2,594 research outputs found

    Ciprofloxacin in multi-resistant infections in childhood: An audit

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    Ciprofloxacin is a new orally administrable fluoroquinolones, with considerable efficacy against multiresistant organisms. Its use in the paediatric age group however, is controversial because of the risk of potential articular toxicity. We retrospectively reviewed ciprofloxacin usage over a 32 week periods (June, 1991-September, 1993) in paediatric inpatients at The Aga Khan University Hospital. Ciprofloxacin was used in 21 cases, singly in 11 (52%) and in combination with other antibiotics in a further 10 (48%). The response to therapy was adjudged as \u27good\u27 or \u27fair\u27 in 13 (62%) cases. Ciprofloxacin was the only sensitive antibiotic in 4 (19%) and resistance to it was detected in another 4 (19%) cases. Despite all efforts, adequate follow-up could only be achieved in a third of the patients. Although no toxic or side effects were detected, in view of poor follow-up and emergence of ciprofloxacin resistant strains, our experience highlights the need to regulate ciprofloxacin use in the paediatric age group

    Geographical and socioeconomic inequalities in women and children’s nutritional status in Pakistan in 2011: an analysis of data from a nationally representative survey

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    Background Pakistan has one of the highest levels of child and maternal undernutrition worldwide, but little information about geographical and socioeconomic inequalities is available. We aimed to analyse anthropometric indicators for childhood and maternal nutrition at a district level in Pakistan and assess the association of nutritional status with food security and maternal and household socioeconomic factors. Methods We used data from the 2011 Pakistan National Nutrition Survey, which included anthropometric measurements for 33 638 children younger than 5 years and 24 826 women of childbearing age. We estimated the prevalences of stunting, wasting, and underweight among children and of underweight, overweight, and obesity in women for all 143 districts of Pakistan using a Bayesian spatial technique. We used a mixed-eff ect linear model to analyse the association of nutritional status with individual and household sociodemographic factors and food security. Findings Stunting prevalence in Pakistan’s districts ranged between 22% (95% credible interval 19–26) and 76% (69–83); the lowest fi gures for wasting and underweight were both less than 2·5% and the highest were 42% (34–50) for wasting and 54% (49–59) for underweight. In 106 districts, more women were overweight than were underweight; in 49 of these districts more women were obese than were underweight. Children were better nourished if their mothers were taller or had higher weight, if they lived in wealthier households, and if their mothers had 10 or more years of education. Severe food insecurity was associated with worse nutritional outcomes for both children and women. Interpretation We noted large social and geographical inequalities in child and maternal nutrition in Pakistan, masked by national and provincial averages. Pakistan is also beginning to face the concurrent challenge of high burden of childhood undernutrition and overweight and obesity among women of reproductive age. Planning, implementation, and evaluation of programmes for food and nutrition should be based on district-level needs and outcomes

    Binary effect of fly ash and palm oil fuel ash on heat of hydration aerated concrete

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    The binary effect of pulverized fuel ash (PFA) and palm oil fuel ash (POFA) on heat of hydration of aerated concrete was studied. Three aerated concrete mixes were prepared, namely, concrete containing 100% ordinary Portland cement (control sample or Type I), binary concrete made from 50% POFA (Type II), and ternary concrete containing 30% POFA and 20% PFA (Type III). It is found that the temperature increases due to heat of hydration through all the concrete specimens especially in the control sample. However, the total temperature rises caused by the heat of hydration through both of the new binary and ternary concrete were significantly lower than the control sample.The obtained results reveal that the replacement of Portland cement with binary and ternary materials is beneficial, particularly for mass concrete where thermal cracking due to extreme heat rise is of great concern

    Using surgical sustainability principles to improve planetary health and optimise surgical services following the COVID-19 pandemic

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    As the world faces crises instigated by environmental disruption, demands on healthcare require sustainable solutions. In this article, we outline the principles of sustainable surgery, how these can be used to optimise surgical services in light of healthcare crises, and how long-term adoption of these principles can help to reduce the carbon and plastic footprint of surgery in the UK and internationally. We describe how planetary and human health are closely related, including the relationship between environmental disruption and emerging infectious diseases
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