Methicillin-resistant Staphylococcus aureus intracranial abscess: An analytical series and review on molecular, surgical and medical aspects

Purpose: Intracranial abscess caused by methicillin-resistant Staphylococcus aureus (MRSA) is rare and unexplored. The aim of the present study is to examine the prevalence, clinical and molecular characteristics, treatment options and outcome of MRSA intracranial abscess over a period of 6 years. Patientsand Methods: A total of 21 patients were included in this retrospective study. The demographic and clinical details of all the patients were collected. Molecular typing including staphylococcal cassette chromosome mec typing, spa typing and polymerase chain reaction of Panton–Valentine leucocidin toxin (PVL) gene for the latter 6 isolates was performed. Results: The paediatric population was the most affected group (33.3%). The primary route of infection was post-operative/trauma in 7 (33.3%) cases. All the patients were treated surgically either by aspiration or excision. Fifteen (71%) patients received anti-MRSA treatment with vancomycin or linezolid, where linezolid-treated patients showed better prognosis. Of the 11 patients who were on follow-up, unfavourable outcome was observed in 3 (27.3%) cases and 8 (72.7%) cases improved. The molecular typing of six isolates revealed four community-associated (CA) MRSA, one each of livestock-associated (LA) and healthcare-associated MRSA with PVL gene noted in all. Conclusion: We propose that timely diagnosis, surgical intervention and appropriate anti-MRSA treatment would contribute to better outcome. The occurrence of CA-MRSA and LA-MRSA infection in the central nervous system signifies the threat from the community and livestock reservoir, thus drawing attention towards surveillance and tracking to understand the epidemiology and implement infection control measures.

Direct Multiple Shoot Induction and Plantlet Regeneration from Cotyledonary Explants of Sapindus emarginatus Vahl (Soapnut).

germination of S. emarginatus in vitro cotyledon explants in BAP/Kn/TDZ (1.0-3.0 mg/L) supplemented MS medium and (2) in plant treatment with BAP/Kn/TDZ (3.0 mg/ L) in combination of 1AA (0.5 mg/L) of the cotyledon explants of plants and maintained under sterile conditions. While the former method resulted in as many as (7.5±8.6 shoot buds) from the cotyledonary explants within four weeks, the latter yielded on average approximately 8 shoot buds from each treated node in eight weeks. The cytokinin treatment in plant consisted of placing sterile filter paper moistened with sterile distilled water over the node and adding different concentrations of 6- benzylaminopurine. The best results for shoot bud regeneration were obtained with cotyledons, when cultured in the presence of (0.5 mg/L) IAA in combination with (3.0 mg/L). The shoots elongated and rooted directly in vermiculite after a pulse treatment with IBA (2.5 mg/L) for 15 min. Fungus growth, a serious problem in S. emarginatus tissue culture, was controlled using a fungicide, Bavistin, along with elimination of organic nutrients from the growth medium.

Seed germination studies on solanum melongena L. under salt stress.

The present work has been conducted on the effect of different concentrations of sodium chloride ranging from 25mg – 100mg of NaCl. The maximum germination percentage has observed at 25mg. beyond this level, the percentage of germination has reduced gradually, in the same way similarly time diffraction has also reduced gradually and 4h duration has shown maximum germination. The shoot and root lengths, fresh and dry weights also increased up to 25mg / in 4h when it is in NaCl and thereafter its gradually reduced.

Comparison of two systems of classification of leprosy based on number of skin lesions and number of body areas involved--a clinicopathological concordance study.

BACKGROUND AND AIMS: WHO guidelines classify leprosy patients for therapeutic purposes into paucibacillary (PB) and multibacillary (MB) leprosy based on the number of skin lesions. An alternative system of classification has been in practice in Nepal from 1985 onwards, based on the number of body areas involved in patients of leprosy. We attempted a clinicopathological approach for comparison of these two systems of classification in leprosy patients for their ability to demarcate patients into groups of PB and MB leprosy. MATERIALS AND METHODS: The study included 108 leprosy patients (80 males and 28 females). Complete clinical examination and body charting was carried out in each patient noting the count of skin lesions and the number of body areas involved. Slit skin smears and skin biopsies were taken from an active skin lesion in all patients. RESULTS: On analysis, it was observed that there was good clinicopathological correlation between patients with 5 or < 5 skin lesions and 2 or < 2 body areas involved. (Clinical 95% and histological 96%) A similar correlation was also observed in the other group of patients with > 5 skin lesions and > 2 body areas involved, (Clinical 94% and histological 96%). There were almost identical numbers of patients represented in these two groups of classification. CONCLUSIONS: Our findings suggest that patients with involvement of 2 or less body areas can be classified as PB leprosy and those with more than 2 body areas involved can be classified as MB leprosy for the purposes of therapy. The study of areas of involvement in leprosy patients not only provides additional patient information but also adds another parameter as a basis for the study of leprosy patients.

Fraser-Cryptophthalmos syndrome with cardiovascular malformations: a rare association.

Fraser-Cryptophthalmos syndrome is a multiple malformation disorder associated variably with cryptophthalmos (hidden eye), anomalies of the head, nose and ears; syndactyly, renal and genital malformations. In this report, we describe a case of Fraser syndrome with cardiovascular malformations: coarctation of aorta, an association not previously described.