Soil Vulnerability Assessment of Afikpo South Local Government Area, Ebonyi State, Nigeria

Remote Sensing and Geographic Information System (GIS) integrated with the Revised Universal Soil Loss Equation (RUSLE) was adopted to estimate the rate of annual soil loss in Afikpo South Local Government. This is important due to the fact that agriculture is the main source of livelihood in the area. The RUSLE factors were computed using data such as rainfall from NIMET, Soil from FAO, elevation from SRTM and Landsat 8 OLI from USGS. The data were used as input in a GIS environment and the annual soil loss was generated using the RUSLE equation. The result shows that the average annual soil loss ranges from 0 to 155, 858 ha/ton/yr. It was also observed that soil erosion was predominant in the southern part of Afikpo South LGA due to the presence of steep slopes in the area. The study serves as preliminary documentation for planning, conservation and management of soil resources in the Local Government.

The Impact of the Episodic Rainstorm Event of 18th April and 5th May, 2018 in Taraba State, Nigeria

The study assessed the two days episodic rainstorm event that destroyed buildings and led to loss of life in April and May 2018 in Taraba State, northeast Nigeria. Data were from primary and secondary sources. A total of 60 copies of research questionnaires and interviews were used, complimented by data from the meteorological observatory of the Department of Geography, Taraba State University and expert eye witness accounts. The results of the study show that the 2-day rainstorm extreme event with high wind speed of over 600 knots (327 m/s) caused devastating damages to building infrastructures in the state and the roofs of buildings and damage to Globacom Telecommunication mast was profound and five people lost their lives with several others sustaining diverse injuries in 17 communities in Jalingo and Wukari. It led to about 62% of the affected to take refuge outside their homes for over three days while other spent more than 10 days. The schools were more affected with an estimated cost of ₦30,000,000 to fix the damaged infrastructures, followed by government buildings which needs about 24,000, 000 and residential building with estimated cost of ₦ 6,275,000. The cost for fixing the infrastructures damaged in Wukari in comparison to Jalingo was ₦ 9,000,000 for residential buildings, ₦ 6,000,000 for government buildings and ₦ 9,275,000 for schools respectively. Prices of roofing sheets increased with about $6 during the period. It was suggested that wind breakers should be encouraged and the cutting down of trees should be discouraged while creating awareness and encouraging afforestation.

Spatial Assessment of Land Surface Temperature and Emissivity in the Tropical Littoral City of Port Harcourt, Nigeria

The study examined Land Surface Temperature (LST) and Land Surface Emissivity (LSE) in a tropical coastal city of Port Harcourt and its environs. Satellite remote sensing of multiple-wavelength origin was employed to derive data from the Landsat Enhance Thematic Mapper (ETM+). Statistical mean and range were used to show pattern of LST and LSE. The study established the relationship and characteristics of land use land cover, built-up area and influence of population on land surfaces. With population of over 3,095,342 persons occupying surface area of approximately 458,28 Km2, rapid vegetal and water body lost have put the city area under pressure of 4.7°C heat bias at the interval of 15 years. From rural fringes to the city center, LST varies with 9.3°C in wet season and 4.8°C in the dry season. During the dry season, LSE is severe in the southern part of the city contributed by water bodies, more vegetal cover and urban pavement materials. Emissivity in the wet season varied with 0.0136 and 0.0006 during the dry season but differs with 0.0165 between the two seasons. One critical finding is that LSE decreases from the rural fringes to the city center and LST increases from the rural fringes to the city center. It is recommended that urban greening at the city center should be practiced and the rural fringes should be explored by decongesting activities at the city center to the outskirts in order to ameliorate the effects of urban heat bias without further delay.

