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Epidemic to Pandemic: Just a Matter of Time 从流行病到流行病:只是时间问题
Pub Date : 2020-03-02 DOI: 10.47489/p000s344z762mc
A. Humayun, M. I. Anwar, S. Alam, U. Iqbal
Epidemic and pandemic potential of all respiratory diseases of zoonotic origin is well known. In recent history global public health threat was inflicted by zoonotic origin infectious diseases with pandemic potential including, Ebola and Marburg haemorrhagic fevers, severe acute respiratory syndrome (SARS), influenza A (H5N1), Middle East respiratory syndrome corona virus (MERSCoV), 1 and the recently discovered COVID-19. Change of epidemic to a pandemic is just a matter of time. A novel Corona virus 2019 (COVID-19) is appearing to be one of the rapidly transmitting diseases because of the social and economic linkages worldwide. Emerging infectious diseases (EIDs) are not new but their incidence or geographical involvement is rapidly increasing. Global temporal and spatial patterns of these emerging infections are studied well in literature concluding significant correlation of EIDs with socio-economic, environmental and ecological factors. It helps to identify regions as ‘hotspots’ for EIDs with a substantial risk of vector-borne and wildlife zoonotic emerging diseases.
所有人畜共患呼吸道疾病的流行和大流行潜力是众所周知的。在近代史上,具有大流行潜力的人畜共患传染病造成了全球公共卫生威胁,包括埃博拉和马尔堡出血热、严重急性呼吸综合征(SARS)、甲型流感(H5N1)、中东呼吸综合征冠状病毒(MERSCoV) 1和最近发现的COVID-19。流行病变成大流行只是时间问题。由于在世界范围内的社会和经济联系,2019年新型冠状病毒(COVID-19)似乎是快速传播的疾病之一。新发传染病并不新鲜,但其发病率或地域范围正在迅速增加。文献对这些新发感染的全球时空格局进行了很好的研究,得出了eid与社会经济、环境和生态因素显著相关的结论。它有助于确定具有媒介传播和野生动物共患新发疾病重大风险的eid“热点”区域。
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引用次数: 1
Volume 33 Issue (4) 第33卷第4期
Pub Date : 2019-12-05 DOI: 10.47489/p000s334-z3196-1-4mc
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引用次数: 0
Frequency of QT Interval Prolongation in Chronic Liver Disease Patients 慢性肝病患者QT间期延长的频率
Pub Date : 2019-12-02 DOI: 10.47489/p000s334z7221-4mc
W. Khan
Introduction: The frequency of QT interval prolongation as published in the international and local literaturehas been variable. Aims & Objectives: To determine the frequency of QT interval prolongation in patientswith chronic liver disease and resolve the variability in the literature. Place and duration of study: Thepresent study was conducted in Gastroenterology and Hepatology Unit Shaikh Zayed Hospital Lahore from1st March 2017 to 31st August 2017. Material & Methods: About 240 patients with diagnosed chronic liverdisease were selected. Electrocardiography (12 lead) was performed in all patients to look for QT intervalprolongation and their mean was calculated for purpose of analysis. Results: Mean age of our patients was53.7±11.9 and male gender was dominant (55.8%). It was noted that QT interval was prolonged in 62 patients(25.8%) while rest of the 178 patients had normal QT interval. Conclusion: QT interval prolongation isfrequently observed (25.8%) in chronic liver disease patients. Therefore, every patient with chronic liverdisease should be investigated for QT interval prolongation.Key words: Chronic liver disease, QT interval, Electrocardiography
在国际和国内文献中发表的QT间期延长的频率是可变的。目的:确定慢性肝病患者QT间期延长的频率,并解决文献中的变异性。研究地点和时间:本研究于2017年3月1日至2017年8月31日在拉合尔谢赫扎耶德医院胃肠病学和肝病科进行。材料与方法:选取240例确诊为慢性肝病的患者。所有患者均行心电图(12导联)检查QT间期延长,并计算其平均值进行分析。结果:患者平均年龄53.7±11.9岁,男性居多(55.8%)。注意到QT间期延长62例(25.8%),其余178例QT间期正常。结论:慢性肝病患者QT间期延长较为常见(25.8%)。因此,每一位慢性肝病患者都应检查QT间期是否延长。关键词:慢性肝病,QT间期,心电图
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引用次数: 0
Histopathological Evaluation of GastroHepatoprotective Effect of Cassia fistula versusNaproxen in Rat Model of Rheumatoid Arthritis 决明子瘘与萘普生对类风湿关节炎模型大鼠胃肝保护作用的组织病理学评价
Pub Date : 2019-12-02 DOI: 10.47489/p000s334z7241-6mc
Hassan Farooq
