Outcome of mechanical mode of induction in failed primary labor induction

To determine the role of an alternate [mechanical] inducing agent in failed labor induction. Quasi-experimental study. Labor Ward at Mother and Child Health Center [MCH], Pakistan Institute of Medical Sciences [PIMS] from May 1999 to July 2003. Women with singleton term gestation and normal live fetus undergoing indicated induction of labor were included if Bishop score was < 5 after 12-18 hours of primary induction with PGE2 vaginal tablets. They were then induced with mechanical method i.e. intracervical foley catheter, if fetal status was reassuring and no evidence of labor onset. The main outcome measure was mode of delivery. Secondary outcome measures were induction labor interval and induction delivery interval after second mode of induction and neonatal Apgar score. Thirty-six women received a second mode of induction for failed induction. Four patients were excluded. Of 32 eligible women, 24 [75%] delivered vaginally. Eight patients [25%] had emergency caesarean section. Mean induction labor interval after second mode of induction was 6.8 hours and mean induction delivery interval was 12.39 hours. Mean Apgar score at 1 minute and 5 minutes was similar in both vaginal deliveries and caesarean sections. When an alternate mechanical method was used, 75% of women labeled as "failed induction" delivered vaginally

Frequency and sensitivity pattern of extended spectrum beta lactamase producing isolates in a tertiary care hospital laboratory of Pakistan

To determine frequency, distribution and sensitivity pattern of Extended-Spectrum

Frequency and sensitivity pattern of extended spectrum beta lactamase producing isolates in a tertiary care hospital laboratory of Pakistan

To determine frequency, distribution and sensitivity pattern of Extended-Spectrum 6 Lactamase [EBSL] producing organism at a tertiary care hospital in Pakistan. All members of enterobacteriacae isolated between April and August 2002 were studied. Isolates were speciated according to standard biochemical tests. Susceptibility testing was performed by Kirby-Bauer method. ESBL was detected using double disc method using cefotaxime versus cefotaxime plus clavulanate according to NCCLS. Statistical analysis was performed by SPSS version 10. Test of significance were calculated using chi-square test. Results : During the study period, 1137/2840 [40%] of the isolates tested were found to be ESBL producing. ESBL positivity was detected in 50% Enterobacter sp., 41% E.coli and 36% K.pneumoniae. ESBL production was noted in 52% of nosocomial isolates tested [415/799]. ESBL was more frequent in patients at the extremes of ages [under 5 years and more than 60 years]. Cross-resistance to non-beta lactam antibiotics [flouoroquinolones, aminoglycosides and co-trimoxazole] was also more frequent in ESBL producing organisms [p<0.05]. A high frequency of ESBL positivity amongst our isolates is documented which is alarming in low-income settings where expensive second line agents are unavailable. Our data supports urgent need for regular screening and surveillance for these organisms