Background: The emergence of resistant strains of bacteria has rendered many useful antibiotics ineffective. The researchers areforced to try combination of two or more antibiotics, or addition of a non- antibacterial to them. Ceftriaxone, a third-generationcephalosporin agent is used to treat many infectious diseases, especially those caused by members of Enterobacteriaceae family.We tested the efficacy of ceftriaxone, alone and in combination with various concentrations of diclofenac sodium, againstEscherichia coli.Objective: To study the synergistic effect of ceftriaxone and its combination with non-antibiotic drug diclofenac sodium againstEscherichia coli ATCC 25922 isolate.Material and Methods: Agar well diffusion technique was applied. 30 µl of solutions of ceftriaxone, and its combination withdifferent concentrations of diclofenac sodium and DMSO were transferred aseptically into the wells. Agar plates were placed in incubator at 37°C for 24 hours. Mean zone of inhibition of each drug was calculated.Results: Ceftriaxone 30µg formed a zone of inhibition of 35 mm. Its combination with 25µg and 50µg of diclofenac sodium formedzone of inhibition of 37.5mm while its combination with 100µg diclofenac sodium formed a zone of inhibition of 38.6mm and formed39.8mm zone of inhibition when combined with 200µg diclofenac sodium.Conclusion: Ceftriaxone activity increased when combined with different concentrations of diclofenac sodium drug showing asynergistic effect of their combination.Key words: ceftriaxone, Diclofenac sodium, E. coli, Synergism
Objectives: To analyze the pattern of maxillofacial injuries and associated concomitant injuries received by a motorcyclist.Methods and materials: This descriptive (cross-sectional) study carried out at the Oral and Maxillofacial Surgery Unit of Hayatabad Medical Complex, Peshawar from 4th December, 2019 to 20th February 2021. A total of 386 patients having road traffic accidents were included in the study regardless of age and gender. Every patient was examined both clinically and radiographically to confirm the site of maxillofacial fracture.Results: Majority of the patients were involved in motorbike accidents (79%) among the patients injured in road traffic accidents. More than two third of the patients were young males (76%) as compare to females (24%). Out of 304 patients who sustained maxillofacial trauma during motor bike accidents, only a minority of victims 38(12.5%) used helmets while the remaining did not. The most common fractured site was mandible (46.7%).Conclusion: Most of the patients encountered in the present study were young males without helmets and mandible being the most frequent site.
Background: Pakistan has the second highest prevalence of hepatitis C in the world after Egypt. Viral hepatitis is a leading cause of morbidity and mortality in Pakistan and, worryingly, reinfection rates are also on the rise. This cross-sectional study was aimed at finding the most common genotypes of hepatitis C in terms of age and sex in a Pakistani cohort. Materials and methods: The authors collected blood samples from 1,260 patients with diagnosed hepatitis C visiting a primary teaching hospital affiliated with Peshawar Medical College, Pakistan, from different districts of Khyber Pakhtunkhwa, Pakistan, between January 2017 and April 2019. Hepatitis C virus RNA was quantified by real-time polymerase chain reaction and genotyping was then performed. Results: The authors found that genotype 3a was the most prevalent type followed by 1a, mixed, and 3b, respectively. Genotypes 2a and 1b were the least prevalent in Khyber Pakhtunkhwa. The most common genotype was 3a, observed in 75.87% of cases. The most common mixed genotype was 3a+1a, observed in 39 cases (3.10%); it had a prevalence of 3.49% in females compared with 2.70% in males. Overall, the most common age group affected by hepatitis C virus was 41–50 years (31.35%), followed by the 51–60 years group (24.45%). Infection rate was comparatively low in other age groups. A significant difference was observed in the prevalence of genotype 3a and 2a among different districts. Conclusion: The authors concluded that genotype 3a was the most prevalent genotype and it was observed more frequently in the female population, with a median age of 45 years.
There is no systemic disease, which so frequently gives rise to disorders of the eye as leprosy does. The study was conducted to determine the prevalence and gravity of ocular complications in institutionalized leprosy patients in NWFP. It is important to provide necessary information to leprosy health workers and general physicians in order to sensitize them to early detection and treatment or referral to appropriate centre.A prospective study of ocular complications of leprosy patients was conducted at the leprosy centre of Lady Reading Hospital Peshawar and the Leprosy Hospital Balakot, district Mansehra. The study included a record of the name, age, sex, type, duration of disease and completion of multi-drug therapy (MDT). Classification of the patients was done according to Ridley and Jopling 5-group system. Visual acuity was tested by Snellen chart and those patients having a vision of less than 3/60 were labelled as blind. Ocular adnexa were examined by naked eye and lacrimal sac regurgitation test was done. Slit lamp biomicroscopy was done for anterior segment examination and direct ophthalmoscope was used for fundoscopy.The authors studied 143 patients in the above mentioned leprosy centres. Out of these, 59 had lepromatous leprosy, 39 borderline tuberculoid leprosy, 9 tuberculoid leprosy, 33 borderline lepromatous leprosy, and 33 borderline leprosy. The majority of patients came from the northern districts of NWFP, including Malakand division and district Mansehra. The male to female ratio was 4:1. The age of the patients ranged from 14 to 80 years and the duration of the disease ranged from 1 year to 48 years. Ocular complications were found in 73% of the patients. These complications included loss of eyebrows in 57 patients, loss of eyelashes in 37, corneal changes (including opacity, ulceration, and/or anaesthesia) in 44, iridocyclitis in 31, lagophthalmos in 36, ectropion in 13, and chronic dacryocystitis in 3. Of the total of 15 (11%) patients who went blind from ocular complications, 16 eyes did so due to corneal opacities, 6 eyes due to cataract, 5 eyes due to chronic anterior uveitis and one eye due to corneal ulcer, panophthalmitis and phthisis bulbi each.A significant number of leprosy patients (73%) have ocular complications. The frequency of ocular complications increases with the increasing age and duration of disease of the patients.
