Open Access Case Study

Cedecea lapagei an Extremely Rare Uropathogen: A Case Report

Hussein Ali Mohamud, Rahma Yusuf Haji Mohamud

Journal of Pharmaceutical Research International, Page 1-5
DOI: 10.9734/jpri/2022/v34i19A35811

Background: Centers for Disease Control (CDC) Laboratories discovered Cedecea lapagei in 1977, and the first case of Cedecea lapagei in humans was reported in 2006. A literature search revealed only one case report of prior isolation of Cedecea lapagei from urine culture, and this is the second case of Cedecea lapagei as an uropathogen reported in the world.

Case presentation: A 55 years old man with chronic renal failure, poorly controlled Diabetes mellitus, and Hypertension presented with acute exacerbations of renal failure and irritative voiding symptoms. After stabilization and empirical antibiotic therapy with Ceftriaxone, the patient’s condition was not improved and deteriorated progressively. After the request of urine culture, the culture was isolated, an extremely rare uropathogen; the Cedecea lapagei. Cedecea lapagei identification has been done using Eosin Methylene Blue agar (EMB). Gram-negative lipase positive bacteria with bacillus in shape, motile in nature that is non-spore-forming, and non-encapsulated Enterobacteria with the final result of >100,000 colony-forming units per ml of Cedecea lapagei were isolated. Mueller-Hinton agar had been used to perform antimicrobial sensitivity and resistance. The pathogen revealed antimicrobial resistance against Ceftriaxone, Cephazolin, Ceftazidime, Cefixime, Ampicillin, and Amoxicillin-Clavulanic Acid while Carbapenems, Fluoroquinolones, Aminoglycosides, and Trimethoprim-Sulfamethoxazole showed a higher sensitivity rate.

Conclusion: This is the second case of Cedecea lapagei as an uropathogen reported in the world. Cedecea lapagei is a rare bacterial infection in humans and has an emerging antimicrobial resistance. Antimicrobial treatment should be aligned with the culture findings once available.

Open Access Short Communication

Inflammation, Infiltration, Necrosis, Abscess and Nicolau Syndrome after Injection of Nonsteroidal Anti-inflammatory Drugs: What is the Reason?

Aleksandr Urakov, Natalya Urakova

Journal of Pharmaceutical Research International, Page 34-38
DOI: 10.9734/jpri/2022/v34i19A35803

It has been established that some nonsteroidal anti-inflammatory drugs (NSAIDs) when administered through injectable preparations have a local irritating effect, even though the preparations are considered high-quality. It seems that this local irritant action is not related to any specific pharmacological action but with the physicochemical properties of the preparation that grossly violate the homeostasis of the tissues. It seems that the local complications at injection sites can be caused by the nonspecific properties of the injectable preparations: denaturing (cauterizing), hypertonic and acidic activity. Each such property, or their combination, has a locally irritating effect, which can cause abscess, necrosis, and acute aseptic inflammation of reversible or irreversible nature, that follows immediately after subcutaneous or intramuscular administration, a condition named “Nicolau Syndrome”. Conversely, injectable preparations of NSAIDs having isotonic or hypotonic osmolarity associated with a neutral or weakly alkaline pH (about pH 7.4), produce a minimal short-term reversible local inflammatory effect and do not cause Nicolau Syndrome after administration.

Open Access Original Research Article

Effectiveness of Chitosan Coating Catheter in Preventing Catheter- Associated Urinary Tract Infection (CAUTI)

Najla A. Obaid, Atheer Mohamed Alzahrani, Bushra Abdulaziz Alaryni, Fatemah Fowzi Almegrin, Rahaf Saleem Alsubhi, Reem Saud Alzahrani, Meshael Alghuraybi

Journal of Pharmaceutical Research International, Page 6-19
DOI: 10.9734/jpri/2022/v34i19A35800

Catheter-associated urinary tract infection (CAUTI) is a serious health issue that develops in hospitalized patients. The number of CAUTI cases could be reduced by preventing microbial adhesion and biofilm formation. Chitosan demonstrates antimicrobial activity against a variety of microorganisms. Coating the surfaces of silicon catheters has been shown to minimize or prevent bacterial adhesion and biofilm formation. In this study, we investigated the efficacy of chitosan, in different molecular sizes, as a polymer-coated silicon catheter. Chitosan of a high (HMw), medium (MMw), and low (LMw) molecular weight, at a pH value of 5.0-6.0, used to coat catheters, was examined using two methods, namely the crystal violet and sonication methods. The first method showed that clinical Klebsiella pneumoniae had a significantly (p<0.05) lower level of bacterial adhesion with MMw chitosan, and Klebsiella pneumoniae ATCC 13883 with LMw of chitosan. Using the sonication method, the MMw chitosan showed a decrease in bacterial viability for the Escherichia coli clinical isolate, Klebsiella pneumoniae reference strain, and Escherichia coli reference strain at to a greater extent than the HMw and LMw. Chitosan with three molecular weights (Mw) showed some antibacterial activity when the time-kill assay was applied. However, overall, HMw chitosan grades were not found to be effective as an antibacterial coating agent, although the MMw and LMw presented a potential antiadhesive polymer material to reduce CAUTI.

