Saturday, April 16, 2011

Trauma Center

In 2008 , I got a chance to ro review the need the for a Trauma center for Pakistan with two of my supervisors. One was the director general health Pakistan. The short communication was published in the Journal of Pakistan Medical Association Vol. 58, No. 10, October 2008. The need for a 24 hours available trauma team was highlighted.

However, even today in a city like hyderabad the Trauma center is lying locked and vacant. The facility is not under use and patients are being directed to other hospitals.

I found this clip whihc takes us through the trauma center lying in a state of dormancy .
http://www.youtube.com/watch?v=Bhc0IlOGgtc

What can be done to change this , so that this facility becomes operable.

Friday, April 8, 2011

New Delhi metallo-beta-lactamase-1 - also affecting Pakistan

Concern for Pakistan and India: Anti biotic Resistance due to NDM-1 enzyme (New Delhi metallo-beta-lactamase-1) - the presence of which in a bacteria makes it a 'super bug' and resistant to antibiotics.

Misuse of antibiotics , which may also result from the resistance to anti biotics, is undermining the International fight against the infectious ailments.(World Health Organization ). After reading this issue in KWGHPR 4/8 , my concern is since there is evidence based data from India and research also considers this problem to be similar in Pakistan.

In a study published in Lancet: http://www.thelancet.com/journals/laninf/article/PIIS1473-3099(11)70059-7/fulltext?_eventId=login by walsh et el : "Dissemination of NDM-1 positive bacteria in the New Delhi environment and its implications for human health: an environmental point prevalence study", it is found that scientists had detected the gene that makes NDM-1, "an enzyme that can be incorporated into bacteria and inactivate a wide range of antibiotics, in New Delhi, India, water supplies used for drinking, washing and cooking" , Reuters report( kelland 4/7).

Lancet paper interpreted : "The presence of NDM-1 β-lactamase-producing bacteria in environmental samples in New Delhi has important implications for people living in the city who are reliant on public water and sanitation facilities. International surveillance of resistance, incorporating environmental sampling as well as examination of clinical isolates, needs to be established as a priority".


KWGHPR 4/8 discusses this further. "NDM-1-positive bacteria have already turned up in the United Kingdom and elsewhere in patients, some of whom had previously been in hospitals in India and Pakistan, but this is the first report to find NDM-1 in environmental samples unconnected to hospitals or infected patients," Nature News reports (Lubick, 4/7). Researchers say the study suggests NDM-1 "is widely circulating in the environment – and could potentially spread to the rest of the world," Associated Press/Seattle Times reports (Cheng, 4/6)

Researchers found the gene in 11 different types of bacteria, including those that cause dysentery and cholera.



Note:
http://www.thelancet.com/journals/laninf/article/PIIS1473-3099(10)70143-2/abstract#
"Emergence of a new antibiotic resistance mechanism in India, Pakistan, and the UK: a molecular, biological, and epidemiological study"
Research identified 44 isolates with NDM-1 in Chennai, 26 in Haryana, 37 in the UK, and 73 in other sites in India and Pakistan.