RESUMO
Patients with cognitive deficits have a prolonged latency and reduced amplitude of the P300 wave. However, no study has correlated P300 wave alterations with the cognitive performance of patients with cerebellar lesions. We aimed to determine if the cognitive status of these patients was associated with P300 wave alterations. We recruited 30 patients with cerebellar lesions from the wards of the N.R.S. Medical College, Kolkata, in West Bengal (India). The Kolkata Cognitive Screening Battery tasks and the Frontal Assessment Battery (FAB) were used to assess the cognitive status and the International Cooperative Ataxia Rating Scale (ICARS) for cerebellar signs. We compared the results with the normative data of the Indian population. Patients had P300 wave alterations with a significant increase in latency and a non-significant trend in amplitude. In a multivariate model, P300 wave latency was positively associated with the ICARS kinetic subscale (p = 0.005) and age (p = 0.009), regardless of sex and years of education. In the model that included cognitive variables, P300 wave latency was negatively associated with performance in phonemic fluency (p = 0.035) and construction (p = 0.009). Furthermore, P300 wave amplitude was positively associated with the FAB total score (p < 0.001). In closing, patients with cerebellar lesions had an increase in latency and a decrease in the amplitude of the P300 wave. These P300 wave alterations were also associated with worse cognitive performance and some of the subscales of the ICARS, reinforcing that the cerebellum has motor, cognitive, and affective functions.
RESUMO
BACKGROUND: Indiscriminate use of antibiotics in urinary tract infections have led to emergence of 'superbugs' worldwide. Periodical review of antibiograms is of utmost importance for optimum patient benefit. OBJECTIVE: To identify the spectrum of organisms responsible for urinary tract infection and evaluate the pattern of antibiotic sensitivity of the organisms. METHODS: Urine samples were collected from all consecutive patients getting admitted in the medicine indoor irrespective of symptomatology. The clean-catch technique of midstream urine was used for patients able to void spontaneously while specimens of catheterized patients were obtained prior to catheter change. All samples were sent for routine examination as well as culture sensitivity tests. Descriptive statistical methods were used with the help of SPSS-15th version. RESULTS: The total number of patients was 262, 160 (60.3%) were male and 102 (39.7%) female. The age of the subjects varied from 18 to 85 years. Significant bacteruria was found in 35.9% patients. The commonest organisms isolated overall were E coli (59.6%) followed by enterococcus spp (14.9%) and Klebsiella (10.6%). Among catheterized subjects apart from E coli (64%), Klebsiella was found to be commoner (12%) than Enterococcus 10%. Most Enterobactereacae showed good response to aminoglycosides, cephoperazone sulbactam and nitrofurantoin. However, organisms like Enterobacter, Citrobacter, Morganella and pseudomonas were poorly responsive to the above and required higher antibiotics like carbapenems, and polymixin B. Staph. aureus was responsive to linezolid and vancomycin only. CONCLUSIONS: The progression of resistance of common urinary pathogens to higher antibiotics is an inexorable process. Our study reveals that new generation cephalosporins, quinolones and macrolides cannot keep up with the rapidity of emergence of multiresistant strains.