Introduction: Rheumatoid arthritis (RA) is a debilitating disease leading to incapacitation and deformity dueto side effects of anti arthritic drugs and chronic need to use these drugs, patients often switch to and preferphytotherapy. Aims & Objectives: The present study was the histopathological evaluation of gastrohepatoprotective effect of Cassia fistula compared to naproxen in rheumatoid arthritis murine model. Placeand duration of study: This three month study was conducted at the Animal House, University of Veterinaryand Animal Sciences, Lahore. Material & Methods: Ninety six male rats were randomly sorted into 12groups (n=8). CFA injection (0.2 ml) was administered in the right hind paw of all groups except Group 1(negative control). Group 2 (positive control) and groups 3-7 (prophylactic groups) were administered orallyBD on 3 consecutive days 1,2 &3, naproxen (25mg/kg), anthraquinone (250mg/kg and 500mg/kg) andmethanolic (250mg/kg and 500mg/kg) extracts of Cassia fistula respectively, the first dose given 30min priorto CFA injection .Groups 8-12 (therapeutic groups) were given naproxen, anthraquinone and methanolicextracts orally BD respectively in the same doses on 3 consecutive days 9, 10 and 11. On Day 15,histopathology of stomach & liver was done. Results: Oral anthraquinone and methanolic extracts of Cassiafistula 500mg/kg vs 250mg/kg BD, in prophylactic groups normalized histology of gastric and liver tissuemore as compared to the therapeutic groups and to naproxen gastrohepatic damage . Conclusion: Cassiafistula anthraquinone and methanolic extracts exhibited greater prophylactic than therapeutic, dose dependentgastrohepatoprotection as compared to naproxen damage to these organs in the CFA rheumatoid arthritis ratmodel.Key words: Cassia fistula, Complete Freund’s Adjuvant (CFA), naproxen, gastrohepatoprotective
简介:类风湿性关节炎(RA)是一种衰弱性疾病,由于抗关节炎药物的副作用和慢性需要使用这些药物,导致丧失能力和畸形,患者经常转向和首选植物治疗。目的:本研究比较决明子瘘与萘普生对类风湿关节炎小鼠模型胃肝保护作用的组织病理学评价。研究地点和时间:这项为期三个月的研究在拉合尔兽医和动物科学大学动物馆进行。材料与方法:雄性大鼠96只,随机分为12组(n=8)。除1组(阴性对照)外,其余各组右后爪注射CFA注射液0.2 ml。第2组(阳性对照)和第3-7组(预防组)分别于CFA注射前30min口服萘普生(25mg/kg)、蒽醌(250mg/kg、500mg/kg)、桂花提取物(250mg/kg、500mg/kg),连续第1、2、3天口服BD;第8-12组(治疗组)分别口服萘普生、蒽醌、甲醇提取物,剂量相同,连续第9、10、11天口服。第15天进行胃、肝组织病理检查。结果:口服黑曲霉蒽醌和甲醇提取物500mg/kg vs 250mg/kg BD,预防组胃和肝组织组织学正常化程度高于治疗组,且对萘普生胃肝损害的影响明显大于治疗组。结论:在CFA类风湿性关节炎大鼠模型中,与萘普生相比,黑曲霉蒽醌和甲醇提取物对这些器官的损伤具有更大的预防作用,而不是治疗作用。关键词:决明子瘘,完全弗氏佐剂,萘普生,胃肝保护
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引用次数: 0
Effects of Commiphora mukul, Withania somniferaand Thyroxine on Thyroid Profile in Murine Modelof Hypothyroidism 金缕草、苦参和甲状腺素对甲状腺功能减退模型小鼠甲状腺功能的影响
Pub Date : 2019-12-02 DOI: 10.47489/p000s334z7271-6mc
Tehreem Zulfiqar
Introduction: Thyroid disorders, especially hypothyroidism are on the rise these days due to unhealthylifestyle and nutritional deficiencies which calls for research in this domain. Monotherapy with thyroxine isconsidered the main line of treatment up till now but besides its beneficial role in normalizing thyroidhormone levels, it has serious cardiac effects which leads to the search of safer natural remedies. Commiphoramukul and Withanias omnifera are considered two such plants with beneficial role in correcting T3 and T4levels respectively. However keeping in mind the diagnostic importance of TSH, the effects of these phytoextracts on TSH levels needs to be established. Aims & Objectives: So the present study is designed toexplore the effects of Ethanolic extract of Commiphora mukul (CMEE) and Withania somnifera (WSEE) onT3, T4 and TSH levels keeping thyroxine as a gold standard in murine model of hypothyroidism. Place andduration of study: This study was carried out in the animal house of PGMI, Lahore. Total duration of studywas 38 days. Material & Methods: 50 female rats were divided into 5 groups. G-1 the control group. G-2received methimazole 60mg/kg/day for 21 days in order to induce hypothyroidism and left untreated for selfrecovery & G3-5 were induced with methimazole in the same way. After induction all the groups were treatedfor 15 days, G-3: CMEE 0.2g/kg/day orally, G4: WSEE 1.4g/kg/day orally and G-5 received the goldstandard Thyroxin 0.6μg/100gm BW S/C. Thyroid function tests were performed in all groups on Day 1,repeated on Day 22 after methimazole administration and on Day 38 following completion of treatment.Results: The results showed that both CMEE and WSEE corrected T3 and T4 levels to significant extent.CMEE had more effect on T3 levels whereas WSEE corrected T4 levels more. TSH levels were also revertedto normal showing the potential of both these extracts to correct TSH besides T3, T4 levels. Conclusion: Thisproves that these extracts may play a significant role in correcting thyroid profile (T3, T4 & TSH) if usedclinically for the treatment of hypothyroidism. However, clinical research is highly recommended in thisdomain.Key words: Commiphora mukul, Withania somnifera, hypothyroidism, thyroxine.
