Nocardia canaliculitis presenting as pouted punctum

A rare case of culture-positive Nocardia canaliculitis is reported that presented with a history of chronic conjunctivitis and epiphora for the last 1.4 years, refractory to multiple treatment courses. Chronic conjunctivitis and a pouted punctum were observed in the right lower eyelid. Probing and sac syringing was performed. The "Sulfur granules" were expressed and subjected to various microbiological analyses. Nocardia sp was grown on culture. The patient was successfully managed with surgical removal of concretions and topical/systemic antibiotics

Methicillin resistant staphylococcus aureus prevalence amongst community versus hospital acquired skin and soft tissue infections

Methicillin resistant Staphylococcus aureus [MRSA] is becoming increasingly prevalent, not only in the hospital acquired but also the community acquired infections. Skin and soft tissues are a few of the important targets for this pathogen. A study was conducted at the departments of surgery, dermatology and pathology, Combined Military Hospital, Gujranwala Cantt to know the prevalence of MRSA amongst community vs. hospital acquired skin and soft tissue infections [SSTIs]. A total of 216 community acquired and 48 hospital acquired SSTIs were included in the study. The pus swabs/pus specimens collected from all the cases were processed for routine cultures. Isolates were identified as Staphylococcus aureus and resistance to methicillin was detected using standard techniques. Staphylococcus aureus was isolated in 64.35% of the community acquired and 72.91% of the hospital acquired SSTIs. Prevalence of MRSA amongst community acquired SSTIs was 26.6% while in the hospital acquired SSTIs was 68.57%. The study indicates quite a high prevalence of MRSA amongst community acquired and a very high prevalence in hospital acquired SSTIs. Further large scale studies are required to monitor the prevalence and spread of MRSA amongst SSTIs

Graft versus host disease in allogeneic stem cell transplantation - 3 l/2 years experience

To evaluate the frequency and outcome of graft versus host disease after allogeneic stem cell transplant in haematological disorders at Armed Forces Bone Marrow Transplant Centre, Rawalpindi from July 2001 to December 2004. Eighty-six patients with various haematological disorders namely aplastic anaemia [n=32], b-Thalassaemia [n=25], CML [n=22] ALL [n=3], AML [n=l] Fanconi's anaemia [n=2], and Gaucher's disease [n=l], underwent allogeneic stem cell transplantation. All patients received cyclosoprin, prednisolone and short course of methotrexate as GvHD prophylaxis. The patients who developed acute GvHD > grade-II or chronic extensive GvHD received steroids at a starting dose of 2 mg/kg body weight along with gradual increase in cyclosporine dosage [max dose 12.5 mg/kg]. The overall incidence of acute GvHD grade-II to IV was 44.2% [n=38/86] where as the incidence of chronic extensive GvHD was 14% [n=12/86]. Acute GvHD was 68% [n=17/25] in B-Thalassaemia, 50% [n=ll/22] in CML, 50% [n=2/4] in Acute Leukaemias and 25% [n=8/32] in Aplastic Anaemia. Chronic GvHD was 25% [n=l/4] in Acute Leukaemias, 18.8% [n=6/32] in Aplastic Anaemia, 18.2% [n=4/22] in CML and 4% [n=l/25] in B-Thalassaemia. The overall survival in acute GvHD was 84.2% [n=32] where as the overall survival in chronic GvHD was 50% [n=6]. The overall mortality in acute GvHD was 15.8% [n=6] and 50% in chronic GvHD [n=6]. The morbidity and mortality due to severe acute and chronic GvHD remains high despite standard prophylaxis against GvHD. New strategies are needed to prevent and treat GvHD

Graft versus host disease in allogeneic stem cell transplantation - 3 1/2 years experience

To evaluate the frequency and outcome of graft versus host disease after allogeneic stem cell transplant in haematological disorders at Armed Forces Bone Marrow Transplant Centre, Rawalpindi from July 2001 to December 2004. Eighty-six patients with various haematological disorders namely aplastic anaemia [n=32], b-Thalassaemia [n=25], CML [n=22], ALL [n=3], AML [n=1] Fanconi's anaemia [n=2], and Gaucher's disease [n=1], underwent allogeneic stem cell transplantation. All patients received cyclosoprin, prednisolone and short course of methotrexate as GvHD prophylaxis. The patients who developed acute GvHD > grade-II or chronic extensive GvHD received steroids at a starting dose of 2 mg/kg body weight along with gradual increase in cyclosporine dosage [max dose 12.5 mg/kg]. The overall incidence of acute GvHD grade-II to IV was 44.2% [n=38/86] where as the incidence of chronic extensive GvHD was 14% [n=12/86]. Acute GvHD was 68% [n=17/25] in