Open Access Original Research Article

Impact of Online AHA Heartsaver First Aid CPR AED Course Amongst Non-medical Post Graduate Students

Parag Rishipathak, Monesh Bhandari, Anand Hinduja

Journal of Pharmaceutical Research International, Page 20-24
DOI: 10.9734/jpri/2022/v34i19A35801

Aim: To understand the impact of online AHA Heartsaver First Aid CPR AED course training amongst non-medical students in Pune, India

Introduction: Global statistics reveal, the mortality rate due to road traffic accidents is as high as 1.2 million per year. Numerous studies have shown that the society at large is in urgent need of more skilled in the form of first aid responder. This goal can be fulfilled and achieved by enhancing the number of first responders within our society.

With the advent of Covid-19 pandemic, opportunities for face-to-face training have significantly deprived critical knowledge sharing to the general population. The pandemic is long drawn and has forced us to devise novel methods of knowledge delivery to ensure that crucial aspects of First Aid and Emergency Care are taught to the general population.

The present study aims to understand the impact of online AHA Heartsaver First Aid CPR AED course training amongst non-medical students in Pune, India.

Objective: To study the impact of online AHA – Heartsaver First Aid CPR AED course among non-medical students in Pune, India.

Methodology: The knowledge retention study was conducted amongst 250 Post Graduate Management students based in Pune. In order to assess the true impact of the AHA - Heartsaver First Aid CPR AED online training, only those students who had not undergone any previous, formal training in First Aid and CPR concepts were chosen for the study. The baseline knowledge of the respondents was assessed with a pre-designed 30 item and pre-validated 30 item Multiple Choice Questionnaire provided by the American Heart Association.

Conclusion: E-learning is the way forward and it allows training of a large group of individuals in a singular event. This can help propagate first aid training to the masses. The study findings are encouraging in terms of improvement in the knowledge scores immediately after a single online training session. Although the knowledge tends to diminish after a period of eight weeks.

Open Access Original Research Article

A Comparative Study to Assess the Problems Faced During Postnatal Period among Mothers with Normal Vaginal Delivery and Cesarean Delivery at Selected Private Maternity Care Hospital of the Nadiad City, Gujarat

Dharti Patel, Divyaben Bariya, Hirvaben Patel, Kapilkumar Makwana, Minesh Prajapati, Nilesh Patel, Nishit Macwan, Pragati Parmar, Richa Patel, Paras Savaliya

Journal of Pharmaceutical Research International, Page 25-33
DOI: 10.9734/jpri/2022/v34i19A35802

Introduction: Postnatal period brings many physiological changes in mothers. This period is crucial for the mother as there is a new addition to her life. Hence the health of the postnatal mother is associated with the type of delivery.

Objective: This study aims to assess and compare the problems faced during postnatal period among mothers with normal vaginal delivery and cesarean delivery.

Methods: Quantitative research approach & a comparative descriptive research design was used with 60 postnatal mothers who had fulfilled the inclusion criteria, among them 30 mothers with normal vaginal delivery and 30 mothers with cesarean delivery were selected using purposive sampling technique. Data was collected using modified standardized observation checklist to assess the problems faced during postnatal period among mothers with normal vaginal delivery and cesarean delivery.

Setting: The postnatal ward of selected private maternity care hospital-N.D. Desai medical college and hospital of Nadiad city, Gujarat.

Results: There was statistically significant difference found in problems faced during postnatal period in group 1 and group 2 which shows that mean difference between group 1 and group 2 was 1.79 and standard deviation 0.15. In group 1 overall percentage of severity of pain according to mild, moderate, severe and no pain criteria were 57%, 20%, 0% and 23% respectively and in group 2 overall percentage of severity of pain according to mild, moderate, severe and no pain criteria were 0%, 70%, 30% and 13% respectively

Conclusion: The study concluded that postnatal mothers with cesarean delivery have to face more problems than those following normal vaginal delivery. The level of pain score was also high in mothers with cesarean delivery.

Open Access Original Research Article

Incidence of Esophageal Varices in Patients with Upper Gastrointestinal Bleeding

Khalidurehman Basharat, Wali Gul Mokhles

Journal of Pharmaceutical Research International, Page 39-45
DOI: 10.9734/jpri/2022/v34i19A35804

Objective: To determine the frequency of esophageal varices as a cause of upper gastrointestinal bleeding.

Methodology: This descriptive cross sectional study was conducted in the emergency room and the department of medicine Khost Provincial Hospital Khost -Afghanistan. Duration of data collection was six months, starting from January 5, 2021 to June 4, 2021. The study included one hundred and six patients suffered from upper GI bleeding. After initial history and clinical examination, upper GI endoscopy was performed to evaluate the cause of bleeding and all the relevant data was entered in the specific proforma designed by researchers.

Results: One hundred and six patients, 60 (56.6%) male and 46 (43.4%)females, of upper GI hemorrhage were included in the study. Mean age was 45.78 years (SD ±14.86) with age range of 21- 85years. Twenty patients (18.86%) had esophageal varices while 28 (26.41%) patients had duodenal ulcer, 31 (29.2%) had gastric ulcer, 14 (13.2%) had Gastric carcinoma,9 (8.49) patients had gastro-duodenal erosions, three patients (2.83%)had Mallory Weiss tear and one patient (0.94) had esophageal growth.

Conclusion: In this area (Khost – Afghanistan) where this study was conducted, esophageal varices are the second most common cause of upper GI bleeding.