Multi-drug resistant typhoid in adults

A total of 100 clinically suspected cases of typhoid fever were studied during the period January 1993 to December 1994. Blood and bone marrow cultures were done to find out the pattern of anti-microbial sensitivity of Salmonella; 44 cases were culture positive. Salmonella typhi was isolated in 81.8% of the cases [n=36] while Salmonella para typhi A was isolated in 18.1% of the cases [n=8]. Salmonella paratyphi B and C were not isolated. All isolates of Salmonella typhi were resistant to conventional anti-typhoid drugs i.e. chloramphenicol, amoxycillin and co-trimoxazole, and were sensitive to aminoglyco-sides-gentamycin, third generation cephalosporin cefexim, cefotaxime, ceftazidime and ceftriaxone and to quinolones i.e. ofloxacin and glomefloxacin. All isolated of Salmonella paratyphi A were sensitive to conventional as well as the newer antibiotics mentioned above. It is concluded that, in view of the alarming increase in the incidence of multi-drug resistant salmonella typhi to conventional antibiotics, typhoid fever must be treated very cautiously, and newer antibiotics must only be used when they are indicated so as to prevent the development of microbial resistance against them

Reversal of left ventricular hypertrophy in asiatic hypertensives with lisinopril

LVH is considered to be a significant risk factor for coronary artery disease and sudden death. Angiotensin converting enzyme [ACE] inhibitors have been demonstrated to be effective for the regression of LVH when used in antihypertensive doses. The aim of this study was to determine the effect of Lisinopril on regression of left ventricular hypertrophy [LVH] in asiatic patients with hypertension. Thirty eight patients of essential hypertension with echocardiographically proven LVH [LVMI> 24 gm/m2 in males and> 122 gm/m2 in females] were studied to evaluate the changes in LV mass and function after the administration of ACE inhibitor Lisinopril. LV mass was calculated from Penn. convention measurement using cube formula of Devereux. Throughout the trial period, the mean arterial pressure was well controlled, at week 0 it was 128.33 +/- 5.81 mmHg, at week 12 it was 106.21 +/- 6.10 mmHg and at week 24 it was 107.26 +/- 3.61 mmHg. All patients showed regression of LV mass. LVMI at week 0 was 160.23 +/- 29.99 gm/m2, at week 12 it was 139.99 +/- 29.36 gm/m2 [P=0.0001] and at week 24 it was 132.52 +/- 30.02 gm/m2 [P=0.0001]. The mean ejection fraction increased by 4.40% [P=0.0001]. In conclusion LVH in hypertensive patients can be reversed by Lisinopril and that too without deterioration of LV function

Study of regional flaps in reconstruction of the post-traumatic defects of lower third of the nose

Twenty patients were selected for this study irrespective of age and sex, who presented with various defects of nose following trauma. Various techniques of Regional flaps were tried and results assessed with the help of Preoperative and postoperative photographs. In our study results were best with forehead flap than other types of regional flaps

Clinical profile of 100 cases of liver abscess

One hundred patients with liver abscess were studied for clinical features and complications. They were diagnosed by radiography, ultrasonography, serology and by needle aspiration. A variety of interesting clinical, haematological and ultrasonographic findings were observed. Literature on liver abscess was reviewed and results compared

Serodiagnosis of amoebic liver abscess by IHA method

Serological test based on IHA [Indirect Haemagglutination Method] was performed in 100 cases of hepatic abscess. The test was 100% sensitive and 94% specific. The cut off point of antibody titer between normal population and patients with invasive amoebiasis was 1:128. Antibody titer in amoebic liver abscess was 1:5242 +/- 2795. A significant [P<0.001] correlation was found between total leucocyte count and antibody titer