, Vytautas, Cornistein, Wanda, Holemans, Xavier, Gu, Yoshiaki, Brothers, Adam, Hersh, Adam, Fernandez, Alfred, Tribble, Alison, Hurst, Amanda, Green, Andrea, Hammer, Benjamin, Lee, Betty P, Kuzmic, Brenik, Shapiro, Craig, Boge, Craig, Haslam, David, Berman, David, Naeem, Fouzia, Johnson, George, Schwenk, Hayden, Orr, Hillary, Maples, Holly, Olsen, Jared, Gerber, Jeffrey, Girotto, Jennifer, Zweiner, Jennifer, Goldman, Jennifer, Gillon, Jessica, Tansmore, Jessica, Manaloor, John, Courter, Joshua, Mongkolrattanothai, Kanokporn, Patel, Karisma, Merkel, Kathryn, Namtu, Katie, Flett, Kelly, Lee, Kelly, Nichols, Kristen, Klein, Kristin, Handy, Lori, Castagnini, Luis, Mazade, Marc, Heger, Margaret, Fernandez, Marisol, Chang, Michael, Crawford, Michelle, Nelson, Miranda, Bennett, Nicholas, Jaggi, Preeti, Hamdy, Rana, Banerjee, Ritu, Olivero, Rosemary, Patel, Sameer, Arnold, Sandra, Ogrin, Sara, Jones, Sarah, Parker, Sarah, Kubes, Sarah, Hymes, Saul, Weissman, Scott, Chan, Shannon, Henderson, Sheryl, Metjian, Talene, Hsia, Yingfen, Lee, Brian R, Versporten, Ann, Yang, Yonghong, Bielicki, Julia, Jackson, Charlotte, Newland, Jason, Goossens, Herman, Magrini, Nicola, and Sharland, Mike

Published
2019
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9. COVID-19 related multisystem inflammatory syndrome in children (MIS-C): a hospital-based prospective cohort study from Kerala, India

Author

Tiwari, Arun, primary, Balan, Suma, additional, Rauf, Abdul, additional, Kappanayil, Mahesh, additional, Kesavan, Sajith, additional, Raj, Manu, additional, Sivadas, Suchitra, additional, Vasudevan, Anil Kumar, additional, Chickermane, Pranav, additional, Vijayan, Ajay, additional, John, Shaji Thomas, additional, CK, Sasidharan, additional, Krishnan, Raghuram A, additional, and Sudhakar, Abish, additional

Published
2021
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10. Use of the WHO Access, Watch, and Reserve classification to define patterns of hospital antibiotic use (AWaRe): an analysis of paediatric survey data from 56 countries

