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Compared to adult medicine, drug use in children is not extensively researched. The objective of present study is to find out drug prescribing pattern in the Department of Pedodontics and Preventive Dentistry and Orthodontics in teaching... more
Compared to adult medicine, drug use in children is not extensively researched. The objective of present study is to find out drug prescribing pattern in the Department of Pedodontics and Preventive Dentistry and Orthodontics in teaching hospitals in Rajasthan, India. A prospective study was conducted in June 2011. A total of 619 prescriptions were collected randomly. Prescribing pattern was analyzed using WHO basic drug indicator. The average number of drugs and antimicrobial agent prescribed per prescription were 2.24 and 0.81 respectively. Antimicrobial agent contained 81.74% of all prescriptions. Most common groups of drugs prescribed by pedodontist were NSAIDS & Antipyretics (37.7%), Antimicrobial (36.4%) and Vitamins (12.3%). Prophylactic use of antimicrobial agents was 5.5 ± 0.5 days. Fixed dose combination (45.6%) frequently used by brand name. twelve percent generic drugs were used. Most of the drugs were from Essential Drug List especially a only one drug was prescribed. T...
Based on the American College of Chest Physicians 2004 antithrombotic therapy for venous thromboembolism (VTE) and the Eastern Association for the Surgery of Trauma 2002 guidelines, placement of an inferior vena cava (IVC) filter is... more
Based on the American College of Chest Physicians 2004 antithrombotic therapy for venous thromboembolism (VTE) and the Eastern Association for the Surgery of Trauma 2002 guidelines, placement of an inferior vena cava (IVC) filter is indicated in patients who either have, or are at high risk for, VTE, but have a contraindication or failure of anticoagulation. Our aim is to compare clinical characteristics and outcomes of patients receiving IVC filters within-guidelines (WG) and outside-of-guidelines (OOG). The 558 patients who received an IVC filter were divided into two groups called WG or OOG. The WG group met the criteria described above and the OOG group did not have a contraindication to or a failure of anticoagulation. The WG group had 362 patients and the OOG group had 196 patients. The OOG group had one (0.5%) patient with post-filter pulmonary embolism (PE), two (1%) with IVC thrombosis, and seven (3.6%) with deep vein thrombosis (DVT). The WG group had five (1.4%) patients with post-filter PE, 13 (3.6%) with IVC thrombosis, and 34 (9.4%) with DVT. All patients who developed post-filter PE had a DVT before filter placement, and patients who did not have a prior VTE event were at a significantly lower risk of developing post-filter IVC thrombosis and PE. Our data do not support the use of an IVC filter outside of guidelines in patients without prior VTE who can tolerate anticoagulation because of the low risk of developing PE.
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A total of 30 cases of leprosy (15 lepromatous and 15 tuberculoid) were studied by histochemical procedures for lipids in the morbid skin. The possible origin and relation of lipids to the presence of lepra bacilli in the lepra cells is... more
A total of 30 cases of leprosy (15 lepromatous and 15 tuberculoid) were studied by histochemical procedures for lipids in the morbid skin. The possible origin and relation of lipids to the presence of lepra bacilli in the lepra cells is discussed.
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The present knowledge of epidemiology, microbiology and pathogenesis of infective endocarditis in both native valve and prosthetic valve endocarditis is described. An attempt has been made to discuss early events in its pathogenesis. This... more
The present knowledge of epidemiology, microbiology and pathogenesis of infective endocarditis in both native valve and prosthetic valve endocarditis is described. An attempt has been made to discuss early events in its pathogenesis. This understanding may help in the prevention and management strategies.
