In vitro efficacy of linezolid against vancomycin resistant Enterococci.

Vancomycin-resistance among Enterococci has been escalating in recent years in many countries. Linezolid, an oxazolidinone is one of the novel drug that promised effective therapy of infections caused by vancomycin-resistant Enterococci (VRE).However, like with most of the previous antimicrobial agents, the clinical benefit of linezolid is being threatened by the emergence of resistant strains of MRSA and vancomycin resistant enterococci VRE, being reported in many countries. This study was conducted to establish linezolid susceptibility of VRE isolates by determining the in vitro activity of linezolid against vancomycin resistant Enterococci, isolated in our setup using fifty VRE isolates. The data collected from this study conclude that the vancomycin resistant Enterococci are 100% linezolid susceptible and presently there is no significant resistance against this unique oxazolidinone in our setup.

Neutrophil lymphocyte ratio (NLR): A well assessment tool of glycemic control in type 2 diabetic patients.

BACKGROUND AND OBJECTIVE: Increased neutrophil lymphocyte ratio (NLR) is a marker as well as predictor of various cardiac and non cardiac disorders. Our aim was to assess the relationship between NLR and different level of glycemic control in type 2 diabetic patients. METHODS: An observational study was conducted at diabetic clinic of Sheikh Zayed Medical College/Hospital, Rahim Yar Khan from September 2016 to February 2017 in which 330 type 2 diabetic patients were randomly divided in to three groups based upon diabetes control according to ADA criteria. Patients in group A with HbA1c ≤ 7% (excellent control), group B HbA1c 7.0-9.0 % (poor control) and group C HbA1c ≥ 9 %(worst control). Patients were assessed in terms of complete blood count and C - reactive protein. RESULTS: As compared to excellent control (Group A) patients with worst control (Group C)showed a high leukocyte count (p.001), high neutrophil count (P.003) and lower lymphocyte count (P 0.44) while patients in poor control (Group B)did not differ significantly. Similarly value of NLR was also significantly higher in worst control (Group C) as compared to poor control(Group B) and excellent control (Group A) diabetes (4.3±2.8, 2.7±1.0 and2.0±0.5(p.001). NLR were found independent predictor of worst diabetes control (OR: 1.809, 95% CI: 1.459-2.401) along with fasting blood sugar (OR: 0.938, 95% CI: 0.995-0.982) and CRP (OR: 1.020, 95% CI: 1.003-1.028). CONCLUSION: Increased NLR level is associated with elevated HbA1c and poor glycemic control in patients of type 2 diabetes mellitus. It can be used as a disease monitoring tool during the follow up of diabetic patients.

Vildagliptin ameliorates biochemical, metabolic and fatty changes associated with non alcoholic fatty liver disease.

OBJECTIVE: To determine the effect of Vildagliptin in non-alcoholic, fatty liver disease patients with dyslipidemia. METHODS: A randomized placebo controlled trial was conducted at outpatient clinic of Medical Unit-I of Sheikh Zayed Medical College/Hospital, Rahim Yar Khan, in which fifty eight patients of NAFLD with dyslipidemia were divided in to two, case and control groups. The case group was given tablet Vildagliptin 50mg twice a day for twelve weeks and control group was given placebo in same way. Body weight, body mass index (BMI), lipid profile, liver enzymes and ultrasound finding of fatty liver were assayed before and after treatment. RESULTS: After 12 weeks treatment of vildagliptin there was significant improvement in following parameters. Body weight and BMI decreased significantly from 88 ± 11 to79 ± 12 kg (p0.036) and 30±4to 27±5 kg/m2 (p 0.005) respectively. Notable reduction in the value of TC, TG and LDL-C (TC:252±24 to 220±20mg/dl (p 0.031); TG: 190±24 to115±22 mg/dl (p 0.005); LDL-C 160±15 to 145±13mg/dl (p 0.004). HDL-C level increased significantly from 29±5to45±4 mg/dl (p 0.001). There was remarkable reduction in aminotransferases level (ALT: 78± 17 to 48±14IU/L (p 0.036). AST: 63.3±13 to41±11IU/L (p 0.002). There was overall 65.5% improvement in fatty liver grading on ultrasound with vildagliptin while non significant effects were seen in placebo group in all of the above parameters. CONCLUSION: Vildagliptin exhibited beneficial effects in non-alcoholic fatty liver disease, Non-diabetic patients with dyslipidemia.