Author

Hsia, Yingfen, Lee, Brian R, Versporten, Ann, Yang, Yonghong, Bielicki, Julia, Jackson, Charlotte, Newland, Jason, Goossens, Herman, Magrini, Nicola, Sharland, Mike, Irwin, Adam, Akula, Akhila, Bamford, Alasdair, Chang, Amanda, da Silva, Andre, Whitelaw, Andrew, Dramowski, Angela, Vasudevan, Anil Kumar, Sharma, Anita, Justicia, Antonio, Chikkappa, Ashok, Slowinska-Jarzabek, Barbara, Rippberger, Bianca, Zhao, Changan, Tersigni, Chiara, Cheng, Chinglan, Harkensee, Christian, Jing, Chuamei, Zhu, Chunmei, Li, Chunyan, Tagliabue, Claudia, Epalza, Cristina, Jacqueline, Daglish, Tian, Daiyin, Jinka, Dasaratha, Gkentzi, Despoina, Dharmapalan, Dhanya, Benadof, Dona, Papadimitriou, Eleni, Iosifidis, Elias, Roilides, Emmanuel, Yarci, Erbu, Majda-Stanisławska, Ewa, Gowin, Ewelina, Chappell, Faye, Torres, Federico Martinon, Collett-White, Francis, Liu, Gang, Lu, Gen, Syrogiannopoulos, George, Pitsava, Georgia, Alvarez-Uria, Gerardo, Renk, Hana, Mahmood, Hana, Saxen, Harri, Finlayson, Heather, Green, Helen, Rabie, Helena, Kandraju, Hemasree, Zhang, Hong, Okokon, Ita, Cross, Jack, Herberg, Jethro, Li, Jianping, Zhang, Jiaosheng, Deng, Jikui, Liu, Jing, Qian, Jing, Yang, Jinhong, Sicińska, Joanna, Hübner, Johannes, Fukuoka, Kahoru, Yao, Kaihu, Cheung, Kaman, Ojeda, Karla, Kaffe, Katerina, Kreitmeyer, Katharina, Doerholt, Katja, Grimwood, Keith, Ledoare, Kirsty, Vazouras, Konstantinos, Shen, Kunling, Tang, Lanfang, Zhang, Lehai, Lin, Li, Ashkenazi-Hoffnung, Liat, Wu, Lijuan, Wang, Lijun, Teston, Lilian, Galli, Luisa, Speirs, Lynne, Tsolia, Maria, Hufnagel, Markus, Knuf, Markus, Duse, Marzia, Ding, Mingjie, Rozic, Mojca, Premru, Mueller, O'Connell, Natasha, Rieber, Nikolaus, Spyridis, Nikos, Tunga, Onkaraiah, Conejo, Pablo Rojo, McMaster, Paddy, Lumbiganon, Pagakrong, Pansa, Paola, D'Argenio, Patrizia, Moriarty, Paul, Nikolic, Petra, Wang, Ping, Paopongsawan, Pongsatorn, Cao, Qing, Deng, Qiulian, Laxminarayan, Ramanan, Kanithi, Ravishankar, Jimenez, Rodolfo, Cao, Sancheng, Singh, Sanjeev, Rees, Sarah, Praveen, Saroey, Kekomaki, Satu, Hackett, Scott, Ashkenazi, Shai, Chang, Si Min, Drysdale, Simon, Koning, Sonia, Subramanian, Sreeram, Murki, Srinivas, Vergnano, Stefania, Gandra, Sumanth, Esposito, Susanna, Anugulruengkitt, Suvaporn, Puthanakit, Thanyawee, Behrends, Uta, Papaevangelous, Vana, Jian, Victoria, Li, Wei, Zhao, Wei, Wang, Wei, Zhang, Wenshuang, Mu, Xiaoping, Dong, Xiaoyie, Jiang, Xiyuan, Chen, Xu, Wang, Yi, Zheng, Yuejie, Horikoshi, Yuho, Aboderin, Aaron, Olayinka, Adebola, Dedeic-Ljubovic, Amela, McCorry, Ann, Enimil, Anthony, Neubert, Antje, solano, antonio, Pignatari, Antonio, Poojary, Aruna, Kambaralieva, Baktygul, McCullagh, Bernadette, Carevi, Biljana, Van Herendael, Bruno, Gormley, Cairine, Carvajal, Camila, Ramírez, Carlos, Fitzgerald, David, Sabuda, Deana, Konopnicki, Deborah, Lacej, Denada, Pierard, Denis, Rios, Edgar, Marshall, Emily, Firre, Eric, van Elzakker, Erika, Shaqiri, Erjona, Darwish Elhajji, Feras, Gawrys, Gerard, Markovic, Goran, Kunsihima, Hiroyuki, Chen, Hui Hiong, Sviestina, Inese, Pristas, Irina, Hoxha, Iris, Korinteli, Irma, Mareković, Ivana, Soltani, Jafar, Labarca, Jaime, AlSalman, Jameela, Horvatic, Jasminka, Frimpong, Juliet Ampomah, Pagava, Karaman, Kei, Kasahara, Okinaka, Keiji, Iregbu, Kenneth, Ghazaryan, Lilit, Raka, Lul, Gessner-Wharton, Mallory, Aldeyab, Mamoon, Cooper, Mandelin, del Castillo, Marcelo, Hojman, Martin, Hudson, Melissa, Alshehri, Mohamed, Ling, Moi Lin, Greer, Nickie, Oduyebo, Oyinlola, Buijtels, Patricia, TEROL BARRERO, PEDRO, Zarb, Peter, Schelstraete, Petra, Nwajiobi-Princewill, Princewill Ifeanyi Philip, Khanna, Priya, Quiros, Rodolfo, Simovic, Sanja, Thompson, Sarah, Chan, Si Min, Burokiene, Sigita, Rachina, Svetlana, Usonis, Vytautas, Cornistein, Wanda, Holemans, Xavier, Gu, Yoshiaki, Brothers, Adam, Hersh, Adam, Fernandez, Alfred, Tribble, Alison, Hurst, Amanda, Green, Andrea, Hammer, Benjamin, Lee, Betty P, Kuzmic, Brenik, Shapiro, Craig, Boge, Craig, Haslam, David, Berman, David, Naeem, Fouzia, Johnson, George, Schwenk, Hayden, Orr, Hillary, Maples, Holly, Olsen, Jared, Gerber, Jeffrey, Girotto, Jennifer, Zweiner, Jennifer, Goldman, Jennifer, Gillon, Jessica, Tansmore, Jessica, Manaloor, John, Courter, Joshua, Mongkolrattanothai, Kanokporn, Patel, Karisma, Merkel, Kathryn, Namtu, Katie, Flett, Kelly, Lee, Kelly, Nichols, Kristen, Klein, Kristin, Handy, Lori, Castagnini, Luis, Mazade, Marc, Heger, Margaret, Fernandez, Marisol, Chang, Michael, Crawford, Michelle, Nelson, Miranda, Bennett, Nicholas, Jaggi, Preeti, Hamdy, Rana, Banerjee, Ritu, Olivero, Rosemary, Patel, Sameer, Arnold, Sandra, Ogrin, Sara, Jones, Sarah, Parker, Sarah, Kubes, Sarah, Hymes, Saul, Weissman, Scott, Chan, Shannon, Henderson, Sheryl, Metjian, Talene, GARPEC and Global-PPS networks, on behalf of the, GARPEC Network, Global-PPS Network, Children's Hospital, HUS Children and Adolescents, and Clinicum

