Utility of Positive Suction Drain Tip Culture in Early Detection of Infection After Total Knee Replacement

Introduction: To compare the frequency of wound infection in positive and negative drain tip culture in patients after primary total knee replacement. Methods: In this descriptive study patients undergoing primary total knee replacement for osteoarthritis were included. Early postoperative wound infection was defined as patient developing redness, pain, heat or swelling at surgical site; or drainage of pus within 7 postoperative days. Positive culture was considered as bacterial growth within 48 hours after suction drain tip was cultured on media. Negative culture was defined as no bacterial growth in 48 hours after placing the suction drain tip on culture media. Closed suction drain tips were sent for culture and sensitivity on 3rd postoperative day. Patients were followed for 7 days for any signs of infection. Effect modification was catered to by stratification for malnutrition defined as serum albumin less than 3.5g/dl; and obesity that was considered when BMI was equal to or more than 30kg/m2. Results: The mean age of patients was 57.28±7.37 years. Positive suction drain was found in 9.17% , while 6.67% had infection among all cases. Among 8 cases with infection there were 6(75%) who were positive on suction drain tip and among 112 non-infected cases there were 5(4.5%) who had positive suction drain tip. There was significant association between infection and suction drain tip positivity, p-value being < 0.001. Conclusion: Suction drain tip culture analysis can predict infection after primary total knee replacement

Bacteriological Spectrum of Pediatric Urinary Tract Infection and Its Drug Sensitivity and Resistance Pattern

Introduction: - Urinary tract infection (UTI) is common infection in children. It has high morbidity and long term sequelae. Objective: To determine the frequency of bacteriological organism of Pediatric UTI and its drug sensitivity and resistance pattern and to improve the treatment of UTI according to culture sensitivity, hence to minimize the resistance pattern and disease burden. Material and methods: It was a descriptive cross sectional study conducted during 2018 over a period of 6 months. Total 225 children with UTI were enrolled. Urine culture and sensitivity reports were evaluated and an isolated microorganism along with their sensitivities to the mentioned drugs was entered through designed Performa. Results: - The average age of the children was 7±.18 years. Common bacteriological agents leading to UTI was E.Coli (59.1%), followed by  Pseudomonas aeruginosa (14.2%),  klebsiella (13.8%) , stapylococcus aureus (8.9%) and enterococcus (4%). Most common organism isolated was E.coli ( 133 cultures). It was fully resistant with amoxicillin clavulanate and ofloxacin (100%), while resistant pattern with other antibiotics, ceftriaxone (88.7%), imipenam (88.7%), ciprofloxacin (75.9%). the most effective antibiotic for E.coli was amikacin (81.2%). klebisella was isolated in 31 cultures. Conclusion: Most common organism that cause UTI was E.coli followed by Pseudomonas Aeroginosa and Klebsiella. These isolates were highly resistant to commonly used antibiotics. Therefore new antibiotics policy should be adopted to treat these infections

Bacteriological Spectrum of Pediatric Urinary Tract Infection and Its Drug Sensitivity and Resistance Pattern

Introduction: - Urinary tract infection (UTI) is common infection in children. It has high morbidity and long term sequelae. Objective: To determine the frequency of bacteriological organism of Pediatric UTI and its drug sensitivity and resistance pattern and to improve the treatment of UTI according to culture sensitivity, hence to minimize the resistance pattern and disease burden. Material and methods: It was a descriptive cross sectional study conducted during 2018 over a period of 6 months. Total 225 children with UTI were enrolled. Urine culture and sensitivity reports were evaluated and an isolated microorganism along with their sensitivities to the mentioned drugs was entered through designed Performa. Results: - The average age of the children was 7±.18 years. Common bacteriological agents leading to UTI was E.Coli (59.1%), followed by  Pseudomonas aeruginosa (14.2%),  klebsiella (13.8%) , stapylococcus aureus (8.9%) and enterococcus (4%). Most common organism isolated was E.coli ( 133 cultures). It was fully resistant with amoxicillin clavulanate and ofloxacin (100%), while resistant pattern with other antibiotics, ceftriaxone (88.7%), imipenam (88.7%), ciprofloxacin (75.9%). the most effective antibiotic for E.coli was amikacin (81.2%). klebisella was isolated in 31 cultures. Conclusion: Most common organism that cause UTI was E.coli followed by Pseudomonas Aeroginosa and Klebsiella. These isolates were highly resistant to commonly used antibiotics. Therefore new antibiotics policy should be adopted to treat these infections

Acquisition of abstract words for cognitive robots

Abstract word learning and comprehension is a very crucial and important issue because of its application and problematic nature. This problem does not just belong to the cognitive robotics field, as it also has significance in neuroscience and cognitive science. There are many issues like symbol grounding problem and sensory motor processing within grounded cognition framework and conceptual knowledge representation methods that have to be addressed and solved for the acquisition of abstract words in cognitive robots. This paper explains these concepts and matters, and also elucidates how these are linked to this problem. In this paper, first symbol grounding problem is discussed, and after that an overview of grounded cognition be given along with detail of methods/ideas that suggest how abstract word representation could use sensory motor system. Finally, the computation methods used for the representation of conceptual knowledge are discussed. Two cognitive robotics models based on Neural network and Semantic network that ground abstract words are presented and compared via simulation experiment to find out the pros and cons of computation methods for this problem. The aim of this paper is to explore the building blocks of cognitive robotics model at theoretical and experimental level, for grounding of abstract words

