Aim: To demonstrate the prevalence of bacterial pathogens and it’s antibiotic sensitivity in children (0-18years) with acute otitis media (AOM) at tertiary care teaching hospital. Materials and Methods: This is a retrospective study of 108 patient’s ear discharge samples with acute otitis media at department of Microbiology, Sri Venkateswara Medical College, during the period January 2018 to December 2018. The specimens / swabs were cultured using aerobic microbiological techniques and Antimicrobial susceptibility pattern to different agents was carried out with the disc diffusion method according to the criteria of the Clinical and Laboratory Standards Institute (CLSI). Results: Cultures from AOM samples/swabs revealed Staphylococcus aureus (58) was the most frequently identified pathogen in children below 6 years. Out of 58, 12 isolates were Methicillin resistant Staphylococcus aureus (MRSA). Pseudomonas aeruginosae was the second most frequently identified pathogen. In our study, most of the Staphylococcus aureus were resistant to Penicillins and first generation cephalosporins; Pseudomonas aeruginosae to fluoroquinolones. Conclusion: The study also reveals that there are differences in the pathogens isolated and their antibacterial susceptibility patterns from different regions. Hence, it is the need of the hour to have a study at the regional level to know the common pathogens causing acute otitis media (AOM) and their susceptibility pattern for an efficient treatment, prevention of both complications and development of antibiotic resistance and finally, the reduction of the treatment costs.

The present study involved in-vivo pharmacokinetic evaluation of sintered matrix tablets of Atenolol in comparison to Atenolol pure drug and unsintered matrix tablets of Atenolol. The objective of the present investigation was to study the effect of sintering technique in development of controlled release dosage form. The Atenolol pure drug solution, both formulated unsintered and sintered controlled release matrix tablets of Atenolol were tested for in-vivo pharmacokinetic study in healthy male New Zealand rabbits (n=3). The plasma concentrations of Atenolol drug were determined by a validated HPLC method. From the time versus plasma drug concentration data, various pharmacokinetic parameters (Cmax, Tmax, AUC, KE and t1/2) were estimated. Tmax for pure drug, unsintered and sintered tablets was found to be 2h, 3hr and 4h with Cmax values of 751.00 ± 10.53 ng/ml, 639.33± 10.40 ng/ml and 518.00 ± 8.54 ng/ml respectively. Increase of Tmax values in sintered tablets as compared to the of pure drug and unsintered tablets suggested slow absorption of drug from the formulated sintered tablets and the availability of drug at a controlled manner. An increase of the elimination half- life (T1/2) and decrease in elimination rate constant (KE) of drug in sintered matrix tablet in comparison to the that of unsintered tablets and pure drug was also observed, indicating the prolonged and controlled systemic availability of drug in biological system. The investigated sintered matrix tablets exhibited a remarkable increase in bioavailability due to prolonged plasma residence and could maintain constant plasma level of atenolol up to 24 hr in rabbits.

Prevalence rates for patients with diabetes mellitus are rising across countries including sub-Saharan African countries, which will continue. As a result, there are an increasing number of patients with insulin-dependent diabetes across sub-Saharan Africa including Kenya. Growing prevalence rates are increasing the costs of treating patients with diabetes enhanced by associated complications. These include both microvascular and macrovascular complications, with hypoglycaemia and generally poor control of diabetes contributing to the burden. Long-acting insulin analogues were developed to reduce rates of hypoglycaemia associated with insulin usage, including nocturnal hypoglycaemia, and improve adherence through improving patient convenience. As a result, they are now included in the Kenyan Essential Medicines List. However, long-acting insulin analogues are typically considerably more expensive than standard insulins limiting their use in practice, especially in countries such as Kenya with concerns with affordability even for standard insulins such as Mixtard®. Consequently, a need to ascertain current utilisation and expenditure patterns for the different insulins including long-acting insulin analogues across Kenya starting with leading referral hospitals. Research in Kenyatta National Hospital (KNH) showed growing use of insulin glargine reaching up to 3.4 to 3.6% of total insulin utilisation in 2019 and 2020. However, prescribing was limited by considerably higher prices (3.4 fold higher) than standard insulins on a defined daily dose basis. Considerably higher prices resulted in no utilisation of long-acting insulin analogues in another leading referral hospital in Kenya. Overall, appreciably lowering the prices of long-acting insulin analogues through instigating local production and other activities should increase their use benefiting patients and the healthcare system in Kenya and wider. These are considerations for the future.