Sensitivity of ciprofloxacin and ceftriaxone in children with urinary tract infections

Background: Urinary tract infections (UTIs) are the 2nd commonest bacterial infections, after respiratory tract infections (RTIs), and may go on to progress into chronic kidney disease among paediatric population. The objective of this study was to determine frequency of sensitivity of ciprofloxacin and ceftriaxone in children with urinary tract infections (UTIs).Methods: This descriptive, cross-sectional study was done at the department of pediatric medicine, Nishtar Hospital, Multan, from 10th August 2019 to 9th January 2020. A total of 165 patients presenting with UTI and aged 2 to 12 years of either gender were included. Urine sample was taken in sterilized container and sent immediately for urine culture and sensitivity tests.Results: In a total of 165 cases, mean age was 5.15±2.50 years while most cases, 113 (68.48%) were between 2 to 6 years of age. Out of the 165 patients, 112 (67.87%) were female representing female to male ratio of 2.1:1. Sensitivity of ciprofloxacin in 53 (32.12%) and ceftriaxone in 107 (64.85%) patients was found.Conclusions: This study showed the sensitivity of ciprofloxacin in 32.12% and ceftriaxone in 64.9% children with UTIs.

Clino-pathological features of urinary tract infection: a study at Nishtar University Hospital Multan, Punjab, Pakistan

Background: Urinary tract infection (UTI) is a common clinical issue among pediatric population and might progress into renal scaring, hypertension as well as end stage kidney disease. This study was aimed at finding clino-pathological features of UTI and antibiotic sensitivity against most common causative agents involved at a tertiary care hospital of South Punjab, Pakistan.Methods: This descriptive case series study was conducted at department of Paediatric Medicine, Nishtar University Hospital Multan from July to December 2019. A total of 100 children fulfilling the inclusion criteria, presenting in outpatient department or emergency section of paediatric medicine department, having positive urine culture and sensitivity were selected. Their detailed history, clinical examination and relevant investigations were done.Results: Out of the 100 children, 73 (73.0%) were female and 27 (27.0%) were male. There were 57 (57.0%) children from 1 year to 4 years age group and 43 (43.0%) were of more than 4 years. Most common clinical presentations were fever 83 (83.0%), urinary symptoms, vomiting 52 (52.0%) and pain abdomen 48 (48.0%). Most common aetiological agents were Escherichia coli 74 (74.0%) and Klebsiella pneumoniae 9 (9.0%).Conclusions: UTI is more common in female children. Most common presentation observed was fever and/or urinary symptoms while most common aetiological agent was E. coli.

role of sentinel lymph-node biopsy in managing lip squamous cell carcinoma patients without clinical evidence of nodal metastasis

Squamous cell carcinoma [SCC] of the lip is a common oral malignancy. Lymph node metastasis occurs lately in the natural history of the disease but it is associated with poor outcome. Sentinel lymph node biopsy [SLNB] is an option that determines the potentially affected lymph nodes especially in clinically negative-node patients. The study aims to determine the feasibility of SLNB as a reliable staging tool in N0 stage lip SCC patients. Eighteen patients with N0 stage lip SCC were enrolled in the study. They were subjected to SLNB using the injection of the radiocolloid material and the Blue dye. The procedure was followed by bilateral supraomohyoid neck dissection in all patients. The pathological results of the harvested sentinel lymph nodes [SLNs] were compared with that of the dissection specimen in each patient. The patent blue dye could localize the SLN in 15/18 patients whilst the radioisotope scanning could successfully identify it in 17/18 patents. On average, 1.8 SLNs were harvested from each patient. Two of seventeen patients with identified SLNs [11.8%] have positive nodal metastases. One of them has two SLNs and the other has only one. No false negativity was reported in the study as all the excised SLNs reflected correctly the status of the lymph node basin. Sentinel lymphadenectomy is a safe and feasible procedure in managing neck of patients with node-negative lip SCC. It can accurately stage these patients

Evaluation of diagnostic indices of lectin antigen and anti-lectin antibodies in amebic liver abscess

