Open Access Case Study

A Case Study of Multi-drug Resistant Surgical Site Infection after Intestinal Perforation Surgery Treated with Antibiotic CSE-1034

Sankalp Dwivedi, Manisha Bhatt Dwivedi, Ajay Dhankar, Anand Thawit

Journal of Advances in Medical and Pharmaceutical Sciences, Page 1-5
DOI: 10.9734/JAMPS/2018/41647

Background: Surgical site infections (SSIs) are one of the most frequent complications associated with surgeries and contribute significantly to morbidity and mortality if not treated promptly.  Poor prognosis associated with SSIs could be partly attributed to the increase in antimicrobial resistance among the causative agents.

Case Presentation:  This is a case of SSI due to multi-drug resistant (MDR) E. coli associated with intestinal perforation surgery treated successfully with CSE-1034.

Conclusions: CSE-1034 can be effectively used for the treatment of MDR SSIs. Utilizing CSE-1034 as an empiric therapy for SSIs could save time, the spread of resistance and can help to cut hospital-associated costs.

Open Access Original Research Article

Trends in Antibiotic Resistance among Major Bacterial Pathogens Isolated from Different Specimens at a Tertiary Care Hospital in India

Vijay Narayan Kulkarni, Manisha Vijay Kulkarni

Journal of Advances in Medical and Pharmaceutical Sciences, Page 1-7
DOI: 10.9734/JAMPS/2018/44300

Introduction and Aim: The know-how of local antibiograms is very important in the light of continuous changes in resistance patterns in different geographical niches. This retrospective observational study assessed the in vitro susceptibility pattern of pathogen isolates from different clinical samples to commonly used antibiotics including Potentox (Amikacin+Cefepime+L-arginine) in our hospital settings.

Methodology: A total of 320 isolates obtained from 1372 respiratory and urine clinical specimens from patients treated for bacterial infections during Jan. 2017 to Dec. 2017 were included in the study.

Results: Of the total 320 isolates, 75% were from urine and 25% from blood. E. coli (48.8%) was the most frequently isolated pathogen followed by K. pneumoniae (22.7%), P. aeruginosa (10.2%) and A. baumannii (10.2%). Meropenem and Potentox were the most active agents against all the isolates exhibiting 86.9% and 87.5% susceptibility rates respectively. The susceptibility to Imipenem was similar to Tigecycline (81.9%) and Amikacin was similar to Cefoperazone-Sulbactam. The lowest susceptibility rate was reported to Cefepime (55.3%) followed by Pip-taz (62.5%). The susceptibility to Colistin was 94.0%. Based on pathogen type, the highest susceptibility was reported towards E. coli and lowest towards A. baumannii. Susceptibility pattern for Amikacin and Cefepime resistant isolates were; Colistin (75.6%), Potentox (51.25%), Meropenem (50%) and Tigecycline (39%), with less than 30% susceptibility to Imipenem, Pip-taz and Cefoperazone-Sulbactam.

Conclusions: This antimicrobial susceptibility data suggest that Potentox can be considered as an important therapeutic option for the treatment of various gram-negative bacterial infections and in cases which are both Amikacin and Cefepime resistant to avoid excess consumption of carbapenems and where Tigecycline is not feasible.

Open Access Original Research Article

Prevalence of Renal Dysfunction and Its Relationship to CD4 and TNF Alpha of HIV Positive Individuals on Anti-retroviral Therapy in Port Harcourt

Beatrice E. Imananaghe-Amene, Ohanador Robinson, Josephine Iruolagbe, A. W. Obianime

Journal of Advances in Medical and Pharmaceutical Sciences, Page 1-10
DOI: 10.9734/JAMPS/2018/40957

Background: Despite the success of anti-retroviral drugs, renal impairment remains one of the most significant complications of HIV. This study aimed to evaluate the prevalence of renal impairment and its association with age, gender, CD4 and TNF alpha of HIV positives in the University of Port Harcourt Teaching Hospital (UPTH).

Materials and Methods: This hospital-based, cross- sectional study recruited 397 HIV positive patients on Anti-retroviral therapy for at least 6 months in the UPTH HIV clinic between June and August 2016. These patients were randomly selected from a cluster of patients attending the HIV clinic in UPTH. Using patient’s folders, age and gender were obtained while blood samples were collected for TNF and CD4 analysis. Estimated glomerular filtration rate was calculated using a modification of diet in Renal Disease –MDRD formula

Results: Prevalence of renal impairment was estimated at 12.7% based on MDRD equation. Females recorded the significantly high prevalence of renal dysfunction at 11.84%. CD4 57.45± 15.33 Cells/μl and TNF alpha 38.51± 22.40 pg/ml were significantly low in patients with renal dysfunction. EGFR correlated negatively with CD4 and TNF alpha.

