In Vitro Susceptibility Of Isolated Shigella Flexneri And Shigella Dysenteriae To The Ethanolic Extracts Of Trachyspermum Ammi And Peganum Harmala

Objective: This study represents the first attempt to investigate the antimicrobial activity of Peganum harmala, and Trachyspermum ammi seeds extract against the isolated bacillary dysentery-causing microorganisms. Methods: T. ammi and P. harmala were extracted by 96% ethanol using Soxhlet apparatus. The extracts were screened for their phytochemical constituents. Their antimicrobial activity against the isolated dysentery-causing microorganisms was evaluated using the agar diffusion method. Results: The antimicrobial activity result showed that, the two isolated bacteria, Shigella flexneri, and Shigella dysenteriae were found to be sensitive to the extract of T. ammi seed with inhibition zones up to 25 mm, compared to the inhibition zone of 20 mm produced by Gentamycin standard drug, this is mainly due to the presence of the different phytochemical in the extract such as tannin, flavonoids, terpenoids which are well known for their antimicrobial effects. The two isolated bacteria were found to be insensitive (zero mm) to P. harmala extract, Amoxicillin, and Amoclan (Amoxicillin+clavulanic acid) standard drugs, this is due to the fact that, the phytochemicals constituents of P. harmala possess the antagonistic effect to each other’s. Addition to; these bacteria became resistant to both Amoxicillin and Amoclan. Conclusion: From the results it concludes, T. ammi seeds extract had a considerable level of antimicrobial activity against bacillary dysentery-causing microorganisms resistant to Amoxicillin and Amoxicillin+clavulanic acid drugs.

Identification of right ventricular infarction in acute inferior wall myocardial infarction by tissue doppler imaging

It's important to identify patient with dominant right ventricular infarction with inferior wall MI in which right ventricular dysfunction is primarily responsible for development of hypotension and cardiogenic shock Jacob, et al., 2000.Aim to assess tissue Doppler imaging is a useful method for the detection of the right ventricular myocardial infarction in patients with acute inferior wall myocardial infarction. Thirty patients, nine females and twenty-one males, admitted to [CCU] at Al-Hussein University Hospital between December 2009 and July 2010, classified into 2 groups, group A 15 without RVI and group B 15 with RVI plus Control group C Ten healthy individuals ;following scheme. History, risk factors, Clinical examination, 12 leads ECG ,Cardiac enzyme and Echocardiography was performed within 48 hours after the MI. As the following. Left ventricular ,Right ventricular study,Pulsed Tissue Doppler parameters show statistically significant difference between groups in JVP, Blood pressure ,cardiac enzymes, Right ventricular ejection fraction ,tricuspid annular motion ,Tricuspid regurgitation, Myocardial systolic velocity, Myocardial early diastolic velocity, Myocardial late diastolic velocity ,Isometric contraction time Jsometric relaxation time, Ejection time, myocardial performance index. The right ventricular MPI increases in patients with RVMI when accompanied by acute inferior wall MI .So RVMI could be diagnosed and predicted correctlyby the use of these Tissue Doppler imaging which are easily obtained

Impact Des Filières De Soins En Phase Aigue Dans L/'amélioration Fonctionnelle Des Avc A Nouakchott

