Antimicrobial resistance profile of methicillin resistant staphylococcal aureus from skin and soft tissue isolates

OBJECTIVES: To evaluate resistance rates in methicillin resistant Staphylococcus aureus (MRSA) against clindamycin, cotrimoxazole, tetracycline, fusidic acid, rifampicin and chloramphenicol isolated from skin and soft tissue infections (SSTI). METHODS: Descriptive analysis of SSTI samples yielding MRSA in clinical laboratory of a tertiary care center; receiving specimens across Pakistan from January 2005 to June 2007. MICROBIOLOGICAL METHODS: MRSA were identified using standard microbiological techniques. Susceptibility testing was performed by disc diffusion according to Clinical Laboratory Standards Institute (CLSI) against fusidic acid, tetracycline, cotrimoxazole, clindamycin, rifampicin and chloramphenicol. Minimum inhibitory concentrations (MIC) of rifampicin were determined using agar dilution method according to CLSI. RESULTS: During the study period 501 MRSA were isolated from SSTI. Overall variable susceptibility pattern with high resistance rates to tetracycline (82%), clindamycin (79%), cotrimoxazole (59%), and rifampicin (50%) were observed. Resistance to chloramphenicol (10%) and fusidic acid (9%) was low. CONCLUSION: There is a strong need in resource limited countries to review the utility of conventional antibiotics for the management of MRSA SSTI as new agents are expensive and not available. High resistance rates were observed against cotrimoxazole, tetracycline and clindamycin. Resistance to fusidic acid, rifampicin and Chloramphenicol was low

Comparison of neonatal respiratory morbidity in neonates delivered at term by elective caesarean section with and without antenatal Corticosteroid

Introduction:Performing elective caesarean section prior to 39 completed weeks,it can lead to breathing problems in neonates as compare to those, who are born through caesarean section without antenatal Corticosteroid. WHO recommends the administration of intramuscular corticosteroids either dexamethasone or betamethason (total 24mg in divided doses) in the antenatal period, when there is a risk of preterm birth. The advantages and disadvantages of a similar regimen given after 37 weeksof pregnancy prior to elective caesarean section (LSCS) to prevent respiratory morbidity in a newborn is yet a topic of discussion.In Pakistan still,many clinicians are doing caesarean section at 37 or 38 weeks without antenatal Corticosteroids. The rationale is to emphasize the use of steroidsbefore caesareanat 39 weeks. Objective:To compare neonatal respiratory distress in neonates delivered between 37 --38+6 weeks of gestation by elective caesarean section with and without antenatal Corticosteroid. Study design:Randomized controlled trial. Setting:Department of Gynae & Obstetrics, unit 2, Shalamar Hospital, Lahore. Duration:Six months from 12th September 2018 to 12th March 2019. Materials and Methods:The study included women who were, planned for elective LSCS at 37-38+6 weeks, divided into two groups .The sample size was 140 (70 in each group),recruited by non-probability consécutive sampling. Inclusion criteria were singleton pregnancy, at 37 to 38+6 weeks for elective LSCS due to indications like primi breech, previous caesarian scar/scars, and maternal wish. All eligible participants were allocated to one of the following groups. Group (A) received an injection of dexamethasone 48 to 72 hours before elective LSCS. Group (B), did not receive an injection of dexamethasone. The outcome to be measuredinthis study were the Apgar score at 1& 5 minutes, the incidence of transient tachpnea of the neonate (TTN) and respiratory distress syndrome (RDS) in newborns,and the need for mechanical ventilation among neonates from two different groups. The data was collected and analyzed by SPSS version 20.Descriptive statistic were applied to calculate the mean and SD for age, gestation age & BMI. Student T-test was used to compare the continuous outcome measures. Neonatal respiratory morbidity was compared in two groups by using the chi-square test at the level of significance of 0.05.Results:Mean age in Group-A was 28.12± 5.6 and in Group-B was 28.97± 6.3 years. There was no statistically significant difference in these groups in termsof Body mass index, gestational age at the time of delivery, age of mother, birth weight, Apgar score at 1 and 5 min,and indications for cesarean section. Neonatal respiratory morbidity was higher in Group-B as compared to Group-A (30% vs.12.9%)p-value-0.013. Conclusion:Antenatal dexamethasone administration significantly reduces the respiratory morbidity among neonates delivered at 37 to 38+6by elective cesarean section. But further studies are required to assess the beneficial role of dexamethasone in the reduction of neonatal respiratory morbidity with a large sample size.Keywords:Neonatal respiratory morbidity, transient tachypnea of newborn, elective caesarean section, antenatal corticosteroids