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The aim of this study was to develop a polymerase chain reaction-restriction fragment length polymorphism (PCR-RFLP) assay for generic and species-specific differentiation of Nocardia from other morphologically similar bacterial... more
The aim of this study was to develop a polymerase chain reaction-restriction fragment length polymorphism (PCR-RFLP) assay for generic and species-specific differentiation of Nocardia from other morphologically similar bacterial pathogens. To examine the utility of the PCR-RFLP approach in species identification, genomic DNA was prepared from 40 soil isolates, 10 clinical isolates and 8 reference strains of Nocardia. A set of oligonucleotide primers was designed from the consensus sequence of the highly conserved groEL gene that encodes the 65-kDa heat shock protein (hsp 65). The primers selectively amplified 422 bp DNA from the genomic DNA of all Nocardia species and isolates. The digestion of the amplicons with the restriction enzyme MspI produced DNA fragments that could differentiate between different Nocardia species regardless of their origin. Additionally, the RFLP patterns obtained with restriction enzymes MspI and BsaHI resulted in the differentiation of six Nocardia specie...
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In this study, using the API-ZYM system, we have reported the enzyme profile of 42 soil strains and 2 clinical strains of Nocardia asteroides isolated locally. Of the 19 enzymes tested, only 7 were demonstrable in over 90% of the soil... more
In this study, using the API-ZYM system, we have reported the enzyme profile of 42 soil strains and 2 clinical strains of Nocardia asteroides isolated locally. Of the 19 enzymes tested, only 7 were demonstrable in over 90% of the soil isolates. These included alkaline phosphatase, esterase lipase, leucine arylamidase, acid phosphatase, phosphohydrolase, alpha-glucosidase and beta-glucosidase. In addition, beta-galactosidase activity was demonstrated in all the strains by the O-nitrophenyl-beta-D-galactopyranoside (ONPG) test. The enzymes which were not demonstrable in > 95% of the strains included valine arylamidase, cystine arylamidase, trypsin, chymotrypsin, alpha-galactosidase, beta-glucoronidase, N-acetyl-beta-glucosaminidase, alpha-mannosidase and alpha-fucosidase. With the exception of valine arylamidase, which was lacking in all but one isolate, the enzyme profiles of the soil isolates were comparable with the clinical isolates of N. asteroides reported in previous studies...
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A pilot study was undertaken to determine the occurrence and distribution of pathogenic nocardiae in Kuwaiti soil. A total of 102 soil samples collected from two localities were investigated by the paraffin bait technique. Nocardia... more
A pilot study was undertaken to determine the occurrence and distribution of pathogenic nocardiae in Kuwaiti soil. A total of 102 soil samples collected from two localities were investigated by the paraffin bait technique. Nocardia asteroides was the only species isolated from 42 (41%) soil samples. None of the isolates fulfilled the criteria required for identification of N. farcinica or N. nova. Thirty one (73.8%) isolates showed equivalent growth at 45 degrees C and 35 degrees C, 17 (40.4%) isolates utilized acetamide for carbon and nitrogen requirements and 3 (7.1%) isolates showed delayed arylsulphatase activity. Only a solitary isolate was resistant to cefamandole. Soil samples originating from the Kuwait University Campus, Shuwaikh, which were rich in humus/organic matter, were more productive for N. asteroides (67%) than the samples which were devoid of it but were mixed with crude oil (39%). Sand samples that lacked organic matter and crude oil samples were least productive...
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A total of 85 patients with multidrug resistant S. typhimurium were isolated between May and September 1991 at the Sir Ganga Ram Hospital, New Delhi, India. Fifty eight (72.5%) patients out of 80 stool culture positives suffered from... more
A total of 85 patients with multidrug resistant S. typhimurium were isolated between May and September 1991 at the Sir Ganga Ram Hospital, New Delhi, India. Fifty eight (72.5%) patients out of 80 stool culture positives suffered from enteritis and 23 (39.6%) of them settled with oral rehydration therapy alone. All strains were sensitive to 4 aminoquinolones (oflaxcin) but five were resistant to third generation cephalosporin (Cefotaxime; MIC between 50-75 micrograms/ml) whereas 88-96 per cent isolated were resistant to most of the other antibiotics. The convalescent carrier rate was prolonged with the use of antibiotics. The phage type of S. typhimurium isolated from the index and other cases was 178 and multidrug resistance strains had seven plasmids (1.2 to 16 kb). Barrier nursing and sodium hypochlorite disinfection helped in limiting the outbreak.
