Prevalence and antibacterial resistance patterns of extended‑spectrum beta‑lactamase producing Gram‑negative bacteria isolated from ocular infections.

Purpose: Extended‑spectrum beta‑lactamases (ESBLs) mediated resistance is more prevalent worldwide, especially among Gram‑negative bacterial isolates, conferring resistance to the expanded spectrum cephalosporins. As limited data were available on the prevalence of ESBLs in this area, the current study was undertaken to determine the prevalence, antibacterial resistance patterns, and molecular detection and characterization of ESBL encoding resistance genes among ocular Gram‑negative bacterial isolates from ocular infections. Materials and Methods: A prospective study was done on 252 ocular Gram‑negative bacterial isolates recovered from ocular infections during a study period from February 2011 to January 2014. All isolates were subjected to detection of ESBLs by cephalosporin/clavulanate combination disc test and their antibacterial resistance pattern was studied. Molecular detection and characterization of ESBL encoding blaTEM‑, blaSHV, blaOXA‑, and blaCTX‑M (phylogenetic groups 1, 2, 9, and 8/25) resistance genes by multiplex polymerase chain reaction and DNA sequence analysis. Results: Of all Gram‑negative bacteria, Pseudomonas aeruginosa (44%) was the most common strain, followed by Enterobacter agglomerans and Klebsiella pneumoniae each (10%). Among the 252, 42 (17%) were ESBL producers. The major source of ESBL producers were corneal scraping specimens, highest ESBL production was observed in P. aeruginosa 16 (38%) and Escherichia coli 7 (16.6%). Among ESBL‑producing genes, the prevalence of blaTEM‑gene was the highest (83%) followed by blaOXA‑gene (35%), blaSHV‑gene (18.5%), and blaCTX‑M‑1‑gene (18.5%) alone or together. Conclusion: The higher rate of prevalence of ESBLs‑encoding genes among ocular Gram‑negative bacteria is of great concern, as it causes limitation to therapeutic options. This regional knowledge will help in guiding appropriate antibiotic use which is highly warranted.

Estimation of high sensitivity C‑reactive protein in patients with periodontal disease and without coronary artery disease.

Background: HsCRP (Highly sensitive C reactive protein) is a global indicator for future vascular events in adults detected in blood stream 48 hours before the cardiovascular event. Periodontal disease may increase blood levels of inflammatory markers like IL-6, CRP and HsCRP. Hence the aim of the present study is to evaluate the presence of elevated HsCRP levels in chronic periodontitis patients. Material and Methods: 100 patients who reported for cardiac master health check up were enrolled in the study. The periodontal status was assessed using periodontal probing pocket depth and clinical attachment level. The decayed, missing and filled tooth was recorded using DMFT index. The venous samples of these patients were obtained for recording HsCRP levels. Results: Pearson correlation was used to analyze the relationship between HsCRP level and probing pocket depth, clinical attachment loss and DMFT. The correlation value was 0.051, 0.025 and 0.101 respectively, the correlation is statistically significant for probing pocket depth and clinical attachment level (P>0.05). Chi- square test was performed to study the association between gender and HsCRP, Diabetes Mellitus and HsCRP and Hypertension and HsCRP; the results showed that there is no significant association between any of the above mentioned factors and HsCRP level in blood. Conclusions: We found an increased level of HsCRP in patients with chronic periodontitis which revealed the susceptibility of these patients to cardiac diseases like myocardial infarction and stroke. Hence present day focus in the line of management of cardiac patient has changed from the periodontal perspective.

Presence of Large Bilobed Thymus In Adult Male Cadaver.