Comparison of neonatal respiratory morbidity in neonates delivered at term by elective caesarean section with and without antenatal Corticosteroid

Introduction:Performing elective caesarean section prior to 39 completed weeks,it can lead to breathing problems in neonates as compare to those, who are born through caesarean section without antenatal Corticosteroid. WHO recommends the administration of intramuscular corticosteroids either dexamethasone or betamethason (total 24mg in divided doses) in the antenatal period, when there is a risk of preterm birth. The advantages and disadvantages of a similar regimen given after 37 weeksof pregnancy prior to elective caesarean section (LSCS) to prevent respiratory morbidity in a newborn is yet a topic of discussion.In Pakistan still,many clinicians are doing caesarean section at 37 or 38 weeks without antenatal Corticosteroids. The rationale is to emphasize the use of steroidsbefore caesareanat 39 weeks. Objective:To compare neonatal respiratory distress in neonates delivered between 37 --38+6 weeks of gestation by elective caesarean section with and without antenatal Corticosteroid. Study design:Randomized controlled trial. Setting:Department of Gynae & Obstetrics, unit 2, Shalamar Hospital, Lahore. Duration:Six months from 12th September 2018 to 12th March 2019. Materials and Methods:The study included women who were, planned for elective LSCS at 37-38+6 weeks, divided into two groups .The sample size was 140 (70 in each group),recruited by non-probability consécutive sampling. Inclusion criteria were singleton pregnancy, at 37 to 38+6 weeks for elective LSCS due to indications like primi breech, previous caesarian scar/scars, and maternal wish. All eligible participants were allocated to one of the following groups. Group (A) received an injection of dexamethasone 48 to 72 hours before elective LSCS. Group (B), did not receive an injection of dexamethasone. The outcome to be measuredinthis study were the Apgar score at 1& 5 minutes, the incidence of transient tachpnea of the neonate (TTN) and respiratory distress syndrome (RDS) in newborns,and the need for mechanical ventilation among neonates from two different groups. The data was collected and analyzed by SPSS version 20.Descriptive statistic were applied to calculate the mean and SD for age, gestation age & BMI. Student T-test was used to compare the continuous outcome measures. Neonatal respiratory morbidity was compared in two groups by using the chi-square test at the level of significance of 0.05.Results:Mean age in Group-A was 28.12± 5.6 and in Group-B was 28.97± 6.3 years. There was no statistically significant difference in these groups in termsof Body mass index, gestational age at the time of delivery, age of mother, birth weight, Apgar score at 1 and 5 min,and indications for cesarean section. Neonatal respiratory morbidity was higher in Group-B as compared to Group-A (30% vs.12.9%)p-value-0.013. Conclusion:Antenatal dexamethasone administration significantly reduces the respiratory morbidity among neonates delivered at 37 to 38+6by elective cesarean section. But further studies are required to assess the beneficial role of dexamethasone in the reduction of neonatal respiratory morbidity with a large sample size.Keywords:Neonatal respiratory morbidity, transient tachypnea of newborn, elective caesarean section, antenatal corticosteroids

Pattern of Thrombocytopenia In Pregnancy At Teaching Hospital Of Rahim Yar Khan, Pakistan

