A prospective study to analyse antibiotic susceptibility pattern of Pseudomonas aeruginosa in a tertiary care hospital

Background: Pseudomonas aeruginosa, a gram-negative pathogen is commonly associated with nosocomial infections. Infections caused by P. aeruginosa can range from superficial skin infections to fulminant sepsis. Antimicrobial resistance is an area of prime concern in pseudomonal infections. The objective of the study was to evaluate and analyse the antibiotic susceptibility pattern of P. aeruginosa at a tertiary care hospital in South India.Methods: The study was carried out at Kasturba Medical College and Hospital, Manipal, India from January 2011 to December 2011. Ten different types of specimens were collected from patients who were culture positive for Pseudomonas aeruginosa. Antibiotic susceptibility was confirmed by disk diffusion technique on Muller-Hinton medium and was performed according to the Clinical Laboratory Standard Institute (CLSI) guidelines.Results: Out of 200 samples of P. aeruginosa 69.5% and 30.5% were from male and female patients respectively. Majority of the specimen from which P. aeruginosa was isolated consisted of sputum, pus and urine. Among the antimicrobial drugs tested, organism was most sensitive to carbapenems (77.5%), piperacillin-tazobactam (77%) and cefoperazone-sulbactam (72%). Resistance rates were high for fluoroquinolones (FQs) (43.5%), gentamicin (40.5%), tobramycin (40.5%), ticarcillin-clavulanic acid (39%) and aztreonam (38%) when compared to cefepime (31.5%), ceftazidime (32.5%), netilmicin (34.5%) and amikacin (35%).Conclusions: Carbapenems and piperacillin-tazobactam were the best antipseudomonal agents with highest sensitivity to P. aeruginosa. FQs, gentamicin and tobramycin were the least effective drugs against P. aeruginosa as monotherapy

A 45-DAY RANDOMIZED, OPEN-LABEL, COMPARATOR STUDY TO EVALUATE THE SAFETY AND EFFICACY OF ZINCOVIT TABLETS WITH GRAPE SEED EXTRACT (NUTRITIONAL FOOD SUPPLEMENT) IN PATIENTS WITH TYPE 2 DIABETES MELLITUS

ABSTRACTObjective: To evaluate the efficacy of Zincovit (ZVT) tablets with grape seed extract (GSE) in patients with Type 2 diabetes mellitus by testing thehypothesis of a greater reduction in plasma glucose levels (fasting blood sugar [FBS] and post-prandial blood sugar [PPBS]) from baseline and after45 days of therapy as compared to standard comparator.Methods: This was a randomized, open-label, comparative (2-arm), prospective 45 days study. Treatment consisted of 2 arms: Antidiabetic drugplus non-pharmacological measure alone or ZVT tablets with GSE plus non-pharmacological measures. A total of 30 patients (15 in each arm) wereincluded in the study.Results: ZVT tablet did not alter the FBS, PPBS, and HbA1c level in diabetic patients compared to diabetic patients treated with placebo. No changeswere seen in any of the safety parameters when given for 45 days.Conclusion: ZVT tablets do not possess antidiabetic activity in spite of good safety profile in our study design. This could be due to several limitationsof the study such as inadequate sample size, short duration of the study, and wrong selection of the patients. A long-term, double-blind, placebocontrolled study in a large sample of population measuring glycemic parameters, and cardiovascular outcomes could give a clear picture of the antidiabeticeffectof ZVT with GSE tablets.Keywords: Diabetes mellitus, Zincovit tablets, Grape seed extract, Antioxidant, Safety parameters

Antimicrobial drug sensitivity pattern of Pseudomonas aeruginosa in respiratory infections

Background: Pseudomonas aeruginosa, a gram-negative pathogen commonly associated with nosocomial infections is the most widespread multidrug-resistant pathogen causing pneumonia in hospitalized patients. Inadequate empirical therapy has been associated with high mortality and morbidity. Objective: To evaluate and analyze the antimicrobial susceptibility pattern of P. aeruginosa in respiratory infections in a tertiary care hospital.Methods: The study was carried out at Kasturba Hospital, Manipal from Jan 2011 to Dec 2011. Specimens of 63 in-patients were analyzed who were culture positive for P. aeruginosa.Results: Majority of patients were aged above 40yrs with a male preponderance. Specimens were taken from patients who were diagnosed with bronchiectasis, pneumonia, COPD, bronchial asthma etc. Overall the organism was most sensitive to carbapenems (87.3%) followed by cefoperazone-sulbactam combination (85.7%). Sensitivity to ceftazidime and cefepime was equal (82.5%) and was more when compared to piperacillin-tazobactam (81.5%). Overall resistance rate was highest for fluoroquinolones (23.8%) followed by aztreonam (22.2%).Conclusions: Hence we would like to recommend cefoperazone-sulbactam as the preferred antipseudomonal agent and carbapenems as reserved drugs in treating pseudomonal lung infections. Use of fluoroquinolones and aztreonam as monotherapy in resistant P. aeruginosa infections should be restricted