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Research Interests: Adolescent, Humans, Child, Female, Male, and 5 moreInfant, Newborn Infant, Streptococcus, Staphylococcus, and Child preschool
Research Interests: Toxoplasma, Adolescent, India, Antibodies, Pregnancy, and 7 moreHumans, Child, Female, Infant, Newborn Infant, Adult, and Child preschool
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ABSTRACT
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Research Interests: Malaria, Adolescent, Humans, Child, Female, and 5 moreMale, Infant, Middle Aged, Adult, and Child preschool
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A multiple skin test survey was carried out in Kuwait on 1200 school children aged 8-11 years, and on 1228 children aged 12-16 years. With only 15 exceptions, all these children had received vaccination with Japanese BCG just before they... more
A multiple skin test survey was carried out in Kuwait on 1200 school children aged 8-11 years, and on 1228 children aged 12-16 years. With only 15 exceptions, all these children had received vaccination with Japanese BCG just before they started school, 5 years and 9 years earlier respectively. Tuberculin positivity was almost 90% in both groups, with a mean response size of 8.7 mm. This was associated with remarkably high responsiveness to many of the other mycobacterial species investigated. Since this high reactivity was also to Mycobacterium ulcerans, a species most unlikely to be present in Kuwait, it is proposed that this might be due to responsiveness to group ii antigen which is present in all slow growing species. Only M. flavescens and M. rhodesiae amongst the fast growing species, were absent as sensitising organisms. After correction for the supposed reactivity to group ii antigen, M. avium B, M. gordonae, M. ulcerans and M. xenopi amongst the slow growing species, also ...
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Research Interests: Medical Microbiology, Adolescent, Streptomyces, Humans, Male, and 4 moreSkin, Middle Aged, Adult, and Mycetoma
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Research Interests: Medical Microbiology, Adolescent, India, Dogs, Humans, and 7 moreChild, Female, Animals, Male, Cattle, Middle Aged, and Adult
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The features of community-acquired acute lower respiratory tract infections in 390 children are described. Half (50%) presented with bronchiolitis, 37% with pneumonia and 13% with croup. Respiratory syncytial virus was the commonest agent... more
The features of community-acquired acute lower respiratory tract infections in 390 children are described. Half (50%) presented with bronchiolitis, 37% with pneumonia and 13% with croup. Respiratory syncytial virus was the commonest agent identified (52% of bronchiolitis, 29% of pneumonia, 51% of croup). Positive bacterial blood cultures were obtained in 10% of the patients, all except one with pneumonia. Fever (> 39 degrees C), a toxic ill look, bronchial breathing, WCC > 20 x 10(9)/l, neutrophils > 5 x 10(9)/l, platelet count > 500 x 10(9)/l, ESR > 45 mm/hr, lobar consolidation and pleural effusion were more likely to be associated with bacterial than with viral pneumonia (relative risk > 1.81; p < 0.05). In areas with limited resources, a high fever, a toxic ill look, bronchial breathing and simple laboratory tests may help to identify patients with bacterial pneumonia.