Conclusion: The prevalence of renal dysfunction was low in this study. Reduced serum TNF alpha level and CD4 count are associated with renal dysfunction. Therefore, age and CD4 may be considered as the predictors of renal dysfunction. Also, female patients in this study may be at risk of renal dysfunction.

Open Access Original Research Article

Socio-Demographic Factors of Parental Self-Medication among Children under 15 Years, at the Teaching Hospitals of Lomé, Togo

Yao Potchoo, Anéwédom Awizoba

Journal of Advances in Medical and Pharmaceutical Sciences, Page 1-6
DOI: 10.9734/JAMPS/2018/44016

Aims: The study aimed to identify the socio-demographic factors and reasons for parental self-medication of hospitalised children under 15 years.

Materials and Methods: The present study was carried out in Departments of Pediatry (Sylvanus Olympio and Campus Teaching Hospitals) of Lomé-commune Region during June 18th to July 18th, 2016: The study included 204 parents (or relatives) with 175 respondents (16 men, 159 women; age range of 17-65 years with a mean of 32±7.5) who practised self-medication in inpatients children (105 females, 70 males; age range 0-14 years). Eligible parents (or relatives) were interviewed, using a questionnaire on self-medication and its determinants, and pretested on a sample of ten parents. Data were computed, the proportions (%) were calculated and the results were analysed using SPSS Statistical software.

Results: Among 204 parents (or relatives), 175 respondents resorted to self-medication to treat children in case of illness (85.8%). The results showed that mothers represented (151 out of 175) in self-medicating for children (86.3%). The age of parents was not associated with self-medication (p = 0.79 for father; p = 0.67 for mother). Absence of health insurance (p = 0.028 for father) and low education level (p = 0.026 for father; p = 0.007 for mother) were significantly associated with self-medication. Parent’s self-medication for children tends to decrease with the increasing age of child among the siblings. The two main factors responsible for parental self-medicating children were found to be lack of financial resources (57.7%) and self-medication as first line parental intervention in case of children’s illness (33.7%).

Conclusions: Self-medication is common in children in Togo. Expanding health coverage, health education, and literacy are needed to reduce children vulnerability and potential adverse effects associated with this practice.

Open Access Original Research Article

Effects of Virgin Coconut Oil on Aluminium Chloride-Induced Alzheimer-Like Dementia in the Prefrontal Cortex

J. A. Olanrewaju, O. B. Akinola, S. Y. Olatunji, J. O. Owolabi, O. S. Fabiyi, U. E. Ukonne, A. B. O. Desalu

Journal of Advances in Medical and Pharmaceutical Sciences, Page 1-12
DOI: 10.9734/JAMPS/2018/35221

Aims: The aim of this investigation is to study the effect of virgin coconut oil on the prefrontal cortex upon aluminium chloride-induced Alzheimer- likes dementia.

Study Design and Methodology: Twenty-eight (28) adult male Wistar rats were used and were randomly assigned into four groups:

Group A: Considered to be the control group which took water and food daily.

Group B: Virgin coconut oil treated group, were administered virgin coconut oil orally with 1700 mg/kg BW for 42 days.

Group C: Aluminium chloride treated group, were administered Aluminium chloride orally with 200 mg/kg BW for 42 days.

Group D:  Aluminium chloride + virgin coconut oil treated group, the Wistar rats were administered Aluminium chloride orally with 200 mg/BW for 21 days and then virgin coconut oil orally with 1700 mg/BW for the next 21 days.

The neurobehavioural investigation was done after the experiment to evaluate learning and memory using Barnes Maze. Animals were sacrificed by cervical dislocation. The whole brain was carefully excised from the skull. Prefrontal cortex was removed and fixed in 10% formal saline for histological analysis which includes H&E stain for general histoarchitecture and Cresyl fast violet for Nissl substance.

Place and Duration of Study: The study was done in Babcock University and approved by the Babcock University Ethics commission (BUHREC) with the BUHREC number 672/16. The experiment took the total of 45 days.

Results: Neurobehavioral study revealed a significant high latency in the animals treated with Aluminium chloride when compared with control and other treated groups.

H &E technique, as well as Cresyl fast violet, did not show any observable altered morphological presentation in the control and VCO treated groups. Also, a cellular density between the control and virgin coconut oil group appears normal across the cortical layers with appreciable spines and neuronal projections. The Aluminium chloride treated group induced degenerative changes in the cortex and was characterized by fragmented pyramidal and granule cell layer with observable pyknotic cells. Also, there was a comparatively increased cell density in the cortical layers of the VCO and Aluminium chloride + VCO treated groups.

Conclusion: Findings from this study support the view that, virgin coconut oil has ameliorative effects which neutralize the adverse effect of Aluminum chloride and tried to restore the integrity of the prefrontal cortex.