Prevalence and Antimicrobial Susceptibility Pattern of Pathogens Isolated from Different Age Groups with Urinary Tract Infection at Tangail, Bangladesh

Background: Urinary tract infections (UTIs) are commonly detected in several hospitals and typical medical health centres. The antibiotic policy must be updated based on current knowledge about causative agents and their antibiotic susceptibility patterns. The goal of this study was to find out exactly how frequently microbes cause urinary infections and their antibiotic susceptibility patterns. Methods: Mid-stream urine samples were analyzed microscopically for a routine examination, and bacterial pathogens were isolated by conventional culture method using Chromogenic UTI media and MacConkey agar culture media. A group of biochemical parameters were utilized for bacterial identification and characterization. Finally, in vitro antimicrobial susceptibility was performed by the Kirby- Bauer disc diffusion methods against 14 commercially available antibiotics. Results: A total of 1288 clinical samples from UTI patients were obtained aseptically, with 398 showing positive growth with a range of bacteria. Females have a higher prevalence of UTI than males. E. coli was the most common pathogen found (82.86%), followed by Enterococcus faecalis (8.44%), Klebsiella pneumoniae (5.63%), Pseudomonas aeruginosa (2.81%), and Proteus mirabilis (0.26%). The majority of the bacteria had a high sensitivity to Meropenem (98.25%); moderate sensitivity to Amoxicillin, Azithromycin, Ciprofloxacin, Gentamicin, Levofloxacin, Ceftriaxone, Cefepime, and Nitrofurantoin; and low sensitivity (20%) to Cefixime, Cephradine, Cefuroxime, Clindamycin, and Trimethoprime. Conclusion: These findings have clinical and epidemiological implications, improving study to identify causative pathogens and pathogen sensitivity patterns in urinary tract infections, as well as clinicians' knowledge of how to choose the best antibiotics and, ultimately, contributing to patient diagnosis and treatment.

Frequency of Gallbladder Stones Among Patients Underwent Abdominal Ultrasound in a Tertiary Hospital in Sana’a City, Yemen

@#Introduction: The Gallbladder stone (GBS) disease is most commonly asymptomatic that may lead to several complications such as ascending cholangitis and obstructive jaundice. In this study the frequency of gallbladder stones among patients referred for abdominal ultrasound at the University of Science and Technology hospital (USTH), Sana’a – Yemen, have been estimated during the period between January and June 2013. Methods: This study is a record-based and conducted at the radiology department in USTH, on cases underwent abdominal ultrasound during the period from January – June 2013. Information were collected from abdominal ultrasonography reports. Results: In this study 4935 patients’ records are included. Of them, 2541 were males and 2394 were females. The frequency of patients with GBS was 5.53%. Multiple stones were observed in 3.57% of patients and 4.34% patients had large stones with size ≥ 5 mm. Females had significantly higher frequency of GBS (8.0%: 191/2394) than males (3.2%: 82/2541) (P < 0.001). It was found that, no significant difference between males and females in harboring small stones (< 5mm) (P = 0.251). However, significantly higher frequency of large GBS (≥ 5 mm) was found among females compared to males (P < 0.001). The frequencies of GBS, small size of GBS and large size of GBS have significantly increased with increasing age (P < 0.001). Conclusion: In this study it was found that females had significantly higher frequency of GBS than males. No significant difference between males and females in harboring small stones. There was a significantly higher frequency of large GBS was found among females compared to males. The frequencies of GBS, small size of GBS and large size of GBS have significantly increased with increasing age.

Recent advances and perspectives of nucleic acid detection for coronavirus / 药物分析学报

The recent pneumonia outbreak caused by a novel coronavirus (SARS-CoV-2) is posing a great threat to global public health. Therefore, rapid and accurate identification of pathogenic viruses plays a vital role in selecting appropriate treatments, saving people's lives and preventing epidemics. It is important to establish a quick standard diagnostic test for the detection of the infectious disease (COVID-19) to prevent subsequent secondary spread. Polymerase chain reaction (PCR) is regarded as a gold standard test for the molecular diagnosis of viral and bacterial infections with high sensitivity and specificity. Isothermal nucleic acid amplification is considered to be a highly promising candidate method due to its fundamental advantage in quick procedure time at constant temperature without thermocycler opera-tion. A variety of improved or new approaches also have been developed. This review summarizes the currently available detection methods for coronavirus nucleic acid. It is anticipated that this will assist researchers and clinicians in developing better techniques for timely and effective detection of coro-navirus infection.

