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ABSTRACT Introduction: With the abundant use of the internet, patients undergoing or interested in orthodontic treatment try to use it to obtain information on pain during treatment. However, YouTube™ is unregulated and may potentially contain inaccurate information. Objectives: Thus, this study aimed to evaluate the scientific quality of the videos on YouTube™ related to orthodontic pain management. Methods: A total of 62 videos related to orthodontic pain management were included in the study. All videos were evaluated by two experienced orthodontists. The video uploader, content, length, upload date, time since upload, number of views, comments, likes, dislikes, Interaction index, and Viewing rate of the videos were recorded and evaluated. The videos were scored using the Quality Criteria for Consumer Health Information (DISCERN), Global Quality Scale (GQS), and Audio-Visual Quality (AVQ), and divided into two groups: Doctors and Non-doctors. Results: The mean DISCERN score was 2.56 ± 0.91, the GQS score was 2.56 ± 1.06, and AVQ was 2.48 ± 0.68. A statistically significant difference was found in DISCERN score of videos uploaded by Doctors compared to Non-doctors, but no statistically significant difference was found in GQS and AVQ scores between both groups (p> 0.05). Conclusions: The videos uploaded by Doctors were better in terms of quality and reliability, as compared to Non-doctors; and the AVQ of the videos uploaded by both groups was adequate. Despite that, both groups did not serve as a good source of information. YouTube™ cannot be considered a reliable source of information in terms of quality and reliability on videos related to orthodontic pain management.
RESUMO Introdução: Com o uso abundante da Internet, os pacientes em tratamento ortodôntico, ou interessados em fazê-lo, tentam usá-la para obter informações sobre a dor durante o tratamento. Entretanto, o YouTube™ não é regulamentado e pode conter informações imprecisas. Objetivos: Esse estudo teve como objetivo avaliar a qualidade científica de vídeos no YouTube™ relacionados ao controle da dor ortodôntica. Métodos: No total, 62 vídeos relacionados ao controle da dor ortodôntica fora incluídos nesse estudo. Todos os vídeos foram avaliados por dois ortodontistas experientes. O responsável pela postagem do vídeo, seu conteúdo, sua duração, data de postagem, tempo decorrido desde a postagem, o número de visualizações, os comentários, os likes, os deslikes, o índice de interação e a taxa de visualização dos vídeos foram registrados e avaliados. Os vídeos foram pontuados usando os Critérios de Qualidade para Informações sobre Saúde do Consumidor (DISCERN), a Escala de Qualidade Global (GQS) e a Qualidade Audiovisual (AVQ), e divididos em dois grupos: Doutores e Não Doutores. Resultados: A pontuação DISCERN média foi de 2,56 ± 0,91, a pontuação GQS foi de 2,56 ± 1,06 e a AVQ foi de 2,48 ± 0,68. Foi encontrada uma diferença estatisticamente significativa na pontuação DISCERN dos vídeos postados por Doutores, em comparação com os Não Doutores, mas não foi encontrada diferença estatisticamente significativa nas pontuações GQS e AVQ entre os dois grupos (p> 0,05). Conclusões: Os vídeos postados pelos Doutores foram melhores em termos de qualidade e confiabilidade, em comparação com os Não Doutores, e o AVQ dos vídeos postados por ambos os grupos foi adequado. Apesar disso, ambos os grupos não serviram como uma boa fonte de informações. Em termos de qualidade e confiabilidade dos vídeos relativos ao manejo da dor ortodôntica, o YouTube™ não pode ser considerado uma fonte confiável de informações.
