Antibiotic susceptibility patterns of bacterial isolates of patients with upper respiratory tract infections

Abstract To evaluate the antibiotic susceptibility patterns in URTIs reporting to tertiary hospitals of Lahore. A cross-sectional study employing 259 culture sensitivity reports obtained from tertiary care hospitals of Lahore. Using SPSS, descriptive statistics were used to estimate frequencies and percentages. In URTIs, S. aureus (5%) was the frequent gram-positive isolate followed by MRSA (1.5%) and MSSA (1.5%), while P. aeruginosa (15.8%) was the prevalent gram-negative isolate followed by Klebsiella (13.1%) and E. coli (6.9%). Against P. aeruginosa, ceftazidime (7.7%), cefuroxime/ceftriaxone (4.6%), amoxicillin (4.3%) and ciprofloxacin (4.2%), were tested resistant, while imipenem (11.2%), ciprofloxacin (9.2%), amikacin (9.2%), meropenem/ levofloxacin/gentamicin (8.1%) and piptaz (6.9%) were found sensitive. Against Klebsiella, carbepenems (7.3%), amikacin (6.5%), ciprofloxacin (5.4%) and gentamicin (5%) were tested sensitive, whereas, ceftazidime (8.5%), ceftriaxone (5.8%), cefaclor (5.5%), ampicillin (4.6%), co-amoxiclave (4.2%) and ciftazidime/ciprofloxacin (3.8%) were found resistant. Overall, imipenem (35%), meropenem (30.8%) and amikacin (31.9%) were the three most sensitive antibiotics, while ceftazidime (25.4%), ceftriaxone (19.2%) and ampicillin (18.5%) were the three most resistant antibiotics. Data suggested that P.aeruginosa and Klebsiella, were the most frequent bacterial isolates in URTIs of Lahore. These isolates were resistant to ampicillin, cefuroxime and ceftazidime, but were sensitive to carbapenem and aminoglycosides

Assessment of knowledge retention ability of undergraduate medical students

Background: Being a natural phenomenon, the knowledge learned by students is quickly forgotten. However, various factors are pertinent for one's memory and knowledge retention ability. This ability is not investigated earlier among pass and fail students of a particular exam

Objectives: To determine and compare short term memory and Knowledge retention ability among pass and fail students of mid-term exam

Methods: 103 first-year MBBS students were examined in 3 cycles after result of mid-term examination announced. These cycles consisted of 2 components related with short term memory [1[st] and 2[nd] cycles] and knowledge retention ability [3[rd] cycle] with one week duration apart

Results: Class attendance of pass, fail and absentees groups demonstrated statistically significant [P<0.0005] difference among them being in the order of pass> fail > absentees and significant correlation with marks obtained. A comparison between short term memory and knowledge retention ability also demonstrated statistically significant [P<0.0005] difference

Conclusion: The quality of learning positively correlates with the class attendance. Short term memory and knowledge retention abilities are significantly better in pass students and statistically correlate with each other. Regular conduct of such tests is suggested to assess short term memory and knowledge retention ability so that appropriate methods to enhance these can be adopted

Assessment of gender dimorphism on sagittal cephalometry in Pakistani population

Objective: To determine and compare the cephalometric values among Pakistani males and females using commonly used sagittal skeletal measurements [ANB, Wits appraisal, Beta-angle] and newly developed cephalometric analyses [Yen-angle and W-angle]

Study Design: Observational, cross-sectional study

Place and Duration of Study: Orthodontic Department of Baqai Medical University, Karachi, Pakistan, from August to October 2013

Methodology: A total of 209 pre-treatment lateral cephalometric radiographs of orthodontic patients were selected from departmental records, comprised of 92 males and 117 females. Radiographs were traced for measurements of ANB, Wits appraisal, Beta-angle, W-angle and Yen-angle. Patients were categorized into skeletal classes I, II, and III on the basis of performed measurements, incisor classification, and profile recorded from their records. Descriptive analysis was used to obtain median interquartile range in both the genders and Mann-Whitney U-test was used to observe gender dimorphism

Results: Skeletal class II was the most prevalent type of malocclusion. There were no difference in the obtained measurements between males and females except the Wits appraisal and Beta-angle in class II patients, which showed significant difference in values [p < 0.05]

Conclusion: Pakistani population has no significant different difference in the craniofacial morphology of males and females, with the exception of Wits-appraisal and Beta-angle in class II cases

Evaluation of acute toxicity, sedative and analgesic effects of Taverniera glabra methanolic extract on mice

