BACTERIAL UTI INVESTIGATION IN MALAYSIA

Urinary tract infection (UTI) is an infection of the parts of urinary tract of the body which include the lower and upper tract. The upper tract of the system include ureters and kidneys; while, lower tract include prostate in males, bladder, and urethra. If the infection is in the upper segment in the tract, it is known as kidney infection. Whereas, lower urinary tract is known as cystitis or bladder infection. Two common type of infection are based on bacteria or fungus. In this study, the objective was to test the bacterial UTIs etiology in the area of Kuala Lumpur, Malaysia. The focus was to identify the proper antibiotics, epidemiology especially high-risk groups as well as positivity rate in terms of gender and age. The methodology of the study was collection and analysis of Urine specimen samples using the sterile container for later sensitivity and culture purpose. Isolated organisms were removed using different biochemical tests and proper antibiograms were found by using the AST or dish diffusion method. Our results based on sampling of 1402 specimens collected and tested showed positivity rate of UTI among 23.25 % (326 out of 1402 patients). The most common caused bacteria causing UTI was Escherichia Coli (E.Coli). the other commonly found bacteria included Enterococcoi, proteus, Klebsiella, Staphylococci, and Enterobacter. Our results confirmed that there was more presence of UTI among female compare to male sample. In terms of age, the common age group was between 22 to 28 years. The Tetracyclin was found to be most resistant antibiogram where as Chloramphenicol was found to be the most sensitive.

ANALYSIS OF SELECTION OF CONTRACEPTIVE METHOD AMONG WOMEN IN TANZANIA

There are numerous methods of contraception selection and making selection among one of these method is an important decision. Commence of suitable contraception is important before starting first post-abortal menstrual period. Generally, it is required to provide individuals and couples about treatments, complications, counseling related to HIV/STI as part of post abortion care. The study is observational in nature and conducted in a hospital in Tanzanian capital. The sample included in the study was 60 patients. The results showed that among illiterate women along with those who have more than 1 living son or who have 4 or more living children prefer permanent method. We also found that contraception method is influenced by different demographic factors including living children gender, couple age, education, and income. Couples who feel that their families are completed mostly opt for permanent method of contraception. Family planning choices is also influenced by desire for a male child.

A STUDY OF INTESTINAL OBSTRUCTION CONSERVTIVE VERSUS SURGICAL MANAGEMENT

Intestinal obstruction refers to the impairment to the abnormal passage of intestinal contents which can be due to the mechanical obstruction or failure of normal intestinal motility in the absence of an obstructing lesion. Extra luminal, intrinsic, and intraluminal are three categories of small bowel obstruction. In this retrospective observational study, patients presenting to the A&E department of surgery unit who had similar condition were screened. The study is based on total of 60 patients out of which 22 patients managed conservatively whereas 38 patients were managed surgically. Common symptoms were abdominal pain and vomiting. 20 patients had previous abdominal surgery; 16 had exploratory laparotomy for abdominal trauma, perforation, gynae procedure, etc. 4 patients developed characteristic of obstruction following laproscopic. 14 patients undergone surgery while 6 patients were managed conservatively. Surgically managed duration was 2.8 days on average. Mean duration for conservatively managed patients was 2.9 days. Among the surgically managed patients, 11 had strictures, 14 had adhesion, 8 had obstructed hernia, 1 had intussusception, and 4 had abdominal TB. Based on the cause of the obstruction, surgical procedure was carried out. History of abdominal surgery was found to be more frequent in whom obstruction was relieved conservatively. The conclusion of the study is that adhesions based on previously conducted surgery are important causes of SBO. Two common method of managing the condition is conservative management and surgical management. The criteria for utilizing particular method is based on several patient related factors. Clinical decisions guide the management of SBO and timing of surgical intervention.

