Browsing by Author "Bharadwaj, Ragya"
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Item Isolation of Multi Drug Resistant Mycobacteria from Extrapulmonary samples in a Tertiary Care Hospital: A Retrospective Analysis(Society for Health Care & Research Development, 2018-03) Bharadwaj, Ragya; Quadros, Shawon; Faruqi, Nafis Ahmad; Pinto, Maria Jose Wiseman; Rodrigues, SavioBackground: Drug resistant tuberculosis has frequently been encountered in India. The prevalence of extrapulmonary multi drug resistant tuberculosis in this country is found to be 3% in new cases and 12-17% in treated cases, which needs to be evaluated. Settings and Design: A retrospective analysis of processed extrapulmonary tubercular samples in Intermediate Reference Laboratory of Department of Microbiology, Goa Medical College, was carried out over a period of one year, from November 2013 to October 2014. Methods: Lowenstein Jensen Media was used for culture processing of 202 samples from clinically suspected cases of extra-pulmonary tuberculosis patients. Drug susceptibility testing was done on the isolated strains using the economic variant of proportion method. Results: Out of 202 samples, 30 (14.85%) were observed to be culture positive for Mycobacterium tuberculosis of which six (21.43%) were found to be resistant to both Isoniazid and Rifampicin. Conclusion: With the advent of immunocompromised states, one has to be aware of multi drug resistant extra-pulmonary tuberculosis as a double edged sword. The early detection in such cases is a need of the hour to initiate prompt treatment.Item Landmark Based Femoral Central Venous Catheterization, A Reliable And Safe Method In Acute Burns Resuscitation: An Institutional Based Study(Society for Health Care & Research Development, 2018-07) Ali, Adil Mahmud; Bharadwaj, Ragya; Faruqi, Nafis AhmadBackground: Central Venous Catheterizations (CVC) is a standard method of intravenous access in resuscitation of acute severe burn patients, with the subclavian and internal jugular veins being preferred over the femoral vein. However the ease of placement and the decreased chance of life threatening complications make it an attractive and safe option for the burns physician. Aims: To study the efficacy femoral CVC in acute burns resuscitation. Methods: This is a prospective observational study conducted over a period of 2 years. Patients with acute severe burns were admitted, and landmark based femoral central venous catheter was placed for resuscitation. Results: A total of 300 femoral central lines were placed in 300 patients. In 84.66% patients the right femoral vein was used and 15.3% patients, left femoral vein was catheterized. In 65% patients catheterisation was done in one attempt while 34.33% patients required 2- 3 attempts. No use of ultrasound was required in any of our patients. The risk of catheter related blood stream infections due to femoral CVC was not higher when compared with CVC placement in other sites (subclavian/internal jugular). Conclusion: Landmark based femoral central venous catheterisation is a quick, reliable and safe method to attain venous access in acute severe burn patients with lesser chances of immediate life threatening complications when compared to other sites of placement.Item Use of Laboratory Risk Indicator for Necrotizing Fasciitis (LRINEC) Score in differentiating Necrotising Fasciitis cases from Soft tissue infections: A Prospective Study(Society for Health Care & Research Development, 2018-05) Bharadwaj, Ragya; Ali, Adil Mahmud; Faruqi, Nafis AhmadBackground: Necrotising fasciitis is a progressive, fulminant, inflammatory infection of deep fascia with secondary necrosis of subcutaneous tissue. The present study was carried out to evaluate the usefulness of LRINEC score to differentiate Necrotising fasciitis (NF) from other soft tissue infections (STI). Methods: Ours was a prospective observational study carried out in a tertiary care setting over a period of one year from November 2013 to November 2014. 150 patients of soft tissue infections were included. Clinical evaluation was done based on the signs and symptoms which included a rapidly progressive oedema, bullae, blue-grey cyanotic lesions, erythema and necrotic patches. The Laboratory Risk Indicator for Necrotizing Fasciitis (LRINEC) score including Haemoglobin count, Total leucocyte count, C - reactive protein, Platelet count, Fasting blood sugar and Serum sodium, was calculated for all the patients. Results: Among 150 patients with soft tissue infection, 108 (72%) patients were clinically proven to be NF, rest 42(28%) were soft tissue infections. Based on LRINEC score out of 42 STI, 15 % had moderate to high risk of NF while out of the 108 confirmed NF cases 55 % had low to moderate risk of NF. Conclusion: The low sensitivity and low positive predictive value achieved in this study as well as other studies makes the LRINEC score unsuitable to be used solely to distinguish NF with other soft tissue infections