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To compare the in vitro efficacy of meropenem, colistin and tigecycline against extended spectrum Beta-lactamase producing Gram negative bacilli by minimal inhibitory concentration. Cross-sectional descriptive study. Department of Microbiology, Army Medical College, National University of Sciences and Technology, Rawalpindi, from June to December 2010. Routine clinical specimens were subjected to standard microbiological procedures and the isolates were identified to species level. Extended spectrum beta-lactamase producing Gram negative bacilli were detected by Jarlier disc synergy method and confirmed by ceftazidime and ceftazidime-clavulanate Etest. Minimum Inhibitory Concentration [MIC[90]] of meropenem, colistin and tigecycline was determined by Etest [AB BIOMERIUX] and the results were interpreted according to the manufacturer's instructions and Clinical and Laboratory Standards Institute guidelines and Food and Drug Authority recommendations. Results were analyzed by using Statistical Package for the Social Sciences version 20. A total of 52 non-duplicate extended spectrum Beta-lactamase-producing Gram negative bacilli were included in the study. The MIC[90] of tigecycline [0.75 microg/ml] was lowest as compared to the meropenem [2 microg/ml] and colistin [3 microg/ml]. Tigecycline is superior in efficacy against the extended spectrum Beta-lactamase producing Gram negative bacilli as compared to colistin and meropenem
Subject(s)
Thienamycins , Colistin , Minocycline , Microbial Sensitivity Tests , Cross-Sectional Studies , In Vitro Techniques , Gram-Negative Bacteria/drug effectsABSTRACT
Multi-drug resistant bacteria are an important cause of mortality and morbidity. In the management of various infections, timely detection and appropriate treatment, in accordance with the culture and sensitivity reports can help improve the treatment outcome. Colistin is a bactericidal antibiotic which is emerging as a reliable solution for treating infections with multi-drug resistant Gram negative bacilli. The aim of this study was to find out the in-vitro efficacy of colistin against multidrug resistant Pseudomonas aeruginosa isolates by minimum inhibitory concentration. This cross sectional, descriptive study was conducted in the Department of Microbiology, Army Medical College, National University of Sciences and Technology, Islamabad from February 2010 to January 2011. Antimicrobial sensitivity testing was done on Pseudomonas aeruginosa isolated from routine clinical specimens received and the strains which appeared resistant to at least one antimicrobial agent in three or more anti-pseudomonal antimicrobial categories were subjected to the Colistin Etest. The MIC endpoint of colistin was read, as per manufacturer's instructions [AB Biodisk, Solna, Sweden]. The isolates showing MIC of 2micro.g/ml or less were considered sensitive, those with 4-6 micro.g/ml as intermediate and >/= 8 micro.gg/ml as resistant. MIC[50] and MIC[90] of colistin against MDR Pseudomonas aeruginosa was determined. A total of 52 MDR Pseudomonas aeruginosa strains were isolated during the period of the study. The highest percentage was isolated from urine [36%] followed by respiratory tract infections [18%] and pus specimens [20%]. The highest percentage of these isolates was found to be susceptible to colistin followed by piperacillin-tazobactam and cefoperazone-sulbactam. A total of 36 [69%] isolates were sensitive, 10 [20%] were intermediate and 6 [11%] were resistant to colistin by Kirby Bauer disc diffusion method. MIC[50] was found to be l.0 micro.gg/ml while MIC[90] was 3.0 micro.gg/ml. Colistin is a reliable solution in cases of infections with MDR, XDR or PDR Pseudomonas aeruginosa
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Colistin , Drug Resistance, Multiple , Microbial Sensitivity Tests , Cross-Sectional StudiesABSTRACT
To compare the sensitivity and specificity of different phenotypic methods for detection of Amp C beta-lactamase producing bacteria. Analytical study. Department of Microbiology, Army Medical College / National University of Sciences and Technology [NUST], Islamabad, Pakistan, from June 2010 to December 2010. A total of 150 clinical isolates were screened for presence of Amp C beta-lactamase by using the cefoxitin disc. The confirmatory methods evaluated were inhibitor based assay [boronic acid], Amp C disc test and Amp C Etest. Three dimensional enzyme extract assay was used as the reference method for determining the sensitivity and specificity. Among the total isolates tested, 62.8% bacteria showed the presence of Amp C beta-lactamase by standard three dimensional enzyme extract assay. Among the three methods compared, boronic acid disk test found out to be highly sensitive [88%] and specific [92%] for the detection of Amp C beta-lactamase producing bacteria. Detection of Amp C production is crucial in order to establish the antibiotic therapy and to attain the favourable clinical outcomes. Implementation of simple tests like boronic acid disk tests in the laboratories will help to alleviate the spread of Amp C beta-lactamase harboring organisms