A Survey to Assess Osteoporosis Knowledge of the General population of Riyadh, Saudi Arabia

Background: Osteoporosis refers to a disorder of the skeletal tissues that affect the density and quality of thebone. In most communities, the disorder is known to affect up to half of the population of women aged above 50years, while affecting up to 205 of men of the similar age. Various research studies have however revealed thatthe majority of people are usually not aware of this condition. Normally, fractures resulting from osteoporosiscan lead to disability, premature mortality or poor quality of life.This study therefore aims to assess the knowledgeand awareness among adult residents of Riyadh in the Kingdom of Saudi Arabia regarding osteoporosis and itsrisk factors. Methods: This study was a cross-sectional, data was collected among adult residents in Riyadh inSaudi Arabia. It used stratified random sampling method for the selection of the study population. For the datacollection, the study used a pre-coded self-administered questionnaire. It used SPSS software version 20 in datamanagement and analysis. Results: 385 completed the survey through the questionnaires, 41.8% were females,and 58.2% were males. From the chi-square analysis, we failed to reject the null hypothesis that there is noassociation between gender and awareness of risk factors associated with osteoporosis. Conclusion: Althoughvarious research studies have asserted that awareness of risk factors associated with osteoporosis is mostworrisome compared to other elements such as attitude and preventive measures, this study deduces thatawareness does not depend on gender or age. Instead, it agrees with assertions from other studies, which indicatethat awareness is positively correlated with levels of education.

Incidence of Metachronous Inguinal Hernia among Children under One Year of Age in Pediatric Surgery

Background: Pediatric inguinal hernia is one of the frequent causes of childhood morbidity. Therefore, the aim of the present study was to determine the incidence of metachronous contralateral inguinal hernia in pediatric patients aged ≤ 12 months, in Northern Saudi Arabia. Methodology: In the present study, records of a series of 90 pediatric patients (aged ≤ 12 months) were presented with inguinal hernia and have subsequently undergone inguinal hernia repair. Results: About 2/30 (6.6%) with left side hernia were found with subsequent right side metachronous contralateral inguinal hernia (MCIH) occurrence. One out of the two 1/2 (50%) was found at the age of 2 months, the other one 1/2 (50%) was at the age of 6 months. The 3/54 (5.5%) with right inguinal hernia developed a contralateral hernia, of whom 2/3 (66.6%) were found at the age of 12 months, and one 1/3 (33.3%) was at the age of 2 months. Conclusion: The findings of the present study suggest that there is a relatively higher incidence of contralateral inguinal hernia if the initial presentation was on the left side, which necessitates a close follow up for those patients; however, there is not enough evidence to support routine exploration of the contralateral groin surgically.

Portal Hypertension of a Delayed Onset Following Liver Abscesses in a 12-Month-Old Infant: A Case Report and Review of the Literature / 대한소아소화기영양학회지

We report a 12-month-old female infant who had a history of neonatal sepsis with liver micro-abscesses that resolved with intravenous antibiotics during neonatal period. During her neonatal admission period, no umbilical vein catheter was inserted. Also, she did not undergo any abdominal surgeries or had a postnatal history of necrotizing enterocolitis. However, the child developed upper gastrointestinal bleeding in form of hematemesis and melena secondary to esophageal varices at the age of 12 months with an extra-hepatic portal vein obstruction with cavernous transformation and portal hypertension subsequently. The child underwent a successful endoscopic injection sclerotherapy. She is now 20-month-old and has portal hypertension but otherwise asymptomatic. We are proposing the possibility of a delayed-onset portal hypertension as a complication of liver abscess and neonatal sepsis.

