Detection and characterization of Streptococcus downei, a rare bacterial species of mutans streptococci from caries-active patients

Background: The oral bacteria, mutans streptococci (MS), are an etiological agent of dental caries. Of MS, Streptococcus downei are rarely isolated bacteria. Aim: The aim of this study was to isolate and characterize S. downei from caries-active subjects. Materials and Methods: In all, 65 dental plaque samples were collected from dental caries-active subjects. All the isolates were further identified and characterized using 16S rDNA sequencing, biochemical tests, antibiogram, and minimum inhibitory concentration (MIC). Results: Five isolates have been identified as S. downei using 16S rDNA sequencing. Phylogenetic analysis showed that S. downei was closely related to S. sobrinus. The biotype traits of these five isolates were IV (n = 3), V (n = 1), and variants (n = 2). The study proposed one new biotype, classified as biotype VIII for the variant strain. The antibiogram tests revealed that all the strains of S. downei were susceptible to all the antibiotics used in the study with higher sensitivity to penicillin and ampicillin. The MIC of ampicillin and erythromycin against S. downei was 0.047 and 0.39 μg/mL, respectively. Conclusion: The study reports the prevalence of S. downei in caries-active subjects and recommends further investigations to determine its role in the disease.

Squint publication in ophithalmic journals from Pakistan: a10 years of literature

Objective: to analyze the publication rate of squint, the most frequent study design used, nature of published articles and yearly breakdown of articles in two ophthalmic journals of Pakistan from 2006-2015

Methods: all editorial, original articles, review articles, case reports published and available on the website of Pakistan Journal of Ophthalmology, Al-Shifa journal of Ophthalmology from 2006 to 2015 was analyzed to determine the publication rate of squint and study design used in different articles

Results: overwhelmingly four hundred and twenty seven [427] original articles published. Eighty six [86] case reports, fifty five [55] editorials, and no review article published on squint. Nine original articles [n= 9] 2.1 %, one case report [n=1]1.2%, one editorial [n=1] 1.8% published on squint. In five different studies prospective study design was used, cross sectional, retrospective, case and control used in three different studies

Conclusion: these findings revealed that publications on squint are less prevalent. Most frequent study design used in published articles on squint was prospective and the nature of articles mostly described the surgical aspects of squint

Idiopathic pulmonary fibrosis in Saudi Arabia: Demographic, clinical, and survival data from two tertiary care hospitals

Idiopathic pulmonary fibrosis [IPF] is rare and can be challenging to diagnose. Limited data is available from the Middle Eastern region, especially Saudi Arabia. This was a retrospective study that looked at all the patients diagnosed with IPF between 2007 and 2012 at two tertiary care hospitals in Saudi Arabia. We collected the demographical, clinical, laboratory and radiological data from the patients' medical records. Medications administered and 1 year survival was also assessed. Between 2007and 2012, 134 IPF patients were identified. Their baseline characteristics [Mean +/- SD] included: age 64 +/- 13 years, body mass index 29 +/- 8 kg/m 2, FEV 1 56 +/- 15 percent of predicted, FVC 53 +/- 13 percent of predicted, FEV 1 /FVC 0.81 +/- 0.09, total lung capacity 75 +/- 13 percent of predicted, diffusing capacity of the lung for carbon monoxide 57 +/- 15 percent of predicted, on home oxygen at presentation 71 [53%], mean ejection fraction 0.50 +/- 0.07, mean pulmonary artery systolic pressure [via echocardiogram] 40 + 22 mmHg, presentation mean S pO2 92 +/- 7%, presentation 6-min walk distance 338 +/- 64 m and lowest S pO2 during 6-min walk test 88 +/- 5%. Patients were predominantly female [56%], and 42% of patients had diabetes and were active smokers. The IPF patients' frequency of hospital admission [n = 99] was 2.4 +/- 1.7 per year and duration of hospital stay [n = 99] was 17.4 +/- 23.8 days. Overall 1 year survival in all IPF patients was good, 93% [124] patients remained alive after 1 year. In Saudi Arabia, IPF patients tended to be slightly older and the disease progression was somewhat slower than reported IPF cohorts in other populations. They had frequent hospital admissions and a long hospital length of stay. The influence of genetics and co-morbid diseases on the incidence and outcome of IPF should be explored further

Novel influenza A [HINI] virus-induced hemophagocytosis: first case reported in Saudi Arabia