Subjects
medicine.medical_specialty, Adolescent, medicine.drug_class, 030231 tropical medicine, Antibiotics, MEDLINE, Psychological intervention, CHILDREN, World Health Organization, Pediatrics, Essential medicines, 03 medical and health sciences, Antimicrobial Stewardship, 0302 clinical medicine, Antibiotic resistance, POINT PREVALENCE SURVEY, SURVEILLANCE, Medicine and Health Sciences, Medicine, Antimicrobial stewardship, Humans, 030212 general & internal medicine, Medical prescription, Child, Neonatal sepsis, business.industry, lcsh:Public aspects of medicine, STEWARDSHIP, Infant, Newborn, Infant, lcsh:RA1-1270, General Medicine, medicine.disease, 3142 Public health care science, environmental and occupational health, Drug Utilization, 3. Good health, Anti-Bacterial Agents, QUALITY INDICATORS, Family medicine, Child, Preschool, Health Care Surveys, Human medicine, business, Pharmacy Service, Hospital
Abstract

Summary: Background: Improving the quality of hospital antibiotic use is a major goal of WHO's global action plan to combat antimicrobial resistance. The WHO Essential Medicines List Access, Watch, and Reserve (AWaRe) classification could facilitate simple stewardship interventions that are widely applicable globally. We aimed to present data on patterns of paediatric AWaRe antibiotic use that could be used for local and national stewardship interventions. Methods: 1-day point prevalence survey antibiotic prescription data were combined from two independent global networks: the Global Antimicrobial Resistance, Prescribing, and Efficacy in Neonates and Children and the Global Point Prevalence Survey on Antimicrobial Consumption and Resistance networks. We included hospital inpatients aged younger than 19 years receiving at least one antibiotic on the day of the survey. The WHO AWaRe classification was used to describe overall antibiotic use as assessed by the variation between use of Access, Watch, and Reserve antibiotics, for neonates and children and for the commonest clinical indications. Findings: Of the 23 572 patients included from 56 countries, 18 305 were children (77·7%) and 5267 were neonates (22·3%). Access antibiotic use in children ranged from 7·8% (China) to 61·2% (Slovenia) of all antibiotic prescriptions. The use of Watch antibiotics in children was highest in Iran (77·3%) and lowest in Finland (23·0%). In neonates, Access antibiotic use was highest in Singapore (100·0%) and lowest in China (24·2%). Reserve antibiotic use was low in all countries. Major differences in clinical syndrome-specific patterns of AWaRe antibiotic use in lower respiratory tract infection and neonatal sepsis were observed between WHO regions and countries. Interpretation: There is substantial global variation in the proportion of AWaRe antibiotics used in hospitalised neonates and children. The AWaRe classification could potentially be used as a simple traffic light metric of appropriate antibiotic use. Future efforts should focus on developing and evaluating paediatric antibiotic stewardship programmes on the basis of the AWaRe index. Funding: GARPEC was funded by the PENTA Foundation. GARPEC-China data collection was funded by the Sanming Project of Medicine in Shenzhen (SZSM2015120330). bioMérieux provided unrestricted funding support for the Global-PPS.