Level of awareness and treatment of anxiety and depression during pregnancy in southeast Nigeria

Background: Anxiety and depressive disorders are somewhat masked by features of pregnancy; hence many women are ignorant of them and are untreated. Aim: To determine the level of awareness and treatment of anxiety and depression in pregnancy. Setting: The study was carried out at the antenatal clinic of Enugu State University Teaching Hospital, Enugu, Nigeria. Method: This was a cross-sectional and descriptive study of 200 pregnant women in consecutive attendance of the antenatal clinic using the Hospital Anxiety and Depression Scale (HADS) and a sociodemographic questionnaire. Results: Of the participants, 23.5% had anxiety and/or depression, 7.5% of them were aware of their condition and only 0.5% of all the participants or 6.7% of those who were aware of their problem received treatment. Conclusion: Anxiety and depression are prevalent among pregnant women. Because of overlap of symptoms of anxiety and depression with those of pregnancy, the awareness is very low; hence many of them suffer immensely without treatment

Clinico-pathologic profile and clinical outcomes of patients with indolent lymphoma at the Cancer Institute of the Philippine General Hospital: A seven-year experience

INTRODUCTION: Indolent lymphoma (IL) is a slowly growing lymphoma, generally refractory to conventional chemotherapy. There are several types of IL, which includes follicular lymphoma (FL), marginal zone lymphoma (MZL), small lymphocytic lymphoma (SLL), mantle cell lymphoma (MCL), and waldenstrom macroglobulinemia/ lymphoplasmacytic lymphoma (WM/LPL). Presently, there are no known data in the Philippines on IL. This study is done to determine the clinico-pathologic profile and outcomes of Filipino patients with IL.METHODS: This study is a retrospective chart review of outpatient department cases of IL seen at the Philippine General Hospital-Cancer Institute from January 2009 to January 2016. The following were documented: age; gender; primary location; presence or absence of B symptoms; type of IL; Ann-arbor stage; prognostic indices for FL and MCL; and staging with bone marrow aspiration and whole body CT scan. Treatment intervention and clinical outcomes were documented.RESULTS: This study showed that SLL was the most common IL. Most were elderly (>40 years old); male; lacked B symptoms; limited disease; and primary location at or near the orbital area. MCL were seen in all risk groups. Follicular lymphoma (FL) were mostly low risk and had grade one histology. Majority had disease control regardless of treatment intervention. Most patients with recurrence/progression after initial treatment had limited disease but were understaged. Most of the patients were not staged with bone marrow aspiration or whole body computed tomography.CONCLUSION: The results of this study are mostly consistent with known literature on IL. Absence of B symptoms and limited disease may indicate a low-grade histology. Observation was the most common option for asymptomatic patients. 

Clinico-pathologic profile and clinical outcomes of patients with indolent lymphoma at the Cancer Institute of the Philippine General Hospital: A seven-year experience

INTRODUCTION: Indolent lymphoma (IL) is a slowly growing lymphoma, generally refractory to conventional chemotherapy. There are several types of IL, which includes follicular lymphoma (FL), marginal zone lymphoma (MZL), small lymphocytic lymphoma (SLL), mantle cell lymphoma (MCL), and waldenstrom macroglobulinemia/ lymphoplasmacytic lymphoma (WM/LPL). Presently, there are no known data in the Philippines on IL. This study is done to determine the clinico-pathologic profile and outcomes of Filipino patients with IL. METHODS: This study is a retrospective chart review of outpatient department cases of IL seen at the Philippine General Hospital-Cancer Institute from January 2009 to January 2016. The following were documented: age; gender; primary location; presence or absence of B symptoms; type of IL; Ann-arbor stage; prognostic indices for FL and MCL; and staging with bone marrow aspiration and whole body CT scan. Treatment intervention and clinical outcomes were documented. RESULTS: This study showed that SLL was the most common IL. Most were elderly (>40 years old); male; lacked B symptoms; limited disease; and primary location at or near the orbital area. MCL were seen in all risk groups. Follicular lymphoma (FL) were mostly low risk and had grade one histology. Majority had disease control regardless of treatment intervention. Most patients with recurrence/progression after initial treatment had limited disease but were understaged. Most of the patients were not staged with bone marrow aspiration or whole body computed tomography. CONCLUSION: The results of this study are mostly consistent with known literature on IL. Absence of B symptoms and limited disease may indicate a low-grade histology. Observation was the most common option for asymptomatic patients.  

