RESUMO
To study the frequency of Clostridium difficile in postantibiotic diarrhoea in patients admitted to the medical ward of a secondary care hospital. Observational study. Sindh Government Hospital, Liaquatabad, Karachi, from June 2002 to May 2009. Adults of either gender who received antibiotics after admission and subsequently had watery stools at least 2 days after admission were selected. The exclusion criteria were past history of inflammatory bowel disease or any type of malabsorption state and those who did not show WBCs in stools. All variables of these patients along with clinical findings, type of antibiotic received, and number of stool motions per day were recorded. Three samples of the stools were sent for detailed reports to analyze the number of leukocytes per high field and culture, on cycloserine - cefoxitin - fructose agar [CCFA]. All findings were entered into and analyzed by SPSS 16 for statistical analysis. Out of the 473 patients who received antibiotics for any reasons, 191 [40.38%] developed diarrhoea. The mean age was 45.6 +/- 17.73 years and male to female ratio was 1.85:1. The average number of stools passed per day was 4.84 +/- 1.24 and all patients showed leukocytes in stool samples with a mean count of 6.67 +/- 0.89/HPF. The stool culture on CCFA was positive for 57 patients [29.18%], while 134 patients [70.15%] were stool culture negative as well as negative for evidence of any parasites; these samples were labelled benign antibiotic associated diarrhoea [BAAD]. Ampicillin and amoxicillin with clavulanate were the most implicated antibiotics in this study. Clostridium difficile is the main putative agent in postantibiotic diarrhoea. In settings with limited resources, use of specific culture media such as CCFA proves to be highly cost effective, and sensitive for this diagnosis. Macrolides and quinolones are the safest agents to prescribe in this context
RESUMO
To study the frequency and severity of tremors in otherwise healthy elderly adults at Sind Government Hospital Liaqatabad, Karachi. This cross-sectional study, was conducted at the Sindh government hospital, Liaquatabad, Karachi from October, 2007-2009. Five hundred otherwise healthy adults of both genders of more than 60 years were selected. After thorough clinical examination, classification and the severity of tremors were assessed by tasks given to the patients by principal investigator which he designed himself. All variables were put in proper register. Data entry and analysis was performed by single researcher on SPSS 16 for biostatistics. The inclusion criteria were adults of more than 60 years of either gender with no history of any systematic or neurological illness and presently not on drugs. The exclusion criteria were disputed age groups and those who cannot sign or write their names because they cannot be assessed by tasks. The mean age was 68.75 years +/- 6.74 with male female ratio of 1.95:1. Out of 500 subjects 84 [16.8%] showed no tremors, 307 [64.4%] had mild tremors only evident on special movements i.e. enhanced physiological tremors [physiological senile tremors] and 109 [21.8%] had moderate to severe tremors evident on movements i.e. kinetic, essential tremors [pathological senile tremors], with family history of 50.45%. Tremors in old age are not part of life. Most of them had enhanced physiological tremors while few were of essential type with strong family history. If these are detected, they should be evaluated and classified and can be managed to make elderly population more useful to their family and the society
RESUMO
To determine the myths and misconceptions about [Tremors] among those who developed this disorder and their health seeking behavior, and also among those who never had tremors, at the psycho-neurology and medical OPD of Sindh Govt. Hospital, Liaqatabad no. 10, Karachi. A single centre based cross-sectional survey, conducted from year 2002 to 2009 at Sindh Govt. Hospital [SGH] Liaqatabad no.10, Karachi. 403 adult patients of either sex with tremors were selected from medical and psycho-neurology OPD's. For comparison 100 healthy individuals from general population, who never had tremors, of the same area were also included. Questionnaires regarding different myths and misconceptions about tremors were filled by the patients/normal healthy people after obtaining the consent. Out of 403 selected patients [61.53% males and 38.47% females] majority belonged to the urban areas. Out of hundred normal healthy people 73 [73%] were males and 27 [27%] were females. Only 8% of the patients considered tremor was a neurological illness, while 33% of the patients and 41% of the general population related it to magic or witchcraft. Overall, females were more inclined to choose alternative medicine and spiritual therapy than males. Myths and Misconceptions about tremors are present in our society because of strong belief and observations. Provision of primary education, health education and using electronic media can play a key role in abolishing these misconceptions