CASE STUDY OF TITANIUM ELASTIC NAIL FOR FRACTURES

Mostly, clavicle fracture is treated conservatively but because of higher rates of delayed union, non-union, symptomatic, malunion cosmetic deformity and other complications, there is increased used of operative management for clavicle fracture. In this regard, plating and intramedullary nailing are common surgical options. The operative technique is also found to be producing favorable results compare to the traditional method based on recent prospective randomized studies. In this study, the objective is to make a comparison between clinical results, operative method, and resulting complications proportion. The study was conducted on 66 patients who had OTA type B DMCFs and underwent surgical fixation with antegrade TENs and 1/3rd tubular plate. The study participants were divided in to two groups based on TENS and other with plate fixation with 1/3rd tubular plate. We conducted evaluation using constant-murley shoulder outcome and dash scores at 6, 12, weeks, 3, 6, and 12 months for determining outcomes. It was observed that among TENS group, there was easier implant removal and minimal complications, less blood loss, lesser operating time, with only complication of shortening of about 0.5 cm in fewer cases. In the other group which is plate group, no major complications were observed except minor one such as deep infection, superficial infection, hypertrophied scarring without pain, and decreased shoulder motion with no case of shortening. In terms of union and stability, no significant differences were found in both groups. Based on the result, it is suggested that TENS is more preferable since it involves fewer morbidity, better cosmetic results, and easier implant removal. Fixation with plate seems to be little more stable and its implant of choice is comminuted fracture.

FINE NEEDLE ASPIRATION CYTOLOGY AS A DIAGNOSTIC TOOL; AN ASSESSMENT

The study is about breast lesions which is a common cause of mortality and morbidity among females. To avoid negative consequences, there is need for urgent diagnosis and treatment. Fine Needle Aspiration Cytology (FNAC) is a useful diagnostic tool and possess higher level of accuracy. In this study, the objective was to determine the accuracy of FNAC in diagnosis of palpable breast lumps. Additionally, the objective was to find the correlation between cytological findings and histopathological examination of surgical specimens. The methodology of the study was based on retrospective study method. FNAC of breast lump was conducted on 271 patients out of which 104 formed the base group. The results showed that there were 104 patients of base study who had average age of 32 years. There were 54 patients with lump in left breasts, and 46 patients with lump in right breasts and 4 patient had bilateral lump. There were 77 patients with benign, 34 patients with malignant, and 3 had atypica;/suspicious lesions on cytological examination. Based on histopathological examination, 77 cases were related to benign, 26 were related to malignant, and 1 with atypical/suspicious. Cyto-histological concurrence was 93.05% and 79.2% for Fibroadenoma and Infiltrating ductal carcinoma respectively. Overall sensitivity of FNAC procedure was 94.17%, specificity 100% and accuracy 93.26%. On the basis of result, it is concluded that FNAC is a simple, reliable method for diagnosis of both benign and malignant lesions and can be used in the evaluation of breast lesions.

A STUDY OF SUCCESS RATE OF BUTTERFLY TECHNIQUE

The use of Tympanoplasty as a remedy for minor perforations is a common trend these days. The technique is in use even from ancient time utilizing those day tools. Common criticism on this technique is that it bring disadvantages such as hospital stay, increased morbidity, and post-operative scar. Therefore, there was requirement to bring a more comprehensive technique. In this study, our objective is to assess the clinical and audiometric success rate of new tragal cartilage plug or butterfly technique tympanoplasty. The study is based on 30 patients who were in age category of 16 to 55 years of age. The results shows that out of 30 patients, 27 patients were based on graft taken up; while, the rest of the 3 patients showed residual perforation with an overall success rate of 90%. The anatomical success was assessed by otoscopy with graft well set in place. The functional success was analyzed by audiogram, which showed decrease in Air-Bone (A-B) gap in 25 patients (83.3%). Our conclusion is that the tympanoplasty method may be considered as an alternative treatment option for repair of tympanic membrane perforations.

A STUDY OF DRUGS USE AWARENESS AMONG STUDENTS IN KENYA

The study aims to assess the substance use related literacy among the medical students in government based medical college in the Nairobi, Kenya. The methodology of the study was cross sectional based on survey method. Result states that majority of students reported there is presence of substance abusing youths are existed in their classrooms. Results also shows that there is low level of self-intake substance and increase assertiveness as found among medical students.