Present study was conducted on crude methanolic extract of stem and root of Taverniera glabra. In Pakistan T. glabra is found in the region of Balochistan only. T. glabra has numerous therapeutic uses in traditional medicine and it is also used for the pain relief. Current study was carried out to evaluate acute toxicity, analgesic and CNS depressant activity of the plant. Acute toxicity was carried out by oral administration of the T. glabra extract from 250 to 2000mg/kg oral dose. Analgesic activity was carried out by acetic acid induced writhing test and formalin test. Central Nervous System [CNS] depressant activity was carried out by exploratory activities [open field activity, cage crossing activity, rearing test] and forced swimming test. Oral administration of the methanolic extract of T. glabra was nontoxic at the dose of 1500mg/kg in the acute toxicity test. Exploratory behavior of mice treated with the methanolic extract of T. glabra showed sedative effects [P<0.05] in open field, cage crossing, traction and rearing test, particularly at the dose of 500mg as compared with standard drug Diazepam. In forced swimming test, mobility time was significantly [P<0.05] increased at 500mg/kg oral dose, and results were significant as compared with control. Methanolic extract of T. glabra produced significant [P<0.05] analgesic effects at the dose of 500mg/kg in the acetic acid induced writhing test and the formalin test. In conclusion, results show that the crude methanolic extract of T. glabra possess sedative as well as potent analgesic effects. Present pharmacological studies are the first ever studies conducted on the methanolic extract of T. glabra

Conception of an ovarian heterotopic pregnancy

Spontaneous heterotopic pregnancy is a rare clinical condition in which intrauterine and extrauterine pregnancies occur at the same time. The occurrence of an ovarian heterotopic pregnancy is a rare singular event comprising only 2.3% of all heterotopic pregnancies, extremely rare among naturally conceiving women. We present a case of a 30-year old patient with a spontaneously conceived heterotopic pregnancy. The patient was admitted to our hospital with left iliac fossa pain and amenorrhea. A transvaginal ultrasound scan showed an ovarian and an intrauterine heterotopic pregnancy. A laparotomy with left oophorectomy was performed at 10 weeks of gestation. The patient was followed up on regular antenatal visits. A healthy baby was delivered via spontaneous vaginal delivery at 38 weeks. Heterotopic pregnancy can occur in women of reproductive age in the absence of any predisposing risk factor; only with an early diagnosis and treatment the intrauterine pregnancy will reach viability with a greater chance of a favorable obstetric outcome

Seroepidemiology of HTLV infection in Sabzevar blood donors from 2007 to 2008

Background: Human T-lymphotropic virus [HTLV], a retrovirus, is the causative agent of adult T-lymphocytic leukemia [ATL] and tropical spastic paraparesia [TSP]. HTLV-1 is transmitted mainly through blood transfusion. Sabzevar is an endemic region for HTLV infection; hence it is essential to detect the prevalence of HTLV1/2 infection in the blood donors of this city

Materials and Methods: In this cross-sectional study, blood samples of all donors referring to Sabzevar Blood Transfusion Center from 2007 to 2008 were screened for HTLV infection using ELISA, and positive samples were confirmed by western blotting. Data were analyzed in SPSS software version 17.0 using Chi squared and Student's t-test

Results: The results showed that 56 of donors [44 male: 78.6% and 12 female: 21.4%] were infected to HTLV, with average age 40.27 +/- 10.02. The prevalence of HTLV infection among all donors was 0.26%. There was a significant correlation between age, marital status, times of blood donation and educational levels and HTLV infection

Conclusions: Regarding lower rate of infection among younger and regular blood donors and donors with higher educational levels, it should be considered to select donors from this population

Temperature changes during and after eccentric contractions and its effect on force and desmin loss in rat

The typical features of eccentric exercise-induced muscle damage is prolonged loss of muscle strength and the most rapid structural change in the fibers is loss of immunostaining for the intermediate filament protein, desmin. In this study isolated perfused rat muscle was used to examine the direct effect of temperature changes on the eccentric contraction-induced force and desmin loss. The left medial gastrocnemius muscle was separated and the entire lower limb was transferred into a prewarmed [35 Degree C] organ bath. Temperature was adjusted to 31 or 39 Degree C during and after eccentric contractions. Maximal isometric force and desmin loss were measured after 15 isometric or eccentric contractions. According to our data, organ bath temperature changes during or after eccentric contractions had no significant effect on force loss. However, a strong correlation between desmin loss and temperature changes during [r = 0.886, P< 0.05] and a weak correlation between desmin loss and temperature changes after [r= 0.699, P<0.05] eccentric contractions was observed. Our results suggest that cooling during eccentric contractions may decrease desmin loss but temperature changes after eccentric contractions have no effect on desmin loss

Study of certain epidemiological aspects of cutaneous leishmaniasis in Khatam County, Yazd Province, Iran