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To determine the frequency of various blood groups in the population of Lehtrar road Islamabad and to compare the results with national and international studies. This cross sectional observational study was conducted at Rawal Institute of Health Sciences [RIHS], from Nov 01, 2011 till Nov 30, 2012. A total of 1,739 subjects including both male and females were analyzed. Blood was collected and ABO and Rh blood groupings were carried out by standard tube method using commercially prepared antisera and frequency of ABO and RhD blood groups was determined. Among ABO blood groups the most frequent was B [33.5%], followed by O [31.3%], A [22.5%] and AB [12.41%], group respectively. Among Rh +ve cases, blood group B was the most frequent with 542 [31.1%] individuals; however among Rh -ve individuals the most frequent blood group was O [63[3.6%]]. The current study revealed that blood group B is the most frequent blood group among the ABO blood group system with dominant RhD positivity in this region
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Aims: Infections due to metallo-β-lactamase (MBL) producing Gram negative rods are a cause of high mortality and morbidity. Early detection by an economical and accurate method may improve patient outcome. This study was aimed to evaluate the diagnostic accuracy of combined disc method for MBL detection by comparing it with MBL-Etest. Methodology and Results: This cross-sectional, validation study was carried out in the Department of Microbiology, Army Medical College, National University of Sciences and Technology, Rawalpindi, over a period of six months. A total of 52 non-duplicate Gram-negative rods isolated from the routine clinical specimens and found resistant to meropenem/imipenem on Kirby Bauer Disc Diffusion method were subjected to two tests for metallo-β-lactamase detection. One was combined Disc test using imipenem with Ethylene Diamine Tetraacetic Acid (EDTA), where a strain showing an increase in zone of inhibition of combined disc of ≥ 7 mm as compared to imipenem alone, was considered as MBL producer and the other one was MBL-Etest for which results were interpreted as per manufacturer’s guidelines. Combined disc method for MBL detection was found to have a sensitivity, specificity, positive predictive value, negative predictive value and accuracy of 97.5%, 100%, 100%, 92% and 98%. Conclusion, Significance and Impact of study: Combined disc method is an economical and reliable method for metallo-β-lactamase detection which can be used routinely in any laboratory.
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Microorganisms adhere to non-living material or living tissue, and form biofilms made up of extracellular polymers/slime. Biofilm-associated microorganisms behave differently from free-floating bacteria with respect to growth rates and ability to resist antimicrobial treatments and therefore pose a public health problem. The objective of this study is to detect the prevalence of biofilm producers among Gram positive and Gram negative bacteria isolated from clinical specimens, and to study their antimicrobial susceptibility pattern. The study was carried out from October 2009 to March 2010, at the Department of Microbiology, Army Medical College/ National University of Sciences and Technology (NUST), Rawalpindi, Pakistan. Clinical specimens were received from various wards of a tertiary care hospital. These were dealt by standard microbiological procedures. Gram positive and Gram negative bacteria isolated were subjected to biofilm detection by congo red agar method (CRA). Antimicrobial susceptibility testing of those isolates, which showed positive results (slime production), was done according to the Kirby-Bauer disc diffusion technique. A total of 150 isolates were tested for the production of biofilm/slime. Among them, 81 isolates showed positive results. From these 81, 51 were Gram positive and 30 were Gram negative. All the 81(54%) slime producers showed reduced susceptibility to majority of antibiotics. Bacterial biofilms are an important virulence factor associated with chronic nosocomial infection. Detection of biofilm forming organisms can help in appropriate antibiotic choice.
