Antibacterial effect of nsaids on clinical isolates of urinary tract infection and diabetic foot infection

Non Steroidal Anti-inflammatory Drugs [NSAIDS] are a group of chemically dissimilar agents that have primary effect of inhibition of prostaglandin's synthesis. Aspirin [Acetyl Salicylic Acid] is used as an analgesic, anti pyretic, anti-inflammatory agent and also have an anticoagulant effect. Tylenol [acetaminophen] is used as pain reliever. The objective of this study was to determine the effect of Aspirin and Tylenol against clinical isolates of urinary tract infection [UTI] and diabetic foot infections. A total of 100 clinical isolates were analyzed. Out of these 50 were urine samples from diabetic patients with UTI and 50 pus samples from diabetic foot infection. Bacteriological study was done by inoculating urine samples on Cysteine Lactose Electrolyte deficient [CLED] media. Pus samples were inoculated on Blood agar and MacConkey's agar. Identification was done by colony characteristics, gram staining and standard biochemical tests and Quick Test Strip [QTS-20] DESTO Laboratories, Karachi. Antibacterial effect of Aspirin and Tylenol were tested against 100 clinical isolates by Replica plate method, Agar well diffusion method and tube dilution method. Concentrations of Aspirin and Tylenol [10 micro g, 50 micro g, 100 micro g, 500 micro g, 1000 micro g] were made in Muller Hinton media. Bacteria isolated from urine samples were Escherichia coli 30%, Staphyloccus aureus 20%, Entrococcus faecalis 10%, S.saprophyticus l0%, Proteus spp 6%, Pseudomonas spp.6%, S. pyogenes 6%, S. agalactiae 6%, S.epidermidis 4%, and Klebsiella spp. 2%. Bacteria isolated from pus samples were S aureus 30%, Pseudomonas aeruginosa 18%, S.epidermidis 14%, Klebsiellapneumonia 12%, Proteus mirabilis 12%, E. coli 10%, P.vulgaris 4%. Aspirin was effective at 100-500 ug concentration against all isolates. Tylenol has marked effect on pathogens at 100 micro g concentration. Aspirin and Tylenol along with analgesic, anti-pyretic, anti-inflammatory properties also have marked anti bacterial effect on isolates from UTI and Diabetic foot infections and inhibits the growth of both gram negative and gram positive bacteria, and both can be used synergistically with antibiotics for effective treatment

Managing shoulder dystocia: perceptions of accoucheurs regarding their training

To assess the perceptions of labour ward staff at teaching hospitals regarding their theoretical and practical training for the management of shoulder dystocia as well as their opinion for further need of such trainings. Across sectional survey. At Islamic International Medical College, Railway Hospital Rawalpindi and College of Physicians and Surgeons Regional Centre Islamabad, from October to November 2008. The study was carried out by using a six item questionnaire. Four items were related to the respondent's training regarding the management of shoulder dystocia while two wete about their response to frequently performed actions which are known to increase the incidence of complications associated with the management of shoulder dystocia. Among sixty seven healthy personnel's involved in the management of parturient in the labour ward, 86.6% [n=58] were doctors and 1 3.4% [n=9] were midwives. The years of experience managing labouring patients ranged from 1 to 30 years. Although only 1 8% [n=1 2] thought that they did not have any theoretical training in shoulder dystocia and 40% [n=27] thought that they did not have any practical training, almost 72% [n=48] expressed a need for more theoretical and 91% [n=61] wanted more simulated training to manage shoulder dystocia. However, only 7.5% [n=5] of respondents involved in this survey said they would use fundal pressure and 1 0.4% [n=7] would apply strong traction to the fetal neck. In the opinion of labour ward attending physicians, the current level of their training for the management of shoulder dystocia is inadequate and there is a need for organizing regular practical training programs to improve their skills in managing this obstetric emergency