ABSTRACT
Anterior open bite is said to exist when there is an actual vertical gap between the upper and lower incisors with the teeth in centric occlusion. The etiology of anterior open bite is multifactorial and can be attributed to genetic and environmental traits, reflected in pathologic [muscular dystrophy and cleft lip/palate] and developmental factors. The objective of this study was to determine the prevalence of anterior open bite in sample of Peshawar population. Three hundred patients reporting to the department of orthodontic for treatment were included in the study. After taking detailed history and clinical examination an impression of each patient was recorded in alginate impression material and models were poured in dental stone. Measurements were done on dental casts for anterior open bite in millimeters [mm] with vernier caliper having least count of 0.01 mm. SPSS [16.0] was used to analyze the data statistically. Frequencies and percentages were tabulated for each variable. The chronological age range of the sample was 15-30 years with a mean age of 16.2 +/- 5.2 years. Female are more in number i.e. 56.6%]. Anterior open bite was present in 14[4.6%] patient. Less severe open bite [<1mm] was more common [9[3%]] than severe [>1mm-2mm] one [5[1.6%]]
ABSTRACT
Multi-drug resistant bacteria are an important cause of mortality and morbidity. In the management of various infections, timely detection and appropriate treatment, in accordance with the culture and sensitivity reports can help improve the treatment outcome. Colistin is a bactericidal antibiotic which is emerging as a reliable solution for treating infections with multi-drug resistant Gram negative bacilli. The aim of this study was to find out the in-vitro efficacy of colistin against multidrug resistant Pseudomonas aeruginosa isolates by minimum inhibitory concentration. This cross sectional, descriptive study was conducted in the Department of Microbiology, Army Medical College, National University of Sciences and Technology, Islamabad from February 2010 to January 2011. Antimicrobial sensitivity testing was done on Pseudomonas aeruginosa isolated from routine clinical specimens received and the strains which appeared resistant to at least one antimicrobial agent in three or more anti-pseudomonal antimicrobial categories were subjected to the Colistin Etest. The MIC endpoint of colistin was read, as per manufacturer's instructions [AB Biodisk, Solna, Sweden]. The isolates showing MIC of 2micro.g/ml or less were considered sensitive, those with 4-6 micro.g/ml as intermediate and >/= 8 micro.gg/ml as resistant. MIC[50] and MIC[90] of colistin against MDR Pseudomonas aeruginosa was determined. A total of 52 MDR Pseudomonas aeruginosa strains were isolated during the period of the study. The highest percentage was isolated from urine [36%] followed by respiratory tract infections [18%] and pus specimens [20%]. The highest percentage of these isolates was found to be susceptible to colistin followed by piperacillin-tazobactam and cefoperazone-sulbactam. A total of 36 [69%] isolates were sensitive, 10 [20%] were intermediate and 6 [11%] were resistant to colistin by Kirby Bauer disc diffusion method. MIC[50] was found to be l.0 micro.gg/ml while MIC[90] was 3.0 micro.gg/ml. Colistin is a reliable solution in cases of infections with MDR, XDR or PDR Pseudomonas aeruginosa
Subject(s)
Colistin , Drug Resistance, Multiple , Microbial Sensitivity Tests , Cross-Sectional StudiesABSTRACT
To compare the sensitivity and specificity of different phenotypic methods for detection of Amp C beta-lactamase producing bacteria. Analytical study. Department of Microbiology, Army Medical College / National University of Sciences and Technology [NUST], Islamabad, Pakistan, from June 2010 to December 2010. A total of 150 clinical isolates were screened for presence of Amp C beta-lactamase by using the cefoxitin disc. The confirmatory methods evaluated were inhibitor based assay [boronic acid], Amp C disc test and Amp C Etest. Three dimensional enzyme extract assay was used as the reference method for determining the sensitivity and specificity. Among the total isolates tested, 62.8% bacteria showed the presence of Amp C beta-lactamase by standard three dimensional enzyme extract assay. Among the three methods compared, boronic acid disk test found out to be highly sensitive [88%] and specific [92%] for the detection of Amp C beta-lactamase producing bacteria. Detection of Amp C production is crucial in order to establish the antibiotic therapy and to attain the favourable clinical outcomes. Implementation of simple tests like boronic acid disk tests in the laboratories will help to alleviate the spread of Amp C beta-lactamase harboring organisms
ABSTRACT
Aims: Infections due to metallo-β-lactamase (MBL) producing Gram negative rods are a cause of high mortality and morbidity. Early detection by an economical and accurate method may improve patient outcome. This study was aimed to evaluate the diagnostic accuracy of combined disc method for MBL detection by comparing it with MBL-Etest. Methodology and Results: This cross-sectional, validation study was carried out in the Department of Microbiology, Army Medical College, National University of Sciences and Technology, Rawalpindi, over a period of six months. A total of 52 non-duplicate Gram-negative rods isolated from the routine clinical specimens and found resistant to meropenem/imipenem on Kirby Bauer Disc Diffusion method were subjected to two tests for metallo-β-lactamase detection. One was combined Disc test using imipenem with Ethylene Diamine Tetraacetic Acid (EDTA), where a strain showing an increase in zone of inhibition of combined disc of ≥ 7 mm as compared to imipenem alone, was considered as MBL producer and the other one was MBL-Etest for which results were interpreted as per manufacturer’s guidelines. Combined disc method for MBL detection was found to have a sensitivity, specificity, positive predictive value, negative predictive value and accuracy of 97.5%, 100%, 100%, 92% and 98%. Conclusion, Significance and Impact of study: Combined disc method is an economical and reliable method for metallo-β-lactamase detection which can be used routinely in any laboratory.
