An assessment of influenza vaccination among health profession students

Health profession students work in close proximity to patients and could be a source of nosocomial influenza. We studied the proportion of health profession students presenting for immunization at an influenza immunization campaign. This assessment is useful to guide future campaigns as we prepare for pandemic influenza.     

Elevated levels of chemerin,leptin, and interleukin-18 in gestational diabetes mellitus

Objective: We aimed to assess the levels of adipokine and their relation to gestational diabetic related clinical phenotypes and fetal growth parameters.

Material and methods: International Association of the Diabetes and Pregnancy Study criteria was used to classify gestational diabetic cases (n?=?208) and euglycemic controls (n?=?300). ELISA assays were performed for insulin, chemerin, leptin, and interleukin-18 (IL-18). Mann–Whitney U test, Chi-square/Fisher exact test, multiple regression analyses, and ROC curves were applied with significant p values of <0.05.

Results: Levels of chemerin, IL-18, and leptin were seven-, four-, and five-folds higher in cases versus controls, respectively (p?p?p?>?0.05) after multiple adjustments. Raised chemerin levels were identified in 96% cases (n?=?201) employing the proposed cut off value?>15.49?ng/ml.

Conclusion: High chemerin and leptin levels are seen in GDM which may be associated with subclinical inflammation suggesting a role in development of insulin resistance.     

Injectable contraception

Injectable contraceptive methods are safe, highly efficacious, and commonly used worldwide. Depo-Provera (depot-medroxyprogesterone acetate) is the most commonly used injectable in the United States. It is a convenient, discrete, and low-maintenance method, and is ideal for patients with contraindications to estrogen use and certain medical conditions. In addition, there are many noncontraceptive benefits to Depo-Provera use. Side effects with this method including irregular bleeding, breast tenderness, weight gain, and the impact on bone mineral density should be taken into consideration when prescribing the method. Other injectables such as Mesigyna and norethindrone enanthate are widely used outside the United States.     

Evaluation of antibiotic use in Pediatric Intensive Care Unit of a developing country

Background:Pediatric Intensive Care Unit (PICU) patients are often prescribed antibiotics with a low threshold in comparison to patients elsewhere. Irrational antibiotics use can lead to rapid emergence of drug resistance, so surveillance of their use is important.Objectives:To evaluate the use of antibiotics in relation to bacteriological findings in PICU of a Tertiary Hospital.Methods:Retrospective review of medical records of all children (age 1 month–16 years) admitted in our closed multidisciplinary-cardiothoracic PICU from January to June 2013 was performed, after approval from Ethical Review Committee. For each antibiotic, indication (prophylactic, empiric, therapeutic) and duration of use were recorded. All diagnoses of infections were recorded according to diagnostic criteria of IPSCC 2005. Results are presented as frequency and percentages and median with inter quartile range using SPSS version 19.Results:All of the total 240 patients admitted in PICU during the study period received antibiotics: 43% (n = 104) prophylactically, 42% (n = 102) empirically, and 15% (n = 15) therapeutically. Median number of antibiotic use per patient in PICU was 3, with range of 1–7. 25% received 1 antibiotic, 23% received 2 antibiotics, 29% received 3 antibiotics, and rest received ≥4 antibiotics. Most commonly used antibiotics were cefazolin, meropenem, vancomycin and ceftriaxone, and most frequently used combination was meropenem and vancomycin. In majority of the cases, (70%) empiric antibiotic combinations were stopped in 72 h.Conclusion:This is the first report of antibiotics use in PICU from our country, which shows that antibiotics are prescribed universally in our PICU. Strategies to assess the need for antibiotic use are needed.