Effect of calcium hypochlorite and chloramine on blood biochemistry and sodium pentobarbital induced sleeping time in mice

Disinfectants are chemical agents used to eradicate, deactivate or kill microorganisms. Chemical disinfectants especially chlorine compound are extensively used for water sanitization. Among these calcium hypochlorite and chloramines are commonly used now a day. Large number of chemical compounds, drugs and endogenous substances are metabolized by hepatic enzymes known as cytochrome P450 enzyme system. Many chemicals are capable of enzyme induction. Enzyme induction may change the metabolism of other drugs and endogenous substances which may alter the plasma concentration of these chemicals. To evaluate the enzyme inducing ability of calcium hypochlorite and chloramine, sleeping time induced by sodium pentobarbital was noted in mice. Normal saline was taken as negative control. Rifampicin, chloramphenicol and grapefruit juice were taken as positive control group. On completion of dosing after 4 weeks, alteration in sleep induction and recovery times was noted and compared. Histological evaluation of liver was observed. Asignificant decrease in sleeping time was observed in calcium hypochlorite and chloramine treated groups. Both calcium hypochlorite and chloramine caused a significant change in liver enzymes and in the values of complete blood count.In histological evaluation both caused fat deposition in the hepatocytes. It was concluded from the study that both calcium hypochlorite and chloramine were hepatic microsomal enzyme inducer

Imipenem Resistant Pseudomonas aeruginosa: The fall of the final quarterback

Objective: To isolate, determine the frequency, and study the demographic trends of MBL positive Pseudomonas aeruginosa from imipenem resistant isolates collected from clinical samples in a tertiary care hospital of Pakistan. Methods: In this cross sectional study a total of 230 strains of Pseudomonas were isolated from various clinical specimens on the basis of culture and biochemical tests. Imipenem resistant isolates were selected by Kirby Bauer Diffusion technique, followed by screening for MBL production by Imipenem EDTA Combined Disk Test. Demographic details of each patient were recorded on a separate questionnaire. Chi-Square goodness-of-fit test was computed to review the isolation of MBL positive isolates [P-value = 0.05] in different specimen. Results: Out of 230 strains of P. aeruginosa 49.5% were imipenem resistant; MBL production was confirmed in 64.9% of the resistant isolates. Resistance to polymyxin B [12.5%] was notable. Majority of the MBL positive strains were isolated from patients aged between 20-39 years [45.9%] and the predominant source was pus [43.24%] which was found to be statistically significant [P-value=0.04]. Outpatient departments [24.3%] and burn unit [21.6%] were the major places for resistant isolates. Conclusion: MBL production is one of the major causes of IRPA. Increasing resistance to polymyxin B is grave. Due to acquisition of MBL strains MDR P. aeruginosa has become endemic in tertiary setups

Congenital constriction ring of limbs in subjects with history of maternal substance use

Congenital Constriction Ring [CCR] is a rare malformation which manifests itself in the form of ring-like constrictive bands. Due to its heterogeneous nature, its etiology remains unclear. Here, we present a series of seven independent individuals afflicted with CCR, which primarily involved the digits. The phenotypic manifestations included terminal phalangeal reduction, anonychia, digit hypoplasia, and acrosyndactyly. Mesoaxial digits in hands and preaxial digits in feet were most frequently affected. Camptodactyly and clubfoot were witnessed in four and one subject, respectively. Curiously, mothers of six of these subjects revealed that they consumed copious amounts of Multani mitti[Fuller's clay] and/or Naswar[nonsmoke-tobacco], during their respective pregnancies. Maternal substance use during pregnancy is not an unusual practice, however, its relationship with CCR as pregnancy outcome remains unexplored. Case-control studies are warranted to elucidate the relationship between the exposure to these substances and the etiology of CCR and/or other limb defects in the offspring

Assessment of patient satisfaction with mental health services in a tertiary care setting

Patients' opinion regarding services has acquired great importance. Patient satisfaction is playing an increasingly important role in quality of care reforms and health-care delivery. The study aimed to measure patient satisfaction in a tertiary care hospital in order to know the patients' perspectives and expectations of the services and make appropriate improvements accordingly. This was a crosssectional study conducted at the Out-patient and Inpatient Departments of the Institute of Psychiatry, Benazir Bhutto Hospital, Rawalpindi, for a period of 8 months from October 2008 till June 2009. Sample size was 246 patients; which included 123 participants from Out-patient and In-patient departments each. Patients aged 18 and above, of both genders, who gave informed written consent, were consecutively recruited for the study. Learning disabled patients, frankly psychotic and those with severe cognitive impairment and severe co-morbid physical illnesses were excluded. Performa was filled in by the participants for their demographic details. The Client Satisfaction Questionnaire-8 was then orally administered in the native language [Urdu/Punjabi] to assess the degree of patient satisfaction. Among the participants, 72% were mostly satisfied, 18.7% mildly satisfied and 9.3% dissatisfied with the psychiatric care. Age was significantly associated with satisfaction however no such associations could be found for gender and economic status. Majority of the patients were satisfied with the psychiatric services. The younger people were more satisfied. Gender and economic status had no influence on patient satisfaction