Antinociceptive and anti-inflammatory effects of N-acetylcysteine and verapamil in Wistar rats

BACKGROUND: Antinociceptive anti-inflammatory drugs have many adverse effects. The goal of this investigation is to study the probable anti-inflammatory and analgesic effects of verapamil and N-acetylcysteine (NAC) in experimental rats. METHODS: Adult male Wistar rats were randomly divided into 4 groups in the antinociceptive study, each containing 6 rats; the normal control group, which received saline (1 mL/kg); the diclofenac group, which received diclofenac sodium (5 mg/kg); the NAC group, which received NAC (125 mg/kg); and the verapamil group, which received verapamil (8 mg/kg). In the anti-inflammatory study, 5 groups were used, the 4 previous groups with the addition of an edema control group, received saline and were subjected to formalin test. Hot plate latency time was recorded for antinociceptive evaluation. Paw edema thickness and biochemical parameters were recorded for anti-inflammatory evaluation. RESULTS: Administration of NAC showed significant prolongation of hot plate latency time at 1 hour when compared to the control group while verapamil showed a significant prolongation of hot plate latency time at 1 and 2 hours when compared to the control group and NAC group values. Administration of NAC and verapamil significantly decreased paw edema thickness at 2, 4, and 8 hours when compared to edema control values. Regarding biochemical markers, NAC and verapamil significantly decreased serum nitric oxide synthase, C-reactive protein, and cyclooxygenase-2 levels compared to the edema control value. In accordance, a marked improvement of histopathological findings was observed with both drugs. CONCLUSIONS: NAC and verapamil have antinociceptive and anti-inflammatory effects comparable to diclofenac sodium.

Lifestyle modifications for hypertension management

Background: Hypertension is often not taken seriously by patients due to its chronic and silent nature. Establishing a proper managing plan that leads to sufficient control of blood pressure will result in the prevention of most complications and comorbidities associated with hypertension. The most important aspect of long term management of hypertension lies in lifestyle modification which includes diet, exercise, and social habits. Non-pharmacologic therapy plays an essential role in reducing blood pressure as well as in preventing the development of hypertension in normal individuals

Aim of the work: this review was to explore the various modifications a patient can make in lifestyle to maintain and manage blood pressure to achieve a better quality of life

Methodology: We conducted this review using a comprehensive search of MEDLINE, PubMed, and EMBASE, January 1976, through February 2017. The following search terms were used: hypertension, management of hypertension, lifestyle modification, exercise, Mediterranean diet, non-pharmacological management of chronic disease

Conclusion: Even a small decrease in blood pressure can lead to huge benefits on a public health scale. Current evidence supports the application of lifestyle modifications to control blood pressure. These modifications include the control of all possible related factors in order to achieve optimal blood pressure which includes sodium intake, dietary modifications such as Mediterranean diet and reducing alcohol intake, exercise, smoking cessation, and meditation. Family physicians must play a very important role in educating, counseling, and encouraging patients about the benefits of these modifications and their impact in over-all health

Osteoporosis: a common health problem in senior adult population of arar city, saudi arabia

Background: Osteoporosis is characterized by compromised bone strength predisposing to an increased risk of fracture, which has significant effects on human health, quality of life

Objective: To determine the prevalence and determinant factors of osteoporosis among elderly in Arar, KSA

Methods: The present cross sectional community based study was conducted in Arar city, the capital of Northern Borders Governorate on 229 adult people aged 60 years and more. Data were collected through personal interviews with the sampled population and filling the questionnaire which guided us to the data of socio-demographic status, smoking, chronic diseases, already previously diagnosed osteoporosis, after ensuring the diagnosis by reviewing the accompanied health reports and/or prescriptions and asking the accompanied caregivers about the case

Results: The mean age of the participants [+/-SD] was 70.5 [+/- 9.4] years. Males were 48% and females were 52%. The overall prevalence rate of osteoporosis found in this study was 24.5%. There was significant relationship between osteoporosis and sex, presence of thyroid disease [P<0.05]. While there was an insignificant relationship between osteoporosis and age group, BMI group, presence of diabetes mellitus and presence of hypertension [P>0.05]

