Objective: To investigate the carriage of Staphylococcus aureus among doctors and nurses in Infectious Diseases Hospital, Kuwait, following the detection of 3 cases of methicillin-resistant S. aureus (MRSA). Materials and Methods: A total of 260 nasal and throat swabs were obtained from 19 doctors and 111 nurses and cultured for the carriage of S. aureus. Forty-three S. aureus were identified based on their growth characteristics on mannitol-salt agar, catalase and tube coagulase and DNA hydrolysis. The isolates were tested for susceptibility to antibacterial agents and typed by phage typing; plasmid analysis and pulsed-field electrophoresis were carried out to determine their relatedness. Results: Of the 19 doctors, 4 (21%) had nasal carriage while only 1 of them had a throat carriage. Sixteen (14.4%) nurses carried S. aureus in their noses and 20 (18%) in their throats. The combined nasal carriage rate for both doctors and nurses was 15.8%, and combined throat carriage was 16.6%. None of them carried MRSA. The isolates were resistant to penicillin G (90%), tetracycline (23.3%), erythromycin (9.3%) and cadmium (100%). Typing of the isolates showed a variety of phage types, plasmid and pulsed-field gel electrophoresis patterns. Discussion: None of the doctors or nurses carried MRSA. Typing of the methicillin-susceptible strains that they carried demonstrated that the S. aureus were different, indicating an absence of a dominant clone capable of spreading. It is important to maintain a low carriage of S. aureus among health-care workers.

ABSTRACT

Background: Metabolic syndrome is defined as a state of metabolic dysregulation characterized by insulin resistance, a predisposition to Type 2 diabetes mellitus and atherosclerotic vascular disease. The changing hormonal milieu with altered estrogen and testosterone ratio is the cause of metabolic syndrome at menopausal transition. Aims and Objectives: This study was designed to determine the incidence of metabolic syndrome and its various components in premenopausal and postmenopausal women from Punjab. Materials and Methods: This study was conducted on 200 females in the age group of 45–60 years attending outpatient department over a period of 2 years in the Department of Obstetrics and Gynaecology, Bebe Nanki Mother and Child Care Centre, Government Medical College, Amritsar. A detailed history and physical examination were done and recorded on a pro forma. Biochemical assessment comprising fasting blood glucose, triglycerides, and cholesterol was done. Metabolic syndrome was assessed as per the modified NCEP ATP III criteria. Results: Twenty-nine percent women were found to have newly onset metabolic syndrome, the incidence in premenopausal group was 16%, and in postmenopausal group was 42%. Among the components, the incidence of hypertension (58%) was the highest followed by waist circumference (42%). Maximum correlation of metabolic syndrome was found with high-density lipoprotein (odds ratio - 7.250) followed by waist circumference (odds ratio - 7.111). Conclusion: The incidence of metabolic syndrome was found to be higher in postmenopausal women than in premenopausal women. Currently, the need of the hour is lifestyle modification to reduce the emergence of metabolic syndrome and cardiovascular diseases.

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Background: Hypertensive disorders of pregnancy are globally a threat to maternal and fetal outcomes. Despite massive efforts worldwide, these disorders continue to be a major adverse influence on the health goals especially in developing countries. The aim of the study was to measure the impact of hypertensive disorders of pregnancy in its most severe form on maternal and fetal outcomes in our region along with the important prognostic factors. The objective of this study was to investigate the maternal and fetal outcome in cases of severe preeclampsia and to evaluate the risk factors and complications associated with adverse outcomes.Methods: Indoor records of pregnant females at more than 20 weeks gestation with preeclampsia with severe features (as defined by the ACOG practice bulletin 222) and eclampsia admitted over a period of one year in a unit of obstetrics at Government Medical College, Amritsar were studied and results were statistically analysed.Results: The incidence of hypertension in pregnancy was 11.85% while that of severe preeclampsia was 6.14%. 57.94% of these women were primigravida’s and 80.16% of the women with severe preeclampsia/eclampsia were in the age group 20-29 years. Severe preeclampsia and eclampsia contributed to 43.75% of maternal deaths (OR 8.8, p value=0.0001) and there was increased incidence of stillbirth (OR 10.03, p value<0.0001) and perinatal mortality (OR 12.97, p value<0.0001). The incidence of preterm birth in cases with severe preeclampsia/eclampsia was 57.14%. Severe anemia as a comorbidity along with respiratory distress and renal impairment were associated with increased probability of maternal death.Conclusions: In addition to ensuring the implementation of routine management principles of, the policy makers should focus on developing critical obstetric care and NICU infrastructure along with dedicated human resources at obstetric centres to manage these high-risk cases. Improvement in the quality of antenatal care can help in diagnosing such patients before the onset of severe features so as to optimize maternal and neonatal outcomes.