Synergy in penicillin, cephalosporin, amphenicols, and aminoglycoside against MDR S. aureus isolated from Camel milk

Abstract This study investigated the synergy testing of penicillin, cephalosporin, amphenicols, and aminoglycoside in the camel milk (n=768 samples), subsequently used for isolation of MDR S. aureus targeting mecA gene. Antibiotic susceptibility of S. aureus showed >90% isolates were sensitive to ciprofloxacin and trimethoprim and resistant against oxacillin, ampicillin, and cefoxitin. Further, 50-85% of the S. aureus were sensitive to gentamicin, oxytetracycline, and chloramphenicol and resistant against cefotaxime, vancomycin, and cefixime. Minimum inhibitory concentration (MIC) of cefotaxime, (C) and ampicillin (A) in combination with gentamicin (G) was reduced by 99.34% and 70.46%, respectively, while with chloramphenicol (Ch), reduction was 57.49% and 60%, respectively. In addition, the Fractional Inhibitory Concentration Index (FICI) of G+A, Ch+C and Ch+G combinations showed synergy against 80%, 60%, and 30% of MDR S. aureus, respectively. Similarly, C+A and Ch+G displayed indifferent interaction against 70 % and 30% of isolates, respectively, while the later showed additive interaction against 10% of MDR S. aureus. Altogether, our results described effective combination of gentamicin and chloramphenicol with ampicillin and cefotaxime to combat MDR S. aureus

Safety and efficacy of ketamine xylazine along with atropine anesthesia in BALB/c mice

Anesthetics are an indispensable prerequisite for surgical intervention and pharmacological animal studies. The objective of present study was to optimize the dose of ketamine (K) and xylazine (X) along with atropine sulfate (A) in order to achieve surgical tolerance in BALB/c mice. Several doses of ketamine (100, 150, 200 mg/kg) and xylazine (10, 15, 20 mg/kg) were mixed and combination of nine doses (K/X: 100/10, 100/15, 100/20, 150/10, 150/15, 150/20, 200/10,200/15,200/20) were evaluated (n=9 per combination). A constant dose of atropine (0.05 mg/kg) was also used to counter side effect. Time-related parameters were evaluated on the basis of reflexes. KX at dose 200/20 mg/kg produced surgical tolerance in all nine mice with duration 55.00±6.87 minutes. The induction time 0.97±0.09 minutes, sleeping time 90.67±5.81 minutes and immobilization time (102.23±6.83 minutes) were significantly higher than all combination. However, this combination was considered unsafe due to 11 % mortality. While, KX at dose 200/15 mg/kg results in none of the mortality, so was considered as safe. Moreover, this combination produces surgical tolerance in 89 % mice with duration (30.00±7.45 minutes). It was concluded that KX at dose 200/15 mg/kg along with atropine 0.05 mg/kg is safe for performing surgical interventions in BALB/c mice.

Molecular detection of Leishmania species in human and animals from cutaneous leishmaniasis endemic areas of Waziristan, Khyber Pakhtunkhwa, Pakistan

Objectives: To detect Leishmania species in human patients, animal reservoirs and Phlebotomus sandflies in Waziristan, Pakistan. Methods: Tissue smears and aspirates from 448 cutaneous leishmaniasis (CL) suspected patients were analyzed. To sort out role of the reservoir hosts, skin scrapings, spleen and liver samples from 104 rodents were collected. Furthermore, buffy coat samples were obtained from 60 domestic animals. Sandflies were also trapped. All human, animals and sandfly samples were tested by microscopy, kinetoplastic PCR and internal transcribed spacer 1 (ITS1) PCR followed by restriction fragment length polymorphism for detection of Leishmania species. Results: An overall prevalence of 3.83% and 5.21% through microscopy and ITS1 PCR respectively was found. However, the statistically non-significant correlation was found between area, gender, and number of lesions. The presence of rodents, sandflies, domestic animals and internally displaced people increased the risk of CL. Using ITS1-PCR-RFLP, Leishmania tropica (L. tropica) was confirmed in 106 samples while 25 of the isolates were diagnosed as Leishmania major (L. major). Similarly, 3/104 rodents were positive for L. major and 14 pools of DNA samples containing Phlebotomus sergenti sandflies were positive for L. tropica. None of samples from domestic animals were positive for leishmaniasis. Conclusions: In the present study, L. tropica and L. major are found to be the main causative agents of CL in study area. Movement of internally displaced people from CL endemic areas presents a risk for nearby CL free areas. To the best of our knowledge, we report for the first time L. major infection in rodents (Rattus rattus) and L. tropica in Phlebotomus sergenti sandflies trapped in Waziristan, Pakistan.