Clinico-pathologic profile and clinical outcomes of patients with indolent lymphoma at the Cancer Institute of the Philippine General Hospital: A seven-year experience

@#<p style="text-align: justify;"><strong>INTRODUCTION:</strong> Indolent lymphoma (IL) is a slowly growing lymphoma, generally refractory to conventional chemotherapy. There are several types of IL, which includes follicular lymphoma (FL), marginal zone lymphoma (MZL), small lymphocytic lymphoma (SLL), mantle cell lymphoma (MCL), and waldenstrom macroglobulinemia/ lymphoplasmacytic lymphoma (WM/LPL). Presently, there are no known data in the Philippines on IL. This study is done to determine the clinico-pathologic profile and outcomes of Filipino patients with IL.</p><p style="text-align: justify;"><strong>METHODS:</strong> This study is a retrospective chart review of outpatient department cases of IL seen at the Philippine General Hospital-Cancer Institute from January 2009 to January 2016. The following were documented: age; gender; primary location; presence or absence of B symptoms; type of IL; Ann-arbor stage; prognostic indices for FL and MCL; and staging with bone marrow aspiration and whole body CT scan. Treatment intervention and clinical outcomes were documented.</p><p style="text-align: justify;"><strong>RESULTS:</strong> This study showed that SLL was the most common IL. Most were elderly (>40 years old); male; lacked B symptoms; limited disease; and primary location at or near the orbital area. MCL were seen in all risk groups. Follicular lymphoma (FL) were mostly low risk and had grade one histology. Majority had disease control regardless of treatment intervention. Most patients with recurrence/progression after initial treatment had limited disease but were understaged. Most of the patients were not staged with bone marrow aspiration or whole body computed tomography.</p><p style="text-align: justify;"><strong>CONCLUSION: </strong>The results of this study are mostly consistent with known literature on IL. Absence of B symptoms and limited disease may indicate a low-grade histology. Observation was the most common option for asymptomatic patients.</p><p style="text-align: justify;"> </p>

Efficacy of tiotropium as add-on therapy for adults with uncontrolled asthma

@#<p style="text-align: justify;"><strong>OBJECTIVE:</strong> The study aimed to evaluate efficacy of tiotropium as add-on therapy on top of standard regimens for uncontrolled asthma, specifically in terms of FEV1, morning and evening PEF, reduction in exacerbations, rescue medication use, and quality of life improvement.<br /><strong>METHODS:</strong> A search was done for eligible trials after which validity screen and data extraction was performed. Results were presented as mean differences, standard errors, and 95% confidence intervals, and graphically as forest plots. Estimates were pooled using the random effects model with I2 and Chi2 tests used to assess heterogeneity. Adverse events were reported as dichotomous variables.<br /><strong>RESULTS:</strong> Four studies were included totaling 1617 participants. The tiotropium group had statistically significant improvement in FEV1 (95% Cl, 0.14 [0.09, 0.19], p<0.00001), morning (95% Cl, 20.03 [11.71, 28.35], p<0.00001) with trend towards benefit in reduction of rescue medications (95% Cl, 0.12 [-0.17,0.4],p=0.42) and quality of life improvements (95% Cl, 0.1 [-0.05,0.25], p=0.20). Homogeneity (I2= 0%, Chi2= 0.47-3.22) was found across studies.<br /><strong>CONCLUSION:</strong> Tiotropium is associated with significant improvement in pulmonary function among patients with uncontrolled asthma, with possible benefit in reduction of rescue medications and quality of life improvement.</p>

Sexual Dysfunction among Filipino breast cancer patients

INTRODUCTION: Sexual function is an important aspect of quality of life, and can be drastically affected in ill patients. Very few studies (and apparently none among Filipinas) looked into sexual dysfunction among females with breast cancer (BrCa); prevalence also is not well defined. This study evaluates the prevalence of sexual dysfunction among Filipino patients with BrCa, and assesses which treatment or if duration of illness, age, BMI, smoking history, diabetes, hypertension significantly contributed to the dysfunction.METHODS: A cross sectional study was conducted among BrCa patients consulting at the outpatient medical oncology clinic of a government tertiary hospital. Study population included those diagnosed and was with breast cancer over a 3-months period, with a calculated sample size of 60 (within 81±10% prevalence rate, Cl 95%). A validated translated version of the Female Sexual Function Index (FSFI) 19-item questionnaire that looked into 6 domains (arousal, lubrication, desire, pain, orgasm, and satisfaction) was used. Sexual dysfunction was defined as an FSFI score of RESULTS: Of the 97 respondents, mean age was 49.4 years old and mean BMI of 24.8. About 78% received chemotherapy, 26% hormonal therapy. 15% radiotherapy, 82% modified radical mastectomy (MRM), and 71% received both MRM and chemotherapy at the time of interview. Duration of cancer wasmonths in 72% of subjects. There were 97.9% who had sexual dysfunction which is similar to prevalence rates (64-98%) in other studies. Age, BMI, smoking history, hypertension, diabetes mellitus, chemotherapy, surgery, hormonal therapy, radiation therapy, and duration of illness were shown not to be significant predictors of sexual dysfunction among Filipinas with BrCa by bivariate analysis.CONCLUSION: Sexual dysfunction is highly prevalent among female Filipino BrCa patients. Knowing such high prevalence should prompt health care providers to include interventions to improve quality of life of BrCa patients, including their sexual life.