导读:由于不健康的生活方式和营养缺乏,甲状腺疾病,特别是甲状腺功能减退症呈上升趋势,这需要对这一领域进行研究。迄今为止,单药治疗甲状腺素被认为是主要的治疗方法,但除了在使甲状腺激素水平正常化方面有有益的作用外,它对心脏有严重的影响,因此需要寻找更安全的自然疗法。黄皮草和大黄草被认为是两种对T3和t4水平有有益调节作用的植物。然而,考虑到TSH的诊断重要性,这些植物提取物对TSH水平的影响需要确定。目的与目的:本研究旨在探讨金针藤(CMEE)和龙茅(WSEE)乙醇提取物对甲状腺素(onT3、T4和TSH)水平的影响,并以甲状腺素为金标准对甲状腺功能减退模型小鼠的影响。研究地点和时间:本研究在拉合尔PGMI动物舍进行。研究总持续时间为38天。材料与方法:50只雌性大鼠分为5组。G-1为对照组。g -2组给予甲巯咪唑60mg/kg/天,连续21天诱导甲状腺功能减退,不治疗自行恢复;G3-5组同样给予甲巯咪唑诱导。诱导后各组均给予15 d治疗,G-3组:CMEE 0.2g/kg/d口服,G4组:WSEE 1.4g/kg/d口服,G-5组给予金标准甲状腺素0.6 g/100gm BW S/C。各组患者于第1天进行甲状腺功能检测,甲巯咪唑给药后第22天和治疗结束后第38天重复检测。结果:CMEE和WSEE均能显著纠正T3、T4水平。CMEE对T3水平的影响更大,而WSEE对T4水平的纠正作用更大。TSH水平也恢复正常,这表明这两种提取物除了能纠正T3和T4水平外,还能纠正TSH。结论:临床应用黄芪提取物治疗甲状腺功能减退,对纠正甲状腺功能(T3、T4、TSH)有显著作用。然而,临床研究是强烈建议在这个领域。关键词:金缕草,苦参,甲状腺功能减退,甲状腺素
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引用次数: 0
Frequency of Various Bleeding Disorders AmongGynecological and Obstetric Patients Presenting withBleeding 以出血为表现的妇科和产科患者中各种出血性疾病的频率
Pub Date : 2019-12-02 DOI: 10.47489/p000s334z7281-6mc
Fauzia Aamer
Introduction: Bleeding issues specific to women and adolescent females are common across the world.These issues can present either due to gynecological causes or obstetric one; however these can result insignificant morbidity and work up needs to be done to rule out any underlying bleeding diathesis. Aims &Objectives: To determine frequency of various bleeding disorders among gynecological and obstetric patientspresenting with bleeding. Place and duration of study: It is a cross sectional study which was conducted inthe Hematology Department, Services Institute of Medical Sciences, Lahore. The duration of study was 6months i.e from 21st Oct, 2018 to 30th April, 2019. Material & Methods: Females with age range of 15 to 50years irrespective of pregnancy presenting as menorrhagia, metrorrhagia or obstetrical bleeding wereincluded. Results: In the present study there were total 140 cases with mean age of 30.14±9.59 years. Therewere 98 (70%) cases that were pregnant. There were 35 (25%) cases presented with PPH (Post PartumHemorrhage), 42 (30%) with IPH (Intra Partum Hemorrhage), 49 (35%) with menorrhagia and 14 (10%) withmetrorrhagia. HELLP (Hemolysis, Elevated Liver enzymes and Low Platelet count) syndrome was seen in 13(9.29%) cases, DIC (Disseminated Intravascular Coagulation) in 2 (1.43%), gestational thrombocytopenia in7 (5%), while factor deficiency in 34 (24.29%) cases; and 84 (60%) of cases revealed none of the bleedingdisorder. Out of total 34 cases of factor deficiencies, vWD was the most common, seen in 20 (58.82%) cases.There was none of the cases seen having deficiency of factor II, VII, VIII, XI, XII. HELLP syndrome wasseen in 11 (84.62%) of the cases with age group 15 to 32 years and similarly both cases of DIC were seen insame age group; but the difference in both the age groups regarding these bleeding disorders was notstatistically significant with p= 0.38. There was no significant difference in terms of pregnancy; however,both cases of DIC were seen in pregnancy with insignificant p value of 0.51. HELLP syndrome was moreseen in IPH affecting 5 (38.40%), factor deficiency in menorrhagia affecting 13 (38.2%) with p value of 0.61.vWD and factor V Leiden presented in 44.4% cases each with PPH, and vWD affected 87.5% of cases in IPHwithout any significant difference with p= 0.42. Conclusion: Bleeding disorders are not uncommon ingynecological and obstetric conditions. Factor deficiency were the most common causes and amongst thesevWD was the most deficient factor. There was no significant association with any confounding variable;however, DIC was only seen in obstetrical conditions.Key words: Bleeding, menorrhagia, HELLP, DIC, IPH, PPH
