O uso do laser de alta e baixa intensidade para o tratamento de hipersensibilidade dentinária: uma revisão integrativa

Objetivo: Determinar as evidências científicas sobre a influência do uso de lasers de baixa e alta intensidade no tratamento da hipersensibilidade da dentina. Revisão de literatura: Foram realizadas buscas na Biblioteca Virtual em Saúde (BVS), incluindo as bases de dados: Literatura Latino Americana e do Caribe em Ciências da Saúde (LILACS); Bibliografia Brasileira de Odontologia (BBO); e National Library of Medicine (MEDLINE). A maioria dos estudos destacam a eficácia dos lasers na redução da HD, com o laser Nd:YAG mostrando-se eficaz na obliteração dos túbulos dentinários e proporcionando alívio a longo prazo. Apesar dos benefícios, alguns estudos alertam para possíveis danos à polpa dentária, especialmente com lasers de alta potência. Considerações finais: Embora os lasers tenham se mostrado eficazes na redução da HD, a escolha do laser deve ser personalizada para cada paciente, destacando a necessidade de aprimorar os protocolos clínicos e adquirir experiência relevante por parte dos profissionais especialistas.

Objective: To determine the scientific evidence on the influence of the use of low and high intensity lasers in the treatment of dentin hypersensitivity. Literature review: Searches were carried out in the Virtual Health Library (VHL), including the databases: Latin American and Caribbean Literature in Health Sciences (LILACS); Brazilian Bibliography of Dentistry (BBO); and National Library of Medicine (MEDLINE). Most studies highlight the effectiveness of lasers in reducing HD, with the Nd:YAG laser proving effective in obliterating dentinal tubules and providing long-term relief. Despite the benefits, some studies warn of possible damage to the dental pulp, especially with high-power lasers. Final considerations: Although lasers have been shown to be effective in reducing HD, the choice of laser must be personalized for each patient, highlighting the need to improve clinical protocols and acquire relevant experience on the part of specialist professionals.

Prevalence and antimicrobial resistance profile of pathogens isolated from patients with urine tract infections admitted to a university hospital in a medium-sized Brazilian city

ABSTRACT This study aimed to determine the antibiotic profile of microorganisms isolated from urine samples of patients with community urine tract infections (UTI) admitted to the University Hospital of the Federal University of Sao Carlos to support an appropriate local empirical treatment. A retrospective cross-sectional study was conducted from October 2018 to October 2020. Data from 1,528 positive urine cultures for bacterial pathogens and antibiograms were tabulated. Bacterial species prevalence and their resistance profile were analyzed and compared by sex and age. For Gram-negative fermenting bacteria, resistance rates were compared between patients with previous hospitalization and the total of infections caused by this group. For comparisons, the Chi-square test was performed, using Fisher's exact test when necessary (BioEstat program, adopting p ≤ 0.05). A multivariate analysis was applied to assess the effect of the studied variables in predicting multidrug resistance. Infections were more prevalent in women and older adults. Gram-negative bacteria represented 90.44% of total cultures. In both sexes, E. coli prevalence was significantly higher in adults compared with older adults (p < 0.0001). For several antibiotics, resistance rates were higher in the older adults compared with other ages and in patients with Gram-negative fermenting infections and previous hospitalization compared with the total of infections by this group of bacteria. The closer to the hospitalization, the higher the number of antibiotics with superior resistance rates. Resistance rates for aminoglycosides, carbapenems, ceftazidime, nitrofurantoin, piperacillin+tazobactam, and fosfomycin were less than 20%, considered adequate for empirical treatment. Only hospitalization in the previous 90 days was statistically significant in predicting infections by multidrug-resistant bacteria.

Perception of first-order grating acuity and second-order spatial contrast sensitivity in anisometropia amblyopia / 国际眼科杂志(Guoji Yanke Zazhi)

AIM: To study the perception of first-order grating acuity and second-order spatial contrast sensitivity in patients with monocular anisometropia amblyopia.METHODS:A total of 715 children(715 eyes)diagnosed as monocular anisometropia amblyopia in our hospital from January 2018 to December 2022 were collected as amblyopia group, and 745 children(745 eyes)with normal corrected visual acuity were collected. The best corrected visual acuity(BCVA), first-order grating acuity and/or second-order spatial contrast sensitivity were measured, repectively. The perception ability of amblyopia patients to first-order grating acuity and second-order spatial contrast sensitivity were analyzed.RESULTS:There were significant differences between amblyopia group and normal control group in the perception of first-order grating acuity(11.58±6.10 vs. 20.27±3.47, P&#x0026;#x003C;0.001)and second-order spatial contrast sensitivity(0.33±0.16 vs 0.12±0.04, P&#x0026;#x003C;0.001). And there were significant differences between mild-to-moderate amblyopia and severe amblyopia patients in first-order grating acuity(12.10±6.23 vs. 8.13±3.70, P&#x0026;#x003C;0.001)and second-order spatial contrast sensitivity(0.32±0.16 vs. 0.37±0.17, P&#x0026;#x003C;0.05).CONCLUSION: The first-order and second-order visual pathway of the cerebral cortex in children with monocular anisometropia amblyopia have different degrees of damage. The injury of severe amblyopia is more serious than that of mild-to-moderate amblyopia.

Sensibilización cutánea a aero alérgenos en niños con rinitis y asma / Skin sensitization to aero-allergens in children with rhinitis and asthma

Introducción: Las enfermedades alérgicas son muy comunes en la población pediátrica. Entre las causas frecuentes se encuentran los aeroalérgenos del ambiente, y la identificación de estos es de gran ayuda tanto para el diagnóstico como para el tratamiento. Objetivos: Determinar la frecuencia de aeroalérgenos, por medio de la determinación de Inmunoglobulina E (IgE) específica a alérgenos comunes por la prueba de sensibilidad cutánea en pacientes pediátricos con síntomas de asma y rinitis alérgica. Materiales y Métodos: Diseño observacional, descriptivo, prospectivo, transversal, población de pacientes de 4 a 17 años con síntomas compatibles con asma y rinitis alérgica que acudieron a un centro asistencial pediátrico en el periodo de estudio. Se realizó por medio de las Pruebas de punción cutánea (PCP). Resultados: La edad media de los pacientes fue de 8 años, 57% pacientes de sexo masculino y 43% de sexo femenino. El 53% de los pacientes presenta rinitis y asma, 45% solo rinitis y el 2% solo asma. El 79% de los pacientes presentó reacción positiva de sensibilización alérgica por medio de la PCP. Teniendo en cuenta la sensibilización por tipo de aeroalérgenos se tuvo que el 64% de los pacientes tuvo reacción positiva a ácaros, 19% a animales 18% a cucarachas, 8% a pólenes y 6% a hongos. Conclusión: La gran mayoría de pacientes con asma padecía rinitis alérgica concomitante y los ácaros del polvo fueron los aeroalérgenos más frecuentemente determinados en las pruebas cutáneas de alergia en niños con asma y rinitis de nuestra población.

