In vitro antimicrobial activity of cefsulodin and kanamycin in combinations

Background:Infectious diseases are the greatest challenge of the world. The main failure in the treatment of infectious diseases is development of antibiotic resistance by the infective agents. Combination drug therapy is proposed to be more successful to contain diseases. But before the selection of combination of antibiotics, it is important to determine interaction of such antibiotics. Two antibiotics may have either synergistic or antagonistic action. In this study it was designed to find out the Minimum Inhibitory Concentration (MIC), and Minimum Bactericidal Concentration (MBC), which is usually used for the quantitative assessment of bacterial sensitivity to antibiotics.Methods:Checkerboard titration in microtitre trays used for this assay, and Fractional Inhibitory Concentration (FIC) and Fractional Bactericidal Concentration (FBC) measured to identify the type of interaction between the two antibiotics. Cefsulodin (Cef) and Kanamycin (Kan) were used against Escherechia coli (Esch. coli) and Staphylococcus aureus (Staph. aureus) to determine the efficacy of these antibiotics in combination.Results:MIC of cefsulodin and kanamycin against Staph. aureus was 3.125 and 3.125 respectively. MIC of Cef for Esch. coli was 6.25 and for Kan 50. FIC for Staph. aureus was 1. FIC for Esch. coli was different in different antibiotic concentrations and the least value was 0.37. There was no bactericidal effect of these antibiotics in combination against these organisms.Conclusion:Combination of two drugs cefsulodin and kanamycin showed synergistic action against Esch. coli and additive against Staph. aureus. So combined drug therapy can be used for better treatment with low toxicity, broad spectrum activity, and prevent emergence of drug resistance organism.

Tuberculous Synovitis of the knee with a discharging sinus

Extra pulmonary manifestations of tuberculosis are reported in less than one in five cases with the knee affected in 8% after the spine and hip. We report a case of tuberculous synovitis of the knee joint with a discharging sinus in a 40 year old female. The diagnosis was made by Ziehl - Neelson stain of the caseating discharge from the sinus, positive Mantoux test and radiological findings. The X-ray chest was normal. The patient responded well to anti-tuberculous treatment

Urinary tract infection due to staphylococcus saprophyticus in young women

Background: Staph. saprophyticus, hitherto; was considered solely as the laboratory contaminant & normal flora of the skin. Studies differ in their opinion about the incidence and age group distribution of this infection. Objectives: To determine the prevalence of Staphylococcus saprophyticus (Staph. saprophyticus). Methods: 200 urine specimens of women aged between 15-35 years, sexually active with symptoms of urinary tract infection, attending the hospital OPD, were analyzed. Results: Out of 200 samples, 85 (42.5%) specimens were found positive for bacterial growth on culture. Staph. saprophyticus was isolated from the urine of two (1%) patients, indicating the low prevalence of this organism as a urinary tract pathogen in our area. Antibiogram of the organism showed susceptibility to commonly used antibiotics. Conclusion: It is wise to subject urine samples to the identification of Staph. saprophyticus routinely for all isolates of coagulase negative Staphylococci to know the actual incidence of infection in the population

Simulation in resuscitation teaching and training, an evidence based practice review

In the management of a patient in cardiac arrest, it is sometimes the least experienced provider giving chest compressions, intubating the patient, and running the code during the most crucial moment in that patient’s life. Traditional methods of educating residents and medical students using lectures and bedside teaching are no longer sufficient. Today’s generation of trainees grew up in a multimedia environment, learning on the electronic method of learning (online, internet) instead of reading books. It is unreasonable to expect the educational model developed 50 years ago to be able to adequately train the medical students and residents of today. One area that is difficult to teach is the diagnosis and management of the critically ill patient, specifically who require resuscitation for cardiac emergencies and cardiac arrest. Patient simulation has emerged as an educational tool that allows the learner to practice patient care, away from the bedside, in a controlled and safe environment, giving the learner the opportunity to practice the educational principles of deliberate practice and self-refection. We performed a qualitative literature review of the uses of simulators in resuscitation training with a focus on their current and potential applications in cardiac arrest and emergencies

International Consensus Statement on Obstructive Sleep Apnea

BackgroundEvaluation and interpretation of the literature on obstructive sleep apnea (OSA) allows for consolidation and determination of the key factors important for clinical management of the adult OSA patient. Toward this goal, an international collaborative of multidisciplinary experts in sleep apnea evaluation and treatment have produced the International Consensus statement on Obstructive Sleep Apnea (ICS:OSA).MethodsUsing previously defined methodology, focal topics in OSA were assigned as literature review (LR), evidence-based review (EBR), or evidence-based review with recommendations (EBR-R) formats. Each topic incorporated the available and relevant evidence which was summarized and graded on study quality. Each topic and section underwent iterative review and the ICS:OSA was created and reviewed by all authors for consensus.ResultsThe ICS:OSA addresses OSA syndrome definitions, pathophysiology, epidemiology, risk factors for disease, screening methods, diagnostic testing types, multiple treatment modalities, and effects of OSA treatment on multiple OSA-associated comorbidities. Specific focus on outcomes with positive airway pressure (PAP) and surgical treatments were evaluated.ConclusionThis review of the literature consolidates the available knowledge and identifies the limitations of the current evidence on OSA. This effort aims to create a resource for OSA evidence-based practice and identify future research needs. Knowledge gaps and research opportunities include improving the metrics of OSA disease, determining the optimal OSA screening paradigms, developing strategies for PAP adherence and longitudinal care, enhancing selection of PAP alternatives and surgery, understanding health risk outcomes, and translating evidence into individualized approaches to therapy

International Consensus Statement on Obstructive Sleep Apnea

Evaluation and interpretation of the literature on obstructive sleep apnea (OSA) allows for consolidation and determination of the key factors important for clinical management of the adult OSA patient. Toward this goal, an international collaborative of multidisciplinary experts in sleep apnea evaluation and treatment have produced the International Consensus statement on Obstructive Sleep Apnea (ICS:OSA). Using previously defined methodology, focal topics in OSA were assigned as literature review (LR), evidence-based review (EBR), or evidence-based review with recommendations (EBR-R) formats. Each topic incorporated the available and relevant evidence which was summarized and graded on study quality. Each topic and section underwent iterative review and the ICS:OSA was created and reviewed by all authors for consensus. The ICS:OSA addresses OSA syndrome definitions, pathophysiology, epidemiology, risk factors for disease, screening methods, diagnostic testing types, multiple treatment modalities, and effects of OSA treatment on multiple OSA-associated comorbidities. Specific focus on outcomes with positive airway pressure (PAP) and surgical treatments were evaluated. This review of the literature consolidates the available knowledge and identifies the limitations of the current evidence on OSA. This effort aims to create a resource for OSA evidence-based practice and identify future research needs. Knowledge gaps and research opportunities include improving the metrics of OSA disease, determining the optimal OSA screening paradigms, developing strategies for PAP adherence and longitudinal care, enhancing selection of PAP alternatives and surgery, understanding health risk outcomes, and translating evidence into individualized approaches to therapy