导言:妇女和青少年女性特有的出血问题在世界各地都很常见。这些问题可能是由于妇科原因或产科原因引起的;然而,这些可能导致微不足道的发病率和工作需要做,以排除任何潜在的出血素质。目的与目的:了解以出血为表现的妇科和产科患者各种出血性疾病的发生频率。研究地点和时间:这是一项横断面研究,在拉合尔医学科学服务研究所血液科进行。学习时间为6个月,即2018年10月21日至2019年4月30日。材料与方法:年龄在15至50岁之间的女性,不论是否怀孕,均以月经过多、子宫出血或产科出血的形式出现。结果:本组病例共140例,平均年龄30.14±9.59岁。妊娠98例(70%)。PPH(产后出血)35例(25%),IPH(产中出血)42例(30%),月经过多49例(35%),子宫过多14例(10%)。溶血、肝酶升高、血小板计数低综合征13例(9.29%),DIC 2例(1.43%),妊娠期血小板减少症7例(5%),因子缺乏34例(24.29%);84例(60%)病例未发现任何出血性疾病。在34例因子缺乏病例中,vWD最为常见,有20例(58.82%)。15 ~ 32岁的患者中有11例(84.62%)出现HELLP综合征,同一年龄组的DIC患者中也出现了相似的情况;但两个年龄组在出血性疾病方面的差异无统计学意义(p= 0.38)。在怀孕方面没有显著差异;两例DIC均发生在妊娠期,p值均为0.51,差异无统计学意义。HELLP综合征多见于IPH 5例(38.40%),因素缺乏多见于月经过多13例(38.2%),p值为0.61。vWD和V Leiden因子分别占PPH的44.4%,而vWD影响iph的病例占87.5%,差异无统计学意义(p= 0.42)。结论:出血性疾病在妇产科中并不少见。因子缺乏是最常见的原因,其中wd是最缺乏的因素。与任何混杂变量均无显著相关性;然而,DIC仅见于产科情况。关键词:出血,月经过多,help, DIC, IPH, PPH
{"title":"Frequency of Various Bleeding Disorders Among\u0000Gynecological and Obstetric Patients Presenting with\u0000Bleeding","authors":"Fauzia Aamer","doi":"10.47489/p000s334z7281-6mc","DOIUrl":"https://doi.org/10.47489/p000s334z7281-6mc","url":null,"abstract":"Introduction: Bleeding issues specific to women and adolescent females are common across the world.\u0000These issues can present either due to gynecological causes or obstetric one; however these can result in\u0000significant morbidity and work up needs to be done to rule out any underlying bleeding diathesis. Aims &\u0000Objectives: To determine frequency of various bleeding disorders among gynecological and obstetric patients\u0000presenting with bleeding. Place and duration of study: It is a cross sectional study which was conducted in\u0000the Hematology Department, Services Institute of Medical Sciences, Lahore. The duration of study was 6\u0000months i.e from 21st Oct, 2018 to 30th April, 2019. Material & Methods: Females with age range of 15 to 50\u0000years irrespective of pregnancy presenting as menorrhagia, metrorrhagia or obstetrical bleeding were\u0000included. Results: In the present study there were total 140 cases with mean age of 30.14±9.59 years. There\u0000were 98 (70%) cases that were pregnant. There were 35 (25%) cases presented with PPH (Post Partum\u0000Hemorrhage), 42 (30%) with IPH (Intra Partum Hemorrhage), 49 (35%) with menorrhagia and 14 (10%) with\u0000metrorrhagia. HELLP (Hemolysis, Elevated Liver enzymes and Low Platelet count) syndrome was seen in 13\u0000(9.29%) cases, DIC (Disseminated Intravascular Coagulation) in 2 (1.43%), gestational thrombocytopenia in\u00007 (5%), while factor deficiency in 34 (24.29%) cases; and 84 (60%) of cases revealed none of the bleeding\u0000disorder. Out of total 34 cases of factor deficiencies, vWD was the most common, seen in 20 (58.82%) cases.\u0000There was none of the cases seen having deficiency of factor II, VII, VIII, XI, XII. HELLP syndrome was\u0000seen in 11 (84.62%) of the cases with age group 15 to 32 years and similarly both cases of DIC were seen in\u0000same age group; but the difference in both the age groups regarding these bleeding disorders was not\u0000statistically significant with p= 0.38. There was no significant difference in terms of pregnancy; however,\u0000both cases of DIC were seen in pregnancy with insignificant p value of 0.51. HELLP syndrome was more\u0000seen in IPH affecting 5 (38.40%), factor deficiency in menorrhagia affecting 13 (38.2%) with p value of 0.61.