Introduction: Allergic diseases are very common in the pediatric population. Among the frequent causes are aeroallergens from the environment and the identification of these is a great help for diagnosis and treatment. Objectives: To determine the frequency of aeroallergens, through the determination of Immunoglobulin E (IgE) specific to common allergens by the skin sensitivity test in pediatric patients with symptoms of asthma and allergic rhinitis. Materials and Methods: Observational, descriptive, prospective, cross-sectional design, population of patients from 4 to 17 years old with symptoms compatible with asthma and allergic rhinitis who attended a pediatric care center during the study period. It was carried out by means of Skin Puncture Tests (PCP). Results: The mean age of the patients was 8 years, 57% male patients and 43% female. 53% of the patients presented Rhinitis and Asthma, 45% only Rhinitis and 2% only Asthma. 79% of the patients presented a positive allergic sensitization reaction through PCP. Taking into account the sensitization by type of aeroallergens, 64% of the patients had a positive reaction to mites, 19 % to animals 18% to cockroaches, 8% to pollens and 6% to fungi. Conclusion: The vast majority of patients with asthma suffered from concomitant allergic rhinitis and dust mites were the most frequently determined aeroallergens in allergic skin tests in children with asthma and rhinitis in our population.

Rendimiento diagnóstico de once indicadores para resistencia a la insulina en una muestra de pobladores peruanos

Introducción: La resistencia a la insulina (RI) es una de las principales causas del desarrollo de patologías crónicas. Es indispensable su detección temprana, por ello es importante estudiar métodos más asequibles y menos costosos como los biomarcadores. Objetivo: Determinar la precisión diagnóstica de once biomarcadores para RI en una muestra de pobladores peruanos. Metodología: Estudio de pruebas diagnósticas. Análisis de base de datos secundario del estudio PERU MIGRANT. Para medir RI se utilizó como referencia la evaluación del modelo homeostático (HOMA-IR) ≥ 2,8. Los biomarcadores se basaron en la ratio de lípidos, los indicadores de lípido visceral, los indicadores con triglicéridos y glucosa (TyG), y los indicadores con cintura abdominal. Para la precisión se utilizó el análisis de la curva de características operativas del receptor y el área bajo la curva (AUC) con sus respectivos intervalos de confianza al 95% (IC95%). Resultados: Se estudió a 938 participantes. La prevalencia de RI fue del 9,91%. En relación con el análisis ROC, el índice TyG - índice de masa corporal (TyG - IMC) tuvo el mayor AUC, tanto en hombres: AUC=0,85 (0,81 - 0,90), corte=241,55; sens=92,5 (79,6 - 98,4) y esp=78,3 (73,9 - 82,2); como en mujeres: AUC=0,81 (0,76 - 0,85), corte=258,77; sens=79,2 (70,3 - 86,5) y esp= 82,1 (78,0 - 85,8). Discusión: Según los datos analizados, el índice TyG-IMC es el mejor indicador para medir RI. Es un índice simple que se puede tomar de manera rutinaria en la práctica clínica diaria. Es conveniente añadir futuros estudios prospectivos que confirmen su capacidad predictiva.

Introduction: Insulin resistance (IR) is one of the main causes of chronic disease. Early detection is essential, which is why it is important to study more affordable and less expensive methods, such as biomarkers. Objective: To determine the diagnostic accuracy of 11 biomarkers of IR in a sample of Peruvian residents. Method: diagnostic tests. Secondary Database Analysis of the PERU-MIGRANT Study. To measure RI, a homeostatic model evaluation (HOMA-IR) ≥ 2.8 was used as a reference. Biomarkers were based on the lipid ratio, visceral lipid indicators, indicators of triglycerides and glucose (TyG), and indicators of abdominal waist. For precision, the receiver operating characteristic curve and area under the curve (AUC) with their respective 95% confidence intervals (95%CI) were used. Results: A total of 938 participants were studied. The prevalence of IR was 9.91%. In relation to the ROC analysis, the TyG index - body mass index (TyG - BMI) had the highest AUC, both in men: AUC=0.85 (0.81 - 0.90), cut-off=241.55; sens=92.5 (79.6 - 98.4) and sp=78.3 (73.9 - 82.2); as in women: AUC=0.81 (0.76 - 0.85), cut-off=258.77; sens=79.2 (70.3 - 86.5) and esp= 82.1 (78.0 - 85.8). Discussion: According to the data analyzed, the TyG-IMC index is the best indicator for measuring IR. It is a simple index that can be routinely used in clinical practice. Future prospective studies are needed to confirm its predictive capacity.

Efeito do pH do gel clareador de consultório na cor e na sensibilidade dentária / Effect of the pHof the in-office tooth bleaching gelon color and tooth sensitivity / Efecto del pH del gel blanqueador dental de consultorio sobre el color y la sensibilidad dental

Introdução:Sabe-se que a busca pela estética é algo cada vez mais crescente. Dentre os procedimentos mais procurados na odontologia estética, destaca-se o clareamento dental de consultório. Diante disso, ainda são poucos os estudos que avaliam os efeitos dos agentes clareadores de diferentes pHs na efetividade clareadora e na sensibilidade dentária.Objetivo:Avaliar a sensibilidade dentária e a eficácia clareadora de géis clareadores à base de peróxido de hidrogênio a 35% com diferentes pHs.Metodologia:Trata-se de um relato de três casos, descritivo e observacional, do tipo boca dividida (split-mouth) para cada estratégia clareadora (gel clareador com pH básico e gel clareador com pH ácido). Foram avaliados três pacientes de25, 26e 27anos de idade.Realizou-se registro de cor por meio da escala VITAClassical e avaliação da sensibilidade dentária pela escala visual analógica. Resultados:Todos os pacientes avaliados apresentaram cor A3 no registro de cor inicial e, após o clareamento dental,atingiram a cor A1. Todos relataram uma maior sensibilidade no hemiarco direito (local onde foi aplicada o gel clareador Whiteness HP que possui pH ácido. Dois pacientes relataram sensibilidade dentária no hemiarco esquerdo em que foi aplicado o gel clareador de pH básico. Conclusões:Observa-se a eficácia clínica dos géis clareadores de consultório à base de peróxido de hidrogênio a 35% na estabilidade de cor após o tratamento clareador, independente do seu pH. Ademais, nota-se que o gel clareador de pH básico promoveu menor sensibilidade pós-operatória (AU).

Introduction:It is known that the search for aesthetics is something increasingly growing. Among the most sought-after procedures in cosmetic dentistry, in-office tooth bleaching stands out. Therefore, there are still few studies that evaluate the effects of bleaching agents ofdifferent pHs on bleaching effectiveness and tooth sensitivity.Objective:To evaluate tooth sensitivity and bleaching efficacy of 35% hydrogen peroxide-based tooth bleaching gels with different pHs.Methodology:This is a report of three cases, descriptive and observational, of the split-mouth type for each bleaching strategy (bleaching gel with basic pH and bleaching gel with acidic pH). Three patients aged 25, 26 and 27 years were evaluated. Color registration was performed using the VITA Classical scale and tooth sensitivity was evaluated using the visual analogue scale.Results:All evaluated patients presented color A3 in the initial color registration and, after tooth bleaching, reached color A1. All reported greater sensitivity in the right hemi-arch (place where the Whiteness HP bleaching gel with an acid pH was applied. Two patients reported tooth sensitivity in the left hemi-arch where the basic pH bleaching gel was applied.Conclusions:The clinical efficacy of in-office tooth bleaching gels based on 35% hydrogen peroxide in terms of color stability after bleaching treatment is observed, regardless of its pH. In addition, it is noted that the basic pH bleaching gel promoted less postoperative sensitivity (AU).

