Occurrence & antibiogram of Salmonella Typhi & S. Paratyphi A isolated from Rourkela, Orissa.

Background & objectives: Almost round-the-year occurrence of Salmonella Typhi and Salmonella Paratyphi A has been noticed in Rourkela since last 13 and five years respectively. The incidence of infection along with the antibiogram of these two serotypes in this area were carried out. Methods: The study was carried out at Ispat General Hospital, Rourkela, India, between January 2005 and December 2008 with 5340 blood samples collected from patients with suspected enteric fever and pyrexia of unknown origin. Isolation, identification and antibiogram of the causative organisms were performed according to standard bacteriological procedures. Results: A total of 298 Salmonella isolates showed an overall per cent positivity of 5.58. Multidrug resistance was found in 11.96 per cent and 15.62 per cent isolates of S. Typhi and S. Paratyphi A respectively. Less than 2 per cent isolates of Salmonella showed resistance to ciprofloxacin. A resistance of 3.0 to 6.25 per cent against third generation cephalosporins was observed among the salmonella isolates. Interpretation & conclusion: A round-the-year occurrence of Salmonella spp. in Rourkela might have been due to the presence of a considerable number of carriers in the locality, poor sanitation in nearby slum areas, and inadequate and contaminated community water supply at times. Higher degree of susceptibility among S. Typhi isolates against various antibiotics was encouraging, but increasing trend of resistance observed among S. Paratyphi A isolates was a matter of concern.

Our Experience of Conscious Sedation as an Anaesthetic Technique in patients undergoing Automatic Implantable Cardioverter Defibrillator.

Ten patients with life threatening ventricular arrhythmias who underwent placement of automatic cardioverter defibrillator ( AICD) under conscious sedation are reported. Our clinical experience, patient,s satisfaction, recovery profile and complications of the technique of conscious sedation is presented and discussed.

Congenital Absence of Pericardium: A Rare Case Associated with Severe Mitral Stenosis with Pulmonary Hypertension.

We report a rare case of congenital absence of pericardium in a 35 year old middle-aged man, who underwent closed mitral commissurotomy done for severe mitral restenosis developed after Percutaneous Transluminal Mitral Commissurotomy (PTMC) six months back. Operation was done under General Anaesthesia through left anterolateral thoracotomy. Pericardial defect was discovered intraoperatively. There was no clinical symptom that could be clearly related to the defect of the pericardial sac pre-operatively. The recovery of the patient was satisfactory and uneventful.

Cervical Epidural Anesthesia for Carotid Endarterectomy.

The successful anaesthetic management using a cervical epidural technique is reported in patients undergoing carotid artery surgery. Adequate analgesia is obtained and the adequacy of cerebral blood flow is easily judged by the patient’s state of consciousness. Cervical epidural anaesthesia could be a safe and reasonable technique for the management of patients who need carotid artery surgery.1 A 54 years old man of A.S.A (American Society of Anesthesiologists) grade- II underwent carotid endarterectomy under Cervical Epidural Anaesthesia (CEA) at C7 – T1 level using a mixture of 0.5% Lidocaine, 0.25% Bupivacaine and Fentanyl citrate. Standard peroperative monitoring including invasive arterial blood pressure and arterial blood gas analysis was done.

Nitrilase-catalysed conversion of acrylonitrile by free and immobilized cells of Streptomyces sp.

The biotransformation of acrylonitrile was investigated using thermophilic nitrilase produced from a new isolate Streptomyces sp. MTCC 7546 in both the free and immobilized state. Under optimal conditions, the enzyme converts nitriles to acids without the formation of amides. The whole cells of the isolate were immobilized in agar-agar and the beads so formed were evaluated for 25 cycles at 50°C. The enzyme showed a little loss of activity during reuse. Seventy-one per cent of 0.5 M acrylonitrile was converted to acid at 6 h of incubation at a very low density of immobilized cells, while 100% conversion was observed at 3 h by free cells.

Gnathostomiasis of the anterior chamber.

Ocular involvement with Gnathostoma spinigerum occurs years after the initial infection that is acquired by ingestion of poorly cooked, pickled seafood or water contaminated with third stage larvae. Here we report a case of gnathostomiasis of the left eye of a 32-year-old lady hailing from Meghalaya, India. Her vision had deteriorated to hand movement. Slit lamp examination revealed a live, actively motile worm in the anterior chamber, which was extracted by supra temporal limbal incision and visual acuity was restored.

Susceptibility of Plasmodium falciparum to chloroquine in tea garden tribes of Assam, India.

P. falciparum was the predominant parasite ( > 80%) species in malaria ridden tea estates of Assam. A simplified 3 day in vivo test to determine chloroquine sensitivity in tea garden tribes revealed that the majority of the cases (85%) were S/RI, 7% were RI, and 3% were RII and 5% were RIII, respectively. Early case detection and treatment were deemed necessary to reduce morbidity and mortality due to P. falciparum in these tea estates.

Percutaneous retrogasserian radiofrequency thermal rhizotomy for trigeminal neuralgia.

Forty patients suffering from intractable unilateral trigeminal neuralgia involving more than one division of the trigeminal nerve were treated by percutaneous radiofrequency thermocoagulation of the trigeminal sensory root. The aim of the operation was to relieve the pain without producing dense sensory deficit in the face. This goal was achieved by making selective lesions in the sensory root with gradually increasing temperature 60 degrees C to 90 degrees C. Three to four consecutive lesions each for 60 seconds have been found to produce excellent pain relief in 77.7% with good and fair results in the rest. The recurrence rate has been found to be 15% during 2 years of follow-up. Considerable dysaesthesia was observed in 5% of cases. Corneal anaesthesia was found in 5% cases while one patient developed neuroparalytic keratitis. Transient trigeminal motor weakness was observed in 10% of patients.