Good survival rate, moderate overall and good respirator quality of life, near normal pulmonary functions, and good return to work despite catastrophic economic costs 6 months following recovery from Acute Respiratory Distress Syndrome.

Introduction: Long-term quality of life, return to work, economic consequences following Acute Respiratory Distress Syndrome (ARDS) are not well described in India. This study was aimed to address the question.

Methods: A prospective cohort study of 109 ARDS survivors were followed up for a minimum of 6 months following discharge.

A Hospital-Based Nonconcurrent Cohort Study on Factors Associated with in-Hospital Mortality in Patients with Laboratory Confirmed Influenza.

Background And Aim: Influenza is a disease with varied clinical presentation and varied mortality reported in existing literature. The study aimed to determine the factors associated with mortality in patients hospitalized with influenza infection.

Materials And Methods: This was a 5-year nonconcurrent cohort study done in a tertiary care center in Southern India.

Clinical Profile and Outcome of Critically Ill Patients with Tuberculosis.

Aim And Objective: Although studies have described the clinical profile of patients admitted to the intensive care unit (ICU) with tuberculosis, it is unclear if the type of tuberculosis (pulmonary, extrapulmonary, or disseminated) impacts outcome.

Matrials And Methods: Demographic data, microbiology, treatment, and outcomes over 5 years (2012-16) were obtained from electronic records. Patients were categorized as pulmonary, extrapulmonary, or disseminated tuberculosis.

Performance of molecular and serologic tests for the diagnosis of scrub typhus.

Diagnosis of scrub typhus, caused by the bacterium Orientia tsutsugamushi, is challenging because of the overlap of its non-specific symptoms with other infections coupled with the lack of sufficient data on the performance of diagnostic tests. Early diagnosis of scrub typhus is crucial to improve outcomes and this study evaluates the diagnostic performance of various tests. The present study aims at assessing the accuracy of various rapid diagnostic tests, serologic tests, and nucleic acid amplification methods on well-characterized patient samples.

Tuberculous ARDS is associated with worse outcome when compared with non-tuberculous infectious ARDS.

Background: Patients with tuberculosis (TB) developing acute respiratory distress syndrome (ARDS) may have a higher mortality when compared with ARDS of other infectious etiology.

Methodology: In this single-centre retrospective cohort study spanning 5-years (2012 to 2016), TB-ARDS patients were age and gender matched (1:2) with non-TB infectious ARDS and followed up until death or hospital discharge. Clinical profile, treatment and outcomes were compared using t-test and Chi-square as appropriate.

Clinical spectrum, aetiology and predictors of acute febrile encephalopathy at a tertiary hospital in south India - A prospective observational study.

Acute febrile encephalopathy is a common syndrome in the tropics with high mortality encountered by emergency physicians. In order to study the aetiology of acute febrile encephalopathy and its mortality and functional outcome over one year, data on all patients >18 years of age with short duration of fever (<14 days) and altered mental status were collected and followed up until one month after discharge. Non-infectious aetiology, found in 29%, portends a poor outcome.

A fatal case of levamisole induced bone marrow failure.

A 20-year-old college student presented with high grade, intermittent fever for 10 days associated with blood stained loose stools after taking tablet levamisole for 17 days for vitiligo vulgaris. He was febrile, had a toxic appearance and appeared pale. Investigations showed neutropaenia with thrombocytopaenia.

Role of Diagnostic Splenectomy in Patients Presenting with Pyrexia of Unknown Origin with Splenomegaly and Non-Contributory Pre-surgical Evaluation.

Aims: To describe the clinical and laboratory profile, post-surgical complications and longitudinal outcomes in a historical cohort of pyrexia of unknown origin (PUO) patients with splenomegaly who underwent a diagnostic splenectomy following non-contributory extensive pre-surgical laboratory and radiological evaluation.

Materials And Methods: This retrospective study was conducted in a 2700 bed teaching hospital in South India, in eligible patients, over a 10-year period.

Results: Out of 38 PUO patients who underwent diagnostic splenectomy, a final diagnosis was established in 30 patients.

Will ceftazidime/avibactam plus aztreonam be effective for NDM and OXA-48-Like producing organisms: Lessons learnt from study.

Introduction: Carbapenem resistance (CR) in Klebsiella pneumoniae is mainly mediated by bla NDM and bla OXA-48 carbapenemases. Newer Food and Drug Administration-approved antimicrobial ceftazidime/avibactam (C/A) has a potent activity against bla OXA-48-like producers. However, its activity is limited in organisms co-producing bla NDM and bla OXA-48-like.

