Publications by authors named "Durga S Meena"

Background: It is documented that COVID-19 survivors have prolonged morbidity and functional impairment for many years. Data regarding post-COVID-19 lung functions is lacking from the Indian population. We aim to evaluate the lung functions in such patients after 3-6 months of hospital discharge.

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Nosocomial bloodstream infections with multidrug-resistant microorganisms have become a common health threat in intensive care settings worldwide. Understanding antimicrobial resistance and the outcomes of these infections is crucial for addressing this issue. This study aimed to investigate the burden, antimicrobial resistance, and 28-day outcomes of nosocomial bloodstream infections in the intensive care unit.

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Background: Infective endocarditis (IE) due to nontuberculous mycobacteria (NTM) is a rare infection, and several outbreaks have been reported in the last 2 decades. However, the clinical spectrum is still poorly understood. This systematic review aimed to evaluate the clinical characteristics and outcomes in NTM IE.

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Article Synopsis
  • Tuberculosis is common in India, while Histoplasmosis is less reported; co-infection is rare but challenging to diagnose due to symptom overlap.
  • A 62-year-old man was diagnosed with both conditions, initially treated with appropriate medications, but experienced complications due to drug interactions.
  • Follow-up treatment adjustments led to significant improvement, highlighting the need for careful monitoring and awareness of potential drug interactions in similar cases.
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Background: Fungal infective endocarditis (IE) is a rare, yet increasingly recognised condition associated with substantial mortality rates. and are among the notable causative agents, presenting diverse clinical manifestations and complexities in diagnosis and management.

Objectives: This study was undertaken to examine the clinical profiles, diagnostic challenges, treatment modalities, and outcomes of four compelling cases involving and endocarditis.

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  • * The case report outlines four instances of extrapulmonary NTM disease in immunocompetent patients, with varied clinical outcomes ranging from meningitis and brain abscesses to cervical lymphadenopathy, highlighting misdiagnoses with tuberculosis.
  • * The findings emphasize the importance of awareness among clinicians regarding NTM disease, as early diagnosis and appropriate treatment are crucial for improving patient outcomes, especially for those with more severe infections.
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  • * A total of 103 adult patients with CRAB-related VAP were analyzed, comparing outcomes between those treated with dual and triple antibiotic combinations involving sulbactam.
  • * Results indicate that the triple therapy (sulbactam, polymyxin B, and minocycline) significantly reduced 28-day mortality and improved other health markers compared to the dual therapy, suggesting it may be a more effective treatment option.
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  • Idiopathic CD4 lymphocytopenia (ICL) is an immunodeficiency syndrome with persistent low CD4 counts and increased risk of opportunistic infections, notably including nocardiosis, which is rarely reported in ICL patients.
  • A 46-year-old woman with a history of pulmonary nocardiosis and ICL presented with symptoms after four years, where tests confirmed the presence of Nocardia otitidiscaviarum.
  • The case highlights the need for regular follow-up and CD4 count monitoring in ICL patients to prevent infections and emphasizes the relevance of secondary prophylaxis therapy following initial treatment.
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Mycotic aneurysms, characterized by vessel wall dilation resulting from infections including bacteria, fungi, and viruses, are a rare but severe consequence of systemic infections. The term 'mycotic' was coined by William Osler to describe the first instance of a fungal-induced infected aneurysm. These aneurysms, accounting for 0.

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Iliopsoas abscess is an infrequent condition characterized by the collection of pus in the iliopsoas compartment. The prevalence of the disease has been increasing in recent years with the emergence of various comorbidities and risk factors. The availability of newer imaging modalities has also improved the detection of new cases.

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Background: The landscape of Pseudomonas infective endocarditis (IE) is evolving with the widespread use of cardiac implantable devices and hospital-acquired infections. This systematic review aimed to evaluate the emerging risk factors and outcomes in Pseudomonas IE.

Methods: A literature search was performed in major electronic databases (PubMed, Scopus, and Google Scholar) with appropriate keywords and combinations till November 2023.

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Enteric fever is a major contributor to rising health care costs in developing countries. Associated disease-related complications and drug resistance further compound this problem. Hemophagocytic lymphohistiocytosis (HLH) is an uncommon complication of enteric fever with high morbidity and mortality.

