ABSTRACT
Objective: To determine the current trend of antimicrobial susceptibility of typhoidal Salmonellae. Study Design: Descriptive cross-sectional study. Place and Duration of Study: The study was carried out in the Department of Microbiology, PNS Shifa Hospital, Karachi, from January 2014 to December 2015
Methodology: Blood culture samples received from the wards and outpatient departments were included. Isolates of Salmonella were dealt with standard microbiological procedures. The antimicrobial sensitivity against the typhoidal Salmonellae was determined using Kirby-Bauer disc diffusion method as per the guidelines of Clinical and Laboratory Standards Institute [2013]
Results: A total of 460 typhoidal Salmonellae were isolated; out of which 270 were Salmonella typhi and 190 were Salmonella paratyphi A. The percentage of MDR isolates of S. typhi was 57% and that of S. paratyphi A was 42%. None of the isolates were resistant to ceftriaxone, while sensitivity to ciprofloxacin [07% and 0% for S. typhi and S. paratyphi A, respectively] was very low
Conclusion: There is high percentage of MDR isolates of typhoidal Salmonellae in our region. The antimicrobial sensitivity of typhoidal Salmonellae to conventional agent has not improved enough to recommend their empirical use. There is almost complete resistance to fluoroquinolones as well, leaving very limited available treatment options
ABSTRACT
Objective: To find out the factors attributed to success and failure by medical students and how have they developed those attributes
Study Design: Mixed method sequential research
Place and Duration of Study: Bahria University Medical and Dental College Karachi, from Mar 2016 to Sep 2016
Material and Methods: In the first phase, quantitative research question addressed the different attributing factors for success and failure among medical students belonging from second to final year bachelor of medicine and bachelor of surgery [MBBS] course through survey questionnaire. A total of three hundred and thirty three students participated in survey. In the second phase, focus group discussions [FGD] and interviews were carried out from fifteen high and fifteen low achievers of different participant classes to probe in depth significant factors by exploring reasons for such attributions
Results: The quantitative analysis of results revealed that significantly large percentage of students passing the professional examination in annual examinations attributed their success to hard work, interest in the medical subjects, faith in their abilities, lectures and tutorials, module examinations and studying in small groups. The students passing in supplementary on the contrary were less hardworking and regular in their classes and faced financial issues.The major themes of attribution to success emerging from focus group discussion [FGD] of high achievers were effective learning strategies, support from parents and family, confidence and communication skills and hard work.The key themes of attribution to failure developed from interviews with low achievers were difficulty in adjustment, irregularity in classes and revision, deficient learning strategies and partisan role of teachers
Conclusion: High achieving medical students attributed their success primarily to internal, controllable and unstable factors like hard work and specific effort following effective learning strategies as well as external factor like support from parents and family. On the other hand low achieving medical students attributed their failures to internal controllable factors like difficulty in adjustment,deficient learning strategies, carelessness, lack of hard work and irregularity from classes
ABSTRACT
Objective: To determine, the susceptibility pattern of carbapenamase producing enterobacteriaceae [CPE] against polymyxinB, tigecycline and fosfomycin
Study Design: Descriptive cross sectional
Place and Duration of Study: The study was carried out in the Department of Microbiology PNS Shifa Karachi, from 26 Sep 2013 to 25 Mar 2014
Material and Methods: All specimens were inoculated on blood and macConkey agar, incubated aerobically at 35degreeC - 37degreeC for 18 to 24 hours. After identification of gram negative rods by colony morphology, Gram's staining and biochemical reactions, these were screened for Carbapenems resistance with imipenem and meropenem 10 microg discs along with routine first and second line antibiotics by Kirby-Bauer disc diffusion technique according to Clinical Laboratory Standard Institute [CLSI] guide lines. All isolated CPE were saved and then inoculated on Mueller-Hinton agar [MHA]. Antimicrobial susceptibility against polymyxin B, Tigecycline and Fosfomycin was done by Kirby-Bauer disc diffusion method using disc polymyxin B 300 units, Tigecycline 15microg and Fosfomycin 200microg. Zone diameters greater than 24 mm were taken as sensitive for Tigecycline 15microg, 16mm for Fosfomycin 200 microg and 12 mm for polymyxin B 300 units
Results: Clinical specimens of 171 patients who fulfilled the inclusion criteria were included in our study. Mean +/- SD of age was 42.02 +/- 22.367 with C.I [38.65 - 45.40]. Out of 171 patients 110 [64%] were male and 61 [36%] were female. In vitro susceptibility results revealed that all the 171 [100%] CPE isolates susceptible to PolymyxinB, while susceptibility against Fosfomycin and Tigecycline was 132 [77%] and 49 [29%] respectively
Conclusion: CPE were found to be 100% susceptible to polymyxinB, while for Fosfomycin and Tigecycline susceptibility was 77% and 29% respectively
ABSTRACT
Objective: To evaluate the clinicopathological characteristics of nasal polyps associated with chronic sinusitis in polypectomy specimens
Materials and Methods: A total of 78 cases clinically presenting with signs and symptoms of chronic sinusitis with nasal polyps were studied over a period of 2 years
