Imipenem Resistant Pseudomonas aeruginosa: The fall of the final quarterback

Objective: To isolate, determine the frequency, and study the demographic trends of MBL positive Pseudomonas aeruginosa from imipenem resistant isolates collected from clinical samples in a tertiary care hospital of Pakistan. Methods: In this cross sectional study a total of 230 strains of Pseudomonas were isolated from various clinical specimens on the basis of culture and biochemical tests. Imipenem resistant isolates were selected by Kirby Bauer Diffusion technique, followed by screening for MBL production by Imipenem EDTA Combined Disk Test. Demographic details of each patient were recorded on a separate questionnaire. Chi-Square goodness-of-fit test was computed to review the isolation of MBL positive isolates [P-value = 0.05] in different specimen. Results: Out of 230 strains of P. aeruginosa 49.5% were imipenem resistant; MBL production was confirmed in 64.9% of the resistant isolates. Resistance to polymyxin B [12.5%] was notable. Majority of the MBL positive strains were isolated from patients aged between 20-39 years [45.9%] and the predominant source was pus [43.24%] which was found to be statistically significant [P-value=0.04]. Outpatient departments [24.3%] and burn unit [21.6%] were the major places for resistant isolates. Conclusion: MBL production is one of the major causes of IRPA. Increasing resistance to polymyxin B is grave. Due to acquisition of MBL strains MDR P. aeruginosa has become endemic in tertiary setups

Serum alkaline phosphatase screening for vitamin D deficiency states

To determine whether serum vitamin D levels are correlated with serum levels of alkaline phosphatase or not. Cross-sectional, observational study. Multi-centre study, conducted at Liaquat National Hospital and Medical College, National Medical Centre and Medicare Hospital, Karachi, from January to October 2009. Patients attending the Orthopaedic OPDs with complaints of pain in different body regions and serum vitamin D[3] levels of

Alendronate a promising/ multi aspect drug in the management of ostoeoporosis

Recently, osteoporosis is regarded as a major health concern due to increase in its incidence, associated morbidities and mortalities. Among antiresorptives, alendronate which is a bisphosphonate is FDA [Food and Drug Administration] approved drug of choice for postmenopausal and glucorticoid induced osteoporosis. It has been also recommended for the prevention of bone loss in perimenopausal women. Currently, it has been also viewed as a treatment option in osteoporotic males. Several clinical trials have highlighted the significant role of alendronate in the management of osteoporosis. Although it was proved to be a safe drug for long time periods but very recently some studies have reported the risk of low energy subtrochanteric and diaphyseal femoral shaft fractures in the chronic users of alendronate. The current review is undertaken to elaborate the different aspects related to this drug in the scenario of osteoporosis management