ABSTRACT
BACKGROUND: Caesarian section is one of the most commonly performed surgeries in India. Determination of the incidence as well as the clinical and financial burden of post caesarian surgical site infection (SSI), is of critical importance for all the stakeholders for rational and fair allocation of resources. METHODS: This study was a prospective observational case-control study. The mean direct and indirect cost of treatment for the cases were compared with the control patients. An unpaired t-test was used to compare the mean between the two groups. RESULTS: Out of 2024 patients, who underwent caesarian section during the study period, 114 had acquired incisional surgical site infection (ISSI), with the infection incidence being 5.63%. The total cost of illness due to post caesarian ISSI was almost three times higher compared to the non-infected matched control group. (P<0.0001). An average length of hospital stay in the ISSI patient group was 10 days longer than that in the control group (P<0.0001) and importantly total length of antimicrobial therapy(LOT) in patients with ISSI was also almost three times higher than the control group (P<0.0001). CONCLUSION: The development of post caesarian SSI imposes a significant clinical as well as a financial burden. The study highlights the necessity of taking effective preventive measures to decrease the incidence of SSI.
Subject(s)
Financial Stress , Surgical Wound Infection , Case-Control Studies , Female , Hospitals, Teaching , Humans , Length of Stay , Pregnancy , Surgical Wound Infection/prevention & control , Tertiary HealthcareABSTRACT
Erectile dysfunction (ED) is a common complication in patients with diabetes mellitus (DM). Sildenafil, a phosphodiesterase-5 inhibitor, is commonly used in patients with ED. This meta-analysis was planned to determine the strength of evidence to assess the efficacy and tolerability of sildenafil in patients with DM-associated ED. Electronic searches were carried out to identify randomized controlled trials (RCTs) which reported clinical efficacy of sildenafil in patients with DM-associated ED. Data were extracted and methodological quality was assessed. Relative Risk (RR) with 95% confidence intervals (CIs) was estimated for the dichotomous outcomes, and the mean difference with 95% CI was estimated for continuous data. Eight randomized controlled trials (RCTs) involving 1172 patients met with our inclusion criteria. In comparison to placebo, sildenafil significantly improved the overall sexual performance in patients of ED associated with DM with relative risk (RR) of answering "yes" to global efficiency question being 3.99 (95% CI: 2.58-6.18) compared to placebo. The rate of discontinuation due to treatment-related adverse reactions was 2.4% in sildenafil arm with RR of 2.67 (95% CI: 0.74-9.62). Sildenafil is an effective and safe medication for the treatment of ED associated with DM.
ABSTRACT
INTRODUCTION: Antimicrobial resistance has been a global concern. Currently, interest has been focused on exploring antimicrobial properties of plants and herbs. One such botanical is Allium sativum (garlic). AIM: To evaluate the antimicrobial activity of fresh juice of garlic. MATERIALS AND METHODS: Varying concentrations of fresh garlic juice (FGJ) were tested for their antimicrobial activity against common pathogenic organisms isolated at SSG Hospital, Vadodara, using well diffusion method. Moreover, minimum inhibitory concentration (MIC) and minimum lethal concentration (MLC) of FGJ were tested using broth dilution method. Sensitivity pattern of the conventional antimicrobials against common pathogenic bacteria was tested using disc diffusion method. RESULTS: FGJ produced dose-dependent increase in the zone of inhibition at a concentration of 10% and higher. MIC of FGJ against the pathogens ranged from 4% to 16% v/v whereas MLC value ranged from 4% to 32% v/v with Escherichia coli and Staphylococcus aureus spp. showed highest sensitivity. CONCLUSION: FGJ has definite antimicrobial activity against common pathogenic organisms isolated at SSG Hospital, Vadodara. Further studies are needed to find out the efficacy, safety, and kinetic data of its active ingredients.
ABSTRACT
OBJECTIVE: Staphylococcus aureus has largely developed resistance to the multiple antimicrobial agents. Garlic (Allium sativum) is claimed to retard development of resistance and produce synergy with conventional antimicrobial agents. The aim of the present study was to evaluate the effect of combination of ampicillin with fresh garlic extract (FGE) against S. aureus by using in vitro method. MATERIALS AND METHODS: Antimicrobial activity of FGE was studied by well diffusion and broth dilution methods. The effect of combination of ampicillin with FGE was studied by using checkerboard method against the clinical isolates of S. aureus. The organisms were exposed to individual antimicrobial as well the different combinations of the two agents and minimum inhibitory concentration was measured. RESULTS: Synergistic interaction was observed by the combination of FGE with ampicillin for all the strains of S. aureus. Mean minimum inhibitor concentration (MIC) of ampicillin per se was 24 µg/ml. Addition of 30-60 mg/ml of FGE reduced MIC of ampicillin to <2 µg/ml. CONCLUSION: This in vitro study indicates synergism between FGE and ampicillin against S. aureus. Evaluation of these combinations in vivo may be warranted.