Introducción: Se sabe que la búsqueda de la estética es algo cada vez más creciente. Entre los procedimientos más populares en odontología estética, se destaca el blanqueamiento dental en consultorio. Ante esto, aún existen pocos estudios que evalúen los efectos de agentes blanqueadores de diferentes pHs sobre la efectividad del blanqueamiento y la sensibilidad dental.Objetivo: Evaluar la sensibilidad dental y la eficacia blanqueadora de geles blanqueadores a base de peróxido de hidrógeno al 35 % con diferentes pH. Metodología: Este es un reporte de tres casos, descriptivo y observacional, del tipo boca partida para cada estrategia de blanqueamiento (gel blanqueador con pH básico y gel blanqueador con pH ácido). Se evaluaron tres pacientes de 25, 26 y 27 años. El registro de color se realizó con la escala clásica VITA y la sensibilidad dental se evaluó con la escala analógica visual.Resultados: Todos los pacientes evaluados presentaron color A3 en el registro de color inicial y, después del blanqueamiento dental, alcanzaron el color A1. Todos refirieron mayor sensibilidad en la hemiarcada derecha (lugar donde se aplicó el gel blanqueador de pH ácido Whiteness HP). Dos pacientes refirieron sensibilidad dental en la hemiarcadaizquierda donde se aplicó el gel blanqueador de pH básico.Conclusiones: Se observala eficacia clínica de los geles blanqueadores de consultorio a base de peróxido de hidrógeno al 35% en cuanto a la estabilidad del color tras el tratamiento blanqueador, independientemente de su pH. Además, se observa que el gel blanqueador de pH básico promovió una menor sensibilidad postoperatoria (AU).

Protocolos de diagnóstico acelerado basados en troponina de alta sensibilidad en el diagnóstico del dolor torácico: una revisión sistemática / Accelerated Diagnostic Protocols Based on High-Sensitivity Troponin in the Diagnosis of Thoracic Pain: A Systematic Review

RESUMEN Introducción: Los protocolos de diagnóstico acelerado de dolor torácico, con el avance de la troponina de alta sensibilidad, permiten identificar a los pacientes que ingresan al servicio de urgencias con dolor torácico de bajo riesgo para un evento cardiovascular adverso mayor, que podrían ser dados de alta de forma temprana y segura, con ahorro de tiempo y recursos. Objetivo: Evaluar ensayos clínicos que utilicen protocolos de diagnóstico acelerado basados en troponina de alta sensibilidad. Material y métodos: se realizó una búsqueda de ensayos clínicos aleatorizados que evaluaran protocolos de diagnóstico acelerado basados en troponina de alta sensibilidad en los servicios de urgencias, en las bases de datos MEDLINE/Ovid, Cochrane y EMBASE utilizando los criterios de evaluación del manual Cochrane y la estrategia PRISMA Resultados: Tras una tamización de 3509 estudios se incluyeron 5 ensayos clínicos que incluyeron 1513 pacientes; se identificaron 409 (27%) altas tempranas, el 91% para el protocolo 0/3 h ESC, 72% para el 0/1 h, 48% para el EDACS, 40% para el HEART, 19 y 32% para ADAPT y 8 y 18% para el cuidado usual. El valor predictivo negativo fue alto, en un rango de 99,1 al 100% La duración media de la estancia hospitalaria fue más baja para los protocolos 0/1 h y 0/3 h ESC, con 4,6 y 5,6 horas respectivamente. Conclusiones: Los protocolos de diagnóstico acelerado en dolor torácico que implementan el uso de troponina de alta sensibilidad permiten lograr alta proporción de altas tempranas con baja tasa de eventos cardiovasculares mayores, con disminución del tiempo de estancia y recursos consumidos.

ABSTRACT Background: Accelerated diagnostic protocols for chest pain, with the advancement of high-sensitivity troponin, make it possible to identify patients admitted to the emergency department with chest pain and low risk for a major adverse cardiovascular event, who could be discharged immediately, early and safely, saving time and resources. Objective: The aim of this study was to assess clinical trials using accelerated diagnostic protocols based on high-sensitivity troponin. Methods: A search of randomized clinical trials evaluating accelerated diagnostic protocols based on high-sensitivity troponin in emergency services was carried out in MEDLINE/Ovid, Cochrane and EMBASE database, using the assessment criteria of the Cochrane manual and the PRISMA strategy. Results: After screening 3509 studies, 5 clinical trials, including 1513 patients, were analyzed. Early discharges were identified in 409 (27%) of patients, in 91% of cases for ESC 0/3-h protocols, 72% for 0/1-h, 48% for EDACS, 40% for HEART, 19% and 32% for ADAPT and 8% and 18% for standard care protocols. The negative predictive value was high, in the 99.1-100% range. Mean length of hospital stay was lower for the 0/1-h and ESC 0/3-h protocols, with 4.6 and 5.6 hours, respectively. Conclusions: Accelerated diagnostic protocols in chest pain using high-sensitivity troponin allow a higher proportion of early discharges with a low rate of major cardiovascular events, with reduction in length of hospital stay and resources used.

The relationship between covid-19 burnout and the moral sensitivity of healthcare professionals

This study aimed to examine the relationship between the burnout of physicians and nurses and their moral sensitivity during the pandemic. This was a descriptive and correlational study. This study was carried out with physicians and nurses who were continuing to work actively during the pandemic. Snowboard sampling method was utilized. The total mean score of the participants on the MSQ was 90.78±19.10. The total mean score of the COVID-19 Burnout Scale was 34.52±9.65. A statistically weak and significant correlation was found between the COVID-19 Burnout Scale and the MSQ total score, as well as the "benefit" and "conflict" sub-dimensions. It was determined that as MSQ total scores, "benefit" and "conflict" scores decreased in healthcare workers, COVID-19 burnout scores increased. In our study, the moral sensitivity of the participants was found to be moderate, and their burnout levels were found to be high. Although there was a weak relationship, it was observed that burnout levels increased as moral sensitivity levels increased. It is crucial that we learn from pandemic experiences and transfer this knowledge to future generations. In particular, we must assimilate these important lessons into training in order to develop and protect the moral sensitivity of healthcare professionals.