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  • Gram-positive bloodstream infections (BSIs) are becoming a significant health issue, particularly in resource-limited areas, with high rates of antimicrobial resistance (AMR) complicating treatment options.
  • In a study conducted in Western India, 210 isolates were identified, revealing that about 29% of cases were healthcare-associated, with coagulase-negative staphylococci being the most common pathogen, and notable resistance to vancomycin and linezolid found in enterococci.
  • The overall mortality rate for these infections was 42.6%, with older age and MRSA infections identified as significant predictors of 30-day mortality.
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Organophosphorus (OP) poisoning is the most common type of poisoning in India. Amongst the OP, monocrotophos poisoning has the highest lethality and need for mechanical ventilation. Monocrotophos is also implicated in causing OP-induced intermediate syndrome, the prevalence of which is 10-40% of all OP poisoning.

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Background: CNS manifestations represent an emerging facet of NTM infection with significant mortality. Due to protean presentation and low index of suspicion, many cases are often treated erroneously as tubercular meningitis or fungal infections.

Objectives: Literature on NTM CNS disease is scarce, with most available data on pulmonary disease.

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Introduction: Carbapenem resistant gram-negative bacterial infections are a growing concern worldwide. However, India is already in the era of a shortage of effective antibiotics for the management of these infections. Moreover, Difficult-to-Treat Resistance (DTR) gram-negative infections, which are not much studied, further complicate the scenario.

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Background: Progress of the Integrated Disease Surveillance (IDSP) is of utmost importance to ensure optimal performance in Jodhpur, Rajasthan, India. The purpose of the study was to document the physical performance of the surveillance system on its core and support functions.

Material And Methods: Mixed method study was conducted between September 2020 to October 2020.

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Background: CNS actinomycosis is a rare chronic suppurative infection with non-specific clinical features. Diagnosis is difficult due to its similarity to malignancy, nocardiosis and other granulomatous diseases. This systematic review aimed to evaluate the epidemiology, clinical characteristics, diagnostic modalities and treatment outcomes in CNS actinomycosis.

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Septic shock due to in immunocompromised patients (particularly HIV) is a well-recognized clinical entity. However, tubercular sepsis in the immunocompetent is still underdiagnosed and under-discussed. Moreover, sepsis is usually associated with gram-negative and other gram-positive microorganisms that can cause similar pulmonary and disseminated disease and can further convolute the diagnosis.

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Purpose: Invasive cerebral aspergillosis (ICA) is a rare but fatal infection affecting neutropenic immunocompromised patients. Recently cases have been reported in non-neutropenic settings also. We hereby present a series of ICA cases in non-neutropenic patients diagnosed at our tertiary care centre in Western India between March to October 2021.

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Fungal endocarditis is a rare and fatal condition most frequently caused by species of the genera and . Fever and changing heart murmur are the most common clinical manifestations. The diagnosis of fungal endocarditis is challenging, with prosthetic valve endocarditis being extremely difficult to diagnose.

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Introduction: Hepatitis B virus (HBV) is known as a metabolovirus due to its impact on lipid and glucose metabolism in the liver. Previous literature showed a trend of hypolipidemia and reduced risk of metabolic syndrome in hepatitis B surface antigen-positive patients. However, data from the Indian population are lacking.

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The emergence of Mucorales infections is an urgent global public health threat rapidly disseminating during the current COVID-19 pandemic. Invasive mucormycosis carries significant morbidity and mortality; this is further compounded by the lack of newer effective antifungals on the horizon. Liposomal Amphotericin (L-AMB) is currently considered the cornerstone of antifungals therapy against mucormycosis; However, two decades later (since the introduction of L-AMB), the outcome remains dismal.

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Cases with SARS-CoV-2 RT-PCR negative pneumonia are an understudied group with uncertainty remaining regarding their treatment approach. We aimed to compare the clinical and radiological characteristics of RT-PCR positive and clinically diagnosed RT-PCR negative COVID-19. This was a single-centre retrospective study conducted at a tertiary care hospital in Western India.

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Progressive disseminated histoplasmosis (PDH) usually presents as fever, anemia, leukopenia, hepatosplenomegaly, lymphadenopathy and pulmonary symptoms. There are few reports on the association of idiopathic CD4 lymphocytopenia (ICL) with histoplasmosis. We describe a 65-year-old female presented with a history of fever, papulo-nodular rash and significant weight loss and diagnosed as progressive disseminated histoplasmosis.

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