ABSTRACT
Background: Orthopedic infections by methicillin-resistant Staphylococcus aureus (MRSA) are becoming more frequent afterdevice implantation, and often resistant to many commonly used antibiotics. The new line of antibiotics such as vancomycin,meropenem, and teicoplanin is being used for the treatment of such infections intravenously. However, these antibiotics canalso be used along with bone cement as a local antibiotic spacer.Aims: The aim of the study was to compare in vitro antibacterial activity of vancomycin and teicoplanin and to know the optimumconcentration of teicoplanin at which there is maximum inhibition of bacteria.Materials and Methods: Three different brands of bone cement discs (Palacos-R + G, surgical Simplex P, and CMW1) withvancomycin and teicoplanin of different concentration used. Inoculating media with bacterial isolates of Staphylococcus aureus(Methicillin-resistant) of strain ATCC 2593 with known minimum inhibitory concentration were used. In each media two discs ofone formulation were placed and labeled accordingly. Readings were taken at 24 h, 48 h, and 6 days.Results: All the cement brands eluted vancomycin equally well, but the zone of inhibition for palacos was marginally highercompared to the other two. Teicoplanin when increased from 400 mg to 1200 mg concentration showed a dose-dependentinhibition of MRSA with an increase in the zone of inhibition in all cements, with palacos being highest.Conclusion: Teicoplanin in higher concentration is a better alternative to vancomycin in MRSA bone infection.
ABSTRACT
Background: Fine-needle aspiration cytology (FNAC) is an established, highly accurate, and cost-effective method for diagnosinglesions in different organs including the breast. The method is minimally invasive without unwanted side effects. At present,accurate diagnosis of breast lesions depends on a triple assessment approach that is combined clinical, radiological, andpathological diagnosis. FNAC is widely adopted for pathological diagnosis of different types of the breast lesions. In developingcountries, like India, malignant causes as well as non-malignant causes are the most common causes of breast lump. FNACproves to be a valuable tool in diagnosing these cases.Aims: This study intended to look the frequencies and various cytomorphological presentations of different lesions on FNACof breast lump.Materials and Methods: In a study period of January 2015–December 2017, in the Pathology Department, GMERS MedicalCollege, Ahmedabad, 430 patients of breast lesions for FNAC came. Those were subjected to cytological evaluation withhematoxylin and eosin, Giemsa, Papanicolaou, and Ziehl–Neelsen stained smears. We assessed the age of the patients, lesionsize, site, type of lesion, and axillary lymph node metastasis in case of malignancies. In addition, the ultrasonography/mammographyof these patients with the clinical presentation was also studied.Results: Age ranges from 13 to 100 years with a mean age of 38 years. Among the lesions, 31.86% fibroadenoma, 23.02%malignant lesions, 11.81% fibrocystic changes, and 20.23% inflammatory lesions were identified. Mean lesion size was3.37 ± 2.08 cm. 12 (12.12%) of malignant lesion cases showed metastasis in axillary lymph nodes.Conclusion: FNAC serves as a safe, rapid, economical, requiring minimal instrumentation, and highly sensitive tool forthe diagnosis of different kind of the breast lesions and ductal carcinoma. The cytomorphological examination of theselesions before operation or treatment serves as an important diagnostic modality. The sensitivity can be further increased bycomplementing with radiological and clinical findings.