Este estudio pretendía examinar la relación entre el burnout de médicos y enfermeras y su sensibilidad moral durante la pandemia. Se trató de un estudio descriptivo y correlacional, y se llevó a cabo con médicos y enfermeras que seguían trabajando activamente durante la pandemia. Se utilizó el método de muestreo de Snowboard. La puntuación media total de los participantes en el MSQ fue de 90,78±19,10. La puntuación media total de la Escala de Burnout COVID-19 fue de 34,52±9,65. Se encontró una correlación estadísticamente débil y significativa entre la Escala de Burnout COVID-19 y la puntuación total del MSQ, así como las subdimensiones "beneficio" y "conflicto". Se determinó que, a medida que disminuían las puntuaciones totales del MSQ y las puntuaciones de "beneficio" y "conflicto" en los trabajadores sanitarios, aumentaban las puntuaciones de burnout de la COVID-19. En nuestro estudio, se observó que la sensibilidad moral de los participantes era moderada y que sus niveles de burnout eran elevados. Aunque existía una relación débil, se observó que los niveles de burnout aumentaban a medida que lo hacían los de sensibilidad moral. Es crucial que aprendamos de las experiencias pandémicas y transmitamos estos conocimientos a las generaciones futuras. En particular, debemos asimilar estas importantes lecciones en la formación para desarrollar y proteger la sensibilidad moral de los profesionales sanitarios.

Esse estudo objetivou examinar a relação entre o burnout de médicos e enfermeiras e sua sensibilidade moral durante a pandemia. Esse era um estudo descritivo e correlacional. Esse estudo foi realizado com médicos e enfermeiras que continuaram trabalhando ativamente durante a pandemia. O método da amostragem em snowboard foi utilizado. A média total dos participantes no MSQ foi 90,78±19,10. A média total na Escala de Burnout pela COVID-19 foi 34,52±9,65. Uma correlação fraca e significante foi encontrada entre os escores totais na Escalas de Burnout pela COVID-19 e MSQ, assim como nas subdimensões "benefício" e "conflito". Determinou-se que como os escores totais na MSQ e os escores "benefício" e "conflito" diminuiram em trabalhadores de cuidados à saúde, os escores de burnout pela COVID-19 aumentaram. Em nosso estudo, a sensibilidade moral dos participantes foi considerada ser moderada e seus níveis de burnout considerados serem altos. Embora tenha havido uma correlação fraca, foi observado que os níveis de burnout aumentaram quando os níveis de sensibilidade moral aumentaram. É essencial que aprendamos das experiências com a pandemia e passemos esse conhecimento para as futuras gerações. Em particular, nós devemos assimilar essas importantes lições em treinamentos, de forma a desenvolver e proteger a sensibilidade moral de profissionais de cuidados à saúde.

Colonización genitourinaria por Streptococcus agalactiae y perfil de sensibilidad en mujeres gestantes

Introducción: Streptococcus agalactiae, también conocido como estreptococo beta-hemolítico del grupo B de Lancefield, adquiere relevancia durante el embarazo debido a la posibilidad de transmisión al recién nacido. Las normas internacionales sugieren realizar tamizaje vagino-anal entre las 35 y 37 semanas de gestación. Objetivo: Determinar prevalencia de colonización por Streptococcus agalactiae en muestras cérvico-vaginales de embarazadas entre 35 y 37 semanas, y en urocultivos de gestantes de cualquier edad gestacional ingresadas en el hospital ginecobstetrico provincial, así como su perfil de sensibilidad. Materiales y métodos: Se realizó un estudio observacional, descriptivo y exploratorio, de corte transversal, entre enero y agosto de 2021, en el Hospital Provincial Docente Ginecobstétrico José Ramón López Tabrane, de la ciudad de Matanzas. El universo estuvo conformado por todas las gestantes de cualquier trimestre a las que se les realizó urocultivo, y estudio microbiológico cérvico-vaginal entre las 35 y 37 semanas de gestación, cumplidos previamente criterios de inclusión. Resultados: El 18,61 % presentó cultivos positivos para Streptococcus agalactiae. Predominó la presencia de positividad en gestantes no diabéticas; se encontró un 18,75 % de urocultivos positivos. Predominaron los aislamientos sensibles a eritromicina y clindamicina, con un 63 %, seguidos de la resistencia inducible a clindamicina (MLSBi), con un 19 %. Conclusiones: El diagnóstico microbiológico de Streptococcus agalactiae en gestantes, es de vital importancia para la prevención de sepsis puerperal y neonatal. A pesar de que los resultados de este estudio muestran perfiles de sensibilidad adecuados, su monitorización permanente garantizaría el diagnóstico precoz de cepas resistentes, dado el ligero incremento del fenotipo (MLSBi) identificado.

Introduction: Streptococcus agalactiae, also known as Lancefield's group B beta-hemolytic streptococcus, acquires relevance during pregnancy due to the possibility of transmission to the newborn. International standards suggest performing vaginal-anal screening between 35 and 37 weeks of gestation. Objective: to determine the prevalence of colonization by Streptococcus agalactiae, in cervical-vaginal samples of pregnant women between 35 and 37 weeks, and in urine cultures of pregnant women of any gestational age admitted to the provincial gyneco-obstetric hospital, as well as their sensitivity profile. Materials and methods: an observational, descriptive and exploratory cross-sectional study was performed, between January and August 2021, at the Provincial Teaching Gyneco-obstetric Hospital Jose Ramon Lopez Tabrane of Matanzas. The universe was made up by all pregnant women of any trimester who underwent a urine culture, and a cervical-vaginal microbiologic study between 35 and 37 gestation weeks, previously meeting inclusion criteria. Results: 18.61% presented positive cultures for Streptococcus agalactiae. The presence of positivity predominated in non-diabetic women. 18.75 % of positive urine cultures were found. Erythromycin and clindamycin-sensitive isolates predominated (MLSBi), with 63%, followed by inducible resistance to clindamycin, with 19%. Conclusions: the microbiological diagnosis of Streptococcus agalactiae in pregnant women is of vital importance to prevent puerperal and neonatal sepsis. Although the results of this study show adequate sensitivity profiles, its permanent monitoring would warrantee the early diagnosis of resistant strains, given the slight increase of the phenotype (MLSBi) identified.

In vitro sensitivity of Malassezia furfur isolates from HIV-positive and negative patients to antifungal agents / Sensibilidad in vitro a antifúngicos de aislamientos de Malassezia furfur de pacientes positivos y negativos para HIV

Introduction. Malassezia is a lipophilic and lipid-dependent yeast genus belonging to the skin microbiota of humans and other animals. However, due to dysbiosis processes or other factors in the host, this yeast can cause different pathologies, ranging from skin diseases, such as seborrheic dermatitis, to fungemia. Isolation of Malassezia furfur has been reported in HIV-positive patients with or without skin lesions. Due to its opportunistic nature and its variable resistance to antifungal compounds, it is relevant to know the Malassezia sensitivity profiles. Objective. To determine the sensitivity to different antifungal agents, of clinical isolates of M. furfur obtained from HIV-positive or negative patients, with or without seborrheic dermatitis. Materials and methods. Assessment of isolates sensitivity to itraconazole, voriconazole, fluconazole, and amphotericin B was performed by two techniques: (1) Broth microdilution using Clinical and Laboratory Standards Institute (CLSI) protocol M27-A3 with modifications; and (2) agar tests using Etest®. Results. Isolates obtained from HIV patients showed an increase in the minimum inhibitory concentration of fluconazole, voriconazole, and amphotericin B, compared with those of non-HIV patients. Itraconazole was the antifungal with the lowest minimum inhibitory concentration (MIC) in most isolates. Conclusion. We observed differences in the sensitivity profiles of M. furfur isolates according to the context of the patient. High MIC of antifungals like fluconazole, commonly used for treating pathologies caused by Malassezia, were identified.

