A baby boy was born at term by forceps extraction following uneventful pregnancy. The baby did not require resuscitation at birth. On routine postnatal check, it was noticed that the baby had left-sided wrist drop (figure 1). An area of palpable subcutaneous nodules with some erythema was identified over the lower part …
We describe efforts towards introducing infection control (IC) practices and establishment of antimicrobial resistance (AMR) surveillance in a public sector hospital in Pakistan. The study was conducted in an eight-bed intensive care unit. IC principles, introduced through interactive sessions, were used as an intervention and their impact was observed by conducting surveillance for ventilator-associated pneumonia (VAP) before and after the intervention. Respiratory isolates of VAP patients in the period after intervention were screened for AMR, and empiric antibiotic at the time of admission was compared with the antimicrobial sensitivity pattern reported. VAP rates were high in general and declined in the period after intervention, although the difference was not significant. Of 37 VAP patients in the period after intervention, 68% had more than one clinically significant organism isolated from the respiratory specimen. Acinetobacter spp. were isolated from 76% of patients and Pseudomonas aeruginosa from 43%. All Acinetobacter spp. and 72% P. aeruginosa were multidrug resistant. The mean stay of the nosocomially infected patients was significantly higher than for the uninfected group (6.5 vs. 2.1 days, P<0.001). Our study suggests IC education needs to be supplemented by a hospital system that facilitates IC practices and development of surveillance programmes.
Hair care products have been on the rise in recent years. The utilization of straightening chemicals, dyes, conditioners, and serums is noticed in men and women alike. Around 50% of women are reported to use various permanent hair chemicals in the United States and Europe alone. The composition of these products includes formaldehyde-releasing chemicals, oxidized para-phenylenediamine, and 4-aminobiphenyl, all of which cause damage and desecration of hair follicles and roots and have a potential role as carcinogens suggesting a strong relation between the usage of these chemicals and possible cancer. Studies have disclosed alarming associations with breast, ovarian, and uterine tumors with the latter being the most common. Moreover, research revealed greater than 65950 new cases with approximately 12550 deaths in the United States due to uterine cancer in 20221. Thus, it is pertinent to highlight the impelling connection between the frequent application of hair straightening chemicals and malignancy involving the uterus.
To compare the duration and side effects of postoperative analgesia of caudal bupivacaine and bupivacaine-midazolam mixture.Single blinded, interventional experimental study.The Department of Anesthesiology and Surgical Intensive Care Unit, Dow Medical College and Civil Hospital, Karachi from May to November, 2002.Sixty children, aged 1-8 years, ASA physical status I and II, undergoing inguinal and urogenital surgery were randomly allocated to receive either 0.25% bupivacaine 0.75 ml/kg (group A) or 0.25% bupivacaine 0.75 ml/kg along with 0.1% midazolam 50mg/kg (group B) by caudal route immediately after induction of general anesthesia. Anesthesia was maintained till the end of surgery. Cardiorespiratory data, sedation and pain score were recorded for 24 hours following recovery from anesthesia. Analgesia was supplemented (diclofenac suppository) whenever the pain score was > or = 4. Duration of analgesia was recorded.The duration of analgesia was 21.41 +/- 2.7 hours in bupivacaine midazolam group and 9.97 +/- 2.25 hours in bupivacaine group, which showed a significant difference (p < 0.001). There was no significant difference in heart rate, respiratory rate, blood pressure and the incidence of side effects in both groups (p = 0.716). The sedation score were significantly higher in bupivacaine-midazolam group during first hour postoperatively (*p = 0.003).Addition of midazolam to caudal bupivacaine provides longer duration of postoperative analgesia without having significant side effects but with higher sedation score for 1 hour postoperatively.
Cervical cancer refers to a malignancy of the lower part of uterus i.e. cervix. It is the fourth most prevalent among women worldwide and tallies for about 30% of cancer cases in the developing world and 5% in the developed world.
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