ABSTRACT
Objective: To investigate and compare the resistance and sensitivity of Salmonella typhi samples to commonly used antibiotics in three major divisions of Bangladesh and to evaluate the gradually developing resistance pattern. Methods:The antibiotic susceptibility of 70 clinical isolates collected from blood, sputum, urine and pus samples were identified by specific antisera and with standard biochemical tests. The patients were divided into 5 age groups. Susceptibility and resistance was also tested by Kirby-Bauer disc diffusion method using 12 regularly used antibiotics. Results:Antibiotic susceptibility test demonstrated that 64.28% isolates of Salmonella typhi were multidrug resistant. Present study suggests that the clinical samples were mostly resistant against nalidixic acid with all age groups and in all three divisions with similar resistance pattern. Resistance is more common among adult people (30-40 years) and children (0-10 years).Salmonella typhi was mostly sensitive against gentamycin, chloramphenicol and ciprofloxacin. Conclusions: Although the population density of Dhaka region is markedly higher than Rajshahi and Chittagong regions, no significant difference in resistance pattern was found. The rate of multidrug resistance is a matter of concern. Physicians should reconsider before prescribing nalidixic acid and cefixime. Further molecular study is needed to reveal the genomic and proteomic basis of resistance.
ABSTRACT
The key target of this review is to compare the efficacies of the different adjuncts and methods used in the management of benzodiazepine dependence (tolerance and withdrawal) and poisoning. A systemic review of randomized controlled trials was carried out to determine which method of adjuvant therapy can be best used to overcome the withdrawal symptoms exhibited during benzodiazepine discontinuation. In addition, different tapering methods employed have also been presented in this review. Zolpidem in combination with cognitive behavioural therapy with a parallel gradual taper after conversion to long half-life Benzodiazepine seems to be a promising method among the several analysed. Finally the efficacies of the two available methods to combat benzodiazepine toxicity, namely flumazenil and naloxone have been discussed and compared.