Introducción. Malassezia es un género de levaduras lipofílicas que dependen de los lípidos y hacen parte de la microbiota de la piel de humanos y otros animales. No obstante, debido a procesos de disbiosis u otros factores en el huésped, esta levadura puede llegar a causar diferentes enfermedades: desde cutáneas (como dermatitis seborreica) hasta fungemias. Se han reportado aislamientos de Malassezia furfur en pacientes positivos para HIV, con lesiones cutáneas o sin ellas. Por su carácter oportunista y sensibilidad variable a los compuestos antifúngicos, es relevante conocer los perfiles de sensibilidad. Objetivo. Determinar la sensibilidad a diferentes antifúngicos de aislamientos clínicos de M. furfur obtenidos de pacientes positivos o negativos para HIV, con dermatitis seborreica o sin ella. Materiales y métodos. La sensibilidad de los aislamientos a itraconazol, voriconazol, fluconazol y anfotericina B, se determinó mediante dos técnicas: microdilución en caldo según el protocolo M27-A3 del Clinical & Laboratory Standards Institute (CLSI), con modificaciones, y pruebas en agar mediante Etest®. Resultados. Los aislamientos obtenidos de pacientes con HIV mostraron aumento de la concentración inhibitoria mínima a fluconazol, voriconazol y anfotericina B, en comparación con los de pacientes sin HIV. Por otro lado, al evaluar la mayoría de los aislamientos, el itraconazol fue el antifúngico con la menor concentración inhibitoria mínima. Conclusión. Se evidencian diferencias en los perfiles de sensibilidad de los aislamientos de M. furfur, según el contexto del paciente, y elevadas concentraciones inhibitorias mínimas de antifúngicos como el fluconazol, usados comúnmente para el tratamiento de las enfermedades causadas por Malassezia spp.

FETAL ECHOCARDIOGRAPHY AS A ROUTINE ANTENATAL SCREENING TOOL FOR DETECTION OF FETAL CONGENITAL CARDIAC STRUCTURAL ANOMALIES.

Background: Fetal echocardiography plays a pivotal role in detecting congenital cardiac structural anomalies. Though foetal echocardiography is mostly reserved for high risk pregnant women, its role as a routine prenatal screening tool needs to be dened. To evaluate the role of fetal echocardiography as a routine Objectives: antenatal screening tool for detection of congenital cardiac structural anomalies.To compare the prevalence of congenital cardiac structural anomalies by fetal echocardiography in antenatal women with low risk and high risk factors for cardiac structural anomalies. The study was carried out in the department of radiodiagnosis, SNMC, Agra. Materials and methods: 500 fetal hearts between 18-26 weeks gestation were evaluated through fetal echocardiography.They were categorised into two groups -low risk (Group I) and high risk (Group II) and scanned through four chamber , LVOT , RVOT and three vessel view. Result: The prevalence of fetal congenital cardiac structural anomalies in this study is 14/1000.Fetal echocardiography had a sensitivity of 85% & specicity of 99%. PPV is 85% and NPV is 99%. The incidence of congenital cardiac structural anomalies in high risk and low risk group was 12 % & 14.8 % per 1,000 respectively. based on these ndings it is highly Conclusion: suggestive that every pregnant woman should be subjected to a detailed fetal echocardiography. Fetal echocardiography should be included as a part of routine antenatal screening irrespective of risk factors for congenital cardiac structural anomalies.

Comparación ecotoxicológica al Cloruro de Sodio en Hydra vulgaris e Hydra viridissima

El aumento de la salinidad en los ecosistemas de agua dulce genera preocupación sobre los efectos adversos que puede provocar sobre las especies dulceacuícolas y el suelo. Las concentraciones óptimas de iones de sodio y calcio para que las especies del género Hydra tengan condiciones fisiológicas adecuadas son relativamente bajas. Este trabajo se enfocó en comparar la sensibilidad de H. vulgaris e H. viridissima frente al cloruro de sodio (NaCl). Las especies fueron mantenidas bajo condiciones de fotoperiodo, iluminación y temperatura controladas. Se obtuvieron las tasas de crecimiento y en ensayos de toxicidad aguda se calcularon las CE50 (Concentración efectiva media) y CL50 (Concentración letal media) como indicadores de la sensibilidad al NaCl. H. vulgaris fue más sensible al NaCl dado que la CL50-96h fue de 1,0 g/l NaCl (entre 0,8 - 1,2 g/l como intervalo de confianza al 95%), mientras que H. viridissima presentó una CL50-96h promedio de 2,6 g/l (entre 2,0 - 3,3 g/l como intervalo de confianza del 95%). Se considera que esta última fue más tolerante al NaCl, probablemente por la relación simbiótica con la microalga Chlorella vulgaris, ya que podría generar un efecto protector. Se espera que comprender el comportamiento de estos biomodelos respecto al aumento de la salinización permita la evaluación temprana de riesgos ecológicos en ecosistemas acuáticos tropicales.

The increase in salinity in freshwater ecosystems raises concern about the adverse effects that it can cause in freshwater species and the soil. The sodium and calcium ions optimum concentrations required for genus Hydra to have adequate physiological conditions are relatively low. This research compared the H. vulgaris and H. viridissima sodium chloride (NaCl) sensitivity. The species were propagated under photoperiod, lighting and temperature-controlled conditions. The growth rates were obtained and EC50 (mean effective concentration) and LC50 (mean lethal concentration) were calculated by means of acute toxicity tests as indicators of sensitivity to NaCl. For H. vulgaris the LC50-96h was 1.0 g/l of NaCl with a range between 0.8 - 1.2 g/l of NaCl, compared to H. viridissima presented an average LC50-96h of 2.6 g/l of NaCl with a 95% confidence interval between 2.0 - 3.3 g/l of NaCl. The H. viridissima was more tolerant, probably the symbiotic relationship with Chlorella vulgaris, can generate a protective effect. Understanding the behavior of these species with respect to increased salinization can allow an early assessment of ecological risks in tropical aquatic ecosystems.

