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1.
Medical Forum Monthly. 2013; 24 (3): 22-27
in English | IMEMR | ID: emr-142527

ABSTRACT

Frequency causative organisms and their sensitivity to the commonly used antibacterial agents in cases of urinary tract infections. Observational study This study was conducted at Medical Wards of Civil Hospital Karachi from 1st November 2010 to 30th April 2011. This study consisted of 415 patients were selected for urine culture and sensitivity from medical O.P.D. and hospitalized patients in medical wards. Detailed history was taken from all the patients with special regard to symptoms and duration of UTI. Inclusion criteria were that all patients who had symptoms of urinary tract infection like frequency of micturition by day and night, painful voiding [dysuria], suprapubic pain and tenderness, hematuria, smelly urine, urgency, loin pain or swelling and patients who had more than 6 pus cells in urine D/R examination. Urine samples from OPD patients were randomly assigned to different reputable clinical pathological laboratories including pathological laboratory of Civil Hospital, Karachi, for urine culture and sensitivity. 415 patients 265[63.8%] were females and 150[36.2%] were males. 415 urine samples who were subjected to urine culture and sensitivity examination. Only 200 [48.2%] samples were found to had infection i.e. significant growth of 105 of microorganism/ml or more, while 142 [34.2%] samples did not show growth of any organism, and 73 [17.6%] samples showed growth between 104 and 105 of microorganism/ml . E. Coli 49.5% is the commonest organism causing UTIs in outpatients as well as in hospitalized patients. The second commonest organism in OPD is Klebsiella 16%, while in hospitalized patients it is Pseudomonas. The antibiotics susceptibility of the isolated organisms during the study and shows the percentage of sensitivity of the isolated organisms. E. coli the most common organism isolated showed high resistance pattern to ampicillin, amoxicillin, and co-trimoxazole 62%, 60%, 70%, respectively. E. coli the most common organism isolated showed a high sensitivity pattern to amoxicillin/clavulanic acid 85%, pipemidic acid 80%, norfloxacin 85%, ofloxacin 92%, ciprofloxacin 90%, tobramicin 98%. Generally a higher percentage of the organisms isolated were sensitive to all these antibiotics except amoxicillin/clavulanic acid which had a high resistance pattern to Pseudomonas 77%. Escherichia coli is still the commonest organism causing urinary tract infection, in outpatients as well as in hospitalized patients


Subject(s)
Humans , Male , Female , Bacterial Infections/epidemiology , Urinary Tract Infections/microbiology , Escherichia coli/pathogenicity , Drug Resistance, Bacterial , Bacterial Infections/epidemiology , Urinary Tract Infections/drug therapy , Escherichia coli/drug effects
2.
Medical Forum Monthly. 2013; 24 (2): 17-21
in English | IMEMR | ID: emr-142541

ABSTRACT

To compare the outcome with and without aspiration of the amoebic liver abscess. Comparative study. This study was conducted at Medical Wards of Civil Hospital Karachi from August 2010 to September 2011. Study consisted of 100 patients and divided into two groups. Both the groups received medical therapy from day 1 which included Metronidazole injection 500mg i/v 8 hourly. Liver abscess was diagnosed on clinical features, ultrasound finding, aspiration with clinical study and serological tests for amoebiasis In Inclusion criteria; age greater than 12 years and less than 60 years and Evidence of liver abscess on abdominal ultrasound. In Exclusion criteria; a] Patients of less than 12 years and more than 60 years and pregnant woman. Mean age of ALA in Group A 36.98+ 3.25 years in both group with male female is ratio of 4:1. Anaemia was present in 76% cases, leukocytosis was found in 90% case. Among them 4[4.44%] cases had leukocyte count greater than 30,000/mm3 with absolute neutrophilia. 16[17.77%] patients had TLC in the range of 21,000-30,000/mm3. However, the majority of cases 70 [77.77%] had TLC in the range of 10,000-20,000/mm3 and only 10 patients had normal TLC. ESR was found in triple figure in 24% cases, whereas in 40% cases it was between 50 and 100 and in 36% patients found below 50mm/1st hour. Liver aspiration was done in 72 cases. The colour of aspirate was reddish brown in 60 cases [83.33%] and yellowish in 12 cases [16.66%]. Air bubbles were not demonstrated in any case. Trophozoites of Entamoeba histolytica were demonstrated in 5 cases [10%]. Serologic test for ALA i.e. indirect haem agglutination test was proved to be very specific with 100% showing high antiamoebic antibody titre. The mean abscess size 6.5 cm in Group A and 7.3 cm in group B. The mean abscess size and the impact of aspiration in terms of normalization in fever, TLC and improvement in LFTs. Percutaneus aspiration is a safe and effective treatment of amoebic liver abscess disease


Subject(s)
Humans , Male , Female , Biopsy, Fine-Needle , Polymerase Chain Reaction , Liver Abscess, Pyogenic , Agglutination Tests
3.
Medical Forum Monthly. 2013; 24 (11): 16-19
in English | IMEMR | ID: emr-161174

ABSTRACT

To Determine the frequency of chronic backache in the nursing staff of a tertiary care hospital. Cross sectional study. This study was carried out at Civil Hospital Karachi from 1[st] November 2011 to 30[th] April 2012. Two hundred seventy two patients were included who fulfilled the inclusion criteria after taking the informed consent. The SPSS version 14 was applied to the data. Data was analyzed through SPSS software. 49 [18%] males and 223 [82%] females. The mean age of study population was 43 +/- 7.5 years and mean duration of job was 19.3 +/- 7.6 years. 10 [3.7%] subjects had history of daily duration of work of less than 6 hours and only 06 [2.2%] work for more than 12 hours daily as compared to this 256 [94.1%] study subjects work for 6-12 hours daily. 05 [1.8%] had history of posture of sitting at most of their working hours, followed by 10 [3.7%] standing, 85 [31.3%] mobile and 172 [63.2%] subjects had non-specific posture. 197 [72.4%] had backache as compared to this 75 [27.6%] did not had backache. Out of 197, 05 [1.8%] had backache at thoracic area, another 05 [1.8%] had backache at cervical and lumbar areas followed by 20 [7.4%] had backache at cervical area and 167 [61.4%] had backache at lumbar area. 77 [28.3%] had the history of radiation of backache. 7 [2.6%] had backache for <6 weeks, 32[11.8%] had backache for 6 weeks to 3 months and 158 [58.1%] had back ache for >3 months. The findings of this study suggest that backache is a common problem in the population of nurses in Pakistan. LBP is a widespread disease affecting nurses but not a major cause of sickness absence in the workplace. Poor knowledge of back care ergonomics and unavailability of lifting equipment are major predisposing factors to LBP among nurses [occupation hazard oriented]

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