effect of hand hygiene compliance on hospital-acquired infections in an ICU setting in a Kuwaiti teaching hospital

Hand washing is widely accepted as the cornerstone of infection control in the intensive care unit [ICU]. Nosocomial infections are frequently viewed as indicating poor compliance with hand washing guidelines. To determine the hand hygiene [HH] compliance rate among healthcare workers [HCWs] and its effect on the nosocomial infection rates in the ICU of our hospital, we conducted an interventional study. The study spanned a period of 7 months [February 2011-August 2011] and consisted of education about HH indications and techniques, workplace reminder posters, focused group sessions, and feedback on the HH compliance and infection rates. The WHO HH observation protocol was used both before and after a hospital-wide HH campaign directed at all staff members, particularly those in the ICU. Compliance was measured by direct observation of the HCWs, using observation record forms in a patient-directed manner, with no more than two patients observed simultaneously. The overall HH compliance rate was calculated by dividing the number of HH actions by the total number of HH opportunities. The nosocomial infection rates for the pre- and post-interventional periods were also compared to establish the effect of the intervention on rate of infections acquired within the unit. The overall rate of HH compliance by all the HCWs increased from 42.9% pre-intervention to 61.4% post-intervention, P < 0.001. Individually, the compliance was highest among the nurses, 49.9 vs. 82.5%, respectively [P < 0.001] and lowest among the doctors, 38.6 vs. 43.2%, respectively [P = 0.24]. The effect of the increase in the HH compliance rate on the nosocomial infection rate was remarkable. There were significant reductions in the following: the rate of overall health care-associated infections/1000 patient-days, which fell from 37.2 pre-intervention to 15.1 post-intervention [P < 0.001]; the rate of bloodstream infections, which fell from 18.6 to 3.4/1000 central-line-days [P < 0.001]; and the rate of lower respiratory tract infections, which fell from 17.6 to 5.2/1000 ventilator-days [P < 0.001]. Similarly, there were significant reductions in the isolation rates of 4 major hospital pathogens [P < 0.001 and P = 0.03]. These findings suggest that although cross-infection in the ICU is a complex process, its frequency can be affected by meticulous adherence to hand hygiene recommendations

Point-surveillance of antibiotic resistance in enterobacteriaceae isolates from patients in a Lagos teaching hospital, Nigeria

This study was carried out to determine a point prevalence of drug resistance and extended-spectrum Beta -lactamase [ESBL] among members of the family Enterobacteriaceae. Consecutive clinically significant non-repetitive isolates obtained from both hospitalized patients and outpatients' samples were studied. The isolates were identified using VITEK 2 while susceptibility testing was performed against 16 antibiotics using the E-test strips. Phenotypic production of ESBL was detected by E-test ESBL method. Positive isolates were confirmed by PCR. Of a total of 102 isolates studied, 43 [42.2%] were Escherichia coli and 32 [31.4%] Klebsiella pneumoniae. These isolates demonstrated remarkable high rates of resistance to the Beta -lactam antibiotics, except the carbapenems and piperacillin-tazobactam. Fifty-two [51%] were resistant to >/= 3 classes of drugs and 29 [28.4%] to >/= 5 drugs. Thirty-eight [37.3%] were ESBL producers. Of these, 21 [55.3%] were E. coli and 12 [31.6%] K. pneumoniae. Thus, the overall prevalence of ESBL-producing E. coli was 20.6% and K. pneumoniae 11.8%. This study showed an alarmingly high prevalence of antibiotic resistance in invasive Enterobacteriaceae isolates and a high prevalence of ESBL producers in the study center. Antibiotic stewardship and other preventive strategies are recommended to reduce the high rate of resistant bacteria in this hospital

study of the microbiology of diabetic foot infections in a teaching hospital in Kuwait