\u0000vWD and factor V Leiden presented in 44.4% cases each with PPH, and vWD affected 87.5% of cases in IPH\u0000without any significant difference with p= 0.42. Conclusion: Bleeding disorders are not uncommon in\u0000gynecological and obstetric conditions. Factor deficiency were the most common causes and amongst these\u0000vWD was the most deficient factor. There was no significant association with any confounding variable;\u0000however, DIC was only seen in obstetrical conditions.\u0000Key words: Bleeding, menorrhagia, HELLP, DIC, IPH, PPH","PeriodicalId":20500,"journal":{"name":"Proceedings of Shaikh Zayed Medical Complex Lahore","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2019-12-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"81784029","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Frequency of Mucocutaneous Manifestations of Asthma in Paediatric Patients Aged 2-14 Years 2-14岁儿童哮喘粘膜皮肤表现的频率分析
Pub Date : 2019-12-02 DOI: 10.47489/p000s334z7251-5mc
Lubna Riaz
.
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引用次数: 0
An Update on Isolation of Extensively Drug Resistant(XDR) Salmonella enterica from Blood Cultures in aTertiary Care Centre 从三级保健中心血液培养中分离广泛耐药肠炎沙门氏菌的最新情况
Pub Date : 2019-12-02 DOI: 10.47489/p000s334z7261-5mc
S. Hameed
Introduction: Typhoid fever is a public health issue, burdening many regions of the world with poor socioeconomic background. Management of this disease faces the major hurdle of antimicrobial resistance. Thepresent study reveals current pattern of antimicrobial susceptibility among Salmonella enterica (Salmonellatyphi & Salmonella paratyphi A) blood culture isolates from typhoid fever cases. Regular data collectionabout Salmonella infections and their response to antimicrobial agents, coupled with a long term commitmentto providing adequate health information systems, is the key to effective planning and policy formationagainst typhoid fever. Aims & Objectives: To evaluate the prevalence of ceftriaxone resistant Salmonellaenterica isolates from blood cultures in Shaikh Zayed Medical Complex for updating nosocomialantimicrobial resistance data. Place and duration of study: This research study was conducted at ShaikhZayed Medical Complex, Lahore from March 2018 to May 2019. Material & Methods: Blood culturespositive for Salmonella enterica were analyzed, taking into consideration the gender & age of patients withtyphoid fever. Antimicrobial susceptibility testing was carried out through disc diffusion method. Therecommended antimicrobial agents for S. typhi (Salmonella typhi) & S. paratyphi A (Salmonella ParathyphiA) (as per CLSI, USA 2018/2019 guidelines; described later), were tested and analyzed during this study withthe main focus on 3rd generation cephalosporin resistance pattern. Among second line treatment options,meropenem and azithromycin were selected for study. Results: Out of 899 isolates of Salmonella enterica(from 13964 samples for blood culture), 849 (94.4%) were S. typhi and 50 (5.6%) were S. paratyphi A. Ofthese, 57.1% isolates were from males, 42.9% from females, 81.7% from children (age less than 12 years) and18.3% were from adults (age more than 12 years). A continuously rising resistance percentage was observedfor 3rd generation cephalosporins over the span of fifteen months. It was 43.4% for ceftriaxone (CRO). Nocase of meropenem and azithromycin resistance was observed during study period. Conclusion:Demographic information was provided by this study regarding high level of resistance among Salmonellaenterica isolates particularly S. typhi .The first line antibiotic drugs