EVALUATING SOCIO-CULTURAL BARRIERS TO ANTENATAL CARE UTILIZATION AMONG REPRODUCTIVE AGE WOMEN IN WUSHISHI AND ZUNGERU COMMUNITIES IN NIGER STATE, NIGERIA: A LOGISTIC REGRESSION APPROACH

More than 33% of Nigerian pregnant women do not use the Antenatal Care service during pregnancy. In 2015, for instance, World Health Organization (WHO) revealed that only 61% of Nigerian pregnant women had attended ANC at least once during their pregnancy period. Only 51% of these women met the WHO standard of a minimum of 4 visits. This ANC rate is, without doubt, lower than the WHO African region average of 77%. The situation in Wushishi and Zungeru communities of Niger State may not be different. Despite the number of health facilities available in these communities, some women of childbearing age do not access antenatal care. Most times, many of them lose their lives during delivery at home, some end up with complications or lose their babies at births. This situation raised concern why pregnant women do not attend antenatal care in health facilities around them? This paper examined the socio-cultural impediments to accessing antenatal care services among reproductive-aged women in Wushishi and Zungeru Communities of Niger State. We used a Multivariate Logistic Analysis. A total of 150 subjects were involved in this study comprising 83 from Zungeru and 67 from Wushishi. The questionnaire used for data collection was a structured consist of 17 items. The results indicated that ethnicity and preference for traditional birth attendant are major influences to accessing ANC in these communities

ASSESSMENT OF ROCURONIUM EFFECTIVENESS FOR PAITENTS

The study is based on succinylcholine which is a routine muscle relaxant for pediatric patients. Rocuronium is newer non depolarizing muscle relaxant. The objective of this study was to assess time, course and duration of both relaxants as well as intubation conditions. This study was blind and randomized in nature and conducted to test the intubating conditions with two separate kind of muscle relaxants in 50 ASA grade I and II pediatric patients who fall in age category of 2 to 6 years who undergone surgery of less than half an hour. Patients were anaesthetized with injection rocuronium 0.9 mg/kg i.v. or with injection succinylcholine 1.5 mg/kg after injection fentanyl 1ug/kg and injection thiopentone 5 mg/kg. The assessment of Neuromuscular blockade was conducted with twitch response of adductor pollicis longus after supra-maximal stimulation of ulnar nerve. We assessed Tracheal intubating conditions using the blinded anesthetist after 1 month and every 15 seconds till patient got intubated. The time of onset and percentage of neuromuscular blockage was also assessed.

INVESTIGATION OF RISPERIDONE; CASE OF SELECTED PATIENTS FROM KENYA

Risperidone is considered as an atypical antipsychotic. It is considered as an effective treatment of psychotic disorders in adults. However, our understanding of its usage among young individuals is limited. In this study, the objective was to identify the safety profile of Risperidone among young children. Methodology wise, the study was conducted among children of less than 5 years old who were treating behavioral problems associated with various childhood disorders. The study was conducted in a hospital in Nairobi, Kenya. Common childhood disorders were diagnosed using the Diagnostic and Statistical Manual (DSM IV) and those associated with disruptive behavioral problems. We used Clinical Global Impression- Severity (CGI-S) and Improvement (CGI-I) scales for symptoms severity and improvement respectively. We took informed consents from parents of the children and initiated Risperidone. The total of 12 patients were included in the study consist of PDD (n=4), PDD plus ADHD (n=2), PDD plus ADHD plus Intellectual disability (n=2), Cerebral Palsy with Epilepsy (n=2) and Global developmental delay (n=2). Baseline and end point CGI scores were 5-6 and 1-2 respectively. Baseline investigations such as lipid profile, fasting blood sugar levels, Electro cardiogram (ECG) were recorded and compared before and after initiation of risperidone. Dose range of risperidone was 0.5-2mg per day. Common side effects were sedation and weight gain in a few patients only. No life-threatening side effects were noted. Our conclusion is that risperidone is well tolerated even in children below 5 years of age over a period of 1 year with improvement in target symptoms.