Understanding mother and child health-seeking behavior in urban Pakistan.

Pakistan has long held one of the highest rates in the world for mother and child mortality, albeit the leading causes of death are largely preventable. Unlike many other low and middle-income countries (LMIC), however, limited research has been conducted within conflict-ridden LMIC like Pakistan on health-seeking behavior. Even less is known about more developed localities within these nations. Between May and June 2016, a pre-tested cross-sectional pilot study was conducted in Islamabad. Seventy mothers were surveyed, and data were used to run descriptive analyses and generate multivariable regression models to evaluate a mother's desire to solicit medical attention. Mothers had higher self-health seeking behavioral scores if they were more likely to pursue care for their children and vice versa. In situations that potentially warranted medical intervention, they were also 1.84 times more likely to solicit care for their children than for themselves. While most women were inclined to take their children to an established provider for a variety of illnesses, many still faced prominent barriers to accessing healthcare. To improve population health in developing nations like Pakistan, evidence-based methods should be adopted that increase healthcare accessibility, improve health awareness, and prioritize the health status of everyone in the family.

Ethanol Lock Therapy for the Treatment of Intravenous Catheter Infections That Have Failed Standard Treatment.

This study used ethanol lock therapy (ELT) to treat intravenous catheter infections that had failed standard intravenous antimicrobial treatment. Of 15 patients enrolled, 13 were successfully treated with ELT. Twenty-one organisms were identified: 12 bacteria, 9 fungi. Eight of the 9 fungi were eradicated, and no patient became hemodynamically unstable on treatment.

An usual approach to treatment of a case of multidrug resistance Pseudomonas aeruginosa peritonitis: parenteral and intraperitoneal aminoglycosides and parenteral colistin.

Infections caused by Pseudomonas aeruginosa are becoming more common and increasingly more difficult to treat due to the continued development of drug resistance. While sensitivity to colistin (polymyxin E) is well known, it is frequently avoided due to concerns of nephrotoxicity. Reported here is a case of a multi-drug resistance pseudomonal typhlitis, bacteremia and pleural cavity infection that required significant intensive care, and serial abdominal washouts. Intra-peritoneal tobramycin in combination with broad-spectrum intravenous antibiotics including colistin were used. Several instillations of tobramycin into the abdominal cavity along with concomitant IV administration of colistin, ceftazidime and tobramycin and per os colistin, tobramycin and nystatin resulted in the clearance of the pseudomonal infection without any evidence of toxicity from the treatment. Intra-abdominal tobramycin with parenteral colistin therapy can be used in complicated clinical settings with appropriate nephroprotection.

Ethanol locks therapy for resolution of fungal catheter infections.

Ethanol locks have been used to treat catheter infections and to decrease the rate at which they occur. Catheter-related infections caused by Candida spp. are especially difficult to manage medically and usually require catheter removal. We report 3 consecutive patients whose catheter infections caused by Candida were successfully treated with a combination of ethanol lock therapy and systemic antifungals.