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To find out the frequency and susceptibility pattern of multi-drug resistant [MDR] Pseudomonas aeruginosa in clinical specimens. Cross-sectional observational study. Department of Microbiology, Army Medical College, National University of Sciences and Technology [NUST], Rawalpindi, from January to September 2010. Routine clinical specimens were subjected to standard microbiological procedures and the isolates were identified to the species level. The antibiotics susceptibility was determined by Kirby Bauer Disc diffusion method and the results were interpreted according to the Clinical and Laboratory Standards Institute [CLSI] guidelines. The frequency of MDR Pseudomonas aeruginosa among all the Pseudomonas aeruginosa strains isolated was found to be 22.7%. These isolates were most sensitive to Colistin followed by Piperacillin-Tazobactam and Cefoperazone-Sulbactum. Increasing fequency of infections due to MDR Pseudomonas aeruginosa is an emerging threat in our set up which can be prevented by prescribing antibiotics judiciously and by adopting proper disinfection measures
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Amp C beta-lactamases are cephalosporinases which hydrolyze cephamycins and are poorly inhibited by clavulanic acid. Amp C beta-lactamases confer resistance to a wide variety of antibiotics and pose both diagnostic and therapeutic challenges. The objective was to detect the frequency and antibiotic susceptibility pattern of Amp C beta-lactamase producing bacteria isolated from a tertiary care hospital of Pakistan. Organisms were isolated from various clinical specimens. First, the screening of the isolates was done by using cefoxitin disc. Screen-positive organisms were subjected to three dimensional extract test for detection of Amp C beta-lactamases. From a total of 100 organism tested, 64 organisms were positive on cefoxitin screen test. Out of these 64, 40 [62.5%] showed the presence of Amp C beta-lactamase. [E.coli n=18, K.pneumoniae n=14, K.oxytoca n=1, Enterobacter species n=5, Citrobacter freundii n=2] by three dimensional extract test. The antibiotics found out to show good activity against these resistant bacteria include meropenem and tigecycline. This is the first study to determine the frequency of Amp C beta lactamases from Pakistan. This study shows a high frequency of Amp C beta-lactamase producing isolates from a hospital, which may lead to serious therapeutic problems
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Humans , Drug Resistance, Microbial , Microbial Sensitivity Tests , HospitalsABSTRACT
Emergence of multidrug-resistant strains of Shigella is a growing concern across the globe. Third-generation cephalosporins are used for treating infections caused by multidrug-resistant Shigellae. However, resistance to these cephalosporin antibiotics due to extended-spectrum beta-lactamases, has emerged as a new problem. So far extended-spectrum beta-lactamases producing Shigella has not been reported from Pakistan. We report such a case in Shigella flexneri from an 8-year old girl with acute dysentery
Subject(s)
Humans , Female , Child , beta-Lactamases/biosynthesis , Dysentery, Bacillary/microbiology , Dysentery, Bacillary/drug therapy , Drug Resistance, Bacterial , Feces/microbiology , Microbial Sensitivity TestsABSTRACT
Infections with extended spectrum beta-lactamase [ESBL] producing organisms continue to be associated with higher rates of mortality, morbidity and health care costs. This study was carried out to find out frequency and sensitivity pattern of ESBL producers among Gram negative rods [GNRs] from clinical isolates of a tertiary care Hospital. A total of 1430 GNRs were recovered from 2347 clinical samples received from admitted patients in Military Hospital Rawalpindi. All samples were dealt by standard microbiological methods. Extended spectrum beta-lactamase detection in these isolates was done by double disc approximation test of Jarlier et al, 1988. Frequency of GNRs among clinical isolates was 61% and about 33% of these were ESBL producers. Escherichia coli were the most frequent ESBL producers followed by Klebsiella pneumoniae. Most of the ESBL producers were isolated from urine followed by catheter tips and pus. Among all the antibiotics tested, ESBL producers showed highest susceptibility to carbapenems followed by amikacin. Organisms showing resistance pattern similar to ESBLs were also significant. Continued surveillance by clinical microbiology laboratories, judicious use of antimicrobial agents and implementation of infection control measures are recommended to reduce the frequency of ESBL isolates