Efficacy of zincoderm G cream against wound infection by Pseudomonas aeruginosa in Sprague-Dawley rats

Background: Zincoderm G cream is a fixed dose combination of clobetasol, gentamicin and zinc. Studies have been carried out for efficacy of each component such as clobetasol and gentamicin in bacterial infections, but as fixed dose combination including zinc has not been reported yet. Hence, a study was planned to assess the efficacy of Zincoderm G cream in experimental wound infection by Pseudomonas aerugionosa.Methods: In the experiment a total of 18 Sprague-Dawley rats (male, pathogen free, 6-8 weeks old) were used. The rats were divided into three groups of six rats each. 25-30 mg of test drugs (Zincoderm G cream with or without zinc) was applied on Pseudomonas aeruginosa infected burn wound affected area of back of rats for 2 weeks. Bacterial infection was assessed by quantification of bacteria.Results: There was 80% mortality observed in P. aeruginosa infected toxic control (cream base) group. Whereas, only 40% mortality was seen in both Zincoderm G cream with/without zinc groups, which were inoculated with P. aeruginosa. Bacterial concentration (Number of colony forming unit/ml wound fluid) was significantly decreased (p<0.001) in P. aeruginosa infected rats treated with Zincoderm G cream with zinc when compared with P. aeruginosa infected control (untreated) rats.Conclusions: We found that Zincoderm G cream with zinc exhibited distinct killing profiles against P. aeruginosa

COMPARISON OF EFFICACY AND ADVERSE DRUG REACTIONS OF MONOTHERAPY VERSUS COMBINATION THERAPY OF ANTIHYPERTENSIVES AMONG DIABETIC HYPERTENSIVE PATIENTS IN A TERTIARY CARE HOSPITAL

Objective: To compare the efficacy and adverse drug reactions of monotherapy and combination therapy of antihypertensive drugs in diabetic hypertensive patients.Methods: A prospective observational study of 18 months duration was conducted in the Department of Medicine of a tertiary care hospital in South India. A total of 200 patients were included in the study. Using a standard proforma, the details of patients such as demographic data and antihypertensive medications were collected and analyzed for efficacy and safety.Results: Of 200 patients studied, 50% received monotherapy whereas the remaining 50% received combination therapy. There was male preponderance (54%) in the study population, with the mean age being 60.07±11.32 years. In monotherapy group, most commonly prescribed drug was amlodipine (38%), whereas in combination group, angiotensin receptor blocker (ARB) or calcium channel blocker (CCB) + beta blocker (18%) was commonly prescribed among 2-drug group and ARB+ thiazide+ CCB (25.6%) among 3-drug group. Monotherapy and combination therapy were analyzed to be equally efficacious in reducing systolic blood pressure and diastolic blood pressure. Based on the adverse effect profile, monotherapy comparatively produced more adverse effects than combination group. Amlodipine-induced pedal edema (56.7%) was the most common adverse effect observed, and it was predominantly managed by changing it to be a better tolerable CCB, namely cilnidipine.Conclusion: The combination therapy may be a better treatment option in selected patient population.Keywords: Systolic blood pressure, Diastolic blood pressure, Amlodipine, Cilnidipine, Pedal edema

EFFECT OF FUCITHALMIC AND SOFINOX EYE DROPS ON EXPERIMENTAL ALLERGIC CONJUNCTIVITIS IN RATS

Objective: To investigate the therapeutic effect of Fucithalmic 1%, Sofinox 0.5% and 1% eye drops against an IgE-mediated allergic conjunctivitis model in Wistar rats. Methods: IgE-mediated allergic conjunctivitis was induced by ovalbumin antigen challenge. Allergic conjunctivitis induced control rats (Group I) received normal saline (0.9% NaCl; 10 µl/eye) whereas Fucithalmic 1% (Group II), Sofinox 0.5% (Group III) and 1% (Group IV) were administered as 10, 20 and 10 µl/eye respectively to the treatment group animals (n=6) for 15 days. Eye scratching behavior, hypothermia and edema was evaluated after topical antigen challenge. Results: Sofinox 1% eye drops (10 µl/eye) significantly attenuated eye scratching behavior, hyperemia and edema in comparison with allergic conjunctivitis induced control (p &lt; 0.001) and Fucithalmic 1% treated rats (p &lt; 0.05). Eye scratching behavior and edema was also significantly decreased in Sofinox 0.5% eye drops (20 µl/eye) treatment group as compared to allergic conjunctivitis induced control rats (p &lt; 0.05). Conclusion: The present study revealed that the Sofinox eye drop is the potential agent that could offer a novel therapeutic opportunity against IgE-mediated allergic conjunctivitis in Wistar rats