were a complete failure in ongoingoutbreak of typhoid fever. The novel results of this study are the high resistance percentages for 3rd generationcehalosporins, whether oral or parenteral. This result is worrisome as it will leave us with no option but toresort to second line drugs. However, an increasing trend of blood culturing was observed in this research.Extensively drug resistant (XDR) Salmonella infection has definitely highlighted the importance of bloodculture and its use as a more preferred diagnostic tool.Key words: Typhoid fever, Extensively drug resistant (XDR) Salmonella enterica, (S. typhi & S. paratyphiA), Antimi
伤寒是一个公共卫生问题,给世界上许多社会经济背景较差的地区造成负担。这种疾病的管理面临着抗微生物药物耐药性的主要障碍。本研究揭示了目前伤寒病例中肠沙门氏菌(沙门氏菌和副伤寒沙门氏菌)血培养分离株的抗菌药物敏感性模式。定期收集有关沙门氏菌感染及其对抗微生物药物反应的数据,再加上长期致力于提供适当的卫生信息系统,是有效规划和制定伤寒防治政策的关键。目的和目的:评估谢赫扎耶德医疗中心血液培养中头孢曲松耐药肠炎沙门氏菌的流行情况,以更新医院抗微生物药物耐药性数据。研究地点和时间:本研究于2018年3月至2019年5月在拉合尔的ShaikhZayed医疗中心进行。材料与方法:结合伤寒患者的性别、年龄,对肠炎沙门氏菌血培养阳性进行分析。药敏试验采用纸片扩散法。推荐的抗伤寒沙门氏菌(伤寒沙门氏菌)和副伤寒沙门氏菌A(副伤寒沙门氏菌)抗菌药物(根据CLSI, USA 2018/2019指南;在本研究中,对第3代头孢菌素耐药模式进行了测试和分析。在二线治疗方案中,选择美罗培南和阿奇霉素进行研究。结果:从13964份血培养标本中分离出899株肠沙门氏菌,其中伤寒沙门氏菌849株(94.4%),副伤寒沙门氏菌50株(5.6%),其中男性57.1%,女性42.9%,儿童(12岁以下)81.7%,成人(12岁以上)18.3%。在15个月的时间里,观察到第三代头孢菌素的耐药率持续上升。头孢曲松(CRO)为43.4%。研究期间未见美罗培南和阿奇霉素耐药病例。结论:本研究提供了沙门氏菌(尤其是伤寒沙门氏菌)高耐药性的人口统计学信息,一线抗生素药物在持续的伤寒暴发中完全失败。本研究的新结果是对第三代头孢菌素的高耐药率,无论是口服还是注射。这一结果令人担忧,因为它将使我们别无选择,只能求助于二线药物。然而,在本研究中发现了血液培养的增加趋势。广泛耐药沙门氏菌感染无疑突出了血液培养的重要性,并将其作为一种更优选的诊断工具。关键词:伤寒,广泛耐药(XDR)肠炎沙门氏菌,(S. typhi & S.副伤寒沙门氏菌),抗微生物药物耐药性,CRO(头孢曲松)耐药性
{"title":"An Update on Isolation of Extensively Drug Resistant\u0000(XDR) Salmonella enterica from Blood Cultures in a\u0000Tertiary Care Centre","authors":"S. Hameed","doi":"10.47489/p000s334z7261-5mc","DOIUrl":"https://doi.org/10.47489/p000s334z7261-5mc","url":null,"abstract":"Introduction: Typhoid fever is a public health issue, burdening many regions of the world with poor socioeconomic background. Management of this disease faces the major hurdle of antimicrobial resistance. The\u0000present study reveals current pattern of antimicrobial susceptibility among Salmonella enterica (Salmonella\u0000typhi & Salmonella paratyphi A) blood culture isolates from typhoid fever cases. Regular data collection\u0000about Salmonella infections and their response to antimicrobial agents, coupled with a long term commitment\u0000to providing adequate health information systems, is the key to effective planning and policy formation\u0000against typhoid fever. Aims & Objectives: To evaluate the prevalence of ceftriaxone resistant Salmonella\u0000enterica isolates from blood cultures in Shaikh Zayed Medical Complex for updating nosocomial\u0000antimicrobial resistance data. Place and duration of study: This research study was conducted at Shaikh\u0000Zayed Medical Complex, Lahore from March 2018 to May 2019. Material & Methods: Blood cultures\u0000positive for Salmonella enterica were analyzed, taking into consideration the gender & age of patients with\u0000typhoid fever. Antimicrobial susceptibility testing was carried out through disc diffusion method. The\u0000recommended antimicrobial agents for S. typhi (Salmonella typhi) & S. paratyphi A (Salmonella Parathyphi\u0000A) (as per CLSI, USA 2018/2019 guidelines; described later), were tested and analyzed during this study with\u0000the main focus on 3rd generation cephalosporin resistance pattern. Among second line treatment options,\u0000meropenem and azithromycin were selected for study. Results: Out of 899 isolates of Salmonella enterica\u0000(from 13964 samples for blood