Ciprofloxacin; the frequent use in poultry and its consequences on human health

Fluoroquinolones are bactericidal agents that exhibit AUC/MIC dependent killing. In general, they are effective against Gram-negative organisms and some mycobacteria. Ciprofloxacin is the members of this group and its bactericidal action involves the impeding of enzyme topoisomerase II and IV. In human beings, this drug is recommended for a variety of infections including typhoid fever, chronic bacterial prostatitis, lower respiratory tract infections, skin infections, urinary tract infections, acute exacerbations of chronic bronchitis, complicated intra-abdominal infections, infectious diarrhea, and uncomplicated cervical as well as urethral gonorrhea. The drug is as effective in animals as in humans, and is therefore used in animals as well. According to European health law and National Office of Animal Health [NOAH], UK, the statutory withdrawal period for veterinary medicinal products must not be less than 28 days for meat from poultry. The chicken used for meat purpose usually is of the age between 6 to 8 weeks, therefore the use of the drug must be discontinued by the age of 2 weeks. Whereas the age of chick at which it usually develops indicated diseases, is 3 weeks. In this situation, it is not possible to attain a withdrawal period of 28 days. Based on these observations, ciprofloxacin use may not be recommended in poultry for treatment of diseases as it may cause unnecessary exposure to humans while utilizing poultry meat and may lead to the development of drug resistance

Alternative medicine; the tendency of using complimentary alternative medicine in patients of different hospitals of Lahore, Pakistan

From ancient times, humankind has used self-created traditional methods for handling the illnesses and continues to use them along with modern medicine. Even today, more than 70% of the world's population still depends on the complementary and alternative systems of medicine [CAM]. The objective of this study is to create awareness of health hazards with the use of CAM therapies and to find out its utility among Pakistani population. Comprehensive questionnaire was developed for the study on the use of CAM and was distributed to 470 patients/attendants in different hospitals of Lahore as well as major hospitals and clinical setups in the peripheral regions of Lahore, Pakistan. Over all, the response rate of the study was 81.7% while 78.1 % population found as CAM user. The most common type of alternative medicine used by patients is from Hakeem [Natural Therapist] which is about 17% and the most frequent disease for which patients often go for CAM therapy is liver diseases [19%]. Respondents found inclined towards CAM only due to its marketed false benefits and not because of their dissatisfaction with conventional therapy. A noteworthy population of Pakistan is using CAM therapies from different practitioners, irrespective of any education and awareness about their disease and long-term drawbacks because of improper treatment of the disease. Though adverse events due to the use of CAM therapy are not unusual still a delay in the proper treatment usually ends up in serious consequences and even loss of lives

Neonatal Intracranial Ischemia and Hemorrhage : Role of Cranial Sonography and CT Scanning

OBJECTIVE: To evaluate the role of cranial sonography and computed tomography in the diagnosis of neonatal intracranial hemorrhage and hypoxic-ischemic injury in an Indian set-up. METHODS: The study included 100 neonates who underwent cranial sonography and computed tomography (CT) in the first month of life for suspected intracranial ischemia and hemorrhage. Two observers rated the images for possible intracranial lesions and a kappa statistic for interobserver agreement was calculated. RESULTS: There was no significant difference in the kappa values of CT and ultrasonography (USG) for the diagnosis of germinal matrix hemorrhage/intraventricular hemorrhage (GMH/IVH) and periventricular leucomalacia (PVL) and both showed good interobserver agreement. USG, however detected more cases of GMH/IVH (24 cases) and PVL (19) cases than CT (22 cases and 16 cases of IVH and PVL, respectively). CT had significantly better interobserver agreement for the diagnosis of hypoxic ischemic injury (HII) in term infants and also detected more cases (33) as compared to USG (18). CT also detected 6 cases of extraaxial hemorrhages as compared to 1 detected by USG. CONCLUSION: USG is better modality for imaging preterm neonates with suspected IVH or PVL. However, USG is unreliable in the imaging of term newborns with suspected HII where CT or magnetic resonance image scan is a better modality.

Giant angiomyolipoma associated with a dilated vessel prone to hemorrhage

Angiomyolipomas are benign neoplasms of the kidney which can clinically mimic renal malignancy. The imaging features are quite characteristic, and diagnosis can be clinched solely based on radiological investigations. Although mostly asymptomatic, they can be a cause of significant morbidity due to size and hemorrhage. We report a case of giant angiomyolipoma with a dilated vessel susceptible to hemorrhage

Hydrometrocolpos due to persistent urogenital sinus mimicking neonatal ascites

A urogenital sinus is a common channel into which both the urethra and genital tracts open. Occasionally there might be transverse obstructing membrane leading to hydrometrocolpos from either uterine secretions or urine. Although the presentation is varied, a neonatal presentation of a large hydrometrocolpos mimicking gross ascites is rare. A 3-day-old female infant was referred to us from periphery as a case of gross ascites of unknown cause. Patient was having rapid and shallow breathing and had gross ascites. The patient was evaluated and was diagnosed to have large hydrometrocolpos. To avoid unnecessary delay in diagnosis and proper treatment the possibility of hydrometrocolpos secondary to urogenital sinus presenting as generalized abdominal distension should be kept in mind. A focused genital examination can help achieve the diagnosis