ABSTRACT
Objective To determine frequency of urinary tract infection among asymptomatic diabetics, the etiological agents, antibiotic sensitivity and the pattern of antibiotic resistance to that organism
Methodology This cross-sectional study was conducted at Taj Medical Complex, Hamdard University Hospital, and Karachi. A total of 395 patients with Diabetes Mellitus were enrolled in our study. All data were transformed in a structured Performa. All lab analysis plus Urine C/S were done with written consent from the patients. Data was maintained and analyzed on SPSS version 20
Result Among the 395 included patients, 44 % [174] were females and 56 % [221] were males. 362 were taking oral hypoglycemic agents [OHA], 9 were under insulin and 24 were taking both insulin and OHA. The mean HbA1c was 8.08 +/- 1.29. Out of 395 samples of urine C/S of asymptomatic diabetic patients, 242 samples showed growth of organisms more than 105 CFU [colony forming units]. The most common organism in 160 [66.11%] cases was E.coli. The other organisms isolated were klebsiella in 37 [15.28%] cases, staph aureus in 30 [12.4%], proteus in 7 [2.3%], enterococcus in 8 [3.3%] case. UTI was found more common in those patients who were taking oral hypoglycemic agents as compared to those who were taking insulin. E-coli- was sensitive to ciprofloxacin in 88.75%, ceftriaxone in 67.9% and imipenum in 100%. Klebsiella was 100% sensitive to ciprofloxacin. It was also 100% sensitive to imipenum. Staph aureus was sensitive to ciprofloxacin in 70%cases and 77% sensitive to ampicillin. E.coli was resistant to ampicillin, cefixime and gentamycin. Klebsiella was resistant to ceftriaxone and pimpedic acid. Staph aureus was resistant to co-trimoxazole. Proteus was resistant to imipenum in 100% cases and enterococci were resistant to amikacin in 100% cases
Conclusion The study concluded that the prevalence of UTI is higher in females as compared to males in asymptomatic diabetic patients. E.coli was the foremost etiological agent of UTI. It was also observed that the diseases incidence increases with increasing age and vice versa. Because of the frequency and severity of UTI in diabetes, prompt diagnosis and early treatment is compulsory to prevent consequent complications
ABSTRACT
Objectives: To review the clinical presentations, management and outcomes of heat stroke patients presented to Hamdard University Hospital, Karachi in summer 2015
Study Design: Observational / descriptive study
Place and Duration of Study: This study was conducted at the Hamdard University Hospital [Taj Medical Complex], Karachi from 15[th] to 30[th] June 2015
Methods: A retrospective analysis of database of 51 patients presented with high grade fever [>1040F] and altered sensorium was performed. All data were transferred to proforma which included patient's demographic features [name, age and sex], clinical and laboratory parameters, treatment given, duration of hospital stay, outcomes [death or alive] and reasons of mortality. The SPSS version 19 was used for statistical analyses
Results: Majority of the patients [63%] were between 61-80 years of age group with mean +/- SD age was 69.24 +/- 11.28 years. Males were affected more than females [60.7% vs. 39.3% respectively]. Out of 51, 41 [80.4%] had co-morbidities and were on regular medications. The mean +/- SD Glasgow Coma Scale at the time of presentation was 10.29 +/- 4.33. The major laboratory derangements were hyponatremia [68.6%], elevated blood urea [52.9%], serum creatinine [41.2%] and alanine transferase [15.6%]. Standard treatment strategies were provided to all patients. Out of 51, 19 [37.3%] patients were expired as a result of multi-organ failure, shock, arrhythmias and rhabdomyolysis
Conclusion: Heat stroke is common in older males especially those who had co-morbidities. It carries a significant mortality due to multiorgan failure and shock