Direct cost of illness for dengue in hospitalized children and adults at a referral hospital in India.

Objectives: To describe the direct cost of illness in pediatric and adult inpatients at a referral hospital in India.

Methods: Inpatients who tested positive for dengue were identified in the hospital records of a single private non-profit hospital over a period of 1 year and line-listed. Hospital discharge bills were obtained for pediatric and adult patients and the median costs by severity of illness for bed and treatment were estimated.

Visceral leishmaniasis with haemophagocytic lymphohistiocytosis.

A 27-year-old man presented with high-grade intermittent fever for 4 months, generalised fatigue for 2 months, intermittent gum bleeds for 1 month and loss of weight of 15 kg. He appeared cachectic with generalised wasting, had pallor and features of reticuloendothelial system proliferation. His liver span was 17 cm.

Risk Factors for Acquiring Scrub Typhus among the Adults.

Background: Behavioral and geographical factors may play a role in the acquisition of scrub typhus infection. In this prospective case-control study, we studied the factors associated with infection.

Patients And Methods: Consecutive adult patients admitted with scrub typhus infection over 10 months were recruited.

Mycobacterial blood culture as the only means of diagnosis of disseminated tuberculosis in advanced HIV infection.

The diagnosis of disseminated tuberculosis (TB) in advanced HIV infection is often delayed because of difficulty in obtaining suitable specimens for culture. A total of 32 such patients from South India with positive mycobacterial blood cultures were studied over ten years. Almost all (90%) had a febrile illness and the majority (68.

Renal cell carcinoma presenting as a cutaneous horn and nodules on the gingiva and scalp.

A 63-year-old man presented with a pulsatile cutaneous horn on the nose and multiple angiomatous nodules on the gingiva and scalp, which appeared over 2 months. He had severe hypercalcaemia, lytic lesions in multiple bones and acute kidney injury. Excision biopsy from the gingival nodule showed a clear cell neoplasm.

Scrub typhus in pregnancy: Maternal and fetal outcomes.

Scrub typhus is an important unrecognized cause for undifferentiated acute febrile illness in India associated with poor fetal outcomes. Maternal and fetal outcomes among pregnant patients with scrub typhus presenting to a tertiary care university teaching hospital from January 2010 to July 2012 were studied. Scrub typhus was diagnosed by clinical criteria along with scrub ELISA positivity or an eschar.

Cost-utility in medical intensive care patients. Rationalizing ongoing care and timing of discharge from intensive care.

Rationale: Intensive care unit (ICU) treatment costs pose special challenges in developing countries.

Objectives: To determine the prognostic value of the "utility" score and evaluate the relationship of willingness to pay assessment to utility score during ICU admission.

Methods: We performed a prospective study spanning 12 months in a 24-bed medical ICU in India.

Cytomegalovirus reactivation in drug induced hypersensitivity syndrome.

Drug induced hypersensitivity syndrome has been reported to a variety of drugs. Reactivation of herpes viruses is associated with relapse of symptoms even as late as five weeks after stopping the inciting drug. We report here a case of drug hypersensitivity with CMV reactivation which was treated successfully.

Rhino-orbital-cerebral infection by Syncephalastrum racemosusm.

Invasive rhino-sinusitis infection has been known to be caused by zygomycetes commonly belonging to the genera Rhizopus, Mucor and Rhizomucor. We report a middle aged diabetic gentleman who had invasive rhino-orbital-cerebral infection with Syncephalastrum racemosum. This genera belonging to zygomycetes group of fungi which usually causes skin and soft tissue infection but invasive infection with this fungus is rarely known.

Salmonella typhi rib osteomyelitis with abscess mimicking a 'cold abscess'.

Salmonella enterica serovar typhi (Salmonella typhi) causing typhoid fever is common in many parts of the world particularly in developing countries. Extra-intestinal manifestations such as osteomyelitis are rare in immunocompetent individuals. We report a case of Salmonella typhi osteomyelitis of a rib with overlying abscess mimicking a 'cold abscess', treatment outcomes and discuss relevant literature.

A rare case of cryptococcal infection of talus with pathological fracture that healed with medical management.

Skeletal involvement occurs in 5% to 10% of reported cases of disseminated cryptococcal infection. We are reporting a very rare presentation of cryptococcal infection of the talus with pathological fracture, which healed with medical management. Our patient had pain and swelling around the ankle associated with fever.