Introduction: Thymus is an asymmetrical bilobed mass of lymphoid tissue.It is the most important component of superior medistinum. Embryologically it develops as a bilobed structure from the third pharyngeal pouches of embryo in common with inferior parathyroid gland. It is clinically important for differential diagnosis of radiological review of mediastinal mass. Its persistence in adults, its embryological and anatomical features are necessary before doing any invasive procedures. Materials And Methods:The study was carried out on six embalmed formalin fixed cadavers of known age and sex in Anatomy Department of Kanyakumari Government Medical College, Nagercoil, Tamilnadu. A large bilobed thymus was found in a 40 year old male cadaver. Result And Conclusion: Thus we found a large bilobed thymus in 40 year old male cadaver.This fact is clinically important for radiologist to make differential diagnosis in case of mediastinal mass.A thorough knowledge of embryology and anatomy of the thymus,normal variations and ectopic location of thymus and its dynamic changes is neccesary before doing any therapeutic,diagnostic and invasive procedures.

Anomalous Origin of Left Vertebral Artery Arising from the Arch of Aorta and Its Embryological Basis.

Background and Aim: Arterial disarrangements within the thorax are common and assume many diverse forms. The anatomic and morphologic variation of the origin and course of the prevertebral segment of the vertebral artery is necessary for vascular radiology, planning of aortic arch surgery or endovascular interventions. The present study is aimed at finding the origin and course of the left vertebral artery from the arch of aorta between left common carotid and left subclavian arteries. Materials and Methods: Present study was done on six formalin fixed cadavers during routine dissection allotted for the first year students of Kanyakumari Government Medical College Asaripallam, Nagercoil. The direct dissection method was used. A comparative analysis was done with previous studies. Result: Usually the vertebral artery arises from supero-posterior aspect of the first part of the subclavian artery. But in a 60 yrs old adult female cadaver showed a variation, that the arch of aorta gave off four branches in which the left vertebral artery arose as 3rd branch between the left common carotid and left subclavian arteries. Conclusion: Variation observed in the study is in par with variation observed in previous studies. The knowledge about the variant origin of left vertebral artery is necessary for interventional radiologists and surgeons to avoid complications in the head and neck region.

Analysis of the Height of Origin of Profunda Femoris Artery from the Femoral Artery with regards to the Inguinal Ligament.

Background and aims: To determine the place of height of origin of profunda femoris artery from the femoral artery with regards to the inguinal ligament. Materials and methods: Routine dissection of 6 formalin fixed cadavers (3 males and 3 females) on both lower limbs (totally 12 lower limbs) allotted for the first year students of Kanyakumari Government Medical College, Aasaripallam, Nagercoil. Result: Among them an unusual origin of profunda femoris artery was observed on the left lower limb in a 60 years old female cadaver (8.33%). The profunda femoris artery arose laterally about 0.5 cms from the femoral artery distal to the inguinal ligament. It arose normally on the right lower limb(3.5 cms from the inguinal ligament). Conclusion: A variance in height of origin of profunda femoris artery and its branches will cause changing in the calibers strongly influencing vascularisation quality of belonging flaps. In occlusion of the superficial femoral artery, the profunda femoris artery forms an effective collateral bed between iliofemoral segment and the popliteal artery and its branches. Percutaneous femoral artery cannulation can cause pseudo aneurysms. When this occurs the puncture site is frequently in the profunda femoris artery, where anatomic relationships make hemostasis difficult to achieve. These complications landed up in the study of relations of these arterial complications in the palpable landmarks.

Responses of aging brain to physical exercise: changes in the substrates of energy metabolism.

Responses of aging brain to physical training was evaluated by quantifying the substrates, glucose, lactic acid, and nucleic acids in cerebral cortex (CC) and medulla oblongata (MO) of the brain in rats. Rats of 1 month (young), 6 months (adult), 12 months (middle-aged) and 18 months (old) of age were swim-trained for 30 days. Glucose content of CC and MO increased with training whereas blood glucose decreased in trained young and adult animals with middle-aged and old animals maintaining constant blood glucose. Brain lactate in these two regions decreased with training in all age groups. However, the old animals showed an elevation in blood lactic acid in trained state, while the other age groups showed a decrease. Nucleic acid content, decreased with age, especially the RNA content in MO showing a larger depletion. However, there was no discernible influence of physical exercise on these parameters. Physical training has influenced the aging brain's adaptability, as seen by increase in its glucose content in young animals and also possible utilization of lactate as an additional substrate in old animals as evidenced by an increase in blood lactic acid.