Routine blood transfusion should not be [routine] in cardiac surgery

To determine if open-heart surgery can be performed in a public hospital in Pakistan without the use of routine blood transfusions. Considering the high prevalence of Hepatitis B and C in the donor population, decreased use of donated blood is the best protection against these and other transfusion transmitted infections. Cross sectional observational study. This study was conducted at cardiac surgery department, Mayo Hospital Lahore. It included patients operated from January 2006 to September 2006. Duration of study was 9 months. Total of 106 patients undergoing open-heart surgery were included in the study. These were all adult patients operated during the first nine months of 2006 by a single group of surgeons. Patients who were re explored for bleeding or had complicated postoperative course or who did not survive the operation were excluded. All the pump blood after cessation of cardiopulmonary bypass was transfused to the patient. Intra and post-operative allogeneic blood transfusions were given based upon strict transfusion criterion. Any patient who received 1 unit of blood[1] or 2 units of blood with post operative haemoglobin of 11 gram per 100 ml or more than 11 gram per 100 ml or more than 2 units of blood with post operative haemoglobin of 12 gram per 100 ml or more than 12 gram per 100 ml was considered to have received unnecessary transfusion[2]. 67 patients [63.21%] did not receive any blood transfusion. 32 patients, [30.19%] were transfused 2 units of blood. 7 [6.60%] patients received more than two units of blood. 8 [7.55%] patients received unnecessary transfusion. Blood transfusions can be eliminated in most routine cardiac operations. As appropriate drugs and technology like cell savers and in pump haemo-cocentration devices become available to us, the number of patients receiving blood transfusions can most likely be decreased further

Prevalence of methicillin resistant staphylococcus aureus [mrsa] infection laboratory study at mayo hospital lahore

To study the prevalence of methicillin resistant Staphylococcus aureus [MRSA] so that recommendation can be made for their prevention and control. Design: 350 Staphylococcus MINUS strains were isolated from Swvab/pus and other specimens randomly. Place and Duration: The samples were processed in the Department of pathology King Edward Medical Lahore College, during June 2000 to December 2000. Subject/The specimens from various types of infection sites suspected on clinical ground were processed by Standard methods and antibiotic susceptibility testing of all the isolates was done by using modified Kirby Bauer Disc diffusion technique. Result: Of these 350 positive cultures for Staphylococcus aureus, 135 were found to be methicillin resistant [38.5%]. This study shows a high prevalence of MRSA, which is of serious concern in Pakistan, In addition to the economic burden for antibiotic treatment MRSA Infections are serious threat to patients and a challenge for doctors

Current status and changing trends of antimicrobial resistance in Saudi Arabia

Due to modern travel and ease of spread of infections, it is desirable to widen knowledge of susceptibility of common bacterial isolates from different parts of the world for optimal clinical management and control programs. Over the past decades, antimicrobial resistance has emerged in all kinds of micro-organisms worldwide including Saudi Arabia. this phenomenon is primarily due to increasing antibiotic use and misuse in humans, animals and agriculture. Additionally, the presence of a large expatriate population and a significant number of visitors to the Kingdom annually for pilgrimage and/or work from all over the world may have also facilitated the importation to Saudi Arabia of drug resistant micro-organisms from other countries. Saudi Arabia has witnessed an increase of drug resistant Mycobacterium tuberculosis, Streptococcus pneumoniae, Staphylococcus aureus and some Enterobacteriaceae in the last decade. We describe the status of antimicrobial resistance in Saudi Arabia which is an important focus of antimicrobial resistance for the Gulf Region

Saddle block with pethidine and cinchocaine for perineal operations in Sir Ganga Ram Hospital, Lahore

Two groups of twenty five patients each undergoing perineal operations in intradural saddle block with Pethidine Hydrochloride 0.5mg/kg and Cinchocaine 0.5%. The site of injection was space between L[4] / L[5]. The motor blockade caused by pethidine was adequate and post operative analgesia was much longer than that of cinchocaine

Etiology of viral diseases in a tertiary care center in Saudi Arabia

In order to establish the prevalence and etiology of viral diseases at a tertiary care hospital in Saudi Arabia, clinical specimens from 38.978 patients were retrospectively evaluated over a 7 year period [1988-1994]. Virus particles were detected in clinical specimens from 3434 [8.8%] patients. The most common virus was herpes simplex [1646 patients], followed by cytomegalovirus [798 patients] and rotavirus [593 patients]. There were also 202 patients positive for adenovirus, 60 for respiratory syncytial virus, 29 for influenza, 8 for parainfluenza, 75 for enterovirus and 23 for varicella-zoster virus. The trends and characteristics of these findings in a specific Saudi population are discussed

Vancomycin-resistant enterococci [VRE] as normal flora of the intestine in patients at a tertiary care hospital

There has been a rapid increase in the incidence of infection and colonization with vancomycin-resistant enterococci [VRE] in American and European hospitals in the last six to seven years, with fecal carriage reported to be as high as 86% on some services. In order to determine the frequency of VRE as normal flora the intestine in Saudi patients, microbiological analysis of stool specimens from 4276 patients from a tertiary care referral hospital was performed. VRE, identified as Enterococcus f-aecium, was found in six patients None. of the patients had any clinical disease associated with VRE. Five were hospitalized patients, four with severe underlying diseases; five had a history of prior antimicrobial therapy with broad-spectrum antibodies and two of them were treated with vancomycin

Saddle block with pethidine for perineal operation in Nishtar hospital, Multan

Twenty five patients who were undergoing perineal operations were given saddle block intradural with pethidine hydrochloride 0.5 mg/kg. The site was lumber 3-4 or lumber 4-5. The motor blockade caused by pethidine was short in duration but post-operative analgesia was much longer in duration

Reactions with 4,5-diphenyl 2-mercaptoimidazole: synthesis of 2-substituted thiazolo [3,2-a] imidazoles

The potassium salt of 4,5-diphenyl-2-mercaptoimidazole [I] was reacted with 3-chloro-2,4-pentaneaione to give the S-alkyl derivative II. Compound II coupled with arenediazonium salts to give the azo derivatives [III]. On heating II and III with poly-phosphoric acid, cyclization took place and 2-substituted thiazolo [3,2-a] imidazoles V and VI were obtained. V Condensed with aromatic aldehydes to yield the cinnamoyl derivatives VII, which reacted with phenylhydrazine and hydroxylamine to give 2-pyr-azolinyl-and 2-isoxazolinyl-thiazolo [3,2-a] imidazole derivatives IX and X respectively