ABSTRACT
Microorganisms adhere to non-living material or living tissue, and form biofilms made up of extracellular polymers/slime. Biofilm-associated microorganisms behave differently from free-floating bacteria with respect to growth rates and ability to resist antimicrobial treatments and therefore pose a public health problem. The objective of this study is to detect the prevalence of biofilm producers among Gram positive and Gram negative bacteria isolated from clinical specimens, and to study their antimicrobial susceptibility pattern. The study was carried out from October 2009 to March 2010, at the Department of Microbiology, Army Medical College/ National University of Sciences and Technology (NUST), Rawalpindi, Pakistan. Clinical specimens were received from various wards of a tertiary care hospital. These were dealt by standard microbiological procedures. Gram positive and Gram negative bacteria isolated were subjected to biofilm detection by congo red agar method (CRA). Antimicrobial susceptibility testing of those isolates, which showed positive results (slime production), was done according to the Kirby-Bauer disc diffusion technique. A total of 150 isolates were tested for the production of biofilm/slime. Among them, 81 isolates showed positive results. From these 81, 51 were Gram positive and 30 were Gram negative. All the 81(54%) slime producers showed reduced susceptibility to majority of antibiotics. Bacterial biofilms are an important virulence factor associated with chronic nosocomial infection. Detection of biofilm forming organisms can help in appropriate antibiotic choice.
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To find out the frequency and susceptibility pattern of multi-drug resistant [MDR] Pseudomonas aeruginosa in clinical specimens. Cross-sectional observational study. Department of Microbiology, Army Medical College, National University of Sciences and Technology [NUST], Rawalpindi, from January to September 2010. Routine clinical specimens were subjected to standard microbiological procedures and the isolates were identified to the species level. The antibiotics susceptibility was determined by Kirby Bauer Disc diffusion method and the results were interpreted according to the Clinical and Laboratory Standards Institute [CLSI] guidelines. The frequency of MDR Pseudomonas aeruginosa among all the Pseudomonas aeruginosa strains isolated was found to be 22.7%. These isolates were most sensitive to Colistin followed by Piperacillin-Tazobactam and Cefoperazone-Sulbactum. Increasing fequency of infections due to MDR Pseudomonas aeruginosa is an emerging threat in our set up which can be prevented by prescribing antibiotics judiciously and by adopting proper disinfection measures
ABSTRACT
Amp C beta-lactamases are cephalosporinases which hydrolyze cephamycins and are poorly inhibited by clavulanic acid. Amp C beta-lactamases confer resistance to a wide variety of antibiotics and pose both diagnostic and therapeutic challenges. The objective was to detect the frequency and antibiotic susceptibility pattern of Amp C beta-lactamase producing bacteria isolated from a tertiary care hospital of Pakistan. Organisms were isolated from various clinical specimens. First, the screening of the isolates was done by using cefoxitin disc. Screen-positive organisms were subjected to three dimensional extract test for detection of Amp C beta-lactamases. From a total of 100 organism tested, 64 organisms were positive on cefoxitin screen test. Out of these 64, 40 [62.5%] showed the presence of Amp C beta-lactamase. [E.coli n=18, K.pneumoniae n=14, K.oxytoca n=1, Enterobacter species n=5, Citrobacter freundii n=2] by three dimensional extract test. The antibiotics found out to show good activity against these resistant bacteria include meropenem and tigecycline. This is the first study to determine the frequency of Amp C beta lactamases from Pakistan. This study shows a high frequency of Amp C beta-lactamase producing isolates from a hospital, which may lead to serious therapeutic problems
Subject(s)
Humans , Drug Resistance, Microbial , Microbial Sensitivity Tests , HospitalsABSTRACT
To describe the frequency of indications, results and different parameters observed during the test. Design: A descriptive study. Place and Duration of Study: This study was carried out in coronary care unit of Holy Family Hospital, Rawalpindi from January, 2001 to January, 2002. Subjects and One hundred booked patients were selected by non-probability convenient sampling. Exercise stress test was done on Quintron Q710 Exercise and Resting ECG System. Patients having suspected coronary artery disease having typical or atypical angina pectoris, any rhythm disorders, and known coronary artery disease 6-8 weeks after myocardial infarction were included in the study. Out of 100 patients, 75 were males and 25 females. Twenty-seven% patients presented with typical chest pain [resting and exertional] and among them 18 had positive test. Among these, 9 [56.25%] male and 2 [33.3%] female patients developed significant ST-T changes in recovery period. Most common ST-T deviation lead was v4 [n=5] in males and lead III [n=2] in females. Out of 60 patients [60%] with atypical chest pain, only 3 [5%] males were found positive. Fifty-eight% patients [44 males, 14 females] were older than 40 years. Patients with inconclusive or borderline test included 10 [10%] males and 2 [2%] females. For primary care physicians, exercise stress testing is a cost-effective tool to evaluate patients presenting with symptoms of classical as well as atypical chest pain. It helps to stratify those with probable coronary artery disease into a high-risk group needing referral and a low-risk group that can be observed