culture), 849 (94.4%) were S. typhi and 50 (5.6%) were S. paratyphi A. Of\u0000these, 57.1% isolates were from males, 42.9% from females, 81.7% from children (age less than 12 years) and\u000018.3% were from adults (age more than 12 years). A continuously rising resistance percentage was observed\u0000for 3rd generation cephalosporins over the span of fifteen months. It was 43.4% for ceftriaxone (CRO). No\u0000case of meropenem and azithromycin resistance was observed during study period. Conclusion:\u0000Demographic information was provided by this study regarding high level of resistance among Salmonella\u0000enterica isolates particularly S. typhi .The first line antibiotic drugs were a complete failure in ongoing\u0000outbreak of typhoid fever. The novel results of this study are the high resistance percentages for 3rd generation\u0000cehalosporins, whether oral or parenteral. This result is worrisome as it will leave us with no option but to\u0000resort to second line drugs. However, an increasing trend of blood culturing was observed in this research.\u0000Extensively drug resistant (XDR) Salmonella infection has definitely highlighted the importance of blood\u0000culture and its use as a more preferred diagnostic tool.\u0000Key words: Typhoid fever, Extensively drug resistant (XDR) Salmonella enterica, (S. typhi & S. paratyphi\u0000A), Antimi","PeriodicalId":20500,"journal":{"name":"Proceedings of Shaikh Zayed Medical Complex Lahore","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2019-12-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"85078125","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 4
Hepatoprotective Effect of Ajwa Date Seed andSimvastatin in Non Alcoholic Fatty Liver Disease(NAFLD) Murine Model of Butter Fed Dyslipidemia 阿枣籽和辛伐他汀对黄油喂养的非酒精性脂肪性肝病(NAFLD)小鼠模型的保肝作用
Pub Date : 2019-12-02 DOI: 10.47489/p000s334z7291-6mc
Farooq Sultan
Introduction: Non-alcoholic fatty liver disease (NAFLD) is a dangerous complication of hyperlipidemiawhich may lead to life threatening hepatitis and hepatic cirrhosis. Internationally, Prevalence of non-alcoholicfatty liver disease (NAFLD) is 20% in general population while 75% in the obese population of USA.1 Sideeffects of allopathic drugs have led the research towards natural products to find out their potential fortreatment of NAFLD. Aims & Objectives: Aim of this study was evaluation of hepatoprotective effects ofAjwa date seed and Simvastatin against NAFLD. Place and duration of study: Study was conducted atanimal house of UHS, Lahore and completed in 6 months. Material & Methods: 40 rats were procured andsegregated into 5 groups with 8 rats in each group. Group 1 was healthy control and group 2 was diseasecontrol. Group 3, 4 and 5 were administered Simvastatin 10mg/kg/day, aqueous Ajwa date seed extract(ADSE) 8ml/kg/day and combination of Simvastatin 5mg/kg/day and aqueous ADSE 4ml/kg/dayrespectively. Total study duration was 36 days. First 15 days were for induction of hyperlipidemia whiletreatment was given for remaining 21 days. Serum total cholesterol (TC), triglycerides (TG) and liverfunctions tests (Serum ALT, AST and ALP) were performed at day 0, 15 and 36 of study. Data was enteredon SPSS 23.0 software and analyzed by one way ANOVA and post hoc tuckey’s tests. P-value of less than0.05 was considered significant. Results: Aqueous Ajwa date seed extract (ADSE), Simvastatin and theircombination showed significant TC and TG lowering and hepatoprotective effects against NAFLD. However,individual drugs were more effective than the combination. Conclusion: Ajwa date seed can be used for thetreatment of NAFLD.Key words: Ajwa date seed, Hyperlipidemia, Simvastatin
