Isolation and identification of multidrug-resistant Escherichia coli from cattle, sheep, poultry and human in Cumilla, Bangladesh

Aims@#Antimicrobial resistance (AMR) is a significant public health concern of modern civilization. The potential risk of AMR is significant in terms of both human and animal health. This study aims to assess the antimicrobial resistance pattern of selected antimicrobials against Escherichia coli of animal, poultry and human origin in the Cumilla district of Bangladesh.@*Methodology and results@#A total of 200 samples were collected from different sources. Isolation and identification of commensal E. coli were performed following standard bacteriological and molecular techniques. Antimicrobial susceptibility testing was performed following the Kirby-Bauer disc diffusion technique. Ampicillin, tetracycline and sulfamethoxazole-trimethoprim resistance genes were detected by polymerase chain reactions (PCR). A total of 152 (76%; 95% confidence interval (CI) 70-81%) E. coli were isolated from cattle, sheep, chicken and human, where 37.5% of isolates were found to be multidrug-resistant (MDR). In the cultural sensitivity test, E. coli showed the highest resistance to sulfamethoxazole-trimethoprim (71%), tetracycline (63%), ampicillin (62%), where gentamicin (23%) showed the lowest resistance, followed by ceftriaxone (26%). The prevalence of resistance genes like blaTEM, tetA, tetB, tetC, sul1 and sul2 were 100%, 95%, 11%, 8%, 58% and 52%, respectively.@*Conclusion, significance and impact of study@#The emergence of multidrug-resistant commensal E. coli and resistance genes circulating in animals, poultry and humans limit the treatment options for serious infections.

A rare case of colonic perforation presenting as Fournier’s gangrene

A 48-year-old obese gentleman with mild pain over abdomen for 10 days followed by pain and swelling in the right side of scrotum with skin discolouration for 2 days. Clinically necrotic patch with pus discharge was noted on the right side of scrotum. Extensive debridement over scrotum was done following which inflamed omentum and fecal contents were noticed from the inguinal canal. Patient underwent laparotomy and an ascending colonic perforation was found. A loop colostomy with partial omentectomy and inguinal hernia repair along with serial debridement of scrotal wound was done. Although uncommon, gastrointestinal perforations should be considered as a potential etiology in Fournier’s gangrene.

Factors that limit access to dental care for person with disabilities

Objective: To assess the perceived barriers to oral health care for persons with disabilities living in Islamabad. Study Design: Cross-sectional study

Place and Duration of Study: Study was conducted at general community organizations in Islamabad providing services to Persons with Disabilities [PWDs] from Jan 2013 to Jun 2013 over a period of 6 months

Material and Methods: A total of 500 persons with disability who were dependent on someone to reach dental facilities were included in the study while those who were not dependent on someone were excluded from the study. A 12-item self-administered questionnaire was used. Patient's demographic data, type of disability and barriers to oral health care were recorded. Finally data was analyzed by using SPSS version 20

Results: Out of 400 respondents the most common disability was physical impairment [33.25%] followed by visual impairment [20.75%] and polio [14.75%]. The major barriers to oral health care were transportation difficulty [48%] followed by high cost of dental treatment [39.5%] and inability to sit on dental chair /co-operate with dentist [31.25%]

Conclusion: Significant barriers exist that limit the access to dental care for Person with Disabilities [PWDs]

Perceived causes of stress among dental undergraduates at army medical college, Rawalpindi