Muhammad S N, G0007109, 2011. The Correlation between the Results
of Resistance to Antibiotics Use of Aminoglikocyte at Dr. Moewardi Hospital in
Surakarta. Paper, Faculty of Medicine, University of Sebelas Maret.
Objective : Bacteria Resistance Test Results should be Directly Proportional to
the Drugs Used. This Study will Explain the Correlation between the Resistance
of Bacteria against the Use of Aminoglikocyte Antibiotics to Patients at
Dr. Moewardi Hospital in Surakarta.
Methods : This was an observational research with cross sectional.
Samples of all patients hospitalized in Dr.Moewardi Hospital and has been tested
in the microbiology laboratory. The amount
of samples taken from medical records during the period January - June 2010. The
sampling technique used was simple random sampling. Intake
of secondary data from the pattern of bacteria carried in the microbiology
laboratory with the help of laboratory staff then analyzes the data to determine the
level and pattern of bacterial resistance to antibiotics Aminoglikocyte.
Results obtained were then compared with a drug released by the pharmaceutical
at the same time period. The data obtained is presented in the form of tables and
charts with Microsoft Office Excel.
Result : The results of data analysis showed that there were significant
differences between the patterns of bacteria and bacteria
resistance test result to Aminoglikocyte. The comparison between bacteria
resistance test and drug release by pharmaceutical showed a fairly significant
difference.
Conclusion : Resistance test result of Aminoglikocyte antibiotics at Dr.Moewardi
Hospital not as expected.
Key words : resistance test, bacteria pattern, Aminoglikocyte.
Objective: To identify rapidly changing antibiotic susceptibility of ESBL & Uropathogens. Study Design: Comparative Cross-sectional prospective study. Setting: Allied Hospitals of Peshawar Medical College. Period: 8th November 2021 to 5th March 2022. Material & Methods: 10-15ml of midstream urine was collected in a sterile container from 158 patients Pus cells, red blood cells, and bacteria were examined using microscopy. The standard loop technique was used to inoculate urine specimen on MacConkey and Blood agar. Plates were incubated for 24 hours at 37oC. A colony count of 105 cfu/ml was thought to be significant. Gram staining of the colonies was performed. The biochemical tests were conducted on API 10S for the identification of organisms. Extended-spectrum beta-lactamase organisms were identified by the double-disc synergy method. The Kirby-Bauer disc diffusion method was used to test antibiotic susceptibility on Mueller-Hinton agar according to CLSI guidelines 2021. A statistical package for the social sciences (SPSS) version 20.0 was used for statistical analysis. Results: Out of 158 urine samples 135 (85.5%) had positive culture growth with 35 (25.9%) ESBL confirmed. Antibiotic susceptibility was Nitrofurantoin (70.1%), Trimethoprim-sulfamethoxazole (26.8%), Ciprofloxacin (51.5%), Levofloxacin (51.5%), Ceftriaxone (25.77%) Cefotaxime (23.7%) Ceftazidime (19.5%) Cefepime (27.8%) Aztreonam (2.1%) Meropenem (86.6%) Amoxicillin/clavulanic (37.1%) Gentamycin (73%) Penicillin (0%). Conclusion: Surprisingly, only nitrofurantoin was found to be advised orally as a suitable drug for the treatment of UTIs among the 13 commonly used antibiotics.