The purpose of this study was to determine the microbiological profile of diabetic foot infections [DFIs] and assess the antibiotic susceptibility of the causative agents. Data were obtained from a retrospective analysis of DPI samples collected from June 2007 to July 2008. Specimens were cultured using optimal aerobic and anaerobic microbiological techniques, and antibiotic susceptibility testing was performed according to the methods recommended by the Clinical and Laboratory Standards Institute [CLSI]. Extended-spectrum beta-lactamase [ESBL] production was measured using the double disk synergy test and the ESBL Etest. A total of 440 patients were diagnosed with DFIs during this period, and a total of 777 pathogens were isolated from these patients with an average of 1.8 pathogens per lesion. We isolated more Gram-negative pathogens [51.2%] than Gram-positive pathogens [32.3%] or anaerobes [15.3%]. Polymicrobial infection was identified in 75% of the patients. The predominant organisms isolated were members of the Enterobateriaceae family [28.5%], Pseudomonas aeruginosa [17.4%], Staphylococcus aureus [11.8%], methicillin-resistant S. aureus [7.7%], anaerobic Gram-negative organisms [10.8%], and Enterococcus spp. [7%]. Vancomycin was the most effective treatment for Gram-positive bacteria, and imipenem, piperacillin-tazobactam and amikacin were the most effective treatments for the Gram-negative bacteria. In conclusion, DFI is common among diabetic patients in Kuwait, and most of the cases evaluated in this study displayed polymicrobial etiology. The majority of isolates were multi-drug resistant. The data gathered in this study will be beneficial for future determinations of empirical therapy policies for the management of DFIs. 2011 King Saud Bin Abdulaziz University for Health Sciences. Published by Elsevier Ltd. All rights reserved

case of adult botulism following ingestion of contaminated Egyptian salted fish [[Faseikh]]

Food-borne botulism is a rare and serious disease caused by potent neurotoxin of the Clostridium botulinum which is a Gram-positive strictly anerobic organism. It manifests clinically as descending paralysis characterized by prominent oculo-bulbar palsies and symptoms and autonomic signs in an afebrile patient with normal sensorium. If not promptly and aggressively treated it may lead to fatality. In this communication, we report a case of food poisoning resulting in adult botulism that responded to early and effective treatment with specific antitoxin and supportive therapy. The patient made a remarkable recovery and was discharged home three weeks after admission. This case is the first to be reported for adult variant botulism in Arabian Gulf States

study of the microbiology of breast abscess in a teaching hospital in Kuwait

To determine the microbiological profile of breast abscess and assess the antibiotic susceptibility of the causative agents. Data obtained from cases of breast abscess over a period of 3.5 years, June 2006 to December 2009, were retrospectively analyzed. Specimens were cultured using optimal aerobic and anaerobic microbiological techniques. The antibiotic susceptibility test was carried out using the methods recommended by the Clinical and Laboratory Standards Institute. One specimen per patient was analyzed. Of the 114 patients, 107 [93.8%] non-lactating and 7 [6.1%] lactating women were diagnosed with breast abscess during this period. Of the 114 specimens, 83 [73%] yielded bacterial growth. Of these, 115 pathogens were isolated with an average of 1.4 pathogens per abscess. Eighteen [22%] of the 83 specimens yielded mixed bacterial growth. There were more Gram-positive pathogens [60, 52%] than anaerobes [32, 28%] and Gram-negative pathogens [22, 19%]. The predominant organisms were methicillin-susceptible Staphylococcus aureus [37, 32%], methicillin-resistant S. aureus [MRSA; 11, 10%], Bacteroides spp. [16, 14%], anaerobic streptococci [14, 12%] and Pseudomonas aeruginosa [9, 8%]. Of the 48 S. aureus, MRSA accounted for 11 [23%]. All MRSA isolates were susceptible to trimethoprim-sulfamethoxazole and vancomycin. Conclusion:S. aureus was the most common pathogenic organism isolated in breast abscesses at Al Amiri Hospital, Kuwait, of which 23% were MRSA. Nearly a third of the cases were caused by anaerobes, particularly B. fragilis. The data present a basis for the formation of empirical antimicrobial therapeutic policy in the management of breast abscess

