Antibiogram Pattern Development of Pyogenic Bacteria and the Evaluation of their Multi-drug Resistance

Purpose: Different studies show consistent predictable bacterial profiles in wound infections, antibiotic resistance and capacity to adapt to a changing environment, which render the pathogens a matter of concern in hospital acquired infections. Therefore, periodical monitoring of bacterial profile and their antibiotic susceptibility pattern is essential. The objective of this study is to determine the commonly encountered pathogens in pus samples along with their antibiotic susceptibility patterns. Methodology: Pus samples received for diagnostic microbiology were processed and identified by standard protocols at the research lab of SZABIST Biosciences Department. Antibiotic susceptibility testing was done by Kirby-Bauer Disc Diffusion method. MS Excel has been used for data compiling and analysis. Standard Deviation has been applied for the results analysis. Results: Among the isolated organisms from pus specimens, Staphylococcus aureus (50%) was the most common followed by Escherichia coli (25%), Klebsiella pneumonia (9%), Pseudomonas aeruginosa (8%), Proteus species (5%) and Acinetobacter species (3%). Quinolones (76.4%), Cephalosporins (66.4%) and Aminoglycosides (41.6%) were found to be the most effective antimicrobials in vitro, whereas Amoxicillin (17.4%), Minocycline (14.6%) and Trimethoprim-sulphamethaxazole (3%) were least effective. The resistance of organisms to antibiotics is increasing steadily as they are becoming more resistant to newer antibiotics, such as quinolones. Conclusion: Doctors and nurses need to spread awareness of antibiotic resistance, and it is their duty to keep themselves updated with the latest antibiograms of commonly encountered pathogens, so that appropriate antibiotics may be provided for the treatment of infections.

Median Nerve Conduction Velocity and Body Mass Index in Mechanical Job Professionals

Background: Obesity is an epidemic in 21st century especially rising among young population of developing nations is measured in terms of BMI (Body Mass Index). It affects almost every system. In present study we aim to investigate any correlation between NCV & BMI among professionals of mechanized jobs involving repeated wrist movements. Method: BMI and median nerve NCV is measured in dominant and non-dominant hand of young active professionals. Results: One way ANOVA is applied and MNCV of median nerve in dominant hand and SNCV of dominant as well as non-dominant hand is found to be significantly decreased but MNCV of non-dominant shows no significant difference. Conclusion: Early changes in nerve conduction due to increased carpal tunnel pressure are more pronounced in dominant hand and SNCV of median nerve could be used as an early screening and diagnostic tool for median neuropathy

Comparison of NCV of Right and Left Limb in Right handed Male Subjects.

Background: Nerve Conduction Velocity is affected by various factors like age gender & temperature. Various studies have been done regarding development of brain and dominance of right or left side, some studies have found differences between left and right hand for nerve conduction. Our aim is to compare NCV of dominant limb to nondominant limb in right hand dominant subjects and to find out if different normal values should be considered in right and left hand. Methods: The Median and Common Peroneal Nerve (CPN) of dominant as well as Non- dominant limb were used for measuring Motor & Sensory Nerve Conduction Velocity (MNCV & SNCV) in age groups of 31-35 and 36- 40 years using Medicaid system. Results: We found p value was insignificant using unpaired t-test for MNCV & SNCV of Median and Common Peroneal Nerve of left and right side. Similarly, the MNCV & SNCV of dominant and nondominant limb for median and CPN were insignificant. Conclusion: Consideration of right or left side dominance is not necessary while measuring NCV in asymptomatic subjects and different set of normal values are not required for right and left hand.

To determine the frequency of Factor V Leiden in cases of Deep Vein Thrombosis and Healthy controls

To determine the frequency of Factor V Leiden in cases of Deep Vein Thrombosis and Healthy controls. This case control study was performed in Armed Forces Institute of Pathology Rawalpindi, From 21[st] March to 25[th] September 2013.One hundred patients with diagnostic evidence of Deep vein thrombosis on Doppler ultrasound/Magnetic resonance imaging [MRI] scan were included in the study through non probability convenient sampling and compared with 100 matched healthy controls. DMA was extracted from the blood sample by kit method. In order to identify Factor V Leiden mutation, the polymerase chain reaction [PCR] method was utilized combined with the Amplification refractory mutation system. Data was analyzed using statistical package for social sciences [SPSS] version 17. In 100 patients of Deep Vein Thrombosis [DVT], frequency of Factor V Leiden [FVL] was 13% and it is was 2% in healthy control group. A significant association was found between FVL and DVT with odds ratio of 7.32 and with P value [P = 0.003]. FVL was found to be highly prevalent among patients of DVT, Signifying strong association between the two

Laringoscópio óptico Airtraq® para intubação traqueal em paciente com grande lipoma na nuca: relato de caso / Airtraq® optical laryngoscope for tracheal intubation in a patient with giant lipoma at the nape: a case report / Laringoscopio óptico Airtraq® para la intubación traqueal en un paciente con lipoma enorme en la nuca: relato de caso

JUSTIFICATIVA E OBJETIVOS: Lipoma é uma doença de crescimento progressivo que pode surgir em qualquer parte do corpo. O seu aparecimento na parte de trás do pescoço, especialmente quando é grande o bastante para causar restrição do pescoço, principalmente da extensão, é um desafio para os anestesiologistas sempre que precisam manejar as vias aéreas. Aqui, o papel do Airtraq® foi avaliado no movimento restrito do pescoço. RELATO DE CASO: Relatamos o caso de uma paciente selecionada para remoção cirúrgica eletiva de um lipoma enorme na nuca, medindo 14 x 12 cm, que apresentou dificuldade para assegurar a permeabilidade das vias aéreas por meio de laringoscopia convencional. Para resolver o problema, usamos com sucesso um dispositivo recentemente desenvolvido, o Airtraq®, que é um laringoscópio óptico para assegurar a via aérea. CONCLUSÃO: O Airtraq® pode ser usado para intubação eletiva em pacientes com movimentos restritos do pescoço.