Conclusion: In conclusion, osteoporosis is a common health problem [24.5%] in the elderly population in Arar city, KSA. Conclusion: Osteoporosis is significantly higher in elderly females. Health education and preventive programs are highly recommended to protect and treat that vulnerable group

Carotid endarterectomy versus medical therapy in stroke prevention

Stroke is one of the leading causes of deaths in different parts of the world affecting individuals of different ages, it is mostly dominant among people having risk factors such drug abuse, having a background of a mild stroke, and overweight. Various approaches including carotid endarterectomy [CEA] and medical therapy have been used as mechanisms for preventing stroke particularly ipsilateral ischemia. However, there are several studies suggesting that even though CEA has the potential of reducing the risks of stroke, incidences of a high residual risk of stroke after carotid endarterectomy since Various cases of increased short-term myocardial infarction after CEA are recorded. Based on the results drawn from randomized trials comparing the effectiveness of CEA and medical therapy ,CEA provides better protection from ipsilateral strokes than the latter. The efficacy of CEA is more pronounced in patients presenting symptomatic and asymptomatic carotid artery disease. The aim of this study was to explore the comparative merits and demerits of using carotid endarterectomy and medical therapy to determine the most appropriate of the two approaches to be used in specific cases

This research concludes that even through both therapeutic methods and carotid endarterectomy have the ability to reduce the predisposition of patients to different events of stroke, each of them have inherent limitations that must be addressed effectively to contribute to overall positive medical outcomes

A Randomized Comparative Study of a Standard Anterior Capsular Release versus Inferior Extended Release for the Treatment of Shoulder Stiffness

BACKGROUND: To compare the clinical outcomes of arthroscopic capsular release in patients with and without inferior capsular release for shoulder stiffness. METHODS: Between January 2010 and December 2015, 39 patients who underwent arthroscopic capsular release for shoulder stiffness were enrolled and randomized into two groups. In group I, 19 patients underwent arthroscopic capsular release of the rotator interval and anterior capsule. In group II, 20 patients underwent arthroscopic capsular release of the anterior to inferior capsule, including the rotator interval. The American Shoulder and Elbow Surgeons score, Constant scoring system, Simple Shoulder Test, visual analogue scale for pain, and range of motion (ROM) were used for evaluation before surgery, at 3, 6, and 12 months after surgery and on the last follow-up. RESULTS: Preoperative demographic data revealed no significant differences (p<0.05). The average follow-up was 16.07 months. Both groups showed significantly increased ROM at the last follow-up compared with preoperative (p<0.05). At the last follow-up, no statistical differences were found (p<0.05) between groups I and II in functional scores and ROM (forward flexion, p=0.91; side external rotation, p=0.17; abduction external rotation, p=0.72; internal rotation, p=0.61). But we found that group II gained more flexion compared to group I at 3 months and 6 months (p<0.05) after the surgery. CONCLUSIONS: Both techniques of capsular release are effective for stiffness shoulder. However, the extended inferior capsular release shows superiority in forward flexion over anterior capsular release alone during 6 months of follows-up (level of evidence: Level I, therapeutic randomized controlled trial).

A Randomized Comparative Study of a Standard Anterior Capsular Release versus Inferior Extended Release for the Treatment of Shoulder Stiffness