Results: Out of 78 cases 57 were non-neoplastic and 21 were neoplastic polyps, out of these only two cases were malignant. Non neoplastic polyps were bilateral in 37 cases and unilateral in 30. Majority among non neoplastic category were of inflammatory polyps [53.73%]. Other types included allergic 26.86%, fungal infection with polyp 14.92% and lymphocytic category 4.47%. Majority of the cases that is 93.58%, including all types of polyps presented with nasal obstruction and signs and symptoms of chronic sinusitis
Conclusion: Nasal polyps with chronic sinusitis diagnosed clinically are not always non-neoplastic in nature. Hence, histopathological evaluation in all such cases is essential to diagnose both benign and malignant masses
ABSTRACT
Objectives: to evaluate the safety of unconventional use of a bone cutting instrument for ritual circumcision
Materials and Methods: record of all the cases undergoing circumcision between January 1, 2002 and December 31, 2006 was collected from the operation theatre logbook and reviewed to work out the incidence of iatrogenic injury, significant bleeding necessitating fluid replacement and adequacy of margins of preputial excision
Results: a total of 329 patients underwent circumcision as social or religious ritual during this 5 years period. No iatrogenic injury to penis took place and no significant bleeding was encountered. The excised margins did not require revision in any patient
Conclusion: the described technique for ritual circumcision using bone cutter can be considered as a safe method when done by trained hands
ABSTRACT
Objectives: Evaluation of effects of delay in presentation on the growth and general health of patients of PUV
Material and Methods: Clinical data of consecutive 25, radiologically diagnosed and endoscopically confirmed cases of posterior urethral valve was collected from the hospital record to study referral pattern, age at presentation, state of health [weight, height, hemoglobin level and serum creatinine level] at the time of presentation and severity of disease
Results: A little more than 50% of patients were referred by adult urologists while 20% patients car-he through their pediatricians. Only 2 patients presented in the neonatal age. Those who presented in the neonatal age had their weight and height well within normal range while 61% of patients presenting beyond neonatal age had their weight below the 3[rd] percentile for age and 65% of them had their height below the third percentile. Similarly those patients who presented in the neonatal age had their hemoglobin levels within normal range while 74% of patients presenting beyond neonatal life were anaemic. Serum creatinine level was raised in both the neonates but returned to normal or near normal after treatment while it persisted at a level above normal for patients who presented beyond neonatal age
Conclusion: There seems to be a need to improve awareness about this disease within the profession as well in the general public. Delay in referral significantly interferes with the growth and development of these patients
ABSTRACT
Objective: To compare the results of valve resection surgery by use of cold knife with those of hot knife
Material and Methods: Medical record of consecutive 28 patients, who underwent transurethral resection [TUR] of posterior urethral valve [PUV] was searched and patients were placed in two groups; those who underwent TUR with diathermy hook electrode [hot knife] were placed in one group [hot knife group] and those in whom cold knife was used for TUR were placed in the other group [cold knife group]. Evaluation was done by comparing the time taken for resection, presence or absence of bleeding at the time of surgery, need for another session of valve resection, incidence of iatrogenic injury and length of hospital stay after surgery
Results: There were 14 patients in each group. There was no significant difference in the two groups as far as duration of surgery, incidence of iatrogenic injury and length of hospital stay was concerned. No bleeding took place in the hot knife group while small amount of bleeding took place in one patient of cold knife group. None of these patients required second session of surgery for residual valve
Conclusion: Cold knife is at least as safe as hot knife for the purpose of resection of PUV
ABSTRACT
To evaluate the knowledge and attitude of health care professionals towards the process of sterilization and disinfection, and to check the adequacy of the reading material accessible to them. Prospective cross study conducted in October-November 2006. Setting: Teaching hospitals of Punjab. The study comprised of three components. In the first part, sections devoted to this subject in the popular books read by the students of operation theatre assistant course and students of diploma in general nursing were examined for adequacy and authenticity of information. In the second part, standard operating procedures were examined regarding sterilization of textile, rubber tubes of suction units and diathermy hand pieces of 20 operation theatres of three teaching hospitals attached to undergraduate medical colleges of Punjab. In the third part of the study, working knowledge of 64 practicing operation theatre assistants and 57 practicing nurses was assessed through a questionnaire. It was found that popular hooks either did not contain the required information or the information provided was misleading or incorrect. Standard operating procedures for sterilization of elected items of all the operation theatres studied fell much below the standard of practice desired in the light of current knowledge and contemporary practices. Finally, the working knowledge of the professionals studied was much below the hare minimum expected by the profession. There is a dire need for upgrading the knowledge and attitude of health care professionals regarding sterilization, besides improving the operation theatres sterilization procedures