BACKGROUND AND OBJECTIVES: Lipoma is a progressively increasing disease which may appear anywhere in the body. Its appearance at the back of the neck, especially when it is large enough to cause restriction of neck extension, poses challenges to anesthesiologists in airway management whenever needed. This paper evaluates the role of Airtraq® in restricted neck movement. CASE REPORT: Case with a huge lipoma of 14 x 12 cm at the nape, and its surgical removal during an elective operation theatre posed difficulty in securing the airway by conventional laryngoscopy. To overcome the problem we successfully used a newly developed device, the Airtraq®, which is an optical laryngoscope for securing the airway. CONCLUSION: Airtraq® can be used for elective intubation in patients with restricted neck movements.

JUSTIFICATIVA Y OBJETIVOS: El Lipoma es una enfermedad de crecimiento progresivo que puede surgir en cualquier parte del cuerpo. Su aparecimiento en la parte de atrás del cuello, especialmente cuando es bastante grande para causar su restricción, principalmente en la extensión, es un reto para los anestesistas que necesitan siempre manejar las vías aéreas. Aquí el papel del Airtraq® se avaluó en el movimiento restringido del cuello. RELATO DE CASO: Caso de una paciente seleccionada para la retirada quirúrgica electiva de un lipoma enorme en la nuca, que medía 14 x 12 cm, y que tuvo una dificultad para asegurar la permeabilidad de las vías aéreas por medio de una laringoscopia convencional. Para resolver el problema, ha utilizado exitosamente un dispositivo recientemente desarrollado, el Airtraq®, que es un laringoscopio óptico para asegurar la vía aérea. CONCLUSIONES: El Airtraq® puede ser usado para la intubación electiva en pacientes con movimientos restringidos del cuello.

Kartagener's syndrome and acute appendicitis

Kartagener's syndrome is a combination of situs inversus totalis, sinusitis and bronchiectasis. Left sided appendicitis can present with problems in diagnosis and during surgery. We present here a case of Kartagener's syndrome and left sided appendicitis successfully managed in a peripheral hospital in Bahawalnagar, Pakistan

Open cholecystectomy; management of ponv: comparison of sub hypnotic dose of propofol vs metoclopramide

Postoperative nausea and vomiting [PONV] are most common and distressing complications after anaesthesia and surgery, leading to various problems. Metoclopramide, a benzamide, used as an anti-emetic, has got various side-effects. Propofol, a short acting induction agent, possesses anti-emetic properties in sub hypnotic doses, without having unwanted side- effects in this low dose. To compare the frequency of PONV in patients treated with propofol and metoclopramide. Experimental study. Setting: Department of anaesthesia and intensive care, Combined Military Hospital Rawalpindi. Duration: 06 months [01[st] July to 31[st] December 2004]. 1 82 female patients scheduled for open cholecystectomy were selected for this study. All of them received general anaesthesia without any prophylactic antiemetic. Out of them, 60 patients who complained of PONV in post anaesthesia care unit [PACU] were selected by non probability convenience sampling and were equally divided into two groups. Group [A] received propofol [0.5 mg/kg] while group 'B' received metoclopramide [0.2 mg/kg]. Recurrence of PONV was recorded 60 min after administration of the study drug. Patients still complaining of PONV 30 min after administration of the study drug received a rescue medication i.e. I/V ondansetron [4mg]. Results: In group [A], 18 patients responded to intervention [60%] whereas 26 [86.66%] patients gave a positive response in group [B] [p; 0.020]. More patients who received propofol needed the rescue medication [40%] than those who received metoclopramide [13.33%] [p 0.020]. Metoclopramide is a better option for managing PONV than propofol

Colonoscopic evaluation of middle aged patients with altered bowel habits

To determine the frequency of colorectal carcinoma in patients above 40 years of age presenting with altered bowel habits by colonoscopy. Design: Descriptive study. Place and Duration of Study: Services Hospital, Lahore between August 2000 to August 2002. Patients and A group of 50 consecutive cases presenting with altered bowel habits meeting the inclusion and exclusion criteria were included in the study. History and physical examination were recorded on a specifically designed proforma. Colonoscopy was done in these patients and any abnormality found was reported and biopsy specimen taken and sent for histopathology. A total number of 17 patients presenting with altered bowel habits were found to be suffering from colorectal carcinoma by colonoscopy. Among these in 30% the lesion was in the rectum, in 9% the lesion was in the sigmoid colon, 6% in the descending colon, 4% at the splenic flexure, 5% in the transverse colon, in 16% the lesion was found at the hepatic flexure and in 30% the lesion was in the ascending colon and cecum. Frequency of colorectal carcinoma is high in patients above 40 years of age who presenting with altered bowel habits. They should be investigated preferably by means of colonoscopy which is the most complete method of investigation and diagnostic procedure of choice in patients with a clinical suspicion of colorectal carcinoma