Background:  Platelet count less than 150 × 109 / L is referred to as thrombocytopenia, which is the second common blood disorder in pregnancy after anemia. Although pregnancy is related with physiological variations in platelet count, however, several pathological conditions also cause thrombocytopenia showing significant impact on health of mother and her baby. The prevalence of thrombocytopenia during pregnancy is 7 to 11%. The physiological thrombocytopenia is multifactorial, related to hemodilution, increased platelet consumption and increased platelet aggregation. Objective: To determine the pattern of thrombocytopenia during third trimester of pregnancy in Rahim Yar Khan. Methodology: This cross-sectional study was carried out at Teaching Hospital of Rahim Yar Khan with effect from May 16, 2022 to September 30, 2022. Five hundred (500) pregnant females in their third trimester were the part of this study. All the study subjects were selected from the department of gynecology and obstetrics at Sheikh Zayed Hospital, Rahim Yar Khan which is a renowned teaching hospital of the region attached with Sheikh Zayed Medical College. Data collection was done on a pre-designed questionnaire. Sample of blood was taken in EDTA and Gel containing vacutainers by convenient sampling technique. Results: The frequency of thrombocytopenia during pregnancy was found 10.4%. Gestational thrombocytopenia was the most common type among thrombocytopenic pregnancies with frequency of 63.46% in comparison to pre-eclampsia 30.76%, HELLP Syndrome 3.80% and immune thrombocytopenic purpura 1.90%. The mean age of pregnant women was observed 27.53±5 years. There is no significant difference in number of thrombocytopenic patients from rural and urban areas (p=0.2). Conclusion: The frequency of thrombocytopenia during the third trimester of pregnancy is observed high, so the regular screening is necessary to avoid any adverse outcome. Specially the patients with Pre-eclampsia and HELLP syndrome should be monitored critically.   Key words: Platelet Count, Thrombocytopenia in Pregnancy, Types of Thrombocytopenia, Pre-Eclampsi

Mixotrophic cultivation of Scenedesmus dimorphus in sugarcane bagasse hydrolysate

Overuse of the fossil fuels to fulfill existing energy requirements has generated various environmental problems like global warming. Emergence of environmental issues due to burning of the fossil fuel resources has provoked researchers to explore alternative sources of fuel. In this scenario, microalgal biofuels could present a promising alternative fuel if produced cost-effectively without competing for freshwater resources and arable land. Aim of the present study was to grow microalgae by employing lignocellulosic waste for production of lipids. Scenedesmus dimorphus NT8c was chosen based on its ability to tolerate heat, rapid growth, and ease of harvesting by overnight settling. Biochemical composition and growth parameters of microalgae were analyzed when cultivated mixotrophically on sugarcane bagasse hydrolysate, a low-value agricultural by-product, that is, currently underutilized. Despite a slight increase in turbidity in the medium, S. dimorphus NT8c cultures raised mixotrophically in 5 g/L sugarcane bagasse hydrolysate displayed significantly higher growth rates compared to photoautotrophic cultivation with an overall biomass productivity of 119.5 mg L d, protein contents of 34.82% and fatty acid contents of 15.41%. Thus, microalgae cultivated mixotrophically are capable of photosynthesizing while metabolizing and assimilating organic carbon, significant increases of biomass and lipid productivity can be achieved. However, high supplementation with organic carbon can result in unfavorable levels of turbidity and bacterial growth, reducing microalgal biomass productivity

Happiness, Gratitude, Life Satisfaction, and Life Orientation among Working and Non-working Individuals

The study was conducted to find differences among working and non-working individuals regarding happiness, gratitude, life satisfaction, and life orientation. Convenient sampling technique was used to collect the data. The sample consisted of 300 individuals; 150 were working and 150 were non-working individuals. Out of 150 working participants, 75 participants were bankers and 75 were teachers. The non-working sample consisted of 75 males and 75 females. Oxford Happiness Questionnaire, The Gratitude Questionnaire-six item form (GQ- 6), Satisfaction with Life Scale and Life Orientation Test-Revised were used to measure happiness, gratitude, life satisfaction, and life orientation respectively. Correlation unveiled that happiness, gratitude, life satisfaction, and life orientation were positively correlated. Independent sample t-test showed that working individuals were happier, more grateful, and more satisfied with life as compared to non-working individuals while non-working females showed higher levels of gratitude, satisfaction, and positive life orientation than non-working men. Further independent sample t test indicated that bankers were happier than teachers. Multiple regression analysis showed that happiness and gratitude predict life satisfaction

