Resolution of a cutaneous lesion associated with a periapical actinomycosis following endodontic surgery: a case report

Actinomycosis is a granulomatous infection of the cervicofacial, thoracic, abdominal and cerebral regions. Cervicofacial actinomycosis usually presents as a palpable mass, which is sometimes painfull and may be associated with a draining sinus tract. Periapical actinomycosis is a cervicofacial form of actinomycosis. Periapical actinomycosis is a persisting periapical lesion that usually do not respond to routine endodontic treatment and persists for a long period of time. In this case report, the healing of a cutaneous and periapical lesion associated with acti-nomycosis following routine root canal treatment and periapical surgery is presented

Detection of extended spectrum beta-lactamases in urinary isolates of klebsiella pneumoniae in relation to bla[SHV] bla[TEM] and Bla[CTX-M] gene carriage

Resistance to contemporary broad-spectrum beta-lactam antibiotics mediated by extended-spectrum beta-lactamases [ESBLs] is increasing worldwide. Klebsiella pneumoniae, an important cause of nosocomial and community acquired urinary tract infections has rapidly become the most common ESBL producing organism. We examined ESBL production in urinary isolates of K. pneumoniae in relation to the presence of bla[SHV], bla[TEM] and bla[CTX-M] genes Antibiotic resistance of 51 clinical isolates of K. pneumoniae was determined to amoxicillin, amikacin, ceftazidime, cefotaxime, cefteriaxon, ceftizoxime, gentamicin, ciprofloxacin and nitrofurantoin by disc diffusion. Minimum inhibitory concentrations were also measured for ceftazidime, cefotaxime, cefteriaxon, ceftizoxime and ciprofloxacin. ESBL production was detected by the double disc synergy test and finally, presence of the bla[SHV], bla[TEM] and bla[CTX-M] genes were shown using specific primers and PCR. Disc diffusion results showed that 96.08% of the isolates were resistant to amoxicillin followed by 78.43% resistance to nitrofurantoin, 49.02% to amikacin and ceftazidime, 41.17% to ceftriaxone, 37.25% resistance to cefotaxime and ceftizoxime, and 29.42% to gentamicin and ciprofloxacin. Both resistant and intermediately resistant organisms were resistant in MIC determinations. Twenty two isolates [43.14%] carried bla[SHV], 18 [35.29%] had bla[TEM] and 16 [31.37%] harbored bla[CTX-M] genes. ESBL production was present in 14 isolates [27.45%] of which, 3 did not harbor any of the 3 genes. Among the non- ESBL producers, 9 lacked all 3 genes and 2 carried them all. No relation was found between gene presence and ESBL expression

Hemoglobin D [Hb D Punjab/ Los Angeles and Hb D Iran] and Co-Inheritance with Alpha- and Beta- Thalassemia in southern Iran

Hemoglobin-D [Hb D] is an uncommon structural hemoglobin variant, which is reported to be prevalent in north western India. There are only a few small series, of this entity in the literature. We report the largest single center experience on this entity from Iran. Between November 2002 and December 2010 as a result of screening premaritally for betathalassemia in Shiraz, Fars Province, Southern Iran, column chromatography, Hb electrophoresis, solubility test, and/or high performance liquid chromatography [HPLC], direct sequencing and restriction analysis were used for hemoglobinopathies and structural Hb variants. The data of 220 subjects with Hb D variants are analyzed in this report. These comprised of 180 carries of Hb D; 92 cases of Hb D Punjab/Los Angeles [beta 121[Glutamic acid -> Glutamine]] and 88 subjects with Hb D Iran [beta 22 [Glu- > Gln]], 3 homozygous cases for Hb D, 17 subjects with betathalassemia- Hb D, 12 with Hb D- alpha- thalassemia- 1, 3 homozygous Hb D- alpha thalassemia- 1 trait, one with Hb D Punjab - sickle cell anemia, and two with Hb D Iran/sickle cell anemia. The carriers of Hb D and homozygous cases for Hb D were not anemic and had normal red blood cell morphology, as they are not usually detected. If Hb D was inherited in combination with thalassemia, the subjects had mild anemia and in some of them, the spleen was palpable [1-2 cm]. Co-inheritance of alpha thalassemia and Hb D resulted in the slightly higher Hb level and lower Hb D level as compared to Hb D/ betathalassemia cases [Hb D 24-37% vs 57-88%]. Co inheritance of Hb D and sickle cell results was moderate to severe hemolytic anemia