Introduction. Les accidents vasculaires cerebraux (AVC) sont sources d'invalidites fonctionnelles par fois tres lourdes pour les patients et de contraintes pour leurs entourages. La prise en charge initiale est determinante dans l'amelioration du deficit moteur et partant du pronostic fonctionnel de ces patients. En Mauritanie cette prise en charge initiale se fait a travers differentes filieres de soins.Objectif. Ce travail avait pour objectif de determiner si la filiere initiale de soins en phase aigue avait un impact sur l'amelioration fonctionnelle des patients victimes d'un AVC a Nouakchott. Methodologie. Une etude prospective evaluative portant sur une cohorte de 82 personnes dont 42 au service de Neurologie du CNP; 40 en Medecine Interne et Cardiologie du CHN; s'etait deroulee du 1er mars au 30 novembre 2006. Les patients victimes d'AVC etaient recus aux urgences du CHN avant d'etre orientes en fonction de la periode du mois : en Neurologie (du 1er au 15); en Medecine Interne (du 16 au 23) ou en Cardiologie (du 24 a la fin du mois). Si les malades repondaient a tous les criteres d'inclusion et apres un consentement eclaire; ils etaient evalues sur le plan du deficit et de la capacite fonctionnelle par deux echelles validees : l'Indice de Barthel et la Mesure de l'independance fonctionnelle (MIF). Ces evaluations etaient effectuees a l'inclusion (J0); a J30; J60 et J90. La qualite de vie etait appreciee a J90 par l'echelle de la qualite de vie (EUROQOL). Les patients admis en Neurologie etaient compares a ceux qui etaient hospitalises dans les 2 autres services. Les comparaisons portaient sur les proportions des patients ayant connus une amelioration au cours du suivi et egalement sur les moyennes de l'Indice de Barthel de la MIF recuperes par les patients.Resultats. Soixante Six pour cent (66) des 42 patients inclus en Neurologie ont ete evalues a terme; ce taux est de 30pour la Cardiologie et 10pour la Medecine Interne (p : 0;0005). La comparaison des caracteres socioprofessionnelles; cliniques et radiologiques ne montrait aucune differencestatistiquement signifi-cative entre la Neurologie et les autres Services. Le delai moyen entre l'installation du deficit et le debut de la reeducation etait de 9 jours en Neurologie et 19 jours en Cardiologie; cette difference etait significative (p : 0;0002). La comparaison des proportions de patients ayant recupere aussi bien au niveau du deficit moteur que de l'independance fonctionnelle montrait une difference en faveur des patients qui etaient suivis en Neurologie. La comparaison des moyennes des echelles recuperees ne montrait aucune difference entre les filieres de soins.Conclusion. L'absence de difference entre les differents services au niveau des aspects socioprofessionnels; cliniques et radiologiques temoignait de la qualite de la randomisation. Il y avait plus de patients qui s'ameliorait en Neurologie que dans les 2 autres Services; ceci semblait etre bien correle avec une prise en charge precoce par la kinesitherapie et avec le suivi regulier des patients. Cependant les patients ne recuperaient pas mieux dans une filiere plus que dans une autre

Risk of developing right bundle branch block [R. B. B. B.] and complete heart block [C. H. B.] during pulmonary artery catheterization in open heart surgery patients

To analyze the incidence and associated haemodynamic disturbances of a new Right Bundle Branch Block [R.B.B.B] induced by Pulmonary Artery Catheter [P.A.C] with a particular emphasis in patients with preexisting Left Bundle Branch Block [L.B.B.B.] in a prospective manner. To establish whether prophylactic placement of a ventricular pacemaker in patients with pre existing L.B.B.B. during pulmonary artery cotheterization is necessary. The study was conducted at the department of Anaesthesiology and intensive care of the Aga Khan University Hospital, Karachi. Pulmonary artery catheterization was performed in 125 adult patients who underwent various open heart surgical procedures. Outcome studied: Incidence of new R.B.B.B induced by P.A.C. and its associated haemodynamic disturbances with a particular emphasis in patients with a pre existing L.B.B.B. was recorded. New R.B.B.B. occurred in 13 [10.4%] patients while none of the 1 1 patients with a preexisting R.B.B.B. developed C.H.B. during the procedure. Development of new block was not associated with any haemodynamic disturbance. Prophylactic temporary pacing is recommended in patients having a pre-existing R.B.B.B. before placement of P.A.C. in previous studies. However, our study does not show that previous R.B.B.B. is at risk of developing complete heart block [C.H.B.] during the procedure. In view of grave consequences of C.H.B. It is recommended that facilities of pacing should be on board in case it happens

Complications of pulmonary artery catheterization: a prospective study in open heart surgery patients

Pulmonary artery was catheterized in 125 adult patients undergoing various open-heart surgical procedures for perioperative haemodynamic monitoring. A standard approach to right internal jugular vein was used in all patients. Complications noted were related either to central venous access, pulmonary artery catheter [PAC] threading and during stay of catheter in the pulmonary artery. Post-operatively, X-ray chest was done in every patient and tip of the catheter was sent for culture once the PAC was removed. There was 8.8 percent incidence of inadvertent carotid artery puncture. Pneumothorax occurred in one patient. Arrhythmias occurred in 49.6 percent of the patients. New right bundle branch block occurred in 10.4 percent of the patients, while none of the 11 patients with a pre-existing left bundle branch block developed complete heart block during pulmonary artery catheterization. There was no incidence of pulmonary artery rupture associated with the use of PAC. There was a 9.6 percent incidence of PAC colonization, which was seen on culture of catheter tip. This investigation revealed a low incidence of morbidity associated with the use of PAC

Early experience with the two patch technique for complete atrioventricular septal defect.

A total of 12 cases underwent repair of complete atrioventricular (AV) septal defect utilising the two-patch technique. There were 4 males and 8 females. The mean age at repair was 9.6 months (range, 3 to 49 months). The average weight was 5.4 kg (range, 3.5 to 13 kg). Five had associated patent ductus arteriosus. A Gore-Tex patch and glutaraldehyde preserved pericardium was utilised for the ventricular and atrial portions of the defects respectively in all patients. Four of these were done under hypothermic circulatory arrest. There were no intra-operative deaths. Early mortality comprised of 2 patients (2/12, 16.6%). One due to a pulmonary hypertensive crisis and the other to septicemia. The mean duration of ventilatory support was 62 hours (range, 24 to 192 hours). The mean duration of inotropic support was 57 hours (range, 24 to 192 hours). Primary repair of AV septal defects using the two-path of technique can be accomplished with a low early mortality in carefully selected patients.