Comparison of Efficacy of Double Dose Oral Terbinafine versus Itraconazole in the Treatment of Dermatophyte Infections of Skin

Objective: To compare the efficacy of double-dose oral Terbinafine and Itraconazole in treating dermatophytic infections. Study Design: Randomized controlled trial (ClinicalTrials.gov: NCT04880980). Place and Duration of Study: Department of Dermatology, Pak Emirates Military Hospital, Rawalpindi Pakistan, from Mar 2021 to Mar 2022. Methodology: One hundred and twenty patients with dermatophyte infections of the skin (i.e., tinea corporis and cruris) diagnosed by clinical presentation and KOH mount were included in this study. After randomization, patients were divided  into two groups. Group-A was managed with double-dose oral Terbinafine, while Group-B was managed with double-dose oral Itraconazole. Clinical response and side effects were seen and recorded initially at two weeks and then at four weeks.Efficacy and adverse effects were compared in both groups at the end of four weeks. Results: Out of 120 patients with dermatophyte infections of the skin included in the study, 59(49.2%) took double-dose oral Terbinafine while 61(50.8%) took double-dose oral Itraconazole after randomization. It was revealed that Itraconazole was more efficacious in achieving cure at the end of 4-weeks as compared to double dose Terbinafine (p-value=0.001), while adverse effects studied were not statistically significant or different in both the groups (p-value>0.005). Conclusion: This randomized controlled trial showed that double dose oral Itraconazole was more efficacious in treating dermatophyte infections of the skin (i.e., Tinea corporis and cruris) compared to double dose oral Terbinafine. Adverse effects were minimal in both groups and were not specially related to any of these medications

The Psychological Impact of Coronavirus Disease 2019 on Patients Attending a Tertiary Healthcare Facility in Pakistan: A Cross-Sectional Study

The COVID-19 pandemic has had a damaging impact on global health. Post-infection, patients may experience mental health difficulties and therefore require suitable psychological treatment and support. The objective of this study was to identify the psychological impact of COVID-19 on patients who were recovering from the physical effects of the disease, and to examine socio-demographic correlates within one month of treatment at a tertiary healthcare facility in Pakistan. A cross-sectional study was employed that utilized the Depression Anxiety Stress Scale-21 and Post-Traumatic Stress Disorder (PTSD) Checklist for DSM-5. A questionnaire was administered to 250 patients, with data collected over three months. Mild to extremely severe scores of depression, anxiety and stress were reported by approximately 43%, 52% and 42% of participants, respectively, and 8% developed PTSD. The incidence of depression, anxiety, stress or PTSD was not significantly associated with gender, age or previous interaction with COVID-19 patients. Depression was significantly associated with levels of education, severity of COVID-19 disease and a patient’s current condition. Anxiety was associated with healthcare worker status. The severity of disease and a patient’s current condition were also linked to the levels of anxiety, stress and the presence of PTSD. Collectively, these results indicate that a high percentage of patients recovering from COVID-19 experience psychological distress

May Measurement Month 2018: a pragmatic global screening campaign to raise awareness of blood pressure by the International Society of Hypertension

Aims Raised blood pressure (BP) is the biggest contributor to mortality and disease burden worldwide and fewer than half of those with hypertension are aware of it. May Measurement Month (MMM) is a global campaign set up in 2017, to raise awareness of high BP and as a pragmatic solution to a lack of formal screening worldwide. The 2018 campaign was expanded, aiming to include more participants and countries. Methods and results Eighty-nine countries participated in MMM 2018. Volunteers (≥18 years) were recruited through opportunistic sampling at a variety of screening sites. Each participant had three BP measurements and completed a questionnaire on demographic, lifestyle, and environmental factors. Hypertension was defined as a systolic BP ≥140 mmHg or diastolic BP ≥90 mmHg, or taking antihypertensive medication. In total, 74.9% of screenees provided three BP readings. Multiple imputation using chained equations was used to impute missing readings. 1 504 963 individuals (mean age 45.3 years; 52.4% female) were screened. After multiple imputation, 502 079 (33.4%) individuals had hypertension, of whom 59.5% were aware of their diagnosis and 55.3% were taking antihypertensive medication. Of those on medication, 60.0% were controlled and of all hypertensives, 33.2% were controlled. We detected 224 285 individuals with untreated hypertension and 111 214 individuals with inadequately treated (systolic BP ≥ 140 mmHg or diastolic BP ≥ 90 mmHg) hypertension. Conclusion May Measurement Month expanded significantly compared with 2017, including more participants in more countries. The campaign identified over 335 000 adults with untreated or inadequately treated hypertension. In the absence of systematic screening programmes, MMM was effective at raising awareness at least among these individuals at risk