First report on molecular characterization of Leishmania species from cutaneous leishmaniasis patients in southern Khyber Pakhtunkhwa province of Pakistan

OBJECTIVE@#To report presence of Leishmania major in Khyber Pakhtunkhwa of Pakistan, where cutaneous leishmaniasis (CL) is endemic and was thought to be caused by Leishmania tropica only.@*METHODS@#Biopsy samples from 432 CL suspected patients were collected from 3 southern districts of Khyber Pakhtunkhwa during years 2011-2016. Microscopy on Giemsa stained slides were done followed by amplification of the ribosomal internal transcribed spacer 1 gene.@*RESULTS@#Leishmania amastigotes were detected by microscopy in 308 of 432 samples (71.3%) while 374 out of 432 samples (86.6%) were positive by ribosomal internal transcribed spacer 1 PCR. Subsequent restriction fragment length polymorphism confirmed L. tropica in 351 and L. major in 6 biopsy samples.@*CONCLUSIONS@#This study is the first molecular characterization of Leishmania species in southern Khyber Pakhtunkhwa. It confirmed the previous assumptions that anthroponotic CL is the major CL form present in Khyber Pakhtunkhwa province. Furthermore, this is the first report of L. major from a classical anthroponotic CL endemic focus identified in rural areas of Kohat district in southern Khyber Pakhtunkhwa.

First report on molecular characterization of Leishmania species from cutaneous leishmaniasis patients in southern Khyber Pakhtunkhwa province of Pakistan

Objective To report presence of Leishmania major in Khyber Pakhtunkhwa of Pakistan, where cutaneous leishmaniasis (CL) is endemic and was thought to be caused by Leishmania tropica only. Methods Biopsy samples from 432 CL suspected patients were collected from 3 southern districts of Khyber Pakhtunkhwa during years 2011–2016. Microscopy on Giemsa stained slides were done followed by amplification of the ribosomal internal transcribed spacer 1 gene. Results Leishmania amastigotes were detected by microscopy in 308 of 432 samples (71.3%) while 374 out of 432 samples (86.6%) were positive by ribosomal internal transcribed spacer 1 PCR. Subsequent restriction fragment length polymorphism confirmed L. tropica in 351 and L. major in 6 biopsy samples. Conclusions This study is the first molecular characterization of Leishmania species in southern Khyber Pakhtunkhwa. It confirmed the previous assumptions that anthroponotic CL is the major CL form present in Khyber Pakhtunkhwa province. Furthermore, this is the first report of L. major from a classical anthroponotic CL endemic focus identified in rural areas of Kohat district in southern Khyber Pakhtunkhwa.

Comparison of mean operative time in patients undergoing Ho:YAG laser lithotripsy and pneumatic lithotripsy in ureterorenoscopy for ureteric calculus

Objectives: To compare the mean operative time in patients undergoing Ho:YAG laser lithotripsy and pneumatic lithotripsy for ureteric stones

Study Design: Cross-sectional study

Place and Duration of Study: This study was conducted at the Armed Forces Institute of Urology, Rawalpindi from August 2015 to 12 February 2016

Materials and Methods: The study included 60 patients requiring ureteroscopic lithotripsy for treatment of ureteric calculi. Patients were divided into Ho:YAG lithotripsy group [30] and pneumatic lithotripsy group [30]. The operative time in minutes was calculated in all patients from initial cystoscopy till ending of ureteroscopy after the stone fragmentation into small particles. All the information was recorded on a specially designed questionnaire

