ABSTRACT
Objective: To determine the frequency of E. coli resistance to ciprofloxacin and common factors leading to it among patients presenting with urinary tract infection
Study Design: Descriptive cross-sectional study
Place and Duration of Study: Department of Medicine, Ayub Teaching Hospital, Abbottabad, from December 2011 to June 2012
Methodology: A total of 166 patients, > 18 years of age of both gender, who presented with features of UTI and had urine culture positive for E.coli were included in the study. The urine samples were further tested for ciprofloxacin resistance and the patients were further checked for the common factors leading to E.coli resistance to ciprofloxacin
Results: Among 166 patients, 41 were male and 125 were female patients. Sixty-six [39.8%] E. coli isolates showed ciprofloxacin resistance. Male gender [p-value 0.001], previous history of recurrent UTI [p = 0.008, OR = 2.37], history of prior use of ciprofloxacin [p = 0.018, OR = 2.16] and history of catheterization [p = 0.005, OR = 4.80] were independent risk factors found in this study for the development of ciprofloxacin resistant UTIs
Conclusion: Ciprofloxacin resistance rates of E.coli were high at over 39.8%. The risk factors that affected the ciprofloxacin resistance rates of E.coli were prior use of ciprofloxacin, recurrent UTI, previous catheterization and male gender. Ciprofloxacin should be prescribed cautiously in patients with these risk factors and urine culture and sensitivity test should be performed for optimal treatment
ABSTRACT
Hodgkin's lymphoma has been traditionally defined as a hematopoietic neoplasm composed of diagnostic Reed-Sternberg cells. More than 70% of the cases involve cervical or supraclavicular lymph nodes. Isolated sub-diaphragmatic lymphadenopathy or organ involvement is rare. We present the case of Hodgkin's lymphoma in a 51 years old female, who presented with obstructive jaundice and lymphadenopathy, empirically treated previously as a case of tuberculosis. Chemotherapy with modified ABVD protocol was given with dose modification according to LFT's. Her liver functions returned to normal levels after the first cycle. The main purpose of reporting the case is to stress definitive diagnosis of the disease before initiating treatment and the modified chemotherapy regimen used in this infrequent presentation of the disease
Subject(s)
Humans , Female , Hodgkin Disease/drug therapy , Jaundice, Obstructive , Lymphatic DiseasesABSTRACT
Chronic rheumatic heart disease is the commonest cause of mitral stenosis. Incidence of rheumatic MS parallels that of acute rheumatic fever. Atrial fibrillation usually develops in the presence of pre-existing ECG evidence of left atrial enlargement and is related to the size of the chamber, the extent of fibrosis of the left atrial myocardium, the duration of the atriomegaly and the age of the patient. The tendency for development of systemic embolization correlates directly with the patient's age and the size of the left atrial appendages and inversely with the cardiac output. Eighty percent of the patients of MS in whom systemic emboli develop are in atrial fibrillation. A descriptive study was designed in the Department of Medicine, K E Medical College / Mayo Hospital and Punjab Institute of Cardiology, Lahore. A total of 129 conservative cases of mitral stenosis were included in this study, based upon convenient patient sampling. A total of 112 patients were followed up properly, the remaining 17 were lost to follow. The results showed left atrial size and MVA have an inverse correlation [p = 0.017]. LAT has a strong association with AF in cases of MS [p = 0.002]. The severity of MS does not influence the frequency of AF [p = 0.24]. It was thus concluded that left atrial size and MVA have an inverse correlation [p = 0.017]. LAT has a strong association with AF in cases of MS [p = 0.002]. The severity of MS does not influence the frequency of AF [p = 0.24]