BACKGROUND: To compare the clinical outcomes of arthroscopic capsular release in patients with and without inferior capsular release for shoulder stiffness. METHODS: Between January 2010 and December 2015, 39 patients who underwent arthroscopic capsular release for shoulder stiffness were enrolled and randomized into two groups. In group I, 19 patients underwent arthroscopic capsular release of the rotator interval and anterior capsule. In group II, 20 patients underwent arthroscopic capsular release of the anterior to inferior capsule, including the rotator interval. The American Shoulder and Elbow Surgeons score, Constant scoring system, Simple Shoulder Test, visual analogue scale for pain, and range of motion (ROM) were used for evaluation before surgery, at 3, 6, and 12 months after surgery and on the last follow-up. RESULTS: Preoperative demographic data revealed no significant differences (p<0.05). The average follow-up was 16.07 months. Both groups showed significantly increased ROM at the last follow-up compared with preoperative (p<0.05). At the last follow-up, no statistical differences were found (p<0.05) between groups I and II in functional scores and ROM (forward flexion, p=0.91; side external rotation, p=0.17; abduction external rotation, p=0.72; internal rotation, p=0.61). But we found that group II gained more flexion compared to group I at 3 months and 6 months (p<0.05) after the surgery. CONCLUSIONS: Both techniques of capsular release are effective for stiffness shoulder. However, the extended inferior capsular release shows superiority in forward flexion over anterior capsular release alone during 6 months of follows-up (level of evidence: Level I, therapeutic randomized controlled trial).

Chemical composition of essential oil of Thymus vulgaris collected from Saudi Arabian market

Objective To focus on the analysis of chemical constituents of the Thymus vulgaris L. (locally known as “Zaitra” or “Za'atar”; Family: Lamiaceae) which is available in the market of Saudi Arabia. Methods The Zaitra oil was analyzed by gas chromatography-mass spectrometry. The mass spectra were compared with the standard spectra available in National Institute Standard and Technique library. Results The results indicated that the Thymus oil is composed of many chemical compounds including α pinene, thymol and caryophyllene which are biologically active and also used in various diseases. Conclusions It can be concluded that the Thymus vulgaris due to presence of many bioactive compounds can be used as a new potential source of medicine for the treatment of various types of illness.

Cord care practices among mothers in a tertiary care center

Objective: to assess the frequency of different cord care practices among mother presenting in a tertiary care center

Methods: this study was conducted on women who are presenting in Gynecology department of Services Hospital Lahore. Women were inquired about the use of method whatever the type for cord care after the delivery of neonates thus information was recorded in a well-defined questionnaire

Results: out of 4000 women, 1757 used desi ghee [43.925%]. 1139 used spirit [28.47%], 423 used alcohol swabs [10.57%], 262 used surma and other things like polyfax, lotions and herbals [6.55%], 219 used gentian violet [ 5.45%], 200 used pyodine solution [5%]

Conclusion: the most common way to care the cord was application of desi ghee that was easily available in urban and rural area

Blood Lead Levels and Childhood Asthma.

Objectives: To measure blood lead levels in children (5-14 y) with bronchial asthma, and correlate with asthma severity. Design: Cross-sectional analytical. Setting: Pediatric Allergy and Immunology Clinic of a Children’s hospital in Cairo, Egypt. Participants: 200 children (127 males) with bronchial asthma and125 age- and sex-matched healthy controls (80 males). Procedure: Blood lead levels were measured by atomic absorption spectrophotometer technique, and were subsequently correlated with asthma severity. Results: No significant difference in mean (SD) blood lead levels was observed between children with asthma [13.3 (4.8) μg/dL] and control group [11.4 (3.9) μg/dL]. 190 children (58.5%) had elevated blood lead levels (>10 μg/dL), with no significant difference between patients (60%) and controls (56%). Patients with elevated blood lead levels had significantly higher frequency of eosinophilia (66.7%) and increased total immunoglobulin E (83.3%) compared to other patients with blood lead levels <10 ìg/ dL (10% and 43.8%, respectively). Patients of asthma with elevated blood lead levels had higher grades of severity of asthma compared to those with blood lead levels <10 μg/dL. Conclusions: Blood lead levels are not significantly associated with diagnosis of asthma but elevated blood lead levels seem to be associated with increased asthma severity and higher frequency of eosinophilia and elevated immunoglobulin E levels.

Hereditary Epidermolysis Bullosa in Saudi Arabia, Epidemiological, Pathological, Ultrastructural Study of Fourteen Patients.

