ABSTRACT
Aims: To analyze and evaluate ‘ring-enhancing’ appearance as a sign in the differential diagnosis of neurological lesions in the brain and clinically correlate such an appearance with patients’ mode of presentation, etiological factors, outcome and mode of management. Study Design: A cross-sectional study was done in 40 patients in whom ring-enhancing lesions were found on neuroimaging. They were retrospectively analyzed in view of their clinical presentation and investigative profile. Material and Methods: The study was conducted at the Dept. of Medicine, Shri Sayajirao General (SSG) Hospital, Vadodara, Gujarat. The study was conducted over a period of 24 months in 40 patients. Results: We observed that infective pathology was the most common etiology in patients with multiple ring-enhancing lesions of the brain. Tuberculosis (TB) and neurocysticercosis (NCC) were the most common infections. Neoplastic etiology was the commonest noninfective etiology. Conclusion: Our study establishes the role of TB as the leading cause of ring-enhancing lesions in the Indian setup as compared to tumors in the Western world. It might serve a basis for early recognition and intervention in these patients. We suggest that in patients with multiple ring-enhancing lesions of the brain, a CSF examination and imaging of chest should always be performed.
ABSTRACT
Present study was carried out to find out the prevalence of methicillin resistant Staphylococcus aureus (MRSA) in school children of Pokhara city in western, Nepal. A total of 184 randomly selected children younger than 15 years were included in the study. Nasal swabs collected were subjected to standard bacteriological culture. S. aureus isolates were identified by mannitol fermentation, coagulase positivity and DNase positivity. Antimicrobial susceptibility test was performed on muller-hinton agar (MHA) by modified Kirby-Bauer disc diffusion method. Out of total 184 nasal swabs, S. aureus was isolated in 31.0% (n=57). Among the isolates, 35.1% (n=20) were from male children whereas 64.9% (n=37) were from female. There was no significant sex difference in colonization of S. aureus. Out of 57 isolates, 56.1% (n=32) were MRSA. MRSA isolates indicated relatively high rate of resistance to antibiotic cloxacillin (68.7%) followed by ofloxacin (40.6%), tetracycline (15.6%), erythromycin (9.4%), ciprofloxacin (6.2%) and vancomycin (3.1%).This study showed a high prevalence of MRSA carriage in school children indicating the spread of MRSA in the community.