Journal of Medical Science and Technology

47 –50

Authors: Dr Asma Aref Idamat, Dr Najeh Yousef Alomari

Urinary tract infection (UTI) is known entity and a common problem in pediatric age group. Children at risk for (UTI) such as vesicoureteric reflux (VUR), pelvi-ureteric junction obstruction (PUJO) and other urinary tract anomalies commonly receive prophylactic antibiotics to prevent nephropathy such as renal scaring ,hypertension and renal failure. Prolonged use of prophylactic antibiotics is common for recurrent (UTI), but this has not been assessed in well-controlled prospective studies. Different antibiotics such as nitrofurantoin, trimethoprim/sulfamethoxazole and nalidixcic acid have been used as prophylactic antibiotics to prevent (UTI) in pediatric age group which proved to be safe in long term prophylactic therapy without major complications. Although it is not easy to perform prospective studies in children because both clinical course and prognosis may be affected by many factors. Infant and children with factors need prolonged use of antibiotic prophylaxis, until there is evidence that these patients are not at risk without prophylaxis. We reviewed thoroughly the up to date literatures and practice guidelines to make sure that we are implementing appropriate use of antibiotic prophylaxis in pediatric urology in our institution being the referral pediatric hospital dealing with the vast majority of pediatric urology/ nephrology cases in the kingdom. We focus on the evaluation and actual benefits of prophylactic antibiotics in vesicoureteric reflux (VUR) in pediatric age group to reach consensus and recommendations for in hospital protocol on the basis of current best evidence. Over the past 3 years we selected a group of patients (N=130), 50 males and 80 females , age 4-7 years ,median age 5, 2 years with grad I-III (VUR).All patients with abnormal voiding , neurogenic bladder and urinary tract anomalies were excluded from the study. All patients who had breakthrough (UTI) or deterioration in the renal function were excluded from the study and managed by surgery or endoscopic injection. All patients were treated by prophylactic antibiotics for 18 months (first trial) then stopped and followed up for another 18 months on no prophylaxis (second trial). At the end of both trials, 100 patients met the inclusion criteria and the results were analyzed. There was no significant break though infection in the second trial and no significant drop in the renal function. Multi resistant bacterial growth was encounter in the first trial, while less resistant bacterial growth was encountered in the second trial. In conclusion, routine use of prophylactic antibiotics for low grade I-III (VUR) in normal urinary tract is not indicated after the age of 4 years without any significant health compromise.

57 – 60

Authors: Maher khader, Ahmed AL- Issa, Fatin Al -Awaisha, Sameera Abuzeat RN, Asma Al Nesraween RN, Tagreed AL-kasassbah RN

Our aim is to determine whether the levels of blood electrolytes assessed using blood gas analyzer and central laboratory auto-analyzer are equivalent. This retrospective study was conducted over six month period (October 2012- March 2013). A total number of 60 paired blood samples were drawn from pediatric and adult patients either in the intensive care unit or in the ward with a variety of diagnoses .Analysis of blood sodium and potassium levels was carried out using a point-of-care blood gas analyzer and a central laboratory auto-analyzer. Statistical measures were employed using paired t –tests. The mean level (± standard deviation) of sodium measured by blood gas analyzer was significantly higher than in the auto-analyzer (141.4 ± 7.3 mmol/L and 137.7 ± 5.6 mmol/L respectively; P˂0.001). Regarding the potassium levels, there was also a significant difference between the mean level (± standard deviation) measured by blood gas analyzer and central laboratory auto-analyzer (3.2 ± 0.8 mmol/L and 4.2 ± 0.7 mmol/L respectively; p˂0.001). Our results showed that sodium and potassium levels measured by blood gas analyzer and auto-analyzer were significantly different.

67 –74

Authors: Mwenya Kwangu, Sandra Chileya, Pierre Yassa, Nason Lambwe, Gibson Sijumbila

The main objective was to investigate the role of glucose 6-phosphate dehydrogenase deficiency in aetiology of essential hypertension. An analytical cross-sectional design was applied to 89 essential hypertensive participants and 89 healthy normotensive participants, making a total of 178. All the participants were aged between 35 and 65 years. Blood was collected for G6PD activity and levels of blood nitric oxide, glucose, creatinine, urea and electrolytes. In addition, routine urinalysis was done. A logistic regression was used to investigate the association of age, sex, nitric oxide levels, and G6PD deficiency with essential hypertension as the dependant variable. The G6PD deficiency was found in 14 (16%) participants with essential hypertension and 9 (10%) control participants. The difference however, in the G6PD deficiency prevalence rate was not statistically significant (p= 0.13). Logistic regression analysis revealed that G6PD deficiency was significantly associated with increased risk for essential hypertension. The analysis further showed a significant association of age and essential hypertension with participants in age groups 46-55 and 56-65 being at higher risk of developing essential hypertension than those in age group 35-45. The study also revealed no association between gender and essential hypertension. The study showed that states that there is no difference in G6PD deficiency prevalence between the essential hypertensive and normotensive adults. The findings also demonstrated a possible role of G6PD deficiency in the pathophysiology of essential hypertension.

79 – 81

Authors: D Anil Kumar, V Shanmuga Priya, J Jaiprabhu, Krishnan Ramalingam

Alterations in plasma concentrations of several trace elements have been reported to occur in type 2 diabetes mellitus. These micronutrients are suspected to have a role in pathogenesis and progression of the disease. In a comparative analysis, the plasma concentration of copper and zinc was estimated in 50 patients with type 2 diabetes mellitus and 50 healthy non-diabetic subjects. Trace elements were estimated by using atomic absorption spectrophotometer. When compared to controls, cases (type 2 diabetic patients) showed significantly higher copper and lower zinc levels (P < 0.0001). Serum copper levels are significantly higher in type 2 diabetes mellitus patients, while serum zinc levels are significantly decreased when compared to controls.

87 – 90

Authors: Dr Jameel Ahmad

Medicines can be given to patients by different routes such as oral, topical, inhalation and parenteral. In the parenteral route of drug administration injections are among the most frequently used methods of drug delivery system and usually given for curative purposes and less than 5% cases for immunization. The correct vaccine administration is a very important component of a successful immunization. In India, 96% of all injections given by private practitioners include antibiotics, vitamins and analgesics and 66% of these injections are said to be unsafe. According to the WHO at least 16 billion injections are given every year in developing countries. The intramuscular (IM) and the subcutaneous (SC) injections are often referred as “basic skills”. The unsafe injection practices can give rise to the transmission of many blood borne diseases and complications such as abscess at the injection site, nerve injury and infections (Hepatitis B and C, and HIV etc). The reuse of syringes is another problem in some countries and it is also common in India. The injection practices are not always rational and research-based practices. So there is need to promote the research based injection practices for the safety of patients and the health care providers. The present article focuses on the issues related to the intramuscular and the subcutaneous routes of drug administration. This is particularly important for health care providers involved in the drug prescribing.

105 – 107

Authors: Anoop Sreevalsan, D Kavitha, Vasantha N Subbaiah

Ovarian pregnancy is a rare form of ectopic pregnancy. Although ectopic pregnancies have been reported to implant in the cervix, ovary, interstitial tubal segment, and at various intra-abdominal sites, majority of ectopic pregnancies are identified in the fallopian tube. Data regarding these unusual ectopic pregnancies come largely from case reports and anecdotal information. Management and treatment of these ectopic pregnancies includes various combinations of surgery and/or systemic and local chemotherapy. In this article we present a rare case of ovarian pregnancy which was diagnosed intraoperatively and managed successfully.