Palindromic Rheumatism: Biology and Treatment Options

Palindromic rheumatism is a syndrome characterized by recurrent, self-resolving, and inflammatory attacks in and around the joints that have long recognized association with rheumatoid arthritis. PR attacks mostly start in small joints i.e. knees, shoulder, and small joints of the hand. Whether PR should be considered as a single disease or prodrome of RA remains a thought-provoking question. Multiple genetic and environmental factors contribute to the development of PR. Many studies have explained the relationship between a high concentration of Anti-CCP antibodies and PR. Potential benefits of Gold therapy have been recognized in literature but still, there are some questions about toxicity and efficacy that need further considerations. In addition to that anti-malarial drugs, Abatacept, Tofacitinib, and Rituximab showed the variable result in different patients and needed further study to validate their medical use. Moreover, yarrow, oat, colchicum, dill, fennel, wild rue, bitter melon, willow, garlic, and burdock seem suitable candidates to treat rheumatoid although their use in PR is still not reported. Additional experimental researches on these drugs lead to an increase in our knowledge to fight against PR in the future using novel therapeutic approaches. We have attempted to cover this topic in a chapter form to provide a comprehensive view and hope that it will serve as a reference for clinicians who treat patients with PR

Effect of Plant Growth Hormones on Shoot and Root Regeneration in Rose under In Vitro Conditions

Background: Rose is a commercially important shrub. This research aimed to observe the influence of different plant growth hormones on development of shoots and roots of Rosa Indica L. in tissue culture.Methods: Various concentrations of N6-Benzylaminopurine (BAP), 1-Naphthaleneacetic acid (NAA), Indole-3-acetic acid (IAA), and Indole-3-butyric acid (IBA) were used in the study. The different concentrations of BAP (2.00, 3.00, and 4.00 mg l-1) and IAA (2.00 and 3.00 mg l-1) were tested for shoot induction. While varying concentrations of IAA and IBA were analyzed for root proliferation.Results: The results of the study indicated that the fastest shoot initiation (17.77 days), the highest number of shoots bottle-1 (3.55), the maximum shoot length (4.72 cm), and the utmost number of leaves bottle-1 (53.67) were observed on MS media containing 3.00 mg l-1 BAP, 3.00 mg l-1 IAA, and 30 g l-1 sugar, while the highest number of shoots bottle-1 were produced under MS + 2.00 mg l-1 BAP + 3.00 mg l-1 IAA + 30 g l-1 sugar. Regarding root induction, the maximum number of roots (4.67) and root length (2.60 cm) were observed under half strength MS media supplemented with 30 g l-1 sugar.Conclusion: The study suggested that MS media containing 3.00 mg l-1 BAP and IAA could be used for tissue culturing rose plants. For root induction, half-strength MS media, along with sugar, could be used. The study gives an insight into potential media compositions for the propagation of rose. The suggested media can have promising uses in commercial multiplication of this important plant.Keywords: Rose; Tissue culture; Micropropagation; MS media; Shoot developmen

Mixed microalgae consortia growth under higher concentration of CO2 from unfiltered coal fired flue gas: Fatty acid profiling and biodiesel production

Biodiesel is produced by transesterification of fatty acid methyl esters (FAME) from oleaginous microalgae feedstock. Biodiesel fuel properties were studied and compared with biodiesel standards. Qualitative analysis of FAME was done while cultivating mixed microalgae consortia under three concentrations of coal fired flue gas (1%, 3.0% and 5.5% CO2). Under 1% CO2 concentration (flue gas), the FAME content was 280.3 μg/mL, whereas the lipid content was 14.03 μg/mL/D (day). Both FAMEs and lipid contents were low at other CO2 concentrations (3.0 and 5.5%). However, mixed consortia in the presence of phosphate buffer and flue gas (PB + FG) showed higher saturated fatty acids (SFA) (36.28%) and unsaturated fatty acids (UFA) (63.72%) versus 5.5% CO2 concentration, which might be responsible for oxidative stability of biodiesel. Subsequently, higher cetane number (52) and low iodine value (136.3 gI2/100 g) biodiesel produced from mixed consortia (PB + FG) under 5.5% CO2 along with 50 mM phosphate buffer were found in accordance with European (EN 14214) standard. Results revealed that phosphate buffer significantly enhanced the biodiesel quality, but reduced the FAME yield. This study intended to develop an integrated approach for significant improvement in biodiesel quality under surplus phosphorus by utilizing waste flue gas (as CO2 source) using microalgae. The CO2 sequestration from industrial flue gas not only reduced greenhouse gases, but may also ensure the sustainable and eco-benign production of biodiesel