Zoonotic Cutaneous leishmaniasis [ZCL] is one of the most important parasitic diseases in Iran and common in rural districts of half of the 30 provinces of the country. In recent years, ZCL has become a serious and increasing public health problem in Yazd province. Following the epidemic of CL in Khatam county of Yazd province, this study was carried out to determine the animal reservoir hosts and human infection in 2005-2006. 300 households were examined in February 2006 and corresponding forms were completed for each household during a house-to-house visit. Rodents were caught by 20 live traps, biweekly from late August to late November 2006. The rodents were identified morphologically and 4 impression smears were prepared from the edge of their ear lobes. The causative agent of the disease was isolated from humans and rodents characterized by RAPD-PCR method. The rate of ulcers and scars of ZCL among the inhabitants was 4.8% and 9.8%, respectively. Leishmania major was also isolated from human indigenous cases in Khatam County. In the study, Meriones libycus, Tatera indica and Rhombomys opimus were recorded and all of them were infected with leishmaniasis. Leishmania major was isolated and identified from R. opimus, too. Regarding the results of the present study, ZCL is prevalent in Khatam. It seems that R. opimus is the main reservoir host of the disease and M.libycus and T.indica also maintain this ZCL focus

KILUSAN LIGTAS MALARIA: Advancing Social Mobilization towards Sustainable Malaria Control in the Province of Palawan, the Philippines

As malaria continues to be a public health problem in the Philippines, its control is now the responsibility of the Local Government Unit (LGU). In this set-up, social mobilization is believed to be the key strategy in effective and sustainable implementation of malaria prevention and control activities. Palawan has always been the most malarious province in the country. Despite untiring malaria control efforts and huge funds spent to curb this malady for which Palawan has become known, this province remains the largest contributor of malaria cases and deaths. Thus, Kilusan Ligtas Malaria (KLM: meaning Movement Against Malaria) has focused on social mobilization in the implementation of malaria prevention and control. Microscopic confirmation of malaria is done by trained village microscopists, while health education-promotion activities, advocacy and linkage building are carried out by trained village community organizers. The noticeable outcomes are the increase in malaria case finding as reflected in the total number of malaria smears done, the increase in microscopic confirmation of malaria, and the decline in clinical diagnoses. Other outcomes include policy development and implementation in the form of executive orders and community ordinances to support the village microscopists and community organizers. Now, the biggest challenge of KLM is maintaining the momentum and sustaining gains.

[Postural deviations from chronic low back pain and correction through exercise therapy]

It has been shown that five deficits of the proprioceptive system and poor motor skills are associated with chronic low back pain [CLBP]. However, the exact mechanism is unknown. The objectives of this study were to assess the dynamic postural balance behavior of CLBP patients, as well as the effects of a specific exercise therapy for the treatment of CLBP and related postural imbalances. Sixteen females with CLBP and 30 healthy females all between 20 and 40 years of age, of similar height and weight, voluntarily participated in this study. Patients underwent a three-month therapeutic exercise program. The disability and back pain of the patients were measured using the Oswestry and Quebec questionnaires, respectively. A dynamic stability platform system [Biodex] was used to evaluate the postural imbalances in both groups. All measurements of the experimental group were repeated after the therapy. Overall deviation of center of gravity [COG] from COBOS in patients and controls were 3 [ +/- 0.3] and 1.3 [ +/- 0.2], respectively. Thus, postural imbalances were 2.3 times greater in the patients than those of the controls. After the treatment, the disability and pain of the patients were diminished by 53% and 58%, respectively. Furthermore, with the improvement of the patients COG deviation, both groups had similar posture. The postural orientation of CLBP patients was significantly improved by the therapeutic exercise program. The applied exercise therapy significantly reduced both the pain and the disability of the patients. Based on these conclusions, we recommend that postural correction be included in regular therapeutic exercise programs

Prevalence of axis-I and axis-II disorders: with special reference to gender, marital status education and socio-economic level

The present research aims to determine prevalence of Axis-I and Axis-II, disorders in patients visiting out patient unit of the Institute of Clinical Psychology, University of Karachi. Archival study Institute of Clinical Psychology, University of Karachi, during January 01, 2006 up to July 31, 2006. In present study, it was hypothesized that 1] There would be a significant difference in the prevalence of Axis-I and Axis-Il disorders. 2] The prevalence of psychological disorders and seeking psychological help would be related to gender, marital status, educational and socioeconomic level of the patient. Out of 430 clients registered during one-year duration, only 125 files were analyzed. Out of 125 patients, 119 were diagnosed on Axis-I-Clinical disorders and other conditions that may be a focus of Clinical attention and 06 were diagnosed on Axis-II-Personality disorders on DSM-l V-TR[1]. Demographic information was taken from Intake form and case history sheet developed by Institute of Clinical Psychology, University of Karachi. Percentages were calculated taking into consideration number of cases on variables of Axis-I and Axis-II, gender, marital status, education and socioeconomic level of the patients diagnosed on Axis-I and Axis-II It is clear from the results that Axis-I disorders are more prevalent than Axis-II disorders. Trends were also noted for more males, unmarried people, more educated and people belonging to middle socio economic class seeking psychological help or/and suffer more from Axis-I and Axis-II disorders than female, married, less educated and those belonging to Upper socio economic class. Looking at the trends through demographic characteristics of the patients seeking psychological help we believe that awareness program may be introduced in different communities in order to develop psychological sophistication among people and to motivate those segments of society who avoid seeking psychological help