Hereditary epidermolysis bullosa (EB) constitutes a genodermatosis group with variable clinical severity. Three main types were identified according to electron microscopy study as follows: simple, junctional, and dystrophic type. Recent discoveries of the molecular basis of epidermolysis bullosa have resulted in the development of new diagnostic tools, including prenatal and preimplantation testing. This classification is important as it will affect patient management and prognosis. Based on a better understanding of the basement membrane zone (BMZ) and the genes responsible for its components, new treatments (eg, gene or protein therapy) may provide solutions to the skin fragility found in patients with epidermolysis bullosa. Biopsies diagnosed as EB in the last 4 years, were retrieved from the database of the king Khalid University Hospital and Military Hospital lab at Saudi Arabia. The aim of the present study was to assess epidemiological, clinical, histological, and ultrastructural features of patients with hereditary epidermolysis bullosa in Saudi patients. Fourteen cases were studied. Male/female ratio was 1:1. There were seven junctional, four epidermolytic and three dystrophic types EB. Electron microscopy study remains the gold standard method for subclassification of epidermolysis bullosa. Dystrophic and junctional types appear to be more severe forms than epidermolytic one.

Cystic panfolliculoma of the scalp: Report of a very rare case and brief review.

Panfolliculoma is an exceeding rare follicular benign neoplasm with differentiation toward both upper and lower segments of the hair follicle. In this report, we present a case of cystic panfolliculoma in the occipital region of the scalp of a 19-year-old female. We describe the histopathological and immunohistochemical features of the tumor and briefl y discuss the differential diagnoses of this rare entity.

Prevalence of burnout amongst physicians working in primary care in Riyadh military hospital, Saudi Arabia.

Background: Burnout is associated with decreased job performance and low career satisfaction. It has a special significance in health care, where staff experience both psychological–emotional and physical stress. Aims & Objective: This study was conducted to determine the prevalence of burnout, and its associated factors, amongst primary care doctors (PHC) in Riyadh Military Hospital RMH. Material and Methods: A cross-sectional survey of PHC was conducted using a custom-designed and validated questionnaire which incorporated the Maslach Burnout Inventory Human Services Survey (MBI-HSS) as well as questions about demographic factors, working experience, health, lifestyle and job satisfaction. MBI-HSS scores were analyzed in the three dimensions of emotional exhaustion (EE), depersonalization (DP) and personal accomplishment (PA). Results: Almost 200 questionnaires were distributed, and 144 were returned to give a response rate of 72%. In terms of burnout, 53.5% of respondents scored high for EE burnout, 38.9% for DP and 28.5% for PA, with 2.78% scoring high burnout in all three dimensions. Just over one-quarter of doctors did not score high for burnout in any dimension. High burnout was found to be strongly associated with several of the variables under study, especially low job satisfaction, expressed intention to change job, tobacco consumption and use of psychotropic medication, younger age, recent graduation, married and board qualified doctors. Conclusion: Burnout seems to be a common problem in PHC doctors in RMH and is associated with personal and workload indicators. Recommendations for improving employment conditions of PHC physicians and future research is needed to explore the problem in depth, develop models to describe the phenomenon and to identify causative factors and effective intervention strategies.

Surgical treatment of keratocystic odontogenic tumour: a review article

KCOT is one of the most aggressive odontogenic cysts with a high recurrence rate, this was explained histopathologically as it typically shows a thin, friable wall, which is often difficult to enucleate from the bone in one piece, and have small satellite cysts within the fibrous wall. Multiple surgical approaches were introduced including decompression, marsupilization, enucleation with or without adjunct [Carnoy's solution, enucleation] and resection. Depending on other studies KCOT can be conservatively treated with enucleation and application of Carnoy's solution or cryotherapy. This can be used specially in the large lesions that when treated with resection, the continuity of the jaw will be interrupted. This technique shows comparable results to other more aggressive techniques

Budd-chiari syndrome with hematemesis at presentation

The deficiency of protein C and protein S has been implicated in the etiology of Budd-Chiari syndrome. We present a case of young man who presented with life-threatening upper gastrointestinal bleeding. The final diagnosis was Budd-Chiari syndrome. We review current information regarding the clinical aspects of this condition