Drug susceptibility, Prevalence and effect of Pseudomonas aeruginosa on wound healing of burn patients.

Objective: To determine the prevalence, antibiotic susceptibility and effect of Pseudomonas aeruginosa in relation to burn patients. METHODS: The cross-sectional study was conducted at the Centre for Advanced Studies in Vaccinology and Biotechnology, University of Balochistan, Quetta, Pakistan, from March 2018 to May 2021, and comprised pus swab cultures were isolated from inpatients with 2nd and 3rd degree burns aged up to 60 years at Bolan Medical Complex Hospital and Sandeman Provinical Hospital, the two main government tertiary care hospitals in Quetta. The samples were immediately cultured, and evaluated using biochemical tests, antibiotic susceptibility and molecular identification using polymerase chain reaction. Data was analysed using SPSS 20. RESULTS: Of the 720 burn wound samples, 424(58.9%) were positive for Pseudomonas aeruginosa; 304(42%) males and 120(16%) females (p<0.02). The overall mean age of the patients was 27.7±6.2 years (range: 1-60 years). The mean total burn surface area was not significantly different in positive 29.6±6.2% and negative 30.3±6.2% cases (p>0.05). The time leading to skin grafts in positive patients was 29.5±6.5 days compared to 22.3±6.3 days for negative patients (p< 0.007), and the time required for wound healing was 25.0±4.7 days and 16.7±5.2 days, respectively (p<0.001). Length of hospital stay of Pseudomonas aeruginosa positive patients was 38.0±7.8 days compared to 32.1±6.8 days for negative patients (p<0.001). Conclusion: Nosocomial infections and multidrug resistance species were observed frequently at the burn wound site. P. aeruginosa.

Diabetes-related Knowledge, Medication Adherence, and Health-related Quality of Life: A Correlation Analysis.

CONTEXT: Even though positive treatment outcomes for type 2 diabetes mellitus (T2DM) are linked to disease knowledge and adherence to medications, inadequate knowledge, poor adherence, and resistance to lifestyle modifications are still common among patients. This situation has been a continuing dilemma for patients and healthcare providers, and these factors negatively affect the health-related quality of life (HRQoL) of patients. OBJECTIVE: The current study intended to evaluate the correlations between diabetes-related knowledge, medication adherence, and HRQoL among T2DM patients in Pakistan. DESIGN: The study was designed as a questionnaire-based, cross-sectional descriptive analysis, with participants being selected using a prevalence-based sampling method. SETTING: The study was conducted at four different healthcare institutes namely Sandeman Provincial Hospital, Bolan Medical Complex Hospital, Al-Khair Hospital and Sajid Hospital, Quetta city, Pakistan. PARTICIPANTS: Participants were 300 patients with T2DM who were receiving treatment at public and private healthcare institutes in Quetta, Pakistan. OUTCOME MEASURES: In addition to collection of demographics, the Urdu version of Michigan Diabetes Knowledge Test (MDKT-U), the Drug Attitude Inventory (DAI-10), and the EuroQol EQ-5D were used to assess diabetes-related knowledge, medication adherence and HRQoL, respectively. The relationships among the 3 variables were determined using the Spearmen rho correlation coefficient, and the results were interpreted using Cohen' criteria. SPSS v.20 was used for data analysis, and P < .05 was considered significant for all analysis. RESULTS: The mean diabetes-related knowledge score was 5.83 ± 1.92, indicating participants' lack of knowledge of T2DM. Moderate adherence was reported, with a mean adherence score of 4.94 ± 2.72. Additionally, the mean EQ-5D score was 0.48±0.36, and the mean Visual Analogue Score (VAS) was 54.58 ± 20.28, highlighting poor HRQoL. The Spearman's rho correlation coefficient indicated significant, moderate correlations among all variables (P < .05; r = 0.053-0.231). CONCLUSIONS: The study found limited diabetes-related knowledge, moderate medication adherence, and poor HRQoL among patients with T2DM in Pakistan. Nevertheless, a positive significant correlation revealed that a directly proportional change in one study variable can improve the others.

Prescribing Patterns for Upper Respiratory Tract Infections: A Prescription-Review of Primary Care Practice in Quetta, Pakistan and the Implications.

Background: To identify and address the potential overuse of antibiotics, it is important to ascertain the prescribing practices of physicians. We, therefore, conducted this prescription analysis to document URTI-specific antibiotic prescription frequency in a public primary healthcare setting of Quetta city, Pakistan. Methods: A retrospective record review was conducted of all prescriptions for URTIs in Combined Military Hospital, Quetta from 1 March to 31st May 2021. The Mann-Whitney U and Jonckheere-Terpstra test was used to evaluate the association between the tendencies of a different group of prescribers. p-value of <0.05 was of statistical significance. Results: Over the 3 months, 50,705 prescriptions were screened and analyzed according to the established inclusion and exclusion criteria. A total of 4,126 (8.13%) URTI prescriptions met the inclusion criteria, of which 2,880 (69.80%) prescriptions contained antibiotics. Among all antibiotics, penicillins (Amoxicillin + Clavulanate) were the most prescribed antibiotic, constituting 1,323 (45.9%) of total antibiotics prescribed for all cases, followed by the Macrolide group 527 (18.2%). The Jonckheere-Terpstra test revealed a statistically significant association between the status of the prescriber and the diagnosis (p = 0.002). Furthermore, a moderate positive trend was reported with specialists being more competent in antibiotic prescribing based on their diagnosis, followed by postgraduates and house officers (τ = 0.322). Conclusion: The prescribing patterns for the management of URTIs in the hospital were inconsistent with current guidelines. Strict adherence to guidelines must be ensured and antibiotic prescribing for URTIs should be discouraged.