Research Interests: Developing Countries, Adolescent, Kuwait, Humans, Child, and 18 moreFemale, Pneumonia, Male, Infant, Incidence, Risk factors, Pediatric Pulmonology, Clinical Sciences, Newborn Infant, Public health systems and services research, Survival Rate, Respiratory Tract Infections, Bronchiolitis, Risk Factors, Seasons, Haemophilus Infections Market, Acute Disease, and Child preschool
Sixty-five patients, many of them immigrant to Kuwait, with bacteriologically proven, adult type, pulmonary tuberculosis were studied by many parameters over the 4 months following diagnosis. Twelve were infected with tubercle bacilli... more
Sixty-five patients, many of them immigrant to Kuwait, with bacteriologically proven, adult type, pulmonary tuberculosis were studied by many parameters over the 4 months following diagnosis. Twelve were infected with tubercle bacilli resistant to at least one anti-tuberculosis drug. Preliminary evidence suggested that this was frequently primary resistance in patients infected in their countries of origin. The Kuwaiti environment results in very high skin test and lymphocyte proliferative responses (LTT) to shared and species specific antigens of mycobacteria in healthy persons. In comparison, patients with tuberculosis lacked cellular responses to group i and group ii antigens, but had increased IgG and IgA binding to mycobacterial antigens in general. LTT responses to added interleukin 2, and production of alpha interferon, were normal in our patients, but induction of gamma interferon in response to phytohaemagglutinin was reduced initially, rising towards normal during treatment. Biochemical and haematological abnormalities present at the time of diagnosis rapidly corrected. The disease differed from that reported in most previous studies in that fever was uncommon, the disease was never fatal, and most tuberculin tests were not necrotising. This implied that a detrimental immunopathological component is less pronounced in those exposed to the Kuwaiti environment, and a hypothesis is put forward to explain this.
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... 258 M. JABAR AL-MOSSAWI ET AL ... The sediment at Sheraton and Amiri Hospital sites is characterized by sandy deposits covering a rocky bottom while Salmiya Clinic is ... At Fahaheel site the sediments are mostly of well sorted sandy... more
... 258 M. JABAR AL-MOSSAWI ET AL ... The sediment at Sheraton and Amiri Hospital sites is characterized by sandy deposits covering a rocky bottom while Salmiya Clinic is ... At Fahaheel site the sediments are mostly of well sorted sandy deposits (A1-Abdul Razzaq et al., 1981). ...
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The aim of this study was to develop a polymerase chain reaction-restriction fragment length polymorphism (PCR-RFLP) assay for generic and species-specific differentiation of Nocardia from other morphologically similar bacterial... more
The aim of this study was to develop a polymerase chain reaction-restriction fragment length polymorphism (PCR-RFLP) assay for generic and species-specific differentiation of Nocardia from other morphologically similar bacterial pathogens. To examine the utility of the PCR-RFLP approach in species identification, genomic DNA was prepared from 40 soil isolates, 10 clinical isolates and 8 reference strains of Nocardia. A set
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This study investigated the incidence of antimicrobial resistance in clinically significant coagulase-negative staphylococci at the Mubarak Al Kabeer Hospital, Kuwait. A total of 104 isolates of coagulase-negative staphylococci consisting... more
This study investigated the incidence of antimicrobial resistance in clinically significant coagulase-negative staphylococci at the Mubarak Al Kabeer Hospital, Kuwait. A total of 104 isolates of coagulase-negative staphylococci consisting of S. epidermidis (67), S. haemolyticus (16), S. saprophyticus (6), S. simulans (2), S. hominis (4), S. albus (2), S. sciuri (3), S. warneri (2), S. capitis (1), and S. xylosus (1) were isolated from clinical specimens over a 6-7 month period and tested for resistance to 22 antibacterial agents and the ability to produce slime. They were all susceptible to vancomycin and mupirocin but intermediate resistance to teicoplanin was detected in seven isolates: 83 and 47.7% were resistant to penicillin G and methicillin, respectively, 57% were resistant to gentamicin, 49.5% to erythromycin, 50.4% to tetracycline, and 52.3% to trimethoprim. Resistance to heavy metals and the nucleic-acid binding compound was also detected. More than half of S. epidermidis, S. saprophyticus, S. simulans, S. hominis, and all of S. haemolyticus were multiply resistant to three or more groups of antibiotics and there was a significant association between slime production and resistance to multiple antimicrobial agents in S. epidermidis. The results revealed a high level of resistance to commonly used agents.