H1N1 is a novel subtype of the influenza A virus. Since its reemergence in 2008, it has been reported to cause a variety of illnesses ranging from mild flu-like symptoms to severe multiorgan failure. We report a case of a young immunocompetent man who presented with progressive shortness of breath and rapidly developed multiorgan dysfunction, including pancytopenia from H1N1 infection during the 2010-2011 influenza season. His H1N1 pneumonia caused severe acute respiratory distress syndrome, respiratory failure requiring mechanical ventilation, rhabdomyolysis, myocarditis, hepatitis, encephalitis, and renal failure. During the diagnostic workup, a bone marrow biopsy was performed, showing hemophagocytosis secondary to the H1N1 infection. Unfortunately the patient died despite aggressive measures. Published reports contain only a few records of H1N1-induced hemophagocytosis. This is the first case report from Saudi Arabia with H1N1-induced secondary hemophagocytosis. It also highlights the fact that the virus is still very virulent and will pose a major annual health risk along with the seasonal influenza for at least the next few years

High frequency of hand foot syndrome with capecitabine

A hospital based cross-sectional retrospective study was conducted to determine the frequency of hand foot syndrome [HFS] with Capecitabine as a single agent and in combination with Oxaliplatin. The study included 43 consecutive cases of colorectal carcinoma and conducted from June till December 2008. Patients on palliative care were excluded. SPSS was used for the application of chi-square test, by keeping the level of significance as p<0.05. Fifteen [34.9%] patients developed HFS, 10 in the single-agent and 5 in the combination group. No significant association of HFS with either regimens was noted [p=0.876]

Association of carcinoma breast: grade and estrogen progesterone receptor expression

To determine the association between histological grade of tumour and estrogen progesterone receptors [ER/PR] expression in unselected invasive carcinoma of breast in Malaysian patients. An observational study. Advanced Medical and Dental Institute and Hospital, Kepala Batas, from year 2002 to 2007. Ethical approval from Ministry of Health of Malaysia was obtained. Retrospective case records of patients presented between 2002- 2007 were reviewed for obtaining information on grade of tumour and expression of ER/PR in unselected carcinoma of breast patients. Records with missing data were discarded. Out of 195 cases evaluated, 42 cases of grade-l tumour were recorded of which 08 [19%] tested positive for ER and 34 [81%] tested negative, 86 cases represented grade-ll tumour of which 33 [38%] tested positive for ER and 53 [62%] were negative for ER, while out of 67 grade-Ill tumours 22 [33%] were positive for ER receptors while 45 [67%] were negative, [chi[2] statistic [df] 4.831, p=0.089]. For PR, 192 cases were evaluated and data was missing for 3 cases on PR status. Grade-l tumour consisted of 39 cases of which PR +ve represented 07 [17.94%] and 32 [82.05] cases PR -ve; 86 cases were of grade-ll of which 31 [36.04%] were PR +ve and 55 [63.95%] PR -ve. Sixty seven cases of grade-Ill tumour of which 19 [28.35%] were PR +ve and 48 [71.64] were PR -ve [chi[2] statistic [df]: 4.297; p=0.117]. ER/PR positivity trend was highest for grade-ll tumours compared to grade-l and grade-l 11 tumours. In general ER positivity was more with grade-ll and grade-Ill tumours compared to grade I tumours. Although results did not reach statistical significance but there was a trend towards ER/PR positivity in grade-ll and III tumours. So far, studies from South East Asia reported ER/PR expression more with low grade tumours

Age specific histologic types of carcinoma breast in Malaysians

The influence of age on various histological types of breast cancer at both age < 50 years and > 50 years to simulate menopause was studied retrospective from 2002 to 2004 in Malaysia. One hundred and fifty five cases were reviewed. Ninety two cases recorded at age < 50 years, 60 [65.2%, 95%CI: 54.6 - 74.8%] were infiltrating ductal carcinoma in 11[12.0%, 95% CI: 6.1-20.4%], ductal carcinoma in situ [DCIS] in 9 [9.8%, 95% CI: 4.6-17.8%], medullary carcinoma in 6 [6.5%, 85%CI: 2.4-13.6%], invasive lobular carcinoma in 4 [4.3%, 95%CI: 1.2-10.8%], mucinous carcinoma and poorly differentiated carcinoma in 2 cases [2.2%, 95%CI: 0.3-7.6%]. At > 50 years of age, 63 cases were recorded. Forty seven [74.6%, 95%CI: 62.0- 84.7%] cases were of infiltrating ductal carcinoma, ductal carcinoma in situ in 9 [14.3%, 95%CI: 6.7-25.4%], mucinous carcinoma in 5 [7.9%, 95%CI: 2.6-17.6%], medullary carcinoma [8.5%] and papillary carcinoma in 1 case each [1.6%, 95%CI: 0.0-8.5%]. Infiltrating ductal carcinoma was the commonest histology at both age < 50 years and > 50 years