Early experience in the surgical treatment of the univentricular heart.

Eighteen patients under went surgical treatment of univentricular hearts between April 1989 till October 1992. All 18 had palliative operations in the form of: a modified Blalock-Taussig shunt (5), pulmonary artery banding (2), bidirectional Glenn shunts (2), conventional Fontan repair (1) and total cavo pulmonary connection (8). There were 11 males and 7 females. The mean age at operation was 4.5 years (range, 1 month to 24 years). The average weight at operation was 12.2 kg (range 2 to 43 kg). Associated anomalies included: transposition of the great arteries (4), pulmonary stenosis (9), pulmonary atresia (1), mitral atresia (1), atrioventricular septal defect (1) and patent ductus arteriosus (3). There were no intra operative deaths. There were 5 early deaths (27.7%). Causes of death were due to: blockage of a modified Blalock-Taussig shunt (1), respiratory failure (1), persistent ventricular arrhythmias (1) and low output syndrome (2). Treatment in the form of a systemic to pulmonary arterial shunt or an operation based on the Fontan principle may offer an initial palliative or definitive correction for this condition.

Total cavopulmonary connection--early results.

Presently total cavopulmonary connection is used as an alternative in complex congenital disorders requiring atriopulmonary connection. From January 1989 till November, 1992, a total of 18 cases underwent total cavopulmonary connection. There were 8 males and 10 females. The mean age at operation was 92 months (range 5 to 504 months). The average weight was 19.6 kg (range 5.25 to 42 kg). Diagnoses included: tricuspid atresia (6); univentricular heart (7); pulmonary atresia with intact interventricular septum (1); double outlet right ventricle, pulmonary stenosis with uncommitted ventricular septal defect (2); corrected transposition of the great arteries with multiple ventricular septal defects (1) and complete atrioventricular septal defect with double outlet right ventricle (1). The mean duration of ventilatory and inotropic support was 127 hours (range 12 to 528 hours) and 140 hours (range 24 to 528 hours) respectively. The average duration of hospital stay was 17.9 days (range 5 to 30 days). There was no intra-operative mortality. Early mortality was 22.2% (4/18). Pre-operative diagnoses of patients who died were: tricuspid atresia (1), univentricular heart (1), complete atrio-ventricular septal defect with double outlet right ventricle (1) and double outlet right ventricle, pulmonary stenosis with uncommitted ventricular septal defect (1). The causes of death were: low-output syndrome (3) and septicemia (1). Although these initial results with total cavopulmonary connection suggest a lower early mortality compared to other modifications of the Fontan principle, long-term follow-up would be necessary to assess the late implications of this procedure.

Thermocardiography of myocardial ischaemia

Thermography is as actively developing science which appears highly suitable for the examination of the heart, 314 patients complaining of dyspnoea, easy fatigability and precardial pain on effort were examined both before and after effort by an 18 leads ECG and thermophil readings. A thermophil M 202 ULTRAKUST production was used. In this work the effect of age appeared little when comparing every age group with the preceding or the following group. On the contrary the sex difference appeared dominant and necessitated the discussion of male and female findings separately. Generally normal men has the cardiac temperature curve negative at V3 position. Normal females has the cardiac temperature curve positive with increased upwards convexity maximum of V4 position, mainly above the age of 30 years. In the age group 40-49 years, the two curves tend to meet at both ends but the right end tend to separate above the age of 50 years. Below the age of 30 years, the two curves have a similar appearance [convex downwards] but the female curve lied far to the positive half. In cases of old anterior infarcts, males and females were warmer than normals [Significant in females; P 0.05]. In cases of old posterior infarcts they were cookr than normals. In case of current anterior and posterior ischaemias in males they were warmer while in females they were cooler than normals. The highest significance of thermocrdiography as a screening test appears to be in latent myocardial ischaemia, females showed warmer curves at rest while males developed significant cooling after effort [P 0.01]. if the confidence limits around the mean in normal males and females could be calculated, ischaemic people could be differentiated from on the bases of the normal curve functions established from normals. Calculation of the mean thermal points [MTP] and the total thermal quantities [TTQ] and the confidence limits in normal people can allow easy detection of ischaemics. Thermocardiography is an easy, reliable, very cheap successful screening test in studies of myocardial ischaemias which can substitute the more costly ECG studies, reserving them for confirmation of suspected cased cases