Microflora of bile aspirates in patients with acute cholecystitis With or without cholelithiasis: a tropical experience

The current study determined the spectrum of biliary microflora with special emphasis on enteric fever organisms in patients with acute cholangitis with and without cholelithiasis or other biliary diseases. The patients were divided into three groups: Group A consisted of patients with acute cholecystitis with cholelithiasis; Group B consisted of patients with acute cholecystitis with gastrointestinal ailments requiring biliary drainage and group C consisted of patients with gallbladder carcinoma. Gallbladder, bile and gallstones were subjected to complete microbiological and histopathological examination. Antimicrobial susceptibility of the isolates was performed as per CLSI guidelines. Bacteria were recovered from 17 samples (32 percent) in Group A, 17 (51.4 percent) in Group B and 1 (1.6 percent) in Group C. The most common organisms isolated were Escherichia coli (11, 29.7 percent), Klebsiella pneumoniae (10, 27 percent), Citrobacter freundii (3, 8.1 percent), Salmonella enterica serovar Typhi (3, 8.1 percent), etc. The majority of Enterobacteriaceae isolates were susceptible to piperacillin-tazobactam and meropenem. As regards Salmonella spp., S. Typhi was isolated from 2 (3.8 percent) patients in Group A and 1 (16 percent) in Group C. Antimicrobial susceptibility of potential causative organisms, the severity of the cholecystitis, and the local susceptibility pattern must be taken into consideration when prescribing drugs. A protocol regarding the management of such cases should be formulated based on observations of similar studies.

Brainstem auditory evoked potentials in children--a normative study.

Brainstem auditory evoked potentials (BAEPs) were recorded from electrodes placed at CZ-A1 and A2 positions in sixty nine healthy children of 3-13 years age. Eighty four ears in 42 male children and 54 ears in 27 female children were tested for evoked potentials using 70 dB HL click stimuli, at a rate of 10 per second with 0.1 msec duration and 2048 responses were averaged and replicated in each ear. The values of various absolute peak and interpeak latencies (IPLs) did not show any sex differences. Mean values of BAEP irrespective of sex were calculated. The values for absolute peak latencies were 1.62 +/- .19 for I, 2.63 +/- .2 for II, 3.75 +/- .21 for III, 4.87 +/- .25 for IV and 5.63 +/- .28 for V and those for IPLs were I-V 4.0 +/- .22, I-III 2.13 +/- .14 and III-V 1.87 +/- .16 msec. The recognizability was 100% for waves I, III and V and 92% for waves II and IV. The 99% tolerance limit (TL) of IPLs (mean + 3SD) was taken as a criterion for clinical abnormality. The 99% IL for I-V, I-III and III-V were 4.66, 2.55, 2.35 msec, respectively.