ABSTRACT
Strongyloides stercoralis is unique among the nematodes, in which it completes its life cycle inside a single human host by causing autoinfection in the host, and it causes hyperinfection leading to persistent and fatal disseminated infections in immunocompromised hosts. The present case report is about strongyloidiasis fatal hyperinfection in a patient with malignant tumor of the tongue on radiotherapy treatment, to highlight the need for clinical suspicion of strongyloidiasis in an immunocompromised host. As per the Centers for Disease Control and Prevention, the mortality in strongyloides hyperinfection syndrome is alarmingly high, a case fatality rate that is almost 90%. Hence, the clinicians should be well equipped to diagnose, treat, and also prevent the fatal consequences of this lethal nematode. Detailed workup for this parasitic infection is crucial, and this case report emphasizes that a simple wet mount stool microscopic examination can clinch the diagnosis.
ABSTRACT
The coronavirus disease 2019 (COVID-19) pandemic has significantly affected all specialty practices in medicine, including the field of spinal surgery. Spinal surgery is unique in that the procedures include not only fully elective and fully emergent interventions, but also involve a separate group of semi-emergent surgeries, where delayed intervention may lead to permanent neurological deficits. Here, we present an evidence-based review on the impact of the COVID-19 pandemic on spinal surgery and our current knowledge about this issue. We conducted a thorough search of the PubMed, Medline, and Google Scholar databases using the keywords, “COVID-19,” “COVID-19 impact on spine surgery,” “coronavirus impact on spine surgery,” “COVID-19 impact on neurosurgery,” “coronavirus impact on neurosurgery,” “COVID-19 impact on spine surgeons,” and “coronavirus impact on spine surgeons” on May 6, 2020. A total of 8,322 articles were identified in the initial search. Articles that were duplicated, those that did not pertain to COVID-19 or spine surgeries, those with details not pertaining to the current topic of interest, and those published in languages other than English were excluded from our analyses. After complete screening, six articles were included in this review. During the previous few weeks, the COVID pandemic has significantly influenced all major aspects of spine surgery across the world. Outpatient care has been gradually shifted from physical visits to tele-health and online consultations. General recommendations have favored the conservative approach over surgeries, although no patient should be deprived of standard care owing to concerns about COVID. The general principles followed by spine surgeons should include early detection of COVID symptomatology; triaging of patients based on underlying spinal pathology; prescription of appropriate investigations to confirm the COVID status; isolation, as needed; selection of optimal management method as per the guidelines; adherence to best intraoperative practices; and ensuring protective measures for non-infected patients, family members, fellow heath care providers, and themselves against the disease.
ABSTRACT
Two hundred and eighteen bacterial isolates obtained from various clinical samples were subjected to Gram stain by conventional method. For all the isolates potassium hydroxide (KOH) string test and sensitivity to vancomycin were done. Gram positive bacteria showed 100% sensitivity to vancomycin as also 100% negativity for string test. Of the gram negative bacteria, 99.42% were resistant to vancomycin while 98.85% were positive for the string test. KOH and vancomycin tests are simple, inexpensive and can be used in addition to Gram staining for rapid identification of bacterial cultures.