Frequency of major risk factors for coronary heart disease in patients of southern Punjab

Background: Coronary Heart Disease [CHD] in most common form of heart diseases and premature deaths

Objective: To determine the risk factors of coronary heart disease [CHD] in patients from Southern Punjab

Subjects and Methods: This retrospective study was carried out in the Community Medicine Department, Nishtar Medical College, Multan in collaboration with the CPE Institute of Cardiology, Multan and Cardiology Ward, Nishtar Hospital, Multan. All patients presenting with acute coronary heart disease, from September to November, 2009, were included in this study. The diagnosis was made by a Cardiologist. Patients were interviewed for the presence or absence of Conventional Risk Factors for CHD. The risk factors studied were gender, smoking, hypertension, positive family history, diabetes mellitus, obesity, dyslipidemia, anxiety and depression. All information was entered into a pre designed proforma. Data was analyzed in SPSS version 10

Results: Among patients of CHD, 70% were males and 30% were females. Smoking habit was seen in about half of the patients [49.50%]. Hypertension was present in 45%, positive family history in 32%, diabetes mellitus in 29.50% of patients 26% were obese, 23% have dyslipidemia while 15% reported to have anxiety and depression

Conclusion: We conclude that after male gender, smoking habit was the most prevalent risk factor seen in our study population. Other risk factors found, in the descending order, were hypertension, positive family history, diabetes mellitus, obesity, dyslipidemia, and anxiety and depression. Our study demonstrates the importance of modifiable risk factors which may be targetted in designing the preventive strategies for CHD

Choosing anaesthesiology as a career: a survey of medical students and residents in Salmaniya medical complex Bahrain. What has changed over the past 15 years?

To determine the factors preventing Bahraini medical graduates to choose anesthesiology as a career. Salmaniya Medical Complex, Bahrain Prospective study 90 subjects included in this study, 42 medical students, 11 anesthesia residents, 30 resident selected from other specialties, and 7 residents selected anesthesia as a career then they changed their mind for other specialties. A set of questionnaire exclusive for each group answered, collected and analyzed Working conditions, lack of respect and financial incentives were commonly cited reasons for making this specialty unattractive. Suggestions were proposed to look into these aspects. The study reveals that anesthesiology remains as unattractive a specialty among Bahrainis as it was fifteen years ago. Efforts to increase its public awareness, improvised and accelerated teaching of anesthesiology to medical students and interns, and increased financial incentives could possibly change the picture

Repeat airway disaster: this time it was fatal

In the July 2000 issue of JBMS, a case of an extremely difficult endotracheal intubation was published. Due to unplanned extubation protocal that patient had developed life- threatening complications in the immediate postoperative period but eventually survived. Considering her difficult airway anatomy, specific instructions were given for her future hospitalization needs. Three years later, ignoring those instructions, the patient reported with labour pain at a peripheral hospital and once again suffered from airway compromise which proved fatal. Running Title: Fatal airway disaster

Urinary tract infection by shigella sonnei

A rare case of urinary tract infection caused by Shigella sonnei is described in a renal transplant recipient adult female on immuno-suppressive therapy. The patient improved and urine cultures became negative after a course of intravenous cefotaxime, given in doses of 1 gm 8 hourly for seven days. The role of S.sonnei in extra-intestinal infections is reviewed

Etiology of ICU infections and antibiogram of the isolates at referral center in Riyadh

Patients undergoing treatment in intensive care unirs [ICU] are prone to increased risk of developing serious and life-threatening infections. These infections become more significant in immunocompromised particularly those caused by multi-resistant pathogens. In order to determine the etiology of intensive care unit [ICU] acquired infections and identify the predominant infecting organisms in a tertiary care hospital in Riyadh. We retrospectively examined the sites of infections, causative agents and their susceptibility to commonly used drugs. Of the 984 specimens processed in 1994, 261 grew normal flora; pathogenic bacteria were isolated from 672 patient specimens. The majority of the specimens yielding pathogens came from respiratory tract [385], followed by blood [149], urine [40], and others. Most frequently isolated pathogens were pseudomonas aeruginosa [153], escherichia coli [152], staphylococcus aureus [103], klebsiella pneumoniae [99] and serratia marcescens [48]. Seven% of the infections were polymicrobial. Susceptibility of the organisms to following drugs was tested: ampicillin amoxicillin and clavulanic acid amikacin, cephazolin, cefoxitin, ceftriaxone, ceftazidime, clindamycin, erythromycin, gentamicin, imipenem, oxacillin, penicillin, piperacillin, and vancomycin. The most inhibitory antimicrobial agent was imipenem which inhibited 98% of both gram-positive and gram-negative clinical isolates