The aim of this study was to evaluate the perceived causes of stress among dental undergraduates studying at Army Medical College, Rawalpindi. Evaluation of student's perception will be helpful in taking measures to improve the academic performance and psycho-social well-being. Modified Dental Environment Stress [DES] questionnaire was distributed among the dental undergraduates during the middle of academic year 2013-2014. The students were included in the study on voluntary basis, 195 questionnaires were distributed and 164 were returned [84% response rate]. The questionnaire was analyzed using SPSS-15. The Mann-Whitney test and Kruskal-Walis test were applied. The level of significance was set at p<0.05. The most common stressor among the 1[st], 3[rd] and final year students was the fear of failing the professional exams [mean and SD were 2.82/1.18, 2.63/1.00, 2.95/0.96 respectively] where as the overloaded feeling due to huge syllabus was the highest stressor among the 2[nd] year students [mean and SD were 3.02/0.96]. Comparing the gender with the stress perception revealed that the 3 most bigger stressor among the female undergraduate students were fear of failing the course, overloaded feeling due to huge syllabus and the fear of dealing with patients who do not disclose contagious disease, where as the male undergraduate students found the overloaded feeling due to huge syllabus as the biggest stressor followed by fear of failing the course and lack of time to do the assigned task. The findings of this study suggest that academic and clinical workloads are the primary sources of stress among the Dental undergraduates at Army Medical College. Dental educators can encourage students to be realistic

Comparison of iron stores in healthy individuals and patients with ischemic heart disease

Excess body iron has been linked to atherosclerosis owing to its pro-oxidative properties. However, inconsistent results have emerged from the epidemiological studies linking iron status and the risk of cardiovascular diseases [CVD]. Objective of the present study is to compare iron stores of healthy individuals and patients with ischaemic heart disease [IHD]. A total of 137 subjects were included in the study, 90 patients of IHD and 47 healthy subjects with no history of IHD as controls. We compared body iron stores of patients and controls. Serum ferritin, serum transferrin receptor [sTfR] and sTfR/ferritin ratio were used as measures of body iron stores. Our results revealed that mean serum ferritin concentration of cases was significantly higher than controls. Moreover, mean sTfR and sTfR/ferritin ratio of controls was significantly higher than the patients. We conclude from our results that IHD patients have higher iron stores than healthy subjects suggesting a possible association between high iron stores and the risk of IHD

Management of parapharyngeal space tumours

To determine the role of clinical features, fine needle aspiration cytology [FNAC] and computed tomography [CT] scan in diagnosing parapharyngeal space [PPS] tumors and treatment options. A descriptive study. From July 2000 to July 2002 at Pakistan Institute of Medical Sciences, Islamabad. Patients diagnosed as having PPS tumors were studied. The medical record of patients was reviewed for their age, gender, clinical features, investigations [FNAC and CT scan] and treatment. The mean age, percentage of different clinical features and the sensitivity and specificity of FNAC was determined. The mean age of patients presenting with PPS tumours was 33.6 years. The most common clinical features were neck mass [93%] and bulge in lateral pharyngeal wall [80%]. The CT scan showed exact location and extent of tumour in 11 out of 15 cases. The sensitivity and specificity of FNAC was 70% and 85% respectively. The most common tumours were neurogenic tumours [6] and salivary gland tumours [4]. Surgery was performed in all except 2 patients with lymphoma in whom radiation and chemotherapy was recommended. This study indicates that PPS tumours are usually benign neurogenous and salivary gland tumours presenting with neck mass and bulge in oropharynx. FNAC and CT scan are important in diagnostic work up and treatment planning. Surgery has the best results in most cases

Association of smoking with lymph node metastasis in early stages of squamous cell carcinoma of tongue

To determine the relationship of lymph node metastasis with smoking in T1 and T2 staged squamous cell carcinoma [SCC] of tongue. An analytical study. ENT Department of Pakistan Institute of Medical Sciences, Islamabad, from 1st January 2001 to 31st December 2002. A total of 60 patients of T1 and T2 of SCC of oral tongue were selected. These patients were divided into two groups on the basis of history of smoking. Also these patients were clinically examined for lymph node metastasis and FNAC done for the confirmation of diagnosis. Odds ratio [OR] and p-value were statistically determined to asses the association between lymph node metastasis and smoking. The odds ratio for patients with history of smoking to develop lymph node metastasis was 1.896 but association was statistically insignificant [p = 0.24]. This study indicates that although smoking increases the risk for lymph node metastasis but the association is insignificant in T1 and T2 staged SCC of tongue