Escala predictiva de los resultados adversos en la hemorragia digestiva alta no varicosa

Introducción: Existen varios sistemas de puntuación para predecir los resultados adversos en los pacientes con hemorragia digestiva alta no varicosa, pero no se han validado lo suficiente y cada uno pertenece a distintas poblaciones fuentes. Objetivo: Demostrar la utilidad de una escala propuesta para predecir las probabilidades de resangrado, de mortalidad y de necesidad de cirugía en los pacientes con hemorragia digestiva alta no varicosa. Métodos: Se realizó un estudio retrospectivo de una prueba diagnóstica en el hospital de Prenda, Luanda, Angola desde enero del 2021 hasta mayo del 2022. El universo estuvo formado por 93 pacientes atendidos durante ese período con el criterio de inclusión de tener el diagnóstico de hemorragia digestiva alta de origen no varicoso. Resultados: De un total de 93 pacientes se obtuvo como desenlace primario una recurrencia del sangrado de 18 pacientes para un 19,35 % del total, seguido con 12 fallecidos para un 12,90 % del total y cuatro fallecidos para un 4,40 % del total. Los valores predictivos de la escala de forma general fueron, al ser aplicada una sensibilidad de 0,91, la especificidad de un 0,92, el valor predictivo negativo de un 0,95 y el valor predictivo negativo de un 0,86. Conclusiones: La escala propuesta tiene una sensibilidad y especificidad adecuada para predecir, en los pacientes con hemorragia digestiva alta no varicosa, la probabilidad de resangrado, de mortalidad y la necesidad de cirugía.

Introduction: Several scoring systems exist to predict adverse outcomes in patients with nonvariceal upper gastrointestinal bleeding, but they have not been sufficiently validated and each pertains to different source populations. Objective: To demonstrate the usefulness of a proposed scoring scale to predict the probability of rebleeding, mortality, and need for surgery in patients with nonvariceal upper gastrointestinal bleeding. Methods: A retrospective study of a diagnostic test was performed at the hospital of Prenda, Luanda, Angola, from January 2021 to May 2022. The study universe consisted of 93 patients attended during that period, with the inclusion criterion of having a diagnosis of upper gastrointestinal bleeding of nonvariceal origin. Results: From a total of 93 patients, the primary outcome was a recurrence of bleeding in 18 patients, accounting for 19.35% of the total; followed by 12 deaths, representing 12.90% of the total, and four deaths, accounting for 4.40% of the total. After the scale was applied, the following general predictive values were obtained: sensitivity of 0.91, specificity of 0.92, negative predictive value of 0.95 and negative predictive value of 0.86. Conclusions: The proposed scale presents adequate sensitivity and specificity for predicting the probability of fatal rebleeding and the need for surgery in patients with nonvariceal upper gastrointestinal bleeding.

Efectividad del tratamiento con atropina versus oclusiones en pacientes con ambliopía refractiva moderada unilateral

Objetivo: Comparar la efectividad del tratamiento de atropina versus oclusión ocular en pacientes con ambliopía refractiva moderada unilateral. Métodos: Se realizó un estudio descriptivo, longitudinal y prospectivo de una serie de casos que acudieron a la consulta de Oftalmología Pediátrica del Instituto Cubano de Oftalmología Ramón Pando Ferrer durante el período comprendido de septiembre del 2019 a septiembre de 2021. La muestra quedó conformada por 44 pacientes, los cuales se dividieron de forma aleatoria en dos grupos de estudio, 22 casos al grupo de oclusiones e igual número al grupo de atropina, que cumplían los criterios de inclusión. Se analizaron las variables edad, sexo, defecto refractivo, agudeza visual mejor corregida, sensibilidad al contraste y estereopsis. Resultados: Predominó el astigmatismo hipermetrópico en ambos grupos de estudio. La media de la agudeza visual mejor corregida inicial en ambos grupos fue de 0,4 LogMAR y mejoró a 0,1 LogMAR al finalizar el tratamiento. La media de la sensibilidad al contraste inicial fue de 1,48 (±19,75) para el grupo de oclusiones y de 1,47 (±20,5) para el grupo atropina, al finalizar alcanzaron 1,59 (±10,1) y 1,57 (±10,0) por orden de mención. La estereopsis inicial fue subnormal en ambos grupos, al finalizar el tratamiento fue normal en el 77,3 % grupo oclusión y el 68,2 % grupo atropina. Conclusiones: La efectividad del tratamiento en pacientes con ambliopía refractiva moderada unilateral con atropina es similar a la que se alcanza con la aplicación de la oclusión ocular.

Objective: To compare the effectiveness of atropine treatment versus ocular occlusion in patients with unilateral moderate refractive amblyopia. Methods: A descriptive, longitudinal and prospective study of a series of cases that attended the Pediatric Ophthalmology office of the Ramón Pando Ferrer Cuban Institute of Ophthalmology during the period from September 2019 to September 2021 was carried out. The sample consisted of 44 patients, who were randomly divided into two study groups, 22 cases to the occlusion group and the same number to the atropine group, who met the inclusion criteria. The variables age, gender, refractive defect, best corrected visual acuity, contrast sensitivity and stereopsis were analyzed. Results: Hypermetropic astigmatism predominated in both study groups. Average initial best-corrected visual acuity in both groups was 0.4 LogMAR and improved to 0.1 LogMAR at the end of treatment. Average initial contrast sensitivity was 1.48 (±19.75) for the occlusion group and 1.47 (±20.5) for the atropine group, at completion reaching 1.59 (±10.1) and 1.57 (±10.0) in order of mention. Initial stereopsis was subnormal in both groups, at the end of treatment it was normal in 77.3 % occlusion group and 68.2 % atropine group. Conclusions: The effectiveness of treatment in patients with unilateral moderate refractive amblyopia with atropine is similar to that achieved with the application of ocular occlusion.

Infecciones causadas por Staphylococcus aureus de la Comunidad. Estudio de sensibilidad y tendencias en población pediátrica. Años 2015 a 2020

Introducción: Staphylococcus aureus (SA) puede ocasionar cuadros infecciosos severos y muerte. La emergencia de cepas resistentes a meticilina constituye un desafío terapéutico. Objetivos: determinar el perfil de resistencia antimicrobiana de: Staphylococcus aureus adquirido en la comunidad (SA-CA), obtenidos de muestras biológicas de niños, entre 2015 a 2020. Material y Método: estudio descriptivo, observacional y retrospectivo. Las muestras para cultivos se extrajeron al ingreso hospitalario del paciente. Para determinación de resistencia y sensibilidad se utilizó normas de CSLI. Resultados: 244 aislamientos de SA-CA. Masculinos 99 (59%), menores de un año: 42 (25%), de 2 a 5 años: 34 (20%), de 6 a 11 años: 50 (30%) y entre 12 a 15 años: 42 (25%). De los aislados, 72% fueron SAMR (121/168) y 28% SAMS (47/168). Se observó un incremento de tasas anuales de aislamientos SAMR en infecciones de la comunidad desde el 2015 al 2020. Los aislamientos se originaron en piel y partes blandas 53,2 %; sangre 37,4%, orina 3,5%, LCR 2,4%, liquido articular 1,7%, abscesos profundos 1,2% y liquido pleural 0,6%. La prevalencia de SAMR-CA fue de 60,5 en el 2015, 59,6 %, 61,5%, 72,2 %, 67,3% y 75,5 % en los años sucesivos. No se aisló ninguna cepa resistente a la vancomicina. El 10,1% de las cepas estudiadas presentó resistencia inducida a la clindamicina. Conclusión: El SAMR se ha establecido como patógeno de la comunidad. La resistencia inducida por clindamicina fue del 10,1%. Un tercio de las infecciones fueron causadas por SAMS. Las prevalencias de SAMS muestran tendencia a la disminución.

