Journal of Medical Science and Technology

108 – 114.

Authors: Moses M, Yassa P, Kapasa M, Hira S, KwanguM, Sijumbila G.

Drugs from the group of xanthines (caffeine and aminophylline) are frequently used to manage premature neonates. This study investigates the effects of aminophylline loading dose administration on serum sodium levels in premature neonates admitted Neonatal Intensive Care Unit (NICU) at the University Teaching Hospital (UTH). We evaluated the effects of aminophylline loading dose on serum sodium ions in premature neonates admitted to NICU at (UTH), Lusaka Zambia. A cross sectional study design was used to answer the question. According to our findings, 165 (51%) of the participants had the serum sodium levels below 135mmol/l and 157 (49%) had their serum sodium levels above 135mmol/l.The findings showed the prevalence rates of hyponatremia to be highest in the weight category of 1-1.5kg and the lowest in the weight category of >1.5kg. We found that weight and gestational age has a significant association with serum sodium levels as evidenced by the P=values (0.041 and 0.009) by multivariate linear regression. In our results the majority of the premature neonates showed a significant decrease in serum sodium levels after taking a loading dose of aminophylline. These results suggest that premature neonates on aminophylline could actually benefit from supplements of sodium ions.

119 - 122.

Authors: Asma Aref Idamat, Najeh Yousef Alomari

Surgical site infection (SSI) in a serious complication requiring prolonged hospitalization, intravenous antibiotics, wound care and dressings resulting in increased cost and resistant bacteria. Despite the new advances in asepsis and surgery, postoperative (SSI), still considered a serious morbidity. Several reports suggest that (SSI) may be prevented by the administration of appropriate antimicrobial regimes. Quality improvement techniques in surgery are in continued practice since long time with the aim to reduce (SSI) rate. Many centers are implementing standardized protocols in using antibiotic prophylaxis for (SSI) to achieve the best outcome. In this study, we present the effectiveness of our hospital protocol for the use of antibiotic prophylaxis for (SSI). After approval of the study from ethical and research committee, the data of all pediatric patients who underwent uncontaminated procedures in general pediatric surgery & urology at Queen Rania Hospital for Children were reviewed prior and after the implementation of the new hospital protocol using the current literature. All patients who had infection, obvious contamination or on antibiotic treatment were excluded from the study. Other exclusion criteria were re operation, diabetic patient, malignancy, steroid treatment, clean inguinoscrotal surgery, circumcision and patients with allergy, blood or metabolic disorders. According to our hospital protocol, antibiotic prophylaxis for (SSI) will continue for 3 doses over 24 hours. The choice of single or combined antibiotic depends on the type of surgery. Cefazolin was the first choice for most procedures. For gastrointestinal surgery Cefoxitin (40mg/kg) and Metronidazole (15mg/kg) were used in combination. Cefazolin (30mg/kg) alone or with Gentamycin (2,5mg/kg) were used for urogenital surgery. Antibiotic should be administered intravenously one hour prior surgery. Procedures and (SSI) were evaluated prior and after protocol implementation. Thirteen pediatric surgeons in the hospital performed 11.000 procedures between March 2010 – March 2014. The minimum follow-up period for (SSI) was 4 weeks, 2000 procedures (group I) met the criteria prior the implementation of the hospital protocol and 2000 procedures (group II) met the criteria after the implementation of the protocol. The (SSI) rate decreased from 8.4 % (group I) to 4.6% (group II). Over all protocol implementation commitment was 86% and improved during the observation interval. The implementation of a standardized protocol for antibiotic prophylaxis in pediatric surgery significantly reduces (SSI). Generally, the protocol compliance was very good and easy to practice. The implementation of the hospital protocol has been considered as baseline in our major medical center and other hospitals for proper assessment of new treatments plans. The identification of factors associated with (SSI) will help in the revision and improvement of protocols in the future resulting in more control and reduction of (SSI) with significant cost effective results, less hospitalization and less bacteria resistance.

130 – 134.

Authors: Gangapatnam Subrahmanyam, Krishnan Ramalingam

Hypertension is an important risk factor in cardiovascular diseases. Microalbuminuria in non diabetic hypertension is an important early marker for cardiovascular risk. Silicon is an important trace element and possesses beneficial effects on cardiovascular events. Mica mines consists of large amount of silicon, hence workers were exposed to huge amounts of silicon dust. Aim of this study is to find out the relation between silicon levels and microalbuminuria in non diabetic hypertensive patients of mica mine workers. We have recruited 61 non diabetic hypertensive subjects from mica mine (group-I), 60 non diabetic hypertensive subjects who were not exposed to mica mines (group-II) and 60 healthy non exposure to mica mines were included as control subjects (group-III). We did biochemical analysis, urine albumin/creatinine ratio and serum silicon for all the study subjects. Among hypertensive groups (group-I&II) we observed serum total cholesterol, and urine albumin/creatinine ratio were decreased in group-I, whereas serum silicon levels were elevated significantly in group-I than group-II. Percentage of microalbuminuria is less in group-I patients (15%) than group-II patients (28%). Among group – I patients, serum silicon shows negative correlation with total cholesterol (r=-0.04, p=<0.05) and urine albumin/creatinine ratio (r=-0.03, p=<0.05) There is a significant inverse relationship observed in group-I towards serum silicon, whereas there was no such relationship found in group-II. Our study concludes Silicon can decrease microalbuminuria which is an endothelial damage marker and hence it has beneficial effect on endothelial functions but exact mechanism of action is not yet clear.

138 – 144.

Authors: N. Jyothirmayi, S.H.R.K.Prasad , N.Mallikarjuna Rao

The present work assesses the antibacterial activity of solvent extracts (aqueous, ethanol, methanol and hexane) of ripe and unripe fruit pulps of Musa x paradisiaca L. cv. Amruthapani against Gram-positive (Bacillus cereus, Micrococcus flavus) and Gram-negative (Escherichia coli, Pseudomonas aeruginosa) pathogenic bacteria by Kirby-Bauer method along with, the minimum inhibitory concentrations (MICs). The phytochemical composition of non-polar solvent extract, hexane, was analyzed, qualitatively, by Gas Chromatography – Mass Spectrometry (GC-MS). The aqueous unripened and ripened pulp extracts of Amruthapani showed minimum inhibition at highest tested concentration against all the test organisms. Ethanolic ripened extracts exhibited good activity against all the test organisms in comparison with unripened pulp extracts and also the methanolic extracts. Hexane extracts showed very little activity against all test organisms even at high concentrations. A wide spectrum of bioactive compounds like phenols, ketones, aldehydes, alkanes, esters and terpenes were found to be present in the hexane extract and may be responsible for antibacterial activity exhibited.