Synergy in penicillin, cephalosporin, amphenicols, and aminoglycoside against MDR S. aureus isolated from Camel milk

Abstract This study investigated the synergy testing of penicillin, cephalosporin, amphenicols, and aminoglycoside in the camel milk (n=768 samples), subsequently used for isolation of MDR S. aureus targeting mecA gene. Antibiotic susceptibility of S. aureus showed >90% isolates were sensitive to ciprofloxacin and trimethoprim and resistant against oxacillin, ampicillin, and cefoxitin. Further, 50-85% of the S. aureus were sensitive to gentamicin, oxytetracycline, and chloramphenicol and resistant against cefotaxime, vancomycin, and cefixime. Minimum inhibitory concentration (MIC) of cefotaxime, (C) and ampicillin (A) in combination with gentamicin (G) was reduced by 99.34% and 70.46%, respectively, while with chloramphenicol (Ch), reduction was 57.49% and 60%, respectively. In addition, the Fractional Inhibitory Concentration Index (FICI) of G+A, Ch+C and Ch+G combinations showed synergy against 80%, 60%, and 30% of MDR S. aureus, respectively. Similarly, C+A and Ch+G displayed indifferent interaction against 70 % and 30% of isolates, respectively, while the later showed additive interaction against 10% of MDR S. aureus. Altogether, our results described effective combination of gentamicin and chloramphenicol with ampicillin and cefotaxime to combat MDR S. aureus

Left Ventricular Filling Pressure Assessed by Doppler Echocardiography as a Predictor of Inhospital Outcome in Patients of ST-segment Elevation Myocardial Infarction.

Background: Left ventricular (LV) filling pressure is an important predictor of short and long term outcome in patients with coronary artery disease. Non invasive assessment of this pressure by Doppler echocardiography provides valuable information regarding the prognosis of patient with ST-segment elevation myocardial infarction. Elevated filling pressure is associated with increased incidence of morbidly and mortality due to ventricular remodeling, neuro-hormonal activation & increased excitability. The aim of this study was to assess LV diastolic dysfunction and left ventricular filling pressure in patients of ST-segment elevation myocardial infarction to predict their in-hospital outcome. Methods: The prognostic cohort study was conducted in National Institute of Cardiovascular Diseases, Dhaka from May 2011 to November 2011. A total of 100 Patients with acute ST-segment elevation myocardial infarction who has received streptokinase therapy were enrolled by purposive sampling. In addition to normal 2D & M mode study, Pulsed wave Doppler assessment of mitral valve inflow patterns was done in apical 4-chamber view to see Peak early (E) and peak late (A) flow velocities, E/A ratio and deceleration time of early mitral flow velocity (DT). Tissue Doppler Imaging (TDI) assessment was done at the lateral mitral annulus in apical 4-chamber view to assess Mitral annular diastolic velocity (E′) and E/E′ ratio. Patients were divided into two groups based on Doppler echocardiography derived Left ventricular filling characteristics. In group I 50 patients with E/E′ ratio <15 and in group II 50 patients with E/E’ >15. Patients were followed up for next 7 days and in-hospital outcomes were compared between groups. Results: The mean age of group-I & II were 53.84 ± 9.2 & 55.14 ± 8.5 years respectively. Male female ratio was 8.9:1.1. Age, sex and risk factors between two groups were statistically insignificant. Regarding in-hospital out come in group-I were hospital stay 5.28 ± 1.06 days, heart failure 28%, arrhythmia 8% and mortality was 2%. On the other hand in group-II hospital stay was 6.04±1.07 days, heart failure 68%, and arrhythmia 24% & mortality was 6%. All these were statistically significant between two groups except mortality. Conclusion: From this study it may be concluded that, left ventricular filling pressure assessed by Doppler echocardiograph predicts in-hospital outcome after acute ST segment myocardial infarction and prognosis is worse with increased left ventricular filling pressure.

Effects of eicosapentaenoic acid supplementation on lipid and lipoprotein profile in hypertriglyceridemic subjects with different proliferator-activated receptor alpha genotypes

We determined the blood lipid-lowering effects of eicosapentaenoic acid [EPA] on hypertriglyceridemic subjects with Leu162/Val in exon 5 and G/C in intron7 polymorphism of peroxisome proliferator-activated receptor alpha [PPAR alpha]genotypes that, to our knowledge, have not been previously studied. A total of 170 hypertriglyceridemic subjects were enrolled and genotyped for Ala54Thr, Leu162Val, and intron 7 polymorphism by the use of a polymerase chain reaction restriction fragment length polymorphism method. After determination of their genotypes, the first 23 eligible subjects who were found as Ala54 carriers and the first 23 eligible Thr54 carriers were enrolled in the study and stratified for PPAR alpha genotypes. Participants took 2 g of pure EPA daily for 8 weeks. Fasting blood lipid and lipoprotein profiles were determined and changes from baseline were measured. We observed significant difference between EPA supplementation and Leu162 and Val162, Interon 7 [GG and GC] carriers [P < 0.001]. We did not observe significant associations between the PPAR alpha L162V single nucleotide polymorphism and multiple lipid and lipoprotein measures. Although EPA consumption lowered lipid and lipoprotein concentrations in Leu162 and Val162 carriers and Interon 7 CC and GC carriers, these differences between the studied groups were not statistically significant. EPA consumption has a lipid-lowering effect in hypertriglyceridemic subjects in both Leu162 and Val162 carriers. But there was no significant interaction between EPA supplementation and PPAR alpha genotypes. Thus, genetic variation within the PPAR alpha Leu162/Val cannot modulate the association of EPA intakes with lipid and lipoprotein profile. However, we must note that the sample size in this study was small

Vitamin E-selenium supplement and clinical responses of active pulmonary tuberculosis

It has been suggested that some micronutrients have antioxidant and immunomodulating effects on the treatment of mycobacterial disease. In this study, we investigated the effect of vitamin E and selenium supplementation on clinical responses in tuberculosis patients. Thirty-five patients with pulmonary tuberculosis diagnosed on the basis of a positive sputum smear for acid fast bacilli or culture for Mycobacterium tuberculosis were selected. Serial sputum examinations were performed before the diagnosis and at the end of every 15 days, during two months of therapy; chest X-ray of all patients were also evaluated. In a setting of double-blind, placebo-controlled trial, the patients were divided into two groups. Group I[n=17] received combination of vitamin E and selenium which composed of 140 mg of +-TE and 200 ?g selenium per day, and group II received placebo. All patients in both groups received the same antituberculosis standard therapy. Clinical examination and assessment of micronutrient levels were carried out before and after 2 months of intervention. In group I, elimination of tubercle bacilli from sputum occurred earlier than in group II [6 weeks versus 8 weeks, respectively; p= 0.001]. At the end of the 2[nd] and 6[th] month of therapy, the median reduction in cavity surface area on chest X-ray in group I was significantly more than group II [2[nd] month: 1.5[0.0-4.5 versus 9.0[4.0-18.0];p= 0.03, and 6[th] month: 0.0[0.0-2.3] versus 6.3[1.0-15.8]; p < 0.05, respectively]. Vitamin E plus selenium supplementation may improve the microbiological and radiological outcomes of the treatment in patients with pulmonary tuberculosis