Published
2019

11. New Particle Formation at a High Altitude Site in India: Impact of Fresh Emissions and Long Range Transport

Author

K. K. Dani, Vasudevan Anil Kumar, Govindan Pandithurai, Vyoma Singla, Adam Kristensson, and Subrata Mukherjee

Subjects
education.field_of_study, 010504 meteorology & atmospheric sciences, Particle number, Population, Air pollution, Cloud physics, 010501 environmental sciences, Effects of high altitude on humans, medicine.disease_cause, Atmospheric sciences, 01 natural sciences, Aerosol, medicine, Environmental science, Cloud condensation nuclei, Relative humidity, education, 0105 earth and related environmental sciences
Abstract

There is a lack of characterization of the aerosol population in Western India, how it is affected by meteorological parameters, and new particle formation and the influence on cloud condensation nuclei (CCN). For this reason, measurements of particle number size distribution, aerosol chemical composition, meteorology and cloud condensation nuclei number concentration were monitored at High Altitude Cloud Physics Laboratory (HACPL) in Mahabaleshwar mountain town in Western India between November 2016 and February 2017. Most air masses in this period originated from the Indian continent to the north-east of HACPL. New particle formation (NPF) events were observed on 47 days and mainly associated with these north-easterly air masses and high SO2 emissions and biomass burning activities, while weaker or non-NPF days were associated with westerly air masses and relatively higher influence of local air pollution. The growth of newly formed particles enhanced the mass concentration of secondary organic and inorganic species of aerosol particles. The mean growth rate, formation rate, condensation sink and coagulation loss for the 13 strongest events was found to be 2.58 ± 0.38 nm h−1, 2.82 ± 1.37 cm−3 s−1, 22.3 ± 2.87 * 10-3 s−1 and 1.62 ± 1.04 cm−3 s−1 respectively. A closer examination of 5 events showed that low relative humidity and solar radiation favoured new particle formation. These NPF events lead to a significant increase in CCN concentration (mean ~ 53 ± 36 %). The NanoMap method revealed that NPF took place up to several hundred kilometers upwind and to the north-east of HACPL.

Published
2018
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13. Molecular Characterization of Methicillin-Resistant Staphylococcus aureus Causing Fatal Purulent Pericarditis

Author

Vasudevan Anil Kumar, Eileen Thatcher, Raja Biswas, Nair Nisha, Rajesh Thachathodiyl, Shamsul Karim, Kavitha R Dinesh, and Aswathy Nandakumar

Subjects
medicine.medical_specialty, business.industry, multi-drug resistant, lcsh:R, lcsh:Medicine, Case Report, medicine.disease_cause, medicine.disease, Methicillin-resistant Staphylococcus aureus, Dermatology, Microbiology, Purulent pericarditis, Sepsis, Staphylococcus aureus, purulent pericarditis, medicine, Multi drug resistant, In patient, business, Pericardial disease
Abstract

Though pericardial disease is common in patients with renal disease, purulent pericarditis is very rare. We report a fatal case of purulent pericarditis and sepsis due to methicillin-resistant Staphylococcus aureus in a 78-year-old male with systemic hypertension and renal disease along with the molecular characterization of its resistant mechanism.

Published
2013
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14. Point Prevalence Surveys of Antimicrobial Use among Hospitalized Children in Six Hospitals in India in 2016.

