ABSTRACT
Objective: To determine whether antibiotics are necessary for all minor wounds presenting to the Accident and Emergency Department at a tertiary care Centre in Pakistan
Methods: One hundred and five patients presenting to the Accident and Emergency Department, Jinnah Postgraduate Medical Centre, Karachi, with open wounds were included in the study and divided into two: Groups A [study] and B [control], with Group-A receiving conservative therapy. Eighty-four patients were included in the final analysis as the rest were lost to follow up. Follow up was done after one week to see how many patients had developed infection
Results: The average age of patients was 27.3 +/-9.7 years with similar baseline characteristics. From these, 51% had superficial wounds; average number of wounds was 1.63 +/-0.99, with an average length of 2.7 +/-1.6 cm. A total of 10 out of 84 patients developed infection at 7-10 days after presentation to the A and E. From these, 3 patients receiving conservative treatment [A, 10%, OR=0.107], and seven patients receiving prophylactic antibiotics [B, 12.96%, OR=0.149] developed an infection. Calculated odds ratio for increased risk of infection in Group-A = 0.72
Conclusion: A conservative approach to antibiotic prescription for minor trauma may be appropriate despite absence of strict asepsis during emergency wound care
ABSTRACT
This study was planned to determine the effect of levo-carnitine on blood glucose and lipid profile in high fat diet fed, streptozotocin induced insulin resistant type II diabetic rats. Randomized controlled trial [RCT] Department of Physiology, Army Medical College, Rawalpindi from 20th to 15 Jan 2009. Ninety Sprague-Dawley rats were divided into three groups; each having 30 rats. Group I [control] was fed on normal diet while in Group II [Diabetic] diabetes was induced by feeding high fat diet and giving the injection of streptozotocin. Group III [Carnitine] was treated like group II to induce diabetes mellitus and later Levo-carnitine 200 mg/kg body weight/day was administered intraperitoneally for 6 days. The blood glucose and lipid profile were significantly deranged in the diabetic and carnitine groups as compared to the control. After levo-carnitine treatment the blood glucose level decreased significantly [p <0.001] in carnitine group [6.2 mmol/1] as compared to the diabetic group [22.7 mmol/1]. The levels of triglycerides, cholesterol and LDL were significantly decreased [P<0.001] in carnitine group 0.5 mmol/1, 1.3 mmol/1 and 0.2 mmol/1 as compared to the diabetic group 1.9 mmol/1, 4.4 mmol/1 and 3.1 mmol/1 respectively. HDL level was significantly raised [p<0.001] in the carnitine group [0.9 mmol/1] as compared to the diabetic group [0.4 mmol/1]. It is concluded that Levo-carnitine administration tends to normalize glycemic control and lipid profile in type II diabetes mellitus. However, human trial is recommended to ascertain its efficacy as an antidiabetic and antidyslipidemic agent for therapeutic use