Antibiotic susceptibility in commonly isolated pathogens from urinary tract infection in a cohort of subjects from low socioeconomic strata

Background and Objective: Urinary tract infection is one of the commonest infections seen in clinical practice. Lack of compliance and unjustified antibiotic prescriptions has resulted in bacterial resistance and is proving as a major challenge in the management of these infections. Our aim was to identify the sensitivity pattern of commonly used antibiotics against urinary tract infections so as to suggest an improvised line of action against bacteria causing urinary tract infections

Method: This was a hospital based cross sectional study extended over a period of four months. Patients were recruited from outpatients department of a tertiary care hospital in an industrial area of Karachi. Adult patients with symptomatic and documented UTI in urine detailed report [pus cells >10] were enrolled after informed consent. A clean catch midstream urine was collected for culture and sensitivity testing using the standard microbiological procedure. Data is analyzed on SPSS 16

Results: A total of 184 samples were collected in 4 months. The Male to Female ratio was 1:2 [n=58/126] with mean age 48.5+/-12 years. 83[45.6%] patients were between 45-60 years. Most common isolated pathogen was Eschericia coli 108[59%] followed by staphylococcus aureus 30[16.4%] and Klebsiella 20[11%]. 55[30%] pathogens showed sensitivity to 4-6 antibiotics, 22[12%] strains to 7-9 antibiotics, 33[18%] were sensitive to

Conclusion: In this low socioeconomic cohort with UTI nearly half the isolated pathogens has shown resistance to most of the commonly used antibiotics recommended in the guidelines especially the floxacin group probably because of its unwarranted use. Therefore, a revised line of management should be developed locally in accordance with the susceptibility pattern of the urinary pathogens to avoid further resistance as well as morbidity of the patient

Anemia in hospitalized patient: prevalence, etiology and risk factors

Background: Anemia is seen in a large proportion of the population especially in developing countries. It poses a major challenge to improving the health indices especially in the female and pediatric populations. Anemia causes increased disability, morbidity and mortality. Presence of anemia prolongs hospital stay and increases the possibility of re-admission. The diagnosis and management of anemia in hospitalized patients will improve outcomes of this population

Objective: The objective of this study was to determine the prevalence of anemia, its etiology and its association with various risk factors

Study Design: Cross-sectional study

Place and Duration of Study: Department of Medicine, United Medical and Dental College, Karachi from May, 2016 to December, 2016

Methodology: All adult patients admitted in the medical wards of Creek General Hospital were included in the study. Anemia was defined as a hemoglobin of <13g/dl in males and <12g/dl in females. All anemic patients were taken as cases while non-anemic patients were taken as controls. Critically ill patients, patients with active bleeding and pregnant women were excluded from the study. The data was recorded on a detailed proforma, and the etiology, severity, type of anemia and associated factors were recorded. The data was presented as means with standard deviation for continuous variables and as percentages for categorical variables. Comparison of different factors with anemia was computed using SPSS 20.0. Chi-square and student t- test were used and p-value of <0.05 was considered significant

Results: Around 71% of the patients were found to be anemic. 72.5% of the female population and 67% of the male population were anemic. The commonest cause of anemia was infection. Majority of the women had microcytic anemia. There was no relationship of age, income, educational status, number of dependents and diet on the presence of anemia. In women anemia was significantly related to breast feeding and parity. Infectious diseases, nutritional deficiency and gastrointestinal loss were the most common causes of anemia in the studied population

Conclusion: Anemia is very common in hospitalized medical patients. Infection and nutritional deficiencies are the most cause of this anemia

most prevalent organism in diabetic foot ulcers and its drug sensitivity and resistance to different standard antibiotics

Objective: to find the most prevalent organism in diabetic foot ulcers and its drug sensitivity and resistance to different standard antibiotics

Study Design: a descriptive and cross-sectional study

Place and Duration of Study: ward 7, Jinnah Postgraduate Medical Center, Karachi, from December 2010 to December 2012

Methodology: ninety-five diabetic patients with infected foot wounds of Wegener grade 2 - 5 who had not received any previous antibiotics were included in the study by consecutive sampling. Pus culture specimen from wounds was taken and the organism isolated was identified. Also the most sensitive group of antibiotics and the most resistant one to that organism was noted

Results: staphylococcus aureus was the most prevalent organism constituting 23.16% [n=22] of the organisms isolated; Escherichia coli with 17.89% [n=17] and Klebsiella with 12.63% [n=12] followed. Males presented more with diabetic foot [n=52] out of 95 patients. The most common age group affected was 41 - 60 years [73 patients]. The organisms were most sensitive to Meropenem, effective in 90 [95%] patients and most resistant to Cotrimoxazole [80, 84% patients]. Out of the 95 patients, 39 [41%] patients were hypertensive, 30 [31.5%] were obese and 14 [15%] were smokers. Staphylococcus aureus was the most prevalent organism overall irrespective to gender, age groups and co-morbidity of the patients

Conclusion: staphylococcus aureus was the most frequent organism in diabetic foot ulcers; the most effective antibiotic is Meropenem and least effective is Cotrimoxazole

Obesity and Diabetes: an experience at a public sector tertiary care hospital

To detect the frequency of Obesity in type 2 diabetic patients. It was a Cross Sectional study carried out at Diabetes Clinic, Medical Unit III, Jinnah Postgraduate Medical Centre Karachi from 1[st] Jan 2012 to 30[th] June 2012. Three hundred and eighty seven [387] type II diabetic patients of either sex and any age were included in the study. Non-purposive convenience sampling technique was used to enroll patients in the study. History regarding diabetes, hypertension [HTN], Cerebrovascular Accidents [CVA], smoking and other tobacco exposure was taken. Physical examination was carried out and height, weight, body mass index [BMI], blood pressure, peripheral pulses and anklebrachial index [ABI] was calculated. Categorical variables such as Gender, Age groups, BMI groups, HTN, smoking, hyperlipidemia and ABI were expressed as frequencies and proportions. Means with standard deviations were calculated for continuous variables such as age, duration of diabetes, BMI, duration of HTN and duration dyslipidemia. For categorical variables, differences between patients were tested using the chi-square test. P value of