Modulatory activity of antioxidants against the toxicity of Rifampicin in vivo / Atividade modulatória de anti-oxidantes contra a toxicidade da rifampicina in vivo

The World Health Organization (WHO) has shown concern about the burden of tuberculosis in the developing countries. Even though rifampicin is an effective drug in the management of tuberculosis, it has been documented to have some toxic effects in humans. Therefore, this study intends to investigate the modulatory effect of vitamins C and E on the hepatotoxicity, sperm quality and brain toxicity of Rifampicin. Forty Wistar albino rats were used, 10 animals per group. Group 1 animals received 0.3 mL of distilled water, the Group 2 animals received the therapeutic dose of rifampicin, Group 3 animals received therapeutic doses of rifampicin plus vitamin E, while Group 4 received therapeutic doses of rifampicin and vitamin C. The administration was performed orally during three months; the animals were sacrificed by cervical dislocation at the end of that period. Blood samples were collected and liver function and lipid profile was analyzed using fully automated clinical chemistry device. The liver, brain and reproductive organs underwent histopathological examination. Sperm samples were collected from the epididymis to achieve count and motility and morphological analysis. Results showed rifampicin alone to raise (p < 0.05) liver function enzymes (Aspartate amino transferase [AST], Serum alanine amino transferase [ALT] and Total Bilirubin) when compared with controls. While the vitamin E treated group showed remarkable protection, the vitamin C treated group showed questionable protection against the rifampicin induced liver damage. Sperm count results showed an important (p < 0.05) increase in the sperm quality in vitamin E and C treated groups. However, the vitamin E plus Rifampicin treated group showed increased lipid peroxidation. The histopathological findings revealed structural damages by rifampicin in liver, brain and epididymis while some remarkable architectural integrity was observed in the antioxidant-treated groups. It can be ...

A Organização Mundial da Saúde tem mostrado preocupação acerca da eclosão da tuberculose nos países em desenvolvimento. Embora a rifampicina seja droga efetiva para o controle da tuberculose têm sido documentados seus efeitos tóxicos em pacientes. Portanto este estudo tem a intenção de investigar o efeito modulador das vitaminas C e E na hepatotoxicidade, qualidade de esperma e a toxicidade cerebral da rifampicina. Quarenta ratos albinos da raça Wistar foram usados, 10 animais por grupo. O grupo 1 de animais recebeu 0,3 mL de água destilada. O grupo 2 recebeu a dose terapêutica de rifampicina. O grupo 3 recebeu doses terapêuticas de rifampicina mais vitamina E, enquanto o grupo 4 recebeu doses terapêuticas de rifampicina e vitamina C. A administração foi feita por via oral durante três meses; os animais foram sacrificados por deslocação cervical após este período. Amostras sanguíneas foram coletadas e função hepática e o perfil lipídico foram analisados usando aparelho automático de química clínica. O fígado, o cérebro e os órgãos reprodutivos foram submetidos a análise histopatológica. As amostras de esperma foram coletadas do epidídimo para contagem, motilidade e análise morfológica. Resultados revelaram que a rifampicina isoladamente aumenta (p < 0,05) os enzimas de função hepática (aspartato amino transferase {AST], alanino amino transferase sérica [ALT] e bilirrubina total) quando comparados com os controles. Embora o grupo tratado com vitamina E mostrasse marcada proteção, o grupo tratado com vitamina C mostrou proteção questionável contra a lesão hepática induzida pela rifampicina. Resultados da contagem espermática mostraram importante (p < 0,05) aumento na qualidade do esperma no grupo tratado com vitamina E e C. Entretanto, o grupo tratado com vitamina E e rifampicina mostrou aumento da peroxidação lipídica. Os achados histopatológicos revelaram danos estruturais pela rifampicina ao fígado, cérebro e epidídimo enquanto uma notável ...

