Background: We aimed to assess the incidence of developing postoperative urethrocutaneous fistulae (UCF) while using either polyglactin 910 or polydioxanone for the repair of subcoronal hypospadias in paediatric patients. Methods: A multicenter, two-group posttest-only randomized experimental design was adopted for the study. The study was conducted at PNS Shifa Hospital Karachi, Combined Military Hospital Malir, Military Hospital Rawalpindi and Combined Military Hospital Multan from 2009 to 2016. Boys between the ages of 1 – 10 years with confirmed diagnosis of subcoronal hypospadias suitable for single stage repair with the Snodgrass technique and also completing a minimum follow up of 6 months were targeted for the study. The subjects were later randomized into PG group (those undergoing urethral repair with polyglactin 901) and PD group (those in whom polydioxanone was used). Both descriptive and inferential statistics were used for data analysis. SPSS v. 21.0 was used for data analysis with p > 0.05 taken as significant value. Results: Two hundred patients with confirmed diagnosis of subcoronal hypospadias were recruited for the study in the proposed study period. Twenty-nine patients (29%) in the PG and 26 (26%) in the PD group developed UCF. There were seven (7%) cases of wound infection in the PG group compared to four cases (4%) in the PD Group; all eleven of the said were among those who developed UCF. Meatal stenosis was observed in six patients (6%) in the PG group and in nine patients (9%) of the PD group. No significant difference in the incidence of postoperative urethral fistula formation with the use of polyglactin 910 versus polydioxanone was however reported by the study findings. Conclusion: As there was no significant difference in the incidence UCF between Polyglactin 910 and Polydioxanone, the choice of suture material should be based on economical variations and availability of the two products.
Backgrounds In Pakistan, despite the surge in antibiotic consumption scanty of literature evidences exist regarding antibiotic susceptibility patterns in URTIs. Thus, we conducted the study to evaluate the antibiotic susceptibility patterns in URTIs.Methods A cross-sectional study was conducted by collecting 259 culture samples from tertiary care hospitals of Lahore, Pakistan. Using simple random sampling, culture reports of even numbered patient were included as per study inclusion criteria.Results Two hundred sixty samples were processed out of which only 144 (55.4%) samples yielded growth, i-e., 42.7% males and 49% females. In males, the resistance was high against ceftazidime (19.3%), ampicillin (13.1%), ciprofloxacin (11.6%) and gentamicin (10.8%), while in female samples it was significant against cefuroxime (6.9%), ampicillin (5.4%), tobramycin (4.6%) and ciprofloxacin (6.5%). Besides, males were sensitive against imepenem (25.8%), amikacin (22%), ceftazidime (19.3%), ciprofloxacin (19.3%) and piptaz (16.2%), while females were sensitive against amikacin (9.2%), imepenem (9.2%) and ciprofloxacin (6.9%). Overall, carbepenems, imipenem (35%) and meropenem (30.8%), were found highly sensitive followed by aminoglycosides (amikacin; 31.9%), quinolones (ciprofloxacin; 26.3%), piptaz (19.2%) among penicillin and cephalosporin, while resistant was maximum against cephalosporin (ceftazidime; 25.4%) followed by penicillin (ampicillin, 18.5%) and quinolones.Conclusion These data suggested that P. aeruginosa and Klebsiella , were the most frequent bacterial isolates in URTIs of Lahore, Pakistan. These isolates were resistant to ampicillin, cefuroxime and ceftazidime, but were sensitive to carbapenem and aminoglycoside class of antibiotics. Thus, health care professionals, policy makers and drug regulators must devise policies to overcome the menace of growing antimicrobial resistance.
To evaluate the antibiotic susceptibility patterns in URTIs reporting to tertiary hospitals of Lahore. A cross-sectional study employing 259 culture sensitivity reports obtained from tertiary care hospitals of Lahore. Using SPSS, descriptive statistics were used to estimate frequencies and percentages. In URTIs, S. aureus (5%) was the frequent gram-positive isolate followed by MRSA (1.5%) and MSSA (1.5%), while P. aeruginosa (15.8%) was the prevalent gram-negative isolate followed by Klebsiella (13.1%) and E. coli (6.9%). Against P. aeruginosa, ceftazidime (7.7%), cefuroxime/ceftriaxone (4.6%), amoxicillin (4.3%) and ciprofloxacin (4.2%), were tested resistant, while imipenem (11.2%), ciprofloxacin (9.2%), amikacin (9.2%), meropenem/ levofloxacin/gentamicin (8.1%) and piptaz (6.9%) were found sensitive. Against Klebsiella, carbepenems (7.3%), amikacin (6.5%), ciprofloxacin (5.4%) and gentamicin (5%) were tested sensitive, whereas, ceftazidime (8.5%), ceftriaxone (5.8%), cefaclor (5.5%), ampicillin (4.6%), co-amoxiclave (4.2%) and ciftazidime/ciprofloxacin (3.8%) were found resistant. Overall, imipenem (35%), meropenem (30.8%) and amikacin (31.9%) were the three most sensitive antibiotics, while ceftazidime (25.4%), ceftriaxone (19.2%) and ampicillin (18.5%) were the three most resistant antibiotics. Data suggested that P.aeruginosa and Klebsiella, were the most frequent bacterial isolates in URTIs of Lahore. These isolates were resistant to ampicillin, cefuroxime and ceftazidime, but were sensitive to carbapenem and aminoglycosides.
will exceed the cumulative cessation cost in the 11th year and it will be 2.5 times in the 20th year; the cumulative medical cost plus productivity saving will exceed the cumulative cessation cost in the 7th year and it will be 3.4 times in the 20th year. ConClusions: Considering the attractive ROI results, it's recommended that SC medicines should be covered in the SC intervention.
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