Résumé
Background: Multidrug-resistant (MDR) colonisers act as a reservoir for transmission of antibiotic resistance and are a source of infection. Exposure to antibiotics by the commensal flora renders them resistant. Antibiotic consumption and hospitalisation are two major factors influencing this. We studied, antibiotic-resistant bacteria colonising rural adult population who had restricted access to health care and presumably had low consumption of antibiotics. Aim: Detection of multidrug resistance genes of extended spectrum ?-lactamase (ESBL-CTX-M), AmpC ?-Lactamase (CIT), Klebsiella pneumoniae carbapenemase (KPC) and New Delhi Metallo ?-lactamase (NDM) in Enterobacteriaceae colonising the gut of adult population in a South Indian rural community. Methodology: Faecal samples of 154 healthy volunteers were screened for Enterobacteriaceae resistant to commonly used antibiotics by standard methods, followed by phenotypic detection of ESBL by double disk synergy method, AmpC by spot inoculation and carbapenemases by imipenem and ethylenediaminetetraacetic acid + imipenem combined E-test strips and modified Hodge test. Polymerase chain reaction was done to detect blaCTX-M,blaCIT,blaKPC-1 and blaNDM-1 genes coding for ESBL, AmpC, KPC and NDM, respectively. Results: Colonisation rate of enteric bacteria with MDR genes in the community was 30.1%. However, phenotypically, only ESBL (3.2%) and NDM (0.65%) were detected. While the genes coding for ESBL, AmpC and NDM were detected in 35.6%, 17.8% and 4.4% of the MDR isolates, respectively. Conclusions: Carriage of MDR strains with a potential to express multidrug resistance poses a threat of dissemination in the community. Awareness for restricted use of antibiotics and proper sanitation can contain the spread of resistant bacteria.
Résumé
The cubital region of the arm is a common site for recording blood pressure, taking blood for analysis and administering intravenous therapy and blood transfusions. During the routine dissection of a 70-year-old male cadaver at the Kasturba Medical College, Manipal, Karnataka, India, in 2015, it was observed that the aponeurotic insertion of the biceps brachii muscle divided into two slips. The medial slip fused normally with the deep fascia of the forearm, while flexor carpi radialis muscle fibres originated from the lateral slip. There was also a single vein in the forearm, the cephalic vein, which bifurcated to form the median cubital vein and the cephalic vein proper. The median cubital vein, further reinforced by the radial vein, passed deep to the two slips of the bicipital aponeurosis and then continued as the basilic vein. During venepuncture, medical practitioners should be aware of potential cubital fossa variations which could lead to nerve entrapment syndromes
Résumé
Objective: The objective of this study is to probe into the normal anatomy of the optic canal by comparison of dry skull and computed tomography [CT] images of live subjects
Materials and Methods: The optic canals of 107 normal subjects were examined by thin layer CT scan images in axial and coronal sections. 25 dry skulls were examined by using sliding Vernier caliper. The width, height of optic canal in both opening [cranial and orbital side] were measured. The medial, lateral walls [LWs] of optic canal were also measured. By using mathematical formula, the area of optic canal was calculated. Student's t-test was applied to compare the results statistically
Results: The height of optic canal at orbital and cranial opening in both CT and direct study was 4.12 +/- 0.63 mm, 3.6 +/- 0.76 mm and 5.7 +/- 0.76 mm, 5.17 +/- 0.81 mm, respectively. The width at orbital and cranial opening in both CT and direct was 2.98 +/- 0.56 mm, 4.59 +/- 0.83 mm and 4.74 +/- 0.47 mm, 5.48 +/- 0.76 mm, respectively. The length of medial and LW in both CT and direct study was 10.63 +/- 1.72 mm, 9.2 +/- 1.33 mm and 9.1 +/- 1.46 mm, 8.66 +/- 1.31 mm, respectively. The area was 1.43 cm[2] in direct study and in CT study it was 1.19 cm[2]
Conclusion: Given parameters may be helpful for surgeons to plan the proper way to approach the optic canal
Résumé
Recombinant factor VIIa is a novel haemostatic agent and was originally developed to treat haemophilia patients. Successful use of the factor in a 30-year-old male patient with pelvic fracture haemorrhage is being described by the authors.