Introduction: Staphylococcus aureus (SA) can cause severe infectious conditions and death. The emergence of methicillin-resistant strains constitutes a therapeutic challenge. Objectives: to determine the antimicrobial resistance profile of: Staphylococcus aureus acquired in the community (SA-CA), obtained from biological samples of children, between 2015 and 2020. Material and Method: descriptive, observational and retrospective study. The samples for cultures were extracted upon hospital admission of the patient. To determine resistance and sensitivity, CSLI standards were used. Results: 244 isolates of SA-CA. Males 99 (59%), under one-year-old: 42 (25%), from 2 to 5 years old: 34 (20%), from 6 to 11 years old: 50 (30%) and between 12 and 15 years old: 42 (25%). Of the isolates, 72% were SAMR (121/168) and 28% SAMS (47/168). An increase in annual rates of MRSA isolates in community infections was observed from 2015 to 2020. The isolates originated in skin and soft parts 53.2 %; blood 37.4%, urine 3.5%, CSF 2.4%, joint fluid 1.7%, deep abscesses 1.2% and pleural fluid 0.6%. The prevalence of MRSA-CA was 60.5 in 2015, 59.6%, 61.5%, 72.2%, 67.3%, and 75.5% in subsequent years. No vancomycin resistant strain was isolated. 10.1% of the strains studied presented induced resistance to clindamycin. Conclusion: MRSA has been established as a community pathogen. The resistance induced by clindamycin was 10.1%. One third of the infections was caused by SAMS. The prevalence of SAMS shows a downward trend.

Características epidemiológicas de la Osteomielitis aguda en niños internados en un hospital infeccioso de referencia

Introducción: La osteomielitis aguda es una infección del hueso que afecta principalmente a los niños y tiene generalmente diseminación hematógena, a veces asociada a un trauma. En la etiología influyen factores, como la edad, el estado inmunológico y las enfermedades concomitantes. En la mayoría de los casos, el principal agente etiológico es Staphylococcus aureus. Es importante el diagnóstico oportuno para evitar secuelas a mediano o largo plazo. Objetivo: Describir las características epidemiológicas de un grupo de pacientes con osteomielitis aguda. Métodos: Se realizó la revisión retrospectiva de los expedientes clínicos de pacientes egresados del servicio de pediatría del Instituto de Medicina Tropical, entre enero de 2016 y diciembre de 2020, con diagnóstico de osteomielitis aguda. Resultados: Los varones con osteomielitis corresponden al 67,8% del total de 59 casos registrados, en cuanto a los signos y síntomas, el dolor, la tumefacción y la impotencia funcional fueron predominantes, la fiebre se documentó en 49 (83,1%) pacientes, se registró antecedentes de cirugía en 37 (62,7%) de los pacientes y complicaciones en 42 (71,2%) de los pacientes, la complicación más frecuente fue osteomielitis crónica El sitio anatómico más frecuente fueron los miembros inferiores. El tratamiento empírico fue realizado con cefalosporinas de 3G en 72,9% de los pacientes, ya sea solo o combinado con clindamicina o vancomicina, un paciente con aislamiento de M. tuberculosis recibió tratamiento HRZE. Se aisló algún germen 44 pacientes (74,5%), el microorganismo predominante fue Staphylococcus aureus en 81,8 %, la mitad (52,3%) correspondieron a SAMR Se encontró una alta resistencia a oxacilina del 55,8% y un solo paciente resistente a clindamicina (2,2%). Conclusión Los hallazgos fueron similares a los reportados en la literatura en cuanto a etiología, sitio anatómico afectado y cobertura antibiótica.

Introduction: Acute osteomyelitis is a bone infection that mainly affects children and generally has hematogenous spread, sometimes associated with trauma. The etiology is influenced by factors such as age, immune status, and comorbidities. In most cases, the main etiologic agent is Staphylococcus aureus. Timely diagnosis is important to avoid sequelae in the medium or long term. Objective: To describe the epidemiological characteristics of a group of patients with acute osteomyelitis. Methods: A retrospective review of the clinical records of patients discharged from the pediatric service of the Institute of Tropical Medicine was carried out between January 2016 and December 2020, with a diagnosis of acute osteomyelitis. Results: Men with osteomyelitis correspond to 67.8% of the total of 59 registered cases, in terms of signs and symptoms, pain, swelling and functional impotence were predominant, fever was documented in 49 (83.1%) patients, a history of surgery was recorded in 37 (62.7%) of the patients and complications in 42 (71.2%) of the patients, the most frequent complication was chronic osteomyelitis The most frequent anatomical site was the lower limbs. Empirical treatment was performed with 3G cephalosporins in 72.9% of the patients, either alone or in combination with clindamycin or vancomycin. One patient with M. tuberculosis isolation received HRZE treatment. Some germ was isolated in 44 patients (74.5%), the predominant microorganism was Staphylococcus aureus in 81.8%, half (52.3%) corresponded to MRSA. A high resistance to oxacillin of 55.8% and a only patient resistant to clindamycin (2.2%). Conclusion The findings were similar to those reported in the literature in terms of etiology, affected anatomical site, and antibiotic coverage.

Frecuencia de Bacilos Gram Negativos en la cavidad bucal de estudiantes de una Universidad de Asunción

Introducción: La cavidad bucal hospeda una gran cantidad de microorganismos, como los bacilos Gram negativos, y entre ellas, bacterias de gran importancia médica debido a su capacidad de producir enfermedades graves para el ser humano, especialmente en pacientes inmunodeprimidos. El objetivo de este trabajo fue determinar la presencia de Bacilos Gram Negativos y sus patrones de resistencia a antibióticos, en una población estudiantil de la ciudad de Asunción, en los años 2019 y 2020. Materiales y métodos: Se realizó un estudio observacional, descriptivo de corte transversal, donde se realizaron hisopados de la cavidad bucal a 35 alumnos de entre 18 a 24 años, de una universidad privada en la ciudad de Asunción. Se requirió consentimiento informado firmado por los participantes y fueron excluidos quienes tuvieron tratamientos antibióticos. Las muestras fueron obtenidas con un hisopo de algodón, posteriormente se colocaron en un medio de transporte para luego ser cultivadas en Agar MacConkey. El cultivo se realizó por 48 horas a 37° centígrados, luego se procedió a la identificación bacteriana. Por último, se realizó el antibiograma. Resultados: De los 35 alumnos se encontró una frecuencia de 48,57% de bacilos Gram negativos. Cepas de Klebsiella pneumoniae fueron las más frecuentes (35,29%). Se observó que las bacterias eran altamente resistentes a la Amoxicilina/Ácido Clavulánico. Conclusiones: La presencia de estos tipos de microorganismos puede ser peligrosa para la salud general de las personas, específicamente de los pacientes con algún tipo de inmunodepresión, debido a la gran la resistencia a antibióticos presentadas por algunas cepas.

