Frequency of group d streptococci isolated from UTI cases among hospitalized patients and their antibiotic sensitivity pattern

Objective: To determine the frequency and antibiotic susceptibility pattern of Enterococci obtained from UTI patients

Methods: A total of 2653 urine samples have been received for culture and sensitivity during the study period, 1387 were culture positive and 117 urine specimens have recovered Enterococci. The repeated urine cultures recovering Enterococci from the same patient and with mix growth were excluded from the study. The patients were asked to wash the perineal area with clean tap water. Females patients were instructed to apart the labia majora and minora to wash the area before collecting sample to avoid vaginal contamination.. Sterile plastic, wide mouthed containers were used to collect early morning, clean catch, mid-stream urine samples, and the samples were processed as soon as possible within 30 min. In case of delay, the samples were refrigerated. The urine samples were inoculated on Cysteine Lactose Electrolyte Deficient [CLED] media [Oxoid, England] and incubated at 37 degree C for 24 hours. Bacterial growth was taken significant as per count [single species count > 105 organisms]. The growth appeared was identified by colonial morphology, Grams Staining, Catalase Test, Bile Esculin test and growth in nutrient broth with 6.5 % NaCl. The antibiotic sensitivity pattern was determined by modified Kirby Bauer disc diffusion method

Results: The eighty six [73.50%] samples showed salt tolerance as growth appeared and turned out as Group D Enterococci whereas 31 [26.50%] did not show salt tolerance as no growth was observed and labelled as group D non Enterococci. The antibiotic sensitivity of the Group D Enterococci by Kirby bauer disk diffusion mehod with Penicillin 81[82.65%], Ampicillin 73[74.49%], Gentamicin 61[62.24%], Vancomycin 90 [91.84%], Linezolid 98[100%], Ciprofloxacin and Levofloxacin 55 [56.12%] and 57 [58.16%], Nitrofurantoin and Fosfomycin is 42 [42.86%] and 34 [34.69%]. While antibiotic sensitivity of Group D non Enterococci with Penicillin 18[68.71%], Ampicillin 9[47.36%], Gentamicin 10[52.63%], Vancomycin 19 [100%], Linezolid 19 [100%], Ciprofloxacin and Levofloxacin is 9 [47.36%] and 9 [47.36%], Nitrofurantoin and Fosfomycin is 11 [57.89%] and 14 [73.68%]

Conclusion: The frequency of the Group D Enterococci is 86 [73.50%] while that of Group D non Enterococci is 31 [26.50%]. The Enterococci are most susceptible to Linezolid, Vancomycin, Penicillin, Ampicillin, Nitrofurantoin, Levofloxacin, Ciprofloxacin, Gentamicin and Fosfomycin in descending order while the non Enterococci are most susceptible to Linezolid, Vancomycin, Fosfomycin, Penicillin, Nitrofurantoin, Gentamicin, Ciprofloxacin and Levofloxacin in descending order

Assessment of socio demographic and environmental factors predisposing to tuberculosis in Lahore, Pakistan

Objective: to understand various predisposing factors for tuberculosis infection that help to prioritize tuberculosis research and intervention among the most vulnerable persons in our population

Methods: it was cross sectional study which was conducted in Lahore .The duration was from December 2013 to May 2015. A total of 129 cases of tuberculosis were included in the study

Results: questionnaire was completed for 129 tuberculosis subjects. 65 patients [51.39%] were male and 64 [49.61%] female, among the total number of subjects, Diabetes was the most common illness among chronic diseases. Smoking was the most common addiction and all smokers were male

Conclusion: there are multiple environmental and host related factors, present in tuberculosis patients in Lahore. A proper understanding of their risk factors will contribute in appropriate disease management

Pseudomyxoma peritonei: a review of 17 cases

To evaluate the various presentations, causes and management of Pseudomyxoma Peritonei [PMP], and to create awareness among young surgeons regarding its importance. Retrospective study from Jan. 1999 to Dec. 2005. Surgical Unit of Khyber Teaching Hospital, Peshawar and Gynaecology and Obstetrics Unit, Hayatabad Medical Complex, Peshawar. All patients who had Pseudomyxoma Peritonei during the study period. The clinical records of all patients undergoing laparotomy for various causes were reviewed and cases of PMP separated. Their biodata, clinical presentation, clinical diagnosis, investigation results, operative findings, histopathology report and outcome were recorded. Out of 23,573 cases that underwent laparotomy 17 cases of PMP were on record. All were diagnosed incidentally per-operatively. Most [47.05%] cases were seen in the age group of 30-40 years and 58.82% patients were females. Abdominal pain, mass, abdominal distension and intestinal obstruction were the common presenting features. Ultrasound and CT scan reported three cases as ovarian cysts, three as multiple encysted fluid collections with thin cyst walls, two as ascites, two as ascites with peritoneal thickening, but none as PMP. Surgery was the mainstay of treatment. Appendicectomy with clearing of mucin in 11[64.70%], oophorechtomy and appendicectomy in 3[17.64%], bilateral oophorechtomy and hysterectomy in 2[11.76%], right hemi-colectomy in 1[5.88%] and second look surgery for complications were done in 2[11.76%] cases. Mortality was 11.76% and due to complication including one due to intestinal obstruction and another due to septicemia following second look surgery. Histopathological tissue diagnosis was available in only 13 cases and included mucinous adenoma appendix in five, mucinous cystadenoma ovary in three, mucinous epithelial cells of unknown origin in four and mucinous cystadenoma of borderline malignancy in one case. PMP is under reported in our setup. Pre-operative diagnosis is difficult and incidental findings usually go unnoticed due to lack of awareness and standard management protocol. There is a need to create awareness among surgeons, radiologists, pathologist and oncologist regarding this condition for the better outcome

Application of fibrin glue in maintaining post operative haemostasis in a thrombocytopenic patient: a novel approach case report

Here we report a case of chronic refractory autoimmune thrombocytopenic purpura [ITP] who presented with severe persistent thrombocytopenia, 3 months history of incisional hernia with aggravating symptoms. Considering the potential danger of acute obstruction, with its disastrous consequences, surgery was performed under cover of fibrin glue and hernia was repaired without any excess post operative bleeding