Management of club foot by ponseti method: our experience

Objective: To present our experience of treating the club foot with the Ponseti way of conservative management. Study Design: Cross-sectional prospective study. Place and Duration of Study: Study was carried out at CMH Sialkot and CMH Rawalpindi, from Jun 2012 to Jun 2015

Material and Methods: A total of 39 children were treated by the same surgeon and 35 cases were included in this study. Ponseti method involves the non-surgical management of clubfoot, involving manipulation and casting techniques. The foot is systematically stretched as per Ponseti method into the normal shape and repeated casts are applied. Equinus is later treated by percutaneous tendoachilles tenotomy if required

Results: Our aim was over correction of the deformity before advising for foot abduction brace. Thirty one [88.57%] cases showed excellent results while we faced difficulty in achieving the required aim in 4 [11.43%] cases

Conclusion: Ponseti clubfoot management technique has reduced the need for extensive soft tissue release and major clubfoot surgery. This technique has been successful in our setup too. We recommend that it may be adopted as the gold standard for clubfoot treatment throughout the country and primary health care physicians should also be trained in this technique so that maximum people may benefit from this

In vitro effect of new antibiotics against clinical isolates of salmonella paratyphi A

Objective: The objective of this study was to determine in vitro MIC patterns of various therapeutic alternatives for the treatment of Salmonella Paratyphi A. Study Design: Cross-sectional study. Place and Duration of Study: Armed Forces Institute of Pathology Rawalpindi, from Jun 2012 to May 2014

Material and Methods: Clinical samples were collected from suspected cases of salmonella infections. Culture was applied on Bactec 9050 special and/or standard media. Suspected Salmonella Paratyphi colonies were tested by API 20E and confirmed by serology. The isolates were also tested for resistance to ampicillin, cotrimoxazole, ciprofloxacin, ceftriaxone, doripenem, imipenem, ertapenem, aztreonam, moxifloxacin, cefpirome, cefepime, gatifloxacin, and chloramphenicol by Kirby-Bauer disc diffusion method. MIC [Minimum Inhibitory concentration] was done on MDR and ciprofloxacin intermediate or resistant cases by E-strips

Results: One hundred and eleven isolates of Salmonella Paratyphi were recovered from 2230 specimens. Resistance by disk diffusion technique noted in Salmonella Paratyphi A was ampicillin 60%, chloramphenicol 40%, cotrimoxazole 38%, ceftriaxone 7.9%, ciprofloxacin 8%, cefpodoxime 7.9%, imipenem and ertapenem 2.6%, aztreonam 1.3%, moxifloxacin 6.6%, and gatifloxacin 1.3%. No resistance was noted for doripenem and cefepime. MIC50 was 0.094 for Cefpirome, 0.125 Aztreonam, 0.25 imipenem and tigecycline, 2 cefpodoxime and 8 for azithromycin

Conclusion: Azithromycin, Aztreonam, Imipenem, tygecycline, cefpodoxime and cefpirome are potential therapeutic agents for resistant Salmonella Paratyphi A infections

Disseminated infection with multiple cold abscesses caused by Rhizopus Arrhizus in an immunocompetent girl

Although infections with fungi, such as Rhizopus species, usually occur in diabetics or immunocompromised patients, they can also rarely affect immunocompetent individuals. We present a case of disseminated infection with multiple cold abscesses in a 13-year, otherwise healthy girl caused by Rhizopus arrhizus

Awareness of hepatitis 'B' among people of khyber pakhtunkhwa province of Pakistan

Hepatitis B virus is causing serious health concerns in countries like Pakistan. In Khyber Pakhtunkhwa province, 0.6 milion people were estimated to be infected with this virus in 2008. The authors aimed to assess knowledge regarding vaccination, testing and routes of transmission of hepatitis B virus among people of Khyber Pakhtunkhwa, as such knowledge among masses will help limit the infection. People belonging to 12 different districts of Khyber Pakhtunkhwa province were interviewed over a period of 5 months from October 2013 to February 2014. A pre-tested questionnaire was used and in-person survey of randomly selected 1,938 people was carried out throughout the province. Ninety-nine percent people said they knew about hepatitis B virus and 42% said they had got tested for it too. Out of them, 63.2% knew that a vaccine is available for hepatitis B virus. The proportion of respondents, who said hepatitis B virus can spread by sharing razors, toothbrush, syringes or sexual contact, was 97.94%, 95%, 99.3% and 77%, respectively. Only 28.7% knew, it can also spread vertically from mother to child during childbirth. People were quite aware of the routes of transmission of this disease, but they lacked knowledge regarding vaccination and prevention of this menace. Settings should be set up where routine preventive care and immunization services are provided