Prevalence of extended-spectrum beta-lactamase producing klebsiella pneumoniae by phenotypic and genotypic methods in Assiut University Hospital

This study investigated the urinary tract infection in Assiut university hospitals to evaluate the rate of infection, and the prevalence of extended spectrum ?-lactamase producing Klebsiella pneumoniae to define the magnitude of the problem and may help to implement appropriate infection control measures. This study was conducted from January 2014 to June 2014. Urine samples were collected from urinary tract infected patients to detect the causative organisms. After antimicrobial susceptibility testing, resistant strains to ?-lactam antibiotics were selected for detection of ESBLs. In addition PCR was done to determine the most common group of beta-lactamase genes responsible for resistance. The study included 340 patients presented to urology department at Assiut University Hospitals. The rate of community and hospital acquired UTI were 41% [140/340] and 59% [200/340] respectively. For community patients the commonest isolate was E. coli [54.28%] followed by Klebsiella pneumonia [29.28%] then Staphylococcus aureus [7.14%], Pseudomonas aeruginosa [1.42%], Coagulase-negative Staphylococcus [3.57%], and Candida species [4.28%].While the pattern of nosocomial isolates was Klebsiella pneumoniae [51%] followed by E. coli [30%] whereas, Staphylococcus aureus [4%], Pseudomonas aeruginosa [11%], Coagulase-negative Staphylococcus [3%], Candida species [1%] Antibiotics sensitivity of K. pneumoniae isolates showed that these organisms were mostly sensitive to meropenem [100%]. Phenotypic confirmatory tests [combined disc method, double disc method and ESBL-E-Test] were done to test K. pneumoniae isolates for ESBL production. It was concluded that 60.97% [25/41] of community isolates and 81.37% [83/102] of nosocomial isolates were ESBLs producers. PCR was done to determine the responsible ESBL gene; it revealed that the common ESBL gene was CTX-M followed by TEM then SHV. Further analysis of CTX-M positive isolates showed that CTX-M-group-1 was the predominant type. ESBLs is a neglected healthcare crisis in Egypt that needs strategies to treat, prevent and control the rising rate. In addition, rapid and clinically relevant antibiotic testing service is always required to provide services. Besides, the controlled use of 3[rd] generation cephalosporin along with implementation of infection control measures are the most effective means of controlling and decreasing the spread of ESBL isolates

Effect of subcutaneous phosphatidylcholine injection used in the treatment of localization obesity on the histological structures of human skin and subcutaneous tissue: a pilot study

Multiple clinical trials have supported the idea that subcutaneously injected phosphatidylcholine [PPC] leads to a reduction in localized fat collection. However, only a few histological studies that explain the mechanism of action of PPC have been published. This study aimed to evaluate the clinical and detailed histological changes in the skin and subcutaneous tissue after PPC injection. Ten female patients with local fat deposits [upper outer thigh] were assessed after a single session of subcutaneous injection with PPC on the basis of thigh circumference measurement, and histological examination of skin biopsy specimens was carried out before and 1 and 2 months after treatment. Histological sections were stained with H and E, Masson's trichrome [for collagen fibers], and by aldehyde fuchsin [for elastic fibers], followed by morphometric study and statistical analysis. Two months after injection, a statistically significant reduction in thigh circumference was found [P=0.045], with leathery tight skin texture at the injected area. Histological examination revealed dermal inflammatory responses 1 month after injection, with destruction of fat cells. These observations were reduced after 2 months with evidence of regenerating fat cells. Statistical analysis showed a significant increase in collagen area% [P=0.025] and statistically nonsignificant increase in elastic fiber area% at the end of the study. A single session of subcutaneous PPC injection had an evident lipolytic effect, with noticeable contouring and skin tightening due to regenerative effect on skin connective tissue, particularly dermal collagen. However, lipolytic effect was partially temporary because of regeneration of fat cells

Ocular changes in leukaemias: a review and a report of 3 cases

A report of three cases of acute leukaemia, in children, demonstrating various ocular changes was given. One meyleoid presented by bilateral proptosis and fundus changes. Another lymphoblastic by bilateral proptosis and subconjuctival haemorrhage. The third was moncytic and presented by poor vision due to marked fundus changes. A review on the different ocular changes in leukaemia was included