Anti-salmonella activity of azithromycin

The in vitro activity of the new azalide azithromycin was evaluated by a standardized agar dilution method against recent clinical isolates of salmonella typhi [88 strains] and salmonella species [91 isolates]. The results were compared with five other commercially available standard drugs. All the isolates of s. typhi were inhibited by 2-16 mg/l of azithromycin as compared to 2-8 mg/l for other salmonella species. Minimum inhibitory concentration range of azithromycin against salmonella was similar to chloramphenicol but superior to ampicillin augmentin erythromycin and tetracycline

comparative evaluation of Sch 25298 a fluorinated derivative of chloramphenicol

To determine the in vitro activity of Sch 25298, a fluorinated derivative of chloramphenicol. Determinations of minimum inhibitory concentration by agar dilution method of Sch 25298 and chloramphenicol against 922 recent clinical isolates. King Faisal Specialist Hospital and Research Centre, Riyadh, Saudi Arabia. Sch 25298 was more inhibitory than chloramphenicol against both methicillin-susceptible and methicillin resistant Staphylococcus aureus, coagulase negative staphylococci, enterococci, Haemophilus influenzae and members of Enterobacteriaceae. Its antibacterial activity against streptococci was comparable with that of chloramphenicol. All the 89 isolates of Pseudomonas aeruginosa and Acinetobacter were resistant to both Sch 25298 and chloramphenicol. Sch 25298 exhibited more potent antibacterial activity than chloramphenicol against most of the bacteria tested. Many of the chloramphenicol-resistant isolates were susceptible to Sch 25298

Comparative in vitro activity of newer cephalosporins

To determine the in vitro activity of six new cephalosporins. Determination of minimum inhibitory concentration of new drugs and their comparison with commercially available cephalosporins in clinical use against recent clinical isolates. King Faisal Specialist Hospital and Research Centre, Riyadh [KFSH and RC], Saudi Arabia. 897 bacteria recently isolated from clinical specimens of patients at KFSH and RC. Cefepime, cefpirome, GR 691 53 and Ro 09-1428 were the most active agents against Enterobacteriaceae and Aeromonas hydrophila, inhibiting >90% of them at

Beta-lactamase production in recent clinical isolates of Haemophilus influenzae and their susceptibility to cefaclor and other antimicrobial agents

The ability of 383 recent clinical isolates of Haemophilus influenzae to produce beta-lactamase was detected by using cefinase discs. It was found that 8% of the isolates elaborate this enzyme. Since cefaclor supposedly is not inactivated by beta-lactamases of H. influenzae, we studied the in vitro activity of this cephalosporin and compared it with other commonly used antimicrobial agents against isolates of H. influenzae from 383 patients at a tertiary care referral hospital in Riyadh, Saudi Arabia. Cefaclor was found to be most active, inhibiting 98% of the isolates tested, followed by amoxycillin/clavulanic acid and gentamicin [95%], chloramphenicol [93%], cephalothin [90%], ampicillin [87%], tetracycline [77%] trimethoprim-sulphamethoxazole [65%] and erythromycin [47%]

Incidence of Chlamydia infections in a large metropolitan hospital in Saudi Arabia

In order to determine the prevalence of Chlamydia trachomatis infections in patients at a metropolitan referral centre in Riyadh we examined various clinical specimens from 19 234 patients during the period from January 1986 to August 1991; 61% of the subjects were females and 39% males. Of the 19 234 patients tested 2210 [11%] yielded positive results for Chlamydia antigen. Positive reactions from ocular sites accounted for 1361 [61.6%] patients and the antigen was detected from genital sites in 849 [38.4%] patients. Chlamydial infection rate in women was 10.8% compared with 12.5% for men; the highest number of positives occurred in the 26-45 year age group

Toxicological evaluation of Safi - a herbal medicine

A wide dose - range of "Safi" was administered to mice and rats as well as to guinea - pigs and its oral toxicity [acute and chronic] was assessed. Also its LD, LD50 and Ed were determined

In-vitro susceptibility of relatively resistant bacteria to imipenem

In vitro activity of imipenem was tested against 965 clinical isolated from a major referral center in Saudi Arabia. Many of these strains were highly resistant to commonly used antibiotics, such as ampicillin, cephalosporins, gentamicin, pperacillin, and ticarcillin. All the 727 isolated of Enterobacteriaceae, Acinetobacter, Staphylococcus aurous, enterococci, and other streptococci were susceptible to imipenem. Of the strains of Pseudomonas aeruginosa [95%] and S. epidermidis [90%] were also inhibited. Nine of the 11 isolates of pseudomonads other than P. aeruginosa were resistant to this antibiotic

Susceptibility of pathogenic bacteria to amoxicillin/clavulanic acid[Augmentin] at a referral hospital

A total of 957 strains of basteria isolated from clinical specimens were tested in vitro to determine the efficacy of amoxicillin/clavulanic acid [Augmentin]. Sixty-seven percent of the 538 strains of Enterobacteriacease, 93% of 174 Staphylococcus aureus, and all the 48 isolates of enterococci were inhibited by Augmentin. All the 156 strains of Pseudomonas aeruginosa, P. Fluorescens, Enterobacter, Serratia, and shigella flexneri were resistant to Augmentin. Augmentin showed considerably increased activity against Escherichia coli, Klebsiella pneumoniae, Proteus species, and staphylococci when compared with ampicillin