ABSTRACT
Background: Contribution of antibiotic prophylaxis in reducing surgical site infection for some procedures is well known. In spite of knowledge about the effectiveness of antibiotic prophylaxis, its administrative regimens are often inappropriate. Objectives: To study the pattern of use of preoperative prophylactic antibiotic and its relationship with surgical site infection (SSI) in a tertiary care teaching Hospital. Methods Hundred case records files of patients admitted in surgical wards of Jawaharlal Nehru Medical College, Aligarh who had undergone open bowel surgery, were randomly selected from the Central Record Section and analyzed for prescription pattern for prophylactic antibiotics according to World Health Organization prescribing indicators for number of antibiotics, antibiotics prescribed by generic name and antibiotics prescribed from ‘Essential Medicines’ List per encounter. Cost of antibiotics, commonly prescribed antibiotics and timing of administration were also studied. Patients who developed surgical site infection and those who did not were compared statistically. Results: Commonly administered antibiotics were Ceftriaxone, Metronidazole and Amikacin given intravenously just before surgery. No relationship was seen between patient’s age, type of surgery or site of disease and choice of antibiotics. No drug was prescribed by generic name. Total cost on antibiotics was Indian Rupees 73.1 to 218.0. Surgical site infection developed in 40 patients. No significant relationship found between administration of any antibiotics or their cost and development of surgical site infection. High degree of resistance to Fluoroquinolones followed by second and third generation Cephalosporins was found in infecting organisms. Conclusions: Prescribing pattern was not based on World Health Organization criteria for rational use of drugs and not evidence based. This study indicates the need for interventions to improve rational use of antibiotic prophylaxis in India.
ABSTRACT
Objective: To investigate antibacterial potential of Trifolium alexandrinum (T. alexandrinum) Linn. against seven gram positive and eleven gram negative hospital isolated human pathogenic bacterial strains responsible for many tropical diseases. Methods: Non-polar and polar extracts of the leaves of T. alexandrinum i.e., hexane, dichloromethane (DCM), ethyl acetate (EtOAc), methanol (MeOH) and aqueous (AQ) extracts at five different concentrations (1, 2, 5, 10 and 15 mg/mL) were prepared to evaluate their antibacterial value. NCCL standards were strictly followed to perform antimicrobial disc susceptibility test using disc diffusion method. Results: Polar extracts demonstrated significant antibacterial activity against tested pathogens. EtOAc and MeOH extracts showed maximum antibacterial activity with higher inhibition zone and were found effective against seventeen of the tested pathogens. While AQ plant extract inhibited the growth of sixteen of the test strains. EtOAc and MeOH plant extracts inhibited the growth of all seven gram positive and ten of the gram negative bacterial strains. Conclusions: The present study strongly confirms the effectiveness of crude leaves extracts against tested human pathogenic bacterial strains causing several tropical diseases. Since Egyptian clover is used as a fodder plant, it could be helpful in controlling various infectious diseases associated with cattle as well.
ABSTRACT
A broad screening protocol, covering the most general phytochemical groups of compounds, was developed on the basis of high performance thin layer chromatography (HPTLC). A total of six TLC systems, comprising three derivatization reagents, two stationary phases and two mobile phases, were included. The screening method was applied for the identification of biomarkers in the chickpea plant exposed to cadmium and chromium. The biomarkers were selected on the basis of significant changes (0.26-4.6 fold) in concentration levels of phytochemicals. Totally, five different amino acids, three organic acids, one sulphur containing compound and one sugar were identified as biomarkers in chickpea exposed heavy metal.
ABSTRACT
Stapled hemorrhoidopexy for prolapsing hemorrhoids is conceptually different from excision hemorrhoidectomy. It does not accompany the pain that usually occurs after resection of the sensitive anoderm. This study was carried out to evaluate the clinical outcome of stapled hemorrhoidopexy at The Aga Khan University Hospital. A sample of 140 patients with symptomatic second-, third-, and fourth-degree hemorrhoids and circumferential mucosal prolapse underwent stapled hemorrhoidopexy from July 2002 to July 2007. They were evaluated for postoperative morbidity, analgesic requirement, and recurrence. Seventy-eight percent were males and the mean age was 45 [range 16-90] years. The mean operative time was 35 [15-78] min. The mean parenteral analgesic doses during the first 24 h were 2.1. All patients received oral analgesics alone after 24h. No significant postoperative morbidity was observed. The mean in-patient hospital stay was 1.3 [0-5] days. Patients were followed-up for 24 [range, 2-48] months. Minor local recurrence of hemorrhoids was seen in four patients and was managed by band ligation. Stapled hemorrhoidopexy procedure was found safe, well tolerated by patients with minimal parenteral analgesic use and early discharge from the hospital