Staphylococcus Aureus: Methicillin Resistance and Small Colony Variants from Pyogenic Infections of Skin, Soft Tissue and Bone

BACKGROUND

Staphylococcus aureus (S. aureus) colonizing the nares, is the leading cause of hospital as well as community acquired infections. The aim of this study was to identify the S. aureus from skin, soft tissue and bone related infections and typing them on the basis of antimicrobial susceptibility profile.

METHODS

Clinical samples were collected from patients with skin, soft tissue and bone related infections from January to October 2013 at Chitwan Medical College Teaching Hospital, Bharatpur. The S. aureus, small colony variants and methicillin resistant strains were identified by standard microbiological methods recommended by American Society for Microbiology. Antimicrobial susceptibility testing was performed by modified Kirby-Bauer disk diffusion method.

RESULTS

Among 333 samples processed, there was positive growth of S. aureus in 66 (19.8%) samples. Among the isolated S. aureus, 10 isolates were small colony variants of S. aureus and all the strains recovered were thymidine independent in this study. Amikacin, vancomycin and teicoplanin were found to be the most effective antibiotics. Methicillin resistance was found in 34.8% isolates of S. aureus.

CONCLUSIONS

It can be concluded that, S. aureus is one of the causative agent of pyogenic infections and the trend of antibiotic resistant is alarmingly high and also the rate of methicillin resistant S. aureus is comparably high in this study.

Red cell alloimmunisation in regularly transfused beta thalassemia patients in Pakistan

BACKGROUND

In Pakistan routine blood group typing of thalassemia patients identifies ABO and Rh(D) antigens only. Therefore, other antigen incompatibilities between blood donor and blood recipient may cause alloimmunisation.

OBJECTIVE

The aim of this study was to estimate the frequency of alloimmunisation and to evaluate the risk factors associated with its development in beta (β)-thalassemia patients receiving regular blood transfusions.

MATERIALS AND METHODS

In total 162 β thalassemia patients were included in this study. An extended red cell antigen panel was performed to detect antibodies. Patients received red cell concentrates, which were matched for ABO and Rh(D) antigens. Clinical and laboratory data were collected and analysed to estimate the frequency of alloantibodies and the factors influencing immunisation in patients on regular blood transfusion.

RESULTS

The median age of patients was 6·7 (range: 0·5-25) years. A total of 14 (8·6%) patients developed alloantibodies against red cell antigens. The most frequently occurring alloantibodies was anti-E (2·5%), anti-K (1·8%), anti-e (1·2%) and anti-D (0·6%). Five (3·1%) patients developed more than one red blood cell (RBC) alloantibody. Age at first transfusion in alloimmunised patients was 1·22 ± 0·87 years. The frequency of blood transfusion in alloimmunised patients was 23 ± 8·81 days and in those without alloimmunisation was 31·8 ± 16 days (p = 0·02). Logistic regression analysis showed no independent risk factor associated with alloimmunisation.

CONCLUSION

The frequency of transfusion was increased in patients who developed alloantibodies. Typing patients and donors to match for Rh and Kell antigens would prevent more than 90% of RBC alloantibodies and reduce the frequency of transfusion in thalassemia patients.

Voice outcomes following endolaryngeal surgery; are we achieving our aims?

OBJECTIVE

To determine voice outcomes in endolaryngeal surgery.

METHODS

Prospective assessment of patients undergoing endolaryngeal surgery in one head and neck team in North Glasgow from 2007 to 2014. Each patient completed a VoiSS (the Voice Symptom Scale) questionnaire at pre-assessment and post-endolaryngeal surgery. Per-operatively, the aim of the procedure was recorded from a choice of seven options in addition to the clinical conditions and the procedure.

RESULTS

One thousand and sixty-six patient episodes were recorded. Thirty-two had incomplete data at pre-assessment and were excluded. Of the remainder, 703 (68%) had complete paired data sets. 'To improve voice' (n = 169, 24%) and 'to achieve a biopsy with no deterioration in voice' (n = 185, 26%) categories had significant outcomes in keeping with the operative aims.

CONCLUSION

This study demonstrated that it is possible to assess patient reported voice outcomes in universal heterogeneous endolaryngeal surgery cohort over a prolonged period. The voice outcomes were in keeping with the stated aims of the endolaryngeal surgical procedures.

Antenatal diagnosis of achondroplasia

We report a interesting case of antenatal diagnosis of achondrpoplasia in a young multigravida who presented with term pregnancy for routine ultrasound assessment which revealed a single, live intrauterine fetus with a discrepancy between femur length (FL) and biparietal diameter (BPD), narrowing of the interpeduncular distance. The diagnosis of achondroplasia was made with a sonological skeletal survey and findings were correlated with radiological skeletal survey after the baby was delivered. DOI: http://dx.doi.org/10.3329/bjms.v13i1.17443 Bangladesh Journal of Medical Science Vol. 13 No. 01 January2014: 84-87

Congenital pseudoarthrosis of the clavicle: a case report

DOI: http://dx.doi.org/10.3126/jcmsn.v8i3.8687 Journal of College of Medical Sciences-Nepal,2012,Vol-8,No-3, 43-46