Uropathogens and their antimicrobial resistance patterns: Relationship with urinary tract infections.

OBJECTIVES: This study was performed to determine the prevalence of uropathogens causing urinary tract infections (UTIs) and to determine their pattern of antimicrobial resistance. METHODS: This study was conducted on 273 urine samples collected from outpatient departments (OPDs) of Qassim University affiliated hospitals. Fully automated VITEK 2 compact system was used in the identification and antimicrobial susceptibility testing of causative microorganisms. RESULTS: Of 273 urine samples, only 89 (32.6%) were found to show significant growth for UTI, and overall, drug resistance was found in 92% (n = 82/89) of samples, with most (80%) being resistant to at least two drugs. Antibiotic resistance was commonly observed in ampicillin (88.3%), piperacillin (72.7%), clindamycin (66.7%), amoxicillin/clavulanic acid (66.2%), and trimethoprim/sulfamethoxazole (50%). The commonly isolated microorganisms were Escherichia coli 24 (27%), Klebsiella pneumoniae 11 (12.4%), Proteus mirabilis 4 (4.5%), Pseudomonas aeruginosa 4 (4.5%), Enterobacter cloacae 5 (5.6%), Enterococcus faecalis 5 (5.6%), and Staphylococcus saprophyticus 3 (3.4%). CONCLUSIONS: This research work has shown that patients with UTI in Qassim are at high risk of antibiotic resistance. The work also showed that multidrug-resistant bacteria can lead to momentous therapeutic problems in OPD patients.

Causes and management of urogenital fistulas. A retrospective cohort study from a tertiary referral center in Saudi Arabia.

OBJECTIVES: To reviewe the etiology and management of urogenital fistulas at a tertiary care referral center. METHODS: We retrospectively identified all patients with urogenital fistula referred to the King Fahad Medical City, Riyadh, Saudi Arabia, between January 2005 and July 2016 from electronic records. We collected data on age, parity, etiology and type of fistula, radiologic findings, management, and outcome. Results: Of the 32 patients with urogenital fistula identified, 17 (53.1%) had vesicovaginal fistula. The mean parity was 5.9 (0-15). Obstetric surgery was the most common etiology, accounting for 22 fistulas (68.8%). Twenty of these (90.9%) were complications of cesarean delivery, of which 16 (80%) were repeat cesarean delivery. Forty surgical repair procedures were performed: 20 (50%) via an abdominal approach, 11 (27.5%) via a vaginal approach, 7 (17.5) via a robotic approach, and 2 (5%) using cystoscopic fulguration. The primary surgical repair was successful in 23 patients (74%), the second repair in 5 (16.1%), and the third repair in one (3.1%). One fistula was cured after bladder catheterization, and 2 patients are awaiting their third repair. Conclusion: Unlike the etiology of urogenital fistulas in other countries, most fistulas referred to our unit followed repeat cesarean delivery: none were caused by obstructed labor, and only a few occurred after hysterectomy. Most patients were cured after the primary surgical repair.

Sensory activity differentially modulates N-methyl-D-aspartate receptor subunits 2A and 2B in cortical layers.

Activity-dependent modulation of N-methyl-d-aspartate (NMDA) receptors containing selective NR2 subunits has been implicated in plastic processes in developing and adult sensory cortex. Aiming to reveal differential sensitivity of NR2 subunits to sustained changes in sensory activity, we utilized four paradigms that blocked, reinstated, or initiated sensory visual activity. Laminar prevalence of N-methyl-d-aspartate receptor subunit 2A- (NR2A)- and N-methyl-d-aspartate receptor subunit 2B- (NR2B)-containing synapses in visual cortex of postnatal and adult ferrets was assessed using quantitative electron microscopy. Light-deprivation at all ages resulted in a downregulation of NR2A, while recovery from deprivation resulted in an upregulation. Furthermore, premature eyelid opening caused a precocious increase of NR2A. Thus, transitions between periods of dark and light rapidly and bidirectionally regulate NR2A, regardless of cortical layer or age. In contrast, NR2B regulation is layer- and age-dependent. Only in layer IV, NR2B prevalence displays a one-time decline about 3 weeks after the initiation of sensory activity upon normal or premature eyelid opening, or upon termination of dark-rearing. Incongruity in patterns of NR2A and NR2B modulation by activity is consistent with involvement of these subunits in two distinct, yet partially co-occurring processes: developmental plasticity with a critical period, and lifelong plasticity that is established in early developmental ages.

Human fascioliasis in Egypt: effect of infection and efficacy of bithionol treatment.

The present study was conducted on 14 patients with established fascioliasis. The effect of infection on the haematological and biochemical parameters was determined and the liver and gall bladder were studied by ultrasonography. Bithionol was given in the dose of 30 mg kg-1 body weight every other day for 5 doses. The therapeutic efficacy was assessed by egg and eosinophilic counts and quantitative estimation of antibody titres by indirect haemagglutination test. Results revealed that fascioliasis caused normocytic hypochromic anaemia and eosinophilia. Serum bilirubin, ALT and AST were within normal range. Ultrasonography showed a normal echogenic pattern of the liver and gall bladder. One case showed thickness of the gall bladder wall which was tender under the transiducer. Fasciola eggs disappeared completely after the 5th dose giving a cure rate of 100%. Antibody titres reached a normal level at the end of the 3rd month post treatment. Bithionol proved to be a potent fasciolicidal drug with minimal side-effects.