Etiology and antibiotic susceptibility patterns of community- and hospital-acquired urinary tract infections in a general hospital in Kuwait

Our purpose was to determine the bacterial profile and prevalence of antibiotic resistance patterns of uropathogens, as well as evaluate the problem with extended-spectrum beta -lactamase [ESBL] producing isolates, causing urinary tract infections [UTIs] in Al-Amiri Hospital, Kuwait, over a 3-year period. Isolates [56,505] from symptomatic UTI cases from January 2005 to December 2007 were identified by conventional methods and the VITEK identification card system. Antimicrobial susceptibility testing was performed by disk diffusion method for Gram-positive organisms and an automated VITEK 2 machine for Gram-negative organisms. ESBL production by the Enterobacteriaceae was detected by the double-disk diffusion method and VITEK-2 system. Significant bacteriuria was detected in 15,064 [26.6%] of the 56,505 urine samples. Escherichia coli accounted for 4,876 [54.9%] from community-acquired UTI [CA-UTI] and 2,253 [36.4%] from hospital-acquired UTI [HA-UTI], followed by Streptococcus agalactiae [1,129, 12.7%] and Klebsiella pneumoniae [962, 10.8%] from CA-UTI cases. Candida spp. [973, 15.7%] and K. pneumoniae [747, 12.1%] were the second and third most prevalent isolates, respectively, in HA-UTI. High resistance rates were observed among the Enterobacteriaceae against ampicillin, cephalothin, ciprofloxacin, piperacillin and trimethoprim-sulfamethoxazole. About 855 [12%] and 291 [17%] of E. coli and K. pneumoniae, respectively, were resistant to ?4 antibiotics. The prevalence of ESBL-producing E. coli and K. pneumoniae in CA-UTI was 12 and 17% and in HA-UTI 26 and 28%, respectively. A high percentage of the uropathogens causing UTI in the Al-Amiri Hospital setting was highly resistant to the first- and second-line antibiotics for the therapy of UTI. ESBL-producing bacteria are highly prevalent in our hospital

Prevalence of periodontal bacteria in saliva of Kuwaiti children at different age groups

Aggregatibacter [formerly Actinobacillus] actinomycetemcomitans, Tannerella forsythensis and Porphyromonas gingivalis and to a lesser extent Prevotella intermedia and Prevotella nigrescens, are Gram-negative species that are associated with destructive periodontitis. Studies from different parts of the world have shown variable detection rates of periodontal organisms. Hardly any data exist on their carriage in children living in the Middle East. This study was designed to determine the detection of these species in the oral cavity of 240 generally healthy Kuwaiti children, divided into five age groups:<6 years [n=40], 6-9 years [n=60], 10-12 years [n=40], 13-15 years [n=40] and 16-18 years [n=60]. Saliva was used as the microbiological specimen, and the samples were analyzed by molecular methods using multiplex PCR. A total of 185 [77.1%] of the 240 children were colonized by at least one of the target periodontal bacteria. In all age groups, P. nigrescens was the most prominent and detected in saliva of 15%, 32%, 63%, 50%, and 47% of the children at the five age groups, respectively. P. gingivalis was detected only occasionally. Only few pathogens were found before the permanent dentition, i.e. at the age of<6 years. The highest carriage rates were from the groups between 6 and 15 years of age. The salivary carriage of the pathogens was essentially similar in the age groups of 10-12 years and 13-15 years. In conclusion, except for P. gingivalis, the examined periodontal pathogens are relatively common findings in Kuwaiti children and colonize the oral cavity from childhood onwards

Comparative efficacy of two methods of skin preparation of the perineal and genital skin of male urological patients

To compare the efficacy of two methods of skin antiseptic preparations of the genitalia and perineum in male urological patients. Prospective study. Mubarak Hospital, Kuwait. Adult male patients of two study groups numbering 114 [group-1] and 117 [group-2] admitted for cystoscopic procedures. The perineum and genitalia of patients in both groups were prepared by applying chlorhexidine-cetrimide mixture [CCM] and CCM plus povidone-iodine solution respectively. Swab specimens were obtained from the perineum and genitalia, before cleaning and disinfection [specimen A], after disinfection and draping [specimen B] and after the completion of the operative procedure [specimen C]. Specimens were cultured on appropriate media and representative colonies identified by standard methods. In groups 1 and 2, the A specimen yielded bacterial growth in 35.1 and 63% of patients, respectively. The commonest isolates in both groups were Gram-positive bacteria [89.2%] while Gram-negative bacteria accounted for only 10.8%. The B and C specimens in group-1 yielded positive bacterial culture in 7.1 and 11.4% patients respectively. In group-2, specimens B and C yielded bacterial growth in 5.1 and 2.6% patients respectively. In both groups, there was a significant reduction of patients with culture-positive B specimens after skin disinfection [p < 0.001]. The isolation rate of bacteria in specimen C in group-2 was significantlylower than group-1 patients [p < 0.001]. The addition of povidone-iodine to the CCM based regimen of perineal skin antiseptic preparation is associated with longer and more effective skin disinfection in male urological patients

