Browsing by Author "Modi, C"

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    Importance of Urine Culture and Antibiotic Sensitivity for Improving Clinicians’ Choice in Treating Urinary Tract Infections
    (Journal of Indian Medical Association, 2024-12) Mannari, JG; Kanjariya, G; Shah, MK; Modi, C; Ganjiwale, J.
    Background: The local antibiogram is essential to prevent the development of multidrug-resistant organisms. The aim of the study was to find out the synchronization of empirical antibiotics with the sensitivity pattern of the urine culture report and to study the differences in the organisms and sensitivity patterns in urinary tract infection (UTI) with and without other comorbidities. Materials and methods: UTI, diagnosed by a positive urine culture report of 300 consecutive patients above the age of 18, was studied retrospectively. The data were processed using the statistical software STATA 14. Results: Out of 300 patients, 58.3% were females. The mean [standard deviation (SD)] age was 54.19 (19.06) years. The most common associated comorbidity was diabetes mellitus (DM) (34.7%). Lower urinary tract symptoms (LUTS) were the most common presenting symptom, followed by dysuria and fever. The most common organism was Escherichia coli in both nondiabetic and diabetic patients (67.3% and 60.6%). Comparing diabetics and nondiabetics, recurrent UTI (15.4 vs 5.1%), infection with extended-spectrum beta-lactamase (ESBL) organisms (67.3 vs 51.5%), and prolonged hospitalization (75 vs 61.2%) were observed more in diabetics. The most common empirical antibiotic chosen was cefoperazone-sulbactam in the diabetic group and levofloxacin in the nondiabetic group. Empirical antibiotics in diabetics matched with the sensitivity in 57.1% of ESBL cases and 47% of non-ESBL cases, while in nondiabetics, this alignment was 40.5% in ESBL cases and 61% in non-ESBL cases. Resistance to oral fluoroquinolone, cotrimoxazole, and nitrofurantoin was 78, 59.3, and 39.6%, respectively, while resistance to meropenem and amikacin was 35.6 and 25.6%. Conclusion: The increasing prevalence of ESBL-positive strains and rising resistance to common antimicrobial drugs raise concerns for future therapeutic options.
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    Primary anaplastic large cell lymphoma of central nervous system--a case report.
    (2005-10-03) Rupani, A; Modi, C; Desai, S; Rege, J
    Central nervous system (CNS) involvement is extremely rare in anaplastic large cell lymphoma (ALCL). Primary ALCL of CNS on radiology is often misdiagnosed as tuberculosis. We report a fatal case of primary ALCL of CNS in a 17 year old male. He came with history of headache and left partial seizures. MRI showed a well- circumscribed lesion in the right fronto-parietal lobe eroding the skull bone. Biopsy showed large pleomorphic cells. Immunohistochemical stains showed positivity for CD30, CD43, EMA and ALK-1. In spite of radiotherapy and steroids, patient expired. Hence a high level of suspicion is essential for early diagnosis and for instituting appropriate treatment.