Results: The mean age and SD of all patients was 36.90 +/- 12.11. The male to female ratio was 49:11. The baseline demographic variables; mean age, gender, side of stone and location of stone were found similar between the two groups [p>0.05]. The type of intra-ureteral lithotripsy was found a significant predictor of mean operative time taken for the procedure. The average operative time taken for Pneumatic lithotripsy procedure increased by 9.13 minutes as compared to the Ho: YAG laser lithotripsy procedure [R[2]=0.33, p<0.001]. The mean operative time was not found significantly different between males and females; age groups; sides of stones and different locations of stones, as a whole, as well as in both groups separately [p>0.05]

Conclusion: It is speculated that the Ho:YAG laser lithotripsy is a better procedure compared to the Pneumatic lithotripsy, in terms of the operative time required for the procedure

Prevalence and diagnostic of head and neck cancer in Pakistan

Head and Neck [HN] cancer is the most frequently identified cancer across the globe and is considered as 8-10 % of all cancers in Southeast Asia. The social and cultural habits are the main cause of the remarkable increase in HN cancer in Pakistan. HN cancers are more prevalent in men as compared to women. The HN cancer in Pakistan is mainly attributed to discrete demographic profile, risk elements, eating patterns and family history. The foremost factors of risk are linked with cigarette smoking, alcoholic drinks and tobacco chewing like paan, gutka, etc. The actual burden of HN cancer in Pakistan is 18.74% of all new cancer cases recorded during 2004 -2014. The data is collected from HN cancer patients who are diagnosed from September 2011 till May 2012 in the Institute of Nuclear medicine and Oncology, Lahore Pakistan. In order to diagnose risk factors of HN cancer, the Logistic Regression [LR] and Linear Discriminant Analysis [LDA] are used as analytical tools. The findings of using these both tools concluded that gender, age, occupation, socioeconomic status, family history, chewing habits, smoking habit, worked in the chemical or dust place, alcohol use are main causes for HN cancer. The main aim of this study is to develop the awareness about HN cancer, its causes and early diagnosis

Investigating psychosocial impact of cleft lip and palate on patients and parents

The objectives of this study are to evaluate the psychosocial impact of cleft lip and palate [CLP] condition among non-syndrome patients and their parents in Malaysia. Total eighty three CLP patients [age > 10 years] and eighty three parents were selected from university of Malaya medical centre [UMMC] and Hospital Kota Bharu I Hospital Raja Perumpuan Zainab II [HKB I HRPZII] Kelantan Malaysia. The Questionnaires were used for determining impact of CLP condition on psychosocial status of patients and parents. It was found that due to CLP condition majority of patients were teased. In addition, the self-confidence of CLP patients was also adversely affected. Among the parents 22.9% felt upset always, 36.1% felt upset often while 8.4% felt upset sometimes about their child oral cleft in the current study. Only 26.5% of the patients reported that they have problems at school due to their CLP condition. About 54.2% of patients were having very good relationship with other children, 37.3% had reasonably good and 8.4% were having quite good relationship with other children. The prevalence of teasing was quite high among the oral cleft patients. The self-confidence was adversely affected because of the cleft condition among majority of the patients

Demographic data on the characterization of oral clefts in Malaysia

The aim of this study was to investigate current epidemiology of several types of oral clefts among the patients receiving treatment at two tertiary care hospitals, namely University Malaya Medical Centre [UMMC] Kuala Lumpur, and Hospital Kota Bharu / Hospital Raja Perumpuan Zainab II [HKB/ HRPZII] Kelantan. This study evaluated the records of 526 cleft lip and palate [CLP] patients with or without additional malformations, who came for treatment during 2003 to 2007. Of the total 526 patients registered in the study hospital records during the study period, 338 were from HKB/ HRPZ II and 188 from UMMC. Majority 86.7% of these patients were in the age group