Introduction: The oral cavity hosts a large number of microorganisms, such as Gram negative bacilli, and among them, bacteria of great medical importance due to their capacity to cause serious diseases for humans, especially in immunosuppressed patients. The objective of this work was to determine the presence of Gram Negative Bacilli and their patterns of resistance to antibiotics, in a student population of the city of Asunción, in the years 2019 and 2020. Materials and methods: An observational, descriptive cross-sectional study was carried out, where oral cavity swabs were made from 35 students between 18 and 24 years of age, from a private university in the city of Asunción. Informed consent signed by the participants was required and those who had antibiotic treatments were excluded. The samples were obtained with a cotton swab, later they were placed in a transport medium to later be cultured in MacConkey Agar. The culture was carried out for 48 hours at 37° Celsius, then the bacterial identification was carried out. Finally, the antibiogram was performed. Results: Of the 35 students, a frequency of 48,57% of Gram negative bacilli was found. Klebsiella pneumoniae strains were the most frequent (35.29%). The bacteria were found to be highly resistant to Amoxicillin/Clavulanic Acid. Conclusions: The presence of these types of microorganisms can be dangerous for the general health of people, specifically of patients with some type of immunosuppression, due to the great resistance to antibiotics presented by some strains.

A study on the microbial spectrum of otitis externa in a tertiary care teaching hospital

Background: Otitis externa is frequently seen illness by ENT practitioners predominantly in children and old age people. The severity sometimes varies from it ranges in severity from a trivial infection to dangerous malignant otitis externa. Furthermore, due to absurd consumption of antibiotics, though there is a fall in development of complications, there is a rise in resistance to various infectious organisms. Mostly, we start treating patients with empirical therapy where sometimes, it leads to occurrence of various antibiotic-resistant infections. For that reason, recent evidence about the organism which is mostly involved in infection and also most importantly the pattern of their response to various pharmacological agents is crucial for the sensible use of the medications for the management. Aim and Objectives: Our study was planned to evaluate and find out the causative organism which is most commonly seen in otitis externa, particularly focusing on drug sensitivity for those organisms, so that efficient management of otitis externa can be done. Materials and Methods: It is a retrospective study conducted in acute otitis externa patients from Novemver 2019 to January 2020. Patients who all presented with ear discharge within 3 months of period, samples were collected with clinically diagnosed acute otitis externa and sent for culture in blood agar, chocolate agar, and Mcconkey medium in vitro and drug sensitivity pattern was identified for individual organisms. Inclusion criteria: Patients more than 18 years having ear discharge within 3 months were included in the study. Exclusion criteria: Chronically discharging ear >3 months were excluded from the study. Results: Pseudomonas organism was frequently encountered pathogen in our study, trailed by Staphylococcus aureus. The organisms identified were very much sensitive to drugs like fluoroquinolones particularly Ciprofloxacin, and Aminoglycosides like Amikacin and almost all were responding to treatment with Piperacillin-Tazobactam, these drugs have an cidal activity over pathogens and are suitable for any age and safety-wise better too. Conclusion: Intermittent assessment and awareness of the bacteriological summary and their drug response profile in a particular geographical area will only help in rational drug prescription. Furthermore, rational usage of drugs will help in reducing any morbidity due to infection which may sometimes develop when treated inappropriately, further decreasing development of dangerous drug resistance.

Bacteriological Assessment of Critical Areas in Three Selected Units in Jodhpur Dental College General Hospital, Jodhpur Rajasthan, India

The hospital environment plays a crucial role in the chain of infection spread. Thus, there is need to attack the chain of infection at its weakest link as the most effective way in combating and/or preventing nosocomial infections. The study aims to assess the common aerobic pathogenic bacteria in the different departments of Jodhpur National University Dental Hospital and to establish the best disinfectant as well as disinfection procedure. A cross sectional descriptive study was conducted. Air and surface samples were taken before and after dental procedures from all the three departments within durations of 14 days. Different antiseptics were used so as to compare their effectiveness. Swabs taken from different places were streaked on blood agar plates and incubated at 37oC under aerobic conditions for 24 hours. After incubation, isolates obtained were appropriately identified. After aerobic incubation of the settle plates at 370C for 24hours, the colonies on each plate were counted and recorded as the number of bacteria carrying particles settling over the area of the plate in a given period of time. The level of bacterial contamination of air is usually expressed as the number of bacteria carrying particles per cubic millimeter. A total of 274 surface samples and 97 air samples were collected. Bacteria were isolated in all air samples while only 255 surface samples had growth. The predominant species in all services was Bacillus spp, followed by coagulase negative Staphylococci, Micrococcus luteus, aerobic spore formers and least was Pseudomonas aeruginosa. The bacteria isolated in the air were similar to those isolated from surfaces. In conclusion, lack of a universal procedure for surveillance of nosocomial infection, presence of pathogenic bacteria, poor hand hygiene and heavy contamination of some important surfaces are the most important problems in our hospitals.

Multifocal versus modified monovision corrections: A non-dispensing comparison of visual assessment in presbyopic neophytes

Purpose: To compare the visual performance of two simultaneous?vision soft multifocal contact lenses and to compare multifocal contact lens and its modified monovision counterpart in presbyopic neophytes. Methods: A double?masked, prospective, comparative study was conducted on 19 participants fitted with soft PureVision2 multifocal (PVMF) and clariti multifocal (CMF) lenses in random order. High? and low?contrast distance visual acuity, near visual acuity, stereopsis, contrast sensitivity, and glare acuity were measured. The measurements were conducted using multifocal and modified monovision design with one brand and then repeated with another brand of lens. Results: High?contrast distance visual acuity showed a significant difference between CMF (0.00 [?0.10–0.04]) and PureVision2 modified monovision (PVMMV; ?0.10 [?0.14–0.00]) correction (P = 0.003) and also between CMF and clariti modified monovision (CMMV; ?0.10 [?0.20–0.00]) correction (P = 0.002). Both modified monovision lenses outperformed CMF. The current study did not show any statistically significant difference between contact lens corrections for low?contrast visual acuity, near visual acuity, and contrast sensitivity (P > 0.01). Stereopsis at near distance was significantly lower with both modified monovision (PVMMV: 70 [50–85]; P = 0.007, CMMV: 70 [70–100]; P = 0.006) and with CMF (50 [40–70]; P = 0.005) when compared to spectacles (50 [30–70]). Glare acuity was significantly lower with multifocal (PVMF: 0.46 [0.40–0.50]; P = 0.001, CMF: 0.40 [0.40–0.46]; P = 0.007) compared with spectacles (0.40 [0.30–0.40]), but no significant difference was noted between the multifocal contact lenses (P = 0.033). Conclusion: Modified monovision provided superior high?contrast vision compared to multifocal correction. Multifocal corrections performed better for stereopsis when compared to modified monovision. In parameters like low?contrast visual acuity, near acuity, and contrast sensitivity, both the corrections performed similarly. Both multifocal designs showed comparable visual performances.