Author

Gandra, Sumanth, Singh, Sanjeev K., Jinka, Dasaratha R., Kanithi, Ravishankar, Chikkappa, Ashok K., Sharma, Anita, Dharmapalan, Dhanya, Vasudevan, Anil Kumar, Tunga, Onkaraiah, Akula, Akhila, Garg, Garima, Hsia, Yingfen, Murki, Srinivas, Alvarez-Uria, Gerardo, Sharland, Mike, and Laxminarayan, Ramanan

Subjects
HOSPITAL care of children, DISEASE prevalence, ANTI-infective agents, HOSPITALS, DRUG resistance in bacteria
Abstract

The prevalence of antimicrobial resistance in India is among the highest in the world. Antimicrobial use in inpatient settings is an important driver of resistance, but is poorly characterized, particularly in hospitalized children. In this study, conducted as part of the Global Antimicrobial Resistance, Prescribing, and Efficacy in Neonates and Children (GARPEC) project, we examined the prevalence of and indications of antimicrobial use, as well as antimicrobial agents used among hospitalized children by conducting four point prevalence surveys in six hospitals between February 2016 and February 2017. A total of 681 children were hospitalized in six hospitals across all survey days, and 419 (61.5%) were prescribed one or more antimicrobials (antibacterials, antivirals, antifungals). Antibacterial agents accounted for 90.8% (547/602) of the total antimicrobial prescriptions, of which third-generation cephalosporins (3GCs) accounted for 38.9% (213/547) and penicillin plus enzyme inhibitor combinations accounted for 14.4% (79/547). Lower respiratory tract infection (LRTI) was the most common indication for prescribing antimicrobials (149 prescriptions; 24.8%). Although national guidelines recommend the use of penicillin and combinations as first-line agents for LRTI, 3GCs were the most commonly prescribed antibacterial agents (55/149 LRTI prescriptions; 36.9%). In conclusion, 61.5% of hospitalized children were on at least one antimicrobial agent, with excessive use of 3GCs. Hence there is an opportunity to limit their inappropriate use. [ABSTRACT FROM AUTHOR]

Published
2017
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15. Congenital Cystic Adenomatoid Malformation: A Tertiary Care Hospital Experience.

Author

Mehta AA, Viswanathan N, Vasudevan AK, Paulose R, and Abraham M

Abstract

Introduction: Congenital Cystic Adenomatoid Malformation (CCAM) is an uncommon developmental deformity affecting the terminal respiratory structures. It is characterized by broncho pulmonary foregut malformations. The reason behind it is an arrest in lung development between 4 th and 7 th week of fetal life., Aim: The present study was conducted to assess the clinical and radiological profile and also to study the role of surgical intervention in patients with CCAM., Materials and Methods: All patients with clinical suspicion or provisional diagnosis of CCAM were included in the study. A clinical questionnaire was prepared to collect data. Computed Tomography (CT) chest with High Resolution Computed Tomography (HRCT) was done for all the patients. Patients were assessed by paediatric surgeon and eligible patients were operated. The procedure conducted was usually open thoracotomy under general anaesthesia. The affected lobes were removed and specimens were sent for histopathological analysis. All included patients were followed up prospectively to find out about their current level of health. Via telephonic interview they were asked about their overall growth, quality of life, activity, rate of respiratory infections and requirement of hospital admission., Results: Total 15 patients with diagnosis of CCAM were included in the study. Of them, 8 (53.3%) were male. The commonest presentation was cough 13(86%), breathing difficulty 11(73%), fever 9(60%), recurrent pneumonia 4(26%), hypoxia requiring oxygen supplementation 6(40%), others 2(12%). Thirteen patients required surgical intervention and underwent lobectomy. There were 2 cases of type I, one each of type II and III, 3 case of type IV while 5 were intermediate type. There was no procedure related mortality. The median duration of hospital stay and all were successfully discharged with median duration of stay 11±16 days., Conclusion: The study concludes that if recognized early, surgical removal of affected lung prevents the complications like recurrent pulmonary infections. The surgery is well tolerated without any post-operative mortality or morbidity.

Published
2016
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