Izloženost štakora niskim razinama olova tijekom fetalnog i ranoga postnatalnog razvoja šteti učenju pasivnim izbjegavanjem kazne kasnije u odrasloj dobi

This follow-up study investigated the effects of low-level lead exposure during prenatal and early postnatal period on learning and memory in rats immediately after exposure has ceased at weaning and later in their adulthood. Male Wistar-derived rats were exposed to lead (as 0.2 % lead acetate solution) through their mothers during pregnancy and lactation until they were weaned. Mothers of control rats were given tap water during pregnancy and lactation. All pups were weaned on tap water at 21 days of age and were followed up until 120 days old. Low-level lead exposure did not affect their body weight at any time during the experiment. Blood lead in the exposed rats was significantly higher on postnatal day 22 and dropped to control values by day 120. Passive avoidance test showed impaired memory retention in the exposed rats on postnatal days 25 and 120. This suggests that exposure to low-lead levels during foetal and early postnatal development of brain tissue can cause memory impairment that lasts into adulthood.Cilj je ovoga prospektivnog istraživanja bio utvrditi kako izloženost niskim razinama olova tijekom gestacije i ranoga postnatalnog razvoja utječe na učenje i pamćenje u štakora odmah nakon prestanka izloženosti (odbijanjem od sise) te kasnije u odrasloj dobi. Mužjaci štakora izloženi su olovu u obliku 0,2 %-tne otopine olovova acetata preko majke tijekom gestacije te za cijeloga trajanja laktacije sve do odbijanja od sise. Sve to vrijeme majke kontrolnih štakora dobivale su vodu iz pipe. Svi su štakorčići odbijeni od sise 21 dan nakon okota i otada piju vodu iz pipe. Praćeni su do 120. dana života. Izloženost niskim razinama olova nije dovela do razlika u tjelesnoj težini između izloženih i kontrolnih štakorčića. Razine olova u krvi bile su značajno više u izloženih štakora 22 dana od okota, da bi do 120. dana pale na razinu u kontrolnih štakora. Test pasivnoga izbjegavanja pokazao je oštećenje pamćenja u izloženih štakora 25. i 120. dana nakon okota. To potvrđuje da izloženost niskim razinama olova tijekom fetalnoga i ranoga postnatalnog razvoja moždanog tkiva može dovesti to oštećenja u pamćenju koje traje sve do odrasle dobi

Practical solutions to challenges in research ethics proceedings of Bangalore conference

On November 3 rd and 4 th , 2012, Manipal Hospital, Bangalore and Association for the Accreditation of Human Research Protection Programs co-hosted a regional conference titled "Practical Solutions to Challenges in Research Ethics." This paper is a synthesis of the major themes of the conference. The authors discuss the current state of the clinical research in India today, need to focus on human research protection programs rather than Ethics Committees or institutional review boards, the factors that influence high-quality research and some practical solutions to improving the quality of research and the protection of research participants

Evaluation of passive avoidance learning and spatial memory in rats exposed to low levels of lead during specific periods of early brain development

Objectives: Widespread use of heavy metal lead (Pb) for various commercial purposes has resulted in the environmental contamination caused by this metal. The studies have shown a definite relationship between low level lead exposure during early brain development and deficit in children’s cognitive functions. This study investigated the passive avoidance learning and spatial learning in male rat pups exposed to lead through their mothers during specific periods of early brain development. Material and Methods: Experimental male rats were divided into 5 groups: i) the normal control group (NC) (N = 12) consisted of rat offspring born to mothers who were given normal drinking water throughout gestation and lactation, ii) the pre-gestation lead exposed group (PG) (N = 12) consisted of rat offspring, mothers of these rats had been exposed to 0.2% lead acetate in the drinking water for 1 month before conception, iii) the gestation lead exposed group (G) (N = 12) contained rat offspring born to mothers who had been exposed to 0.2% lead acetate in the drinking water throughout gestation, iv) the lactation lead exposed group (L) (N = 12) had rat offspring, mothers of these rats exposed to 0.2% lead acetate in the drinking water throughout lactation and v) the gestation and lactation lead exposed group (GL) (N = 12) contained rat offspring, mothers of these rats were exposed to 0.2% lead acetate throughout gestation and lactation. Results: The study found deficit in passive avoidance learning in the G, L and GL groups of rats. Impairment in spatial learning was found in the PG, G, L and GL groups of rats. Interestingly, the study found that gestation period only and lactation period only lead exposure was sufficient to cause deficit in learning and memory in rats. The extent of memory impairment in the L group of rats was comparable with the GL group of rats. Conclusions: So it can be said that postnatal period of brain development is more sensitive to neurotoxicity compared to prenatal exposure