Antimicrobial susceptibility of organisms isolated from sputum culture of Karachi, Pakistan

Our study aims to contribute to developing antibiotics prescription guidelines at a national and a regional level directed by the antibiotics susceptibility patterns and rapidly emerging resistant organisms. This study is designed to observe the antimicrobial susceptibility in sputum culture isolates and drug resistance patterns against various antimicrobials. This was a retrospective cohort study; data was collected from two laboratories from 1st Jan to 15 July 2007. All laboratory reports were analyzed using SPSS version 19.0.The sputum culture was found positive for microbial growth in 217 reports out of 864 total [25.11%]. The leading organisms were 25.8% Klebsiella pneumoniae, 23.5% Streptococcus pneumoniae, 18% Pseudomonas aeruginosa and 12.9% Staphylococcus aureus. S.pneumoniae and S.aureus were sensitive to the combination of beta lactam antibiotics and anti-beta lactamase while K.pneumoniae and P. aureginosa were susceptible to fluoroquinolones, macrolides and aminoglycosides. The total yield of sputum culture was 25.11%. The gram positive cocci which were isolated were mostly resistant to beta lactam antibiotics alone i.e. only 45% of S. pneumoniae and 33% of S.aureus were sensitive to Amoxicillin alone. Sensitivity to Co-amoxiclav was still high. 90% and 85% of S. pneumonia and S.aureus respectively were sensitive to Co-amoxiclav. The P.aeruginosa resistance to Amikacin in our study is 10%

Perceptions and practices of fasting in Ramadan during pregnancy in Pakistan

Islam clearly exempts fasting in Ramadan during sickness, pregnancy, and breastfeeding. Yet, some women prefer to fast despite realizing their increase in nutritional demand during pregnancy. Nurses and other healthcare providers face a difficult task of providing appropriate medical advice to Muslim women regarding the safety and impact of their fasting. The present study was conducted to examine the concepts and practices of maternal fasting during pregnancy in Pakistani Muslim women. A cross sectional study was done in 2008 on 353 females from gynecology departments of hospitals in major cities of two provinces of Pakistan. Non probability convenient sampling technique was used and a questionnaire was used to collect data from females who had experienced pregnancy during Ramadan at least once in life. Questions related to perceptions and practices of fasting in pregnancy along with demographic data were asked. Analysis was done on SPSS version 16. Chi square test was used to assess associations and P < 0.05 was considered statistically significant. All ethical considerations were taken into account for the respondents. Out of the total, 309 [87.5%] fasted during their pregnancies while 43 [12.5%] did not fast at all. Among those who fasted, 42.5% [n = 150] fasted for the whole month, 23.8% [n = 84] fasted on alternate days, 10.5% [n = 37] fasted only on weekends/ holidays, and 10.8% [n = 38] fasted on particular special days. The majority perceived no harm and risk caused by fasting to them or to fetus during pregnancy. Although adverse effects during fasting were frequently reported, only 24% break their fast. A significant association was found between gravida and education with fasting [P < 0.05]. A total of 88% of women believed that fasting during pregnancy [in good health] is "obligatory" while 12% thought otherwise. Pakistani Muslim women showed a strong compassion for fasting in pregnancy despite overall decrease in maternal health indicators. There is a need for nurses and other healthcare providers in all Muslim countries and especially in non Muslim countries with cultural diversity to be fully aware of the effects of fasting in pregnancy so that they can act promptly ensuring safe and healthy delivery.