非酒精性脂肪性肝病(NAFLD)是高脂血症的一种危险并发症,可导致危及生命的肝炎和肝硬化。在国际上,非酒精性脂肪性肝病(NAFLD)在普通人群中的患病率为20%,而在美国的肥胖人群中患病率为75%。1对抗药物的副作用导致了对天然产物的研究,以寻找其治疗NAFLD的潜力。目的:本研究的目的是评价红枣籽和辛伐他汀对NAFLD的肝保护作用。研究地点和时间:研究在拉合尔大学保健所动物舍进行,6个月完成。材料与方法:取大鼠40只,随机分为5组,每组8只。1组为健康对照组,2组为疾病对照组。3、4、5组患者分别给予辛伐他汀10mg/kg/d,水溶阿吉瓦枣籽提取物8ml/kg/d,辛伐他汀5mg/kg/d与水溶阿吉瓦枣籽提取物4ml/kg/d联合用药。总研究时间为36天。前15天用于诱导高脂血症,其余21天给予治疗。于试验第0、15、36天分别测定血清总胆固醇(TC)、甘油三酯(TG)和肝功能(ALT、AST、ALP)。数据采用SPSS 23.0统计软件录入,采用单因素方差分析和事后塔基检验进行分析。p值小于0.05为显著性。结果:Ajwa枣籽水提液(ADSE)、辛伐他汀及其联合用药对NAFLD具有显著的TC、TG降低和肝保护作用。然而,单独用药比联合用药更有效。结论:红枣籽可用于NAFLD的治疗。关键词:红枣子,高脂血症,辛伐他汀
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引用次数: 0
Evaluation of Renal Function Parameters inNormotensive and Pre-Eclamptic Pregnant Women atDifferent Stages of Pregnancy 不同妊娠阶段血压正常和子痫前期孕妇肾功能参数的评价
Pub Date : 2019-12-02 DOI: 10.47489/p000s334z7231-4mc
Farhana Mukhtar
Introduction: Pre-eclampsia is one of the most common causes of maternal and fetal complications in developing countries. Owing to its multisystem involvement, hypertension and proteinuria in pre-eclamptic women may lead to acute or chronic renal failure. Early diagnosis is vital to avoid this organ failure. Aims & Objectives: To assess renal function by measuring and comparing four renal function parameters including Blood urea Nitrogen (BUN),serum creatinine, creatinine clearance and 24-hr urinary protein in pre-eclamptic and normotensive pregnant women at different stages of pregnancy. Place and duration of study: This prospective and observational study was conducted in 2009 at Shaikh Zayed Hospital. The patients were taken from Gynae and Obstetrics OPD, with 24 weeks of gestation. Material & Methods: In this study, 25 normotensive Controls and 25 pre-eclamptic pregnant women (cases) were included. Serum and urinary samples were taken at 24 weeks, 28 weeks, 32 weeks of gestation as well as at term (38 weeks). Blood urea nitrogen (BUN), serum creatinine, spot urinary protein and urinary creatinine were measured by clinical Chemistry Auto analyzer Dimension AR. Whereas, 24 hours urinary protein and creatinine clearance were calculated later. Results: BUN level of cases were significantly high as compared to controls at 32 weeks and at term (p<0.01) however creatinine clearance was found to be significantly low (p>0.05) in pre-elamptic women only at 38 weeks. Apart from other results, 24-hours urinary protein was found to be significantly high (p<0.05) in pre-eclamptic women as compared to normotensive women at all stages of pregnancy. Conclusion: Our study showed that BUN, Creatinine clearance and most importantly 24-hr urinary protein may be used to assess the renal function in relation with the severity of pre-eclampsia. Key words: Pre-eclampsia, Blood Urea Nitrogen (BUN), Proteinuria.
先兆子痫是发展中国家产妇和胎儿并发症的最常见原因之一。由于其涉及多系统,高血压和蛋白尿在子痫前期妇女可导致急性或慢性肾功能衰竭。早期诊断对于避免这种器官衰竭至关重要。目的:通过测定和比较不同妊娠阶段子痫前期和血压正常孕妇的血尿素氮(BUN)、血清肌酐、肌酐清除率和24小时尿蛋白等4项肾功能指标来评价其肾功能。研究地点和时间:这项前瞻性和观察性研究于2009年在谢赫扎耶德医院进行。患者均为妊娠24周的妇产科门诊患者。材料与方法:选取血压正常的对照组25例,子痫前期孕妇25例。分别于妊娠24周、28周、32周及足月(38周)采集血清和尿液样本。采用临床化学自动分析仪Dimension AR测定血尿素氮(BUN)、血清肌酐、斑点尿蛋白和尿肌酐,并计算24小时尿蛋白和肌酐清除率。结果:与对照组相比,孕32周和足月时,孕前妇女仅在孕38周时BUN水平显著升高(p0.05)。除其他结果外,与妊娠各阶段血压正常的妇女相比,子痫前期妇女24小时尿蛋白明显高(p<0.05)。结论:我们的研究表明BUN、肌酐清除率和最重要的24小时尿蛋白可用于评估肾功能与子痫前期严重程度的关系。关键词:先兆子痫,血尿素氮,蛋白尿。
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Proceedings of Shaikh Zayed Medical Complex Lahore
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