Mycobacterium tuberculosis breast infection mimicking pyogenic abscesses in Kuwait

To present 2 cases of primary breast abscesses caused by Mycobacterium tuberculosis mimicking pyogenic abscesses in healthy young females. Two young non-lactating Indonesian and Indian women, aged 27 and 29 years old, respectively, presented with breast abscesses caused by M. tuberculosis. The breasts presented as huge, swollen, hot, tender masses with a discharge at the subareolar site. Surgical drainage revealed deep abscess with copious amount of pus, samples of which were positive for acid-fast bacilli [AFB] and later confirmed as M. tuberculosis by positive cultures in Becton Dickinson BBL Migit and BACTEC 12B media. The initial therapies with clindamycin were changed to 4 anti-tuberculous drugs as soon as the smears showed the presence of AFB. The patients were discharged a week later, but both were lost to follow-up. Mammary tuberculosis should be considered in the differential diagnosis of breast lesion, especially in patients from endemic areas

MONRATE: A descriptive tool for calculation and prediction of re-infection of Ascaris lumbricoides (Ascaridida: Ascarididae)

The study presents an interactive descriptive tool (MONRATE) for calculating and predicting reinfection rates and time of Ascaris lumbricoides following mass chemotherapy. The implementation was based on the theoretical equation published by Hayashi in 1977, for time-prevalence: Y=G [1-(1-X)N-R] as modified by Jong-Yil in 1983. Using the Psuedo-Code of the MONRATE tool, the calculated monthly reinfection rates (X) for the LGAs are (names are locations in Nigeria in a region predominately populated by the Yoruba speaking tribes of Nigeria whose traditional occupations are agriculture and commerce): Ewekoro (1.6 %), Odeda (2.3 %), Ado-odo/Otta (2.3 %), Ogun Waterside (3.8 %) and Obafemi/Owode (4.2 %). The mathematical mean of ‘X’ values in the study areas for Ogun State was 2.84. The calculated reinfection time (N months) for the LGAs are varied such as Ado-odo/Otta (12.7), Ogun Waterside (21.8), Obafemi/Owode (22.92), Odeda (25.45), and Ewekoro (25.9). The mean value for N in Ogun State was 21.75. The results obtained from MONRATE were compared with those obtained using the mathematical equation and found to be the same. Rev. Biol. Trop. 55 (3-4): 755-760. Epub 2007 December, 28.

Se presenta una herramienta descriptiva e interactiva (MONRATE) para calcular y predecir las tasas y tiempo de reinfección con Ascaris lumbricoides tras un tratamiento de quimioterapia. Nos basamos en la ecuación propuesta por Hayashi en 1977 para el tiempo de prevalencia: Y=G [1- (1-X)N-R], según la modificó Jong-Yil en 1983. Utilizando el código Psuedo de la herramienta de MONRATE, las tasas de reinfección mensuales (X) para varios sitios de Nigeria, África, son: Ewekoro (1.6 %), Odeda (2.3 %), Ado-odo/Otta (2.3 %), Ogun Waterside (3.8 %) y Obafemi/ Owode (4.2 %). El promedio matemático de los valores de "X" en el área de estudio del Estado de Ogun fue 2.84. El tiempo de reinfección calculado (N meses) para LGAs es variado: Ado-odo/Otta (12.7), Ogun Waterside (21.8), Obafemi/Owode (22.92), Odeda (25.45) y Ewekoro (25.9). El valor promedio para N en el Estado de Ogun fue 21.75. Los resultados del programa MONRATE son iguales a los producidos por la ecuación.