Background: Increased epidermal growth factor receptor (EGFR) expression has been implicated in several tumors and is associated with increased tumor advancement as well as a potential drug target. The objective of the study was to compare the immunohistochemical expression of EGFR in oral squamous cell carcinoma (OSCC) with oral potentially malignant disorders (OPMDs) and their demographic and pathologic parameters. Methods: This study was a comparative cross-sectional analytical study. It was conducted at the Department of Pathology, Peshawar Medical College, Riphah International University, Islamabad, Pakistan, from March 2021 to February 2022. The sample size was calculated through G Power. Thirty-eight cases of oral squamous cell carcinoma and 38 cases of oral potentially malignant disorders (OPMDs) were included in the study. Statistical analysis was performed using the Statistical Package for Social Sciences version 20.0. χ 2 tests and Fisher exact tests were applied to compare categorical variables. Results: Mean age of OSCC was 61.6±13.9, with age range from 26 to 90 years. The male-to-female ratio for OSCC was 2.16:1. Buccal mucosa was the most common site involved (34.2%). The most common histologic type was well-differentiated OSCC (71.05%) followed by poorly differentiated (16%) and moderately differentiated (13.15%). The mean age of OPMDs cases was 59.16 ± 10.81 with a male-to-female ratio of 1:1.2. Buccal mucosa was the common site (55.3%), followed by the tongue (18.4%). The OPMDs with dysplasia were 55.2%, and without dysplasia were 44.8%. A total of 55.7% of cases of OSCC showed positive EGFR expression as compared with 36.9% OPMDs cases. A higher number of low-grade OSCC cases showed increased EGFR positivity (59.3%) as compared with high grade (45.45%). EGFR positivity in OPMD cases without dysplasia was 41.2% as compared with cases with dysplasia (33.3%). The EGFR expression in OPMD cases was higher in the ≤50 age group ( P =0.001) and in females ( P =0.032), which was statistically significant. Conclusions: EGFR expression by Immunohistochemistry may not be a helpful prognostic marker to determine the risk of OPMDs progressing to higher grades of dysplasia or invasive cancer. However, further studies relating this tumor marker to stage, lymph node metastasis, hematogenous metastasis, survival outcomes, and treatment response may give useful information regarding the utility of this marker.
OBJECTIVE: To synthesize three experimental resin based composites (RBCs) out of a commercial preperation (Control) by impregnating into each a fixed weight (0.01%) of titanium dioxide (TiO2) and three different weight % (0.01, 0.02 and 0.03) of proanthocyanidin (PA) and to compare antibacterial property, from the zones of inhibition of streptococcus mutans (S. mutans), of the specimen restorations made in the experimental and control RBCs. METHODOLOGY: In the first phase, Streptococcus mutans were isolated and identified from the oral cavity of patients and identified on the basis of morphogenic appearance of colonies and confirmed through catalase test and microscopic examination. Isolates were then incubated and cultured for sensitivity. Specimens for control and experimental RBCs were made through a metallic mold having 2mm thickness and 5mm diameter for all the 4 groups. Specimen restorations made in the commercial as supplied RBC acted as the control (Group A). Specimen restorations in the Group B, C, and D were made in each of the experimental RBCs modified with 0.01% proanthocyanidin (PA) and 0.01% titanium dioxide (TiO2), 0.02% PA and 0.01% TiO2 and 0.03% PA and 0.01% TiO2. The antimicrobial property of all the specimen restorations in all the groups was evaluated by Bauer-Kirby (Disc Diffusion) method through the formation of zones of inhibition of S. mutans colonies on blood agar plates. Data were computed using SPSS version 21 for descriptive statistics and analyzed using one-way ANOVA with p value 0.05 taken as significant. RESULTS: The range of the zone of inhibition for specimen RBC restorations (N= 12) containing PA and TiO2 was 0.00 for Group A, 10-12mm for Group B, 12-14mm for Group C and 9-10mm for Group D. The mean inhibition zone for the experimental restoration specimens was 11±2mm for Group B, 12.7±1mm for Group C and 9.7±1mm for Group D compared to no inhibition zones (0.00 mm) with the control RBC Group A. The order of the inhibition zones from maximum to minimum was Group C > Group B > Group D > Group A. The differences between the mean values for the control and the experimental RBC restoration specimens were significant (p < 0.000). The specimen restorations in the Group D appeared under cured and could impact on their mechanical properties. CONCLUSION: Irrespective of the mentioned concentrations, impregnating PA and TiO2 rendered the RBC antimicrobial. RBC restorations made with the experimental RBC with 0.02% PA and 0.01% TiO2 proved relatively more effective in terms of antimicrobial effect. KEY WORDS: dental materials, resin based dental restorations, antibacterial resin based composite, proanthocyanidin, titanium dioxide.
This study was carried out to search for mutations in the gene encoding for Non- Structural Protein 5A, specifically in the interferon sensitivity determining region of hepatitis C virus (HCV) genotype 3a, isolated from serum samples of patients not responding to treatment with oral Ribavirin and Interferon alpha injections.This descriptive case series was conducted on HCV patients reporting in the attached teaching hospitals of Peshawar Medical College selected by consecutive sampling technique from 1st July to 31st December 2012. Amino acid sequencing was performed at the Centre of Applied Molecular Biology Lahore. Patients showing no clinical response after 6 months of combination therapy with Injection Interferon alpha + Ribavirin and still having positive polymerase chain reaction (Declared Non-Responders) were included in this study.Amino acid sequencing was performed on HCV isolates from twenty non-responder and five responder patients. All these sequences were compared with Newzealand1 (NZL1) sequence from the gene bank for mutations; 0-7 mutations were observed in responders as compared to 10-27 mutations in non-responder patients (p value <0.005).We were able to determine that there is a positive correlation between the number of mutations in NS5A ISDR and non-response to combination therapy. Synonymous mutations >10 and non-synonymous mutations >7 in this region suggest poor response to treatment.
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