ABSTRACT
Background and Objective: Urinary tract infection is one of the commonest infections seen in clinical practice. Lack of compliance and unjustified antibiotic prescriptions has resulted in bacterial resistance and is proving as a major challenge in the management of these infections. Our aim was to identify the sensitivity pattern of commonly used antibiotics against urinary tract infections so as to suggest an improvised line of action against bacteria causing urinary tract infections
Method: This was a hospital based cross sectional study extended over a period of four months. Patients were recruited from outpatients department of a tertiary care hospital in an industrial area of Karachi. Adult patients with symptomatic and documented UTI in urine detailed report [pus cells >10] were enrolled after informed consent. A clean catch midstream urine was collected for culture and sensitivity testing using the standard microbiological procedure. Data is analyzed on SPSS 16
Results: A total of 184 samples were collected in 4 months. The Male to Female ratio was 1:2 [n=58/126] with mean age 48.5+/-12 years. 83[45.6%] patients were between 45-60 years. Most common isolated pathogen was Eschericia coli 108[59%] followed by staphylococcus aureus 30[16.4%] and Klebsiella 20[11%]. 55[30%] pathogens showed sensitivity to 4-6 antibiotics, 22[12%] strains to 7-9 antibiotics, 33[18%] were sensitive to
Conclusion: In this low socioeconomic cohort with UTI nearly half the isolated pathogens has shown resistance to most of the commonly used antibiotics recommended in the guidelines especially the floxacin group probably because of its unwarranted use. Therefore, a revised line of management should be developed locally in accordance with the susceptibility pattern of the urinary pathogens to avoid further resistance as well as morbidity of the patient
ABSTRACT
Objective: To determine the frequency of knee osteoarthritis in adult patients with Diabetes mellitus and its association with body mass index [BMI] in kg/m[2] and waist circumference [WC]
Methods:This is a cross-sectional comparative study at a tertiary hospital based in an industrial area of Karachi. Patient population comprised of all adult diabetic subjects. Clinical and demographic data was obtained with detailed musculoskeletal examination on all patients. BMI and WC were measured as kg/m[2] and cm respectively. Data was analyzed on SPSS version 15
Results:A total of 413 subjects were recruited. Among them diabetic and non-diabetic subjects were 210 and 203 respectively. Mean age of diabetics was 50.7+-10.2 years as compared to non-diabetic subjects i.e. 49.5+-10.5 years. Proportion of male subjects was 72[34.3%] and 71[35.0] respectively in both groups. Mean duration of diabetes was 6.2 years. Frequency of knee osteoarthritis [OA] was found to be 52[24.8%] and 54[26.6%] in diabetic and non-diabetic respectively. Among the diabetic group 6 [18%] subjects with OA had normal BMI [18.5-22.9] whereas 4 [16%] were overweight [BMI 23-24.9] and 41[27.5%] were obese[BMI >/=25]. Near 98% [n=51] of the diabetic patients with OA had high waist circumference. Females [n= 42, 31.1%] were more frequent than males [n=9, 16%] in the diabetic subjects with OA and a higher WC
Conclusion:Both diabetic and non diabetic group did not show any difference in the frequency of knee OA. However, frequency of knee OA showed a significant difference between overweight and obese category of BMI.WC appears as a strong predictor of knee osteoarthritis
ABSTRACT
To determine the frequency of newly diagnosed diabetes mellitus in acute ischaemic stroke patients. Observational study. Jinnah Postgraduate Medical Centre, Karachi, from June 2007 - June 2008. This study included adult patients [age > 30 years, both genders] with the diagnosis of acute ischaemic stroke. Patients who were known to have diabetes mellitus prior to stroke, had a non-lacunar stroke or were admitted to intensive care units for any reason were excluded. Detailed history and examination, fasting blood sugar, fasting lipid profile, a non-enhanced CT scan brain and electrocardiogram were done on every patient. Data were entered on a preformed proforma. The results were analyzed on SPSS version 10. Chi-square test was applied. P-value <0.05 was considered to be statistically significant. A total of 250 patients were enrolled. The male: female ratio was 1: 0.9. Mean age was observed as 60.9 +/- 10.1 years. In total, 50 new cases of diabetes mellitus were identified [20%]. Average fasting blood sugar in diabetic subjects was 148 +/- 10 mg/dl. The most common risk factors in the newly diagnosed diabetic subjects were hypertension 26 [52%], smoking 18 [36%] and hyperlipidemia 14 [28%]. Atrial fibrillation and myocardial infarction were seen in 12 subjects [24%] and 9 subjects [18%] respectively. Twenty percent patients with acute ischaemic stroke had un-diagnosed diabetes. Therefore, it is advisable to screen acute stroke patients for diabetes to reduce their long-term morbidity and mortality