Attitudes, perceptions, habits of smoker, non-smoker general practitioners and why they fail to motivate patients to quit smoking

To investigate attitudes, perceptions and habits of General Practitioners [GPs] who smoke and those who do not smoke cigarettes, with particular attention to smoking cessation. Two physician groups were targeted: GPs who smoke and those who do not smoke. They were screened based on the inclusion and exclusion criteria. A unique country-specific questionnaire was developed to conduct a 20-minute telephonic interview. Survey was started from December 2006 and completed in May 2007. Simple statistical calculations were used to interpret the data. GPs view smoking as the most harmful behaviour among the risk factors. 94% agreed that smoking should be classified as a medical condition and if it were so would encourage more smokers to quit smoking and they have suggested the need of prescription therapies for their patients to quit smoking. Significant discontent exists between physicians and smokers. The main cause of this discontent is physician perceived inability to provide successful solutions to quit smoking due to low awareness level and lack of training. This issue, when properly addressed, can be useful as an additional tool to aid patients in quitting

Clozapine induced neutropenia in patients suffering from schizophrenia: a multi centre audit

To determine the frequency of clozapine induced neutropenia and its associated clinical features among the patients suffering from schizophrenia. Cross sectional, comparative study. The study is based on the blood count reports from various centres in Pakistan using Clozapine during a period 1992-2005. The medical records of 917 patients with a diagnosis of schizophrenia, aged 18 years and above were reviewed. Patient's profile was evaluated consisting of gender, dose of clozapine, duration of treatment and complete blood count [CBC] findings including white blood cell [WBC] count or absolute neutrophil count [ANC], before starting the treatment. The case records showing WBC count below 3000 and ANC count less than 500 were identified and details of the clinical and sociodemographic variables were recorded on a proforma. Thirty eight patients [4.1%] developed clozapine induced neutropenia. Median duration of clozapine treatment in these patients was 6.0 years that was significantly higher than Median = 1 year of those patients who did not develope neutropenia [p < 0.001]. An inverse correlation [r = -0.046] was observed between ANC and duration of clozapine induction. Median dose [mg] of clozapine induced neutropenia patients was higher [200 vs. 150, p = 0.262], however statistically insignificant. The incidence of clozapine induced neutropenia of our study is comparable with that of worldwide reported incidence. Prolongation of treatment also increase the incidence

Prevalent nosocomial gram negative bacilli and their sensitivities by mic's. an analysis of the data of Liaquat National Hospital-1999

To evaluate the prevalence of aerobic gram-negative bacilli and their sensitivity pattern, at Liaquat National Hospital Karachi, in the year 1999. Perspective collection of clinically significant 100 nosocomial gram-negative bacilli from ICU's. One hundred consecutive gram-negative isolates were identified by standard cultural methods and minimum inhibitory concentrations were checked, using E-Test strips. The samples were taken from Intensive Care Units between October and December 1999. The most frequent isolates were Escherichia coli 31 percent followed by Pseudomonas aeruginosa 22 percent, Klebsiella spp 18 percent, Proteus Mirabilis 13 percent, Pseudomonas spp 4 percent, Serratia spp 4 percent, Acinotobacter spp 3 percent. Most of the isolates of dominant species in the year 1999 that is E-Coli, Pseudomonas aeruginosa Proteus spp and Klebsiella spp were multi-resistant to Quinolones, Broad Spectrum Penicillin and cephalosporins [2nd, 3rd and also the 4th generation]. The study indicates that only imipenem has inhibited most of the isolates and susceptibility was 96 percent. Other antibiotics include broad-spectrum penicillins and quinolones have not inhibited more than 60 percent of the organisms. Therefore, imipenem represents a preferable emperic initial therapy when there is concern that an infection may be caused by a producer of ESBLs. Amikacin along with one broad spectrum B-lactam drug could be an another alternate