Assessment of predictor variables and clinical consequences associated with surgical site infection in tertiary care setting, Karachi, Pakistan

Among the well-known Health care-associated infections [HAIs], surgical site infections [SSIs] contribute to considerable high mortality and morbidity rate, substantial prolongation in hospitalization period and extra expenses in terms of treatment cost. This study was aimed to evaluate the predictive variables associated with surgical site infections, and their clinical consequences. This was a prospective, cross sectional study conducted in the surgical department of tertiary care setting in Karachi, Pakistan. Each patient was followed up from the time of admission until time of the discharge postoperatively for 30 days. A total of 554 surgical procedures were performed and 81 SSIs were identified. The predictor variable/risk factors significantly associated with the presence of SSI were age, gender, BMI, ASA score, co-morbid condition, surgical wound class, emergency surgeries, duration of surgery, type of anesthesia, prosthetic implant, pre operative length of stay and pre operative blood transfusion. Outcomes of such studies may be utilized in the design of a multi factorial practice to get better patient's safety and clinical outcomes

Incidence of drug interactions in intensive care units in tertiary care settings: Classification, facts and measures

Drug-drug interactions [DDIs] are extremely significant concern, particularly in sensitive population including pediatric and geriatric. Propensity for the development of DDIs is high in patients admitted at intensive care units [ICU]. This study was conducted to evaluate the DDIs incidence, facts and measures in ICU. From a total of 150 cases studied for ICU patients, with the mean age of 56.37+/-12.45 years, 55.33% were male and the rest were female 44.66%. The demographic information like age, gender and main diagnosis details of study participants that were extracted from the patients' clinical record. A statistically significant association between the drug interaction and the number of drugs prescribed per prescription was observed [p <0.0001]. Concerning the onset of outcome, 52% of DDIs distinguished as delayed onset of effect [past 24 hours] and 35% were categorized as rapid onset [within 24 hours]. Despite the facts regarding patient safety and minimizing DIs error, polypharmacy is still frequent in critically ill patients admitted in ICU attributed high risk of adverse reactions due to use of multiple interventions to treat severity of disease condition. Such studies may be used to develop an effective tool for the diagnosis and management of DDIs

Drug utilization and prescribing pattern of antibiotics in a tertiary care setups; trends and practices

Irrational, over and misuse of antibiotics arise as global concern in both hospital and community settings and lead to adverse events including antimicrobial resistance, associated health problems, amplified hospitalization stay and cost. Hence, Drug Utilization Evaluation [DUE] studies are designed to evaluate and improve the prescribing, administration and the rational use of medications. The present study was designed to assess the pattern of antimicrobial drug utilization in in-patients cohort of tertiary care setup in Karachi, Pakistan. This cross sectional observational study was conducted in retrospective manner. World health organization [WHO] guidelines and criteria are considered to evaluate the appropriateness of drug use in various disease conditions. ATC/DDD system was applied to determine the study outcome. High frequency of antibiotics utilization found in respiratory tract infections of both lower [LRTI] 16.8% [n=42] and upper [UTI] 13.2% [n=33]. The estimated total number of drug units administered per month was greater with cefixime [46] and ciprofloxacin [45] both. DDD/100 bed days drug utilization of antibiotics was higher with ciprofloxacin, cefexime and meropenem [47, 46 and 29.25] correspondingly. In conclusion, the current investigation signifies extensive scope for progress in prescribing trend. Drug adherence to customary guidelines of disease management and constraint policies to endorse judicious drug use may be considered vital in healthcare setup

Ergonomic hazards to dental surgeons: a cross-sectional study

Ergonomics is the working condition which facilitates the performance of labor and promotes worker's welfare. Dentists all around the world have been challenged with issues related to the musculoskeletal system. Mostly musculo - skeletal problems start during the learning period of the dentist and then continue throughout his/her life, affecting spine, neck, shoulders, hands and other body parts. The aim of this study was to assess the awareness of graduate and postgraduate dental students about the role of ergonomics in dentistry and to evaluate the presence of any pain I discomfort during the last twelve months

A cross-sectional study was carried out on 120 dental graduate and postgraduate students working in Armed Forces Institute of Dentistry, Rawalpindi using the Standardized Nordic Musculoskeletal Questionnaire. All of the respondents endorsed the significance of maintaining an ideal posture during their clinical activities. However, 65% reported that they seldom assumed an ideal posture during work. About 70% of the participating dentists reported one or more episodes of musculoskeletal disorders over the last 12 months. The highest frequency was observed for lower back ache [65%] followed by neck pain [53.3%] and pain in wrist I hand [37.5%]. A positive correlation was found between the musculoskeletal disorders and the average working hours per week [P<0.05]

Bridging the gap. quality of communication between prosthodontists and lab technicians

This descriptive study was carried out at dental out-patient department of Liaquat medical University Hospital Hyderabad from January 2013 to December 2013. Thirty-five patients wearing auto polymerized [self-cured] fixed partial dentures provided by unqualified and qualified dental practitioners were assessed. Condition of oral health was evaluated on the basis of proper history and clinical examination. Prosthesis condition was also assessed. Oral health of underlying soft and hard tissues was carefully evaluated after removing the prosthesis with the help of slow speed hand piece without jeopardizing oral tissues. It was evident in this study that fixed partial dentures made from auto polymerized [self cure] acrylic resins had adversely affected the oral tissues compelling the patients to visit the qualified dentist for proper treatment of their problems

Reversal of haloperidol induced motor deficits in rats exposed to repeated immobilization stress

Stress is defined as a non specific response of body to any physiological and psychological demand. Preclinical studies have shown that an uncontrollable stress condition produces neurochemical and behavioral deficits

The present study was conducted to test the hypothesis that a decrease in the responsiveness of somatodendritic 5-hydroxytryptamine [5-HT]-lA receptors following adaptation to stress could attenuate haloperidol induced acute like effect. Results showed that single exposure [2h] to immobilization stress markedly decreased food intake, growth rate and locomotor activity but these stress-induced behavioral deficits were not observed following repeated [2h/day for 5 days] exposure of immobilization stress suggesting behavioral tolerance occurs to similar stress

An important finding of present study is a reversal of haloperidol-induced motor deficits in animals exposed to repeated immobilization stress than respective control animals. It is suggested that stress induced possible desensitization of matodendritic 5-HT-1A as well as 5-HT-2C receptors could release dopamine system from the inhibitory influence of >erotonin. On the other hand, an increase in the effectiveness of postsynaptic 5-HT-1A receptors elicits a direct stimulatory influence on the activity of dopaminergic neuron and is possibly involved in the reversal of haloperidol-induced parkinsonian like symptoms in repeatedly immobilized rats