Diagnostic indices of Gal/Gal NAc lectin antigen and anti-lectin antibodies for amebic liver abscess were evaluated to see their usefulness. Forty [40] clinically suspected cases of liver abscess patients admitted in the Rajshahi Medical College Hospital [RMCH], Bangladesh during January to December 2007 were included. Liver abscess pus from all cases were tested for small subunit of ribosomal RNA [rRNA] gene of Entamoeba histolytica by Real Time PCR and only PCR-positive cases were further analyzed for detection of Gal/Gal NAc lectin antigen and anti-lectin antibodies in their liver abscess aspirates, plasma, saliva and urine using Enzyme-linked immunosorbent assay [ELISA] methods. Except liver abscess pus, all other samples were also tested for 20 patients suffering from diseases other than liver abscess, who served as controls for the study. Out of 40 patients, 39 were PCR-positive and considered as confirmed cases of amebic liver abscess. The rate of detection of lectin antigen and anti-lectin antibody in liver abscess pus was 12.82% and 56.41% respectively. Diagnostic sensitivities of lectin antigen in plasma, saliva and urine were 15.38% [95%CI 6-31%], 07.69% [95%CI 2-22%] and 00% respectively, while sensitivities of anti-lectin antibodies in all those samples were 100% [95%CI 88-100%], 87.17% [95%CI 72-95%] and 56.41% [95%CI 40-78%] respectively. Diagnostic specificities of lectin antigen was 100% in all specimens but for anti-lectin antibodies, specificities were 100% [95%CI 88- 100%] in plasma, 50% [95%CI 28-78%] in saliva and 70% [95%CI 46-87%] in urine. Overwhelming majority of cases [94.87%] received Metronidazole therapy for variable period before sample collection, which is correlated with low rate of antigen detection. Detection of lectin antigen for amebic liver abscess has very limited or no role where Metronidazole is used indiscriminately but detection of anti-lectin antibodies especially in plasma [100% sensitivity] and saliva [87.17% sensitivity] are excellent to satisfactory. Estimation of plasma IgG can be recommended as serodiagnostic tool for symptomatic amebic liver abscess

Haemobilia: a rare cause of gastrointestinal bleeding

Iatrogenic injury to hepatic duct leading to pseudoaneurysm and haemobilia can occur following laparoscopic cholecystectomy. We report a case of a 60 years old man presenting with haematemesis found to have pseudoaneurysm of accessory hepatic artery 4 months after laparoscopic cholecystectomy. Diagnosis was made by computed tomography [CT] scan followed by celiac and mesenteric artery angiogram. The bleeding was successfully treated with coil embolization

Training in reference management software: a part of new medical informatics workshops in Pakistan

Researchers in Pakistan can increase writing productivity, reduce errors in manuscripts and improve quality of their papers by hands-on workshops on bibliographic reference software. A workshop was conducted in an interactive tutorial format using an overhead projector to show screenshots of software at each step. Our Workshop included:1 starting the Endnote program [www.endnote.com];[2] manually entering a reference of a journal article[3] searching and importing references from PubMed[3] inserting a reference in Microsoft Word document in a journal-specific format;[4] essentials of journal article formatting; and[5] the ethics of respecting other peoples of intellectual effort by proper citations and avoiding plagiarism. A post-workshop test was administered to assess whether instructional objectives were attained. All the participants passed the post-workshop multiple choice questions and 85% rated the workshop as good, very good or excellent. A workshop on reference formatting in research writing is useful to promote high quality research work. We recommend holding workshops twice a year on research article formatting and reference software at medical colleges in Pakistan and other developing countries

