RESUMO
Increased vancomycin minimum inhibitory concentration [MIC] levels in Staphylococcus aureus and their association with vancomycin treatment failure are well-known problems. Few studies have recognized progressive increases in glycopeptide MIC levels for S. aureus strains in recent years. This study determined glycopeptide and daptomycin susceptibility among methicillin resistant S. aureus [MRSA] strains. A total of 776 clinical isolates of MRSA recovered from 2009 to 2012 were studied for glycopeptide and daptomycin susceptibility using the E-test method. The vancomycin MIC geometric mean [GM] of the MRSA isolates was 0.923, 0.944, 1.134 and 1.294 mg/L in the years 2009, 2010, 2011 and 2012, respectively, and the trend significantly increased over the years [P< 0.0001]. Similarly, the teicoplanin MIC GM was 1.47, 1.49, 1.8 and 2.04 mg/L in the years from 2009 to 2012, respectively [P< 0.0001]. MIC shifts were not found for daptomycin [P> 0.232]. A significant increase in the MIC for glycopeptides was observed among the clinicalA. MRSA isolates at our center over a 4-year period. However, the daptomycin MIC did not increase in the observed MRSA isolates
RESUMO
To determine the pattern of headache and its associated symptoms in school going children. The data of all the school going children attending the Headache Clinic in the Dept. of Neurology, Dhaka Medical College Hospital were retrospectively reviewed. A total of 1021 patients from October 1996 to September 2011 were selected. Data were collected through a predesigned questionnaire containing information on age, sex, social status, clinical features, opthalmoscopic findings, management, and in selected cases imaging results. The mean age of headache in school children was 12.6 +/- 1.08 years with relatively older age of presentation among girls. The sex ratio was 1.64:1 in favor of girls at older age. Tension type headache [71.1%] was the most common form of headache, followed by migraine [18.4%] and mixed headache [6.7%]. Though the girls had more frequent headache of both tension type [59.4%] and migraine [68.1%] variety, the latter was significantly associated in girls [p<0.001]. Headache was of moderate severity in 53.3%, whereas severe headache was experienced by 19.9% of the children. The children commonly had nausea and/or vomiting [47.2%], as well as photophobia [24.7%] with headache. Mental stress [34%] and sunlight [30.9%] were common triggering factors whereas a sound sleep relieved headache in the majority [59.4%]. Paracetamol [83.3%] and nortryptyline [62.8%] were the most commonly prescribed drug taken by them. Headache is a major health problem in school children, apart from other common health issues at this age. With increasing age, the girls more commonly suffer not only from migraine but also with other chronic headache. The direct causal association is yet to be determined