Mesenteric panniculitis

A 68 years old female was referred from the clinic for ultrasound pelvis on 03-02-2003. She had pain in the hypogastrium for the last 2 months. On clinical examination no significant abnormality was detected. Her laboratory investigations were within normal limits. Ultrasound pelvis was normal but incidentally, a hyperechoeic mass was noted anterior to abdominal aorta and inferior to the pancreas. The size of the mass was 7.4 x 6 cm and vessels were traversing through the mass. CT scan was advised for further evaluation. CT scan was performed after 2 weeks which showed soft tissue stranding in the mesenteric fat, anterior to aorta, at the same level described in the ultrasound report. Superior mesenteric vessels were traversing the mass. No abdominal or pelvic lymphadenopathy was noted. These features were consistent with mesenteric panniculitis [Figure 2]. The case was managed conservatively and follow-up was planned. The patient had a follow-up ultrasound examination performed 6 months later which showed resolution of the earlier findings. The patient was asymptomatic at the time of follow-up

management of health promotion by Jordanian pharmacists

Pharmacists are increasingly being held accountable for their patients' health outcomes. This accountability is not limited to clinical outcomes, but also includes responsibility for the effects of disease and treatment on patients' quality of life [QoL]. Indeed, QoL is a centerpiece of the philosophy of pharmaceutical care. Health Promotion and Disease Prevention is one of the major domains of pharmaceutical activities. Specific activities include developing health programming and assisting patients in making lifestyle changes to improve health outcomes. A major core activity in pharmaceutical educational goals is addressed by our College of Pharmacy in order to incorporate education in health promotion and disease prevention. Any pharmacist may participate in health promotion and those working in community and hospital practice are well placed to do so. The purpose of this work was to identify the preperedness of pharmacists to counsel their patients and how the Jordanian pharmacists' see and manage health promotion as part of their responsibility. A survey instrument was constructed in order to extend the benefit of this study to patients, health care providers, or to a third party. Health promotion beliefs, the pharmacists' confidence in their ability to help patients change their behavior and the perceived barriers to integrating prevention into daily practice were measured. The collected data were analyzed using SPSS version-10 program. Results of the study indicate that pharmacists most frequently participate in health education/disease-preventing activities directly related to the dispensing or selling of medications. Pharmacists, uniquely positioned as the most accessible health care providers in the community, can dedicate their considerable strengths to organize their own efforts and motivate their patients. The majority of pharmacists claimed the need for Continuous Education CE programs that should be directed toward sharpening pharmacists' skills in health promotion

Studies on Henneguya infection in the african catfish clarias lazera

From investigating 1261 Clarias lazera caught from the main Rosetta Nile Branch and its tributaries at Edfina, Lower Egypt, cysts of the myxosporidian protozoan Henneguya were observed in 156 fishes [12.37%]. The cysts were localized in the suprabranchial organ [10.23%] within the primary gill lamellae [1.74%] and rarely in the intestine [0.4%]. During the course of the study, the incidence of infection peaked in August [48.1%] and was at its minimal level in December and January [0.8%]. Examination of the cyst contents revealed the presence of vegetative trophozoites and spores of Henneguya. The spores appeared spindle shaped with a long tapered caudal process. Two equal polar bodies and an iodinophilous vacuole were identified within the spore. According to the spore measurements, the three types of cyst were caused by a single species. Matching the spore measurements with other morphologically similar Henneguya species, it appeared that, they are different. The name Henneguya clarii sp. nov. was suggested to this myxosporidian

Myxosoma tilapiae as a new species [Myxozoma: Myxosporea] in wild oreochromis niloticus in lower Egypt

From examination of 1328 wild 0. nilolieus [Tilapia nilotica], macroscopic and microscopic cysts were detected on the skin, gills, eyes, hepatopancreas and kidneys. Eye affection was in the cornea and splenic affection was either of the ordinary cyst forming type or of the non cyst forming type. The latter was characterized by paleness of the involves splenic part. Impression smears revealed the detection of Myxosoma spores, which were compared and discussed in details with other myxosporideans, and was considered as Myxosoma tilapiae n.sp. The spores obtained from different organs were similar in morphological status. Quantitative data on the prevalence and distribution of Myxosoma cysts was studied

On the shedding of spring viraemia of curp virus

Spring viremia of carp virus was presented in the liver of fish till 2.5 months p.i. Amazing was the presence of the virus in the intestine [especially the last segment] starting at the 2.5 months and persisted as long as 4 months p.i. This point should be considered from the epizootiological point of view